Loading...
HomeMy WebLinkAboutT&T LT 1 · 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 Permit Number: ,~,9~,/c~O IOfo PIDNumber: Name: ~ II ~'~.S , L~,'L[~',~ Wastewater System: [] New [] Upgrade ^ddress: ¢-O'4qt "¢J¢,.¢¢-~,--'* I~---o~ ABSORPTION FIELD Phone: IN°-°fa_~°'°ms: ~ Deep Trench [~ Shallow Trench [~ Bed iD Mound [Z] Other LEGAL DESCRIPTION SoilRating: I, ~' GPD/Sq. Ft. Total Depth from original grade:'7 I Lot: Block: Subdivision: )epth to pipe bottom from original grade: Gravel depth beneath pipe I T Fh Ft. Township: I Range: I Section: Fill added above original grade: Gravel length: · / -- ,/ 1/'/.- Ft. ,~::~ ~'~ Ft. I I ~ Number of lines: I Distance~be~tweea lines: WELL: New [] Upgrade Gravel width: --~ Ft. I Ft. Classification {Private. A.B,C): Total Depth: Cased To; fotal absorption are~ ~ ~-~ Pipe materiah Date installe : Driller: Date Driged: Static Water Leveh Installer: I Pump Set at: I Casing Height Above Ground; Yield: q'"~ GPM ~' >4,0 Ft~ ¢¢_ ~ pt. TANK SEPARATION DISTANCES ¢('s~,tic , . ' d,o~din, OS.T,E.~. TO Septic Absorption Lift Holding 'ublic/Pdvate Ma~f.ao.t~u~r~[: __ Ca,acity in gallons: From Tank Field Sladon Tank Sewer Lines~..~ v~. ~-¢ ! Material; .,~ ~ Number of C%rtments: S~ao~ LIFT STATION W~t~r t',t~,~ NO~ · Lot Size in gallon~; I ~anufacturer: "Pump on" level at: I "Pump off" le~l at: High water alarm at: Foundation 1 ~ ~,~ CurtainDrain ~N~,l~-- N,~ P"mPM¢k~'M°d~' I~'ectrica''nspe°ti°"~perf°rm~dbv: Remarks: BENCH MARK L°¢ati°n and ©eseripti°% tO-~ Fl, Ef~INEER{S SEAL Department of Health and Human Services approval Date: 7-2/- ?,~ Reviewed and approved by: , ~ 72-013 {Rev. 9/91) MOA 25 i B Well SWING TIES: AC 13.5 FT DC 71 FT AD 23 FT BO 67 FT AE 75 FT BE 37 FF ~5 50 75 $£ALD l' = 50 Fl, Well Well 100 1£5 150 TOBBEN SPURKLAND P.E. II 203 W 15TH. AVENUE II ANCH. AK. 99501 LOT 1 T & T F/ILLIA~ £. COLLINS SEPTIC SYSTEM ASBUILT DATE: JUNE 17, 1994 SHEET: 2/5 GRID: 2640 Si:ondord [renohes: c°' Wide 62,5' Lon2 7' Peep 5' Sewer rock $' Cover ( 1' oddJt:iono/ Pi//) c i:onk 0 ND SCALE Non/ M/ro£/ 140 95.1 ~~ 5 F~ oF ~ept/c Rock ND SCALE //// ///~' ~ LbgL~ -- Insulotlon 95.4 ~ Wder of 84 1500 GaL sepi:ic i:onk BENCH MARK TOP FOUNDAtiON ASSUtdED ELEVAHON: 100.00 /vT TOBBEN SPURKLAND P.E. 205 W15lh Ave Ak 99501 LOT 1 T & T WILLIAM R. COLLINS SEPTIC SYSTEM DESIGN DALE' MAY 17, 1994 SHEET: GRID: 2640 LOCATION OF WELL WATER WELL RECORD UREU FROM=F3casing top E]ground surfaco WELL DEPTH: Depth of hole: ~.~ / ROREHOLE DATA: Depth Depth of casing: ~ / Material Type and Color From To DATE OF COMPLETION DEPT/~H/~'O STATIC WATER LEVEL: ~.7~ ft be~ow ~'t0p of caning E] ground surface METHOD OF DRILLING:/,,~.air rotary [~ cabin tool ~ other USE OF WELL: l~'domostic [] ir¢ioetion [] monitor E] public supply E] other Casing ty~:...~ F ~. to ~ft WELL INTAKE OPENING TYPE: ~ open end ~ s~reened [3 pe~orated ~ open hele Depths of ope~i~0$: to ft SCREEN TYPE: Slot/Mesh Size: GRAVEL PACK TYPE: Volume used: Diam: .... in. Length: , ~t Depth to top: dUN p 0 1994 * MUR PUMPING LEVEL AND:YIELD; ~ ~) ft after ,/ h[~ pumping~gpm INTAKE DEPTH: it Horsepower: WELL DISINFECTED UPON COMPL~ION? ~ YES ~ N0 CONT~C~OR INFORMATION: REMARKS: ~ ',,;~q;s~e[~ ~si~ess Name ~~;},~~ ~._ ~¢ PLEASE MAlL WHITE COPY OF LOG TO:DNR/DiViSiON OF WATER ':',,~, ~'. . It .'¢ ' . PO BOX 772116 EAGLERIVE~ AK 99577-2116 GROUT TYPI;: ~ Volume: Depth: from ft to ft PAGE 1 OF 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940106 DESIGN ENGINEER: K~ OWNER NAME:COLLINS WILLIAM OWNER ADDRESS:il501 HILL CIR DATE ISSUED: 5/02/94 EXPIRATION DATE: 5/02/95 PARCEL ID:01516364 LEGAL DESCRIPTION: T&T LT LOT SIZE: 45236 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / 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 ~ 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 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE ORIGINAL PERMIT WAS SUBMITTED FOR A FOUR BEDROOM DESIGN SYSTEM. ON MAY 17, 1994 THE APPLICANT REQUESTED THAT THE DESIGN BE CHANGED TO FIVE BEDROOMS. THE ORIGINAL PERMIT WAS ISSUED FOR A FOUR BEDROOM SYSTEM MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 DESIGN. THIS WAS REVISED ON 5/17/94 TO A FIVE BEDROOM SYSTEM DESINGWHICH IS APPROVED. ISSUED BY: /.~~~ --' PAGE 2 OF 2 DATE: 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 WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940106ENGiNEERiNG ~ ~ DESIGN ENGINEER:~ ~.~,~/ OWNER NAME:COLLINS WILLIAM R & OWNER ADDRESS:20441 PTARMIGAN ROAD EAGLE RIVER, AK 99577-8736 DATE ISSUED: 5/02/94 EXPIRATION DATE: 5/02/95 PARCEL ID:01516364 LEGA~ DESCRIPTION: T&T LT 1 LOT SIZE: 45236 (SQ. FT.) NUMBER OF BEDROOMS: ~ THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / 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 (18AAC?2) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS' · A sLOpE OF 25~ OR GREATER. ENTRY INTO THE DRAINFIELD FROM THE SEPTIC TANK MUST BE AT THE MIDPOINT OF THE DRAINFIELD~ RECEIVED BY: ISSUED BY: DATE: ~//"~Z'7/~" y DATE: ~4;~~ T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, AlaDka 99501 Subject: Permit SW 940106 Lot 1 T & T S/D Gentlemen; May 17, RECEIVED MAY 1 8 1994 D MunicipaJity of Anchorage ept, Health & Human Services 1994 I have been requested by Mr. William R. Collins to revise the septic system design for which the referenced permit was ob- tained. The attached documented shows/th~ location of the installed well and a proposed location for ~droom septic system. T.SPURKLAND P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 1 T & T S/D WILLIAM R. COLLINS Ground Water at 12 ft. Use Standard Trench Soil Rating. From test 5/9/94 <1 min/in = gal/min Receiving soil is 65% sand Required Area per Bedroom: 150/1.2 = 125 Finish Floor Elev. 113.5 Ground Surface at Absorption Field 109 Testhole Total Depth 13 Less 6 feet 7 Rock Depth 5 Additional fill , 1.5. ~' ~ sq.ft. Number. of.Bedr~omS: : :~ ' Length of Trench 62.5 SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 62.5 FT. TOTAL WIDTH 2 FT. TOTAL DEPTH 7 FT. ROCK DEPTH 5 FT. COVER 3 FT. SEPTIC TANK 1500 GAL. The installation of this well and septic system will not impact adjacent lots. The well location conforms to the siting of the existing wells in the area, and will not prevent the adjacent lot owners from developing these lots or replacing the existing septic systems. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Pending and/or concentration of surface runoff will not result from this installation. 1 Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED POR: Uotli~,,~ LEGA'DESCR,PT'ON: kO"L) ~--~-- 5 6 7 8 9 10 11 12 13 14- 15- 16- 17- 18- 19- 20- DATE PERFORME[ Township, Range, Section: WAS GROUND WATER ENCOUNTERED? DEPTH? Monitoring? ~-~' ~ gate' SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~, J (minutes/inch) PERC HOLE DIAMETER __ COMMENTS TEST RUN BETWEEN __ FT AND FT PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE- DATE: /~/~,~ /7< /'~ ~ Y' 72-008 (Rev, 4/85) ~ ~elll CLASS.,~'4 $0 0 ! ! LOT 1 LOT 4 50 100 150 ~00 c~50 SCALE: 1~ = i00 Fl,, LITT £ LOT 3 J J SEPTIC SYSTEM DESIGN DATE: NAY 7, 1994 SHEET: 1/$ GRID: 2640 TOBBEN SPURKLAND P.E. LOT 1 T & T 205 W 15TH. AVENUE ANCH. AK. 99501 WILLIA~I R COLLINS 07, 7 R'FPL ACEMENT TP, ENCH P£IMA£Y T£ENCH ~o[e FF £= 3% 113, 5~ ~)- ~'ell 104 £5 0 £5 I® SC~LE: F' 50 FL 100 1~5 lifo Well TOBBEN SPURKLAND P.E. II II 205 W 15TH. AVENUE ANCH. AK, 99501 (907) 279-~91 § LOT~ Tk T S/D WILLIASf R. COLLINS I SEPTIC SYSTEM DESIGN DATE: ~IAY 7, 1994 SHEET: 2/$ GRID: 26,¢0 S/;ondord Trenchey ~' ~/ide 6~.5' Lon9 7' Deep 5' Sewer rock 3' Cover ( 1' oddlt/ono! £111) ND SCALE Mir'oFi i40 Cleonouts / Noni~o~  4 ~ ?opsoll 4' Co vem NL7 SCALE 1500 9ol Sep/;/c /;onk 4' h/in Cover over Tonk Ex/s/;, Ground 1~00 9ol, septic tank T SEPTIC SYSTEM DESIGN DATE: MA)' 17, 1994 SHEET: G£1D: 2640 rOBBEN SPURK;Am P.E. LOT 1 T g 203 W151h Ave Ak 99501 WILLIAM R. COLLINS PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH A1XrD HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940106 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:COLLINS WILLIAM R & OWNER ADDRESS:20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 DATE ISSUED: 5/02/94 EXPIRATION DATE: 5/02/95 PARCEL ID:0151636~ LEGAL DESCRIPTION: LT 1 LOT SIZE: 45236 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS THIS PERMIT IS FOR THE CONTRUCTION DISPOSAL FIELD /SEPTIC TANK / WELL ALL CONSTRUCTION MUST BE IN 1. THE ATTACHED APPROVED DESIGN 2. ALL REQUIREMENTS SPECIFIED 15.55 AND 15.65 A_ND THE REGULATIONS (18AAC72) AND 3. THE ENGINEER MUST NOTIFY D PRIOR TO EACH INSPECTION. CALLING 343-4744 OR 343 4. FROM OCTOBER 15 TO APRIL ABSORPTION SYSTEM UNDER WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON B. COVERED, SEALED AND 5. THE FOLLOWING SPECIAL ANCHORAGE OF ALASKA kINKING WATER AT LEAST 2 HOURS PROVIDE NOTIFICATION BY ~681 AFTER BUSINESS HOURS .5 A SUBSURFACE SOIL DURING FREEZING CODE CHAPTERS DISPOSAL (18AAC80). SAME DAY EATED TO PREVENT FREEZING SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: · 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)694-2359~FAX (907)696-8111 April 20, 1994 On-Site Services DHHS 825 L Street Anchorage, AK 99501 Dear Sirs: REF: Lot 1, T&T Subdivision Attached is our request for an on-site well and sewer permit for the above lot. As shown on the site plan, there are no conflicts with existing on-site well, sewer systems or with potential reserve areas. In addition, there are no public wells within 200' of the property. This lot is generally flat north to south with a 5%- 6% slope running east to west. There is adequate area directly east and west of the test hole location on the lot to install both an original and a replacement system. The natural slope will provide positive drainage away from the proposed installation site. There is no surface water within 100 feet of any portion of the proposed installation. We are initially anticipating the use of a lift station in conjunction with the absorption system based on the preliminary foundation location, however we will be able to complete a final determination upon the finished foundation elevation being established. We performed a soils test in the proposed absorption area, and conducted two percolation tests on this property. In addition, excavation was made west of the proposed absorption system and found the soils to be consistent. The design we are submitting is based on the worst case soil percolation test. Thank you for your consideration of this request. If there are any questions, please call me at 694-2359 or leave a message. Sincerely, Ke~meth M Du'f~~ KND Engineering Attachments: On-Site Well and Sewer Application Wastewater Absorption System Details Site Plan Soils Log/Percolation Test s i G N DETAILS k./ WASTEWATER ABSORPTION SYSTEM LIST 1 T & T SUDDI¥ISIBN Ld n CLEANDUTS <TYP) 13RIGINAL ?, FINISHED GRADE UNCLASSIFIED FILL (FRI]H TRENCH EX) FILTER FABRIC SEWER ROCK 54' TRENCH (TYP) I I CALCULATIONS FOR HOLE SPACING, 1. RESIDUAL HEAD = 5' 2, 174~ HOLE - 1,77 GAL @ 30 PSI 3. 30 GALS (PUNP DELIVERY) / 1,77 GALS PER HOLE = 17 HOLES 4. 50 LF DISTRIBUTION LATERAL - 3,1~' SPACING ADSURPTII]N SYSTEM SIZE CALCULATIBNS~ SOILS RATING = 0,8 GPD/SF 4 BEDROOM = 600 GPO 600 GPO ~ 0,8 GPD/SF = 750 SF TRENCH AREA FROM SBILS TEST, DBTTOM BF TRENCH ~ 10.5= 7' TRENCH 750 SF ~ (2)(7') = 54 ' MIN TRENCH USE I 54 'L x 7'D x 3'\4 TRENCH FOR 54' LENGTH PREPARES FOR~ SAM NEWBY 88al RAGGED TDP CIR ANCHHRAGE, AK, 99508 KND Engineering 20441 Ptarmigan Blvd. Eagle River, AK 99577 NOT TO SCALE 4-S2-0408 S]'TE PLAN WASTEWATER ABSBRPTIBN SYSTEM LOT 1 T & SUB 8 SEPTIC WELL UNDEVELOPED SEPTIC HOUSE TANK EST HDLE RADIUS AREA WELL 3 SEPTIC LOT SIZE: 32,148 SF LESS: PERIMETER 6,962 SF HDUSE FBOTPRINT AND DRIVEWAY 7,120 SF TBTAL AREA AVAILABLE FDR A9SBRPTIDN SYSTEM 18,066 SF PREPARED FBR~ SAM NEWBY 88al RAGBED TBP CIR ANCHBRAGE, AK, 99508 KND Engineering 20441 Ptarmigan Blvd. Eagle River, AK 99577 DATE, 4-t 94 tD~AVING fl SCALE, 1' : 100' q-51-0402 PERFORMED FOR: LEGAL DESCRIPTION: Municipality ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Sam Newby Lot l, T&T Subd. 1 2 3 4 7 8 9 10 11 12 13 14 15 16- 17- 18- 19- 20- COMMENTS Sheet 1/3 SLOPE SITE PLAN WASGROUND WATER NO ENCOUNTERED? S IF YES, AT WHAT ~ DEPTH? p E 3/16/94 Oepth to W~ter Af~ ne Oate ~ Monitoring7 : Reading Date Gross Net Depth to Net Time Time Water Drop 0 3/8 12:30 - 3 7/8 1 12:35 5' 4 I/N" 2 12:40 ~' 4 I/~ ~/~'~ 3 12:45 5' 4 b/lb 3/Ib" 4 12:50 ~, z~ $/~ 7/'1 b" 5 12:55 ~5' '3 ]/4 b/lb" 6 13:00 5' $ Ib/I m/8" 7 13:05 5' 4 3/8" 7/16" 8 13:10 5' 4 5/16 9/16" 9 13:15 5' 5 5/16' 6/16" Hole Pre-soaked~ ~rior to testing * Added water PERCOLATION RATE 1 ~ (minutes/inch) PERC HOLE DIAMETER ~ in: No correction made TEST RUN BETWEEN 4 FTAND. 5 FT / \# PERFORMED BY: ~M['i i r~//'-~. ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFEC THIS DATE. DATE: 4.,[ ?~,/qZ[ 72-008 (Rev. 4/85) PERFORMED FOR: LEGAL DESCRIPTION: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Sam Newbv Lot l, T&T Subd. 4- 5- 6- 7 8 9- 10- 11 12 13-- 14- 15 16 17 18 19 2O COMMENTS Sheet 2/3 WASGROUND WATER ENCOUNTERED? NO SLOPE SITE PLAN IF YES, AT WHAT DEPTH? p~ 3/16/94 Depth to Water ~ Oato:~ Monitoring;) ..vne pre-soaked )nor 1;o res;lng 8" PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ Gross Net Depth to Net Reading Date Time Time Water Drop 3/8 13:18 2 7/2 - 10 13:20 2 2 15/16 1/16 13- 13:2b b 3 b/16 3/8 12 13:30 5 3 3/8 //lb 13 13:35 b 4 3/lb //lb 4/20 14:00 mu l/u -- 1 14:0b b IU I/2 3/u 2 14:mu b IU bls 4/8 3 14:15 5 10 7/8 2/8 TESTRUNBETWEEN ... 3 1/~TAND 4 1/bT Perculation rate higher on 4/20/94 Verified results of 3/8/94 testing on 4/20/94. possibly due to better ground conditions. Des.ign based on lower Perc. rate. Stopped . ,:i. : verifiaction test after 30 min. as it exceeded, 3/u/gg testing. ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN E HIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: Sam Newbv LEGAL DESCRIPTION: Lot l, T&T Subd. Township, Range, Section: N~ ]/4, S24, T12N, R3W 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 19- 20- COMMENTS Sheet 3/3 WAS GROUND WATER ENCOUNTERED? NO S L IF YES, AT WHAT O DEPTH? p 3/16/94 E neplh [o Water After 3/31 / 94 Monitoring? None Oale: 4/_PR/QA SLOPE SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop 4 4/20 14:20 5 11 4/8 5 14:25 5 ll 1/2 Z~/8 6 14:30 5 11 1/2 4/8 ....... Znd of Tes :ing .......... PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN __ FT AND Continuation of 4/20/94 verification test. FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72+008 (Rev, 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: 4/20/94 PERFORMED FOR: LEGAL DESCRIPTION: ~ ~ I 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19- Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 20- Township, Range, Section: WASGROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SLOPE SITE PLAN Depth to Water Alter~ ~?/,~ Monitoring? ~ Oate: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER -- TEST RUN BETWEEN __ FT AND FT COMMENTS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THiS TEST WAS PERFORMED IN DATE: ' MUN C PAL TY OF ANCHORAGE DEPARTMENT OF HEALTH & ~. Division of Environmental Serv ces .... . . On-Site Services Section P;O.'90~ :196650 Anchor'age,'Alaska, ."9951g;6650 343-4744 ' CERTIFICATE OF HEALTH AUTHORITY ' APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION '" Complete leg~.l'description Location (site address or directions) It .~O I '-'Fl ILL r ' C I ~ , -- ' Lending agency "": Mailin{~ ~address Anent : ' ' - · -' Address 'Property owner ' ' ~,-~;I,~ ~ ~_o Lie ~" Day phone Uailingaddress ; ~.'2-o~q~ '~-~.-~.~/~,..~.'~-._ ' ' Day phone r ' ' ~ : : :DaY'phone '.' :,: Unless otherwise requested, HAA will be held for pickup ': .;'" ~" ~ :-: :~:? ~ "'i'i ~:;-:'-."- ? .~" - 2. NUMBER OF BEDROOMS: ATER :-~-:: :": .... ' Individual well - . .................... .............. - well Oommunity . . . Public water ...... NOTE: If community well system, provide written confi~r~ation from State ADEC attest-.- ing to the legality and status of system. · 4. TYPE OF WAS · .:.:NOTE:. If community ., -.".? attesting 72-020(Rev. 1/91) Front MO^#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 -~-'-,~b-~-,'~ ~ ~~,~ "~- t~- Phone ~ - ~ ~ 1 ~ Address ~o% ~/~- M '~o > EngineeCs signature ~ ~ Date ~/~ I iq ~ / ' 6. DHHS SIGNATURE ~ Approved for M bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments /C- By: r .~,.~,/';; ,- Date The Munioi~ali~ of Anchorage Depadment of Health and Human Se~ic~ (DHHS) i~ues Health Authori~ Approval CeAificat~'bas~ only upon the representations given tn paragraph 5 above by an independent profe~ional eng'i~r registered in the State of Alaska. The DHHS does this as a cou~esy to purch~e~ of homes and their lending institutions in orderto ~tis~ ceAain federal and state requirements. ~mploy~ of DHHS do not conduct inspections or anat~e data before a ceAificate is i~ued. The Municipali~ of Anchorage is not responsible for erro~ or omi~ions in the prof~ional engin~fs work.' Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L., -~ ~ - {" ~,"~-- ~ I J~ Parcel I.D. A. Well Data Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level1 -./ Cased to / If A, B, or C, attach ADEC letter. ADEC water system number G I Casing height ~ / Wires properly protected (Y/N) ~-/ / FROM WELL LOG AT INSPECTION H 'D g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line g.p.mrl-I o ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: ' Coliform ~ Nitrate (~. ¢_~ / Other bacteria Date of sample:/ 8/]~/~ Collected by: 9¢L4,v~ ~ --c,z.4 )- ~ ~ B. SEPTIC/HOLDING TANK DATA Date installed ~/i o I ~ ~ Tank size I ~ ~ Compartments Cleanouts (Y/N) '7/ Foundation cleanout (Y/N) y Depression (Y/N) High water alarm (Y/N) ~('///--~ Alarm tested (Y/N) '~'///"~- Date of pumping J~//:~ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot J 0 ;.~ To property line ~ Surface water/drainage On adjacent lots ~ [0--~ Foundation Absorption field --~ Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed (¢ [, u / '~.~,./ Soil rating (GPD/Ft2) I, ~__ Length ~, .~ Width .~ Gravel thickness ~ System type Total depth Total absorption area ~ ~c~ Cleanout present (Y/N) Date of adequacy test t"/J.z~ Results (pass/fail) Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Depression over field (Y/N) for ~ After test If yes, give date Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water _ ~'~ Curtain drain On adjacent lots -~ /1_ ~ Property line To existing or abandoned system on lot Cutbank ~ D Water main/service line Driveway, parking/vehicle storage area E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guMelines in effect on the date of this inspection. Date ~1%l lq ~ HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number NORTHERN 3330 INDUSTRIAL AVENUE 2505 FAIRBANKS STREET TESTING LABORATORIES, INC. FAIRBANKS, ALASKA 99701 (907) 456 3116 · FAX 456-3125 ANCHORAGE, ALASKA 99503 (907) 277-8378 · FAX 274~645 Newby Construction 8321 Ragged Top Anchorage Ak 99504 Report Date: 08/24/94 Date Arrived: 08/19/94 Date Sampled: 08/19/94 Time Sampled: 1000 Collected By: Attn: Our Lab #: A133093 Location/Project: Lot 1 T&T Sbdvo Your Sample ID: 11501 Hill Circle Sample Matrix: Water Comments: Lab Number Method Parameter * Definitions * B = Below Regulatory Min. H = Above Regulatory Max. E = Estimated Value M = Matrix Interference D = Lost to Dilution MDL = Method Detection Limit Date Date Units Result * MDL Prepared Analyzed A133093 EPA 353.3 Nitrate-N mg/1 0.81 0.10 08/22/94 ~ j RepOrted By: Anth ~j~ . Chemistry Supervisor Lange