HomeMy WebLinkAboutSCIMITAR #3 BLK 1 LT 11AiA
NO
L4
3A os ,w k e a,00 ()
MUNICIPALITY OF ANCHORAGE
_
/j DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME C�J•J /,� �^
�//C L G �j�� L� /
PHONE
NEW
❑ U PG RAD E
MAIL G ADDRES$^Po s s-;
LEGAL DESCRIPTION
LOCATION r
- I _
NO. OF BEDROOMS
DISTANCE TO:
We� /�
Abscrpt> arep/
Dwellingi� .rL�
PER -
U Y
„
5
f
H Q
Manufacturer /� /�
J'—rC=�J�
Ma n I �G
No. of compartments
P
W �
Com'
W
Liq. ap . yj,p,gal l ons
�jCJ
IF HOMEMADE:
Inside length
Width
Liquid depth
1'
DISTANCE TO:
Well
D Iling
PERMIT NO.
Jzz
-F
Manufacturer
Material
Liquid capacity in gallons
=
DISTANCE TO:
Well/z'
/ ,_
Fou f
Nearest of line
l'-+
PERMIT NOuj
No. of lines
Lengt e ch ]?fe f
Total l as!
7'
Trench d
Distance betw§ej�li s y�
W
P ¢
inches
F
Top of tile to finis rade f„�.,
IV� erie,benea ti e �2 /
- (�
Total effective a sorption area
.�
inches
Length
Width
epth
PERMIT NO.
W
0
Q l-
as
w
Type of crib
Crib diamet
Crib depth
Total effective absorption area
LU
DISTANCE TO:
Well
Building foundation
Nearest lot line
Class
Depth
Driller
Distance to lot line
PERMIT NO.
w
R:DISTANCE
TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATIOG
INSTAL
17 C .
REMAR S
l
>Gk t`2 k 1 1(jJ-"01'#7F
41u
0 "1
o �e z-
t_
t�3Rolaeit A. Shafa; o
°o No.
_^c
APP D DATE LEGAL--t'"'•+ rs-;
p]
r T
7:7AI3,(Aev.3178)
Departmen" f Health and Environment Protectiorf,' —
825�y Street, Anchorage, AK.`—'49501
264-4720
Permit # 1 # # # HANDWRITTEN PERMIT # # #
WELL AND/OR O4-SITE SEWER PERMIT n 121Y.
Applicant: Mailing Address: PL7
Location: Phone Number:
Legal Description: zd f a Q/h I �E%l�i[ Lot Size:
Type of Soil Absorption System Is:
Trench:_ Drainfield: _ Seepage Bed: Holding Tank:
Maximum Number of Bedrooms:_ Soil Rating(sq.ft/br) 5 S ,
The Required Size of the Soil Absorption System Is:
DEPTH — 2 LENGTH ;. GRAVEL DEPTH � WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in 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(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE _ ®dam GALLONS # #
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
# # # TWO(2) INSPECTIONS ARE REQUIRED # # #
Backfilling of any system without final inspection and approval by 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 or 150 to 200 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 is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
# # PERMIT EXPIRES DECEMBER 31, 1 9 3 3
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I and stand that the on-site sewer system may require enlargement if
the es'd ce is remodeled to include more that 3 bedro
Signed: Issued by: a
Appl c t
Date: y `/ - r3
SWP/024 (1/81) Y�t
PERFORMED
LEGAL DESCRIPTION
DEPTH
(FEET)
J �
2
bJ
3 d
4 0 �.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
5 J 1I
6 6rX/V
7
Gross
8
0
7457-E Z'
Reading
0
Time
9-
Water
Drop
10
10-
11
11
s
12
13
`
14-
415
a
is-
14
16
1617
-
17
18
19
20
COMMENTS_
I
PERFORMED Bf
72-008 (6/79)
OF A
�ryC�1 P, Bln
)w/
SLOPE
J SOILS LOG
❑ PERCOLATION
TEST
DATE PERFORMED:
SITE PLAN
WAS GROUND WATERS
j)
ENCOUNTERED? 4{• L
O
IF YES, AT WHAT E �r /
DEPTH?
Gross
Net
Depth to
7457-E Z'
Reading
Date
Time
Time
Water
Drop
)w/
SLOPE
J SOILS LOG
❑ PERCOLATION
TEST
DATE PERFORMED:
SITE PLAN
WAS GROUND WATERS
j)
ENCOUNTERED? 4{• L
O
IF YES, AT WHAT E �r /
DEPTH?
PERCOLATION RATE
TEST RUN BETWEEN FT AND
CERTIFIED
(minutes/inch)
DA
Gross
Net
Depth to
Net
Reading
Date
Time
Time
Water
Drop
c"y
is
a
14
PERCOLATION RATE
TEST RUN BETWEEN FT AND
CERTIFIED
(minutes/inch)
DA
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION CJ PERCOLATION
I� TEST
1 825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: / ' / v S%!C S {��•S DATE PERFORMED:, &/
LEGAL DESCRIPTION: /"r Il /J�K l ('r/V)-r alre,
SLOPE SITE PLAN
i
(; lJIJ ( �PIVO T 60AVs.L,
2
:d
3-
4-
6 4 6 :t5
7 Eil IU n (�P,AVJ,L
s0/62
16
17
✓r 4.
's
Gross
Time
9
Depth to
Water
fl°n=.o-•. an •° acus
iJ Robert A. Sha <
10
v ``e. No. 1457-E ° `^
qq I a°
11
�•1�•
\,tom
,2
u
rode
• l0£5S�•
13
tom. �
,
14
quo ® M
15
_ ¢ t� _FneOoe•
16
17
Date
Gross
Time
Net
Time
Depth to
Water
fl°n=.o-•. an •° acus
iJ Robert A. Sha <
18
v ``e. No. 1457-E ° `^
qq I a°
19<t.�Jp
\,tom
tt
rode
• l0£5S�•
tom. �
20
COMM
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
�o L
L
O
P
E
.,
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
Af
tt
PERCOLATION RATE/ (minutes/inch)
TEST RUN BETWEEN FT AND FT
PERFORMED 8Y: CERTIFIED BY:e o�/ DATE:
I f. 1 J CtY�g 1
fi ivy J it•/6J
72-008 (6/79) ` tt'i. f '.•J - -'f,°
/ATER WELL RECORD
STATE OF ALASKA I
1
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Surveys
F
-
or filing Permit No.
i. LOCATION'OF WELL --(Plsoee aamplete either -to,Ib or It.)
-A.D.L. No.
la. oro 9h Subdivision Lot Block Ib. 1/44trs.
s��ca2�
Section No.
Township N C] Ranee EE) Meridian
_
'iia_ 3 _af_of-a,_
S❑ Wo
1 lc: VISTANCE AND DIRECTION FROM ROAD INTERSECTIONS
_
�'�2 -af! i f e�
-3. OWNER OF WELL: r ,/
-
Address: gJaRJ %�/2
-Strut: Address, and Area of Well Locaflon
v
2 WELL LOG -.
Feet Below --
.8urfoce -
q, WELL, TH: (final) 5. DATE OF. COMjl1ETION p
L/ - / 2`f
z
. ."
_ . —
Material`Type,
Top
Bottom
., i�• _1_,•Qn� .. ..7// �eA.'
n.
..
6. ❑ Cable tool tory C] Driven-. Dug',
�
D Augsr is C3 Bored � other;
._ 20 - /25
2i!-..-�aVe
_
SE; Domestic Public Supply Industry
Irrigation C] Recharge Commerl Cal
r
4Q' navel . 139
t _
i
D Teel Well � Other: .
C
r
V r. /
S. CASIN Q Thr /,A Welded
r/✓ /r ibs./ft,
-In.
' 11Q �,�m �Q_I _ QF,�.. nQ
qiLf
/G/I
/74
diem. to ft. Depth Weight •
<. -"ILO.. eR 1/10c' tva e? LRC c '
dlom.- In. to. fl. Depth Stickup -}t.
,,2Qei1/�•CORe. - -/`� /�?
9. FINISH OF WELL: 7/
iLactwce
/
l
Type: C,2en Hgo e Dlametert 6q
y�een� ne
2c 0
Slot/Meeh 3lzs: Length:
E.
Sol between n. and ft.
( naCiLULe
-2�0
2(5
Gackflilinq Gravel pack
1 n
"naCfwLe
10. STATIC WATER LEVEL: ft.
neemtone;
3
275
oaf.
Above or Below land surface
`
/
t
Equipment used:
'
//0/
440
i
Lraeen��'z`�oRe L
fnaC ll/LQ .i/Xbten.'-_Loc
%it
4/f.
f
11 . PUMPING LEVEL. below land Urfa" and YIELD
r
it. after hrt. Pumping g•P•m•
y2QeR�• nP_
` t
IfJJ
�
t
}t. after - hre. Dumping g•D•m•
-
12.GROUTING Well Grouted: � Yes � No
r
`
"-
Motr ria!: Neat Cement Other:
MUNICIPALITY OFA
I,
eFL
ENVIRONMENTAL PROTECTION
13, PUMP: (If available) HP
N
N
[
Length of Drop Pips ft. capacity - q.0•m.
r
---
Subm. ❑ Jet O Centriflcal -. 0 Other
r
[
.LD
f
`
-
-
14. REMARKS: t - rr•h'
r. �rr.;1 %e j #e q.� l u� �l•' 1�
/ems/rn��Z.ii�n� aft
o
lL'S-1, 0
16. WATER WELL CONTRACTORS CERTIFICATION:
7 1
Water Temperature —° ❑ F t.-.1 C
- This w I was drilled oder y jurisdiction and this report is true
�'rL�xLLy�oR
to the best of my knowledge and belie i; -
,�Ln�
- Rt�pl■��7end Business Na e . / -
% ,04 aC1.Lf_ : �t.LV(�/Lr i�r
2s -
Contract License Number
97577
l.'. ,��UX -:
- Address:
aR r.
93
' �.1 all ?Lt�fL�
-' Signed: i
ti
(late: ,
-
Authorized Repreeenfaliv
1I
form 02-WWR'(II/81).�-Co;pj Distribution:
WHITE-StaleOGGS,
____ -
PINK -Driller. CANARY -Customer
•
• �� 8L
•� _'~1 Municipality of Anchorage
On-Site Water and Wastewater Program 4' � 1I
(907) 343-7904 s ..
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-132-90 Expiration Date: 1 2_`1 -/ 7
1. GENERAL INFORMATION
Complete legal description SCIMITAR#3 BLOCK 1, LOT 11A
Location (site address) 19603 BELDUQUE COURT, CHUGIAK,AK 99567
Current Property owner(s) PATRICK&ALLISON BUDKE Day phone
Mailing address PO BOX 671686, CHUGIAK, AK 99567
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual
Individual Well ® Holding Tank ❑
Individual'Water Storage ❑ Community ❑
Community Class —Well ❑ Public Sewer ❑
Public Water System El
WaiverNariance request for: Distance:
Received by: 46,4c I .1 I Date: f f /17
COSA to be released to the engineer,unless of Pe(requested by the engineer.
COSA Fee $ Waiver Fee $
Date of Payment 7 Date of Payment
Receipt Number 620d) Receipt Number
COSA# 405U? Nig Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ARCTERRA CONSULTING,INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD., EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 911/2017
THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested.
The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use,
local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the
system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function
satisfactory for current or future occupants or can ArcTerra guarantee that no unseen ��
encroachments,deficiencies or discrepancies exist. �� Or` z
�
Pf, Til 7* }
6. DSD SIGNATURE
System #1 Approved for 3 bedrooms. + �� KENNETH M. uu
rov
System #2 Approved for bedrooms. + rT 7
116 -
% Air
Disapproved. 1 o•. •
Conditional approval for bedrooms, with the following stipulations:
�.�'�4t�j jTY(OI7
`G)
(
ft
e
0
ONSIT
wgTE.R AND ;
▪ PRoGo
• WASTE
- - rsvts
By: � �.,. `� Original Certificate Date: 9 " i' "(
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory / Arsenic Advisory.
Well Flow Advisory 5
f Other
COSA blue sheet_10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: SCIMITAR#3 BLOCK 1, LOT 11A Parcel ID: 051.132.90
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID # Well Log (YIN) Y
Date completed 1/2411983 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y
Total depth 465 ft. Cased to 170 ft. Casing height(above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 1/24/1983 8/22/2017
Static water level -- ft. 161 ft.
Well production 1+ g.p.m. 0.58 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 3.65 mg/L
Arsenic.` ° ug/L Date of sample: 8/22/2017 Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC f STEEL a installed-1344004
mss; '44-11
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping 51/0/t1 Pumper JRs
C. ABSORPTION FIELD DATA-MT extends approx.2.5' below invert
Date installed 4/15/1983 Soil rating (g.p.d./ft2 or ft2/bdrm) 85 System type DEEP TRENCH
Length 26 ft. Width 5 ft. Gravel below pipe 5 ft.
Total depth 7 ft. (Measured 8/22/17) Eff. absorption area 260 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 8/22117 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test dry 0 in. (30"below inv.) Water added 600 gal. New depth 30 in. (at inv.)
Elapsed Time: 5 min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN) _
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 1001+ _
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+
Animal containment areas 501+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 1001+
F. COMMENTS
Per visual inspection and pumper,septic tank appears to have normal operating levels and functioning. Approximate 300-gallon water
storage bladder in crawl space. Monitoring tube extends approx.30"below invert. Field readily absorbed 600 gallons.Similar well flow
observations as 1997 well flow.
G. ENGINEER'S CERTIFICATION
t certify that I have determined through field inspections and
review of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date. ` OF AI\
y
Engineers Printed Name KENNETH M.DUFFUS /�4� �151
Date 9/112017 * • `
COSA canary sheet_2-6-15.docr
t;�� L81oti�, �
Municipality of Anchorage
Development Services Department
Building Safety Division 5 4 i LIV
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Water Well Advisory
Certificate of On-Site Systems Approval (COSA) # OSC 17141 8
During a recent COSA on-site inspection and test of the potable water
supply well on Block 1, Lot 11A of Scimitar #3 subdivision, the well's
productivity was determined to be .58 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 3-bedroom
residence is .31 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
\ \\
X \
LOT 12 x
I
J x
BELDUQUE
COURT o r=�, x S x
o• �x� �S 234'
I
\ rf'o �� x�x��7yc' �2"�y
/5, x\,,30 �V 75 x
\ \ °� \ �rivTy ,x�x 757 8,>'
C*
y ��\V / FSMT \x\• �� CD
``1 / x\x\a x E--.
6ti /®WELL �x�i� 0
•.•O
60 ��. a
OOO�IA.
Ti o
`�"'
, 1*\,;:fl",\,
o_
‘0C)
0,P
r--
O
GRAVEL O
D/W KD
N
W
E-',
86.4' N E�-i
LOT 10A oU)
co -53-- `_, N W
80 1° w
PI
N
1-7% 's VI- ` 9i li o a4
0 �� w. o,' 2$o a rn `, o O '-
ta x
o. G`(1\0 0. ' 0 U
N o5 i
a
N o 0, ao.s °°
13'GPN'C o•��5 'o O ►�+
5p o" �6�P� ` U
• KD
co O -0-••
z S w N U7
y I W
ZI- Z
LOT 11A J =
BLK 1 SEPTIC . o I
VENT � -til
(typ) U
W
(/1
rn
a-i
I 1� a
N00'15 00 W 163.50'
N00'15'00"W 163.50'
ANCHORAGE RECORDING DISTRICT, ALASKA
0 =FND REBAR
AS-BUILT OF:
SCIMITAR SUBDIVISION UNIT No.3 =FND AL CAP MONUMENT
LOT I 1 A BLOCK l PLAT 83-20 _``"`` \>,,NI,
, LAND j�tj>
SURVEY CERTIFICATION: 1,John L. Schuller, have conducted a = �F A��` ���10 �� f
physical survey of this property as shown on this drawing and that the �' ......• `
improvements situated thereon are within the property lines and no li`: `1� � '41 �� ���G
enchroachments exist other that noted. ,, 49TH / *#I ,�a ,�
EXCLUSION NOTES: It is the owners responsibility to determine the % % x r
L.) ` a r
existence of any easements,covenants, or restrictions which do not '
appear on the recorded subdivision plat. Under no circumstance should I�. .•.J HN L. SCHULLER. % �
any information on this drawing be used for construction of fences, r�r -10408 ���� ,, , i
structures, improvements, or for establishing boundary lines. (1;a ••n •Z J• J °"'i" "" ~
,aA °�- 7 ,a i 1831 Talkeetna Street
WORK ORDER NUMBER: AUG 29, 2017 SCALE:1�=30� E-MAIL: �k\``"==`�/ Anchorage, Alaska 99508
1 7-040 DRAWN BY: CHECKED BY:GRID NUMBER: BOOK/PAGE: (907) 227-1455 office
JLS NW1261 170153 (907) 274-4992 fax
From: Brent Western bmwkndeng@ak.r g
Subject: Re:SCIMITAR#3 BLK 1 LT 11A
Date: September 15,2017 at 10:39 AM
To: Ecklund, Timothy J EcklundTJ@ci anchorage ak us
Cc: Dea Duffus dea@arcterra.net
Per visual inspection, the deck which is 6 inches from grade has no pier blocks or supports impacting the septic tank.
Brent M.Western
Project Manager
ArcTerra Consulting, Inc.
907-440-4601 Cell
907-868-3791 Office
907-868-3793 Fax
"Quality is never an accident;it is always the result of high
intention,sincere effort,intelligent direction and skillful
execution. It is the wise choice of many alternatives."
--William A Foster
4 44,i
•
4
� t
On Sep 15,2017, at 10:34 AM. Brent<brentwestern( gmailcom>wrote:
Sent from my iPhone
Begin forwarded message:
From: "Ecklund, Timothy J"<EcklundTJ@ci.anchorage.ak.us>
Date: September 14, 2017 at 4:24:11 PM AKDT
To: 'Brent' <brentwestern@gmail.com>
Cc: 'Dea Duffus'<dea@arcterra.net>
Subject: SCIMITAR #3 BLK 1 LT 11A
<Onsite Review Comments pdf>
%7
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES A��HUu���
Division of Environmental Services �11Y �� 01\11S1014On-Site Services Section -, Aouvlas
P.O. Box 196650 Anchorage, Alaska 99519-6656W1RO �rv� 519g�
343-4744
CERTIFTH AUTHORITY
APPROVAL IFOR ACATE OSINGLE LFAMILY DWELLING
Parcel I.D. # Ci51 _ !3 2 _ 9(2 HAA #
1. GENERAL INFORMATION
Complete legal description CIM 17A� S/� LST
Location (site address or directions) M03 9E1_0UQU r_ CT .
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.1191) Front MOAa21
wKp 5641- 71o7
Property owner hN ( WIU_lAi"S
Day phone HMA" 188-2-22-2—
Mailing address
Lending agency
Day phone
Mailing address
Agent C ?-_A1vNi= C06L
Day phone 68(- 6y6Y
Address ?E79L LS -(-,4-7E
r bq&L,—t� 2,uE'f(_
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: KEE\/
3. 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.
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.1191) Front MOAa21
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.
Alaskari
Name of Firm Wa. 1. .er ... Sees Phone
Address
Engineer's signature
6. DHHS SIGNATURE
Approved for
Disapproved.
Additio
By:
Conditional approval for
bedrooms.
Date /0
�,.� - k,%%V. �
OF
•p �g n4 a4c °
a' r
P D E-7953
D
bedrooms, with the following stipulations:
C.
4UTIC
Date 0-09-'27_
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 courtesyto 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. 1/91) Back MOA X21
NUN�ti�rAl1TY Off' ANGN Jtu v�
Municipality of Anchorage ��vv��C EMA1,SERVICES DNiSN�
DEPARTMENT OF HEALTH & HUMAN SERV fi99i i
Environmental Services Division s MOM
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343 4744
Health Authority Approval Checklist V
Legal Description: L7 IIA"/&411 SPw17,44 S�0 Parcel I.D.: DSC -/ -%
A. WELL DATA
Well type t IL1t)87 If A, B, or C, attach ADEC letter. ADEC water system number f�,J 1A
� 1/
Log present &N) kS Date completed / ay
Total depth
Sanitary seal &N)
4'ATTAc4Eo
Date of test
Static water level
Well production
6c:, Cased to / �0 Casing height (above ground) I,/-
Wires
,
FROM WELL LOG
!%aH1s3
/yoT 61 U&PJ ON %,
It
Wires properly protected ON) Yk.S
AT INSPECTION
lv%6h�
rs )-'
r q6m.
WtFL�w 047/+-
/+-
WATER SAMPLE RESULTS:
Coliform 0 Nitrate + n��/ u - Other bacteria
Date of sample: /�/46�9� Collected by: J F f�
B. SEPTIC/HOLDING TANK DATA
Date installed I5I Tank size NCO 6ftL Number of Compartments —,?— Cleanouts&N)
(1' 1/
�
Foundation cleanout
N) 1E-9 Depression (Y fi o High water alarm (Y/N)
Date of Pumping O9/aa19q Pumper
C. ABSORPTION FIELD DATA I_
Date installed S) S3 Soil rating (g.p.d./ft2 or /bdr n) System type lac
Length a 6 Width 60` Gravel thickness below pipe 6o" Total depth TKLL N"Uf SumP
S ,w. a'SF
Effective absorption area S r Monitoring Tube present (Y N) �� upDepression over field (Y/0 deo
Date of adequacy test /06 6 Results (Pass/Fail) PflSS For bedrooms
Fluid depth in absorption field before test (in.); W `Immediately after 5(63 gal. water added (in.): �2
(Vvas"CAa)
Fluid depth ICI ��(ins) Minutes later: Z Absorption rate = y�)O g.p.d.
Peroxide treatment (past 12 months) (Y/O NOT LowN If yes, give date WA
a�.5" 3r1c�w Trav, � ,� "
72-026 (Rev. 3/96)* UL1(4 t -VL, = � y � Su�..p �xzcNoS ��y 31.5 13�LOw
LUQ. LVL = 1_" 4%0V&- -INV,
O '�S c�2lBu7l�w PIPs
Ui�w- LUL = «.0 9G"w ZNV. (ANAGLF-- Tu MEAS. L'OWfA1, o`tOi3"OF
D.LLIFT STATION/A-
Da e-instladed
Manhole/Access (Y/N)
High water alarm
E. SEPARATION DISTANCES
ump on" level at*
Ions
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot loo - On adjacent lots
i
Absorption field on lot SOC) 4- On adjacent lots
Public sewer main
Sewer /septic service line
"Pump off" level at*
NIA Public sewer manhole/cleanout
dna 1�c
o �4
NIA
,� t�V Lift station AA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5 + Property line /0 �1 Absorption field 5 f Fe- TNcp, kePnRT
Water main/service line (� �f Surface water/drainage 106�F— Wells on adjacent lots /Oy r�
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line /D 4 Building foundation 10 1-f Water main/service line
Surface water I bu , k Driveway, parking/vehicle storage area _ Z
Curtain drain Notlltfr f MLO" Wells on adjacent lots 1,00'4-
F. ENGINEER'S CERTIFICATION
l certify that I have
in conformanugri h
inspections and review of Municipal
)s in effect on this date.
Signature
Engineer's Na e
Date 1-4 2"
HAA Fee $ Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Date of Payment
Receipt Number
104 -
Surface
U4 -
cord that the aDQ, . stetps are
14.
a-sn
'off ryA.Gorw
5,
t
-
MUNICIPALITY OF ANCHORAGE
M E M O R A N D U M
WATER WELL ADVISORY
HEALTH AUTHORITY APPROVAL NO.'\AN.9_7cnLI�F)
During a recent Health Authority Approval on-site inspection
and test of the potable water supply well on Lot ((
Block ( of :�'iwli�a r Subdivision, the well's
productivity was determined to be D._qb gallons per minute.
The minimum well productivity required by this Department
(AMC 15.55) for a 5 bedroom residence is 0.312- gallons
per minute. Although the subject well currently exceeds this
minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction
of non-critical water uses such as washing cars and watering
lawns and gardens may be required.
This advisory must be attached to all copies of the subject
Health Authority Approval.
Alaska Water & Wastewater
8471 Brookridge Drive — Anchorage — Alaska 99544
Phone (907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
October 13, 1997
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Subject: HAA for Private Well & Septic System. Lot 11A, Bk 1, Scimitar S/D #3.
To whom it may concern:
The subject lot has a 3 bedroom house on it which is served by a private well and septic system.
The results of the field investigation and adequacy tests are summarized as follows:
WELL: Attached is a copy of the well test data. The total duration of the test (including
pumping and recovery cycles) was approximately 8.5 hours. The total pumping time was 5.67
hours. The recovery rate after the last pumping cycle was 0.46 gallons per minute. It can be seen
that there was a small decrease in the recovery rate after each of the pumping cycles. Based upon
this data it was determined that the capacity of the well exceeds the Municipal requirements for a
3 bedroom house (.31 gallons per minute). The ability of the well to comply with M.O.A
standards may vary seasonally.
SEPTIC SYSTEM ADEQUACY TEST: Attached is a copy of the adequacy test field
measurements. Based upon this data, it was determined that the absorption rate of the trench
exceeds 450 gallons per day, as required for a 3 bedroom house.
NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not
limited to, seasonal surface water infiltration, groundwater variations, septic system
maintenance (frequency of septic tank pumping, usage of biological additives), condition of
drainpipe and pipe joints (which can be damaged by seismic activity and deteriorate with age),
type of substances deposited in septic system (cigarette butts, sanitary napkins, mise. objects),
and the amount of water being introduced on a continual basis. Consequently, the results of this
adequacy test are only valid for the specific day of the test. Furthermore, because of the limited
NmetEP '732 Cau oas avE2 8.5 vrcu04 043 ni,�K s�
It/
nature of this investigation, it is possible that there are hidden defects which may not have been
detected. No warrantee is made regarding the future performance of this well or septic system
If you have any questions, please contact me at 337-6179, or on my digital pager at
1-800-481-1162. Thank you for your assistance.
moo` we_ CD u LD tj Y C -e7- ,a.,y P�� ij
1-74 I • -5riLI C=VC-' PUMP IS C' 1-74-
L06—)%Q'L06—) w� w t s 4651 Dom'
So g -4A4 "LOw t S
V ,� lcao w nl
ooaooa
Jwww==
Nwi�oo
rUU
NWLLuyy
X880
a
yuGLL Fl w 1,=�;7. �ft?4_ � l2—
�e r,v�,zaa Sly �11-3 A Loz //A.1 614(
Wlal�a
TmE-
SW L
Gas
PUFF .PaD
(Z4TF
CCsPek)
4 10
10;12
���'
1�Y'
+qy=
0t`/
5 = 9ss
11:3`i
jat
+A& Soca
11.42
, 0q`t•5
+18,5 = SIM>
1�,3
1 co
r ll yh
+35= 553.5
119
�z ao
, Jyy5
4-30= S83•S
1•S
> Wel-r— 94� ity
— SEa 12Ecouety
TizS i ►7A74.
NWIClun - cap 6- K-xsE &Q
W!79 Fcow 7u2nvCi�? O/V Ft4(.L
FRom 't' yi*, 4-o I1' 3 = 161 M)r,. tc)n. 10744
ISI
177E7 b//z07 E 0h �ditwi
G/�/L41 lJ
m
6
N��mN
M,wMm
`...
" •
?-nnnF
0000DDO
CCCccc
mmmTTT
v
177E7 b//z07 E 0h �ditwi
G/�/L41 lJ
m
6
N��mN
M,wMm
`...
" •
?-nnnF
0000DDO
CCCccc
mmmTTT
O
O
Q
Z
C
0
In
o
rC7-
IP
177E7 b//z07 E 0h �ditwi
G/�/L41 lJ
m
6
N��mN
M,wMm
`...
" •
?-nnnF
0000DDO
CCCccc
mmmTTT
aoa000
wwww==
_ wwo
WNNFUU
NLWwYY
�(21NN QQ
D 4 rof ��rr
Isci m cTA4L
T1AAP
iW(Z-
Gprw-�NS
l�f�D1✓1�
M7
V CIW-%P)
ST
1 SS, Or `f
t2-61= YS3
;)B,S"
35 ���'`
lz:zo
15cr /tit's
+130.s =
S,f
35,1zI�
SToPPF /nnot i ki to iw7
�SSMw iRY
Sy(�;Tp,� A6soiz&,-c--0 Y32G,-L rw Lflla
Ff� zwo&
�j`�6 Su/t4P
DUla-5 P -W -x N�
FULL- DRP714 IN7< ?Qr—&
L
A Au
{tL0 Ir+4u
gIVS(Amle
(Y F -,-JO 0
/U"Uo= ;t1'lze1$&oW INv
32`11IiUQ = ► u AgavE Div
i
,4
� tuck-
.
r .
cc
�• fir, F�•� 1 rr .
f J
scar �..�rd • �`c�
r
r
AS••BUILT
I hereby certify that I have surveyed t* 10 fol;ovring desm.bcd
property:, a ' ;l,d,i.5/ack IF
_ r _
Anchorage Recording i'recinet;Alas ca, and that the impr.ove-
mPmts situated. thereon are witWn the .property Vries and do
not overlap or'encroadh .on the. property lying adjacent there-
to; that no improvements on, property lying adjacent thereto
encroach an the premists In question and that there are no
�� roadways, UAnsmission lanes or oche visible easements on
`a 'es±Y r -ars saidproperty
exeeptas=mdicatedhereon_
this- .day o?
HOEERT C. JOHNSON-
' SCALE: Registeredland Sum yor No. 88�NLS
Box 456. Eagle River, Alaskz
Phone (007) 6614-2543
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES p}1
Division of Environmental Services Mei
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 1. D. # C 6 � - \ 11 - c� r)
1. GENERAL INFORMATION
Complete legal description
HAA#
Lot IIA; Black 1; Scim.itan Subdivision #3
Location (site address or directions)
19603 Betduclue Count
Property owner Kon & Debbie F2onoy Day phone 688-4248
Mailing address P U Bax 671056 Chug.iak A.easka 99567
Lending agency
Mailing address
Day phone
Agent Jean Mc Dani.e2 EXSELL REALTORS Day phone 276-3333
Address 3333 Denae�l st4aet suite #lu) AnchotLage, Ataska 99503
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 \,'
3. TYPE OF WATER SUPPLY:
XX
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.
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 S & S ENGINEERING Phone
17034 Eagle River Loop Road No. 204
Address
Engineer's signature
6. DHHS SIGNATURE
_42L_ Approved for ZgLe� bedrooms.
Disapproved.
Conditional approval for
Additional Comments
IN
Date 0-�
OF A
°a
0
`tin_ •
°row°aa°ea°cilaoaue'ae �
1•IAf`ER
No. 32 5
ip
"*fee, 11
4ht'� OFESSIOt5
bedrooms, with the following stipulations:
NUTIONw
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 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(8ev. 1;91) BaCk MOA 021
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: `-�"r �� A` Z! 1 SlaHtro�
g p Parcel I.D. _ 4�V_ 432""yd
A. WELL DATA
Well type ZA\k Ae(F If A, B, or C, attach ADEC letter. ADEC water system number . a
/-Z N_g 3
Log present((/N) Date completed f a Drille* I`� D emJ4OSa�
14-
Total depth 4 (p 55 t Cased to 10 r Casing height Z
Sanitary sea[V/N)
Date of test
Static water level
Well flow
Pump level
FROM WELL, LOG
1- `23
0Y_
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot 1 oa'
Wires properly protected ON) _
AT INSPECTION
1 U'9
�$ yP f do
g.p.m. 1, i
t)iL iJ )1EUL
ISt'. 7Jf� TD
Quo S�c.-C
; On adjacent lots
Absorption field on lot t> d t
; On adjacent lots L v o k
�I�
`� �¢
Public sewer main
Public sewer manhole/cleanout
r't'I
t (�
ewer service line ZS
Petroleum tank �-`>� t }
1 'v
WATER SAMPLE RESULTS:
iil
GU�
/tooa
D Ao d 6l
Coliform Nitrate
• Other bacteria
Date of sample: �'� $ -`� b ( `� ' -`t Z
Collected by: S & S ENGINEERING
77034 Eagle, River Loop Road No. 204
Eagle River, Alaska 99577
B. SEPTIC/HOLDING TANK DATA
��Tank
Date installed 1`143 size
C>tx> Compartments Z
Cleanouts CYN) Foundation cleanout (5f/N) T Depression (Y'&
High water alarm (Y& A
Alarm tested (Y/N) �1A
Date of pumping S 12 -w
Pumper :Tff-, GESS Pat. L
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot (not 4- On adjacent lots 1 D a t 4'- Foundation
To property line 1c>; Absorption field 5 t - Water main/service line
Surface water/drainage 100 t
r!
72-026 (Rev. 7191) Front CONTINUED ON BACK PAGE
ym
oZ
Z
m y
Z r
t-
0 O
C
ti z
o O
< D
rn G7
Z
C. LIFT STATION
Date installed
Size in gallons
Vent(Y/N)
High water alarm level
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
Meets MOA electrical codes (Y/N
SEPARATIO ANCE FROM LIFT STATION TO:
n lot
On adjacent lots
D. ABSORPTION FIELD DATA
_ " P level at
tested
Surface water _
'i
Date installed 61 C63 Soil rating $S �I �� System type 'rte 1Lhi
Length
Total absorption area
Width L-vbV Gravel thickness
2 lv D C�
Cleanouts present &N)
Total depth
Depression over field (Y& .-S Date of adequacy test
Results as ail) PDfS for ! ikC-Fdz- ca,) / bedrooms
Peroxide treatment (past 12 months) (YA9Y ^S If yes, give date 'ilk
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
k
Well on lot t oo t On adjacent lots l o U v Property line ) t
k
To building foundation I t To existing or abandoned system on lot
On adjacent lots �� t Cutbank "'1 � Water main/service line_
Driveway, parking/vehicle storage area
S6
Surface water
tGC-) tk
Curtain drain $13
E. ENGINEER'S CERTIFICATION
to t'r
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe /u!W%sg%%of this inspection.
G���o�oya0000e0 `tl�go„Cl�
5 � S F, M"E, ING ns jr a09"J° 4J�,
Signature River loop Road No. 204
r
o `�4 Jh v 144 F�
age River, Alasica 995?7P eod3GoGa:'; e,<,afeYeereoe 'r�
i„
Engineer's Name
Date
HAA Fee $ /'7 b ` (] y
Date of Payment � �� �Z
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
�q'* uun amaoe o'�
F
�P ►-E
S & S ENGINEERING
170$4 Eagle River Loop Road .Hky PM
Eagle River, Alaska 99577
l'tL-
1D -q-7-
VA
�P ►-E
S & S ENGINEERING
170$4 Eagle River Loop Road .Hky PM
Eagle River, Alaska 99577
Time
APPLI _ ,NT FILLS OUT UPPER HA,,_._; ONLY
Property Ow.;er
M
. -
CS In
Phone
Mailing Address
g • R Z - :r Zip Code995-/7:Z94-441-
,
Buyer Ken
Florey
Dat*��s
j
Address 333
RaSberry Rotl.dq. fanchoraa ce, AK Zip Code 99502
Lending Institution�t
r g
�.3.1211.E:1' O:t'ta.�;0 _ _.. _
Phone
Address
Business Park ��lv ., xnncho1arj,e AX rZip Code
--
561-1744
Realty Co. &Agent
AA
RE/T^(�.r o eagle Ri'Ver, Inc., (Jit'; MOnt,1 uey
Phone
Address PO
Box 848, -agle River, AK Zip Code 99507
694-1.200
Legal Description
Lot lif, Block 1, Scimitar ;J,1'3
Street Location 'lTEiy
Beld_uoue Court
( p,�APPROVED BEDROOMS
Type of Residence
OF APPRO NVIrcam„frsat PrptecttBn„
( ) DISAPPROVED
DC7 Single Family
( ) CONDITIONAL APPROVAL'
S— 1;
❑ Multiple Family
No. of Bedrooms -3
DATE
❑ Other
BY:
WL]Supply
❑ Individual
Cla.SS It Cfr 1:=:; (, 11
..
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
❑ Community
Well To Absorption Area
For wells drilled prior to that date, give well depth (attach log
if available).
❑ Public Utility
Well to Tank
Sewer Disposal
1983
)CI 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
Date
Date
Date -tom •
J
Dat*��s
j
Inspector
Inspector
Inspector
Inspector
Field Notes: �j) � �3C�
MAY 13 1983
�N �°
�
"tAuuc'paNty of Anct)uraga"
"t72pf,
of t-t8ai.
( p,�APPROVED BEDROOMS
'CONDITIONS
OF APPRO NVIrcam„frsat PrptecttBn„
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL'
S— 1;
DATE
BY:
Soils Rating
Date Sewer nstalled
Well To Absorption Area
Well Log Received
Septic Tank Size
Well to Tank
72023 (3182) `