HomeMy WebLinkAboutBROADWATER HEIGHTS TR H LT 11Broadwater
'D
Heights
Tract H
Lot I I
#050-081-55
:. GREA , ER ANCHORAGE AREA BM JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOS,�A jL-SYSTEM
NAMEV'I/" LCCy '�"`�' MAILING ADDRESS �Z'' S! 2 1 � PHONE bei
LOCATION =' LEGAL DESCRIPTION �- f I T1'g4 pY�
SEPTIC TANK:
DISTANCE 3f JAAA,�_
NUMBER OFFROM WELL MANUFACTURERMATERIALJJ'44-6-COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY !� GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL (JAC, _FOUNDATION
NUMBER OF LINES_ I DISTANCE BETWEEN LINES
NEAREST LOT LINE
TOTAL LENGTH
OF LINED
TRENCH WIDTH IN. TOTAL EFFECTIVE
ABSORPTION AREA L//,o SQ. FT. LENGTH OF EACH LINE
f- DEPTH OF FILTER
�r
DEPTH: TOP OF TILE TO FINISH GRADE S MATERIAL BENEATH TILE PF. ABOVE TILE IN.
WELL: C
TYPE-_ CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC
FOUNDATION LOT LINE , SEWER LINE , TANK-
CESSPOOL
ANK_
CESSPOOL
APPROVED
, OTHER SOURCES
DISAPPROVED
DISTANCES: _-
INSTALLED BY:..
SEWER LINE DEPTH:
�(
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form EQ -032
REMARKS
SEEPAGE
SYSTEM -
G. A. A.
YSTEM_
G.A.A. B.
DEPHRTMENT C HEHLTH HND ENYIRONMENTHL � ]�ECTION '
2516 E, [UDOR RD., ANCHORAGE, HK 99507
276-2221
L4 EE L. L. Fl P4 E> CA 1-4 'l -T- E�*-. F*.--.-.: i. -A Fi.-H.'.. �=:l o-, 0�
PERMIT NO. ( 76461
APPLICANT DUNCAN MCCLOUD JR PO BOX 795 EAGLE RIVER HK 694-9924
LOCATION SKYLINE DRIYE
LEGHL L11 TRH BROHDWHTER HEIGHTS LOT SIZE 23000 SQUARE FEET
TYPE OF SOIL HBSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)- 12'!
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
��F-A ����F 1-1= �-fHE*- ��"".0, F'E'E., L_ �����= �
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD.
THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND HND 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 OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
FT?KK;fR_jl:K&EEE> ��F=""TTc_ 1_*F-lr-4F---__. fL42'ICDCa C3KL.L.C=S��;:
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAY.'',*'';
OF THE WELL COMPLETION.
SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER
INSTALLATION.
Fm FE F1 P1 3. K 0 1 �(D P4 E= ��K F:W-,* I F=-
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS.
SIGNED:___ _7-��_k_�___jjfsjj't67§�7UD---------HPPLICHNT DUNC
Performed for
Legal Description:_
This form reports:
GRLAi Lk Al'A,ok iIAok. I', 6-A UUROUGii
Department of Lnvironmental Quality
3330 "C" Street r --
Anchorage,
Anchorage, Alaska 99"3 /Ze1?ae674ed �y Aladl
SOILS I,O(A - PEROL,ATION TEST
Date Perforuihd�r
Soils log Percolation test
Depth
Feet j
f�r.l
2 6B0 )rl
4--
L-
�J1lC
10 - -/'-o auJ 2GU�2./�?�f
12 -
i3 - '_,v r _OfA
O i= G uC.Nlir•��10t\(
14 -
o � 6
Was ground water encountered? ye6 If yes, at wilat depth?w:�
/i • " ,.�: � , �..�� air./in� GJ�..'. ��r,� , /rn 6e, f�; ; �,c �7v:� "I 4 / �j � f /.moi f' C.c�; .,l (G_
heading
Date
Gross Time
Net Time
Depth to Water
Net Drop
I
Was ground water encountered? ye6 If yes, at wilat depth?w:�
/i • " ,.�: � , �..�� air./in� GJ�..'. ��r,� , /rn 6e, f�; ; �,c �7v:� "I 4 / �j � f /.moi f' C.c�; .,l (G_
heading
Date
Gross Time
Net Time
Depth to Water
Net Drop
Percolation rate minute.
-Proposed i nstal 1 at7 on SeeTage Pit Drain Field
Depth of Inlet �Deptj to Bottom o'f pit or trench
COMMENTS: �:uz���.t�or_ ah�[��4 r� 0-U1N_is�.'.'" _r`%L._'>L��'._._
Pr;rforr:4d By By: C1Y' <« J -'� _u Date ..r .....
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DOC Co. tlba
SULLIVAN ATE WELLS
P.O. BOX 670272, OHUGIAK, ALASKA 99567 o TELEPHONE 6882759
OWNER OF LAND ,N0140.% `. � i16` _j -j DEPTH OF "LLL
Ft. to
ADDRESS - _ ST.-aT[C LF 4f4I OF,Li\TER
1: F. - f-;,0
writ
LEGAL DESCRIPTION / SI _JJA_f `_ t P _._
_Ft.
From
DATF. -Started _ � �� Ended .. GALS. PER NR
_Ff. ____--__.._-
From.
PERMIT NUMBER _____ _- KIND OF CASING"'
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KIND OF FORMATION:
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o Ft. iAAM=�.- e ����.._.. Fqrom to—
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MISCL. INFORMATION:
DRILLER"S NAME -� - -
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 050-081-55 Expiration Date: 1-10-13
1. GENERAL INFORMATION
Complete legal description Lot 11, Tract H, Broadwater Heights
Location (site address) 12330 W. Skyline Drive, Eagle River, Alaska 99577
Current Property owner(s) David FOX Day phone (330) 979-9479
Mailing address 314 Bradford Drive, Canfield, OH 44406
Real Estate Agent Audrey Mason @ Re/Max ER Day phone (907) 242-7777
2. TYPE OF DWELLING:
F Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
.Naiver/Variancerequest for: instance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the gi eeer.
Date:
W
COSA Fee $ RI) • Waiver Fee $
Date of Payment /()17A3 Date of Payment
Receipt Number M51 W "C%e.(I & Receipt Number
COSA # Q SG/3/ 08 Waiver #
3
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
M
Individual
El
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public VVateer System
n
U
o...r.., c..,.....
ruvnv vcvrc
r1
LJ
.Naiver/Variancerequest for: instance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the gi eeer.
Date:
W
COSA Fee $ RI) • Waiver Fee $
Date of Payment /()17A3 Date of Payment
Receipt Number M51 W "C%e.(I & Receipt Number
COSA # Q SG/3/ 08 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 Pinard Engineering
Address PO Box 871347, Wasilla, Alaska 99687
Engineer's Printed Name Paul E. Pinard, P.E.
6. DSD SIGM1IATURE
-- System #1 Approved for 3 bedrooms
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
Phone (907) 357-3647
bedrooms, with the following stipulaons: 3
By: G°�/ / c/ / Original Certificate Date: J ��
6
The nici 1 o nchorage 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
WsA blue sheet 5 e c
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: Lot 11, Tract H, Broadwater Heights
A. WELL DATA
Well type PVt If A, B, or C provide PWSID # Well Log (Y/N) Y
Date completed 1976/1995' Sanitary seal (YIN) Y Wires properly protected (YIN) Y
Total depth 400 ft. Cased to aedmck ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 6/95 9/26/13
Static water level 60 ft.
Parcel ID: 050-081-55
Well production 0.9 9 -
p.m -WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate 1.41 mg/L
Arsenic ND ug/L Date of sample: 9/17/13
28.1
0.33
Collected by: Pinard Engineering
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Fiberglass
Tank size 1000 gal. Number of Compartments 2
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
Date of pumping 8/12113 Pumper JRs Pumping
C. ABSORPTION FIELD DATA
Date installed 8/31/76
Cleanouts (YIN) Y
High water alarm (Y/N)
N
Date installed 8131/76 Soil rating (g.p.d./ftp or fe/bdrm) 125 sf/bdrm System type Deep Trench
Length 41 ft. Width 4 ft. Gravel below pipe 5 ft.
Total depth 10 ft. Eff. absorption area 410 fe Monitoring tube Y Depression over field N
Date of adequacy test 9/26/13 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 42 in. Water added 60 0 gal. New depth 43 in.
Elapsed Time: 195 min. Final fluid depth 42 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date
D. LIFT STATION
Date installed _
"Pump on" level at
Datum
Size in gallons
in. "Pump off' level at in.
Cycles tested
E. SEPARATION DISTANCES
WELL ON LOT TO
Septic tank/lift station on lot
80'*
Absorption field on lot 100'+
Public sewer main NA
Sewer /septic service line 25'+
Animal containment areas 100'+
Manhole/Access (Y/N) _
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout NA
Holding tank NA
Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 51+ Property line 51+
Water main NA Water service line 101+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
3' * 10'+
Property line Building foundation
Water Service line 10'+ Surface water 1001+
Curtain drain None Known Wells on adjacent lots 100'+
Absorption field 51+
Surface water 100'+
Water main
NA
Driveway, parking/vehicle storage 10'+
in.
F. COMMENTS
* Well was extended in 6/95 from its depth of 176' to a new depth of 400; well log attached.
Waiver granted for 80' separation of ST to well. Waiver for T SAS to PL referred to but not found.
G. ENGINEER'S CERTIFICATION
I certify that l 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 Printed Name Paul E. Pinard, P.E.
Date 10/7/13
COSA brown sheet 10-10-12.doc
4"' 4GL: ..09 Dcc C4�.�EGPmn '.
A e „
r''t'�vE� ark
Cl1�r,I�e� z
Vt
Municipality of Anchorage aL
Pq. !
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ei.anchorage.ak.us
(907)343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # 131519
During a recent COSA on-site inspection and test of the potable water
supply well on Tract H, Lot 11 of Broadwater Heights subdivision,
the well's productivity was determined to be 0.33 gallons per minute. The
minimum well productivity required by this Department (AMC 15.55) for a
3 -bedroom residence is 0.31 gallons per minute. Although the subject well
currently exceeds this minimum requirement, all parties concerned are
advised that the production capacity of the well may fluctuate. Restriction
of non-critical water uses such as washing cars and watering lawns and
gardens may be required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
v
PINARD ENGINEERIM
1 P.O. Box 871347
Wasilla, AK 99687
(907) 357-ENGR (3647)
ADEQUACY TEST
LOCATION: Lot 11, Tract H, Broadwater Heights
APPLICANT: David Fox
314 Bradford Drive
Canfield, OH 44406
SEPTIC TANK TYPESIZE: Fiberglass/1000 Gallons, per MOA Records
ABSORPTION SYSTEM: Deep Trench, per MOA Records
DAILY FLOW:
3 BEDROOMS x 150 GAL/BR = 450 Gallons
TEST DATA
1�
JOB NUMBER: 13-317
DATE OF TEST: 9126113
FIELD STAFF: PJ Pinard
NUMBER OF BEDROOMS: 3
SCUM: 0.0' SLUDGE: 0.0'
NEEDS TO BE PUMPED: Yes No XX
CURRENTLY IN USE: Yes XX No
Time
Flow
Rate
Volume
Cumulative
Volume
Septic Tank
Septic
Tank
Soil Absorption System
Comments
pM
(GPM)
(GALS)
(GALS)
Liquid Level
*
A Level
Monitor
Tube 1*
A SAS
Level
Monitor
Tube 2*
A SAS
Level
515
4.0
-
4.0'
-
3.5'
-
Start Flow -Meter 164100
5:30
4.0
60
60
4.P
0.1'
3.6'
0.1'
164160
5:45
4.0
60
120
4.P
0.0'
3.6'
0.0'
164220
6:00
4.0
60
180
4.P
0.0'
3.6'
0.0'
164280
6:15
4.0
60
240
4.1'
0.0'
3.6'
0.0'
164340
6:45
4.0
120
360
4.1'
0.0'
3.6'
0.0'
164460
7:15
4.0
120
480
4.P
0.0'
3.6'
0.0'
164580
7:45
0.3
120
600
4.1'
0.0'
3.6'
0.0'
164700
8:15
-
10
610
4.P
0.0'
3.6'
0.0'
Stop Test- 164710
RECOVERY
Date
Time
ST MT
SAS MT
9/26
8:30
PM
4.0'/-0.1'
3.5'/-0.1'
*ALL MEASUREMENTS IN FT.
TEST: PASSED XXX FAILED
COMMENTS: System appears to be operating satisfactorily. There was 3.5' of measurable liquid in the SAS MT
prior to beginning the test. With the addition of 610 gallons to the system (signiflcantly more than
the design daily flow), the level immediately rose 0.1' where it stabilized for the remainder of the
test. A recovery measurement, taken 15 minutes after stopping the test flow, showed a return to the
starting condition.
Reviewed by: Paul Pinard
Date: 10/7/13
71M.RT91A k'101�I4401I r
t
P.O. Box 871347
Wasilla, AK 99687
(907) 367-ENGR (3647)
WELL FLOW TEST
LOCATION: Lot 11, Tract H, Broadwater Heights Subdivision
DRILLER: Sullivan Water Wells
DATE WELL COMPLETED: 6/96
WELL DEPTH: 400'
STATIC WATER LEVEL (top of casing): 28.1'
JOB NUMBER: 13-317
DATE OF TEST: 9/26113
FIELD STAFF: PJ Pinard
Time
Elapsed
Time
(Minutes)
Static
Water
Level
Flow
Rate
(gpm)
Cumulative
Gallons
Pumped
Remarks
5:15 PM
-
28.1'
4.0
- Start Test - Meter
164100
5:30
15
45.9'
4.0
60
164160
5:45
30
68.3'
4.0
120
164220
6:00
45
107.3'
4.0
180
164280
6:15
60
152.1'
4.0
240
164340
6:30
75
199'
4.0
300
164400
6:45
90
244'
4.0
360
164460
7:00
105
286'
4.0
420
164520
7:15
120
333'
4.0
480
164580
7:30
135
351'
4.0
540
164640
7:45
150
392'
0.7
600
164700
8:00
165
393'
-
610
164710
8:15
180
393'
-
610 Stop Test -
164710
RECOVERY
9/27/13
All well protection features are adequate.
7:20 PM
86.0' Recovery rate A 0.33 gpm — note home/system in use during this time.
Average Flow Rate: 3.4 gpm
Comments: DURING THIS TEST, THE WATER SUPPLY WELL WAS CAPABLE OF
PRODUCING 4.0 GPM. THIS TEST DOES NOT CONSTITUTE A
WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM
WILL CONTINUE TO FUNCTION AND PRODUCE AT THIS RATE.
Reviewed by: Paul Pinard l"a'
Date: 1016/13
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 S & S ENGINEERING Phone -q�9
17034 Eagle River o.
Address ska 99 Roe
Engineer's signature Date
..�Y'e�e4i Xp6e� ty
!� • �,y�J rib tf .
t'` c
... - - "'�"'' 1PtlYieno.ss:y[��f•PwaE r f ,
. . •�v? f��MO.�k,.J1Me9+kh.oi amiwi N
•r j.. � , iia.' 1!!i7 -E ;:.. e" y ,,'•
DHHS SIGNATURE k)a•�gR r...q,t;�: "^
XApproved for bedrooms.
Disapproved. -
Conditional approval for `bedrooms, with the following stipulations:
Additional Comments
� t!
411TIr
Date —3
T he Muhicioality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Alfproval
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 thei'rlending institutions in orde'rto 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. 1/91) Back MOA 821
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Parcel I.D.
A. Well Data I
Well type Ye,k-� ate_ If A, B, or C, attach ADEC letter. ADEC water system number +�\�
Log present 6�N) Date completed 1 `l to Driller S E�
Total depth 1 Cased to 5f -v Casing height l Zii
Sanitary seal ON)
J)
Wires properly protectedON)
�
FROM WELL LOG
AT INSPECTION
O z
Date of test
Static water level
5�
Well flow
ylL
g.p.m. 23. o C�,Pr�
g,�.
Pump levell
SEPARATION DISTANCES FROM WELL TO:
p "'
Septic/holding tank on
-I
lot �3d�
; On adjacent lots
Z
Absorption field on lot
o 1 ; On adjacent lots
1 n a
r
Public sewer main
'� "6,-
Public sewer manhole/cleanout
p,
2�
'Zs
service line
Petroleum tank
//Sewer
WATER SAMPLE RESULTS:
Coliform
Nitrate
b . 4 -7 Other bacteria
Date of sample:
% - 1-7- 5 4
Collected by: S { S C-
SA
B. SEPTIC/HOLDING TANK DATA
Date installed 1 C1 I t, Tank size Compartments Z
Cleanouts &N) Foundation cleanout (%N) Depressio(� (Y& r`
High water alarm (Y/0 r ` Alarm tested (Y/N_ 71 A
Date of pumping 1 - t f5 -I + Pumper L4 -'s 5 Paa L�
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot U On adjacent lots lad t Foundation
d -
To property line 10 Absorption field 1 Water main/service line
Surface Ovate /draina e \ v a t
L-0
72-026 (3/93)• Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
lot
D. ABSORPTION FIELD DATA
On adjacent lots
Manufacturer
Manhole/Access (Y/N)
--lipurrivel at
es tested
Surface water
Date installed 1 C�-1 �_ Soil rating (GPD/Ft2) 1 2s fP-- System type T
Length A- k( Width 4 � Gravel thickness 5 Total depth /a
Total absorption area f /0 � Cleanout present &)N) Depression over field (Y/&
Date of adequacy test / fit- 5 11 Results ass ail) &A -S'S for 3 Bedrooms
V V
Water level in absorption field before test 9 After test 3
Peroxide treatment (past 12 months) (Y& �D �� IL l o J wS If yes, give date `S'
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot t C>'t> On adjacent lots t o Property line -3
To building foundation L o r To exis ing or abandoned system on lot `� l
On adjacent lots �"
C> Cutbank ~
1 Water main/service line
Surface water l J Q ` Driveway, parking/vehicle storage area
Curtain drafpc-1 �(vk �
E. ENGINEER'S CERTIFICATION
1 certify that 1 have checked, verified, or conformed to
S & S ENGINEERING
Signature 17034 Eagle River 1 ee
Eagle River, Alaska9 57
Engineer's Name
Date / A_
HAA Fee $ bC>,u-)
Date of Payment t - 9L -'l �LI _
Receipt Number a (oak U7
72-026 (3/93)' Back
JA10A nd HAA guidelines in
e;
r�
flykJ
Sp �4-
�Gt a Clete, �s inspection.
Waiver Fee $
Date of Payment
Receipt Number
Commercial Testing & Engineering Co.
'ZAL Environmental Laboratory Services
SINCE 1908
REPORT of ANALYSIS 5633 B Street
Chemlab Ref.# :94.0272-3 Anchorage, AK 99518-1600
Client Sample ID :LOT 11 BLK H BROADWATER HTS Tel: (907) 562-2343
Matrix :WATER Fax: (907) 561-5301
Client Name :S & S ENGINEERING
Ordered By :RAY
Project Name
Project#
PWSID :UA
WORK Order :75065
Report Completed :01/20/94
Collected :01/17/94 @ 12:20 hrs.
Received :01/18/94 @ 13:00 hrs.
Technical Director:STEPHEN C. EDE
Released By
Sample Remarks: ROUTINE SAMPLE COLLECTED BY: RAY
QC Allowable Ext. Anal
Parameter Results Qual Units Method Limits Date Date Init
------------------------------------------------------------------------------------------------
Nitrate-N 0.47 mg/L EPA 353.2/300.0 10 01/19 LLH
See Special Instructions Above UA = Unavailable
** See Sample Remarks Above NA = Not Analyzed
U = Undetected, Reported value is the practical quantification limit. LT = Less Than
D = Secondary dilution. GT = Greater Than
<s
a®1 BGG
y Member of the SGS Group (Soci6td Gdn4rale de Surveillance)
ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA
Awl
�4.
Munic pality of Anch rage
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
March 1, 1994
Robert Shafer, P.E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
dhhs
Subject: Waiver Request for Lot 11 Block H Broadwater Heights S/D
Waiver Request #WR940004, PID #050-081-55, HA940051
Dear Mr. Shafer:
Your request for waiver(s) of the required 100 foot horizontal
separation of a septic system to a private well has been approved.
The approved separation distance(s) are a private well to the
septic tank on property of 80 feet.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
ljm:#6
Concur:
t_
john Smi, P.E.
rogram Manager
On-site Services
5 _52L
MUNICIPALITY OF ANCHORAG_
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR940004 PID# 050-081=55 HA# HA940051 Permit #
Date Received: Jan 28, 1994
Legal Description: Lot 11 Block H Broadwater Heights Subdivision
Engineer: Robert Shafer, P.E., S & S Engineering
17034 Eagle River Loop Road, Suite 204, Eagle River 99577
Applicant: Charles Fox
Waiver Requested: Well to septic tank on property of 80 feet
Criteria: 1. Geology:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Points:
Waiver is Granted: Waiver is NOT Granted:
List Conditions or Reasons for above: SPIE 11 /% /� 011F>
Date: 2 - 219-t74 By:
Reviewer
Rec #: 25621/2407 Amount: $ 625.00 Date Paid: 1-28-94
• MUNICIPALITY OF ANCHORAA
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR940004 PID# 050-081=55 HA# HA940051 Permit
Date Received: Jan 28, 1994
Legal Description: Lot 11 Block H Broadwater Heights Subdivision
Engineer: Robert Shafer, P.E. S & S Engineering
17034 Eagle River Loop Road Suite 204, Eagle River 99577
Applicant: Charles Fox
Waiver Requested: Well to
septic tank on property o
V"A_J,od. 0
Criteria: 1. Geology:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Points:
Waiver is Granted: Y Waiver is NOT Granted:
List Conditions or Reasons for above: SFf fel/q Cf/E/'
1t
Date: 2 - 2 8_ 9¢ By: ✓
a Reviewer
Rec #: 25621/2407 Amount: $ 625.00 Date Paid: 1-28-94
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January 27, 1994
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
` r<IVER, P��
Municipality of Anchorage MUNICIPALITY OF ANC.HUKAGE
HEALTHAUTHORITY
DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION
APPROVALS
825 L Street
P.O. Box 196650 JAN 2 8 1994
Anchorage, Alaska 99519-6650
RECEIVED
SEWER & WATER
MAIN EXTENSIONS
REFERENCE: Lot 11 Tract H Broadwater Heights
Request you issue a Health Authority Approval on the
SEWER &WATER
referenced property and grant a waiver for the horizontal
INSPECTION
separation distance between the septic tank and the well
serving this property at 80 ft.
A risk analysis was performed using the State of Alaska,
ENGINEERING
Department of Environmental Conservations Separation Distance
REPORTS
Waiver Guidelines. Our results are as follows:
A. WATER TABLE:
From the well log we can see that the well depth is
WELL INSPECTION
& FLOW TEST
176 f t . From the well flow test performed on January 21,
1994 we see the static water level to be at 33 ft. Using 33
ft as the aquifer water table:
= 4.0 pts.
SITE PLANS
B. SOIL SORPTION:
From the soils log used in the design of the septic
system the receiving soils for the septic system are sandy
gravel with some silt. From the well log there appears to
ROAD DESIGN
mixed gravel to 16 ft. with bedrock extending down to the
bottom of the well.
= 2.7 pts.
C. PERMEABILITY:
With the soils as described above use "sandy gravel
SOIL TEST
with bedrock"
= 1.5 pts.
D. WATER TABLE GRADIENT:
PERCOLATION
With the static water level in the well to be 33
TEST
f t . and with the well to be approximately 20 f t . up hill from
the septic tank the hydraulic gradient is approximately 0% to
-5%.
= 2.5 pts.
STRUCTURAL&
E. HORIZONTAL SEPARATION:
MECHANICAL
INSPECTIONS
The horizontal separation distance between the
septic tank and the well is at 80 ft.
= 2.2 pts.
TOTAL POINTS = 12.9 PTS.
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Page 2
January 27, 1994
Lot 11 Tract H Broadwater Hts.
Since the septic tank does not normally allow effluent to
reach the soils prior to reaching the absorption area, the
probability of contaminating the soils at less than 100 ft.
to the well is mitigated by the fiberglass tank.
Nitrate levels measured at 0.47 mg/l and satisfactory
bacteriological water analysis show no possible pollution.
The area down slope to the north west of this property is
undeveloped and covered with vegetation which would prevent
migration off property.
Also at this time we request you issue a waiver for the
separation distance between the leachfield and the property
line at 3 ft. We feel this has no impact on surrounding
properties.
If we may -)be of further service please contact us.
SiAcerely,
A Shafer, P.E.
Y31VMA
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LOG OF DRILLING by A & L DRILLING COMPANY
.
OWNER OF LAND
-------------- ------------------------------------------------------
DEPTH OF WELL. ------ ------- -----
Z16
�ADDRESS
STATIC L£VEL OF WATER FT. '' -----------
---VWELL
WELLSITE ��-' --'' ?�C• � < ' � c,_ �' `� f� �` DRAW DOWN FT. � (� J
DATE—STARTED -- ✓ =
-- ----------------- GALS. PER HR. -------------------- --------------- --------- ---------------- --
DATE—ENDED -----
PC
----- ------------ --------------------------------------------- KIND OF CASING Ll '/1 ------------------------------------- ---------
KIND OF FORMATION:
+fl
FROM.... -•------------FT.
TO....-------------FT.�---
th0"'A---------•------------ FT. TO. ----------------_----FT...............................
FROM ' 6 -----•-•-••---..FT.
TO j
FT...`.•°,-= ---- ---------------` f` FROMFT. TO FT..
Cf
FROM ----- 1 -----------FT.
c
TO--•--�-- - -----------
z �.
FT.-!/'.:�..:.,. - -x!- FROM ------------------------ FT. TO ------------------.-.-..FT.-------------- --•------ ---
t„ --
u------------
` �'
FROM...
FT. TO.-------•J----•-------FT.--i*--_...--
.. ....... FROM ------------------------FT. TO -•--•---------------•--.FT.------•----------------- ----
FROM-- �---l--J----------FT.
TO----- --- - ----------FT.
� `= FROM FT. TO FT.
f
�... � ----------
1 /
71--'`":%"---��.
.
I 1
c'..--- \.---
FROM '�
FT. TO--'-4--�'---• ------
FT.'?," --- `� FROM FT. TO FT.
.SG
Lam-• u...�.
FRO ........FT.
TOx'�-`-.--••-
FT. FROM.... FT. TO. FT.
_'_---'t......... Z. �l G C.
FROM------ ------ ------------
FT. TO----• ----- ------------------
FT..-- FROM---- --•----- ---------- FT. TO -------------•----------FT.----------••------•..... .
MISCL. INFORMATION:
DRILLER'S NAME4.':_A*
w.�------
MUNICIPALITY OF ANCHORAGL_
Department of Health and Environmental Protection
•\\/ 825 L Street, Anchorage, Alaska 99501.
264-4720
Z-kequest for Approval of Individual Sewer and Water Facilities
i.
1. Property Owner:
C 12.0
Mailing Address: < ISa% Phone: 'r41131ed
E,,cjte Rivev
2. Name of Buyer:
Mailing Address:
3. Lending Instituti
Mailing Address:
4. Realtor/Agent:
Mailing Address:
Phone:
Phone:
5. Legal Description: kt-+ If 7_yac� #c154h
Street Location: /'Ve Bk -I've
T
r,
Single Family Residence: (C-)- Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply: *Individual Well (p,)- Public/Community System ( )
If Individual Well, well depth / 7.S'
If Community System, name of system
8. Sewage Disposal System: *tn-site System Public System ( )
If On-site System, date of installation: Q(,� 1i7(,,
*NOTE: A well log is required on ALL wells drilled since 6/75.
**If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77
