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NORTH SLOPE #1 BLK 4 LT 1
North Slope #1 Block 4 Lot 1 #050-511-01 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S W C7 3 m Z 1 2 PID Number: 0 S 0 51 Lf Name: 5\6avt. aIrO,-KA.fro r Wastewater System: taw O Upgrade Address: 19 5,q 3 r �a �� �v ABSORPTION FIELD Phone: (p Q L -2 13 i 0 No. of Bedrodm ' ❑ Deep Trench hallow TrenCh ❑ Bed O Mound ❑ Other L1EGAL DESCRIPTION SoilRating:/� (� t� TotalDept�nlfromonginalgrade: 2 'ire Z V • GPD/Sq Ft. l Lot: ,1 Block: L ybdivi io :� D 1 • 7 l0 1 Depm to pipe b0t1=tM original grade: it.117-11- Gravel depth beneath pipe 2.3 fiFt. Township: , 1 Range: / Seco n: Fill added above ori incl rade: • Ft. Gravel len & Ft. WELL Ild IV2W ❑Upgrade Gravelwidth: 'at>etreenines: Number Oflines: Oonce Z Ft. Ft. Classification (P�rivjate, A.B.C).j- Tlrl �l 1 e' Total Depth: �Do Ft. Cased To: DD Ft. Total absorption area: LO SO. Ft. Pi aCmaterial: 11 W A J Dnller, • < f 1 B 1 .J W • ` 1 `1 P/1L Date tilled: -V Static Wat Lawl: Ft. Installer. O Itid� � Date Installed 10,03 D0 Yield:Pump set at((]] —l0 Das ng /klght AnOve Ground: TAN K GPM Ft. Z Ft. SEPARATION DISTANCESeptic ❑Holding ❑S.T.E.P. To Sw c Absorption Litt "Ming bI nwte Manufacturer K sCs Capacity in gallons: Z50 From Tank Field ststion Tank swmLinse R,er��Pi� •+^ WeR 108 toZ N A 1 Material: Number of Compartments: Z Surface None, Kf— LIFT STATION /�Jo►tc. Lot S -7 N/ /� /_ C 1 & 7 Size In gall Manufacturer. Line i Foundation 27 1 140 Nle /p (:) "Pump on- level at: I at: •_ High water alarm at: Curtain ► 1� ,1, ,_ Pump wed Electrical Inspections pe o Dy:•�7•,_� Drain BENCH MARK " Remarks: Location and Description:.?, No o (r I Assumed El vation- 1-, � 7 r AW s� 11 H T9 .. % � �.. .. .. // Inspections performed by: �bwlP -I^G0 S�.F'S Dates: is 8 9 d3 �— 2n to o3 GREGORYALAMEBERLE CE 9254, Department of Health and Human Services approval t�\\�OFES`�A► Reviewed and approved by: Date: 11 2 a 72-013 (Rev. 2/91) MOA 25 i i T 1 BLOCK 4 1.5 CIA C9tk MZ0 I / _ 21 u.')H°f'R5 oF"QlsE DBH IU WID C WOUN 7IPEDNOKCNCCIUNTCRCD \NCIVATCR ENCCIUNiCRED3i SC1 8-12-03 j` VA7ER IN STANDPIPE 8-19-03 0 \�40_ 80 R / SCALE SITE PLAN -- AS -BUILT EBERLE ENGINEERING SERVICES 3875 MARIAH DRIVE EAGLE RIVER, AK 99577 907-696-0402 (phone and FA' HptiSE CAL. LOT 16 BLK 4 FEATME Y31.3383 3 4 CI -- -- CIA -- C2 — -- C7 SP -T TI T2 .64.6 — — C4 30.6 67.8 — -- 39.6 69.1 -- -- 'C6 40.0 69.6 — -- C7 315 82.3 -- -- CB 48.4 70.3 — -- C9 85.9 501 -- -- SI 84.7 49.1 -- — C10 58.4 78.9 -- -- C11 92.7 64.0 -- — S2 92.0 64.0 — -- VELL — 59•/- 73•/- 253 93 -/- OF A 3./ - OFA 411 00, 11 009TH *.4 ,..... ..... .� GREG SOU CE 9254 bl8 TWO WIDE TRENCHES WITH SPLITTER CIA C3 MIT13P- FG•1183 ��� c111 T�•11.20 1..1 \ i� 1 Co FG•t13] •�TOP ROCK •11021 ' eN!� 1250 CAL. BTAND^M BUT -108 30 UPPER TRENCH TANK 103.7v vil OG•1109 UP 6 PIPE -11007 BOT -109M Tip.71P PIPE FG•1131 FG -112.9 01 4. BOT•BOTTON Q TRENCH — OG•I093 TOP .K 09.1. _.-1-11. --. �.— . -. _TOP 6 TPffE.10&97 707.100]0 LOVER TRENCH BUT -10630 1 66' I MITES D S fTTER NIDVAY BETWEEN TRENCHES 2) GEQABRIC FDES SAW ER PLACED OVER SEVER ROCK BEFORE 7ACUF BOTH TRENCKS 3/ LLILEARD VMLATICN PLACED OVER TANK SEASONALLY HIGH GROUNDWATER LEVEL PROFILE STANDPIPE 4-3-98 99.� 74 NTS ICR❑SS-SECTION AND PROFILE INu,I ua—Uul I LH I tt lU/J/ EBERLE ENGINEERING SERVICES 3875 MARIAN DRIVE EAGLE RIVER, AK 99577 907-696-0402 (phone and FA' STANDPIPE 8-12-03 195.0 ASSUMED MA NO WATER �sOF•Atq��1 ow ;49TH* Ry ALAN EBERLE CE 9254 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. a I. a n c h o ra o e. a k. us (907) 343-7904 8 <f(ENGINEER'S, SEAQit Of �/��,Zi• _ Cc 9254 Soils Log - f /'' ) Performed For: Q, y(- l�.tlQ,L<G3 Q V Dale Performed: ff Legal Description: _PO Y U •t ( B 1i Township, Range, Section: Slope Site Plan 1. 2- 3- 4- 5- 1 15- 5- 16- 17- 18- 19- 16- 18- 19- Brl COMMENTS COMMENTS iS GROUND WATER ENCOUNTERED? 1 IF YES, AT WHAT DEPTH? 1 ` Depth to Water After Monlp Ing? Date: 'U O S L O P E 3 ;LZ PERCOLATION RATE (mW*,A m) PERC HOLE DIAMETER TEST RUN BETWEEN _ n_ FT AND FT 5 PERFORMED BY: &CZAl W I RTIFY THAT THIS TE TAS PERFORMED IN ACCORDANCE ITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 1, 03 uCertf f ieb �rfthng logby � DOC CO. dba �g SULLIVANMATER WELLS �n P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2750 OWNER OF LAND: 1jGR�.i 6�CW.✓Q O FF BORE HOLE DATA . DEPTH ADDRESS: LEGAL DESCRIPTION: y d DATE: - PERMIT NUMBER: 0 ? i. --TAX tOENTIFICATION NUM'BER:' Is well locates at approved permit location? .1 Yes J No ..: t`` Method of Drr ling: Wir rotary u cable tool Depth of well -1 CIO 1 Casing Type S ` 0-__L Wall Thickness ,'S J inches Diameter y�� / inches. depth / 0 feet Liner Type: t . Casing Stickup Above Ground: feet Static Water Level: (I y feet j Recover Rate: _l gpm Method of Testing: 41 L' Well Intake Opening Type: &-d-p-een end J open hole ` J Screened;_ Start feet Sto ed feet U Perforations Start feet StDpped9^ feet ' rft Crrl Grout Type: /Sr.yT�"'� volume Depth: from 0 feet, to ') O feet Well Disinfected Upon Completion? O No ' Method of Disinfection: C44L 0 1 J'.JcF So / p j%"M ( Comments:,, .J(, ;j/2 U JFK/.3✓rOEti r .i ATTENTION: It is the responsibility dl the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING e e• 04i i {� O Parcel I.D. ��—� I I —V I Permit Number SW Property Mailing address ( phone ZD Mailing address (2) E. f2 ' / t- 1�� 11 Zip Code G G S DD Legal description (Lot, Block & Sub'd.) a i c)f..,ln � S (� P #� !.3 4 L.1 Legal description (Section, Township & Range) UV) % Vl n Y✓K, Lot Size LA 35 0 Acres q.Ft. Number of Bedrooms LA THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. (Signature of property owner or authorized agent) Permit Fees: Waiver Fees: Date of Payment: I Vrr j V :( Date of Payment: Receipt Number: < '�'i�� �S k Receipt Number: (Rev. 12/00) MUNICIPALITY OF ANCHORAGE Development Services Department Onsite 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 Permit Number: SW030212 Legal Description: I &ffi Slope #1 Block 4 Lot 1 Design Engineer: 0821 Eberle Engineering Services Owner Name: Brian & Kathy Owner Address: 195463rd Street Eagle River. AK 99577 - Date Issued: Jun 23, 2003 Expiration Date: Jun 22, 2004 Parcel ID: 050-511-01 Site Address: Unknown Lot Size: 43560 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. Q Disposal Field Q Septic Tank Holding Tank Ej Privy Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by catling (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 dosed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM A BEDROCK/GROUND WATER MONITOR FOR THE UPGRADE SITE. Received By- Issued y Issued By. Date: 0 Date:6/2 3 03 Municipality of Anchorage • —t Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING �q (o Parcel I.D. © G O ` 5111 — O 1 Permit Number SWO302 / 2 -FL,Jjf,'D - I I Property ow Mailing address ( Day phone Mailing address (2) Tak!R f 2 fti V Qr . > Zip Code C7 9 S� % Legal description (Lot, Block & Sub'd.) �� k No . SGDSe SI% i K t» Legal description (Section, Township & Range) 5tc.'f46-k 3 2 , '►-f 4 N) E 1 SM Lot Size THIS APPLICATION IS FOR: Number of Bedrooms T Sewer Only ❑ Well Only ❑ Sewer and Well 14 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. of property owner or dulhbrized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12100) Waiver Fees: J Date of Payment: �� �> Receipt Number: I LEGAL Description: Lot 1 Block 4 North Slope Subdivision, Addition 1—Section 32, TUN, RIE, SM This note is concerning Permit Number SW030212 Monday, June 28, 2003 Dan Roth, PE MOA DHHS On -Site Services Dan, The well driller placed the well approximately 90 ft west and a little north of its approved position on the site plan on Lot 1, Block 4, North Slope Subdivision, Addition #1. Please see attached sheets. As such, the now existing well's position will still have no impact on the surrounding adjacent properties—per required distances between the well and all septic components. The proposed septic tank on this property, however, will need to be relocated to attain the necessary 100-11 separation distance. The attached sheets show the proposed new location for the septic tank on this property, Lot 1, Block 4, North Slope SD. Neither does this lot's proposed new septic tank location infringe on any adjacent property's well or septic components' separation requirements. Sincerely, l qz��� Greg Eberle, PE Eberle Engineering Services Eberle Engineering services WELL AND SEPTIC SYSTEM APPLICATION NARRATIVE LEGAL: Lot 1 Bik 4 North Slope Subdivision, Add'n 1—Section 32, TUN, RiE, SM Sunday, June 15, 2003 IMPACTS TO ADJACENT PROPERTIES The location and design of this wastewater system Is expected to have no impact on adjacent properties. There are no wells or surface waters within 100 feet of this proposed design. The nearest existing septic system on neighboring properties is to the west on Lot 2, Block 4 and lies approximately 90 feet from the proposed system. Other neighboring systems and wells are shown on the plot plan drawings. The design location causes no Impact on reserve areas on neighboring lots. There are no known curtain drains. TOPOGRAPHY North Slope Subdivision consists of single family homes with rural zoning located about 10 miles southeast of the main population of the town of Eagle River. Lot 1 Block 4 slopes generally south from 10 to 20%; the vicinity of the proposed septic trenches slopes more gradually—approximately 3% north to south and less than 3% east to west. The subdivision Is developed with electricity, phone, and natural gas. LOCAL WATER LEVEL An 11 -foot deep soils -investigation pit was dug on site in 1998 and a standpipe inserted to that depth for monitoring groundwater. Groundwater was sounded at a depth of 7 feet BGS In Spring 1998. In May 2003, the groundwater level was 8 it BGS. PERCOLATION TESTS AND SOILS The soil immediately underlying the 64nches thick surface organic layer consists of sand and gravel with silt, occasional cobbles, and boulders to 18 inches, SP -SM underlain by GP -GM to GM to 4.5 ft BGS; the 1998 soils investigation Indicates GM/SM from 4.5 to 11 feet below ground surface. Three Falling Head percolation tests were performed in accordance with Alaska DEC specifications In the holes indicated on the attached sheets. The soils percolated in the 6 to 15 minutesrnch range, resulting In a design rate of 0.8 GPD/SF or 188 SF/BR by Table 1 per AMC 15.65 for the wide trench requirements and specifications. Included: 1 -0n -site SewedWell Permit Application for a Single Family Dwelling I -Narrative (this sheet) 1 -System Specifications 1 -Vicinity Site Plan -100 sale 1 -lot Well and Septic System Layout Plan -40 scale I -Cross -Section and Profile 1.5 -foot WIDE Trench Drainfield Design Shat 3 -Soils and Percolation Sheets Eberle Engineering services 3875 Mariah Drive Eagle River, AK 99577-9757 Phone/FAX 907-696-0402 SPECIFICATIONS FOR ONSITE SEPTIC SYSTEM LEGAL: Lot 1 Block 4 North Slope SD Addition 1 --Section 32, TUN, RIE, SM June 16, 2003 A. GENERAL 1. The septic plans are for a single-family, 4 -bedroom residence. 2. The site plan and profile drawings shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verged in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage and Alaska Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent mufti -family wells. 7. The excavation is to be exactly in the area shown on the site plan; any deviation requires engineer approval. 8. it is always recommended that a surveyor locate the nearest tot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled. B. SEPTIC TANK 1. Septic tank shall be 1250 gallon. C. 5 -WIDE DRAINFIELD 1. The trenching is to maintain uniform total depth. 2. The bottom of the trenches shall be level throughout their entire lengths and their perforated pipes and sewer rock top and bottom of equal elevation. 3. The total depths of the trench excavations are not to exceed 3.0' at any point. 4. The effluent lines within the trenches shall be laid level within 0.03'. 5. The sewer rock gravel is to be covered with typar fabric material if not insulated. 6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent Is to be placed over the trenches. 7. The area over the trenches Is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and teachfields must not be closer than 100' to any existing private well, 150' to any Class "C" well or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH= 3.0' GRAVEL DEPTH = 12' under pipe, 2" over pipe TRENCH LENGTHS (CENTER) = 66' TRENCH WIDTH = 5' SOIL RATING= 0.8 GPD/SO.FT BEDROOM CAPACITY = 4 SEPTIC TANK SIZE = 1250 GAL. SEWER AND PERFORATED PIPE DIAMETER = 4' Twenty-four (24) hours notice required for all Inspections. ro „�2R� �oa TRACT 3-1 TERI SD 02 TRACT 2-2 TERI SD 62 �1 OT 16 VEIL 722 0 SLR 6 orc 1 SLDES 4OttOTRAL ►ROPDSE➢ VELL LR'Aimll / ESIS11% WELL oV/ A pq�D� vK Oso JI TAN: �•�� .�� -IES6 64LU>iS 0 LIYT • POST pCA • 1S1(R — 24}U/ / / PIED TES / RaT D' F 15' GS W)RILK 3 CUITN V 6 E D LR 7 WTIl11VPI10 TREE LIrT 2 IDD' VELL RAMI SLK J EXISTINGEXISMOC VEL R,..a O Lm t UpARUk RLS 9 TRACT 3-7 TERI SD 62 enc Q Q 100 200 ft SCALE BLDGS & SYSTEMS W/IN 200 FT • G,QTN ` • •" •••• LEGAL; LOT 1 BLK 4 NO. SLOPE SD ADD'N 1VZ OWNER; BRIAN GRANDORFF CONTRACT❑R/BUILDER ,� ,e i '1GTGJ"?YI�'•S•M••E ✓i JOB NO., 03-001 DATE; 7/29/03 ENGINEERING SERVICES I••s•;t,EBERLE CES254+1,•, � 3875 MIDVE EAGLE RVER,AK99577 907-696-0402 (phone and FAX) 10, (/TI i o 0 17"y Y fgSfMfNT LOT 16 io\ BLK 4 WELL 7-22 03 SEPTIC LOT 1 BLOCK 4 ORIGINAL PROPOSED WELL LOCATION p� SfD fP S 114" PR❑POSE HOUSE .tic /� ROPOSED TAN 36.0 c,1250 GALLONS TH _ 66.0 J 0 2 1 1 ' T` P/26/98 APPROX. POSITIO 30.0 F RELOCATED 4 _ BIC / PROPOSED TANK J TH SE-03 / / P --BENS MARK=100' HEX BOLT 5' ABOVE GS NORTH FACE OF 15' DB C❑TT64iOOD TREE 0 40 80 1t 2 SCALE SITE PLAN--WELL COMPLETED ,�ti0F.A4'xllj LEGAL, LOT 1 BLK 4 NO, SLOPE SD ADD'N 1 9• OWNER: BRIAN GRAND❑RFF CONTRACT❑R/BUILDER: 1100JOB •• •••• •' .GR EGORYAUHEBEBLE•.• i NO., 03-001 ATE, 7/29/03 EBERLE ENGINEERING SERVICES lam•' CE OW 3875 DRIVE (1 •`���� EAGLEMI RIVER, AK 99577 907-696-0402 (phone and FAX) Min FG El. 0.5 ft e Stand i Above Existing Grade Standpipe With Insul. (See Notes) rr. n Top of Rock 1.5 ft Below EG Pipe Invert 2.0 f t Below EG_ WL El. 7' BGS Apr Bottom of Trench El. 3' Below EG WL El. 8' BGS May 10' min. Trench Bottom El. 102.3 Separation Standpipe set 1998 TWO WIDE TRENCHES Twin 5'-w1de Trenches NTS Length 66 ft QI11*111 - Maximum digging depth 3.0 ft BGS - Blueboard Insulation to cover sewer lines and tank where soil cover is less than 3 feet thick. - Geofabrlc fines barrier over top of sewer rock and 3 feet minimum soil cover unless wide trenches are Insulated. - Minimum cover with Insulation Is 2 feet House Foundation Wall Foundation / Flow Splitter to CO d 1-4 ft 11 C❑ CO Cos `Cos Min FG El. 0.5 ft MTs Above Existing Grade lWith Insul. (See Notes) Bottom El. 3' Below EG Two 5 -Wide Trenches 66' CROSS-SECTION AND PROFILE I OWNER: BRIAN GRAND❑RFF C❑NTRACT❑R/BUILDER: 3 NO.; 03-001 1 DATE; 6/21/0: EBERLE ENGINEERING SERVICES 3875 MARIAH DRIVE EAGLE RIVER, AK 99577 907-696-0402 (phone and FAX) COS Top Rock 1.5' Below EG Pipe Invert 2' Below EG f OF A4 11, ty .SEGORYAU EBEALE ;. CE 9254 9 rs / 1250 W gal Foundation Tank to Tank 17' Tank 5' Minimum to Trench TWO WIDE TRENCHES NTS Bottom El. 3' Below EG Two 5 -Wide Trenches 66' CROSS-SECTION AND PROFILE I OWNER: BRIAN GRAND❑RFF C❑NTRACT❑R/BUILDER: 3 NO.; 03-001 1 DATE; 6/21/0: EBERLE ENGINEERING SERVICES 3875 MARIAH DRIVE EAGLE RIVER, AK 99577 907-696-0402 (phone and FAX) COS Top Rock 1.5' Below EG Pipe Invert 2' Below EG f OF A4 11, ty .SEGORYAU EBEALE ;. CE 9254 9 s 03 L + t , Rock 4 � N®.r-f - s 6 s D , Add � Cts. 4f1 W►de, P��e.,(j 2f2 h�"� (AMC t5.65) TAA -co (0*L -r, vl>� 6 9 8 twc►�w-t�-s r4- tektk— soil :s car-wEL A sAN-b , Littt,. 54(i') ,po*:49TH* GMEGM.0254 iU A &IB1o3 50 , t Z f V 4 8AJ�Qw-s . #. u = 13 -------------- Lo -- Lo ►.,q . Muniefp EA of Anchorage � DEPARTMENT OF HEALTH d HUMAN SERVICES 825'L' Swat. Anchorage, Alaska 99502-0850 SOILS LOG — PERCOLATION ES I +Q� An Tif SE -o3 PERFORMED FOR: Sl. �' Yttiyr� DATE LEGAL DESCRIPTION: I 1rtl-, T O Oa RN QNl S 'PAA �SIhNL 7%-91 �'1I *�I 1 twuw W/SII 2 lSvs�^{ nioiST "IzftvkL��r+. V*6_ si It•, aab�te61 b "s 3-j 18a (x1 Intva ( „a(AV. x'G, 4 Be a�sL Ihk— 315 6- 6 7 a 9- 12- 13 1213 14 15 is 17 19 19 20 'GREGOPIYAMBERLE/1.0 Ig CE 8254 U ti E ®©mm im ��■�r��■�nom�7ir�■ s���rz�-��r.�m■�n�i� �c�l � �rrr�s:>. �r•� ■>�m mar PERCOLATION RATE --6— terwawwKN MAC ►IOIE DNMETER �k TESTRUNDETWEEN Z-5 "AND 31 FT KWOAMED BY: I CERTIFY THAT THIS TEM WAS PERFORMED IN A=OROANM WITH ALLSTATE AND MUNICIPAL GUIDELINE81N EFFECT ON TN3 DATE. CATL' OFA 49TH MwnWpaUty of Anchoaga .r • DEPARTMENT OF HEALTH fl HUMAN SERVICES 1 '• GBEGGBYAAA ESELE 825'1. -Street. Anchorage. Alaska 99502-0850 �.: SOILS LOCI —PERGOLA �,. CE 9254�� 7 SW -o PERFORMED f011: DATE PERFORMED: h►�. O LEGAL DESCRIPTION: 4) I +M_ e1, 1 K T OR[11MCw.� S ''1. 1 I SIAL A \ 1.s 2 B yet Wlalit.017Ct�L a SAND t� tt 1. is t, Cabbies 4 rap- 4t``► JMIw.Y. 6 . Bad- �- �F•ls= 4•s{�ar:s e 8 BC6 9 . 14 15 • 18 17 19 19 UPERCO ION RATE &7 Inwwewnay PMRC 1,+01.5 twwETEn 1 TEST RUN BETWEEN '3 "AM Bets COMMENTS PERFORMED SY: 1 CERTIFY THAT TNS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL QUIDEL10" IN EPFLCT ON THIS DATE DATE i Municipe ty of Anchorage DEPARTMENT OF HEALTH A HUMAN SERVICES 825 *V Street. Anchorage. Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �AN �+`-X.HCQL DATE LEGAL DESCRIPTION: Lor I suc i[_ T TownsNp, Range. Section: 13 14 15 16 17 18 19 00"m OLope q0 WAS GROUND WATER i IF YES, AT WHAT DEM? to VhW Aft (P St TI zR 5:11 a 3-' co �e v%�I 6 4 5- '�>•��t�ltY��O 6- 5 7- 7 /. bM/ 8 SM �/� 10 • • 11'R. CO." 12 13 14 15 16 17 18 19 00"m OLope q0 WAS GROUND WATER i IF YES, AT WHAT DEM? to VhW Aft AIA ONNEWMEMEMEN '�>•��t�ltY��O p -j I 1 N 1 f PERCOLATION RATE ESQ_ (mwaea/uitA) PEAL MOLE DIAGETER L� I' TEST RUN BETWEEN I FT AND FT COMMENTS PERFORMED BY. _ I ACCONDANCE WITH 72-M tRw. 4084 CERTIFY THAT TM TEST WAS PERFORMED N GUIDELINES W EFFECT ON TM DATE DATE --14 13 11 f Municipality of Anchorage Development Services Department o +� Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: GREG EBERLE Legal description: NORTH SLOPE SUED, BLOCK 4 LOT 1 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. 30 FE' DEEPER THAN THE WIDE DRAINFIELDS. ® Water monitoring results inadequate. GROUND WATER MONITOR DOES NOT REACH UPGRADE SITE ❑ 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. 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: 6/19/03 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Legal description North Slope #1 Block 4 Lot 1 Site address 3830 Harca St, Eagle River Current property owner(s) Brian & Kathryn Grndorff X Come _14 Ov Expiration Date: .,J.1_ -25--T2 The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: , WEMAZOVILM40 ffin[01011_4�, W"d 0V- -A -I 5 W401 &q 4-6 1/\ I s ro N B Original Certificate Date: ��'2_ C os -et m_sz wd ;6 cts-eA oNA U (DA TCD ll ZO-L 2 - This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality ot Anchorage, Development Services Department (DSID) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Absorption Field Advisory Tank Age Advisory Other Well Flow Advisory Nitrate Advisory Arsenic Advisory COSA Approvaljune 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-511-01 Complete legal description North Slope #1 Block 4 Lot 1 Location (site address) 3830 Harca St. Eagle River, AK Current property owner(s) Brian & Kathryn Grandorff Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: FZI Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: © -Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age 19 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 55d Waiver Fee $ Date of Payment `�'a 5'a0 Date of Payment COSA # 0 SC221 '310 Waiver # COSA Application—June 2022 Legal Description: North Slope #1 Block 4 Lot 1 Parcel ID: 050-511-01 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA © Well log is filed with Onsite (or attached) Date drilled 6/23/03 Total depth 100 ft Cased to 100 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 39 in. Date of flow test for COSA 6/27/22 Static water level at beginning of test 54 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping 6/1/22 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) $/9/03 ❑✓ ALL standpipes present per record drawing Total measured depth from grade 5 ft (max) Measured depth to pipe invert from grade 3.3 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. © Monitor tubes go to bottom of effective_ If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced _gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist—June 2022 Well production at time of test 5.1 gpm Water storage tank volume - gallons Well disinfected for -coliform test? ❑ Yes ® No V Coliform bacteria is Negative Nitrate 14.7 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Arct,erra Consulting Date 6/27/22 C-AJFT STATION ❑ Require nt+ Age of lift station . Lift station material Comments: mance completed Adequacy test date 6/27/22 Results © Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 0 in Elapsed time 10 min Final fluid depth 0 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 19 in Effective depth used 0 in Effective depth remaining 19 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' © Yes if No ft %71 Yes if No ft Neighboring Tank > 100' © Yes if No ft Private Sewer/Septic Line > 25' © Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft © Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' © Yes if No Tank to Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: the surface, changes use, soil characteristics, groundwater may being by The life Field to Property Line > 10' Yes if No ft Private Wells > 100' Yes if No Water Main > 10' © Yes if No ft Community Wells > 200' FZ] Yes if No Water Service Line > 10' ✓0 Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS ft ft ft ft G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm .ISG 1P r ,:--- PhoneL ep I l Engineer's Printed Name Date d Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The the the to the the day tested. ��4pl�Ati� � 14 t r �ir assessment of condition of well and septic applies only conditions as of The due be from ...••••...... •. +. •�.• $$ now and absorption rates may change to subsurface conditions that may not observed inland local levels that fluctuate during �7�� $$ the surface, changes use, soil characteristics, groundwater may being by The life a A .7 the year and the water usage of the A mily served the system. operational of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the (Ajy, '..¢g ....... evaluator of the well and septic system. Therefore, AreTerra cannot give any estimate of how long a r F system will function satisfactory for current or future occupants or can ArcTerra guarantee that no p •.�•••+••+•• •*n-•.:• M unseen encroachments, deficiencies or discrepancies exist ¢$ �� : K E J i,., E --1K ra,r Ui is _IV or V CE .' • AV Ar COSA Checklist June 2022 41f��$��g�4 ��� DEVELOPMENT SERVICES DEPARTMENT On -Site water and wastewater Section www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC 221370 Subdivision: North Slope #1 Block 4 Lot 1 907-343-7904 Fax: 343-7997 A water sample revealed a nitrate concentration of 14.7 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 x6650 *www muni org From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filterthat contains a media with a strong affinityfor negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical' methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. August 18, 2022 l c 9'�11ztzA CONSUI,TING, INC 20441 Ptarmigan Bld, Eagle River, AK 99577 Office (907) 696-61 1 1, Fax (907) 868-3793 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: North Slope #1 Blk 4 Lot 1— COSA review OSC221370 Well Nitrate Investigation Per your request we conducted additional investigation into high nitrate levels found during our testing on 6/27/22; We reviewed thirteen wells in the immediate area. While theredoes not appear to be any consistent tie between them, most of the information on the nitrate levels is more than 15 years old. Based on that investigation I would like to point out the following: 1) This well was scoped by Sullivan Water Wells to a level of 60' and no cracks or any other signs of infiltration from surface waters was found. 2) This well was drilled by a reputable well driller, into an unconfined aquifer and shows that a bentonite seal was installed. 3) The well log shows several different soils layers some of which would provide an effective barrier to surface infiltration. 4) An adjacent property, Teri #2 Tract D3 also showed high nitrates during testing on Oct 10, 2010. A new well was drilled on the property which went into an aquifer that was 20 feet higher and saw their nitrates reduced to 0.69 mg/L. In 2018 there was a significant seismic event that occurred in Eagle River impacting the area. At this point there is no way to ascertain what impact that, or other events in the area, may have had, however it does not appear that the elevated nitrates are being injected into the aquifer from this well, nor does it appear that they are going into the aquifer from the on-site septic system based on the layers identified on the well log. 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 Considering the above, without a comprehensive study of the area, water sampling of the surrounding wells for current nitrate levels and an extensive investigation into the adjacent properties' on-site systems there is no way to effectively determine the cause of the nitrate increase in this one sample. The effort described above is beyond the scope of our COSA inspection to verify the possible causation of high nitrate levels found in this well or the surrounding areas. As such we are requesting approval of the COSA with a standard notice regarding the high nitrates. We also believe that a point of use RO system be installed for potable water. If you have any questions, please contact me at 696-6111 /FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. Duffus, P.E. 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Dea- ArcTerra 3830 Harca Street Eagle River, AK 99577 Camera Inspection Report Ran camera down well 60+ feet. No cracks or breeches found in well. Date: 7-13-22 r N G r c Informational Water Quality Report Watercheck enjamin Craig Ordered By: Mat -Su Test Lab 9161 East Frontage Road Suite 15 Palmer, AK 99645-2749 ATTN: Anne Gleason Definition and Legend Sample Number: 942763 Location: M221205, OHB Type of Water: Well Water Collection Date and Time: 11/9/2022 3:58 PM Received Date and Time: 11/11/2022 9:34 AM Date Completed: 12/8/2022 This informational water quality report compares the actual test result to national standards as defined in the EPA's Primary and Secondary Drinking Water Regulations. Primary Standards: Are expressed as the maximum contaminant level (MCL) which is the highest level of contaminant that is allowed in drinking water. MCLs are enforceable standards. Secondary standards: Are non -enforceable guidelines regulating contaminants that may cause cosmetic effects (such as skin or tooth discoloration) or aesthetic effects (such as taste, odor,or color) in drinking water. Individual states may choose to adopt them as enforceable standards. Action levels: Are defined in treatment techniques which are required processes intended to reduce the level of a contaminant in drinking water. mg/L (ppm): Unless otherwise indicated, results and standards are expressed as an amount in milligrams per liter or parts per million. Minimum Detection The lowest level that the laboratory can detect a contaminant. Level (MDL): ND: The contaminant was not detected above the minimum detection level. NA: The contaminant was not analyzed. The contaminant was not detected in the sample above the minimum detection level. The contaminant was detected at or above the minimum detection level, but not above the referenced standard. The contaminant was detected above the standard, which is not an EPA enforceable MCL. The contaminant was detected above the EPA enforceable MCL. These results may be invalid. Total Coliform by P/A No bacteria sample was submitted. Inorganic Analytes - Metals Aluminum ND mg/L 0.2 EPA Secondary 0.1 Arsenic ND mg/L 0.010 EPA Primary 0.005 Barium ND mg/L 2 EPA Primary 0.30 y Cadmium ND mg/L 0.005 EPA Primary 0.002 Calcium 43.8 mg/L -- 2.0 Chromium ND mg/L 0.1 EPA Primary 0.010 Copper 1.052 mg/L 1.3 EPA Action Level 0.004 Iron ND mg/L 0.3 EPA Secondary 0.020 Lead ND mg/L 0.015 EPA Action Level 0.002 Lithium ND mg/L -- 0.001 Magnesium 7.42 mg/L -- 0.10 Manganese ND mg/L 0.05 EPA Secondary 0.004 Mercury ND mg/L 0.002 EPA Primary 0.001 Nickel ND mg/L -- 0.020 If Potassium ND mg/L -- 1.0 Selenium ND mg/L 0.05 EPA Primary 0.020 Silica 9.9 mg/L -- 0.1 Silver ND mg/L 0.100 EPA Secondary 0.002 Sodium 5 mg/L -- 1 Strontium 0.225 mg/L -- 0.001 1 Uranium ND mg/L 0.030 EPA Primary 0.001 Zinc 0.037 mg/L 5 EPA Secondary 0.004 Physical Factors Alkalinity (Total as CaCO3) 96 mg/L -- 20 Hardness 140 mg/L 100 NTL Internal 10 Page 2 of 5 12/8/2022 2:56:11 PM Product: Watercheck Sample: 942763 Status Contaminant Results Units National Standards Min. Detection Level pH 6.6 pH Units 6.5 to 8.5 EPA Secondary Total Dissolved Solids 150 mg/L 500 EPA Secondary 20 Turbidity 0.2 NTU 1.0 Inorganic Analytes - Other EPA Action Level 0.1 Bromide ND mg/L -- 0.5 Chloride 10.0 mg/L 250 EPA Secondary 5.0 FI de Nitrate as N Nitrite as N ND 1.8 ND mg/L mg/L mg/L 4.0 10 1 EPA Primary EPA Primary EPA Primary 0.5 0.5 0.5 Ortho Phosphate ND mg/L -- 2.0 ® Sulfate 16.0 mg/L 250 EPA Secondary Organic Analytes - Trihalomethanes 5.0 Bromodichloromethane ND mg/L -- 0.002 Bromoform ND mg/L -- 0.004 Chloroform ND mg/L -- 0.002 Dibromochloromethane ND mg/L -- 0.004 Total THMs ND mg/L Organic Analytes 0.080 - Volatiles EPA Primary 0.002 1,1,1,2 -Tetrachloroethane ND mg/L -- 0.002 1,1,1 -Trichloroethane ND mg/L 0.2 EPA Primary 0.001 1,1,2,2 -Tetrachloroethane ND mg/L -- 0.002 1,1,2 -Trichloroethane ND mg/L 0.005 EPA Primary 0.002 1, 1 -Dichloroethane ND mg/L -- 0.002 1,1-Dichloroethene ND mg/L 0.007 EPA Primary 0.001 1, 1 -Dichloropropene ND mg/L -- 0.002 1,2,3-Trichlorobenzene ND mg/L -- 0.002 1,2,3-Trichloropropane ND mg/L -- 0.002 Page 3 1,2,4-Trichlorobenzene of 5 12/8/2022 2:56:11 PM ND mg/L 0.07 EPA Primary Product: Watercheck 0.002 Sample: 942763 Status Contaminant Results Units National Standards Min. Detection Level 1,2 -Dichlorobenzene ND mg/L 0.6 EPA Primary 0.001 1,2-Dichloroethane ND mg/L 0.005 EPA Primary 0.001 1,2-Dichloropropane ND mg/L 0.005 EPA Primary 0.002 1,3 -Dichlorobenzene ND mg/L -- 0.001 1,3-Dichloropropane ND mg/L -- 0.002 1,4 -Dichlorobenzene ND mg/L 0.075 EPA Primary 0.001 2,2-Dichloropropane ND mg/L -- 0.002 2-Chlorotoluene ND mg/L -- 0.001 4-Chlorotoluene ND mg/L -- 0.001 Acetone ND mg/L -- 0.01 Benzene ND mg/L 0.005 EPA Primary 0.001 Bromobenzene ND mg/L -- 0.002 Bromomethane ND mg/L -- 0.002 Carbon Tetrachloride ND mg/L 0.005 EPA Primary 0.001 Chlorobenzene ND mg/L 0.1 EPA Primary 0.001 Chloroethane ND mg/L -- 0.002 Chloromethane ND mg/L -- 0.002 cis-1,2-Dichloroethene ND mg/L 0.07 EPA Primary 0.002 cis-1,3-Dichloropropene ND mg/L -- 0.002 ' DBCP ND mg/L -- 0.001 Dibromomethane ND mg/L -- 0.002 Dichlorodifluoromethane ND mg/L -- 0.002 Dichloromethane ND mg/L 0.005 EPA Primary 0.002 EDB ND mg/L -- 0.001 Ethylbenzene ND mg/L 0.7 EPA Primary 0.001 Methyl Tert Butyl Ether ND mg/L -- 0.004 Methyl -Ethyl Ketone ND mg/L -- 0.01 Styrene ND mg/L 0.1 EPA Primary 0.001 Page 4 of 5 12/8/2022 2:56:11 PM Product: Watercheck Sample: 942763 Status Contaminant Results Units National Standards Min. Detection Level Tetrachloroethene ND mg/L 0.005 EPA Primary 0.002 Tetrahydrofuran ND mg/L -- 0.01 11f Toluene ND mg/L 1 EPA Primary 0.001 trans-1,2-Dichloroethene ND mg/L 0.1 EPA Primary 0.002 trans-1,3-Dichloropropene ND mg/L -- 0.002 Trichloroethene ND mg/L 0.005 EPA Primary 0.001 Trichlorofluoromethane ND mg/L -- 0.002 Vinyl Chloride ND mg/L 0.002 EPA Primary 0.001 Xylenes (Total) ND mg/L 10 EPA Primary 0.001 We certify that the analyses performed for this report are accurate, and that the laboratory tests were conducted by methods approved by the U.S. Environmental Protection Agency or variations of these EPA methods. These test results are intended to be used for informational purposes only and may not be used for regulatory compliance. National Testing Laboratories, Ltd. 556 South Mansfield Street • Ypsilanti • Michigan Page 5 of 5 12/8/2022 2:56:11 PM Product: Watercheck Sample: 942763 1 ,M Municipality of Anchorage •. 1\\tr`,� •'��, Development Services Department'; Building Safety Division .. , "`JJJ Onsite Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.sk.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _QCD — (;-I-/ _O If HAA# f% USO S I 1. GENERAL INFORMATION Expiration Date: 2 Complete legal description NORTH SLOPE #1 SUBDIVISION* LOT 1 BLOCK 4, ❑ Public Water System ❑ Location (site address or directions) 3830 HARCA STREET * EAGLE RIVER, _AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address BRIAN do KATHY GRANDORFF Day phone 694-3870 3830 HARCA STREET • EAGLE RIVER AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well N Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site N 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 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,/ verify that my Investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the onsite watersupply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm 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 & 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 fdentirtable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fuctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. S. DSD SIGNATURE Approved for _—L bedrooms. Disapproved. Conditional approval for bedrooms, with the following Phone 337-6179 Date t t It d OF C/O" . ON-SITE ••�'�G?'s WATER AND PROGRAM "'�//JJIJJIIInf' Attachments: / HAA Checklist J Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: Original Certificate Date: (Rev. 11101) Municipality of Anchorage Development Services Department mming Safety Dmwm On m water & Wastewater Program 4700 South Bagew St. P.O. Box 19WW Anchorage, AK 995198650 www.d.anehorage.ak.us (907)343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: NORTH SLOPE N1 SUBDIVISION, LOT 1, BLOCK 4 Parcel ID: A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Well Log (YIN) Y Date completed 7/22/2003 Sanitary seal (Y/N) YES Wines property protected (Y/N) YES Total depth 100 ft. Cased to 100 ft. Casing height (above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test 7/22/2003 10/28/2005 Static water level 64 ft. 55 R. Well production 10 g.p.m. 4.08 g.p.m. WATER SAMPLE RESULTS: *PREVIOUSLY SUBMITTED TO MOA. Coliform 0 colonies/100 m1. Nitrate 1.45 mg./L. Other bacteria 0 oolonies/100 ml. Arsenic: N/A rngJL. Date of sample: 9/19/2005 Collected by: 'GREG EBERLE, P.E. B. SEPTICIHOLDING TANK DATA Tank Type/Material PREMIER/HDPE Date installed 8/9/2003 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation deanout (YM) YES Depression over tank (YM) NO High water alarm (YM) N/A Date of pumping 5/14/2005 Pumper JRS PUMPING C. ABSORPTION FIELD DATA Date installed 8/10/2003 Soil rating gii.d. r R'/bdrm) 0_8 System type SHALLOW TRENCH Length 66 R. Width 5 ft. Gravel below pipe 1.2/2.3 ft. Total depth *_ft. Eff. absorptlon area 750 ft' Monitoring tube YES Depression over field NO Date of adequacy test 10/28/2005 Results (Pass/Felt) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 600+981, New depth 2 in. Elapsed Time: 158 min. Final fluid depth 0 In. Absorption rate >= W (0 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ High water alarm level at in. Meets alarm & circuit requirements?, 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 59+ Property line 50+ 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 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 1006+ F. COMMENTS ,A -t t .G n 4z4 ant 'r"A..r- pn A%^n F. SAS An,E r N J 4 L^ -Tad 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. Engineers Printed Name JEFFREY X GARNESS Date t1b JOS- HAA oS HAA Fee $ Date of Payment Receipt Number (Rev. 12101) 0 OR.j--r— STa�A !r Waiver Fee E Date of Payment Receipt Number 31 05 05:38p Brian October 31, 2005 To Whom It May Concern: Re: North Slope Subd. Addn No 1 Lot 1, Block 4 3830 Harca St Eagle River, AK 99577 907-694-4696 In regards to the septic system at the above address, I am verifying that there is 2" Blueboard Rigid Insulation over the septic tank as well as the leech fields. 424h$y6jfGn�dorff 70-110 NORTH SLOPE SUBD•, ADDN. NO. 1 LOT 1 BLOCK 4 43.560 S.F. 50' i GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI. R.L.S. 4726 WEST BSTH AVENUE ANCHORAGE. ALASKA 99502 PHONE 248-5454 DATE 9/7/2005 JOB NO. NSS114 I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT. ALASKA NOTE: NO CORNERS SET THIS DATE. . OF of 1O P•.•,,.....,,,Ar , qs • �: ,. yr 49Th ••.. ... � b4 .fA. Gostoldl : 0kk—= LS -6091 .' 4 AV • • Jt Municipality of Anchorage I . -.• Development Services Department Building Safety Division On -Site Water and Wastewater Program s, „ 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. C)50-511 —of HAA# 65 1. GENERAL INFORMATION Complete legal description Location (site address or Current Property owner(s) Mailing address Expiration Date: o the 5b 4* rection v �l V(a _174y -t1 —�l4- '/A* , tk y- 1 N,., _Diyphone in 7012,..,��. o; 17577 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. BEDROOMS: q 2. NUMBER OF 3. TYPE OF WATER SUPPLY:/ TYPE OF WASTEWATER DISPOSAL: Individual Well 9__ 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. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm "AW(e_ LVL-yt r S1/Phono (096 —0Y0Z- Address 3 A i F Vv .1 rAG J Lr V zV Engineer's Printed NameGV.,0,41Q 1r e Date L O . .. .. j • C"uLflY hl111 EiiEIilE 5. DSD SIGNATURE ��'• CE 9254 • �'i Approved for bedrooms. 1,; Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: Original Certificate Date: (Rev. o+rz) 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 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L-Ot l � 0 Hit c7�0 46-ircel ID: A. WELL DATA SD ) 4:� l Well typetetf4r If A, B, or C provide PWSID # IiT Well Log (Y/N') P 5 Date completed22111�03 Sanitary seal (Y/N) Wires properly protected (Y/N) P S Total depth (CO ft. Cased to too ft. Casing height (above ground) :Z-7-ff_in. FROM WELL LOG AT INSPECTION Date of test -717-2- Static water level 4P /-1 ft. ft. Well production ! G g.p.m. g p m WATER SAMPLE RESULTS: Coliform b colonies/100 ml. Nitrate Other bacteria colonies/100 ml. Arsenic: mg./l. Date of sample:/Drj Collected by: B. SEPTIC/HOLDING TANK DATA I ' Tank Type/Material Date installed Tank size fZO gal. Number of Compartments 7i Cleanout((Y ) o tf ��L Foundation cleanot6 ,/N) 11�_ Depression over tank (U IJ High water alarm (Y/( _ Date of pumping h9AJ — Pumper __ anlr�llf I C. ABSORPTION FIELD DATA Date installed 3 Soil rati (g.p.d./ or ft2/bdrm) 0. System type 5- W i, Length 66 ft. Width S ft. Gravel below pip€ l,7+ ft. �'7 Total depth it. Eff. absorption area 750 ft2 Monitoring tube Depression over field 00 l Date of adequacy test Results (P s/Fail) For bedrooms W✓ Fluid depth in absorpf n field before test _ in. Water added_ gal. New depth in. u5 Y/ - Elapsed Time: min. Final fluid de _ in. Absor Ion rate >= g.p.d, ny rejuvena Ion treatment (past' mo.) /N &type) If yes, give da D. LIFT STATION R%) Date installed ,S,,, gallons "Pump on' level at "Pump off level at Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Jo -2, I o2I Public sewer main M A Sewer /septic service line 71 in. High w*d'r alarm level at in. alarm & circuit requirements? On adjacent lots Z0© On adjacent lots 1-7 I Public sewer manhole/cleanout ,v Holding tank NX SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Z 7 t Property line T51 Absorption field lot Water main IJ A- Water service line 00t � Surface water ��►�- t Wells on adjacent lots 1 �� SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line � Building foundation L�O I_ Water main iJ IN r Water Service line r Surface Water NO Kf— Driveway. parking/vehicle storage �O Curtain drain NO vac Wells on adjacent lots 13W F. COMMENTS G. ENGINEER'S CERTIFICATION COL V: •• asf�It( I certify that I have determined through field inspections and 00* - 49 >t review of Municipal records that the above systems are in ;.4 conformance with MOA HAA guidelines in effect on this date. �' • :• • • • + ..... • • • • • • • . Gag ©� (� � �I `, . --*f GAE60R1 ALAN EBEIUf . Engineer's Printed Name l XX>Z I A ` P'V �f CE 9254 ;{ r Date�,`,,'4�' HAA Fee $ Waiver Fee 5 Date of Payment /` 11 95 Date of Payment Receipt Number 7 -535L. -AL -Receipt Number (Rev. 17101) r