HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 6 LT 11Lake Ridge
Terrace
Block 6
Lot 11
#051-313-33
Municipality of Anchorage
Development Services Department • °` �`
Building Safety
Division,
On -Site Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519650
www.d.andlmage.akus (907) 343-7904
Page 1 of 2
On -Sits Wastewater Disposal System and/or Well Inspection Report
Permit Number. SWO10016 PID Number: 051-313-33
Nam:
ROGER THOMPSON Wastewater System: ❑ New ■ Upgrade
Address:
14724 TERRACE LANE a EAGLE RIVER, AK 99577
ABSORPTION FIELD
Phone•. No. of Bedrooms:
(907) 696-05'516 4
DDeep Trench DSholiow Trench Deed DMound DOther
LEGAL DESCRIPTION
Sol nounip
'°�'
tvo/se.
R R
Lot: BbOk: Subdivision:
11 6 LAKERIDGE TERRACE
Dept: to ppm bottom wan prpinol erode
OravN beneath pipe
Township: — Range: Section:
Fa added sew. arlOMel pose
R R
Drorl Nngt,:
— —
#?
R R
WELL: ❑ New ❑ Upgrade
Draw wwiu
L
Number of lkm Dbtona betsm Wwe:
Clarification , AAF); 'T'" Owed To:Teta
oeeorPDan
R R
Pipe mebeem:
R R
$a.
R
Odom Dab On%&
910110 Voter IlrekDab
addled:
R
RPC EXCAVATING
2/10/2001
fiats:
puns sat At
Desire heightActor Ground:
VMR
R
TANK
SEPARATION
DISTANCES -
■Septic 0Holding 0S.T.E.P. 0Other
To
Teptk
�Flwdan
Uft
Ho'dZg
0-pcosT inoouomn
From
Station
saw truss
ANCHORAGE TANK
1250
well
100'+
—
—
—
25'+
�'• STEEL
Number a compartments:
2
Surface water
100'+
-
-
-
-
LIFT STATION
Lot Line
5'+
—
_
_
_
sae In sallow:
Monuracteer.
Foundation
5'+
_
_
_
_
co WW at p air
mini water sowm sir
Curtain Drain
NONE
KNOW
P MMaw k �ee1ea1 biroectlene per7°n wd y'
emarks: EXISTING SEPTIC TANK WAS CRUSHED
BENCH MARK
AND BURIED ON SITE
lsootbn and Drorlplore
TOP OF HOSE BIBB
Assumed Elevation:
100.00
R
mrrrsrtaes epu\u
'. 0oo604Q�
���F.. • s�4p
Inspections Performed by. AWWC, INC. Dates: 1st 2/10/2001�
4
.�.:... .. .......
2nd 2/12/2001
Q e r A. Garness•� '
Department of Health and Human Services approval
Popgv •• 7953 e`
Reviewed d and approved by: Dater •27-o/
4�Qa Prafessb��dc'�
ALTERNATE SITE. 20' X 16'
r----1 BOTTOMLESS INTERMITTENT
SANLIFT D L 5 REQUIRE
STATION ANDD AND
I I \ LOT LINE WAIVER.
I I \
a .t z
I A I
ZP OF TMX
AT N.ET95M
/ I ��92T5
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
6901 DEBARK ROAD, SUITE 2B - ANCHORAGE. AK 99504' FHOIIE (907;337-6179 - FAX (907)336-324
PREPARED FOR: PHONE NUMBER:
ROGER THOMPSON (907) 696-0516
LEGAL DESCRIPTION:
LAKERIDGE TERRACE SUBDIVISION; LOT 11, BLOCK 6
TYPE OF WORK:
AS -BUILT OF SEPTIC TANK UPGRADE
FAVL am 9751+/-
I 52
NEW 070 CKLON
5MC TANK
!/12/200
WN BY:
J.L.M.
LE:
1"=30'
E NUMBER:
2OF2
Arauf - 95511
ATOXtr- 9256 1
ALASKA WATER & WASTEWATER
CONSULTANTS. INC.
IQVIL LVb rCRLVLAIIVN ItJll
LEGAL DESCRIPTION: LAKERIDGE_TERRACE SUBDIVISION; LOT 11, BLOCK 6,
PERFORMED FOR: ROGER THOMPSON DATE: 696-0516
(f 1 8 y TEST HOLE #11
GM/SM
9-
10-
11 1011
12
13-1
14-
15-
16-
17-
18-
19
41516171819
20
COMMENTS:
DATE
I#];fi
SEE AS -BUILT DRAWING
DATE
I,SOIL
CLASSIFICATIONS
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
GW
ORGANICSGP111111111ML
OR
PRIOR
'
I
11:111!11%//%CL
NNH
•
12:29
-
6"
MH
2
%//%CH
30
2-3/4"
3-1/4"
�1lllltl�
•Sc
12:59
-
6"
-
GM/SM
9-
10-
11 1011
12
13-1
14-
15-
16-
17-
18-
19
41516171819
20
COMMENTS:
DATE
I#];fi
SEE AS -BUILT DRAWING
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
PERC CAVIrY
PRESOAKED
PRIOR
10 TEST.
2/9/01
1
12:29
-
6"
-
2
12:59
30
2-3/4"
3-1/4"
3
12:59
-
6"
-
4
1:29
30
3"
3"
5
1:29
-
6"
-
6
1:59
30
3"
3"
PERCOLATION RATE
10
(MIN./INCH)
PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN
5.0
FT. AND
5.5 FT.
PERFORMED BY ALASKA WATER & WASTEWATER I, JEFFREY A. GARNESS, CERTIFY THAT THIS
IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Feb 06, 2001
Expiration Date: Feb 06, 2002
Permit Number: SW010016 Parcel ID: 051-313-33
Legal Description. T*AwE TEIi� BI.k ' 6 LT 11 f ' 7
Design Engineer: 0041 AK Water B Wastewater Consultant Site Address: 014724 TERRACE LN
Owner Name: ROGER THOMPSON Lot Size: 19400 SQ. FT.
Owner Address: 14724 TERRACE LANE Total Bedrooms: 4 Permit Bedrooms: 1
EAGLE RIVER, AK 99577-9243
This permit is for the construction of:
❑ Disposal Field 0 Septic Tank F-1 Holding Tank ❑ Privy ❑ Private Well Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and dosed on the same day.
B. Covered, sealed, and heated to prevent freezing.
TO THE CONSTRUCTION OF THE 1250 GALLON SEPTIC TANK THE ENGINEER $HALL;)-`
ISTRATE TO THIS OFFICE THROUGH SOILS TESTINGIGROUND WATER MONITORING AND° ,
4ING THAT THIS PROPERTY HAS THE SPACE TO CONSTRUCT AN UPGRADE ABSORPTION FIELD'
Received By:
Issued By:
Date: 0 -- & -tom/
Date: 2 —6 ^O/
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
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051 —313 - 33 Permit Number SW 0100/6
Property
Mailing address (1Ciel 577
Mailing address
Legal description (Lot, Block & Sub'd.)
Day phone &q16 -6611v
Zip Code
Legal desc iptiof voS ctiOn, Township &Range)
Lot Size (-1$7-4$�—= Acres/Sg.Ft. Number of Bedrooms ti
THIS APPLICATION IS FOR:
Sewer Only
❑
Well Only
❑
Sewer and Well
❑
Water Storage
❑
Sewer Upgrade
EL
THIS PROPERTY CONTAINS:
Hot Tub
❑
Jacuzzi
❑
Swimming Pool
❑
Water Softening Unit
❑
Therapy Pool
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
Permit Fees: (139-0 • o 0 Waiver Fees:
Date of Payment: 1— 31-0] Date of Payment:
Receipt Number: a iD Receipt Number:
(Rev. 12/00)
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
December 27, 2000
Roger Thompson c/o
Prudential Vista Real Estate
16635 Centerfield Drive
Eagle River, Alaska 99577
Attn: Eva Loken
Subject: Lakeridge Terrace, L11, B6. Well & Septic System Evaluation.
Dear Mr. Thompson:
Per your request we performed an evaluation of the well and septic system which serve the
subject property. Our findings are summarized as follows:
WELL: We were unable to find a well log on file at the Municipality of Anchorage, however,
based upon the septic system installation records the, the well was in existence on 8/15/75 and is
112 feet deep. Per the 1984 health certificate paperwork the well is 119 feet and cased to greater
than 40 feet below grade (The HAA check sheet refers to an attached letter as support
documentation). The well casing height, drainage around the casing, and the encasement of the
well wires (in electrical conduit) are all in compliance with MOA regulations. Prior to the start
of the adequacy test the static water level was 80 feet below the top of the casing (BTC). Over a
period of 243 minutes, 630 gallons was pumped from the well (2.59 gpm). During the first 60
minutes of the test the water level dropped 24 feet in the casing and remained within 1 foot of
that level throughout the rest of the test. Based upon our data, the well production is at least 2.5
gallons per minute.
SEPTIC SYSTEM: The septic system consists of a 1000 gallon steel septic tank (installed
8/1975), a seepage pit/crib (installed 8/1975) and a trench type drainfield (installed 6/1986). The
adequacy test was performed on the trench only. On the day of the test the liquid level in the
trench was 9.5 inches in one sump and the other was dry. One -thousand & thirty-six (1036)
gallons was added to the trench, which caused the level to rise to 66 inches (and 54 inches in the
other sump). The first 52 gallons introduced caused a rise of 6 inches in the sump, the remaining
984 gallons caused an average rise of 51 inches (19.29 gallons per inch) Eight -hundred and
thirty (830) minutes later the liquid level had dropped an average of 19.25 inches, indicating
approximately 375 gallons had been absorbed. This corresponds to an absorption rate of
approximately 650 gallons per day, which exceeds the MOA absorption rate for a 3 bedroom
�p�q�J nj�E fznerL. 4— 9&&100--4
6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246' Website: akwwc.com
r house (450 gallons per day). It should be noted that the trench had to be filled to 100% of its
absorption capacity in order to achieve this absorption tate.
If you have any questions, please contact me at 337-6179, or visit our website at akwwc.com.
Thank you for cginsidering AW WC for your engineering needs.
P.E., M.S.
6901 Debarr Road, Suite 2-13 * Anchorage, Alaska 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
January 30, 2001
Municipality of Anchorage
Developmental Services Department
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic Tank Upgrade for Lot 11, Block 6, Lakeridge Terrace Subdivision
To whom it may concern:
The existing 4 bedroom house is currently served by an on-site well and septic system. The
conventional septic system contains a 1000 gallon septic tank and is inadequatly sized. In order
to obtain a Health Authority Approval, the septic tank needs to be upgraded. The drainfield has
been sized for a 4 bedroom house. We are proposing that the existing 1000 gallon septic tank be
replaced with a new 1250 gallon septic tank.
1. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
2. TOPOGRAPHY: There are no slope concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
P.E., M.S.
NOTE: Attached is a site plan drawing, a design drawing„ and a 5 page construction
specification letter which are all part of the design package for this septic system.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
6901 DE9MR ROAD, SUITE. 20 • ANCHORAGE, AK 99504 • PHONE (907)337.6179 • FAX (907)33"24
PREPARED FOR PHONE NUMBER:
ROGER THOMPSON (907) 696-0516
LEGAL DESCRIPTION:
LAKERIDGE TERRACE SUBDIVISION; LOT 11, BLOCK 6
TYPE OF WORK:
SITE PLAN
LOT 2. BLOCK 4—A
LAKE RIDGE TERRACE
LOT 3, BLOCK 4—A
LAKE RIDGE TERRACE
LOT 4, BLOCK 4—A /
LAKE RIDGE TERRACE /
1
1/30/2001 pF
AWN BY:
K.D.W.
ALE. e
in = 100'
;E NUMBER: `
1 OF 2 r A. Gal
p� —7953
�s
Q^s
O Cp^o fessioo
I'm, ss
/
I
I
I
1/
1
I LOT 8, BLOCK
I LAKE RIDGE TERRACE
A I '
I �
/
�
I
I j LOT 9, BLOCK e
1 / LAKE RIDGE TERRACE
I /
j
l
L----------- I
--T�------
PROPOSED SEPTIC
I \ LOT 10, BLOCK 6 I
TANK UPGRADE
I \ LAKE RIDGE TERRACE
\\ - EXISTING FOUR
EXISTING SEPTIC
I \ BEHOUSE
SYSTEM
y / LOT 1, BLOCK 4—A
/ �L j LAKE RIDGE TERRACE
`�\
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
6901 DE9MR ROAD, SUITE. 20 • ANCHORAGE, AK 99504 • PHONE (907)337.6179 • FAX (907)33"24
PREPARED FOR PHONE NUMBER:
ROGER THOMPSON (907) 696-0516
LEGAL DESCRIPTION:
LAKERIDGE TERRACE SUBDIVISION; LOT 11, BLOCK 6
TYPE OF WORK:
SITE PLAN
LOT 2. BLOCK 4—A
LAKE RIDGE TERRACE
LOT 3, BLOCK 4—A
LAKE RIDGE TERRACE
LOT 4, BLOCK 4—A /
LAKE RIDGE TERRACE /
1
1/30/2001 pF
AWN BY:
K.D.W.
ALE. e
in = 100'
;E NUMBER: `
1 OF 2 r A. Gal
p� —7953
�s
Q^s
O Cp^o fessioo
I'm, ss
/
I
I
I
1/
REMOVE IXISIING
SEPTIC TANK AND
INSTALL REPLACE WITH A
DOUBLE NEW 1250 GALLON
1 1 CLEANOUTS \ SEP11C TANK
I
1
qjIXI5S SEPDC
... DATE: oQOQp��
1/30/2001 o F OQ
!c�u 1
�IL�loe msl emenl DRAWN BY: :s44
ALASKA WATER & WASTEWATER K ° "'
CONSULTANTS, INC.
SCALE: c 30� k.:. ' "" ...S�t Y�/
6901 DESARR ROAD SUITE 2B • ANCHORAGE AK 99504' FHONE(907)337-6179' FAX (907)330-3246 NI
PREPARED FOR. PHONE NUMBER: PAGE NUMBER: (��/
ROGER THOMPSON (907) 696-0516 2 OF 2 Q j fro A. ess. � F
LEGAL DESCRIPRON: QO -7953 9`
LAKERIDGE TERRACE SUBDIVISION, LOT 11, BLOCK 6 QQm .Fg
TYPE OF WORK: ��s^�dprofesslcn��o�'
DESIGN OF SEPTIC TANK UPGRADE ���40poo�Q
MUNICIPALITY OF ANCHORAGE
Dvr—RTMENT OF HEALTH AND HUMAN SER'~'ES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
i2 .� ,S
Name
erg
DISTANCES
FROM TO
SEPTIC
TANK
ABSORPTION
FIELD
WELL
Address
%/0 Q/ii ! f r �t l< sf°.+vidr 955
WELL
/Orf
Aol
'� r
PhonPhones)w
Permit No. No. of Bedrooms
—
LOT LINE
.35-1
5
LEGAL DESCRIPTION
Lot
/V
Block
6
Subtlivision
Leif 7?1r Ce
FOUNDATION
4S00`
6p7
Township. Range, Section
S N a arl S
AS -BUILT DIAGRAM
(Show location of well,
septic system, property
lines, foundation,
mac • driveway, water bucks
TANKS p
CR SEPTIC ❑ HOLDING
Manutacumeyr Capac ty in gallons
EXrJr/N at N/fN /49i,9
Material No. of Compartments f
S1-tt/
TYPE OF SYSTEM a
yRENCH ❑ BED El W. DRAIN El OTHER M rialet(g :
Depth to pipe bottom from Total depth from original grade Z
original grade
FT 9 FT �
Fill added above original grade Gravel depth beneath pipe
FT 6 FT
Gravel length Gravel width
area
.�? SZ SQ FT.� FT
Number of hoes Soil rating 2Ywr pipe material
SO FT q T,., 3v 3,V JI0
Installer Date Installed
�rr 6i'%1 .6,11 F/.o 6-
WELLS
f PRIVATE ❑ OTHER (Identity)
Classification (A,B,C) Total Depth Cased to
P� NATE �l S FT ton � FT
Installei Date Installed;
Lt.✓ArrJ Axiillli Fi
REMARKS:
o(� trr.ai AGN c�. a.Io�t-o�.. 4r r
Scale: .
OWr✓6r %iarJ QJba•r/f j wiai {av Inspections Performed by.
bDle Rfyer Efullatorin.Services'
4 Yse(L Date P. P. Pax 773261
Eagle River, AK M71
ci 3 B. re. 7Atlj?S 894-5195
I !�? /certify that this inspection was performed according to all
Municipal and State guidelines in effect on this dale: ��j Y6
11P1=`At4='vED Ili 1 -6115 SEDRoona.S otilt}/
Health Department Approval: "4� Date:
rz-ura Nissl
�A
Louis A. Bolero ' : Z!4
CE -6736 .a
Liv
74
per
f
fd
CIS
kr
N % N 31:—r
4 0
BJN
AS
eo - S.4
So
1,491—H
YWOVP-oo,
Lou i
CE
00.
'*ROF
Wr
;or
-491H 4�
jo.
io WJ4.4�0
it.Va"Um C
,
No. LS
veFS
1.
S-33 U X 3L.r
hereby girtify that LOT BLOCK
L
Ar
nchorage,,Recording District, A aska has been y me and
hat no encroachments existexcept as shown' hermon. It Is that,1,`ti Ch
esponsibility of the,owner to,determine the*existence-.o a
sementsi covenantsp�.:or restrictions which do not pp n the �u
ecorded subdivision plat. Listed, distances prevai- l a
a ascaling
hould not be •attempted, to determine,unshown dimensions. This,—
urv*j,1,s*not adequate for, nor should it be used foPh
stab.. shing, boundary .,ir.fence lines.
-ATE DRAWh
0
1
EAGLE RIV "3
ENGINEERING SERviCES INC.
P. 0. Box 773294
EAGLE RIVER, ALASKA 99577
Phone 694.5195
JOB A" e /"i .$Cc, c� .iy1t e
SHEET NO. / OF 2
CALCULATED BY DATE
CHECKED BV DATE_
rwucri l1.., a . A own.
EAGLE RIS
ENGINEERING SERviCES INC.
P. O. Box 773294
EAGLE RIVER, ALASKA 99577
Phone 694.5195
JOB loth Tisy �iw sca P sys�c r
SHEET NO. OF 'Z
CALCULATED BYDATE
CHECKED BY DATE_
ml ,m mai.
SCALE yr';
of G/tsi✓oA.
�'_fo c -u tiot.s
..... .......
014
...........
41 -
r ♦
}r 0 iPnG� ®�Y��4i�• • 9� �
¢�
Louis i1...flDfSfQ . :
CO -6736
l
t4 "ROFESSIONP
ml ,m mai.
June 2, 1986
w
la
MATANUSKA ELECTRIC ASSOCIATION, INC.
P.O. BOX 1148
PALMER, ALASKA 99645
David G. Berry
1710 Blue Spruces Lane
Eagle River, Alaska 99577
Re: Encroachlrent into electric utility easement
Dear Mr. Berry:
Matanuska Electric Association, Inc. has no objection to the
septic leachfield and any vent pipes encroaching into our ten
foot utility easement along the back lot line of your Lot 11,
Block 6, Iakeridge Terrace Subdivision.
This non -objection is conditioned by the stipulation that
Matanuska Electric Association, Inc. will be held harmless
from any and all damages that may result from the existing
and future use of the easement.
If you require additional assistance, please contact our office.
Sincerely,
David Ingalls
Real Estate and Properties Officer
ALASKA'S Fill^I RFC--wjcoRPORATED 1941 -ENERGIZED 1942
TELEPHONE
1907) 7454231
MU" I Q�F•AL I'TY C) F= ANC/^ACIFCACaE
DE:PARTMEN. OF HEALTH AND ENVIRONMENT#„_ PROTECTION
825 L STREET, ANCHORAGE, AK 99501
264-4720
CI N -- E3 I T E E3 E W A F2 F• E= F=< M I -r
PERMIT NO: 860165 UPGRADE
DATE ISSUED: 06/11/86
APPLICANT: DAVID BERRY �-mf 1, ,e s�fia••<k �a v�
ADDRESS: 1710 BLUE SPRUCE fm Ste.
EAGLE RIVER, AK 99577
CONTACT PHONE: 688-3443
LEGAL DESCRIP: SUBDIVISION: LAKE RIDGE TERRACE LOT: 11 BLOCK: 6
SECTION: 25 TOWNSHIP: 15N RANGE: 2W
LOT SIZE: 18000 (SQ.FT. OR ACRES)
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. T will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.'
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well} wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION
MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL
INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED
ELECTRICIAN.
SIGNED \
DATE:
APPLICANT: DAVID BERRY
ISSUED BY
---
-------------------
DATE.
.4
3 8�roo .� l%Ps�r a.11t Sc.e 4�gi
V
1e Cr"�s S�¢ �i cc�{� p
2 E E-
6� G qq&:
�?-•-sem., �r 4,/,.e 2.5
¢ 1 C&•,e�t.
-fbtn.( oFgPtc� -- S.o f,6
C�v�.-.�'�l Iso lci..._tt
ennd. 6 c_ti yaQ S
n
Ti'titic S{�L � !,'cQs�- �� ��-IIOKCy 1✓�-
(,PKC
�!>I I i'40•T I'� —� �'T :J �'N/I�.A� W`�-_� �/ [�/J!
6.7 ¢+.0 l .ti cel• .
EAGLE RIVER ENGINEERING
SERVICES
Lou Butera P.E.
P.O. Box 773294
Eagle River, Alaska 99577
Telephone (907) 694-5195
M47 28, 1986
Mr. Steve Morris
Civil Engineer, On-site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
REF: Lot 11, Blk 6, Lakeridge Terrace
Dear Mr. Morris:
The enclosed application is submitted for issuance of a septic
upgrade permit for a 4 bedroom home useage on the above referenced lot.
The permit to upgrade will require a 51_ lot line 'setback for the
trench due to lot dimensions and in ,order to satisfy setback
requirements to local wells. This lot line setback will not impact any
septic system installation to the West as this land is owned by the
Municipality and is being used as the route for the Eklutna pipeline
which is located approxi -mately 100' west of the lot line. The trench
location will be on property and permission is being obtained from
utilities for location in the easement as shown on the attached site
plan. It is also noted that the new trench is to be placed 12' from
the existing seepage pit. This will not pose a problem as an
exploratory test hole has shown that there is no sign of septic
leachate in a test hole excavated 10' distance from the pit sidewall to
a depth of 12'. This is probably due to the fairly high percolation
rating of the soil. The location of this test hole is shown on the
site plan. The ,additional rabsorbtion area to be added is 384 sq. ft.
as the owner desires to add the maximum amount of absorbtion trench
possible while the excavator is on the site. In reviewing this permit
request it must be`realized.that no consideration was made in the past
for replacement sites when a well or septic system was installed, this
now results in our having to request variances to allow the system
installation.
If there are any questions or if additional information is
required please feel free to contact me at 694-5195.
Sincerely,
Lou Butera, P.E.
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: 4044VIA6G Ys^y / DATEPERFORMED: `sfeZ� �'�
LEGAL DESCRIPTION: J -UJ �/ .�/c'�k 6i 44 ire efs4e %-erract. 7-jsw deaw Sft..A3
SLOPE SITE PLAN
1
2
3-
4-
5-
61 5 6
13
%/.so;l Sf ORGAwrc
(SM)
S'115 jc' v I r
WAS GROUND WATER
ENCOUNTERED? Alb
7a..,
&Y►nn. oI'M. ja IF YES, AT WHAT �S
DEPTH?
14
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
15
15-
/"'
.y°.°•OeNC .bQ®`�R 1"1
16
jr-
E. co
,� • .y ('
17
F ..°
.
/
18
�19t
...........
Louis A. ButerO I p4i
OaiP�
CE -6736 t.'.
19
&y
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
S'3���
20 LlS If
dn 4d�'
PERCOLATION RATE o_7 3 (minutes/inch)
TEST RUN BETWEEN E FT AND 4' FT
COMMENTS /77...`, t r %. Le //.+S7'a I*W 4 -dE 01 c7- cs / .. G A,, 7-,
PERFORMED BY: Eagle River EnalneefBM Bliftes;- CERTIFIED BY: L4`7+ - DATE:
P. 0. Box 773294
Eagle River, AK 9957T.
72-008 (6/79) 694 -SM
EAGLE RIVER ENGINEERING SERVICES
P.O. BOX 773294
EAGLE RIVER, ALASKA 99577
694-5195
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Lot 11, Block 6, Lakeridge Terrace
A. GENERAL
1. The drawing and or site plan shall be a part of this specification.
2. All materials and workmanship shall meet the requirements of
the Anchorage Department of Health and State D.E.C..
3. All soil tests are advisory to the design and are to be
verified or modified in the field by the engineer.
4 All excavations and depths are advisory and are to be verified or
modified in the field by the contractor to meet MOA, D.E.0 require-
ments.
5. It is the responsibility of the owner to obtain all necessary
permits or easements and to locate any adjacent multi -family wells.
6. It is always recommended that a surveyor locate the nearest lot line
position and the location of any easements.
B. DRAINFIELD
1. The septic tank outlet shall be uncovered and an additional 500
gallon tank added in series for a total tank capacity of 1500 gallons.
2. The bottom of the trench shall be level, plus or minus 1.5".
3. The total depth of the trench excavation is not to exceed 8' at any
point .
4. The upgrade trench is to be connected to the existing seepage pit so
that the overflow from the seepage pit is absorbed by the added trench.
5. A cleanout is to be placed between the seepage pit and the upgrade
trench and between the 500 gallon tank and seepage pit.
6. The trench gravel is to be covered with typar fabric material.
7. Soil or combination of soil and extruded board insulation to a depth
of 4' or equivalent is to be placed over the bed.'
8. The area over the bed is to be finish graded to prevent ponding
of surface water runoff.
9. The septic tank and leachfield must not be closerthan 100 feet to
any existing private well, 150' to any Class "C"well, or 200 feet
to any community well.
LEACHFIELD DIMENSIONS
TOTAL DEPTH= 8'
GRAVEL DEPTH= 6'
TRENCH LENGTH= 32'
REQUIRES 2" insulation or 2'mounded soil
GRC"fER ANCHORAGE AREA BOUGH
c�fl� Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME /Q C C MAILING ADDRESS 5Tt4_P,/H-ONE_ $A-aB/3
LOCATION?��/CSG LEGAL DESCRIPTION 10 T/ -Ae'oef1 Gi Z_4fG /e Z'0L4
SEPTIC TANK:
DISTANCEL NUMBER OF
FROM WELL �6d 'F MANUFACTURER (L u K�OWA) MATERIAL ST G '.. COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH. LIQUID DEPTH LIQUID CAPACITY 000 GALLONS.
SEEPAGE PIT: � y a� f m
NUMBER OF PITS ` DIAMETER _OR WIDTH LENGTHLL, e DEPTH .
LINING MATERIAL CRIB SIZE: DIAMETER —DEPTH— DISTANCE FROM: WELL 6
/ TOTAL EFFECTIVE
BUILDING FOUNDATION22, NEAREST LOT LINE Z6 �. ABSORPTION AREA (WALL AREA) /OZQ
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
t
TYPE ,r•/�</�/G�� CONSTRUCTION T/09� % DEPTH ZZ DISTANCE FROM:
BUILDING NEAREST �
-C -L. NEAREST ,N" SEPTIC /6 SEEPAGE �d0 �-
FOUNDATION LOT LINEJ12L2_1_. SEWER LINE r� TANK.L—, SYSTEM
CESSPOOL OTHERSOURCES
APPROVED DISAPPROVED - REMARKS
DISTANCES: DIAGRAM OF SYSTEM
INSTALLED BY:
PIPE MATERIAL: Nr� 2y Ids
LOT SLOPE:/ 5�7�'+ [ u!�5
REMARKS:SO/L
ADDfl
DATE46/15ZZ APPROVED.
G.A.A.B.
Form No. E"31 ^
SEEPAGE PIT: a a )e a 9 X/O &V inq l8"/ (deo eQ
NUMBER OF PITS� .,.ADIIAMETER OR WIDTH -0'Z, LENGTHZ1,� DEPTH,.
LINING MATERIAL,�AdIk CRIB SIZE: DIAMETER_DEPTH_DISTANCE FROM: WELL L00
TOTAL EFFECTIVE
BUILDING FOUNDATIONNEAREST LOT LINEaA; . ABSORPTION AREA (WALL AREA) /10.10 SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE "411 CO CONSTRUCTION 574A-04'eO • DEPTH I;e DISTANCE FROM:
BUILDING NEAREST NEAREST �00f SEPTIC `OO SEEPAGE
FOUNDATION LOT LINE - SEWER LINE , TANK SYSTEM IlDO I"
CESSPOOL OTHER SOURCES _rep OF WeA1 IASe/p9 Re Se9Lrld
APPROVED_' _DISAPPROVED X REMARKSWr-.L 11f/ WET* /09'ee'
DISTANCES:
INSTALLED BY: S�
PIPE MATERIAL: 0417- _De0d,
LOT SLOPE: //p g4-5 7- TO p/eSr
REMARKS: 50/.1, TCS%
aOOp %O 14.0
Form No. E"31
DIAGRAM OF SYSTEM
///V/MeST' 0A,;, 4-'
apa(�.G
X
a
DATE
*3
�,oa�' aR�AM ter.
t�,+K•
1�1
APPROVED
G.A.A.B.
GRE ER ANCHORAGE AREA
BOA D'dGH'
a
GAflQ Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE
DISPOSAL'.
SYSTEM
NAME /r
�e" a �% MAILING ADDRESS-TrZe Ir BOK
& P/iltts�PHONE
LOCATION]&"eST
jV1;y, AAA A�5d9e-SIP LEGAL DESCRIPTION
�0�% �.� '.I3�OC�E
G LAKE KOe
SEPTIC TANK:
DISTANCE
FROM WELL /04P MANUFACTURER � MATERIAL
�TcL
NUMBER OF
COMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH LIQUID DEPTH
LIQUID CAPACITY_,, OO GALLONS.
SEEPAGE PIT: a a )e a 9 X/O &V inq l8"/ (deo eQ
NUMBER OF PITS� .,.ADIIAMETER OR WIDTH -0'Z, LENGTHZ1,� DEPTH,.
LINING MATERIAL,�AdIk CRIB SIZE: DIAMETER_DEPTH_DISTANCE FROM: WELL L00
TOTAL EFFECTIVE
BUILDING FOUNDATIONNEAREST LOT LINEaA; . ABSORPTION AREA (WALL AREA) /10.10 SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE "411 CO CONSTRUCTION 574A-04'eO • DEPTH I;e DISTANCE FROM:
BUILDING NEAREST NEAREST �00f SEPTIC `OO SEEPAGE
FOUNDATION LOT LINE - SEWER LINE , TANK SYSTEM IlDO I"
CESSPOOL OTHER SOURCES _rep OF WeA1 IASe/p9 Re Se9Lrld
APPROVED_' _DISAPPROVED X REMARKSWr-.L 11f/ WET* /09'ee'
DISTANCES:
INSTALLED BY: S�
PIPE MATERIAL: 0417- _De0d,
LOT SLOPE: //p g4-5 7- TO p/eSr
REMARKS: 50/.1, TCS%
aOOp %O 14.0
Form No. E"31
DIAGRAM OF SYSTEM
///V/MeST' 0A,;, 4-'
apa(�.G
X
a
DATE
*3
�,oa�' aR�AM ter.
t�,+K•
1�1
APPROVED
G.A.A.B.
NAME OF APPLICANT
INSTALLATION LOCATION
GRE"""ER ANCHORAGE AREA BOF JGH'
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
�
3330 "C" STREET ANCHORAGE, ALASKA 99303 /
TELEPHONE 274-4341 /Ce Int
Akza is a/c
SEWAGE DISPOSAL SYSTEM — APPLICATION AND 'PEMIT
C" ` e MAILING ADDRESS
C `L J/•R 99e
A o 7`
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK
•
SEEPAGE PIT
DRAIN FIELD OTHER
J,Q m
TYPE AND SIZE OF FACILITY TO BE SERVED
'e"'
T
C
i//0
FINANCED THROUGH '
TO BE INSTALLED BY
NOTE1 THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
SOIL TEST RESULTSV-"//Djj
t H r tIC
l 5 O N'
Ll
COMPLETION DATE ANTICIPATED _it
FINAL INSPECTION 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZEyJ 60 TYPE Y/ t/ SEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT I DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL J
/ Q /
SEPTIC TANK d . SEEPAGE PIT DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK SEEPAGE PIT � '
DRAIN FIELD �UALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN. FIELD
I
SEPTIC TANK, -/4" /", SEEPAGE PIT �. DRAIN FIELD �—.
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND. INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS. ✓ s / V ; R �,�
sCRttwr�6'%A
GRAVEL BACKFILL I f/
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G�X�Ltu R, S,
G.A.A.S.
v ^OR
LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
9 DATE V APPLICANT'S SIGNATURE
FORM NO. EQ -016
AREA
DIAGRAM OF SYSTEM
AND THAT THE ABOVE
GREATER ANCIIO1',AGE AREA DOROUGA,
Department of Environmental Quality
3330 °C" Street
Anchorage, Alaska 99503
SOILS LOG - PEROLATION TEST
Performed for /lla*_ ,fie ---Date Performed 7/ ->—
Legal Uescription:
This form reports: Soils log C —�— PercoaT tion tes
Depth
Feet
2-
3
4
5
6
7-
8
10 _ S/0
.00
11 -
12 -
13 -
14 -
Was ground water encountered? ec) If yes, at what depth?'
Reading
Date
Gross Time
Net Time Depth to Water
Net Drop
ET
Percolatlon rate nn nun.
-Proposed installat of r Seepage Pit Drain Field
Depth of Inlet Depth to bottom of pit or trench
COMMENTS:
Performed
EQ -040 (6/74)
0
u
Municipality of Anchorage
Development Services Department
Building Safety Division 'fh�Ili
On -Site Water d Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. DSI ---7, COSH# D 0d t- 3Q 7
1. GENERAL INFORMATION Expiration Date: Z— G
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
LAKERIDGE TERRACE S/D• BLOCK 6 LOT 11
14724 TERRACE LANE • EAGLE RIVER AK • 99577
GILBERTO do SANDRA RAMOS Day phone 696-7180
14724 TERRACE LANE ' EAGLE RIVER AK • 99577
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
Day phone
Day phone
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
.Individual Well
0
Individual On-site
0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems
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 samples. (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 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 (les 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.
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountored 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 soils condition, groundwater 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 the system. Satisfactory lost
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden dofects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for —r bedrooms.
Disapproved.
Conditional approval for bedrooms, with the fllowing
Phone 337-6179
Date li ZLi 10(3
ON-SITE
Attachments: ///7Jj� � t))) 1),
COSA Checklist Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: Original Certificate Date: 7/03
)R. 11105)
Municipality of Anchorage
(� Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: LAKE RIDGE TERRACE- BLOCK 6 LOT 11 Parcel ID: 0 _1- 313 33
A. WELL DATA :PER M.O.A. RECORDS.
"112' PER 8/15/1975 INSPECTION
Well type PRIVATE If A, B. or C provide PWSID# NIA Well Log (Y/N) NO
Date completed 'S 1975 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth *0105 ft. Cased to •40+ ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 11 / 11 /2008
8�
Static water level 84 ft
Well production N
g.p.m. 0.96 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 3.73 mg./L. Other bacteria 0 colonies/100 ml.
Arsenic: _u gJL. Date of sample:! ! 11 2008 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 2/10/2001
Tank size 1250 gal, Number of Compartments 3 Cieanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N)_ N/A
Date of pumping 11/11/2008 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA eE ow xISTING GRAD
Date installed a/las%,sib = TRENCH
Soil rating (g.p.d./ft o a /bd 24s /
21/ System type CRle
Length 2e ft. Width 22 ft. Gravel below pipe 6a ft.
•9.23/ 252 + 1020
Total depth 10 ft. Eff. absorption area 1272 ft' Monitoring tube YES ' Depression over field NO
Date of adequacy test =,/1 /1 1 /2008 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 41 In. Water added 737 gal, New depth69 in.
Elapsed Time: 120 min. Final fluid depth 60 in. Absorption rate >= 600+
g.p.d.
Any tejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
**TESTED 1986 TRENCH ONLY.
D. LIFT STATION
Date installed Size in gallons ManholelAccess (YIN
Hi h water alarm level at in.
LDattu
mp on" level at in�Cycles
�Ieve: id
Meets alarm & circuit requirements?
e
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO: E
Septic tank/lift station on lot 1 00'+ On adjacent lots 100'+ k
Absorption field on lot
100'+ On adjacent lots 100'+
Public sewer main N/A Public sewer manhole/cleanout N/A
25'+ Holding tank N/A
Sewer /septic service line g
Animal containment areas
50'+ Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 51+ Property line 5'+ Absorption field 5'+
100'+
m
Water main N/A Water service line 10'+ Surface water
Wells on adjacent lots 1004
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
+51+ Building foundation 10'+ Water main N/A
Water service line
10'+Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONKNOWN Wells on adjacent lots 100'+
k
F. COMMENTS x E
♦PFR tgR6 INSPECTION REPORT PREVIOUSLY APPROVED /1 k
G. ENGINEER'S CERTIFICATION!•
I certify that I have determined through field inspections and 0 * ; ,, „ . ... ..........
review of Municipal records that the above systems are in 0
conformance with MOA COSA guidelines in effect on this e °rne. s:'
date.
Engineer's Printed Name JEFFREY A. GARNESS��Q o• — 5
Ith.. ^ovv
Date11'11+ Og edP Ofea alo^°oo
��Onaaoo�
COSA Fee $ 2 30 1-1 2S
Date of Payment!� 1 11,H U�
Receipt Number 2s �
(Rev. 11105)
r S
WaiverFee $
Date of Payment �f �T/L�
Receipt Number 3 7a
Municipahty of Anchorage
VO. Ik,x VXHL;'A) 0 Aochiiragc. Aht%ka, Q.6111 -1i( -A) a 47M I1 r gmv Sir, CI
� I lllirc: ISMIi 1:4S:1li:illl • hnx: CNIi 1:i7A841R1 hup://"v�r.numi.ur;;
1Jayor Jfark Begich De-velopmerit Sen -ices Deptirtrticlll
November 21, 2008
Gilberto G. and Sandra E. Ramos
14724 Terrace Lane
Eagle River, AK 99577-9277
Dear Property Owners:
RE: Encroachment: Septic Pipes in Utility Easement
Lake Ridge Terrace, Block 6, Lot 11, Grid NNN'0553, 14724 Terrace lane
rent
q4 . S' i
Department
The Right of Way Division has reviewed a request for a letter of nonobjection to the existing two septic
pipes, which encroach approximately 6' into the 10' Utility Easement at the west property line. On the
as -built survey dated February 21, 2001 (Seward & Associates Land Surveying), submitted with the
request, the petitioner has shown the encroachments.
This letter of nonobjection is issued with stipulations, and by using it the petitioner is agreeing to the
following:
1. Municipality of Anchorage (MOA) will be held ham -Jess, now and forever, for any damages or
injury to any person as a result of the encroachments.
2. All applicable codes and regulations will be observed and maintained within the easement.
3. This letter of nonobjection will in no way preclude MOA from full use and enjoyment of its
rights within any portion of the easement.
4. Additional and extraordinary costs incurred during any future required construction, repair or
reconstruction of MOA improvements to accommodate any or all of the encroachments shall be
paid by the property owner.
5. Letters of nonobjection from the following utilities are attached:
®
Anchorage Water & Wastewater Utility
❑
Alaska Communications Systems
❑
Chugach Electric Association, Inc.
®
Matanuska Telephone Association
®
Matanuska Electric Association, Inc.
®
Enstar Natural Gas Company
❑
Municipal Light & Power
®
GCI Cable of Alaska
❑
Eyecom (Girdwood Cable TV)
❑
No letters required
All letters of nonobjection should be retained in your permanent files. If you have any questions, please
call me at 343-8033.
Sincerely,
l�Y`� m4'i,
/'ily, Jack L. Frost, Jr.
Right of Way Supervisor
Concur
Property Owner(s)
Community, Security, Prosperity
O:ID"elopneniSeNim!RON '�Non-objeaion lenorVnke Ridge Terence. 81k6. Lm it. Rnmo,.dx
Municipality of Anchorage
-tel Development Services DepartmentL
Building Safety Division , .. , , .
On -Site Water 8 Wastewater Program
4700 Bragaw Street 1
P.O. Box 196650
Anchorage, AK 99519-6650
www,muni.org/onsite
r (907) 343-7904 ♦F_
f4lioo CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. n 3) 3 — 33 COSA# (0!2039:7
1. GENERAL INFORMATION Expiration Date: 2 , 17— 0 Gi
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
LAKERIDGE TERRACE S/D: BLOCK 6, LOT 11
14724 TERRACE LANE • EAGLE RIVER. AK * 99577
GILBERTO do SANDRA RAMOS Day phone
14724 TERRACE LANE • EAGLE RIVER, AK " 99577
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well 0
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
Day phone
Day phone
696-7180
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems
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 samples. (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 engineers 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 Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site Ater supply and/or wastewater disposal system Is (are) safe, functional and adequate
for the number ofbe&ooms and type of structure indicated herein. I further verify that based on the
Information obtained from the Municipality of Anchorage riles 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 SUMe codes, ordinances, and regulations in effect at the time of installation. : 1,
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineers Printed Name JEFFREY A. GARNESS, P.E. Date 11 I o 6
Engineer's Comments:
In conducting this evaluation, GEG, VD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines d Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
/
Conditional approval for bedrooms, with the fllowing stipulations:
Attachments:
COSA Checklist Arsenic Advisory
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
✓ Maintenance Agreements
Supplemental Engineer's Report
Other
By: 1 Original Certificate Date:
(Rw. 11105( /
r-\ Municipality of Anchorage
C• --1 Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onsite
(907)343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
- t
Legal Description: LAKE RIDGE TERRACE; BLOCK 6, LOT 11 Parcel ID: 09—/ - 313 - 33
A. WELL DATA ,;112 RECORDS.
ER 8/ 5/1975 INSPECTION
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) NO
Date completed '5/1975 Sanitary seal (YIN) YES Wires properly protected (YIN) YES
Total depth "105 ft. Cased to `40+ ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 11/11/2008
Static water level PJPft. 84 ft.
O
Well production N g.p.m. 0.96 g,p,m,
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi. Nitrate 3.73 mg./L. Other bacteria 0 colonies/100 ml.
Arsenic: ug./L. Date of sample:l 1/11/200 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 2/10/2001
Tank size 1250 gal. Number of Compartments E Cleanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alar (YIN) N/A
Date of pumping 11/11/2008 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA I -BELOW EXISTING GRADE
6/8/1986
TRENCH
Date installed 6/15/1975 Soil rating (g.p.d./ft'o /bd 245 System type CRIB
21/ 3/ 6/
Length 29 ft. Width 22 ft. Gravel below pipe 4 ft.
09.25/ 1252 + 1020
Total depth 10 ft. Eff. absorption area 1272 ft' Monitoring tube YES Depression over field NO
Date of adequacy test '• 11/11/200 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test' 41 in. Water added 737 gal. New depth 69 in.
Elapsed Time: 1120 min. Final fluid depth60 in. Absorption rate >= 600+ g.p,d,
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
**TESTED 1986 TRENCH ONLY.
D. LIFT STATION
Date Installed Size in gallons Manhole/Access (YIN)
"Pump on" level at in. 'Pump oft" leve High water 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
1
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service fine 25'+
Animal containment areas 50'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field
Water main
Wells on adjacent lots 100'+
Water service line 10'+ Surface water 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 'S'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and p` ! `� - Yn
review of Municipal records that the above systems are In 0"""" " ' " """ "
conformance with MOA COSA guidelines in effect on this
date. J e orne s.
Engineer's Printed Name JEFFREY A. GARNESS
Q o� •. I 5 �FO�
Date it )14 1013 �� 1e0'' fl L \Low
PForesslo� 4�
��400oo�c
COSA Fee $ L1 30 A- 1-7 S
Date of Payment
Receipt Number.
(Rev. 11105)
Watver-Fee $ /1
Date of Payment
Receipt Number
Municipality of Anchorage e e
•� 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
Nater Well Advisory
Health Authority Approval # 080397
During a recent Health Authority Approval on-site inspection and test of the
potable water supply well on Block 6, Lot 11 of Lake Ridge Terrace
subdivision, the well's productivity was determined to be 0.96 gallons per
minute. The minimum well productivity required by this Department (AMC
15.55) for a 4 -bedroom residence is 0.41 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.
May 25 04 11i0la
Eva Laken 907 609 6476
v
P.1
ASBUIL7 SMIARD 6 ASSOCIATEStLBND bUKVr XiftU b R�UVL`f
I HEREBY CERTIFY -THAT I HAVE SURVEYED THE..SOF At
'
( FOLLOWING DESCRIBED PROPERTYr r •
.fsi�/C�fffPT
DATE r r V- ''�9�,.t �.
AND THAT NO ENCR=HMENTS ?7 IST EXCEAS T M {
INOICATED. IT IS THE RESPONSIBILITY -OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY GRID,
i EASEMENTS, COVENANTS OR RESTRICTIONS iYu/�•f•� ��* �� ai
WHICH DO NOT APPEAR ON THE RECORDED SUBDI• 1 s •.
vISfON PLAT. UNDER Nor SHOUT FB' 4•• Ls 6918
' ANY DATA HEREON BE USED FOR CONSTRUCTION �� �S
�+� r
0= TAE
FENCE LINES, OR FOR ESLISHING BOUND- pgAWNr
ARY LINES.
Q�C171� tTc(rZo
Municipality of Anchorage
• ^� Development Services Department •`'
/ Building Safety Division
On -Site Water and Wastewater Program •• •••
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Recerti-Ptce Lo►)
Parcel I.D. 051-31333 HAA #_ O 4 O /
Expiration Date: 3 — / - O -6-
1. GENERAL INFORMATION
Complete legal description Lot 11 Block 6 Lake Ridge Terrace
Location (site address or directions) 14724 Terrace Lane, Eagle River. AK 99577
Current Property owner(s) Prudential Relocation Day phone
Mailing address 14724 Terrace Lane, Eagle River AK 99577
Lending agency Day phone
Mailing address
Real Estate Agent Barbara Crittenden/Prudential Vista Day phone 689.6464
Mailing Address 16635 Centerfield Drive Eagle River AK 99577
Unless otherwise requested, HAA will be held by DHHS for pickup. NAA picked up by:
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
- Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
19
Individual Holding tank
❑
Community On-site
❑
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) on properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also Issues HAAs upon request to home owners. 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 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.
(P�. t lm)
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown
foo , I verify that Authority App oval
stigation
based on procedures outlined in the Health Authority App
roval 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. 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 in compliance with all applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Eng. Svc.
Phone - 272-8218
Address P.O. Boz 102954 Anch AK 99510
Date
Engineer's Printed Name Steven R. Pannone P.E.
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious 'o�OF ,1,-
engineering analysis of the system in ac
with MOA DSD Guidelines & Regulations. The ♦ P� � „
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 �! {x F• 49TH
during the year, and the water usage of the family being served by the system These conditions are jo,,, : ,,, .........«.......
outside the control of the evaluator of this system All systems eventually �at therail ande ate n hidden defects ... ...............
tisfactory test results 001
do not guarantee future performance of the system, nor do they guaranteeSteven R. Ponnon,
or encroachments. PES can therefore not provide any Warrarmry for future performance nor give any
estimate of how long the system will continue to meet the operational requirements of the ADEC or i '% No. CE 8149.e,
MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon ••....
d t�C.°
or use of this report by any other person or parry is not authorized nor will it confer any legal right t#44
#4 t(
whatsoever. �,hl•?.�
6. DSD SIGNATURE
</Approveci for _LL bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
M,
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By
Expiration Date:
(Pe . tvae)
Original Certificate Date: 1 2 L!: O
Reissue Date:
Municipality of Anchorage e
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program +
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.enchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 11 Block 6 Lake Ridge Terrace Parcel I.D.: 051-31333
A WELL DATA
Well type P If A, B, or C provide PWSID #
Date completed X1415 Sanitary seal ygg
Total depth 10S ft Cased to _49 -+_ft
FROM WELL LOG
Date of test
Static water level Not 6,vallable ft
Well production g.p.m
Well Log N
Wires properly protected ygg
Casing height (above ground) 20 In.
AT INSPECTION
91912004
82 ft
1.5 9 -p.m
WATER SAMPLE RESULTS: 51.31,260y
Coliform "6�/ colonies/100 ml Nitrate 4,04 mgll Other bacteria `-8— colonies/100 ml
Ne -Lb zrc"`t P(
Date of sample: 919/2004 Collected by: Laura Pannone
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Anchorage Tank Steel
Date installed 2110/2001 Tank size 1250 gal Number of Compartments $
Cleanouts Y Foundation cleanout Y Depression over tank y High water alarm N _
Date of pumping 1112612003 Pumper JR's Pumping
C. ABSORPTION FIELD DATA See 5(204-t OY)
Date installed $1151197 Soil rating (g.p.d./ft2 or ft2/bdrm) 4 System type Crib/Trench
IKslcn &1S/8 5
Length X28 ft Width ft Gravel below pipe ft
Total depth 11.5 ft Effective absorption area JMfe Monitoring tube x Depression over field
7rehct', %C'-to?,Z. TreAa,.,.;z52
Date of adequacy test 5/3/2004 Results (Pass/Fail) Pass* r For 4 bedrooms
Fluid depth in absorption field bef . test 77 in Water addedM gal. New depthZ2 in.
I re#1411 T5- $ 7-re,1Ct. s& ,5
Elapsed Time:1440 min Fir1@I fluid dept L in Absorption rate >= 600+ g.p.d.
I Nail CJA 5-5
Any rejuvenation treatment (past 12 mo.) (Y/N& type) N If yes, give date
(Rev. 11199)
D. LIFT STATION
Date installed Size in allns
'Pump on" level at _ in`Pump ofP IdveT f, _ in
Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 105.5
Absorption field on lot 100.2
Public sewer main NIA
Sewer /septic service line _29'+
Manhote/Access
High water alarm level at _ In
Meets alarm & circuit requirements?
On adjacent lots 100+
On adjacent tots 100+
Public sewer manhole/cleanout NIA
Holding tank 190+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 25'+ Absorption field 1g'+
Water main 50'+ Water service line _20'+ Surface water 100+
Drainage 100+ Welts on adjacent lots 100+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: -
Property line ' Uhl Building foundation J5'+ _ Water main 50'+
Water Service line 20'+ Surface water 100+ Driveway. parking/vehicle storage So'+
Curtain drain None Observed Wells on adjacent lots 100_
F. COMMENTS
G. ENGINEER'S CERTIFICATION : fid' `9 '
1 certify that I have determined through fleld inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date. ............... e�en . none?
Steve i o Pannone. P.E. 1��j ., � CE Brag
Engineer's Printed Name q (U,..•'�.�
Date ,'t.0i
40
HAA Fee $ N 3
Date of Payment 524 / Gq
Receipt Number 5 ?'
(Rev. 11199)
Waiver Fee $
Date of Payment
Receipt Number
ap
Municipality of Anchorage
.� Development Services Department
Building Safety Division
On -Site .. �.,
Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FORA SINGLE FAMILY DWELLING c/
Parceli.D. 051-313-33 HAA# C-)qZ� 2S
0 it
Expiration Date: — D 3
1. GENERAL INFORMATION
Complete legal description Lot 11 Block 6 Lake Ridge Terrace
Location (site address or directions) 14724 Terrace Lane Eagle River AK 99577
Current Property owner(s) Anthony Grootens I Day phone 622-0200
Mailing address 14724 Terrace Lane Eagle River AK 99577
Lending agency Day phone
Mailing address
Real Estate Agent Eva Loken 0 Prudential Vista Day phone 689-6476
Mailing Address 16635 Centerfield Drive Eagle River AK 99577
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank ❑
Community On-site ❑
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) on properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to home owners. 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 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.
(Rm »W)
S. 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 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. 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 in compliance with all applicable Municipal and State
codes, ordinances, and regulations in effect at the time of Installation.
Name of Firm Pannone Eng. Svc. Phone 272-8218
Address P.O. Box 102954 Anch AK 99510
Engineer's Printed Name Steven R. Pannone P.E. Date
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious
engineering analysis of the system in accordance with MOA DSD Guidelines & 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 AV
OF
outside the control of the evaluator of this system All systems eventually fail and satisfactory test results 0'
do not guarantee future performance of the system, nor do they guarantee that there are no hidden defect,/.,,
or encroachments. PES can therefore not provide any warranty for future performance nor give any
estimate of how long the system will continue to meet the operational requirements of the ADEC or
MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon 1
or use of this report by any other person or party is not authorized nor will it confer any legal right
whatsoever.
6. DSD SIGNATURE
49TH
..r ... ..........
;Steven �nnone:
No. CE 8149
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
Attachments:
ON-SITE •• c�
� m
.
PROGRAM
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: Original Certificate Date: �o
Expiration Date: Reissue Date:
)Rev. 11199)
■°ate 1 9.ti_ .� - J��te -'#.. _ .._, 4L Aix
Municipality of Anchorage11"1
• '� Development Services Department
Building Safety Division "
On -Site Water and Wastewater Program 6 " a * r
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 11 Block 6 Lake Ridge Terrace Parcel I.D.: 051313-333
A. WELL DATA vo
Well type P if A, 8, or C provide PWSID #,__ Well Log P , I,
Ves Lkd'
Datecompleted..A-155 Sanitary seal V_�Ie& Wires properly protected
Total depth _10—ft Cased to -Aft—ft Casing height (above ground) 20 In.
FROM WELL LOG AT INSPECTION.
Date of test it
` $13/2004
Static water level of Available ft 81 ft
Well production 9 -p -m 1.57 9 -p.m
WATER SAMPLE RESULTS:
Coliform „R _colonles/100 ml Nitrate :4.64 mgn Other bacteria 0 colonies/100 ml
Date of sample: 5!312004 Collected by: Laura Pannone
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Anchorage Tank Steel
Date installed 2/10/2007 Tank size 1250 gal Number of Compartments I
Cleanouts Y Foundation cleanout Y Depression over tank N_ High water alarm NIA
Date of pumping 11/26/2003 Pumper JR's Pumping
C. ABSORPTION FIELD DATA
Date _iinstal�8/1 IS 9775 Soil rating (g.p.d.e or ft%drm)" System type Cribrrrench
Length 29 Width 22 ft Gravel below pipe 4 It
Total depth Effective absorptiion area 02 fe Monitoring tube Y,I y Depression over field yL�fN•
�( ii+rr � Z ,^ate^ S¢e SC%-I'ron F: Cc, Ale *$ TyyTT
Date of adequacy test 1312004 Results (Pass/Fail) ss" For 4 bedrooms
oLt
Fluid depth in absorption field before test Z in Water added60 gal. New depthL in.
.b. 01
1-1-anc1 Tmh-ck .5G,5
Elapsed Time: 1440 min Final fluid dept 77 in Absorption rate >= 600+ g.p.d.
"_Vx�K 65
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date
.(Rev. WWI
16�
D. LIFT STATION
Date installed _
"Pump on" level at
/)� _ s s -464'9fzYtAn gall o/► Manhole/Access
ofP' level �tL in High water 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 105.5 On adjacent lots 100+
Absorption field on lot 100.2 On adjacent lots 100+
Public sewer main NIA Public sewer manhole/cleanout N/A
Sewer /septic service line 25'+ Holding tank 100+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation _5'+ Property line 251+ Absorption field 15'+
Water main 50'+ Water service line 20'+ Surface water 100+
Drainage 100+ Wells on adjacent lots 100+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 5' tA)D t �� Building foundation 151+ Water main : 50'+
Water Service line 20'+ Surface water 100+ Driveway, parking/vehicle storage 50'+
Curtain drain None Observed Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION W' "♦♦
I certify that t have determined through field Inspections and i ,r H '� ♦♦j
..... ...........
review of Municipal records that the above systems are in 00 .........i. ♦
conformance with MOA HAA guidelines in effect on this date.%
��'.Steven R. •Pannone Y7
Engineer's Printed Name Steven R. Pannone. P.E. ♦i� '•. No. CE 51 49
Date ♦ • •••.............!• •
HAA Fee $ o Waiver Fee $ t
Date of Payment O / Date of Payment
Receipt Number �� TJ / Receipt Number
(Rev. 11/99)
May 2504 l l i Ol a Eva Laken 907 669 6476 P.1
2s�a'
ASSUILT SEWARD 6 ASSOCIATES LAND SURVEYING 694-O829
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE'',_,, �F *`
f FOLLOWING DESCRIBED PROPERTY, go,
Q
Cq
«LF�YirGG�ETE�P.erfGr�tmT/Cel '..DATE,
AND THAT NO ENCROACHMENTS iiIST EXCEPT AS
INDICATED. IT IS THE RESPONSIBILITY OF THE Z 2/ i �; TM �V g
OWNER TO DETERMINE THE EXISTENCE OF ANY BRID, °"" •• d
EASEMENTS. COVENANTS, OR RESTRICTIONS it/W6.r� .7.'r-4 . ;4�aaq
WHICH DO NOT APPEAR ON THE RECORDER SUSDI- o,,..,. *..k s.w..a +' a �/
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FS` L5-6918 =`f
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING
BOUND -DRAWN,
ARY LINES.
cipali'y of Anchorage`
.:
Complete legal description
LAKE=RIDGE =TERRACE=SUBDIVISION: LOT 11; BLOCK•
6.
Location (site address or directions) 14724=TERRACE LANE • EAGLE RIVER AKT-99577
Cunent Property owners)
ROGER ,THOMPSON" Day phone
696-051 t3'
71
Mailing address` .
14724 =TERRACE LANE '*EAGLE RIVER, AK 99577
Lending egenq
Day phone
Mailing address ,
Estate
Real Estate Agent , -
EVA . LGKEN w/ PRUDENTWL VISTA Day phone
689-6464
Mailing address
16635 ' CENTERFIELD DRIVE • EAGLE -'RIVER, AK, 99577
Unless otherwise requested, HAA wAl behold by DSD for plokup.
2. NUMBER OF BEDROOMS:
4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
® Individual On-site
Individual Water Storage
❑ Individual Holding tank
❑
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 5 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of tills (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 engineers work.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1,770.00 at, or prior
to closing for the engineering services provided.
Doc,
4. STATEMENT OF INSPECTION BY ENGINEER Ci
As certified by my seal affixed hereto and as of the val/dationdeto shown below, l verify that my
Investigation, based on procedures outlined In the Health AuthodtyAppmval 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. l 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(em) In compliance with all applicable Munidpal
and State codes, ordinances, and regulations In effect at the time of installation.
Name of Firm - ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179
Address, ,6901 DEBARR ROAD, SUITE 2B • ANCHORAGE, 'AK 99504
Engineer's Printed Name JEFFREY A. `GARNESS, P.E. Date
tngmeers comments:
in conducting this evaluation, AMNYC, Inc. attempted to provide a Morough,
conscientious engineering analysts of the system In accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results descrtbed the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to madity identifiable features. The operational file of aff wells and
septic systems depend on the local soils condition, groundwater kwis that may
fluctuate during the year, and the water usage of the family being served by Me system.
These conditions are outside the conird of the evaluator of tie system. Satsfactory test
results do not guarantee future performance of the system, nor do tieyguarantee that
there are no hidden defects or encroadnents. AWWC, Inc. can Merefore not provIde
any wenanty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. Tire content of this report is for
Me sole benefit of the owner Ilsted above. Anyreliahce upon cruse of this report by any
oMer person orpartyis not authorized, nor will t conferany legal right whatsoever.
5. DSD SIGNATURE
_,e!�_ Approved for _-4— bedrooms.
Disapproved.
Conditional approval for bedrooms, with the fllowing stipulations:
C Note: The well for this property meets existing State and Munic
fo
�q°PPON,
*rC'.
c'so
ON-SITE
WATER AND tTt'
WASTEWATER
PROGRAM
z INN
.oaJV-bm.3'eTSEV��ks'
There are nitrates present. It is suggested that periodic testing be performed
to insure the wells continued suitability. Current nitrate concentration is5.96
mg/1. EPA maximum concentration is 10.0 m¢/l. More info on nitrates is available
from On -Site Services,CPD,343-4744
Attachments:
HAA Checklist Manitenance Agreements
Septic System Advisory Supplemental Engineer's Roort
Well Flow Advisory Other /i�% �'ra-�G A "t/.h 5"/—
By: _ i (i Original Certificate Date:
FW. +swoh
Municipality of Anchorage
� ; 4
Development Services Department
Budding Safety Division
On-Sfte Water 8 Wastewater Program
4700 South Bregaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchomge.ak.us
(907)343-7904
HEALTHAUTHORITY APPROVAL CHECKLIST F
Legal Description: LAKERIDGE TERRACE SUBDIVISION; LOT 11, BLOCK 6 Parcel ID: 051-313-33
*PER M.O.A. RECORDS
A. WELL DATA **112' PER 8/15/1975 INSPECTION REPORT
Well type PRNArE If A B, or C provide PWSID# N A Well Log (Y/N) NO
Data completed *5/1975 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth ** 105 ft. Cased to '40+ A. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION 3
Date of test
11/3/2000
3 v
Static water level �� ft. e0 fL
a
Well production g.p.m. 1.95 g.p.m.
WATER SAMPLE RESULTS:
t Coliform colonies/100 ml. Nitrate 5 mgA. Other bacteria colonies/100 mL
Date of sample: 2/12/2001 Collected by: AWWC,' INC.
i
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
STEEL Data Installed 2/10/2001
d
k Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (YM) NO High water alarm (YM) N/A
Date of pumping NEW Pumper
? C. ABSORPTION FIELD DATA IOTEST PERFORMED ON rn NCH ONLY
Date installed s 151 1975 Soil rating (g.p.dJfVo /bd 245 System type FRENCH/CRIB
t Length 21'/29' ft. Width 3'/22' ft Gravel below pipe
Total depth —V-10' ft. Eff. absorption area Zoz6 fe Monitoring tube YES Depression over field NO
Date of adequacy test 11/7/2000 Results (Pass/Fail) PASS For *4 bedrooms i.
' Fluid depth In absorption field before test 9.5 in. Water added 1036 gal. New depth s6 in.
' Elapsed Time: 830 min. Final fluid depth 46_75In. Absorption tate >= 600+ g,p.d, s
a
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
Date
"Pump on" level at n. "Pump oft" l- -�In. High water alarm level at in.
Dam 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'+
Public sewer main N/A
On adjacent lots 100'+
Public sewer manholetcleanout N/A
Sewer /septic service line 25'+ Holding tank N/A
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:
*PER 7/22/1986
INSPECTION REPORT
Property line *5'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 50'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
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 0 ........ ' • • ' • •' • ` ....
conformance with MOA HAA guidelines In effect on this date.
fr s
Engineer's Printed Name JEFFREY A. GARNESS o��09�' E 53
Date oZ — I to -1n>1 �0`*� '' • .... o��,o
HAA Fee $ Waiver Fee $
Date of Payment
Receipt Number.
(Rev. 12fOO)
Date of Payment
Receipt Number
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
Application Date
t. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 11 Block 6 Lake Ridge Terrace T15N R2W Sec. 25
Location (address or directions)
Hillcrest Rd..
(b) Applicant NameDave Berry Telephone: Home 688-3443 Business 264-6627
Applicant Address' 1710 Blue Spruce Lane Eagle River AK 99577
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder Q; Buyer ❑ ; Other ❑ (explain);
(d) Lending Institution City Mortgage Telephone 694-3503
Address Centerfield Drive Eagle River AK 99577
(e) Real Estate Company and Agent
Address _
Telephone
(f) Mail the HAA to the following address:
pickup by applicant
2. TYPE OF RESIDENCE
Single-family [C Multi -Family ❑ Other
Number of Bedrooms 43
3. WATER SUPPLY
Individual Well R) 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 ID Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
72-025 0+/84)
Page 1 of 2
f'*,N em
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
Aq certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm Telephone
Address EAGLE RIVER ENGINEERING SERVICES
Date s���/&6
EAGLE RIVER, AK 99577
694-5195
4 ` hdlh*r's Seal
is ",�"�� i;��# °• fa u)
...n..........
Louis A. autero
CE -6736
6. DHEP APPROVAL
Ap roved for 3 be by Date
Approved X Disapproved Conditional
Terms of Conditional Approval
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 in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MOA)
aFDrvryOF Op HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Mgr2� 0�6
284-4720
2 Legal Description: �cf 11 ATI -'r4 *e
-
Legal 86' JQa(�t %rr'oc¢ rl5 N 2z w Sec 2r
A. WELL DATA ` ,{re,O
Well Classification �2 ! ✓A T r If A, B, C, D.E.C. Approved (Y/N) N�4
Well Log Present (Y/N) Ze!4 a ate Completed y •/5 JS' Yield
Total Depth t / �� + Cased to �L/o Depth of Grouting IV .4 ✓�+�"/Y
Static Water Level SIS / Pump Set At
! y
Casing Height Above Ground o2 Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) % Depression Around Wellhead (Y/N) N
Separation Distances from Well:
To Septic/Holding Tank on Lot /ov ; On Adjoining Lots rr"' �
To Nearest Edge of Absorption Field on Lot �G` ; On Adjoining Lots moi° o
To Nearest Public Sewer Line To Nearest Public Sewer
Cleanout/Manhole To Nearest Sewer Service Line on Lot
Water Sample Collected by E.Jlc je" '^ r "'s �• : Date y'43 .0Z"
Water Sample Test Results
Comments /vc// 02+c .rxr 2 rid °Vn +s fJk c cared J+ `40
B. SEPTIC/HOLDING TANK DATA
Date Installed /'.7S Size No. of Compartments
Standpipes (Y/N) y — Air -tight Caps (Y/N) y Foundation Cleanout (Y/N)
Depression over Tank (Y/N) /V Date Last Pumped 6
Pumping/Maintenance Contract on File (Y/N) N11'f ; for
Holding Tank High -Water Alarm (Y/N) i✓Ih Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water -Supply Well / To Building Foundation lcJ !
To Property Line r/o To Disposal Field /O
To Water Main/Service Line �/" To Stream, Pond, Lake, or Major Drainage
Course Al /A
Comments
page 1of2
C. ABSORPTION FIELD DATA
0
Soils Rating in Absorption Strata X700 �R2 Type of System Design ff- ase -,e2
Date Installed 6 7
Length of Field a -Z
Width of Field ?4
_ Depth of Field
Gravel Bed Thickness 6
Square Feet of Absorption Area /C -Z
Standpipes Present (Y/N) Y
Depression over Field (Y/N) N
Date of Last Adgquacy Test -S gd
Results of Last Adequacy Test S4 A,;+e.
Separation Distance from Absorption Field:
To Water -Supply Well /OO
To Property Line oZ U
To Building Foundation
To Existing or Abandoned System on
Lot N/Q
; On Adjoining Lots ?a
To Water Main/Service Line 1,/0
To Cutbank (if present) ^!�/4
To Stream/Pond/Lake/or Major Drainage Course
w14
To Driveway, Parking Area, or Vehicle Storage Area
t/U
Comments
D. LIFT STATION A/,
Date Installed
Size in Gallons
"Pump On" Level at _
High Water Alarm Level at
Tested for
Electrical Codes (Y/N) _
Comments
Dimensions
Manhole/Access (Y/N)
— "Pump Off” Level at
T Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Check Permitted Bedroom Rating Against HAA Request"
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed Date 4-/z
_
Company MOA No.
Receipt No.
p w,
Date of Payment
iP2 , ✓ 9^
Amount: $ 6 C)„_ rtgineer's Seal
Page 2 of 2
72-028 111/84)
lours A. Butera
CE -6736
pROFE55`�-J .-
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date71'.�-M Ice', _3
(a) Legal Description (include lot, block, subdivision, section, township, range)
_1�T 1 t OK to Lara 2-1066 1—C 12 enc t
Location (address or directions)
1-7/0 6L(4F S2&LtC67 1.AnIL=
(b) Applicants
ne -
Applicants Address /-7 /V $lur 5g2u cc- C -N,%, a-ugc z A -r gGs77
(c) Applicant is (check one) Lending Institution
Buyer E::l ; Other [=I (explain);
OwnerAttilder ry%:-T ;
(d) Lending Institution '94,jk Telephone Ai&- 7ZO6
Address Ppy.c11 7012 AKe.4acA.66 /4k 49S -1U
(e) Real Estate Co. 6 Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. Type of Residence
Single -Family Multi -Family Q
Number of Bedrooms 3
3. Water Supply
Individual Well M Community =
Other (describe)
Public M
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 VK: Public Q Community Q Holding Tank M
Note: If community well system, must have written confirmation from the State
L Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
r
Lvf
5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein. I further verify that,
based on the information obtained from the Municipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in affect on the date of this inspection.
Name of Firm A 6C S Telephone 5'0-70 10
Addres
(ENGINEER SEAL)
6. DHEP Approval
Approved for bedrooms Byl
Approved >- Disapproved
Terms of Conditional Approval
CAUTION
Conditional'
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ,ENVIRONMENTAL PROTECTION
(DREP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS 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 REQUIRE-
NENTS. 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 IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2[ 7-19-84
C. Reid, Jr.
2251-E
Conditional'
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ,ENVIRONMENTAL PROTECTION
(DREP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS 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 REQUIRE-
NENTS. 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 IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2[ 7-19-84
MUNICIPALITY OF ANCHORAGE (MOA)
IEALXH AITIHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
a3A13D3N
boa £ 030
N011031OU 1V1N3WNOMIAN3
7 H11V3H 40 '1d30
ROV"WH7NV 40 A111VdQ1NnN
A. MLL DATA Legal Description: fht l 'RIO
laKe�Q"
well Classification 171V✓44- If A, B, cc C D.E.C. Approved(Y )
Well Log Present (Y' Date Complete y Yield
Total Depth -/�-1 / I9 _I steed to %4/0 � Depth Geouti 0n /
Static Water Level 49L.4p719 Pump Set At LIrY)��J�xyc .
Casing Height Above Ground ,1��� Sanitary Seal on Casing
Electrical Wiring in Conduit ) Depression Around Wellhead (iAA
Separation Distances from We
To Septic/Holding Tank on Lot boil Cn Adjoining Lots 4-100
To Nearest Edge of Absorption Field on Lot tCD *- ; On Adjoining Lots X100"t
To Nearest Public Sewer Line Azh To Nearest Public Sewer
Cleancut/Kanhole To Nearest Sewer Service Line on LotA
Water Sample Collected By f Date
water Sample Test ResultsSF
Com�ents nue -2j
ciu� a 0
-,�-A . frft __. IL.
B. SEPTIC/HOLDING TANK DATA'
Date Installed v Size 'J&rb No. of Ca:giartmsnts
Standpipes Y ) Air -tight Caps (YA) Foundati Cleanout (Y
Depression over Tank (Y ) Date Last Pumped q)act
Pumping/Maintenance Contract on File (YIN) ; for
Holding Tank High -Water Alarm (Y/N) Temporary Holding, Tank Permit (YIN)
Separation Distances frcn Septic/Holding Tank:
To Water -Supply Niall IUI/ � To Building Foundation H/
To Property Line tk&'JC— To Disposal Field 31,#
To Water Main/Service Line t- 1t ' To Stream, Pond, Lake, or Major Drainage
Course
Ccmnents
Go --
(Page., 1 sof 21_
4 ot>
�a13t$
2-15+84
k l l
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata �IEY� Type of System Design ",t,&
Date InstalledSl�lSI ,�S Length of Field Lq /
Width of Field aid Depth of Field 12.51
Gravel Bed Thickness /o/
Square Feet of Absorption Area iD2j'5Standpipes Present i*DN)
Depression over Field (Y Date of Last Adequacy Test 11hajt4
Results of Last Adequacy 'asst Saii P'A -fin _ ya 6, 20100
Separation Distance fran Absorption Field:
To Water -Supply Well 1 l O ' dF To Property Line .Hap
To Building Foundation f4 ;L' To Existing cr Abandoned System cn
Lot : On Adjoining Lots _ Zp�
To Water Main/Service Line } 94 :K- To Cutbank(if present) IJIA-
To Stream/Pond/Lake/or Major Drainage Course-r-yaol
To Driveway, Parking Area# or +
VehicleStorage Area
`A,,&
CCMTents .' VYtQ" AV w oAA k rf.,,. 1 O uW n n . �,o,� A ,.
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at " u Off" Level at
High Water Alarm Level at Vent (YIN)
Tested for Pumping Cycles dueing Adequacy Mast. Meets MOA
Electrical Codes(Y
Comments .
** Check Permitted Bedroan Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MSA HAA "lines. in effect
on the date of is i coon.
Signed Date c C
Company Pvc, C MOA No. -D2t�� �
ti
e;
a%
KBl/d5/s ;. C. rpt t 1
(Page 2 of 21 t°
2-15-84
111
P"41� r'
ALASKA E110011Ii1E(1TAL C011TROL SERUM, Inc.
Enqineerinq 5 Enuironmental Studies
NOVEMBER 29 1984
DAVID BERRY
1710 BLUESPRUCE LANE
EAGLE RIVER AK 99577
SELLER — DAVID BERRY BUYER —
SUBDIVISION — LAKERIDGE TERRACE BLOCK — 6 LOT — 11
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 1020 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 284 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON SEPT 29 1984 .
A FLOW TEST WAS PREFORMED ON THE WELL. 284 GALLONS OF WATER WAS
PUMPED AT A RATE OF 2.6 GPM OVER A DURATION OF 3 HOURS.
THE DRAWDOWN WAS 23.25' WITH A RECOVERY TIME OF 60 MINUTES
AND THE STATIC WATER LEVEL WAS 77.51 FEET.
THE WELL IS ADEQUATE FOR THIS 3 BEDROOM ROME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
1200 Test 33rd Auenue, Suite E • Anchorage, Alaska 99503 • (901) 561-5040
11/24/84
Dear Mr. Barry,
Our son called us from Alaska and said you needed
information regarding your well. Hopefully the following
statement will fill your needs on Lot 119 Block 6,
Lakeridge Terrace Subdivision.
As you know, ,the house was built in 1975. We drilled
the well ourselves in late May, 1975. To the best of my
recollection the well was drilled to 128 feet and was
cased all or nearly all the way. I have no doubt that
the well casing exceeds 40 feet in depth, sincewe always
put the casing all the way down.
We would be happy to give you further information, but
If we still have a copy of it, it would be stored in our
files in Alaska, and our son Dean says he hasn't found
anything,
Hope this helps. If you need anything else let us
know.
Sincerely,
a
MUNICIPALITY OF ANCHORAG;+'S
DEPARTMt, OF HEALTH AND ENVIRONMEN _L PROTECTION
825 LStreet, Anchorage, Alaska 99501
� /�,27�1, ext. 224 or 225
C`y Date Received: May 26, 1977
#1: Time 2:3 m. #2: Time i"V)(ifft #3: Time /'QQerA
Date 5-27 7 Firday Date /(11, 1 L . Date /.
Insp KenLe�y Insp nfZOA Insp clxc6ll
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
} 1. Lending Institution Request: Alaska National Bank of the North
Mailing Address: Pouch 7-010 Calais II Phone: 278-4581
2. Property Owner: Kathy Swires Phone: 688-3343
Mailing Address:
! 3. Legal Description: Lot 11 Block 6 Lake Ridge Terrace Subdivision
+L
4: Single Family Residence: (:) Number of Bedrooms: three
Multiple Family Residence: '( ) Number of Bedrooms:
5. Well Systeme Individual Well (x) Community/Public System ( )
4
t
Permit # Depth of Well Well Log on File ( )
Construction Bacterial Analysis
6. Sewage Disposal System: On-site System (x)x Public Utility ( )
! Permit # Installed Installer: «, Q Z a
r Septic Tank Size 4nm Manufacturer
f �-
Absorption Area .Soils Rate Material
7. Distances: Well to Septic Tank r to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
}' to Nearest Lot Line
r:
'k
1
y 7
?
IAUelPALITi OF ANCHORAGE
`
1 !.'. ..
DEPT. OF h ,Ll"� Ior"&
..
GREATER ANCHORAGE ARLI.
BOROUGH
;I oNt,leruu PeUiSCT10N
�ytia;^
Department of Environmental
"C"
Quality
2 6 10-77
3330 St., Anchorage, Alaska
99503 - 274-4d1Y
F F , /
RECEIVED
REQUEST FOR APPROVAL
OF
INDIVIDUAL SEWER & WATER
FACILITIES'
1. Type of
Inspection:' CMRO VA
FHA
CONV x
2. Property
Owner: Kathy Swires
343
Mailing Address: - Day Phone (E20— y
3. Name of Buyer: David Berry
Mailing Address: Day Phone
4. Name of Lending Institution: Alaska National Bank of the North
Mailing Address: Pouch 7-010 Calais II Phone'278-4581
5. Name of Realtor or Agent: Hansen / Ohrt (Dick Brown)
Mailing Address: 401 E. 36th. Ave. Phone 279-0491
6. Legal Description: Lot 11 Blk. 6 Lake Ridge Terrace S/D
Location: Eagle River
7. Type of Facility to be inspected: Home No. Bdrms.3
8. Water Supply
Type of Supply: Public Utility Individual x
If Individual, number of dwellings presently served 1
If Individual, depth of well
Sewage Disposal -System
Type.of System: Public Utility
If Individual, date of installation _
Individual (on-site) x
�`���'E �.-w �... �-. �� ■� Rei e ��
s
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 11 Block 6 Lake Ridge Terrace Subdivision
Affadavit Attached: ( ) Letter Attached: ( )
7Approved: Date:rov Date:
Department Worksheet: 3'yl
t r
Wi GREATER ANCHORAGE AREA BOROUGH 1\0 D� Department of Environmental Quality`i 3330 "L" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection 93'6'4..7
pate of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
0 ovv-
1. Approval requested by: )L-aSii,I 1�A j ,)r —,11c
Mailing Address: r', . yi c�;o r'%,<1a+�A� Phone:'?
2. Property Owner: 114,(P10 y 4 0.74 c i-CY Phone: 6�1 a' n'
Mailing Address: 5 R A'ou'r&, a �c 'ills' C'huG i.,
3. Legal Description: ,'toi %/ , k/p 't f�f �a� c y in r e',p p� x
4. Location, �7rr /,c-
5. Type of facility to be inspected No. of bedrooms
f"At" .r ot-
6. Well Data:
A. Type .%,. B. Depth
C. Construction- D. Bacterial Analysis 42-I -%1
7. Sewage Disposal System:
A. InstalledB. Installer1,h',7i`'
C. Septic Tank: 1. Size %Cir c' 2. Manufacturer
D. Seepage Pit: I. Absorption Area D Z 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank %C ..Absorption area i`f r F Sewer Lines
Nearest lot line , Other contamination
B. Foundation to septic tank Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
•':;Page 2�of two pages - Rist for Approval of Individual?er &Water Facilities
11e,9e1 Description }
r
Comments
ApprovedDisapproved Date
Approval,Val,id for one year from date signed
Greater Anchorage,Area(loro9dW,-Department of Environmental Quality
} DIAGRAM OF SYSTEM
f' accurateythat trepre en tion ofLthe subjelun 111C4e erya wayeryfacilities and hese facilities 3
are operat' g s isfactorily.G%/
Date
SIGNED
i
EQ -034 (1/74)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
- 3330 "C' Street, Anchorage, Alaska 99503 — 274.4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO VA FHA CONV -
2. Property Owner: Harryand Madeline M. Mackey
Mailing Address:
Star Route Box 1175 Chugiak, Day Phone 688-2813
_ _r Danny and Kathy Swires
Mailing Address: Day Phone
4. Name of Lending Institution: Alaska Bank of the North
Mailing Address: Pouch 7010, Anchorage Phone 277-5511
5. Name of Realtor or Agent:
Mailing Address: Phone
6. Legal Description: Lot 11 Block 6 Lakeridge Terrace Subdivision, Eagle River
Location: Hillcrest Circle
7. Type of Facility to be inspected: Single Family No. Bdrms. Three
8. Water Supply
Type of Supply: Public Utility Individual XXX
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility Individual (on-site) xxx
If Individual, date of installation
EQ -037 (1/74)
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