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Home My WebLink AboutEAGLEBROOK BLK 1 LT 2Eaglebrook Block 1 Lot 02 #017-121-22 Municipality of Anchorage Page 1 of 3 Development Services Department Onsite Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.d.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW030279 PID Number. 017-121-22 limn.: Ron Shine Wastewater System: New 14850 Northfield Drive Anch., AK 99516 ABSORPTION FIELD Pte: W.mwcla."a"t.: 345-2122 Four 4 Sand Filter Bed LEGAL DESCRIPTION So. RM1% TMM Depth kam a" 1.0 GPOFF 1.0 Ft. 6a Lal sleawiwwl 1 2 Ea iebrook De"ftmemp nk"n Cn7wwV� c+..M E -PM twI Me, +1.5 Ft. .5 Ft. TSV: Rapp: sln Fatwa.a.o. wWMWww Grnal Lwvn 3-4 Ft. 40 Ft. Well: New Gl. wan. W ftw CO an.. P.two aFhvFn InF.: 15 Ft. 4 3 Ft CMuiMCMwn (Ptrv.u, A B, Ck TaW D.PaI CpeO b'. Iwai Mwrp.Rn ww. Pp MMwal Private 101 Ft. 101 Ft 600 FP ASTM 3034 PVC DM Alpine Driilin 12/21/2004 DMF DnN.e StMx Wow LtN*I:kWFler 15 Ft. Acres e Systems DMF 1"6161WI 6/11-14/2004 YiMa. 10 Pune sw M:Carp Aa C/o TANK CGPMI Ft. 2 Ft SEPARATION DISTANCES STEP To Septic Absorption Lift Holding >ublrjPfta1e "- yn From Tank Field Station Tank sewerue Anchorage Tank 1,500 VIM >100' >100' >1 00' N/A >25' Ste Steel T M c"rv.rimwMF Three suen.wMw>100' >100' >100' N/A LIFT STATION to Lir >54 >10' >5' N/A 250 or Anchorage Tank/Orenco Fauna.tnn >5' >10' >5' N/A •P"'°an• 42 42 •ParnP "r .1 4 422 NpnwlwM " 44 n n In. cut.n Dr..t 1 >20' >20' 1 >20' PMroMwaMZ Orenco ENarraitmpM pwbrmwey Municipality of Anchorage R«n.Ms " k Distribution i BENCH MARK and Sand Filter Bed. Back Deck Southeast Corner. Aswwod EMv tion: 100.0 FL Engineer's Stamp •••••�ttuaaa •4••� p Inspections performed by: MEA Dates: 1 6112/20/0�4� 49th /\ -, 2nd 6/14/2004 t y MICHAEL E. ANDERSON W Department of Health and Human Services approval No. EE -4381 Reviewed and approved by: Date: O - O #� 4��fo •••-•-•" p �• ''s: nu, taw, ;:S::a •• L N C7 � `O N N n N _ � O IL z° 0 C3 play42+olv a S Zn w 4) C) w �e oo¢ o uW CDE P: omty wC ^ 3 m �±?+ N N _ �3 W o E h Q 06 .O m Z y O O 7 / R Z 7,40 t \ N M g A z. O m nn�i 9i� n000� � in'vi�ai / Y O o: m � w a ay _ gg ti au&7 a/gas .01 ��l I :W F U ls� .. r cli 0 J Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519.6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SW030279 N / N i 1,500 Catton STEP Tank Page 3 of 3 PID No. 017-121-22 82.0 PROFILE AS -BUILT - Scale: V • 10' 4 VZL C ANDERSM No. cc-uei J+ 1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM 4700 SOUTH BRAGAW ANCHORAGE, AK 99519 PROJECT #: SOILS LOG - PERCOLATION TEST PERFORMED FOR: Ron Shine DATE PERFORMED: 6/7/2004 LEGAL DESCRIPTION: Lot 2. Block 1. Eaalebrook Subdivision TEST HOLE # 5 SLOPE Organic Layer-OG/PT Silty Sand SM Organic Silt with Sand OL ML/SM Silt to Silty Sand a WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: DATE: noun a ANKRs No. Q1)n a 9 Ar No S L 0 6, P E 6/14/2004 SEE SITE PLAN READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 6/7 11:33 8.5' 1 12:03 30 7.5' 1' Recharge 12:04 8.5' 2 12:34 30 7.75" .75" Recharge I I 12:35 I I 8.2S' 3 1:05 30 75" PERC RATE: 4_ MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 2.0 FT. AND 3.0 T. COMMENTS: Test Hole Pre Soaked Prior to Percolation Test. TEST PERFORMED BY: ED SANDERSON I, MICHAEL F. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 8/11/2004 SID:O AUG 17'04 14:24 No.001 P.01 on ■ 8/17/2004 8.;04. PAGE 1/1 RightFax si ■ •il►xF ... pace I 0i 1. Inspection Report ; Ftunlelpailty of Anchorage, building 6sfety Division 4700 South Drs9sw }_ o - ' t' , a �'' t• r INPOs i43-7962 •' Z NtYOIC! i4i-0700_' INSPlCf10Ns PAX (907)249-7777, ,~u•� tRON SHINE Permit 03-0777 NaMo .. Phone 227-9201 ' t� 114850 NORTHFiELD DR 938-7851 , Y Inspection Date 8%17/2004 UK I LT 2 NIS EAGLEBROOK JOogsn»nb or Directions, PM CALL 30 MIN B4 FOR ONSITE MTG on Y: Inspection '. �';..c.' FIrolEleCtsical :,Relnspeetl' jr �q NONCOMPLIANCE OBSERVED ❑ pp tECTTQNS EMN174LAS EXPLAINED BELOW a " NE AT NEXT ❑ DO NOT CONCEAL UNTIL REINSPECTION 13tres DN . ,•a tIAL- A1111' a;9 1, �tset � 'J/`i 3 � 'h '..; U -•J/ w• `101 i ,�,... :�<, � •Date: f.,b. .•, o-�� Yd'. Yet 11 .c a'.' I .. P -.. K .reCyj� Snt t v 1•S. u< y..tir, J r-O/�7R004. �a;Y: f(4t `fYi{�i•V-Mror.tvi.. . ... , i j ( N�:, -'i rn cso;,zgNo002Bi5.(x)0 Municipality of Anchorage Aak 11 Department of Health and Human Services 825'L' Street sm P.O. Box 196650 Anchorage. Alaska 99519-6650 Rick Mystrom http Jlw ci anchorage.sk.us Mayor Permit Number: #SW 030279 Date of Issue: 7-31-03 Parcel Identification Number: 017-121-22 Date Started: 2-21-04 Date Completed: 2-21-04 Is well located at approved permit location? ® Yes ❑ No Legal Description: Eaolebrook Blk 1 Lot 2 Property Owner Name & Address: Ron Shine 14850 Northfield Dr. Anchorage, Alaska 99516 Borehole Data: Soil Type, Thickness & P: aver Stra:a Depth (ft) From To Method of Drilling ® air rotary ❑ cable tool Casing type: steel stick-up 0 2 Wall Thickness: .250 inches organics 2 14 Diameter: ¢ inches Depth: 101 feet gravelly silt 14 65 Liner Type: silty cobbly gravel gravelly silt silty water sand &gravel 65 81 81 96 96 101 Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 15 feet pumping level: 101 feet after 2 hours pumping 10 gpm Recovery Rate 10 gpm Method of Testing: airlift Well Intake Opening Type: ® Open End ❑ Open Hole ❑ Screened Startfeet Stopped feet ❑ Perforations Startfeet Stopped feet Grout Type: bentonite rranules Volume: I Depth: Start 0 feet Stopped ? feet 'Pump --:--In take - Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets RECEIVED Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 MAY 0 �a 2004 Anchorage Alaska 99511 61UNICiPALITY OF ANCHORAGE ENVIRONNIENTAL SERVICES DIVISION Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property ....... .... .. .... �.•�� ..� .0 � �. __..0 � .. .. �... . rr�..... a •r... .. n. _.•... .. �.. •. rn �_.. .r... •..•. . MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Jul 31, 2003 Expiration Date: Jul 30, 2004 Permit Number: SW030279 Parcel ID: 017-121-22 Legal Description.EAGLEBROOK SUBDIVISION BLOCK 1 LOT 2 Design Engineer: 0041 AK Water & Wastewater Consultarn Site Address: 14850 NORTHFIELD DRIVE Owner Name: RON SHINE Lot Size: 96770 SQ. FT. Owner Address: 14850 NORTHFIELD DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. A 66516 - This permit Is for the construction of: 0 Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. Q Private Well ❑ Water Storage 2. All requirements specked 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 DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 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: Q 1 as Date: a3 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.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017 ' / 2 / . 2 2 Permit Number S'w030279 Prope owners) RON SHINE Day phone X227-9201 Mailing addresW}1 P.O. BOX 220829 • ANCHORAGE. AK SI7E #ailing address (2) 14850 NORTHerl ix DRrve 9gS16 Zip Code 99522 Legal description (Section, Township & Range) N/A Lot Size 96 770 Acres ) THIS APPLICATION IS FOR: Number of Bedrooms 4 Sewer Only ❑ Well Only ❑ Sewer and Well 0 Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS, INC. Permit Fees: � 160 f"` 100;f � 5o Ov Date of Payment: 6121/03 Receipt Number. Vo Waiver Fees, Date of Payment: Receipt Number. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (F FAX MEMO DATE: 6/812004 TO: Joe Goodall WITH: MoA/On Site Services FROM: Mike Anderson SUBJECT: Lot 2, Block 1, Eagle Brook Subdivision Septic System Permit No. SW030279 MESSAGE: The owner of the subject lot has moved the house much closer to the north lot line. The design location of the primary absorption bed is now too close to the house with the 4:1 fill slope from the top of the bed. We have moved the bed to the southern property line. A new test hole was placed to verify soil conditions. The exact characteristics were found at this location as were found in Test Hole No. 3. In addition a test hole completed by Bruce Corwin in 1987 was found which appears to be suitable for use near the new bed. Please modify the permit to allow the new location of the sand filter. 4 Pages Being Transmitted. Please call 522-7773 if not complete. FAX MEMO DATE: 5/23/2004 TO: Joe Goodall WITH: MoA/OnSite Services FROM: Mike Anderson SUBJECT: Lot 2, Block 1, Eaglebrook Subdivision Septic System Permit No. SW030279 MESSAGE: The owner of the subject lot wants to place an Intermittent Bottomless Sand Filter instead of an Advantex System. The location and size of the absorption bed will be identical to that shown in the original design. Two feet of coarse sand will be placed as shown on the original design to provide separation from groundwater. All aspects of the original design remain unchanged with the exception that the ISF will be used instead of the Advantex. Please let me know if you have any questions. 1 Page Being Transmitted. Please call 522-7773 if not complete. 0 PERFORMED LEGAL DESCRIPTI Municipality of Anchorage DEPARTMENT OF HEALTH 8 HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST OE ET) W 1 -V— V'W_ TH." 1 PPA.T 2 ML -brown orvA,.r. silt 3- 4 4 7 i SEN INEER'S SEAL) 1 C• : 1. Covvrin i� �'w DATE PER Township, Range, Section: SLOPE 1—r --m. r- -„ - N. SITE PLAN. 8 O � o sW - 100�/ Coxr.p Sand t13 nry7� 0 �I `• 10ATER 00 `' + I �r�,Ii ENCOUNTERED?��PS O'�+\�8i O O �1 1 SI.IQ'I l.{ j�'a 1lci IF YES. AT WHAT 1 0 O O I Hao? 12 O ISo ��IIEPTH? �,2 e 0 o v t10 — Depth W Water Aller • • r,�8713 O O Monitoring? Date; 3 '� FFF O 14 p Ertp .,•...- 15 +C, �.• .�. 16r Ie�r.TO s •a,.y..-c 1s 20 1 PERCOLATION RATE TEST RUN BETWEEN I PERFORMED BY: I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN IN 72-008 fRev. 4851 (mmutevinch) PERC HOLE DIAMETER �T AND FT Z---i--C- ERTIFY THAT THIS TEST WAS PERFORMED IN THIS DATE. DATE: /� ;7 4- -NVASTENNTAT ER ANTS, INC. LJUIL LUU — rtKLUL.ANUN ItJll v LEGAL DESCRIPTION: EAGLE BROOK SUBDNISION; LOT 2. BLOCK 1, QA'A '. PERFORMED FOR: RON SHINE DATE: 3/14/2003v�04 DEPTH __ (PAGE 1 OF 2) Q� (feet) ORGANICS TEST HOLE 11 Mll (PAGE 1 OF 2) SM TO SOIL CLASSIFICATIONS SM/ML GW 0RG GP MLI GM CL 4 ORGANIC SILT GC OL , 6ffr�y A. Gc:Aess.� 7953 cQ ev edPro f as sioflo\ ��OOOOo'�o rT I I I DEPOSIT — OL °..°° a SW MH TH13 5 ..1., SP CH Q 71-1824$� !j SM % OH CURTAIN DRAIN 6 { I SC PER LOT 3. BLOCK 1 PROPOSED DESIGN 7 U 101111111111 /TkilL 11 1 13 14 VEC 1 S L 16, 17 �\\ .TM#4 TH110 1 11 PER LOT 3 PBLOCK 1 / / PROPOSED DESIGN Ld 0 1 100' DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 3/14/2003 1 1 4:51 — 6- UPPER 2 5:21 30 5• 1 - BENCH 3 5:23 — 6• — 4 ' 5:53 30 5 1/4- 3/4' 5 5;54 — 6' — 6 6:24 30 5 1/4- 3/4' 1B S 1 19 S` PERCOLATION RATE 40 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 2.0 FT. AND 2.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: MATT FISHER COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS ER RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: a ALASKA WATER & WASTEWATER CONSULTANTS, INC. May 30, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Ref: Proposed Well and Septic System for Lot 2, Block 1; Eagle Brook Subdivision ADVANTEX"' TREATMENT SYSTEM To whom it may concern: 1. GENERAL: The proposed 4 bedroom home will be served by a private well and septic system. Four test holes were excavated on the property. We are proposing to design the septic system around the 30 foot radius of test hole #3. Due to shallow groundwater and the limited amount of receiving soils we are proposing to use an Advantex treatment system and a bed type drainfield. The well is to be located in the area shown on the site plan and design drawing. 2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring, and the percolation test results. As can be seen on the attached logs, there is a naturally occurring OL layer between 3 to 5 feet. A percolation test was performed in this material and determined it to be suitable for on-site septic. Approximately one month ago, the soils condition was discussed with Jim Cross and he verbally approved the OL lense to be suitable. 3. DRAINFIELD APPLICATION RATE: The intent is to install an Advantex Treatment System that will allow the use of a small drainfield in the area around the 30 foot radius of test hole 0. The Advantex system has received class III approval and we are going to use an application rate of 1.0 GPD/FT. 4. TRENCIi DESIGN: a. Percolation Rate: 30 & 40 minutes/inch b. Proposed Application Rate: 1.0 gallons/day/f2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 600 fie f. Total Depth: 1.0 feet (max.) 3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507 Ph: (907)337-6179' Fax: (907)338-3246' Website: akwwc.com g. M.O.A. Approved Sand Filter Depth: 2+ feet h. Effective Depth: 0.5 feet i. Width: 15 feet j. Minimum Length: 40 feet long k. Effective absorption area: 600 R2 Note: The distribution line is to be 1.25 inch sch 40 pvc with 1/8 inch holes spaced 18 inches on center (24 holes per lateral, 72 holes total). 5.ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will be manufactured by Anchorage Tank & 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. 6. SURFACE WATER: There is no surface water within 100 feet of the proposed septic system upgrade. 7. TOPOGRAPHY: As can be seen on the attached topography site plan the area around the proposed drainfield is fairly flat. 8. 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 .E., M.S. NOTE: Attached is a site plan drawing, a design drawing, an Advantex detail, a trench detail, four soil logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907)337-6179 • Fax: (907)338-3246' Website: akwwc.com I I/ ---------------------J L-------- - 7/ /I LOT 1, BLOCK 1: EAGLE BROOK S/D ! i z (SEE DESIGN. PACE 2 ! \ 1 \ 1 V LOT 4, BLOCK 1; EAGLE BROOK S/D PROPOSED 4 BEDROOM ASEPTIC ARS LOT 3, BLOCK 1; EAGLE BROOK S/D ALASKA RATER & WASTEWATER CONSULTANTS, INC. 3101 E TIAOR ROAD. SNTF 101' ANCHORAOF. AK 99507 • FNONF f"7)33]-0179 • FAS f90T)SSR-376 REPARED FOR PHONE NUMBER: R orl- I1I ; Y� LOT 1, BLOCK 3: EAGLE BROOK S/D CURTAIN DRAIN {PER LOT 3. BLOCK 1 f 1 PROPOSED DESIGN I LOT 2, BLOCK 3; / 1 EAGLE BROOK S/D LOT 3, BLOCK 3: EAGLE BROOK S/D DRAIN 1 I EAGLE 4, RROO S/D 1 i/30/2003 WN BY: J.L.M. I.E. 1" = 100' RON SHINE 227-9201 1 OF 4 :AL DESCRIPTION: LOT 2, BLOCK 1; EAGLE BROOK SUBDIVISION 'E OF WORK: SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM FAM /JJJ PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 1 FOOT DEEP MAXIMUM BY 15 FEET WIDE BY 40 FEET LONG. ADD 2.0f FEET OF M.O.A. APPROVED / SAND FILTER AND THAN 0.5 FEET OF CLEAN, WASHED SEWER DRAINRDCK. THE DISTRIBUTION UNE IS TO BE 1.25 INCH PVC WITH i MCH HOLES SPACED 18 INCHES ON CENTER (24 HOLES PER LATERAL. 72 HOLES TOTAL). PROPOSED 1500 GALLON ADVANTIX TREATMENT SYSTEM WITH UFT STATION • (SEE DETAIL, PACE 3 OF 4) y [SEPTIC AREA S INSTALL I WNOATION :LEANOUf I Fw 1 IXISTING SOUO PIPE FOR CURTAIN DRAIN NOTE: THE CONTRACTOR SHALL HAVE THE PROPOSED 100 F0OT WELL RADIUS AND THE NORTH LOT UNE FLAGGED B A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. ALTERNATE SITE v, ``/• •• .. BY. J.L.M. I � � � I\ • �0 TRR R NV RA ASTE4 NNIATER I EXISTING y* SCALE CONSULTANTS, INC. -1 CURTAIN """' .. ' ' .. '"' ""' DRAIN I PREPARED FOR: PHONE NUMBER: 1 RON SHINE 227-9201 2 OF 4 PROPOS r 953 ss.-. k) WELL LOT 2, BLOCK 1; EAGLE BROOK SUBDIVISION .�q�o� ��dp�ofeeslo�6 �0400000� TYPEOF WORK: DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM / � / 0-13 i Z v, ``/• •• .. BY. J.L.M. ,DRAWN FALASKA � � .• • �0 TRR R NV RA ASTE4 NNIATER y* SCALE CONSULTANTS, INC. -1 = 4OF """' .. ' ' .. '"' ""' 3701 F. TUDOR ROAD. SUITE 101 • ANCHORAGF. AK 09S07 • P ANF (007)117*V0 • FAX (007USA-SM6 PREPARED FOR: PHONE NUMBER: PACE NUMBER: RON SHINE 227-9201 2 OF 4 Q y • , C V004/�' r 953 ss.-. k) LEGAL DESCRIPTION:QA LOT 2, BLOCK 1; EAGLE BROOK SUBDIVISION .�q�o� ��dp�ofeeslo�6 �0400000� TYPEOF WORK: DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM NOTE: JIM CROSS, P.E. NAs THE AD'VANTIX wwuAl AdvanTex" Treatment System AX20 -Mode la 10 40x94Pod =" e• rEPaA;ze DRAINFIELD S• PVC PUMP-= + 7 (TYP.2) � ' f 6* PM COURM =0 A TANK INLET ORENCO _ BIOTUBE OPTIONAL SCREENED VAULT SURE SECRON OF S• PIPE ,.�.•��,•�.,. .,. OVER TNM CONNECOON TD�A� 4 BEDROOM ORENC° DMI) r;FIBERGLASS ADVANTEX TANK: EFFLUENT PUMP BRRIMCE EKGVATIDN DATE: op6o4 5/28/2003 0 °�� y ` n v� .• ..s4o `yip DRAWN BY: C.J.G. X ALASKA WATER & WASTEWATER oa s�NSULTANTS, N.T.S. N.T.S. COINC. O """ "' ""' 3701 E T D ROAn. SURF IM • ANCNORAOF. AK 00507 • PNONF (00))551-0170 • FAX (907M34-3740 0 PREPARED FOR: PHONE NUMBER: PACE NUMBER: RON SHINE (907) 227-9201 3 OF 4 Q '•,je iF QO ••• Go ss.:DO E 7 Sf7 LEGAL OESCRIPTION: LOT 2, BLOCK 1; EAGLE BROOK SUBDIVISION �•,�'' 04�d .•• �c,�o� TYPE OF WORK: rp(eeS1OW6. po DDOp0000� DETAIL DRAWING OF ADVANTEX TREATMENT UNIT FEET LON r----------------------------------- IOMT ►TO125' 50' S0• I i IO ---------------- !Ir2lts' THE DISTRIBUTION LINES ARE TO BE 1.25 INCH PJC WfTH i HOLES SPACED 15 INCHES ON CENTER (24 HOLES PER LATERAL. 72 HOLES TOTAL). - . aa• THE DISTRIBUTION LINES ARE TO BE 125 INCH PVC WITH i HOLES SPACED IS INCHES ON CENTER (24 HOLES PER LATERAL. 72 HOLES TOTAL).- GRADE .,r. "r. 2+ FEET OF li_ ill•I BRACING MIDI LE AS NEED ALASKA WATER & NVASTEWATER SCALE: C.J.G. p :7— CONSULTANTS, INC. 4 �• y* :..... ..........:... )Oi F TUTOR ROAD. S1POR TF 101 • eu(MGGF, e[ 0030) • M))J ONF fR0J1-eAN.T.S. V • FAX (00)IJJR-J1L6 , SPARED FOR: PHONE NUMBER: PAVE NVMkRLH: V �� — RON SHINE (907) 227-9201 4 OF 4 I.� •�� QQ P .J f . Orn ss; + )AL DESCRIPTION: Q ° 79 �E OF LOT 2. BLOCK 1; EAGLE BROOK SUBDIVISION O�Q�tj°dprefeeelc DETAIL DRAWING OF PROPOSED DRAINFIELD D�pppoo�� opd00 ALASKA WATER & WASTEWATER CONSULTANTS, INC. T9orN—WWRW.-NUffr 29 1 kOOV4& AV 04504 6 KOMC oo wc: 90 p ...:...... 0 SOIL LOG - PERCOLATION TEST 0 LEGAL DESCRIPTION: EAGLE BROOK SUBDMSION, LOT 2, BLOCK 1 OO1p •.J f y ness.: PERFORMED FOR: ROBIN RAINWATER DATE; 8/7/2001QQ�� •., C 7953 Few �p 4•. •........••'�oAdd DEP111 dProfs S104co (feet) ORGANICS TEST HOLE 1 �4�oo�pa 1 SOIL CLASSIFlCATIONS 3 2 GW---'- "� ORG U' 3 ;.; + GP ML GM CL TEST HOLE w SM/ML LOCATIONS ARE J 4 GC OL APPROXIMATE TH12* 0_i 0?0% SW MH cl 5 SP CH SM : OH �� I 6 Sc \\ \\ SRE PLAN TMj1® \ \ I--100- Q 7 1 I 8 j% 9 ML BLUE �0 10 11 12- 13- 14- 15- 16- 2 131a1516 17 18- 19 PERCOLATION RATE N/A (MIN./INCH) PERC. HOLE DIA. 6- (INCHES) TEST RUN BETWEEN 4.5 FT. AND 5.0 FT. 20 COMMENTS: WATER IN PERK HOLE PERFORMED BY ALASKA WATER do WASTEWATER I, JEFFREY A. CARNESS. CERTIFY THAT THIS AS /PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO DATE GROUNDWATER 11' 8 7 01 5.5' 8/13/01 5.0' 4/23/03 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) GR N�GN O v � 0 ER OR�EO -- P r\0 ALASKA `VATER R WASTENIVATER CONSULTANTS, INC. 6901 DEPM ROAD, SURE 20 • M DOW AK 99604 • P"C- (907)337-4179 • FAX. (907)1.9-=4E • WEISM ok,.ecom SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: EAGLE BROOK SUBOMSION, LOT 2, BLOCK 1 PERFORMED FOR: ROBIN RAINWATER DATE- 8/7/2001 DEM (feet) ORGANICS TEST HOLE 2 7-1 SM/ML BLUE 8 t 9 D.O.I i. 110 ' 12 1 17 DEPTH TO GROUNDWATER DATE DRY 8/7/01 • CLASSIFICATIONS 81301 4c 1' 5/1/02 3.5' 'j ;�I 2 IGW 30 •. 5 1/2- 3 ;a� j 11 1GPIIIlilillML TH1O ' ; 11 30 �� 11 5 4:28 JJ — 2/ � u�lulGMiiia.CL CSS 2 3/4' 5 1/4' 4GCORGANIC • 9 •.MH d ININN SP CH z�a • • X1111111 7-1 SM/ML BLUE 8 t 9 D.O.I i. 110 ' 12 1 17 DEPTH TO GROUNDWATER DATE DRY 8/7/01 7' 81301 4c 1' 5/1/02 3.5' 4/23/03 J If y Ga es' 7g •`pc DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING TEST HOLERELd LOCATIONS A 8/13/01 1 3:28 APPROXIMATE THS24V >I – 2 of 30 1/2- 5 1/2- 3 3:58 j 11 SITE PLAN 1"-100' TH1O ' ; 11 30 �� 11 5 4:28 JJ — 2/ � ��i CSS 2 3/4' 5 1/4' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/13/01 1 3:28 – – 2 3:58 30 1/2- 5 1/2- 3 3:58 — — — 4 4:28 30 1 3/4' 5 1/4- 5 4:28 — — 6 4:58 30 3/4' 5 1/4' 19� PERCOLATION RATE 5.7 (MIN./INCH) PERC. HOLE DIA. 6' (INCHES) 20 TEST RUN BETWEEN 2.0 FT. AND 2.5 FT. COMMENTS: PERCOLATION TEST RESULTS ARE FOR UPPER BENCH ONLY. PERCOLATION TEST PERFORMED BY JOE MARCHETTI. PERFORMED BY ALASKA WATER k WASTEWATER I, JEFFREY A. GARNESS, CERTIFY THAT THIS IW4 PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: e ALASKA AVATER & WASTLNVATI✓R CONSULTANTS, INC. 6901 DESWL ROAD, SURE 26 • ANQ40PAGG AK 99504 • PHDHE: (907)117-6179 • FA)L (907)1.16-72" • I OMM' ok..aaom SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: EACLE BROOK SUBDIVISION; LOT 2, BLOCK 1, PERFORMED FOR: RON SHINE DATE: 3/14/2003 (feet) f BTS{ (PACE 1 OF 2) _ =EORGANICS ITEST HOLE #31 1 ====: ML TO SM/ML DEPTH TO GROUNDWATER DATE 13.0' 3/14/2003 TO SOIL CILAAaal—F MCAT 10N 3/21/2003 4.0' ISM/ML 6' w 2 GW'. 30 OR IJ UPPER BENCH 3 5:23 PER LOT BLOCK ONK 1 PROPOSEO�DESIGN i — IIIIIIIIIML 4 5:53 30 5 1/4- TH#4 II�IIIJI 5 CL 4— — \\1 j ORGANIC SILT 6:24 GC 1 OL DEPOSIT - OL SW IillllllMH l , sp CH SITE PLAN 1"-100' Ic��ts�SM • SIC ML TO SM/ML DEPTH TO GROUNDWATER DATE 13.0' 3/14/2003 5.0' 3/19/2003 5.0' 3/21/2003 4.0' 4/23/2003 �ffr�ylA. t�acr�ess: ISE} -7953 F� I I .• 9� o� DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/14/2003 1 4:51 THp3 6' w 2 THJ2,0 30 5- IJ UPPER BENCH 3 5:23 PER LOT BLOCK ONK 1 PROPOSEO�DESIGN 6' — 4 5:53 30 5 1/4- TH#4 5 5;54 — T"'\1® — \\1 j J P8LEOCK 6:24 30 1 PER LOT 1 PROPOSED DESIGN 1f , SITE PLAN 1"-100' DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/14/2003 1 4:51 — 6' — 2 5:21 30 5- 1' UPPER BENCH 3 5:23 — 6' — 4 5:53 30 5 1/4- 3/4- 5 5;54 — 6• — 6 6:24 30 5 1/4- 3/4 - PERCOLATION RATE 40 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 2.0 FT. AND 2.5 FT. A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: MATT FISHER PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: IN ACCORDANCE ALASKA WATER & WASTEWATER CONSULTANTS, INC. 90 • - SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: EACLE BROOK SUBDIVISION; LOT 2, BLOCK 1, PERFORMED FOR: RON SHINE DATE: 3/14/2003 (feet F1 i11�C�1�11 1 6� W 0 7 CL o V) Z 9 O 10 Q U 1t LL - V) 12- 13- 0 2 13 U 14 J 15 � 16 Lj LLJ 17 V) u 18 DEPTH TO DATE GROUNDWATER OF � 1 EE PPO S SEE SITE PLAN (PAGE 1 OF 2) DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/14/2003 1 4:51 — " 111111111 -LO 12 BENCH �Ilui 5:21 5:23 iiia. 5' 6' %� NNH • 30 5 IIIIIIIII 5 5;54 — 6- lillll� Baa • 30 5 1' DEPTH TO DATE GROUNDWATER OF � 1 EE PPO S SEE SITE PLAN (PAGE 1 OF 2) DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/14/2003 1 4:51 — 6' - -LO 12 BENCH 3 5:21 5:23 30 — 5' 6' 1WER' — 4 5:53 30 5 1' 5 5;54 — 6- 6 6:24 30 5 1' 19� PERCOLATION RATE 30 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: MATT FISHER COMMENTS: PERFORMED BY AKWWC. INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS 9tRFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 97 W03 of gsdp0 ALASKA WATER & WASTEWATER o00 CONSULTANTS, INC. 6001 DM -M ROAD. SUITE e * ANDOWL AV 96504 6 PHONZ- (90 7)337-6179 wr: rv.a.ewn SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: EAGLE BROOK SUBDIVISION; LOT 2, BLOCK 1, O� D '. a Ca ess.- PERFORMED FOR: RON SHINE DATE: 3/14/2003 �p0� -795 (feet) Ptr. ORGANICS 4��4O000��6�0 TEST HOLE #4 1 2 3 4 5 6 M 11 12 13 14 15 16 17 18 DEPTH TO GROUNDWATER GW MmEfm O- tt GP111111111ML 3/19/2003 ORGANIC SILTGMCL 4.0' • - • r//J,.GC HNN • 1!SWIilllllllMH 5 7/8- 8'3 N YES ❑ NO 3 //%CH - 31111111 • y:�'i?sc 30 1 5 3/4- M 11 12 13 14 15 16 17 18 DEPTH TO GROUNDWATER DATE DRY 3/14/2003 4.0' 3/19/2003 4.0' 3/21/2003 4.0' 4/23/2003 ( fat TH13 w ® THJ2® PECURTAIN LAT 3 DRAIN 1 PROPOSED DESIGN TH14 \ � THJ1 \ j PER L5OLID OT PBLOC%j 1 PROPOSED DESIGN IF /j SITE PLAN 10-100, DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/14/2003 1 4:50 - 6' - 2 5:20 30 5 7/8- 8'3 N YES ❑ NO 3 5:22 - 6' - 4 5:52 30 1 5 3/4- 1/4' 5 5:53 - 6' - 6 6:23 30 5 3/4- 1/4' 19 PERCOLATION RATE 120 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: MATT FISHER PERCOLATION TEST PERFORMED BY: MATT FISHER COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA PE FORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: C ALASKA WATER F& WASTEWATER CONSULTANTS, INC. June 10, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Soil Concerns regarding Lot 2, Block 1; Eagle Brook Subdivision. Attention: Dan Roth It is our understanding that you have some concern with the OL tense soils classification between 3 to 5 feet in Test Hole 0. As can be seen on the logs for Test Holes #2 & #4, this same OL layer exists also in these areas. Based upon this data, we are concluding that this layer is naturally occurring. The soils above the OL layer do not appear to be fill. Also, no roots, leaves, etc., were found in the OL layer. A percolation test was performed in this layer and found the rate to be 30 minutes/inch. All this information was discussed with Jim Cross approximately one month ago in a phone conversation. fie verbally approved using this OL layer as a suitable on- site septic syste4naterial. If you have any further questions, please contact us at 337-6179. Thank you ford u assistance. .E., M.S. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Far: (907) 338-3246 • Website: akwwc.com 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.enchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: ALASKA WATER & WASTEWATER CONSULTANTS. INC,. Legal description: EAGLEBROOK SUBD. BLOCK 1 LOT 2 The attached paperwork has been reviewed and Is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. _ ® Additional soils information needed. PLEAS ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. _ ❑ Incomplete; missing_ ❑ Incomplete; missing _ ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. _ ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ❑ Other. _ Name of reviewer. DAN Date: 6/6/03 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of Anchorage Development Services Department Building Safety Division ) 1 On -Site Water 8 Wastewater Program y )✓ 4700 South Bragaw St. I JeN P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 V vile, Aqj-�'ly°CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING O Parcel I.D. bl a — 1:21-.22 HAA1t_ 1. GENERAL INFORMATION Expiration Date: 619loi Complete legal description EAGLE BROOK SUBDIVISION, LOT 2. BLOCK 1. SEPTIC SYSTEM SIZED Location (site address or directions) . 14850 NORTHFIELD DRIVE + ANCHORAGE. AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MARKO HRGOVIC Day phone 250-2069 14850 NORTHFIELD DRIVE • ANCHORAGE. AK 99516 Day phone RONA FLORIO w/ HOMES UNLIMITED Day phone 279-8877 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 SEPTIC SYSTEM SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. 1 further verify that based on the Information obtained from the Municipality of Anchorage tiles 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 Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines 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 readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may gucfuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any otherperson or party Is not authorized, nor will it confer any legal right whatsoever. kkkk �i�OFIf �y0'•�. Q, •.'Pym V :' ; WATER AND "s stipul@IpoR Phone 337-6179 Date q ZZ as 5. DSD SIGNATURE `'� Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other B Original Certificate Date: 10T- (R". T(Rev. 17)01) Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water 6 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorsge.ak.us (907) 343-79W HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: EAGLEBROOK SUBDIVISION: LOT 2. BLOCK 1 Parcel ID: 017-121-22 A. WELL DATA WELL LESS THAN 2 YEARS OLD. NO TEST NEEDED, Well type PWATE If A, B. or C provide PWSID# N/A Well Log (YM) YES Date completed 2/21/2004 Sanitary teal (YEN) YES Wires properly protected (YM) YES Total depth 101 ft. Cased to 101 ft. Casing height (above ground) 24+ in, FROM WELL LOG AT INSPECTION Date of test 2/21 /2004 Static water level 15 ft, ft. Well production 10 g,p,m, g.p.m. WATER SAMPLE RESULTS: Coliform 0 coloniesH00 ml. Nitrate 0.1 mgJL. Other bacteria 0 coloniesH00 ml. Arsenic: N/A mgA. Date of sample: 4/4/2005 Collected by. GEG. LtD. B. SEPTICIHOLDING TANK DATA TankTypefMaterial STEEL/S.T.E.P. Date installed 6/11-14/2004 Tank size 1500 gal. Number of Compartments E Cleanouts (YIN) YES Foundation cleanout (YM) YES Depression over tank (YM) NO High water alarm (YIN) YES Date of pumping 4/15/2005 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA Date installed 0111-1412004 Soil regi .p.d ftlbdnn) 1_0 System type ISF/BED Length 40 ft. Width 15 ft. Gravel below pipe 0.5 ft. Total depth Eft. absorption area 600 fe Monitoring tube YES Depression over field NO Date of adequacy test •• Results (Pass/Fag) — For 4 bedrooms Fluid depth in absorptkm field before test = in. Water added =gal. New depth =kn. Elapsed Time: = min. Final fluid depth = In. Absorption rate » 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN 6 type) NONE KNOWN If yes, give date THAN SYSTEM LESS TW2 YEARS OLD. NO TEST NEEDED. DRAINFIELD DRY ON 4/4/2005 D. LIFT STATION Date installed 6/11-14/04 'Pump on" level at TIMERin. Datum BOTTOM OF TANK E. SEPARATION DISTANCES Size in gallons 1500 "Pump air level atTIMOn. Manhole/Access (Y/N) YES High water alarm level at 44 Cycles tested 3 Meets alarm b circuit requirements? Y _ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 101+ Surface we 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 100+ Surface water t 00'+ Driveway, parkinglvehide storage 100'+ Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and....4 review of Municipal records that the above systems are in conformance with MOA HM guidelines in effect on this data • .. , ... • , ........ V. ess.� Engineerh Printed Name JEFFREY A. CARNESS Date olesslo" HAA Fee S 4&n) Date of Payment Receipt Number IRs'• 121e1) Waiver Fee $ Date of Payment Receipt Number 04-11-05 03:22PM FROII-CT4E ESI, SCS ENV SERVICES —S&%- 9075615301 T-410 P.02/06 F-321 SCS ReLA 1051731001 All Dates/Times are Alaska Standard Time Client Name Gamess Engineering Group, Ltd. Printed Datc/Time 04/0812005 14:07 Project Name/p Various Collected Date/Time 04/042005 13:32 Client Sample ID Eagle Brook S/D Lot 2 Black 1 Received Date/Time 04/0412005 15:30 histris Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Ink Haters Department Nitrate -14 0.100 U 0.100 Microbiology Laboratory Total Coliform 0 ml/L EPA 300.0 B (<-10) 04104/05 CAh1 cot/100mL SM209222B A (<-1) 04104/05 TLF 4-20-05; 7:22PM; ;907 6616301 M 2/ 6 97 mi ;GS ReEp 1051783001 ]Sent Name Garness Engineering Group, Ltd. Project Name/# Eaele Brook S/D Lot 2. Blk I :hent Sample ID Eagle Brook S/D Lot 2, Blk 1 datria Drinking Water All Dates/11mes are Alaska Standard Time Printed Daidrime 041202005 11.09 Collected DateMme 04/062005 14:37 Received DateMme 04/062005 1524 Technical Director Stephen C. Ede ;ample Remarks: EP300 - Sample rerun outside of hold to confirm original concentration. Concentration confirms. Allowable Prep Analysis 'arameter Results PQL Units Method Container ID Limits Date Date Init satals Department Hardness as CaCO3 89.9 5.00 mg/L SM20 2340B C 04/08/05 04111/05 SCL lrivate Individual Analysis Aluminum 20.0 U 20.0 ug/L EP200.8 C 04/08/05 04/11/05 SCL Antimony 1.00 U 1.00 ug/L EP200.8 C (<-6) 04/08/05 04/11/05 SCL Arsenic 5.00 U 5.00 ug/L EP200.8 C («50) 04/08/05 04/11/05 SCL Barium 7.48 3.00 ug/L EP200.8 C (<-2000) 04108105 04/11/05 SCL Cadmium 0.500 U 0.500 ug/L EP200.8 C (o-5) 04/08/05 04/11/05 SCL Calcium 25700 500 ug/L EP200.8 C 04108/05 04111105 SCL Chromium 1.00 U 1.00 ug/L EP200.8 C (o-100) 04108105 04/11/05 SCL Copper 17.0 1.00 ug/L EP200.8 C (x.1300) 04/08/05 04111105 SCL Iron 443 • 250 ug/L EP200.8 C (o-300) 04/08105 04/11105 SCL Lead 1.03 0.200 ug/L EP200.8 C (o-15) 04/08105 04111105 SCL Magnesium 6270 50.0 119/1, EP200.8 C 04108/05 04111105 SCL Manganese 48.7 1.00 ug/L EP200.8 C (<-50) 04/08105 04/11/05 SCL Chloride 1.11 0.100 mg/L EPA 300.0 A (<-250) 04/08/05 XM Phosphorus 200 U 200 ug/L EP200.8 C 04108105 04/11/05 SCL Fluoride 0.125 0.100 mg/L EPA 300.0 A (<-2) 04108/05 XM Potassium 908 500 ug/L EP200.8 C 04/08105 04/11/05 SCL Nitrate -N 0.100 U 0.100 mg/L EPA 300.0 A (r--10) 04/07/05 CAM Selenium 5.00 U 5.00 ug/L EP200.8 C (<-50) 04/08/05 04111105 SCL Nitrite -N O.I000 0.100 mg/L EPA 300.0 A (o-1) 04/07/05 CAM Sodium 4460 500 ug/L EP200.8 C (<-250000) 04108/05 04/11105 SCL Silicon 4640 200 ug/L EP200.8 04/08/05 04/14105 SCL Silver 1.000 1.00 ug/L EP200.9 C (<-100) 04/08/05 04/11/05 SCL Thallium 1.00 U 1.00 ug/L EP200.8 C (r--2) 04/08105 04111/05 SCL Sulfate 9.48 0.100 mg/L EPA 300.0 A (<-250) 04108105 XM 4-20-06; 7:22PM; :907 6616301 i 3/ 6 FM GS RetM 1051783001 'tient Name Garness Engineering Group, Ltd. 'reject Name/# Eaele Brook SID Lot 2. Blk I 'lient Sample ID Eagle Brook S/D Lot 2, Blk 1 latrix Drinking Water All Dates/Ilmes are Alaska Standard Time Printed Date/Time 0420/2005 11:09 Collected Date/rime 04/06/2005 14:37 Received Date/rime 04/062005 1524 Technical Dinctor Stephen C. Ede srunetcr Results PQL Units Method ContainerlD Allowable Limits P1ep Analysis Date Date Init rivate Individual Analysis Zinc 11.7 5.00 ug/L EP200.8 C (a=5000) 04/08/05 04111105 SCL Total Dissolved Solids 128 10.0 mg/L SM20 2540C B (o-500) 04/12/05 KP Nickel 2.00 U 2.00 ug/L EP200.8 C (o-100) 04108/05 04111105 SCL HCO3 Alkalinity 112 10.0 mg/L SM20 23208 B 04/06/05 KAL CO3 Alkalinity 10.0 U 10.0 mg/L SM20 2320E B 04/06/05 KAL OII Alkalinity 10.0 U 10.0 mg/L SM20 2320B B 04/06/05 KAL Conductivity 210 1.00 unthos/em SM20 25IOB B 04/06/05 KAL PH 7.87 0.100 pH units EPA 150.1 B (6.5-8.5) 04/06105 KAL Alkalinity 112 10.0 mg/L SM20 2320E D 04/06/05 KAL .•MAY -09-2005 NON 10:06 AM DYNAMIC PROPERTIES FAX NO. 9072617446 P ' llir. S. 2005 8:30A11 Garness Ensineerins Group -!Ltd. NO -5723 P. I ADVANCED WASTEWATER TREATMENT IYSTEM MAINTENANCF. AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING DETWF.ENMUNICIPALITY OF ANCHORACE AND -A. -^!j THIS A4GMORANDUM OF UNDERSTANMIXG made and entered into as of this day of 1-11t2:!a of 20 0 rIby and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICTPAUrY." in consideration ol'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 I located at Iq Of /V o /177 P/" Q2! db' Anchorage, Alaska. 2. Definitious. A. Alteration. Any change to the desi6m or function of as 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 AW WTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hcrchtafter, "AMC")15.65. S. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time ofproperty sale and title transfer in accordance with AMC 15.65. PA .•MAY -09-2005 MON 10:06 AM DYNAMIC PROPERTIES FAX NO. 9072617446 P. 03 May. 9. 2005 3:30AM Garness Engineering Group i1td. No -5723 P. 2 i. li • These approvals certify that the systems art adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any roan -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 AWTS that were included in the original design which would allow the AW WTS to continue to perform as designed. E. Permit (Construction) Ar. On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater'frcatment System Operdting Permit. Anaatwe} permit, issued by the Municipality, that allows the Owner to operate an AW WTS, 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 I F,e& Owner shall pay to Municipality an annual fee of�,t'D > (S.Q.00), payable on or before the issuance of the operating permit and annually thereafter. The Annual fee is due on or before the anuivcrsary date of the approval by the Mtmlcipality of installed system. 4. J,rM. The term of this Memorandum of Understanding shell be for the life of the AW WTS. MAY -09-2005 NON 10:06 AN DYNAMIC PROPERTIES FAX NO. 9072617446 P. 04 May. 9. 2005 8:30AM Garness Eniineerins Grouol.iLtd. No.bIZ3 P. 3 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. S. Alterations, lastallalign__and RemovalAdditional 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 Reysim. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AW WTS 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 ages 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 penniL Thts 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: ",.j, t n sr�a e .� r, C. Owner acknowledges that the fine schedule for failing to maintain and repairan AWWTS are codified in AMC 14.60. _ NAY -09-2005 NON 10:07 AN DYNAMIC PROPERTIES FAX NO. 9072617446 P. 05 Var. 9. 2005 8:3IAY Garness En6ineerins GrounHLtd. N04 M F. a ii 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 AWWTS upon 24 hours written notice. F. Owner aarees that any We 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 speci frcation guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AW WTS. 7. Nonwaiver. The failure of either party at any time to enfurce 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 patty thereafter to enfurce each and every provision hereof. 8. Atntudment. A. Phis 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. A. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the panics are: •MAY -09-2005 MON 10:07 AM DYNAMIC PROPERTIES FAX NO. 9072617446 P. 06 •Uar. 9. 2005 8:31AM Girness Eneinserine Groupiq W. No -5723 P. b I.�J Owner: A. �:'rn v\V— ^. — i a Anchorage: furchasingOflicer 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. SeverabIIhv. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions orthe Memorandum oflJnderstanding. e STATE OF ALASKA TIIIRD JUDICIAL DISTRICT MUNICIPALITY: By: Title: Date: ) ss. The roregoing instrument was ackn wledged before me this 9. day of. MQ 2 by 111L14�—t' { li'i!i'1l'�tICl , the / I of on behalf of the cipaiity of Anchorage. NOT Y YUDLIC FOR My Co4imission. expires: �i MAY-09-2005 MON 10:06 AM DYNAMIC PROPERTIES FAX NO. 9072617446 P My 9. 2005 8:300 Garness Ensinesrina GrouvliLtd. No-5723 P. I ! ADVANCED WASTEWATER TREATMENT YSTEM MAINTENANCF. AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWF.E MUNICIP LITY OF�lNCHORACE AND � c*--r "� . til ; ( fe v— THIS NffiMORANDUM OF UNDERSTANDTNG made and entered into as orthis � day of Ald4 of 20 0 by and between �b, + +- P. lA, t � [•Y. herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICTPALTI'Y:' In consideration ofthe 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 i I located at M3ib No 477 r)GLo At dl.' Anchorage, Alaska. 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 afproperty sale and title transfer in accordance with AMC 15.65. 02 MAY -09-2005 MON 10:06 AM DYNAMIC PROPERTIES FAX NO. 9072617446 P. 03 Nay. 9. 2005 2:30AM Garnets Entineering GrouprLtd. No.5123 P. 2 These approvals certify that the systems aro adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Drmage. 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 AW WTS that were included in the original design which would allow the AW WTS to continue to perform as designed. E. Permit (Construction) An On.Sitc Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Trcatmcnt System Operating Permit Att-awuaf permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all 1he 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 I FcS.L Owner shall pay to Municipality an sanual fee o11 0_ '0__4�> (8_Q.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. 'Ac toren Ofthis Memorandum of Understanding shalt be for the life of the NAY -09-2005 NON 10:06 AM DYNAMIC PROPERTIES FAX NO. 9072617446 P. 04 May. 9. 2005 8:30AM Garnets Ensineerins Groul Ltd. No.VZ3 P. 3 +i I The term begins on the date of approval by tho 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. S. Alterations, Installsji2n 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. INAinicnance and Repair%. 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 it 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. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWT'S are codified in AMC 14.60. MAY -09-2005 MON 10:07 AM DYNAMIC PROPERTIES FAX NO. 9072617446 P. 05 1iay. 9. 2005 8:310 Garnets Entineerintt Groohl.td. Ne.VZ3 F. a li 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 AWWTS upon 24 hours written notice. F. Owner agrees that any We or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. 0. 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 AW WTS. 7. Nonwalver. The failure of either party at any, time to enforce a provision of this Memorandum of Undcrstanding 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. Atnendment. A. "his 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 Mcmontndum of Understanding as an amendment. A. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representative of the parties are: MAY -09-2005 NON 10:07 AM DYNAMIC PROPERTIES FAX NO. 9072617446 P. 06 liar. 9. 2005 8:31 AM Girness Ensinserlas Gr wl,i Ltd. No .5723 P. b Owner: T' nbd,-f i 6y - Anchorage; Qmrchesing 011icer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdktion: Chniee of Law. Any civil action arising from this Memorandum or 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 or Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severabiliri._ Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum orUnderstandirig. OWNER: �p Date: 9,.ZLbS 01, ' STATE OF ALASKA THIRD JUDICIAL DISTRICT MUNICIPALITY: By: Title: Date.- )ss. ate: )ss. 2 Tlic forego by ac I I Ip_ before me this Q, da of t �g(/ ,the y of on behalf or the Municipality orAnchorage. I NOT PUBLIC FOR AS My C rn sslon expires: ALAS 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. 017-121-22 HAA# (7 T I/ Expiration Date: - 2 D — O 1. GENERAL INFORMATION Complete legal description Lot 2. Block 1. Eaglebrook Subdivision Location (site address or directions) 14850 Northfield Drive Current Property owner(s) Ron Shine Day phone 344-2122 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 14850 Northfield Drive Day phone Day phone Unless otherwise requested. HAA .will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Four 4 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.. TYPE OF WASTEWATER DISPOSAL: . ® Individual On-site ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I 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 wastrv.ater 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 9/28/2004 4L 'etowet r- wacnw 5. DSD SIGNATURE �rct+No CrfN Approved for bedrooms. 4`D'. 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: �� Original Certificate Date: ma.,zw> Municipality of Anchorage • Development Services Department Building Safety Division On-Slts Water 3 Wastewater Program 4700 South Bragaw, St. P.O. Box 19WW Anchorage, AK 995198650 www.cl.andxnge.sk.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST 1=10r715, A• WELL DATA Well type Private Total depth 101 ft. Data of lest Stalk water level Well production If A, B, or C provide PWSID # _ Sanitary seal (Y/N) Y Cased to 101 ft. FROM WELL LOG WATER SAMPLE RESULTS: 15 ft Coltform _Q_—colonies/100 ml. Nitrate .10 mg./I. B. SEPTICIHOLDING TANK DATA Tank TypeiWaterial STEP/Steel Tank size 1.600 gal. Foundation cleanout (YIN) Y Date of pumping C. ABSORPTION FIELD DATA Number of Compartments,j Depression over tank (Y/N) ff Pumper Now Construction Well Log (Y/N) Y Wires property protected (YIN) Y Casing height (above ground) min. AT INSPECTION R Other bacteria 0 colonies/100 ml. Cleanouts (YIN) Y High water alarm (YM) Y Date installed Soil rating (g.p.d./fe or ft2/bdrm) LQ System type Sand Filter Length 40 R Width 15 R Gravel below pipe Z R Total depth LQ R Eff. absorption area eft° Monitoring bibs Y Depression over field N Data of adequacy test Results (Pass/Fail) For _ 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 8 type) N If yes, give date D. LIFT STATION Date installed 8/11/2004 Size in gallons 250 Manhole/Access (Y/N) Y 'Pump on' level at 42 in. 'Pump off" level at 42 in. High water alarm level at 44 in. Datum Bottom of Tank Cycles tested Now Const. Meets alarm 8 circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift statkm on lot >10(Y Absorption field on lot >1W Public sewer main N/A On adjacent lots >t00' On adjacentlots >1W Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation >V Property line >V Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >117 Water main >10' Water Service fine >10 Surface water >100' Driveway, parkinglvehicle storage >25' Curtain drain None Noted Wells on adjacent kits >t00' F. COMMENTS G. ENGINEER'S I cer fry that I have determined through field inspections and ��a? 49th Pq review of Municipal records that Bre above systems are in conformance with MOA HAA guidelines fn effect on this date. T� � raGMEL E MMM Engineer's Printed Name Michael E. Anderson. P.E. Data 8/1MOD4 Vh, l � HAA Fee S S% Waiver Fee $ Date of Payment 6—/A— e i,� Receipt Number SL 487 rlkT (Rev. 12000) Date of Payment Receipt Number A d A 77 K �u ►o eG e•S oi'le/ �7 UD•eGt ejj 4 A lie, ISO £0'd T00*0N MLT GO.ST onu O:III 08-18-04 08:22AM FROM -CUE ESI, SCS ENV SERVICES SGS RcE# 1044943001 Client Name Anderson Engineering Project Name/N Lot 2, Block 1, Eagle Brook Client Sample 1D Lot 2, Block 1, Eagle Brook Matrix Drinking Water 9075615301 T-659 P.02/03 F-068 All Dates/Times are Alaska Standard Time PrintedDate/flme 08/17/2004 11A3 Collected Date/Plme 08/11/2004 13:45 Received Date/rime 08/11/2004 14:00 Technical Director Stephe Ede Released Sample Remarks: Pmamelcr Results PQL Units Method Container ID AllowablePrep Analysis Limns nem Date lnit Waters Department Nitrate•N 0.100 1.1 0.100 mg/L EPA 300.0 B (r--10) 08112104 JJB Microbiology Laboratory Total Coliform TNTCOB col/100mL SM209222B A (<-1) 08/11/04 DKC