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HomeMy WebLinkAboutTANAINA VALLEY LT 5 Municipality of Anchorage Page ? of_'5 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposa~ System and/or Well Inspection Report Permit Number: -% p'-/ ~/O 2. "/~ PID Number:. ,¢)//O ~/~O _ Name: Wastewater System: ¢6 New [] Upgrade Address: Phone: ~?~ ~/'/ No. of~edrooms: ~DeepTrench ~ShalJowTrench ~Bed ~Mound ~Other bob Block: Subdivision: 3epth to pipe bosom from original grade: Gravel depth beneath pipe Township:/~ ~ Range: Section: Fill added above original grade: Gravel length: WELL: D New ~ Upgrade Sravel d~p~'P Number of lines: ]Distance between lines: Classification (Pdvale, A,B,C): Total Depth: Cased TO: Tota~ absorption area: Pipe materiah Driller: ¢ Date Drilled: Static Water Level: Installer: Yield: GPM I Pump Set at: Ft. I C~sing Height Above Ground:Ft. TANK SEPARATION DISTANCES ~septic ~ Holding ~ S,T.E.P. To Sepdc Absorplion Lilt / ~ , ~uMi~ Manufacturer: Capacity in gallons: From 'rank Field ~ Stallon/ Tank Sewer Lines ~/~ ¢~~/~ Material:/ Ir; ~///) ./Number of Compartments: Lot Size in gallons: Foundation /// ~¢)' ,~] 'Pump on" level at: Curtain ~ '~ u.~ Make~ Remarks: BENCH MARK .... ~~ SEAL Inspections performed by:_ ~. ~ ~ bi> ~" Dates: lst_~ Department of Health and Human Serwces approval ( ~,¢ ,o ,0 ~., Reviewed and approved by: ~~ Date: ~- 72-013 (1/91) MOA 25 Permit No. .9'/4/ ~'/~ ,2~/'/' Page ~ 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 Legal Description: ~AL 72-013 A (2/91) MOA 25 Permit No. ~/ PI~O~ Page ~'~ of ~' Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 · Ahchorage, Alaska 99519-6650 ® Te{ephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: PID No.: ¢11¢¢1~~2 72-013 A (2/91} MOA25 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 WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910294 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:DENALI SUPPLY INCORPORATED OWNER ADDRESS:7021 DRIFTWOOD PLACE ANCHORAGE, AK 9951~ DATE ISSUED: 9/17/91 EXPIRATION DATE: 9/17/92 PARCEL ID:01105180 LEGAL DESCRIPTION: TANAINA VALLEY LT 5 LOT SIZE: 38507 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE lin 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER MUST NOTIFY DHHS AT LEAST 2 }~URS PRIOR TO EACH RECEIVED BY: DATE: ISSUED BY: ~Ol+~ ~\1~-~ DATE: LOT 5 TANAINA LOT6 EN lS (10/7U) August 27, 1991 Municipality of Anchorage DHHS 825 L Street Anchorage, Alaska 99501 Impact Statement For On-site Design Lot 5 Tanaina Wells: This lot is served by a community well system and the construction of a septic system should have no impact on the well. ~'~,S. terns;. The construction of a wastewater system on this lot should have no effect of wastewater systems on adjacent lots due to the distances to neighboring systems. Houses to the weSt are served by a community wastewater system. Re~.e.: ']'here is no problem with having enough room on this lot for a reserve system. Dr,;~J::LO.g~: Drainage on this parcel is from east to west. Due to the slope and sandy soils in the area there is usually no standing water in the area. Hopefully this meets the requirements to provide information for development of this lot. If you have any questions please contact me at 344-4551. Yours Truly, Michael E. Anderson, P.E. Municigality ot Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street. Anchorage. Ala.s~,a ~J502-0650 SOILS LOG -- PERCOLATION TEST 3 4 5- 6 ~/~ry 7 8 11 13 14 18 17 18 19- 20 DATE P Town,,nip, Range, Section: St. CIPE SITE PT,AN t Municit~ality o! Ancl~ora~je OEPARTMENT OF HEALTH & HUMAN 825 *L' $tre~L Anchom§e. Alaska 99502-06~0 SOILS LOG -- PERCOLATION TEST 4381 PERFORMED FOR: 1 2 :3- 5/~ 6 7- 8 10 11 13 14- 15 17. 18- 20 Township, Range, Section: SLOPE WAS GROUNO WATER ENCOUNTERED? IF YES. AT WHAT 0 F..YI'H? SITE PLaN PERCOLATION RATE ?z~' tmt.,~te~n~l PERC HOLE. DIAM.-[ER TI~'T RUN EETWF..E~ ~' I~ ANO -~ FT Z 2O I Sw 5 7 9 0 $2,442 I.L 19 I? 16 I0 Tom Fink, Mayor . unic pality Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196550 Anchorage, Alaska 99519-6650 January 10, 1991 Denali Supply, Inc. 7021 Driftwood Place Anchorage, Alaska 99518 Subject: Lot 5 Tanaina Valley Subdivision Permit #900067, PID #011-051-80 The subject permit, issued by this office well and/or on-site wastewater system has 31, 1990. for a single family expired as of December 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 needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site wastewater system, the original as-built inspection report (three-part form) 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, %he fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 a combined on-site wastewater and well permit. for If you have any questio,~s, Since,r~ ly/, / / Pro~,~am Manager On-~ite Services please call this office at 343-4744. JW/ljm:200 enc: Copy of Permit "Kids Are Our Future" :[ I :1 li:;l :t:? t :t:F:'ix I'I](:~ I ,:'.,, I: ~i.l.l. :.n~i'!:.~-.,.l.l. I'.I1~ ~i'y~tc')m :i~/ ,'.i(:::r:(::H~da;u'~c(:) ~,~:i.'l:.l'i aJ.] I"11][~ (:::l::~:l~:]~f~ and .~;,, I ~-~i t.:t a~!l~(',r-~ lt.(:~ all I'1(:}~ /::il'iCl ~J~,.{.,t~',c:) (:ii (~]~.,':t~i;l::~','~ I'C.~i:]LI:iI'C~iIIfF'II'I,~i 'ICH ['h('~ ~;(.~1:. I;:),':~::1:: i:l:i.!~i~..:)liC:r?:~ il'('illi :).I'i'/ C~i'(:i,~.ii~:ill~.J ~.~,,):I,:1.~ i~,F:':ifili~:.iWi~it'~.l~)t~ (::lJ.~]il:ll::)~'~it, ~'fi~'li, i:~[i/ C:)I" Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN.SERVICES 825 "L" Street, Anchorage, Alaska 99502-(]650 SOILS LOG m PERCOLATION TEST LEGAL DESCRIPTION: ~ ~" ~-,/~/~/~/'.,4/..~ V/~L~:'// Township, Range, S~tio~:' SLOPE 1 2 4 5 6 7 8 9- 10- 11- 12 13 14 15 16 f7 18 19- 20- ~'p WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEFTH? SITE PLAN !Ii Reading Date T~me 'rime Water Drop I PERCOLATION RATE __ (mmule~'mcri) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND , ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIO~IN~S IN ~FECT ON THIS DATE DATE 17 19 C.~-SW E/~4 3 I 7 16 14 TT.?I' w 12 ANDERSON ENGINEERING P. O, BOx 240773 Anchorage Alaska 99524 907 33% 8367 April 4, 1990 DHHS - On Site Services 825 L Street Anchorage, Alaska 995O1 Attn: Robbie Robinson Re: Lot 5 Tanaina Valley I~NVIRONM~NTA[ PRO~:C~ION RECEIV t) Dear Mr. Robinson, This letter is a follow up to our recent conversation regarding the subject property. The reason a sand filter was not included in the absorption system design was due to the soils analysis which indicates the natural soils, to a depth of at least i6 feet are predominately sands. This negates the reasoning of requiring the construction of a sand filter into the system. If you have any further questions please contact me at 561-5829 Yours/~ruly, ~/~ ~ '~. Wayhe McFadden WALTER J. HICKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICF 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99503 (907) 349-7755 February 19, 1992 FOR: Wayne McFadden PWStD#214706 My review of the records on file in this office reveals that the Country Lane Estates Subdivision Class "A" Public Water System, is in compliance with the routine coliform bacteria sampling requirements listed in Table C, and with the inorganic sampling requirements listed in Table B of 18 AAC 80.200. Sincerely, Byron Roys Environmental f--ngineer BR/cf 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. # ._~)//0~../,,~0 HAA# /"J- 4 1. GENFRAI. INFORMATION Complete legal description Location (site add'ress or directions) Property owner Mailing address Lending agency Day phone Day phone .Mailing address- Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: individual welt Community well _ X 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 X 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. 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 hereim I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and i.nspection, 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 /Z~bL?T/--~orJ -~-",'J~;/~J~-E'/~J~, Phone ~7~ ~ qllO Address ~0, ~0~ ~¢077~/ ~Cot, ~ ~ ~9~ EngineeCs signature ~~ ~~ Date ~[~/~1 SIGNATURE Approved for ,~zj~z,'z_.('/-~-? bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date 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 & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. A. WELL DATA Well type~m/7/Un ~ If A, B, or C, attach ADEC letter. Log present (Y/N) Date completed_ ADEC water system number Driller Total depth __Cased to Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot g,p.m. AT INSPECTION ; On adjacent lots Absorption field on lot ; On adjacent lots Public sewer main · Public sewer manhole/cleanout Public sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Collected by: Other bacteria B, SEPTIC/HOLDING TANK DATA Date installed /~,//~,~/'g/ __ Tank size Cleanouts (Y/N) ,V _ Foundation cleanout (Y/N) High water alarm (Y/N) Date of pumping lie t,~/ ~ ~ ST R IJc~o Compartments y' Depression (Y/N) __ Alarm tested (Y/N) /~'//'/¢ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /./oid~_ ~ L.o-F On acljacent lots Foundation // / To property line ,5'/-// _Absorption field ~ / .... o / _Water mmn/servme line ~ Surface water/drainage _[q¢^f ~ I~.t .L/r4E'A _ 72-026 (Rev. 3/~1) Front MOA 21 CONTINUED ON BACK PAGE LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LiFT STATION TO: Well on lot D. ABSORPTION FIELD DATA Date installed Length /Z~- Width Total absorption area Depression over field (Y/N) Results (pass/fail) /PA ~;% On adjacent lots N Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot t~o~JF- ~J /,(OT To building foundation .2 ~ ' On adjacent lots / ~ 7 / Surface water kJo~E /N Curtain drain kl0cJE l/'J Manufacturer 4~-/¢z¢--~_ Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water Soil rating Gravel thickness cC / Total depth Cleanouts present (Y/N) Date of adequacy test ~'~J f o r _../¢2/¢ ,¢,¢/-/ // If yes, give data __ System type bedrooms On adjacent Iots_~ Property line To existing or abandoned system on lot Cutbank AlOnE /~J AEE-~.Watermain/serviceline Driveway, parking/vehicle storage area E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Engineer's Name Date Waiver Fee: $ Date of Payment Receipt Number