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HomeMy WebLinkAboutASPEN HIGHLANDS #1 BLK 1 LT 1Aspen Highlands Block 1 Lot 1 #017-013-25 Municipality of Anchorage Development Services Department Building Safety Division i Onsite Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On-Site Wastewater Disposal System and/or Well Inspection Report SW020162 PID Number. 017-013-25 Permit Number. Name: Wastewater System: 1111New ❑ Upgrade RON DOUGHTY Address: 12800 TRACY WAY • ANCHORAGE, AK 99516 ABSORPTION FIELD Phone, No. of Bedrooms: 3 O Deep Trench ■ Shadow Trench O Bed O Mound 00Ner (907) 257-2809 LEGAL DESCRIPTION rad Dept, hon, etynet tree• 0.8 Dpa/so- 10.39 MAX n Block: Lot Subdivision: D.qn to pa bottwn Sem enptn°l Wed` °1eYd depth be"mth PIPC 4.16 1 1 ASPEN HIGHLANDS 6.23 MAX rt n Township: Range: Section:— — A added Dewe srgs,d Wada Drwnel tett np 60 n — SEE DWG In. rwa wWc Number aY.ae owa. between i re: WELL: ■ New El Upgrade 5 n 1 n Ckwe r.tion P, . A.B.0 . Tad VwN Cased Ta Tad 0""tien e.a 600 pipe w p 3034/ SCH 40 PVC. PRIVATE 347 n 63 n so. rs oa. wmea: Salo war te.t este CAT'S EYE EXC. Dats 6/27-7/12/2002 ALPINE DRILLING 9/14-16/02 61 n iod:pump:'` At Cc"" "t Abaftaround TANK 5 ow UNKNOWN rt. 2 m SEPARATION DISTANCES 0Septic 0Holding ■S.T.EP. Oother Saptie Absorption Uft Holding /Prhola wp1Mdoc°eM'�' ANCHORAGE TANK 1250 Tank Fwld station Tank sw.er tkn« Numer a ow parenrde: Welltoo'+ 100'+ too'+ — 25'+ STEEL 2 rUne 100'+ 1000+ 100'+ — — LIFT STATION 5'+ 10'+ 10'+ — — sw In 911two 1250 aawrraanR.r. ANCHORAGE TANK ORENCO SYSTEMS M wa OL O 61&7 OL Kqh water eb nn et: Foundation 5'+ 10'+ 10'+ — — 41• 41" 45" pump MOke a Moes EMclrkd erpeauene pelor,nad er Curtain Drain NONE KNOW j2o OSI o5 HHF M.O.A. MARK Remarks:BENCH uza"n and Deanpuan: BETWEEN 6.5 — 10.39 DEPTH SOIL WAS TOP OF MANHOLE A CLEAN SP TO SP—SM SOIL Aeenrd °wane` 95.98 n ENGINEER'S SEAL ° AKWWCr Dates: 1st XINC. 27/2002 Inspections performed by: 1 9 *.. 2nd 6/28/2002 Q 3rd 7/12/2002 Je fry G mess:'••* �0�0 Development S rvices Department Approval t'• E— 3 ........... • �� v Reviewed and approved by: Date: /z )s TL 4s�e 4°° rofessiol, °4�Oo��o (R. ,vat) RE PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SW020162 017-013-25 NEW TRACEY WAY WELL 1 � ` I I � NEW 1250 GALLON \ I S.T.E.P. TANK � I � \ I / NEW DRAINFIELD -J FCO TN�3 I ♦TMJ2 �TH/1t I � ALTERNATE SITE ST1 86.705 25.49 5T2 91.355 26.52 MH 92.835 26.435 MTt 01.90 49.985 MT2 133.28 30.475 yp� 10,7,02 0� '�. DRAWN BY: v .— f B.S.G. p ALASKA «TATII:R7SN NV1ASTI:«'ATER SCALE:„ _ o° "': 10>I OFRA00 ROAD $IIITc jq' eac Q6E dbStST'44(�it�j0p111V-0�)0' FAX (00)11M -A16 1 40 IEPARED FOR: PHONE NUMBER: PACE NUMBER: RON DOUGHTY 257-2809 2 OF 3 Q �' GAL DESCRIPTION: ASPEN HIGHLANDS SUBDIVISION: LOT 1, BLOCK 1, PE OF WORK: 44� AS—BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM ..\;a ....... A.ess: —7953 •• `kG ..... •� GSQO PERMIT NUMBER: AS -BUILT DRAW P017 ID NUMBER: SW020162 017-013-25 rFINAL GRADE - 95.95-95.90 CAST IRON PIPE TOP OF TANK AT 1 WAS USED FROM NIST- 90.90 TOP a< TANK AT THE HOUSE TO THE OUTLET- 90'89 S.T.E.P. TANK. RNM OFRUNO� I I NEW 1250 GALLON AT 9AET- w.3,5_/ D.3a S.T.E.P. TANK TH#1 TH#3 FINAL DRADE - 98.55-99.07 INSULATION . 97.43 H 97.N. GR97.93 93 \ // �RTER fA9RlG 1.257 PVC W TH 1/4' HDLE O 3.0' ON CENTER -INERT OF PIPE - 91.70 iM OF - 07.54 RELATIVE ELEVATION OF BOTTOM RELATIVE 81.43 H2O O 81.43 ON 8/27/02 ELEVATION OF BOTTOM OF OF TE - 80.93 TESTHOLE - 80.93 (TESTHOLE DRY) DATE: 10/7/02 DRAWN BY: I G �,,._. B.S.G. AIASKA & «'ASTEMTATI:R SCALE: -CONSULTANTS. INC.N.T.S. 6901 (IFRARR ROM. SVITF 7R • AN[HORACF. AK 90504 • P NF (007)357-4179 • FAX (007)1317-1714 TEPARED FOR: PHONE NUMBER: PAGE NUMBER: RON DOUGHTY (907) 257-2809 3 OF 3 :GAL DESCRIPTION: ASPEN HIGHLANDS SUBDIVISION; LOT 1. BLOCK 1 fPE OF WORK: PROFILE AS -BUILT OF NEW SEPTIC SYSTEM OCT -e4-2002 14:35 3456934 P.02 i Municipality of Anchorage Department of Health and Human Services 825'C Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Rick Ayshom hapllww xLenchoraP.M.w Mayor Permit Number. #SW 020162 Date of Issue: 6-11-0Z Parcel Identification Number: 017-013 25 Date Started: 9-14-02. Date Completed: 906-02 is well located at approved permit location? ® Yes ❑ No Legal Description: aspen Hinhlands #1 Blk 1 Lt 1 1 Property Owner Name & Address: Ron Doughty - Colony Homes 2340 Loren Circle Anchorage Alaska 99516 r Borehole Data: Depth (1t) Soil Type. Thickness & Water Strata From To stick-up Fitly gravelly silt bedrock 0 2 2 5 5 59 59 347 Method of Drilling air rotary ❑ cable toot Casing type: steel WallThickness:.250 inches Diameter. ¢ inches Depth: 63 feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 61 feet Pumping level: 34Tfect after 2 hours pumping 5 tern Recovery Rate: ¢ gpm Method ofTesting:j it Well intake Opening Type: ❑ Open End ®lOpcn Hole ❑ Screened Stayt feet Stopped feet i1 Perforations Start feet Stopped feet Grout Type: bentonite!! 8 Volume: LbM Depth: i Start 0 feet Stopped feet Pump: Intake Depth feet Pttm size hp� Brand Name _. _ .. • Well Disinfected Upon Completion? ®Yes ❑ No Method of Disinfect ion: chlorine tablets Comments: Well Driller. Alpine Drilling & Enterprises PO x 110496 Anch, rage Alaska 99511 Attention: The well driller shall provide awell logo the property own within 30 days of completion an a property i 1 il--bA-07 02 LOT f COMM ENTS oyr r• il<•'. IONS: C:OMIvlr:j;1?$: Yr.OR. SHELTtlN ELECTRIC Co.. . :, - Ific Sol f.,4, INSPECTION 131.:(?Ofi) :1f�A1.11•Y Of Ay(JjOfIA{;} �1J11.)Ci;;Af f:7Y OJL':S1011 3;0o Lgsq 'ru1]bFt ROAD .GG5.3464 IN$PFC7lON: FAX(907J34y12]S .!•' :)O .Pf;)iMl'1 {Lbw% u ____�TI'Iro►at�l 33Z99 _DLOCHSUTiDivl� % n+srtaroro 7J01Jii$I. L ry ann $ 02 t1bNS: Pica z f� •TJO; - 4Unit7L'fiEWSjzEC70, 33g'32�b t0: rAezr,,e,4 - A V- �, QOM:• ���� r CO(,p+`,,,� gwt-�KrS TO'd a K6950E 92:80 Z00Z-TZ-r10N 50' C LU I '1, bLUUK 'I 40.531 S.F. T RAOY W4 FINAL STRUCTURE AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYE THE AS -BUILT PROPERTY DEPICTED ABOVE AND THAT N *sulk�tlk• ED. GASTALDI LAND SURVEYI CNCROACHMENTS EXIST EXCEPT AS INDI `�! OF •AI.ASk. JEFF A. GASTALDI. R.L. IT IS THE RESPONSIBILITY OF THE OWNER TO 1 4 •••'• E.NT*t.�P� #� 4726 WEST 88TH AVEN DETERMINE THE EXISTENCE OF ANY EASE DO �AE� *: a5L" �`� • ANCHORAGE. ALASKA 99 20VENANTS OR RESTRICTIONS WHICH APPEAR ON THE RECORDED SUBDMSION �.y LIR......................... PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY HEREON BE USED FOR CONSTRUCTION 0 D A••••�e11" A•Gostott•••• Nth'•. 9 "/ '• LS -6091 at CNiD o.�[ ESTABLISHING BOUNDARY OR FENCE LINE ��S^''••. 7tiep tG/15/200? 1 "=30' r MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water b 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: SW020162 Legal Description: ASPEN HIGHLANDS #1 BLK 1 LT 1 Design Engineer. 0041 AK Water & Wastewater Consultan• Owner Name: Ron Doughty Owner Address: 12800 Tracy Way Anchorage , AK 99516 - �/roG /D. 349,4+01 6•zg-oz 12 ;eo Date Issued: Jun 11, 2002 Expiration Date: Jun 11, 2003 Parcel ID: 017-013-25 Site Address: 012800 TRACY WAY Lot Size: 40531 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of. ❑✓ Disposal Field 0 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. Received By: Issued By: D f.P rN 6WAN4t� 9� Date: L. — t2 — O"L Date: On oZ Municipality of Anchorage Development Services Department Building Safety Division .. ... Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. h .1 "1 - 0_5 -,a S Permit Number Propertyowner(s) RON DOUGHTY Day phone 351-3617_ Mailing address (1) 12800 TRACY WAY •ANCHORAGE AK Mailing address (2) Zip Code 99516 Legal description (Lot, Block & Sub'd.) LOT 1 BLOCK ASPFN HIGHI ANDS Si ISOMSION Legal description (Section, Township & Range) N/A Lot Size tit) 53 I Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: ❑ Sewer Only ❑ Well Only ❑ Sewer and Well 0 Water Storage Sewer Upgrade ❑ THIS PROPERTY CONTAINS: El H13Jacuzzi Tub ❑ Swimming Pool ❑ Water Softening Unit Therapy Pool ❑ I certify that the above Information Is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER do WASTEWATER CONSULTANTS INC. Permit Fees: 3 7 5' 1- 1 S Date of Payment: - 7 0 2 - Receipt Number. O _ q q'q Waiver Fees, Date of Payment: Receipt Number. ALASKA WATER & WASTEWATER CONSULTANTS, INC. June 5, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed and Well Septic System Design for Lot 1, Block 1, Aspen Highlands Subdivision To whom it may concern: The proposed 3 bedroom house will be served by private well and septic system. Three test holes were excavated on the property. The septic system will be designed around the 30 foot radii of test holes #1 and #3. We are proposing that a 1000 gallon septic tank and a five foot wide drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 0.8 gallons/day/ftZ should be used. 2. TRENCH DESIGN: a. Percolation Rate: 3.33, & 14.1 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/ftz c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 563 ftZ f. Total Depth: 9 feet (max.) g. Effective Depth: 4 feet It. Width: 5 feet i. Reduction Factor: 0.50 j. Minimum Length: 60 feet long k Effective absorption area = 600 flZ 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic 6901 Debarr Road, Suite 2B • Anchorage, AK 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwe.com system. 4. TOPOGRAPIiY: The area for the proposed septic system is a 5%-10% slope running approximately northeast to southwest; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, two soils log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debar Road, Suite 2D • Anchorage, AK 99504 Ph: (907) 337-6179' Fax: (907) 338-3246 0 Website: akwwc.com MOUNTAIN EST. S/D !ARK LOT 1, BLOCK 2 J I I L� I I ASPEN HIGHLANDS 12 S/D 1 I I LOT 1, BLOCK 2 / I ' \ MOUNTAIN . S/D TZ. BLOCK NO CONCERN 1 I ��— ��� ASPEN HIGHLANDS 12 S/D I --� LOT 2. BLOCK 2 I 1 MOV PARK EST. S/D I I PROPOSED SEPTIC SYSTEM (SEE DESIGN PAGE 2 OF 2) LOT 3, BLOCK 2 LOT 1��� NO CONCERN ' // PROPOSED \ J 1— 3 BEDROOM HOUSE \\ L-1 I 11 1 MOUI PARK EST. LOT 4, BLOCK 2S/D NO CONCERN ALTERNATE SITE \ MOUNTAIN PARK EST. S/D j I T112 TIij3 /ASppl HIGHLANDS /1 S/D \ LOT 3. BLOCK 2 I I I + �' / .c\ NO CONCERN I 1 TH11 1 LAT 2. BLACK 1 r __—_—_J _ _ _ I IPPO 1 ---------------1 MOUNTAIN PARK EST. S/D I I 1 ����fi�v'/�/ \ \'< LOT S. BLACK 2 1 I r'/�/ NO CONCERN i I ARP LOT 13. DDS 11 S/D LLJ I \\ \\ \L ASPEN HIGHLANDS 11 S/D I i I I \ \ 1 ,LOT 3, BLOCK 1 MOUNTAIN 7 RKpEK . S/D-- \ \ 1 1 NO CONCERN I LLJ L1 J I I ASPEN HIGHLANDS 11 S/D—I ' \ ASPEN HIGHLANDS 11 S/ MOUNTAIN PARK LST. S/D I J I I LAT 12, BLACK 1 I I 1 LOT 4. BLACK I LOT 8, BLACK 2 l {\ y 5/2002 ALASKA RATER & WAST EV"Wr RS C.J.G. <� ; ` 77 - CONSULTANT S. INC. 1" c 100' t 6001 DFPAPP POAD. SUITF ?4 • ANGNOPAGf. AN 00504 • FNONf (007)531-6170 • FA% /001)) AmL6 REPARED FOR PHONE NUMBER: PACE NUMBER: i1,......:... RON DOUGHTY 257-2809 1 OF 2 6y1 G mess: 1 EGAL DESCRIPTION: 44 ° . E 3 •• .• •< !� F, ASPEN HIGHLANDS SUBDIVISION; LOT 1, BLOCK 1 �Ytit0. •......... YPE OF WORK: �V,�a%d ^sof eslLc�o SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM LOCATION i / TRACEY WAY INSTALL FOUNDATION �' ;r .'' • I CLEANOUT �'•• •�' PROPOSED 1000 .+.•.• '�GALLON SEPTIC TANK A/SrrETH13 EXCAVATE TH/2 THJI A TRENCH THATNIS 9 FEET DEEP BY 5 FEETDE BY FEEETTMAXIMUM LONG. ADD 4�FEET OFA 'CLEAN. WASHED SEWER DRAINROCK. INSTALL TRENCH PARALLEL TO SLOPE CONTOURS. NOTOE4 THE CONTRACTORN AND THEE SOUTHPEAST �OTDLI EO FLAGCE PRIOR TO CON UCTION OF THE SEPTIC SYSTEM \ 5/31/2002 f" t `a► •. S 0� DRAWN BY: �� r' �.-^-. ALASKA WATER & WASTEWATER C.J.G. . . .* -SCALE: CONSULTANT S. INC. 1 = 40' '. 990 UFRGRR GR 99504 • FHMF (007)357- 179 • FAX (907)336JH.G I PAGE NUMBER: PREPARED FOR: PHONE NUMBER: RON DOUGHTY 257-2809 2 OF 2 .... .... .. ........ e y A. ess: DO QOOsDJ ., -7953 : ' `t►�Q�J LEGAL DESCRIPTION: ASPEN HIGHLANDS SUBDIVISION; LOT 19 BLOCK 1, , 4pp0°d"Fereeeic^6o� �O�oo� TYPE OF WORK: DESIGN DRAWING OF PROPOSED WELL AND SEPTIC SYSTEM AT.ISKA NVATER & WASTEWATER --- CONSULTANTS. INC. LEGAL DESCRIPTION: ASPEN HIGHLANDS S/D• LOT 1 BLOCK 1 PERFORMED FOR: RON DOUGHTY DATE: 5/2/2002 Df et) � TEST HOLE 1 ORGANICS GM & ML SM w/ SOME GRAVEL DEPTH TO DATE GROUNDWATER DRY 5/2/2002 DRY 5/13/2002 1 .. • by +W3 % THHZ+ • T41 / I � I I � , 1 I I SITE PLAN I 1--100' DATE READING CATER LOCK •- W READING EL NET DROP (INCHES) 5/2/2002 nll�illn 4:00 n�lil!11 6- %//% 0• 4:10 10 3- 3- II1111111 4:10 RMY _ /lu /% illlllsl 420 �.�� • 3- 5 DEPTH TO DATE GROUNDWATER DRY 5/2/2002 DRY 5/13/2002 1 .. • by +W3 % THHZ+ • T41 / I � I I � , 1 I I SITE PLAN I 1--100' DATE READING CATER LOCK NET TIME(MINUTES) W READING EL NET DROP (INCHES) 5/2/2002 1 4:00 — 6- 2 4:10 10 3- 3- 3 4:10 — 6- — 4 420 10 3- 3- 5 4:20 — 60 — 6 4:30 10 3- 3- 7 4:30 — 60 — 8 4:40 10 3- 3- 9 4:40 — 6- — 10 1 4:50 10 3- 3- 11 4:50 — 6- — 12 5:00 10 3- 3 - PERCOLATION RATE 3.33 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6.0 FT. AND 6.5 T. A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO SOILS LOGGED BY: JASON WOOD PERCOLATION TEST PERFORMED BY: JASON WOOD COMMENTS: PERFORMED BY AKWWC. INC. I. JEFFREY A. GARNESS. CERTIFY THAT THIS IMS P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ALASKA WATERTC.TWASTI�WATI?R LEGAL DESCRIPTION: ASPEN HIGHLANDS S/D• LOT 1 BLOCK 1 PERFORMED FOR: RON DOUGHTY DATE: S/2/2002 (fe't=_ ORGANICS TEST HOLE 2 SIFICA N 2- 3- 4- 5- 6- 7- 8• 9• t0• 11. 12 13 14 15 16 17 18 GM&ML 1010 mm 6,do liselIIIIUN DEPTH TO DATE GROUNDWATER DRY 5/2/2002 DRY 5/13/2002 1 i e ti, 1 I $443 / i TH1_$ $� / I I I I , I 1 SITE PLAN 1'100' DATE READING I CNET DROP LOCK (MINUTES) WATER I NET TIME I READING EL (INCHES) —00 4\!G9 tot l PERCOLATION RATE 120+ (MIN./INCH) PERC. HOLE DIA. 5 (INLHtS) 19 TEST RUN BETWEEN 6.0 FT. AND 6.5 T. 20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO SOILS LOGGED BY: JASON WOOD PERCOLATION TEST PERFORMED BY: JASON WOOD COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W S P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: <11o L _ooao4pp0 ALASKA WATER &'NVASTENVATER 3 4:46 — F4AD. SWt CONSULTANTS, INC. - 90 ai..aaan SOIL LOG — PERCOLATION TEST �.. :.... 6001 DWO LEGAL DESCRIPTION: 5:16 : , , ASPEN HIGHLANDS SUBDIVISION: LOT 1BLOCK 1 O•.Je r Gamess: OQ —7953 PERFORMED FOR: RON DOUGHTYDATE: 5/3/2002 •: F`vp0 Q� q�G 44��04poSSW DEPTH_ _ 6" — (feet)_—'— 6 rFEST HOLE #31 30 3 7 8" ORGANICS SOIL Cl ASSIFICATIONS-_------ 2 GWORG :h c GP r ML 3 GM CL GC OL 4 °. •°• SW MH / '. •'•'• SP CH 5 SM : OH SC 6 7 GM & ML / DEPTH TO "2 nye / DATE 4 GROUNDWATER I 6 DRY 5/3/2002 DRY 5/13/2002 .l g ; SITE PLAN , I � 1"i100' 10 CLOCK NET TIME WATER LEVEL NET DROP 11 DATE READING TIME (MINUTES) READING (INCHES) 5/3/2002 1 4:15 — 6" 12 2 30 3 3/4- 2 1/4 13 14 GP—GM 15 "c; 16 iso,• >.., 17 B.O.11. FEE 18— PERCOLATION RATE 14.1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JASON WOOD PERCOLATION TEST PERFORMED BY: JASON WOOD COMMENTS: PERFORMED BY AKWWC. INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: — 3 4:46 — 6" — 4 5:16 30 3 7 B" 2 1 B" 5 5:17 — 6" — 6 5:47 30 3 7 8" 2 1 6 -or I Co L4 1 I 1 I I I 1 1 \ \ \ \\ \ 1 \ MOUNTAIN AR EST. S/D LOT 1 BL CK 2 ASP HI DS 02 S/D OT i OCK 2 MOUNT N P K EST. /D T 2, LOCK 2 0 CO ERN AS Ed LAND K 2 D lA MOU AIN PARK EST. S/ OT 3, BLOCK 2 NO CONCERN MO AIN P EST S/D LOT 4, OC NO CON N MOUNTAIN 3 B K 25 PEN HIGHLANDS 1 S/ !� NO CONGER LOT 2,K 0 pCAT10N MOUNTAIN PARK EST. S S{, tJ• LOT 8, BLOCK 2 CONCERN ASPEN HIC DS 1 S/D LOT 1 BLOC 1 ASPEN HIGHLANDS %1 D VLOT 3, BLOCK 1 MOUNTAIN K EST. S 0 LOT 7 BLOCK 2 NO ONCERN Ld 0 co JAS HIGH DS / S/D ASPEN HHIC4, ALOCKHLNDS,1 ls6�-` MOUNTAIN PARK S/D LOT 1 BLOCK LOT 8, BLOCK = \ DAE. OF 4p DRA/25/ 2 O SGAI c. o v . 1 ^ oo. p..... 6901 DFRARR ROAD SUITF 9 ' ANf NDR6G. AK OOSOL VNONF ( D !33)-6A0 FAX • ( 17)359-3746O PN NUMBER: BER: O PR PAG NU RON DOUGHTY 2 809 F 1 LEGAL DESCRIPTION: 0 9 C eQ ASPEN HIGHLAND S/D; L T 1, TYPE OF WORK: ��Q�P�ofassl° °o`er SITE PLAN DOppp�O n • • C LjG •lic.A`. Municipality of Anchorage On-Site Water and Wastewater Program 2 $ (907) 343-7904 , $A C T'/ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-013-25 Expiration Date: 1 Q a S _r 7 1. GENERAL INFORMATION Complete legal description ASPEN HIGHLANDS#1 BLOCK 1, LOT 1 Location (site address) 12800 TRACY WAY,ANCHORAGE,AK 99516 Current Property owner(s) ROLAND &CHARLOTTE'S FAMILY TRUST Day phone Mailing address 12800 TRACY WAY,ANCHORAGE,AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (wfwo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class_Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: / (' l Date: 7—o.-2(.5--- / J COSA to be released to the engineer, unless oth ryfi a requested by the engineer. COSA Fee $ 594e Waiver Fee $ Date of Payment 7 la kilt 9 Date of Payment Receipt Number OC)//W Receipt Number COSA# 05a1W303 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 711/2017 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC_..ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore,ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments,deficiencies or discrepancies exist. r OF AL 4• TI1 �* } 6. DSD SIGNATURE /-iso I� System #1 Approved for bedrooms. + / l;E\r`ti1H }1. System #2 Approved for bedrooms. ^ 7 -tis Disapproved. Conditional approval for bedrooms, with the following stipulations: ��\1i1' OF Al ON Y� WATER SITE AND n WASTEWATER z PROGRAt By: ( vim Original Certificate Date: ��.-Z 5 17 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska, The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10.1C.12.doe 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: ASPEN HIGHLANDS#1 BLOCK 1, LOT 1 Parcel ID: 017-013-25 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 9/14-1612002 Sanitary seal (YIN) Y Wires properly protected (YIN) Y Total depth 347 ft. Cased to 63 ft. Casing height (above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 9/14-1612002 6121/2016 Static water level 61 ft. 55 ft. Well production 5 g.p.m. 3 g.p.m. WATER SAMPLE RESULTS: Coliform el colonies/100 mL Nitrate Iv. mg/L Arsenic: Al!) ugIL Date of sample: 6/30/17 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/STEEL Date installed 6/27-7/12/2002 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) Y Date of pumping 7'07117 Pumper S4-4y) C. ABSORPTION FIELD DATA Date installed 6/27-7/12/2002 Soil rating (g p.d./ft2 or ft2/bdrm) 0.8 System type SHALLOW TRENCH Length 60 ft. Width 5 ft. Gravel below pipe 4.16 _ ft. Total depth 10.9 ft. (Measured 6121/16) Eff. absorption area 600 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10-19-16 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 18 in. Water added 450 gal. New depth 22 in. Elapsed Time: 1440 min. Final fluid depth 18 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed 7/12/2002 Size in gallons 1250 Manhole/Access (YIN) _Y "Pump on" level at 41 in. "Pump off' level at_41 in. High water alarm level at 45 in. Datum BOTTOM OF TANK Cycles tested 2 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 1001+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ _ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ _ 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 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. i �� OFAI� 1 Engineer's Printed Name KENNETH M.DUFFUS fi ' "f- dif '7 Date 7/112017 - *A, 9 TH�/� 1� COSA canary sheet_2-6-15.doc + ms71 s; KENNET girl'E� y \NIC_111 + • Municipality of Anchorage • r Development Services Department Building Safety Division 5, E, On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # OSC 171303 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 1 of Aspen Highlands #1 subdivision. This inspection revealed a nitrate concentration of 6.21 milligrams per liter (mg/L) was reported for the property's well water sample. 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. Nitrate Fact Sheet 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 caned 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 filter that contains a media with a strong affinity for 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. Municipality of Anchorage • Development Services Department Building Safety Division 2, — Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. �'Ol3'ots COSA# ��o0a31 1. GENERAL INFORMATION Expiration Date: - l ' ' L+ " 0 IG Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address ASPEN HIGHLANDS #11: LOT 1, BLOCK 1, 12800 TRACY WAY • ANCHORAGE. AK 99516 RONALD DOUGHTY Day phone 257-2809 12800 TRACY WAY • ANCHORAGE. AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the 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 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 CARNESS 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 /S v'6 Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines B 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 idonliflablo features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. 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. 5. DSD SIGNATURE ✓ Approved for 3 bedrooms. Disapproved. Conditional approval for Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory bedrooms, with the fllowing stipulations: Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other • WATERtc,1? WASTEWATER PRl7RRAM By: ne�� - � U/ Original Certificate Date: — / L4— 0 G x/21- - 4or ,A- 11I % Municipality of Anchorage .. • ^' Development Services Department Building Safety Division On -SRO Water 6 Wastewater Program 47W Bregaw Stroet P.O. Box 198850 Anchorage, AK 99519 M www.muni.orglonsite (907)343-1904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL CHECKLIST Legal Description: ASPEN HIGHLANDS S/D• LOT 1, BLOCK 1, Parcel ID: 017-013-25 A. WELL DATA Wen type PRIVATE If A, 8, or C provide PWSID# N A Well Log (YM) YES Date completed 9/14-16/02 Sanitary seal (YIN) YES Wims party Protected (Y/N) YES Total depth 347 ft. Cased 10 63 It. Casing height (above ground) 18+ In. FROM WELL LOG AT INSPECTION Date of test 9/14-16/2002 5/3/2006 Static water level 61 ft. 55 ft. Well production 5 g.p.m. 2.9 g.p.m. WATERE RESULTS: ,I/1 Coliform coloniesl100 ml. Nitrate 6' ---g ll. Other bacteria �colonies/100 ml. Arsenic: NO ugA. Date of sample: 5/3/2006 Collected by: GEG Ltd. e. SEPTICIHOL.DING TANK DATA Tank TypelMateriai S.T.E.P./STEEL Date Installed 6/27-7/12/02 Tank sits 1250 0. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES Date of pumping 5/.6/2006 Pumper ISAAC'S PUMPING c. ABSORPTION FIELD DATA Date installed 6/27-7/1zltoos7/1x12002 Soil rating .P r ftlbbdrm) 0_8 System type TRENCH Length 60 ft. Width 5 ft. Gravel below pipe 4.16 ft. Total depth 011.0-r 1.5 t. EQ. absorption area 600 ft' Monitoring tubeYES Depression over field NO Date of adequacy test 5/3/2006 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test 4 in. Water added 531 gal. New depth 8_5 in. Elapsed Tye; 145 min. Final fluid depth 4_5 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN 6 type) NONE KNOWN If yes, give date D. LIFT STATION Date installed 7/12/2002 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at 41 in. "Pump oIP level a1 41 in. High water alarm level at 45 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot t 00'+ On adjacent lots 100'+ Absorption field on lot t 00'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/deanout N/A Sewer /septic service line 25'+ Holding tank N/A 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'+ Water main N/A Water service lure 10'+ Surface water 100'+ Wells on adjacent lots t 00'+ 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, parldnglvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION ..93i I certify that I have determined through field inspectlons and review of Municipal records that the above systems are in """""' ' • • • • • • • • • • • • • • • • conformance w9h MOA COSA gutdellnes in effect on this date. .. ....... ............... f e Game a,: Engineers Printed Name JEFFREY A GARNESS Date ASAob �•f•.; 'vfl�.R .�4`� COSA Fee0d?'� Date of Payment � �-7/ Receipt Number 9g1d (Rev. 1 V05) Waiver Fee $ Date of Payment Receipt Number SGS ReLM 1062200001 Client Name Garncss Engineering Group, Ltd. Project Nsme/M Aspen Ilighlands Lot 1 Block 1 Client Sample ID Aspen Ilighlands Lot 1 Block 1 Slatri: Drinking Water PWSID 0 All Dates/rimes arc Alaska Standard Time Printed Date/rime 05/12/2006 16:52 Collected Date/time 05/03/2006 13:30 Received Date/time 05/032006 14:00 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results PQL Units Medved Container ID Limits Date Date Init Metals by SCP/M3 Arsenic ND 5.00 u8/L EP200.8 C (<=10) 05/04/06 05/11/06 SCL Waters Department Nitrate -N 6.14 0.100 mg/L EPA 353.2 D («10) 05/03/06 ALR Microbiology Laboratory Total Coliform 0 coUl00mL SM209222D A (<-I) 05/03/06 TLF Municipality of Anchorage • ''` Development Services Department ;vim < • 4 ; Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 060231 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 1 of Aspen Highlands subdivision. This inspection revealed a nitrate concentration of 6.14 milligrams per liter (mg/L) was reported for the property's wellwater sample. 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. Nitrate Fact Sheet 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 filter that contains a media with a strong affinity for 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. 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.cl.anchorage.ak.us j;%)(907) 343-7904 CERTIFICATE '11& S;44r OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 017-013-25 HAA# /'1t'OZO1�19 1. GENERAL INFORMATION Expiration Date: 3I 1z 103,= Complete legal description ASPEN HIGHLANDS SUBDIVISION: LOT 1, BLOCK 1, Location (site address or directions) 12800 TRACY WAY ' ANCHORAGE AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address COLONY BUILDERS Day phone 345-0371 2340 LOREN STREET ANCHORAGE AK 99516 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well E Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site E 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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior to closing for the engineering services provided. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat 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 bn-site water supply and/or wastewater disposal system is(are) safe,functional and adequate for the•ndmber of bedrooms andtype 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 Finn ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 2B • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, AKW WG Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the fest, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory fest results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the Fllowing 337-6179 Date IQ 0? IF Vqr-.••• -cti ON-SITE Attachments: HAA Checklist Manitenance Agreements Septic System Advisory Well Flow Advisory Supplemental Engineer's Reort Other By: Original Certificate Date: i ILIz /c_i_ (Rev. I=') Municipality of Anchorage Development Services Department Building Safety Division On.Ske Water & Wastewater Program• 470D South Bmgaw St P.O. Box 196850 Anchorage, AK 99519-M www.djuchcrage.ak.us (907) 343.7904 HEALTH AUTHORITY 'APPROVAL CHECKLIST Legal Description: ASPEN HIGHLANDS S/D• LOT 1. BLOCK 1. Parcel ID: 017-013-25 A. WELL DATA Wel type PRIVATE If A. 8, or C provide PWSID# N A Wen Log (YIN) Date completed 9/14-16/0 SaNtary seat (Y" YES Total depth 347 ft. Cased to 63 ft. FROM WELL LOG Date of test 9/14-16/2002 Static water level _ 61 ft. Wen production _5 g.p.m. WATER SAMPLE RESULTS: n Conlo_.3 coloniestl00 ml. Nitrate 3117 mgA. Wires properly protected (YIN) YES Casing height (above ground) 24+ In. AT INSPECTION R. g.p.m. Other bacteria .,O_,_colonlesl100 ml. Arsenic: N/A mglL, Data of sample: 11/21/200 Collected by: AKWWC• INC._ B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date Installed 6/27-7/12/02 Tank size 1250 gal, Number of Compartments 3 Cleanouts (YIN) YES Foundation deanout (YM) YES Depression over tank {YIN) NO High water alar (YIN) YES Date of pumping NEW Pumper - C. ABSORPTION FIELD DATA Date installed s V-J.p.d1s/2ao2Sonrating rftibdr) 0_8 System type TRENCH Length 601 fL Wkfth 5 ft. Gravel below pipe 4.16 ft. Total depth *11.4-11-91L Eff. absorption area630 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fan) - For 3 bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = In. Absorptlan rete " - g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) - If yes, give date - D. LIFT STATION Date instanede/27-7/12/02 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at 41 in. "Pump or level at41jn. High water alarm levet at 45 in. Datum BOTTOM OF TANK Cycles tested NEW Meets alarm & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots t o0'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 1 oo'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 1001+ Driveway, parkkrghrehide storage 10'+ Curtain drain NONE --KNOWN Wells on adjacent kfs 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certily that I have determined through Beld inspections and review of Municipal records that the above systems are /n "' • • conformance with MOA HAA guidednes in effect on this date. . .. .... .......... '• A. a: Engineer's Printed Name JEFFREY A GARNESS pay 7953 Date P�Ora's HAA Fee $ c7/0 -F -10U -T36;2 i Date of Payment U --M-02 Receipt Number -21023 (wv. lamb Waiver Fee $ Date of Payment Receipt Number 12- 2-02; 3962PM; ALCUE Environmental Services Inc. CT&E RcLg 1028108001 Client Name AK Water & Wastewater Consultants Inc. Project Name/# Aspen Hizhlands Ll. BI Client Sample ID Aspen Ilighlands Ll, Bl 111atris Drinking Water PWSID 0 Sample Remarks: :907 6616301 • 2/ 3 All Datesfrimes are Alaska Standard Time Printed Date/time 12/02/2002 13:40 Collected Date/time 11/27/2002 14:44 Received Date?ime 11/27/2002 15:15 Technical Director S� h�Ede� Released By s..ai Ai iA w. Allowable Prep Analysis Panmctlr Results PQL Units Method Limits Date Date Init Waters Department Nitrate -N 3.17 0.200 mg/L EPA 300.0 Microbiology Laboratory Total Coliform TNTC OB col/100ml. SM19 9222B fl 4 11/27/02 1S 11/27/02 KAP