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by
SULLIVAN WATER WELLS
P.O. BOX 670272, OHUGIAK, ALASKA 99~67 , TELEPHONE 688,2?$9
o~
LEGALDESCR[~IO~ ~ &L~ ~1~ ~ I DRAW DOWN
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MISCL, INFORMATION:
RECEiVE-D--
OCT I 1997
Municipality of Anchorage
Dept. Health & Human Services
PAGE
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 PE}~MIT
PERMIT NUMBER:SW970193
DESIGN ENGINEER:AND ENGINEERING
OWNER NAME:ARCTIC DEVCO INC
OWNER ADDRESS:2607 PUFFIN POINT CIRCLE
ANCHORAGE, ALASKA 99507
PARCEL ID~J~2~-- ~3,~ ~% '~\ - ~-~[~
LEGAL DESCRIPTION:
,~I_Si/_-RiLW--S~-C--L0 SW--S.OR NW4
DATE ISSUED: 7/16/97
EXPIRATION DATE: 7/16/98
LOT SIZE: 54998 (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:
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 S~LME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS
RECEIVED BY: ,. "~...~. ,,,.~
ISSUED BY:
~'~ND ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
June 24, 1997
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
MUNICIPALITY OF ANCIffORAc~E
ENVIRONMENTAL SERVICES DIVISION
RECEIVED
Subject: New sewer/well permit - Glenn View S/D, Lot 9
Gentlemen:
On June 13, 1997, we excavated two new testholes for the subject property. There is
one previous testhole which was dug during the preliminary plat process, however
it was not suitably located for the four bedroom house which is proposed for this lot.
The results of these tests and water monitoring are attached.
We propose to install a shallow 5' wide trench. Although the original testhole
indicated water it was located in a lower portion of the lot and not representative of
the site. 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 that there will 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,
i-{(ilx[ iD Engineering
Kenneth M. Duffus~ P.E.
attachments:
On-Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
VASTEWATER SYSTEH ]?ETAILS/SITE PLAN
i LE]T 9, GLENN VIEW ESTATES S/D
VACANT , o.,. .
~ ~OT~8uYsTE :[5 LOT 8
LOT l] SPLI ~0 O0
LOT ]0
/ lO' EQUESTRIAN/WALKWAY ESNT. ~T ~
FK=o.oo ~=000
OES~GN ~BTAZLS
4 80RM X ]50 GPD - 600
600 GP~/],~ G~ PBR S~. Fr. 500 SQ, F T
500/(5~ w~de) x 0,5 R~ (4.0~ G~AVBL) 50 Fl',
INSTALL SOALL~W TRLNCH 1 5' WH}E X 4' ~EEP X 50' L~NG
To~ deplh oE sys~e~ ;s 5.0' Erom orgmo~ 9rode,
~-- l'ot~t dep'th oF graver is q.0' betow pilse.
~ ~'/~ 1. USE 1~50 GALLON SEPTIC lANK. INSLJI AlE TANK IF <4' C[IVER.
~ ~- , 4. ADDITIONAL KILL WILL I~E ADDED BVER SYSTEH I'U ACHIEVE
~ m c~ ?'~ ~ ~ PREPARE~ FBR: I<ND ENGINEERING
aARON SCOTT EAGLE: B~V[-_B, Al<. 99577
~~ P607 PUFFIN PT, CIR. (90/)696-CHI/Fax (907)696
ANCHBRAGE, ALASKA 99507 DATE, 6/~3/97 1DRAWING ~1
i SCAI E: 1~ lO0' 9704a S~
Municipality of Anchorage
DEPARTMENT OF HEALTH & FtUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
4
5
DATE PERFORMEE
Townsh,p, Range, Section:
15
16
17
18
t9
20
WAS GROUND WATER
ENCOUNTERED?
SLOPE SITE PLAN
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DA] E DArE _ _~_~_,,?
12-008(Rev 4:85)
Municipalily o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502 0650
SOILS LOG -- PERCOLATION TEST
2
3
4
5
6
7
8
9
10
'11
12
13
14
15
16
17
]8
19-
20
PERFORMED
7ownship, Range, Section: ~
SLOPE SITE PLAN
WASGROUND WATER
ENCOUNTERED?
S
YES, AT WHAT ~)
DEPTH?IF t/~/ P
E
Deplh lo Waler Alter ~ , ,
mm.,? o,,e:
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
{minutes/tach) PERC HOLE DIAMETER
TEST F~UN BETWEEN / FT AND '~- Fl
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE
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. # ~..'.'.'.'.'.'.'.'.~_! - '5-Z./' -- z_//_~,
¢%\ - %A\- '~
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
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 (Rev. 1/91) Fronl MOA #21
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
Address
Engineer's signature
KND Engineering
20441 Pta[migan Bvd.
Eaqle Rive~, AK 99577-87~
Phone
Date
DHHS SIGNATURE
Approved for ~' ~)//{~c'~ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DH HS 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.
72qY25 (Rev. 1/91) Back MOA ~
MUNICIPALITY OF ANCHOP, AG,/I~
Municipality of Anchorage eNVIRONMENTAL SERVICES
DEPARTMENT OF HEALTH & HUMAN SERVICES nftT
Environmental Services Division .... /
825L Street, Room 502. Anchorage, Alaska 99501. (907)3~3~!
VED
Health Authority Approval Checklist
Parcel I.D.: O5'/ - :~'2/~ Ye
A. WELL DATA
Well type ./~ 4//
Log present (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ~'/~ ~7
Total depth ,~¢/ ' Cased to ¢_~.4//'/ / //
· Casing height (above ground) .--~,.~
Sanitary seal (Y/N) / Wires properly protected (Y/N). ¢
FROM WELL LOG
Date of test ~'/¢' ~
Static water level /Ye
Well production //¢,~
AT INSPECTION
g.p.m. ,,/~ g.p.m.
WATER SAMPLE RESULTS:
Coliform ¢
Date of sample: ~-.~_Z. -- ~'~'
B. SEPTIC/HOLDING TANK DATA
Date installed ~ ~,.-¢% ~ ? _
Foundation cleanout (Y/N) _
Nitrate
Tank size _~ .~:~
~:~, /~ /~J /,/'/~ Other bacteria
Colloctedby: .~/,&/'/J~ ~.,~-~./¢ ,~'~'.~'~'
Number of Compartments .,2~ Cleanouts (Y/N) /
Depression (Y/N) ~ High water alarm (Y/N) ~
Date of Pumping ------- Pumper
C. ABSORPTION FIELD DATA
Date installed ¢- ~ - ¢ ?
Length ,.~-~. ~, ' _Width
Soil rating (g.p.d./ft2 or ft2/bdrm) /. ,¢_- System type
~ ~ Gravel thickness below pipe '/7'¢, ~ _ Total depth
Effective absorption area //,¢~ ¢
Date of adequacy test
Fluid depth in absorption field before test (in.); ..--" Immediately after gal, water added (in.)_:.----/ __
depth (ins) Minutes let .~'~_ _ _ Absorption rate = _/"' g,p,d,
Fluid
Peroxide treatment (past 12.g[3erffhs)~(Y/N) If yes, give d~'"/'.
72-026 (Rev. 3/96)*
Monitoring Tube present (Y/N) ~/ Depression over field (Y/N) A// _
Results (Pass/Fail) ~ For. ¢ bedrooms
Do
LIFT STATION
Date installed .~ Size in gallons j
Manhole/Access (Y/N) /~"Pump on" level at* "//~Pump off" level at*
High water alarm level at* ~ *Datum ~
Cycles tested ./'~/ ~
E. SEPARATION DISTANCES
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
SEPARATION DISTANCES FROM WELL ON LOT TO:
!
On adjacent lots
On adjacent lots
Public sewer manhole/cleahout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
/
Foundation /~ ¢ Property line /'~
Water main/service line ~.~ ~ Sudace water/drainage
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
!
Absorption field
Wells on adjacent lots /'~
Property line /~ ~L Building foundation /E) ~-/- Water main/service line ~.:~
Surface water / ~) /~- Driveway, parking/vehicle storage area
Curtain drain /~::~,¢) ~7~ Wells on adjacent lots /¢-~ O
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal records
in conformance with MOA HAA guidelines in effect on this date.
Signatur~
Date
HAAFee $ "~;¢¢) ' ~
Date of Payment ~/~,/~/,~.~/
ReceiptNumbe, '"~---~¢/¢" (~'~/)
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
SEP 29 '97 04:54PM MTL AMCHORAgE
NORTHERN TESTING LABORATORIES, INC.
3~30 [NI)USI'RIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 , FAX 456-3125
800,5 SCHOON s'rRFt: r ANCHORAGE. ALASKA 99518 (907) ::Hf)-I('IOD · FAX 349-1016
F~D Engineering
20441 Ptarmigan Blvd.
~agle River, AK 99577
Att~ Ken Or Dee
Our Lab #:
Looation/?roje
¥ou~ Sample ID:
Sample Matrix:
Lab
Number Method
A152209
Pressure Tank
Lot 9 Glenn View Estates
Water
Parameter
Units
Report Date: 09/26/97
Date Arrived: 09/23/97
Date sampled: 09/22/97
Time Samplsdt 1400
Collecte~ By:
Present in Blank
Above Regulatory Max
Estimated Value
Matrix Interference
Lost to Dilution
MDL ~ Method Detection Limit
Date Dare
Result * MDL Prepared Analyzed
A152209 SM 4500E Nitrate-N mg/L 0.60 O.lO 09/25/97
Reporte~y:-'Dani~l J. Bacon
Operation~ Manager
SEP ~9 '97 04:55PM MTL RMCHORR~E
NORTHERN TESTING LABORATORIES, INC.
3330 INDUS'rRIAL AVFNUE FAIRBANKS, AI,ASKA 99791 (907) 4,56-3116 * FAX 456-3125
8005 SCHOON STREE] ANCHORAGE, AI~,SKA 99518 (907) 349-1000 * FAX 34g- ~016
DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA
KND Engineering
20441 Ptarmigan Blvd,
Eagle River AK 99577-3736
Phone Number:
Fax Number:.
Collected by: KMD
Sample Type: Untreated Routine
Method of Analysis: Membrane Filtration (SM 9222
Comments:
Date Received: 9/23/97
Dale Analyzed: 9/24/97
Date Reported: 9/25/97
Next Sample Due:
Comments
$ =
U =
POS =
ND
TNTC =
CG =
HaM =
SA =
Time Received; 14:10
Time Analyzed: 13:30
Time ReDoKed: 18:03
Satisfactory
Unsatisfactory
Positive Test Result
None Detected
Too Numerous To Count (>200 Colonies)
Confluent Growth
Heavv Sediment Masking, Results May Not Be Reliable
Sample Age >30 Hours But <48 Hours, Results May
Not Be Reliable
Sample Age >48 Hours, Too Old For Analysis
Resample Require(~
Old =
R :
NT = No Test
* # Colonies/100 mi '*# CoJonies/ml
8amble Sample Total* Fecal Other* HPC**
Date Time Coliform Coliform Bacteria Result Lal~ Location Comments
9/22197 14:00 0 ND 3 NT A02719 Lt 9 GlennView ErrL, Satisfactory
Pressure Tank
Shard L, Trask Environmerr~l Anaiy~t
Norlhera Testing Laboratories, In~ Anchorage, AK
9f2~/97