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HomeMy WebLinkAboutPREUSS #1 BLK 1 LT 2 REMPruess #1
Block 1
Lot 2 REM
#050-571-08
Municipality of Anchorage
Development Services Department °
Building Safety Division
On-Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 2
www.cl.anchorage.ak.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW0504s2 PID Number: 050.571-08
lhl r
Wastewater System: ❑ New ® Upgrade
Add,...
20144 EAGLE RIVER RD,
ABSORPTION FIELD
PMOM Ihnw. or s.drwme
0 Dep Tr.xh 0 ShMiow T(WXh 0 Bed O Lund O Omar
LEGAL DESCRIPTION
�`ewq
7o1i10ig1*—o g -vat
1.2 GPDa a
4.9 FI.
sia Lot BuDdmawn
1 2
oe m b ppe bm m lean ttgnat Vada
Grew apin MMM ppa
PREUSSt1
2.8 Ft.
2.1 Ft
TOMwW Rw" 8Mwn
Fa wad itt-- rW ane
Great L.qm.
14N 1W 8
0.5 Ft.
53 FI.
Well: ❑ Upgrade
❑ New rade
G " "d ^'
a,.ro. ain.. Dulatge Uatwan knM
C4.Wnkon iPMne. A B. CI TOW Depen GW ro
EXISTING PRIVATE I
5 Ft.
7" w. ixxx, N
1 0 Ft
Pipe MaterlY
I
Fl
375 FP
ASTM 3034
older
Date DrdW
sw c water Lew
kM
Date IrWab
FI
SCOTTS SERVICES
1111/2008
YWd
Pump bat M
"" Maya Aoore Geutl
GPM
FI.
Ft
TANK
SEPARATION DISTANCES
® septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
Lift
Holding
lubwPavate
—
lr
From
Tank
Field
Station
Tank
Sewer Line
ANCHORAGE TANK
1500 Gat
105'
120'
—
—
♦2y
" ""'"
STEEL
Mem. d Canp.m z
1
2
s-f—wat.
+100'
+100'
—
—
LIFT STATION
La Lm
+5'
+10'
—
—
�e NO LIFT
wu.
Gat
Fauwatgrl
+5•
+1 Q'
—
—
Pump.t' Mw at
-PU 7 Ww M
In
m
m
C~ Oram
�/�
+50'
+50'
—
—
Para L4xe a Ladat
Ebancat m.peraOn. vatramed w
R.n.k.
Actual field conditlons allowed Installation of 7 of sewer rock
BENCH MARK
Instead of 1', reducing length of leachfield to 53'
Loukon.n Da.aw.an _
BOTTOM STEP OF DECK STAIRS
w.wrt
100 FL
Inspections performed by: CHRISTOPHER WOOD Dates: 1" 1111/2006
ngirtp $1(trp
•1FL';VS'�'
P�'
2w 111112006
l} �TH 'i
Development Services Department Approval
*, :•
_
Conditional Approval Date:
CHRISTOPHER R. WOOD
p
l
k ' CE:10387 ;
Reviewed and approved by: Date: /9 08
=ti ssl
cw. IMAIe,
Permit No. SW050462
Page 2 of 2
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT
ON—SITE WATER & WASTEWATER PROGRAM
4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650
On—Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: PREUSS#1, LOT 2, BLOCK 1
5 b9"59"50"E 134.
SWING TIES OC 10' UTILITY EASEMENT
D 6yv a 00 \j N -o DIVERLL TRER VALV€
I D ®Ht IEACHFlELD
NEW 1500AL ORtGtHAI.
SEPTIC TANK
B.M.
HOUSE
Lot 2
3 ..
O_O_ • 'DRIVEWAY " •' ; ' '
O I
O WELL
Z
0
104
0 - CLEANOUT S 89'59'50"E 134.30'
- WELL ELEVATIONS
(NOT TO SCALE)
- _ F SRS OFF DECK
AMONITOR TUBE LASSUELEVTION
• 100•
- RG1�ALw►J Or QtRG•7t
ORIGINAL GROUND
LEVEL AT, 97.66
MT -1 5' FILL MT -2 \ TH-1
050-571-08
SCALE 1'-40'
12/27/2006
ENGINEER'S SEAL
2' IN ULAT N3• INSULATION W
95.7 2.5'YPARx-94.8
96.1 1.5ON GAL o° 2.1' GRAVEL. o IN .V.T. Q••....
•.. ° O �° CHRISTOPHER R. MDOD..A
° P 92.7 85. QO f'•. CE -10387
91. 91.8 94.8 BOTTOM OF T.H. 0����r�'••.•,,,•..�•`e��oo�
92.7-1�wORXESSIIT Qo
MUNICIPALITY OF ANCHORAGE �lSb
Development Services Department n�
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 PERMIT
Upgrade
Date Issued: Dec 29, 2005
Expiration Date: Dec 29, 2006
Permit Number: SWO50462 Parcel ID: 050-571-08
Legal Description: PREUSS #1 BLK 1 LT 2 REM
Design Engineer: 0024 Eagle River Engineering Services Site Address: 020041 EAGLE RIVER RD
Owner Name: DIANE PATTERSON Lot Size: 23838 SO. FT.
Owner Address: 20114 EAGLE RIVER RD Total Bedrooms: 3 Permit Bedrooms: 3
EAGLE RIVER. AK 99577-8746
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify 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.
IIdI�V' Cg'A.S WocpS CA4-a10
Fo,c DESicn/ etiAMAZ.
rt CVAj1Y-/pF. r3.TlJM JF
SFC)I�
•pv�VEL 'JI L' PE 7H6
SAmcy -r gjna .V 6E
Z of tf."« rrVz O&pT
r/, 5-r 4v, 0E
qND .3'3' a E-6rn .
M
Received By:
Date: 12 / 2cjks—
Issued By: Date: o;
Parcel I.D.
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
050 - 57 I - D 8 Permit Number SW
Property owners) Drat- _PCcif4ry0n Day phone 6c)q - 963y
Mailing address (1) a I f y t;!LLali- i2'yt.#-- Rd'
Mailing address (2 1 Zip Code C19511
Legal description (Lot, Block & Sub'd.) -44 a
Legal description (Section, Township & Range) cc� • , ' T1 YA/, 21 al/
Lot Size -2 3, F38 Acres Number of Bedrooms R -
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade [r
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 Famjly Dwql�ng and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees: V 6 O Waiver Fees:
Date of Payment: / 2 " 2 1 - 0 S' Date of Payment:
Receipt Number: z9 13 Receipt Number:
(Rev. 12100)
broadwater hts
Goodall, Joe P.
From: Chris Wood [crwood@gci.net]
Sent: Thursday, December 29, 2005 2:53 PM
To: Goodall, Joe P.
Subject: Preuss Sub Lot 2 Block 1
Page 1 of 1
Joe,
spoke with the AWWU Sub Station, and they Indicated that a water booster station was located on the north
edge of the property at Lot 18 Block 1 Preuss Subdivision #2. This does not Impact the Installation of our newly
designed leachfield, as we are more than one -hundred feet away from any of the water lines.
Sincerely,
EAGLER RIVER ENGINEERING SERVICES
Christopher R. Wood, P.E.
— Original Message
From: Goodall Joe P
To: 5rwood@gci_net
Sent: Wednesday, December 28,2005 11:11 AM
Subject: broadwater hts
<<LOT00023.TIF>> <<LOTOOOOI.TIF>> <<LOT00002.TIF>> <<LOT00003.TIF>> «LOT00004.TIF>>
<<LOT00005.TIF>> <<LOTOOOO6.TIF>> <<LOT00007.TIF>> <<LOT00008.TIF>> <<LOT00009.TIF>>
<<LOT00010.TIF>> <<LOT00011.TIF>> <<LOT00012.TIF>> <<LOT00013.TIF>> <<LOT00014.TIF>>
<<LOT00015.TIF>> <<LOT00016.TIF>> <<LOT00017.TIF>> <<LOT00018.TIF>> <<LOT00019.TIF>>
<<LOT00020.TIF>> <<LOT00021.TIF>> <<LOT00022.TIF>> <<LOTOOOOO.TIF>>
12/29/2005
Eagle River Engineering Services
Christopher R. Wood, P.E.
10421 VFW RD. Suite 201
Eagle River, AK 99577
December 29, 2005
Dan Roth
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Prcuss #I Subdivision Lot 2 Block 1
Narrative & Permit Application
Dear Mr. Roth:
(907) 694-5195 tel
(907) 694-3297 fax
Eagle River Engineering Services (FRES) was contacted by the owner of the property noted
above to investigate a failing septic system that was backing up into the house. It was
determined that the leachfield was surcharged, and a new leachfield would have to be installed.
A test hole and soils percolation test has yielded slightly silty sand with some gravel, with a fast
percolation rate. A 4' cutbank exists within 4 feet of the proposed leachfield, but we do not
believe this to be a potential problem. The depth of the distribution pipe at its closest point to
this cutbank will be 5' below the ground surface. As part of the leachfield upgrade, a new septic
tank will be installed. The homeowner indicated that they intend to install a tank with a larger
than specified capacity.
The proposed 3 bedroom septic system and well will have very limited impact on adjacent
properties for the following reasons:
1. The surrounding lots are well laid out, so there is room for wells, septic systems
and alternate sites.
2. Immediate neighboring septic systems are all +20' distance, and no private (or
community) wells within 100' of the proposed septic system.
3. Drainage will not be affected and is not a major consideration in our design.
Installation of this 3 bedroom upgrade will not adversely affect the wells or septic systems or
reserve areas on adjacent lots. If you have any questions please call our office at 694-5195.
Sincerely,
EAGLE RIV R E G� j1`jE�SERVICES
Chrlstop er R. WoodjP.E.
Principal
U003\05.136SEPTICNARRATI VE
Lot 18
(VACANT)
1
SNX66µDRAINFIELD
4' CUTBA
el
0
Cl
O
lu4
WELL
Lot 17
10' UTILITY EASEMENT
r
12TH -1 MIN
1160
IG LEA
AAIN
'w"
11
HOUSE/
I �
Lot 2 \\
\\ •DRIVEWAY.•
r
K
100'
i WELL
i
Lot 16
SEPTIAREA
i�WEDQ0_--------
00 00
MIN.
Lot 3
3�
p NEIGHBOR'S WELL
M
O
O
O
VA
\\\ S 89'59'50"E 4/4.30 �.
1. N0� tlKACE WATER +100'. i
® \ – TEST HAQLE — — – EASEMENT 2. NO KNOWN -CURTAIN DRAINS
o MONIT9k TUBE 0� – PROPOSED LEACH FlELD 3./N0 SEPTICS WITHIN .30: UNLESS -NOTED
EE��kkWWLL��RR – EXISTING LEACH FIELD � NO WELLS WITHIN 200' UNLESS NOTED
+ – ©– DRIVEWAY
WELL/SEPTIC SITE PLAN `.��
LEGAL: PREUSS#1 LOT 2, BLOCK 1
OWNER: DIANNE PATTERSON
I
CONTRACTOR: UNKNOWN
JOB 05-136 DATE: 12/28/05 SCALE 1"=40'
EACLE RIVER ENGINEERING SERVICES ,, s ''alRisCE o R.
0
P.O.A EACLE Box 773294
(907) 9RIVER,
-5195 FAX.•5(907) 694-3297 ,, 1 ��%•:E:�: �`'
Eagle River Engineering Services
Christopher R. Wood, P.E.
10421 VFW Rd. Suite 201 (907) 694-5195 tel
Eagle River, AK 99577 (907) 694-3297 fax
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Preuss fill Lot 2 Block 1
October27,2005
A. GENERAL
1. The well and septic plan is for a 3 bedroom single family residence only.
2. The drawing and or site plan 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 verified or modified 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, 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 multi -family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
8. Any remaining open test hole excavations shall be filled and monitor tube removed.
B. SEPTIC TANK
I. The sewer piping from the house shall be 4" PVC 3034 laid at 2% grade maximum — 1% minimum
and insulated with 2" of burial foam if shallower than 3 R., with 2 ft. minimum.
2. Septic Tank shall be a minimum of 1,000 gallon tank of MOA approved construction, insulated, or
place with 4' of soil cover, min. Estimated burial depth or burial Is 6', so a tank rated for deeper
than 6' may be required.
C. DRAINFIELD
1. The drainfield is to be placed as shown on the site plan. Contractor shall take extreme care ensure that
10'separtation distance is maintained between the leachfield and lot lines.
2. The bottom of the drainfield excavation shall be level, plus or minus 1.5", prior to placing gravel.
3. The total depth of the drainfield excavation shall not exceed 6 fl. at any point in relation to natural
ground surface.
4. The drainfield gravel shall be covered with typar fabric material.
5. Soil or a combination of soil and extruded board insulation to at depth of 3' or equivalent is to be
placed over the leachfield.
6. The area over the drainfield is to be finish graded or mounded to prevent ponding of surface water
runoff.
7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any
Class "C" well, or 200 feet to any community well.
8 Due to the tight fit of the leachfield between the well radius, test hole, and lot lines, it is highly
recommended that a licensed land surveyor stake the well radius, lot line, and utility easement
to ensure no encroachments are made during construction.
UEms\DOCS\WPDOCS\2005\05-136drainfield- spec.doc
Eagle River Engineering Services
Christopher R. Wood, P.E.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH= 6' GRAVEL DEPTH = 1' under pipe, 2" over pipe (3.5' total)
DRAINFIELD LENGTH =66' DRAINFIELD WIDTH = 5'
SOIL RATING= 1.2 GPD1W BEDROOM CAPACITY= 3 total
SEPTIC TANK = 1000 gallons min., Deep Burial Rating recommended
Twenty-four (24) hours notice required for all inspections
\\Fres\DOCS\WPDOCS\2005\05-13tidrainfield- spec.doc
EAGLE RIVER
ENGINEERING SERVICES
10421 VFW RD Suite 201
Eagle River, Alaska 89577
(907) $94-5195
ERES Project No.: 05-136
Calculated By: CB
Date: 122812005
Legal: PREUSS#1, LOT2, BLOCKI TEST HOLE 1
Single Family 3 Bedroom Dwelling
Shallow Trench Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom = 450 gallons
Percolation rate = 1.2 minutes per Inch
Wastewater application rate = 1.2 gallons per day per square foot
Required absorption area = 375 square feet
Trench width (W) = 5 feet
Gravel depth (D) = 1 feet
Required length = Shallow trench factor • Required absorption area / W
Shallow trench factor = (W + 2) / (W + 1 +2 D)
Shallow trench factor = 0.88
Total Excavation Depth = 6.0 feet
Required length = 66 feet
05-136DRAINFIELDCALC.xls 1:16 PM 12/28/2005
EAGLE RIVER SENGINEERING
10421 VFW RD, 201
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX: (907) 694-3297
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: DIANE PATTERSON DATE PERFORMED 12/21/200
LEGAL DESCRIPTION: PREUSSMI LOT 2, BLOCK 1
— TEST HOLE # 1 SLOPE
1
TOPSOIL
TAN
5I,TY SAND
W/SOL1E GRAVEL
OCCASIONAL COBBLES TO 12'
10 WAS GROUND WATER
tt ENCOUNTERED? NO
12 IF YES AT WHAT DEPTH NONE
ncHr CRAY ;LT
13DEPTH TO WATER AFTER NONE
MONITORING?
21
22
COMMENTS,
••�E OF A(
.cl)
'.CHRISTOPHER R. WOOD.
CE -10387
TOWNSHIP RANGE SECTION T14N.R1W.SEC8
SITE PLAN(NOT TO SCALE)
DATE: 12/28/05
PERC TEST RESULTS
2%
READING
DATE
GROSS TIME
�u vnm cmr
DEPTH TO WATER
NET DROP
1
1221/2005
10:27
0:00
610
Lot 2 • ;,_:::
0
2
12212005
10:32
5:00
6' 3
5/8
5
5/8
3
12212005
10:34
0:00
5110
0
DATE: 12/28/05
PERC TEST RESULTS
2%
READING
DATE
GROSS TIME
NET TIME
DEPTH TO WATER
NET DROP
1
1221/2005
10:27
0:00
610
0
2
12212005
10:32
5:00
6' 3
5/8
5
5/8
3
12212005
10:34
0:00
5110
0
4
12212005
10:39
5:00
6' 3
5/8
5
5/8
5
12212005
10:40
0:00
5' 10
0
6
12212005
10:46
5:30
6' 3
5/8
5
5/8
7
12212005
10:47
0:00
5' 10
0
B
12212005
10:52
5:45
6' 3
5/8
5
5/8
PERCOLATION RATE- 1.02 (MINIINCH)
PERC HOLE DIAMEtER=6'
SOILS LO ED BY HAR ES BALZARINI PERCOLATION TEST BY: CHARLES BALZARINI
I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE
AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Z
GRLnicR ANCHORAGE AREA BOi%wJGH
Department of Environmental Quality
US
3330 C Street
Anchorage, Alaska 99503
1NSP TE SEWAGE DISPOSAL SYSTEM _yam ,!
NAME
C H Aal�f' 0('ADDRESS 130Y 4-5%l 14 A PHONET7-'-v��'I
LOCATION OFF E,kLC /r/["CQ ^00t9A7 LEGAL DESCRIPTION l0 / 2 OL y�Gw'SS SSD
SEPTIC TANK:
DISTANCE f7 NUMBER OF
FROM WELLbMANUFACTURER $u,,vSrT MATERIAL / J-STiLS COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITY /J49" GALLONS.
r��wrff
SEEPAGE PM: /
NUMBER OF PITS DIAMETER OR WIDTH �'', LENGTH -90, DEPTH 7 'ioVDejC P/NG
Wetil tat
LINING MATERIAL CRIB SIZE: DIAMETER—DEPTH— DISTANCE FROM: WELL
'•Z���� / TOTAL EFFECTIVE
BUILDING FOUNDATIONAL, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE'S CONSTRUCTION S^I� • DEPTH S5 t(- DISTANCE FROM:
BUILDING NEAREST •�+ NEAREST i SEPTIC ' SEEPAGE
FOUNDATION~ `�b LOT LINE, SEWER LINE � 6D TANK i(lD , SYSTEM 16U
CESSPOOL OTHER SOURCES _
APPROVED DISAPP OVEO REMARKS
DISTANCES: DIAGRAM OF SYSTEM
will 13e, U,eaieu 131,
INSTALLED BY: '414 41 pealthf O
PIPE MATE^RIALXAS/ JXc1--'
c1--'
lxlrTN YLkF
LOT SLOPE:
REMARKS: S0I1-
�IFf77 T 70'PcrP Ave,61ft
2 0 2 fl0 P[�pQM • DATEE1151,7-5
Form No. EQ -031
7, Ie,vrN= 60 '
pfAvel ct vDs,t
10
APPROVED
G.A.A.B.
11-
GRr' R ANCHORAGE AREA 8 JGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330"C -STREET ANCHORAGE. ALASKA 99303
TELEPHONE 274.4961
SEWAGE DISPO AL SYSTEM -APPLICATION AND PERMIT
i
NAME OF APPLICANT C % �MA ADDRES4, l'Z fK
/ 95C
INSTALLATION LOCATION
L L FCl
LEGAL DESCRIPTION /
INSTALLATION OF: SEPTIC TANK EEPAGE T DRA N /
TYPE AND SIZE OF FACILITY TO BE ��`��
\ O
PE R•M}IT N NO.
(0 fiq
C 4zf -9on9
PHONE
OTHER
FINANCED THROUGH TO BE INSTALLED BY r-7'/� -F- /
SOIL TEST RESULTS
'7- •"?S' 1� Z C�B•fC ANO Es THIS PERMIT IS 1 T VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION:
24 HOUR NOTICE REQUIRED.
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL
QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
n
SEPTIC TANK S12E G
TYP ��—�rr��I
GE AR IZE
11
[+
n �✓ / J
Y E1
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK '42
FOUNDATION TO SEEPAGE PIT DRAIN PtELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK - 5- SEEPAGE PIT DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK /n' Q ! SEEPAGE PIT
DRAIN FIELD /11!5!' ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
SEEPAGE PIT
DRAIN FIELD�/�'t�, ' / /'
SEPTIC TANK�._JL_ SEEPAGE PIT (aO DRAIN FIELD
TO RIVER. LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
/� r/ �j//��
GRAVEL BACKFILL/\ � �,✓ya-�
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.S.
OR
LICENSED DESIGNER
j
OF
A
I CERTIFY THAT I AM FAMILIAR WITH THE REOUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBE SY TEM IS IN ACCORDANCE WITH SAID CODE.
DATE /M) APPLICANT'S SIGNATURE "' �•^'f'
FORM NO. EO -014
v
0
,
II
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i p
/oT Z) �LocC.
ST�u X0.1 �iJT6/l�12)
V
b
Prrasl it 1i7 o crrr la4.,m Ay
STALLION ENTERPRISES
Ferles-f. d fcr Fraik O'Conner%_ 'Date Pr-foraec 8 Sept Z5__
ie;.al R•-a;tf;t:Qn: Lor 2 P1oek 1 Pruess
1}:1+ Fo.^.+ Rep:rto a: Sola LoF X7CPe:.o:.eti�c, .est_-�
ra t r•
F'tet SOIL :tu.Ti crEF.1ST1_'F
2
4
6
8
10
WCATION SKFTCH
-f•-
top-
Gm
I
The sediments were very com-
pacted with a high cobble
and boulder content. Tha
contactes between
Gm to Gw were gradational and
erratic.
---
i
-
I
i-
—
j--
i
"�
Gm
to
Gw
a.:.
-
Gm
Gm
to
1
1
,-
7Gm
i
,ey Crocr.d Mater [ncount•red7_N_o _
II las, At Hhot Dept%?
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Municipality of Anchorage
Department of Health and Human Services
825 V Street
Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor
September 26, 1996
Dee high, P.E.
DIII Consulting Engineers
800 East Dimond Boulevard
Suite 3-545
Anchorage, Alaska 99515
Subject: Waiver Request for Lot 2 Block 1 Preuss Subdivision #1
Waiver Request 4WR960049, PID #050-571-08, RA950387
Dear Mr. High:
Your request for waiver of the 100 foot horizontal separation of an on-site septic tank to a
private well has been approved. The approved separation distance from the private well
to the septic tank is 95 feet.
This waiver approval applies to the existing septic tank to well separation only. Any
future upgrade to either will require all separation distances be met or another approval
from this department
If there are any further concerns or questions regarding this waiver, please call our office
at 3434744.
Sincerely,
allUIL ( A pv--�
ames P. Williams
Civil Engineer
On-site Services
JPW/Ijm:Miller
r-� n
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR960049 PID# 050-571-08
Date Received: September 20, 1996
HA# IIA950387 Permit #
Legal Description: Lot 2 Block 1 Preuss Subdivision #1
Engineer: Dee High, P.E., DHI Consulting Engineers
800 East Dimond Boulevard, Suit.- 3--545, P.nchorage, Ak 99515
Applicant: Brenda Nillpr
Waiver Requested: Private well to on-site septic tank of 95 feet
Criteria: 1. Geology:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Points:
87.03
`f
a,$
Waiver is Granted: Waiver is NOT Granted:
List Conditions or Reasons for above:
Rec #: #02242/2505 Amount: $ 625.00 Date Paid: Sept 20, 1996
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DHI CONSULTING ENGINEERS
Civil e Surveying Planning
W.0.96287
WAIVER .^
TO
SEPARATION DISTANCE �^
WELL TO SEPTIC TANK Sip 201``9'96
PROPERTY: Lot 2 Block 1, Pmeess Subdivision Addition 1 pI��r�V-�D
A recent survey of this lot found the separation distance between the well and septic tank
was less than the 100 feet requirement by code. When the current Owners bought the
property the distance was reported to be greater than 100 feet.
1. EXISTING CONDITIONS:
The septic tank is 95' from the well.
Pruess Subdivision was developed in the early 1970. The subject lot has had a septic and
well system since 1975 (over 20 years). The septic system consist of a 1,000 gallon fiber
glass tank with a "deep trench" leach field.
A private, 6" well was drilled in 1976 to a depth of 353 feet. The static water level was
305'. A flow test In 1996 was run at 4 gallons a minute, though there are indications that
the well is capable of greater quantities. Static water table was measured at 307'.
The ground generally slopes from north to south. The Subdivision consists of lots of
approximately 26,000 square feet. The average population density is about 8700 square
feet per bedroom.
II. SEPARATION DISTANCE ANALYSIS:
A) Vertical separation between the water table and the bottom of the septic system:
BelowGround
Water Table 307 feet
Difference in Ground Elevation between Septic Tank & Well 10 feet+/ -
Bottom of Tank -8 feet
Total Vertical Separation 309 feet
Estimate ADEC point value = 9.4
G as.,, (,7-112-- s5 -os) Q�2o/n--
Dimond Center Tower, 5th Floor •/800 E. Dimond Blvd., Suite 3-545 • Anchorage, Alaska 99515
(907) 344-1385 • Fax 344-1383
B) Soil Type:
Wells in the area range between 82' to 353'. The surface soils appear to be clean
sands and gravel to the depths of about 16 feet. Below that it is non water bearing
hard pan consisting of silts with sand or gravel (range 16' to 300'). Below the 300
feet depth the soils are primarily sands with some gravel.
Estimated ADEC point value = 3.2
C) Permeability:
From 0-16 feet, the soils are highly permeably consisting of clean sands and gravels.
From 16 feet to 300 feet, the material varies, but consists primarily of hard pan (non -
water bearing) consisting of sands and silts. We estimate the percolation rate to be
in the range of 40-60 minute per inch. Below 300 feet, are clean sands with a high
permeability.
Estimated ADEC point value = 2.5
D) Water Table Gradient:
The water table in this area is not contiguous. There are large variation of the static
water table within short distances. Based on the static water table elevation between
Lot 17 (to north) and Lot 2 (directly south), the water table gradient is about 2%.
This would be a gradient from the septic tank towards the well. Though this is a
gradual gradient, it has a negative impact since the gradient is toward the well.
Estimated ADEC point value = 2.0
E) Horizontal Separation Distance:
The horizontal separation distance between the tank and well is 95 feet.
Estimated ADEC point value = 2.9
Total ADEC point value = 20.0
CONCLUSION:
Based on the geological, hydrological and other physical characteristics, there is little chance
of contamination from household sewage. The total ADEC point value of 20.0 also indicates
a low probability for any contamination to occur. This is supported by the recent coliform
and nitrate test of the well water, which showed zero coliform and zero nitrates, after 20
years of continuous operation. Noting that this problem was not caused by the current
Owners, the low population density, to low daily waste water flows (450 gpd) and the small
reduction in the separation distance (5%) all support a low risk to public health. We
recommend approval of this waiver.
O F A - % %
Dee High, P. . Date
DHI Consulting E neers j,• .�• , r;
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W.O. 96287
ADJACENT LOT OWNERS
Lot 1, 3, 16, 17, and 18
Lot 1, Block 1 Pruess Subdivision
William English
20019 Eagle River Road
Eagle River, Alaska 99577
Lot 3, Block 1 Pruess Subdivision
Gisela Arndt
20109 Eagle River Road
Ealge River, Alaska 99577
Lot 16, Block 1 Pruess Subdivision
Lee Baker
20110 David Ave.
Eagle River, Alaska 99577
Lot 17, Block 1 Pruess Subdivision
Thomas Jennings III
20038 David Ave.
Eagle River, Alaska 99577
Lot 18, Block 1 Pruess Subdivision
Holling Living
Micheal Holling
10521 Constitution Circle
Eagle River, Alaska 99577
LUCAS AVENUE
2s8' S.W. ao s.W. (7os�)
339' T.D. 82' T.D. --T
EAGLE RIVER ROAD
CE -5807 d�c
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O\Eoso�~
S.W.-STATIC WATER LEVEL
T.D.-TOTAL DEPTH OF WELL
DHI CONSULTING ENGINEERS WAIVER
H CML SURVEYING PLANNING
- Telephone: (907)744 -was rte: (w7)3"-1353 SEPTIC TANK TO WELL
°°° ` Dnia"p "°""-545. ORAE& AUM M15 LOT 2 BLOCK 1 PRUESS SUB.
0.0. 96287 COMP. FILE 287CAPAD SCALEI•-100' DATE 9-19-96
LOT I
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•� Municipality of Anchorage .,_
4i_— On-Site Water&Wastewater Program
(907)343-7904
123 ; iiii:';
S, '- Y4:;. ,
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL - ..li
o a
Parcel I.D. 050-571-08 Expiration Date: 2
957E
1. GENERAL INFORMATION
Complete legal description PRUESS S/D#1; BLOCK 1, LOT 2 REM
Location (site address) 20041 EAGLE RIVER ROAD, EAGLE RIVER,AK 99577
Current Property owner(s) MIKE AND DIANE PATTERSON Day phone 244-4429
Mailing address 20114 EAGLE RIVER ROAD, EAGLE RIVER,AK 99577
Real Estate Agent TIFFANY JOHNSON Day phone 376-0270
2. TYPE OF DWELLING:
• Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: .
Individual Well U Individual On-site U
Individual Water Storage ❑ Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for. N/.- // Distance: -
l
Received by: ,_..ilar Date: %//L//( S
COSA to be released to the engineer,unless'otherwise requested by the engineer.
COSA Fee $ 5c L Waiver Fee$
'Z
Date of Payment /if t _ Date of Payment
Receipt Number O /��(p) Receipt Number
COSA# .if/`,� 7 J Waiver#
•
•
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(are)safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179
Address 3701 E.TUDOR ROAD, SUITE 101 *ANCHORAGE,AK,99507
Engineer's Printed Name JEFFREY A.GARNESS, P.E. Date 'l`ii i
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the 4•0,11.'1111M\ll t 1
guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the 44. OF 4/a
condition of the system/s on the date/s of the evaluation.Separation distances were measured to readily identifiable features. 4I t \�,...• ... ]♦
Hidden defects or encroachments may exist that were not identified during the evaluation.The operational rife of all wells and septic \C_ • • .
systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during •••• •
• the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the systems.These •
= 4 i� I •;*•1.conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the ; 0
systemfs;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system.GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of thecurrent systems fail.The content of this report is for the sae benefit of the person/party who retained GEG.Reliance upon the �n• •Ili
- A. Gam-ss :•14J iinformation provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not $ G '; •C - •' =kr:authorized.In short,GEG disavows any legal duty to anyone other than the person/pa#y who paid for this report. • '.2 ,c
Arr
•
�• •p•............•P•:.:
6. DSD SIGNATURE ��F�
LICENSE ,4lt ;s"+��•
/// ___ System#1 Approved for 3 bedrooms.
System#2 Approved for bedrooms.
Disapproved. �:-.''' •.`
='' ON-SITE
Conditional approval for bedrooms, with the following stipulatiorI DATER AND
;i WASTEWATER r
?RouRAM ;c-
II� / p
By: ( lM 1- -ell/-- -,4-11/444--,- Original Original Certificate Date: -/ -/ Li-i. W
The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for enors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist ? .'
Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other •
(Rev.10/12112)
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: PRUESS S/D#1; BLOCK 1, LOT 2 REM Parcel ID: 050-571-08
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 1/8/1976 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES
Total depth 353 ft. Cased to UNKNOWNft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 1/8/1976 8/30/2018
Static water level 305 ft, 302 ft.
Well production 18 g.p.m. 4.0 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 ml. Nitrate ND mg./L. Collected by: GEG, Ltd.
Arsenic: <5 ug./L. Date of sample: 8/28/2018
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 1/11/2006
Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) NO
` r _
Date of pumping CM Q- (V Pumper -..\ S t`v►^ .16
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE AT MONITORING TUBE ON WEST END.
Date installed 1/11/2006 Soil rating 1.-p.d./ 3or ft2/bdrm) 1.2 System type 5-WIDE
Length 53 ft. Width 5 ft. Gravel below pipe 2.1 ft.
Total depth *5.8 ft. Eff. absorption area 375 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test **8/31/2018 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 1,106 gal. New depth 3.5 in.
Elapsed Time: 375 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) ***NO If yes, give date -
*HOUSE HAS BEEN VACANT SINCE FOR OVER 60 DAYS. DRAINFIELD WAS PRESOAKED WITH 1,773 GALLON ON
8/30/2018. DRAINFIELD REMAINED DRY DURING PRESOAK. ***SEE HOMEOWNERS QUESTIONNAIRE.
D. LIFT STATION
Date installed ize in gallons Manhole/A -..
"Pump on" level at in. "Pump off' - - . . ...h water alarm level at in.
Datu i Cycles tested Meets alarm & circuit require' - .
E. SEPARATION DISTANCES *NOTE:DID NOT FIND EAST STANDPIPE FOR 1976 TRENCH
SEPARATION DISTANCES FROM WELL ON LOT TO: DURING SITE VISITS.CHRISTOPHER WOOD, P.E.'S 2006
DESIGN DRAWING SHOWS ITS IS OUTSIDE 100'WELL RADIUS.
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot `100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'4-
Sewer
00'+Sewer/septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation *5'+ Property line 5'+ Absorption field 5'+ (ASSUMED)
Water main 10'+ 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 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*MET SEPARATION DISTANCE AT TIME OF INSTALLATION TO FOUNDATION AND/OR VISIBLE SONOTUBES FOR DECK;HOWEVER,
THERE ARE SOME 4X4 POSTS FOR THE DECK/SAUNA THAT ARE APPROXIMATELY 4 FEET FROM THE CENTERLINE OF THE TANK.
THESE 4X4 POST APPEAR TO HAVE BEEN PRESENT DURING THE 2006 SEPTIC TANK UPGRADE AS PER CHRISTOPHER WOOD,
P.E.'S DESIGN AND RECORD DRAWINGS.SEE ATTACHED PHOTOS.
..�suSii►iii I_
•.44. •OF. ' 1/4
G. ENGINEER'S CERTIFICATION =,`P••.•• ..1. •••.,•• .
0. \ '.. ..
I certify that I have determined through field inspections and .• 4'. I� ',* t•
review of Municipal records that the above systems are in • •
conformance with MOA COSA guidelines in effect on this I •
date. 1��1:� f' e i A. Ga ess/i
Engineer's Printed Name JEFFREY A.GARNESS •j '.p 'l.•. C ••��i
•
Date Ili)/ •. •ARES ��P•
LICENSE �� ��
#AECC884 r���"�
(Rev. 10/12/12)
1
N
Lot 18 Lot 17 Lot 16
10' UTILITY EASEMENTS WOODEN FENCE
1
[ 9O34.30
SEPTIC PIPES
WI cids
'n 20.2'x20.2' SHED
10.2'x10.2' SAUNA
/ ,' SEPTIC PIPES
Z \2.0' CANT ,.,z(i)/ 0_ 40.9' 10 - -.\ Ia
/ rn \O .) 49.5' _ 0
91
ow o �� 1
/ Lot 1 'a- \�: 2.Gk CANT Ip Lot 3
W 1 \ r
2.0' CANT 24 ..,..A\
_
/ CT
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v
o
'oo PROTf�Tn'f DRIVEWAY
\ 0
IRg0��s WELL I
ro WOODEN FENCE
Lot 2 I .
1 23,838 s.f.
— N 89.59'00.W 134.30'
/
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EAGLE RIVER ROAD
PLOT PLAN AS BUILT K SCALE 1, = 50' GRID NW 0056 Project No. 18-469/Ai
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates , inc . (907) 522-6476 Phone
. (907) 522-4625 Fax o0�0 F ��\k�
Professional Land Surveyors kenOlangsurvey.com v
jonathanOlangsurvey.com � '�
I hereby certify that I have surveyed the following described property:
LOT 2, BLOCK 1, PREUSS SUBD. ADDITION No. 1 (PLAT No. 69-156) 0 *' 4 9� \ :mss•OQ
Anchorage Recording District, Alaska, and that the improvements situated thereon are / 0
within the property lines and do not encroach onto the property adjacent thereto, that Q i� Q
no improvements on the property lying adjacent thereto encroach on the surveyed QO �y K� O
premises and that there are no roadways, transmission lines or other visible �, •
easements on said property except as indicated hereon. 4 (( LS ..11
0�tli% • -5 02.• SJag
Dated this the Day of ` tai sr (s-- LOi , at Anchorage, Alaska Q A •' NO o
• 404RO�SsioNA�-�a
it is the responsibility of the owner to determine the existence of any easements, 040000''
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
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. 0 b-5?l-Og HAA # Qq �`f7 '1�
e
Expiration Date: 12 - 2 7 - O
1. GENERAL INFORMATION
'Complete legal description 9. 61ogle /. Pr ri4 55- SU 1 'vii ig n dl
Location (site address or directions) ? Do -z// Z,9 lee t9lye r %1d.; E".9 /t Ri de r AK
Current Property owner(s) DAEL oyf 971 s 44 Se u m o r Day phone J_ 1'7-Y
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
Day phone
Day phone
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 4 by an independent professional civil
engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and _State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm De u 9 /.a s f: Kr_n Phone' 909-796 - /07S
Address 9fC•d E. 19Hff:n Dry, P,,v/mar ASC. 99G -9a -
Engineers Printed Name Dnu 0 /1s f: Ken/eV Date C1 • 7.d • o
OF
5. DSD SIGNATURE If &!I— -Ws- - ,-
T. Mkli
/
1Approved for 3 bedrooms. '�+ gt75
Disapproved. �
Conditional approval for bedrooms, with the following stipulationg` Nom-`
Vim- . -• •-
`�
Additional Comments `�; WATER AND
c PROGRAM
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineers Report
Well Flow Advisory Other
By: Original Certificate Date: a -.23- Og
(Rw. 01102)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 995196650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST .
Legal Description: LoY.7,Sloe k PreuSS 5uh..0/ Parcel ID:_QX-O-5%/-O
A. WELL DATA
Well type 1pza4 &-- If A, B, or C provide PWSID # _
Date completed 1&71, 76 Sanitary seal (Y/N)
Total depth ZLJ ft. Cased to 3 S3 ft.
FROM WELL LOG
Date of test 1/1/76
Static water level 305 ft.
Well»producdon
/t
WATER SAMPLE RESULTS:
Coliform colonies/100 ml.
Arsenic:_' mg.A.
B. SEPTICIHOLDING TANK DATA
Well Log (Y/N)
Wires property protected (YM) 16
Casing height (above ground) 2-1 in.
AT INSPECTION
9l/,10H
ft.
g.p.m. 3, y g.p.m.
Nitrate -4•/ mg.A.
Date of sample: &a/
TankType/Material $401�i64{7/#11,"&
Tank size / o oe gal. Number of Compartments _L
Other bacteria t oolonies/100 ml.
Collected by: Frewl MC le!v
Date installed -7176
Cleanouts (Y/N)
Foundation cleanout (YM) y � Depression over tank (YM) N High water alarm (YM) W
Date of pumping ee ve Pumper ✓ fr �r..y .!c
C. ABSORPTION FIELD DATA
Date installed 1//`T/lf Soli rating (g.p.d./te or® LDS System type french
Length 6d ft. Width of ft. Gravel below pipe
Total depth/4P ft. Eff. absorption area Ede fe Monitoring tube V «« Depression over field
Date of adequacy test _ j,(( f)[Q�_ Results (Pass/Fail) ".Os For 3 bedrooms
�r
Fluid depth in absorption field before test pfyr d
in. Water added gal. New depth'�n.
Elapsed Time:sJ/ min. Final fluid depth yG in. Absorption rate >= *5'D g.p_d,
Any rejuvenation treatment (past 12 mo.) (YM b type) /Y If yes, give date
D. LIFT STATION
Date installed
'Pump on' level at_ in.
E. SEPARATION DISTANCES
Size in gallons
`Pump off'
Cycles tested
Manhole/Awns (Y/N)
level at
Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
i
Septic tank/lift station on lot On adjacent lots
Absorption field on lot /0s/ On adjacent lots
/00/1,
Public sewer main Nen& Public sewer manholelcleanout
Sewer /septic service line 70 Y" Holding tank 4zf
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation /0 t Property line 4"0 f • Absorption field /0 /
Water main �0 Water service line st Surface water / C e f
Wells on adjacent lots /00 d
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
in.
Property line /0"Pr Building foundation /J -f' / Water main NIA
Water Service line asf , Surface water /00! Driveway, parking/vehicle storage
40ne /(nezv l
Curtain drain rb Wells on adjacent lots /00 t
sw✓M civ .< s+�-..✓cC..re.y/
F. COMMENTS 9144*wwA*`, tl`erwts`"f`ent`"'G Ava4;4
•+t'•K yj_y�fy�,•y tiasic..ci..lKilc.,L sswce�+ frfc ,d�e�ir11� .�`•�1•���+t�`��'+`�`'CltLt�..
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and j ; 48m ir-A ' 1!
review of Municipal records that the above systems are in , • • • " • S'
conformance with MOA HAA guidelines in effect on this date. m • • •,
Engineer's Printed Name DDu 9 4f 3 7' n leLZ
•'• CEetn ,
�•2A + ► .........
Date 1_ ;r._.rr1.�.
HAA Fee S u '
Date of Payment lb3
Receipt Number -57
(Rev. 12101)
Waiver Fee $
Date of Payment
Receipt Number
sm
SGS ReEN
1046052001
All Dates/rimes are Alaska Standard Time
Client Name
Douglas Kenlcy P.E.
Printed Date/time 09/21/2004 12:01
Project Name/N
L2, (;1, Preuss N I
Collected Date/rime 09/142004 16:30
Client Sample ID
L2,111, Preuss N I
Received Date/rime 09/15/20)4 11:24
Matrix
Drinking Water
Technical Director Stephe '. Ede
Released Ry
Sample Remarks:
Paramctcr Results PQL Units Method Container ID Allowable Prep Analysis
limits Date Date Inil
Waters Department
Nitrate -N 0.100 U 0.100
Microbiology Laboratory
Total Coliform 0
mg/L EPA 300.0 D (<=10) 09/15/04 110
coV100mL SM209222D A (<=1) 09/15/04 DKC
Sent By: RE/MAX OF EAGLE RIVER, INC.; 9076900214; Sep -1.04 20:09; Page 2/2
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ESTABLISHING
MUNICIPALITY ANCHORAGEAIL
OF HEALTT H 5 HUMAN SERVICES _ AZZ
Division of Environmental Services low
On -Site Services Section CuLltg
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. q C !,i \ - bQ — HAA a VA
1. GENERAL INFORMATION
Complete legal description Lot 2 Block 1 Preuss ha+il ion \
Location (site address or directions) 20041 Eagle River Road
Property owner r
aron e�ili Day phone +is-vuv.
Mailing address P O Box 877358 Wasilla AK 99687
Lending agency Nnrt h1 --a u^-�QagP Day phone 376-2308
Mailing address d Suite 101 Wasilla AK 99654
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well X
Community well
Public water
NOTE: if community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system. -
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site X
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
on0.In.. ,Nq F,m, ..A -I-
5.
6.
M
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, l verify that my
Investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm_DH>-Cons ut i ngEngi/neers Phone 344-1385.
Address 800 E.\)9imond\Blvd. Suite 3 545, Anchorage, AK 99515
Engineers signature ti Date LL 276
OF 4j,
DEE dQ HIGH, : w J . `•
D�tJiS ��
SIGNATURE l 4Q �O,pR'oQ'q
...
��
1 Approved for Jbedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an Independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct Inspections or analyze data before a certificate Is issued. The Municipality of Anchorage Is not
responsible for errors or omissions in the professional engineers work.
72-M(P.'M) 9x. WA Ell
i?]
W.O. 96287
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERMAE C E I V E D ARL
Environmental Services Division
825"L" Street, Room 502 * Anchorage, Alaska 99501* (907) 343911 4 1996 so
Health Authority Approval Checklist
Municipality of Anchorage
Dept. Health & Human Services
Legal Description: Lot 2 Block 1 Preuss Subd. Parcel I.D.: 050-571-08
A. WELL DATA
Well type private If A. B. or C. attach ADEC letter. ADEC water system number
Log present (YRS Y Date completed 1 / 8 / 7 6
Total depth 353 Cased to 353 Casing height (above ground) j 1. 9'
Sanitary seal (Y/N) _Y Wires property protected (YIN) Y
FROM WELL LOG AT INSPECTION
Dam of test 1/8/76 8/27/96
Static water level 305 307'
Well production 18 g.p.m. 4.0 g.p.m.
WATER SAMPLE RESULTS:
Coliform
Nitrate
Dateofsample: 8/27/96 Colleetedby: Dustin High
B. SEPTIC/HOLDING TANK DATA
Dam installed 9 / 75 Tank Sim 1 000 Number of Compartments 1 Ckanouts (Y/N) Y
Foundation cleariout (Y/M Depression (Y/N) _ dHigh water alarm (Y/N) Nona
DateofPumping Pumperroto Rooter
C. ABSORPTION FUMD DATA
Dam installed of 7 S Soil rating (g pAdit 0&) tbie- System type Trench
Lente 60' Width 7' Gravel thickness below pipe 5' Totaldepth 9.62'
Effective absorption area 60 0 Monitoring Tube pmsent(Y/N) Y Depression over field (Y/N) N
Dam of adequacy test 8 12 7 /96 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test (in.); _0 Immediately atter 60%al. water added (in.): 24 . 5
Fluid depth 6 _ 5 (ins.) Minutes later: 1 263 Absorption rate - 502 0 a.p.d.
I; Peroxide treatment (past 12 months) (YIN) N If yes, give date
092000 gallons of water was added to system prior to running the test.
D. LIFT STATION
Date installed
Manhoic/Accest (Y/N)
High water alarm level at'
Cycles tested
E. SEPARATION DISTANCES
Sin in
"Pump on" level at*
'Datum
"Pump od" level at*
SEPARATION DISTANCES FROM WELL ON LOT TO: DA.
Septic/holding tank on lot 95 ' t IV A10 40it On I t lots 105'+
Absorption field on lot 105'+ ; On adjacent lots 105'+
Public sewer main None Public sewer manhole(cbeanout None
Sewer /septic service line 7._'._# Lift station None
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10' Propertline 40'+ Absorption Held 10'
Water main/service line 25'+ Surface wanes/drainage lone Wells on adjacent kns 105'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Budding foundation 15'+ Water maidservice line 4 0 ' +
Surface water _ _None Driveway, parking/vehicle storage area 40' +
Curtain drain None Known Wells on adjacent lots 10 5 1 + Property line 10'
F. ENGINEER'S CERTIFICATION
/ certify ! ave determined thru cid inspections and review
in conjo ce tr MO.4 I Rr deiin effect on this date.
Signature
Engineer's Name -J G.I
Date ?-34&
HAA Fee S , ,D .00 Waiver Fee S 2,� (ice
Date of Payment -i\ cl to % Date of Payment
Receipt Number � b Q -'; Ol i 1 2 / Receipt Number
Rev. 8/95 OSS: haa.wk.doc
rm