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 ..... CO. A -7 , i IIr I // - 1-- a -I If CO. A -7 , i IIr I // - 1-- ■ 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"' c From ---Ft. KIND OF FORMATION: _ From-0—Ft. to r +E---Ft_,�_X..L'E_a7�`="t-�e-� �"_ From. Ft. to—_Ft. _ o Ft. iAAM=�.- e ����.._.. Fqrom to— FromPILL Ft. t,,241' Ft, //Ft. `4` Ft. to ' 41� Ft. _4 1,1fQ y From__ Ft. to Fro r¢ Ft. Ft. to Ff. to g il% Ft. Y 1 From—Ft to _Ft. From6_�'~t- - _- Fromt' Ft.Ft. +��'`Y-. `'""..`from. Ft. to Ft From -_.--Ft. s � . .L From�5++' .erg 1Y�J . -Ft. to__7 l Ft l�. .moi' :z�.'"d <- From Ft. to _.Ft. -Ft. From From Ft. e`s i ��- aR F oi» -Ft. to _Ft. .— _— From Ft to Ft4)� Aj'j t 4 s A5/HQ r" Frmn ___Ft. to Ft._ From From Ft. to _Ft. ___ Frmn -Ft. to_ _Ft. From Ft. to_ _Ff. ____--__.._- From. Ft. to Ft. From ---Ft. to—Ft. _ ---- From ___-_._Ft.to Ft. From Ft. 4o—. -Ft. __. From- Ft. to Ft. From Ft. to Ft. From -_.--Ft. to -Ft. From Ft to ---Ft. .— -- From Ft. to_ - Ft. From Ft. to ---Ft._ _ _. From- -F.. to Ft. Froin Ft. to Ft. _ ___ _.- From. -. _ _-___-Ft. to.____Ft. From --Ft, to--- Ft. - From Ft. to -.--.Ft, 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 W,*I V EJB? I? ELIP UEST AOR t67- // &f5. // B/p0/¢QLv/izTF_R HEmAn $u (AAAI VE,j NV Q u ES r NUAIeEX Wri9¢000¢ W,IIV,cfl HFQu E,Sr FOR o1v-Lor WEll Ta sE-pT1e- T/9Nk ar 8o F,5E - 5 EPT / c P gr�q — %k(F 5F PTic 7wmt /u att6sT/0Av covo kerco /.v o9a6 ' 7ol. %` TI4NK /S 4 /000 GgLLON, 2 eomPAIPTMFv7- Su�vS,� T PLr)-sric. TlIE W/9S I vsTl9LL. ED Ifvo INSF'ECrEO fis oem-,6 8.3 ' FROr( T/-cE oti W1EL THERE Is No of lv/NY oli HOW / T C,-tME TD FE. % Al F s E PrI c Tlgivl< / S L O C14 rr rJ ON Tim F_ 0)0,00 SATE 5.119E goAt FROM r/7(tF 6vt-=LL ANO 15 TKF W E [4 dA., A S C a PE. F1? d ,,t PO TF A r,,- A+*'9416kT/4,G /-Poj %'HE SF-prl(, S j'S%FMS /,v 1,�e1f AREA REPonr 9.s S'D/t co*c,7,ia.vr ARF_ S/4NDY�G�R�rv,�ts wiTN fomE Su.T a.ITH S--/o-t/Nurc 3 or Ed pE� INCH. L� ItiarT CSI SFAS, Al tf 0 p Gr 14rrz/Q f)e r1. DE.O Oc%r z DEr'r G ro 6-041-1 ,orfl'r-H. z �Cv z tv F L L A4 r,- — 1-14E bvELL IN (?UESTMV 1S 176 ffU rorlgi. pEIP7w. /3 EDROCk /S FNC0UN7F-RED /97' 16FfF7-. TME frgr/c a,�4rrtf LEVfZ /S 33 FEET. FN Sa/i. PR/6,Y ro 5,vcvuvrER'A,6 OR. /s /4 S1171v 5#APP G/pAvfL. TME PERC. 1'ifrF- of rkif Solt w.rrs rMIN//u, J'tit/J ro/L /S AA. FaCE4L ENT F1 r nlv6 MATF_X1,9Z OF SEI°r'/C rAA.,& F_ FAL uENT. 7 -HE �-ELC /,v OaEsriow /s ttP6RAPIEN7- FROM rrlE 3EP07-1c IA' LF-v/4r o %A/vk /9�PplQO�(tMAT�`Gy � / F- /aiv O/4 % /a f T 1S SAFE 7-0 ASf ursE S'Z 6AfR z -7% fpOr. 1n -EGL /n- QuE:r/VIV r0 714E EN6ipd-46Y/.vG s/FPrOC "N%'. I,V L L S M Pt F S /w O/ C)g 7-f Q c al- / Fo/p r+ . 4 7 w� If. N / T-/?,* 7 -ex. rN/S law /V I r/? n e- I-TvEL /4/lp/otrr--5 T/-eA-r soy[ s r/-//sj" THE S �s TF M f ! N 7 i -e F ,:;14R F -A An r -o 4o roRB/w& l�TO ARE r'4 A/ 7 / 7' r14 � F FICLgrL-T /s RF- c F/vIN6 ^vrpaA'rt' rReArms wr r7- JJ A-07- ati�surrL 7 -"F -RF_ /S S/ -ML L ow BEIii�OG/.� TqI N/TR,97 E.V AVC 1-114# G•-�1�.� SO�I.S /?FCF�/v/vG JrAPr/c rwwk 7-00 C bkRf& 4AoO ,EFfEkEA.T Or =-$ iv P r G o r rP EA -TP - n R DEQu,4 rE L IL" pn, v R T v THE BE, 'Ck . or C, C. 5. D. W . G. f v r S. C. l�. d. PL'�//1/TS SOIL. SyIQ OT/aN P4mg#trn-►Ti �r-En 7- 'a. 'a. R. x ga • . _ u =.z -� z z, s Z . 2 [ e;wCL oN G�? Al w�1 /✓}2 G,�Nn ro��rL /S. 8 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 oW vgd v Z ou d36 W �Jk — Q� P a •` \ to ID 31VOS --- o . _05' - „! W r � in oW vgd v Z ou d36 W �Jk — Q� P a •` \ to ID 31VOS --- o . _05' - „! 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