The URL can be used to link to this page

Home My WebLink AboutSHADY ACRES LT 27CShci. dy Ac L. ot 27¢ #015-273-70 Municipality of Anchorage Department of Health and Human Services Buitding Safety Division On-Site Water and Wastewater Pmg~am, 4700 South 8ragaw Street P.O. Box 196650 Anchorage, AK g9519-6650 Page I of 4 www.cl.anchotage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW C3 I C~C~ ~.c~, PID Number: (:~ LS'- 7_T.~-~ a,~: WastewaterSystem: [] New [] Upgrade Mik~ ~r~n 4~01 I nmftn Ln .q.q~07 ABSORPTION FIELD LEGAL DESCRIPTION 1,2 ~.~f t0.5 " 27¢ r~: Shady Acres 3,5 n. 7 0 n, 4~/45 in, Well: [] New [] Upgrade ~'"~'~: 313 n. 2 14 Private /~'4. n. /'(~, . 630~630 Fe F81013034 PVC Alpine Drilling ~/lt~! 17--I ~ Red Doq Masonry 413012001 y~: ~,,,. ~. .. c.~ ..~,. ~,,~.,,,: TANK SEPARATION DISTANCES ~sep~c I-/Holding F'I$.T.E.P. I-1Other:. Tank Field Sta§on Tank S~.. U. Anch. Tank 1250 wa 105 103 90 Steel 2 ~,~'"w"~ 100+50 100+12 ~ s~.: c~ ~,~,.:LIFT STATION I r~,.,~ 32.5 43.2 '~'""""'"'~": "~"~ ""' ~'" ": c~...~ 100+ 100+ ,,~ ~.~ ~.~ """'~: BENCH MARK Final Inspection 6123101 FF Garage 108o0 FL Engineers Stamp Inspections performed by:. Pannone En,q. Svc Dates: 1"4/3012001 ~'~/" 49T--." 2'"04/3012001 .. ,~.=_.,~ " Department of Health and Hum, ap ServiceR, approval /_ /. , ~,teven R. Ponnone/L~, ~..,,..,~ 'q,e~,b .............. .~. p~-...- ,,~, SVOlOO-z~ AS-BUILT P.i.I). NQ,¢I~'~-Z:~-''~> i~ rATER SUPPLY SYSTEM LOT E7C TIEN, R3~, S33 TI 55.0 3~,5 Pg[C RAT[~ HIN/INCH C,~Vork~RAVIN~E7CS33TI8N,~VB TE 5g,5 40.8 I~5~F/~R/4 ~R HOUSE ~ 6L4 43.8 600 SF R~OUIR~ ~%1- ~V 71,6 60.9 ~EEP TREN~, 7' EFF, ~~~~ ~ C1 69.0 60.Q 45 LF. 1D' TOTAL ~EPTH T~TAL AR [A=630 ~F ~ 6~,~ ~3,~ C4 64,~ 85,6 PREPA~E~ FB~ PANNBNE ENG, SVC, LLC Mr. Mlchaet L. Green P. ~, BOX 10~954 ~ 4801 Lore%%m Lmne ANCHORAGE, ALASKA 99510 Ancho~o~e, AK 99507 (9o7) 56~-6~9 227-3522 P, 272-8218 F~x ~AI ~ 1'=~0' I AS-BUILT DETAILS VASTE~*/ATFR ABSrlRPTII]N SYSTEM LOT 27C Ti2N, R3V0 S33 C~\~/or k\I)RA~/IN~\27CS33TI~N.I]~/G I,I I PREPARED FOR~ M~'. Mich:el L. I~-een 4801 Lore~t~ Lmne Anchorage° AK 99507 (9~7) 561-6~19 PANNnNE ENG. SVP-,oLLC P. O. BDX 102954 ANCHDRAGE, ALASKA 99510 272-8218 PHI]NE & FAX ;DAT~' 7-8-01 NJ]T To SCALE AS-BUILT Munici ali of Anchorage p ty . Department of Hes2a t.Lh. satnr detHuman Services P.O. Box 196650 Anchorage, Alaska 995194650 Pick Mystrom htt p:l/www.cl.a nchorage.ak.us Mayor Permit Number:. #SWp10029 Date of Issue: 3-12-01 · Parcel Identification Number:. 015-273-70 Date Started: 4-11-01, Date Completed: 4.'12-01, Is well located at approved permit location? [] Yes [] No Legal Description: Property Owner Name & Address: Borehole Data: 5ell Type, Thickness & Water Strata stick-up 7ravelly silt silty sandy gravel gravelly cobbly silt silty cobbly gravel water sand & gravel Shady Acres Lot 27c Michael L. Green 4801 Loretta Lane Anchorage, Ak 99507 Depth (ft) From To 0 2 2 11 11 67 67 134 134 178 178 186 Method of Drilling [] air rotary [] cable tool Casing type: steel Wall Thickness: .025, inches Diaractcr: _.6 inches Depth: 186 feet Liner Type: Diameter: __ inches Depth: Casing stickup above ground: _2 feet feet Static water level (Eom ground levcO: 121 feet Pumping level: 186 feet aRer _2 hours pumping 20 + gpm Recovery Rate: 20+. gpm Method of Testing: air lift Well Intake Opening Type: [] Open End [] Open Hole [] Screened Start feet Stopped []Perforations Start~feet Stopped feet Grout Type: Bentonite # 8 Volume: I be Depth: Start .QO feet Stopped_+ feet Pump: Intake Depth __ feet p.m? size hp Brand Name Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: Clorfne Tablets Comments: Well Driller: Alpine Ddlling & Enteqodses P 0 Box 110496 Anchorage AK 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Mar 12, 2001 Expiration Date: Mar 12, 2002 Permit Number: SW010029 Legal Description:[~hady Ac~-s Design Engineer: 0062 Pannone Engineering Services Owner Name: Michael L. Green Owner Address: 4801 Loretta Lane Anchorage, AK 99507- Parcel ID: 015-273-70 Site Address: 4801 Loretta Lane Lot Size: 44499 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 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 DSD at least 2 hours prior to each inspection. Provide notification by caIling (907) 343-7904 ( 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. Issued By: ~ Date: Date: Property Owner Name Mailing Address Legal Description '~-~ C_. MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Sewer/Well Permit Application ~) w/.~ ~.2 SINGLE FAMILY DWELLING Pamel I6~enMflc. a~oo Number Day Phone ..~'~' Zip Code w~ . 4~' nducted b '~'Approved Engineering Firm I-I Municipality (permit fee included) Inspectidns will be co y: Does your house contain any of the following: [] Hot Tub [] Swimming Pool [] Therapy Pool [] Jacuzzi [] Water Softener Unit This application is for: [] Sewer Only L~ewer and Well rq Sewer Upgrade [] Well Only [] Water Storage this application is being made for a Single Family Dwelling and ~ I Properly Owner/Well Ddller certify that the above information is correct. I further certify that in accordance with applicable Municipal Codes. Fees:. Receipt il Permit Waiver Fees: Receipt I Waiver 72-012 (Rev. 4/98)° Pannone Engineering Sen'ices, LLC Consulting Engineers (907~} 22%3522 P.O. I~ 1(12954 Anchorage, Alaska, 99510 (907)272-8218 Fax June 6, 2000 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 27C, NE4, T12N, R3W, S21 Well & Septic Permit Gentlemen: My firm was contacted to investigate the possibility of installing of a new system at the above referenced property. Currently the lot is undeveloped. A single test hole was excavated on May 11, 1995 and the infocmation is on file with your department. The soils information was used in the subdivision of Lot 27 into three parcels. A copy of the soil report and percolation test results is attached. Ground water was checked on June May 30, 2000, and was found to be dry to 16.5 feet. No bedrock was encountered in the test hole. The lot is approximately 1.25 acres in size. Lot 27C slopes to the South at a rate of approximately 1 to 2 percent, and drops off steeply (approximately 10%1 along the northern side of the property. The proposed installation will be located in the south east comer of the lot on a flat area. The proposed location will be greater than 100 feet away from the proposed well serving this property and 25 feet from the water service lines. The surrounding systems are located greater than 100 feet from the proposed installation. The lots surrounding this lot are devclopcd, but do not conflict with the proposed installation. The proposed installation will not impact the future development of the surrounding or existing lots. See attached design. The new system will maintain over six feet vertical separation to the bedrock and over foar feet vertically to the ground water. The o~'ner may install both the primary and reserve drain-fields at the time of installation. Please contact me at 272-8218 or 227-3522 if you have any questions. ~?~-**(~3~,%~,, Sincerely, ...: ~ ~Y , o g.....~. ~ ..z ................. 2,.....~ ne, P.E. o.-o~e;~ $ Attachments: -,.e~ ~.~ ............. ~ La PERMIT ND, DESIGN Pa.D. ND, C,~D~A~TN~TI~W~ PERC RAT[= ~MIN/IN~ ~ ~ ~7~. DEEP TRENCH, 7' EFF, ~2~~n 45 LF, ID' TOTAL DEPTH z, ~ ~ ~ 12500 SEPTIC TANK ~~.~ ........ ' PEEPARED FOE, PANNQNE ENG. SVC, LLC .~ Mr. Mlch~et L. Green ~;~%~[~...,~ ANCHORAGE, ALASKA 99510 Anchorage, AK 99507 '~ .... ~'~-- (907) 561-~E1g ~7-35E~ P, ~7E-SEI8 F~X DESIGN DETAILS ~/ASTE~/ATER ABSnRPTIDN SYSTEM LOT 27r. TIPN, R3~/, S33 P.I.I). NO, W C,\VorN\I)RAVING\:~7CS33T12N.I)~tG PREPARED FOR. Mm. Michael L. Opeen 480! Loret~ L~ne Anchorooe, AK 99507 (907) 561-6819 PANNONE ENG. SVC.,LLC P. 0. BOX 108954 ANCHDRAGE, ALASKA 99510 878-881B PHONE & FAX !DATIr~ 6-6-00 ,NOT TO SCALE DESIGN 8OH~8 ~ - PERCOLATION TEST PANNONE ENGINEERING SERVICES P.O. BOX 102954 ~'~C~O~.~, ~ ~5~0 (907) 272-82~8 PERFORMED FOR: Mr. l~l-. Green LEOAL DESCRIPTION; Lot 27Cf T12Nf R3W~ 833 OR Topsoil OP- BOll DATE PERFORMED: 11-1-00 ~i ! __ i/'/,/ EAST ll~h WAS GROUND WATER ENCOUNTERED? No IF YES, AT WHAT DEPTH? -0-' DEFrH TO WATER MO~l~Ol?~IO? DATE: 11-400 TE3T HOLE 6' &, 6' PEROIATION RATE l{mtn/Inch} PERCHOLE DIAMETER 8 inches TEST RUN BEIFI'EEN 4 FTand 5 FT COMMEKI~: Test hole excavated by A+ Home Svc. Test Hole was presoaked before perc test. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL OUIDLINES IN EFFECT ON THE DATE OF THIS TEST. 4, $ ! ~4 I~, ILO~I Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-273-70 - 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Expiration Date: ~' -- ~ q- 0.2... Lot 27C Shady Acres S/D 11130 Shady Lane~ Anchora.qe~ AK 99516 Current Property owner(s) Mr. Michael L. Green Day phone 561-6219 Mailing address 11130 Shady Lane, Anchora.qe, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwfse requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTE-WATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site Public Sewer [] The Municipality of Anchorage Development Services 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home ownem. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a pdvate 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. (Rev. 11,~) 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation based on procedures outlined in the Health Authority Approval Guidelines for 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 typo 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 cedes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone En.q. Svc. Phone 272-8218 Address .P.O. Box 102954, Anch~ AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date Eng. inee. rs Comments:/n condectLqg an adequacy test, I attempt to provide a thorougk, conscientious engineering analysis of the system in acc, ordenco ~th MOA DSD Guidelines & Regulations. The reported re~Its de.'.'.'.'.'.'.'.'.~fi bo the performance ofth¢ system under the condidous encountered at the time of the te~t, and separation distances measured to readily i&'ntifiable f~ture~. The oporatiousl lifo of all wells and septic s~tcm.s dclx:nd on the local soil condition, ~und wah.'r Icvels flint may Iluctuate doring tho )'car, and the water usage of thc family being saved by thc s~em. These conditions are outside the control of thc evaluator of this system. All systems eventually fail and satisfactory ~t results do not guorantcc future ix:~fonannce ortho s~tem, nor de they gumantee tJ~t there are no hidd~ defccts or encroachments. P-ES can therefore not provide any warranty for future pcfl'ormanco nor g:vc any e~'timate of how long the .system ~ill continue to meet the operational requirements of the ADEC or MOA DSD. Thc content ofttfis report is for thc sole benefit of thc owner listed above. Any reliance upon or usc of this t~port by any other person or ~ is not authorized nor will it confer any legal fight v,'hatsoever. 6. DSD SIGNATURE Approved for L/- bedrooms. Disapproved. Conditional approval for ,,- %:....' .......... e~g~,, Nc.C. e14~ bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory ~! WATER AND · - '. WARTFWATER : X Expiration Date: Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: ,~4-..~. ¢I - 0 _~_ Reissue Date: Municipality of Anchgrage Development Services Department Building Safety Division On-Site Water and Westewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorege.ak.us (907) 343*7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 27C Shady Acres S/D Parcel I.D.: 015-273.70 A. WELL DATA Well type P Date completed 4/1~2001 Total depth 1116 It If A, B, or C provide PWSlD # Sanitary seal _Y. Cased to 1116 It FROM WELL LOG Well Log Y Wires propedy protected Y_ Casing height (above ground) ~4" in. AT INSPECTION Date of test 4/12/2001 4/12/200t Static water level 12t It Well production ~0 ' g.p.m ~0 g.p.m WATER SAMPLE RESULTS: Col~oma ~-~''''' coldni~tlO0 mi 'Dete of sample: ~b~/~} ~)x B. SEPTIC/HOLDING TANK DATA Tank Type/Material Al~ch, Tank Steel Nitrate I ,_.R(~ mg/I Other bacteda Collected by: Laura Pa~lflofle ~lonies/100 mi Date installed 4/~0/2001 Tank size 1250 gal Number of Compartments 2 Cleanouts Y Foundation cleanout Y Delxession over tank N High water alarm NIA Date of pumping' ~f°Lt } Pumper NewSvstem C. ABSORPTION FIELD DATA Date installed 4/3012001 Soil rating (g.p.dJff2 or fl2/bdrm) 1.2 aod'eQ .System type Deed Trench r Length 41~ It Win'th ~ It Gravel below pipe _!7.._ It ... Total depth t0.5 ft Effective abso~ptk:~ area ~ ft~ Monitoring tube _Y . Depression over f~td N . gal. New depth in. Absorption rate >= g.p.d. If yes, give date Date of adequacy test ,~ Results (Pasha/Fail) p For 4, bedrooms Fluid depth in absorption field before test ~ in Water added Elapsed Time: 0 min Final fluid depth.- ;',,, in Any rejuvenation treatment (pest 12 mo.) (Y/N & ty~) ~ ..... (Rev. D. LIFT STATION Date inslalled 'Pump on' level at in Manhole/Access in' High water alarm level at, Ee Jn Datum SEPARATION DISTANCES Mee~s alarm & cimuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 11)5 Absorption field on lot 103 Public sewer main ~5.+ ' · Sewer/septic service line ;~1~'+ On adjaceot lots, 100'+ On adjacent lots 100'+ Public s~wer manhole/cteanout ~5.+ Holding tank 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 32,5 Water main 25+ Drainage 105.+ Property line. Water service line ;~5.+ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: . Property line 12' Water Service lind- 25'+ Cmlain drain 11)0+ COMMENTS Building foundation 43,2 Surface water 105.+ Wells on adjacent lots 100'+ A__h~oq~ion field Surface water 11)0'+ Water main Driveway, patking/~hicle ~to~age' ~0°+ G. ENGINEER'S CERTIFICATION I cen'/fy that Ihave determine/throu~t fle/d inspecf/ons and revfew of Municipe/ records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P.E. Date, ~-/'~ 7-/~,"Z_ . W,Y-Z~Z 1Z:4'lP~ FIO/-CT/-r FJIIViR~f~NTA'~ SRY g~?~Gl~3~l T-Q31 P.OZ/03 Fo$85 j~..~. OT&£ Envtmnmen~ SMYIcim ~ P~ D~c D~ 0.2Go ms~L Ep^~o.o {<to) ~t~lOOmL S~%lSg222n ~se Iccaio'[' ,o,~ the st;ucture[s) ~;ho,,m c~ this r~ord drawing L5 ~ L7 (as~buflt) comp~as w,th ~tie 21, [ i ~ ~s~'~'~'~ 5~.~ ~ ~ ffi . ~:..:~..~..~:,~ ~ ~;~y~ ~ ~, ...... 0. 30.~' $CALE~ 1' : 40' i 0 zooz ~o' ~cou · ~c., s~. ~ ~c ~ ~ = N89'53'28"E 168.47' ~ ~ ~ ~ ...... FO~: Date Scale ~gal Description I-3-02 ~_SHO~ ~t 27C [Block La~Mark Grid ~-BUILT ~.~s~.~.~ 2635 S~Y ACRES 9330 ~rd D~ve, S~ 203 A~choraRe, ~aska 99507 Dra~ b~ Field Book (907) 5~z-6050 TEG/~ S~D~SION by me, or at my dMecUon, ~d ~at ~e ~provemenb situl~d ~e~on ~ ~.. are ~thln ~e pro~e~y ~es and do not overlap or enc~ach on ~e ~.~f. ~ prope~y I~Z adjacent ~ere~ u~ess o~e~e sho~. ~at no ~ ~-. ..... ~re~s~s ~ ques~on ~d ~at ~r~ ~e no rosdw~. v..~.~.....~..¥ ~es or o~er easemen~ on o~d prope~ except as sho~. ~~ ................ It is ~e responsibiUty of ~e o~er or b~der, prior ~ ~on, d.~l C~ E ~ very proposed b~ding ~de relaUve ~ f~sh g~de ~d u~ty ~ff'. LS-7326