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HomeMy WebLinkAboutSKYLINE VIEW BLK 1 LT 22 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: ~u~E:J°°°t~ PID Number: O~ I lq ~. %5 Name:~A~ ~ ~ Wastewater System: ~New ~ Upgrade *d~re,,~ ~ ~,W%~. ABSORPTION FIELD Phone: ~Lt- O~O~ No. of Bedrooms: ~ O DeepTrench ~ShallowT~ench D Bed 0 Mound ~ Other LEGAL DESCRIPTION soi~ Rating: Total Depth from original grade: J , ~ GPD/Sq. Fi. Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe Lot: ~ Block: [ 5K~E{~ VIE~ ~ ' Ft. ~ / Ft. Township: Range:.~ ~ Section: =ill addedo,~aboveo,~origin~l grade: Ft. ~ Gravel length: ~/ Ft~ I WELL: ~New ~ Upgrade Gravel width: ~ I Number of lines:[ Dislance between Ib,~:. ' Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption are~: ~ Pipe material: ~%~ ~ t ~T~ ~ Ft. ~' Ft. ~'~ ~ '~- SQ. Ft. Driller: Date Drilled: StaticWater Levek Installer: Date installed: Yield: Pump Set at: Casing Heigh, Above 2~und: TAN K ~ a.M ~%' F~. [~ Ft. SEPARATION DISTANCES ~s~p~ic ~ Ho~din~ ~ S.T.E.~. TO Septic Absorption Lift Holding ~ublic/PrivAte Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~ N 0 ~ ~ I~ Material: Number of Compartments: Well- ~OH~ I01~ ~ ¢ ~e ~L Surface '.p ' -- LIFT STATION Water ~ OD I Do ¢ '~ ~ . LineL°t ~% ~ ~ ~ ~ ~ ~ Size in gallons: Manufacturer:~ , ¢ ~ "Pump on" level at: ~ "p~I ~t: High water alarm at: Foundation ~--.~O g~ t~~ . ~[El~.i~l~cti~sperformedby: Curtain Drain Remarks: BENCH MARK Location and Description: Assumed Elevation: ENGINEER'S SEAL ~ -~/ ~ '..'~ Inspections performed b~:~.o34 E~¢e m... L~. ,o.d. Ne. a~tes: 1st G- 9 o-~¢ i [~*¢-~'~ ...... Eagle River, Alaska 99S77 2nd ~ - D 1 - q% ~,~ .......... ['~.~ ROBERf C. COWAN Department of Health and Human Services approval ~,%~_ ...v?, Beviewed and a~proved by: Dato: ~/~-' ~>~ -,~ 79-013 (Rev, 9/91 ) MOA 25 Permit No. sw950095 Page 2 of Municipality of Anchorage 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 LOT 22, BLOCK 1, SKYLINE VIEW S/D Legal Description: 05119255 PID No.: ST2 FINAL GR.~DE MT1 C04 FINAL ~RADE NEW 1000 GAL SEPTIC 95.2' TANK 92~0 · NO WATER:.: FOUND WELL LOT 22 ................... ~'"'"'"~"'"'f60'O"~'X~~ ............................................... _~:' SEPTIC TAiN 72-013 A (1/g3) * . 04 I~NEV? TREI I J C05 Ai B FCO 2612' ST1 55'~ 14' . ST.2...5~.~. .19.~. C01 40! 23' 002 41 ! 25' 003 43' 28' 004 29' 41' MT1 30! 35' ~eC~ O 0 O 0 © 0 0 0 0 : o 0 '44 o 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:SW950093 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:IZAAK WALTON LEAGUE OF AMERICA OWNER ADDRESS: P.O. BOX 670650 CHUGIAK, AK 99567 DATE ISSUED: 5/25/95 EXPIRATION DATE: 5/25/96 PARCEL ID:05119233 LEGAL DESCRIPTION: SKYLINE VIEW BLK 1 LT 22 LOT SIZE: 15750 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 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 (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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. DATE: ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. May 19, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTFI AUTHORITY APPROVALS SDNER & WATER MAIN iD(TENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW T EST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYST EM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 22; Block I; Skyline View Subdiv~ion Request you issue a permit to d~ a w~l and install a septic system A t~st hole was excavated and a percolation test performed. The approximate location of th~ test hole is located on the attached site plan. At the time of excavation no waten was encountened and after seven day ground water monitoring, the monitoring tube wa~ found to be dry. This property has enough are~ for a future septic upgrade which can be see~ on the attached site plan. We do not anticipate any advise effects on neighboring properties by the installation of the proposed septic system. There are no points of contamination within the proposed w¢~l radius which can be seen on the attached site plan. The proposed 1000 gallon septic tank is to be placed outside the, weZ1 protective, radius. Attache,d is a site plan which depicts the location of the proposed tank. If you require, additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 o EAGLE RIVER, ALASKA 99577 z w ALT. SITE NYqd Ills Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: [~:;~--'~'"~7-- "~t~ [ 1 2 3 7 8 9 10 11 12 13 14 15 16 17 18 19 2O DATE PERF Township, Range, Section: SEAL) ROBERT C. 6OWAN _E - 880 . .m% SLOPE WAS GROUND WATER ~, ENCOUNTERED? 8!L IF YES, AT WHAT DEPTH? A pO E SITE PLAN I Deplh Io Water A]~,~ _ ~'~'"~ Dale: Moniloring? / Gross Net Depth to Net Reading Date Time Time Water Drop \ '~-t~-h~ 7:1o ~ '~ J~-- -'-- ~ ~ ,, ~ o ~'l~~ ~ PERCOLATION RATE TEST RUN BETWEEN (minutes/tach) PERC HOLE DIAMETER __ FT AND. ~'~ F'[ COMMENTS $ & S ENGINEERING ~-4>.~I cA, ,,,..23~ CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: 1~O;~4 Ea~lJe River L~p F, oa~ N~, 2~ ACCORDANCE WITRCrcJ~B ~[~llt~ ~f~l~CJ~;[L GUIDELINES IN/EFFECT ON THIS DATE. DATE: "~/"'~ ~ "~ ~ 72-008 (Rev. 4/85) ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. REALTR AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 22, Block 1, Skyline View S/D May 18, 1995 GENERAL: The scope of this project includes the installation of a 1000 gallon septic tank and a leachfield trench to serve the proposed three bedroom residence on the referenced property. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 22, Block 1, Skyline View S/D May 18, 1995 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout sha].l be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bo'ttom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed- up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers 'the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be instal, led when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Lot 22, Block 1, Skyline View S/D May 18, 1995 MINIMUM MATERIAl, SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC Yes Yes ASTM F810 (HDPE Yes No ASTM D2662 (ABS Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the %200 sieve. When sand is being used as a filter material, it's gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 22, block 1, Skyline View S/D May 18, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER 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 Parcel I.D. # ~) ..5--// ~ ~ 33 1. GENERAL INFORMATION Complete legal description Lot 22; Block I; S~y!in~ View Location (site address or directions) Property owner Mailing address Paul Sulik 1209 Howard Street Iris Street Chuqiak~ AK Day phone Boise, Idaho 83706 (208) 336-7891 Uending agency Mailing address Day phone Agent Gre~ Erkin~/ Erkins Real E~tate Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well ×XX 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. XXX 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 S & S ENGINEERING 17034 Eagle River Loop Road No. 2^v'4 Phone ~..c[/¢ - .). '7 -7 ft Address Eagle RJver~ Alas}(a 99577// Engineer's signature ,~~Li. ~_~ Date. ~'/~- ¥/¢/~ DHHS SIGNATURE Approved for /~ Disapproved. Conditional approval for bedrooms. '1~.~ ¢',~; -r,...~,~k~ ~ ~ bedrooms, with the following stipulations: By: 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. 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 mVI ONMm'rAL S RWC S D V SION Municipality of Anchorage SEP 2 4 1996 DEPARTMENT OF HEALTH & HUMAN SERVIGES Environmental Services Division g E C E IV E D 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: L~¢'1.-- 173 I ~;F-~/ui,&r.- '~,g,.3 '~ Parcel I.D,: O~."// ¢',2~% A. WELL DATA Well type t)~ 4 ¢¢¢F.- If A, B, or C, attach ADEC letter, ADEC water system number ~ ~'> Log present ~,l) Total depth ~-~¢ ' Cased to .~'-/~3 ' Sanitary seal ~.~. ) FROM WELL LOG Casing height (above ground) Wires properly protected~;~(~N) ¢ AT INSPECTION Date of test Static water level Well production g.p.m. /'" g.p.m. WATER SAMPLE RESULTS: Coliform d2 Nitrate Date of sample: ¢t / ' ~l / q G B ~'~P-~-C~HOLDING TANK DATA Date installed ~ --,J-f~)$-- Tank size Other bacteria O Collected by: Foundation cleanout~4) ~ Depression (Y~4~ ,~ Date Of Pumping ¢4-~/,.).¢.,.o Pumper o.,O ~-~ ~/,,-,£~ S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Number of Compartments Z~ Cleanouts High water alarm (~',~ /, '2_~ System type :-~ ' Total depth Depression over field (Y/{~2 For '-~-gal. water added (in.): Absorption rate = - ~ g.p.d. / If yes, give date C, AB, SORPTION FIELD DATA D~!e installed ~-4 (-~9,5~ Soil rating (g,p,d./fl2 or fF/bdrm) Length ~7/¢/' ~' Width Gravel thickness below Pipe EffectiVe, absorption area ,~79 / Monitoring Tube present~N)~ Date of adequacy test ~///~ ~/'')-4''~2 Results (Pass/Fail) ~ Fluid depth in absorption field before test (in.); ~ Immediately after Fluid depth (ins) Minutes later: Peroxide treatment (past 12 months) (Y.~ bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" le_~y~ve~-'--'~'"'-'"%~"Pump off" level at* High water alarm level _a.E~-'~ *Datum 'C---y~ested E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ~holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM S~'~"~HOLDING TANK ON LOT TO: Foundation ,/// Property line ~ ~ / Absorption field Water main/service line /'~ ~'~P Surface water/drainage Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line ~'~-~ J Surface water /09 /.-r- Curtain drain /'J/,4 Building foundation ~/, J Water main/service line Driveway. parking/vehicle storage area ~o Wells on adjacent lots ENGINEER'S CERTIFICATION , certify that, have determined thru field inspections and review of Municipal records in conformance with ~A H~A_ouidelinesJn effect on this date. Signature Engineer's Name ~ ~¢ ~ ~ ~ ~ - _ ~O ~ ~ Date '? l~y /R G HAA Fee $ r)ate of Payment ~//~--/-¢//~ Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Ord.'ed By PW$ID Hitrate. N u) ENVIRONM6NTAL I~ACILiTII~$ IN 200 W. Poi.Jr Drive . Anehome~, AK !t~6t 8'.1805 Tel: (907) 552-2343 Fax: {907) 561,5301 AJtow~bte Prep AnaLysis UnJt~ Method Limlt~ Date Date init 0:t00 ee/k $~18 &$00-#o,IF og/Zl/v6 E~C 0 c01/100~ SMqO 9~JL~ 09/20/96 T~V