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HomeMy WebLinkAboutWOOD CLIFF LT 1Woodcliff Lot 1 #011-271-15 /' , 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: ,~ ~/jc~ O ~l/¢ PID Number: ~ Name: Wastewater System: ~New ~ Upgrade ~'~:~.O, ~o~ ~qo~2~ ABSORPTION FIELD Phone: ~ No. of ~rooms: '~Deep Trench ~ Shsllow Trench ~ Bed ~ Mound ~ Other Total Depth from original grade: LEGAL DESCRIPTION sog*a,i.~: I. ~ GPD/Sq. Ft. Lon Block: Subdiv~ion: )epth to pipe b0~om from original grade: Gravel depth beneath pipe Township: ~ Range: I Section: Fill added above original grade: Gravel length: WELL: ~ New B Upgrade ;ravel width: ~ Ft. JI -- Ft. Clarification (Private, A,B,C): Total Depth: Cased TO: Total absorption area: Pipe material: Driller: ~ Date Drilled: StaticWater Level: Installer: Date installed: P~p Set at: Casing Height Above Grouad: SEPARATION DISTANCES ~s.ptio u Holding B S.T.E.P. TO Septic Abso~tion Lift Holding 3ublic/Pd~te Manufacturer: Capacity in gallons: Welb I~D ~ ~ ~ ~ ~/~ Material: 5 ~ ~ ~ Number of Core. merits: Sudace Water ~ ~ ~ ~ LIFT STATION F°undati°n t~ ~ "Pump on" level at: [ "Pump off' level at: I High water alarm at: Drain ~ ~ ~ ~ BENCH MARK Remarks: , · ENG NEER~S-SEAL Inspections pedormed by: '~ %- Dates: 1st 7 ¢? Depadment of Health and Human Se~ices approval r 72-013 (Rev. 9/91 ) MOA 25 I×/ ! STANDARD TRENCHES: ~[4YfAL LENGfH 60 F[ TO[AL DEPTH I! £T EFFECtiVE ROCK 8 FT / / J ~ S~/ING TIES AE 58 L~ I / / / // / SCALE, 1' = 58 FE ITOBBEN SPURKLAND P.E. 20J l¢ 15TH. AVENUE ANCH. AK. 99501 (907} 279-$916 PERMIT # SW9902!6 WOOD CLIFF lOT ! STEVE ANDERSON PI~ # 011 R71_ 1.5 srPrlC SYSTEM As DATE: SEPT. 20, 1999 SHEET: 2/3 GRID: 2 WCLOOOI2. DWG £ ~ondord Tmenches: £' W/de 60' L on9 10' Deep 8,0' Sewer rock 3' Cover Foundo t/on Cleon out 0 1500 9ol Septic $onk Double Cleon REPLACEMENT TRENCH ~ .... 90. 7-- 8,0 Pi. o£ Sepi,lo t~ock Effective 3' Cover 95_~ ND SCALE 95.40 1500 9oL sep6'c tonk BENCH MARK, FIRST LEVEL FLOOR ASSUMED ELEK 100.00 ?T TDgBEN SPURKLAND P,E. 20~ ~l~h Ave II Anchorage Ak 99501 LOT 1 SFEVE ANDERSON SEPTIC SYSTEM AS BUILT I DATE, SEP. 20, 1999 SHEET, 5/5 GRID: ~2~ WCLOOOIS. DWG PERMIT// SW990216 PARCEL ID 011-271-15 Wello~m~: STEVE,: ANDERSON M-W DRILLING, Inc. P,O. Box 110378 i 10330 OI,.i Seward Highway (~07) 349-8~3S ANCHORAGE, ALASKA 995~ 1 DRILLING LO~ i' i~x,a~lon (~ o/; Township, Range, Section, ti ]~ow"; or cttstance main road Ca~ed to360-52 feet land suxface, F~m/~h or, well (check one) · : LOT I t WOODCLIFF $/D : ANCHORAGE t AK St~ o~ .~C.~t-~ 6" Depth of Hol~, 361 feet 22 Da~ o~ C~mpl~t PERMIT~ SW980084 Dep~ in feet ~F'otmd 0 .TO_ 2 2 TO 12 12 TO_ 16 16 .TO_. 166 166'.TO__234 234 TO 241 241'"TO 262~ 262 TO_ 274 274 _TO_. 283 283 345 345 TO. 355 355 ~) 361 ,U~ of W"I~OMESTIC openend( x );,.' . SIDTY ........... GRAVEL: , SANDY~ SILTY,.. C~AL CHUNKS, HEAVING CLAY: SILTY, WET AND HEAVING, COAL LENSES, BRACKISH SM~LL WATER GRAVEL: SANdY/SILTY, DIRTY HEAVIBNG WATER GRAVEL: SANDT, CLEANED UP FAST ~'~ ' l -- CUSTOMER SILTY '~;'~ WEU. LOG ~ ([fiforrnetions penetrated size of materl~~'-i~ .... Si cx uP , MAY 4 1999 Municipality o* An~e GRAVELLY Dept. Health & Human Services (minute) ior 1.--/--.----hour~ with 100% . ft. MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 PO. Box 196650, Anchorage, AK 99519-6650 (9O7) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jul 26, 1999 Expiration Date: Jul 25, 2000 Permit Number: SW990216 Legal Description: WOOD CLIFF LT 1 Design Engineer: 0007 Tobben Spurkland, PE Owner Name: Steve Anderson Owner Address: PO Box 190228 Anchorage, AK 99519-0228 Parcel ID: 011-271-15 Site Address: 008600 BLUFFWOOD CIR Lot Size: 86263 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 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. Received By: Issued By: Rick Mysh'om. umc pamy of Anchorage Department of Health and Human Services 825 "L' Street P.O. Box 196650 Anchorage. Alaska 99519-6650 April 29, 1999 Stephen W Anderson PO Box 190228 Anchorage, Alaska 99519 0228 Subject: Lot 1 Wood CliffSubdivision Permit # SW980084 PID # 011-271-15 The subject permit, issued April 29, 1998 by this office for a single family well and/or on- site wastewater system, has expired as of April 29, 1999. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site Wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. f~ely, Program Manager On-site Services enc: Copy of Permit 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:SW980084 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:STEVE ANDERSON OWNER ADDRESS:PO BOX 190228 ANCHORAGE, AK 99519-0228 DATE ISSUED: 4/29/98 EXPIRATION DATE: 4/29/99 PARCEL ID:01127115 LEGAL DESCRIPTION: WOOD CLIFF LT 1 LOT SIZE: 86263 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION 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 (18AAC80). 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. SPECIAL PROVISIONS: RECEIVED BY: ~ ~U~' ~ ToSPURKLA % 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 1 WOOD CLIFF S/D STEVE ANDERSON No Ground Water or Impervious Layer to 16 ft. Use Standard Trench Soil Rating. .8 g.p.d./sqft No. of Bedrooms 5 Required Area per Bedroom: 150/0.8 - 187.5 sq.ft. Total area required: 937.5 sqft Testhole depth 16 feet Bottom Rock At 10 feet Top Rock At 2 feet Rock Depth 8 feet TotalTrenchLength 940/16=58.75ft Use60ft SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 60 FT TOTAL WIDTH 2 FT TOTAL DEPTH 10 FT ROCK DEPTH 8 FT COVER 3 FT SEPTIC TANK 1500 GAL. The installation of this septic system will not prevent wells from being installed on the adjacent lots. 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. Ponding and/or concentration of surface runoffwill not result from this installation. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 4 7 9 10 14- 17 ~o 18 19- 20- COMMENTS ~v~OO [~ ~ L'I, F~' Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN S L IF YES, AT WHAT O DEPTH? p E Depth lo Water Alte~ Monitoriag? ~ 0ate: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE '~ (minutes/inch) PERC HOLE DIAMETER TESf RUN BETWEEN :~ FT AND ~///Z.- FT PERFORMED BY: ~ ~ I T~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE· DATE: '~ ' '~0~ ¢/c~' 72-008 (Rev. 4/85) TOBBEN SPURKLAND P.E. 202 W 15TH. AVENUE ANCH. AK. 9950! (907) 279-59!6 · OOD CLIFF S/D S~TIC SYSTEM DES/CAi LOT 1 DATE: morch 30, 1998 SHEET: 2/$ GRID: 2522 STEVE ANDERSON PE£MIT # PID # ~CLOOO12, D~/6 PRIMARY TRENCH Stondord Trenches: Foundotlon Cleon out 1500( 90( Septic Doub{e Cleon ZTuts L~' Fi/de 60' Lon9 lO' fleer 8.0' Sewer rod< 3' Cover £EPLACEMENT TRENCH ND SCALE Moni%ot~ C~eonoul~s 3' ~over J 8,0 P% o£ £mp%ic R'ock Effective ND SCALE ]500 9al, septic tonk 3ENCH MARK. ASSUk~ED ELEK IO0. O0 FT SPURKLAND P,E. 203 W15th Ave Anchopage Ak 99501 WOOD LOT ! STEVE ANDERSON SEPTIC ~Y2TEM DESIGN DATE: MARCH $~ 1998 SHEET, GRID: ~3~ PERMIT~ SW98XXXX PARCEL !D YY WCLOOOIJ. DWG 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 ©11- 5 HAA# ~-~'~_-'"~-~"7,'~ 1. GENERAL INFORMATION Con; plete'iegal description Location (site address or directions) Property owner Mailing address Lending agency Mailin. g address Agent o Address Day phone Day phone 'Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well NOTE: Community well Public water 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. (Rev, 1/91) Front MOA#21 Se 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. NameofFirm ""~¢bJ~-~-H ~/~,~F-~L~-,t/J ~-J-~,", Phone ~'~/~ Address ~o~ ~ )~'~, ~ ~'~ Engineers signature ~ ~,-~,Z~ Date ~/~ DHHS SIGNATURE ~ Approved for Disapproved.I Conditional approval for Additional Comments bedrooms. bedrooms, with the following stipulations: By: 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 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 engineer's work. Legal Description: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES ~ /~) Environmental Services Division 825 L Street, Room 502. Anchorage, Alaska 99501 · (907)?~44 Health Authority Approval Checklist · ~, ~'~ ~,. A, WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Date completed Cased to ~ ~ ~ If A, B, or C, attach ADEC letter. ADEC water system number y y' ~-x/~ / ~' q Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION . FROM WELL LOG Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate ~ ,iL~ Other bacteria Collected by: '~ ~ B, SEPTIC/HOLDING TANK DATA Date installed ~/~'7/ ~ r~ Foundation cleanout (Y/N) Date of Pumping I~vA Tank size );~'~2,~ Number of Compartments ~, Cleanouts (Y/N) ,'7" Depression (Y/N) Pumper High water alarm (Y/N) C. ABSORPTION FIELD DATA Date installed ~7//~?//~/,~ Length ~, ~Width Soil rating (g.p.d./ff2 o~ /', Gravel thickness below pipe System type ~-',~-/~-~ Total depth Effect!ye absorption area ~'~-~- Date of adequacy test /~/~ Monitoring Tube present (Y/N)_~/__ Depression over field (Y/N) __ Results (Pass/Fail) ~ For ~ Fluid depth in absorption field before test (in.); Fluid depth ~ (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) Immediately after V/gal. water added (in.): Absorption rate = g.p,d. If yes, give date J .bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested "~ level at* *Datum E. SEPARATION DISTANCES "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/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 SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ ¢) Property line /~ O Absorption field Water main/service line ..~rp 'P Surface water/drainage ~q/C) SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Wells on adjacent lots '~"~ t¢~=> Property line [ O Surface water f.4, ~ Curtain drain iq lC, Water main/service line Driveway, parking/vehicle storage area '7'0 Wells on adjacent lots ~) / ~ F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records~,h~ the above systems are in conformance with MOA HAA guidelines in effect on this date. Signature Date Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ __ Date of Payment _ Receipt Number '02-23-00 16:U FROM-CTE ENVIRONMENTAL 561§301 T-0~6 P.01/01 F-783  CT&E Env~ro~manta~ S~rvic~t~ Tel; n~mg Water ~ysis Repo~ fo~ Total Colifo~ Bacte~a ~' O~ ~o~CTING S~L~ Fax: pUBLiC WA~R ~Y~T~M I'~' ' L~~ sAMPLE DA~: Da~ 02-17-00 22:20 FROg-CTE ENVlRON~I~NTAL T-946 P.02/03 F'634 CT&E ReLt~ 10005660(11 Ciient Name Tobbcn Spurk]a.qd Project .~ame~ Lot i Woodcliff Clieut Sample Il) Lot 1 Woodchff Matrix Dm~g Water Ordered By PWSID 0 Printed Date/'rlme 02/17/2000 14:47 Collected Date/Time 02/14/2000 8:30 geeeJved Dare~ime 02/14/2000 8:45 Techniea~ Dire~to~ Stepl~ea C, Erie WAT~R~ EPA 300.0