Loading...
HomeMy WebLinkAboutT15N R1W SEC 3 SW4NE4 PTNT15N, RlW, Section 3 Portion of SW4, NE4 #051-053-51 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: '-~'~"-)~'¢[OZ~ / ~ PID Number: 0~[~ O~'~ ~ ~': ~y ~"~ ICy Wastewater System: ~New D Upgrade ~x 4~1 qT~ ABSORPTION FIELD Phone: ~_ ~-~ I.o. of Bedrooms:~ ~ Deep Trench ~ShallowTrench ~Bed ~Mound ~Other LEGAL DESCRIPTION so,,~..~: O.~GPD/Sq. Ft' T°ta'Depthfr°m°riginalgrade) o' Township: 15N [ Filladdedaboveoriginalgrade, Gravelie th: Number of Fines: I Distance belween lines: WELL: D New ~ Upgrade Gr~v~id~h: ~ Ft. ~ ~O' Ft Cla.glfLcation (Private A.B.C): Total Depth: ~ Total absorption area:. P'pe material: Driller: ~illed: Stalic Water Level: Yield: Pump Set SEPARATION DISTANCES : ~Septic D Holding D S.T.E.P. To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Cap~city in gallons: S~,~CeW~I00'~ ~00'+ ~ LIFT STATION Foundation , ~teralarmat: Remarks: ~6r~sl~a Pu~/6. BENCH MARK .......... 17o34Eagle River Loop Road, NO. 2~ E ~/~9~ Department of Health and Human ~erwces approvm ~e~;",.. ., ,,.~ Reviewed and approved by: ~l~ ~/ ~ ~ Date: g' ~ ~' 0 C -...~t.,.,,:oo, 72-013 (Rev. 9/91) MOA 25 PERMIT NO SW990418 PACE 3 OF 3 Hunicip, ati~ of' Anchoncee DEPARTHENT OF HEALTHAND HUM"AN SERVICES EN¥1RONHENTAL SERVICES DIVISION P.D. Box ]96650 @Anchopoge, Aloska 99519-66500Telephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL PORTION SW¼, NE¼, SECTION 3, T15N, R1W P.I.D. NO. 051--053--51 ffFINAL GRADE 94.6' ~ __/ 90.4,~! NEW 1500 GAL ~--~ SEPTIC ~90.2' TANK CO1 C03 C02 MT1 .JCO1 = 94.8' , ~// ,C0;iN_Af3~3R[DE C04 MT2 'C03 ~ 996113,' ~X~MT1 = 85.6' ~-MT2 = 85.6' A B FCO i 33.5' 25.5' ~. T. S. ST1 36.0' 45.5' ST2 44.5' 53.5' DBL1 40.5' 55.5' DBL2 48.0' 56.5' A FS 79.5' 94.0' NO WATER FOUND C02 116.5' 105.0' C03 82.5' 98.0' Ir~ ~ I~ ROBERT' C, COW.~IN ~..Z~.~~ C04 122.0' 118.0' '~"~.\ CE-880i MT1 109.5' 100.0' MT2 117.0' 114.0' A B FCO 33.5' 25.5' ST1 36.0' 45.5' ST2 44.5' 53.5' DBL1 46.5' 55.5' DBL2 48.0' 56.5' FS 79.5' 94.0' C01 72.0' 78.5' C02 116.5' 105.0' C03 82.5' 98.0' C04 122.0' 118.0' MT1 109.5' 100.0' MT2 117.0' 114,0' P~:RM[~' NO SW990418 PAGE 2 OF 3 F'lunicip. o. tit. of' ~l~h~ ~jOl~N DEPARYMENT OF HE~[TH SERVICES ~NVIRONMENT~L SERVICES DIVISION P.O. Box ]96650 ~Anchopcge, At~sk~ 99519-6650~Tetephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LBGA~ PORTION SW~, NE~, SECTION 5, T15N, RIW P.i.D. NO. 051--053--51 MUNICIPALITY OF ANCHORAGE Department of Health end Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Nov 23, 1999 Expiration Date: Nov 22, 2000 Permit Number: SW9904'18 Legal Description: T15N R1W SEC 3 SW4NE4 PTN Design Engineer: 0003 S & S Engineering Owner Name: Tammy Bradley Owner Address: PO Box671475 Chugiak, AK 99567- Parcel ID: 051-053-51 Site Address: 022116 OLD GLENN HWY Lot Size: 141570 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of: [] Disposal Field [] Septic Tank [] 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: Date: ate: //- ROBERT C, COWAN, P,E. WELl_ INSPEO11ON &FLOW'rEST SOiL 1'EST November 9, 1999 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Aaachorage, AK. 99519 REFERENCE: Portion of SW¼ of NE¼ of Section 3, T15N, R1W It is requested that you issue a permit to install a septic system with a pressurized trench and lift station to serve the proposed five bedroom dwelling on the referenced property. Two test holes were excavated and percolation tests performed. The approximate location of the test holes are located on the attached site plan. Ground water was monitored as shown on the attached soils logs. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/bjj Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 " EAGLE RIVRR, ALASKA 99577 Municipalily ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: 2 3 4 ? 9 10 11 12 ]4- 15 16 17 18 19 2O SLOPE SITE PLAN WAS GROUND WATER / IF YES, AT WRAT ,~ E PERCOLATION RATE __ TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER __ FT AND FT COMMENTS PERFORMED BY: S & $ ENGINEERING i .... CERTIFY THAT THIS T ST WAS PERFORMED IN . ACCORDANCE W'~N~%~AL GUIDELINES iH EFFECT ON THIS DAT". DATE: 72-008 (Rev. 4/85) Municipality ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 ? 9- 10 11 12 13 14- 15- 16- 17- 18- 19 2O SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? DEPTH? Deplh lo Water After Monitoring? E Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE 1~"~ (minules/inch) PERC HOLE DIAMETER TEST RUN BETWEEN '~ ,FTAND ~ FT COMMEN~S PERFOnUE~B¥: 11034;agleRiverLoopROadNo. z~ /~ v - ~ - ~ , w ACCORDANCE wlT~R~A~ GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) (ENGINEER'S SEAL) /~.~.'~ Municipality of Anchorage. (~t~J DEPARTMENT OF HEALTH & HUMAN SERVICES ~ 825 L Street, Anchorage, Alaska 99502-0650 - PERFORMED FOR: I ~t~ y ~O Y DATE PERFORMED: J~ LEGAL DESCRIPTION: ~ /ff ~ W~ /~ Township, Range, Section. 4- 5 6 7 8 9 10 12 13 16= 20- ~.O.H. COMMENTS WAS GROUND WATER ENCOUNTERED? ~/ D S IF YES, AT WHAT ~ ~ DEPTH? p E Depth to Water After ~ Monitoring? Date:. SLOPE SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop ,e.'~,¢,~ o ~', ..~:..: ~' - ~ :. :~ ~'/~ ~o I ~o~ ~,~ ~ ~/~" -~ '/~" PERCOLATION RATE J '~-' ~" (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN '~'O FTAND /Z FT S &S ENGINEERING PERFORMED BY: 17034 Eagle Eiver Loop Road Ne, 2~ ~ v-, ACCORDANCE WE~R~~AL GUIDELINES IN EFFECT ON THIS DATE, DATE: 72-008 (Rev. 4/85) Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anohorage.ak, us (907) 343-4744 Parcel I.D. 051-053-51 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: Portion of SI? 1/4, NE 1/4, Section 3, T15N, R1W Location (site address or directions) 01d Glenn Highway CurrentPropedyowner(s) Tammie Bradley Day phone Mailing address PO Box 671475, Chugiak, AK 99567 Lending agency Premier Mortgage/CatAilport Dayphone 696-070l Mailing address 11901 Business Blvd., Bldg. B, Eagle River, AK 99577 Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: 5 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Cer[ificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72 025 iRe,/ 01'001' 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 based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. S & $ ENGINEERING 17034 Eagle River Loop Road No, Name of Firm __~l,~ River. Alas{ca 995~7 Phone G Address Engineer's Printed Name Robert C. Cowan Date DHHS SIGNATURE P-/' Approved for .~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: /C., - / C - C ~ Original Certificate Date: Reissue Date: Municipality of Anchorage i ECEIVED Department of Health and Human Services Division of Environmental Services On-Site Services Section 825"L" Street Room 502 JUL 05 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us NtUNICI?ALI[¥ OF ANCHOR/kG[: ' ~ TAL SEB. VJCES D V · qR~qNMEN Il (907) 343-4744 Legal Description: HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type ~ R *,,/,.',Fr~ Date completed u J/( Total depth I 3-O ft Cased to FROM WELL LOG If A, B, or C provide PWSID # Sanitary seal ~/-~ ft Date of test / Static water ,evel ff Woll production / g.p.m WATER SAMPLE RESULTS: Nitrate Collected by: Coliform. o colonies/100 mi Date of sample:. -7/3'/oo B. SEPTIC/HOLDING TANK DATA Tank TyP~/Material Date installed Tanksize ) 6"'0 o Parcel I.D.: Cleanouts Y~'J FOundatiOn cleanout Date of pumping ~J/~ _ /v C, ABSORPTION FIELD DATA Well Log ,~ 4) Wires properly protected Casing height (above ground) )~. 4 in. AT INSPECTION /oo )1~ /.~ mg/I Other bacteria ft g.p.m colonies/1 O0 mi S & S ENGINEERING 17034 Eagle River Loop Road No. 204 ;..u~lie ~Jver, Alaska ~577 gal Number of Compartments ~- Depression over tank ~,o High water alarm Pumper Date installed ~¢'/&f'/oo Soil rating g~.p.d~r ft2/bdrm) O. ~ System type 'T,~ ~"~ ~-i'/~ · Length /~ 0 _ft (r,~,~ Width ~ fl Gravel below pipe ~ ft Total depth ~ fl Effective absorption are~ ¢~ f¢ Monitoring tube ~J Depression over field ~ o Date of adequacy test ~/~ ~ ~ Results (Pass/Fail) For ~ bedrooms Fluid depth in absorption field before t~t~added__ gal. New depth in. Elapsed Time: m~fl~d d~th in Absorption rate >= __ g.p.d. Any rejuven~ (~ ~ (YIN & typ~ .If yes, give date __ 72-026 (Rev. 01/00)* LIFT STATION Date installed "Pump on" level at __ Size in gallons__ Manhole/Acce~-~--~'~-~-- in "Pump off"~water alarm level at __ in Meets alarm & circuit requirements Datum ~cles tested __ SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ©N LOT TO: Septic tank/lift station on lot / o 0 '-¢'- Absorption field on lot Public sewer main Sewer/septic service line '~. On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ) 3 Properly line ! ~- Water main ~ ,/~ Water service line Drainage ~//~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / ,' Property line '~ &~ Building foundation ,g' I Water main Water Service line Curtain drain Absorption field / ~¢ + Surface water Surface water ) e o Wells on adjacent lots Driveway, parking/vehicle storage F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. (_.', Engineer's Printed Name ~ 0 8 ~,~ ~ (~ ,,~,¢~ Date '-//,.¢- ,,/o ~ HAA Fee $ ~ .oo Date of Payment '~¢ L~--~S;)~) Receipt Number ~)~,.5-"~-~ //(~'-/'~'~ Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)*