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HomeMy WebLinkAboutSCIMITAR #2 BLK 3 LT 18cimitnr #2
Block
Lot 18
#051-132-60
Municipality of Anchorage page 1 of 4
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW970307 PID Number: 0511 3260
Name: MM&M Contracting, Inc.
Wastewater System: >fl "New ❑ Upgrade
Address:
P. 0. Box 670495, Chugiak, AK
ABSORPTION FIELD
Phone:No.
688-1236
of Bedrooms:
3
❑Deep Trench ❑Shallow Trench Ad ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade: �
GPD/Sq. Ft.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
18 3 Scimitar No. '2
, Ft.
Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
1-5 Ft.
Ft.
WELL: gkNew ❑ Upgrade
Gravel width:
I t;
Numberoflines:
Distance between lines:
1
-
Ft.
3
Ft.
Classification (Private, A,B,C):
Total Depth:
Cased To:
Total absorption area:
Pipe material: A-jTM -P-5,ozlst
Private
600 Ft-'i
600 Ft.
6+57 SO. Ft.
F—'0.10
Driller:
Date Drilled: 1
Static Water Level:
Installer: MIA WI
Date installed:-!P
Sullivan
8/26/971
100 Ft.
Yield:
Pump Set at:CasingHeightAboveGround:
TANK
2 GPM
Ft. Ft.
SEPARATION
DISTANCES .12104eptic
❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
' /Private
Manufacturer. t,
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
,4m
OC70
Welt,
Material:
Number of Compartments:
Watere .
1>15-0
N/r¢
N�/+
>/,vr
LIFT STATION
�� /
�t
�/
��
Size in gallons:
Manufacturer:
Line
Llne
/4
Foundation
¢
li
1i4
/V'
"Pump on" level at:
"Pump oft" level High water alarm at:
CurtainI
�/
y
Pump Make&Model ncalInspections performed by:
Drain
(�(
/t
Remarks:
BENCH MARK
�.�� ,G �� G
1;054`r-
Location and Description:
garage slab
Assumed Elevation:
100.0 Ft
ENGINEER'S SEAL
VW
. ..�,G OF Al y8
€n
!
Inspections performed by: �Dates: 1s y Ib- 7 '0. �AIL l �• .0
f 18 7
�+'. N410HAEL E. ANDERSO
3 rd 12 /18 / 9 .,
Department of Health and Human Services approval 1i VAI,. 4381.E w
®
Reviewed and approved by: ^^-L-- Date: l 15 95 ill `®®OFESS0
_Z:�
72-013 (Rev. 9/91) MOA 25
Permit No. SW970307Page 2 of 4
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: Lot 18, BLK 3, Scimitar Subd. , No. 2 PID No.: 05113260
16 1/
-- --------- --
l�pva �2I,.
ell
s r Y I bed
- - --- — ----� z 5?i to ----
PLAN AS -BLT
1" = 20'
LEGEND
SP1 Septic Pump, compartment 1
SP2 n n ®®®®®®�"� 2 _^
C Clean Outer_ OF ALS �j
MT Monitoo T h All0
)LH*
----, -
I E, AMERSON
4391-E
Permit No. SW970307
Page 3 of 4
Municipaiity of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit No. SW970307
Page 4 of 4
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519=6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: Lot 18, Blk. 3, Scimitar Subd. No. 2 PID No.:
--- — ------ ----
05113260
- — --- -
�1;Mr a�:�a .� ,�F��� i����ti�ww \\/\\\\moi70,y ��V �V1�1 iq 'r \\
1,000 G
septic k Sand,,.
0
--r - - - -- —- --- -- -- — ELEVATION AS -BLT --
i . — ------ ------
j 1" = 10il
�I .. LEGEND
SPJ Septic Pump, compartment 1
--------- - - -- -- --° - -- _ - - - -- — - - - -- SP2 u u u 2
C Clean Out
— - - - - - .. -- ----------*—' --- MT Monitor Tube
- �—
------ - -- - ---- --- - ---- --- -
-- — -
TH
------- ........... ....
-----------.?_�A'JAIGHAELLE ANDERSOM A
FROM MMM CONTRACTING PHONE N0, 6881238 Sep. 04 1997 01:34PM P1
AUG -29-97 FRI 12:18 PM``' JLLIVAN WATER WELLS 2759444444444444 P.02
U �j
'Tatifleb
by
DOC Co. Jbt
SULLIVAN WATER WELLS
P.O.13OK0T0272,CHUOIAK,ALASKA 99557 • TELEPHONE 888.2759
OWNER OF LAND JJni M ' r DEPTH OF WELL,
ADDRESSitl
Jr3L/�`'$L��_ g - - _ ST.AT'1�C-LEYEL OF WATER FT. / G�
LEGALDESCRIPTIQN �+a. RlAe -�Jw �t�1lr RAt DOWN FT. - -
DATE - Started 1 ndedJAW_q(C 4 GALS. PER NR -- - -
PERMIT NUMBER
KIND OF CASING. - t -
KIND OF FORMATION:
From_Q_Ft. to Ft. � d� f��� T� `���rctif+ 4"" �Frr�[�i. to.,.�,r..Ft _
From�Atl—Ft. to�,Ft. .�Q.6,RCid X j� 9 r✓�0'T'FCt6 _._F!. to—Ft. -�
From Ft. to Ft. Fran, ^Ft. to—Ft. -
From Ft. 10 Ft. - From—Fl. to -._FI
From.._,.__. Ft, to Ft. - From. __ ---Ft. to_......_...-Ft•_�. -r
From—pt, to- --Ft• _ From„ _ Ft. to-- Ft.
From. Ft. to Ft. From ,Ft. to Ft.
From Pt. to - _ -Ft. , , - - From Ft. to Ft. --
From Ft to FI
Ptom Ft. to Ft. From --Ft. to_ .- Ft. —
Fmm�Ft. to Ft. From Ft. to—Ft, - -
From Ft. to FL From -Ft. to—Pt. -
From Ft. to Ft. From Ft. to -,Ft.
From Ft. to Ft. From Ft. to.._,.�Ft, -- —
Front Ft. tq_,,,,____.Ft.— _ Froin—Ft. to—Fl.From—Ft, to Ft, From -_Ft. to Ft.
FrOM _ -Ft.to Ft-
MISCL.INFORMATION: _
Cti'4510` yO��Q�o,[�t-i�-�it9 .,.4 e� r`Qa►'n " �,�L,>'��t��7k:,0
1� tt pveve...q�'rt~1:
`FROM MMM CONNTRAACTING
PHONE NO. : 6881238
Sep. ly VL ( 0,3:,tUHM Fl
CENTRAL RAVING PRODI1CTS
- • w
1 Iw�l'w./w i •�•
SAAJ
PA04CT NO.
fON
sUIEC"r
d
cil s_'uwaMITTEDBY
._ FIEW NO.
PLED FAQM
DA1 a AVORTED ----
ATIoN DEPTH �... _....
. nAI E ALGEItlkD
LA© NQ LAD N0. — _
CAO N0,
SATE SAM PWD DATE SAMPLED
DATE Sah+PGED .,.��..
AIN M JAT- 1 1T1 1
'ASSING p� t SPCC.
5IEY� FaCdined
5•
a-
n
14+
I•
y.• I I
OTAL WT. TESTEb
GMS
VAW
{1}Lil Wile $1►Yttl, Ant�hNtupv, Alrnhi E'-t'+i:>•;IIHJ�{
rltttnue PJYJ Gr&$!iil54 at !X,'-'240?
M oA- Url
4
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW970307
DESIGN ENGINEER:ANDERSON ENGINEERING
OWNER NAME:SULLIVAN KATHARINA
OWNER ADDRESS:P.O. BOX 670495
CHUGIAK, AK 99567
PARCEL ID:05113260
LEGAL DESCRIPTION:
SCIMITAR #2 BLK 3 LT 18
LOT SIZE: 52154 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
J-1 V 5 ('\
5 e,cr-�
PAGE 1 OF 2
DATE ISSUED: 9/11/97
EXPIRATION DATE: 9/11/98
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
1. VERIFY 6 FT OF SEPARATION FROM BEDROCK TO BOTTOM OF
SEPTIC SYSTEM.
2. THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN
COARSE SAND WITH 4% OR LESS PASSING THE #100 SIEVE AND
2% OR LESS PASSING THE #200 SIEVE. A SIEVE ANALYSIS
1�-11-OA
�
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
MUST BE PROVIDED ON THE SAND �U%SED./� —
RECEIVED BY: /' �`�� �-�_S/-L eX DATE:
PAGE 2 OF 2
ISSUED BY: DATE: 7 �l
August 19, 1997
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Lot 18, Block 3, Scimitar Subdivision No. 2
Septic System Design
Impacts to Adjacent Properties
Dear On Site Services Engineer:
We hereby apply for a permit to install a new septic system on Lot 18,
Block 3, Scimitar Subdivision No. 2. The attached site plan and backup
documentation identify the location, size and components of the new
septic system proposed to serve the bedroom home to be constructed on
the lot. The lot currently has two wells onsite. The primary absorption
system and the reserve site have been placed outside the 100' protective
radius of each well.
The testhole placed in the area of the proposed absorption bed revealed
poorly graded gravels and sands with a percolation rate of less than 1
minute per inch. A 2' thick sand liner will be placed beneath the bed to
slow the percolation rate and increase the treatment time for the septic
effluent. No groundwater was noted during excavation of the testholes nor
during the ensuing monitoring period. We are therefore proposing
placement of a 43' long by 15' wide absorption bed for disposal of septic
effluent.
The ground surface of the lot is fairly flat, but begins to slope at a rate
approaching 20% near the northwest boundary. The ground surface in the
area of the proposed shallow bed is nearly flat.
If the system is constructed as designed the following statements apply:
1. The system, if constructed as designed, will have no adverse impact
on the wells in the area or those to be constructed in the future.
Lot 18, Block 3, Scimitar No. 2
August 19, 1997
Page Two
2. The system, if constructed as designed, will have no adverse impact
on existing septic systems in the area or those to be constructed in
the area.
3. The system, if constructed as designed, will have no adverse
impact on reserved space, either surface or subsurface, on any lots
located in the area.
4. The system, if constructed as designed, will have no adverse impact
on drainage patterns in the area. The current drainage pattern w i I I
be maintained.
Sincerely,
ww, "x E
Michael E. Anderson, P.E.
Attachments
NONE ■Ew www ■m .wmmw
LOCATION MAP
y�
- f
x
t-
/X y.
m ' IV
V✓e�� \
it7k
o° '
3IPK�m
1.
.En UI
SITE PLAN
SCALE V = 50'
I
L
LOT 18, BLOCK 3, SCIMITAR NO. 2
100,
pRor `�
RA�1VgCT��F
FOUNDATION CLEANOUT
THREE BEDROOM HOME
1,000 GALLON
SEPTIC TANK
MONITOR TUBE "5
SYSTE1V1 PLAN
NO SCALE
3- D
Z , a,.
LOT 18, BLOCK 3, SCIMITAR SUBDIVISION
NO. 2
DESIGN FACTORS:
Three Bedroom Home
Perc. Rate: LT 1 Min./Inch
Application Rate: . 8 GPD/SF
SYSTEM REQUIREMENTS:
Shallow Bed System
1,000 Gallon Septic Tank
2' Sand Liner Required
3 Bedrooms
X 150 GPD
= 450 Gallons
Per Day
450 GPD/.7
GPD/SF =
643 SF
643 SF/ 15
LF (Width of
Bed) = 43 LF
Total Length of Bed
Therefore: Construct a Shallow Bed System 15' Wide X 43' Long.
Distribution Piping to be Placed at .3.5' Below Ground Level.
Cater -I E-
�'AV-4� tem
l OO jW CO
i/Wool�2a n if r�lD
i Z,414-tr 07M &Z VGL CsA�L) oL.L
t
6'iZ= SPCC4F) C.Aa'/DSI �
Z,�n 5►on sJO,t Z- 1n
TYPICAL SHALLOW BED SECTION
(NO SCALE)
NOTE: Minimum 4' Separation From Ground Water
Grade Area to Drain Away.
F•'
rE
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
a
PERFORMED FOR: MM&M Contracting DATE PERFl- RMED: gM✓%
e
LEGAL DESCRIPTION: , I Township, Range, Section:
REPTH SUI N ii %/
12
13
15
16
17
18
19
�1
WAS GROUND WAT
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Wttu AkaIVO
Miopi Mnq?
Reading Date Gross
Time
(IfEE,j)
Depth to
Water
Net
Drop
A
/
►3
4
v,17,%+
2
3-
ro.0
b
��1
' IT. 10
0
4
'e0
r1
o
/
6-
7 7
D;
6..
9
O
f7 e
11
12
13
15
16
17
18
19
�1
WAS GROUND WAT
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Wttu AkaIVO
Miopi Mnq?
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
$ IS 9l Z,;157;33
/
►3
i
v,17,%+
o v
1!;,? 1
nLo
' IT. 10
r1
o
/
20 -{ r ki
IL�JI PERCOLATION RATE (minutesrmch) PERC HOLE DIAMETER 4o
TEST RUN BETWEEN —V--- FT AND 5* FT
COMMENTS Ma+-cri a1 p rrQol X68 fAai-cr than 1 mi mii-a par i nr+h
z
2' thick sand liner required.
PERFORMED BY: 1M4� La-4-'�ER FY THAT T IST T WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE-- ,%�
PERF
LEGA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TEST RUN BETWEEN FT AND _e-' FT
COMMENTS Material 8Prrolatac faatcr than 1 mint'tE' per jpnh
2' Thick sand filter recruired_.
PERFORMED BY/ I " T"""�^�-' �""'a�-'�ER�IFY THAT HIS EST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE--
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 18, BLOCK 3, SCIMITAR SUBDIVISION NO. 2
GENERAL:
1. The scope of this project includes the procurement and
installation of a new 1,000 gallon septic tank. It also
includes the construction of a new 43' long by 15' wide
shallow absorption bed. The distribution pipe in the bed to
be placed 3.5' below the existing ground surface. A 2' thick
sand liner is required beneath the bed due to the rapid
percolation rate of the underlying material.
2. Construction shall be in accordance with the approved site
plan, design drawings, Municipal Permit with any special
provisions or conditions, and all applicable State and
Municipal Wastewater Disposal Regulations.
3. The Contractor shall be
responsible
for
obtaining all
underground utility locates
and for the
layout
of the septic
system and verification of
the location
of all
lot lines.
4. Unless specifically agreed otherwise, the contractor shall
be responsible for final grading areas subsequently
depressed from soil settling. Property owner shall be
responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must
be certified by the Municipal Department of Health and
Human Services for system installations. Owners installing
their own systems must receive prior approval from D.H.H.S.
before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 1,000 gallon septic tank must be procured from an
approved source and installed at the location shown on the
Site Plan.
Lot 18, Block 3, Scimitar No. 2
August 19, 1997
Page Two
2. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts
for pumping access.
3. The septic tank shall be sufficiently bedded to prevent
settling or shifting of the tank.
4. All standpipes on the septic tank shall extend a minimum of
12 inches above final grade.
5. Tanks installed without 4' of cover shall have a minimum of
2" of direct burial insulation.
6. A foundation cleanout shall be installed one to four feet
from the building foundation. Two cleanouts are required
between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive
slope exists away from the septic tank.
ABSORPTION BED CONSTRUCTION:
1. The absorption bed shall be constructed to the dimensions
shown on the design. The bottom of the bed shall be within
2" of level.
2. Distribution piping
must
be placed
level with perforations
down atop a level
bed of
drainfield
rock. Rock should then
be placed over the
pipe
to provide
a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between
the drainfield rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the
locations shown on the design. The portion below ground
must be perforated.
Lot 18, Block 3, Scimitar No. 2
August 19, 1997
Page Three
5. Contractor shall verify the septic tank and drainfield are a
minimum 100' away from any private water wells in the
area, 150' from a Class "C" Well or 200' from any community
well.
6. Direct bury insulation must be placed over the distribution
system if less than 3' of backfill depth is available. Finish
grade over the trench must be mounded to prevent
settlement or depressions.
7. Grade area surrounding the absorption trenches to drain
away.
8. A minimum 2' of accepting soil is required below the
drainfield rock for a 5' wide trench. Contractor shall verify
this condition prior to placement of the rock. All pockets of
unacceptable materials must be removed and replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a Municipally approved
septic tank manufacturer.
2. The following pipe materials . are approved for use in septic
system installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C.
(perforated and solid), ASTM F810 or H.D.P.E. (perforated,
but not solid) and ASTM D2662 or A.B.S. (perforated and
solid).
3. Insulation shall be at least 2" thick extruded direct burial
polystyrene (Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
Lot 18, Block 3, Scimitar No. 2
August 19, 1997
Page Four
5. A permeable geotextile fabric (Typar, Mirafi or equal) must
be installed between the final drain rock layer and the
native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than
3% passing the #200 sieve.
INSPECTIONS:
A minimum of two inspections are required by Municipal
Ordinance. These inspections must be conducted under the
supervision of a professional engineer registered in the State
of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation
of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement
of the geotextile fabric, gravel, distribution piping,
standpipes, cleanouts and insulation. No backfill should be in
place at the time of inspection.
Contractor shall provide a copy of all field survey layout and
construction notes for use in preparing the certified as -built
of the completed system.
0Alums � ty o Anchors a
®epariment c7 Health and Human Services
0
825 U' Street
Rick rLlystrorn. P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor
September 11, 1997
Michael E. Anderson, P.E.
Anderson Engineering
PO Box 240773
Anchorage, Alaska 99524
Subject: Waiver Request for Lot 18 Block 3 Scimitar #2
Waiver Request #WR970054, PID 4051-132-60, SW970307
Dear Mr. Anderson:
Your request for a waiver of the required 10 foot separation
between an on-site wastewater disposal system and a lot line has
been approved. The waived distance is 2 feet from the absorption
bed to the east property line.
This approval applies to the existing on-site wastewater disposal
system lot line separation only. Any future upgrade to the on-site
wastewater disposal system will require all separations be met or
another approval from this department.
If there any further questions or concerns regarding this waiver,
please call our office at 343-4744.
Sincerely, /
Anthony Ki
Civil Engineer
On-site Services
ljw 447
Sullivan
lU S \ - \ SQL - Lu
MEMORANDUM
RECEIVED
DATE: September 9, 1997 SEP 9 1997
TO: Anthony Kim, MOA- DHHS Municipality of �,;;,.;;,,; ..ge
�4� Dept. Health & Humari Seg vices
FROM: Mike Anderson, P.E.
SUBJECT: Lot 18, Block 3, Scimitar Subdivision
Septic System Construction Permit
We have revised the design for the septic system for Lot 18, Block 3, Scimitar Subdivision to
provide as much separation distance as possible from the bluff line located near the west edge of
the property. The alternate system will be a pressurized upflow filter which requires a 113 square
foot absorption bed. This bed will be placed as shown on the attached Site Plan. The primary site
will be placed within 2' of the east property line to allow room for the alternate site. A lot line
waiver request is attached for your review.
The owner of the property wishes to maintain both wells currently on the lot. The northernmost
well will be used to provide water to a horse which will be housed on the lot. The other well will
serve the house. Both wells provide very little water with the northernmost well shown as
producting no water and the other well 13 gallons per hour. Well logs are attached for your
review. I am attempting to locate more legible copies and will forward them to you upon receipt.
I have also enclosed a cross section of the lot at the absorption bed locations. As you can see the
proposed configuration will allow nearly 40' of separation from the bluff. Soils on the lot are very
clean and a sand filter will be placed to slow the percolation rate of the effluent. It is unlikely that
effluent will ever surface at the bluff line because of the fast percolation rate.
The absorption bed for the alternate site can be placed as much as 10' below the ground surface if
necessary to provide additional distance from the bluff line. No groundwater was found in the
testholes nor was any noted during the monitoring period. It is my opinion therefore that an
alternate site can be placed on the property which will be sufficient distance from the bluff that no
effluent will ever surface or be cause for concern.
IL 2C -t tNTo Anchor ic
Department of Health and Human Services
825 "L" Street
Rick Mystrom. P.O. Box 196650 Anchorage. Alaska 99519-6650
Mayor
September 11, 1997
Michael E. Anderson, P.E.
Anderson Engineering
PO Box 240773
Anchorage, Alaska 99524
Subject: Waiver Request for Lot 18 Block 3 Scimitar #2
Waiver Request #WR970054, PID #051-132-60, SW970307
Dear Mr. Anderson:
Your request for a waiver of the required 10 foot separation
between an on-site wastewater disposal system and a lot line has
been approved. The waived distance is 2 feet from the absorption
bed to the east property line.
This approval applies to the existing on-site wastewater disposal
system lot line separation only. Any future upgrade to the on-site
wastewater disposal system will require all separations be met or
another approval from this department.
If there any further questions or concerns regarding this waiver,
please call our office at 343-4744.
Sincerely,
Anthony Ki
Civil Engineer
On-site Services
1jw #7
Sullivan
MUNICIPALITY OF ANCHORAGE`
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR#(CO)DjC(6 PID# 051-132-60 HA# Permit
Date Received: September 9, 1997
k
Legal Description: Lot 18 Block 3 Scimitar Subdivision
Engineer: Michael E. Anderson, P.E., Anderson Engineering
PO Box 240773, Anchorage, Alaska 99524
Applicant: Katharina Sullivan (Property owner)
Waiver Requested: lot line waiver of 2 feet from the absorption bed to the
east property line
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: Waiver is NOT Granted:
List Conditions or/� `Reasons for above: �)
Date: {{ By:
Name of Rev'ewer
Rec #: 03206/2960 Amount: $ 115.00 Date Paid: Sept 9, 1997
September 9, 1997
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Lot 18, Block 3, Scimitar Subdivision
Lot Line Waiver Request
Dear On Site Services Engineer:
The attached Site Plan shows the location of the proposed absorption bed and the alternate site. In
order to provide as much distance as possible from the edge of the alternate site to the bluff line the
primary site must encroach within 2' of the lot line. We are therefore requesting a lot line waiver
be issued allowing this encroachment.
Two wells are currently in place on the lot. Both wells have marginal production rates, but the
owner of the property wishes to maintain both. The well to the north will be used to water a horse
to be kept on the property. The well to the south will serve the house. By placing the primary
absorption bed within 2' of the lot line the edge of the alternate site will be nearly 40' from the
nearly 38% slope. No other configuration will provide an acceptable distance from the slope.
The lot line abuts a 60' right of way for Tulwar Drive. The road is currently only 24' wide so no
infringement on any improvements in the right of way occur. No conflicts with wells or septic
systems occur if the edge of the absorption bed is within 2' of the lot line. No easements exist
along this lot line. Placement of the system within 2' of the lot line will present no impact to
existing or future improvements.
Please let me know if you have additional questions.
MSincerely,
Michael E. Anderson, P.E.
Attachments
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SITE PLAN s �vGIMIT k
SCALE 1" = 50'.ak
LOT 18, BLOCK 3, SCIMITAR. SUBDIVISION
NO. 2 (ALT. SITE)
DESIGN FACTORS:
Three Bedroom Home
Perc. Rate: LT 1 Min./Inch
Application Rate: 4 GPD/SF
SYSTEM REQUIREMENTS:
Shallow Bed System
Upflow Filter With Tank
2' Sand Liner Required
Pressure Distribution System
3 Bedrooms X 150 GPD = 450 Gallons Per Day
450 GPD/4 GPD/SF = 112.5 SF
112.5 SF/ 10 LF (Width of Bed) = 12 LF Total Length of Bed
Therefore: Construct a Shallow Bed System 10' Wide X 12' Long.
Distribution Piping to be Placed at 3.5' Below Ground Level. Placement
of System to be in Accordance With Specifications Provided by Anchorage
Tank.
p
Aa'U2-
AL JA�Uu—ILL..
//7///
Lark
Ons
s
S.Or , Z.S� 4
NOTE:
(NO SCALE)
Minimum 4' Separation From Ground Water
Grade Area to Drain Away.
8HEET NO. OF
CALCULATED BY
DATE
CHECKED
nmcau®k. G+ r mon
FROM 11Mh1 CONTRACTING
!\U. . 4aU V aGriy
00r13r97 )0►53 ,'E 907 608 2310
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fly
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f$t (N' LAND , 1.; l: ,S;,�lt rUf� •" b[el"filOF W1:I•l, 6. ()c.
WINS
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MIN(11., INVO1iMA'1'It1N:
Pont-It• Fax Nots
7671 tete
rt' t�
To
po,ltlepl.
}j, �y e:. . ;,_.i.,•... �'��lY Phone Y
1' /..
Fax r
r.�
t5.asriaVa;`iF
Municipality of Anchorage
On -Site Wafer and Wastewater Program H } k. 9>'...
\� (907) 343-7904
Parcel I.D. 051-132-60
Certificate of On -Site Systems Approval
Expiration Date:
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Scimitar #2, Block 3, Lot 18
20262 TulwarDr.
Current Property owner(s) Brian Galegher & Irene Ferguson Day phone
Mailing address
Real Estate Agent
20262 Tulwar Dr. Chugiak, AK 99567
2. TYPE OF DWELLING:
E Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual
0
Individual Water Storage
0
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver/Variance request for:,
Received by:. �-� Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ Z Waiver Fee $
Date of Payment (&C-1 s
Receipt Number 07-2196
COSA# CSC, 151032
Date of Payment
Receipt Number
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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA COSA
guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system.. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone
6. DSD SIGNATURE 2
V, System #1 Approved for J
System #2 Approved for
Disapproved
Conditional approval for
Date 1/19/2014
vdo��1�
OF ACS
LQ
TPH
bedrooms Sfeveri R. Pont
bedrooms ��s'.,CE-8149
bedrooms, with the following stipulations:
A e
Original Certificate Date:41V
`J
.TKe 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 — X Other
COSA blue sheet 5
If more than 1 septic system is on the lot:
COSA Checklist # 1 of I
Structure served by this system 1
Certificate of On -Site Systems Approval Checklist
Legal Description: Scimitar #2, Block 3, Lot 18
A. WELL DATA
Well type Private If A, B, or C provide PWSID #
Date completed 8/26/1997 Sanitary seal (YIN) Y
Total depth 600 ft. Cased to 600 ft
FROM WELL LOG
Date of test 8/26/1997
Static water level 100
Well production
0.22
ft.
9 -
p.m -
Parcel ID: 051-132-60
Well Log (YIN) Y
Wires properly protected (YIN) Y
Casing height (above ground) 18+ in.
AT INSPECTION
1/19/2015
73 ft.
0.25
9.p -m.
WATER SAMPLE RESULTS:
Coliform Neg colonies/100 mL Nitrate 0.49 mg/L
Arsenic ND ug/L Date of sample: 1/19/2015 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 1,000 gal. Number of Compartments 2
Date installed 9/16/1997
Cleanouts (YIN) Y
Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N
Date of pumping e �� Pumper / e c A
C. ABSORPTION FIELD DATA
Date installed 9/16/1997
Length 43 ft.
Soil rating (g.p.d./ft2 or ftz/bdrm) 0.8 GPD/SF System type Bed
Width 15 ft. Gravel below pipe 0.5 ft.
Total depth 4.5 ft. Eff. absorption area 645 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 1/19/2015 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 2 in. Water added 535 gal. New depth 2 in.
Elapsed Time: 90 min. Final fluid depth 2 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons
in. "Pump oft' level at in.
E. SEPARATION DISTANCES
WELL ON LOT TO:
Cycles tested
Septic tank/lift station on lot 100+
Absorption field on lot 1,00+
Public sewer main 75+
Sewer /septic service line 25+
Animal containment areas 50+
Manhole/Access (Y/N) _
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout JDO+
Holding tank 100+
Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+
Water main 10+ Water service line 10+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line Building foundation 10+
Water Service line 10+ Surface water 100+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
* WR#970054 **Water
Absorption field 5+
Surface water 100+
Water main 10+
Driveway, parking/vehicle storage
has 1,140 gallon storage bladder.
***Corner of field near edge of driveway. rtwt* /S,_f3�,4 ©w r; (Q,
G. ENGINEER'S CERTIFICATION
i certify that / 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.
Engineer's Printed Name Steven R. Pannone
Date 1/28/2015
COSA brown sheet 10-10-12.doc
in.
Municipality of Anchorage p4oE
Development Services Department
Building Safety Division
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 151032
During a recent COSA on-site inspection and test of the potable water
supply well on Block 3, Lot 18 of Scimitar #2 subdivision, the well's
productivity was determined to be 0.25 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 3 -bedroom
residence is 0.31 gallons per minute. The subject property's water system
satisfies the code requirement for a low producing well to include water
storage. 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.
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve(@t)aneneak.com
February 10, 2015
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Rd.
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Scimitar S/D Unit 2, Block 3, Lot 18
Driveway Explanation
Ladies and Gentlemen:
I am writing to clarify the driveway on the above referenced lot. The survey as -built performed by Karabelnakof
Surveys depict the driveway being circular, which placed the driveway over the drain field for this property. I was
informed that the survey was performed in the winter and they were unable to verify that the gravel actually
extended over the drain field. I reviewed Google earth photos as well as Street View photos to gain clarification of
the issues. These views dearly show that the drain field area is overgrown with grass and that the driveway gravel
ends near the stairs to the main level of the house. The "cut' in the trees appears to have been from the installation
of the drain field in 2005.
Based on photographic data, the driveway does notextend over the drain field. The as -built has been revised and is
attached.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments: Revised As -built
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
N
I
SCALE: 1 "=40'
0' 20' 40' 80'
LOT 3
./
LOT 18
BLOCK 3
10' x 20'
Anchor Easement
/ Chain Link Fence /
/ Clean OutT
( YP•)
/ )(9 Total)
•`SSee House o Q) a
Power Pole Detail Below
W/Anchor
0
3 3 � 9s a �,4i•
k6 Gravel
�� A6 Drive. /
Well /
'o.
Gni / Wood Deck -
LOT 17 ° Steps
3 / Ramp
Landing
/ Steps
30, / Wood Deck
/ ao, ?2,
ob� Cantilever
/ 6o W
Wood Shed ^'
(No Foundation)
LOT 19
•2R
Y2—Level
Split Entry
Wood
Frame r
HOUSE & SHED DETAIL
SCALE: 1 "=20'
I hereby certify that an accurate survey of the following ,described
property:
SCIMITAR SUBDIVISION
LOTT 18� BLOCK 3
•• • *�I was made on _ January 28, 2015 and that the improvements
49TH — •,•••�� 0, situated thereon are within the property lines and do not overlap or
=gaQr encroach on the property lying adjacent thereto, that no
' improvements on the property lying adjacent thereto encroach on
Lee lnikoff. 0 the premises in question and that there are no roadways,
�•No.o. 31 3143-5;' transmission lines or other visible easements on said property except
��'... • as indicated hereon. Easements other than those shown on the
lot - � �++ record plat may not appear on this drawing.
Anchorage Alaska, this 10th day of February 2015.
LSte
Cantilever
ing
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 995195650
www.ci.anchorage.sk.us
(907)343-7904
www- ca -a .,
Y •
Y
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
Parcel I.D. 051.13260
FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
HAA # W 1)114
Expiration Date: G —;?,!y — O 5"
Complete legal description Lot 18, Block 3, Scimitar Subdivision No. 2
Location (site address or directions) 20262 Tulwar Drive
Current Property owner(s) Michelle Myers Day phone 688.1236
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
P.O. Box 670495 Chugiak. AK 99567
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
Two 2
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
®
Individual On-site
ED
❑
Individual Holding tank
❑
❑
Community Onsite
❑
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation,
based on procedures outlined in the Health Authority 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. 1 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 Anderson Engineering Phone 522.7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 312412005
iiKl(aavti c wmcrsso+ j .
5. DSD SIGNATURE ♦��'� NI rF�4,l
Approved for 2 bedrooms. ''♦ ♦�Sst �.•'•.
App
Disapproved.
Conditional approval for bedrooms, with the following stipulations:..
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
ON-SffE:�
WATER AND
PROGRAM
Li'l_ ... • .G
X Maintenance Agreements
Supplemental Engineer's Report
_ ( Other
; W,..
By: /.f /. /-:'g_e,� Original Certificate Date: 3 0 s
(lin. 12M
Municipality of Anchorage ,
• Development Services Department
Building Safety Division `
On -Site Water & Wastewater Program •' "'
4700 South Bragaw St.
P.O. Box 198850 Anchorage, AK 99519-6850
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
•_I acs • • 1 -11!112. 1. a 1 10.1
A. WELL DATA
Well type Private If A, B, or C provide PWSID # _
Date completed28 BH997 Sanitary seal (YM) Y
Total depth eft Cased to 600 ft
FROM WELL LOG
Date of test tif2 "7
Static water level 100 R
Well production .22 9 -
p.m -WATER SAMPLE RESULTS:
Coliform _9_oolon"100 mi. Nitrate .169 mg.A.
Date of sample: 319x= Collected by: TLK
B. SEPTICIHOLDING TANK DATA
Tank Type/Material SeWdSteel
Tank size 1.000 gal. Number of Compartments j
Well Log (YIN)
Wires properly protected (Y/N) Y
Casing height (above ground) tin
AT INSPECTION
101.3 R
.25 g.p.m.
Other bacteria colonies/1DO mi.
Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping 316!2005 Pumper Sannary Pumpers
C. ABSORPTION FIELD DATA
Date installed 9171997 Soil rating (g.p.d.Atz or ft/bdrm) ,6 GPDISF System type Shanow Bed
Length 43 fL. Width
ft Gravel below pipe .5 ft
Total depth 4 ft Eff. absorption area % .fe Monitoring tube Y Depression over field N
Date of adequacy test 3 1 21 21111 5 Results (Pass/Fail)Pass For g bedrooms
Fluid depth in absorption field before test Q in.
Elapsed Time: 440 min. Final fluid depth Q in.
Water addedM gal. New depth,! in.
Absorption rate >= 300 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Data installed
Size in gallons
Manhole/Access (Y/N)
'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
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot >100' On adjacent lots >1W
Absorption field on lot >100'
Public sewer main WA
Sewer /septic service line >2S
On adjacent lots >100'
Public sewer manhole/cleanout WA
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >S Property line >>
Water main WA Water service line >10' Surface water >1W
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >10' Water main >10'
Water Service line >10' Surface water >100' Driveway, parking/vehide storage >2S
Curtain drain None Noted Wells on adjacent lots
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Michael E Anderson, RE
Data 312N 005
HAA Fee $ 430 ~ t / 75 M � JJ H Waiver Fee $ _
Date of Payment 2 �" D Date of Payment
Receipt Number(�SZZy� rr /i4 Receipt Number
(Rev. 12100) r
49t4g`1�
E a10ER501 a G
Municipality of Anchorage
• Development Services Department
Building Safety Division
—� On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Water Well Advisory
Health Authority Approval # 050114
During a recent Health Authority Approval on-site inspection and test of the
potable water supply well on Block 3, Lot 18 of Scimitar #2 subdivision, the
well's productivity was determined to be .25 gallons per minute. The
minimum well productivity required by this Department (AMC 15.55) for a
2 -bedroom residence is .20 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.
/ FROM COUNTRY REALTY
Z 4—
. w�f17
PHONE NO. : 9076881238
5c or.�a-r
'�' • as � . \
.. ,• � .ice
n
t<;
V
C
F4
in
N
Mar. 04 2005 06:56PM P2
�s.✓iJsJ � Vf��.�T� .. j/••o� .
AS -BUILT
I hereby certify that I have surveyed the following desmbed
fe.TISW KI
Anchorage Recording Prednct, Alaska, and.that.the�p rove
meets situated thenrori are within the property tines and. do no
'overlap or encroach on the property tying ed0cent thereto, thr
no improvements on property lyinadiacent thereto era
on the premises in, question, and that there are no
trammrsson limes or other 49sibk easements on'said•pro
except as indicated hereon.' .
Dated at Eagle River, Alaska
of PJcy. 19f
R0BF3t7 C.•7QHNS0N "7
SCALE:r Registered land Sorveyo•
1•r �,� Box 77-04%, Eagle River
Phone (907) 6.94-7543
03-23-05 12:31PM FROM-CTLE ESI, SCS ENV SERVICES
9075615301 T-256 P.02/05 F-051
SCS RCCN
1051260001
All Datcs/rimcs are Alnska Standard Time
Client Name
Anderson Engineering
Date/Time
03232005 8:37
Project Namc/N
iPrinted
S' ho f �(j
IA tlt_ 3 S(„�wv,t rol(._Collected Date/lime
03/092005 12:45
Client Sample ID
Hose Bibb/
s Received Da1C/lime
03/092005 13:36
Matrix
Drinking Water
�(%
e"8Technical Director
Stephen C. Ede
Sample Remarks:
Parameter -
Rcsults
PQL
Units
Method
Container ID
Allowable Prep Analysis
Limits Date Date
snit
Antimony
1.00 U
1.00
ug)L
EP200.8
D
03/10/05 03/1 UOS
SCL
Nickel
5.95
2.00
ug/L
EP200.8
D
03/10/05 03/11/05
SCL
Selenium
5.00 U
5.00
ug/L
EP200.8
D
03/10/05 03/1 M5
SCL
Thallium
1.00 U
1.00
ug/L
EP200.8
D
03/10/05 03/11/05
SCL
Metals Department
Hardness as CaCC[3
131
5.00
mgll.
SM20 2340B
D
03110105 03/11/05
SCL
Private Individual Analvais
Aluminum
20.0 U
20.0
ug/L
EP200.8
D
03/10/05 03/11/05
SCL
Arsenic
5.00 U
5.00
ug/L
'EP200.8
D
(<-50)
03/10/05 03/11/05
SCL
Barium
42.9
3.00
ug/L
EP200.8
D
(<-2000)
03/10/05 03/11/05
SCL
Cadmium
0.500 U
0.500
ug/L
EP200.8
D
(<=5)
03/10/05 03/11/05
SCL
Calcium
25000
500
ug/L
EP200.8
D
03/10/05 03/11/05
SCL
Chromium
2.65
1.00
ug/L
EP200.8
D
(<=100)
03/10/05 03/11/05
SCL
Copper
60.7
1.00
ug/L
EP200.8
D
(<-1300)
03/10/05 03/11/05
SCL
Iron
250 U
250
ug/L
EP200.8
D .
(«300)
03/10/05 03/11/05
SCL
Lead
2.48
0.200
ug/L
EP200.8
D
(<=I5)
03/10/05 03/11/05
SCC
Magnesium
1660D
50.0
ug/L
EP200.8
D
03/10/05 03/11/05
SCL
Manganese
6.85
1.00
ug/L
EP200.8
D
(«50)
03/10/05 03/11/05
SCL
Phosphorus
200 U
200
ug/L
EP200.8
D
03/10/05 03/11105
SCL
500 U
500
ug/L
EP200.8
D
03/10105 03/11/05
SCL
Potassium
14600
500
ug/L
EP200.8
D
(^250000)
03/10/05 03/11/05
SCL
Sodium
• 4930
200
ug/L
EP200.8
D
03/10/05 03111105
SCL
Silicon
1.0011
1.00
ug/L
EP200.8
D
(«100)
03/10105 03/11/05
SCL
Silver
1920
5.00
ug/L
EP200.8
D
(«5000)
03/10/05 03111105
SCL
Zinc
4.94
0.100
mg/L
EPA 300.0
B
("250)
03/09/05
XM
Chloride
0.163
0.100
mg/L
EPA 300.0
B
(«2)
03/09/05
XM
Fluorite
0.169
0.100
mg/L
EPA 300.0
B
(<-10)
03/09105
XM
Nitrate -N
O.IOOU
0.100
mg/L
EPA300.0
B
(o-1)
03/09/05
XM
Nitrite -N
37.7
0.100
mg/L
EPA 300.0
B
( «250)
03/09/05
XM
Sulfate
Parcel I.D. #
MUNICIPALITY OF ANCHORAGE
u DEPARTMENT OF HEALTH & HUMAN SERVICES Fx'
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
05113260 HAA. �CI��C��InSC
1. GENERAL INFORMATION
Complete legal description Lot 18, Block 3, Scimitar Subdivision No. 2
Location (site address or directions)
Property owner MM&M Contracting., Tnc _ Day phone 688-1236
Mailing address P n Rnx 670_4Ar, Chllgiak, AK99567
Lending agency Day phone
Mailing address
Agent Day phone
ArlrirARR
Unless otherwise requested, HAA will be held for pickup.
"Tw 0 Vii)
2. NUMBER OF BEDROOMS: Th=e!2!� )
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 MOA #21
5. STATEMENT Or 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 Anderson Engineering Phone ';63-71 �S
Address
P.O. Box 240773 An
Engineer's signature
6. DHHS SIGNATURE
__L Approved for bedrooms.
Disapproved.
Conditional approval for
Additional Comments
By:
NUTlr
AK 99524
Date 12/19/97
bedrooms, with the following stipulations:
Date / - l ` S'
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-M (Rev. 1/91) Back MOA N21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES RECEIVE
�'1
Environmental Services Division
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 34AFK41 9 199
Municipality of Anchorage
Health Authority Approval Checklist Dept. Health & Human Services
Legal Description: Lot 18, Block 3, Scimitar No. parcel I.D.: 05113260
A. WELL DATA
Well type Pr i va tP If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) Y Date completed Deepened 8/26/97
Total depth 600' Cased to 6 0 0 ' Casing height (above ground)
Sanitary seal (Y/N)
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform
FROM WELL LOG
Wires properly protected (Y/N)
AT INSPECTION
Nitrate ° iz.l ivt L Other bacteria
Date of sample: 12/18/97 Collected by: A. Harala
B. SEPTIC/HOLDING TANK DATA
RE
9.p -m.
Date installed 9/16/97 Tank size 1 .0 o n Number of Compartments _ 2 Cleanouts (Y/N)y_
Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N)
Date of Pumping New Pumper Cnnctrncti on
C. ABSORPTION FIELD DATA
Date installed 9 /17 / 9 7 Soil rating (g.p.d./ft2 or ft2/bdrm) g System type ch a 1 1 nG, RArl
Length 43' Width 1 5' Gravel thickness below pipe STotal depth 4'
Effective absorption area 64 S' Monitoring Tube present (Y/N) y Depression over field (Y/N) N
Date of adequacy test NPw CnnGt --Results (Pass/Fail) Pa GG For 3 bedrooms
Fluid depth in absorption field before test (in.); Immediately after_ gal. water added (in.):
Fluid depth (ins) Minutes later: Absorption rate = g.p.d.
Peroxide treatment (past 12 months) (Y/N) If yes, give date
72-026 (Rev. 3/96)`
D. LIFT STATION - None on Lot
Date installed
Manhole/Access (Y/N)
High water alarm level at' _
Cycles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at`
"Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
>100'
>100'
Sewer /septic service line >25'
On adjacent lots
On adjacent lots
"Pump off" level at`
>100'
>100'
Public sewer manhole/cleanout
Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation
>5'
Property line
>5'
Absorption field >5'
Water main/service line > 10 ' Surface water/drainage > 10 0 ' Wells on adjacent lots > 10 0
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line > 10 ' Building foundation > 10 ' Water main/service line > 10
Surface water >100' Driveway, parking/vehicle storage area >501
_
Curtain drain None on Lot Wells on adjacent lots > 10 0
_
F. ENGINEER'S CERTIFICATION
! certify that l have determined thru field inspections and review of Municipal re�ystems are
in conformance with MOA HAA guidelines in effect on this date.y�9
Signatures ; { a M), �g
j r .
Engineer's Name Michael E. Anderson, P.E.�"°"".d�...... z��1
y [ACHAR E ANDEERSCN +.
Date 12/19/97
4381-G .
HAA Fee $ ?�(�C) C;l� Waiver Fee $
Date of Payment I q - n -,i-)
Receipt Number
72-026 (Rev. 3/96)*
Date of Payment
Receipt Number
1 s► CT&E Environmental Services Inc.
CUE Ref.#
Client Name
Project Name/#
Client Sample lD
Matrix
Ordered By
PWSW
980055001
Anderson Engineering
Scimitar
Ut 18 Block 2 Scimitar
Drinking Water
Parameter Results
Nitrate -N 0.121
Waters department Analyses
Client PO#
Printed Date/Time 01/12/98 13:11
Collected Date/Time 01/06/98 15:00
!deceived Date/Time 01/06/98 16:00
Technical Director: Stephen C. Ede
Released By
Allowable Prep Anatysis
PUL Units Method Limits Date Date tnit
0.100 mg/L EPA 300.0 10 max 01/07/98 GCP
Totat Coliform 0 col/100ML SM18 9222D 01/06/98 TMW
1=020'd TO2ST9SL06 39HdOH9Nd IS3 3810 91:91 86Ei—FT—NHr