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Home My WebLink AboutDEARMOUN LT 11 /'-~ MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL sySTEM AND/OR WELL INSPECTION REPORT ~ UPGRADE IZ~O IF HOME.DE: ~O ~ Well Uwelling PERMIT NO. DISTANCE TO: ~ DISTANCE TO: ~ DISTANCE TO: OTHER 501C ~E~T ~ATING IN~TALLER ..... REMARKS o ...... 72-O13 (Rev. 3/78) WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological I~ Geophysical Surveys WELL LOG Feet Below 4. WELL DEPTH: (final) 5. OATE OF COMPLETION MelerlOI Type TOp Bottom 8. CASINO: ~ Yhrladed ~ Welded /~/. ~ Above er ~ Below land surface ~ ,,. ,,,., / ~-.~-,~ ~.~ ,.,.-. O s~.. D "' 0 c..,,.,.., 0 o,., 15, Wafer Temeeralure ~ F ~ C '%~ ThI...Il wot drilled ondlr my Jurisdiction and Ibis report Il t~v. lathe b, sl,f .y knowledge and belief; Z DEPRRTD1ENT G,- HEALTH AND ENYIRONMENTAL PROTECTION · 825 'L' STREET, ANCHORAGE, 264-4?20 &WELL A~D O~--S I TE SE[qER PER£~ I T PERMIT NO. ( 8~045~ ) APPLICANT WILLIAN C HIGGINS LOCATION LEGAL BOX lii46F ANCHORAGE 9951i F45-0~02 LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTE~! IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR>= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= ii LENGTH= ~5 GRI::~¥EL DEPTH= 7 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REnU I RED SEPT I C TFII',IK $ I ZE= 125C~ GALLONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERYE. ------ T%~O ( 2 ) INSPECT I 0~$ ARE REQU I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELl", ~.150 TO ~00 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC MINIMUM DISTANCE FROM A PRIYA~E WELL TO R PRIVATE SEWER LINE IS ~5 FEET AND TO R COMMUNITY SEWER LINE IS ?5 FEET· WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PER~ ! T EXP I RES DECEI'~BER 2~_~ ~-98~ I CERTIFY THAT -,~ l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~ ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MO~E THAN 4 BEDROOMS. S I GNED: -~ P ~F_. ~[~'~--~?F_~_ I AM-C"~?~-~---- ....... ¥4. 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~' PERCOLATION TEST 825 L Street, Anchorage, AlaskI 99501 264-4720 SOILS LOG -- PERCOLATION TEST JJ LEGALDESC.,.,O.: ~ tqr mnun .c'-'X_~h"liVi,<o'iOn. LO'}' ii '-[-. H.~...~ SLOPE · SITE PLAN OL.. c~o.~rated 6% 7' 8L aha 5i 11 12 13 14- 15. 16- 17- 18- 19- 20- ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop q..z~ Z m,'n. $.zz .-5'/ PERCOLATION RATE ~'"~ {minutes/inch) TEST RUN BETWEEN /"//t/~ FT AND ~'~' FT _ z. ALASKA EllUIROI1FI1EI1TAL COI1TROL $£RUICES, IRC. Supplemental Soils Information. Subdivision ~--~RV'Y'T~ODY-) Block '~ LOT II LOT II LOT LOT TH I TH ~ TH TH 1 2 3 4, 5' 6- 7 8 9 10 11 13- 14 15 17 18- 19- 20- OL ~ G~ 3- [Tm¢"::Jdt'. 7 8 10 11 13- 14- 15 16 17 18 19. 20- 6 9- 10- 11 13- 14- 15- 16= 17- 18- ~9- 20- 1 2 3 4 5 6 ? 8 9 10- 11 13- 14- 15- 16- 17- 18- 19 20 1200 ~J(sl 33rJ Autnu¢. Sud¢ ~ · An¢&ere~t. Ale,ko 99so) · (907) 276.1361 .t ALASKA i IiUIR01 ITlerlTAL COFITROL $1 RUICI S, IllC. ~nqin~erincI $ ~nuironmenloJ Slurries August 22, 1983 Department of Health & Environmental Protection 825 L. Street Anchorages Alaska 99501 Attn: Robbie Robinson Dear Robbie: MUNICIPALITY OF ANCHORAGE DEPT. OF H~ALTH ~', ENVIRO~M~:NTAL PROTECTION AUG 2 3 igV3 RECEIVED On August 18, Hr. Helvln Covtures owner of Lot 12s DeArmoun Subdivision, complalned that the septic system just installed on Lot 11 to the vest of his lot was only 50 feet from his well. The excavator and I carefully looked all over Lot 12 for a well but could find none. Hr. Covture later came out and showed the excavator the locatlon of the well ~completely within the house and buried under boards and rubble, which is why it vent undetected by the excavator and inspectors. The distance from the yell to the closest part of the leach field vas found to be 97.5 feet, and 102 feet from the furthest end. The septic tank is 110 feet from the veil. Hr. Cowture is no longer vorrled about the distance between the system and his well, therefore. He had formerly thought the excavator would be building the leach field right next to the property line where a "Test Hole" sign had been cast off, which would have brought the system far too close to the well. Therefore, since the septic system is only 2.5 feet too close to the well~ and since the vel1 was concealed so that the excavator and inspectors were not aware of its presence~ and since the owner of the well is no longer complalning~ ye hereby request a waiver of the well-to-leach field distance to be allowed to be only 97.5 feet. Sincerely, Approved by: Darcy/Bevens Engineering Ceologlst 1200 U.les! 33r~1 Auenut, Suite B * Anc~orocl¢, Alaska godS03 · (~07) 276-1361 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. # (~C~- LiC) ~ -Cy,~ HAA# 1. GENERAL INFORMATION ~)~_ L:~ (c~c~.~ Completelegaldescription LO7 11 .~~3.~_.; C ~=._~_--37.~.? S'u'BD. Location (site address or directions) 1 3701 ERVI~I ROAD OF~ D~.zL~ND ROAD Property owner PARC'IA CAMPBK~3. Mailing address Lending agency Mailing address Day phone 564-2323 13701 ~:3~'v'IN ROAD ANCHORAGEr ALASKA 99516 G/" ~,-~. Day phone 3. Agent C,~,,,,~,/' ~/e[,d' ~7-- Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 '~ TYPE OF WATER SUPPLY: Individual well ~( Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. 4. TYPE OFWASTEWATER 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. -6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the valida!ion date shown below. I verify that my investigation of this Health Authority Approval application shows that the on-site water SUpl:)y 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 inves.ti..qation 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. Nameof Firm ~ Address 800 ~:. D~'f~'~, E~gineer's signature DHHS SIGNATURE ,~" Approved for bedrooms, - Disapproved.' Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 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. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: TX'~' 11 B[.O(~ C DEA-.~I(~f Sb'~D. Parcel I.D. A. Well Data Well type '~e~'l,'~ L=~-r~,{ L. If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ¥Cc.~ Date completed. ~'-.~-- 8 '~ Driller D~TA DRI[E~ING Totaldepth 46'~'~ Casedto 4(;'~'~ Casing height 2 Sanitary seal (Y/N) ~ (~) Wires properly protected (Y/N) ~' ~ FROM WELL LOG Date of test 8/26/~:)~ , Static water level 29' Well flow 4.5 ~) Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/hoMing tank on lot 103 ' (~) Absorption field on lot Public sewer main N/A Sewer service line WATER SAMPLE Coliform O ~.~, -, . , ~ .'Nitrate Date of sample: ~ ,,al~:~' ':J'/O'%~ctedby: : On adjacent lots ; On adjacent lots //O',' Public sewer manhole/cleanout ,/~ Petroleum tank Other bacteria B. SEPTIC/NOLDING TANK DATA Date installed ~'/~' ~ Tank size 1250 Compartments 2 Cleanouts (y/N) ¥ Foundation cleanout (y/N) ¥ Depression (Y/N) High water alarm (y/N) /,,J/~.~.., Alarm tested (Y/N) ~J/~ Date of pumping ~':: ~' -? 5'-/~ '~ ;:- Pumper ~T.r~., P~'~T,n SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 103 ' TO pmpen'y line %7 ~ Sudace water/drainage On adjacent lots 15,~ ~'+ ~) Absorption field 1 ~' Foundation 34.6 ~ Water main/service line N/A I RECORDED BY DHI ~._OYEE 2 DHHS FILE CONTINUED ON BACK PAGE C. UFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level /Ma~a~r~ / 'Pump o~ Meets MOA electrical code~)/~ SEPARATION DI~,,,CE' FROM LIFT STATION TO: Well on lot .- .,/" * On adjacent lots D. ABSORPTION FIELD DATA Date installed Length' 25''(~ ' W'~h Total,absorption area 350' Dateof adequacy test 2/9/94 Manhole/Access (Y/N) 'Pump off" Level at,/ Cycles tested / ~~water. Waterlevelinabso~Xionfleldbefo~eles{ .5'-1 1/2" Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Soil rating (GPD/FFJ Gravel thickness Clean°ut Present (Y/N) ¥ · - Results (pass/fa~) · / .*% 7' (D Total depth // Depression over field (y/N) 3 '" Ntertest , 5'-2" .ff yes, give date ~ ,System type Well on lot 100' . To building foundation On adjacent lots /~)-r Surface water N/A Curtain drain N/A On adjacent lots ~Qq~-r Property line 34 ' .To existing or abandoned system on lot Cutbank N/A Watermain/service ine, 42' E. ENGINEER'S CERTIFICATION DrivewaY. parki .ngNehide storage area 8' I cerb?y ~at I have checked. , ~ verified, or conformed to all MOA and HAA guidelines HAA Fee $ Date of Payment Rece~ Number Waiver Fee $ Date of Payment Recei~ Number. I~-o/1B,/95 15: 1! ffl'I~Z-RCIPL. TESTII'i~ '* 9~' 344 1~3 H0.492 ~ CT&E Environmental Services Inc. Laboratory Division .'-___ -_-- ,s..,,-~ Laboratory Analysis Report Technical Director 8T~4RN C. EDR " 200 W. Po~or D~ive. An~ho~egeo AK 99518-1605 -- Tel: (907) 6fl2-2343 Fax: (907) 561-5301 I~J/1B/95 15:4~ CO~{I~RCIAL 'IESTI~'~ ~ ~ ~ 138~ H0.~93 Q~2 CT&E Environmental Services Inc. Drinking.Water Analysis Report for Total Coliform Bacteria ~oo w Anchorage. AK 99518-1605 P..E.41) /NSTRtrCTION$ ON RE~RSE $[J)E BEFORE COLLECTING S~LE Tel: (~7) Fax: (g07} 581-5301 ~UST ~ co~ ~ wA~ s~L~ ~o ~ co~ ~ ~o~o~v ~ ~RIVA~ WA~R ~ ~ ~isfa~o~ 0 Ilnsa~sf~o~ ~ew sample ~a s~c~l dalWe~ mai ~///. Anm~l~ Bk~an K~A~ O MM~MUO c~ =~, z~c~ ' H~r ofcoloflic~100 ~b~e~.No. R~ut~ . Anstyst ~ ~ufine B T~nted W~ter $~t ~ ~D.~C. ~ Jun ~ Repent Sample (for ~Gtiae sample 0 ~n~nt~ Water D 5~clal Pu~ose Time ~llecteR Client noli~ o[~nsalJsfa~ SAMPLE L~ON ~1c¢~ ~y ~,~ ~.,. ,~,~.,;,.. ~Qo,,TO FOLLOW MembeaM Filter; D~dC6unt ~ ~on~lO0 el Verlfi~t~e: LTB BGB COLIFI~M Fecal Coliform CenfiruJnt~n Final Memb~ ~ter ~ultl , ~ ~J;for~l~ mi [3 [3 APPLIC"'~IT FILLS OUT UPPER HAL'~,ONLY s,/P~ phone Address Zip ~e ~ Other ~ Holding Tank NO~E: THE INSPECTION ~E MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED, Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: MUNICIPALITY OF ANOclOP. AOE /.~./~ DEPT. OF H~t~Ttl E~IRO~MSNT~ ~ NOV 2 8 ~.~ ~ o ~ RECEIVED ~) APPROVED ~DROOMS 'CONDITIONS OF APPROVAL ) DISAP~OVED ~ilsRating Date~wer Install~ Well To ~sorption Area /a~ 'r Well tog Recolv~ aA~C