HomeMy WebLinkAboutPOLLOCK HOMESTEAD BLK 2 LT 3AS
—
_
i
DIVISION OF ENVIRONMENTAL HEALTH
DRINKING WATER and WASTEWATER PROGRAM
555 CORDOVA STREET
ANCHORAGE, AK 99501
http://www.state.ak.tis/dec/lome/htni
Kenneth M. Duffus, P.E.
KND Engineering
20441 Ptarmigan Blvd.
Eagle River, Alaska 99577-8736
TONY KNOWLES, GOVERNOR
Telephone: (907)269-7696
Fax: (907) 269-7650
December 24, 2001
Subject: Lot 3, Block 2, Pollock Homestead Subdivision, Holding Tank and Class C PublieWater
System, ADECProjectN=amber 586; Review
Dear Mr. Duffas:
?'hisJsJiritSoonse to;youu submittals roc ived.in '.n?s oifice.o;i Novernbe1: 1 . -Z001i in w'hi, il'}xi: 2 address
F11y; co_►cerns on the issuance softine final operation approvals for the above -referenced project. 1 hu ve
completed my review of the submdttef" information, the Dep 1imerkt`; files on:r ;is FWility, ani State
Wastewater Disposal arid D.inking Water Regulations.: Basest oi.i.his re le:v, .[have the ;folluw ing
comments.
Separation Distance Waiver
As noted in my May 31, 2001 letter, with the relocation of the lift station within the foundation of the
building, the separation distance waiver between the existing source well numbei-2 and the lift station is
no longer required under State Wastewater Disposal Regulations.
Drinking Water System
From the submitted information, it appears that the existing Class C public water system now meets the
minimum requirements of the State Drinking Water Regulations and guidance. Therefore, in accordance
with State Drinking Water Regulations [18 AAC 80], final operation approval is granted. A signed copy
of the Class C public water system Registration Form, constituting final operation approval, for this
facility is enclosed.
The Public Water System Identification Number assigned to this Class C public water system is 218655.
Please ensure that this number is placed on all water sample laboratory forms to ensure that the public
water system is properly credited for the sample results.
Kenneth M. Duffus Page 2 12/24/01
Wastewater Holding Tank
Based on the submitted data, the wastewater holding tank (4,000 gallon) was installed in accordance with
the minimum requirements of the Wastewater Disposal Regulations and the construction approval issued
on May 3 l., 2001. Therefore, in accordance with State Wastewater Disposal Regulations [ 18 AAC 72],
operation approval is granted. A Construction and Operation Certificate with the operation portion of the
certificate signed, constituting this approval, is enclosed.
These approvals do not imply the granting of any additional authorizations, nor obligate any local, state,
- federal regulatory body to grant required authorizations.
Thank you for your cooperation and coordination with this Department. If you have any questions, please
do not hesitate to contact me.
Sincerely,
Keven K Kleweno, P.E.
Environmental Engineer
Enclosures: As Stated
cc: Trevor Fairbanks, ADEC, DW/WW WJo Enc:
Jim Cross, P.E., MOA w/o Enc_.`. _
A. 1. Public Water
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
INVENTORY AND SOURCE REGISTRATION FORM
FOR
CLASS C PUBLIC WATER SYSTEM
Name and Location:
Legal ddscription of property:�G� j�, Gtr, �� ZC • ������, ,�,/
Number of people served daily:
Number of service connections: %
Public Water System Owner: -
Owner Address: .12 4•a
_ �"c"., f i .�G,s=� (../c�.'-� � (_�- . � J ? � G7 Lam. c% '� i � � > .r i•.�.ie�_ �4u%L14 22,26
Owner Phone: � t� S — � J � �7 � �
A. 2. Required Check List:
0
$75.00 registration fee as required by 18 AAC 80.1910.
Results of nitrate and coliform water samples do not exceed the MCL set at 18 AAC 80.300.
(attach reports from certified laboratory)
ElSource
water protection requirements of 18 AAC 80.015 have been met.
(see section B. page 2 for details)
PSI
Minimum separation distance requirements of 18 AAC 80.020 have been met.
(see section B. page 2 for details)
El
Cross -connection provisions of 18 AAC 80.025 have been met.
(see section B. page 2 for details)
A. 3. Public Water System Source:
(circle
yes or no)
YES
&fQ_i� Well depth is less than 30 feet to the first opening for water collection.
(NO
YES
Well is located less than 50 horizontal feet to a surface water source.
YES
Source uses an infiltration gallery, spring, rain catchment, or surface water.
YES
NO Source requires treatment to meet an MCL set at 18 AAC 80.300.
If answer YES to any of the above Public Water System Source, then complete section C. on page 2.
or Department use only
This water system is hereby granted department approval to operate. The following public water system identification
number is being assigned to this public water system:
BY TITLE
DATE
ADEC Staff Signature
(rev 10/99) Page 1
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
CONSTRUCTION AND OPERATION CERTIFICATE
FOR
DOMESTIC WASTEWATER DISPOSAL SYSTEMS
A. APPROVAL TO CONSTRUCT
Plans for the construction or modification of
located in
by
domestic wastewater disposal system
, Alaska, submitted in accordance with 18 AAC 72.210
have been reviewed and are
approved.r171 v
conditionally a oved (see attached conditions). �P� T��i � 3l ° l V,
BY
TITLE DATE
If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must
be submitted for review and approval before construction.
B. APPROVED CHANGE ORDERS
Change (contract order number or descriptive reference) Approved by Date
C. APPROVAL TO OPERATE
The "APPROVAL TO OPERATE" section must be completed and signed by the Department before this system is made available
for use.
The construction of the W.is domestic wastewater disposal system was completed
WA�
on �_ (date).
The system is hereby granted interim approval to operate for 90 days following the completion date.
BY
TITLE DATE
As-built/record drawings, submitted to the Department, or an inspection by the Department, has confirmed that the domestic
wastewater disposal system was constructed in substantial conformance with the approved plans. The system is hereby granted
final approval to opera
BY n'
TITLE
DAT
Distribution: 1. Retain original for project file
2. Make copies for distribution
MUNICIPALITY OF ANCHORAGE ®e�
f DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264.4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME -
PHONE ❑NEW
7/ -VU PGRADE
MAILING ADpRES
/r �Y 7L
LEGAL DESCRIPTION
(]J�1 ` / �, /y, �/
6 � L r cJ C� C - fC f' 61"% 1 E� S 7-e IT)
LOCATION
NO. OF BEDR OMS
v Y
Well
DISTANCE TO: r Absorption area c
�
r
Dwelling t� O
PERMIT NO.
aa
LU IZ—
Manufacturer
Material
(t'C
No. of ompartments
y.
Liq. capacit in gallons
IF HOMEMADE:
Inside length ,___
Width
Liquid clegth
.�___
2
DISTANCE TO:
Well
Dwelling
s
PERMIT NO.
TH
ManufacturerMaterial
�~
Liquid capacity in gallons
g
DISTANCE TO:
Well 96 r
Foundatioi� ®
Nearest lot line r �6 r
PERMIT NO,
t®
,wj LL Z
z
No. of lines Length of each line
(V
Total length of lines Trench wid
Distance bet ean lines
F cc
42 Z__
Top
cc H
of tile to finish grade#
Material beneath the
Total effe rive absorption area
� inches
V vl?�
w
Length Width
Depth
PERMI INO.
U
a1•-
wa
uj
Type of crib
Crib diameter
Crib depth
Total effective absorption area
to
DISTANCE TO:
WeII
Building foundation
Nearest lot line
_j
J
Depth
Driller
Distance to lot line
PERMIT NO.
Lu
DISTANCE TO:
Building foundation
Sewer line
Septic tank
I
`
G�
Absorp ' reds)
,—
OTHER
PIPE MATERIALS
r
�p--�� /a�((
TEST
SOILTES
INSTALLER
l-�a b5br�
REMARKS
C
10
C
f
APPROVED DATE LEGAL
__` -"V,�
u
MUNICIPALITY OF ANCHORAGE
Department f Health and Environmenta-ect on
825 Street, Anchorage, AK. ro Ol
264-4720 '2t)
# # # HANDWRITTEN PERMIT # # ?�b�ihaar'�7
Permit #
WL`AND/QR ON-SITE SEWER PERMIT o1
o;
Applicant:,� `�a c L 5cj_�`�J Mailing Address:
Location: Phone Number: l�
Legal Description: Qq�-,K,�i
,CC"-_4nA-Zec( Cliot Size:"71
--
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: _ Holding Tank: _
Maximum Number of Bedrooms: rj Soil Rating(sq.ft/br) 'S'
'S (1D
The Required Size of the Soil Absorption System Is:'
DEPTH �� LENGTH (L, L . GRAVEL DEPTH Z WIDTH S _
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
# REQUIRED SEPTIC(HO-L-D-rNG) TANK SIZE _ /'56n GALLONS #
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
# # TWO(2) INSPECTIONS ARE REQUIRED #
Backfilling of any system without final inspection and approval by this departmeni
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line .s 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3
I certify that: ,
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the sys"m in accordance with codes.
(3) I understand that the oto -site sewer system may require enlargement if
the residence is remodeled to include more that, bedrooms.
Signed: . Issued by: y����
Date:
SWP/024(1/81)
DG ll, li;; f2l OI HPi1LTl{ i�i'iD - I`JV/I�tU�J I -A;. I'Ro _
(Permit if: 821114
January 31, 1983
TO: Permit Applicant
Subject: Lot- 3 Block 2 Pollock Homestead Subdivision
A permit .issued by this department for an individual well.
and/or on-site sewer system has expired as of December 31,
.198 2.
Permits are issued on a calendar year basis, as stated ort
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
�U P-4 I C_- 1: 1:;j pq C- V_ r4` F�l I:A EE
DEPARTMENT i HEALTH AND ENVIRONMENTAL . OTECTION ��v
825 /L' STREET/ ANCHORAGE., HK. 9951
264~4720 U
PERMIT NO. ( 82111����-r EE ����F.,;! p, jr.-H X r
APPLICANT SID BOUSCHER SRA BOX 475C 99507 ]45-1506
LOCATION
LEGHL B2L] POLLOCK HOMESTEAD
LOT SIZE 999999 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: DRHINFIELD
MAXIMUM NUMBER OF BEDROOMS = 5 SOIL RATING (SQ FT.BR)---. 85
THE RE8UIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
�E,. F-za -F 1-1 ="- F -I'm �E-F ir-4 03, -T �j -_ �RZ-V 0 F�� 1=1 "'w'"IE L_ ��r---o I- i -I Zz"
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD
THE DEPTH OF H TRENCH OR PIT IS THE"DISTANCE BETWEEN THE SURFACE OF THE
�
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET)�
1� ����� �� �
'T_ 1-1 � ��������
THE�
GRAVEL. IS THE MINIMUM DEPTH OF GRAVEL B~TWEEN THE OUTFALL. PIPE
AND
THE BOTTOM OF THE EXCHYHTION (IN FEET). �
I MZ� �F
P-4 IF-'- J- ���
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
muMBEM OF RESIDENCES THAT THE WELL WILL SERVE.
�—����
BnCx�ILLN
��UFHNY
<
�2� ���������D�� �F��
SYSTEM WITHOUT
����1 Fe��
vuPnn/ME/-4/ WILL
BE
FINAL INSPECTION
SUBJECT TO PROSECUTION.
AND
APPROVAL BY THIS
MINIMUMDISTHNCE BETWEEN A WELL HND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100F--EEFOR RPRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING
uruN/HE TTYPE OF PUBLIC WELL
MINIMUMDISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY -SEWER LINE IS 75 FEET
OTHERREQUIREMENTS MHY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS HRE
AVAILABLE TO INSURE PROPER INSTALLATION.
_L _"S NED ;R
I CERTIFY THAT
l:IHMFAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH ByTHE MUNICIPALITY OF HNCHORHGE
2: I WILL INSTALL THE SYSTEM IN HCCORD�''NCE WITH THE CODES
]�IUNDERSTHND THAT THE ON-SITE SEWERSYSTEM MAY REQUIRE
�ENLHRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS.
SIGNED� ��= 1e- �- -------
APPLICANT' SID BOUSCHER --~~~
ISSUED
~~~DHTE�_�,� � � ~7 / 8 _~
d�� SOILS LOG
MUNICIPALITY OF ANCHORACfV-NICIPALI-iY OF ANC:;ORAGE
L"r-1
DEPARTMENT OF HEALTH AND ENVIRONMENTA T -CT,I, N -; ERcoLATION
I �I�'Ml�? Q... I..�.:, EST
1 / 825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST �'G i ����
EVEDi
PERFORMED FOR: �� �l.J( .7 l�L��� i,C�C� 1#(.� 1= DATEAPER� O RMED: 0
LEGAL DESCRIPTION: --1-0 I K cQ. f) E/ L-k=U •�"A U W G'--: - li AVV� _
SLOPE SITE PLAN
DEPTH
OF 5P T) V {�-• fc-�f C,= C) u
1Z F.Axj 1;7-
2 0 RC>ONDF-0 C_�
3
4 f7
--
•pp)CfL VlL�7
7 j 'C7 L� r /
s ; 1 Cl fk)v� y
LH
9 ®�
10 u-1. >'_
11
12
13
Date
Gross
Time
Net
Time
Depth to
Water
9
C)F•/ 1a
14
`I �
15
•
d
�r e••9 �ef
■
f
�f T F1
16
■
No 2225-E
17
•:)
. JUNE 254 1971 cV��
18•`
l"•r�, e,
r`S`•e••fnv.,e.ro9 wI
�aki
19-
20
WAS GROUND WATER S
ENCOUNTERED? Q L
O
P _
IF YES, AT WHAT E
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
■
■
WAS GROUND WATER S
ENCOUNTERED? Q L
O
P _
IF YES, AT WHAT E
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE
(minutes/inch)
/"�� ; // /TEST RUN�BEETWEEN /�/7 FT AND --_ FT
COMMENTS ' f !=• U' �}IJ'�L•� �,.�..1"'�Z..L'�'I.�'tP �'j R _
PERFORMED BY:CER'r1FIED BY: `f --D A T E:
72-008 (6/79)
oULTIN��ENGINEER lPo�o
Sidney Bouschor
SRA Box 475-C
Anchorage, Alaska 99507
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WATER:
SEWER:
DATE OF TEST:
TEST PROCEDURE:
TEST RESULT:
S E W E R A D E Q U A C Y
Lot 3, Block 2, Pollock
On Rabbit Creek Road
Sidney Bouschor
Single Family Unit
On Site System
203W. 15th AVE ""' SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-3916
tiL��O FAf �Tr
O O
August 26, 1983yti�q�A�TtiCy
O�N'
.7 . CTi Co
�� j�'t,•,� o'l�
T E S T
No Municipal Records
Septic Tank and Drainfield.
Dimensions Unknown
Approximate Installation Date 1966
August 19, 1983
System was inspected on August 16th. No evidence of
drainfield, no sumps or cleanouts. Vent for tank in
place.
On August 19th., water eas added to the tank at a steady
rate of 2.25 gal. per minuit. This was as fast as the
well could deliver. The following readings were taken:
TIME
FLOW
VOLUME
DEPTH
-0-
2.25
-0-
47
10
2.25
22.5
48
20
30
2,25
45.0
49.5
40
2.25
67.5
50.5
50
2.25
90.0
51.5
2.25
112.5
52.5
60
90
-0-
-0-
51.0
-0-
-0-
49,0
This system accepted 61 gallons of water in a period of
40 minuits, or 92 gal. in one hour. This is far in
excess of the minimum requrement of 150 gal. per bedroom per
24 hour.
URORAMRIe9
ii�
CHEMICAL & GI LOGICAL LABORATORIES i' ALASKA, INC.
TELEPHONE (9071.279.4014 ANCHORAGE INDUSTRIAL CEN14l6RICIPALITY c)r I +
274.3364 5633 B Street 17f;PT. Of: li"ALIH
I!NVIItONMeNTAL PROTE
r.: �
Drinking Water ,Analysis Report for Total Coliform BacUl"
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
Result" Analyst
L
ETD
48 Hours
I.D. NO.
Lw--�
�-
L ---J
water System Name
48 Hours
Phone No.
Mailing Address
City
States Zip Code
SAMPLE DATE:
Mo
Day
Year
SAMPLE TYPE:
❑ Routine
❑ Check Sample (for routine sample) Treated Water
with lab ref. no. p Untreated Water
❑ Special Purpose
SAMPLE
NO. LOCATION
11
2 III
3 L�
4 I�
06.1220 (b)
Rev. 1978
Date Collected
READ INSTRUCTIONS
to Received
BEFORE
Time Collected
Collected By
TO 13E comM`ftbV LABORATORY
Analysis shows this Water SAMPLE to be:
❑ Satisfactory
❑ Unsatisfactory
❑ Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample.
Date Received _
Time Received
Analytical Method:
❑ Fermentation Tube
O Membrane Filter
Lab Ref. No.
Result" Analyst
L
ETD
48 Hours
EEI �^
Lw--�
�-
L ---J
�s
48 Hours
.No of colonies/ 100 nil- or No of Positive portions.
BACTERIOLOGICAL WATER ANALYSIS RECORD
source
-
1m
Tlm. weceweA - _ o.m. Lab. Nc
Presumptive lentil 10ml loml
loml loml 1.0ml 0.1ml —
24 Hours
48 Hours
Confirmatory
�-
24 Hours
—
48 Hours
EMB
COLLECTING SAMPLE Multiple Tube Report:
Membrane Fllterl Direct Count
Verification: LTD
Final Membrane Filter Results
Reported By _
Broth 24 hours:_--erotn 48 nours:
10ml Tubes Positive/Total loml Portions
- _ Coliform/100m1
coliform/loornl
Date —
Tlme:— —a.m.
p.m.