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HomeMy WebLinkAboutGATEWAY TO THE PARK BLK 1 LT 10Gateway to the Park Block 1 Lot 10 #067-601-05 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 141410 PID Number: 067-601-05 Dwelling: N Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New N Upgrade Name: Wendy M. Loya ABSORPTION FIELD ❑ Deep Trench N Shallow Trench ❑ Bed ❑ Mound Address 32459 Eagle River Road, Eagle River, AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 7 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3 Ft. Gravel depth beneath pipe 4 Ft, Subdivision Block Lot Gateway To The Park 1 10 Fill added above original grade Varies 0.44 — 0.82 Ft, Gravel length 40 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of LinesDistance -- between lines -- Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 400 Ft' 1 Ft. Well 498'6 100'+ NA NA NA TANK Sl Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer EXISTING Capacity I 1000 Gal. Surface water 70'+ 60'+ NA NA Material Number of compartments Lot Line 5'+ 101+ NA NA 2 NA Foundation X 10'+ NA NA LIFT STATION Manufacturer Capacity Gal. Curtain Drain NA '50'+ NA NA Remarks `None known. MOA WAIVEY" Pump on level atPump in. off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by nfi d 3034 PIPE MATERIAL House to tank 3034 Installer Northern Excavation dT Dralnfleld 3034 co/MT 3034 Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft Inspectioection 1' 10/1/14 10/1/14 Location and description n 20 3`° 10/1/14 0 Bottom of Siding COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL _►� \ SOF ALq�� Conditional Approval: Date 9TH 1 •Tri c�y-[. z-. 10 PKEN U ETH M. ➢U$ SY y / P� 7116 Approved ( l �� Date f'f"gsjo Aw inspection Keport_e-vtz:ooc AS -BUILT SYSTEM DETAILS/SITE PLAN GATEWAY TO THE PARK BLOCK 1, LOT 10 w \ WELL )AM EXISTING J+ 1BRHOUSE PID 067-601-05 PERMIT#:OSP141410 LOT 10 c 0 x 0 v :r l B U n n 85.71 FINAL --FILTER i- -C) :zi o FIELD BOOKS FABRIC &INSULATION O Z EXISTING %• % 81.89 {=.SEV1%EJ2 RO,iyK TANK TRENCH nilCo: DATE: KMD DWG. FILE: REJ CONNECTED TO EXISTING`. SEPTIC TANK, ABANDONED 00 ACAD RLE 0„/ ?�,�,��� EXISTING ABSORPTION BED oa�\T'I,T !r� .� &ADDED2 POST-TANKCOs. SE905 N l I SCALE: ` BOH t ITH14-1 c 0 x 0 v :r l B U n n 85.71 FINAL --FILTER i- -C) :zi o FIELD BOOKS FABRIC &INSULATION OR16INAL GF EXISTING DRAM 1000 -GAL 81.89 {=.SEV1%EJ2 RO,iyK TANK TRENCH OF Al *.0 0 /*49TH */ KENNETH M. DUTW. CE 7116 /. WP �FESBIOStA�' �� A DQ DCItI A11 I.i BOH = BOTTOM OF TESTHOLE CO = CLEANOUT MT = MONITORING TUBE ?REPARED FOR: WENDYLOYA 32459 EAGLE RIVER RD. EAGLE RIVER, AK 99577 i- -C) :zi o FIELD BOOKS COMPUTED: OR16INAL GF BOUNDARY: DRAM STAKING: CHECKED. f3mw ASSUILT: DATE: KMD DWG. FILE: REJ GRID: 09/23 ACAD RLE JOB Na: SE905 40' LO- 0 40' I I i GRAPHICS SCALE SCALE: 1:40 85.33 i- -C) :zi o 84.89 OR16INAL GF VARIEIS 0.5' 8189 77.89 I SCALE: NTS BOH 70.89 SCALE: NTS 1 OF 1 oti �gCTERR,, a Z O 4 G ` \ Z Y n4 9 eR' K. 9 517'0S Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp:/Iwww.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program went �o S r h e arrmen **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP141411 COSA#: Permit#:OSP141410 PID#: 067-601-05 Legal Description: Gateway To The Park, Block 1. Lot 10 Engineer: ArcTerra Applicant: Wendy Lova Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the surface water has been approved. The approved separation distance is 60.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another ap rov 1 fro this e ent. r gckP V � o�a�,�y ke sy4 � c 4,,,,k t s oT�ro ved �o a fbd Aon, d 4 ❑ The affected ajd acent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................ 0.. Waiver is Granted: X Waiver is not Granted: Date: t & Approved bv2sk Name of Reviewer ............................................................................. **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP141411 COSA#: Permit#:OSP141410 PID#: 067-601-05 Legal Description: Gateway To The Park, Block 1. Lot 10 Engineer: ArcTerra Applicant: Wendy Lova Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the surface water has been approved. The approved separation distance is 60.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another ap rov 1 fro this e ent. r gckP V � o�a�,�y ke sy4 � c 4,,,,k t s oT�ro ved �o a fbd Aon, d 4 ❑ The affected ajd acent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................ 0.. Waiver is Granted: X Waiver is not Granted: Date: t & Approved bv2sk Name of Reviewer ............................................................................. On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141410 Tax Code Number: 06760105000 Work Type: Septic Upgrade Permit Effective Dates: September 29, 2014 to September 29, 2015 Design Engineer: ARC TERRA CONSULTING INC Subdivision: GATEWAY TO THE PARK Site Legal Address: GATEWAY TO THE PARK BILK 1 LT 10 G:0905 Owner/Address: LOYA WENDY M 32459 EAGLE RIVER RD EAGLE RIVER AK 995779751 Site Mailing Address: 32459 EAGLE RIVER RD, Eagle River This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 43586 Total Bedrooms: 3 N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Condition of the septic tank shall be verified. Provide results on the final inspection report. Received Issued By. Municipality of Anchorage�nt s �f �Ylt G P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 Department htti)://www.muni.orci/Onsite Development Services Division On -Site Water and Wastewater Proaram **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP141411 COSA#: Permit#:OSP141410 PID#:067-601-05 Legal Description: Gateway To The Park, Block 1. Lot 10 Engineer: ArcTerra Applicant: Wendy Lova Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the surface water has been approved. The approved separation distance is 60.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another awrovV fro this e ent. vAepp►'oV�� ��s, �llespp��c4o,.,k Is �ffrvUed �odp a�'ee%o�,vl^4A4 "lo/a%ly ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ................................................•.............................1 Waiver is Granted: X Waiver is not Granted: Date: �7 Approved b . Name of Reviewer ............................................................................. MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERANELL PERMIT APPLICATION Parcel I.D. 067-601-05 Property owner(s) WENDY M. LOYA Day phone 39459 FAGI F RIVFR RnAn_ FAGI F RIVFR_ AK 99577 Mailing address Site address 32459 EAGLE RIVER ROAD, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) GATEWAY TO THE PARK BLOCK 1,LOT 10 Legal description (Township, Range & Section) Lot Size 43586 Sc. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Single Family [�] Absorption Field F� Initial (SF) ❑ Septic Tank ❑ Upgrade (w/wo ADU) Duplex (D) ❑ Holding Tank ❑ Renewal c y�l( ellin)s ❑ Privy ❑ ,"' SF a r D Private Welloovr ❑ / 141 RU ��1� Water Storage ❑ t / i ir" a� " j THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: FIELD TO SURFACE WATER 60' Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. owner or Permit/Rush Fees: 6)001 Date of Payment: L{ 1 Waiver Fees: O5_1� Date of Payment: ! Receipt Number: 0566 .0_1 Receipt Number: 025 Permit No. 0-�-? Waiver No. nSP I`41� 11 Permit App_9-1-12.doc 00,3'i September 23, 2014 ARC 1 >CRRA CONSULTING, INC 212 E. 51"Ave, Anchorage, AK. 99503 Office (907) 868-3791, Fax (907) 868-3793 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Upgrade Sewer Permit & Surface Water / Septic Tank Waivers Gateway to the Park B1, L10 It has been determined that the absorption field of the subject property is saturated. Subsequently, the owner has requested we proceed forward to obtain a septic permit to upgrade the septic system. Waivers from surface water to septic field of 60' and 70' to septic tank is requested with this submittal. Existing grade from the tank and proposed field run away from the creek and an existing swale and driveway exists that runs over 170'+ from the creek that mitigates potential impacts. Also the existing tank that has been in use with no apparent issues since 1983 is approximately 3' from the foundation and therefore request a waiver to foundation and tank of t at this time. The general slope of this lot is from northeast to southwest at a grade of approximately 7-12yo over the septic area. On September 15, 2014 a testhole was performed to investigate soils and groundwater. The results of this test are attached for your review. The proposed upgrade will serve the existing 3 -bedroom house. We propose to install one 5 -Wide 38' long trench. Groundwater was not encountered at excavation or at monitoring. FWN* c The property and adjacent lots are served by 0+i-19hc water. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system or granting of these waivers. If you have any questions, please contact me at 868-3791 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. Duffus, P.E. Attachments: On -Site Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN GATEWAY TO THE PARK BLOCK 1, LOT 10 NOPUBLIC WELLS WITHIN 200- OF PROPOSED SYSTEM, NO PRIVATE WELLS WITHIN 200'OF PROPOSED SYSTEM EXCEPTASNOTED. NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. Scale: 1"= 100' PAGE 1 OF 2 OF AZTH -z-K �IS F'ESSIOIIP yr 1 �I LOT, —_— LOT 11 10 ao B6: Rp LOT 10 7 % �n zs u} LOT. r FLAG WELL RADII, PROPERTY LINES & ESMTS PRIOR TO CONSTRUCTION DESIGN DETAILS 3 BDRM X 150 GPD = 450 GPD 450 GPD/1.2 GPD PER SQ. FT = 375 SQ. FT (375 / 5'(W)) X .5(RF) (4.0' GRAVEL) = 38 FT. TRENCH USE 1 TRENCHES - 38 (L) X 5' (W) X 4.0'(D) Total depth of system is 7' max from original grade. Total depth of gravel below distribution pipe is 4.0' . NOTES: 1. CONTRACTOR TO ABANDON EXISTING ABSORPTION BED. 2. INSULATE TRENCHE WITH 2" HD BURIAL FOAM IF < T COVER. 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. Y COVER IF REQUIRED. 5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS & SEPTICS, EASEMENTS, & OTHER SETBACK REQUIREMENTS. PREPARED FOR: WENDY LOYA 32459 EAGLE RIVER RD. EAGLE RIVER, AK 99577 FIELD BOOKS BOUNDARY: BOt, STAKING: STA ASBUILT: REJ DWG. HL ACAD FILE: FILE COMPUTED: DRAWN: BMW CHECKED: KMD DATe: 09 /23i GRID: SE905 JOB No.: 14-190 �RCTERRI voti a � r O 4 Z " 2 h R�bFRSUITING l� AK. 88571'.11ye WASTEWATER DISPOSAL SYSTEM DETAILS GATEWAY TO THE PARK BLOCK 1, LOT 10 1 ti, / 770EXISTING t� INTI ' �O 3 -BR HOUSE 72 O 0 �� S C`7 i •-' �Y� 0,` J _ Lt� i CONNECT TO EXISTING O Q v SEPTIC TANK, ABANDON ° `,co EXISTING ABSORPTION BED 0 Z /t o f /, Pco & ADD 2 POST -TANK COs. 4 4 ' --- o 00 ,! MT �\ , 0 �l N 000 \\ \^yryo SF�'ci MT o rya f RH14 F(O l4 72-1�520°/ _ 7% l s `� Qo r 4 �N�f \ � • QFL F1` Ci o��� N t ���C 6" J s mN�i 2i� �O J�OQ O Q KENNEL F /J1111' CE -7f16 10 FLAG FLAG WELL RADII, PROPERTY LINES & ESMTS PRIOR TO CONSTRUCTION PREPARED FOR: WENDY LOYA 32459 EAGLE RIVER RD. EAGLE RIVER, AK 99577 FIELD BOOKS c PUTED: BOUNDARY: BOUNDARY DRAWN: BMW STAKING: STAKING CHECKED: KMD ASBUILT: REJ DAM 09/23/14 DWG. DILE: GRID: SE905 ACAD At - FILE JOB N9.: 14-780 Scale: 1"= 30' PAGE 2 OF 2 �gCTER � m s q ^S c S x Yme cG R/4F`VSIILTING �51� �' 4K. 995]7�� t�RcTERR�q Office (907) 868-3791, Fax (907) 868-3793 ARC 1mERRA CONSULTING, INC 212 E. 51"Ave, Anchorage, AK. 99503 "t e Office (907) 868-3791, Fax (907) 868-3793 SOILS PERCOLATION TEST Performed for: Wendy Loya Date Performed: 09/15/201 .► �, OF ALS �q Ti l P KENNEPH M. DL♦ F -� ANr Project: Gateway to the Park Bl, L10 TEST HOLE # TH 14.1 Depth (Feet) SEE ATTACHED SITE PLAN Org/OL GM/GP B.O.H 15- 16- 17- 18- 19 - HOLE PRESOAKED 20- PRIOR TO TEST FOR HOLE LOCATION Was Ground water encountered? NO What depth? NA Depth to water after monitoring? DRY Date? 19/22/14 Reading Date Gross Time Net Time Depth to Water Net Dro 1 9/15/14 1:00 - 6" - 2 1:10 10 min 11/16" 5 5/16" 3 * 1:11 6" 4 1:21 10 min 14/16" 5 2/16" 5 * 1:22 - 6" - 6 1:32 10 min 15/16" 5 1/16" 7 * 1:33 6" 8 1:43 10 min 14/16" 52/ 9 1:44 6" 10 1:54 10 min 14/16" 5 2/16" Il * I:55 6" 12 2:05 10 min 15/16" 5 1/16" * Water Added 7Percolation Rate 2 (min/in) Pere Hole Diameter 6" un Between 3 feet and 4 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. MUNICIPALITY OF ANCHORAGE • 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION J ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet- Anchorage, Alaska 99501 Telephone 264-4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME • PHONE D NEW ❑UPGRADE MAILING ADDRESS LEGAL DESCRIPTION aL -(V.04-T1�f ,.t LOCATION O'V. NO. OF BEDI OD U x DISTANCE TO: W I Absoa=are,• /_ ��i _T Dwelling / r IC PERMIT NC}—`�i� C` / F2 yFQ• Manulacturer P� )G� No. of compartments Lia• a ci in,ga{lons Insideleng[h v IF HOMEMADE: Width Ligwd tlepth d /7Z DISTANCE TO: Well Owalting PERMIT NO. =ZhQ, Manufacturer Material Liquid capacity in gallons W = DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. u. Z Z ~ No. of lines Length ch To[al length of lines Trench width xt Dis[ance between lines O H Top of the to finish grade Material beneath tile all Total effective absorption area inches Length /_ Width Dep / /sO `' PERMI O. Ls. Q d sti Type of cnb Crib .am leTota el ectiw ebsorpuon area W W W DISTANCE TO: We Buil i fyuqsla[ion Nearest lot line , J J Class^ V Dept / !l' p Distance to lot line PERMIT NO. W DISTANCE TO: Building foundati6n Sewer line Septic tank Absorption arealsl OTHER PIPE MATERIALS In f C SOIL TEST ING INST O• f �A�C REMARKS (t :: `c• r Ioban. A. Se•.Ar ; MUNICIPALITY OF ANCHORAGE Department f Health and Environments ?rotection 825 L Street, Anchorage, AK. X9501 ,9__'C_ 264-4720 HANDWRITTEN PERMIT Permit A /�'CC,�+ /W,SLL AND/OR ON-SITE SEWER PERMIT C/ / Applicants_ U F0�2Gr C_��ljS! Mailing Address: /0 sN3I.�}ij24 Location: Phone Number: Legal Description: Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed:X Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) L/3 Q,oe The Required Size of the Soil Absorption System Is: //``.�3 / 6 4 G4,6 d e/ DEPTH _ LENGTH �. GRAVEL DEPTH G "'a" WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ �GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * ' * TWO(2) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set fo h by the Municipality of Anchorage. (2) I w' nstall the tem in accordance with codes. (3) re nde ad that,-IEa on-site sewer system may require enlargement if r7'yemodeled to include more tha bedrooms. t Signe Issued by: pp scant _ Date: SWP/024(1/81) ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: SOS• DATE PERFORMED: —/' /& `O J LEGAL DESCRIPTION: L..,i 10 =a±z D -i' IC SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 'Z2—s PIX 6-c . WAS GROUND WATER ENCOUNTERED? ISCZl-10M OF }jeLr IF YES, AT WHAT DEPTH? . OF At LOP Reading Date Gross Time Net Time Depth to Water Net Drop 07" - :ZD f >SZ f> 1 u 2- 3 1. r �� u _;;t- -71 P l0 ►� 1 Z S Z-! 'Z0 v 98 e •,;PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND Sz FT S & : E:1GiNEEdING //j PERFORMED BY: ep(; �_ CERTI FI ED BY: DATE: tcr.3LE.RlJEF ALASKA S2577 PH. 6:4-2070 72408 (6/79)_'-- by DOC "r SULLIVAN WATER WELLS /.O.9OXVZCHMAK.ALAEKAEMS7 • TELE►NONE EE62fEY owmm OF LAND STE,, E r..IAA crk -0-JoC ADDRESS rm . r .44 1.r F ,Q LEGALDESCRWn M L J!ll AKe / C.Frc t�A7 % o r DATE -SUnW °4/�-r df; Dmv OF wELL 6 O S STATIC LEVELOF WATER FT. T 4 bR W DOWNow'�N . GALS. PER IDI / y% o KIND OF CASING 6 S D 4 FERYIL' NUN= r lCMD OF FORMATION -n hra 0 Ftto..It iFmmFt t* Ft Frac Fttt ' Lk/►lIX�� 6ip�►.O��S groin Ft 4a - Ft` lras�l_Ftto fa Ft c110'►' t �ie'A G From—Ft. *�rptzM1wpr t:7r. OF t E 4+x�tirON hams zFt tab!_Ft Jho G� M 40- L ? From Ft b -- Lt.. ...... h� vt r. gt 'aJit �tQ !rte ltta__IK. Frain PL b Ft From Ftp+ Ftp-a--4�A From Ft to—Ft, From Fib •g.KFCEi . Fmm---Ftto Ft ' F.as Ftb��r. From Ftb rL Orem }t b�FL ham Ft i . • Ft . has •* +s' *t Ft Ft to Ft Fig .yt_:..:.T �. sr.Fmr- at/tet .'a.-'s:••'�•�+ya�.. :� ice•., :."'.' ....•. w.�:•.•...-��... ham � From Rt M t Fros�Ftb Ft Pram Ft toFt FromFtt. Fres Ft toFt From Ft bit. FramFtro Ft Frame •tb Pe ICBM DUUMIATION: DRnl=3NAME by DOC Co. aba SULLIVAN WATER WELLS P.O. BOX 272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND S 7-E,� E c.J/<r ADDRESS .740 r'OX JG /j F LEGAL DESCRIPTION _L /7 i'/�' / .¢Tc u✓/J i l D DATE -Started Ended / Q/21AP PERMIT NUMBER KIND OF FORMATION: DEPTH OF WELL -60 r S Q" STATIC LEVEL OF WATER FT. / ( TNF �,srt r DRAW DOWN FT. GALS. PER HR /Cfb O KIND OF CASING r 0%) From O Ft. to ;?/ Ft. Y/LJ4 �RIiIC[ C4AYFrom Ft.to Ft From Ft. to Ft. /l; Lt z:'.,7 From—Ft-'to—Ft rom - Ft. to Ft. I« From Ft. to ---rr�:_;• •Err c� From"7'-) , Ft. toLLFt. J,410 6401105Z- ? From D'?T. CT NETT TFnlOY FL From From Fl. to From Ft. to Ft. 'e4J,4 %r 4!. From Ft. to Ft From Ft. to Ft. From � Ft. to Ft.[ From Ft. to Ft. From /' r Ft. to FtR E C L I V From Ft. to Ft. From Ft. to Ft. From Ft. to FL From Ft. to Ft. t From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. MISCL. INFORMATION: From Ft. to From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From ' Ft. to Ft. From Fl. From Ft. to Ft. From Ft. / C. DRILLER'S NAME PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE LEGAL DESCRIP LOT SIZE: U-1 L_1 t •4 I i::: I F'I=i LL I T'T iD F= rt t -j C-"0 R n G E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 CDt4—" I TE 640080 03127184 L4ELL F'ERth I T WAKELAND CON'_ TR. SRA BOX 2415 EAGLE RIVER, AK 99577 654-2661 SUBDIVISION: GATEWAY TO THE PARD( LOT: 10 SECTION: 9 TOWNSHIP: 13N RANGE: 1E 43586 (SQ. FT. OR ACRES) BLOCK: 1 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. I WILL INSTALL THE SYSTEM IPJ ACCORDANCE WITH ALL MOA CODES AND REGULATIONS, AND IPJ 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. SIGNEC> muAl -iiii!��__'-------------- DATE: �� APPLICANT: 4JAKELAPJD OPJSTF. ISSUED BY , 62.,,er7 3 DATE: • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I. D. 067-601-05 1. GENERAL INFORMATION Expiration Date: / " c - t,� Complete legal description GATEWAY TO THE PARK, BLOCK 1, LOT 10 Location (site address) 32459 EAGLE RIVER ROAD, EAGLE RIVE, AK 99577 Current Property owner(s) WENDY M. LOYA Day phone Mailing address Real Estate Agent 32459 EAGLE RIVER ROAD, EAGLE RIVE, AK 99577 Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ COmmUr`��„ ('1a -s _ Well ,ate ..�, r-1 J r,..., ty . olmmuni 1—I — Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: COSA to be released to the engineer, unless COSA Fee $ oZ(�$•6r'�' Date of Payment Lb 12_11y On r -- Receipt Number ©553 COSA# 0566 ISZ3 Date: Id -6 —/� by the engineer Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 10/01/14 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen ff OF AZ encroachments, deficiencies or discrepancies exist. 6. DSD SIGNATURE System #1 Approved for P riser u. nue i S' y � bedrooms. s f ' System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: / ' 6 I L% Thenicipality Anchorage Development Services Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not, responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAblueshe t_104412.dm If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: GATEWAY TO THE PARK, BLOCK 1, LOT 10 Parcel ID: 067.601.05 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 10/2111983 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 61 ft. Cased to 60.5 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 1012111983 8/26114 Static water level 14 ft. 20 ft. Well production 30 g.p.m. 4+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.280 mg/L Arsenic: ND ug/L Date of sample: 91212014 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC / STEEL Date installed 101511983 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 8126114 Pumper JRs C. ABSORPTION FIELD DATA Date installed 101112014 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 System type SHALLOW TRENCH Length 40 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 7.44 ft. Eff. absorption area 400 112 Monitoring tube Y Depression over field N Date of adequacy test NA- NEW SYSTEM Results (Pass/Fail) For 3 bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons "Pump off' level at _ in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot f00 f �] ✓r Absorption field on lot 100'+ Public sewer main 75'+ Sewer /septic service line 25'+ Animal containment areas 501+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation *3' Property line 51+ Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots 1001+ On adjacent lots 1001+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 1001+ Absorption field 51+ Water main 10'+ Water service line 101+ Surface water *701+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main 101+ Water Service line 101+ Surface water *601+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. i OF AZ , Engineer's Printed Name KENNETH M.DUFFUS Date 1012114 COSA brown sheet_10-10-12.doc A KENNETH M. D F 1 g 7116 w�' of p�OF'ES5lOt:+at' in. F1kY. (A44111ED) i0.0M( eULtlN9 9EIBK% N 46 I'vesle aIL euaL.n sErvAa 239?61 Ixrrt euuMY. sEleKlt 0 00 '3 OSS •� \` WELL 99S, .0 eHisnNa / � t / / 0 `� 2 • m Oqo 'So / , 9�Fr 0�`F , 361, 25' / 1 I / c s / / / / a \ly\ Nam roo, Fti�a ;a 0 F UNOER NO ORCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABUSHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES nNANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY, LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. El Lor %RwY SURVEY TYPE SYMBOLS ❑ FOUNDATION AS-BUILT SET REBARASPHALT DRAINAGE ElRNAL STFk47VRE AS-9UILT [] "T'ws-aulLr wR�Y Tow)ORAPNY O FOUND REBAR .0 0 9 WOOD FENS..:I CONCRETE ... ...Lor ... AS- T .. SET W WCATI A r ... N 1"M SET OO Il ASSUMED ELEV. •X--X—K METAL FENCE ® WOOD DECK PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION*+ rT►�rxkt qC��♦y Prepared by Robert E. Johns, Jr. & Assoc. PLOT PUN I I,w..Y wIYY M I MN FA>.k?Y MM).! ♦.••�E • • •'•'•• ♦�P • "" ♦ • •• Professional Land Surveyors MI. NUM « wla..x.c a a ew w enr. a..... w .d w tll. e..l a my '� ♦ r �r'• �� 1700 Brink Drive. ANCHORAGE, ALASKA 99504 Pw J••••••; •�.. '�' Rec. Lot S.F. Rea. Plot File No. FOUNDATION AS-BUILT t ll����11 � 49th • •• , 1,.1 •' Scale. II .,� 1 1 50 Date Surve d: Drown b Y Cheake° b 4 Nalrt L .YML i. MCy vtlly 1M 1 - % „ .,,.x 10/03/14 REJ JM K MNww .wlt Inas -. ROBERT JOHN, a Ar `♦♦ •'• Date orawn: 10/03/14 Grid SE905 WD 14 480 nNAL NRE AS-BUILT L PaMI E .Nr..Y. Ir.CY aaly IMI I s cA I XPi 4� Zt —S J r ♦ ••••••• : ••: • • Jl • Legal DC6CYIOLIarI: M. rla•we m M-a+l Y•.r a u. wI w .r aw a u. ��. ••.............•an : a G Lot 10 Block 1 .wee.... a u:aoa ,ww.w.ea,.,.-i. .mile ,.'+� p �� rofeaslonol 1. �o ���,,,��.•• GATEWAY TO THE PARK Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. Obq-tonl-05 COS A# b(o0147 Expiration Date: 1. GENERAL INFORMATION Complete legal description _44T -E. JA N Tltt Ph(Zlc Q I L I D Location (site address) 37y59 4f+e tt RiJc'2 lLo tD Current Property owner(s) PAT(Zi GK G eobZre-H . ?ESu�h Dayphone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 32yS9 EAticr lZX2tA Rl)- Ei? Ar- 51677 Day phone SMtitTE tJ+aV6,4(P9Kb6N1-.Z Dayphone 273-770 Unless otherwise requested, COSA will behold by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL - Individual Well Erll�- Individual On-site L�1 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 Onsite 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 sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certlfied by my seal affaed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. n)ver Engineering Services phone 69 y -Sl 9 s' Name of Firm 30491 VPX Rd., Suite 29' Address Eagle River, AK 99577 Engineer's Printed Name C-6PX510Plf6YZ P_ 000-11 Date 5/02-/v 6 5. DSD SIGNATURE 10%CHRwmHERRWOOD `� CE:103$T. Approved for bedrooms. ti na,..••t�c e Disapproved. ��OOssro' c Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report X Other By: (/"• Original Certificate Date: �. plm 11105) Municipality of Anchorage • Development Services Department Building Safety Division ' On -Site Water & 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: 4Rl c 4h'1 TV —10C PkR r- 91 L f O Parcel ID: O ce 7- G o i- 0 A. WELL DATA Well typezmJRre If A, B, or C provide PWSID # Well Log (©N) Ye 5 Date completed Jg.[7j/ep3 Sanitary seal 6)N) _'.5 Wires property protected ()N) x/E S Total depth ,_6 _ft. Cased to yo'r ft. Casing height (above ground) 17 n. FROM WELL LOG AT INSPECTION Date of test 10 ZZ I /43 'b 129 Ag Static water level / c/ ft. 2 2. 9 ft. Well production r) g.p.m. 3 . 'Z 9— p.m-WATER SAMPLE RESULTS: Coliform _0-colonies/100 mL Nitrate N D mg/L Other bacteria 4Z colonies/100 mL Arsenic: .0 D mgll Date of sample: ff 27 06 Collected by: �NRS 5 LJoc 1� B. SEPTICMAL-BINtB TANK DATA Tank TypelMaterialG�S7F'A-L- Date Installed /O l oS /`8'3 Tank size 1, c>e D gal. Number of Compartments _7 Cleanouts &N) yt S Foundation cleanout ((M) ` '5 Depression over tank (Y4R N O High water alarm (YA &i 0 Dateofpumping 5/2 ns Pumper %,+At �f�Y OH�nOt25 C. ABSORPTION FIELD DATA Date installed /O Soil rating (t#.44RLor fe/bdrm) 213 System type 13e a Length 4400— ft. Width 2-0 ft. Gravel below pipe O• S ft. Total depth _�L_ ft. Eff. absorption area I& fe Monitoring tube,_ Depression over field _Vo Date of adequacy test 9 ! Results (Pass/Fail) P465 For 3 bedrooms Fluid depth In absorption field before test _6 in. Water added -AL gal. New depths in. Elapsed Time:Z min. Final fluid depth VA in. Absorption rate >= 4 SO g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/9& type) ,t/O If yes, give date ulq D. LIFT STATION Date installed Size in gallons _ Manholel�Ac ss (�IJN� 'Pump on' level at _ in. 'Pump otP levelOlt) Vn- FT High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/10stati" on tot `�`o W Ry20003 Absorption field on lot t /00 Public sewer main -t- Sewer Sewer /septic service line f 2 S On adjacent lots 1-/00 On adjacent lots d' /v0 r Public sewer manhole/cleanout -frog r Holding tank I Animal containment areas •t- 75-f Manure/animal excrete storage areas 1'40 " SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 3 1 Property line4 io r Absorption field 't S Water main t r o' Water service line +to ' Surfacewater 76 , lyP I15Oo29 Wells on adjacent lots +/rg0 r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line fro ' Building foundation t/o r Water main Water Service line t /o Surface water 14 2 wp9 CAnZ Driveway. parking/vehicle storage t S Curtain drain 45'0 ' Wells on adjacent tots •rroo ' F. COMMENTS oriteps I=AJ A(AAKsT 2ooL/06 tW tit 2001_ -� ,- 4,.4, G. ENGINEER'S CERTIFICATION %Aa �I certify that I have determined through field inspections andreview of Municipal records that the above systems are inTe conformance with MOA COSH guidelines in effect on this date. D Engineer's Printed Name GHRLS?yPMCQ R- y,1604!� CE: iu Date S OL cs Q COSA Fee $ 'f -'3p • n Date of Payment 6710/O (0 Receipt Number 1"lgt' 9 (Rev. 11/05) Waiver Fee $ Data of Payment Receipt Number �- V 7C � C1 h • t m 0 frisK P�•oFI / f' rtl �(CN�A. '•bV` E�NNT. "'—� Ar •7YYF. /-- ~.r lrMNT. T -NO CORNERS SET THIS DATE. A6 3 & ASSOCIATES LAND 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE$ FOLLOWING DESCRIBED PROPERTY= Lot 10' 1" = 40' • Block 1, Gateway To The Park Sudivision DATES '�,.•• 0FR� '9 AND THAT NO ENCROACHMENTS EXIST EXCEPT AS 8/30/92 �: �Q;r S,f t4 INDICATED. IT IS THE RESPONSIBILITY OF THE i ��'/� H�••••';P OWNER TO DETERMINE THE EXISTENCE OF ANY GRIDt �•••••• ••••• •::•.� EASEMENTSrCOVENANTSr OR RESTRICTIONS.., SE905 WHICH DO NOT APPEAR ON THE RECORDED SUBDI- �•` """ ; W.n• Mark s.w..d VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB �� �•, 15x6918 ANY DATA HEREON BE USED FOR CONSTRUCTION 31-56 few'••. OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWNi\:skxt" ARY LINES. t{�q-IL DMS Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program` 4700 South Bragaw St. '" "� P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FORA SINGLE FAMILY DWELLING Parcell.D.v _ Q&q—/d)l-bJ HAA# t�iougg Expiration Date: 1. GENERAL INFORMATION Complete legal description /of/` ,l,.kl 9.1 to Ale- Location leLocation (site address or directions) Current Property owner(s) Sfi.v4 e fi%C1'j.1%re Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: _ 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 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm DoLiy�i�s 7—A- e n icy Phone 69-07) 716 -1073 Address Engineer's Printed Name le q Date I - 7-t • v i ICJ /�•,`7 jr •I• 5. DSD SIGNATURE ,t q L/111 Approved for bedrooms. ' (E81176 Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory . Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: l% /,f/. �ep—' Original Certificate Date: (R". 01M) Municipality of Anchorage • �' Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.sk.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: d s i A0, 12/0 c /1 /, G A fe U109' /07/e FWeP Panel ID: n (0 7 to O 1- C7 S A. WELL DATA Well type IgLL✓ r & If A, B, or C provide PWSID # _ Date completed'#Z�lf3 Sanitary seal (Y/N).- Total depth eft. Cased to yo —tft. FROM WELL LOG Date of test Static water level /y ft. Well production 3d g,p,m, WATER SAMPLE RESULTS: Coliform .0 L_colonies/100 ml. Nitrate L -JJ mg./i. Arsenic: = mg./I. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Well Log (Y/N) )/ Wires properly protected (Y/N) y— Casing height (above ground) /A in. AT INSPECTION 9 6 X2.9 ft. 3..� g.p.m. Other bacteria 0_ colonies/100 ml. Collected by: _Freol /fel �ey Date installed _ /OIf3 Tank size /Ooo gal. Number of Compartments _,L_ Cleanouts (YIN) Foundation cleanout (Y/N) Depression over tank MN) V High water alarm.(Y/N) Date of pumping /3 O `/ Pumper J49s 120""4 C. ABSORPTION FIELD DATA Date installed /,0/?.* Soil rating (g.p.d.fle or® 913 System type 8 Ga ' Length Alf ft. Width �O ft. Gravel below pipe D• S ft. Total depth Y ft. Eft, absorption area 94,0 ftp Monitoring tube _— Depression over field _ V Date of adequacy test /S l' y, Results (Pass/Fall) 74AiA For _3 bedrooms Fluid depth in absorption field before test 0 in. Water addedL9 / gal. New depth 4-9 in. Elapsed Time: 4�_ min. Final fluid depth 9 -,._in. Absorption rate >_ -1X0 O g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) A/ If yes, give date D. UFT STATION Date installed 'Pump on" level at _ in. E. SEPARATION DISTANCES Size in gallons n Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Manhole/Access (YIN) level at Meets alarm 8 circuit requirements? Septic tank/lift station on lot 4f (we i/iyvrc�u+hldOnadjacent lots lel a; Absorption field on lot //3 / On adjacent lots /Ce r Public sewer main Public sewer manhole/cleanout 41,14 in. Sewer /septic service line .g 5"7 Holding tank A11,4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Y•JF't Property line /C>• Absorption field ✓� �` Water main iY/9 Water service line Surface water o., f, /e) Wells on adjacent lots %OD t " SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /O t Building foundation lel;4 Water main N/�9 Water Service line .I 5y Surface water '/-P Driveway, parking/vehide storage /C Curtain drain yo exist Wells on adjacent lots iee F. COMMENTS ,9 i1ilCA~ro 4/. >~i.,.[ it J. S"!f".sa,v os`.�sL Ar&^W G. ENGINEER'S CERTIFICATION r pg; , :1 I oedi/y that I have determined through field inspections and • • 9TH • •' • % review of Municipal records that the above systems are in ..r . conformance with MOA HAA guidelines in effect onthisdate. 1�7YEY; Engineer's Printed Name ,0U cr /,-q .5 / /Yeti leV 'tip. •'•,: CEE176 �e Date HAA Fee $ q • e1) Waiver Fee $ Date of Payment 9 64 Date of Payment Receipt Number. 8 _ Receipt Number (Rev. 12/01) Attachment to Health Authority Approval Checklist comments: Lot 10, Block 1, Gateway to the Park Subdivision An adequacy test on the septic system was attempted on 8/29/04, along with the well test. This was following a very heavy rainfall on 8/27/04. Normally adequacy tests aren't affected by rainfall, but this rainfall did seem to have an effect on the water level in the soils, possibly because of the runoff coming from the hillside. Therefore, it was decided to try the test again after the soils had returned to normal. The system was previously tested in 2002 and there was no initial water in the bed. The water level at the end of the test rose to 9" after 682 gallons were introduced. The fluid depth was 2" after an elapsed time of 80 minutes. On the 8/29/04 test, the initial water level in the monitoring tube was 3-1/2", but there was no water in the distribution pipe. After only 224 gallons of water was put in, the water level in the monitoring tube was at 7-1/8". it was also noted that there was 3-1/2" of water in the distribution pipe. The test was stopped at this point. After an elapsed time of 90 minutes, the water in the monitoring tube was at approximately 8" and the water in the distribution pipe was still at 3-1/2". A subsequent septic test was conducted on 9/18/04, at which time there was no initial water in the monitoring tube or the distribution pipe. The first sign of water in the monitoring tube was after 260 gallons of water had been introduced, which measured 3". An additional 231 gallons was put into the system, for a total of 491 gallons, at which time the water in the monitoring tube rose to 8-3/4" and there was 2" of water in the distribution pipe. Two recovery readings were taken. The first was taken 30 minutes after stopping the water, at which time there was 7-3/8" in the monitoring tube and no water in the distribution pipe. This indicates that the monitoring tube is lower than the 6" normally encountered in a bed. The second recovery reading, taken 6 hours and 33 minutes later, had a reading of 3-1/8" in the monitoring tube, which accounted for an absorption rate of greater than 450 gallons per day. Evidently the rainfall did have an effect on the bed, as the second test corresponded to the initial test taken in 2002. Douglas T. Kenley, P.E. Municipality of Anchorage ' Development Services Department'+: i Building Safety Division -- On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 067-601-05 HAA# <sli a0a0Mqf' 1. GENERAL INFORMATION Expiration Date: �41/0102 Complete legal description T`GATEWAY TO THE PARK SUBDIVISION: LOT 10, BLOCK 1.' Community Class Well ❑ Public Water System Location (site address or directions) 32459 EAGLE RIVER ROAD * EAGLE RIVER. AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MIKE BIRTLES Day phone 694-6663 32459 EAGLE RIVER ROAD • EAGLE RIVER, AK 99577 Day phone PAM REYNOLDS w/ PRUDENTIAL VISTA Day phone 16635 CENTERFIELD DRIVE • EAGLE RIVER. AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 242-9975 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $2135.00 at, orpdor to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage 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 State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER do WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 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, groundwaterlevels 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. AWWC, Inc. 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 orparty is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE X Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: HAA Checklist %( Septic System Advisory Well Flow Advisory L'. Manitenance Agreements ON-SITE m= ATER'ANU �STEWATER UJ1111111111 Supplemental Engineer's Reort Other WAIVER LE7M? WR020003 By: % Original Certificate Date: (Fiat. 17100) Municipality of Anchorage • Development Services Department Building Safety O"na Wastswa�Pmgram 4700 South Bragow SL P.O. Box 108850 Anchorage, AK 695198850 www.ClAwhoragealLus (907) 343.7604 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: GATEWAY TO THE PARK S/D: LOT 10. BLOCK 1. Parcel ID: 067-601-05 A. WELL DATA Web type PRIVAIE If A, B. or C provide PWSID# N/A Date completed 10/21/83 Sanitary seal (YM) YES Total depth 61 ft. Cased to 60.5 ft. FROM WELL LOG Date of test 10/21/83 Static water level 14 ft. Well production 30 — 9 -p.m - Well Log (YIN) YES Wires properly protected (YIN) YES Casing height (above ground) 120+ in. AT INSPECTION 12/18/2001 23 ft. 6.0+ g.p.m. WATER SAMPLE RESULTS: Coliform 4L- coloniesl100 ml. Nitrated • 51 mgJL. Other bacteria -4d--colonies1100 ml. Date of sample: 12/18/2001 Corrected by: AWWC. INC. B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date Installed 10/5/83 Tank size 1000 gal. Number of Compartments 2 Cieanouts (YIN) YES Foundation cleanout (YM) YES Depression over tank (YIN) NO High water alarm (YM) N/A Date of pumping 12/18/2001 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed101/83 Soil rating (g.pAJMDo 213 System type BED Length - 48 ft. Width 20 ft. Gravel below pipe 0.5 ft. Total depth 4A ft. Eft. absorption area 960 ft' Monitoring tube YES Depression over field NO Date of adequacy test 12/18/2001 Results (Pa3WFail) PASS For 3 bedrooms Fluid depth in absorption field before test U in. Water added622 gal. New depth 9 in. Elapsed Tine:NO min. Final fluid depth 2 in. Absorption rate >- 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN if yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at _in. E. SEPARATION DISTANCES High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot •96'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent kits 100'+ On adjacent krts 100'+ Public sewer manhole/deanout N/A Sewer /septic service One 25'+ Holding tank N/A ***FROM FOUNDATION SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO, TO CENTER OF PIPE Building foundation ••'3.5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 0'76' Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One 10'+ Building foundation 10'+ Water main N/A Water service line 106+ Surface water 0•42' Driveway, parkinglvehide storage 100'+ Curtain drain NONE KNOWN Wells on adjacent kits 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 . • • • • • .' • • • •' • • . • •. • coMormance with MOW HAA guidelines in effect on this date. e Gamess Engineers Printed Nam JEFFREY A GARNESS •• 7953 ` i Date j2�a7/� a^e°jDroe.■.Wed�'� HAA Fee $ `l`Ca�J Com_ Waiver Fee $�— Date of Payment�r�y� Date of Payment �` I aR) ( 0 Receipt Number j 3q l.o Receipt Number l 39 a (Rev. 12M) 1/10/2002 Municipality of Anchorage George P. 'Wuerch, Mayor Department or Public Works Bttildimg, Safety Division P.O. Box 196650 a 4700 S. Braga«• Strcet Anchorage, Alaska 99519-6650 • (907) 03.8301 htgt://%% iiv.ci.anchotagc.ak.us Jeffrey A. Gayness, PE 6901 Debarr Road, Suite 2B Anchorage, Akaska 99504 Subject: Waiver Request for Gateway to the Park Subdivision Block 1 Lot 10 Waiver Request #WR020003 Parcel ID #067-601-05 HAA# HA020005 Dear Mr. Gayness: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to private well has been approved. The approved separation distance is 95.0 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J.oth Civil Engineer On -Site Water & Wastewater Program 'Municipality of Anchorage Development Services Department • Building Safety Division On-Sitc Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR020003 PID#: 067601-05 HA#: HA020005 Permit#: Date Received: 12128/01 Legal Description: Gateway to the Park Block 1 Lot 10 Engineer. Jeffrey A. Gamess Alaska Water & Wastewater Consultants. Inc. Applicant: Mike Sirtles Waiver Requested: 95 feet from Well to Septic Tank Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation If Total: Waiver is Granted: �_ Waiver is not Granted: List Conditions or Reasons for above: J'L`E /47rA/" /E,6 r Date: / tO 2 By: Df%N Name of Reviewer Red#: 13921 Amount: $M Date Paid: 12128/2001 '/JIVE/? R E 4 uE sT FOR 6AT-E wA Y TO THE PARK SNB $Lk / Lor wA,vER AtouESr Mg. A/kHDER W14020003 WAIVEli REQuESr FDR ov-1.or WATEI? WELL To SEPTIC TAtik OF qs PEFT. SEPT/L V/9 Ter — CO.,17-A eTRO rev OCT. /i8? 1wWW rf1E Sue neer SEPTIC TMA/K If a vs7RwtTEp /N A GM SOIL rM4T pER Co1.14Tf_ S Ar 2 o N�N1/NCN. rmu TYPE OF SO/L. /S ��" VEIQy 6000 AT TREA7*IA16r ANY POr6NT/AL SfPrIC 74AIM Er -AL` T =� T)4#fT M/ty LEAK FROAA rh(E SFPr/c MvA IN QUEST/ON, THE AAA """ StPTIC 71911k 15 Loe.4TE0 UR'PER A STA0RWAY fi01A/6. UP TO Pfff FRONT DaOR AT ME SOuTLJ COWER OF T/fE HOUSE. LF �fF1k T WEi?6 to OVEQFtow FRoµTKI= SCAT/C TANK IT woHLP TI,*Vtl- 4U,40 A TME PECK INrO r/ff DR,vcuA4Y /NFre0N7— OFT,c/E 6,6e.966- _ W&ULD CERTAINLY VE H-AED /MH EO/ATFC 7; ZT ALSo wouLD Ivo r TRgVCL TOI..AIZpJ TKP, WELL IN 47u 6 ST/44,1 TL(F S E/o r/ t TAWS S SLIGHTLY UP61slNP/E.vr FKoM rH6 WELL RoweVAIT /r /srv.� fAFtf_ CONrouR tvJTl! 7llE Sul�3uRfyCE f/rJ/?/4HL/G &RI4t�/.A.v JN T"I 15 XREA. -I WELL 196rw— Tme trgrrie a:ett. a.ws tONfrKKtTzO /N otr /983. rT /$ &/ FCET DEIP M,4,rot fNCONaTEO Ar S"2 FtEr, Mg STAT/C 1vA7E� LEVEL 15 Ar Z3 tHEIRE Imp- NUtiIE/POuS 7-lfleK LNj',ERS pp ' CL#y 4 6Kaw6L To C ONF/.vE THE w4rbR FRO,c CUN►I4Ml.vrfr/OAv PO TE.vTl.*LY Hilt R4TiNG- FRcH TffE fuRF146E. w47-rA !I¢,u.?LES 7-5$7-540 lti0Ie-ArC- NO $AC r691A J°)Q E p EA/T' ANV Nl ralYT E S Of . S-1 /►. pA. of A. D. E. wjll TE iQ Tl9 91- F V. W G. for $. G . K. SCprtc 714PK $ � OEEP —.4j. 0.47- 4¢' r = 4 X�.oyts'o NNN W w N SOlL SoR T/ ON eco C � 2 4- f"I wr+Tr,-n rooLE GR,4O1Eiyr RSSkM F x(71?/Zdti%AL fE�/9�gTlGN SONCL us/ o.t/ G1Pl9�VT W4 / vele 0 GRAAIV TOTRL 3:J �6 2.7 1.20' 2,8 /7.4 ALASKA WATER & WASTEWATER CONSULTANTS, INC. December 28, 2001 Municipality of Anchorage Building Safety Division Onsite Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Waiver Request and Health Authority Approval for Gateway to the Park Subdivision; Lot 10, Block 1, The existing 3 bedroom house is served by a private well and septic system. The well that serves the subject property was drilled on November 21, 1983, and the septic tank was installed on November 5, 1983. AKWWC, Inc. shot the separation distance with a Topcon GPT -1003 total station and determined the distance from the edge of the well to the edge of the first tank clean-out to be 97.73 feet. To account for the fact that edge of the septic tank is probably about 12-18 inches closer to the well, we are requesting that your grant a 95 feet separation distance ewaiver from the well on the referenced property to the septic tank on the referenced property. The following items are justification for the waivers: • Attached is a topography drawing that was prepared by S&S Engineering in 1995. It can be seen that the lot slopes from northeast to southwest. If the septic system was to overflow, the effluent would not travel toward the well head. The location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. The other path of contamination is subsurface migration wastewater should the tank begin to leak. As can be seen on the attached well logs (L9, Ll 1, & L12), the aquifer appears to be confined at a depth of 50 to 90 feet. Once this confining geological soil strata is penetrated, the static water level rises to within 20-30 feet of the ground surface. The confining soils are clay, clay/gravel, and hardpan which have served to protect the underlying aquifer. Recent water sample results indicated no bacteria was present, and nitrate levels were not elevated. Based upon the aforementioned facts, it appears that there is minimal risk associated with the requested waiver. please contact us at 337-6179. Thank you for your assistance. I.S. 6901 Debarr Road, Suite 211 • Anchorage, AK 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com RAOI�' \ � �,TIOH of ADO 91°L I APPROx' 1 -EXISTING FOUNDATION / CLEANOUT (FCO) / EXISTING 1000 GALLON / SEPTIC TANK / /-EXISTING DINIE/-XAFD 110,110,110, ALASKA «'ATKR R WASTEN'ATElR CONSULTANTS, INC. 6901 OFPAPP POAD. SUITE ?8 • ANGNOPAGF. AK 90504 • P~ (901)331-0A9 • FAX (901)338-3746 4EPARED FOR: PHONE NUMBER: MIKE BIRTLES (907) 696-6663 GATEWAY TO THE PARK SUBDIVISION; LOT 10. BLOCK 1 OF WORK: SITE PLAN FOR WAIVER APPLICATION 12/19/2001 J.W.M. 1"=40' NUMBERWfe 1 OF 1`FG ,v4 W w t �v il 0 rn \ WJE CIA Y N w L. o °d z w a, o J'0 L) ~ \ W O WWO O \ w O F- W �a r \ '=Z d L) \ a Z z W� a c� Y v �Cly�db . • \ •~(� 4 O J ►j ��� �� �d F•- = u � \\ O 0 At oW 4 O J \\ :X Vj totij sy / -16Y�y N C? NVrld 31IS ilt•.K •0t' _ ••� - �':.. - »-•r - .. •n t f.[, mall+. •«.ya t+'�'1r+.•,t o Y'♦'�"Y'•�'i�^r*s'L •rr J • • MUNICIPALITY OFANCHORAGE t S 1 r a f Y' • r DEPARTMENT OF HEALTH & HUMAN•SERVICE3 ^ Division Environmental Services k4..ryY1: iR'Zv7 OnVlte $efViC83 SBCttOnt•'✓� fL.. "S L: L i..^`3'J^ia '' — - ' P O -Boz 196850 V'Anctiorage Alaska 89519-8650 J• -A11!' il.i«'L.. ni.2NM{'7�'•r 4.iY.r•.�Lwa} i.Fq. !,Trs 7,4i'r { 4_j-�ti.+rLwawr._1.; ♦" Ji . ': �.rt l Y •,a, lir\ rwi•«f �w�nril;l N.�•f r.{; tl,.• A.a.we,l9 qr♦ � l'••H CERTIFICATE OF HEALTH AUTHORITY-:'-- s _ APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I D S OG7 �l00/ cS z.7.HAAM {.6Q\ � _ •� _ _ -z •tr<n 1R � .. rr._ �. ��.•.-i .....::...•f•: .::.c.e.s'.. -.,.t . .:: _: - rJ:i ONl:neF enr l �T r+n a �rwct ' -_ . ,..._. _ r _ .. 1.GENERALINFORMATION c ;• Lot 10• ,.:•. -d 'BLock 1 Ga 2uzcu #o xire Park Subdcvcscon . =•Cornmplete legal descripttony• _ . .. :".•. ....-5 .�_�.• -_. .- _-.moi..•: .._-•:•: .... '. . .. -y. 1 - •pw •y Y. n -•r 1 ���'•� A r ... V Location (site address or directions) rw;Property owned . Don and Sttccu 02 Hcekman - Dayphone 552 .5o1J . w ; ti ; HC83 Box 2493 EagLi RtveA AK 99517 - 1 Mailipg$t3"dress'.� r. I1 Lending agen'IF. ! _ t ' Day phone xr ZZ Oz' Z tMailing address ' t < Day phone o v' as .Y. u•' :'r �l. ,. - �, it�Yv ^.Ns. -±L � .yjs f�:�� ✓y. ,.cf w �..r �- iw~r•- . -- t- u.,.y.-4...>; r•ri nrti rrir «9 •-^♦.��Y'.r.'. "39 t/n/ess oth•Terwise requested, HAA -will heheld four plokup�-�.,- +,g..�.;,, fir, --+ NUIfABE O BEDROOMS • 3 - 3. TYPE OF WATER SUPPLY- .,t. z -_- �► ' 4 ,_, x X)CX c �A w Ind�iv dual wellpL t illy► wpCommunitywell /. r f � r^. lyi i n.a r p n r e yr � ,,r .. -.-:. d•. J T. '7Ft�iiTiN"!I�' NOTE:' if community welt system, provide written confirmation from State ADECat-test [' ti frig to the legsilly and status of system-,,:.. c r ' �,• r._,i-•`� 'f.� .��E the 1' .:.+. a w L 1 i �i;�rl 1r�, �� i�!• jl� ��'. c � ' 14ijTTYPE OF WASTEWATER DISPOSAL } L� "•r L7 Pl • Y-�a 1 .jhl ril s. } •�,1 J • yyy 1'- ._. � �lt f.rtll la f 1 1➢': ���.i �a Individual o ite �� .. -Holding tank ',W - f. r t ii.lRi' a t 'iN4COTTUflIty ORLSItB %;A," -M+.ntrarn 1 a... L R4'Yr �vwvt d04 ;,4.,;t y45n-eri'•"e tS^ it. ti ei. ��7!! ?Tis 1 ' tiit'tioirr ,�iA++ PubliC sewer • L s� c �i ; . LI r ? a ..� n. v'f Cr'a•:r t�J Ea+r. Q .. �. vr;'� .'..'"{ i. J , Ci R M_ » el r !ni n. w yf f r p i 71 NOTE tf communrty wastewater system, provide written confirmation from State ADEG ^ ^ c '` attesting to the legality and status of system - .:-T1-0271M+,IM) . Frons MOA Rt l •.. 1. n.'fv .... �.. '_... .: :._.s r :._. ._.. :`' 4 5 STATEMENT- OF INSPECTION BY ENGINEER 46 _..� ` As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply,.., and/or wastewater disposal system is safe, functional'and adequate. for the number of bedrooms ' and type of structure indicated herein I further verify that based on the information obtained from the Municipality of Anchorage flies and from my investigation and inspection, the on-site water ' supply and/or wastewater disposal system Is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm : S t S ENGINEERING — - --7 Phone °- °I �/ -3-9 9 " _17034 Eagl* River Loop Road No. 204 .--_.Address - _ ...... = Engineers signature Date6 47. i V V, va'T C ROEERr C emAN #�Q t t i, , G4 CE_8 80 & DHHS SIGNATURE \ _ �Il`� OFR~$i� 9 � a 13 X Approved for . 3 bedrooms _ r lw.: r '. _. •.Z nt :. � u -n ..� n .a r. � Y o t' � r v.' �t ,pis�pro,�_• , ,, '. ::: { i '..,;. ♦ -'...�• r' !r 4�.? ,.y , t rl. �•t Jam' � ' Conditional approval for ' : bedrooms wrth4the following stipulaUons� y V .•F `Lk eJ/ ' i' � Z . 4'- + y.>�At'F r, itt.r ..+�-..:'� ur -n '. t � �.f 1:,. r } ! yJ,M1 .- f •da x.64 4 ,1a. .. r'1' ' ..w y ,- r 4 it Comments •� _ r t� •!4 l ;« iltn t f L ] \ 1 e .f.� r w. �♦ i ._." f)wF,.r.i .. '•i!.... fi.tt. Z. .,`r'1 q1:.-0..-..1 l.. ... ;...Jt.,1.. __ ��-.:_•..+...r,...: :..x _..\..-.._��—\-, _^`r.h.r - i1r . `�, t`I ..•• 'r ,rr `// .1 ,. r�l-s �Sf , -_ < 1•-: r.�}o Date' !0- •�2 - 9r "\\�lSllr' ''jn �'i gut •tl 4 J w h L�4 ,I�.irrt � r'.•;y ,r/4 L :-r s �-.i.a.� iCurY 'tly.7 i s,CAUTION i?helMunict 'li of nthora a De pe ty� \� 4 g partment of Health and Human Services (DHHS) issues Health Authority i A - rove! t %rtiflca 44pp a ` 4pased only upon the__representattons given In paregrep,, 5 above by an independent Pro onal gipeer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes r .4, ,. ,. .. andttretrlendmglns�itubonsInordertosatisfy certain federalandstatereyuireinents EmployeesofDHHSdonot conduct-inspections or. analyze data before a certificate is issued. The Municipality of Anchorage is not :... responsible for errors or omissions in the professional engineefs work -." - c^•' •'.>'rims isw iMl'94u ypAm .. .. .. 1 _.. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:L-,,r 10 (.t=L4!=j v-6 Parcel I.D. O V7 - l,o - 0S A. Well Data Well type PR-i.l If A, B, or C, attach ADEC letter. ADEC water system number Logpresent®N) _Date completed /0-}1.95, Driller S� �-✓.�/ Total depth L1 ' Cased to G 1 ' Casing height /1" Sanitary seal (Y N) v Wires properly protectedA?/N) V FROM WELL LOG AT INSPECTION Date of test I o -a 1-83 oz Static water level n•� rn Well flow 30. o g.p.m. S, / g.p.m. C `R o W " Pump levell _ VX UlL M 0cy SEPARATION DISTANCES FROM WELL TO: 6 °m Septicfholding tank on lot /oo ; On adjacent lots z Absorption field on lot �! 9 / : On adjacent lots 0 Public sewer main �- Public sewer manhole/cleanout Sewer service line 2 S- / Petroleum tank -� S WATER SAMPLE RESULTS: Coliform Nitrate D. L/0 Other bacteria O Date of sample: S_S Collected by: e_ a c Fr,rrrN"p1mr_ 17034 Eagle River Loop Road No. 204 B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99577 Date installed 40 - 9,7 Tank size /00 o Compartments Z Cleanouts @N) / Foundation cleanout (DIN) �✓ Depression (YAR J High water alar (Y&Q / Alarm tested (Y/N) '0j1A Date of pumping Pumper _X' P(J 04"-I / SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /'00 On adjacent lots /00 / Foundation 3 To property line ✓v ' Absorption field /0 Water main/service line ID 1 Surface water/drainage -#G 7G ' To l.Jr-.e-,ol i rrE n/r Aolia F F /DR..rr7 r11 G ; 72-=rAM*F m Off./ aE-s.r SIDE- 'Sr- [.aT �•�j, � •'• �;- h', ,�CONTINUED ON. BACK PAGE,. 50-0 A-rTrAz� aij6D aA-t(LE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (YIN Vera (Y/N) High water alarm level 'Pump on' level at Meets MOA electrical codes (Y/N) SEPARATION LIFT STATION TO: tested at on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed! - to - 03 Soil rating (GPD/Ftz) Z13�y System type 66- •D Length /M Width 20Gravel thickness 6•s Total depth Total absorption area 9G o Cleanout presentaN) T_Depression over field (Y,®—/ Date of adequacy test 6 - L - 9S Resufts ass ail) 1AV5 for 3 Bedrooms Water level in absorption field before test b After test D Peroxide treatment (past 12 months) (Y� �o.IE �c. /oma✓ If yes, give date � 4 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot_ 113, On adjacent lots /oo ., Property line To building foundation 9-4, To existing or abandoned system on lot 'ej 1 On adjacent lots 3 o r Cutbank P44 Water maiNservice line io r Surface water Driveway, parkingNehicle storage area S } Curtain drain '4 - - y2 r '7"o ld re x-4 rmc t /ed JsfF D,t,.B,.✓/4E �N r�0 Of e aT E. ENGINEER'S CERTIFICATION.. I cer y that I have checked, verifed, or conformed to all MOA and HAA guidelines in effect on bedate of this inspection. ZZ. •�+•- f Signature Engineers Name 1?d/34a r C . Co ,,,I .n- ROBERT C. COWAN Date 6 /7 In r CE -8801 HAA Fee $ -100 . ea) Date of Payment Receipt Number rtlnZ 72-028 (393)• Bade Waiver Fee $. qan.L2-� - DateofPaymena Receipt Number HC 83 Box 2493 Eagle River, AK 99577 S & S Engineering 17034 N. Eagle River Loop Road, Suite 204 Eagle River, AK 99577-7804 Dear Mr. Cowan, July 27, 1995 RECEIVED JUL 31 1995 Munic.paiay ui Anchorage Dept. Health & Human Services Reference the Municipality of Anchorage Health Authority Approval Number HA950211 and associated Waiver you performed for me on Lot 10, Block 1, Gateway to the Park. On careful review of your work I have several concerns I would like you to address. a. On page 3 of the HAA certificate you list the "intermittent runoff drainage" as being on the west side of the lot. This "surface water" is on the east side of the lot. b. The elevations listed on the contour lines on the site plan submitted for the waiver are not correct. Please refer to the Municipality's as -built records for Mt. Kiliak Circle and the State DOT's records for Eagle River Road. c. I requested you provide copies of all field notes from your work at the time of payment. I have not yet received these documents. Please correct the HAA certificate and waiver data and resubmit to the Municipality. Provide me and the new owners (MrJMrs. Birtles) a copy of all field notes and the convected, MOA - approved documents. Sincerely, ._ Donald C. Hickman cc: Mr. Daniel Roth MOA, Dept. of Health and Human Services Division of Environmental Sciences On -Site Services Section PO Box 196650 Anchorage, AK 99519-6650 MrJMrs. Birtles PO Box 773133 Eagle River, AK 99577 ON Miniicipaliiy of Anchorage Department of Health and Human Services 825 "L" Street Rick Mysrrom. P.O. Box 196650 Anchorage, Alaska 99519.6650 Mayor 343-4744 June 27, 1995 Robert C. Cowan, P.E. S 6 S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 10 Block 1 Gateway to the Park Waiver Request #WR950029, PID #067-60-05, IIA950211 Dear Mr. Cowan: Your request for a waiver(s) of the required 100 foot horizontal separation of a septic system to the surface water has been approved. The approved separation distance(s) are a septic tank and leachfield to the surface water of 76 feet and 42 feet respectively. This waiver approval applies to the existing septic system to surface water separation only. Any future upgrade to the septic system will require all separation distances be met or another approval from this department. Should the operation of the subject wastewater disposal system cause any contamination or degradation of the subject surface water, this waiver will become void. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljm -} MUNICIPALITY OF ANCHORAGr, Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR#lrNC'j GI-,nQ0i PIN 067-601-05 HA# HA950211 Permit # Date Received: June 23, 1995 @ 2:45 p.m. Legal Description: Lot 10 Block 1 Gateway to The Park Engineer: Robert C Cowan, P E, S& S ENgineering 17034 Eagle River Loop Road, Suite 204 Eagle River 99577 Applicant: Don/Stacy Hickman Waiver Requested: Septic tank & leachfield to surface water of 76 &_ 42 feet respectively Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: x_ _ Waiver is NOT Granted: List Conditions or Reasons for above: SEE EN[/AfERJ fiMfir/EO raf0 tjaR, t ETiER 4 FH0T06.fAPd1 OF 7UtrIFMATIVAV Or TIM faMEN(E hATF1�NAwE/p // S/TE Uisir DS' McSCLF YIELDED TNF rgAfE rDvlLkJ/O VS. Date: L27 -Fr By: OAU Rorty Name of Reviewer Rec 1:01025/340 Amount: $ 920.00 Date Paid: 6- z-95 HEALTHAIITHORITY APPROVALS SEWER& WATER MNN EXTENSIONS SEWER & WATER INSPECTION ENGINEERINGSTLIDiES ANDREPORTS WELLINSPECTION & FLOW TEST SITEPLANS ROADDESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN June 23, 1995 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 ROBERT C. COWAN, P.E. ROBERTA. SHAFER P.E. CML ENGINEERS (907)694.2979 FAX(907)694-1211 REFERENCE: Lot 10 Block 1 Gateway to the Park Subdivision Request you issue a Health Authority Approval on the referenced property and grant a waiver for the horizontal separation distance between the stream and the septic tank and leachfield serving this property at 76 feet and 42 feet respectively. The mitigating factors involved which support the issuance of the waivers are as follows: 1. Reference the site plan/topo and photos, surface effluent would not flow toward the stream. A drainage ditch has been excavated that will divert any effluent that might surface. 2. Heavy vegetation between the leachfield and the stream would prevent the migration of effluent. In our opinion, the separation distance requirement prescribed by 18AAC.021 is not necessary in this case. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 W / v / / \5 M9d 311S I -OV = „L= „t O MUNICIPALITY OFANCHORAGE HUMAN • DEPARTMENT OF HEALTH b HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # Ct�-1 —114!11- nS HAA # 1,1 ci �ntia 1. GENERAL INFORMATION Complete legal description .410 �% G'prr�*e Qy h-6 Oita 94jo Location (site address or directions) III 1 i7t-res *0-4C' f 41 Property owner (fit u-1 ars. Day phone Mailing address Zy 13 Ro Lending agency Day phone Mailing address Agent '0C NY_ Day phone -69e-5 2.00 wJ/t..Y A+J Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water -.;-19340 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site t� Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Ft".1/91) front MOA121 5. 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 �Milo `i ^' � Phone C�iL �t�i7 Address Zo z. o !"—"• nom` C'�•`�'A" 'Q� �7�1 SZ 7 Engineer's signature DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments By: _ bedrooms. Date Da,;d I DayY.+n KO. 2"205{ bedrooms, with the following stipulations: Date f � 9' The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. nets (n .11911 BKX MOA021 Municipality of Anchorage Department of Health & Human Services i HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: -L"r 10 Parcel I.D. f AnwwM' vz.� T v A. WELL DATA o&7-LoI-oS Welt type 2674tl0l"l If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed ZeA4 P3 Driller S..s �'v f.✓ Total depth i Cased to 40 Casing height I / Sanitary seal (Y/N) y Wires properly protected (Y/N) y . FROM WELL LOG AT INSPECTION m �2 Date of test l o' z/ l f� .3 gL"Z"1y i ;;a_ T� 3 6 Static water level f / 2.0.5,— n Well flow 30 T o m� Pump level . .. 7 rn N N o SEPARATION DISTANCES FROM WELL TO: Z Z Septic/holding tank on lot 1 c o ; On adjacent lots Absorption field on lot 113 ; On adjacent lots Public sewer main Public sewer manhole/cleanout Public sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform r Nitrate Other bacteria O Date of sample: g/ �o/q Collected by: Azko"".4"' B. SEPTIC/HOLDING TANK DATA Date Installed Tank size 1000 Compartments Z Cleanouts (Y/N) - y Foundation cleanout (Y/N) Y Depression (Y/N) A< High water alarm (Y/N) AIAlarm tested (Y/N) "tl Date of pumping SY SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s)onlot [co Onadjacentlots Imo +' Foundation 3 To property line 9.5= AbsorptionfieldWater main/service lineVo� Surface water/drainage�+ Sid• p 4 '/ / y/U INTC/LMT?V+vT f-ct a.0/1� 72 -MO .Li1)Fro MOA 21 - - /JiLFAishLi- &AJ t�-) e -r- CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off' level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Surface water Date installed 1 J 15 Soil rating 2"/6 Vi'''e System type 83R Length— '40' Width w Gravel thickness /Z" Total depth 4"r Total absorption area 160 Cleanouts present (Y/N) % Depression over field (Y/N) Date of adequacy test Results (pass/fail) PSS for 3 bedrooms Peroxide treatment (past 12 months) (Y/N) /L/ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /I 3 On adjacent lots 1052 4 Property line 4'2 - To building foundation Z4- To existing or abandoned system on lot N°Arii On adjacent lots A/o ,& Cutbank Nom Water main/service line 4/0 Surface water oPOO it 4- Driveway, parking/vehicle storage area L0 r . / Curtain drain A1oAN;- oN yV s.otr .+shat 4-2.' > E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidellnesi"ffed on•the date of this Inspection. tA .rru• . . 1 ••: � •'';ai?t fi K� L '� � Signature �!a " •��»"�'1 La _. EngineersNameWo 'e 42.2-4""j 7� , p; a'a:-�w� � „'�j •, Date i 7I ���.•.• 1+0. 2245-6 , r IpROFESStpv.� HAA Fee $ Date of Payment _ �9 Receipt Number Fl -026 piw. 2191) B• MOA 21 Waiver Fee. S Date of Payment Receipt Number D. R. DAYTON, P.E., R.L.S. z' ERM29c Chugiak, Alaska 99567 (907AMM1 20210 Donalar St. 696-2417 August 13, 1992 WELL FLOW TEST Legal Dlscription: Lot 10, Dlk 1, Gateway to the Park Subd. Date of Test: August 12, 1992 Depth of well: 611(per well log) Static Water Level: 20.4' measured from top of casing Test: The well was pumped for 1 hr. 43 min. producing 450 gallons. Results: . The average flow during the test was 4.4 gallons per minute. Conclusion: The well is currently functioning adequately for a 3 bedroom home. D. R. DAYTON, P.E., R.L.S. WRIMMMM Chugiak, Alaska 99567 (907)N 20210 Donalar St. 696-2417 August 13, 1992 ADEQUACY TEST Legal Description: Lot 10, Blk 1, Gateway to the Park Subd. Date of Test: August 12, 1992 Septic System: 1000 gallon, 2 compartment steel tank (DHHS Records) Absorbtion System:20' x 48' bed (DHHS Records) Soils Rating:.213 sq, ft. per bedroom (DHHS Records) Test: 450 gallons of water were injected into the absorbtion bed in a 1 hr 43 min. period. Results: The absorbtion bed accepted the daily design flow in 1 hr. 43 min. with a 0.21' rise in the water level in the monitor tube. The monitor tube water level returned to the original position within 15 minutes after the water injection was stopped. Conclusion: The system is currently functioning adequately for a 3 bedroom home. David 0. D")OM NQ 9906! MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIR0,DZENTAL ff- TH DEPARTMENT OF HEALTH AND EUVIROK ENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date / -7 7- & (a) Legal Description (include lot, block, subdivision, section, townsh , range) -L.=-I- /0 I3L K. -rr, - —Lkc Location (address or directions) 6fy-2/o(cl (b) Applicants NameSTt!Y,5 Telephone - Home Business Applicants Address q:;Z D, 130X Z4�� �{ F (c) Applicant �is (check one) Lending Institution Owner/builder{--__: ; Buyer ; Other = (explain); (d) Lending Institution x, %i%/lTLl6YL Telephone Address �,alL p�/yL- / (e) Real Estate Co. b Agent 11CAJ Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single -Family Multi -Family m Number of Bedrooms 3 3. Water Supply - Other (describe) Individual Well 5�_ Community =1 Public Q 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 Public [ Community 1= Holding Tank Q Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. (Page 1 of 21 5. Engineering Firm Providing Insrections 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 effect on the date of this inspection. Name of � � w Date 6. DHEP Approval �.• 1 EnomEn.-M l Telephone CIVFR. ALAS.Ck =Zn q sfly��f`jM '+ L of At. �+1 (ENGINEER' 5T Approved.�for� bedrooms Approved%` Disapproved Terms of Conditional Approval /I7 rc% bbwi A. E►abr �9 Co 'J` • Ho. W7•E .•i r.. 1• tic> r By ° f •,R•�.. r� Date 7 30 Conditional CADTION THE MUNICIPALITY OF ANCHORAGE DEPAR=4ENT OF HEALTH AND EWIRWO ENTAL PROTECTION (DHEP) 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 REQULQE- MENTS. MIPL0'6EES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICI?ALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 21 7-19-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) MUNICI OF ANCHORAGE DEEPT.PT. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST - FEBRUARY 1984 IJUI 101qR4 RECEIVED Well Classification 5.1If A, B, or C, D.E.C. proved(Y/N) We(a ll Log PresentN) Date Completed Z/ 3 Yield TO6Am• Total Depth 66 cS Cased to 9-0 cad Depth of Grouting Static Water Level _ /�'� " Pump Set At [J ,` Casing Height Above Chian+ gD'� Sanitary Seal on Casing Y ) Electrical Wiring .in`CondLfit�,iY�N) Depression Around Fbllhead ()_ Separation Distan6es from Wb11: ' To Septic/Ho3dHvIg Tank on Lot /00 On Adjoining Lots ASO 17� To Nearest Edge of Absorption Field Lot /� 3 • On Adjoining Loots /,SZ To Nearest Public Sewer Li 'J/A, To Nearest Public Sewer Cleancut/Manhole -"X4 Tb Nearest Sewer Service Line or. Lot 9Q /t` Water Sample Collected By Date Water Sample Vest Results Camlents_ Q L.I L FLbc -r" -57- u fir. --co -77�iz chi' .SEair� B. SEPTIC/t122SMG TANK DATA Date Installed / gB3 Size �/ ObD No. of Compartments Z Standpipes 'N) Air -tight Caps 5� m Foundation Cleanout (QN) Depression over Tank Me Date last d Pumping/Maintenance Contract on File (Y ) for Holding Tank High-water Alarm (Y )'v Tgmporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply IJell To Building Foundation / To Property Line To Disposal Field s To water Mair,/Service Line N,4 T tream Pond, Lake, or Major Drainage Course Comments [Page 1 of 21 2-15-64 C. ABSORPTION FIELD DATA %% Soils Rating in Absorption Strata 2 /3 91/2- Type of System Design ig Date Installed /i�3 T Length of Field S Width of Field Depth of Field Gavel Bed Thickness Square Feet of Absorption Area Standpipes Present (01N) Depression over Field (y9)) to of last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: //,?To water -Supply Well ��To Property Line /(� To Building FouDdation / 9 To Existing or Abandoned System cn Lot N ; On Adjoining Lots 3 To Water Main/Service Line A-- ( To (Ltbank(if sent) 34) To atn/Pond/Lake/or Major Drainage Course oo To Driveway, Parking Area, cc Vehicle Storage Area /O f Crnments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Dimensions Manhole/Access (YIN) "Vow off" Level at / Ment (YM) Cycles daring Adequacy 'lbst. Meets MOA *" Check Permitted Bedroan Rating Against HAA Request '* I certify that I have checked, verified, or oonfcrmed to all MOA HAA Guidelines in effect on the date of this inspection. ' O� , p q,:f�1 N Signed A A R [y() pnVA Date) %i r B R Ca:Qany �i,.BLE +�j11AXCZ T""i MOA• • � S i KBl/d5/s (Page 2 of 21 2-15-84