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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 f f 7C -/ Je e IV 3 �m I Wr9 ma If sf R` � NQ �i / 3 i rr 4� IF 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 Rrcbi4 Pun► Tprfiltrb Ort1Ztno Koo fly A & 14 ]lRILIANt; (; MPANY b0%BY, EArtC H►VER, Al ARRA 89DYr • 1E1 r[•iiQNE 40�•160K f$t (N' LAND , 1.; l: ,S;,�lt rUf� •" b[el"filOF W1:I•l, 6. ()c. 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Ft.. _ I+rmu FL to. _ ._H. ... �. i'(ou► i'1.tu. ._>iY. l�rr►n►. 1't.tu_ .Fl.. ... _ From _ Pl. eu_. Fl, _ Praill .. Fl. I% -Ft.. lerua+. let. ill, Fl. Frant I'ru m. ._Pt. to. f'1._. 14om I't, ln,_,_ F1. ,. lerpm _Itt. Itr.. let.. 1'rr►nt ._ Tf, to•_ _M, 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