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Home My WebLink AboutFALLING WATER BLK 3 LT 3Fal li*ng Wate4 #050-772-09 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SIW 9r&9P0,Z. PID Number: O50 -- 77 - 2a? Name: Nq / Tuckel Wastewater System: New ❑ Upgrade Address: 9-532 6trarl Cire&- EjIP.K A99f7? / J JJ ABSORPTION FIELD Phone: No. of Bedrooms: q ❑ Deep Trench AShallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: I, Total Depth from original grade: r Z GPD/Sq. Ft. S. 09 Lot: Block: Subdivision:Depth 4A to pipe bottom from original grade: Gravel depth beneath pipe L 2 Ft. Fill added above original grade: �I_ /, S S, oo Ft. Gravel length: Township: Range: Section: Ft. • WELL: (New ❑Upgrade Gravel width: Number of lines: Distance between lines: Ft. Ft. Classification (Private, A,B,C): P.-;Vq fc Total Depth: 0 Cased To: Total absorption area: + Pipe material: 13303 cf ow? FL //Ft. 500 SO. Ft. F®I o Driller: f-le�� Date Drilled: 6r'v 98 Static Water Level:Installer: Date installed: Oro - ;2-7- 9$ / D Ft. Yield: 2 Pump Set at: Z 0 0 I Casing Height Above Ground: TANK GPM Ft. ?—'+ Ft. SEPARATION DISTANCES XSeptic ❑ Holding ❑ S.T.E.P. To From Septic Absorption LIN HoldingPublic/Private Manufacturer: T Capacity in gallons: 11256 Tank Field Station Tank Sewer Lines /JNCLj. 04 Welh /fid /� /�D1� 2aj4, Material: Peel NumberofCompartments: 2— Surface Surface Water /Dal+- /0614 - - - LIFT STATION Lot I /D +- I 10 f — — — Size in gallons: Manufacturer: Line Foundation /6 I+ /0,+ - 'Pump on" level at: " Pu ' level at: High water alarm at: Curtain Drain /d o I f /DO l� _ Pump Make el Electrical Inspections performed by: Remarks: No 'k/,r-,001w, CU�4wj," d.a`/h BENCH MARK .�NS N ca T7l(Lr overLocation ltr+Gti /ihCS and Description: ga/F�vv,-- Si& C9�c Assumed Elevation: /D Ft ENGINEER'S SEAL .: OF A�%I 10 co•-If ,W boo` ®� Inspections performed by: %C/V� �Ni%hC<r��-eP Dates: 1st Ob'2S-g� •••• ••i•' •••64 2ndio 9�4� V®® Kennc;fh M- Uu �+ni6A ' "' Department of Heal andu an Services approval •••��o Reviewed and approved by: Date: 3-5-99 @101 pROFEW ®P=�` \\ao®® 72-013 (Rev. 9/91) MOA 25 IANT s v1 w AS—BUILT SYSTEM DETAILS/SITE PLAN Permit SW980082 FALLING WATER S/D, LOT 3, BLOCK 3 PID#050-772-09 I I I ' 3 I � A II �� LOT 20 4 BDRM ° °--n SFD BM a A � I CD I cu TWPOF SLOPE >25%� A—C=13.2' s B—C=43.8' A—D=20,9' U B—D=50,0' E A—E=28.1' B—E=53,6' A—F=91.7' B—F=118.3' p 250 G SEPTIC KENNETH M. D � S / CE -71 ' W 1�P�G SS o� i 1250 S,T_1Id Ik98 Q O d CT -RVE SYSTEM WELL* O )111 #98-1 SCALE, 1" = 50' AL COMPUTED. BOUNDARr_JOHNSON EI KMD STAKINGJOHNSON `NFCKED� KMD ASBUILT. JOHNSON dd 96,92 FINISHED GRADE 7,10 9 SE804 ACRO FILL 98042.DWG FILTER FABRIC INSULATION I ygRIES T 93,53 93,58 SEWER ROCK 3.0' 38,73 c 90,51 64,9' PREPARED FOR: SCALE, NTS 83,01 BON HAL TUCKER QUAIL CIR, EAGLE RIVER, AK 99577 FIELD BOOKS COMPUTED. BOUNDARr_JOHNSON DRAW KMD STAKINGJOHNSON `NFCKED� KMD ASBUILT. JOHNSON DATE'. 17/19 DWG. 19LE: GRID: SE804 ACRO FILL 98042.DWG JOB N°. 9804.2 -- LE�A\I I j) ENGINEERING 20441 PTARMIGAN BLVD. 8 EAGLERIVER, AK 99577-8736 907)696-6111/FAX((907)696-8111 ILKND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST ��.OF • 41 ik,/ . �T� fib• �: � �0 a• u• s sees •.a•s • 0 nge Kenneh! f'us �� e Performed for: Hal Tucker Date Performed: 8/25/98 1� Project: Falling Waters Blk 3 Lot 3 TEST HOLE u 98-2 0 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - SEE ATTACHED SITE PLAN ORG- rootmat layer FOR HOLE LOCATION GM- medium dense cobbles to 8" Numerous boulders B.O.H. Was Groundwater encountered? NO Whatdepth? NA Depth to water after monitoring? DRY Date? 6/25/98 Reading Date Gross Time Net Time Depth to Water Net Drop 1 6/25/98 12:45 11" - 2 12:55 10 min 11/4" 93/4" 3 12:56 4 1:06 10 min 1/2" 101/2" 5 1:07 - 11" - 6 1:17 10 min 1 3/8" 910/16" 7 1:27 11" - 8 1:28 10 min 1 7/8" 915/16" 9 1:29 11" - 10 1:39 10 min 1 7/8" 915/16" 11 1:40 - 11" - 12 1:50 10 min 1 7/8" 915/16" * Water Added Percolation Rate 1.1 (min/ in) Perc Hole Diameter 6" Test Run Between 3 feet and 4 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. HEFTYDRUNQ W I-ER WELL RECORD 5540 IAKULA on OF AL AS'KA Y i DEPAR rME T OF NATURAL RESOURES t` AN@0AAGF, AK 99516 i (907) 345-0693 Divloio l of 001001001 a 09OPhysicol Surveys I Drilling Pert 11 N Gr LOC TIO OF WELL (Pleole Complal either la, lb or Ia.) A.0 L. N , lo. orough 9'ybCivlelon Lot Blo k Ib, y, etre, Section No. Tornehlp No Rt not EO Meridian lc, ISTANOE ANO;OIRECTION FROM ROAD INTERSECTIONS S, OWNER OF WEI L: _. Address: I� Ir1ei Aaan and Area of Well Location 2. VviEllL00 Feel Belo Su, lot Bel: 4• WE,,LLLDDEnPTHI ( Inol: S. 097E OF gOMPLETIp Material Type Yap a011om-•��Lff• (`� [Cable lool 'folory C3Orlven a Dug InsL-`. ❑ Auger C '$tied 0 eor$d ❑ OIher I T.USEI MDom111'a Q Publie'Svpply ❑ Indullry .3 ❑ Irrigal 0n U Recharge' 11 Commerical ' ( Q Tee# W 11 (J Other: I 11 e. cps DI O T read I Q III ' I _ _� (f dloln.ln, ro_ _ fl. Daplh W01ph1 Ibt,�ll, Io__ 11, Depth Sllckup fl,' 9, FINISH Of WELL Type' Dlom$terl Slot /Muh 61n1` �� Length: --�� Sol between I1. and / rt. —•—� Backfllling _ gravel pack 10, STATIC WATER L :VEL /4A_ f 1, 0 Above or 'flow load lurlece De11 ' equipment Nd I 11, PUMPING LEVEL ulov and surface and YIELD I1. Off it bre. pumpinp 0•D,m. 11. aft r —hre. pumping 9-p.m, 99 12.OROUTINO Wolf irou, I: yes C] No tEi q Malerlali � N$t1 Co ne OIMr:�-, i �1�. n Ufv ' IS, PUMP: (11 avail tele) NP Lenglb of Drop PI ,a —11. Capacity 0•o.m.' 0 Subm. 0 lel '] Centr111oa1 Other "'—�'"—'~--•II - 19. REMARKS: ^- '• ^/� BRItfiyNep@1--.-- "- ��lti IS 200 I -�u r�►t�o Y la, W TER WfLL S "�,�y"AeY1FICA ION: AN JHORA04 M 99516 le. Water YfmP•rolur a � p O C IrIs well we • a - toy Y&34'9%9My )urledlcllon Old Ibis rcporl Is Irye to the best of my knOwisdae and be fell ' RYp Ivr Busin Yit NOMe,- � � , Ceti License Number tl 04C. 1 _ 1 VA� 0016: ro ern Inlive Farm 02 WWQ (11/611 ._,.L.....,.... .......... ....Cop! •Olrhiaulien: WHITE • stau 1 Cu IDmI __H OCAS, PINK CANARY- ; 1.__ _...... _ _ . 10 "d MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980082 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:TUCKER HAL E & REBECCA J OWNER ADDRESS:9532 QUAIL CIRLE EAGLE RIVER, ALASKA 99577-8634 PARCEL ID:05077209 LEGAL DESCRIPTION: FALLING WATER BLK 3 LT 3 LOT SIZE: 60463 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 4/28/98 EXPIRATION DATE: 4/28/99 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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED B ISSUED BY: )ATE: )ATE: ' 2p l' 1 24-Q8 SEE EA061NGl+2J AJmcmrD WELL t0C*r1o41 (K�4�vre D,�T60 6'-22-9g ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 11/FAX (907)696-8111 April 10, 1998 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer/well permit - Falling Water S/D, Lot 3, Block 3 Gentlemen: The owner has requested we proceed forward to obtain a well and septic permit on the subject lot. On April 2, 1998 we dug one testhole for the proposed upgrade. The results of this test are attached. We have designed our system utilizing the testhole we excavated for the four bedroom house which is proposed for this lot. The lot will be served by individual well. We propose to install a 5' wide deep trench. We did not find any water during our monitoring. Additional fill will be placed over the system to provide a minimum of 3' of cover when complete. There are no public or private wells within 200' of our proposed system location except as noted. There is neither surface water within 100' nor any curtain drain within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, ]XII''lU Engineering c Kenneth M. Duffus .E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLA FALLING WATER S/D, LOT 3, BLOCK 3 NO PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. OFIle � / UNNPTII M. DSQ J / CE 7116 t � \\ 1XOF'ESSIO0'�' AW EDf I I I0 > �I DESIGN DETAILS L 4 BDRM X 150 GPD = 600 GPD 600 GPD/1,2 GPD PER SQ. FT. = 500 SQ, FT (500/(5')) X 0.5(RF) (4.0' GRAVEL) = 50 FT. TRENCH Total depth of system is 6.0' from original grade, Total depth of gravel below distribution pipe Is 4.0' NOTES 1. USE 1250 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM„ 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INT❑ SEPTIC TANK, 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED. PREPARED FOR: HAL TUCKER QUAIL CIR, EAGLE RIVER, AK 99577 F1111) LD BOOKS .... BOUNDARY .... ... STAKING ASBUIII: GwG. HIE: ACAD IILE.: 98042.D COMPUTED. DRAWN:KMD__... CHECKED KM D DATE" 4/10 GRIL: SE804 JON No.: 98042 Scale: 1'= 100' tN DEE A VIII or •.'f' of Municipality of Anchorage •� *, DEPARTMENT OF HEALTH & HUMAN SERVICES •• •• ••'•• • 64699404606 t 825 "L" Street, Anchorage, Alaska 99502-0650 ..ee*, 006 a •64:. .• SOILS LOG — PERCOLATION TEST Wit; Kenneth M. D s t t� CE7116 Qom. /,r/// / ,4I1`pROFESSIONP=¢ y Q PERFORMED FOR _i—ra=--�u4-/��1-_-__ DATE PERFORMED l�_'�___ z�/B LEGAL DESCRIPTION -Township, Range, Section __`�•`- - ------------------- DEPTH SLOPE SITE PLAN IFEETI- 1 A , 2 3 4 ` r 5 Q 6 67 t 7 r 8 9 10- 11 0 11 12 =�= 13- 14 15 1s 17 18 19 20 COMMENTS 14122. Loc /�+CCliil�rl �Gnslll// Codd/cs � ✓✓8" rct�a��.sl1 6�-ou�r� 06arSG !?u�ri6crous doul��rs — 80A Fro beV WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? S L fY O P E Depth to Water After Monitoring? � Date: — -3--JB Reading Date Gross Time Net Depth to Time Water Net Drop N I /I Z41/ N -e 5 31v'* ,. Z.' s / Reading Date Gross Time Net Depth to Time Water Net Drop I /I Z41/ N 5 31v'* ,. Z.' s / // ,r PERCOLATION RATE (minutewinch) PERC HOLE DIAMETER - �O TEST RUN BETWEEN _� FT AND -5 FT PERFORMED BY. ,�Nn rte` /L/✓j G1�// Q_ I 7) � f�L[, 5 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STAT AND MUNICI AL GUIDELINES IN EFFECT ON THIS DATE DATE. 72 -WB (Rev. 4/85) KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 June 19, 1998 RECEIVED Municipality of Anchorage JUN 2 3 1998 Dept. of Health & Human Services On -Site Services Section Municipality of Anchorage P. O. Box 196650 Dept. Health & Human Services Anchorage, Alaska 99519-6650 Subject: Well relocation - Falling Water S/D, Lot 3, Block 3 Permit # Gentlemen: The owner has requested we relocate the proposed well site. The well drillers tried two times and hit refusal on both holes. The new proposed location is outside any septic areas and the well protection radius shall be maintained. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, IKHD Engineering Kenneth M. Duffus, P.E. attachments: On -Site Well Site Plan WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLANT FALLING WATER S/D, LOT 3, BLOCK 3 --,� --y-'C- \VACANT NO PUBLIC WELLS WITHIN 200' [0 PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPTAS NDTCD. m I w I I I � I K> 1 J Tt I Ski I IKENNETH M. D[/ //CE -7116 ,W� % 1 \ % I'ROFF�/5ID�Py � - 10'x ID' UtIL Esnt it DESIGN DETAILS LE I nT n 11 1 1 1 1 1 1 4 13DRM X 150 GPD - 600 GPD 600 GPD/1.2 GPD PER SQ. F1. - 50(l SQ. FT (500/(5')) X 0.5(RF) (4.0' GRAVEI-) - 50 1 T, TRENCH Total depth of system is 6.0' from original grade. T otal depth of gravel below dlstrlbu Cion pipe is 4.0' N❑I-ES I USE 1250 GALLON SEPTIC 1 ANKINSULATE TANK I- <4' CHVFR 2. INSULATE TRENCHES WITH P' HD I3URIAl FOAM, 3. CHNTRACTHR WILL ENSURE MAXIMUM P% SLOPE INTO SEPTIC TANK, 4ADDITIONAL. FILL WILL. DE ADDED HVCR SYSTEM TO ACHILVI- MIN. 3' (-,L]VER IF RFQUIR D PRF PARED E❑R HAL TUCKER QUAIL CIR, EAGLE RIVER, AK 99577 HELD BOOKS 'Z' rbh' I I I I � DRAWN: I I I \ STAKING. — CHECKED: LOT 4 \ ` \ DATE: I I DWG. TILL: K N D LOT 3 SE804 ACAD Fae: 98042.DWGI J09 No 98042 \ SEPTIC \ \ I \`\ VACANT \ \ LOT 20 \\ \\ 4 ➢ORM-___,•.. II SF➢ K B FCO 125 GAL o __-- _—}— ;---------- 42. e TDP MF SLOPE >25% -T CD CD PRI]PUSED PRIMARY /7. ----------------------�_ C❑UR -_ Co • o.PRO -11 RESERVE --,� --y-'C- \VACANT NO PUBLIC WELLS WITHIN 200' [0 PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTED NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPTAS NDTCD. m I w I I I � I K> 1 J Tt I Ski I IKENNETH M. D[/ //CE -7116 ,W� % 1 \ % I'ROFF�/5ID�Py � - 10'x ID' UtIL Esnt it DESIGN DETAILS LE I nT n 11 1 1 1 1 1 1 4 13DRM X 150 GPD - 600 GPD 600 GPD/1.2 GPD PER SQ. F1. - 50(l SQ. FT (500/(5')) X 0.5(RF) (4.0' GRAVEI-) - 50 1 T, TRENCH Total depth of system is 6.0' from original grade. T otal depth of gravel below dlstrlbu Cion pipe is 4.0' N❑I-ES I USE 1250 GALLON SEPTIC 1 ANKINSULATE TANK I- <4' CHVFR 2. INSULATE TRENCHES WITH P' HD I3URIAl FOAM, 3. CHNTRACTHR WILL ENSURE MAXIMUM P% SLOPE INTO SEPTIC TANK, 4ADDITIONAL. FILL WILL. DE ADDED HVCR SYSTEM TO ACHILVI- MIN. 3' (-,L]VER IF RFQUIR D PRF PARED E❑R HAL TUCKER QUAIL CIR, EAGLE RIVER, AK 99577 HELD BOOKS COMPUTED: BOUNDARY: _ DRAWN: K M D STAKING. — CHECKED: KMD ASBUT L -- DATE: Q DWG. TILL: GRID: SE804 ACAD Fae: 98042.DWGI J09 No 98042 Scale: 1"= 100' NL1v1 LL -)J ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99517-13736 (907)696-6111/FAX (907)696-8111 Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 't CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-772-09 Expiration Date: 1. GENERAL INFORMATION Complete legal description FALLING WATER; BLOCK 3 LOT 3 Location (site address) 3108 MISTY MOUNTAIN ROAD *EAGLE RIVER AK 99577 Current Property owner(s) SORVOJA MARKKU Day phone Mailing address 3108 MISTY MOUNTAIN ROAD *EAGLE RIVER, AK 99577 Real Estate Agent BROOK STILTNER Day phone 244-6742 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site O Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaiverNanance request for: N/A r Distance: Received by: Date: COSA to be released to the engin unless otherwise requested by the engineer. - COSA Fee $ `Jd�, : Date of Payment Receipt Number U 3r a31 COSA# M 1611-d(0 Waiver Fee $ Date of Payment Receipt Number 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. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm 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 Engineers Comments: in conducting this evaluation, GEG provided an engineering evalualion of the well androreeptk system in accordance with the guidelines and regulations established by the Municipality of Anchorage and induShypracdoes. The reported resulls describe the condition of the system/s on the defers of the evaluation. separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), qualify of construction (materials and workmanship), and the water usage of the family utilizing the sysfemls. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the sysleays; fherelora. GEG makes no warranty (express orimplied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well w septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person pady who retained GEG. Reliance upon the information provided in this report by any otherperson orparty, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duly to anyone other than the person/party who paid for this report. 6. DSD SIGNATURE 0 System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: ON-SITE 1 S1V n WASTEWATER ER Original Certificate Date: 2- '1 `/ b The Municipality or Andhorage 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 errors or omissions in the professional engineer's work. 7. ATCOSA Check COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other IR- imunc% 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: FALLING WATER; BLOCK 3, LOT 3 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 6/1998 Sanitary seal (Y/N) YES Total depth 220 ft. Cased to 211 ft. FROM WELL LOG Date of test 6/1998 Static water level 160 ft. Well production 2 g.p.m. WATER SAMPLE RESULTS Coliform 0 colonies/100 ml. Arsenic: ND ug./L: B. SEPTIC/HOLDING TANK DATA Parcel ID: 050472-09 Well Log (Y/N) YES Wires properly protected (YIN) YES Casing height (above ground) 10+ n. AT INSPECTION �~ �� 1/12/2016 145 ft, 1.95 g.p.m. Nitrate ND mg./L. Collected by: GEG. Ltd. Date of sample: 1/12/2016 Tank Type/Material SEPTIC/STEEL Tank size 1250 gal Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 1/6/2016 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA BELOW EXISTING GRADE Date installed 6/27/1998 Cleanouts (YIN) High water alarm (Y/N) N/A Date installed 6/37/1998 Soil rating .p.d:/ or ftlbdrm) 1_2 System type SHALLOW TRENCH Length 64.9 ft. Width 5 ft. Gravel below pipe 3.0 ft. Total depth *9.92 ft. Eff. absorption area 500+ fe Monitoring tube YES Depression over field NO Date of adequacy test 1/12/2016 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 17 in. Elapsed Time: 5 min. Final fluid depth —17— Any rejuvenation treatment (past 12 mo.) (Y/N & type) Water added 600 gal. New depth 20 in. in. Absorption rate >= 600+ 9_p,d, NONE If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO Septic tank/lift station on tot 1 OD'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent tots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ 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'+ Water main 10'+ Water service line *UNK Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property tine 10'+ Building foundation 10'+ Water main 10'+ Water service line *UNK Surface water 1 DO'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *BASED UPON THE TOPOGRAPHY, IT IS LIKELY THAT THE WATER SERVICE LINE -RUNS DOWN THE DRIVEWAY. G. ENGINEER'S CERTIFICATION I certify that f 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 Pry�t Name JEFFREY A. GARNESS Date z�l3�i�• (Rev. 11105) 4111' N_S ie 'mss/� II i i j a cr6r 'T SEWAED h ASSOCIATES .LAND SURMING A k�6829 -.°� I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY, i9l�i.✓6!s/.f�9Pt� 6e�J�.C®.C<?� AND THAT . ISESPSIBIT TY OF &S INDICATED. 1T IS Tiff RESPONSIBILETY OF THE TH RESPONSIBILITY OWNER MUNE THE ENffi AHY..'GRID, EASEMENTS, OONANTSr -OR 'RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED $USDI- VISION PLAT. UNDER NO CIRCUMSTANCES SFgUIO ANY DATA KFREOId BE USED FOR CONSTRUCTION OF FENCEARY S iNES, OR FOR €STASLISMIND BMW- i Q- •• d' - ; s A? • « .n.:. •/•"•• 'p f if'•., L5-6918 ; I�? . AWARN - ' DATE. /a/r/c3✓ F6r - / DRAWNr Q l �} r de 4111' N_S ie 'mss/� II i i j a cr6r 'T SEWAED h ASSOCIATES .LAND SURMING A k�6829 -.°� I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY, i9l�i.✓6!s/.f�9Pt� 6e�J�.C®.C<?� AND THAT . ISESPSIBIT TY OF &S INDICATED. 1T IS Tiff RESPONSIBILETY OF THE TH RESPONSIBILITY OWNER MUNE THE ENffi AHY..'GRID, EASEMENTS, OONANTSr -OR 'RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED $USDI- VISION PLAT. UNDER NO CIRCUMSTANCES SFgUIO ANY DATA KFREOId BE USED FOR CONSTRUCTION OF FENCEARY S iNES, OR FOR €STASLISMIND BMW- i Q- •• d' - ; s A? • « .n.:. •/•"•• 'p f if'•., L5-6918 ; I�? . AWARN - ' DATE. /a/r/c3✓ F6r - / DRAWNr Q l �`hu,r-'rte: /2/za�cSr Municipality of Anchorage • Development Services Department 4.5 Building Safety DivisionOn-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 Parcell.D. ont�- t1ga-t)q 1 Current HAA # 1) [ t)(Q i e�) Expiration Date: - 3/'2C-114 ]i 15 phone 9'f1 — ST Lending agency Day phone Mailing address Real Estate Agent j5 l6,4 l ok&tr Day phone "9 <</7g - Mailing Address 3S clekiz 2F/EGB 4A r4CLElet ✓f-oe Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER;OF BEDROOMS. 3. TYPE OF WATER SUPPLY: Individual Well A Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site /F 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. a 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 �/�flTfi/1 /M En/l' Phone —7 Address /7a3? ,g 5;4" P. Cn2cGE F�� QrG Engineer's Printed Name STF✓E� 1 6 Date ....l.:. `# R, % sroven W. t 5. DSD SIGNATURE tiffs'' FE 6256 Approved for q bedrooms. NOFESSN' Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: A p' r� (� Original Certificate Dater aw _.(Rev. 01/01) Municipality of Anchorage �( Development Services Department Building Safety Division On -Site Water& Wastewater Program s 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HFALTH AUTHORITY APPROVAL CHECKLIST Legal Description: geLGIA19y,,/47-6Z 11-3 63 Parcel ID: n_ -17 a -09 A. WELL DATA Well type . If A, B, or C provide PWSiD # _ Well Log (Y/N).— Date completed joe Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth 220 ft. Cased to 2 /f ft. Casing height (above ground) - ZZ !J in. f - FROM WELL LOG AT INSPECTION Date of test 2 '/' Static water level /4'0 ft. J S� ft. Well production 2 9.p.m, 02 g.p.m. WATER SAMPLE RESULTS: Coliform _colonies/1100 ml. Nitrate Q� J mg.A.�uJ Other bacteria d colonies/100 ml. Arsenic: mg.A. Date of sample:[/OCf Collected by: Al B. SEPTIC/HOLDING TANK DATA Tank Type/Material6AIr-9d,&Cj! 4 //L�/S rE� Date installed _ oC— of 7— ?'P Tank size 1x50 gal.: Number of Compartments a Cleanouts (YIN) Foundation cleanout (Y/N) . Depression over tank (Y/N) _AL High water alarm (Y/N) IVI,4 Date of pumping 'S:2mper 9 f U C. ABSORPTION FIELD DAT Date installed o? Soil rating (g.p.d./ft2 or ) System type j 10 . r 7-�?a/C b/ Length �y_ 9 ft. Width s ft. Gravel below pipe 3 ft. Total depth _7 ft. Eff, absorption area.5047 ft' *Monitoring tube 4— Depression over field —Vo Date of adequacy test 3o O Results (Pass/Fail) P .t r For bedrooms Fluid depth in absorption field before test in. Water added gal. t New depth in. Elapsed Time:%4?(5 min. Final fluid depth 4 in. Absorption rate >= (�rOj 6 g.p.d.-OL Any rejuvenation treatment (past 12 mo.) (YIN & type) VA4 If yes, give date Date installed Size in gallons Manhole/Access (YIN) "Pump on" level _ in. "Pump off" level at _ in High water alarm level at" in. Datum Cycles tested Meets alarm & circuit re rements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift statiowo- n lot 113a rt On adjacent lots Absorption field on lot Public sewer main' Sewer /septic service line—.? f On adjacent lots 1d6 't Public sewer manhole/cleanout AfI4 Holding tank A 14 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation /a Property line/0 f Absorption field 5� Water main rr Water service line /Q ' Surface water /dd is Wells on adjacent lots /Qp rf SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /d' rt Building foundation _ /O rr Water main 6 llk �� r i� Water Service line G.f� Surface water 161:1 r Driveway, parking/vehicle storage 20 Curtain drain UA(k Wells on adjacent lots MCI ,* F. COMMENTS G. ENGINEER'S CERTIFICATION qI .......... �'�� `'•,F9�1 Aw 1�fJT14 & I certify that I have determined through field inspections and in /..•.. .:. ..........•••• •• review of Municipal records that the above systems are I ..9 t. conformance with MOA HAA guidelines in effect on this date. . y �'••" °"""-'.. Steven W. f a n , Engineer's Printed Name Cza(6 ,ja'� ;•.' pE 6256 fi r _STFr/F Date /y&0An\ OFEsrsi'��"�' HAA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number GI V98 KM Receipt Number (Rev. 12/01) 12-08-04 12:24PM FROM -CUE ESI, SGS ENV SERVICES SG$' SCS ReLa 1047802002 Chow Name North Rim Engineering Project NamNN Various Client Sample ID Falling Water 4 3; 63 Matrix prinking Water PWSID 0 Sample Remarks: 9075615301 T-195 P.03/08 F-436 All Datesaimes are Alaska Standard Time Printed Date/Time 12/07/2004 14:34 Collected Date/Time 12/01/2004 11;00 Received Daterrime 12/0212 10:07 Technical Director QStepSe ItaltReed/�res.+f/rte de Allowable, Pap Analreis Peamcna Results PC!L Uinta MemoG Cnnsaincr 111 Lirnab Dare Dale Init Waters Department Nitrate -N . O. i0o L' 0.100 mg/L EPA 300.0 B (ter 10) 12/02/04 B3A Hiarobiology Laboratory 'fotalColifmm 0 coS1100mL S.M20922213 A (-1) 12/02/04 OPT fog* �ss 141 .. _.. 1-1, ice'rra-r ply ASBUILT SEWARD h ASSOCIATES LAND SURVEYING 64- 82 I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALE= FOLLOWING DESCRIBED PROPERTY= f."V 14/6/d.1°Js'a.Pfr/ CaT"i.Rr'9 DATE=�5�. AND THAT NO ENCROACHMENTS EXIST EXCEPT AS iz INDICATED. IT IS THE RESPONSIBILITY OF THE Z.L"* OWNER TO DETERMINE THE EXISTENCE OF ANY GRID= i••••• •� EASEMENTS, COVENANTS, -OR 'RESTRICTIONS fEBmY � � WHICH DO NOT APPEAR ON THE RECORDED SUBDI- pa� Due.. Mtrk Lw.rd :: Ar VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB- / fy�'•, is-asia ANY DATA HEREON BE USED FOR ClONSTRUCTION �� OFFENCE LINES, OR FOR ESTABLISHING BOUND -DRAWN= �Ma��s'A`+ ARY LINES. MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# 650— 77— 2aq HAA# -1k� t`i( ('X 1. GENERAL INFORMATION Complete legal description FaILn./ Location (site address or directions) GG(�s�h l�uu.�r �Oi�h ��• �f� /S/✓�� J Property owner /�'J l Day phone Mailing address 953 2 Ct'ua� �'`�� , Ea fC✓ R✓�r� ��' Lending agency Day phone Mailing Agent Address — Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 95'r'�-7 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 �— 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. 72-025 JAft. 1/91) Front MOA 021 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 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 k�tvlb En ('intPi;h Address 26 y y ( /1A Engineer's signature ,51V,"/. Eli 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments By: wTIC Phone 196 _6 /// Date 3 4 V A4 .Q1� .•�•NI•p�1e Ktt lA. � ;i '•� C° 71/15 r ®p OFESS bedrooms, with the following stipulations: Date 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 engineer's work. 72-M (Rev. 1/91) Back MOA 021 e Municipality of Anchorage P!IAR Q 1999 DEPARTMENT OF HEALTH & HUMAN SERVICE�UNICIPALITY OF ANCH Environmental Services Division ENVIRONMENTAL SERVICES 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: Fal�in� G✓a�P,� �� 34 &f 3 Parcell.D.: A. WELL DATA Weli type Pii ✓alit If A, B, or C, attach ADEC letter. ADEC water system number _ Log present (Y/N) l Date completed 46 -22 --,?e Total depth o%,i b Cased to A// Casing height (above ground) Sanitary seal (Y/N) 1 Wires properly protected (Y/N) y FROM WELL LOG Date of test D �' 2 Z - 90 Static water level /66 Well production 07 9 -p -m WATER SAMPLE RESULTS: Coliform b Nitrate -e—M)?L AT INSPECTION Other bacteria b Date of sample:_/45 Collected by: y,r B. SEPTIC/HOLDING TANK DATA g.p.m. Date installed 66,2,5`90 Tank size /� 2 Sa Number of Compartments 2- Cleanouts (Y/N) Y Foundation cleanout (Y/N) _ Y Depression (Y/N) /) High water alarm (Y/N) Date of Pumping '"� Pumper C. ABSORPTION FIELD DATA Date installed 0(0 A7- 9$ Soil rating (g.p.dJW or ftz/bdrm) 1,2- System type s lr'F&4r 1 %rye/% Length � �. 9 Width S , Gravel thickness below pipe 3 r Total depth 6 • S'9 Effective absorption area 566 Monitoring Tube present (Y/N)--Y- Depression over field (Y/N) N Date of adequacy test Results (Pass/Fail) For Fluid depth in absorption field before test (in.); y after gal. water added (In.): _ Fluid depthes later: Absorption rate = c.p.d. Peroxide treatment (past 12 months) (YM) If yes, give date 72-026 (Rev. 3/96)" D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES "Pump on" *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons "Pump off" level at* Septic/holding tank on lot M r On adjacent lots /UD r r r Absorption field on lot On adjacent lots /DU 4 - Public sewer main NI %a Public sewer manhole/cleanout N%4 Sewer /septic service line 215' 1 ,- Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation )61 '- r Property line /� "F Absorption field /y 14- Water main/service line Z S Surface water/drainage /06 Wells on adjacent lots 166 -e- SEPARATION SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / 0 1't- Building foundation /6 �- Water main/service line Z S^ /.* Surface water /,061+ Driveway, parking/vehicle storage area 7 Curtain drain /06 1-/- Wells on adjacent lots lo 6 4- F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recoT6 in conformance with MOA HAA guidelines in effect on this date.'( AVV-- '' Signature. r° Engineer's Name -14 a Date Z �d � :• CE l HAA Fee $ Waiver Fee $ Date of Payment / �/ Date of Payment Receipt Number - ! � t�[ ad Receipt Number 72-026 (Rev. 3/96)* 2S / 4 are MAR -02-99 TUE 05:19 PM KND.ENGINEERING 907 696 8111 P.01 P'If iF.' 9c 95 -ITL H11CH0PGIGE NORTHERN TESTING LABORATORIES, INC. 3,130 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 09701 1907) 456.3110 • FAX 456-3125 ANCHORAGE. ALASKA 99513 (9071349. '1000 FAX 3M19.1016 5005 SCf 004 STREE'' PRUDHOE BAY, ALASKA 00933 {907) ee`J•21x3 FAX 659,2146 POUCH 3a0J43 KND Engineering 20441 ptarmigan Blvd. Bogle River, AYC 99577.3736 Attn: Dea 1 uKw Client ID: palling Waters B3, L3 Client Project #: Source: NTL Lab#: A160112 Sample Matrix: Water Comments: Method parameter SM 4500 NO3 Nitrate -N Units Report Date: Dato Arrived: 2/19/99 Sample Date: 2/19/99 Sample Time: 11:30 Collected By: *Of Legend •� Mgt, a MolkM ROW Level MCL ■ MmContamiwtLevel t3 = Present to Method Blank E Estiloafed Value M = Matrix Interference H = Above MCL D = LO;tTO))iludon Result MRL mg/ CMRL 0.10 i ate Dale prepared Analyze 3/2/99 RECEIVED MAR 4 1999 MUniCII)FA lY 0 an Services C).Pt. Wealth & PRELIMINARY REPORT' Reported Results Have Not Passed Through FiW Quality Control Review