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TIMBERLUX #3 BLK F LT 4
Timbcrlux #3 Lot 4 Block F #018-271-89 Municipality of Anchorage Page 1 of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SWO00105 PID Number: 018--271 --89 ~ame:DOLORES SOLANA Wastewater System: [] New · Upgrade Addre~a: 15000 LONGBOW ANCHORAGE, AK 99516 rNO~rH/SOUTH] ABSORPTION FIELD Phone: 273-7256 NO, of Bedrooms: c/o BONNIE HOCHSTEIN: (907) 3 · Deep Trench [] Shallow Trench [] Bed [] Mound []Other LEGAL DESCRIPTION 0.6 c,D/~. ~ 8.06/8.02 MAX, 4 F TIMBERLUX #3 106/1.55 MIN r~ 6.01/6.05 - - - 0.07 - 1.52' r~ 65' (2 @ 52.5') WELL: [] New [] Up 2.5 r~ 2 15 rt. DENALI S&D 8/1/00 - 8/2/00 .. .. TANK SEPARATION DISTANCES o Se... U .old~.. · S.T.E... From Tank Reid Station Tank s,w,. U.. ANCHORAGE TANK 1250 Well 100'+ 100'+ 100'+ -- 25'+ STEEL 2 S..ace 100'+ lO0'+ ~00'+ - - LIFT STATION Water Line 5'+ 10'+ 5'+ -- - 1250~ ANCHORAGE TANK Foundation 5'+ 10'+ 5'+ -- -- 42"I 42" 46" Curtain ~20 OSI 05 HHF M.O.A. I Remarks: *TANK AND TRENCHES HAVE BEEN INSULATED. BENCH MARK GARAGE FLOOR 100.00 ,~ ~. ,,.~ ,,,,~ u.~~'~t'" l~l'k'"/ ~! ~ ' '..'.."~. ~ Inspections performed by:. AWWC, INC. Dates: 1st 8/1/2000 ~..".-.'t.~'~7~?.) .t'.~.~ ...... ':..% 3rd 8/8/2000~ '~ ~e; " ' ' ' Department of Health and Human Services approval ~:o¢_ -..:_ ....- Reviewed and approved by: ~-//- .¢ ~/, ~ Date: ~' -/¢ .~o [~,~".',~,~ PERMIT NUMBER: AS :BUILT DRAWING PARCEL ID NUMBER: SWO0010,5 ' 018-271-89 MH 59 7 31 8 / / ~'~NEW DRA~FIELDS EACH MT1 86.0 94.4- 32.5 FEE'~ LONG WITH ~.. /~"~ MT3 96.1 109,9 EVERY 2.1.3 FEET (+/-). "~'- /// MT4- 114,0 116.6 6 FEET OF EFFECTIVE. ;: i;i ~ 8/9/2000 .... '~J' ~,% "., ~ A B DBL1 45.5 14-.3 DBL2 45.9 15.5 ST1 54.0 25.1 ST2 58.1 30.4- MH 59.7 ,.31.8 MT1 86.0 94-.4 MT2 106.7 102.1 MT5 96.1 109.9 MT4- 114.0 116.6 DRAWN BY: K.D.W, ALASKA WATER & WASTEWATER B~A~: ~ CONSULTANTS, iNC. 1" = 50' PREPARED FOR: PHONE NUMBER: PACE NUMBER: DOLORES SOLANA (907) 742-4259 2 OF LEGAL DESCRIPTION: TIMBERLUX SUBDIVISION #5; LOT 4, BLOCK F ~fPE OF WORK: AS-BUILT OF SEPTIC SYSTEM UPGRADE .ERM~ .UM.R: AS BUILT DRAWING SWO00103 ' 018-271-89 t' 9¢,2 - [01,2 /- 1'Of' ~ I~ / f2 ~ NORTH TRENCH SOUTH TRENCH ~f CO ~f ~ r - I00,~ (AV~,) ~ I~,~ ,~ 8/9/2000 :o~ ~Y: ~;" ~ / ~ "'P~UO~ ~~ WATER & W~TEWATER K.D.W. CONSULTANTS, INC. ~ 1" DOLORES SO~NA (907) 742-4239 3 OF 3 T~U.E~,x SU.D~WS~O. ~*; LOT ~..LOC~ , AS-BUILT Of SEPTIC SYSTEM UPGRADE ' MUNICIPALITY OF ANCHORAGE Department of Heaith and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 15, 2000 Expiration Date: May 15, 2001 Permit Number: SW000f93 Legal Description: TIMBERLUX#3 BLK F LT 4 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Dolores Solana Owner Addrass: 15000 Longbow Dr. Anchorage, AK 99516- Parcel ID: 018-271-89 Site Address: 015000 LONGBOW DR Lot Size: 44867 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil abso~otion system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: ,~--- Date: ~/.~00 ALASI WATER & WASTEWATER CONSULTANTS, INC. May 11, 2000 Municipality of Anchorage Department of Health & Human Services Division of Envirommental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref:. Septic Upgrade Design for Lot 4, Block F, Timberlux #2 Subdivision To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The existing system consists of a 1000 gallon septic tank and a 39 foot long deep trench. The existing trench is in a state of failure and is in need of an upgrade. One test hole was excavated on the property. The proposed septic system will be designed within the 30 foot radius of this test hole. We are proposing that a 1250 gallon S.T.E.P. tank and a deep trench type drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached is a log which shows the soil classifications, groundwater monitoring, amd the percolation test results. The soils below the organic layers are a GW material to a depth of 3 feet. From 3 feet to 14.5 feet (bottom of test hole), is a SM material. No groundwater was encountered during the excavation of the test holes. A percolation test was performed between the depth of 5.0 feet to 5.5 feet which had a percolation rate of 20 minute/inch. It is our opinion that due to the overall appearance of the soils, a application rate of 0.6 gallons/day/fl2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 20 minutes/inch b. Allowable Application Rate: 0.6 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 750 ft2 f. Total Depth: 8 feet (max.) g. Effective Depth: 6 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 64 feet long (2 ~ 32') 6901 Debarr Road, Suite 2B ~ Anchorage, AK 99504 - Ph: (907)337-6179 - Fax: (907)338-3246 k. Effective absorption area = 768 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The trenches are to be installed on top of the generally flat bench towards the south end of the lot. The trenches will be closer than 50 feet, but greater than 35 feet from a slope that is greater than 25%. The subject slope is to the east of the proposed trenches, and drops at approximately 50% (estimated) down to Longbow Drive. The slope is vegetated. Given the facts presented, it is my opinion that there is minimal risk in granting a 35 foot waiver to this slope. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soil log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B - Anchorage, AK 99504 - Ph: (907)337-6179 - Fax: (907)338-3246 'L __d MANYTELL AVENUE --'---~--'----...........% I /~- /------. - ~ I .1.., ' WE PlUS I LOT2,BL0¢KF, / ~'- "% % ~ [ 'k,<; / ",,. 5% .:,~:,¢:'"'- -"-3, s)~ 012000. ALASRA WATER & WASTEWATER ....w. ~?~...;'..-, 7_ ¢ I¢' '.:.?,~,?,. CONSULTANTS, INC: SCALE: . §901 DEBAER ROAD, SUITE EB ' ANCHORAGE. AK ggE0~. · PHONE (~07)557-GJTg · FAN (907)3~8-~2/*~ 1" = 100' PREPARED FOR PHONE NUMBER: PAgE NUMBER: . DOLORES SOLANA (907) 742-42,59 I OF 2 LOT 4, aLOCK r, nMBE.LUX #2 U(i~.~.'~., ..... ..."~-}¢ SITE PLAN FOR DESIGN OF SEPTIC SYSTEM UPGRADE D~WN BY: ~ . CONSULTANTS, INC. s~: ;~ DOLORES SO~NA (907) 742-4259 2 OF 2 f ~"'~ TIMBERLUX ~ 2 SUBDIVISION; LOT 4, BLOCK F ". DESIGN OF SEPTIC SYSTEM UPGRADE ~%~ w^ a & w^s w^ a coss z rrs, isc. l SOIL LO0 - PERCOLATION TESTJ LEGAL DESCRIPTION: TIMBERLUX i¢2 SUBDIVISION; LOT 4, BLOCK F PERFORMED FOR: DOLORES SOLANA DATE PERFORMED: 4/27/2000 ORGANICS DEPTH 2 ~ ....... ~'- SOIL C~SSIFICATIONS GM CL i GC OL % % SW MH \ DEPTH TO H#I GROUNDWATER DATE DRY 4/27/00__ SM DRY 5/1/00 10 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) REABIN6 (INCHES) 12 5_~1/00 PERC. HOLE WAS PRESOAKEB 4+ HOURS PRIOR TO TESTING 13 1 ~:25 6" 2 4:55 30 4 1/2" I 1/2" 14 3 4:55 6" 4- 5:25 30 4- 1/2" 1 1/2" 16 6 5:55 30 4 1/2" 1 1/2" 17 18 19 PERCOLATION RATE 20 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 5.0 FT. AND 5.5 COMMENTS: PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMj~D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE; ~"/¢¢ DEPTH TO GROUNDWATER DATE DRY 4/27/00 DRY 5/1/00 DRY 5/4/00 Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE . / FROM WELL jo6~ MANUFACTURER ! INSIDE LENGTH ~ ,INSIDE WIDTH ,-~T ~<-~-2/~ MATERIAL LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY /~ GALLONS. NUM.EROF~. ~. D,AMETER '~ OR W,DT. J ./ LENGTH 3?, DEPT. /z' LINING MATERIAL ,____ _ CRIB SIZE: DIAMETER DEPTH DISTANCE PROM: WELL ~Z TOTAL EFFECTIVE 7//~ BUILDING FOUNDATION , NEAREST LOT LINE '~ ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION TyPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC x SEEPAGE .~ FOUNDATION_ LOT LINE SEWER LINE TANK, /00 SYSTEM // CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: PIPE MATERIAL: LOT 5LOPE: REMARKS: DATE F'ERMIT NO. HF F L I _.HNT LOI-:RT ! ON LEGAL DEFARTMENT~ HEALTH AND ENI,,'ZR,:,NMEN~Lt~OCEC:T~ON 7~/-UO 25~6 E. TIJDOR RD.., RNOHORRGE, RkO. 9~587 ~.~ ~/_ ~ EIr4--S' I TE SEI4ER PERM I T ~,~¢'" ~ H~NRY KRIZMRN F'O BO>( 2¢t12 ~44,_,4~ LONG BOW [)RIVE L 4 B F TIMBERLU;,~ ~]: LOT SIZE 45¢}4& SEJJRRE FEET T"r'PE OF SOIL HBSURE, TIUN ..,..r_TEfl IS: TEEN_.H i-.1A:~:IMUM NUMBER OF BEDROOMS SOIL RATING "--~ -'' '"-- '-.:,L-, FT,. BR..'- i4E~ THE REO. LIE'ED SIZE OF THE SOIL HB:,uRFTIuN "',"r'STEf'I I_. E:'EF'TH= 12 L E I'-.I t3 T H-- i-~-6 G E: R'...' E L g, EF'TH-- 6 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRtNFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFBLL PIPE AND THE BOTTOM OF THE EXCRVRTION (IN FEET). E:EL';!Li I RE[) SEPT I C TR l'4k": E:RCKFILLING OF RN¥ _,.rSTB1 WITHOUT FINHL INz, PEL. TION AND RF'F'RO',,,'AL BY THIS DEPARTMENT WILL BE .~LBJEuT TO PROSECUTION. MINIMUM DISTANCE BETI4EEN R HELL AND ANY ON-SITE SEWAGE DISPOSAL S~'STEM IS i00 FEET FOR R PRIVRTE WELL OR 200 FEET FOR R PUBLIC WELL. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS RRE AVAILABLE TO INSURE PROPER INSTALLATION. F"EE:F1 T T "v'RL I P FOR OhiE I 1: FORTH BV THE MUNICIF'~ITM OF ANCHORAGE. 2: I HILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. g: I LINDERSTRND THAT THE ON-SITE SEWER S~STEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. -RPPL I C~4T -HE['~RY ~ I ZMAN IbCJED ...... DATE ..... CERT tFb' THAT I BM FAMILIAR WITH THE REC~UIREMENT$ FOR ON-SITE SEWERS AND WELLS RS _,ET ENLHR~EMENT IF THE . o chorag ,Alaska 9503 P.erforf~ed for . Mr. Hank Krizman · Date performed 4-6 & 7-76 Leg. al Description: Lot 4, Block F Timberlux~Subdivision AdditiOn ~3 This form reports: Soils log Yes Percolation test Yes Depth Feet I- 'Topsoil 2- Silty Sandy Gravel .(GP-GM) Silty Gra.velly Sands (SP-SM) 13 L Silty Sandy Gravels 14 - otqom.o res: ~as grouna wa~er enc0un~r~? (GP-GM) No If yes, at what d~pth? Reading ' Date I GroSs Time Net Time Depth to H2D Net Drop 4-6-76 0 1245 hours 4~" ~ 4-7-76 24 hours 1245 hours 188" 140" 4-7-76 0 1300 hours 48" 0 4-7-76 3 hours 1600 hours ~4" 46" 4-7-76 4 hours 1700 hours 102.6" 54.6" .-.Percolation te 1"/7 , minute.s FProposed installation: Seepage Pit ...... 'Drain Field· yes'" Depth of Inlet . Depth to bottom of pit or trench .C0)~M~NTS: 1'40 Square feet drainage area required per bedroom No bedrock or.ground water encountered . ' · ~ · dames D. r~acK ' TEST LAB PERMIT NO. MUNICIPALITY OF' HNC AGE - DEPHRTMENT OF HEALTH AND ENVlROMMENTAL TECTION 25i0 E. TUDOR RD'., ANCHORAGE., BK. 995~ b~ELL PER~M I ~' HPPLICHNT LOCATION LEGAL ~HNK KRIZMA~ LONGBOW DRIVE L4 BF TIMBERLU,. SUBD WEST ~4TH HUE LOT SIZE ~44-8550 45041 SQUHRE FEET MINIMUM DISTANCE BETWEEN 8 WELL HND ANY ON-SITE SEWAGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIYATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS HRE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. SPECIFICHTIONS HND CONSTRUCTION DIAGRAMS ARE HYBILABLE TO INSURE PROPER INSTHLLHTION. PE~_~M I T b"AL I [) FOR C,~'-IE '~EAR FROr-1 ISSUE I CERTIFY THHT i~ I HM FHMILIHR WITH THE RE~UIREMENTS FOR ON-SITE SEWERS HND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2~ I MILL INSTHL~TME SYSTEM IN ~CCO~NCE ~H THE CODES, MUnicipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastawatar Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak, us (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL 'FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-271-89 '1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address TIMBERLUX #5; BLOCK F~ LOT 4 15000 LONGBOW DRIVE *ANCHORAGE, AK CLIFFORD PEDNAULT Day phone 15000 LONGBOW DRIVE *AN.CHORAGE~ AK Day phone C/O AGENT CARLA NICE W/ PRUDENTIAL Dayphone 242-2427 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well - · Individual On-site · Individual Water Storage [] . Individual Holding tank [] Community Class Well [] Community On-site ~ [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 On-Site 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 cedified 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(am) 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 557-6179 Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: in conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily 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 ara outside the control of the evaluator of the system. Satisfactory test results do nat 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 tong the system will continue to meet the operational raquirements 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 at'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 Disapproved. Conditional approval for bedrooms. E;~ WATER AND bedrooms, with the following stipulation~::~ w~.STEWATER Attachments: CaSA Checklist Septic System Advisory Well Flew Advisory Nitrate Advisory / (Rev. 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Or,g,na, Cert,,,oateOate: Municipality of Anchorage Development Services Department Building Safety Division On-Site Weter & Wostewoter Program 4700 Elrnore Rood P.O. Box 196650Anchorege, AK 99519-6650 www.ci.anchorage.ak.us (907) 543-7904- CERTIFICATE OF ON-SITE SYSTEHS APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type PRIVATE IfA, B, orC provide PWSID~ N/A Date completed BEFORE 9/7/76 Sanitary seal (Y/N) YES Totaldepth 126 ft. Casedto '40'+ ft. FROM WELL LOG UNKNOWN TIMBERLUX S/D #3; LOT ~-, BLOCK F Parcel ID: 018-271-89 *BASED UPON SURROUNDING WELL LOGS Date of test Static water level 70 ft. Well production 5 . g. p. m. Nitrate~ ~) mg./L. Date of sample: 8./8./12 WATER SAMPLE RESULTS: Coliform 0 colonies/lO0 mi. Arsenic: ~J E~) ug./L B, SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Date of pumping 7/12/12 C. ABSORPTION FIELD DATA Date installed 8/2/2000 Length 65' (2 @ 32.5')ff. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 8/8/1 2 65 ft. 6.42 g.p.m. Date installed 8/I/2000 Total depth*8.16/8.41ft. Eft. absorption area 784 ft2 Monitoring tube YES Depression over field NO Date of adequacy test *.8/8/12 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 13 in, Water added 450 gal. New depth 22 in. Elapsed Time: 150 min. Final fluid depth 15 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date - **NORTH TRENCH TESTED ONLY. SOUTH TRENCH HAD 50" OF LIQUID IN IT. STEP TANK AND TRENCHES WERE INSULATED PER INSPECTION REPORT. YES ~8ELOW EXISTING GRADE] d 2 Soil rating (g.p../ft orO 0.6 System type DUAL TRENCHES Width 2.5' ft. Gravel below pipe 6.01/6.05 ff. Cleanouts (Y/N) Depression over tank (Y/N) NO High water alarm (Y/N) Pumper MCDONALDS PUMPING YES YES Collected by: GEG. Ltd. YES D. LIFT STATION Date installed 8/1/00 "Pump on" level at 42 in. Datum BOTTOM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absoq~fion field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas. 50'+ Size in gallons 1250 "Pump off' level at 42 in. Cycles tested 3 Manhole/Accese (Y/N) YES High water alarm level at 46 in. Meets alarm & circuit requirements? YES On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDiNG TANK ON LOT TO: Building foundation 5% Property line 5'+ Water main N/A Water service line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 1 O' + Curtain drain NONE KNOWN F, COMMENTS Building foundation 10'+ Surface water 100'+ Wells on adjacent lots. 100'+ Absorption field 5'+ Surface water 100'+ Water main N/A Driveway, parking/vehicle storage 10'+ G. ENGINEER'S CERTIFICATION I ceriffy 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. Engineer's Pdnted Name JEFFREY A. GARNESS Date COB^ Fee Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number. $ HERESY CERTIFY THAT I HAVE PERFORMED A ~ORTGAGEE'S INSPECTION OF THE POLl. OWING .~ESCRII~ED PROPERTY, ~NCHORAGE RECORDING DIEFRICT, ALASKA AND THAT 'HE VISIBLE IMPROVEMENTS SITUATEO THEREON ARE ¥1THIN THE PROPERTY LINES ANO NO VI$1BLE ~NCROACHMENT$ EXIST OTHER THAN IATED AT ANCHORAGE, ALASKA THIS _BTH DAY OF AUGUST 2000 . HOLTLA~D SURVEYING 8032, TEL, 345-5513 Parcel I.D. #. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Sita Services Section P.O. Box 196650 Anchorage, AJaska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 018-271-89 1. GENERAL INFORMATION Completelegal description TIMBERLUX SUBDIVISION ~3: LOT 4. BLOCK F Location (site address or directions) 15000 LONGBOW DRIVE ANCHORAGE. AK 99516 Property owner DOLORES SOLANA Day phone Mailing address c/o PRUDENTIAL VISTA Lending agency Mailing address Day phone Agent BONNY HOCHSTEIN w./PRUDENTiAL VISTA Dayphone (907) 275-7256 Address 4241 "B" STR~:ET ANCHORAGE, AK 99505 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: ff community well system, provide wdtten confirmation from State ADEC attest- lng to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide wdtten confirmation from State ADEC lng to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ¢Y21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1500.00 at, or prior to, closing for the engineering services provided. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspect!on, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal a~n~l State codes, ordinances, and regulations in effect the date of this inspection. ../~ j/,, on / Name of Firm ALASKA WATE~&~ ~STEXNATER CONSULTANTS, INC. Phone (907)337-6179 Address 6901 DEBARR ~OAD,/eL~/'I ,2~~ A~CH~tRAGE, ALASKA 99504 Engineer's Signature L ...-~'¢//~ ~ Date ¢/ /~0 In conducting this evaluation, AWWC, ln / a,~omln/,/ ed to pr~'O~ '~ a thorough, consciontious enginee~'ng ana' lysis of tho system in accordance with ADEC and I~DA[DH~ ~ Guidelines & Regulations. The reported results described the performance of the system under the conditions ~countered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, ground water levels that may fluctuate during the year, and the water usage of the family being se/ved by the system. These conditions are outside the control of '=' 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. AWWC, Inc. can therefore not provide any warranty for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or pariy is not authorized, nor will it confer any legal right whatsoever. 6. DHHS SIGNATURE . ~ Approved for ,~ Disapproved Conditional approval for bedrooms bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Depadment of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1191) Back MOA ¢¢2'~ Computer Version Legal Description: A. WELL DATA Well Type PRIVATE Log present (Y/N) Total depth 126' Sanitary seal (Y/N) RECEIVED Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERV Environmental Services Division 825"L" Street, Rm 502 Anchorage, Alaska 99501 (907) Health Authority Approval Checklist TIMBERLUX S/D #3; LOT 4-, BLOCK F Parcel I.D.: YES Date completed Cased to 126' YES 018-271-89 FROM WELL LOG UNKNOWN g.p.m. Date of test Static water level 70' Well production 5 WATER SAMPLE RESULTS: Coliform 0 Date of sample: 7/27/2000 B. SEPTIC/NOLDING TANK DATA Date installed 8/1/2000 Foundation cleanout (Y/N) Date of Pumping NEW C. ABSORPTION FIELD DATA Date installed 8/2/2000 Length 65' (2 © 32.5')Width Effective absorption area 784 Date of adequacy test NEW If A, B, or C, attach ADEC letter. ADEC water system number N/A BEFORE 9/7/76 Casing height (above ground) 12" Wires prepedy protected (Y/N) YES AT INSPECTION 7/27/2000 65' 6.9 g.p.m. Nitrate 0.5 mq/L Other bacteria 0 Collected by: A.W.W.C., INC. IS.T.E.P. TANKI Number of Compartments 2 Cleanouts (Y/N) YES Tank size. 1250 YES Depression (Y/N) NO High water alarm (Y/N) YES Pumper - [NORTH/SOUTH] Soil rating (g.p.d./fl2 or ff2/bdrm) 0.6 System type TRENCH 2.5' Gravel thickness below pipe 6.01/6.05 Total depth 8.06/8.02 Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO Results (Pass/Fail) For Fluid depth in absorption field before test (in.); Imm~ I_.l.l~m_m._e.~a~t~ly'a~6~gal. watar added (in.): Fluidde tph ~ Absorption rate= P.~e~ment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* Computer Version D. LIFT STATION Date installed E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line 100'+ On adjacent lots 100'+ 100'+ On adjacent lots 100'+ N/A Public sewer manhole/cleanout N/A 25% Lift station 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Water main/service line 10'+ Surface water/drainage 100'+ Absorption field 5'+ Wells on adjacent lots. 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 10% Building foundation 10'+ Water main/service line Surface water 100'+ Curtain drain NONE KNOWN F. ENGINEER'S CERTIF~ATIO~ /~ of Municipal r~cord~ t~ a~ tl)e ~Y/ove ., ystems are in conformance with MOA HA~ gu~fef ~o~ this date. Signature Engineer's Nam , JEFFREY A. GARNESS Data 10'+ Driveway, parking/vehicle storage area 10% Wells on adjacent lots 100'+ HAA Fee $ ~(~, ~'~' Date of Payment Receipt Number 72-026 (Rev. 3/96)* Computer Version Waiver Fee $ Date of Payment Receipt Number Mailing Address Buyer OUr U..E. Zip Code Lending Institution Realty CO. & Agent Legal Desoript~n Street Locati~ Zip Code Zip Code Zip Code Phone Phone Water Supply ,~ Individ ual ~£- . Community ~ Public Utility · Sewer Disposal ,/~ Ipnud~lVi cd ~l;li Ii t y ~ Holding Tank ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drgled prior to that date, give well depth (attach log if available), Year Individual Installed: .~.~?.~- When Connected to Public Utility; NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ( ~ ) APPROVED BEDROOMS '~ *GONDITION8 OF APPROVAL Sails Rating Date ~wer Installed Well To ~sarptian Area Well Log Received ~ Well ,o Tank //~ Septic ,~k Size ALASKA UlROnmenTAL CONTROL S ICeS, inc. ~§i~¢rinq ~ ~nuironrnenlol Studi~s JUNE 16 1983 MuNICIpALITY OF ANCHORAGE DEPT. OF HEALTH ENVIRO~M2NTAL JAN PENNINGTON ANCHORAGE AK 99501 SELLER - KRIZMAN BUYER-WHITE SUBDIVISION-TIMBERLUX ~3 BLOCK-F LOT-4 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 468 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 675 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 GALLONS IS INADEQUATE BY 250 GALLONS FOR THIS HOUSE OF 4 BEDROOMS. --~.- OF 4/. ~1 ~?..' ~ '.. :f- ~ 1200 LUcst 33rd Auer]u¢, Suite [~ · Anchoraq¢, Alasko 99503 ·/907) 276-1361 ALASKA uIr onm nTAL CONTROL S IC S, ,nc. ~n§i~eerin§ $ ~nuironmcntal ~1udies MAY 19 1983 JAN PENNINGTON ANCHORAGE AK 99501 SELLER - KRIZMAN BUYER-WHITE SUBDIVISION-TIMBERLUX #3 BLOCK-F LOT-4 ADEQUACY TEST POR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 468 SQFT. THE SYSTEM IS CAPABiM OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 675 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE E~ ~TIC TANK VOLUME OF ~ 5": ........ "-~ 1000 IS ADEQUATE FOR 1200 k. Ucst 33rJ AucDu¢, 5ui1¢ [~ · Ancho¢~¢, Alaska 99503 ,, {907) 276 1361