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Home My WebLink AboutCRESTWOOD LT 9A-1 · ' Municipality Of Anchorage Page ! of :2_ 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: 5 lA/c~) Il (o PID Number: Name: ~.~//~/~ ~ ~,/~ ~O ~ ~ ~ ~ Wastewater System: D New ~pgrade Add~: J /~7~5 ~J~c;~ Dr ~~~~ ABSORPTION FIELD Phone: ~No. ofB~rooms~ ~D.pTrench ~ Shallow Trench ~Bed ~Mound ~Other Total Depth from origi~l grade: LEGAL DESCRIPTION ~'"'~"~: /,~ ~,~.~. /o.U'-//. ~ ' WELL: D New ~ Upgrade e~e~: ~ ~L ~ ~ F~. Numar o~lin~: ~ Db~ ~ ~: D~II - - D~ Dril~: ~a¢ Wa~r ~1: I~lle~. Date insalJ~: / SEPARATION DISTANCES ~s,pti~ o Holding ~ S.T.~P. From T~k Reid S~on T~k ~r Un~; w,~' /~ + IOO ~ -- - ~ ~ 5 Suda~ ~ w,~,r /OD ~ /~ + -- -- /~'~ LI~ STATION Lot ~ I / Si~ in g~lo~: ~ M~m~ F°undati°n ID'+ 10'+ -- -- __ "Pump on" ,., at: ~,~e, =: Remarks: BENCH MARK ~u~ ~o~ .e o ~,~. ~.. ~epa~ment of Health and Human Se~ices a~~ ~ Reviewe~ an~ a~prov~ ~y: ~//~ ~~~ D'te: 7- ~ -ee '~~~ 72-013 (ney. e/gl) MOA 25 K D 0 A-C=107,8' B-C=68.4' A-D=l15,9' B-D=75,1' A-E=168.6' B-E=ll~,~' A-F=PO1,6' B-F=14t,O' AS-BUILT SYSTEM DETAILS/SITE PLAN Pe~'~it swssoi~6 CRESTA/BDD S/D, LET 9A PIDt*O15-361-Oi 70.00' CB SYSTEM TH RESI Lot 10A TH ~ D 50 S.T, d~ ~-.~ ~ ~ PREPARED FOR: (* 49T * FIELD BOOKS A,C. PAVEMENT 4 BDRM SCALE: I' = 50' uz dd d~ BRIGINAU GRADE ~ ~ ' I ~ r1LT£R Fn~RIC'-~ VN~I£S ~ '~IB50 GAL "" ' ~ SHIRLEY GILARBWSKI 15765 HOLBEIN DRIVE COLORADO SPRINGS, CB 80921 CO,II. rE0: D.^WN: KMD CH£C~[D: KMD 7/3/99 , 2 4 38 JOe No,: 98024 SCALE, NTS ]]~~ ENGINR~RING 20441 PTARMIGAN BLVD; EAGLE RIVER, AK 99577-8736 1907)696-6111 {/tAX, 190~7/696-8111 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: Design Engineer: Owner Name: Owner Address: SW980116 0070 KND ENGINEERING Shirley Gilarowski 15765 Holbein Drive Colorado Springs, CO 80921- Parcel ID: 015-361,91' Legal Description: CRESTWOOD LT Site Address: 009501 BIRCH RD Lot Size: 45600 SQ. FT. Total Bedrooms: 4 9 ~(~L2,~ Permit Bedrooms: 4 Date Issued: May 15, 1998 Expiration Date: May 15, 1999 This permit is for the construction of: [] Disposal Field [~ Septic Tank [] Privy [] Private Well Holding Tank 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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: ^. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Received By: Date: Issued By: Date: April 27, 1998 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Upgrade Sewer Permit - Crestwood S/D, Lot 9 Gentlemen: On April 11, 1998, we excavated two testholes for the subject property. The results of these tests and water monitoring are attached. We propose to install a 5' wide shallow trench. There was no water observed during the testhole excavation or after monitoring. Due to the depth of the system additional fill will not be required. This lot slopes from south to north at approximately 5-10% which is away from the proposed house and any surrounding wells. There is sufficient area for the primary and reserve system within the radius of the testhole for the four bedroom single family residence. The existing field and tank will be abandoned in place. The proposed upgrade is in conjunction with a short plat being processed separately by the owner. There are no public or private wells within 100' of our proposed system location. There is neither surface water within 100' nor any known curtain drains within 50'. We do not expect that there will be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, ~i~D Engineering Kenneth M. Duff attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test '~EL'L & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN K D CREST~BBD g/D, LOT 9 _ 5-,_o,, AVE, VACANT E SY,TE ' Lo,. ," .............. ,r ~..;,~ . "* .... ./ ..~ ,~ '~ '. ~ L~ '. .......... I ~.f~] ; ..~rca : t J VACANT VACANT .... ~~---~ .... ~ - ~ -~ ........... ~ ~ .................... VACANT VACANT x / / [ DESIGN DETAILS ~ PU~LI'C V~ Vlql-IIN 200~ DF PRDPDSE]B SYS'TD~ NO PRIVAT£ VL:IJ.$ VTll. II'N EOO' PRDPDSE]B SYSTEH EXCEPT AS NOTE]B, NO SEPTIC SYSTENS VrrHZN L~O' QF PRQP~SE]B ~LL EXCEPT AS N[]TE~ 4 B])RM X 150 GPI) = 600 GPI) 600 GP])/1,2 GP]) PER SQ. FT, (1.3 MIN/IN.)= 500 SQ, FT - (500/(5')) X O,5(RF) (4.0' GRAVEL) = 50 FT. TRENCH To'cai depth o¢ system Is 10.0' Cpom oploln:l grade, Total dep~ch oF gr~vel below dls~crlbu~clon pipe Is 4,0' , NnTES~ 1, USE 1250 GALLON SEPTIC TANK, INSULATE TANK IF <4' COVER, 2, INSULATE TRENCHES WITH 2' HI) BURIAL FOAM,, 3, CONTRACTOR ~/ILL ENSURE MAXINUM 2% SLOPE INTO SEPTIC TANK, 4, AI)])ITIONAL FILL WILL BE AI)])EI) OVER SYSTEM TO ACHIEVE MIN, 3' COVER IF REQUIRE]), 5, CONTRACTOR TO ABANI)ON TANK/FIELI) IN PLACE, PREPARED FOR~ SHIRLEY GILARD~/SKI 15765 HOLBEIN ]]RIVE COLORAI)O SPRINGS, CO 80921 FIELD BOOKS COMPU'IB): BOUNDARY; LANG DR~WN: KMD STAKING; LAN(; CHECKED: KMD ^S~J~LT: LANG DWG. FILE: D^m 4/27/98 ~ 2438 Scale: 1'= 100' ~~) ENGINEERING ~0441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 19071696-8111/~AX 19071896-8111 ACAD FILE: I 98024. DWG '~ N~: 98024 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST WAS GROUND WATER ENCOUNTERED? $ IF YES. AT WHAT ~/~ (~ DEPTH:? P E I~ni~'ing? ! ~'*/_~,.~" .,,*'~1 s*'t,~.'**~*~.,.*.*.?.** ~ I I F,~ ... c~,,, ./~ I DATE PERFORMED: Township, Range. Sect,o.: ~ ~ ~- / SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop q./ I-q/5 . F. ..', Ir.. ,~v PERCOLATION RATE (m~nutes/,nch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND __ FT COMMENTS -, ACCORDANCE WITH ALL STATE(~ND MUNIC . : / [ 72-008 (Rev. 4/85) WAS PERFORMED IN Municipalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS .~ /P-. WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? ~4~- Kenneth M. Du~ i ~I I DATE PERFORMED: Township, Range, Seclion: ~ ~ ~-~ SLOPE SITE PLAN Oeplh Io Water AJtet.,-. Mo~loring? Gro~s Net Depth to Net Reading Date Time Time Water Drop / q-/I-q~ /.~:2:~ --- /1" -- Z 12 :_50 ..5',,.,~,'~ 7 ~/~' ~ / ~' ~ ~ 12; ~1 ~ I!' - PERCOLATION RATE ./.¢'7 [mmuteulnch) PER(; HOLE DIAMETER ~" TEST RUN BETWEEN ~'"~' FTAND 7",~ WAS PERFORMED IN 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. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 015-361-0~' ½c~i HAA # GENERAL INFORMATION Complete'legal description Crestwood S/D Lot 9A Location .(site address or directions) Property owner Shirley Gilarowsld Day phone Mailing address 15765 Holl~in Dr., Colorado Springs, CO 80921 563-5600 Lending agency Mailin. g address ' Agent. Greg McNeil/Williwaw Realty Address Arctic Blvd., Anchorage, AK Day phone Day phone 563-5600 e Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 - TYPE OF WATER SUPPLY: Individual well []. Community well o Public water Fl 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. 72.025 (R~t. 1/91) Front MOA~21 STATEMENT OF INSPECTION BY ENGINEER AS certified by mY seal affiXed. h'eret0"and as o~the validatiOn da{e shown'below, I ve~;ifY-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 inf~'rmati0n obtained from the Municipality of Anchorage files and from 'my investigation and inspection, the on-site water supply and/or wastewater disposal system isin compliance with'all'M~?cipal'andSt'ate codes, ordinances, and 'regulations in effect on the"date~of'thiS rnspeCti°n.' KND Engineering Name of Firm Address 20441 Ptarmigan Blvd., Eagle River, AK 99577 Engineer's signature, 696-611 ! DHH8 SIGNATURE "' i/ Approved for .Fo R Disapproved. Conditional approval for bedrooms. bedrooms, with the follOwing stipulations: Additional Comments The Municipality of Anchorage Department of 'Healthand Human Services (DHHS)~. iSSues Health A..uthority 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 courteSYto purchasers o.f. homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze date before, a certificate-is iSSued.-The Municipality-of--Anchorageis not .responsible for errors or omissions in the professional engineer's work. dUNICIPALITY OF ANCH0.PJ~GE · ' 3EPARTMENT OF HEALTH AND Municipality of AnchorageENVIRONMENTAL SERVICES DIVISI~ ~,i. ~.);DEPARTMENT OF HEALTH & HUMAN ~:~ ~" ~; Environmental Services Divisio~cHnr~AGE, ALASKA 99519-6650 825 L Street, .Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 - Legal Dps~_ riOt!On: A. WELL DATA Well type N Log present (Y/N) , : :":= Total dept. b Unk. Health Authority Approval Checklist Crcstwood S/D, L9A Pamel I.D.: JUL 0 6 999 015 361 0 wtUNICIPALITYOFANCHOP, AGE - - ~N~IRONM~al ec%,;~ ...... ,.ES OlVl$10b If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to 40' + Casing height (above ground) Wires propedy protected (Y/N) Y N/A 13" Date pLtp_s.t Static wat_ ~e_r.!eyel Well pr.o_dg_c~jo_ .n_ FROM WELL LOG Unk. Unk. Unk. g.p.m. AT INSPECTION 6/14/99 56' (TOC) 3.5 gpm+ g.p.m. WATER SAMPLE RESULTS: 0 2.61 0 Nitrate Dqte o_f, ~.sampl_p; 6/14/99 Collected by: Other bacteria KND Eng. B. SEPTIC/HOLDING TANK DATA Date installed i: 6/9/98 Foundation c!eanout (Y/N) N/^ Date of Pumping Tank size 1250 Number of Compartments 2 Cleanouts (Y/N), Y N N Depression (Y/N) High water alarm (Y/N) N/A 'Pumper Y C. ABSORPTION FIELD DATA · -Date, installed 6/10/98 Soil rating (g.p.dJfF or ~/bdrm) 1.2 Length :-, 50' Width 5' SF Effective absorp.'do~_~ea Date of adeqp_.acY test ;~} ~ NEW Fluid depth in.. ~_ab~o. _rpt~n field before test (in.); Fluid depth : N/A (ins) Minutes later:. Pero~'Lde_.~_ea_~tn~e_n__t_(l~S. _t 12 months) (Y/N) Gravel thickness below pipe Monitoring Tube present (Y/N) NEW Results (Pass/Fail) N/A * Immediately after N/A Absorption rate = N/A Y 4.2' If yes, give date System type Total depth D. Trench DepressiOn over field (Y/N) 4 For NH~al.--- water added (in.): N/A q.p.d. N/A N bedrooms N/A 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES N/A N/A Size in gallons "Pump on" level at* *Datum N/A "Pump off" level at* F. SEPARATION DISTANCES FROM WELL ON LOT TO: 100'+ Septic/holding t~nk ~n lot 100'+ Absorption fie!d on lot. Public sewer main 100'+- On adjacent lots. On adjacent lots 100'+ 100'+ Public sewer manhole/cleanout N/^ Lift station 25'+ Sewer/septic service line SEPARATION DISTANCES FROM SEPTIC/HOLDiNG TANK ON LOT TO: Foundation ! 0'+ Property line ] 0'+ Absorption field, 25% 100'+ Water main/service line Surface water/drainage Wells on adjacent lots 100'+ 10'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line !0'+ Building foundation !0'+ Water main/service line Surface water Driveway, parking/vehicle storage area, · NONE Y,J'qOW~ Wells on adjacent lots 100'+ Curtain d ,rain 25'+ 25'+ ENGINEER,S .CERTIFICATION ~a~ that I have determined thru field inspections and review of Municipal ,records tha~. I in conformance with MOA HAA guidelines in effect on this date. . Signature ~ .Kenneth M. Duffus, P.E. Engineer's Name 7~6~99 Date HAA Fee $. Date of Payment Receipt Number 72-026 (Rev, 3/96)* Waiver Fee $ Date of Payment Receipt Number CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 992669001 KND Engin~ring Crcstwood S/D Lot 9 Crestwood S/D Lot 9 Drinking Water Sample Remarks: Client PO~ Printed Date/Time 06/16/99 11:17 Collected Date/Time 06/14/99 13:30 Received Date/Time 06/14/99 14:35 Technical Director: Stephen C. Ede Paramter ResuLts PgL Units Method ALLowabLe Prep AnaLysis Limits Date Date Init Totat Coliform Nitrate-N o 2.61 coL/lO0mL 0.500 mg/L SN18 92ZZB 06/14/99 KAP EPA 300.0 10 max 06/15/99 06/1~/99 SCL