Loading...
HomeMy WebLinkAboutTUXEDNI PARK BLK 2 LT 3 Name Address Phone,s) ~Pe m t ~o. No, Ol Bedrooms ~7-735ql q~ ~ Township. Range, Section TI3_N MUNICIPALITY OF ANCHORAGE D ~/--O~_~--Z t/ DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT DISTANCES  SEPTIC ABSORPTION TANK FIELD WELL TANKS [] HOLDING Capaoty m gallons No. ol Compadments TYPE OF SYSTEM '~ SEPTIC Manutaclufer Mater~al FT [] TRENCH ~BED Depth tO p~pe 1~3ttom horn ~.~ FT ~ Se FT ! .,~SQFT ~05q ~ [] W. DRAIN [] OTHER Total clepth Irom orlg,nal grade FT ;z ?,_ - ,-//'z_ FT Gfave~ Oepth ~neath p~pe ~. q FT Gravel ~ FI FT (PRIVATE WELLS [] OTHER Ildentifv) ] Dial Deplh I Cased to ~ / FTI ~ I FT Dale Insiaued. REMARKS: WELL LOT LINE FOUNDATION h, Jo Jr AS-BUILT DIAGRAM IShow location of well. sephc eystem, property hnes. Iounoatlon. 13~lveway. water boches, elcl -- ' Ins~s Pedormed by: ~,~ ~r ~1 ~" ~ ', I 72-013 ~3/85) M U N I C I P A L I T Y O F A N C H 0 R A G E Department of Health &. Human Services 825 L Street, Anchorage, Alaska 99501 .34.3-47~0 0 N - S I l- E S E W E R,~ W E L L P E R M I T Date I~mut?d: 09/21/90 Enginee~ Designed Owner' Name: ROBERT LARSEN (]wn~;.:r Address: 4784 MILLS I)RIVE ANCHORAGE, AK 99508 Day Phone: 337-7554 F'arc~l Id: 041-022-24 Lot L~,gal: Subdivision: TUXEDNI PARK Lot: ~. Block: Section: 6 Township: 12N Range: ~W Lot Size 77989 (sq. ~t. or acres) Max Bedr'ooms: This Permit: 4 Total Capacity: 4 SEPTIC TANK: Minimum total septic tank capacity: 1,~50 gallons.. Each septic tank must have at least 2 compartments. Depth to top of septic tank(s) < 4.0 fe~.crL eequiro~ insulation over tank(s). WELL_: Log must be submitted to Municipality of Anchorage Department of Health and Human Services within 50 days of well completion. ]'FILS PERMIT EXPIRES 1~/31/90 AND VALID FOR A SINGLE FAMILY HOME. I CERTIFY THAT: 1.. I am familiar with the requirements for on-site sew~_~rs and wells as set !orth by the Municipality o~ Anchorage (MOA) and the State of Alaska. I will install the system in accordance with all MOA codes and regulations, anc! in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State o~ Alaska require.~ments for the set back dis'Lances ~r'om any existing well, wastewater disposal system or' public ~(?,,,*oraqc? system on this or any adjac,~nt or nearby lot. 4. I unde~rstand that this per-mit is valid !'or a maximum of 4 bedrooms. 1 also undt{)rstand that the capacity of the total system is 4 bedrooms and any c)nlarooment will require mn additional permit. Signed: ,~' ~ (Owner) I ~su~d By: ALASKA I UIROI I i EITAL COI TROL $ RUIC S, IFIC. ~qinecrioci ~ ~nuironmcnlel Stuclics SPECIFICATIONS FOR BED WASTEWATER TREATNENT SYSTEN LEGAL DESCRIPTION: LOT 3, BLOCK 2, TUXEDNI PARK SUBDIVISION 1.0 GENERAL 1.1 The Drawings, sheets 1 through 5, shall be part of thls specification. 1.2 All materials and workmanship shall meet the requirements of the Hunlcipality of Anchorage, Department of Health & Human Services (DHHS), the conditions of the permit, and all applicable rules and regulations currently in effect. 1.3 All excavations and depths are advisory, and are to be verified or modified in the field by the Engineer or inspecting agency. 1.4 It is the responsibility of the .property owner or installer to adhere to approved design for the installation, to maintain the specified separation distances and to have the appropriate inspectibns. 1.5 It Is the responsibility of the property owner or Installer to report to the engineer any observed conditions which would put the system in violation of state or Municipal regulations. 1.6 If the Installation is not inspected by an AECS engineer, AECS will not be responsible for the Installed system. An engineer at AECS should be consulted prior to construction, to determine the number of Inspections that will be required and to explain what these Inspections wtll involve. 2.0 SEPTIC TANK 2.1 If there ts an existing septic tank It may be used If It meets the capacity requirement for the residence. The structural Integrity of the tank must be verified. 2.2 The septic tank shall be a UPC-approved two-compartment tank, constructed of 12 gauge steel with bttumasttc coating and set level on undisturbed soil. If the tank ts buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 Inch burial type polystyrene rigid board insulation. (907) 279-5553 2.3 2.4 2.5 2.6 2.7 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 feet 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 DHHS or Alaska Department of Environmental Conservation (ADEC). Piping shall be fitted with a mechanical watertight calder coupling on the outlet and inlet of the septic tank. Piping shall be 4 inch solid PVC ASTM D-3034 or cast Iron, sloped a minimum of 1/4 inch per lineal foot on the inlet side and 1/8 inch per foot on the outlet side. If the piping is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. Cleanouts shall be installed as designated and capped with air-tight rain caps (Jim Caps or *iequtvalent). and extend a minimum of 1 foot above ground level. If a lift ,station Is required it shall be a combination lift station septic tank per Anchorage Tank and Welding, Inc. using an ORENCO lift station design. Specifications and design drawings are on file at the Municipality and with the engineer. 3.0 SEEPAGE BED 3.1 The gravel for the bed shall be 0.5 to 2.5 inch. screened rock with less than 3 percent passing the No. 200 sieve. All substitutes must have prior DHHS approval. 3.2 The bottom of the excavation shall be level and raked with the backhoe blade to ensure that the bottom has not been compacted during excavation. 3.3 Sand. for leveling, shall have a size distribution which meets the requirements of MOA code 15.65.077. 3.4 The distribution pipe shall be perforated 4 inch rigid PVC with a minimum crush strength of 1500 3.5 pounds and shall Beet the approval of DHHS for use as dratnfteld pipe. If the systeB is a pressure distribution systeB, see Section 5.0. All pipes shall be laid level, and spaced according to the drawings. Nonttor standpipes shall be placed as shown in the drawings. They shall be 4 Inch rigid PVC ASTM D-3034, or cast Iron. The section shown with holes Bay be either drilled 0.5 inch holes on 6 inch centers on opposing sides of the pipe, or a section of regular perforated sewer pipe Bay be clamped to the solid section with a no-hub coupling or solvent Joint. The perforated section of the ~onttor tube shall be located In gravel only. The portion of pipe above the sewer rock shall be solid. A rubber raincap (Jim Cap or equivalent) shall be placed over the top of the pipe. 3.6 The gravel shall be covered with a layer of nonwoven engineering fabric. 3.? The side slope of the Bound shall be slope ! f~ot vertical to 3 feet horizontal. 3.8 The bed shall be planted with a white clover and red fescue mix, or with Kentucky bluegrass. 4.0 INSPECTIONS 4.1 This 'bed will require a minimum of three Inspections. The first inspection wtll be of the open excavation, to assure that the systeB is Installed In the proper soil strata, correct depth and ~eet BlntmuB specified design paraBeters. 4.2 The second Inspection wtll be after placeBent of gravel, monitor standpipes, and distribution pipe, to verify proper Installation and position of pipes prior to backfill. 4.3 The third Inspection will be after final backfill grading and seedinz to ensure that adequate soil cover has been provided over the bed. 4.4 The Inspection of the septic tank or lift station Installation can be incorporated with any one of the above listed inspections. 4.5 The lift station will require either an MOA electrical Inspection or certification by a licensed electrician depending on whether the building code applies to this part of the city. 5.0 PRESSURE DISTRIBUTION SYSTEMS 5.1 The lateral and header pipes are to be Schedule 40 PVC or ABS in the sizes indicated on the drawings. 5.2 The laterals are to be level within plus or ntnus one Inch. 5.3 All Joints are to be solvent welded. 5.4 There shall be 2.5 inches of rock over the top of the headers and laterals. 5.5 The holes In the pipe are to be properly sized and spaced. 5.6 The holes shall be clean with no cuttings still attached to the pipe or left free inside the pipe. 5.? Holes may be reverse beveled If it does not Increase the outside hole size. ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET "0. / OF CHECKED BY DATE ~ ~ ~.[~ ...... '~...~.~.....~.._l~..~.../.~,~' ...... , ................ ~ ;_..., ..... ................... ~ ........................................................ ~ ~ ................................. ' ! ~ - , C~,l~.....:~.t,~... ~ ~.... ~ ~.~..~,.~...~..__~_~.~_/&~_:E~_~.!~..~(~ ........... J ..... ..... ~._._~ ........ , ...... .. ...... L..._.: ....... ~,....~, ~- ...~,......,-~...../~ ,..-...=---.~ .......... i ........ =-.-.~ ........ ~ .__~ .... ~..__'........_: ....... ~ ..... ~.......,..,~.z.~.~.~.x.zz,~...~....._z.~.~._...~ .......... [ ........ ~ ......... L_......: ....... ~ ......... ~ .......... ~.__..~... :._L_.L_L_Z_._L_] ....... ~ .... L._L_L--L.-~_--J :. I ' ~ ~ : : i i i I : ! ' I · · ~ ~ Z <~ .J 0 H O. PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST LEGAL DESCRIPTION: DEPTH (FEET} 7 - .~.'-.':: ' , - 9 - '* ' '~°, 11 -,>-...% 12- Township. Range, Section: SLOPE 13- SITE PLAN ? · WAS GROUND WATER ~ENCOUNTERED? L IF YES. AT WHAT O DEPTH? p Depth to Water 7 0,,e: - Gross Net Depth to Net 14 Reading Date Time Time Water Drop 15- 16- / 17- 18- 19- 20- PERCOLATION RATE {minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ~ FT AND __FT PERFORMED BY; '~' ~ '¢~/ I ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:---- 72-008 (Rev. 4/85) ·. DOC Co. SULLIVAN WATER WELLS F P.O. BOX 670272, CHUGIAK, ALASKA 99567 * TELEPHONE 688-~759 OWNER OF LAND ; /..~/?' //~,/~..~'A=,:c.J DEPTH OF ~'ELL ~/ ,~ ADDRESS ~'~' ~/~ ~ ~;~' ~ S/ATIC LEVEL OF WATER F'r. LEGAL DESCRI~ION~ ~-~ ~/ff "& ~ -{ ( ) ~ .~D.~ I ~ ,-~ I)RAW DOWN:FT. DATE -Started Ended / O GALS. PER HR ' PERMIT NUMBER / KIND OF CASING ~ ~ S~-*' - KIND OF. FORMATION:'. ~ /~ .... ' ....., ~ From ~ "~.to t. C~/~ -~lC~O From ~' 'Ft. to ' 'Ft. ~ From"~~' '~ Fi. to 1~ Ft. From From 1 3' *' Ft. lo /t/~ Ft. ' / <t 'i t.,o From Ft. Ct ~ ~ From From .~ Ft. to--Ft. ' ~0 3 ~d~OC~ ,. :~r From ' Ft. to ' Ft. Ft.' lo ' Ft. Ft. to Ft~ '~' F?om' l' From From From From , Ft. to t Ft. · , Ft.qo Ft. Ft. to--irt. Ft. to Ft. , Ft. to Ft From FLto ' Ft. '\ '" ' ' Ft. ~ From "ft. to '~From Ft... ,i° ' ' ." ~:t. ~Lrom , F"L'tO:' .;: Ft. ~CL. INFORMATION: T. S F'URI.(I A I~ID F'. F.,_ 6751 ~. DIHOND ~LVg, (907} 279491& Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: HAA for Lot 5, Block 2 Tuxedni Park June 4, 1995 Gentlemen; We are applying for an HAA for subject property. Both the well and septic system was installed in 1990, but the residence is in the process of being finished at this time. The owner is con- verting the construction loan to permanent financing. Yours MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 parcel I.D.# ~/' 1, GENERAL INFORMATION Complete legal deScription CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING e e Location (site address or directions) Property owner Mailing address Lending agency Mailing address ' Agent Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: .-~, TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-02,5 (Rev. 1/91) F~ont MOA SlUeLUUJOO I~UO!I!PPV :suo!lelnd!ls §UIMOIIOJ eql qllM .'SUJOOJpgq Joj le^oJdde leUO!l!puoO 'pa^o,ddes!a 'SLUOOJpeq JOj pe^oJddv ? ;II:lrlJ.YNOlS SHHQ 'sapo3 elelS pu~ led!o!unlAI lie HJ!M eoU~!ldLUoo u! s! mm, sks lesods!p JeJ~Ma~,S~M Jo/pu~ klddns J~)Jl~M {91!S-UO ~)qJ 'uop, oadsu! pue UOIJE§I1SeAU!/{UJ LUOJJ pue Sel!J oJ~I~JOLJDUV JO ~i!led!o!unlAI eLI1 LUOJ~t peu!elqo UO!I~LUJOJUJ eLI1 UO pesEq 1eLI1/~J!J~3A J~)LJlJnJ I 'U!eJ~LI pel~o!pu! eJnlonJ3s jo ed/q pu~ sLuooJpeq ,to JeqLunu eLI1 JOJ elenbep~ pu~ I~UO!lounj 'ej~s $! LUelS/[$ lesods!p J~I~M~9:JSI~M Jo/pu~ ~lddns J~)),I~M O:IJ$-UO eqJ 1~ql SMOLIS uo!leo!ldde I~^oJddv/q!JoqlnV qll~eH S!Lll JO UOp, I~J:JS~gAU! /~UJ I~LI1/gJJ~A I 'MOleq UMOqS el~p UO!I~p!IeA eLI1 J0 S~ pU~ OJ~)JOq pex!JJ~ I~eS/[uJ/Iq paji!pe3 sV -g 1::133NIDN:I kl:l NOI.LO3dSNI .dO ..I. N3iN3J.YJ.S 'S Legal Description: A. Well Data Well type ~ Log present (Y/N) Total depth Sanitary seal (Y/N) Municipality of Anchorage ~, Department of Health and Human Services ." HEALTH AUTHORITY APPROVAL CHECKLIST Y If A, B, or C, attach ADEC letter. ADEC water system number Date completed t O/1 O l ~ O Driller ,~ I Casing height Wires properly protected (Y/N) Cased to Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate AT INSPECTION g.p.m. ; On adjacent lots ; On adjacent lots 'Public sewer manhote/cleanout Petroleum tank /, ~"(-~ Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) ~'/ High water alarm (Y/N) Date of pumping Tank size ! ~-~'pO Compartments ~., Foundation cleanout ~/N) y Depression (Y/N) Alarm tested (Y/N) i~J//~ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot t~ ~ ~ To property line ~{~ Surface water/drainage On adjacent lots ~ 1 ~.9.~ Foundation Absorption field ! '~ Water main/service line 72-no6 {3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION ~,,~//.~ _ Date installed Size in gallons Vent (Y/N) 'Pump on" level at High water alarm level Meets MOA electrfcal codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION Well on lot ~. On adjacent lots Manufacturer Manhole/Access (Y/N) 'Pump off" Level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed ~ 0 It o I ~ O Length /-~_'~ Width 'Total absorption area ~'~) Date 'of adequacy test Water level'in ~bsorption field before test Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~ ~'~ To building foundation On adjacent lots Surface water ~%J ¢-) ~-t.~ Curtain drain Soil rating (GPD/Ft~) /~ .~ Gravel thickness Cleanout present (Y/N) Results (pass/fail) System type Total depth "/ Depression over (Y/N) field for If yes, give date On adjacent lots ~/'/-~.~ Property line /'~.~ To existing or abandoned system on lot r~/,~.~.. Cutbank ~ ~,~-71~ Water main/service line '> .~,'- O Driveway, parking/vehicle storage area ~ L~ E. ENGINEER'S CERTIFICATION Bedrooms I certify that I h. ave checked, verified, or conformed to all. MOA and HAA guidelines in effect. . on.the, date of this inspection. HM Fee $ // Date of Payment Receipt Number · Waiver Fee $ Date of Payment Receipt Number 7~-026 (3/93)* Back COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES "'~=~ '~ REPORT of ANALYSIS Chemlab Ref.~ :93.2578-! Client Sample ID :L3 B2 TUX~NI Matr ix : WATER 5633 B STREET ANCHORAGE. AK 99518 TEL: (907) 562-2343 FAX: (907) 561-5301 Client Name :TOBBEN SPURKL~ND, P.E. WORK Order :66871 Ordered By :. Report Completed :06/08/93 Project Name : Collected :06/04/93 @ 09:00 hrs. ProJect~ : Received :06/04/93 @ 13:40 hrs. PWSID :UA Technical Director:STEPHE~C. EDE Released By : ~C ~_. Sample Remarks: ROUTINqE SAMPLE COlLeCTED BY: UA. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init Nitrate-N 1.26 mg/L FPA 353.2/300.0 l0 06/07 LLH * See Special Instructions Above UA = Unavailable ** See Sample Remarks'Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Less Than D = Secondary dilution. GT = Greater Than ~,~5~'~ Member o! the SGS Group (Soci~t~ G~n~rale de Surveillance) ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA