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HomeMy WebLinkAboutT15N R1W SEC 8 LT 33 SE4\\Sn (L\WD SEcA la\ 2C CDSI- OR\ - a5 LA .')3 L'lLI f'" ~' MUNICIPALITY OF ANCHORAGE  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 P~J~N_E LEGAL D~CRIPTIO~ g 'tq z g , . Liq/~,llon, '~ HOME'DE; In,ide length Width Liquid depth ~Oz~ ~ BISTA~CE TO; Well~ --Dwelling . . . PERMIT ~0. ~ ~''~" ND. of lines /~ Length W~dth PERMIT NO. ~ ~ , Type of crib Crib diameter Cfi Total ef f~ti~ absorption area ~m DISTANCE TO: Well ~u~d~g f~undation Nearest lot line ~ Class Depth Or .r O~stance to Io[ line PERMIT ~ DISTANCE TO: Building foundation Septic tank Absorption area(s) .. OTHER P PIPE MATERIALS / .~:v"..'.'. .... , ~,.. ,,-,:.... ....,~ ~ .- ~'1 /~'~7~ ~ . . . ~. ~,~% N3. 145'1 E · .~T ~, [Rev. 3/78) t PERMIT NO. 01'4--!:: I TE SEI~IER PERM I T 888426 ) APPLICANT JIM KNOX LOCATION BO~*~ERY LANE TYPE OF SOIL ABSORPTION SYSTEM IS: SR BOX 892 CHUGRIK LOT SIZE DRRINFIELD 688-250? ~000 SQUARE FEET [1AXIMUM NUMBER OF BEDROOMS SOIL RATING (SO FT?BR)= 100 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= ~. 5 LEhlGTH= 42 GRAVEL DEPTH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND RND THE BOTTOM OF THE EXCAVATION (IN FEET). THE TRENCH IWIDTH IS 5. 000 FEET. THE GRAVEL DEPTH IS THE MINII~UM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM Of THE EXCAVATION (IN FEET). REQU I RED SePT I C TAt~K S I ZE= :LOOO GALLOI'-,I$ PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF AN',' WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER Of RESIDENCES THAT THE WELL WILL SERVE. .... TWO ( 2 ) INSPECT ION$ ARE REQU ! RED BACKFILLING Of ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SE~IAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM R PRIVRTE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND. TO A COMMUNIT~ SEWER LINE IS 7~ FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT i: I RM FAMILIAR WITH THE Ret~UIREMENTS FOR ON-SITE SEWERS AND WELLS AS Set FORTH BY THE MUNICIPALITY Of ANCHORAGE 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. PERFORMED FOR: .LEGAL D~SCRIPTION:- 6 8 MUNICIPALITY OF/~,NCHORAGE .- I'1 PERCOLATION DEPARTMENT OF HEALTII AND ENVIRONMENTAL PROTECTION TEST /)ouch G-G50o Anr,5orage.~leska S0502 27G-222f ,. SOILS LOG -- PERCOLATION TEST SITE PLAN 10- 11- 12 13 14 15 16 17 18 19- 20- Robert ENCOUNTERED' DEPTH' Gross Net Depth to Net Reading Date Time Time Water Drop '/4/3 / PERCOLATION RATE (m;nut es~;nch! · .,4,~' ' ' /' TEST RUN BF,~WEEN,~ . FT AND p~R~ORMED . r~ - · DRAWN CKD. SHT. I ./I I I N /,~wsion of Geological 6 Geopl~¥$icol Surveys .,~.¢hI !$ ~ 65I --.,__.,__.,__' c) 15 sE] I ~ .. ~-H-- ! ~.merlc~ Legion Post 33 S~d Or~vel 3' 37 S~d ~p Pea ~rave~ Wa~r I0. aTATIC .~°c~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES ~'~ ~ 7- 0~'~) DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 ApplicationDate Oc~be¢ ~r 1997 · ' ' ' " ~ ' ' . ; GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) · '. ,.. :. (a) Legal Description (include lot, block, subdivision, section, township, range) SE Po~,Zo~ o~ Lo~. 53; TISI, I; RI~; $~c/~Zor~ 8 Location (address or directions) Property Owner .7~u~1~..& $. Kl~0~( Telephone: Home 4~-f.~07 Business MailingAddress ~.0. Sq¢ 6711~7. C~g~E: ~bn qq~7 Lending Institution ' ~ Mo~q~q~ Telephone Mailing Addmss A~E~ZO~ S~ O~, A~eho~. A~ Real Estate ~mpany and Agent ~ (b) (c) (d) Address Telephone (e) Mail the HAA to the followina address: or;. Check here Eq, if hold for pick up. List contact person and day phone number below. · . S !; S ENG~NEER~IqG/694-~979 17034 E~z~te YJ.u¢.,~ Loop Ro,~dt Suite 504 E~z.q,te. i~,Z.u~t.~ A,t.~/ut 99571 , 2~ 'TYPE OF RESIDENCE Single-Family [] · Number of Bedrooms ~. WATER SUPPLY "divi a We, m Community I'"l Public I-I "- Note:If community well system, must have written confirmation from the State Department of Environmental Conservation ..... attesting to the legality and status. · 4. T SEWAGE DISPOSAL Onsite ~] Public I-I Cor~munity I=1 Holding Tank I=1 ' ' Note: If community well System, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 ~-~s fRev ~86) Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify thai 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 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 Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date S & S ENGiNcc. A~N¢ ~.?~?-4 _c~_l, Rtve~ Loop Road No. 2G4. Eagle River, Alaska ~)577 Telephone DHHS APPROVAL Approved for *'~ bedrooms by Approved ~' Disapproved Terms of Conditional Approval Conditional, /o - 0°7 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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 engineer's work. Page 2 of 2 7~s ,.~, 8,~) e.ck A. WELL DATA /~UNICIPALr~Y OF ANCHOIb~EINICIPALITY OF ANCHORAGE (MOA) ---" SERVICES Ol',~TH AUTHORITY APPROVAL (HAA) ENVIRON~,r-r~e,~,. CHECKLIST - FEBRUARY 1984 OCT 2 1987 264-4744 . . Legal Description: /--~." '~C~"~'I~,-~ ~ ~ ~ RECEIVED ' Well ClassificMion Well Log Present Total Depth ,~ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (~)N) Separation Distances from Well: To Septic/l;~ Tank on Lot ~ °~::' If A, B, C, D.EC. Approved (Y/N) e-~/~6~ · Date Completed ( )t~--. Yield [~."~. ~,~F.4. ~ Cased to ~ I~ Depth of Grouting ~ ~ I Pump Set At ~. ~" Sanita~ ~al on CasingS) Depression Around Wellhead (Y~ "~ ~ : On Adjoining Lots To Nearest Edge of Absorption Field on. Lot ~ c,3_. ; On Adjoining Lots To Nearest Public Sewer Line ~.5/,~, To Nearest Public Sewer Cleanout/Manhole ~'~/~ To Nearest ~wer ~ice Line Water Sample Colle~ed by ~~ ; Date Water Sample Test Results ~~ ~ ~mments ~ ~ tP~ ~ ~ SEPTI~ TANK DATA Date Installed Standpipes ~N) Air-tight Caps Depression over Tank (Y/~) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: rc:~/~'C::) Size ~ E::::~C~c~ No. of Compartments Foundation Cleanout (Y/~) /~;te Last Pumped ; for Temporary Holding Tank Permit (Y/N) /~/'A To Water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation To Disposal Field .' I'"~ '*~F.. · . - ~..-. To Stream, Pond. Lake, or Major Drainage Page I of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~/~E~ Width Of FiEld ~ ~ Type of System Design \ ,-.Z~ Length of Field Depth of Field '~.~ ~-~c~J;::~:~ Gravel Bed Thickness Square Feet of Absorption Area ~ ~T' ~:~ Standpipes Present (~N) Depression over Field (Y/~). Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field~ . .: To Water-Supply Well [ (~'3...~ To Property Lir~e To Building Foundation j Lot ~t//~.' To Water Main/Service Line ~ C~ ~JF To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Existing or Abandoned System on ; On Adjoining Lots '~ t Jr' To Cutbankl(if present) LIFT STATION , ~ '/~. Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y~N) Dimensions ,Manhole/Access (Y/N) "Pump orr' Level at Comments Vent (Y/N) ~during Adequ;~cy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request I Certifysthat& $1 havec, t]ec~i~erified,ENGiNE, eK or conformed to all MOA//.-,and HA.A guidelines in effect on lhe date of th~s' inspection.' Signed 17n-x =_~,- ~,~-- tm~. ~.1N~ Compa~J~gle RlYer' Alaska 99577 MOA No. Receipt No. ,' '-'/' ~-' Date of Payment · - ' ' · '. ' ', Amount: $ ~' c.~_~._~ *~;./~/ ~.e.~.~...?~ Page 2 of 2 . . , un c pa..ty .... of P.O. BO""96650 ANCHORAGE, ALASKA 99519-6650 (907) 343-4200 TONY KNOWLE$, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES October 30, 1987 Robert A. Sharer, P.E. S & S Engineering 17034 Eagle River Loop Eagle River, Alaska 99577 Subject: Waiver Request for SE Portion of Lot 33, Section 8, T15N, R1W, SH, Waiver Number WR87-067 Dear Mr. Shafer: Your request for waive~ of the required separation distance of a private well to a residential septic tank on the subject lot has been approved. The required 100 foot separation distance has been waived to 82 feet. Based upon the Alaska Department of Environmental Conservation point system for distance waivers, the total points indicates that this well should be free from risk of any bacteria contamination. This waiver applies to the existing septic tank/well-separation only. Any future upgrade ofkhe septic system will require another waiver approval from this department. Sincerely, Civil Engineer On-Site Services cc: Gus Andress, P.E., Manager On-Site Services/Water Quality ROBERT A. SHAFER October 23, 1987 CIVIL ENGINEER 694-2979 HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUSIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage Depart~ent of ~eal~h and H~man Services 825 L Stre~ Anchorage, Alaska 99501 REFERENCE: SE Portion of Lot 33~ Section 8; T15N; RIW~ SM. Request you issue the attached Health Authority Approv~ and grant a waiver for the horizontal separation distance between the private we~l and the septic tank located on the reference property at a distance of 82 feet. Prior to the on-site wast~water disposal syste~ b~ng i~talled on this property a waiver was granted by the Municipality of Anchorage for a horizontal separation of 80 feet. A risk analysis has been performed and it appears that no bact~rialogical pollution is possible from this source. Attached for your review are the following document, s: A. Coliform and nitrate analysis of water taken from the w~ll located on the reference property. B. A flow test report for the reference w~l.. C. Risk analysis waZver review worksheet. D. A plot plan showing r~ative distances betw¢,en on-site wast~at~r disposal systems and w~lls. Eo A w~ll log from a well located on a lot located near the ref~Lenceproperty.. It is our opinion that the ho~zontalseparationdistance prescribed by 18AAC72.021 is not required in this case. If you require additional information, please contact USo cer~ly, ~O~ERT~SHAF~ PiE.~ RAS/ss MUNICIPALiTy OF ANCHORAGE ENVIRONMENTAL SERVICE,?, D/VISIoN OCT 8 3 1987 RECEIVED 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 ROBERT A, SHAFER Oc.t. obe.~. ~$, 19,~7 CIVIL ENGINEER 694-2979 ENGINEERING STUDIES AND REPORTS ROAD DESIGN ON SITE WASTE WATER ~$POSAL SYSTEM DESIGN 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID I 92-0040440 Client PG: : V~BAL Req t: Client Sq:l ID: l~33, SE(3 8, TISdt RIW 10-15-87 S~le Ren'~ : OC~ 15 87 O~clered By : R. SCtg. Z,~ Sen~ Reports To: $ & S {21GINE~IHG Il SC~.AEFE2 17034 EAGLE I~IVER LI33P RD., 1204 EAGLE RIV~, H. 9?577 Special Instruct: ~JL~LYSIS REPCRT BY ~LE Work Cr~r No. : 3426 Client Account = ~{~ Date Report Printed: OCT 19 87 $16:02 Released By : 3.,~'C.,' Reports Addre~ t2 Ch~lab Ref I: 8040 Lab ~pl ID: i MJtrlx: Water Allow=lc Parameter Tested Result/Units Metho~ Limits NI~TE-H 1.0 mg/l 10 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA,%~ Ico NC. TELEPHONE (907) 562.2343 5633 B Street Anchorage, Alaska 9~518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER [] PUBLIC WATER SYSTEM I.D.# ~ PRIVATE WATER SYSTEM Namo Phone NO. City State Mo. Day Year Zip Code SAMPLE TYPE: ~ Routine I~ Check Sample (for routine sample with lab ref. no. r~ Special Purpose ) I-I Treated Water r-I Untreated Water SAMPLE NO. LOCATION 4 [ Time Collected Collected By I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ~ Satisfactory [--I Unsatisfactory [] Sample too long In transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received Analytical Method: Membrane Filter * No. of coloniesll00 ml. Lab Ref. No. Result* I I-~ I FT-1 I CF1 I IT1 Analyst BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter:. Direct Count Colllorml100mi BEFORE COLLECTING SAMPLE Verification: LTB BGB Final Membr!~Z~l~s ~ Reported B y/.~.,,e'~W' __~ .... Date ~.- w MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL $ ERViC£ST~,ei,~ION TNTC = Too Numberous To Count OB = Other Bacteria OCT 2 5 1,987 RECEIVED Coilformll0Oml a.m. p.m. PROJECT: ?~"t'~--~ 17034 Eagle River Loop Road Eagle River, Alaska 99577 MUN/CIPA[/Ty OF ANCHORAGE OCT 5 J 87 REi EIVED ROBERTA. SHAFER CIVIL ENGINEER 694-2979 DATEOFTEST: ~'~ WELL DEPTH; [)~"' FT. CASING: DATE DRILLING COMPLETED: STATIC WATER LEVEL (Top of Casing): ~.~..~.. ,~.~ I.,~ FT. SCREEN: DRILLER; FT. DATE: CLOCK ELAPSED TIME SINCE DEPTH TO DRAWDOWNI PUMPING PUMPING STARTED/ WATER, FT. RECOVERY RATE, GPM REMARKS TIME STOPPED, MIN. I '. ~(~' 0 ~,"~,. (swl) 0 0 Start -~.~ to --,~' ~" -z-' c~" ~,,"~-- ~,J~ ~t~ 35 ~*~ ~'~ ~,~ ~5 ~GO ~(lhour) ~ ~,, ~. .~,~ ~..... / ~. .~ ~.~ , ~ ~, .. ~ECOW~ 20 25 35 Comments: ~..~.~ Flow is not Guarant~d Su~equent Va~fions ~n Occur. DATE RECEIVED: ENGINEER: MUNICIPALITY OF ~NCHOR~GE DEPARTMENT OF HEALTH ~ND HUF2OI SERVICES WAIVER REVIEW WORKSHEET S & S ENGINEERING Eagle RiVer, ANdca ~577 APPLICANT: WAIVER ~USSTED: CRITERIA; 1) Geology: Points: A. Water Table ~.~-- B. Soil Sorption ..~-,~ . C. Permeability ~.~ D. Water Table Cradtent E. Horizontal Separation TOTAL: I'Z..~'~ WAIVER IS. granted, with conditions listed DATE: not granted for reasons listed below: ..... / '~ ~ ............. * ~.