HomeMy WebLinkAboutCABIN BY THE CREEK LT 1[if
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES C-) I
Environmental Health Division L/
825 "L" Street, Anchorage, Alaska 99502, Telephone 264 -4720 -=T -r--;2
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
4kgai"' TO SEPTIC ABSORPTION
Address FROM TANK FIELD WELL
3 �%C
D E _ Dr WELL Alor 1N Y 7-
Phone(s) Permit No. No. of Bedrooms
941-&661 p0 33 LOT LINE :2O
LEGAL DESCRIPTION `0
Lot Block Su isio
FOUNDATION IV07-- E7+
Township, Range, Section
77 G
,/� - AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation,
, driveway. water bodies. etc.)
TANKS
X SEPTIC ❑ HOLDING
Manufacturer Capacity in gallons
E !'00co
Material I No. of Tompartments
TYPE OF SYSTEM
❑ TRENCH X BED ❑ W. DRAIN ❑ OTHER
Depth to pipe bottom from Total depth from
original grade
original grade 3
ye' FT ¢ 7r> 5 FT
Fill added above original grade Gravel depth beneath pipe
/ IIA FT AJ, )If
Gravel length Gravel width
59 FT �(`>, S FT
Total absorption area Distance between lines
2 /O SO FT 75 FT
Number of lines Soil rating Pipe material
SQ FT
['
■mmm6 iidr"m
1«O M1
1NME + 91
'&SON&A
tONPRI&I
IRWIN", fog
IMMENE1
72-013 (3/85)
Install r •
�rl�►
ate Installed
I(�D
!d C
O
WELLS
b
180"
❑ PRIVATE
❑ OTHER (Ident'
OF
Classification (A,B,C)
q6tal Depth Cased to
= 1 5
FT
FT
r)
Installer
Date Installed:
�9
= SS 3
REMARKS:
Scale:
Perfo by:
Ins ections r ed !
f 4
Date:
e
w
0.i •9
MineI
certify that this inspection was performed according to all
Municipal and Slate guidelines in effect on this date:
dv+
r
Health Department Approval:
ter`"`"—� ""
Date:
72-013 (3/85)
MUN1L1�*L1// u)' �N�Hu�*6E
Department o� Health & Human Services
825 L Street, Anchorage, Alaska 99501 343-47�0
ON-SITE SEWER PERMIT
//ate l`ssued: 10/05/90 Engineer Designed
O�r.er Kame: PAT QF OREGON INC.
Day Phone:
��nnr A�dress: 1013 EASl DIMOND BLVD.
ANCHURAGE, AK 99515
�'-i Lera>: S:bd�vision: CABIN
B/
THE CREEK
�2N Range:
3W
Sectjon: 2� 7ownship:
�-ot C1zc 441+4 /sq.{t. or acres)
ria,2��ruoms: This Permi�: 3
Tota1
Capacity:
3
�'L!'{IL� [AN�: Min/mum tot�] septic
tank
capacity:
1,�00 gal1ons. Each sppt'�
^e | .`/�"�L have ai leest 2 compartxenLs.
��'� )eq;ires �nsulatiun �ver tank�s).
Depth
to top of septic
�.|�� F��`Mi[ EXPIRES �2/31/90 HND
VALID
|�OF( 1-
i NATT�CHEU
UESIGN.
!%'0|��! �.!1.|!.C. F'RI(�R [O INSPECTIONS
BY E�GlNEE�,
lF AFTER
| 1 �|uURS, CALL �4�-4��1 ANU LEAVE
A MESSAGE.
��[|
1. i ax {amiliar wzth the requirements
for on'site
sewers and wel]s a� =eL
Municipality o�
Ar.�horage
(MOA)
and the Stats o{ A1as a.
�. l ��1i instal1 the systen zn
accordance
with
all MOA codes and ,egu1�Li�:s,
a�d z: compliance with the design
� � wl1 adhere to a�l �UA and
State
criteria
o{ Alaska
o� this perm1t.
reqe�remen�s for the set �ar�
n�stanc�es irom any ex�sting weli,
s.�;era3e system on ��i any
adjacent
wastewater
or
disposa1 system or �'�blic
nearby �ot.
' u���e.'s�and tha/ thi ��
is
valid for
a max1mum of 3 be�rooms. l
��=c un'�*'st ihat pacizy
of the tota1 system �s 3 bedrocns and
^ry e�/!a,gem=c�. _wi^ll rm�q���`e
ar/
additional
permit.
Cj
�r,de�elo�a�
, /RGA fe oA
_ ----,We ,
1
ol'
DIRokse
Val
r /
x oo
Soi/s2a�
/J'o s'y,T-/e y/
-
o ��` ¢'� PPr� sFu�erlo•fe
m � SFO S�c'Tirnv Se war /act %a '= Z % "
,BED PGA/
NOTE SEl�1 /E2 SYS T /� DE 7 /L S
All Dimensions And Locations Must Be Fic.1d Verified Prior To Construction
SEWER. SYSTEM LOCATION -PLAN
LOT BLOC SUBDIVISION
SECTION/ TOWNSHIP/ RANGE
f
i rro 6� SCALE4 /IIS / NOTE,
+Y !
The Accuracy of Location Of Ezisiting-And
1 A +{ t �$ Proposed Property corners, Wells, and .Septic
DRAWN BYE Systems Indicated Is•Not Exact. Di.ensions
+��°`" .. ' % •.� i ."<,ns4s^• indicated 11ave Been Detcr.ined By Useof cloth
NORTH
Tape and/or Municipal Records, And Not By
r✓��,p,:�y " ,r � s ao�ao�gx� �► ":,:� ' �9, µ i Surveying Techniques .
Y f
! ` t 3 PREPARED FOR -
"LIP OG
kS�`,, r: •' '0.'•4+0 e~
�ar,�� �+tt{,tre r�.Y:t�?4 Srt t�t1Qs��ttBBLS:
S� K r� DATES SHEET ` OF /
�L i S_�q
WASTEWATER NARRATIVE FOR LOT 1, CABIN BY THE CREEK
The location of the wastewater disposal systems on the subject
property should have no negative affects to the adjacent
properties or the environment for the following reasons:
WELLS
The proposed well on this property is properly separated from
the planned wastewater systems. Surrounding wells are also
well away from proposed sewer system components.
WASTEWATER SYSTEMS
The wastewater systems proposed for this property have been
located so that there will be no effects to any surrounding
properties. All setback distances have been satisfied as
required. Further the soils are of such a nature that
treatment will be assured over a long term period.
RESERVED SPACE
The wastewater systems on this property have no effect in
taking away reserve area set aside on other adjacent lots.
There is also adequate reserve on the subject property for
further replacements as required.
SURFACE AND SUBSURFACE DRAINAGE
The wastewater system will have no impact to surface water
drainage due to the location and the fact that the contours
will remain unchanged. Subsurface drainage will be unaffected
since treatment of wastewater is assured before it reaches
groundwater tables. The topography of the lot is fairly flat
along the north and east sides of the property and where the
sewer systems are proposed. The land to the west of the sewer
system slopes off to the creek, but there is over 200 ft. of
distance to the creek from the system. Slope limits have been
shown on the sewer system location plan.
SIZE OF BED SYSTEM PROPOSED
The proposed beds are established at 18 ft. wide for two
logical reasons. First of all a 15 ft. wide bed would need to
be 75 ft. long or 5 times as long as it is wide. We do not
believe this a good design and feel that 18 ft. wide by 62.5
ft. long provides a ratio closer to 1 to 3 (3.47) which has
been proven to provide better treatment distribution in beds.
Second, we feel that 6 ft. spacing between lines is better than
5 ft. and have built beds like this for years with great
success. We see little if any merit in making this bed 15 ft.
wide based solely on some arbitrary dimension establishment and
feel that an 18 ft. wide bed is the best solution based on the
foregoing.
;.
7,V MINO;
1
f 5c -
m ` :051'5'e2/e sbac� Camp 62`/
�%/�S `
Soi /s
'eq A,I'l
13���xlr �= 450 _ //2 5 4:7'
- - ---- - -
� Min if«� a �" e
�-
-- (0 2 5 1
m i h'Eo Sic i—/err`-, 5e uJ 1- /-o,i
/,gEO PGA �
NOTE: 5zg iAl sYS 7 �M ISE 7�J /LS
All Dimensions And Locations Must Be Field Verified Prior To Construction
SEINER. SYSTEMLOCATION -PLAN
2 BLOCK SUBDIVISION
Cie/ti BY �� c�E
SECTION/TOWNSHIP/RANGE
SCALE6 �/= O NOTEt
The Accuracy Of Location Of Fxisiting And
Proposed Property Corners. Wells, and Sep
•
Po Y
r �'^ R DRAWN eye /` Systems Indicated Is -Not Exact. Dimension
NORTH indicated lfavc 8ccn Determined By Use Of Cloth
Tape and/or Municipal Records, And Not By,
.r ,•.•:•S .:'�'' Surveying Techniques
PREPARED FOR,
OATEN SHEET `
F
... ... _ s
municipality, of Anchorage
at I1Cf�
DEPARTt,IENT OF HEALTH & HUMAN SERVJ
825 -'L" Street, Anchorage. Alaska 99502-0e5
SOILS LOG - PERCOLATION T
P C- f- 0 R r". C D r --0R: //t//'4 k /1�Z- / Aj
A-- Township. Range.
LEGAL 0ESCRIPT10N! SLOPE
2-
3-
4-
6-
7
9-
W�
%VAS GROUND WATER
10 ENCOUNTERED?
S
IF YES, AT WHAT
O
DEPTH?
12 -
UP to td AU
13 Ron: M07
14-
15-
16-
17-
18-
19 -
'n1'r kl,�
TC PCRF R &4
SITE PLAN
[a
20- PERCOLATION RATE (mickutestk%chl PERC HOLE DIAMETER
7( T RUN BE EN FT AND FT
COMMENTS
L --L
PERFORMED By- -eeftTIFY THAT THIS TEST WAS PERFORMED (N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEL I//
INqaEI:rE HIS DATE- GATE:
72.008 (Rev. 4/85j �YT
WWI=
E5
20- PERCOLATION RATE (mickutestk%chl PERC HOLE DIAMETER
7( T RUN BE EN FT AND FT
COMMENTS
L --L
PERFORMED By- -eeftTIFY THAT THIS TEST WAS PERFORMED (N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEL I//
INqaEI:rE HIS DATE- GATE:
72.008 (Rev. 4/85j �YT
Q h`unicipa(ity of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERV(
825 "L" Street, Anchorage. Alaska 99502-06
SOILS LOG - PERCOLATION TE �.
PERFORM. EO FOR: /-G/ b/
LEGAL OESCR(PTION: ZOAL /
1
2-
34 3-
4
5 A jM
6-
7
Si 1 sau
Z'f, bfn
9
lfl
11
12
13
14-
17-
18-
19
4171819
20
COMMENTS
/ e.
Township. Range.
SLOPE
WAS GROUND WATER
ENCOUNTERED?
L
IF YES, AT WHAT O
DEPTH? P
E
Otgtit fa lYzttr t11tt�A ��
kaaiLxit�p? � (3zLt
S(TE PLAN
N
m
V
.`�
- /M�MCZWW-
M�W-��
Jt !�
PERFORMED BY:
ACCORDANCE WITH ALL STATE. AND MUN(CIPAL
?2008 (Rev. 4/851 1
PERCOLATION RATE (minutesiinchl PERC HOLE DIAMETER
TEST SUN BETWEEN e — FT AND " S FT
'HYZZD� ` CERTIFY THAT T IS T/� WAS PERFORMED (N
lll/ EFFE O THIS OATS DATE: _ f /6 `Zd -
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
L�
Parcel I.D.# Or; 'SZi— `I� HAA# I/G
1. GENERAL INFORMATION
Complete legal description G.ot 1 Ccc4 ,.'7 - S y - A e - Crree k-
#� Z
Location (site address or directions) 106 2 t 13aro^, k S,/-.
Property owner fFr>� � DOfee" ria 0�_(f Day phone 5641 -S Z a�
Mailing address /3a mon St Ae- chvr0 f ,4 Lc 9'S
Lending agency Day phone
Mailing address
Agent Odin o e I T eAl e` Tack Com , Day phone X63 - sSGO
Address 3 Z01 C" S>� ff� chogP !} k 99s o3
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: ` _' RECEIVED
3. TYPE OF WATER SUPPLY: APR 2 g 19� (
Individual well ✓ Municipality of Anchorage
Dept. Health & Human Services
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Hol6iog 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 (Rev. 1/91) Front MOA #21
S. 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 F�a>L � Tcctin ;cel Sere«y Phone 3 ys'- +3rS_
Address 11S -3c? macho A 6C 919S1161
Engineer's signature Date `�/ Z-719
6. DHHS SIGNATURE
J Approved for
Disapproved.
Conditional approval for
Additional Comments
bedrooms.
bedrooms, with the following stipulations:
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
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division MUNICIPALITY OF AN(_jjUKAUt
825"L" Street, Room 502 • Anchorage, Alaska 99501 0"MUM4ERVICES DIVISION
APR 2 9 7997
Health Authority Approval Checklist RECEIVED
Legal Description: 6 .n - 64 - Ae - Creek # 2 Parcel I.D.: 6 5- - S 2 / , `12
A. WELL DATA
Well type P V 1�
Log present (Y/1)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
6/20/93
Total depth I q9' Cased to 1'i9' Casing height (above ground) S '
Sanitary seal (Y/1)
Date of test
Static water level
Well production
FROM WELL LOG
6/eoI93
WATER SAMPLE RESULTS:
0
Wires properly protected (Y/1) Y
AT INSPECTION
yl 2 Z/ 9 7
Sys
g.p.m. 7,S t g.p.m.
Coliform O ruf
/rGOm t
Nitrate 4 0. Ireq/ Other bacteria
NCy+c repor/ro(
Date of sample:
y / ?Z / 9 7
Collected by: F /a t /,,r 7"Pch
SS -c
B. SEPTICIHOLDING TANK DATA
Date installed 0 9 3 Tank size 0_ Number of Compartments 2 Cleanouts (Y/1)l_
Foundation cleanout (Y/1) Y Depression (YY/1) N High water alarm (Y/1) P. R.
Date of Pumping y / 2 y 19 7 Pumper J_ rcr « cf
C. ABSORPTION FIELD DATA
Date installed 6'0_3 Soil rating (g.p.d./ft2 or ft2/bdrm)0. y� System type Tre" CA
:t z
Length 104:�; 5- Width 1, 3' Gravel thickness below pipe 6 S , Total depth I
Effective absorption area 13 SY d Monitoring Tube present(Y/N) Y Depression over field (Y/1) N
Date of adequacy test ' >+ / 2 2-/ 9 7 Results (Pass/Fail) 1'a sJ For Y bedrooms
9 3 73" -
Fluid depth in absorption field before test (in.); ti 3" Immediately after I?z3gal. water added (in.): i!�6'' w
70 ?/ti a (-F)
Fluid depth CY ° H (ins.) Minutes later: Y 3 Absorption rate = > i �fQ g.p.d.
Peroxide treatment (past 12 months) (Y/1) NaAe_ ko aur,, If yes, give date AA
D. LIFT STATION V. A.
Date installed
Manhole/Access (Y/1)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at*
*Datum
"Pump off' level at*
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot -> too' ; On adjacent lots > 100,
Absorption field on lot /10, ; On adjacent lots > r ao '
Public sewer main N. A Public sewer manhole/cleanout N. A
Sewer /septic service line > Z f' Lift station N- R:
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10 Property line Z7, Absorption field �Z 20
Water main/service line > /D' Surface water/drainage >/c49' Wells on adjacent lots - //S
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation to ' Property Line i 7 Water main/service line > 16'
Surface water 1 as, Driveway, parking/vehicle storage area 2 a'
Curtain drain Non 2 f ern Wells on adjacent lots > foo'
F. ENGINEER'S CERTIFICATION
- d
1 certify that 1 have determined thru field inspections and review of Municipal records tbat i e aAove systems are
in conformance with MOA HAA guidelines in effect on this date.
Signature
Engineer's Name -1-h e-,,�o re F. /It ac> - Engineering Seal -Here
Date `/ / Z 7 / 9 7
HAA Fee $ 3co-=
Date of Payment Z--' � AF
Receipt Number
Rev. 8/95 OSS: haa.wk.doc
Waiver Fee $
Date of Payment
Receipt Number
TO * ,!J -10101
A16w.' CT&E Environmental Service
CT&E Rd.# 971907001 Client PO#
Client Name Flattop Tecbnical Srv. printed Date/Time 04/25/97 21:32
Collected Date/Time 04/22/97 11:40
Project Name/JJ Li , Cabin by the creek /12 ReceivedDate/rime04122!97 12:35
Client Sample ID Front nBib Technical Director: Stephen C. Ede
Matrix Drinking g Watcr
Ordered By Released By
PWSID
Sample Remarks:
Sample collected by: T, F. Moore
CT&E Microhiology Drinking Water Program cestitil;ation status » provi�iorwl as of 418197.
Allowable Prep Anatysis
Parameter Results POL Unite Method Limits _ Date Dste snit
0.100 U 0.100 my/L SM18 4500-NO3F 10 max 04/23/97 JRL
Nitrate -u 04/22/97 RAM
Total Coliform 0 col/t00mL SM1S 92228
T0iT0'd T02S T9S L06 30kJd0HJNd 1S3 381J 2T:ZZ L66T—SZ-8dd