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HomeMy WebLinkAboutF & D LT 1A Municipality of Anchorage Page ~' of "Z.., DEPARTMENT OF HEALTH AND HUMAN SERVICES 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: c~. ~,~t ~_~.~ PID Number: ~:::~c::~'~4 Name: ~/'U pg rads ~l ~ ~t~ ~ ~ ~~ Wastewater System: D New Address: ~ ~. ~~ ~ ~ ABSORPTION FIELD Phone: ~ No. of B~ooms: ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION Sol, Rating: Total Depth from original grade: ,~ ~1 ~ GPD/Sq. Ft. Lot:~~ ~BI°ck: ~ ~~di'' 'v~~ Depthtopipebottomfromorigina~de:Ft. Graveldepthbeneathpipe ~ Ft. Township: [Range: ~Section: Filladdedab°ve°rigi~algrade:lO - ~ Ft. Gravellength: D~stanc ~ Ft. WELL: D New Q Upgrade Gravel ~:~1~ Numb~rof lines: I ' ~ Ft. . Cl~~, A,B,C): TotaIDepth: Ft. Cased To: Ft. Totalabsorption ar~ SQ. Ft. Pipematerial'.~ ~'~' Driller: Date Drilled: Static Water Level:Ft. I~~ ~, Date ins~ Yield: I Pump Set at: [Casing Height Above Ground: ~u ~. ~. TANK SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private ~a~ ~~~ Capacity~~ From Tank Field Station Tank Sewer Lines Well ~1 ~ ~ ~ ~1~ ~~ Number of ~artments: Surface Water ~ ~ ~ ~ ~ ~ LIFT STATION Lot I ~ Size in gallons:I~ Line ~l~ ~ ~ ~ ~ I "Pump on" level at: ~ "Pump off" level at~rm at: Foundation ~ ~ ~ ~ ~ CurtainDrain ~ ~ [~ ~~ Pump Make & M°del I Electrical Inspecti°ns performed bY: Remarks: ~ ~ ~~ ~~~. ~ BENCH MARK Location and Description:  Assumed Elevation: ~A~;.'" A-'"~ Inspections performed by: s s s EN~N~ERING Dates: 1st. ~- ~4~ 17034 Eagle River L~p Roa~Ne. 2~2nd ~.~ '~~FE~ Eagle River, Alaska 99577 Department of Healt.~d Huma~rvices approval, t;~t'.- Reviewed and approved ~ '~ Dat 72-013 (1/91) MOA 25 Permit No. ~'Z. C~'7 Page Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report 72-013 A (2/91) MOA 25 PAGE 1 OF 1 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 (UPGRADE) PERMIT PERMIT NUMBER:SW920157 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:CHYNOWETH JIMMIE OWNER ADDRESS:3961 W. DUNKELD ST. RIVERTON, UT 84065 DATE ISSUED: 6/26/92 EXPIRATION DATE: 6/26/93 PARCEL ID:05021123 LEGAL DESCRIPTION: DONAHO HOMESTEAD #1 BLK 2 LT 1 LOT SIZE: 52236 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: ...... DATE: DATE: ROBERT SHAFER, P.E. ROGER SHAFER, P.E. June 23, 1992 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES 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 DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Donaho Homestead Add. No. 1, Block 2, Lot 1 Request you issue a permit to upgrade the septic system serving the referenced property. An adequacy test was performed on the existing system and the absorption capacity of the existing trench was found to be inadequate. The existing system is an undocumented system. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The ground water monitoring tube within the hole has been checked and found to be dry. Attached is an upgrade design which shows the location of the proposed trench. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information for your review, please contact us. Sincerely, ROGER J. RJS/LSU/1 su 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 I"= 40' SCALE UPGRADE HIGHLAND DRIVE Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL D ESC R I PTI 0 N :-'~-~2C,- ~. 2 3 4 7 14 15 16 17 18 19 2O C O M M E N T S~'~., .~l~j~"'?~. DATE PERFORMED: Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? L IF YES, AT WHAT O DEPTH? p E Monitoring? ,_.-.,/c~/ Date: / Reading Date Gross Net Depth to Net Time Time Water Drop ~ ,, ~/~. ~/~" " [ ~ ~ ~ " ~/~" '/~" TEST RUN BETWEEN "~ (minutes/inch) PERC HOLE DIAMETER __ FT AND ~ FT PERFORMED BY: 5 & $ ENGINEERING 17034 Eagle River Loop Road No. 204 T ,T ' UIDELINES]N ACCORDANCE WITH J~l~J~ ~Jr~i~,N~,l~l~ 72-008 (Rev. 4/85) EFFECT OK THIS DATE, CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Lot I; Block 2; Donahoe Homestead #I Location (site address or directions) 10519 High Bluff Drive Property owner J,O~m,(. & Joa~¢ Chy~cow¢,Ch . Day phone Riverton, Utah Mailing address Lending agency Mailing address Day phone Agent Bcooke S.¢L6~ne~. Addressllg01 Business Blvd. #103 Eagle Rive% Alaska Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: CENTRY 21/COLONIAL REAL ESTAT~ay phone 696-8600 99577- XX 3 ~ 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 ×X If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 72-025 (Rev. 1/91) Front MOA #21 5. 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 of this Health Authority Approval application 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 S & S ENG;NEF. R~NG Phone 17034 Eagle River Loop Road No. 204 Eagie kiver, Alaska ')YSY7 Address Engineer's signature DHHS SIGNATURE /~ Approved for Disapproved. Conditional approval for Date bedrooms. bedrooms, with the following stipulations: Additional Comments Date 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. 72-025 (Rev. 1/91) Back MOA #21 Legal Description: A, WELL DATA we, ' A, B, or C, attach ADEC letter. Log present ~N) "/' , Total depth Sanitary seal~?N) Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. ADEC water system number Date completed ~" '~'''' "7"7 Driller Cased to ~ ~ Casing height Wires properly protected ~;ZN) Date of test' Static water level Well flow FROM WELL LOG Pump level SEPARATION DISTANCES FROM WELL TO: I Septic/holding tank on lot ~, ~ 1 Absorption field on lot \ \ ~' Public sewer main g.p.m. AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Sewer service line ~n~ Z Petroleum tank WATER SAMPLE RESULTS: Coliform '~ Date of sample: "'7 Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts~N) High water alarm (Y/N) Date of pumping Tank size Compartments Foundation cleanoL~;~N) ~ Depression (Y/II~) Alarm tested (Y/N) Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ ~ On adjacent lots ~ ~-Jr- Foundation To property line \~> ~ Jr' Absorption field Water main/service line Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed '~- ~ C:>- I I Length ~:~"~ Width Total absorPtion area Depression over field (Y~ Peroxide treatment (past 12 months) (Y~:> Soil rating Gravel thickness System type Total depth Cleanouts present) V Date of adequacy test for bedrooms If yes, give date -"-'--'- To building foundation On adjacent lots '"~ c:>~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1 ~ ~ On adjacent lots / <5>r::>l ~'~ Property line To existing or abandoned system on lot Cutbank I-~//~' Water main/service line Surface water Curtain drain Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S ENGINEERING Signature 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Engineer's Name Date "'7- ~ ~-~ ~ HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 May 17, 1978 977301 Jim Chenoweth Star Route Box 193-D Eagle River, Alaska 99577 Subjectl Permit Expiration A permit issued by this department for well and/or on-site sewer installation on Lot 1 Block 2 Donahoe S~bdivision has expired since the issue date exceeds one(l) year. In the event you still plan to install the well and/or on- site sewer system, a new permit is required. The original soil test may be used to obtain a current permit. If the well has been drilled, a well log should be sent to this department to document the installation date. If you have any questions regarding the above matter, please contact this office immediately at 264-4720. SLncerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/ljh R&M CONSULTANTS, INC. 5024 CORDOVA II BOX 6087 · ANCHORAGE, ALASKA 99502 · PH, 907-279-0483 · TLX, 090-25360 May 12, 1977 R&M No. 751155 Jim Chynoweth SRI Box 193 D Eagle River, Alaska 99577 Subject: Soil Investigation for Sanitary Sewer System, Lot 1, Block 2, Donahoe Subdivision, Eagle River, Alaska~ Dear Mr. Chynoweth: At your request of May 6, 1977, we conducted a subsurface soils investi- gation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage, Department of Health and Environmental Protection. This investigation, which was accomplished on May 10, 1977, consisted of a test hole excavated to a depth of 15 feet below the existing ground surface. The location of the test hole is shown in attached Drawing A-01. Excavation was accomplished with a backhoe. A sample was taken at the depth shown on the soils log in attached Drawing A-01. The sample will be held in storage at our lab for approximately six months. In addition, all material excavated was continuously monitored by an experi- enced engineering geologist. The topography at the excavation site is generally horizontal. At the time of the investigation the site had been stripped of original ground cover. The soils encountered in the excavation are shown in the test hole log in Drawing A-01. Groundwater was not encountered in the test hole. Bedrock was not encountered. Subsurface conditions may vary in other parts of the lot. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this letter. Very truly yours, R & M CONSULTANTS, INC. Jeffrey M. Ayres Staff Geologist Robert L. Schraeder Associate JMA:RLS:gld Attachments: Drawings A-01, B-01, B-02, Table 1 XC: Department of Health & Enviornmental Protection ANCHORAGE FAIRBANKS JUNEAU VALOEZ WASILLA LOCATION SKETCH I Not To Scale Distances shown are approximate and have not been measured by surveying methods. TEST HOLE LOG Scale: 1"=3' A 0o0~ GRAVELLY SAND W/SO~ SILT (SM-GM),Many Cobbles, Occasional Boulder, Brown 1.5' GRAVELLY SAND W/TRACE SILT (SP-SW), Many Cobbles, Occasional Boulder, Brown, _.~lightly Moist --5.0' GRAVELLY SAND W/SO~.~ SILT (SM-GM), Many Cobbles, Occasional Boulder, Brown Slightly Moist This log depicts subsurface soils observed within the test hole at the location shown. See Drawings B-01 and B-02 for explanation of symbols. 'T.D uzz ATE: 5-11-77 L,SCALE: see above LOCATION SKETCH ~ID TEST HOLE LOG JIM Ct~IOWETH GRID: J JPROJ. NO 751155 ,113wG'N°' ~,-Ol SOILS' -CLASSIFICATION, CO..NS.ISTENCY AND_ SYMBOLS CLASSIFICATION: Identification and classification of.' the sol/ is accomplished in accordance with the Unified Soil Classification System. Normally, the grain size distribution determines classification of the soil. The soil is defined accordLng to major and minor constituents with the minor elements serving as modifiers of the major elements. For cohesive soils, the clay becomes the principal noun with the other majdr soil constituents used as modifier; i.e. silty clay, when the clay particles are such that the clay dominates soil properties. Nllnor soil constituents may be added to the classification breakdown in accordance with the particle size proportion listed below; i.e. sandy silt w/some gravel, trace clay. no call - 0- 3% trace - 3 - 12% some - 13 - 30~ SOIL CONSISTENCY - CRITERIA: Soil consistency as defined below and determined by normal field and laboratory methods applies only to non-frozen mater{al. For these materials, the influence of such factors as soil structure, i.e. fissure systems, shrinkage cracks, slickensides, etc., must be taken into consideration {n making any correlation with the consistency values listed below. In permafrost zones, the consistency and strength of frozen soils may vary sig-nificantly and unexplainably with ice content, thermal regime and soil type. Cohesionless N*(blows/ft) Relative Density Loose 0- I0 Medium Dense 10 - 30 Dense 30- 60 Very Dense - 60 *Stand,~Lrd Penetration "N": 0 to 40% 40 to 70% 70 to 90% 90 to 100% Blows per foot of a 140-pound hammer falling 30 inches on a 2-inch OD split-spoon except where noted. 'Cohesive T- (tsf) Very Soft Soft Stiff Firm Very Firm Hard 0 - 0.25 0.25 - 0.5 0.5 -t.0 1.0 - 2.0 2.0 -4.0 -4.0 DRILLING SYMBOLS WO: Wash Out WD: WL: Water Level BCR: WCI: Wet Cave In ACR: DCI: Dry Cave In AB: WS: While Sampling TD: While Drilling Before Casing Removal After Casing Removal After Boring Total Depth Note: ' Water levels indicated on the boring logs are the levels measured in the boring at the times indicated. In pervious unfrozen soils, the indicated elevations are considered to represent actual ground water conditions. In {~npervious and frozen soils, accurate determinations of ground water elevations cannot be obtained within a limited period of observation and other evidence on ground water elevations and conditions are required. DWN: L.D.S. GENERAL NOTES tS'~'O N/A /=~OiJ. NO GENERAL [DWG. NO. B-OI STANDARD SYMBOLS ~ ORGANIC MATERIAL ~ COBBLES E~ BOULDERS ~ IGNEOUS ROCK ~ SANDY SILT ~. CLAY ~ CONGLOMERATE ~ M'ET~ORPHIC ROCK ~ SILT GRADING TOSANDY SILT SILT SANDSTONE '~"~ ' ICE, MASSIVE SCATTEP. ED COBBLES (ROCK FRAGMENTS) ' ~ ~ ~ INTERLAYERED SAND SAND MUDSTONE ICE - SILT 8~ SANDY GRAVEL SAMPLER TYPE SYMBOLS · St ..... 1.4." SPLIT SPOON WITH 47~ HAMMER Ts .... SHELBY TUBE Ss ..... 1.4" SPLIT SPOON WITH 140# HAMMER Tm .... MODIFIED SHELBY TUBE SI ..... 2.5" SPLIT SPOON WITH 140-# HAMMER Pb .... PITCHER BARREL Sh ..... :>.5" SPLIT SPOON WITH 340# HAMMER Cs .... CORE BARREL WITH SINGLE TUBE Sx ..... 20" SPLIT SPOON WITH 140~ HAMMER Cd .... CORE BARREL WITH DOUBLE TUBE Sz ..... 1.4" SPLIT SPOON WITH 340# HAMMER Bs .... BULK SAMPLE Sp ..... 2.5" SPLIT SPOON, PUSHED A ..... AUGER SAMPLE Hs ..... 1~4" SPLIT SPOON DRIVEN WITH AIR HAMMER G ..... GRAB SAMPLE HI ..... 2.5" SPLIT SPOON DRIVEN WITH AIR HAMMER NOTE: SAMPLER TYPES ARE EITHER NOTED ABOVE THE BORING LOG OR ADJACENT TO IT AT THE RESPECTIVE SAMPLE DEPTH. TYPICAL BORING LOG BOR/NG NUII,fSE/~..,~.i~ H. 30-1§ DATE D/~ILLED..,~iO- 21- 70 SAMPLEt~ TYPE~, Ss AFTEt~ BOt~IIVG. 9' ~/ATEt~ TABLES H.5'~ WHILE Dt~ILLttVG~' F/~OZEN Elev. 274 6 '"~'~ ELE;/'~T/'Z"N ,.V FEET All Samples Ss''~'''S'zIMPLEtY TYPE O' ORGANIC MATERIAL Consld Visible Ice 0'-7' ICE+ML I' ICE - SILT Estimate 65% Vis~blelce 90, 56.? °/o,80. Spcf~, ML· T' SANDY SILT ~~ /APP~OXI~AT~ ~T~ATA CHA~ L;ttle toNoVisible Ice 13'-30' Vx ~IC~, DESC~/PTION ~ C~IFICARON 7 o o (CO~PS OF ENG/N~S METHOD) Ss ~ 2,5~1 ~o,85.gpcf, 28, GP~ ~ ~ ~ ~ ~ UNIFIED 0~ FAA CLASSIFICATION ~ ~ WATE~ CONTENT ~--B~OWSXFOOT SAMPLE NUMBE~ · ' SANDY GRAVEL Cd 95 SCHIST ~ GEN~P~L/Z~D EO/L O~ POCK ~ WEIGHTED AVE~AG~ ~ ADDITIONAL DATA AKAILABL~ ON SUPPLE~ENTAL LAB SHEETS R ;~ M. CONSULTANTS, iNC. OAT~ 2- 18-7~ J SCALE NONE JDwN e~' 34272 LDS EXPLANATION Of SELECTED SYMBOLS GLB iPRo.~. No, GENERAL JDWe NO. B-O? M-W DRILLING' INC. DRILLING LOG Well Owner .Use of Well ~>~';":; ~ Location (address of: Township, Range, Section, if known; or ~listance main road Size of casing. ~'~ .Depth of Hole static water level ~ ? © Screen ( ); Perforated ( ). Describe screen or perforation Well pumping test at [0 gallons per ~r) of drawdown from static level. Date of completion .5 / 2 / ? 7 · ~':~'~ feet Cased t°' o :~. feet (below) land surface. Finish of well (check one) open end ( (minute) for .i. hours with W[I.L LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness ); TO. -~' ' ...... .TO. ':-~": Gravelly hax,,u~,~, cobb'i~ .TO '''~ ~.,rave!lv ~a~ii,~'~ ,%: .TO. 7L7: Loose gravel, cobbly TO. . ~ ~ ~(~r?~v~iiY hardpan . ,.. ~i.~ · Cou[rac[or 814 & 973 2--STATE