HomeMy WebLinkAboutBENT BIRCH LT 2
Municipality of Anchorage Page
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
N~me: ~/~ ~[~ Wastewater System: ~New D Upgrade
Address:
//~1 ~l~[~n ~? ~ I~ ~~ ABSORPTION FIELD
Phone; J No.o~Bedrooms; ~ ~Deep Trench ~ Shallow Trench D Bed ~ Mound ~ Other
LEGAL DESCRIPTION so,.~..~: Total Depth from original grade: /
~ Subdiy~ion: Depth to pi~ ~om from original grade: Gravel depth beneath pipe
Township: J Range: J S~lion: Fill added above odginal grade: Gravel lenglh:
WELL: ~New D Upgrade Gravel widlh; ~ Ft. / J ~A F
ClassiflcMio~P~ivate/A,8,C): Total Depth: Cased To: Total absorption area; Pipe matedah
SEPARATION DISTANCES ~s~ptic ~ Ho~di.~ ~ S.T.E.P.
Water /00% I00'~ -- -- -- LIFT STATION
Lot
Cu~ain
Remarks: BENCH MARK
J Assume-Elevation:
ENGINEER'S SEAL
Department of Health and Human Se ices approval
Reviewed and approved by: ~~ ~ Date: ~-9'9~ ~ J%.~--'-->~
AS-BUILT SYSTEM DETAILS/SITE PLAN P~-~i, sw99oo55
BENT BIRCH S/D, LBT 8 PID#051-17~-44
TOE BF SLOPE
/ TH ~KND98 c ~ C
........................................
~64.78
~AN~ I~ SE~ER RDCK
i DISCBVERY TRAVEL
~ ~ ~ EAGLE RIVER~ AK 99577
(907)694-8585
~O~SslO~ ..... m.~ *S.U,LT: SEWARD .mi: 7/26/99 ~AG~E RIVER, AK 99577z8786
acaor,Le:99011.DWo uoa.o.: 99011 (907)696-6,11/~ (907)696-81~t
P,O. BOX 6702?2, CHUGIAK. ALASKA 995B? .. TELEPHONE 688-2759
OWNER OF IANO
ADDRESS
6ORE HOLE DATA
LEGAL DESCRIPTION
PERMIT NUMBER. ~OO -.~'S" Date of Issue
TAX INDENTIFICATION NUMBER_~'~ /
Is well located at approved permit location? ~ ~ No
Method of Drilling: [~ll~rotary ~ cable tool
Depth of well: ~__.
Casing Type ,~'r£E ~_ _Wall Thickness _L~._~'O _inches
Diameter_~// __.inches, depth / ~) [ feet
Liner Type: /DD,,,J E. '
Casing Stickup Above Ground: ~ ..feet
Static Water Level ('from ground level): ~ . feet
Pumping level: .__feet afte~ hrs. pumping _gpm
Recover Rate: ~'~ __gpm
Method of Testing:
Well Intake Opening Type: ~pe~ Eh;~ ~1 Open Hole
I~ Screened; Start__ feet Stopped feet --
[] Perforations Start_ .~f.e~,,~Stopped _feet
Depth: from__...~_. _feet, to '"----'--'
_feet
Pump Intake Depth:
Pump Size~ hp Brand Name
Well Disinfected Upon Completion? i]~.-~es ~ No
Comments:
~. L,;~ .....
JUL 30 1999
D llers Name
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper ~uthori~. Mu.nici;ali~
of Anchorage: Department of HeaRh & Human So,ices and/or Oepa,ment of Environmental Conse~at on. MatSu Borough:
Depa~ment of Environmental Conse~atio~.
MUNICIPALITY OF ANCHORAOE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 995~9-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SW990066
Legal Description: BENT BIRCH LT 2
Design Engineer: 0070 KND Engineering
Owner Name: Linda Frank
Owner Address: 11421 Old Glenn Hwy #102
Eagle River, AK 99577-
Date Issued: Apr 08, 1999
Expiration Date: Apr 07, 2000
Parcel ID: 051-171-44
Total Bedrooms: 3
Site Address:
Lot Size: 137045 SQ. FT.
Permit Bedrooms: 3
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
Private Well [] 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: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-61 il/FAX (907)696-8111
March 24, 1999
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: New sewer/well permit - Bent Birch SID, Lot 2
Gentlemen:
The owner has requested we proceed forward to obtain a well and septic permit on
the subject lot. On November 22, 1998 we dug one testhole for the proposed system.
The results of this test is attached. The general slope of this lot is from southeast to
northwest. Slopes range from in excess of 25% to approximately 5 - 10%. There are
several benches on the lot and the property has had significant re-contouring. The
on is in an area that has not had significant disturbance. We have designed our
system utilizing the testhole we excavated for the three-bedromn house, which is
proposed for this lot. The lot will be served by individual well.
We propose to install a 2' wide deep trench. The soil percolation varied initially but
stabilized at I min./in. Water was not encountered during the excavation or
monitoring.
There are no public or private wells within 200' of our proposed system location
except as noted. There is no surface water within 100' of the proposed system and
there are no known curtain drains within 50'. We do not expect there to 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~) Engineering
iments: On-Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
WE[L/WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN
BENT BIRCH S/D, LOT 2
/ VACANT VACANT
/
LOT 41 LET 40
DESZGN 3ETAZLS
3 ~gRN X 150 GPD = 450
450 GP9/1,2 GPD P~R gQ. FT. (1,0 HZN/~N.)= 375 gQ, FT
375/(~'(~) X ~'(9)) (6' GRAVEL) = 31,~5 FT. TRENCH
USE I TRENCH - 31,~5(L) X ~' (~/) X
PRDPDsEDND PUBLICsYSTEM.~ELLS ~ITHIN ~O~' DF TO~O( depth oF system )s 10' F~om oPigin~L
NO PRIVATE ~ELLS ~ITHIN ~00' DF TO~ depth oF 9~ovd below d(st~ibution pipe is
L USE 1000 GALLBN SEPTZC TANK, ~NSULATE TANK ~F (4' CBVER,
2, ~NSULATE TRENCHES ~TH 8' H~ 3UR~AL FBAN,
3, CBNTR~CTBR ~ZLL ENSURE NAXZNUN 2X SLBPE ZNT8 SEPTIC TANK,
4, CBNTRACTBB ~LL ENSURE ALL SEPARAT~BNS TB ~JACENT
~~ WELLS ~ SEPTICS.
~ : EAGLE R~VER, ~K 99577
(907)694-8585 PAGE 1 BF B
SEWARD earl: 5/19/99
~- ~eA~ss~°~ ~ *s.,~.,: EAGLE RIVER, AK 99577-8736
*c*.r,LS:99011.DWO oO~.o.: 99011 (007~696--611~/~ (007)696--8111
K
WASTEWATER DISPBSaL SYSTEM SI=TAILS
SENT ]~IRCH S/D, LOT a
PREPARED FOR:
LINDA FRANK
DISCOVERY TRAVEL
11421 OLD GLENN H~Y, ~102
EAGLE RIVER, AK 99577
(907)694-8585
FIELO BOOKS
COMPUTED:
80UNOARY: SEWARD oR^~: KMD
STAmN¢: SEWARD CHECKEO: KMD
ASBUILT: SEWARD
DWG. FILE:
ACAD FIL£: 99011 .DWG
o^~e 3/19/9 9
GRID: NWl155
JOB No.: 99011
Scale: 1#=
PAGE 2 OF 2
KH~) ENGINEERING
20441 PTARMIGAN l~LVD.
EAGLE RIVER, AK 9957?-8736
{907)696-6iii/taX {907)696-8111
I~ND ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
Performed for:
Project:
Depth
1-i
2-
3-
5-
6-
7-
8-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20-
SOILS PERCOLATION TEST
Linda Frank Date Performed:
Lot 2 Bent Birch
TEST HOLE # 99-1
Org.- root, mat
SP/SW - clean, sloughing
B.O.H.
SOIL SIMILAR TO TEST
HOLE KND 98-1
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO What depth?
Depth to water after monitoring? N/A Date?
Reading Date Gross Net Depth to Net
Time Time Water Drop
1
2
3
4
5
6
7
8
Percolation Rate (rain/in) Perc Hole Diameter 6'
Test Run Between feet and feet
NO PERCOLATION TEST PERFORMED ! TO VERIFY SOILS ONLY
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and
Municipal guidelines in effect on this date.
Parcel I.D. Cf
MUNIClPALITY'O~: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"
051-171-44' NAA Cf ~=~ I~C;[°~ O-~q~l'~
1. GENERAL INFORMATION
_ Complete legal description
Bent Birch Lot 2 --
Location (site address or directions)
Linda Frank
Property owner
Mailing address
Day phone
Lending agency
Mailin. g address
Agent
Address
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
: : .Community on-site
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
~" ": Publcsewer - ": r : ' '
NOTE: If community wastewater sYStem; provide written confirmation from stale ADEC
attesting to the legality and Sta{us of systern~
STATEMENT OF INSPECTION, BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown ~elow, i verify that my
'nvestigation 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 inspeqtion, the on-site water
supply and/or wastewater disposal system is in C0mpiiance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection,
KND Engineering 696-611 l
Name of Firm
2644-i Pt,and~ai Blvd., Eagi~ Riv~, AK 9.9577 Phone
Address
Engineer's signature
· ' Dat~; 7/28/99
DHHS~SIGNATURE
Approved fo~: '~ bedrooms.
Disapproved: .........
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
Date ~'. (~. (~2~ (~
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 DH HS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Emp oyees of DHHS do not
conduct'ir~specti~n,; 6'r, analyze dana"before a certificate is iSSued The Municipality of Anchorage iS not
responsible' f0r err°~"~; 0~ni~si0ns in the Pr0fasSional engineeCs'work'
Municipality of Anchorage JUL
DEPARTMENT OF HEALTH & HUMAN SERVICES ~UN*C~P^LITY
Environmental Services Division ~NVIRON~ENTAL SE
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Legal Description:
Health Authority Approval Checklist
Bent Birch Lot 2 051-171-44
Parcel I.D.:
A. WELL DATA
Ind.
Well type
Log present (Y/N)
Total depth 105'
Sanitary seal (Y/N)
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
0
Coliform
Date of sample: 7/22/99
SEPTIC/HOLDING TANK DATA
Date installed 5/12/99
Foundation cleanout (Y/N)
N/A
Date of Pumping
IfA, B, or C, attach ADEC letter. ADEC water system numbe~'
5/5/99
· Date completed
Cased to 105' 3.5'
Y y
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
3 ~ g.p.m.
g.p.m.
FROM WELL LOG
5/5/99
50'
Tank size
Y
Nitrate
0.652
Collected by:
Other bacteria
KND Engineering (Dea)
1000 Number of comPartments 2 Cleanouts (Y/N) ¥
N N/A
Depression (Y/N) High water alarm (Y/N) · ~ ~
Pumper
C=
ABSORPTION FIELD DATA
Date installed 5/12/99
Length 32' Width
Effective absorption area 400
Date of adequacy test .. N/A
Soil rating (g.p.d./fF or fF/bdrm) 1.2 gpd/sfsystem type Deep Trench
2' Gravel thickness below pipe 6.3' Total depth 10.95
Monitoring lube present (Y/N) Y Depression over field (Y/N) N
Results (Pass/Fail) P For 3 .bedrooms
Fluid depth in absorption field before test (in.);
Fluid depth N/A (ins) Minutes later: N/A
N
Peroxide treatment (past 12 months) (Y/N)
N/A immediately after N/A gal. water added (in.): N/A
Absorption rate =. N/A
If yes, give date
g.p.d.
72~026 (Rev. 3/96)*
D. LIFT STATION
Date installed
N/A
Size in gallons
Manhole/Access (Y/N)
"Pump on" level at*
"Pump off" level at*
High water alarm level at*
*Datum
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
100'+
Septic/holding tank on lot
100'+
Absorption field on lot
N/A
Public sewer main
lOft+
Sewer/septic service line
On adjacent lots ]00'+
100'+
On adjacent lots
Public sewer manhole/cleanout
Lift station
N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation iff+ Property line ]0'+ Absorption field .
10'+ 100'+
Water main/service line . Surface water/drainage Wells on adjacent Lots
10'+
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Propertyline ~0'+ Building foundation ]0'+
100'+
Sun, ace water
Curtain drain No Known
Water main/service line 10'+
D~iveway, parking/vehicle storage area ~0'+
Wells on adjacent lots ] Off+
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal records that the above systems are
in conformance with MOA HAA guidelines in effect on this date.
Signature
Kenneth M. Duffus, P.E.
Engineer's Name
7/28/99
Date
HM Fee $
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
~%O~sstO'~~' ~
72-026 (Rev. 3/96)*
~UG 07 '~ 02:$0PH HTL ~HCHOR~GE P.1~1
NORTHERN
$~30 INgUSTRIAL AVENUE
§005 $CH00N STREET
PO(iCH 340043
TESTING LABORATORIES, INC.
FAIRBANKS, ALASKA 99701 {g071456-3116 - FAX 456,3125
ANCHORAGE, ALASKA ggS18 (g07) 349-1000. FAX 3a9-1016
PRUOHOE BAY, ALASKA 99734 [907) 659-2145 · FAX 6~9-2,146
DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA
KND Engineering
20441 Ptarmigan Blvd.
Eagle River,
AK 99577-3736
Phone Number: ( )696-61'11
Fax Number: ( )696-8111
Coflected by: Dea
Sample Type; Routine
Method of Analysis: Membrane Filtration (SM 9222
B)
Comments:
Date Received:
Date Analyzed:
Date Reported:
Next Sample Due:
Comments S
U =
POS =
ND =
TNTC =
CG =
HSM =
SA =
8/$/99 Time Received: 16:45
8/6199 Time Analyzed: 14:00
8/7/99 Time Reported: 14:53
Satisfactory
Unsatisfactory
Positive Test Result
None Detected
Too Numerous To Count (>200 Colonies)
Confluent Growth
Heavy Sediment Masking. Results May Not Be Reliable
Sample Age >30 Hours But <48 Hours, Results May
Not Be Reliable
Sample Age >48 Hours, Too Old For Analysis
Resample Required
Old =
R -~
NT = No Test
* # Colonies/100 mi ** # Colonies/mi
Sample Sample Total' Fecal Other* HPC**
Date Time Coliform Coliform Bacteria Result Lab~ Location Comments
8/4/99 21:00 0 NT 0 NT ACl1125 BENT elRCH LOTe2 Satisfactory
Shirr[ L, Trask En ~r~0nmental Analyst
Nmthern Testing Laboratories, Inc Anchorage, AK
8/7/99
JUL-2?-99 ]6:54 FROM-¢TE ENVIRONMENTAL
' Z~_. CT&E £nvironmen,al Service,~ lnc.
5615301
T'244 P.02/03 F-g~3
CT&E Ref,#
Client Name
Projcc~ Namc/~
Client Sample ID
Matrix
Ordered By
PWSID
8ample P. emarks:
993673001
KND Engineering
Ben: Birch LoT 2
Bent Birch LoT 2
Driak/ng Wa[er
0,652
o.~oo n~l/L
A[towabte Prep AnaLysis
EPA 300.0 10 max 07/231~9 07/23/99 SCL
SM18 9225B 07/2~/99 JOT