HomeMy WebLinkAboutSUNDI LAKE BLK 1 LT 3
Municipality of Anchorage Page I of
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: ~z ~.~. ~ ~{~.~ PID Number: ~ ~l- 1~ - l~
Name:
~A~ ~OUI ~ ~o~ Wastewater System: ~New D Upgrade
Address:
tfft~ TA~t4EE~H~ ~ ABSORPTION FIELD
Phone: ~-- ~, ~ ~No. of~ooms: ~Deep Trench ~Shallow Trench ~ Bed ~ Mound ~Other
Total Depth from original grade:
LEGAL DESCRIPTION Soil Rating: I GPD/Sq. Ft.
Lot: ~ BIock:~ S~Subdivisi°n:~ Depth to pipe bottom from 0riginal~ grade:~Ft, Gravel depth beneath pipe ~ Ft.
WELL: D New D Upgrade Gravel~: ~ ~ Ft. Numberlof lines: J Distanc~ between lines:Ft.
Classification (Pri, vate. A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:
Date Drill d: Static Water Level: Installer: Date installed:
Yield: ~ Pump Set at: Casing Height Above Ground:
I0~ GPM ~ Ft.J ~'~,. TANK
SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P.
To Septic Absorption Li~ Holding Public/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~. T~
Well ~ I ~ J ~ Material: ~ ~ Number of Comps~ments:
Sudace ~ ~ ~
Water 13o- I~o~ LIFT STATION
Lot Size in gallons:~ Manufacturer:
Line
Foundation ~ ~ ~ ~ ~/~ "Pump on" level at: J "Pump off" ~evel at: High water a~arm at:
Cu~ainDrain ~ ~ =ump Ma~e & Model ~ Electrical Inspections pe~ormed by:
Remarks: BENCH MARK
Location a d Descdptiom
Inspections performed by: ~ Dates: 1st "/~(R~ : )' '
Department of ~.~ Hu~e~vice, appro,al . ~ ~
Reviewed and approved Date 7 ~L
TBM BDTTDM SIDING
ASSUMED ELEV,
100.00
16
29, 5
YACANT
LOT £
\
\
SCALE: 1' = $0 FT,
TOBBEN SPURKLAND P,E,
· Moni'tor
Clean Our:
38
4-INCH ~E£F
Standord Trench~
38' LONG TOTAL
12' DEEP
7' DF SEWER ROCK
1000 GAL
NO SCALE
M/mo £i 140
6 £ee~ o£ Septic Rock
.... / £1eonouf;~ ---~
/ ' O0 ~ool Sepg/c Tonk J
80,
BOTTOM OF TESTHOLE
TDBBEN SPURKLAND P,E,
203 W15TH, AVENUE
ANCH, AK, 99501
LUT 3 SUNDI LAKE S/Z9
SECTION 10 TI~N £41d
LOUIS MASS
9^T£, MA?CH 19, 1993
SHEET, 3/3 GRID, 2224
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE 1 OF
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW920365
DESIGN ENGINEER:TOBBEN SPURKLAND, P.E.
OWNER NAME:MASS LOUIS JOHN III
OWNER ADDRESS:1911 TALKEETNA STREET
ANCHORAGE, ALASKA 99508
DATE ISSUED:10/23/92
EXPIRATION DATE:10/23/93
PARCEL ID:01113103
LEGAL DESCRIPTION: SUNDI LAKE BLK 1 LT 3
1
LOT SIZE: 20100 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD / WELL 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 (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
DATE:
DATE:
20~ ~ lS~h. ~w~e~ Sui[~ 20B
ANCHOR~GE, ALASKA 9950!
(907) 279-3916
SEPTIC SYSTEM DESIGN
LOT 3 SUNI) I LAKE
LOUIS MASS
No Ground Water- or Impervious Layer to 16
Use Standard Trench
Soil. Rating.
Frem test Sept. 28~ 1992
>1 rain/in = Filter Sand Required
See attached sieve analysis
In Situ Soil Satisfy ~ilt. er
sand r'equir'ement.
Required Area per Bedroom:
150/1'Z' = 150 sq.~t..
Finished Floor" Elevation Lowest Floor
Gr'ound L-]urface at Absorption Field
90.00
88-90
Testhole Total Depth
l_ess 6 .Feet
Less 4 ~eet Cover
Rock Depth
16
10
6
6
NLUnber o.F Bedrooms 3
l.ength o.F Trench 3 × J50 /
SYSTE~I CONFIGURATION
12 = 37.5
STANDARD TRENCH
TOTAL LENGTH 58 FT.
TOTAL WIDTH 2 FT.
TOTAL DEPTH 10 FT.
ROCK DEPTH & FT.
COVER 4 FT.
SEPTIC TANK 1000 SAL.
Septic System Design
l...ot 3 Sundi Lake S/D
In~ installation o-~ this septic system will not' prevent wel
'~rom be ~nstalled on the adjacen't lots,,
The proposed septic system wi.].][ not change the general slope
t. he area. Fond.~.ng and/or concen'tration o~ surface runo~ will n
~"esult ~l"(3m this installation,
The insitu poorly graded sand (SP) contains a gravel ~r'acti
that shiYts T~h~ gradation curve to the le~t. Deleting the grav
~raction giw~s the ~ollowing gradation ~or t~he sand.
.~eve ~ % Passing Y. Passing
Requi rement
:ti} 86 85- 100
2 } 60 60 - 90
60 10 0- :[5
20" 0 0 - 5
This ma'terial mee'ts the :i. ntent, ion of 15. 65. 060, D
Septic Sy.~'tem Design
L..c~t '~ I~ -
· -:, ~,uncb. Lake S/D
TDBBEN SPURKLAND P,E,
203 W 15TH. AVENUE
ANCH, AK, 99501
LOT £ ~
N
50 100 1~0 £00
SCI}LE~ 1' = 100 FT.
£50 300
LOf 3 SUNDI LAKE S/.~
SE~,, I0 FI2N R41V
LOU1S ttA$S
SEPTIC SYSTEN DESIGN
BATD L1£[, 13, 1992
SHEET, 1/3 GRID £££4
LBI' 4
LOT 3~
RE~L~£EMENT'~RENL~
/ \
pROP' ~NEgAY
pRgp~SF.D RR~$vACANT
LOT £
SCALD 1' = $0 FT,
TBBBEN SPURKLAND P.E.
803 ~/ 15TH. AVENUE
ANCH, AK, 99501
LDT 3 SUNDI LAKE $/D
SEC, lO TIBN R41,/
LOUIS MASS
SEPTIC SYSTEM DESIGN
DATE: OCT, l,~, 19~2
SHEET, ~/'~ GRID, 2224
Monitor
d-INCH PENF
Oeen
Clean ~lut
1000 GAL TANK
Standard TPench;
38' LONG TOTAL
10' BEEP
6' DF SE~/EN R£CK
NO SCALE
Mira£i 140
6 feet o£ Septic Rock
C{eonout5
nltor
JO00 ~al SepSIc Tank
- Ex/sS, Ground
~ 4 £t Co,vet
ll. over Tank
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORMED: ~:~/'~,~l ~ ~--
LEGAL DESCRIPTION: L~C~,
1
2
3
4
5
6
7
8
9
10-
11
13-
14-
15-
16
17
18
19
2O
Township, Range, Section:
st 1¥
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT IS
DEPTH? pO
Monitoring? ~ Date:
SLOPE SITE PLAN
Cross Net Depth to Net
Reading Date
Time Time Water Drop
COMMENTS
PERFORMED BY:
ACCORDANCE WITH ALL STATE AND MUNICIPAL GuIpELINES IN EFFECT ON THIS DATE.
72-008 ~Rev. 4/85)
PERCOLATION RATE "~ (minutes/inch) P~RC HOLE DIAMETER __
TEST~RUNBETWE~N ,.~ , FTAND ~,~ FT
Well Owner
M-W DRILLING, Inc.
P.O, Sox 110375 · 10330 Old Seward Highway
(907) 349-9535
ANCHORAG E, ALASKA 99511
Lou Mass
DRILLING
37-186
O/i - t
Use of Well Domestic
Location (address of: Township, Range, Section, if known; or distance main road
Lot3 Block 1 Sundi Lake Subdivision
Size of casing 6"
Static water leve]
Depth of Hole 99 ~ feet Cased to 99 ' feet
65' ft. ~..o~)i' [below) land surface. Finish of well (check one)
Screen ( ); Perforated ( .- ).
Describe screen or perforation ·
Well pumping test at, lO...gallohs pei (~)
of drawdown from static level.
Date of completion
Depth in feet from
ground surface
(X,~,.);
open end "'"
(minute) for 1 hours with 100,%
O TO. 2
2 .TO_ 3
__ TO 97
97 TO 99 .
__~O
_TO
,,_TO.
TO-
ft.
__TO
TO.
TO_--
..TO
TO.
NWWA Certified Contractor
1 --CUSTOMER
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
~, '~ --' t 0---~ NAA# ~ ~-~C:~ ~ ~'~ I. ,~'L'~
1. GENERAL INFORMATION
Complete legal description ~,~ 2~ ~ V-,.'~
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Day phone
Day phone
Agent
Day phone
Address
Un/ess otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
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 (Rev. 1/91) Front MOA#21
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 I o'~Jo.¢_~l ~'¢~,/J,-~-'~.~ Phone
Address ,~,O~ ~ I 5' ~
Engineer's signature ~ ~1/ Date
DHHS SIGNATURE
~ Approved for
/
Disapproved.
bedrooms.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
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. Em ployees of DH HS 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 engineeCs work.
724)25 (Rev. 1/91) Back MOA/Y21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L~)/~.{ ~ 'L¢.~- ParcelI.D. OII-
A. WELL DATA
Well type '~
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
If A, B, or C. attach ADEC letter. ADEC water system number
Y Date completed ~/'¢'-V/~P' Driller
C~ ~ Cased to (~ Casing height
Y
Wires properly protected (Y/N)
Y
FROM WELL LOG
Date of test
Static water level ~' '-~
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot I t~:~
Absorption field on lot t Dj~
Public sewer main h4fA
Sewer service line ~ /u-~
AT INSPECTION
g.p.m.
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ¢
Date of sample: g/l//¢
Nitrate
Collected by:
Other bacteria'
B. SEPTIC/HOLDING TANK DATA
Date installed
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping
Tank size 1, ~ Compartments
Foundation cleanout (Y/N) '"/ Depression (Y/N)
r',//,,~ Alarm tested (Y/N)
'. /%///',z~ Pumper "
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot I ! O
To property line ! 7;)
Surface water/drainage
On adjacent lots '~ / t.'-z~ Foundation
Absorption field 10 Water main/service line
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Manufacturer
Size in gallons
Vent (Y/N)
"Pump on" level at
Manhole/Access (Y/N)
"Pump of'f" le~/el at
High water alarm level
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 t¢ ~
Length "~ (~ Width
Soil rating l ~t~¢'~
Gravel thickness
System type
'7' '¢' Total depth 1.2,
Total absorption area /4 6 ~
Depression over field (Y/N) ~
Results (pass/fail) ~
Peroxide treatment (past 12 months) (Y/N)
Cleanouts present (Y/N)
Date of adequacy test
for
r,./o
bedrooms
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot 'J C0 &"
To building foundation
On adjacent lots ~>
On adjacent lots "~ / ~ Propertyline
To existing or abandoned system on lot
Cutbank t~///Fk, 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 rffect, oo .t,ho~date of this inspection.
Sionaturo t~ ........ · · '.
Engineer's Name I o ~ ~pu~~ ~'-- ~"~ ...... '~ ';
HAA Fee $ //'~
Date of Payment
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
72-028 (Rev. 3191) Back MOA 21
203 UESI 1§TH, ~VENUE SUITE 206
ANCHORAGE, ALASK~ 99502-~90~
(907) 279-5716
rFFIVEI)
LEGAL:
RESIDENTIAL WELL INSPECTION
L. ot 3 B].c)ck 1 St..u-ldi L.ake
MAR b 0 199;
~ ~ ~,i A Jch0rage
Dept, d~a~h & Human Services
LOCATION:
8325 Sundi Drive
OWNER: L.euis Mass
TYPE OF WELL: Private~ Single F:'am:Lly
WELL LOG AVAILABLE:
INSTALLATION REQUIREMENTS MET:Yee
WELL YIELD FROM WELL LOG:
10-12 Gal, lc)ns per Minute
PUMP YIELD FROM TEST:
'7 GalIons per' Mir'lL~te
DATE OF INSPECTION: March 28,~ :1.993
TEST PROCEDURE: Well was pL*rlq:~ed at a ceristarr~, rate wh:Lle the
16 ...... ~. was '~oLtrn~ at 60
pr'c)be. At the beg:i, nning of the t. est war. er :~,,,=','
fee't: be:Lew top o'F casing. At a pumping rate e-F 7 gallons per
minut, e the wa'L:er' ]Lew~:.Z dropped te 68 feet after :L5 m:Lnutes o.F
DLUflping at-'r(:J refnair]ecJ a~: theft, level ¢ar' t.J]e CJLU",~'~.i(]f] 0'[; the res(:.
a te'[~al (::)f 090 (]tall(]l']t~ were pL.u~p0l, d iR a time period o~: 2 heLtr~.
aflcJ 4~ hl:LI]Ll~]es,, The well recovered '~.o 60 feet wi'(:hJ.¢] 5 foifilL.ttet~.
TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested *Cor E.CoIi
and tetai nitregen on March 12~ 1993
E.Coli 0,, Total N:i. troqen Nene De't:.ec'~ed rog/1.
blax. allowable ]"otal Nitrogen 10 rog/}..
TEST RESULTS: This well meets the requir'ements o~ the
Muni(::ipality o'¢' Anchorage,,
THIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE FOR MORE
THAN FOUR HOURS
The I'lunic:i.F)al requ:i, rement -For' well 'Flew is ItS] gall. erie o'f wa'[:et"
per bedroom per day,, 'l"h:Ls ~e:tl 6=~xceed this requirement. The
assessment o'~ the c::er]di'klien ef the wel i appl les c~nly i:o the
c:onditic~ns as of the day tested,, The flow r'ate may change dL.t¢~ to
ar'icj (:hanges :i.n 'L'.he ].and use and other- factors that may irfl[ga(]t the
aquifer feedin(:~l the well..
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
Chemlab Nef.~ :93.0998-1
Client Sample ID :L3 E1 SUNDI LAKE
Matrix : WATER
Client Name :TOEEE~ SPU~KLAND, P.E.
Ordered Ny :TOEBEN SPUBKLAND
Project ~ame :
Projectt :
PWSID :UA
RBPORT of ANALYSIS
Collected :03/11/93 0 17:10 hrs.
Received :03/12/93 @ 08:35 hrs.
WORK Order :63978
Report Completed :03/12/93
Technical Dizecto[ jSTE[HE~_C. EDE .
Released By =~3~~F----~
Sample
Remarks:
ROU~INB SAMPLE COLLECTED BY: T.S.
QC Allowable Extract Analysis
Parameter Results Qual. Units Method Limits Date Date Init
NITBATE-N 0.1 U ~g/1 EPA 353.2/300.0 10 03/12/93 MCB
See Special Instructions Above UA = Unavailable
See Sample Remarks Above NA = Not Analyzed
Undetected, Repo~ted value is the practical quantification limit. LT = Less Than
Secondary dilution. GT = Greater Than
I1~,~ SGS Member of the SGS Group (Soci~t~ G~n~rale de Surveillance)