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HomeMy WebLinkAboutBRUIN PARK BLK 2 LT 1 LESS N25'Bruin Park Block 2 Lot 1 #016-102-09 Municipathy of Anchorage •" '' , bevelopment Services bepartment Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 1%650 Anchorage, AK 99519-6650 Pageof3 ls www.cl.anchorage.ok.0(907) 343-7904 t ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: o _*� / PID Number. 01—10D-09 Name: Qv Mild Wastewater System: New ❑ Upgrade Address 77 e-twr wo in e & ABSORPTION FIELD 5g9J107 phone 2 9 7�- 7 ` � Number of ooms: / 7 E3 Deep Trerrich KShallow Trench O Bed D Mound Other, LEGAL bESCRIPTION Spl RatkDepth"netnal Iran grade: Total DepD p ,�, , Block � Lot: Subdivlslort 1 6f-k Depth to pipe bottom ban original pada: Gravel depth beneath pipe: Ft. FI. Township: Range: Section: L Sr Fall added above original grade: Gravel Length: ��Ft. t/5 Ft. Well: 19 New ❑Upgrade Gravel vddlh: Number of Ines: Distance ba"an tines: .5 Ft. ��- Ft Classlacalion IpV�, A, B. CJ: Total Depth: ' r +tet. cased kr. J 14/ 7 Total absorption arar r•^ p Methal. 11A Fts a nen /v t lhsn Oels Dn56-- ro"1( Stalk Water LLI7 AFL Nsla br O ^J Date halaXed"' is �^ �s I e I tyl-�r�/ 6 a i/nand: e I l/.11 l//!1 s}.�—IL\ Yield. Pump t at U k Casing Haight Above TANK OI �J GPM n W rl FI. FL SEPARATION bISTANCES CK Septic I] Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding PubgdPrivat M a`^'°r rr Capaalr 15 From Tank Field Station Tank Sewer Line nG or-a — Rh Gal. Well 33' o _ y Material: J Number of Cm panvr. ne 7 v G L Surface Water oO LIFT STATION Lot Line 141, ¢e. Marndacturet Foundation S % tp �CCJ m -pump on• level at: Pump Wph water alarat In.„ In. Pump Maks b M Electrical Inspections performed by curtain Drain aye ✓ipinA? Remarks BENCH MAkK Location and Desaryborc -rAre.51161d orF �e Lp Assumed Elevation: I ©© f� clr FL t fie' ;f •'% S 8 S ENGINEER 17034 Eagle River Loop Road, No. 204 Inspections performed by: a Dates: ia1 r0"k 2"d 1 O S'i 1 % -,1 ; ROBERT C. COWAN�� i �j`^c�;:� beveloptnetitSetvicesbeparthiehtApproval CE-8801 heviewed and approved by: Date:.' -0-3 tilt �,•_.... ,•;,,:- .;' •"ir-��♦ (New. H1l0o) L` 1.r4 PERMIT NO. SWO10 431 PAGE2 OF 3 Municipalit of Anchora e DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 •Anchorage, Alaska 99519-6650 • Te'l�ephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1, BLOCK 2, BRUIN PARK S/D P.I.D. NO. 016-102-09 O'MALLEY ROAD ' 25' R.O.W. --------------------------------- ' . fjo THA NEW 5 BEDROOM D HOUSE a i� Q I IluN CO1 8 w �::j nrl > 1 l ^AT H o ►—+ STI O` `�� Z T FCO ' N � I A NEW E ' Igg ANKGALLON y DBL1E & DBL2 ' MT 2 CO2 SCALE .. ...... .......r LOT "Y ?r, ROBERT C COWAN l� c. •. CE - 6801 ++ a f\•.... '.,' ,.``�V� ! PERMIT NO. SW010431 PAGE 3 OF 3 municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Te'l'ephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1, BLOCK 2, BRUIN PARK S/D P.I.D. No. 016-102-09 ST1 S 96.9' FINAL GRADE 2" INSULATION 91.0' NEW 1500 90.8' GALLON SEPTIC TANK B FCO33.0 ST 1 34.0 CO1 ST240.0 S4. Mrr CO2 IvIT2 COI = 95.6' DBL144.0 DBL246.0 CO2 = 97.1' C01 59.5 26.5 FINAL GRADE CO2 25.5 74.0 MT2 25.5 74.0 2" INSULATION-a'•O- 001 = 91.6' SR CO2 = 91.5' N. T. S. M r 1= 8?. & MT2 - 87.7' V .1� � r NO WATER FOUND 4 A,� ROBERT C. COWAN �j�c�.rti. 81.7 B.O.H. CE 01 HFALTHAUfHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERINGSTUDIES AND REPORTS WELLINSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DtSPOSALSYSTEM DESIGN ROBERTC. COWAN. P.E. ROBERTA. SHAFER, P.E. AApril 23, 2003 CMLENGiNEERS P (907) 694-2979 FAX(907)694-1211 MUNICIPALITY OF ANCI IORAGE Department of Health and I luman Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 1; Block 2; Bruin Park Subdivision A test hole was excavated and percolation test performed on the above referenced lot. The approximate location of the test hole is located on the attached inspection report. Though the end of the trench extended outside the test hole radius during construction, the soil remained consistent throughout excavation of the fl-e�e-h , We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/ts 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 ... _....r .........f. ill�l..uw......a.. u...�........ ... _:.a. u......... .......:. ... ...... ................ .... _ ........... _..... ...w. ....... .. Sent By: THE ALASKA MACSTORE; 1 HEFTY DRILLING `s 3540AKULA DRIVE ANCHORAGE, ALASKA 905116 (907) 345-0593 9072725097; Apr -22-03 2:52PM; Page 1/1 S1'A'I'f; OF ALASKA' t1 1111'P SRT NIRNT Or NA•fURAI, RUOURCUS . MINING. LAND, WA'l'F.R HYDROLOGIC SURVEY wATi;a wrl.t:'1.00, Drilling Started: ly/�f/_e! , Completed: /D /sU. Q.& Ciiy/Duroug!+: Subdlvia)on/tSSS: tltnekt Lrlt r'ropertyOwnerNnlncAAdd ross:� a 9, „ / -M '114 t.�l1/4 1/4 1, Meridian Township lunge Sitl;1nt h of of or .+ Lat:N Lon W f NA12:2TOlt Yy t kvation: RORF.1(OLEDATA:Irrowgrounitsurfacr; Dept11 Drillingnuthod:}T4,Airrotary,0 Cnblctool. 011ier Material: Type, Color & wetness From 119 Well use: r Public supply, 7 Doincstic, Cl Other t'� Q Depth of holt: ft, Caiting stickup: ft ; 1 Casing type: cJAat 'Thickness •• inches p t ' Cisinl; dianutur: .16 inches Casing depth tjv' Z ft .I„ Ya vxb Liner type. Diameter: inches Depth: ft rstatic J� Witicr l t-1.111 It'll of rns;n; t:. 19-) ficin ,� I IA, ISD t3.OG 1'untpin�t b:vcl.0 yield: rl:ei after hours at ;;pm Ruutvcry ra lo: gpin, Method of testing: 9cvclopInc it method: Duration: 1 .•� Of i ` A y s V�` 16C_ Well Imab: opeoing type. U Opeu end, 0 Optu hole ri Scrccned; carr. R Stopped ft I U 7�J Screen typo: SloUmesh size �V4 i f {r J Perrortncd.Start: '..i;;,: , ' ft, Stopped 1t Sinn: ft, Stopped ; R �J biSte ( . i[tt�d I U� Note: r i..4q.Pq Ire � n I Grouttype: .. o►{LJa, Volume I D,ipth; ftom_y fr, It att –I_lei to –� LM/��i�ri�//�lob Iun, intatc d pili: e 1 ump size hp, Brund numc: Wns well disinfected upon 9,Wplotion? , No / i Mclllnd tir tlisinreetion: r' cq, `• Dr)Bur comments/ disct:tlincrr. l 1 Well Driller Name: th v�d t.h•tyc,1 6 IVA04t vq Ld /l�•' �Jy TT Company Name: HEFTY RILLING Moiling Address: 3540 AKULA DRIVE /,- ,r /�%% Y•a:(L. LU� 11<�.A City: ANCHORAGE Statei, At89516-- .... •«— Phone Number: 907 45-0593 Drillers Signature: InN' feQ UifCf Illy i tUI11' 1•I rill} NC!I InN Ili wY111P Illi 1 • 1J:dY\'%�,aYC=:II�CIC�'VIaI.k,(AKlIWIIteila.0i.020. .-A o2n,16.15.020 end AK repdntinru 11 AAC 9}.14n). DEPARTMENT OF NATURA1.RiSOURC Stining, Land S Water Ilydrotogir Surve, 550 W 7th Ave.. Suite 90aA Anchorage, A109501J577 •TtIcpltone (907) 20-809 and FAX (907) 562. 1 •d uI AL1.41 Within 111e City of Anchorage, it is required that a copy or the well log be sent to the appropriate*eity office within 60 days rind that another eopj of the well tog be sent to the well/preperty owner within 30 drys.. Permit Number: ;3 (a) /' JD 013_1 Dam of lssuc: Parcel Idcn6riinttit+n Number: _ k well lnwcd al atpprovori pertnit location? 0 Yes or I 1 No d9 t : C0 EO 91 JCIU r MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 i6h's /V4'A.-Y '(olZ s - c I Q ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SWO10431 !Legal Description: BRUIN PARK BLK 2 LT 1 LESS N25' Design Engineer: 0003 S & S Engineering Owner Name: Raymond Long Owner Address: 7768 Cherrywood Circle Anchorage , AK 99507 - Date Issued: Oct 15, 2001 Expiration Date: Oct 15, 2002 Parcel ID: 016-102-09 Site Address: 010800 FOREST DR Lot Size: 45580 SO. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of: Disposal Field Z Septic Tank F-1 Holding Tank Privy Q✓ Private Well Ej Water Storage 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 ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: —/& 2- Z,?�_ Date: /0—(S— —dI Qitc�l Date: 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. d 11.9 - I Ua — i7 j Permit Number SWO/043/ Property owners) g aj M o tJD LaEN C-, Day phone Z-tz -1 T9 Mailing address (1) �'�l�tb Clnur acn1, Cacc\sem Mailing address (2) .� •+�•�. t _ r_A� Zip Code c, `i S O �- Legal description (Lot, Block & Sub'd.) Lot M c Ck Z g 1'w'r\'PdrV. S1D Legal description (Section, Township & Range) Lot Size I" I ?:aj -Ams/Sq.Ft. Number of Bedrooms yr 415 S -q O THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well X Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. 1 further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. n/j7Z XT'ti ' S & S ENGINEERING (Signature of property owner or authorized agent) Eagle Riven Alaska 99572 u� Permit Fees: yO- Waiver Fees: Date of Payment: i' o / s - /a I Date of Payment: Receipt Number: (Rev. 12100) 011116 Receipt Number: S&S ' MIEALTHAUTHORIIY APPROVALS SEWER 6 WATER MAIN UTENSIOIS SEWERLWATER INSPECTION ENGINEERINGSTUOIES AND REPORTS WELLINSPECTION S FLOW TEST SITE PLANS ROADDESIGN SOMEST PERCOLATION TEST STRUCTURAL6 MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN lIG ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX(907)694-1211 October 4, 2001 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, Ak. 99519 REFERENCE: Lot 1, Block 2, Bruin Park S/D It is- requested that you issue a permit to install a well & septic system to serve the proposed five bedroom dwelling on the referenced property. A test hole was excavated and percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 9/24/01 water was not found. After seven days of ground water monitoring the test hole was found to be dry. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not"prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/jhm Enclosure E: 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER. ALASKA 99577 U" FOREST pJ O U J ;O � ttty : •- �' Wry U a 4 k+o , i ``�^, • • ., f, Ste. W Q�Iz W I zo az 0 0 E- sa odW W 3SnOH ^' =0 a <o <oh 0eaiz O a rn �''� 0. W� wam Faz / Q s z¢ <m N a to m aoa-3 w u 4 �xNaW-CzZ I S.00 180 ci . 3-t QQ:z O[..OpUf+. tgfG Qi C)cowzt) Q a3< q>< Q rntnt Ff'Ou Z a - 3115 31 I in x y Iwo C\2 U a U" FOREST pJ O U �3 ,�-� j sniova Baa ,00► W Q�Iz W I n W 3SnOH CQ U w W� C7ancQ zwwwoz es Q s W pow w owa� � O n C4 aa� d PN N ti N rVaaV au,aa� I ' k n IY �Li by W 0 CVJ > a w O )VW C7 VVV ,09 = „I HOISSQ M -P :a c" HV'Id SJAS W � O F O N. NDN M Z QW w O N d H N W of W (Y a = W < FOREST pJ �3 ,�-� j sniova Baa ,00► I 3SnOH W� 43SOd02id Q I o v ooa a�Ii u 4 I S.00 180 ci I � M r � I - 3115 31 I in x y Iwo of to / I ' k n IY �Li by W 0 CVJ > a w O )VW C7 VVV ,09 = „I HOISSQ M -P :a c" HV'Id SJAS W � O F O N. NDN M Z QW w O N d H N W of W (Y a = W < Municipality of Anchorage Development Services Department ,; .�P,.•'-'..........•.,,1�c`,414 Building Safety Division 'W+� On -Site Water and Wastewater Program �'.�( �. 14� 4700 South Bragaw SL / . i' "' •. ' ... „ .ir P.O. Box 196650 Anchorage, AK 99519-6650 j"/� www.G.anchoraoe.ak.us.., (907) 343-7904 1 ROBERT C. COWAN �? j CE -8801 ;�•,.r Soils Log - Percolation Test r p MC� �/ Performed For: / �%� Y L o �v (, Date Performed: Legal Description: J-0 7- v' g L k A BR#oJ n/ PARK S�,a Township, Range, Section: 1 1 1 1 1 1 1 1 1 1 0.2G.Ar1 (_ S 6-M Grl/5P Sr"/ M L 17. o. /l. WAS GROUND WATER ENCOUNTERED? N 0 S IF YES. AT WHAT DEPTH? L Depth to Water Aftp Monitoring? Duey E Date: /y/JD/o/ Reading Date I Gross Time I Net Time I Depth to Water I Net Drop EN 14119 PERCOLATION RATE ��_ (minutesnnch) PERC HOLE DIAMETER L " TEST RUN BETWEEN FT AND _ -1 1/L FT COMMENTS VI5VO4I•t_y,1'•I0,C6_ 7_/-j4 FJ S'0 •), ►tel" pAf! _7Wi k NO. Pt S 8 S ENGINEERING PERFORMED BY: 117014 Eagle River Loon Road No. 204 4,rNt ,CERTIFY THAT THIS TEST%NAS PERFORMED IN AC Uj j� r;vlaWd ffM AND MUNICIPAL GUI ELINES IN EFFECT ON THIS DATE. DATE: )0//0101 s&s\ '111eCRI11rr ROBERT C. COWAN, P.E. �lA,a° 7 CIVILENGINEERS 'dA"" (907) 694-2979 ' FAX (907) 694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM HEALTHAUTHORIN APPROVALS CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWER&WATEn MAINEXTENSIONS REFERENCE: Lot 1, Block 2, Bruin Park S/D October 4, 2001 SEWEn&WATER MPECTION GENERAL: 1. The scope of this project includes the installation of a 1500 gallon septic tank and a new trench to serve the proposed five bedroom residence located on the ENGINEERINGSTUDIES AND REPORTS referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all WEttIMPEcnoN a PLOW TEST applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground SITE PLANS utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROAD DESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department to do system installations. Owners installing SOIL TEST their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: PERcbuTXW TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. STRUcruRAL& MECH MCAL usPEcnoNs 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP -SUITE 204 -EAGLE RIVER, ALASKA 99577 Page 2 Lot 1, Block 2, Bruin Park 311) October 4, 2001 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed 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. 6. 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. 2. 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. 3. 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. 4. 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. 5. 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. Page 3 Lot 1, Block 2, Bruin Park SID October 4, 2001 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. 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. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. 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. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. 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: Page 4 Lot 1, Block 2, Bruin Park 31D October 4, 2001 1. 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. 2. 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. 3. 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. 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. CONTRACTOR/INSTALLER Anchorage Municipality On -Site Water and Wastewater Program 10/10/01 From: Raymond Long 10800 Forrest Dr. Anchorage, AK 99516 646-0946 To Whom It May Concern: I am applying for prior approval for performing my own septic tank and drain field installation. My experience with using a back hoe is for personal use. I have used one in the past for installing 2 septic systems, removing roots, and landscaping. I have never used one professionally. I am renting the back hoe from United Rental on the Old Seward Hwy between Dimond and Omaley. I V i` -�\ To r l,- -6 a t 1- I FIEALTNAUTIIO111TY A MICIVAI.S SEWEnsWATEn MAIN ExTENMONS SEWER 6 WATEn a4SrEctlon ENGINE MING STUDIES AND nF..roms WELL RlSrECTION S rLOW ZEST SNE MANS,, nOADDESIGN SOIL TEST rEnCOLANON TEST SITRIC1UIlALs MECI IAMCAL INSPECTIONS CNSITE WASTEWATER DISPOSALSYSIEM DESIGN S&S� j[11LE1ZI1lG Date: G bo/ a L Municipality of Anchorage DEPARTMENT OF FIEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 4 REFERENCE: )3 Lor_ n00EnT C. COWAN, PE. n08EnTA. SI IAfEn, P.E. CIVIL ENGWEEnS (907)694-2979 fAX(907)694-1211 P94k- The septic in pections for the r;eferenced property were performed on /0 ;k o and /o 33-/o . Prior to submitting the On-site Wastewater Disposa System and/or Well Inspection Report we are waiting for the hittit-T S✓R vf- 7 to be completed. If we may be of further service please contact us. Sincerely, lkwz 400m� Robert C. Cowan, P.E. 17004 t4onm EAGLE nIVEn LOOP • SUITE 204 • EAGLE nIVEn, ALASKA 99517 p A i -14 1Y IY 1,iEA!6 Kiilt� , If,';* _1101 IF. NJ* IP 10 A& *ism 4 T1 Aam .0. p 6p Municipality of Anchorage O • Development Services Department Building Safety Division On -Site Water and Wastewater Program 5 „ i 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING" Parcel I.D. 01b —)O>--09 HAA# 1*0;080q Expiration Date: 8-G-03 1. GENERALINFORMATION L>✓ss AlaS_� . °'-:Complete legal description LST 1 l3Lo rc a' B �vr �✓ P A� X ..::'Location (site address or directions) J O $a O Fo R Cs r DR. ve- ,v hF . Current Property owners) �R yr�o�n L o n� G Day phone Mailing address` %0 too matt r7- P es v j;R AwC.11 . .4.c ClcyS G Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA wff be held by DSD for pickup. /0.3 2. NUMBER OF BEDROOMS:: S 3.. -TYPE OF WATER SUPPLY: _._. TYPE OF.WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ - val Holding tank Indiidu ❑ - Community Class -~ - Well - ❑ Community On-site ❑ Public Water System _ .. _... _ _. _... ❑ _ 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 4 by an independent professional civil engineer registered in the State of Alaska. 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. (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 ora public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. S & S ENGINEERING Name of Firm 17034 Eagle River Loop Ross: Nt%,c-: Phone _ G°1`/— D-9-79 Address Eagle Rlrer, Alaska 99577 Engineer's Printed Name RDS &ti r C. Cow.4^, Date 9/z.3 A 3 t. OF 5. DSD SIGNATURE . ROBERT C 'COW nN 7c Approved for bedrooms. l�`��.�, �: - I got j�.a•; Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By:Original Certificate Date:_ Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99518-6650 www.ci.anchorage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST 1.4 sS /V zs Legal Description: L®T J51 -#c -Pc 1 O 1t vN PARK Parcel ID: 016 ' 1 1- 01 A WELL DATA Well type PR4VATIL if A. B, or C provide PWSID # = Date completed /011610 ( Sanitary seal &)y'Ef Total depth I q 7 ft. Cased to 17 It. Date of test Static water level Well production FROM WELL LOG 1034 101 WATER SAMPLE RESULTS: g.p.m. Coliform __Q._colonies/100 mi. Nitrate 19-4 mg.A. Arsenic: Ali Date of sample: 'Y/)'//v 3 B. SEPTICIHOLDING TANK DATA Tank Type/Material S 15 cL S r c i L_ Tanksize ) S'o 0 gal. Number of Compartments Well Log (9N) Y9 s Wires properly protectedON) Yf X Casing height (above ground) / S t in. AT INSPECTION g.p.m. Other bacteria 0 colonies/100 ml. Collectedb5 & S ENGINEERING No. 204 e .joie River, Alaska 99377 Date installed /0 /X 5-10 / Cleanouts &) YE f Foundation cleanout (%) Y4I Depression over tank (YA1 00 High water alarm (YI& N O Date of pumping N l A - N 4-6✓ Pumper C. ABSORPTION FIELD DATA I O�zs✓�0 Soil rating ;LS tem sNq"V w Date installed 1 g g.p.d./ft' r flz/bdrm)� System type 7 A e... C_ AO Length 7 S` ft. Width S ft. Gravel below pipe 1� ft. Total depth 10 ft. Eff. absorption area Iso fe Monitoring tube WJ Depression over field u 0 Date of adequacy test P l4 - N[ w Results (Pass/Fail) For S bedrooms Fluid depth in absorption field before test , in. Water Elapsed Time: _ min. Finalpth'=—in. depth, in. Absorption rate >= g.p.d. Any rejuvenatio nt (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump ofr level E. SEPARATION DISTANCES tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankilift station on lot 1 9.3 Absorption field on lot 1-30 Public sewer main IJ AA Manhole/Access (Y/N) alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots 7 O D 4,4 Public sewer manhole/cleanout N 14 Sewer /septic service line a f Holding tank ,V /A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S Property line ii Absorption field Water main H /A Water service line ; Surface water /00 4 Wells on adjacent lots 1 00 ff in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line g Building foundation 1 B Water main Al 44 Water Service line /0 f Surface water l O U f Driveway, parking/vehide storage 60 4 - Curtain drain Nv N t ,._ F. COMMENTS 'c A'nww Wells on adjacent lots % d0 �'f i= G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and ..�/ ,. ..,... .. review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date.�plfEAN,a Engineer's Printed Name 8 k R T Co E. 4 Date q1 2 3/0 3 J� HAA Fee $ 3 -)Lt. Waiver Fee $ / Date of Payment a 3 /a 3 Date of Payment Receipt Number t0 3 Y a t"' Receipt Number (Rev. 12/01) 4-18-03;10:12AM; WO SCS Ref.# 1032102001 Client Name S & S Engineering Project Name/# Lot 1 Block 2 Bruin Park Client Sample ID Lot 1 Block 2 Bruin Park Matrix Drinking Water Sample Remarks: ;907 5615301 to 2/ 3 All Dates/Times are Alaska Standard Time Printed Date/Time 04/18/2003 7:47 Collected Date/Time 04/14/2003 13:00 Received Daterrime 04/14/2003 14:40 Technical Director Stephen C, Xde Released Byr/tsi� Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date Init Waters Department Nitrate -N 0.200 U 0200 mg/l. EPA 300.0 (<=10) 04/15/03 is Microbiology Laboratory Total Coliform coV100mL SM18 9222E (<=1) Rds4AN a 04/14/03 KC rs 4-19-03;17:04 ;CT and E S& S Engineer Ing ;5815301 a 2i 2 M�~ ME Environmental Services Inc. V `rte Laboratory Division FAF- 200 W. Potter Drive Drinking Water Analysis Report for Total Coliform Bacteria Anchorage, AK 99518-1605 Tel: (907) 562.2343 READ INSTRUCTIONS ONREVERSE SIDE BEFORE COLLECTING S"PLE Fax: (907) 561.5301 MUST BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY t] PUBLIC WATER SYSTEM I.D. # L l l � M Analysis shows this Water SAMPLE to be: PRIVATE WATER SYSTEM Satisfactory c3. Unsatisfactory �P Send Ressler PJ' Sendinvoice O Sample over 30 hours old, results may . e FntG1NEERING - I.- be unreliable mwft n� e.v�r 17034 Eagle River S99 77 .ea O Sample too long in transit; sample should r aaa um I. Rolm—'—F..IN . nol be ovei3Atours old at examination to indicate reliable results. Please send v �s new sample via special delivery mail. .1r Rete"d eived �7 O SendResalts O Sendinvoice nalysis Began wnwnr rM Analytical Method: Membrane Filter 13 MMO-MUG Citysimt P Cc& 1032184 �'1��Res°It' Analyst SAMPLE DATE: ® � L" IJ I Mouth bay Year SAMPLE TYPE: W Routine 0 Treated Water Sent to A.D.E.C. Anch Fbks Jun ❑ Repeat Sample (for routine sample )Z Untreated Water Fazed with lab ref. no. /03 .-Jd 0 �- ) Date: Time: O Special Purpose Time Collected Client notified of unsatisfacto results: n' SAMPLE LOCATION Collected By ❑ ❑ �. L-bT l QLtC g/t✓J.J PAttKtaoPM L%'6 CJW�t,� Phoned Spoke with Fazed ?]elm hint late: Time: BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-MUG Result, Total CoUformm E. Coli Membrane Filter. Direct Count e/ - Cotooles/100 ml Verification: LTB BGB COLIFIRM mrC- ree Neieae.+re Count Fecal Coliform Confirmatlun os +Other aeete6a Final Membra a titer Results y. Coliform/100 ml Reported8 ,�—'f-3TIme l �/(( An Comments: rv� Member of the SGS Group (Socidt6 106n6rale do Surveillance) ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO. WEST VIRGINIA . . . . . . . . . . . . . . ...... NORTH 125.50' (REC) NORTH 125.930 (MEAS) 759 cn 0 70 rn z 0 35.0' GRAVEL DRIVE Ef M 1 "W 292.49' (MEAS) 751 TH 291.911 (REC) )REST DRIVE T 0 TW ;u zC r- Z 10 � -0 CAI CD > cn m Ln a) K) It) E0 to c: I W N 00c o — Nc Y ` I t .uIf 1N �r D: Y 0 c: o+ , . : -n 0 p • C • • • • • °a % #•� AN m I W N 00c o — Nc ` t .uIf x m c I W N 00c o — Nc