Loading...
HomeMy WebLinkAboutWILLIAMSON #2 BLK 3 LT 4Williamson Block 3 Lot 4 #015-074-04 Municipality of Anchorage Page ~l of DEPARTMENT OF HEALTH AND HUMAN SFRVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~ ,,,,3'~' ~, oo~/?~ PID Number: 0 ~ 5 - o'/ff - oq Name: ~60~¢ I,g~o~-~4 Wastewater System: ~ New D Upgrade Address: No. of B~rooms: Phone: ~ - ~Z~ ' E] Deep Trench ~Shallow Trench ~ Bed D Mound D Other LEGAL DESCRIPTION SoilRating: i.. '2 TotalOepth fro~ri~inalgrade: GPD/Sq. Ft. Subdiv~ion: '~3 Dep[h to pipe bottom from odginal grade: Gravel depth beneath pipe LOt: ~ Block: ~ (~lbLt~Ofl ~ ~ Ft, ~ Ft. Township: 1 Range: ~ Section: Fill added above original grade: Gravel length: WELL: com~,~,~ew D U~~ Ct.vel width: Number of tines: I Dismc~b~t,e~n'i.es: Classification (Private, A,B,C): ~tb: Cased To: Total absorption area: Pipe material: ~' -- Ft~ Ft, ~ O O SQ, Ft, fleld:~ I P~mP Set at: Casing Height Above ~round: TAN K ~ GPMJ Ft. _ Et, SEPARATION DISTANCES a s~pti~ ~ Ho~ing ~ To Septic Absorption Lia Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Stet[on Tank Sewer Lines ~c~o~Ge ~ Material: Number of Compa~ments: su~o~ STATION~ Water Icc)+ ~o'~ ..... LIFT Lot ~ ~, Size in gallons: Manufacturer: Line lO ~ ~0 ~ .... High water alarm at: Foundation P~m e & Model CurtainDrain -~ "~ ~ ~ ~, ~ ~ ~lectri~al Inspections performed by: Remarks: BENCH MARK Location and Description:  Assumed E~evation: Inspections performed~4Eagle RIv;r, Alaska 995~Eaale River Loom goaa. No.~ DateS:2nd~' - ~%'''~lst 5-z~-q4 ~ 2~~~t ....... , ........................ 72-013 {Rev. 9/91) MOA 25 SW960042 2 2 Perml~ No. Pnge of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SI-'RVlCES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater r)isposal System and/or Well Inspection Report Legal Description: LOT 4, BLOCK 3, WILLIAMSON S/D #2 PIDNo' 015-074-04 PROPERTY SERVED BY 30MMUNITY ~ ,. 'd~; LOT ~ -~~ FCO 8.5' 29. scA~ ~" - ~o, ST1 44' 46 ST2 55' 53 DBL1 56' 55 DEL2 ~ 58 C01 63' 77 MT1 60' 74 C02 81 ' 62 MT2 81 ' 64 NO iROUND WATER 72-013 A (Rev. 9/91 } MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519 6650 ON SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960042 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:WILMOTH SHAUN KIMBERLEY OWNER ADDRESS:5015 E 98TH AVE ANCHORAGE, ALASKA 99516 PAGE 1 OF 1 DATE ISSUED: 4/04/96 EXPIRATION DATE: 4~04/97 PARCEL ID:01507404 LEGAL DESCRIPTION: WILLIAMSON #2 BLK 3 LT 4 LOT SIZE: 16234 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 (18AACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ~// HEAl TH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER &WATER INSPECTION ENGINEERING STUDIES ANOREPORTS WELL INSPECTION & ELOWTEST ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ROBERT C. COWAN, RE, ROBERT A. SHAFER, RE. March 19, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P00. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 4, Block 3, Williamson S/D Addn. ~2 Request you issue a permit %0 install a septic serve the proposed four bedroom house on the property. system %o referenced A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered in the test hole. The monitoring tube within the test hole has been checked and found to be dry. This property has enough area for a :future septic upgrade which can be seen on the attached site plan. This property will be served by a Community Water System. There are no points of contamination within the proposed well radius which can be seen on the attached site plan. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/g Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 ' EAGLE RIVER1 ALASKA 99577 8GALE © SITE PI.AN F -uO oO DESIGN F HEALTH AUTHORITY ,'~PPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER rNSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION &FLOWTEST StTE PLANS ROAD OESIGN SOIL?EST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER O~SPOSAL SYST EM DESIGN ROBERT C. COWAN, RE. ROBERTA. SHAFER, P.E. ON--SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 4, Block 3, Williamson S/D Addn. March 20, 1996 GENERAL: 1. The scope of this project includes the installation of a 1250 gallon septJ, c tank and leachfield trench to serve the proposed :four 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 be 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 the tank. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP ' SUITE 204 . EAGLE RIVER, ALASKA 99577 Page Two Lot 4, Block 3, March 19, 1996 Williamson S/D Addn. ~2 e Septic tanks installed wlth 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 leaehfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undJ. sturbed 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. Page Three Lot 4, Block 3, Williamso S/D March 19, 1996 Addn. 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. Any septic tank proposed for installation must be constructed by a Municipally 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. e Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal)· Septic tank inlets and outlets shall be f'Ltted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and 'the native soil backfill. Ail 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.0.A. or D.E.C. requirements. Page Four Lot 4, Block 3, Williamson S/D March 19, 1996 Addn. ~2 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: 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 backfilled before this inspection. 2e 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. e The final inspection is to occur upon final 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. Page Five Lot 4, Block 3, Williamson S/D March 19, 1996 Addn. 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. CONTtLACTOR/INSTALLER Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SF-RVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~?~.- ~/~ ~ L~-~"~. '~'~ DATE PERFORMED: LEGAL DESCRIPTION: L~¢'¥~/~¢~ ~..~,Z~'~'~,~--Y~'~As _ Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19- 20- WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN IF YES, AT WHAT DEPTH? Oeptl, ~o Water A_~lie~ .! .~_ i_,~.~ ~oni~odno? ~. Y~'"~ Da~e: Gross Net Depth to Net Reading Date Time Time Water Drop ~ ~ ~ -- ~,1~~ : ...... I,-~ V ~ -~ ~>,(~ ', -~, PERCOLATION RATE (minutes/tach) PERC HOLE DIAME'rER COMMENTS PERFORMED BY: S~ ~ S ENGINEERING I '-~"~//~ 17034 Eugle River Loop Road Nn '~n~ X ACCORDANCE WITH A~lai~IL~A~,FV~[~i~]~UIDELI'~Efl~r'~ EFFECT ON THIS DATE, 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O, Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUT' ORITY APPROVAL FOR A SINGLE FAMILY DWELLING ParcelI.D. 015-074-04 1, GENERAL INFORMATION Complete legal description Location (slte address or directions) 5015 E. Block 3, HAA# 0 I Expiration Date: Williamson S/D #2 98th Ave, Anchorage, AK 99516 Current Property owner(s) Jim &Kim Lane Mailing address 5015 E. 98th Ave., Lending a~ency Day phone 346-4822 Ancho~.a'ge, AK 99516 -c Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class A Public Water System Well TYPE OF WASTEWATER 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 AJaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. 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. (Certificates may be reissued for a period of up to one year with valid water samples.) 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 eh'ors or omissions in the professional engineer's work. STATEMENT OF INSPECTION'BY. ENGINEER As certified by my seal affixed hereto and'as of the validation date shown below, I verity that my Investigation, based an procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-s te water supp y and/or wastewater disposal Syste~n.ls(~re) ~afe, functional and adequate for the number of bedrooms and type of structure Indicated herein.'l further verity that based an the information obtained from the Municipality of Anchorage flies and from my Investigatioh and Inspection, the an-site water supply and/or wastewater disposal system Is(ara) in compliance w~th all applicable Municipal and State codes, ardinances, and regulations in effec! at the time of instaflation. ' ' $&SENGi~IE~[~'I~IG ": ' ' ' ' ' ' Name of Firm ,,, , .,...,.., ,,,.~ .,;..~ ~u,..~- Phone Address Ea~le River, Alaska 99577 Robert C. Cowan, P.E. Engineer's Printed Name 5. DSD SIGNATURE )~/'. _Approved f0r Disapproved, Conditional approval for Date I/,I/0 / bedrooms. -' bed}o~)ms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: I - / l" 0 I (Rev. Municipality of Anchorage Development Services Department Building Safety Dl~sion On-SIta Water & westewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 w~an~.cLanchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescriptlon: LoT ~ 131. a,(~' .3 Lv,,-,-la,'~'~,,, ,~ 7.. ParcellD:Ol,~- A. WELL DATA Data completed Total depth Data of test Static watar level / It. Well production J g.p.m. WATER Coliform.,/ colonies/100 nd. Nitrata eQat~ sample: Collected by: ff A, B, or C provide PWSID # ~10(~ Sanitary seal (Y/N) - .,~.ee'lfmperly pmtect~ (Y/N) Cased to lt. J Casing height (above ground) FROM WELL LOGJ AT INSPECTION g.p.m. mg./I. Other bacteria __ colonies/l O0 mi. B. SEIrFIC/HOLDING TANK DATA TankType/Material $'E~'~ ~' / $?¢d, Tank size I 3, $ 0 gal. Number of Compartments Foundation cteanout (~/N) 'Yg$ Depression over tank (Y~I) Data of pUmping I~,,/,~e Pumper Date installed S"/ 3 ) /gt G Cleanouts (~) '¥~ $ High water alarm (Y~) ~ ~ Co ABSORPTION FIELD DATA Data installed ,g'/a l/q~, Soil rating ~'or ~lbdrm) )' ') Length 'g ~' ft. Width '..{" ft. Total depth ~ ~. fl. Eft. absorption area ~ OD ft2 Monitoring tube Data of adequacy test 1 lid [ 0 ~ Results ~Fail) I°/f~ 'f Fluid depth in absorption field before test (~ in. Water adde~ '/~. gal. Elapsed Time: j ~ min. Final fluid depth ~ in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (YIN & type) ..~,'~ 4- ~< ~ g ~, ~ System type 'T' R ~ ~ c ,~ Gravel below pipe .3 ft. Depression over field a/O For I./ bedrooms New depth 3' in. ~ O C) g.p.d. If yes, give date ~-' D. UFT STATION Date installed Size in gallons Manhole/Access (YIN) ..... on" level at ~vel at 'Pump Datun~ ~ Cyctes tested Meets alarm & circuit requirements?. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main S~ Ho~dlr~ tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: On adjacent lots Public sewer manhole/cleanout Building foundation ~ 5' '4.- Properly line ,~' '4- Absorption field Water main t 0 Water service line ) 0 -t- Sun'ace water Wells on adjacent lots ,~. f lO0 .4 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line I 0 Building foundation 5"0 4 # f Water Service line ] 0 4, Surface water I O 0 ~ Curtain drain ~*~,~. ~,~. Wells on adlacent lots ~eO ¥- Water main Driveway, partdng/vehicie storage. F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspecfJons and rev/ew of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name /~O~''~T' C. Data I ~,,lot .ece,pt.umber (Rev. 1Z, O0) ~'.. ,~; ...... ,. '... ~ r,' ~ .~ .*-' ' . J "- .",,*-";' Waiver Fee $ Data of Payment Receipt Number