HomeMy WebLinkAboutKNIK HEIGHTS BLK K LT 6AKnl*k Heights
Block K
Lot 6A
#018-232-35
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME ,. '~ PHONE [] NEW
!., 34-¢
MAI LING ADDRESS
LEGAL DESCRIPTION
~' Well ~q ~:~tionarea Dwelling PERMIT NO.
I DISTANCE TO: ~.1 ,
~:Z IManufacturer ,~ I~'~ ~')~r ~=1'~' JMaterial No. of compartments
ILiq, capacity in gallons '1F HOMEMADE' Inside le[gth -~ I Width Liquid depth
~ DISTANCE TO' I[Well~1 /~/ ' Dwelling I PERMIT NO,
~ ~ ~ Manufacturer ~/ Material ~~lons
~ I - [Well ¢ Fo~ation / I Nearest lot line PERMI~ NO.
~ [ DISTANCE TO:
~m~Z~ [~N°'°fjlines, ~-- ,
~ DISTANCE TO: ~ell Bo~ldm9 foundation
~ Class .,/ Depth DriP7-- '
~/n/~ Building foundation ~; i~ - Septic tank
~ ~ DISTANCE TO: Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
MUNICIPALITY OF ANCHORAGt:;
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Streel, Anchorage, Alaska B~5D1 264.4720
SOILS LOG - PERCOLATION TEST
[[~ SOILS LOG
~'""/P E R CO L ATION
TEST
DATE PERFORMED:.
12
19
20
SLOPE
SITE
WAS GROUND WATER
ENCOUNTERED? L
0
IFYES, ATWHAT ,~('9 J"¢'~' J~.~E
DEPTH?
Gross Net Depth Io Net
Reading Date Time Time Water Drop
PERCOLATION RATE_ / '7
TEST RUN BETWEEN -,~, <~ -. FT AND
(minutes/'inch]
~--'~, "~'" ,- FT
~ ,,~,~ MUNICIPALITY OF ANCHORAGE
i, iJl,~)~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
~ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
. [] UPGRADE
MAI LING ADDRESS
LEGAL DESCRIPTION
m Well ~ I Absorption a~ea t Dwelling PERMIT NO.
DISTANCE TO' ..... ~ ~
~ ~ Manufacturer ~*~e/ P~b~ Material -- No. ofcompart~onts
-- ~ Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid deptl~
~,, W~II 12~¢ . -- F~u'~dation Nearest lot line PERMIT NO.
~ ~ ~ NO. of lines Length of each line Total length of lines Trench widtb Distance between lines
~ Top of tile to ~c~h fir~ ~X/5~t~ ~ Mat~rial beneath tile ~ ¢~ Total effective absorption area
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
[u Well -B~ilding foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Drill0r Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
SOIL TEST RATING P~C ~r d~ ~/~
REMARKS _ ~ ~
i]il;;:Ol, lhil:) F:II",!t]:, !l'l~Z I]:CII"!'()I'"! O!::' ]'HI' I];;:':;C;F!',,,'i:;!T]]i)?',I ( ;!:!',! l:-~:}ZiTl' )
'!'i'i!!!?.l::T ]!;S NO ;;i:;;'!' t,!]!]i)Tt'! !;()!?.
'i!il:;i (]iil:;?F:l',,,'l]]l. !)!]?'!I ! ]];i:; i!'!E I"'i;[i",I) !'"II !1"i i]:,E;T:"!"H O1:::' (;ii;;'.l::!',./!!'! l:::!;Tl,!iiEi?i !!iii] i]])l !!!;:!:::!I. ! i::' }'!::'ii
?!i',!i) i'i'II;:] !',() ! !('IH O!:: i'I It!; t~;;':;(]:F:iVt:!!']]O!",! ( ;!;!",! !::'!!]!~!]!'
!"i iii i'4 i ?!i_.11"! l') ]!i ;}:i;'!'!:::!I'-,IC:!::L (i;li}i"! i.,IIj}]I.Ei",! I:::i 141}}i! .i t:;I?',!t) !;::iI'-,!'~" 9!".i"-::i; ]i] '!'t'!:] i:}i;i:}l,.IF:H]il!:] i) ]i ;!i;!::'(]i!;F:ii ?/:':; ~ I i'i
:l([i!i!) !:::'i:~]1111' F:(])t;]i F;i i:::'l~;il]iVl:::!'l!i] !,.!i!].! ;
;].'.lO !'ii]i ;?fiji;ii !::;'i!i!il] !::?~i]!1'! 1::! F:'ljf!;t. ]]!i]; !4!i]]1.1. !i, li]:::'E]i",!!)]]!",l(:i il!>(Jl!",i i'!'ll:i; !"~"!:::'!i:] i]!i.:" !:::'i. ii::',i ]i(]]'
t: :I 'Y' Fi ]!' i !:;:l!i:i. i:; ] I? ]i] ?-,l;::i;!Jt:;];l]i !::'I;;:()F'!;!]:;]: ] i',!?;TFi;, i !::1 i"(
!:Iiff,il i'H i;?~" i'! I1: !'II!I,!]'()]i]I::'F!!. ]i'!"'? Cfi;
;!:; ]] i,.i] L.i. ]i i",!;:i; i r:!i.l !1!I]i ;]i;'~";!!i;'!-t:i]t"i J]H I'::!l])(i]:()i;;;!]:,l::!i'-.l(';l:i !,.!]iTi! i'i !!~]
]ii:: i[ !ii'-.!E:,li:i]:;il;i!;rF:l!'.,!E) TI'!I:::!'I t'!.!i_( (]il'.,i .'.]i;]]!'~]; ;!:14-!:i!,.717. ii!;'r':iii'!'l:r? !'II;:iY !;11!)i;!1!iI]?;iiIi
F::! i ::' I:::' ! .);(:~,! ! i;il IFil:;;;'! F. i:i;i"il TH ·
10 _
12
14 -
16
Steven A. Johnson
Box 76
Chugiak, Alaska
Phone: 688-3085
Performed for
Legal Description
Test Pit Location
Soils Log
Percolation Test
99567
~.~u3~+ __~, ~'~v% ~ Date
feet
Total depth this test
AVERAGE ABSORPTION AREA REQUIRED FROM SOILS LOG = ~%~
ft.2/bdrm.
DATE NET TIME (Min.) NET DROP (In.) PERC RATE (Min/in~_
ot/~/v~. 3o_ s,oo ~,o
,-B~_ %,~ 8,0
'~ ~_ 2, o o /.5, o
Percolation rate
.minutes/inch
WATER WELL LOG
FOSS DRILLING
1336 Ingra Street
Anchorage, Alaska 99501
qJNICIPALITY OF ANCHORAGE
DEPT. O;: t'EAL'fH &
ENVIRONMENTAL F'[:.~ ¢!:CTION
OEO :::, 1978
SIZE OP CA~ING~.~ DEPTH OF HOLE~.~PT. CASED TO ~ c~ g~ .~
STATIC WATER LEVEL ~ ~ FT. YIELD.~.~._GAL.PER.MIN. WITH~
PT ..
FE~ OF DRAWDOWN.
REMARKS
DATE COMPLET~_/ ! ~ ~ g ~.~, ~.PUMP TO BE SET AT
::!.!;;:;!!i -I' !? ;ii:li!~:ii J:: !ilii I i::'J:;;:!?!"! /:::! i::'l .!~!!;i. i! Jif: !'!~!i! J, li~!j~il :~I Ir'~liii:' itl !:',!llii I .~?~.';!j',j '! !' II:i !'"i'li::'!:i !;ii:: !:'1 l!i:I i!i ii~:
56 � 8 9 71)
•
•
Municipality of Anchora materi,
On-Site Water and Wastewater Program x. 10 „
(907) 343-7904 a MAR 2 12018 E T Y
Certificate of On-Site Systems Appro . o/ s L.,
Parcel I.D. 018-232-35 Expiration Date: Cr-- Z 7-1
1. GENERAL INFORMATION:
Complete legal description Knik Heights; Block K, Lot 6A
Location (site address) 13300 Ridgewood Circle*Anchorage.AK 99516
Current Property owner(s) Richard Maki Day phone 441-6975
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well El Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: A. C L4 _ 1 Date: y70e
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ Waiver Fee $
Date of Payment I i/4' Date of Payment
Receipt Number Y51 I Co—)G� Receipt Number
COSA# �� l�/D/`"// Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my.seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 ii Engineer's Printed Name: Jeffrey A. Garness Date: 3 i t//
00000p�O„
oa
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system
in accordance with the guidelines and regulations established by the Municipality of Anchorage and O OF AC .v h
industry practices. The reported results describe the condition of the system/s on the date's of the O P • n
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or if • ��;; AVO
encroachments may exist that were not identified during the evaluation. The operational life of all wells 4 • * OA
and septic systems depend upon a variety of variables, including but not limited to, soil conditions,
groundwater levels (that may fluctuate during the year), quality of construction (materials and
workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and /.. . ... • ..
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the / .••J- f- •. Go ness; a
system/s; therefore, GEG makes no warranty(express or implied)regarding the future performance of QO G _ -. ;�g
the well or septic system. GEG makes no representation whether an altemative well or septic system h 4,:. • / ,,,.. •c�4
can be installed on the property in the event either of the current systems fail to perform adequately in �� �r •��•• os
the future. The content of this report is for the sole benefit of the person/party that retained GEG to �04dProfessloc°o�
perform the evaluation. Reliance upon the information provided in this report by any other person or 000000••
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
#AECC884
6. DSD SIGNATURE
/r System #1 Approved for bedrooms
f System #2 Approved for bedrooms
Disapproved \G\QPLITY OF,y
Conditional approval for bedrooms, with the folloc stipulations.v
O y
•. WA w_ ,7-4„,,,
lrE ��
�ASTEWAT rT'_
,oma ` RpGRA44 R oma_:
j!' ,sI.Z.01,I('
By: } Lw t ` Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist Nitrate Advisory /c---.
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet_10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: Knik Heights; Block K, Lot 6A Parcel ID: 018-232-35
A. WELL DATA
Well type Private If A, B, or C provide PWSID# N/A Well Log (Y/N) Yes
Date completed 11/28/1978 Sanitary seal (Y/N) Yes Wireserl
ro
p p y protected (Y/N) Yes
Total depth 244 ft. Cased to 236 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 11/28/1978 1/31/2018
Static water level 223 ft. 226.7 ft
Well production 10 g.p.m. 4+
g.p.m.
WATER SAMPLE RESULTS:
Coliform N6Cr colonies/100 ml. Nitrate rl '7 mg./L. Collected by: GEG. Ltd.
Arsenic: "" ug./L. Date of sampl 1 r
G
B. SEPTIC/HOLDING TANK DATA 30 year—old fiberglass septic tank may be
approaching the end of its useful life
Tank Type/Material Septic/Fiberglass Date installed 1978
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Yes
Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N) N/A
Date of pumping 10/19/2017 Pumper Isaacs Pumping Service
C. ABSORPTION FIELD DATA *Below Existing Grade at Sump
**1973
Date installed 5/23/1985 Soil rating (g.p.d./ft2o ft2/bdr ) 206 System type Deep Trench
Length **62 ft. Width 2.0+ ft. Gravel below pipe **8 ft.
Total depth *12.5+ ft. Eff. absorption area**618 ft2 Monitoring tube Yes Depression over field No
Date of adequacy test 1/31/2018 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test Dry in. Water added 602 gal. New depth 20 in.
Elapsed Time: 120 min. Final fluid depth 6 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date —
Sump extends approximatley 7.5 feet below invert
**Does not include 1978 trench
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off" level at 'a '• wa er alarm level at in.
•- - •• 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 100'+
Absorption field on lot 100'+ On adjacent lots *85.7
Public sewer main 75 + Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
10'+ Buildingfoundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 0'
Curtain drain None Known Wells on adjacent lots 100'+
F. COMMENTS
*WR#040071
.o6OO��00
G. ENGINEER'S CERTIFICATION 4: '' 's!.OF 4, C9��
oo/P. S,�4p0
I certify that 1 have determined through field inspections and Q 4 T I . . *Oa
review of Municipal records that the above systems are in i" vA
conformance with MOA COSA guidelines in effect on thisIf VA
date. Q ' -f ' 4. Gar ess.• a0
Engineer's Printed Name JEFFREY A. GARNESS v l'' C —7 • \c`�O
i
4Qe, -411./.6
Date i t'/t ' �OpO�ofessi000�
�O000
#AECC884
(Rev. 11/05)
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- _____•_�o. Tele., Fled _ (__ E,___mt. --- - - -- -
5 8 9`56'oc"W 2 8 0.9 5 •s.aun.T NO CORNERS SET THIS DATE
.` I hereby certify that I have performed■ e inspection
v';1+ .%‘.�1 me following described progeny:L
f, : ,Vlock K, Kt-1;k Hcr4, r ,S1..Ea.
....e,•..:
f.,-. !.••• ,f r. Anchorage Recording Precinct. Alaska. and tat me
/:1,' ..'ertprdv•mace staled thereon we mew the property e
Ye and
. ..• , .r. P; do not overlap or ewhamsch on the property lying whams
thereto.that no improvements on property lying ad(acent thereto
encroach on the premises In question and that there are no
-‘s.'••.• - roadways.transmission os or other visible easements on said
1. ''1tsr.ss•-.!• • property ed gaacept as hereon.
Anchorage.MaksA
S 2 1,r day ci n r S T 20 IA¢
EASEMENTS OF RECORD.OTHER THAN
FRED WALATKA&ASSOCIATES
THOSE SHOWN ON THE RECORI>EO (907)21&1868 Engineers and Surveyors
PLAT ARE NOT SHOWN HEREON •'" r''
MUNICIPALITY OF ANCHORAGE
�•�
DEVELOPMENT SERVICES DEPARTMENT
( • ,0712)�,t 907-343-7904
On-Site Water and Wastewater Section `\ Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On-Site Systems Approval 14 OSC181099
Subdivision: Knik Heights, Block: K, Lot: 6A
A water sample revealed a nitrate concentration of 9.9 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.O. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids,and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org
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 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING/�
ParcelI.D._01821V7� 32 - HAA# i AG91g_'l�
Expiration Date: I
1. GENERAL INFORMATION
Complete legal description Knik Heights, Block K, I of 6A
Location (site address or directions) 13300 Ridgewood Cir, Anchorage, AK ^9' 16
Current Property owner(s)—Lynn Smith Day phone 345-1011-5.
Mailing address PO Box 111751 nnrhoragg,AK 9951 1`
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD
for pickup.
2. NUMBER OF BEDROOMS:
—2-
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
Individual Water Storage
❑
Individual Holding tank
D
Community Class Well
❑
Community On-site
Public Water System
❑
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 4 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. (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 verify 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. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all
applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation.
Name of .N/ ENGINEFRING,• •/
696-6LLI-
Address 20441Ptarmigan Blvd.,
99577
Engineer's Printed Name Kenneth M. 1 Date 11'
Engineer's Comments:
This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the
condition of the well and septic applies only to the
conditions as of the day tested. The flow and absorption
rates may change due to subsurface conditions that
may not be observed from the surface, changes in
land use, local soil characteristics, groundwater levels
that may fluctuate during the year and the water usage
of the family being served by the system. The operational
life of all well and septic systems are subject to these
various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system.
Therefore, KND can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can KND guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
5. DSD S GNATURE
Approved for e_;?, bedrooms.
Disapproved.
Conditional approval for
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
bedrooms, with the following
C
Maintenance Agreements
Supplemental Engineer's Report
Other AWxal•_ Mvy,— c �X
By: 4_0 l! �_ Original Certificate Date: d
Deve
Ai
ff
alled 1 9 7 S ` Tank si
rating (g.p.d.W or ftz/bdrm)
4 lA.
I U115
�eve
+ `YC.> d^ � eye,,. a. pi w-..n.Hlgh Waiter
� at water afarn
tecl` Nieetsalarni
In �_.
3quirements?
i
0
)al records that the above systems are in ® 1'9 e
h MOA HAA guidelines in effect on this date. or +¢
, s eeo eeaeui
d Name Kenne h M Duffus ..g......"
�n CPOKenre:hCE
�) t- (4 Date of Payment
Receipt Number
Re
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
Nitrate Advisory
Health Authority Approval # HA040460
During a recent Health Authority Approval on-site inspection and test of the
potable water supply well on Block K, Lot 6A of Knik Heights subdivision,
a nitrate concentration of 5.3 milligrams per liter (mg/L) was reported for the
property's water well sample. The Environmental Protection Agency (EPA)
maximum contaminant level (MCL) is 10.0 mg/L. Although the subject
water well sample is less than the MCL, it is suggested that periodic testing
be performed to insure the wells continued suitability. More information on
nitrates is available from the On -Site Water and Wastewater Program, at
343-7904.
This advisory must be attached to all copies of the subject Health Authority
Approval.
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 99519-6650
www.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: KND Engineering Inc
Legal description: Knik Heights, Block K Lot 6A
SA FE T
The attached paperwork has been reviewed and is being returned for the following reasons:
❑ Original signature or stamp missing on
❑ Calculation error in design. _
❑ Additional soils information needed.
❑ Water monitoring results inadequate. _
❑ Discrepancy in information submitted.
❑ Topographic information missing or inadequate. —
❑ Incomplete; missing _
❑ Incomplete; missing _
❑ Additional adequacy test information needed. _
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing. —
❑ Locations of all soils, percolation and water monitoring tests not shown. _
❑ Proposed system too deep for soils information submitted. _
❑ Well log required. _
❑ Omission in narrative.
❑ Insufficient fill over tank or field._
Name of reviewer: Julie Makeln P.E.
Date: 9/14/2004
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
1�Iunicipality of Anchorage
�r niS; ilk
P.O. Box 196650 • Anchorage, �Uaska 99519.6650 • Tcicphone (907) 343-8301 • Fax (907) 3435200
4700 Bragaw Street • Anchorage, Alaska 99,507 s a . E r
Mayor Mark Begich NmiV.M11M.0'g
Building Safety Division
10/8/2004
KND Engineering, Inc.
10441 Ptarmigan Blvd.
Eagle River, Alaska 99577-8736
Subject: Waiver Request for Knik Heights, Block K, Lot 6A
Waiver Request #WR040071
Parcel ID #018-232-35
HAM HAO40460
Dear KND Engineering, Inc.:
Your request for a waiver of the required 100 feet horizontal separation from the
absorption field to private well has been approved. The approved separation distance is
85.7 feet. This waiver is granted for the encroachment of the absorption field on Knik
Height, Block J, Lot 2 to the water well located on Knik Heights, Block K, Lot 6A.
This waiver approval applies to the existing absorption field to private well separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Julie Makela, P.E.
Civil Engineer
On -Site Water & Wastewater Program
Community, Security, Prosperity
Lo4, aI , pmA 1 t .°p . u,)c,,-tvaz- ; Vu a,
Knik Heights, Block K, Lot 6A
Parcel ID:018-232-35
Waiver for 85.7 feet from existing well on subject property to existing absorption field on
Knik Heights, Block J, Lot 2
Issued October 8, 2004
General
1. Total coliform or other bacteria was not detected for the water sample collected from the well.
2. The nitrate sample taken from the subject well is 5.3 mg/L,
3. The nitrate sample taken from the well on Block K, Lot 8 is 5.09 mg/L.
4. The nitrate sample taken from the well on Block J, Lot 3 is 3.35 mg/L.
5. Camera survey of subject well verged integrity (no breaks or perforations).
Well (Block K. Lot 6A)
The well on Block K, Lot 6A was installed in 1978 at a total depth of 244 feet. The static water level
at the time of installation was 223 feet, and is currently 227 feet. The well is cased to a depth of at
least 40 feet.
Absorption Field (Block J Lot 21
The absorption field on Block J, Lot 2 was installed in 1992. The absorption field is 65 feet in length,
with an effective absorption area of 6 feet, and a total depth of 10 feet from original grade. The
property was originally developed as a single family dwelling. The dwelling is currently used for a
commercial business (Bed & Breakfast).
ADEC Criteria Points
Water Table 7 6
Static water level in well on Block K, Lot 6A on 8/10/04 227 feet
Total depth of absorption field on Block J, Lot 2 -10 feet
1/190=x/117 x=0.6+7 217 feet
Soil Sorption 3.5
Silt
Permeability 2 0
Silt
Water Table Gradient 2 9
Ground surface slope in area is generally flat
0% slope
Horizontal Separation 2.4
85.7 feet between well on Block K, Lot 6A and absorption field on Block J, Lot 2
1/25=x/10.7 x=0.4+2
Total Points 18.4
As per ADEC waiver guidelines a point value of 18.4 is almost sure to be free of any form of
contamination from household sewage.
KND ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)
October 4, 2004
Dan Roth, Supervisor
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Knik Heights, Block K, Lot 6A
Dear Dan,
Per your request, we have taken nitrate samples of adjacent properties (Knik
Heights Block K, Lot 8 and Block J, Lot 3). Knik Heights Block K, Lot 8 had a
nitrate result of 5.086 mg/L--similar to the subject property. It appears that
elevated nitrate levels are not just isolated to the subject well, but to the local
area.
Additionally, we had Brian Willey of AAROW Pump & Well Service, LLC scope
the well for any potential deficiencies. Brian saturated the wellhead the night
prior to scoping the well and subsequently did not find any cracks or leaks in the
casing or pitless. The well casing does not appear to be compromised and is
functional.
We respectfully request that the waiver and Health Authority Approval be
granted. If you have any questions or require additional information, please
contact me at 696-6111/FAX 696-8111.
Respectfully,
D Engineering, Inc.
Kenneth M. Duffus, PE
Attachments: Water Analysis Results
KND ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
September 14, 2004
Dan Roth, Supervisor
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Knik Heights, Block K, Lot 6A
Dear Dan,
Per your request, we have re -verified the separation distances between the septic
systems adjacent to the well located on the subject lot. The septic system located
on Knik Heights, Block J, Lot 2 was measured at 85.T+/- to the subject property's
well. Since the subject well was drilled in 1978 and the encroaching on-site
wastewater system on Knik Heights, Block J, Lot 2 was installed in 1992—we
request that the waiver fee be waived for the owners of the subject lot.
Accordingly, we are requesting a waiver to 85.7 feet between the referenced
water and wastewater systems.
Per ADEC Separation Distance Waiver Guidelines for SCRO:
• Water Table (227' static water level) 8.30 points
• Soil Sorption (See attached well/soil logs) 1.75 points
Permeability (See attached well/ soil logs) 1.75 points
• Water Table Gradient (0%) 2.90 points
• Horizontal Separation (857) 2.40 points
TOTAL: 17.1 POINTS
The point total indicates that the well would almost sure to be free or no
contamination possible from any form of household sewage contamination.
However to implement additional alleviating measures we would recommend
that due to the increasing presence of nitrates in the area, the encroaching
portion of the referenced septic system be abandoned as soon as possible.
We respectfully request that the waiver and Health Authority Approval be
granted. If you have any questions or require additional information, please
contact me at 696-6111 /FAX 696-8111.
Respectfully,
KND Engi ering, Inc.
Ke e . Duffu, PE
Attachments: As noted
WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN
KNIK HEIGHTS S/D, BLOCK K, LOT 6A
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SEPTIC Oi
BLOCK J��
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SEPTIC
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i' EXISTING WELL
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8A LOT 6A.
BLOCK K
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SEPTIC SEPTIC C
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Ar PREPARED FOR:
rr LYNN SMITH
/ v1 PO BOX 111751
* TH * / ANCHORAGE, AK. 99511
KENNETH M. D b S FIELD BOOKS COMPUTED:
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M. PILE` MID: 2936
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Scale: 1"= 50'
PAGE 1 OF 1
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORIVIATION
(a)
(b)
(c)
Application Date ~_~'~
Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Applicant Name ~'/~~/~ ..... Telephone: Home ~J~-~/O/-5-
Applicant Address /, ,~_(~_¢ /d?¢~, ~.t,-~¢/~,2¢¢¢¢~ /¢~, _
Applicant is (check one): Lending Institutioe g; Owner/builder~; Buyer ~; Other E] (explain);
Business
(d) Lending Institution
Address
Telephone
(e) Real Estate Company and Agent
Address
Telephone
(f)
Mail the HAA to the following address:
',_'~..L~.
TYPE OF RESIDENCE
Single-FamilyJ~ Multi-Family El
Number of Bedrooms
Other
WATER SUPPLY
Individual Well [~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4, SEWAGE DISPOSAL
Onsite J~ Public [] Community [] HoMing Tank []
Note: If community well systern, rnust have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 %.;,u~111 8,ii
ENGINEERING FIRM PROVIDING iNSPECTIONS, TESTS, FI/,E SEARCH, DATA AND INFORMATION
A,s certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I fudher verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm_
Address
Date
DHEP APPROVAL
Approved for ';"'/~-~--~; ~ bedrooms by
Approved ~ Disapproved
Terms of Conditional Approval
Conditional
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions m the
professional engineer's work.
Page 2 of 2
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description: ~-~-
__ S' O. 7 '-r'L'2.
MUNICIPALITY OF ANCHORAGt2
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
1985
Well Classification
Well Log Present (Y/N) yc¢~% Date Completed //" ¢'-~' ;'~ Yield
Total Depth ¢.~z,/.Z~"
Cased to '~ ~ ' Depth of Grouting
Static Water Level ,~,~.,~_ Pump Set At _ ~'~'/'~--
Casing Height Above Ground /Z" Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) ,,4¢0 Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot /Q¢¢ ¢'' ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot /~ '~''' ; On Adjoining Lots
To Nearest Public Sewer Line A,'//,89 To Nearest Public Sewer
Oleanout/Manhole . To Nearest 8ewer Service Line on Lot
Water Sample Collected by ..¢/~,4¢¢¢-~7.,I¢/~/ ; Date --..'~-/~-4~-
Water Sample Test Results -~'
Comments
____ if A, B, C, D.E.C. Approved (Y/N) _/~/q
B, SEPTIC/HOLDING TANK DATA
Date Installed /'~ ~,,~ _
Standpipes (Y/N) ~
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N) ~/./~
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ~ / ¢''
To Property Line /~¢"" ~
To Water Main/Service Line _r~"'/
Course
Size /~2Z:~.~'d~_ No. of Compartments _
Air-tight Caps (Y/N) _.Z~/¢--~' Foundation Cleanout (Y/N)
Date Last Pumped J~'/'¢-~-- ~-
;for
Temporary Holding Tank Permit (Y/N)
7
To f3uilding Foundation . ¢~"¢~'Z/
TO Disposal Field _~"~ /
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed /~
Width of Field ,¢~¢¢~/-"
Square Feet of Absorption Area ~¢~-
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well /~¢4;7/
To Building Foundation ~
To Water Main/Service Line ~?.'~;-
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
~/~ Type of System Design
Length of Field ~
Depth of Field ,// /
Gravel Bed Thickness 7~
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line /;~
To Existing or Abandoned System on
; On Adjoining Lots ~ '*
To Cutbank (if present)
LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test, Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify th~~cd,~, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed y//~,/~ Date -~//~-~/~.,~'*
Company _~L/~.~,-/-~,~, ~.~.~ MOA No.
Receipt No, ~ ~ ~)~'~ ~
Date of Payment ~_ ~ ;~ '1 - ~
Amount: $ z}
Page 2 of 2
72-026 (11/84)
/~;~o
I0:
10;.5-1
MUNICIPALITY OF ANCHoRAGi!
DEPT. OF HEAL]il .~,
ENVIRONMENTAL . ~ , ....
'"" '~1985
RECEIVED
"-I ll~; '~- *UNt¢IPALITY OF ~,NCHORAGE ~ ~...~ ]t~J
MUNICIPALITY OF ANCHORAGE ~Nv RONMrNTAL J)~.(-q ~CTrQN
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street-Anchorage. Alaska 99,O1 ~A~ ~g '('-'-j.j/~]
ENVIRONMENTAL ENGINEERING DIVISION ~C~ V~D
Telephone 264-4720 .
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page t, Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER PHONE
SMITH, Stuart F. and Lynn C. ~7~.94/272-35~
99503
HAILING ADDRESS
c/o 801 W. Fireweed, Anchorage, AK
PROPERTYRESIDENT(Ifdifferentfromabove)
same
2,[]UYER
same
PHONE
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION PHONE
Security Nationat Bank 276-6800
MA~LING ADDRESS
2525 "C" Street, Suite 502, Anchorage, AK
4. REALTOR/AGENT
n/a
MAI LING ADDRESS
5, LEGAL DESCRIPTION
99503
..I PHONE
Lot 6, Block "K", Knik Heights Subdivision
STREET LOCATION
NHN Ridgewood Circle, Anchorage, AK 99507
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four
~ SINGLEFAM LY ~ Two [] Five
[] MULTIPLE FAMILY ~
[] Three [] Six
[-- Other
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
¢
8. ,~EWAGE DISPOSAL SYS'rEM
~ NDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
ATTACH WELL LOG. A well Icg is required for all wells drilled
since June 1975. For wells drilled prior to that date. give well
depth (attach Icg if available.)
"*lf individua/on-site, give installation date I 0-78
If system is over two (2) years old an adequacy test is required
by this DepartmenL
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONL,
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME , TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS: '
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
ONE '~ THREE [] FIVE [] OTHER
SINGLE
FAMILY
[] MULTIPLE FAMILY ~i~ TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
~1 INDIVIDUAL DEPTH OF WELL /
~ COMMUNITY
DATE DRILLED
~ PUBLIC UTILITY I//7 ~
Connection Verified LOG RECEIVED
~ ~ ~ ~q- qol..~ ~~ ,
3, SEWAGE DISPOSAL SYSTE~ PERMIT NUMBER
~ INDIVIDUAL/ON -SITE DATE INSTALLED
UPUBLICUTILITY I~l%' ~t ~tS¢ ~ ~ ~
Connection Verified INSTALLER
~Septic Tank or O Holding Tank ~& ~
Size:~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4, DISTANCESwELL TO: Septic/Holding Tank ~bsorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
~ v (~ n
~ APPROVED FOR ~ BEDROOMS ~
~CONDITIONAL APPROVAL (letter must accompany certificate}
DISAPPBOVED
DATE BY (Title) /
LEGAL DESCRIPTION
72-010 (Rev, 3/78)