HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 3 LTS 9 AND 10 STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF MINING, LAND & WATER
Alaska Hydrologic Survey
WATER WELL LOG Revised 08/18/2016
Drilling Started: ____/____/______ Completed: ____/____/_______ Pump Install: ____/____/_______
City/Borough Subdivision Block Lot Property Owner Name & Address
Well location: Latitude Longitude
Meridian ____________ Township ______ Range _______ Section _______ , _____ 1/4 of _____ 1/4 of _____ 1/4 of _____ 1/4
BOREHOLE DATA: (from ground surface)
Suggest T.M. Hanna’s hydrogeologic classification system*
https://my.ngwa.org/NC__Product?id=a185000000BYub3AAD
Depth
From To
Drilling method: Air rotary, Cable tool, Other
Well use: Public supply, Domestic, Reinjection, Hydrofracking
Commercial, Observation/Monitoring, Test/Exploratory, Cooling,
Irrigation/Agriculture, Grounding, Recharge/Aquifer Storage,
Heating, Geothermal Exploration, Other
Fluids used:
Depth of hole: __________ ft Casing stickup: ___________ft
Casing type: __________ Casing thickness: _________ inches
Casing diameter: _________ inches Casing depth: __________ ft
Liner type: _________ Depth: _____ ft Diameter: _____inches
Note:
Well intake opening type: Open end, Open hole, Other
Screen type: _________, Screen mesh size: ____________
Screen start: ________ ft, Screen stop:________ ft, Perforated Yes No
Perforation description: Perf from: ________ ft, Perf
to: _______ft, Perf from: ________ ft, Perf to: ________ ft
Gravel packed Yes No Gravel start: ______ ft , Gravel stop:______ ft
Note:
Static water (from top of casing): _______ ft on____/____/_____ Artesian well
Pumping level & yield: ______ feet after _____ hours at _____ gpm
Method of testing:__________________________________________
Development method:______________ Duration: ____________
Recovery rate: _________ gpm
Grout type: _________________ Volume __________________
Depth: From ___________________ft, To ___________________ft
Final pump intake depth: __________ ft Model: _______________
Pump size: _____________ hp Brand name: __________________
Include description or sketch of well location (include road names,
buildings, etc.):
Was well disinfected upon completion? Yes No
Method of disinfection:
Was water quality tested? Yes No
Water quality parameters tested:
Well driller name: ..................................................................................
Company name: ...................................................................................
Mailing address: ....................................................................................
City: __________________________ State: AK Zip: ___________
Phone number: (________) ________- ______
Driller’s signature:
Date: ______/______/_________
Anchorage Municipal Code 15.55.060(I) and North Pole Ordinance 13.32.030(D) require
that a copy of this well log be submitted to the Development Services Department/City
within 30 days of well completion.
City Permit Number: _____________________________
Date of Issue: _____/____/_________
Parcel Identification Number: ______-_______-________
*Guide for Using the Hydrogeologic Classification System for Logging
Water Well Boreholes by Thomas M. Hanna NGWA Press
AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a
copy of the well log be submitted to the Department of Natural
Resources within 45 days of well completion. Well logs may
be submitted using the online well log reporting system
available at:
https://dnr.alaska.gov/welts/
OR email electronic well logs to
dnr.water.reports@alaska.gov
North
n
CASE TO 40 FT
25
n
SW
Anchorage
NES
L09 & 10
PO BOX 110378
115
138
B3
99511
907 4000
7
WAYNE WESTBERG
40
NW
n
J & L GRAY ,LAKE RIDGE TERRACE
002W
Municipality of Anchorage
4180
015N SE
n
M-W DRILLING INC
open hole
345
n
Lakeridge Terrace
Lot 9 & 10
Block 3
#051-313-14
Municipality of Anchorage Page 1 of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES.
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW000440 PID Number. 051-313-14
Name:
RAY PRICHARD
Wastewater System: O New ■Upgrade
Address:
17719 BLUE SPRUCE EAGLE RIVER, AK 99577
ABSORPTION FIELD
Phone:
(907) 345-0043
No. of Bedrooms:
3
0Deep Trench ■Shallow Trench ClBed OMound ■Other*
LEGAL DESCRIPTION
sss R•tv r.
•2.0
Told Depth from orlg� pear
cpo/5a. n.
TOP OF SAND ® O.G. it
Lot Black: Subdivision:
9 & 10 3 LAKERIDGE TERRACE
Depth M pipe eoaorn eom odgh l pwr
+0.5'
&svW depth ew th p,pr
0.5
n.
rL
Township:
Range:
Section:
FM soda Deep.. a,psd rode:
Gow k gin:
_
—
—
3.0'-3.5' Ft.
45 r<
WELL: ❑ New l7 Upgrade
Draw .Wlh:
5
W ew of anew
1
DYtenoe ed.ewl Lner
—
r<
In.
Ck,eefc Pdvote, A C : Told Depth:
Ta
Told oboorptlon vex
pipe mdvbk
R
rL
225 so. rL
ASTM D-3034/SCH 40 PVC
Dr . Dote DrOW:
Slnlio Wdv Lew:
Lwtop .
EAGLE MTN. EXC.
Date kwWW:
10/18-20/2000
R
ndx
P SO w
� Height &�
TANK
DPM
r,
n
SEPARATION
DISTANCES
aseptic 0Holding ■S.T.E.P.
To
Septic
Tank
Absorption
Feld
Uft
Station
Holding
Tank
Mk/PrNats
Soww Lkeq
Maedechaer:
ANCHORAGE TANK
Copa4d ti ed
1500
From
Well
100'+
100'+
too'+
—
25'+
Nale bk STEEL
Nunlbw d eanwanrn 2
SurfacWater
Water
100'+
100'+
100'+
-
-
LIFT STATION
Llano
5'+
10'+
5'+
—
—
1500
ANCHORAGE TANK/ RENCO SYSTEMS
Foundation
5'+
10'+
5'+
—
—
saw on �
—TIMER A
r.d aL
TIVATED—
N—o evw d 0.
1 46"
Curtain
Drain
NO�N
Pump slake a MW -
20 051 05 HHF
Deculow ewpedlane Wfomwd ey:
ALCAN ELECTRIC
7MKNOW
�E
Remarks: • THIS IS AN ADVANTEx FILTRATION
BENCH MARK
Loadfan era D••crliuo•:
SYSTEM.
TOP OF FLASHING OVER CMU AT POINT
"C" ON GARAGE
Aernwd Etvvot :
100.00 In.
eMaetee¢s
oo�0 4
o�
4
P
Inspections performed by: AWWC, INC. Dates: 1st 10/18/2000
-37
........ . . .......... 21
2nd 10/18/2000
3rd -4th 10/19-20/00
D
QO. P • J fr A. rness.: T7
�4
H
Department of Health and man Services approval
� • -7953 svv
Reviewed by:106-1-Date-11-Ag-10D
and approved
10rofesslon0005'
oO00�0���
—015 . 91") Lrae 25
PERMrrNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
SWO
SW000440 051-313-14
1 — 10' UTILITY EASEMENT 4 I
\ \ TEST HOLE
\ PERFORMED BY I
KENNETH M. DUFFUS,
\ P.E., ON 6/22/98
8 Al,
NEW DRAINFIELD� LOT 9
NEW 1500 GALLON•
S.T.E.P. TANK WITH
ADVATEX FILTRATION
SYSTEM
A 1 B 1 C
FC01 149.770134.585 76.725
C01 63.655 38.415 61.280
FCO2 79.080 52.035 4.085
ST1 91.080 76.965 45.655
MH 97.740 85.215 54.695
CO2 105.28 94.415 64.635
MT1 103.82 93.645 65.475
co -3-1140.711135.38 109.01
MT2 1139.821134.86 109.17
LAIRUNE. INSTALLED I
INTO CRAWLSPACE IN
GARAGE FOR POSSIBLE
FUTURE CONNECTION TO
_�A NR BLOWER
� I
r
NG THREE
OM HOUSE
\ LOT 10
GARAGE
BLUE SPRUCE LANE \ /
9
SEPTIC TANK AND
DRAINFIELD WERE
f" a 10/26/2000 P a F
e i SA 1 DRAWN BY: pp .
ALASKA WATER & «TASTENVATER SSE: C.J.G. �.
CONSULTANTS, INC. 1 ^ = 40
6901 DFRARR ROAD. WTE ER • ANCHORAGE. A6 00504 • P~(007)337-0170 • FAX 07)336-3716
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: O ••
RAY do MARGIE PRICHARD (907) 345-0043 2 OF 3 Q fir A.
LEGAL DESCRIPTION: QQ °L• E-7!
LAKE RIDGE TERRACE SUBDIVISION; LOTS 9 do 10, BLOCK 3, �04�, ' •..,
TYPE OF AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM) 4 %=
II
PERMTTSWO NUMBER: A S � B U I LT DRAWING F051 ID NUMBER:
SW000440 051-313-14
ORIGINAL GRAM Af
TE5f HOLE - 95.83
iPJCX1.N4f
POD5
for Oft
Af Wf - 95.55
- 95M CAVGJ
965 Af A
fP19.lXN)E -99.55
mi
NSW 1500 ci&LON
5,T.U. TANK
Mf
f0F 0f W- 9589 (AVG.) �
Bottom Of lee
- 9535(AVGJ
`MxXOf PPE
- 963!,(AVG)
ODER 0.5'+ Of
LEVELiz 5AW
10/26/200
DRAWN BY:
ALASKA «'ATKR & NVASTIMIATL'R SCALE: C.J.G.
CONSULTANTS, INC. N.T.S.
6901 DERARR ROAD. MATE NI • ANCHORAGE. AK 99304 • P~ (901)337-6179' FAX (007)3393246
PREPARED FOR: FHONE NUMBER: PAGE NUMBER:
RAY do MARGIE PRICHARD (907) 345-0043 3 OF 3
LEGAL DESCRIPTION:
LAKERIDGE TERRACE; LOT 9 do 10. BLOCK 3.
TYPE OF WORK:
PROFILE AS—BUIT OF SEPTIC SYSTEM UPGRADE (ADVENTEX SYSTEM)
of mMNOLB
-10.49
07 Of f"
)LW -9588
rmw
TOP Of %V IS
Af ORIGINAL GRAM
GROIACIWATER Af 9083 ON I
10/ I5/ 00 8 10/ 18/ 00.
5EE AffAC&P LETTER.
—7953 : f�
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN IUNICIPALITY OF ANCHORAGE
AND _ eStq-, T 12Ct U
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
42-1111ay of of 20Q , by and between \�,C, ,
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as A A v eL n ttA- located
at L 1 fg q <,- / D , %qj� c-/�_ 3 , Anchorage, Alaska.
L_/iltG K 1D6 - TCRR/Icc- u* 1771`1 8Ive_ SPrvice
2. Definitions.
A. Alteration. Any change to the design or function of an AWWTS that
includes the installation or removal of any parts, components or pieces
not included in the original construction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On -Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
These approvals certify that the systems are adequate for the homes that
they support and meet the codes that were in place at the time of system
construction.
C. Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
D. maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included in
the original design which would allow the AWWTS to continue to
perform as designed.
E. Permit (Construction) An On -Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AWWTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On -Site Wastewater System Construction Permit and
all relevant provisions of AMC 15.65
3. Fee. Owner shall pay to Municipality an annual fee of Z C R O
($ 0 .00), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
4. Term. The term of this Memorandum of Understanding shall be for the life of the
AWWTS.
The term begins on the date of approval by the Municipality of the installed system and
shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On -Site approval is issued to
the new owner or transferee of the property.
5. Alterations, Installation and Removal of Additional Equipment. Owner agrees
not to make any alterations, removal of parts or additions to the AWWTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AWWTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AWWTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AWWTS
Operating Permit is: C -(mNUI %
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AW WTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AW WTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AWWTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
nor in any way effect the validity of the Memorandum of Understanding or any part
hereof, or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the same
formality of this Memorandum of Understanding was executed and such writing shall
be attached to this Memorandum of Understanding as an amendment. .
B. For the purposes of any amendment modification or change to the terms and
conditions of this contract, the only authorized representatives of the parties are:
Owner:
Anchorage: Purchasing Officer
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severability. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
OR'NF.R:
By:
Z %— eel -
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
�Q f2e�ac jYlt7✓lgage.
By: ( ETH F���/i
Title: 0 9 ':-- �F�i
Date: q
PUBLIC
) ss.
The foregoing instrument was acknowledged bfore thisd� day of &&.1 ZK ,
2t�, by EJU5rtbVA ��C'mtrn She = =&.r, QA604" of
, on behalf of th Municipality of Anchorage.
My Commission expires:
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
November 9, 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
RECEIVED
NOV 15 2000
Municipality of Anchorage
Jf3Pt Health & Human Service,,
Ref: Groundwater Concerns at Lake Ridge Terrace Subdivision; Lot 9 & 10, Block 3
To whom it may concern:
This letter is to address any groundwater concerns for the new drainfield installed on
10/18-20/2000 for the referenced property. According to Kenneth M. Duffus, P.E. (KND
Engineering) soils log, groundwater was encountered at 5 feet on 6/22/98 and then at 4.1 feet on
8/3/98. Prior to the installation of the drainfield.the monitoring tube was checked and
groundwater was found to be at 5 feet on 10/15/2000 and on 10/18/2000, which is considered to
be the high groundwater season. It is our opinion that the 8/3/98 performed by KND
Engineering, which showed groundwater to be at 4.1 feet, is probably not accurate, given that the
test hole around the monitoring tube was an open pit which probably allowed rainfall and surface
runoff to skew the readings. It is our opinion that the groundwater readings taken by our firm on
10/15/00 & 10/18/00 is the accurate high groundwater level.
Prior to the installation of the drainfield, original grade shots were taken and found the ground
level at the test hole to be at 95.83. Due to that irregularities in the contours, excavation was
limited to 4.5 feet above the groundwater level taken on 10/18/2000 and a 0.5 foot below the
original grade shot at the test hole (95.33). The sand filter level was brought up to the elevation
of the original grade at the test hole (95.83) which would give a 5 foot groundwater separation
distance from the bottom of the new drainfield to the high groundwater level.
If you have any gftstions, please contact us at 337-6179. Thank you for your assistance.
P,E.. M.S.
6901 Dcbarr Road, Suite 213 * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
i
i
Alcan Electrical Engineering, Inc.
6570 Arctic Spur Rd.
Anchorage, Alaska 99518
Fax Cover Sheet
DATE.
November2, 2000
TIME:
12:17 PM
TO:
AWWC
PHONE:
337$179
Jeff Gamess
FAX:
338-3246
FROM:
Alcan Electric
PHONE:
563-3787
SMpp Bringmann
FAX:
5628286
RE:
Lot 9 and Lot 10, Block 3 of Lakeddge
Subdivision
RECEIVED
N0V 15 2000
Municipality of Anchor++,a
Oept. Health & Human So.. ces
Jcff-
In regards to the sewage lift stations that Akan connected at the above mentioned
locations. All electrical work performed by Alcan was done to 1999 National Electrical
Code, (NEC) standards.
If you have any questions please contact me.
Thank you!
Number of pages Including cover Asst 1
i l 'd OZWON X1810313 NV31V N11:1 0001'Z 'AON
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) 3434744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW000440
Legal Description: LAKE RIDGE TERRACE BLK 3 LT 10
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: Ray Prichard
Owner Address: 17719 Blue Spruce
Anchorage . AK 99516-
1-no�ec tray--�
/o/Woo Gg lc2 p' ,'�
is// 9/od
Date Issued: Oct 17, 2000
Expiration Date: Oct 17, 2001
ParcelID: 051-313-14
Site Address: 017719 BLUE SPRUCE LN
Lot Size: 26500 SO. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy El Private Well El 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 tailing
(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 closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date:
Date:/0 —/7-0O
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
October 3, 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic System Upgrade for Lots 9 & 10, Block 3, Lake Ridge Terrace Subdivision
RECIRCULATING TRICKLING FILTER (AdvantexT,) SYSTEM
To whom it may concern:
1. GENERAL: The existing 3 bedroom home is served by a private well and septic system.
The existing septic system is surcharged and must be upgraded prior to the sale of the house. The
property owners recently purchased Lot 9, which is vacant. On 9/15/98 a sewer permit was
issued (SW980359) for the installation of a Reactex septic system on Lot 9. This permit has
since expired. Per your approval, we are proposing to revise the previous design to utilize the
Advantex technology, and modify the drainfield size to meet the application rates recently
established by the department.
2. SOILS: See the attached log prepared by Ken Duffus, P.E., which shows the soil
classifications, groundwater monitoring, and the percolation test results.
3. DRAINFIELD APPLICATION RATE: The intent is to install a Recirculating Trickling
Filter (Advantex) System that will allow the use of a small drainfield in the area around the 30
foot radius of the test hole. The size of the drainfield will be based upon an application rate of 2
GPD/FT2. We are proposing to install a 5 foot wide drainfield that is 45 feet long and has an
effective depth of G'. We will excavate to a depth of 1 foot, install a 1 foot layer of filter sand,
and then 6 inches of clean, washed sewer drainrock below the distribution line.
4. TRENCH DESIGN:
a. Percolation Rate: 20 minutes/inch
b. Allowable Application Rate: 2 gallons/day/O
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 225 f12
6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Far: (907)338-3246
f. Total Depth: 1 foot (max.)
g. Effective Depth: 0.5 feet
It. Width: 5 feet
i. Reduction Factor: 1
i. Minimum Length: 45 feet long
j Effective absorption area = 225 fi2
4. ORENCO PACKAGE SYSTEM: The STEP tank with the trickling filter will be
manufactured by Anchorage Tank A Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their
standard STEP tank, it is equipped with a high water alarm per M.O.A requirements.
5. SURFACE NATER: There is no surface water within 100 feet of the proposed septic
system upgrade.
6. TOPOGRAPIIY: As can be seen on the attached site plan, the average topography of this
property is less than 10 percent, running from approximately east to west. In short, there are no
slope concerns.
7. CLOSING: I am open to any suggestions from your department that would be an
improvement to the proposed system. I am unaware of any negative impacts that this installation
would impose on adjacent wells, or septic systems. If you have any questions, please call us at
337-6179.
.E., M.S.
NOTE: Attached is a site plan drawing, a design drawing, a trench profile, an Advantex profile,
one soil log, and a 7 page construction specification letter which are all part of the design
package for this septic system.
6901 Debart Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246
i
--------------------- ------------------------1 I
JAMES WAY
��
1
LAKERIDGE TERR.S/D FRIDGE TERR. S/D
LAKERIDGE TERR. S/D LAKERIDGE TERR. 5/D LOT 6, BLOCK .3 LDT S, BLOCK J.
OCK J,
LAKERIDGE TERR. S/D I LOT 6, BLOCK 3, LOT 7, BL�--���`♦
LOT 1, BLOCK 6,
LAKERIDCE TERR. S/D 1 A -'1/ __—
LOT 2, BLOCK 6, t— I --f"---
1 T---—,-1
EXISTING
BEDROOM HOUSEI ♦ / / 1
I /
♦
�1 �_ � ` ' �� ♦ uvroi/irr �ro1
LAXERIDGE TERR. S/D
LAT J, BLACK 6.
2
1 i
LAKERIDGE TERR. S/D \
LOT 4, BLOCK 6, \\ 1
1 I
I 1
1 1
LAKERIDC
LAKERIDGE TERR. S/D LOT 4,
LOT 6, BLACK Sym
`-SARC
--J
------------'7
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
6901 DEBARR ROAD. SUITE TB • ANCHORAGE. M 99504' M4ONF (907)377-0179' FAX (907),736-074
PREPARED FOR PHONE NUMBER:
RAY & MARGIE PRICHARD (907) 345-0043
LEGAL DESCRIPTION:
LAKE RIDGE TERRACE S/D; LOTS 9 & 10, BLOCK 3,
TYPE OF WORK-
SITE PLAN FOR DESIGN OF SEPTIC SYSTEM UPGRADE
`3EPRC
ARE�D
H JANE'--
\ \
1 1
7�S/D"
BLOCK 5.
10/3/2000
r------------
1WN BY;
11
1 LAKERIDCE TERR. S/D
/ I
I LOT 12A, BLOCK 3
H JANE'--
\ \
1 1
7�S/D"
BLOCK 5.
10/3/2000
1WN BY;
K.D.W.
�
74)
qA
uE
loo,
1 " = 100'
.....
1
.......1
14
;E NUMBER:
iI
.. 6:
1 OF 4
61 f r
A. Gorness;%
—7953 .`
V1.�._•�
..... 'neo?
4• NR LINE TD TRICKLING FILTERS \
FROM CRAWL SPACE OR GARAGE. 3'
/ MINIMUM BURIAL AND INSULATE WfT I 1
/ 2' WIDE BOARD NSULATION THAT IS
2' THICK. NO BUD OR NR
COMPRESSOR REQUIRED AT THIS TIME.
— .
—PROPOSED DRAINFIELD. EXCAVATE k—1
LAT 9 1
TRENCH THAT IS ONE FOOT BELOW
ORIGINAL GRADE MAXIMUM (REMOVE ALLI
ORGANICS). BY 3 FEET WIDE, BY 45 JJ
ABANDONED
FEET WAC. ADD ONE F00T OF LEVEUN�
\
\SAND, AND 0.9 iEET 01 CLEAN. WASH
3 OF 4
\
SEWER pRNNROCK. SEE PAGE
FQR DETAILS. NSfALL TRENCH PARALLEL
\ TO SLOPE CONTOURS.TEST
\ HOLE I
7.777-71��.
PERFORMED BY
I
PE. ON 8/22/98
CO \ \
LOT 10
i
EXISTING THREE /
BEDROOM HOUSE
INSTALL FOUNDATION
UT PVC. MOUND SOIL COVER I OLEAPREESENT NOT
& INSULATE AS REOUIRED
PROPOSED 1500 GALLON ( \
S.T.E.P. TANK AND ADVANTEX INSTALL FLOW r
FILTRATION SYSTEM. SEE PAGE DNERTER IF GARAGE I T
4 OF 4 FOR DETAILS. GRAVITY FLOW
TO EXISTING I I
FIELD CAN BE I I
OBTAINED I I I
/ � I
BLUE SPRUCE LANE_ �C
I
a
ALASKA «'ATF4,k & NVASTI;`VATER
CONSULTANTS, INC.
...... wen•m w•n n•Ts sw • .R .,Cl AK 0930L • PHORF (907)3374179 ! FAX O7)338-374.
10/3/2000
K.D.W.
1"=40'
RAY AND MARGIE PRICHARD (907) 345-00432 OF 4
LL DESCRIPTION:
LAKE RIDGE TERRACE SUBDIVISION; LOTS 9 & 10, BLOCK 3
OF WORK:
DESIGN OF SEPTIC SYSTEM UPGRADE (ADVANTEX)
EXISTING SEPTIC
-EXISTING SEPTIC SYSTEM TO
BE USED AS A RESERVE SITE.
LOCATIONS ARE APPROXIMATE
TANK TO BE
COMPLETELY
ABANDONED
7.777-71��.
•.
-EXISTING SEPTIC SYSTEM TO
BE USED AS A RESERVE SITE.
LOCATIONS ARE APPROXIMATE
9PP0RTA5REQIA
I' or arm WA4fD
5`NER DRAA=.
PROPOSED GRAINFIELD. EXCAVATE A
TRENCH THAT 5 ONE FOOT BELOW
F'�' ORIGINAL GRADE. BY 5 FEET WIDE. BY
45 FEET LONG. ADD ONE FOOT MINIMUM
OF SAND. AND 0.5 FEET OF CLEAN.
FUER FAXIC
r -T' NRLATIQN
EXfAVATEOUFN.L
QFCvH.1C5. Am A" PERFORATED DP FFM Vft T' OF
A MALML'M OP I' DFAIN?LL'X OVER TOP OF PPE AkV
OF 5w 6" OF DMAARA7.INTER hE FPE.
%1� SLQPE
10/3/2000 0 ► �p
LASKA «ATKR & «A DRAWN BY:
A
' f r [� � � WASTE
CONSULTANTS, INC.
6001 OEBARR ROAD. $lX7E n' ANCHORAGE. AK 995M+PONE H 001)371 -0I]0 + FM(907)336-3246e-!]LO N.T.S.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RAY AND MARCIE PRICHARD (907) 345-0043 3 OF 4 QQ m : fr A. arnes-
LEGAL DESCRIPTION: Q $� ' E-7953
LAKE RIDGE TERRACE SUBDIVISION; LOTS 9 do 10
TYPEPROFILE VIEW OF PROPOSED TRENCH 44��D0000��oo�
AdvanTex Treatment System s NOTE: THEOSS
ADVANTEX MANUAL
AX Series - Mode I C9
c• "e9
Three (3) 34x48 Pods `r
THE BOARD INSULATION TO BE
INSSTTALLLL•ED CHER THE SEPTIC TANK & 4'
BEYOND ON ALL SIDES EXCEPT UNDER
THE ADVANTEX FILTER. THIS WILL ALLOW
FOR HEAT TO ESCAPE FROM TANK &
RISE TO THE FILTER ABOVE R.
INLI
FILTERS CONNECTED
TOGETHER.
THE TANK SHALL BE SIZED PER ANCHORAGE TANK FOR A THREE BEDROOM HOUSE
TOP OF TANK A
INLET - 96.81
Y n+wunoN�l[�
INLET
INVERT OF BUNG—/
AT INLET - 98.31
FINAL GRADE
- 99.0 + FASSK AM K0(T
M9AA= F809" M05
i 1500 GALLON C MIN.)
Ak 5SEPA"
4e
7
10/3/200
if _.. _f'. _ I DRAWN BY:
ALASlU «TATER & `VASTI:WATER SCALE. K.D.W.
CONSULTANTS, INC. N.T.S.
6901 OFBARR ROAD, WTE 28 • ANCIIORAGF, AK 99504' "40NE 907).557'6179 • FAK 9072358-526
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
RAY AND MARGIE PRICHARD (907) 345-0043 4 OF 4
LEGAL DESCRIPTION:
LAKERIDGE TERRACE SUBDIVISION; LOTS 9 do 10. BLOCK 3
TYPE OF WORK:
PROFILE VIEW OF PROPOSED TRENCH AND ADVANTEX SEPTIC TANK
L'I1iPH
EFFLUENT
PUMP
OF TANK AT
ET - 96.73
1
1
THE AX -10 PODS
SHALL BE PLUMBED
SO THAT THEY CAN
EACH BE ISOLATED.
j ..:
-C ••0lS9!
C 7953
..• •' .�oQ�,
0
PrOfee sl0naa
j
�
�''n\ TT��1 �1�LJ ENGINEERING
20441 PTARMIGAN BLVD. �~~
EAGLE RIVER, AK 99577-8736
0�,.C'
49M • %'f
71
SOILS LOG - PERCOLATION TEST D�"• Q/7c/fib
Performed for:
-Rr' -1 �,��� Date Performed: G�u ,, , ;
Legal Description: %u k[ ✓� d4c Te ma[ -en 3f k � Lee 4- 9 TEST HOLE s %8
Lepcn /
(Feet) as4a"/"" r7kT
2-
3- 1 �
4 C; /ay
5- J
Ia
7-
$iown, /oaJe'
s- Sme4e'j $-7
9-
10-
>3o N
11-
12-
13-
14-
15-
16-
17-
is-
19-
20-
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Groundwater encountered?— What depth?.5
Deoth to water after monitoring? L Date —16,12418
Reading
Date
Gross
Time
Net
Time
Net
Drop
2
/1.00/q
'03
oDeh
Wo1
-
9 (o
2-—
3
/:34/zo
/� /Ni'
✓ 7/roy
4 rro M
/2
/I:SS
/�nlih
•`' /o
Percolation Rated (min/in) Perc Hole Diameter_
Test Run Between - 5 feet and /• 5 feet
1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date: 51VA5
Sent By: Alaska Water and Wastewater Con; 907 338 3246; Oct -4-00 11:49;
• V. VV ♦V.. VY.VV •.,., YVIY�Y,. VV V,Y.• ....`.,.V.`M...`....• J` --
Municipality of Anchorage
Department of Health and Human Services
825 OU Street
P.O. Box 198880 Anchorage. Alaska 99519.6650
bryrJMww. da rrhora9a. dcus
Dear Homeowner/Prospective Buyer.
Page 1/1
The on-site wastewater disposal system you are purchasing/installing is an "alternative" wastewater
disposal system. This system, known as an AdvanTex Treatment System Septic System:, is
undergoing testing within the Municipality of Anchorage under the Alternative System section of the
Wastewater Disposal Regulations (AMC 15.65). There are certain risks involved with the ownership
of one of these systems:
1. The technology used in this system has been shown to be effective in other areas. The system
is currently undergoing a two-year testing period in Anchorage under the guide= of the
Department of Health & Human Service$ (DHHS) and the State of Alaska Department of
Environmental Conservation (ADEC) to determine its effectiveness in a subarctic environment.
2. The system for this property received a vertical separation distance waiver fiom both the State
of Alaska and Anchorage Municipal Codes to ground water. This waiver was granted due to
the system's expected performance within the site conditions on this property.
I (we) certify that I (we) have read the above statements and am(are) aware of the risks outline. I (we)
also certify that I (we) am (are) in the process of purchasing (property legal description):
LOT 10, BLK 3,5 LOT 9, BLK 3 LAKERIDGE TERRACE EAGLE RIVER ,ALASKA
RAY A. PRICHARD
urebaser N (Purchaser Name)
orthaser tvm=) (Purchaser Siouan)
Notadu: Below
State of�
On � day of C 2019
_ personally appeared before me,
V/ who is personally known tome
whose iderrity 1 proved on the basis of
whose Identity 1 proved on the oathhlinmarion of
a credible witness to be the signer of the above docomeat, and hels ow a si c
— - (Notary Public Signature)
(Notary Public Printed Name)
My commission expire 615- 02
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
ANCHORAGE RECORDER'S OFFICE
550 W 7TH AVE SUITE 1200
ANCHORAGE AK 99501-3564
(907) 269-8899
REC DATE RECEIPT NUMBER
10/17/2000 1478370
BANK CD/CHECK NUMBER: 2108
RECEIPT DESCRIPTION
RECORDERS OFFICE FEE
CASH AMOUNT:
0000 RECEIPTED AMOUNT:
$0.00
$23.00
SERIAL NUMBER INFORMATION
YEAR:2000 BEGINNING NUMBER : 52486 ENDING NUMBER : 52486
BEGINNING BOOK :3708 PAGE NUMBER :206 ENDING BOOK :3708 PAGE NUMBER :20
RECORDING FEES $21.00 FILING FEES
COPY FEES CONFORMED COPY FEES
PLAT FEES CERTIFICATION FEES
MANUALS OVER SIX NAMES FEES
NON REFUNDABLE UNAPPROVED FORM FEES
OTHER FEES PLAT COPY FEES
COPY SEARCH FEES INFORMATION SEARCH FEES
MICROFICHE COPY FEES
REMITTER: RAY A PRICHARD
12790 OLD SEWARD HWY UNIT B
ANCH AK 99515
COMMENTS: D/EASEMENT R&M PRICHARD
RECEIPT - DO NOT PAY
NOTE: ORIGINAL RECORDED DOCUMENTS WILL BE RETURNED FROM
MICROFILMING IN 4-6 WEEKS.
$2.00
,ice sai:
BK 03708PG0206
DEED OF EASEMENT
Grantor RAY PRICHARD and MARGIE PRICHARD, Grantor, of 12790
Old Seward Highway, Suite B, Anchorage, Alaska 99515, hereby grants
to Grantee, RAY PRICHARD and MARGIE PRICHARD, of 12790 Old Seward
Highway, Suite B, Anchorage, Alaska 99515, a certain easement with
respect to the following described real property:
Parcel 1 - Burdened Property
Lot 9, Block 3, Lake Ridge Terrace Subdivision, Anchorage
Recording District, State of Alaska
Parcel 2 - Dominant Property
Lot 10, Block 3, Lake Ridge Terrace Subdivision,
Anchorage Recording District, State of Alaska
1. SEWER and DRAINFIELD EASEMENT. Grantor grants to Grantee, his
heirs, successors and assigns, an easement for installation,
access, repair and maintenance of a septic and drainfield on and
across Parcel 1; said easement being conveyed for the use and
benefit of Parcel 2; the users of said easement assume all risk of
use, releasing the other user. Said easement is more particularly
described in the attached Exhibit 1.
2. DURATION OF USE. Grantor grants to Grantee, his heirs
successors and assigns, a continuing and uninterrupted right to the
easement until such time as a community or municipal sewer system
is installed adjacent to Parcel 2 and made available to the owner
of Parcel 2. At such time as the municipal or community sewer
system is installed, then this easement shall terminate within 18
months of the date that such system is made available to Parcel 2.
Termination may be effected by the filing of a notice of vacation
of easement by either of the owners of Parcel 1 or Parcel 2 at the
end of the 18 month period noted above.
DATED is
_1 day of October, 2000.
in
10/13/00 FRI 09:53 FAX 907 345 0247 DIOMEDE 12)003
BK03106PG0.201
Ll� TOOL
1 L__-_-- ---
--
-- -----a -- ---r— ---- --- I f ------ ------
E14STRW Nou I
II I mum" 1TEM. se
Lm 14A2A.. 3. OU"
I $
tAun 3. TERM
Lm a 9LOCK turB� Rmc sa F#,=
2 O!' 3 roll newts. � 1 1
- - - - - - - - - - \
I 1 1 ! I 1
• 1 L / / T
I I
UIwu= IOtR. s/9 ► I / !
LOT 4. MACu R. L%
\ `\
•• Ste/ % %
1\`` 111==K
x3!/D IDT 4. MDC),f ��/ K IAKEm000 TOM. S/O /
I �i 7••C� tA. MOCK S.
• / /
_/ /
CAM
FN' •rl� 10/3/2000 Q i�
• _
ft
ALASKA WATER & WASTEWATER ,G,L K ' moi;'
CONSULTMITB.MIC.•---�-�• 1. s 100• •• •• ......L"ns••
Lutes • rpeow7/ • Pat
PHM TRAetR VACS NL%URX .... ...:.. ' •'
IOR ...
RAY t MAROIE PRICHARD (907) 343-0043 1 OF 4 r A.
LtwL OmmwnR-7953 ,•f�
LAKE RIDGE TERRACE S/D: LOTS 9 t 10, BLACK 3. ,' •...,.. .. •''' ;
PC 61f Wft5. ~�qbe
S M PLAN..FOR ; DESIGN OF'S&M SYSTEM UPGRADE (ADVANTEft)
EXHIBIT
PAGE . OF 2
'
JAMES WAY
_—
--- ------
cim
4Lw
I
LA VIXIM nM. s�O
IAKEIWCE 1[RR, S/0
LOT 7. MDCK3�-
a. A= J.
--++`
ULm fx
IDT !. MACK ].
0.
i
`+++ �
e
�`♦
Ll� TOOL
1 L__-_-- ---
--
-- -----a -- ---r— ---- --- I f ------ ------
E14STRW Nou I
II I mum" 1TEM. se
Lm 14A2A.. 3. OU"
I $
tAun 3. TERM
Lm a 9LOCK turB� Rmc sa F#,=
2 O!' 3 roll newts. � 1 1
- - - - - - - - - - \
I 1 1 ! I 1
• 1 L / / T
I I
UIwu= IOtR. s/9 ► I / !
LOT 4. MACu R. L%
\ `\
•• Ste/ % %
1\`` 111==K
x3!/D IDT 4. MDC),f ��/ K IAKEm000 TOM. S/O /
I �i 7••C� tA. MOCK S.
• / /
_/ /
CAM
FN' •rl� 10/3/2000 Q i�
• _
ft
ALASKA WATER & WASTEWATER ,G,L K ' moi;'
CONSULTMITB.MIC.•---�-�• 1. s 100• •• •• ......L"ns••
Lutes • rpeow7/ • Pat
PHM TRAetR VACS NL%URX .... ...:.. ' •'
IOR ...
RAY t MAROIE PRICHARD (907) 343-0043 1 OF 4 r A.
LtwL OmmwnR-7953 ,•f�
LAKE RIDGE TERRACE S/D: LOTS 9 t 10, BLACK 3. ,' •...,.. .. •''' ;
PC 61f Wft5. ~�qbe
S M PLAN..FOR ; DESIGN OF'S&M SYSTEM UPGRADE (ADVANTEft)
EXHIBIT
PAGE . OF 2
10/13/00 PRI 09:57 FAX 907 375 0277
UlU3EUE '� 10002
BK031.08PG020B.;
40 Amt Lig TO TROCLIMC m7m
' MINIMI OLWOL AND IdURATL W7TN
/ 2' WIC OWD INSUTAT" 71MT is
RAIrWItE75lm TWM mummtma Im Oft Tm
LOT 0 1 r'S 6� � aT is Ow .tel NU wll LOT 10
\PUTNo APO ERIC !t>e'r a /
\IpY1�11Q CIA
OCrEffR. � rACK 3 0!
\ 70 @41ALLIADICH
COMPLETELY
JMIDIA�'P �I
TEST HOU ONTWO
Pr_ owmi
6/22/00
PC
r ! AOM
MND
WSULL t01/1OM71T
MOUSOL ONO
t PVC
uuAS XCONAM \ t
PROPOSED 1500 GMIOW I \ \ ` ".••
S.TLP. TANK AND ADWMa�Q � I GAWC
Ir—
TLTWAMsa R"M Ow" W" FLO
. TOM IN or . rDA OQAIt 70 OIMnw4
arrAmm
/r^--�\ ..r �.i:: �. L' is :=��•I 1t
f /
r:nrrG��/G!NE- .mil •' �
sueq��!�7ALS SMap:2OVE SAM -0
BL SPRUCE LANE APPROVED A5_b T`5f, —�
- --'�•7CN pI oup, REr:_)FIA1T .
1
ALASKA WATER & WASTEWATER
K.D.W.
�`.
.r..�..� CONSULTANTS, INC. •-•�^'^�
�; 40'
...:.
.. .......:"
• [ •
141H • rY
MUYOER:
P
, ••• ••••�••
MOMO ITlIt PIIOIIE
RAY AND YARWE PRICHARD
(907) 345-0043
2 Or 4
�'t
r y A.,
LEGAL 000FIF110
LAKE RIDGE TERRACE SUBDMSION;
LOTS 9 t 10. BLOCK 3
. '' • .•'
,•,••.
•+hWIN
•
or BOOL
DESIGN 'Or%SEPTIC-SYSTEM UPORADE (ADVANTE*
0 5 2 4 8'6 `�
2000 OC 17 Ali 10:16
EXHIBIT.=_
H011CRAGE U'
REQUESTED BY '
PAGE2- OF
2-
RECQRDICG DISIRICT
_ '
""—
GREA."\R ANCHORAGE AREA BOR( GH
�flll�s Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME /!y' �F �P CL MAILING ADDRESS PD 1�3ox 9�9 ellKs4k ##S PHONE -777-1'179
LOCATION LEGAL DESCRIPTION �QT /0 0ce0Afre /'Ipfe, TP.',Iee
SEPTIC TANK:
DISTANCE-�7 f . NUMBER OF
FROM WELL MANUFACTURER - MATERIAL 44411elerc COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY_kc GALLONS.
TILE DRAIN FIELD: s°/sr'y �vST7L<<D
'
,` - , TOTAL LENGTH,
DISTANCE FROM WELL AQ_FOUNDATION �f' NEAREST LOT LINE OF LINES J
a-F3L..
NUMBER OF LINES7DISTANCE BETWEEN LINESi; � H
>/ TRENCH WIDT. IN. TOTAL EFFECTIVE
ABSORPTION AREA �Il SQ. FT. LENGTH OF EACH LINE Y3/ X 51/7 M )a3
DEPTH OF FILTER �/
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILEIN. ABOVE TILE IN.
WELL: //��*,
TYPE✓0lel��V CONSTRUCTION SrI%V12'¢4eU' DEPTH �DISTANCE FROM:
BUILDING NEAREST NEAREST
FOUNDATION 10e. LOT LINE 30 . SEWER LINE
CESSPOOL -11'4.
APPROVED
DISTANCES
INSTALLED BY:
SEWER LINE DEPTH:
OTHER SOURCES
DISAPPROVED REMARKS
PIPE MATERIAL:
LOT SLOPE:
REMARKS:`Uell/
re 3 / �a3 r• /%' 7//73.
Form EQ -032
SEPTIC ;0 SEEPAGE i
TANK 73 .- SYSTEM-
0087f
YSTEM
DIAGRAM OF SYSTEM
DATE &27,4�p APPROVED
G.A.A.B.
H
Y
In
%
3
I�CSj).
A
r
M
�
T
esu
•
`'•
4-
DATE &27,4�p APPROVED
G.A.A.B.
�[ R ANCHORAGE AREA BOROUGH iIw
Uv \
PARTMENT OF ENVIRONMENTAL OALITrrJ E MIT N
i 4
q ]0 "C" STREET ANCHORAGE, ALASKA 993
f e \ TELEPHONE 214.4561
:fid QF _.,
WA DISPOSAL SYSTEM — APPLICATI D PERMIT 1.3o
NAME OF APPLIt A� �"Q'G MAILING AD E P�E 2-
+�-'--ZLk
INSTALLATION LOCATION
LEGAL DESCRIPTION 'G / /n
T�"'�x
INSTALLATION OF; SEPTIC TANK � BE 'AG IT AIN FIELD � O MER
TYPE AND 612E OF FACILITY TO BE SERVED
FINANCED THROUGH TO TALL 1 BY
SOIL TEST RESULTS �"J OTE, T P IIS NOT VALID WITHOUT SOIL TEST
♦COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR 41OTICE R IR D. BACKFILL OF YSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF
ENVIRONMENTAL OU ITY ,rte H/ORITY W BE U(Al c�_{`F•.�TO PROSECUTION. ,,J//�n
SEPTIC TANK SIZE �L o�� TYPE 1!! ^" i� SE AREA SIZE �1CLL'�5.� TYPE C/ ����
MINIMUM DISTANCES. REOUIREMENTS
r
FOUNDATION TO SEPTIC TANK
-7/
FOUNDATION TO SEEPAGE �1T
SEPTIC TANK TO SEEPAGE PM WAIL
- "�
SEPTIC TANK _—�*TAN";f�--
DRAIN
TO NEAREST LOT LINWELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIFIELD
SEPTIC TANK. SEEPAGE P/ —
TO RIVER. LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
V
N FIELD _ a
GE il•i• 0
CONSIDERAREAWELLS.
EEPAGE�PTY.
DRAIN FIELD 14122'
CRIB CROSSING GAP OF
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPT 7, TANK AND SEEPAG71T
FITTED WITH AIRTIGHT REMOVABLE CAPS. \\\
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALL1011. N. �[1
G.A.A.U.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
F
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AN T OVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I
DALE` U 'u 9 1 I� APPLICANT'S SIGNATURE m�S'�.;� Zt ` /1
FORM NO. EO -01 6
ui
J
�
I
4
Sol■■■■
■
f■.■E■■■■■
■�
, fid,
■
F
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AN T OVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I
DALE` U 'u 9 1 I� APPLICANT'S SIGNATURE m�S'�.;� Zt ` /1
FORM NO. EO -01 6
.001A it i 6011 U Lli', i KION'•ILi'.. �,u QJ AL J i Y CASL I
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
Performed For James Polyefko Date Performed July 2, 1973
Legal Description: Lot 10 Block 3 Subdivision Lake Ride Terrace
This Form Reports Soils Log xx 1'erco anon est
Depth
Feet
2'
4
6.
Soil Characteristics
sandy silt 2 71 'ML
Gray silty gravel' GM
with 6" seam of clean sand
Was Ground Water Encountered? No �o
P
If Yes,•At What Depth?
Reading Date
I
Gross Time I Net Time iDepth to H2O Net Drop
,
rercoiation ►tate minute
Proposed Insta ation: Seepage Pit xx Drain Field
Depth Of Inlet Depth To Bottom Of Pitr -Trench
ench_
COMMENTS: 210 sq. ft. of drainage area is required per bedroom.
lest Performedy R. E. Carlisle Data Certified By:
ALASKA mi\FR At R ►..ten-cnra* e * An' m777 Date: tuly 3. 1973
Municipality of Anchorage MAT
• Development Services Department
Building Safety Division + ;
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 05,11-q`151-114 HAA # 04406-71
Expiration Date: Ll- — S' O
1. GENERAL INFORMATION
Complete legal description Lake Ridge Terrace, Rlpck 3, Late 9 & 10
Location (site address or directions) 17719 Blue Spruce Lane,FaglA River, AK 99577
Current Property owner(s) Robert & Theresa Wick Day phone
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
Day phone
2. NUMBER OF BEDROOMS:
_3
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 KND FNrINFFRING, Inr_ Phone (407) F;c)f;-I;l 11
.. a ...
Engineer's Printed Name __Kenneth M_ Duffi is Date 17129104
Engineer's Comments:
This Investigation was completed in compliance with '
ADEC and MOA regulations. The assessment of the
condition of the well and septic applies only to the
conditions as of the day tested. The flow and absorption
rates may change due to subsurface conditions that
may not be observed from the surface, changes in
land use, local soil characteristics, groundwater levels
that may fluctuate during the year and the water usage
of the family being served by the system. The operational
life of all well and septic systems are subject to these
various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system.
Therefore, KND can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can KND guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
5. DSD SIGNATURE
Approved for 3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
r.. 0.,�_
Z
ATER AND
WA"— SIEVPAItK
PROGRAM
o '
X Maintenance Agreements J1JTSEv:.
Supplemental Engineer's Report
Other
By:C%���'OLZ: Original Certiricate Date' — .S ' 0 6,
ryir' t/�ir%;
1-0-r- C?
I ".7o .
AS -BUILT
LcT 10
1 hereby certify that 1 have suryyed the following described
property: L v �. E� /�� 3
L o -1�_. R:.I,y' _•• `, ;r -r r s r_t_ '�U 1.
.:
Anchorage Recording Precinct, Alaska, and that the improve-
I..-
ments situated thereon are within the property lines and do not
K rt ;
overlap or encroach on the property lying adjacent thereto, that
•. �: ;; .,•, +.� ''-''1
'`.'. `Qr
no improvements on property lying ad'acent thereto encroach
s ti -
on the premises in question and that t�ere are no roadways,
transmission lines or other viable easements on. said property
except as Indicated hereon.
Gr
Dated at Eagle River, Alaska
thisayo( 3i4N,, fg2.aDLi
ROBERT C. JOHNSON Rr�• .
SCALE: Registered land Surveyor No. 88O -LS
30' Box 77-0456, Eagle River, Alaska 99577
Phone (907) 694-2543
a` , t rn �! art � L'• ' • ;+,p, -
'fl .i>�•r.'• L i{�^: V'.A Niter.
si
Fr..i1 c{..e�kl:rarie.aa•'
AS -BUILT
A hereby certify that I have aurveyee t?he following described
property:-� O '
'Anchorige'Recording Precinct, Alaska, and that the improve•
ments situated thereon are within the Property lines and do not
overlap or encroach on the property lying adjacent thereto, that
no Improvements on property IvfngR adjacent thereto encroach.
on the premises In question and. that there are no roadways,
transmission lines or other visible easements on said property
except as Indicated hereon..
Dated at gle River Alaska
this Z day ni_wk) ]a'
RO�[tiKTC,JOil\SON' [�
SCALE: Registered I and Sun•evor hu.
&ry 7740456, Eagle River, Alaska 995:,
Phone (9(Y•) 694.25.17
.I
lip iCll
t
;•
•j
1
1,
t,i
a` , t rn �! art � L'• ' • ;+,p, -
'fl .i>�•r.'• L i{�^: V'.A Niter.
si
Fr..i1 c{..e�kl:rarie.aa•'
AS -BUILT
A hereby certify that I have aurveyee t?he following described
property:-� O '
'Anchorige'Recording Precinct, Alaska, and that the improve•
ments situated thereon are within the Property lines and do not
overlap or encroach on the property lying adjacent thereto, that
no Improvements on property IvfngR adjacent thereto encroach.
on the premises In question and. that there are no roadways,
transmission lines or other visible easements on said property
except as Indicated hereon..
Dated at gle River Alaska
this Z day ni_wk) ]a'
RO�[tiKTC,JOil\SON' [�
SCALE: Registered I and Sun•evor hu.
&ry 7740456, Eagle River, Alaska 995:,
Phone (9(Y•) 694.25.17
.I
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0511-1111-114
1. GENERAL INFORMATION
g,o •J 1..i de
<z
C' fir'
HAA # NUP1.1
Expiration Date: 3 ` A I - OS
• • - -•. •- • .•1.4 •T -To . 1 PTA 9 k 0 991M1
Location (site address or directions) 17719 Rlue BlueSpruce Lane,Fag-le River, AK 99577
Current Property owner(s) Robert & Theresa Wick Day phone
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Day phone
205 E Benson Blvd.. Anchorage, AK 99503
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
❑
CommunityClass 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 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 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.
'•• �' a •.� . .. ..
Engineer's Printed Name -Kenneth M ntiffue Date 12122/04
Engineer's Comments:
This Investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the
condition of the well and septic applies only to the
conditions as of the day tested. The flow and absorption
rates may change due to subsurface conditions that
may not be observed from the surface, changes in
land use, local soil characteristics, groundwater levels
that may fluctuate during the year and the water usage
of the family being served by the system. The operational
life of all well and septic systems are subject to these
various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system.
Therefore, KND can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can KND guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
X Conditional approval for 3 bedrooms, with the following stipulations:
attached maintenance agreement which shall be returned to this office
before an unconditional approval is issued.
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
BY: n �• �� �P "� Original Certificate Date: )L 2 `�
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal DescriptiA L7 0 Parcel ID: 051-313-1
4
A. WELL DATA
Well type-MLYM if A, B. or C provide PWSID # Well Log (Y/N) N
Date completed 8/1975 approx.-Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 138 ft. Cased to -4D*—Jt. Casing height (above ground) 1 8'
FROM WELL LOG AT INSPECTION
Date of test 12121104
Static water level ft• 1 1 6 ft.
Well production 9 -p -m 5.67+
9•P•m.
WATER SAMPLE RESULTS:
Coliform __Q_colonies/100 ml. Nitrate 0.724 g.A. Other bacteria _0 coloniss/100 ml.
Arsenic: _1 mg.A. Date of sample: 12/17/04 Collected by: KND Engineering
B. SEPTICIHOLDING TANK DATA
Tank Type/Materiat PST�/STEEL Date installed 10/18/00 Tank size 1500 gal.
Number of Compartments 2 Cteanouts (Y/N).X
Foundation deanout (Y/N) depression over tank (Y/N) N High water alarm (YM) Y
Date of pumping 12/22/04 maintenance/not _pumped Pumper A+ Home Services, Inc.
C. ABSORPTION FIELD DATA
Date installed 1 O/20/00 Soil rating (g.p.d.Ae or ft lbdrm) _Z.QSystem type TRENCH - Advantex
Length 45 ft. Width S ft.Gravel below pipe 0.5 ft.
Total depth 3.233.48 ft. Eff. absorption area 22.5_fe Monitoring tube Y Depression over fteld N
Date of adequacy test 12/21/04 Results (Pass/Fall) PASS For 3- bedrooms
Fluid depth in absorption field before test 0 fdrvt in. Water added 510 gal. New dept LSA in.
Elapsed Time: 1440 min. Final fluid depttL 0 LIIW in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) N if yes, give date
D. LIFT STATION
Date installed 10/18/00 Size in gallons 1500 Manhole/Access (Y/N1 Y
`Pump on' level at Timer in. 'Pump off" level at Timer in. High water alarm level at 411in.
Datum Bottom of tank Cycles testeQZ_ Meets alarm 6 circuit requirements?—Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAifl station on lot 100'+
Absorption Held on lot 100'+
Public sewer main 75'+
On adjacent lots _ 100'+
On adjacent lots 100'+
Public sewer manhole%learlout 10 0 1 +
Sewer /septic service line 251+ Holding tank 10 0'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line _5_' + Absorption Held 5' +
Water main 10'+ Water service line 10'+ Surfacewater 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, park)ngivehide storage 10 1 +
Curtain drain 50'+ Wells on adjacent lots 100'+
F. COMMENTS
Absorption Held _surcharged w/ 1500 gallons on 12/20/0: thouse vacant for 7 months)- Advant Y
System/Lift Station serviced by A+ Home Services. Inc.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field Inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Kenneth M. Duffus
Date 12/22/04
HAA Fee S430.00 +116-0
n
Date of Payment
Receipt Number 10
(Rev. 12(01)
Waiver Fee $
Date of Payment
Receipt Number
X« Olh M.
CE 711
V,
9'
S�Ir�fn
lit, t 0 Fr cr rex t
rex
/YOU J.1t.
s
4.� m
I
lEsck<1•,
j—
Df7 t v--,
It,
rt
AS•BUII.T
1 hereby certify that I have sumeyejthe following described
property:l.oi' /O, f.��c__ c• Y <� .
Anchorage Recording Precinct, Alaska, and that the improve
itu
ments sated thereon arc within the property lines and do not
overlap or encroach on the property lying adjacent thereto, that
no Improvements on property lying adjacent thereto enrnoach
on the pn•mises in questum and hoar there are no roadways.
transmission lines or other visible easements on said property
except as indicated hereon.
Dated at Eagle River, Alaska
this Z `- day of— 4e 19.��
SCALE: RU ERT C. )U)LNSnki a.g� �[(�� e
1„ I Registered Land Surveyor No. ha4�LS
"3 O WX 77-)456. Eagle River, Alaska 99577
Phone (907) 694-2543 ,
p/ u{
J$aWsr-
r
LoIr t?
I hereby
i
4
AS -BUILT
that'l have suryyad the following described
r Y. 8 /oe- l< i
i -]- A & 4 G 9" I S—N R 2 W S M
Anchorage Recording precinct. Alaslu, and that the Improve-
ments actuated thereon are within the property lines and do not
overlap or encroach on the Property tying adlaoent thereto, that
no Improvements on property Id gad attnt thereto encroach
on the premises in queanon and that trere are no roadwa"
. trarumisscon Bnea or other visme easements on saki property
txeept as indicated hereon.
Dated at Ea ]a River, Alaska .
l2- day o��„a_rei, tl20oC
SCALE. ROBERT C. JOHNSON .�N,
1„ Registered Land Surveyor No: LS
�O
Phone (M (M6 �Rhyer, Alaska 99577
■I
MCS
' MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES M}i
Division of Environmental Services
_
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519.6650
(907)343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
Parcel I.D. # 051-313-14 HAA # Al R C'1' �r
1. GENERAL INFORMATION
Location (site address or directions) 17719 SLUE IF SPRUCE I ANF EAG1117 RIVER- AK 99577
Mailinq address
Lending agency
Day phone
Mailin,c
kTent aY W/ REMAX PROPFRTIFS D.(007) 694-2761
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site xxx
Holding Tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
ing to the legality and status of system.
72-025 (Rev. IM) Front MCA #21 Computer Version
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid 51,500.00 at,.
or prior to, closing for the engineering services provided.
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 of this Health Authority Approval application shows that the on-site water supply and/or
wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of
structure Indicated herein. I further verify that based on the Information obtained from the Municipality of
Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater
disposal system Is In compliance with all Munlcip I and State codes, ordinances, and regulations in effect
on the date of this inspection. 4`
Name of Firm
Address
Phone (907)337-6179
Engineer's Signature 1l Date 11 Aa:
In conducting this evaluation, AK=, Iryc. ttempte rovide a thorough, conscientious engineering analysis of the
system In accordance with ADEC and MO 6j hS Guidelines & 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, ground water levels that may fluctuate during the year, and the
usage of the family being served by the system. These conditions are outside the control c
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.
All=, Inc can therefore not provide any warranty for future estimate of how long the
system will continue to meet the operational requirements of the ADEC or MOA DHHS.
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 tight whatsoever.
6. DHHS SIGNATURE
Approved for 3 bedrooms
Disapproved
Conditional approval for
Additional Comments
M
bedrooms, with the following stipulations:
Date 1I—��-00
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.
72-025 (Rev, 1191) Back MOA 921 Computer Version
RECEIVED
Municipality of Anchorage 15 2000
DEPARTMENT OF HEALTH & HUMAN SERVI09
Environmental Services Division
825 wV street, Rm 502 Anchorage, Alaska 99501 (90'QliMtiil4$VOF ANC
HORA
ENVIRONMENTAL SERVICES D
Health Authority Approval Checklist
Legal Description: LAKE RIDGE TERRACE: LOT 9 do 10. BLOCK 3. Parcel I.O.: 051-313-14
A. WELL DATA
*PER 8/27/1975 INSPECTION REPORT
Wen Type PRIVATE If A. B. or C, attach ADEC letter. ADEC water system number N/A
Log present (YM) NO Date completed *APPROX. 8/1975
Total depth 0138* Cased to 40'+ Casing height (above ground) 18"+
Sanitary seal (YIN) YES Wires property p (Y/N) YES
Date of teat
Static water level
Well production
0 0 0 92—'T01TWI131N[�.'c�
AT INSPECTION
9/5/2000
115'
g.p.m. 7.0 +/— g.p.m.
WATER SAMPLE RESULTS:
Conform 0 Nitrate 1.14 ma/L Other bacteria 0
Date of sample: 11/1/2000 Collected by: A.w.W.C.. INC.
B. SEPTICfHOLDING TANK DATA *THIS IS AN ADVANTEX FILTERATION SYSTEM.
Date instaned 10/18-20/00 Tank size $1500 Number of Compartments 2 Cleanouts (YIN) YES
Foundation deanout (YIN) YES Depression (YIN) NO High water alarm (YIN) YES
Date of Pumping NEW Pumper
C. ABSORPTION FIELD DATA
*THIS IS AN ADVANTEX FILTERATION SYSTEM.
"BELOW FINAL GRADES
Date installed 10/18-20/00 Son rating (j�or fMftrm) *2.0 System type TRENCH
Length 45' Width 5' Gravel thickness below pipe 0.5' Total depth **3.23'-3.48'
Effective absorption area 225 SO.FT. Monitoring Tube present (YM) YES Depression over field (YIN) NO
Date of adequacy test NEW Results (Pass/Fall) — For 3 Bedrooms
Fluid depth in absorption geld before test On.); — Immediately atter — gal. water added (In.):
Fluid depth — (Ins) Minutes later. — Absorption rate' —
Perordde treatment (past 12 months) (YIN) — if yes, give dal —
72-Q25(RW.3WCWWAWVffWW
D. LIFT STATION
'THIS IS AN ADVANTEX FILTERATION SYSTEM.
Date Installed 10/16-20/2000 Size to gallons '1500
Manhole/Access (YIN) YES •Pump oW level ar TIMER pump Or level at- TIMER
High Water alarm level at* 46' —*Datum BOTTOM OF TANK
Cycles tasted NEW
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
SepUdholding tank on lot 100•+ On adjacent kris 100•+
Absorption field on krt 100,+ On adjacent kris 100•+
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer/septic serve one 25'+ LIR station 100'+
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Foundation 5•+ Property line 5•+ Absorption field 5•+
Water malNseMce line 10•+ Surface water/drainage 100'+ Wella on adjacentkris 100•+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
Property one 10•+ Building foundation 10'+ Water malNseMce one 10'+
Surface water 100•+ Driveway, parkingivehicle storage area 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. ENGINEER'S
I car* that I I
orMuMdpal rlry
with MOA U4
Engineers
it
o�
HAA Fee S
field Inspections and review
systems are In conformance
on this date.
Date of Payment — �'� — a v \
Receipt Number4 G A/ / 9 ��/ca l
72-M OW. 3W Comp Aw V w w `T
Walver Fee
Date of Payment
Receipt Number
l yd Ameee'
CE -7933
j4�rNEVf/ /74, P6
"HORAGE
• DEF •11 j,t ' 'c or•: f•..d<� HUMAN
M AN SERVICES
tion
Cts 6 / c 1 iska 99519-6650 "
I AUTHORITY
APF MILLY DWELLING
Par cel l.D.# 051-313-14 • HAA# HA 00oX-6 r
0/0101
1. GENERAL INFORMATION
Complete legal description JAKE RIDGE TERRACE SUBDIVISION- LOT 10 BLOCK i
Location (site address or directions) 17719 BLUE SPRUCE LANE EACIF RIVER AK 99577 -
Property owner RAY & MARGIE PRICHARD Day phone (9 7) 345-0043
Mailing address 17719 BLUE SPRUCE LANE EAGLE RIVER AK 99577
Lending agency Day phone
Mailing address
Agent RANEY W/ REMAX PROPERTIES —Day phone (907)_694-2761
Address 16600 CENTERFIELD DRIVE EAGLE RIVER AK 99577
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
3
xxx
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 xxx
Holding Tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
ing to the legality and status of system.
72-025 (Rev. 1191) Front MOA #21 Computer Version
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 oulrned In the Health AuthorltyApproval Guidelines for this application,'.
shows that the on-site water supply and/or wastewater disposal system !s(are) safe, functional and adequate
for the number of bedrooms and type of structure Indicated herein../ further verify that based on the
Information obtained from the Munidpairty of Anchorage riles and from my Investigation and Inspection, the
on-site watersupplyand/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 Finn ALASKA WATER & WASTEWATER CONSULTANTS, INC.
Address 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY A GARNESS, P.E.
Engineer's Comments:
in conducting this evaluation, AWWt , Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidollnes 6 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 readiytdontiriable features. The opera tionalllfo of a.11 wells and
septic systems depend on the tical soils condtion, groundwater levels that may .
fluctuate during fire year, and the water usage of the familybeing 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 encroa chmon is. AM%V, Ina can therefore not provide
any warranty or &lure estimate of how long the system will continue to meet rho
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 h confor any legal tight whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the filowing
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Phone 337-6179
Date
Manitenance Agreements
Supplemental Engineers Reort
Other
ON-SITE ••�,��
WATER AND
WASTEWATER
PROGRAM
By:- Original Certificate Date: 3 " 2 ' 0
Qw. 1avo>
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services DMslon
825'L• Street Rm 602 Andro950
rege. Alaska 91 (97) 0 9434744
Health Authority Approval Cheddist
Legal DeSdiption: LAKE RIDGE TERRACE,• LOT 9 & 10. BLOCK 3. Parcel I.D.: 051-313-14
A. WELL DATA
*PER 8/27/1975 INSPECTION REPORT
Weti Type PRNATE if A. 8, or C, attach ADEC letter. ADEC Water system number N/A
Log present (YM) NO Date completed *APPROX. 8/1975
Total depth '138' Cased to 40'+ Casing height (above ground) 180+
San" seal (YIN) YES Wltes Properly, p (YM) YES
Static water level
AT INSPECTION
9/5/2000
115'
7.0 +/— 9.PJM
WATER SAMPLE RESULTS: Q ,+�(
Coliform Co Nitrate �� Z oil - Other bacteria_—[---
Dew of sample: 3/16/01 Collected by: A.W.W.C.. INC.
B. SEPTICIHOLDING TANK DATA
*THIS IS AN ADVANTEX FILTERATION SYSTEM.
Date Witalled 10/18-20/00 Tank size '1500 Number of Compartments 2 Clesr>outs (YIN)- ES
Foundation deanout (YIN) YES Depression (Y/N) NO Hgh water alarm (YRO YES
Data of Pumping NEW Pumper
C. ABSORPTION FIELD DATA
*THIS IS AN ADVANTEX FILTERATION SYSTEM.
'*BELOW FINAL GRADES
Deta inalalted 10/18-20/00 SOP reting 0�or it2lbdnn) 02.0 SYStam type TRENCH
Length 45' Width 5' Gravel Iwdaness below Pipe D.5' TOtai depth ••;.23'-3.48'
Effective absorption area 225 SO -Fr. Monitoring Tube Present (YIN) Depression over field (Y/N) NO
Data of adequacy test NEW Results (PasslFapl) — For.3 Bedrooms
Fluid depth In absorption Held before test pn* — immediately atter — gal. water added Qn.r —
Fluid depth — ons) Minutes later: — Absorption rate • —
Peroldde treatment (past 12 months) (YIN) — If yes. give dal —
72-M Ww. 3W cbmpuhw VOrdw
D. LIFT STATION
' THIS IS AN ADVANTEX FILTERATION SYSTEM.
Data installed 10/18-20/2000 Size in gallons •1500
Manhde/Ac ess (YM) YES "Pump ow level or TIMER 'Pump otr level or TIMER
Hgh water alarm level at' 46' 'Datum BOTTOM OF TANK
Cycles tasted NEW
13 SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septidholding tank on lot 100'+ On adjacent lots 100'+
Absorption geld on lot 100'+ On adjacent lots 100'+
Public sewer main N/A Public sewer manhole/deanout N/A
Sewedseptlo service Une 25'+ LIR station 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+
Property One
5'+
Absorption geld
5'+
Water mainfservice One 10'+
Surface wateddralnage
100'+
Wells on adjacent lots
100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
Property one 10'+ Building foundation 10'+ Water maln1serAce one 10'+
Surface water 100'+Driveway, perang%rag
nlae storage area 10.+
Curtain draln NONE KNOWN Wells on adjacent lots 100'+
F. ENGINEER'S CERTIFICATION
I cer* that I"deftlWnG4
with
Engineers
HAA Fee
Date of Payment
Receipt Number
rl-MO r M 3=r CwvuW Vw"
WeV 6rsPoWons and revfew
� syt�ptems are in confamence
on Is date.
Waiver Fee $
Date of Payment
Receipt Number