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HomeMy WebLinkAboutSEA TURN BLK 1 LT 8Sea Turn Block 1 Lot 8 #017-121-47 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121307 Tax Code Number: 01712147000 Work Type: Septic Upgrade Permit Effective Dates: November 09, 2012 to November 09, 2013 Design Engineer: ANDERSON CONSTRUCTION & ENG'G Subdivision: SEA TURN Site Legal Address: SEA TURN BLK 1 LT 8 G:3138 Owner/Address: RUMFIELD SCOTT G & LINDA J 14800 ZIRCON CIRCLE ANCHORAGE AK 995164335 Site Mailing Address: 14800 ZIRCON CIR, Anchorage This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank Lot Size in Sq Ft: 56063 Total Bedrooms: 3 N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: !i /A/' MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. of iL — n ( ^ y ?2 /� Property owner(s) S e'O ?V f4ii., t/ 1 r (%L Day phone Mailing address Site address IC400 Z:trCon Gy V - Legal description (Sub'd., Block & Lot) S'cQ wrrt L u4 - Legal description (Township, Range & Section) Lot Size5'U/ 0 3 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ® Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank ❑ Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 411,4 �11,4 (Signature of property owner or authorized agent) Permit/Rush Fees: 553rd Waiver Fees: Date of Payment: CP I n I I a- Ck- XwL I Date of Payment: Receipt Number: IS 6''5 a Receipt Number: Permit No. oSPId% 'i Waiver No. Permit App_9-1-12.doc Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 Nov. 9, 2012 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Sea Tum Subd. Blk 1, Lot 8, Revision letter and response comments To Whom it may concern: This is a request for a new 3 bedroom septic system. A test hole was excavated along the north property line, the soils consisted silty -sand (SM) material with some small silty gravel layers (GM) for the entire 14 foot depth. Water was observed at 9.5 feet during the excavation and at 9 feet after the 7 day monitoring period. The perc rate was measured at 8 minutes per inch. The new system will consist of a 64 foot long by 3 foot effective, 5 -wide trench parallel to the contours, seethe site plan. The old system will be abandoned in-place due to the encroachment of the neighboring well. The surrounding property to the north is vacant and the neighboring properties on either side are occupied but they will not be impacted by this new system. The slope is flat as you enter the lot, then gradually slopes down about 3 percent to the northwest with no cut banks or open water with 200 feet. The scaling of the drawing has been corrected. The existing field and neighboring wells have been revised to match the existing system layout. The contours are two feet and this has been labeled on the 50 scale site plan. The design calculations have been revised to three feet of effective depth due to the seasonal high ground water measurements, thus the length was increased to 65 feet. Please call me if you have any questions. Sincere y Michae N. Anderson, P.E. DESIGN CRITERIA - 3 BDRM X 150 = 450 GPD SOILS = 450/0.8 = 562 GPD (562 GA/5)*0.58 = 65' (TH#1) 0.5' ORG 7wh e H2O ® 9' *W 2012 VACANT LAND — — — — —EXISTING SEPTIC — — — — — — — — TURN S/D \ BLOCK 1, LOT 7 Fi 4.0TRENC ' DEEP 3.0' EFFECTIVE 5.0' WIDE 65' LONG (TH#1) 0.5' ORG 7wh e H2O ® 9' *W 2012 VACANT LAND — — — — —EXISTING SEPTIC — — — — — — — — TURN S/D \ BLOCK 1, LOT 7 �� NSEA \ i\ WELL \ \ � \ \%� � 11A T BLOCK URN1. LOT 4> \\` EXISTING HOUSE SEPTIC\i / / \ �_...✓ EXISTING WELL \ \ 100' RADIUS \\ \ / SEA TURN S/D \ V BLOCK 1, LOT 6 \ \ O \ v/ // 14' PROPERTY OVER �-FlLT ER ERFABRIC 0 PIPE SM -4•p SEWER ROCK 5.0' SEPTICEEPTIC FIELD SECTION SEA TURN S/D BLOCK 1, LOT 9 i/ WE 1 1 � .W \ � i -- ��EXISTING WELL ` ,•100' RADIUS j SEPTIC� `----'' Septic Design Prepared for SCOTT & LINDA RUMFIELD SEA TURN, BLOCK 1, LOT 8 Anchorage, Alaska SEA TURN S/D BLOCK 1, LOT 10 Michael N. Anderson, P.E. DATE: 11/6/2012 4661 NATRONA DRIVE DRAWN: DJR ANCHORAGE, ALASKA 99516 345-3377 / FAX: 345-1391 1 SCALE: 1"=100' } i VACANT LAND W/ NO SLOPES GREATER THAN 25% OR OPEN WATER WITHIN 200' � I � f ; SEA TURN S/D\V I 1 \ it - i BLOCK 1. LOT T ;, 1250 GALLON yyy 7� STEP TANK 1 EXISTING TANK t I TO BE PUMPED ;' AND CRUSHED �`1 PROPERTY LINE I SEPTIC + Y r SEPTIC —ZIRCON CIR— ( / Septic Design Prepared forvj SCOTT & LINDA RUMFIELD ... .•��E OF qp�� �.�p •..... ........ SEA TURN, BLOCK 1, LOT 8 49♦♦ Anchorage, Alaska ■,,,,,;`., „T" ' ♦ 0 ....... .. ... ♦ 01 0 ........................................:.. Michael N. Anderson, P.E. DATE: 11/6/2012 18_". MICHAEL N. ANDERSON;:. 4661 NATRONA DRIVE DRAWN: DJR ♦♦1� N 1� 14'x— : ANCHORAGE, ALASKA 99516 ••.....• 345-3377 / FAX: 345-1391 SCALE: 1"=50' 30' EASEMEgT ---- 20' L)rILrLY—EASEMENT \ 2' CONTOURS Al i EXISTING HOUSE I � I � f ; SEA TURN S/D\V I 1 \ it - i BLOCK 1. LOT T ;, 1250 GALLON yyy 7� STEP TANK 1 EXISTING TANK t I TO BE PUMPED ;' AND CRUSHED �`1 PROPERTY LINE I SEPTIC + Y r SEPTIC —ZIRCON CIR— ( / Septic Design Prepared forvj SCOTT & LINDA RUMFIELD ... .•��E OF qp�� �.�p •..... ........ SEA TURN, BLOCK 1, LOT 8 49♦♦ Anchorage, Alaska ■,,,,,;`., „T" ' ♦ 0 ....... .. ... ♦ 01 0 ........................................:.. Michael N. Anderson, P.E. DATE: 11/6/2012 18_". MICHAEL N. ANDERSON;:. 4661 NATRONA DRIVE DRAWN: DJR ♦♦1� N 1� 14'x— : ANCHORAGE, ALASKA 99516 ••.....• 345-3377 / FAX: 345-1391 SCALE: 1"=50' Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. ci.a nchorace. ak. us (907) 343-7904 �r••� :J�fl+r ' 49TH ; k .• e• 4 ..........., ••-•a:•::•..•.••.••.• ' MICHAEL N. ANDERSON .'et. CE - 9469 : y Soils Log - Percolation Test F9� •.,,,..• '��*`° r Performed For: //'�� tQ l�' 12ta rvt l` r Ir l Date Performed:_ I �i Legal Description: 7e.*4 r r„ IF Lo Township, Range, Section: �N(7arntZ C� tdkss) S, �y e,ong 5� W� 'SJwt Pj Cay zvS, 11 14 —Its 040 15- 16- W WAS GROUND WATER Date ENCOUNTERED? Net Time IF YES, AT WHAT DEPTH? Q� 1 Depth to Water After Monitoring? ry l i7 Date: / Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop " f 3rtl PERCOLATION RATE (minureunch) PERC HOLE DIAMETER to II tt (TEST RUNBETWE,EN 'Z FT AND 7 FT COMMENTS ae r tl 4 t �� S %aitr r PERFORMED BY: M N4 r CERTIFY THAT THIS TEST WA PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: _u I K 12-- _ _o MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & ENVIRONMEN-rAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 \-- ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW /' / ',�f p ( ''e4 A (�'��-I fi/?—" ❑ UPGRADE MAILING ADDRESS - LEGAL DESCRIPTION LOCATION n NO. OF BEDROOM J Well Absorption area Dwelling .� PERMIT NO. DISTANCE TO: Uy w2 Manufacturer Material _ /J No. of compartin F N Liq. capacity in gallons /000 IF HOMEMADE: Inside length Width Liquid depth _j y DISTANCE TO: _ Well Dwelling _ PERMIT NO. J2 2 z F Manufacturer Material Liquid capacity in gallons O wr DISTANCE TO: Well n/ /y�� ! Nr Foundation G%!!l/ Nearest lot line 'Q l PERMIT NO. -G�9_ LL z No. of lines -G— Length of ea'c/h r ' Total length of line / / Trench y� Ith. "C:. Distance between lines p/l F- ? x ,lyine —_� 9 '�/� % �/ �� inches CCF Top of tile to finish grade Material beneath tile Total effective absorption area 0 inches Length Width Depth PERMIT NO. W C7 Q F Type of crib Crib diameter Crib depth Total effective absorption area w LU Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. W W � DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ^� PIW r 1 / E,— r SOIL TEST RATING O:a iJ .i INSTALLER REMARKS LEGAL— ft-' )� APPROVED e DATE Z2�� (2 e- i 72-013 (Rev. 3/78) (/ � �U �I �I ���I �� �� ���" ������21{0�J ��� \ DEPARTMENT HEALTH AND ENVIRONMENTAL '::OTECTI8N / ^0 �25 '� STREETj ANCHORAGE. HK 9��01 ��0u X � - 264-4720 L- L- ��� CK r-A_S3 1 -T L- E-:-:. 11-4 r----- I 'T � PERMIT NO. ( 800]44) QT� `l ``' \- HPPLICHNT GERALD & SRA BOX 460-H 99507 276-1777 LOCATION ZIRCON CIRCLE RHBBIT CRfte LEGHL. . { LOT SIZE 50000 SQUHRE FEET TYPE OF SOIL HBSORPTION SYSTEM IS: DRHINFIELD M80.4I1,1UM NUMBER OF BEDROOMS ] SOIL RATING (SQ Fl�BR)---- .150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS/ ���1-11-1=3 "--. �����1-1= RE.' 0 rP ei I..."�L- ������ � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETNEEN THE SURFACE OF THE GROLIND AND THE BOTTOM OF THE EXCAVATION (I@ FEET). -F H ����I--- t -A �I F-- -IF H I ! =-. `�5. 0 RON 1--_l F- UE: -11- THE GRAVEL DEPTH IS TME MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIpE AND THE BOTTOM OF THE EXCHYHTION (IN FEET). lf�I[F-G!Kj I I r-" -IF Fl V-4 U.", _,-. I �-_, c- .. ::LC -1 �������-o P-4� PERI'lIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTION5 OF ANY WELLS ADJACENT TO TI -1I15. PROPERTY AND THE NUMBER OF RESIDENCES, THAT THE WELL WILL SERVE. -Ir H 4 Co �;2 �-� 1 t,-4 !:-; F -"u U--- 0- -r 3: (--K r-4 Fj r -d C- F-� EE G! 1,-J 1 F: -'F -"n BHCKFILL. ING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL HND ANY 8N -SITE SEWAGE DISP0SRL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE 1471-1- TO H PRIVATE SEWER LINE I -C; 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED FIND MUST BE RETURNED TO THE DEP8RTME-14T WITHIN 30 DHYS OF THE WELL COMPLETION. OTHER RE8UIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS FIRE AVAILABLE TO INSURE PROPER INSTALLATION, ����I -T- FZ" #-- I E-MLIR ���(Z-1 I CERTIFY THAT 1: I HM FAMILIAR WiTH THE REQUIREMENTS FOR ON --SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INS -TALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I U-JEERSTHND THAI' THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THWBEDROOMS. SIa�������_ APPLICHNT GER --LD 8, ELIZHBEr.&� / ALLHRD /// 11 / / r3 d(n -DATE...--Z/.. Nv SOILS LOG MUNICIPALITY OF ANCHORAGE �, ❑ • +.E,, DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION r TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: ��[[GL/ 1 �!'� ) DATE PERFORMED: Tj�Yo LE=GAL DESCRIPTION: C',4` tiCr%� 7� yyD PE > SLOPE SITE PLAN E 4' .J 2- 3 4 5 7 8 9 10 11 12 13 14 15 16 17 18 19 20 z-7 .5' 410 . ......_G—.. COMMENTS 5- vl-Z/ e C a �� �; i 9 C L tc WAS D�i( ENCOUNTERED? ��-f�' rT IF YES, AT WHAT /C\ _0 E �7 r DEPTH? �o40F At 000rr,.,rr��� a, �!rrcea s r„ee,R,orprrlHr�B,® ��F NO. 1732•E i June 22, .1468 r�ke�",. PERFORMED BY: 72-008 (6/79) Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN :7�r 4„%CERTIFIED B (minutes/inch) FT AND FT I DATE: b�o -JaX� Wuvw ID211161 INQU WWK %(Pp I, NtOM j.tqo 'S� 'It 110UWbo. A ANCIfff0MtAGY&q AILAhiKKA 90*9102 SIX INCH WATER WELL DRILLED AND CASED OUTTO THE DEPTH OF MAO DRILL.FD ATTHE RATE OF PER roar. 11tit 1"('d 34 3604 PROPERTY OWNER LOCATION Or WELL, SITF-.-.-- f3e)uI'Le C,j.oa,6 o.f kaupoAt Dlu'--Way IDERILLER WELL LOG: I Cta,i- tv�!Ah 30,9z', vArtuct. 128 Tee�t, 77>-72/' S"'J.,ty, 4aadly. q"?avel, IlyzaL 40';�o C-4ay- 1.24-428, (oocl A w(,,t .wady. c.4ay.0 15% (peeve.(_. 128 Tee�t, 77>-72/' 00.,te,'t 4(Ulu-e Ue"IAJ, 4tttjj,, 1.24-428, (oocl f -L -Le. gAvve.1 ihottytaf1a Nate)lytoda.cA"I'all, of ovm. lo -')'//L Go fect'oj.. f -e -at oll- ho'Uolll. C(;,),t, al, Co/m'= of ll",c.,-J.t Seat: rf22,50 314 pvriq-� 4hou,U), Im in'64aUo'd, terl, COST INCLUDFS ALL, LA13OR AND MATERIAL FOR COMPLETION OF SAID DRILLING. )AtRITr. CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THI'4.' SUM Or. 0 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS 80 SERVICE CHARGE OF 1Y,% PER MONTH WILL BE ASSESSED ON PAST DURACCOUNTS- MUNICIPALITY OF ANCHORAGE 0* 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. # 017-121- 47 { HAA #k�`:`1 1. GENERAL INFORMATION Complete legal description Lot 8; Block 1; Seaturn Subdivision Location (site address or directions) 14800 Zircon Circle Anchorage, AK _ Property owner Al Art-eson Day phone 345-1869 Mailing address 14800 Zircon Circle :anchorage, AK 99516 Lending agency Day phone Mailing address -- Agent FBarbara Bowden/ERA Professionals Day phone Address-'­ Unless ddress" Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XX Community well _ Public water 2-3300 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 XX 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 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 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 Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature Alaske Water & Phone 337!6 /77 ANCHORAGE, Wastewater Consultants, hom fhaii be PAID $ r1(�S 4 or prior to, closing for the Engineering Services Provkfe& 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments (f bedrooms, with tfie following stipulations: 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. 72-025(Rn.1/91) Back MOAN21 Municipality of Anchorage RECEIVE (g DEPARTMENT OF HEALTH & HUMAN SERVICES APR 26 1999 Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (90WL) 'W ANCHORAGE t NVIRONMENTAL SERVICES DIVISION Health Authority Approval Checklist Legal Description: �J'i dl(9(! C Lu/'y1 _ Parcel I.D.:_� A. WELL DATA pp "� Well type r// Ua If A, B, or C, attach ADEC letter. ADEC water system number _ Log present) Date completed �" / /"0 U u Total depth t 2- S \ / Cased to /02 Y _ Casing height (above ground) Sanitary seal(Y N) _ Y Wires properly protectedN) FROM WELL LOG AT INSPECTION Date of test I,- % Static water level (� 0 Well production g.p.m. 0 g.p.m. WATER SAMPLE RESULTS: Coliform Nitrate J� Mq L Other bacteria �- Date of sample: y' Collected by: AK wa&,L (fWadkwn(n . (���ea �ahfis . (Ke , S�rnp/c" Dh '/-/9- 99 B. SEPTIC/HOLDING TANK DATA Date installed Tank size /000 Number of Compartments a CleanoutstN) (Y Foundation cleanout N) _ Depression (Y6l A High water alarm (Y&f Date of Pumping q_Z?,� Pumper Aom L ry/C e,5' C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) 15*0 Bye_ System type frenc�i Length (1/iD Width 5 Gravel thickness below pipe � —Total depth Effective absorption area `i50 Monitoring Tube present@N)__�/ Depression over field (Ytl lel Date of adequacy test _ Li- 7- `�9 Results (Pass/Fail) _ PQSS For __ - bedrooms Fluid depth in absorption field before test (in.); 10 Immediately afterrl55gal. water added (in.): le- J Fluid depth 9.25 (ins) Minutes later: a5 Arf Absorption rate = 4,50-1- g.p.d. Peroxide treatment (past 12 months) (Yo f Ono _' Air dw t'7 If yes, give date 72-026 (Rev. 3/96)' 1- /hUerf f0 60?�Oh I O SC�rr��D /e // D. LIFT STATION Date installed Manhole/Access (Y/N) _ High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in evel at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: , Septic/holding tank on lot /04 Absorption field on lot /Oy / e— "Pump off" level at* i On adjacent lots !OD On adjacent lots Public sewer main Public sewer manhole/cleanout �f Sewer /septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation /off Property line /U Absorption field Water main/service line /O Surface water/drainage /00 f Wells on adjacent lots /DO SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation 3 % Water main/service line 025 Surface water /OU t Driveway, parking/vehicle storage area 01 50 �t Curtain drain f'lO W kf Wells on adjacent lots % 7li F. ENGINEER'S CERTIFICATION e OF AI / certify that I t in e u fiel inspections and review of Mu P', ;t t ',H in conforma e with A uidelin s in effect on this date. -- P z Signature �,� :np oa d e• too," Engineer's Na %u' YA. M p a .7953 Date 4 -IJ -7`, '"�- f a�sso4�li'' e •t;,., JFpSSi� HAA Fee $ �� P0, cI cy Waiver Fee $ c _ Date of Payment � / I Date of Payment Receipt Number 0.x%3 j!� `� L Receipt Number 72-026 (Rev. 3/96)* APR -14-99 17:27 FP,ON-CTE ENVIRONMENTAL ME Environmental Services Inc. CM Ret.# 991489wi Client Name AK Water & Wastewater Consulwlis Inc Project Nave/n SCAMM, l..ot 8, Bk 1 Client Semple TA Seamm, Loi 8, Bk 1 Matrix Prinking Water Ordered By. MIA 0 5618301 T-0113 P.02/03 F -UT Client Pt# Printed VaterTitne 04/14/99 13:15 Coliected AatelTittle 04/08/99 17:30 Received Ante/'Time 04i09/99 1::05 Techoicnl Director: Stephen C. Ede Releasw By Attoanble Prep Ana Ly5i6 Pararnexerr Results Kt. Tr UniTS t7ECno4 Liil)!CS _ paee pate Inst Total Coliform 11 08/100 K, NO Coll smiB 92228 04/09/99 KAP Nitrate -N 0.500 u 0.500 ma%L EPA 800.0 10 max 04/09/99 04/09/99 SCL MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES M 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 Parcell.D.# 017-171-47 HAA# 1. GENERAL INFORMATION Complete legal description Seaturn, Lot 8, Block 1 Location (site address or directions) — 14800 Zircon Circle, Anchorage Property owner Keith & Celeste Sampey Day phone Mailing address 14800 Zircon Circle, Anchorage, AK Lending agency N/A Day phone 345-7086 Mailing address Agent Jim/Real Estate Support Services Day phone 1-800-829-7377 Address 7825 Washington Ave. South 000, Minneapolis, MN 55439 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well X 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 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 1121 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 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 Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Eagle River Engineering Services Address P Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. 773294, Eagle River, AK 99577 iz L?k bedrooms. Conditional approval for Additional Comments Phone 694-5195 Date 5 ..i ".r .. • �.••10 b �Cd O. bedrooms, with the following stipulations: 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. 72-025(Rev.1/91) Back MOAa21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: :]�C/l;rUA'-/V L07 �' LPA Parcel I.D. A. WELL DATA Well type 67 If A, B, or C, attach ADEC letter. ADEC water system number NVA Log present (Y/N) �/E `� Date completed 0,5 / 90 _ Driller /IIvif 4/�/� Total depth L g Cased to 1 Z F Casing height Sanitary seal (Y/N) %��� = Wires properly protected (Y/N) YCS FROM WELL LOG AT INSPECTION Date of test Static water level '% r Well flow g.p.m. g.p.m. t� Pump level SEPARATION DISTANCES FROM WELL TO: CD caw Septic/#e4ing tank on lot — f /00 ; On adjacent lots f ADD Absorption field on lot /Z/ % ; On adjacent lots A Public sewer main 4NLI Public sewer manhole/cleanout Sewer service line 71 /0 7 Petroleum tank / omc J/�f�/%� WATER SAMPLE RESULTS: Coliform •ell, Nitrate At� 01 / Other bacteria Date of sample: U//05,293 Collected by: 0 B. SEPTIC/KGJ.MNG TANK DATA Date installed lalogAo Tank size /DDG Compartments L Cleanouts (Y/N) y5 Foundation cleanout (Y/N) _ y��� / Depression (Y/N) High water alarm (Y/N) Alarm tested (Y/N) /y Date of pumping 0Z� ®193 Pumperij/{C /S SEPARATION DISTANCES FROM SEPTIC/HQtDtNG TANK TO: Well(s) on lot /CJD On adjacent lots /0(2" Foundation %Z To property line -Absorption field 10 �recc�c.F) Water main service line Surface water/drainage 6Z14 -0– ✓ 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y. SEPARATION DIST_APd�E FROM LIFT STATION TO: Well D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water Date installed DBD ��L� Soil rating �5� ��C' System type 40,CA/A/ CGU Length 6,b Width / �` f�rav I thickness 7 y -Total depth Total absorption area Cleanouts present (Y/N) Depression over field (Y/N) A( -Z Date of adequacy test Results (pass/fail) /�JSS for bedrooms Peroxide treatment (Past 12 months) (Y/N) If yes, give date Z/,/4 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wel I on lot /q cJ On adjacent lots "I/x Property line i To building foundation 3 % To existing or abandoned system on lot i On adjacent lots t n Cutbank 81 A Water mala/service line �© v Surface water N14 Driveway, parking/vehicle storage area -/-/0/ Curtain drain NU1/rC ///'�'�L'�N% E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name7.rG F /Z/9 Date ,,era ° 7,. HAA Fee $ 7D` CJD Waiver Fee: $ Date of Payment// Date of Payment Receipt Number/- f:7 (o40� Receipt Number 72-026 (Rev. 3/91) Back MOA 21 NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 4563116 • FAX 4563125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 • FAX 2749645 Eagle River Engineering P.O. Box 773294 Eagle River AK 99577 Attn: Louie Butera Report Date: 01/08/93 Date Arrived: 01/07/93 Date Sampled: 01/05/93 Time Sampled: 1500 Collected By: MD Comments: Lab Number Method Parameter Units Result ---•--------------------------------------------------•------------------- A121923 EPA 353.3 Nitrate -N mg/l <MDL Reported By: Susan C.r. tfental Microbiology Supervi8 Date Date MDL Prepared Analyzed ----------------------- 0.1 01/06/92 * Definitions * B = Below Regulatory Min. H = Above Regulatory Max. Our Lab #: A121923 E = Estimated Value Location/Project: Seaturn 8/1 M = Matrix Interference Your Sample ID: Lot 8, Blk 1 D = Lost to Dilution Sample Matrix: Water MDL = Method Detection Limit Comments: Lab Number Method Parameter Units Result ---•--------------------------------------------------•------------------- A121923 EPA 353.3 Nitrate -N mg/l <MDL Reported By: Susan C.r. tfental Microbiology Supervi8 Date Date MDL Prepared Analyzed ----------------------- 0.1 01/06/92 G MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services j ` DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # 0 1 J 1 �a � I >-�1 HAA # �A( SS_�n'- 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Tz,J F-3pj 5e&3S .Location (addr d?dtrec (b),Property,owaier. Telephone: (home) 9/�yBusiness'" Mailing'Address A' -';J j B1,QCll ?iiia /S5,40oAhl_l PM 98a2-7 (c) Lending - Institution / �r Telephone Mailing Address j6 /.044/ (d) Real Estate Company and Agent ��i�rAX 77Z4'7�-/5A Address 7-61'10 ewbo✓Q Telephone 7,74 z76 1 /�< 9Y_sz 3 (e) Mail the HAA to the following address: (or check here`4 if hold for pick up.) List contact person and day phone number below: SGS i`>/de u/1- 2. TYPE OF RESIDENCE Single-Family'O Number of bedrooms 3 3. WATER SUPPLY Individual WeIM 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 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. 7/8B) Page 1 of 2 Z_S- al sE,49rr,eJ 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 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 �% CS Telephone x'79 –S'SS3 Address /T/Z / 33 / f6t)4'y' 1�4- 75 5 Date 7—/7-97 j few h4� ••• 0.t7 • 4 �•*i "t0 00066 •0660i* f A* see .a6 Engin r rpt §e Y C REID, JR. g ` CE - 2251 : w k, foot a be 6*9 64060 AV 6. DHHS APPROVAL --�--- Approved for —bedrooms by Date Approved 4�<_- Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 orderto 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 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • Haalth Authority Approval (HAA) CqE„ K1[I.I,ST - FEBRUARY 1984 t 343-4744 Legal Description: A. WELL DATA Well Classification If A, B. C, D.E.C. Approved (Y/N) Well Log Present &N) Date Completed 8"�� Yield 4AM I i Total Depth /-", Cased to Depth of Grouting i4- i Static Water Level 7F — Pump Set At t� Casing Height Above Ground / Sanitary Seal on Casing ON) Electrical Wiring in Conduit (DN) Depression Around Wellhead (Y8 SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot /eTo'-�- ; On Adjoining Lots M7 To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots — /OV To Nearest Public Sewer Line i1 To Nearest Public Sewer Cleanout/Manhole d A To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results 7- A//71?o*7&1 �- Comments d6t-L . F4,,nJ -7—C37- 7-/7-89. B. SEPTIC/MOLDING TANK DATA Date Installed �"8 �� Size /a-� No. of Compartments— J Standpipes) Air -tight Caps&N) _ Foundation Cleanout (ON) Depression over Tank (YoN Date Last Pumped 7 -/f -8'q �f^AG5 Pumping/Maintenance Contact on File (Y/N) ; for IdIA Holding Tangy HigHWaterI ,Y/N) N /i) Temporary Holding Tank Permit (Y/N)J114 SEPARA1'QN,DIST�S-��£�/I EPTIC/HOLDING TANK: To Water-Supply,We1To Building Foundation /Z'S To Property'LM..,ry, /t) y4 'To Disposal Field /a To Water Ma(Ft/Ser+rice Lined �` To Stream, Pond Lake,or,Malor brainage Course x - Comments 72-026 (Rev. viae( Front Page 1 of 2 0 4,X 61 56gTNxot/ C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata / Type of System Design b�'A-1'J'`AF42� Date Installed �'�'Length of Field (06 / i Width of Field % Depth of Field ' I/ Gravel Bed Thickness y Square Feet of Absortion Area e171 Statndpipes Present (YYN) — Depression over Field (Y16 Date of Last Adequacy Test — Results of Last Adequacy Test FQuATr- SEPARATION DISTANCE FROM ABSORPTION FIELD: —/7—,?9 To Water -Supply Well -f To Property Line i To Building Foundation /O f To Existing or Abandoned System on Lot �4 ; On Adjoining Lots TA r To Water Main/Service Line /D f To Cutback (if present) N 1Q To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area /e) Comments D. LIFT STATION Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments — Dimensions Manhole/Access (Y/N) . _ "Pump Off' Level at Vent LY/Ni - Cycles during Adequacy Test. "Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA guid���4i inspection. %� °•••°.•°• q Signed °. Company �EC1 �° —•°•.•• °°..• Date '/ MOA No. oz -7 Receipt No. - _.�l / 41 Date of Payment Amount: $ Z On Receipt No Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 the date of this 0006 - a ROY C. REID, JR. Y CE - 2251 .• a I1 4 � ••••••..•• e 4 neer's Seal HEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99510 TELEPHONE (907) 562.2343 FEDERAL TAX ID N 92.0040440 ANALYSIS REPORT BY SA14PLE for Work Order 4 16229 Date Report Printed: SEP 1 89 0 02:54 Client Sample ID:L8 B1 SEATURN 0/3 TAP Client Name A E C S PWSID :UA Client Acct AKECSRP Collected AUG 28 89 e Ins. P.O.# NONE RECEIVED Received AUG 28 89 0 16:15 hrs. Req B Preserved with :AS REQUIRED Ordered By Analysis Completed :AUG 30 89 Send Reports to: Laboratory Superyl . soX STEPHEN C. EDE 1)A E C S Released By"Iw::-5 C �b 2) Special Instruct: Chemlab Ref 4: 7223 Lab Smpl ID: 3 Matrix: WATER Allowable Parameter Tested Result/Units Method Limits -------------------------------------------------------------------------------------------------------------------- IIITRATE-11 ND(0.10) my/1 EPA 353.2 10 Sample SAI4PLE COLLECTED BY A. WEIN Remarks: 1 Tests Performed See Special Instructions Above UA=Unavailable ND= None Detected See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT=Greater Than ` s - C DATE RECEIVED INSPECTION APPOINTMENTS - "v TIME TIME Ill TIMEI DATE DA DATE- SINGLE FAMILY ❑ Two ❑ Five SQ INSPECTOR _ INSPNTOPECTOR ,SUPPLY St{ , INDIVIDUAL- *ATTACH WELL LOG. A well log is required for all wells drilled IP_,' 1CHORAGE since June 1975. For wells drilled prior to that date, give well DEPT. Of- H`AI.TI1 & depth (attach log if available.) MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL K,(ALCTIOR DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION - - 7( INDIVIDUAL/ON-SITE** 825 L Street - Anchorage, Alaska 99501 - ( 4 NOV 1 11980 ❑ PUBLIC UTILITY ENVIRONMENTAL SANITATION DIVISION NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Telephone 264.4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. P%�AtPERTYOWNER - - - - - - - - PHONE MAIC DR G uc A c� PROPERTY RESIDENT (If different from above) - - - - - PHONE- - 2. BUYER � � � � � PHONE MAI LI NG ADDRESS 3. LENDING INSTITUTION PHONE 7 �I `' S / �f� ]� W/L i7t� � Ue � MAILING ADDRESS s 4. REALTOR/AGENT ✓ 'J PHONE MAILING ADDRESS - - - - - 5. LEGAL DESCRIPTION STREET LOCATION _ // le /_U d F V-1 k,C'O!'U 6. TYPE OF RES] ENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER ,SUPPLY St{ , INDIVIDUAL- *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM r - �` 7( INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) IuI 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/CN -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED —� INSTALLER r ❑Septic Tank or ❑ Holding Tank Size:_ If Tank is homemade give dimensions: SOILS RATING LD TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVEDFOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 6� _V BY vc� Q� 72-010 (Rev. 6/79) 825 "L" SI'REET ANCHORAGE, ALASKA 99501 (907)264-4111 GEORGE NA. SUL[ IVAN, MAYOR DEPARI HENT OF I-If-ALTII AND ENVIHONMFN-FAL PROTECTION November 18, 1.980 Gerard/Elizabeth Allard Star Route A Box 460-A Anchorage, Alaska 99507 Subject: Lot 8 Block 1 Seaturn Subdivision Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: (1) A well _log submitted to this office for our review. (2) The water analysis report needs to be delivered to this office from the Chem Lab, 5633 B Street, for our review. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: First National Bank of Anchorage Post Office Box 720 99510