HomeMy WebLinkAboutGATO DEL SOL LT 1
Municipality of AnchoragePage ! of /
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: ~'~/~'~_f)O .~ ~, PID Number:
Name: ~ ~, ~ ] ~ ~ m Wastewater System: ~ New ~ Upgrade
Address: J ABSORPTION FIELD
~¢ '~1 ~ ~ ~ Deep Trench ~ Shallow Trench ~Bed UMound UOther
LEGAL D ESCRI PTI O N so~, Rating:~, ~ GPD/Sq. Ft. Total Depth from or,~al, grade:
L : ~ ~
~ ~ k ~ Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township: Range: Section: Fill added above original grade: Gravel length:
WE L L: ~New ~ U pg rade Orave~ width: 1~ Ft. Number~of lines: Distance between~ lineS:Ft.
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:
Ft. Ft. ~ 5 ~ SQ. Ft.
Driller: Date Drilled: Static Water Level: In~aller:
,Yield: GPM Pump Setat: F. Casing Height Above Ground:Ft. ~ i TANK
SEPARATION DISTANCES ~Septic U Holding ~ S.T.E.P.
To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank S .... Lines ~
Material: Number of Compartments:
s.,f~c~ ¢ ~¢0+ -- LIFT STATION
Water J ~ ~ ]~O ~,
Lot O~ Size in~~
Foundation ~+ ,~ ~ -- "Pump ~~alarm at:
Curtai~Drain /~ /~ /~ /~'~ /~ ~ Pump~ Electrical Jnspections performed by:
LocaUon and Description:
/ j ~ Assumed Elevation:
ENG ~EER'S SEAL
~opadmen~ o~ H t d Hum Serwcos apprCval]
Reviewed and approved by:~~ (~ Date://
72-013 (Rev. 9/91) MOA 25
Permit No. ~;/,~,~)~ 5'~ 1 of 5
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 AnchorGge, AlaskG 99519-6650 Telephone:543-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
015-472 27
SPLIT
Leg~]l Description Lot 1, Block 1 GATO DEL SOL PID No: iLNOTpRoCESS
2 7
WELL
WELL
I
WELL LO,
2
APPROX. LOC.
SEPTIC AREA
1 12 th AVE.
Permit No. 500 ~,~ 5 ~, Page 2 of 5
Municipality of Anchoroge
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Aloska 99519-6650 Telephone:343-4754
On-Site Wastewa~er Disposal System and/or Well InspecUon Repor~
015-472-27
SPLIT
Legal Description Lot 1, Block / GATO DEL SOL PID No: i~O~RoCESS
.SEPTIC SYSTEM PLAN VIEW
1" =50'
DESCRIPTION
NOTES BM A~ ASW PROPER~ CORNER EL=100I
1. CO~CTOR TO VERI~ NIN. SQ. FOOTAGE BM B B NW PROPER~ CORNER
PRIOR TO P~CING TOPSOIL,
.'
OF SEPTIC ~S.
AS BU LT "
~, DIS~RBEO AR~ SHALL BE SEEDED TO
PRINT EROSION.
DraINS W~HIN 100
OF ,o FE~ FROM PROPER~
6,A*LD.H.H.s.CONSTRUCTION STANO~DSHALL SRECIFICATIONs.CONFORM
FROM A~OINING WELLS PRIOR TO EXCAVATION
OF SYSTEM.
-~ one3
Perm([ No..~t,..) ~/~ O~ 5' ~
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
015-472 27
SPLIT
Legal Description Lot 1, Block 10ATO DEL SOL PID No: iLNOTpRocESS
ORIG. GRADE
FINISH GRADE
SEPTIC SYSTEM PLAN VIEW
HORIZ 1"=40' VERTICAL 1"=4-'
D~.ours ^~ , ~ c~°~~°~~
C~. TANK~ . o ~ ~' I 2" 94
42' I
~ ~¢~ ......... ~,,,,~.~,_
~.-' A "-~
~..- · ~ '..~5
~....;.~?
......
ABSORPTION SYSTEM PROFILE
H~RiZ 1"=20' VERTICAL f'=lO'
PROPOSED COVER
I
I~h~'q~THS MEASURED FROM:r'3casing top ~ground surface
· :JlI~N~LE DATA:
Depth
.:Nlate~tal Type and Co~ot From To
WELL DEPTHs.
Depth of hole: · -~' ~, '~ f DATE OF COMPLETIOiV
~ '-~ft below ~ tb~ of easing ~ ground
M~HOD OF DRILLING: ~ air ro~ary ~ cable to~
~ other
~SE OF WELL:~ ~omostiC ~ I~tl~atlOn ~
~ public supply ~ot~er . .
W~ INTAKE OP~O TY~E~ ~ open end
D Perforated ~ ~01~ '
Depths of openings: _ ., . _ to .... . ....~ _ ft
Slot~esh ~ize:. . Length:
G~VEL PACK TYPE:
VD=urea,used; ~. Depth to top~ .............
GROU~ TYPEt · Volume:
PUMP INTAKE D~P~Hi. - ~t
PLEASE MAIL WHIT£ COPY OF LOG TO:
DN~1pJVISION OF WATER
PO ~3OX 772116
F~£1~ fli~'ffR AK 99677.2116
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:SW930056
DESIGN ENGINEER:ARCTIC SLOPE CONSULTING GROUP
OWNER NAME:PATTEN ALLEN
OWNER ADDRESS:ill61 HIDEAWAY TRL
ANCHORAGE,AK
DATE ISSUED: 4/12/93
EXPIRATION DATE: 4/12/94
PARCEL ID:01547227
LEGAL DESCRIPTION: T12N R3W SEC 24 SW4SW4NE4NW4
LOT SIZE: 54450 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
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 (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
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:
DATE:
DATE:
ASCG
Calculations
System Calculations for LO1 1, BLK 1 GATO DEL SOL 29-Mar-93
Page 1 of 1
Tank Size
4 Bedrooms = 1250 Gallons
Absorption Field Sizing
MUNiC~PAUTY OF ANCHORAGE
ENVI~ONM[..NTAL SERVIC.~S DIVISION'
,'.?~ 0 2 199;5
RECEIVED
Using an acceptance rate of 0.8 gal/SF/day ~'
and a daily load for 4 bedrooms of 600 gal/day.
Req'd Absorption Area = 600 gpd / 0.8 gpd per SF = 750 SF--~''~
System Dimensions
42.0' X 18.0' = 756.0 SF
The laterals are to be spaced 6.0' apart and 3.0' from
edge of the bed.
Per.mit No.
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519 6650 Telephone:545-4744
On-Site Wastewater Disposal System andJor Well Inspection Report
015-472-27
SPLIT
Legal Description Lot 1, Block 1 GATO DEL SOL PID No: iLNOTpRoCESS
5
~. II
: BM Ak~ ASW PROPER~ CORNER EL=lOOm
~ BM B~]BNWBMPROPER~A BM B CORNER
. ·
TH~~
· ~?~" ......... .'
SITE MAP
Perroit No. Page 2 of 3
Municipolit¥ of Anchormge
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaske 99519-6650 Felephone:343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
015-472-27
SPLIT
Legal DescripLion Lot 1, Block 1 GATO BEL SOL PID No:
~¢~ ~'~ FUTURE
T RNATE FIELD 1
~~ ~5 ~ PROPOSED
BM A P/L
SEPTIC SYSTEM PLAN VIEW T2
1" =50' T5
DESCRIPTION
1. CO~CTOR TO VE~I~ ~IN. 50. FOOTAGE BM B BNW PROPER~ CORNER
PRIOR TO P~CING TOPSOIL.
2. CA~ION SHALL BE T~EN TO MINIMIZE
REMOV~ OF EXISTING ~G~A~ON OUTSIDE
'"'
~, DIS~RBED AR~ SHALL ~E SEEDED TO '"
PRINT EROSION,
DraINS WITHIN 100 ~ OF NEW
A D.H.H.S. STANDmD SPECIFI~TIONS.
7. CONT~CTOR TO VERI~ 100' MIN. SEPA~TION
PAGE .5 OF 3
Permit No,
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 I-elephone:343-~744
On-Site Wastewater Disposal System and/or Well Inspection Report
015 472-27
SPLIT
Legal Description Lot 1, Block 1 GATO DEL SOL PID No: iLNOTpRocEss
PROPOSED SURFACE
SEPTIC SYSTEM PLAN VIEW
HORIZ 1"=40' VERTICAL 1"=4"
- MO~)~ING PROPOSED CLEANOUTS
PROPOSED MOi~J]'[~iNG
,, .4 cL~ouTs, ! ~ ,,
~ PROPOSED COVER I ASSUME EL 100
~,N~ TANK1250 ~ ~_ B.O.P.94.5~ 95
~..' ~ '..~2
,~,~ .. ..~
ABSORPTION SYSTEM PROFILE
HORIZ 1"=20' VERTICAL 1"=10'
PROPOSED COVER
SOILS LOG - PERCOLATION TEST ...--~....?....~.t.~'),,,
ASCG
PE~D ~R: AC~OE ~, ~C. ~ ..'~49th
......... .............. ~.co~,o~,~ ~.~ .... ~ LEO~ D~ON: ~T 1 B~K 1 GATO D~ SOL ~ ........................ ~ ~
~8~, ~O, ~ ~ 1/4$~ 24,T.~.~ SM ~ ~.*~". ."_&
DA~ PEr--D: ~C~3 ,t,-
~T HOLE s~ s~ P~
0 ~ A~ AISW PROPER~ CORNER ~L=~ooI
~ ~GA~IC ~ 2 15g' 3y
4 ~'....~'~
6 -' '-o PE~
~. ; GRAVELLY/SAND /
7' . ~,'~, WITH COBLES
O-- BROWN LOOSE
8'. a Z W~ ORO~ WA~R
' - ~ ~CO~D? N
lff o b' D~ ~ WA~ ~R
,' MO~O~G? - DA~: 1 ~93
~,, x SANDY FINE GAR~
~' o, o MANY COBLES
. .o. GR~ ~T D~ TO
~. ,~,
~ '~ NO. DA~ ~ ~ WA~R DROP
14- ~ ~ 1 ~5HAR93 11',~5 0 m~n 5'-0,0"
- ~. o ~ 11',30 5 mln 5'-1-1/~'
~ ~a~) 3 11:35 10 mln 5' ~, ~.0'
16- BOSOM HOLE 4 11:40 15 min 5'-&-1/~
17- 5 11:45 20 min 5'-0. 0" 2.0"
6 11:50 ~5 min 5'-0. 0" ~.0"
I~- 7 11:55 30 mln 5' 0.0" &,0"
~ 8 ~ - -
~ 10 ....
P~CO~ON ~ ~ ~~ P~C HOLE D~R
~~: PERC HO~ ~ P~-SO~D ~R O~ HO~ P~OR ~ ~G
PE~O~ BY: ~ L~R ~ ~T ~ ~ W~ P~O~D ~
A~O~ ~ ~L ~A~ ~ ~~ G~E~ ~ E~ ON ~ DA~:
April 5, 1993
ENGINEERS · ARCHITECTS · SCIENTISTS · SURVEYORS
Mr. Dan Roth
Municipality of Anchorage
Dept. of Health and Human Services
825 L Street
Anchorage, Alaska 99501
Re;
Septic System and Well Approval
Lot 1, Block 1, Gato Del Sol
(currently being platted)
RECEIVED
APR 5 1995
MU;l~C~pality of Anchorage
Dept. Health & Human Services
Dear Mr. Roth:
Attach is the permit application for installing a septic system on the above referenced lot. Below
is a narrative of probable impacts to adjacent properties.
Adjacent Wells - There are no existing wells within 100 feet of the proposed new septic
system. The well for the lot will be drilled in the southeast corner, approximately 200'
from the proposed septic area.
Adjacent Wastewater System - The proposed bed absorption system is the first system
on the lot. The proposed system will not adversly effect the future sites on the
surrounding lots.
o
Reserved Space - The soil conditions on the lot are very good. There is enough room
for a future system to the north and east of the proposed system.
Drainage - Positive drainage away for the field will be maintained. No concentrated
surface water will be directed toward the field and no existing streams are within 100
feet of the proposed field.
The installation of this on-site system will have no probable impacts to adjacent well or septic
systems. The proposed system's separation distance radius will include parts of adjacent lots,
but will not interfere with the on-site systems on these lots.
VAry truly yours,
~ Me'r, P.E.
Sr. C~I1 En~neer
CSM:EG:MLT: 1110-0026.051
30} ARCTIC SLOPE AVENUE, SUffE 200 · ANCHORAGE, ALASKA 99518-3035
(907) 349-5148 · FAX (907) 349-4213
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. #
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
Day phone 34/5~ ~/2. 7_-.
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
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.
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 inves_ti_gation 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.
Address ,50 / ~'~-'~'~'
Engineer's signature
DHHS SIGNATURE
X Approved for 4:~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates I~ased 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 (Re~'. 1/91) Back MOA #21
Municipality of Anchorage /~
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
Parcel I.D.
If A, B, or C, attach ADEC letter. ADEC water system number
A. Well Data
Well type ~-~0~ '~:~
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date completed Driller
Cased to Casing height
FROM WELL LOG
Wires properly protected (Y/N)
Date of test
Static water level
Well flow
Pump levetl
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot ) ~ ~-t-
Absorption field on lot
Public sewer main /~
Sewer service line
g.p.m.
AT INSPECTION
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate
Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed ~' / ~ / ~' ~ Tank size I '~ ~ C~
Cleanouts (Y/N) ~ Foundation cleanout (Y/N)
High water alarm (Y/N) "-----
Date of pumping ~
Compartments
y Depression (Y/N)
Alarm tested (Y/N)
Pumper ~
SEPTIC/HC ..... .u TANK TO:
SEPARATION DISTANCES FROM ..... '"
Well(s) on lot I O ~ d-
To property line '--J- c~ 4-
Sudace water/drainage
On adjacent lots l ~,~ ~
Absorption field ~-
Foundation ('~ ~
Water main/service line ~'~ -/-
72-026 (3/93)' Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"~-dmp off" Level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LI~A~ION TO:
Well on lot ,/ On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length ~.' Width
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
Soil rating (GPD/FF) .. ~ System type
ldO2 I Gravel thickness ~-~ ~ Total depth
Cleanout present (Y/N) '~ Depression over field (Y/N)
Results (pass/fail) ~ for
---' After test
If yes, give date
Bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot / 0
To building foundation
On adjacent lots
Surface water
Curtain drain
On adjacent lots I D ~ + Property line
To existing or abandoned system on lot
Cutbank ! O ~+- Water main/service line
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certi~ t3at I hauo checkod, verified, or con[ormed to all MOA and HAA guidefines k~
of this inspbction.
Signature
Engineer's Nam, e
Date
HAA Fee $ ~, '~ P~
Date of Payment
Receipt Number ~-~'--,.Z~_~-._ (~'-///~ /~
72-026 (3/93)* Back
Waiver Fee $
Date of Payment
Receipt Number
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
TELEPHONE (907) 562-2343
5633 B Street
Anchorage, Alask~ 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
p UBLtC WATER SYSTEM LD. #
RIVATE WATER SYSTEM ~ v (
- Phone No.
Mo, Day Year
sAMPLE TYPE:
~ Routine
[] Check Sample (for routine sample
wlth lab ref. no.
[] Special Purpose
[] Treated Water
~ Untreated Water
SAMPLE
No,
1
2
3
4
LOCATION
Tim. Colleolet
Collected By
~\'$o o_.."I-
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
j~%Satisfactor/
[] Unsatisfactory
~ Sample too long in transit; sample should
not be over 30 hours cid at examination
ta indicate reliable results. Please send
new sample via special deilvery mail.
Date Received 1\//I %
Thne Received ~
Analytical Method: Membrane Filter
* No, of colonies/lO0 mi,
Lab Ref. No, Result* Analy.~
i FT-]
LTT-1
REAl::) INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
BACTERIOLOGICAL WATER ANALYSIS RECORD
Membrar~e Filter: Direct Count
Verification: L$1~ __
Fecal Coliform Confirmation
Final Membrane Filter Resulta~
Reported By ~//~/ .~.>.~.
BGB
Coliform/leO mi
TNTC = Too Numerous To Count
OB = Other Bacteria
Coliform/lO0 mi
[?oo
PART ONE OF TWO:
REMAINDER TO FOLLOW
ENVIRONMENTA1 LABORATORY ~=RVICE$
Chemlab Ref.~ :93.6134-'i
Client Sample %D :GETO DEL SOL L! BI
Ma%rix
REPORT of ANALYSIS
5533 B STREET
ANCHORAGE. AK 995~8
TEL: (907) 562-23~13
FAX; (907) 56~-5301
Client Name :ALPINE DRILLING WORK Order :73191
Ordered By :DAVE HARPER Report Completed :11/16/93
Project Name : Collected :11/12/93. @ 11:30 hfs
Projects : Received :il/12/93 @ 14:45 hfs
PWSID :UA Technical Director:STEPH~N~. EDE
Sample Remarks: ROUTINE SAMPLE COLLECTED BY: C.T.
QC Allowable Ext. Anal
Parameter Results Qual units Method Limits Date Date Init
Nltrate-N 0.10 U mg/L EPA 353.2/300.0 l0 11/i5 [LH
* See Special Instructions Above UA ~ Unavailable
** See Sample Remarks Above NA = Not Analyzed
U = Undetected, Reported value is the practical quantification limit. LT = Less Than
D = Secondary dilution. GT ~ Greater Than
Mem~e~ (~f lh~ SGS Qroup ($Ooi~t~ G~n~ale de Surveill~noe