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HomeMy WebLinkAboutSEAVIEW HEIGHTS BLK 1 TR 6?LL,.4su)JLO Q U (. h4 q% 04,a� d (a &4� 16Le k +' mu -ani- I MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION A ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAMEPHONE NEW 1- (`'�f V J ' t- l�"/�� /!` ------- ❑ UPGRADE MAI LING ADDRESS `afy c� �46? J� %)p LEGAL DESCRIPTION LOCATION f� NO. OF BEDROOMS DISTANCE TO: Well Absorption Tarea Dwelling A,{/� PERMIT NO. U Y L) �rG7 r✓ /111`1'-_ I- Z Manufacturer s Materia e No. of compartment 4 LU la. U) Liq. capacity in g �ya ons IF HOMEMADE: Inside length Width Liquid depth DISTANCE TO: Well Dwelling m PERMIT NO. JOE 2 Z Manufacturer Material Liquid capacity in gallons Q DISTANCE TO: Well _ate! � -- Foundation Nearest lot line PERMIT NO. Lu a J LL z No. of line Length of each line Total length of lines Trench width Distance between lines I„ Z ru inches � P _,_ ___ Top of tile to finish grade ___ Material beneath tile Total effective absorption area p inches Length n l Width•_ f Depth / / Q F- Type o�,cxib Crib diameterel. _7 Crib depth /' / Total effective absorption area w DISTANCE TO: Well % Building founflOt /j / ®� Nearest lot line / Class Depth Driller Distance to lot line PERMIT NO. � DISTANCE "f 0: Building founclation Sewer line Set) C tank Absorption areas) OTHER PIPE MATERIALS SOIL TEST RATING - INSTALLER REMARKS _ P'T V" LEGAL AvQ 1, APPROVED DATE 72-013 (Rev. 3M) U I F= F -4 L_ I -T-'-r' +l+ F-- DEPARTMENT nc HEALTH AND ENV I F:ONMENTAL lTECT I OtJ ::-M ', STREET, ANCHORAGE, AK. ?'3'- 264-4-720 W E - L Fi td C" C+ r -a —'= I T E = E L• -(E �• F' E F t•1 I ��/6 r 3 v a Qo PERMIT NO. C gvcwgP( ) I Co APPLICANT ��� -e c VVI 6L �clra/ >�Z LOCAT I OFJ (� LEGAL I_ CP 81 S -P C�, i/I e w 14-r 3 LOT ' I:_E 2 z Uo U�,n TYPE OF '-OIL ABSORPTION SYS TEM I S : 0 1 ( MA XIMI IM NUMBER OF BEDROOMS = 3 SOIL RATING, (51) f=Tr'BR?= � �s_ THE REQUIRED SIZE OF THE SOIL FIBS ORPT I ON SYSTEM I S : C:"EF'TH= 1'3 LEr-4v_3iTH= )3 K 13 C-1F_FiEL-- C:•EF'TH= ARE FEETf711 7 L 16 i5(, � ZaP �T THE LENGTH DIMENSION I5 THE LENGTH :IN FEET? OF THE TRENCH 'DR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EriCAVAT I ON -, I N 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 CIN FEET?. F FEE G?1_1 I F'E0', = EF' -r T G TFirJh- I =I=— (DD 0 CiHLL+=+r•t PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THI_ PROPERTY AND THE NUMBER. OF RESIDENCES THAT THE WELL WILL SERVE. ---- -FL••J0 ' ti HF= E F:Ei U I F<E:EN --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPEC:TION AND APPROVAL BIT 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 OF' 150 TO 2100 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE: IS 25 FEET AND TO A COMMUNITY SEWER LINE I= 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 20 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND C:ONSTRiC'TiON DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F E fi I T E: F I F~: E= C� 1-= E I'7 E: F= L: 1 _=+ := ►� I C:EF:T F'T' T AT\ 1 : I A FAM I IRP.. WITH THE : J I F' MENT_ FOR ON-SITE SEWERS AND WELLS AS SET FORTH B'T THE MUNICIPAL C I PAL T Y OF A G_.Hr AGE. ^c : 1 J�ILL I a5 AL t HE f TEM P AC •OF:DANCE WITH THE CODES. ': I DE TRF > HA T E O►J-S E S 41ER STEM MAY REQUIRE ENLARGEMENT IF THE RES IDE a E R C 16ELI D Ti- i i � .� GRAN 3 BEDROOM=. S 1 GFIED : -�� APPLI ISSUED BY- _- ..-------------- ��� _ ___ � -.___C?ATE_ ��/�a --•-- 'v'4. 0 r I / 1 r MUNIGIPAUT ' OANCHORAGE ti .w U€PARTMEM OF HEALTH A#+3C; €NVIRONMENYAL F (3IE 7jott [ l PER,Ci+L.-;i+)tl 3s 0011 S1.00 18GO v€i 01ttnt t� €t} ,,,_. _ ,3 �' .... '• � ` f l--- L*AI ?LkVOF AI.-£::__mye,, r .: r`_� f3F 5C`i: (G'l 1t,JrJ: �d <.�.i � �kf '�^' a� " �_ %s'�_'�,er,,•� /�^'� 3p4'':xi `� �„'!��„�,` LtFP1#: jr ",Lfi,(£ 411E PLAN. 1EEy�i PON0091'K .1 9�v�"i' YJ:'+9 i;ftGUNCa 1"lA7 Cri 3- Y1 3 �, A,7 1Yqr4i ; k^- Nut I inu, f t?£:PIP? 20 _._ PCFIC MA -TION AA -It i `' ii 1:teq ACT. CEN — rl AML+ C{�it;§Chfi._ ! P1 4 , �`� ,r'����r' E s,*t ���� �.r �' ���� � .�cu �,Y*�,�%�-r l �"` � s,: � ;:?r �%A r�t�t-o ,�a. r ,• ,Ifr",�'� ��P, 3�tfU,BY: ___. n -ow 17fr+.',iC� ea �2 w �CLc �k / 0 i ( n O-urxGA t,Jm ,cPa ii/i �lilisJ f� .�1aR end �i>ee Cluecc r`o 6.0 c LLL # " /std t �, 3 i 20 _._ PCFIC MA -TION AA -It i `' ii 1:teq ACT. CEN — rl AML+ C{�it;§Chfi._ ! P1 4 , �`� ,r'����r' E s,*t ���� �.r �' ���� � .�cu �,Y*�,�%�-r l �"` � s,: � ;:?r �%A r�t�t-o ,�a. r ,• ,Ifr",�'� ��P, 3�tfU,BY: ___. n -ow 17fr+.',iC� ea �2 w �CLc �k / 0 i ( n O-urxGA t,Jm ,cPa ii/i �lilisJ f� .�1aR end �i>ee Cluecc r`o 6.0 c LLL # " /std SOILS Loc. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF WEALTH AND ENVIRONMENTAL PROTECTION EJ PERCOLATION t Pouch 6650, Anchorage, Alaska 99502 276.222TEST `! 1" SOILS LOG — PERCOLATION TEST PERFORMED FGR:_—10"--e—_ 0/ �YtY%Q�J` DATE_ PERFORMED: LEGAL DESCRIPTION: DEPTFI [ SLOPE SITE PLAN (FEET) �Of/I�I r"IJOT r!%�J� I_-.�_-__1_.__��-_i 1 2 3 4 5 6 7 II 9 10 11 12 13 14 15 16 17 18 19 F� cap WAS GROUND WATER S t ENCOUNTERED? m/0L I 0 P " 914 E IF YES, AT WHAT DEPTH? �errt-yyeay yi�r1e a'and3 yraaa'iny ar�dycilYb male;"n �rr�d�/ mecl"awol '�tW4"al 69"d .Jgnwy i Reading Date Gross Net Depth to Net Time Time .�'f�lf� p Drop. Or A 20 / PERCOLATION RATE � �l%F2�(iB�� �U �liNe%�inutes/inch) �(//�Lv�l E'fJ�r7Y1qV6 T ST RUN BET EEN m FT AND FT COMMENTS ���/iI%i1�/%� Il/ Iit7 O /oo 7 Vav 41.4"d cin J111W6 gtv/�7 PERFORMED BY:.IED BY:_ DATE: 72-00B (7/76) v WAS GROUND WATER S t ENCOUNTERED? m/0L I 0 P " 914 E IF YES, AT WHAT DEPTH? �errt-yyeay yi�r1e a'and3 yraaa'iny ar�dycilYb male;"n �rr�d�/ mecl"awol '�tW4"al 69"d .Jgnwy i Reading Date Gross Net Depth to Net Time Time .�'f�lf� p Drop. Or A 20 / PERCOLATION RATE � �l%F2�(iB�� �U �liNe%�inutes/inch) �(//�Lv�l E'fJ�r7Y1qV6 T ST RUN BET EEN m FT AND FT COMMENTS ���/iI%i1�/%� Il/ Iit7 O /oo 7 Vav 41.4"d cin J111W6 gtv/�7 PERFORMED BY:.IED BY:_ DATE: 72-00B (7/76) 20 / PERCOLATION RATE � �l%F2�(iB�� �U �liNe%�inutes/inch) �(//�Lv�l E'fJ�r7Y1qV6 T ST RUN BET EEN m FT AND FT COMMENTS ���/iI%i1�/%� Il/ Iit7 O /oo 7 Vav 41.4"d cin J111W6 gtv/�7 PERFORMED BY:.IED BY:_ DATE: 72-00B (7/76) A I 0 u (9 z LLM ui z z LIA SL 0 00 Ni0 Ni 7 1.4 OH E -q ca i< au V) 0 00 Ni0 Ni 7 rd A: v): W; U U Eo 0): col! 0, cni jj: "q w i NiNi NiUi VIi U cd >iCDi a); 4j: r,4, f.4 i to a. U.) f2i Ln: n: M i 00 Q M 4. (N:: C'q: : < rl r-4 H r-4 H N: 0 0 0 0 0 0 H E-4 E-1 P OH E-iPE-4PE-( V) rl CY) i 00 C) cn: r-4: C14: C14 7i �: ON rq! ,-4: r-4: r -I r-1 �: r( CN: CN: -.-P -Zr; Lf) i C'4 (N 0 0 0 0 0 CY) c"I CQ kF4 N 4j: L) > r -t 14: p co b:> Q aj: (Lt. !41 M (0:. r.4 cu:, 0 V%, 0 11 to u): pq v): pq Ni OD: N: Cl) rt r-' CN -:T c v): Ln fq W., Ll i V) M: Ni00 1 ra m r-4: r -I Le1 `Di r-1: co rw co to k+ � ro 0): col! 0, cni 5: "q w i U >iCDi a); 4j: f.4 i to a. 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N ro v U U N q v N ro N v .A W •G yA 't r-1 v Q) co v v u u 3 3 OD r� -�T L N N I� N d u1 N N T w a a Q M MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.Q. Box 196650 Anchorage, Alaska 99519-6650 343-4744 I CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # _ �!�' "" HAA # 1. GENERAL INFORMATION Complete legal description 7akc' ELoGc- Location (site address or directions) 6e I ID Vj• _bf_myr., l B t"JD . Propertyowner SKIP _Ptz'r-,'4E*SAI4.t-1.1.. Day phone z`FB'-ZSSL. Mailing address Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: _1 3. TYPE OF WATER SUPPLY: Day phone Day phone Individual well XXx Community well Public water �\ NOTE: If community well system, provide written confirmation from State ADEC attest=' ing to the legality and status of system. 4. 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. 1/81) Front MOA x21 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 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 furtherverify 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. Name of Firm 41,J DG_1`ZSO4 Phone f 4qqS!S ) Address QC). Ecx ZL/0.773 )4NC,4©a-A G' , AIL- q 9 5_z4 Engineer's signature Date�t3 1 1 q c- 6. DHHS SIGNATURE Approved for Disapproved. 2 bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments }, By, 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. 72-M(Pe.1/91) Back MOA#21 ® Municipality of Anchorage IaL MEM Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �R (°� 9lt7 Uz- �� S /l��'=�1 /4r5 Parcel 1. D. �/ j m j -7 1 - i Z - A. Well Data Well type P/Z 1 V A -7-c-- Log present (Y/N) Total depth Z Lo / A, B, or C, attach ADEC letter. ADEC water system number N/A Date completed G B Driller P�Nr l Cased to / `A9 I Casing height Z Sanitary seal (Y/N) Y Wires properly protected (Y/N) 7 Cleanouts (Y/N) y Foundation cleanout (Y/N) Y Depression (Y/N) FROM WELL LOG AT INSPECTION Alarm tested (Y/N) Date of test �6 P D 9 / 9 .9 LL SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot > 100 , > /0o Foundation cn Static water level r4-1, !V `J" r S r-L-`� / 7• � Surface water/drainage /\/ 0,4 e ) Well flow g,p.m.`� • 7 g.p.m. M Pump levell A1,9-+- LJ s-riaj UN L/ -,q () W 4 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot %/d/©� _\ ; On adjacent lots Absorption field on lot _ (�5� L%Aw On adjacent lots _ Public sewer main > / Public sewer manhole/cleanout '-;;,/0Ur Z)f Sewer service line ti qG Petroleum tank .0J Dn/ C WATER SAMPLE RESULTS: Coliform Ca Nitrate .10 rune / L Other bacteria Date of sample: 2113 lg4 Collected by: A B. SEPTIC/HOLDING TANK DATA N I ! cc Date installed -1716L60 Tank size /, Z`, CU COAG Compartments / —to 0 Cleanouts (Y/N) y Foundation cleanout (Y/N) Y Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N) Date of pumping q/l-`� // /l / q� Pumper L42 120ci -gg- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot > 100 On adjacent lots > /0o Foundation To property line > / D Absorption field > S Water main/service line > L S Surface water/drainage /\/ 0,4 e 72.026(3193)• Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access Vent (Y/N) "Pump on" level at"Pump off" Level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DI FROM LIFT STATION TO: of On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed i/1B/cS0 Soil rating (GPD/Ftz) �D() t I2 �0 System type Length /Z-•� Width Z `� Gravel thickness Total depth Fla' Total absorption area 3OD T=r7 z' Cleanout present (Y/N) Y Depression over field (Y/N) Date of adequacy test 9%191 g 4 Results (pass/fail) Pa SS for dm Bedrooms Water level in absorption field before test '31 Aftertest -3 / Peroxide treatment (past 12 months) (Y/N) 1AJ If yes, give date AJ/A, A' SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 98/ On adjacent lots '�/ 00� Property line *>/ 0 To building foundation Z -D I To existing or abandoned system on lot 1A On adjacent lots >� r Cutbank ? 50 Water main/service line Surface water 14C) AJ Driveway, parking/vehicle storage area z Curtain drain 140AJ ,,� SEC ft%AlV t 11/7- 6 19 n E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines Jmb.ff*6,&&h`ffi-P_d�te of this inspection. Signature ,, ] Engineer's Name �V ` /GNA4-L-L Av O c;iLso f 1 JI I Date t. HAA Fee $ �� 6�9 Waiver Fee $ Date of Payment �/%� Date of Payment Receipt Number �(� %�(�� Receipt Number 72-026 (3/93)' Back CT&E Ref.# Client Sample 11) Matrix ClientName Ordered By ProjectNamc Project# PWSID Commercial Testing & Engineering Co. Environmental Laboratory Services r717�lW7Z717���� X1717 ���17��1771 f� LABORATORY ANALYSIS REPORT 94.4698-1 TRACT 6 BLK I SEAVIEW HEIGHTS S/D WATER ANDERSON ENGINEERING ALAN ANDERSON UA Sample Remarks: ROUTINE SAMPLE COLLECTED BY: AH. WORK Order 82175 Allowable Printed Date 09/16/94 @ 11:16 lus. Collected Date 09/13/94 @15:35 lus. Received Date 09/13/94 @17:00 lus. Technical Director STEPHEN C. EDE Released By: �k- QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init ---------------------------------------------- Nitrate -N 0.10 U g ------------------------------------------------ m /L EPA 353.2/300.0 10 09/14/94 CMR * 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 5633 B Street, Anchorage, Al( 99518-1600 — Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA r�cco5 MUNICIPALITY OF ANCHORAGE pN` epartment of Health & Human Services } �cISION OF ENVIRONMENTAL SERVICES j a 343-4744 CERTI"ICA f`��I PECTION FOR HEALTH AUTHORITY APPROVAL OF ON -SIT AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # r V& HAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Tract 6: Block 1; Seaview Heights Subdivision Location (address or directions) • • n��•re ••-•- .- (b) Property owner Metropolitan Mortgage Telephone: (home) Business Mailing Address P.O. Rox 2162f Spokanex Washington 09210 (c) Lending Institution Same A4 nwner Telephone Mailing Address ATTENTION: Eddie Schimps (d) Real Estate Company and Agent Address Telephone SIMPSON COMPANY/Beth Simpson P.O. Box 112342, Anchorage, Alaska 99511 345-6644 (e) Mail the HAA to the following address: (or check here t�, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING/694-2979 17034 Eagle River Loop Road, Suite 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family E� Number of bedrooms — 3 �v 3. WATER SUPPLY Individual Well70 Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site IN Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 Z }o Z abed pre (9B/L ASH) M-ZL •ilaoM s,aaaulbuo leuolssa}oad oql ul suolsslwo ao sao.ua aol alglsuodsai lou sl a6eaogouy }o Alllsdlo!u n W ayl ,panssl sl aleol}llaao e aao}aq elep azAleue ao suolloodsul lonpuoo lou op SHHa }o saaAoldw3 •sluawaalnbai alels pue lsaapa} ulelaao /}sues o} aapao ul suollnlllsul bulpual clay} pue savoy }o saasego�nd o} Asa}anoo e se sly} scop SHHa a41 'e�lsely }o al,3lS ay} ul paaalsl6aa aaaulbue leuolssa}oad luapuodopui ue fq anoge 9 ydea6ejed ul uanlb suolleluasaadaa ay} uodn Aluo paseq paleol.jpao lenoaddy f\l!ao4lny 411,3aH sonssi (SHHa) saolnaaS uswnH pue glleaH }o luewlaedaa absaogouy }o /llledlolunW aql lenoaddy leuolllPuoO }o swaal leuoll!puoo panoaddesla Panoaddy a1,34 Aq swooapaq ao} Panoaddy -IVAoaddV SHHa •9 a1s0 G fi'� % aanl2� aIfie3 ssai Ppy VDZ ON nL'oZ auogdalal wall }o aweN L 6 j✓2� uolloadsul slgl }o alsp ay} uo loa}}a ul suolleln6aa pue 'saoueulpao 'sapoo alelS pue ledlolunW lie gl!M aoue!Idwoo ul sl wa}s/\s lesodslp aaleMalssM ao/pus Aiddns aaleM 01!9-uo aql 'uolloadsul pue uolle6llsanu! !w woa} pue sal!} a6eaoyouy }o /�}lledlolunW aql w04paulelgo uollswao}ul ay} uo paseq }eq} /�}!aan aaglan} I 'ulaaaq poleolpu! wnlonals }o ad (l pue swooapeq }o aagwnu oql aol alenbape pue leuolloun} a}es s! wals�s lesodslp as}eMalseM ao/pue llddns aaleM al!s-uo ayl 1,341 sMogs lenoaddy /\I!aoglny glieaH pus olaaay pax!}}e leas (w (q pa!}l}aao sy sigl }o uo!leb!Isanul �(w l,3gl /\}!Jan I 'Molaq uMogs alep uol1,3P!Ien aql }o se N0IIVWd0dNI QNV VIVO `HOaV3S 3'IId `SIS3 `SNOLLOUSNI !DNIalAOad Wald ONI833NION3 '9 MUNICIPALITY OF ANCHORAGE (MOA) a• Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1994 343-4744 Legal Description:,, P `f' 0C'_k:_1 A. WELL DATA Well Classification `Z� N) /a pA l'14 If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) fir.—Date Completed (r2--._ Yield j Golvt Total Depth ZOO Cased to 4p Depth of Grouting l 0 Static Water Level / 2 Z r Pump Set At V < Casing Height Above Ground I Z + Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) l Depression Around Wellhead (Y/N) n) SEPARATION DISTANCES FROM WELL: 7 To Septic/Holding Tank on Lot / rw-) ; On Adjoining Lots (moo To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots ! o To Nearest Public Sewer Line lA To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Z Water Sample Collected by ,�iJG ir_J���CI ; Date _ _/ O — — `Z O Water Sample Test Results 4S sf-A0.1/oV,W�4 tic/tOr A.)i±,e ✓b�e5 Comments (�)tA(uPJ (/ Epi U�ra� J -f 1Ar-Ae B. SEPTIC/HOLDING TANK DATA Date Installed-fSizeNo. of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanout (Y/N) *-A) Depression over Tank (Y/N) nJ Date Last Pumped — :" — Pumping/Maintenance Contact on File (Y/N) ti ; for pi Yt Holding Tank High -Water Alarm (Y/N) ��J6 Temporary Holding Tank Permit (Y/N) N W SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 00 r� To Building Foundation ( c) '+ / r To Property Line (0 f To Disposal Field 3 i To Water Main/Service Line to To Stream, Pond, Lake or Major Drainage Course C20 Comments°kC-(e�ANou/ l oc Ated OtJ (5t /eUe�o s e H0Mf- 5'CIrL) CC S 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ( 00 0/16L?_ Type of System Design !S� e 0 t4r:i Date Installed Length of Field f Z 5 Width of Field (Z Depth of Field L Gravel Bed Thickness Square Feet of Absortion Area 00 Statndpipes Present (Y/N) Depression over Field (Y/N) 6) . Date of Last Adequacy Test 10 Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well* S� To Property Line Z To Building Foundation .+ To Existing or Abandoned System on Lot On Adjoining Lots 3 0 -r To Water Main/Service Line (0 f ToCutback (if present) 58 To Stream, Pond, Lake, or Major Drainage Course AJ/ A To Driveway, Parking Area, or Vehicle Storage Area Pr + ( OC- rA +e 0/ a Comments 494r_I Ccl w ra I V e r ✓' t D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level a-_ Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) _ **Check Permitted Bedroom Rating Against HAA RequeA** "Pump Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect oQ thoo�_Ahis inspection. MUNICIPALITY OF ANCHORAGE NOENVIRONMENTAL SERVICES DIVISIO � Signed r�r k®v+;;ti ROW N® 2�� 99577 a &'!. Company , i Lir r,. nlaNOW 13 1990 Y ee"re`s Date �a MOA No _ cLv —oo RECEIVED fir �< .,. e. i>1r• �; t.• s Receipt No. Alamo _� Receipt No. Date of Payment 1 I- 13-' O Waiver Fee: $ L�r LSU Amount: $ () Date of Payment 1 I — 13 -9U 72-026 (Rev. 7/88) Back Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF, ALASKA, INC. 5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order # 29641 Date Report Printed: OCT 1.9 90 @ 15:52 Client Sample ID:TR 6 B1 SEAVIEW HTS PWSID :UA Collected OCT 23 90 @ 14:30 hrs. Received OCT 24 90 @ 14:15 hrs. Preserved with :AS REQUIRED Analysis Completed :OCT 24 90 Laboratory Super s r -STMEN C.��jjE''DE Released By : ` — f4 Special Instruct: Chemlab Ref #: 904470 Lab Smpl ID: 1 Matrix: WATER Client Name S & S ENGINEERING Client Acct SNSENGP P.O.# NONE RECEIVED Req # Ordered By : R. SHAEER Send Reports to: 1)S & S ENGINEERING 2) Parameter Tested Result Units Method ------------------------------------------------------------------------------------ NITRATE-N ND(0.10) mg/l EPA 353.2 Sample ROUTINE SAMPLE. Remarks: SAMPLE COLLECTED BY RJS. Allowable Limits ------------- 10 1 Tests Performed See Special Instructions Above UA -Unavailable ND- None Detected See Sample Remarks Above NAR Not Analyzed LT -Less Than, GT -Greater Than ttIDfDFi/D' v GSp y , Point Campbell Area Reference Map—P9 T \ (l 1 n. V ^ G 148 161 -<®>- 163 Y 9 x PI i2C'D r W2,VEl. QUARK -f GR. 2323 162 © COPYRIGHT 1985 JMR Municipality of Anchorage �;�� Department of Health and Human Services 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 November 28, 1.990 Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Tract 6 Block 1 Seaview Heights S/D Waiver Request #WR900054, PID #011-171-12, HAA #HA900490 Dear Mr. Shafer: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 88 feet from the private well to the seepage pit. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, &W;� V� Daniel J. Roth Civil Engineer On-site Services ljm:#6 Concur: Jn Smith ogram Manager On-site Services IVogIvFf? H6161 -?17 W R/ -LIF_ -R- 86 Qu F sT Fa R r_1?4(,7- 6 ocar 64 40, w4I�F� �c•uM,of� wIP 9oo�yo REQu.E STIFV _GE - JP/ T T 6 w - C_ ( , Gv F-ZL /7_0 _AE Su?Pl- EO 15 - --- �!;I�ArErg- 1.70A4RiIL�6 .r77/e47`/q,_f. _r/(E_ F19f7' . - TAF /V Eheau,v7--. �IEr?F _T 2 ¢_7- - To- F- E_ SEIoN -- - - j,.A'_Qyc t_FE�--Iv_/4-1 _ FNCo"ivT-,6REEO_ R_% THE 130 770^1- OF - -- R T r2,,Io ' PFE1P EIL o &A 1!1 F0 -K -TKF - PuRaof�r _OF _ 7-k Or w.4�i��r<;_ !� C y 4. ca L4 r E Z2 e9 T _ 2 4 7 F FtYE - - - -- IIS rid rt C- - - G-19. 1`E1?- LE V CL - - / S _ - 4 7-- 24f%/6/F - tn. EtL ra o?' Mdf_T-0 •��c �u/�'��c� i HP u T _ H bE Qk.9 77F- _ _ %A 997- 1F .v r rRO^l /f F'oge lo, !I!!, !, - w_ n rc/ f AE Ate ! It,, L' .5z_ k' u t FSR-.�+ r _ 24 7_ f1 L 5a rl-IlRF ----RRFE.IA u L T_ TtL49 f _ of S/ N_ /tiNp- SAND} 6IF _vEL - F,C�_ _[. J3_%�S �'(LL '��� �� ✓JNF_T/P.sT_E_ 4''it r,=Ip. _ _w_ArFn r�r1�6N ra��oJc r- _- �p P4/-I--c7_10A--_ oF_ _ til /?09 rj su r-_CaLT (A./E-LL_ )0iVILLF0 40L f 0�P1 A MUNICIPALITY OF ANCHORAGE ENVIRONMENTALSF.RVICESDIVISIUN ROBERT SHAFER, P.E. ROGER SHAFER CIVILENGINEERS A (907)694.2979 RECEIVED vemben 8, 1990 FAX 694-1211 Eq r'E RIVER,A�PS�P MUNICIPALITY OF ANCHORAGE. SERVICES DIVISION HEALTH AUTHORITYENVIRONMENFAI. Muntic,i.pa.P.i-y o•� Anchorage APPROVALS DEPARTMENT OF HEALTH AND HUMAN SERVICES ), 1 1990 825 L StiLeet R E C E I E D AnchoiLage196650 Ata,,sk 99519-6650 V SEWER & WATER MAIN EXTENSIONS REFERENCE: Tnac-t 6; Btock 1; Seavtiew Heights Subdivision; Reque6t you .issue the attached Heatth Authontity Appnova2 and gnawt a wa i-ven between the pn,ivate wee2 and the 6eepage pit on .the 4e6eneneed SEWER&WATER INSPECTION na en.t at 88 p p y U . The wetZ was comp2e.ted June 6, 1980. The septic 6ystem was tinsta22ed, inspected and the lessen .6epanation di.6tanee appnaved by the Mun.ic.i-patity o� Anchorage (MOA) on Juty 18, 1980. A water 9 sewer ENGINEERING STUDIES AND REPORTS ,, p .� appnovawas tissued on Juty 15, 1982. A jLisk anaty6tis was pen6onmed u6ting the State o6 Alaska, Department obi EnvilLonmenta2 Consenvati-ons' Separation Distance Wai.ven Guidetines. Ouh WELL INSPECTION 4mut.tJ ane a6 6ottow6: & FLOW TEST A. WATER TABLE: From the weft dog bon the ne6eneneed pnopenty, water was 6ti4st SITE PLANS encountered at 247 to 248 6t. deep. Tki,6 teave6 a separation distance between the seepage pit and .the water table o6 appnoxtimatety 235 6t. = 7.7 points ROAD DESIGN B. SOIL SORPTION From the weft lag there ane vahious strata o4 dti56en.ing eompo6tit%an. However, the Boit tayens above the aqu,i6eu SOILTEST senv.ing this weld appear to be mastty composed o6 clay. In eonstidenation o6 the sandy tayens bum 0-117 6t. we w.itt u.5e "clay 9 sand equal". = 4.5 pt6 PERCOLATION C. PERMEABILITY TEST With the 6oits as duckibed above use "6tizt on bandy clay". = 2.0 pts STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Tract 6; Block 1; Seaview Heights Subdivision November 8, 1990 D. WATER TABLE GRADIENT: Since the well does not appears to draw water gram within bedrock, .the hydraulic gradient can be bigured using the maximum waters level drawdown and the horizontal separation distance. Water Uirst encountered at 247 to 248 bt. Maximum drawdown equals 260 bt. well depth minus 247 water table which equals 13 bt. The separation distance is 88 bt. There4ore, the hydraulic gradient is approximately 140. .8 pts E. HORIZONTAL SEPARATION: The Horizontal Separation Distance is 88 4t. = 2.5 pts TOTAL POINTS = 17.5 Therebore, it appears that "No bacterialogical pollution possible, but chemical pollution passible but unlikely from household chemicals." Others mitigating 4actors involved which support the issuance ob the waivers are as hollows: 1. The well log shows several layers ob sail (including clay layers) which would detour the migration o6 septic e64tuent Brom the seepage pit to the water aquiber. 2. This is an area consisting oU large lots. This indicates a low septic density. This will insure a low septic system (i.e. contaminate) density bor the area. 3. The septic system on this property has been in use 6or 10 years. the systems have been in use long enough gor contaminates to maize their way into the well ib they were ever to do so. However, baeterialogieal and nitrate results Urom the reberenced well were 6atis6actory. As a matter o6 gact, there were no nitrates at all detected. It is our opinion the horizontal separation distance prescribed by 18AAC72.021 is not required in this case. Attached {nor your review ane the hollowing documents: A. Well log on the reberenced property. Adjacent property well log. B. Septic system as -built. C. Water analysis results. D. Anchorage Area Was Map. Page Three Tract G; Btock 1; Seaview Heights Subdivi4 ion November 8, 1990 16 you have any quesionb, or tib you require additional ingorma.ti.on 4or your review, pf4ae contact ue. 21 RT A. SHAFER, P.E. gm ,7 JY_ r v r APPLI VT PILLS OUT UPPER "A, ONLY Property Owner (�� 1 <( _ (, `'>�I :-IZ. 11) fa [v Phone (li- IN Zip Code J Mal;lng Address > fe Buyer ... Date Address •1 , Zip Code Lending Institution =- ta' ��,� � tj- �' ��I''--�� -. Phone Address P C, (`., (-t J j C \'� Realty Co. 8 Agent .,j Phone Address""""—_---- - Zip Code Legal Description Street Location 1 Type of Residence 'CONDITIONS OF APPROVAL k" Single Family ❑ Multiple Family No. of Beds ❑ Other Water upply BY: C Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community Well Log Received %V U For wells drilled prior to thatate, give well depth (attach log if available). ❑ Public Utility Well to Tank a U Sewer isposal I Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time fe Date Date Date (LZ all Inspector Inspector Inspector Inspector Field Notes: W d 1 ( 3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE BY: C Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received %V U Septic Tank Size _. S-0 — (go Well to Tank 12023 (3182)