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Home My WebLink AboutELMORE #2 BLK 8 LT 8172 ql P.O. bUX 6650 ANCHORAGE. ALASKA 99502-0650 (907) 264-4111 DEPARTMENT OF HEALTH & HUMAN SERVICES January lO, 1986 TO: Permit Applicant Subject: Permit ~ 850369 Lot 8 Block 8 Elmore Subdivision A permit issued by this Department for an individual well and/or on'site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/1Jw eric: Copy of Permit ILLIN 1' E; 1'/'"~.'~ L 1' TY 13F DEPARTMENT OF HEALTH AND ENVIRONMENTAL ~ROTECTIO~ 825 L STREET, ANCHORAGE, AK c?c7501 264-4720 ON--S I TEE SEEI~ER PERI~ 1' T PERMIT NO: DATE ISSUED: 8505&9 ENGINEERED DESIGN 0&/28/85 APPLICANT:. ADDRESS: CONTACT PHONE: LEGAL DESCRIP: LbT SIZE: 3AMES F. ALLISON 8400 HARTZELL ROAD ANCHORAGE, AK 99507 544-0501 SUBDIVISION, SECTION: 54 40280 (SQ.FT. LOT: 8 TOWNSHIP: 12N RANGE: 5W OR ACRES) BLOCK: 8 I c~rt'iry that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 5. I will adhero to all MOA and State of Alaska requipements fop the set back: distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot.. IF A LIFT' sTATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTA'INEDi (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION.REPORTI AND (5) THE ELECTRICAL WORK MUST BE BONE BY ~ ~CENSED ELECTRICIAN. ISSUED BY __~__ _,~,_~~__ __.~_____ ,2 .... .__DT. _ ............. '-. ~ : · ALASKA ENVIRON""NTAL CONTROL SERVICr.,,, INC. : 1200 West 33rd Avenue. Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 .... :--q ...... ~ ..... ~--T---~ ...... ~ ....... ; ' '' - ' .............. '"-"' --' ~ ~ .... ~ I ~ , . ~ / ' ' '~ t ' ~ ' ~ · . I ~ ~ . -~---~~-l.-~=~-~~.l : I [ I , L_~ ' l_ ~ '" ~ '; ' ALASKA ENVIRONI~.ENTAL L *~," . ! ' CONTROL SERVIC~, INC. . : 1200 West 33rd Avenue Suite B i '*", . ANCHORAGE. ALASKA 99503 Pho~ 561.5040 SHEE?'NO 2~m~ OF ~ I I I I I** i ALASKA ENVIRONMENTAL CONTROL SERVI{'''~*, INC. 1200 west 33rd Avenu= Suite B ANCHORAGE, ALASKA 99503 Phone 561o5040 DATE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 ~, ~( SLOPE DATE PERFORMED: SITE PLAN 6 9 10 11 12 13- 14- 15- 16- 17- 18- 19- 20- PERFORMED BY:'e'~ ~- e~ 72°008 (6/79) WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN .(minutes/inch) FT AND FT CERTIFIED BY: ~.~Y~ '<'~ SPECIFICATIONS FOR BED ~ASTEWATER TREATMENT SYSTEM - LOT 8, BLOCK 8, ELMORE SUBDIVISION 1.0 GENERAL 1.1 1.2 1.3 1.4 1.5 The drawings, sheets I thru 3, shall be part of this specification. All materials and vorkmanshlp shall meet the requirements of the Municipality of Anchorage, Department of Health & Human Services, (DHHS) the conditions of the permit, and all appllcable rules and regulations currently in effect. All excavations and depths are advisory, and are to be verified or modified in the field by a I~HS approved inspector. It is the respouslbillty of the installer to adhere to approved designs for installation, to maintain the specified separation distances, and to have the appropriate inspections. If the inst~llatlon is not inspected by au AECS Engineer, AECS will not be responslble for the installed system. An Engineer at A~CS should be consulted prior to construction, to determine the number of Inspections that viii be required and to explaln ~/aat these inspections will involve. 2.0 SEPTIC SYSTEM 2.1 2.2 2.3 The septic tank shall be a UPC-approved two - compartment tank, constructed of 12-gauge steel with bitumastic coating, set level on undisturbed soil, and insulated with an overlying layer of 2 inch DOW extruded blue styrofoam board. The septic tank shall be a minimum of 5 feet from The house foundation, and a minimum of 5 feet from The absorption area. The septic tank and bed shall be a minimum of 100 ft. from any private well or body of water, 150 feet from Class C wells, and 200 feet from Class A or B wells, unless otherwise specified. Less than the required separation distance must have prior approval or waiver by Alaska Department of Envlronmental Conservation (ADEC). 2.4 Piping shall be fitted with a mechanlcal watertight 2.5 Calder coupling on the outlet and inlet of the septic tank. Piping shall be a-inch solid PVC or cast iron, sloped a minimum of 1/4" per foot. Cleanouts shall be installed as designated and capped with air-tight rain caps (Jim caps or equivalent), and extend a minimum of 2 feet above ground level. 3.0 SEEPAGE BED 3.1 3.2 3.3 3.4 3.5 3.6 The gravel for the bed shall be 0.5 to 2.5 inch, screened rock with less than 31 passing ~200 sieve residual. All substitutes must have prior DHHS approval. The bottom of the excavation shall be level and raked with the backhoe blade to insure that the bottom has not been compacted during excavation. The distribution pipe shall be 4-inch rigid PVC with a minimum crush strength of 1500 lbs. All pipes shall be laid level, and spaced according to the drawings. T~o ~onitor standpipes shall be placed as sho~n in the drawings. They shall be rigid PVC ASTH D-3034, or 4" diameter cast iron. The section sho~n with holes may be either drilled 0.5" holes on the 6 inch centers on opposite sides of the pipe, or a section of regular perforated sewer pipe may be clamped to the solld section with a no-hub coupling or solvent joint. A rubber raincap (3im cap or equlvalent) shall be placed over the top of the pipe. If the final grade over the bed is less than 4 feet above the gravel, insulation is required, using DOW extruded blue styrofoam board. There shall be 1" of insulatlon for every foot of soil less than the required 4 feet of cover, but there must be at least 18" of soll even though insulation is used. the solid pipe extending from the septic tank to the dralnfleld shall also have 4 feet of cover or an equivalent layer of insulation combined with soil to prevent freezing of the llne. If insulation is not necessary, then the gravel must be covered with a layer of a non-woven fabric (such as Hirafai, Fibretex 200 grade, Poly-filter X, or equlvalent). 3.7 The top and sides of the bed should be planted vlth a ~hite clover and bed rescue mix or blue grass. · (?4'~,ATER ANCHORAGE AREA BORO~ u'~H · ~ ' DEPARTMENT .~--- · ~ HEALTH 327 EAGLE ~. ANCHORAGE, A~S~ ~501 279-2511 I~SP~CTIO~ R~PORT O~-SIT~ S~WAG~ DISPOSAL SYSTE~ D,S,ANCEFROM WELL a ¢' N U,,,,EROF z MATERIAl COMPARTMENTS ' LIQUID LIQUID CAPACITY ~. (~'~--~ GALLONS. INSIDE LENGTH //x INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF P,TS I OUTS,DE D,AMETER ORW'DTH ///L- .LENa,H /~'. .DEPTH ,/,~' /~( ,O,STA.CE F.OM WEL, q ~,~' .BU,LD,.O FOUNDA.,O. e' ~: L,..-G MA,~.,., _ j~ > q~- s~.,,. NEAREST LOT LINE ~ ~ TOTAL EFFECTIVE ABSORPTION AREA ~ALL AREA) TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LI. NES~'"'~ ABSORPTION AREA FOUNDATION , NEAREST LOT LINE SQ. FT. LENGTH OF EACH LINE TOTAL LENGTH OF LINES ----r'/~ ~I~FEctlvE DEPTH: Top OF TILE TO FINISH GRADE WELL: 'RIPE /'" C4 ~ .~ , DEPTH / O > NEAREST - SEPTIC tot LINE , SEWER LINE /t q ,taNl~ DISTANCES: DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROM · WATER , BUILDING FOUNDATION__ ~,, SAMPLE. . NEAREST / .'.'" SEEPAGE h/'~ . X~ OTHER ((~ ~, , SYST~ I. ~/ (~ / CESSPOOl , SOURCES DIAGR~ OF SYST~ GRe~i eR ANCHORAGE AREA bO[.uUgH RE..,TNO /__~C~ DEPARTMENT OF E:NVIROHMENTAL DUALITY · SSOO TUDOR ROAD POUCH SEWAGE DISPOSAL SYSTE~ ~ ~PPLIC~TIOH ~HD PERMIT INSTAL~TION OF: SEPTIC TANK ~ SEEPAGE PIT ~ DRAIN IELO OTHER FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS ~O~l THIS PERMIT IS NOT VALID WITHOUT ~IL COMPLETION DATE ANTICIPATED T ~, FINAL INSPECTION~ 24 HOUR NOTICE: REQUIRED. BACKFILLING OF ANY SySTeM WITHOUT FINAL INSPECTION BY THE HEALTH D£PARTMEHT AUTHORITY WILL SE SUBJECT TO PROSECUTION. MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD WATER MAIN TO SEPTIC TANK SEEPAGE PIT GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF CREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 213-68 AND THAT THE ABOVE DESCFURED SYSTEM IS IN ACCOROANCEWITH SAIDCODE.~ ~,/~t ~ ~ ~ GREA~ ANCHDRAGE AREA BOROUGH DEPART ~ ~ OF Ef?/IRON~4ENTAL "' 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE Performed For j. Brake Legal Description: Lot_~__Biock 8 This Form Reports Soils Log ~ !Lot 8 & 5 Depth Feet Soil Characteristics Brown silty sand (Sl~ Gray sandy gravel '(GW) ' ---s~ightly silty.5' - i. Was Ground Water Encountered? nn If Yes, At Wh~t Depth?. Date Performed 9/1~/71 Subdivision._F:J_~re~o. 2 ),ercolation Test L_/j_,_ -Rd'd3i~ -- -- Da'te O~3ss'T~e ~-Tiine { Depth to H20 } Net Drop { , Percolation Rate Minute Proposed Installation: Seepage Pit X Drain Field Depth Of Inlet Depth To Bottom Of Pit Or Trench COMMENTS: ~ lnD ~q,,.r~ F~t of drminzge mrea is required net bedroom. Test Performed By R. ~. 6a£{.£s£e Data Certified By: NATIONAL TESTING SERVICES, INC. Date: ¸1, Dale C. Foss dba Foss Drilling 1336 Ingra Anch., Ak. 99501 James Alliason 8400 Hartzell Rd. Anch., Ak. 99507 Jim: In reference to the well Located at; lotS, block 8 Elmore Subdivision(Anchorage). I removed the pump. Sounded the well and determined the following information; well depth: 99' casing depth: 99' static water level: 66' below groun~ level g.p.m.: 7 pump: 1/2 bp. Jacuzzi, model #SS4B-S2/A date: 12/6/85. S~u~erely, RECEIVED Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) ~"~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY Location (address or directions) / 4 ~-r~ -. (b) Applicant Name J~/ J~U--t£~/ Telephone:Home ~$'~ ~; Business Applicant Address l~40~ H~T~e'/-~- ~-~ ~cflO~-~t: A~- ~'~ I (c) Applicani is (ct~e'ck'one): Lending Institution r'l; Owner/builder~; Buyer r"l; Other I-I (explain); (d) Lending Institution Address Telephone (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RE~NCE Single-Family J2t'-"~ulti-Family I-I Other Number of Bedrooms "~ WATER SUPPLY Individual Well~ Community f-I Public 1'3 Note: If community! well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsit6q~/' Public I-I Community rl Holding Tank I-~ Note:Ill community wel system, must have written zc~, nfirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page I of 2 'ENGINEERING FIRM PROVIDIN~ INSPECTIONS, TESTS, FILE SEARCH, DA 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 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 fur[her verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm /~' Cc-<: ~' Telephone ~'~4; J ~--o cf O Address Date '"' ! Approved for ~.*,~"~ edroo ms Approved t~'" Disappro~d ' Conditional Terms of Conditional Approval Date /'"~--J/~:~ --'7"~~ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered tn the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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 engineers work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MO~,, r HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: ~'L/vt o,~ ~" ~ ,2, WELL DATA Well Classification /~ U~. '~ If A, B, C, D.F-C. Approved (Y/N) Well Log Present ~ Date Completed /~-~'~ Yield Tote, pfh cased to ' De tho, Grout,ng Static Water Level Pump Set At Casing Height Above Ground Electrical Wiring in Conduit Separation Distances from Well; To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Sanitary Seal on Casing {~N) Depression Around Wellhead (Y~ ; On Adjoining Lots ; On Adjoining Lots /00 -~ I O~ -+ To Nearest Public Sewer Line. '--' . To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Water Sample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed Standpipesi~N) Depression over Tank (Y/~) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well / / ~ ' TO Property Line '~ '~ ' To Water Main/service Line ~* /D ' Course ~7- /'~O" ~"/~--~-)- Size /OOO No. of Compartments ~- Air-tight Caps ~) Foundation Cleanout ~)N) Date Last Pumped ~ ~' ; for - ~ Temporary Holding Tank Permit (Y/N) To Building Foundation ~ ?, To Disposal Fietd To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026{11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Dale Installed ~ -/5' Width of Field J 5- Square Feet of Absorption Area over Field (Y/~). Depression Results of Last Adequacy Test Separation Distance from Absorption Field: / 2-,.3- ~'/'Z[., Type of System Design Length of Field Depth of Field ~'. Gravel Bed Thickness Standpipes Present ~N) Date of Last Adequacy Test To Water-Supply Well / / (~ To Building Foundation ~' ~-,~ Lot ~T .~ ~ To Water Main/Service Line ~ 7'- ! O To Stream/Pond/Lake/or Major Drainage Course TO Driveway. Parking Area, or Vehicle Storage Area C'~ T' ~O Comments To Property Line /C) To Existing or Abandoned System on ; On Adjoining Lots ~ ~-' .~ 0 To Cutbank (if present) "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments . ~ Dimensions ~ Manhole/Access (Y/N) ~ ~ Pump Off" Level at ~ ~~.~ -'""'~'~ ~during Adequacy Test. Meets MOA *' Check Permitted Bedroom Rating Against HAA Request ** I certify that I h_.~3~'...,checked,J/erified, or co, nformed to all/_AMOA apd HAA guidelines in effect on the date of this inspection. Signed . ~¢~'~~ Dale /Z/~//":~'~'' Company ,~t ~'~',~ ' /~ c MOA No Rece,pt.o..SLorcq- / .: · Date of Payment Amount; $ ,(/~?' ~:~Z~ Engineer's Seal Page 2 of 2 72-026 (1 CHEMICAL & Gr~OLOGICAL LABORATORIES oF ALASKA, INC.. TELEPHONE (907} 562-2343 5633 e Street ~ Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM I.D.# PRIVATE WATER SYSTEM · Mailing Address Phone No. City State Mo. Day Year Zip Code SAMPLE TYPE: I-] Routine cI Check Sample (for routine sample with lab ret. no. [] Special Purpose ) I-1 Treated Water [] Untreated Water SAMPLE NO. LOCATION 31 I 41 1 51 I Time Collected Collected Sy I TO BE COMPLETED BY LABORATORY A~lysls shows this Water SAMPLE to be: ~ Satlsfactory . I-] Unsatisfactory I-~ Sample too long In transit; sample should not be over 30 hours old at examlnatlon to Indicate reliable results. Please send new sample via special delivery mall. oat,,ec,lved //-~q'~.- T~me Rec,Iv,d ,~'~'~ Analytical Method: Membrane Filter No. of colonlesll00 mi. Lab Ret. No./. Result* I/.'~,~,,- ~.~1 ~ I Im I IIT! I IITl I II-I'-I Analyst,' BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filler:. Direct Count Verification: LTB Final Membrane Filter Resulte./ BGB Time: Collformll00ml Collforml100ml //-~ ~'- p.m. TNTC = Too Numberous To Count OB = Other Bacteria