Loading...
HomeMy WebLinkAboutMCMAHON BLK 2 LT 12McMahon Block 2 Lot 12 #017-041-13 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 Waslewaler DiSposal Syslem and/or Well Inspection Report Permit Number: ~'(vtP~)OOC)'7~--j PID Number: O~'~~ ~ J-- "~": G~ryA~b~ Wastewaler System: ~New ~Upgrad. *~'~:~OJ/~.r~o~&~ek~a, ~n[~,~.~ ~l~ ABSORPTION FIELD ~h°""'3~--~/lO I"°'°'Bedr°°~s:~ DDeepTrenc. ~Shal,owTre,.ch DBed UMound LEGAL DESCRIPTION Soil .atir. g; 0' ~ G~D/Sq. Fl. r ~,~,. lo'al Dep,h from orJgi.a, grade:O,= Lot: S~bdiv~ion: ) pth Io pipe bottom Irom off inal grade: Gravel depth benea{h pipe SEPARATION DISTANCES ~Seplic ~ Holding g S.T.E.P. .,,, Surface w~t.~ I00~'~ ~.~ {00'+ LIFT STATION Lot Si~allons: Manufacturer: ~ [ / Remarks: '~' ~,O'R' /~U~ BEN6H MARK I~ ~ ~pgc~o ~ O.C. ~ P~ Po~w~O. ~/~cx'''''.~.- ]2034 Eagle River Loop Road, Ne. ~ . ~--_ _ ~', ~ ' ~ Inspections performed by:~.~- m~.r, ~b~a ~sT? Da~es' 1st ~ - ~ E~ ,'~ 2nd ~-~-~ I ~ . ROBERT C. COWAN ......... ~,%~~0 '*,~.., c~-~8o~ ueparlmenl Ol HeaJln and Human ~erwces approva~ '~?);", <>,~.. .,,,.,"~,~ Reviewed and approved by: ~/ ~ ~Date' ~-~ ~-o~ 72-013 (Rev. 9191) MOA 25 PERMIT NO. SW000074 PAGE 2 OE 3 Hunic[p. o, Ut oF Anchoro. cie DEPARTMENT OF HEALTHAND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 OAnchopc9e, A/cskc 99519-6650~)Te[ephone: 343 4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT gESAb LOT 12, BLOCK 2, McMAHON S/D P.LD. NO. 017 041 13 %'X20~ UTILITY L EASEMENT 100' WELL RADIUS SHop GARAGE MT3 \ [Iq vIT4 FURRO UTILITY EASEMENT NEW 1000 GALLON SEPTIC TANK BASIN INSULATION UNDER DRIVEWAY SCALE: 1" = 40' ROBERT C. COWAN CE - 8801 PERMIT NO. SW000074 PAGE 3 OF _ 3 Municip, a/i~ oF Anchoraae DEPARTHENT OF HEA~THAND HUKAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box ]96650 OAncho~o. ge, Alaska 99519-6650 ®Telephone: 343 4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 12, BLOCK 2, McMAHON S/D P.LD. NO. 017--041--13 ST1 PINAL GRADE ST2 CO1 INSULATED 98.5 NEW 1000 GAL. POLY. TANK MT1 MT2 = MT1 = 100.0'~ MT2 SAND ~FILTER MT1 = 9?.3 A B C FCO 83.0' 78.5' _ ST1 44.5' 65.5' - ST2 45.5' 66.0' - MH 48.0' 70.5' - MT1 78.5' - 72.5' MT2 41.5' - 22.0' ,,tT3 27.0' - 16.0' MT4 72.5' - 72.0' 98.2' MT3 MT4 GRADE = 101.5' = 101.7' DISTRIBUTION SAND ~FILTER MT2 97.3' MT3 = 98,8 A WATER FOUND 80.3' B.0.H. ® 93,3' MLrN~2CIPALIT¥ OF ~C~IO~GE - B~LD~qG SAFETY DIVISION 4700 SO'UT[I B~iGAW SI~EET, tN, gPEC770~: Vo~e: (907)34~0~ E~)~35 IN)VO~JAYION: (90D343~211 Dz>JLY ELECTRIC 4011 F~Ji~OW C~EK 1~). ~>AI2;': 7/3/00 COMiWEN2~ E,~Y ,I3,~PECTIOAr: E!ze!x~C-q Rough TOTAL P,05 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 / q/o'75 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Apr 25, 2000 Expiration Date: Apr 25, 2001 Permit Number: SW000074 Legal Description: MCMAHON BLK 2 LT 12 Design Engineer: 0003 S & S Engineering Owner Name: Gary Abbas Owner Address: 4011 Furrow Creek Road Anchorage, AK 99516-2829 Parcel ID: 017-041-13 Site Address: 004011 FURROW CREEK RD Lot Size: 34400 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 noti~ 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. 5. The following special provisions. THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN CONCRETE SAND WITH 4% OR LESS PASSING THE #100 SIEVE AND 2% OR LESS PASSING THE #200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED ON THE SAND USED OR OBTAINED FROM AN APPROVED SOURCE. Date: SOIL April 13, 2000 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 12, Block 2, McMahon S/D ROBERT C. COWAN, P.E. CI~/IL ENGINEERS (g07) 694-2979 FAX (907) 694-121 It is requested that you issue a permit to install a septic system upgrade to serve the existing three bedroom dwelling on thc referenced property. A test hole was excavated and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 4-10-00 water was found at 6 feet. After seven days of ground water monitoring, water was found at q feet. 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 properties. If you require additional information, please contact us. Sincerely, 17034 NORTH EAGLE RIVER LOOP ° SUITE 204 · EAGLE RIVER, ALASKA 99577 Robert C. Cowan, P.E. RCC/bjj Enclosure = 60 DESIGN SITE-PLAN SCALE > OOm ~ m~m . j ~ A -- · ~ '~ ~ ~ , ~ ~FOm ~ Z ~ ( :1 ~ L om ii> .. ; / ' ,-~ f ~ -... ~-- L , X o o, ~ ~ ~ -~ ~ ~ , ', %'~ ~_ o I . -~ '.: j ~ ~Z~ I I ' ~,~':'~:, --:' 1" : 60' DESIGN SITE-PLAN /~ (----.. ( /~ ~t ~N/X ~ D/ ~ ~ ~ ~ ~"~ o ..... ~_ ~ x~ ~ ~ ~ / .~x~"~,~,. ~ ~ ~- LORRAINE STREET aF~ I '~ "¢~,~: .~' ~'-~ "~ PERFORMED FOR: LEGAL DESCRIPTION: Municipality of Anchorage. DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3- 4- 5- 6- 7 8 9- 10- 11 13- 14- 15- 16- 17- 18- 19- 20- SLOPE WAS GROUND WATER ENCOUNTERED? tF YES, AT WHAT DEPTH? ~'~ Deplh to Water Alter / CoP ¢,., Monitoring? SITE PLAN g'Z7,¢ o// Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ) ~ '.~-.L (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ]'/ FT COMMENTS ~'~ ~ /~T- '¥~ ~ ~- ~/1~ OF ~- 1/-~ 'T /~0 ~"~- ,¢~. ~ C--/¢- V ~¢- 7- / 0,~ . (,~-./~ 0 ~' ~',0 PERFORMED BY: .......... CERTIFY THAT TH~TEST WAS PERFORMED IN ,/u~e eagle ~lver Loop Road NO. 2~ I ACCORDANCE W~B~X;B~b~AL GUIDELINES IN EFFECT ON THiS DATE, DATE: 72-008 (Rev. 4/85} ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 12, Block 2, McMahon S/D April 13, 2000 GENERAL: The scope of this project includes the installation of a 1250 gallon septic tank, a lift station, and/t new trench~to serve the existing three bedroom residence located on the referenced property. 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. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 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: A septic tank is to bc constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of thc tank. 17034 NORlft EAGLE RIVER LOOP · SUITE 204 " EAGLE RIVER, At~SKA 99577 Page 2 Lot 12~ Block 2, McMahon 5/D April t3, 2000 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there 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. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier 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 minimum 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. 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. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot t2, Block 2, McMahon S/D April 13, 2000 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 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. Insulation shall he at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Canlder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leaclff~eld gravel layer and the native soil backfill. Ali leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the//200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: 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: Page 4 Lot t2, Black 2, McMahon $/D April 13~ 2000 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 baekfilled before this inspection. The second inspection must be conducted after the placement of 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 fmal 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. 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 ANCHORAGE AREA Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME //~'/~'~ /'~'/¢~.,-~/~?./~/~;2'~~/ MAILING ADDRESS ~'~'.~2'~' /--~.-¢/~'~//~'¢~J~¢'-/~¢. PHONE_~=~.~._ ..~Tj~ LOCATION .~--J"~./~.~..z';; ~:~./~-.~,~¢~.¢~-~.~/ ~.x~'. ~ LEGAL DESCRIPTION ~/~'~/'~__,- ,~/~"'~';-;~/- ./,',',',',',',',',~ ~/~'"-~:~"'-."~'~.- SEPTIC TANK: DISTANCE NUMBER OF FROM WELL-"/~--2¢2/;~ MANUFACTURER--~'2/~'v'-~g~-~'~4VIATERIAL~~'~-~'~'~-~-/ COMPARTMENTS ¢¢¢/~/'¢'~ INSIDE LENGTH_ INSIDE WIDTH LIQUID DEPTH .LIQUID CAPAClTY./'L~'`?~// GALLONS. SEEPAGE PIT: NUMBER OF PITS ¢¢~"~/'/~'~. DIAMETER -- OR WIDTH~, LENGTH ~--~, DEPTH LINING MATERIAL¢'~-~--/¢~//-/-/~ CRIB SIZE: DIAMETER ~' DEPTH ,'~ /DISTANCE FROM: WELL ~'¢~-~/~¢'-///~- / TOTAL EFFECTIVE BUILDING FOUNDATION ~2'~¢ /, NEAREST LOT LINE~¢~/---) ~. ABSORPTION AREA (WALL AREA) ~/~ -U~ SQ. FT. ADDITIONAL ABSORPTION DISTANCE FROM: BUILDING / NEAREST NEAREST SEPTIC ¢ . / SEEPAGE FOUNDATION -~'~ LOT LINE /~ ~-., SEWER LINE./¢/¢ ~TANK //~ ,'~ SYSTEM CESSPOOL~/~/2/g'//' OTHER SOURCES APPROVED DISAPPROVED DiSTANCES:/¢~ ~z~ ~ .~- /-~¢~ ~ INSTALLED BY: ~-¢'~/-~'¢-'~ PIPE MATERIAL: LOT SLOPE: REMARKS: Form No, EQ~031 DIAGRAM Of SYSTEM DATE ~'~--g-~"'~"'?/~'/ APPROVED '¢~ ~ ~'~"- // G.A.A.B. GrE~ATer ANCHORAGE AREA BOROUGh/~~ ~/' ' '~ PERMIT NO. DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C"STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456! SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT SEEPAGE PIT ~ DRAIN FIELD ., OTHER TO BE INSTALLED ~¥ INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS ~ NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT t~ · , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL ~ f , SEEPAGE PIT ~ / DRAIN Fi'ELD SEPTIC TANK TO NEAREST LOT LINE, WELL TO SEPTIC TANK · SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK /~:) , SEEPAGE PIt DRAIN FIELD . SEEPAGe PIt ~. DRAIN FIELD TO RIVER, LAKE. STREAM, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit Fitted WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IN ACCORDANCE WITH SAID CODE, DATE , . APPLICANT'S SiGNATUre "Ow' t~si is v~orth a thousand opinions" Legal Description: Lbt(X Block >Subdivision /~q63~}V,/J This gorm Reports Soils Lo~ ,~y~,~ Percolation Test ~e~th . . Feet Soil Characteristics 1 7 ... 5~.~ .~ ~-~' was._Ground Water Encountered? I~ Ye~, ~t what Depth? 'i Readin~ Date Gross Time Net Time Depth to H20i Net I , I ~ I ' Perco'lation Rate Hinute Proposed Installation: Seepaoe Pit ~> Drain Field Deoth of Inlet ' ' DeDth'tl~o Bottom Of Pit Or T~ench cn~l~ENlS:.. ~ ,5'~ ~, ~/~',~ ~ ~,.~,.~ ...... '~.~. ~,~e~ '/ ~<~. ~-~ Performed By ~-~ .lq9 ~A Data Certified 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 www.oi.anchorage.ak.us (907) 343-4744 Parcel I.D. 017-041-13 1. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# d,~()~'~) ,~'d Expiration Date: Block 2, GENERAL INFORMATION Complete legal description Lot 12, Location (site address or directions) McMahon Subdivision 4011 Furrow Creek Road Current Property owner(s) Gary Abbas Day phone 348-61}0 Mailing address 4011 Furrow Creek Road, Anchorage AK 99516 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: NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer The Municipality of Anchorage Department of Health and Human Services (DHHS) 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) on properties 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 properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Cedificates 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 re¢ponsible for errors or omissions in the professional engineer's work. 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 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. S & S ENGINEERING Name of Firm 17034 Eagle River L~p Roa~J ~ ~_t~J~ Eagle River, Alaska ~/95/)' Address Engineer's Printed Name RoberL C. Cowar~ DHHS SIGNATURE /,,/~ Approved for ~ bedrooms. Disapproved. Conditional approval for Phone · Date ~ ~4, h,,..; ............ bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: / © ~ ~ (~- ~ o Original Certificate Date: ? ~ ~Z. ~ ¢ 0 o Reissue Date: 75 025 ~Rev 91 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 R [~ C E IV E D P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 dUL 17 000 ~ MUNICIPALITY OJ' ANCHUlU~GE HEALTH AUTHORITY APPROVAL L..~HECKLJ,.~'~'~NMENTALSERVJCES DJVje''~ Legal Description: L.eT- A. WELL DATA Well type Date completed Total depth / ~' (~ ft Cased to FROM WELL LOG IfA, B, or C provide PWSID # __ Sanitary Seal '7~'¢-d' ~/O+ ft Date of test Static water level ) Well production WATER SAMPLE RESULTS: Coliform O colonies/100 mi Date of sample: '-I/Iq/oo B. SEPTIC/HOLDING TANK DATA ft g.p.m Nitrate ~./;6 mg/I Collected by: Ol7 Well Log ~'~$ Wires properly protected __ Casing height (above ground) AT INSPECTION ~-. 3. g.p.m in. Other bacteria O colonies/100 mi S & S ENGINEERING 17034 E,~r;;e I~ver Loop Road ~,~ Eagle River, Alaska 99577 Tank Type/Material 3~.m', c_ /'P~ ~-¥ ~ ~h"f~.~.~ ;._ Date installed (,;,)~.r./oo Tanksize /0oo gal Number of Compartments ~ Cleanouts '/65 Foundation cleanout ¥&5- Depression ever tank /v O High water alarm __ Date of pumping ¢/4 - ~ ,~ ~ Pumper '- C. ABSORPTION FIELD DATA Date installed (;/~-(~//0o Soil rating (g.p.d./ft2 or ft2/bdrm) ¢' ~' System type Length 1~ 6, ~t¢ro¥,~ Width ~ ft Gravel below pipe O,5- ft Total depth .~ ft Effective absorption area $8-0 fF Monitoring tube "/~ J' Depression over field Date of adequacy test t'///~ ~ ~ ~ Results (Pass/Fail) For _~ bedrooms Fluid depth in absorption field before test ~ded__ gal. New depth.__ in, Time: ~ fluid depth in Absorption rate >= g.p.d. Elapsed Any rejuve~tment (past 12 mo.) (Y/N & type) .If yes, give date __ 72-026 (Rev. 01/00)* D. LIFT STATION Date installed ~'/~('/~ o "Pump on" level at z/ ~ in Datum ~,a Size in gallons ~.'/,~ "Pump off" level at ,$-/.5- in Cycles tested '2- Manhole/Access ¥~ 5- High water alarm level at ~H,~¢ in Meets alarm & circuit requirements E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot / o e Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots ? Ob ¢- / 0 o ~/~ On adjacent lots /ce "¢ v/4 Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ,c/O. 5- / Property line z-.). ;~. ~- Water main Iv/A Water service line /'o ~,~ Drainage t,////¢ Wells on adjacent lots / ~ o ~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line . 0 Building foundation ) ~ Water main Water Service line Curtain drain Absorption field '~,o -~- Surface water / o o V- Surface water / o 0 Wells on adjacent lots __ Driveway, parking/vehicle storage P 0 -~ F. COMMENTS 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 ~ 8,¢ ¢./L 7 C, Date '-I /I '1 /0 o HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)~ Waiver Fee $ Date of Payment Receipt Number 3'UL-19-2000 08:23 S&S ENGINEERING 90? 594 1211 P.05/0S EnVironmental S~rvices Inc. 1003820003 $ & S Ending NIA Loc 12 Blk 2 McM~t0t~ S/D DrL~-~g WaTer Cliea~ ]Prin~ed D acc~J, me 07/18/2000 16:00 Collected DAte/Time 07/14~000 9:45 Re;ejved ~c~im~ ~/14~000 10:55 Tecanic~ ~r~or S~phen CEde Released By Prep AnaWsb Da:c ,, ,, .D~¢ Init 0,500 tng/L EPA ~00 O 10 max O?lba/O0 SCL Microb~.olo~ Total cot/100mL SMI8 92'~ 0~/t ,WOO TOTRL P.05 ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELLINSPECI'ION & FLOWTEST SOILIEST July 14, 2000 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services PO Box 196650 Anchorage, AK 99519 REFERENCE: Lot 12, Block 2, McMahon Subdivision Request you grant a waiver on the referenced property for the horizontal separation distance between the leachfield and the south and west property lines at 0 feet. We do n~ expect any adverse effect on the adjacent property. If you require additional i~formation, please contact us. Sincerely, · R6bert C. Cowan, P.E. RCC/skh 17034 NORTH EAGLE RIVER LOOP SUITE 204 EAGLE RIVER, ALASKA 99577 S & S Engineering ATTN: Robert Cowan, PE 17034 Eagle River Loop Rd, #204 Eagle River, AK 99577- July 20, 2000 Subject: Waiver Request forMCMAHON BLK 2 LT 12 Waiver # WR000053 Lot Line Request for Parcel ID 017-041-13 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 0 feet. Tkis waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require ail separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Engineering Technician III On-Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Services Waiver Review Worksheet WR#: WR000053 PID#: 017-041-13 HA#: HA000308 Date Received: July 18, 2000 Legal Description: McMahon Subdivision, Lot 12, Block2 Engineer: S & S Engineering 17034 Eagle River Loop Road, #204, Eagle River, AK 99577 Applicant: Gary AbbaS Waiver Requested: 0 foot lot-line waiver Permit~: Criteria: 1. Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 2. Special Conditions: 3, Other: Total: Waiver is Granted: List Conditions or Reasons for above: Waiver is not Granted: Date: '~- ~ ~'0 o Rec#: 06550 Amount: $115.00 Date Paid: 7/18/00 '~~.C~~C ~ ~-~,MUNICIPALITY OF ANCHORAGE~--~ DEPARTM5 'OF HEALTH AND ENVIRONMEN'~ ~ PROTECTION . 825- L Street, Anchorage, Alask~ ~99501 ~' 279-2511, ext. 224 or 225 ~~/~ Date Received: May 19, 1977 #1: Time ~,'/.~/.~/p,l¥). ~--~2~/~me ~ #3: Time _]]~/~ Date ~Z~~to ~-~ ~ Date ~-~~ i REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILI~IES~ 1. Lending Institution Request: Alaska Mutual Savings Bank Mailing Address: Post Office Box 1120 99510 Phone: 274-3561 2. Property Owner: Jim D. Stanley Mailing Address: Star Route A Box 1567X Phon~.49-1522 (w) 3. Legal Description: Lot 12 Block 2 Mc Mahon SubdiVision 4: Single Family Residence: Multiple Family Residence: Number of Bedrooms: 2 Number of Bedrooms: Well System: Permit # Construction Individual well ~ ) Community/Public System ( ) Depth of Well Well Log on File ( ) Bacterial Analysis Sewage Disposal System: On-site System (~ Public Utility ( ) Permit # Installed ~--~e3~ ~ Installer Septic Tank Size /~c3~p Manufacturer Absorption Area ~~' Soils Rate ~_~ Material Distances: Well to Septic Tank ~z/O~ to Absorption Area '~ to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: 2. Property Owner: STANLRY, Jimmy D. Mailing Address:--~SRA Bo× i567X 3. Name of Buyer: none Mailing Address: n/a 4. Name of Lending Institution: Mailing Address: ?' 0. Bo× il20 5. Name of Realtor or Agent: n/a MUNICIPALITY OF ANCH©; ':,GE DEPT. OF HEALTH xL:(,kiVED VA FHA CONV X~ Day Phone: 349-1522 (work) Day Phone:. n/a Alaska Mutual Savings Bank Phone: 274-3561 Mailing Address: n/a Legal Description: Lot 12, Blk 2, McMahon Subd. Phone: Location; Furrow Creek Rd. 7. Type of Facility to be Inspected: Well & Septic 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation No. Bdrms. Individual Individual (on-site) XKX 72-003(3/76) ~ Pag~ Twd ~. '~ Department of Health and Environmental Protection Request for Appr~oval of Individual Sewer and Water Facilities Legal Description: Lot 12 Block 2 Mc Mahon Subdivison Comments: Affadavit Attached:~~ )~ Approved: ~ v Disapproved: Letter Attached: ( ) Date: Date: Department Worksheet: