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HomeMy WebLinkAboutT15N R1W SEC 18 LT 197AOnsite File T15N R1W Section 18 Lot 197A #051-232-61 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program / PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 n n http://www.muni.org/onsite �. < r Del >attmcnt On -Site Water System Permit Permit Number: OSP211451 Effective Date: 10/22/2021 Work Type: Well Upgrade Expiration Date: 10/22/2022 Tax Code Number: 05123261000 Site Legal Address: T15N R1 W SEC 18 LT 197A G:1054 Site Mailing Address: 18126 BIRCHTREE ST, Chugiak Owner: GLEASON RUSSELL & CARLA Lot Size in Sq Ft: 46079 Design Engineer: Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Q Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: Issued By: Date: JNJIUMUPAUTY OF Development Services Department On -Site Water & Wastewater Section �- Y Phone: 907-343-7904 Fax: 907-343-7997 Sly ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel 1. D. (J, j Property owner(s) .°� v _ �/ 4::�; T,�cw�� /�� �n�, Day phone 3--)-5- C/J j-10,�2-0 Mailing address!/ S inr �, �r��y� « rl,.)--� Site address Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size ' Sq. Ft. Number of Bedrooms -3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (E all that apply) Absorption Field ❑ Initial Single Family (SF) Septic Tank 1:1Upgrade E](w/wo AD U) ❑ Holding Tank ElRenewal ElDuplex (D) Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage THIS APPLICATION INCLUDES A" REQUEST FOR: �,�� /U, r ✓�S-� �% � ���J _ p !/cam �/'C�c-. � � n � 7%' �iC�� � aV istance: I certify that the above information is correct. I further certify that this is in accordance with applicable Munic' al Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: It a 5 ( Waiver Fees: Date of Payment: -/0 1 bot T Date of Payment: Receipt Number: 0 31 � 3 � Receipt Number: Permit No. _ 0 5f 111 `( 5 1 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc ,%NMM�� Sa VniPs.uyittiianK.wnii/ .com/history-growth/) FAQs (https://greertank.com/fagblVtSWW/� M*RKE5U_- (h6pb�@j%IqjqMrr6j$ownloadE9a "k FaHNgi ttps;l/grprtOF�Lfflfyn/news/) Contact (https://greertank.com/contact/) and still growing... 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Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater DiSposal System and/or Well Inspection Report Permit Number: ~J~l~C)t'/~1 PID Number: O~;J ' ~ ~,.7-. - (~ Name: ~p_¢~ (~,J~t~ Wastewater System: D New D Upgrade ~d~,: ABSORPTION FIELD Phc.e: C~>/~ C~) I N°'°f B~rOOms: ~-ZO~ ~-~oG D Deep Trench B Shallow Trench DBed DMound DOther LEGAL DESCRIPTION so, Total Oepth from origi~ Town~p~ Range: ~¢ Section: [~ Filladdedaboveoriginalg~-- ~ngth: Ft. Gravel width: ~of lines: Distance baleen li~eFs~. WELL: ~Xl~,¢~ New g Upgrade / Ft.Pipemat~,. Total absorption a )tiller: ~Drilled: StaticWater Levek I¢ Date installed: Yield: Casi.g Height Above Ground: TAN K SEPARATION DISTANCES ~Septic U Holding a S.T.E.P. To Sept[c Absorption Lift Holding Public/PHvate Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~~ ~ ]~ ~ Well- JO~'~ J OO~ ~ ~ ~t~ Material: ~ Number of C~adments: su~c~ oo~ ~ ~ ~ LIFT STATION Water Jo~l~ J Lot Size ~nufacturer: Line JOt+ JOl~ ~ ~ "Pump on" level at; ~at: JHigh water alarm at: Cummin . ~o~ ~ ~ p~ ~ElectricallnspectionspeHormedby:--- ~" '~ Drain BENCH MARK Remarks: ~ ~ ~INE~ ~ Location and Description: Assumed Elevation: E~GINEER'S SEAL Anchorage, Alaska 99504 ~ % ~/~ fl ~A. o.rn.,, .. Department of Health and Human Services approval --t~;..... ..... Reviewed and approved bv: ~~ ~ ~. Date: ~ -~ 4-~ 72-013 (R~v. 9/$1) MOA 25 PER~IT NUMBER AS-BUILT Dl~ING PARCEL lO SW980179 051 -2.32-61 -- ' / ST~ / S? / / ~ ST2 57.5, 87.1, ~4.4~ ~.4 / / 3BL1 57,3 86.2 ~ I / / , )BL2 57.5' 85.3' .,~ .... . ~ ~ / ;02 57.7' B2.4' ' J ~ ~ / ' ~T1 57.9' B1.2' ~. SEPTIC TANK ~a5.6~/ · ~ ~ ~ (APPROX, LOC.) X.~/~ '~;~ / / / / / A~S~ WA~R ~ ~ASTE~A~R ~.. ........ [0~ ~7~, 115~, R~W. S[ClI0~ 18, ¢%: ..... ~.~.~.,~, ....... :... AS-DUILT SURVEY OF SEPTIC TANK UPGRADE ~.~, ~....~, ; , 'REPAREO FOR: PHONE NUMBER: JEFF QUINN SSS-2033(H)/3a4-SSO6(W) )ATE:6/15/98j~w, ~: ms--E:1" A.C.G. = 40' / ,A 5178' FCO 21.2' 301 57.9' 92.8' 3T1 57,9' 92,0' ST2 57.3' 87.1' )BL1 57.3' 86.2' )BL2 57.5' 85.3' ,~02 57.7' 82,4' ~T1 57,9' 81.2'__ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PEP/~IT bK3MBER:SW980179 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES OWNER NAME:QUINN JEFFREY R OWNER ADDRESS:18126 BIRCHTREE ST CHUGIAK, ALASKA 99567 DATE ISSUED: 6/16/98 EXPIRATION DATE: 6/16/99 PARCEL ID:05123261 LEGAL DESCRIPTION: T15N R1W SEC 18 LT 197A LOT SIZE: 52615 (SQ. FT.) NI/MBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN D. NCHORAGE 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 ~ CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: June 15, 1998 Alaska Water & Wastewater 7320 East Chester Heights Circle ~ Anchorage - Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref2 Collapsed Septic Tank Upgrade Design for Lot 197A, T15N, R1W, Section 18, To whom it may concern: The existing 4 bedroom house is served by a private septic system and well. The existing septic tank has collapsed and a new tank will need to be installed. Due to to unsafe sink hole and health hazard, we request you issue an expedited permit to replace the existing septic tank. A new 1250 gallon septic tank is proposed to be installed as shown on the attached site plan. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance./~ Sincerely~ t I I LOT 187, T15N, i i.~-- ........ ---. LOT 189, T15N, RlW, SEC. 18 i i -'" LOT 188B, T15N, i RlW, SEC. 18 I I ~ RlW, SEC.' 18 i/ MINK CREEK DRIVE I ~ ~c~s "c' / ~,~~ ~ /// ' ~ '', ~ C~UDE H. SMITH ~ , / / ~, I S/D, LOT 2 PROPOSED SEPTIC T~ (SEE PAGE 2 Of 2) WE~ ~ I II ~ ~ ~/ ', THIBAULT LOT 202, T15N, / ~ ~ ; S/D, LOT 2 rlW, SEC. 18 x I LOT 203, T15N, RIW, SEC. 18 I ~ ~ THIBAULT I I I ~ ~ S/D, LOT 1 ~ I I PREPPED ~: ..... LOT 197A, TISN, R1W, SECTION 18, . SITE P~N 688- 2033(H)/384-5606(W) ~;~4 "..~.. ....' ~,~ J.L.M. 1 = 100' 1 OF 2 ,r ~. ~ / / \ / ~ j . ~ / ~ ~k~ ~ ~ ~ ~ // / ~. /~"--. / 1. CO~OR IS TO VERI~ G~E AND PROPOSED LOT 197A. T, SN. R,W, SEOTION 18. DESIGN OF NEW SEPTIC TANK TO REP~CE COL~PSED TANK PREPARED FOR: PHONE NUMBER: ~.~~"_ JEFF QUINN 68S-2033(H)/384-3606(W) 0AT%/15/98 J~WN ~: JS~: J.~: J.L.M. 1" = 20' 2 OF 2 I:;?.EX;!LIZF:E[) %]'.?:E OF "[HE %CC[L. THE LENG"[H r.>]3qEN~;IOl'..I :1~:?~; 'T'HEL L. ICNGTH ,:L]Lr.,I FEE?T? THE E:,EF:'TPf OF I::l "I'F~'.IENC:bl OF~: F:'I'I" :1:[~; THE [:,~:~?I"F:IhlCE E:E'I"HE[EN THE ~;I..IF;i:FI:::II:3E CIF FI'"II]-}: IZ~f;?.Ol. Jf.,l[) I::lf'~[:' TI'-IIE I?,OTTCII'q Cfi::: THE: E:',*:C:Ffv'FFr I ON ( ]: I'.,I FE~L[ET ::'. I F.[...H ....H E ....... '[I'"IEF;~tE~ :1: :~ F,I[3 '.E;ET [,.I :[ D'TT'I F:'" F;: ...... ' ':'::' "l"l"l[J[ [3[;[I[:1¥EL I..[.[ IH .[.. 'I'HE: I:tN[) THE E~CITTOP'I Cfi:' THE E',:.~',C:I:::I',,~FITZON I...I ..I I.I. I FII:::'I:::'I,.. I C:I::INT I'1 .... THE I',.[::..:::,F" LIN:;:, ]. [::, I L .[ I T "l"l:i:l ~ I",~l:::'l::ll:;i:t'"l TH I :E; 13, EF::'F:ff;15fHEI",I'T' I)l..llq'. ]: lq[3 'l"Hliii: ]; I",I:E;"I"I:::I[ ......... l l::rT' T Z[ I',,I ............ I',1. ,I, I::.....'~ I i' I*: [)F::' I:::ll",l~'r' b.l[:.l.l" ........ ':;' I:::ll),,:fl:::f[3[iiZi",lT TCI 'TF'I ]: :i!!; F'[;i:CIPE[RtTh" I:::IF,I[) THE ........I. [.. [,..i' I...[ ..... THI:::fT' "T'HIZ klE:L..I... 14 Z L.I.,.. : ,E.F.., [~. I'.,II...IlvtEi:E[,~: 131::' '"" .....': ........ ;:'~ :' FI B. '1. F, i'l..I , ::i!; I G N [ii: [): FI[::'I:::'L :[ C:FIN I :E;tE;LIE:[)E',"r' .... SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222f SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST PERPO.MED EOR: ~/Z_£ V · E~A' DESOR,PT,ON: /~¢ WAS ~.OUND WATER ENCOUNTERED? SLOPE SITE PLAN IF YES, AT WHAT DEPTH? E i I 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~t//~ (minutes/inch) 72-008 (7/76) GAAB-HD I G.P ~"~ ANCHORAGE AREA BOROI ~' DEPA,,,MENT OF ENVIRONMENTAL QUALI'I ¥' 3500 TUDOR ROAD ANCHC)RAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SiTE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: MAILING +,,.~/~.,~,.~'/.~t~'~ ~/://--"~:/,'~/C" ADDRESS__ PHONE LEGAL DESCRIPTION -/~'"0~"'/'/~C., "'"'~'~'~% DISTANCE FROM WEU LIQUID CA PAC ITY -./'~'"'~ '--'~'~ .GALLONS. NUMBER OF ~ MATERIAL ,_~' .~-'.~,~z_ COMPARTMENTS ~"~'~'~/ ~r~/,,/~':'~ ~ ~~ LIQUID INSIDE LENGTH ~ .INSIDE WIDTH ~'~ DEPTH SEEPAGE SYSTEM: SEEPAGE PiT:''~--2~/~'''/'''~/f/~'~ NUMBER OF PITS_ LINING MATERIAL~-~ NEAREST LOT LINE__ OUTSIDE DIAMETER ~ OR WIDTH__ ~ . LENGTH '"~' , DEPTH '~- c';~.-'~./,~"~ DISTANCE FROM WELl .//~'-")~'~ ~' , BUILDING FOUNDATION ~"/ : TOIAL EFFECTIVE ABSORPTION AREA (WALL AREA} ~ SQ. FT. TILE DRAIN FIELD: NUMBER OF ~ DISTANCE BETWEEN LINES ABSORP~i~AREA __SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TtLE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEAIH TILE TOTAL LENGTH , OF LINES IN. TOTAL EFFECTIVE IN, ABOVE TILE W E L L: /",~'.,/~/J..c~:..~'~' '''~ TYPE --.~-.~'~'-'z~'~'~''~ DEPTH .//..b~ / LOT LINE -.m~ '''/~ NEAREST .,/~.%~. ,. SEPTIC , SEWER LINE ~:, TANK DISTANCE FROM -" WATER , BUILDING FOUNDATION.~/~'~' ~ SAMPLE :/'~ , NEAREST SEEPAGE OTHER ,~¢~'~/~ / /Z~)/'.~''' CESSPOOLJ~)~-~''- SOURCE~ . SYSTEM DISTANCES: DIAGRAM OF SYSTEM ~.A.A.B. Well Owner M-V~/ PI ,!.LING, inc. P. O. Box 4-1728 · 2911 Dawson A C 907-279~1741 ANCIIOI%AGE, ALASKA 99509 DRILLING LOG Use of Well Dom LocatiorL (address o[: lownshq), Range, SecLion, if known; or distance main road Size of easing Static water level_ Screen ( Describe screen or perforation. Well pumping test at_2~__gallens per (l~(~i') of drawdown from static level. _Depth of ttole__lff5 .__feet Cased to_ ~'~_ ...... feet _ft. (:~1:~5~;[) (below) land surface. Finish of well (dmck one) open end ( ); Perforated ( ). (minute) for___l hours with 1,_0 .. Date of completion__ eo ,., ..... l,j Ti: WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color mad hardness x ); ft. .......... )_.f .,u ds;_ e ~,,_, v c~].~.' c9 ~ ,,qra','~l } v Wsvb/e ~', t','estbergl/ 1 -- CUSTOMER DUMPTRUCKS - LOADERS - ,<HOE - BASEMENTS SEWER. EMS GRAVEL TOPSOIL Hamilton Excavating POST OFFICE BOX 155 CHUGIAK, ALASKA 99567 PHONE 688-26 I 8 May 1/+, 1979 %Hley Denson Box 966 Eagle River, Alaska 99577 TO t~HOM IT M~~ CONCerN: Hami].ton F~cava%Jng installed a 1250 ~allon borough approved sewer system for the Denson's in July of 1971~ on Lot 197 Blm Subdivision Sec. 18 · N 15 N R 1W. Attaehe~ you will f~nd a copy of the invoice from Stack Steel. for the said tank with the UL ~. Please fee] free to contact me further if you need other information. DUMPTRUCI'(S - LOADERS - KHOE BASEMENTS SEWER, EMS GRAVEL TOPSOIL MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O, Box 196650 Anchorage, Alaska 99519-6650 843-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D,# 051 -232161 ~ GENERAL INFORMATION Complete legal description . Lot 197A; T15N; R1W; Sec. 18 Location (site address or directions) .. Property owner Mailing address Lending agency Mailin. g address Jeffrey 0uinn 18126 Birch Tree Street 18126 R~nh Tr~ R~rmet Chugiak, AK Day phone. Chuqiak, AK Day phone 688-2033 99567 Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well XX Community well Public water 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 xx 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) Front MOA#21 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. ALASKA WATER & WASl~ Name of Firm Address EngineeCs signature WATEE %,~'. Phone 'E2B ~ .- - Date Alaska Water & Wastewater Consultan~t.s, ~ 8halt be PAID. $ 7OC) -- .1~ or prior to, closing for the Engineering Services Provided, DHHS SIGNATURE J/ Approved for t~''~)/-J/~ 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 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. Legal Description: A. WELL DATA Well type PRIVATE Log present (WN) Total depth 175' Sanitary seal (WN) .. dUL. Z~P 1999 ~ MumcEpality of Anchorage /~.~\ DEPARTMENT OF HEALTH & HUMAN SER .V. VlI~oi~P~ ~o.~,~.~~ Environmental Se~ices Division ',.~ ~,~.,,.,-.~..~,~.~.~v.~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist LOT 197A, T15N, R1W, SEC. 18 ParcelI,D.: 051-232-61 If A, B, or C, attach ADEC letter. ADEC water system number N/A YES Date completed Cased to 56' Date of test Static water level U/K Well production WATER SAMPLE RESULTS: Coliform 0 Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed 6/17/98 Tank size Foundation cleanout (Y/N) YES Date of Pumping 7/9/99 C. ABSORPTION FIELD DATA Date installed 5/24/79 Length__~ 39' Width YES FROM WELL LOG 5/22/72 5/22/72 Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION ,7/9/99 42' 2,0 g.p,m, 1.35 18"+ YES g,p.m. Nitrate 7/23/99 Pumper 0.5 mq/L Other bacteria 0 Collected by: AWWC, INC. *SEE A'FrACHED LETTER 1250 Number of Compartments 2 Cleanouts (Y/N).__ Depressiorl (Y/N) NO High water alarm (Y/N) NO JR PUMPING YES Soil rating (g,p.d,/fF o~ 125 ~ystem type TRENCH U/K Gravel thickness below pipe *5' Total depth * 10' Effective absorption area 390 SQ FTMonitoring Tube present (Y/N) YES*Depression over field (Y/N) NO + CRIB Date of adequacy test 7/9/99 Results (Pass/Fail) PASS For 4 bedrooms 0" Immediately after 600gal, wateradded (in.): 136 Absorption rate = 600+ g.p,d, NONE KNOWN Ifyes, givedate - Fluid depth in absorption field before test (in,); Fluid depth 11" (ins) Minutes later:. Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (WN). High water alarm level at* E. SEPARATION DISTANCES Size in gallons~ ~ "Pu~ "Pump off" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 100'+ 100'+ Absorption field on lot Public sewer main N/A Sewer/septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Lift station N/A N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 5% Property line Water main/service line 10'+ .Surfacewater/drainage 100% SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10% Building foundation 10'+ Absorption field Wells on adjacent lots 5j 100'+ Water main/service line 10'+ Curtain drain Surface water 100'+ NONE KNOWN Wells on adjacent lots Driveway, parking/vehicle storage area 0' 100'+ F. ENGINEER'S CERTIFICATION I certify that/hav.~de~er~ed~'u f/eld inspections, Signature Engineer's ~me ~ ~NESS Date are HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)~' Waiver Fee $. Date of Payment Receipt Number Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers Jnly 23, 1999 Municipality of Anchorage Department of Health & Human Services Division of Enviromncntal Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 9951%6650 RECEIVED JUL 29 1999 D MUnicipality o , ept. He~lm s , , t At~Chora Ref: Septic Adequacy Test for Lot 197A, Section 18, T15N, R1W To whom it may concern: On July 9, 1999, we performed a adequacy test on septic system for the referenced property. According to the previous Health Authority Approval and M.O.A. records the drainfield consists of a 39 foot long trench that has an effective depth of 5 feet and also a crib which the size dimension are unknown. Anew 1250 gallon septic tank was installed on June 17, 1998. Also, on 6/17/98, a 2" steel monitoring tube (with the bottom 6 feet perforated) was installed into the trench. On 7/9/99, 600 gallons of water was added to the monitoring tube which was dW prior to the start of the test. The water added caused a liquid level rise of 17 inches fi'om the bottom of the monitoring tube (still 3.5 feet below invert), i36 minutes after the water was stopped, the liquid was found to be at 11 inches from the bottom of the uronitoring tube (6 inch drop). Based upon this data, it appears the drainfield will absorb 600 gallons per day which is adequate for a 4 bedroom house. We ,~quest that a 4 bedroom Health Authority Approval be granted for the referenced property.. Si , J E., M.S. Presidefit [J ,,~1~. OT&E Envimr~mem;nl Serv,==~ In=, B618301 T-245 P.02/03 F-g?? LI 19VA Let I~IA Client Pgnted l~a~/Tim~ 07/~7/9g 15:48 Collec~ed Dat~/T|me 0?/23199 1 O.}OO u O,~O0 r~J/L E~A ~00,0 10 }Y~ 07/~3799 07/~3/99 SCL 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. # 0~1 - 1. GENERAL INFORMATION Complete legal description Lot 19 'Sec 18; T15N; R1W Location (site address or directions) 18126 Birchtree Street Chugiak, AK /l~rOpedy own~¢'" "~m /.,'Mai nO 9ddress -'Lending agency '~, M~iling address Agen'i Address Imperiale 'P.O. Box 672049 Day phone 688-3464 Chugiak, AK 99567 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: 3 TYPE OF WAsTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to t~e legality and status of system. ,; XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72~25 (Rev. 1/91) Front MOA#2i 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. S & $ ENGINEERING Name of Firm 17s34 EaCe River Loor~ Road No. 204 Phone o~ c~ 5/- ~_q '7 ~ Eagle River, Alaska 99577 Address Engineer's signature '"~///~ ~--'~- ./'~ ~ ~ Date ?/P-~/cf 7 DH7 SIGNATURE Approved for -.~ Disapproved. Conditional approval for bedrooms. 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 DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Em ployees 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. MUNICIPALITY OF ANCHOP, AGE ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage JUL 2 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Divisior~ ~4~.~C4~ I V E 825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) Health Authority Approval Checklist Legal Description: Lc)'r' ~ c1'~: S~,~,, I~ '~"'15"~.: ~.k~.~. Parcel I.D.: A. WELL DATA Well type Log present ~) Total depth Sanitary seal (~) ,,~ 0 <5-1 -,,?,32- &f If A. B. or C. attach ADEC letter. ADEC water system number Date completed ~ --- 2,~ - 7 Z. Cased to S'~ Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ~ Date of sample: FROM WELL LOG ~ ,~ g.p.m. B. SEPTIC/HOLDING TANK DATA Casing height (above ground) Wires properly protected ~)'N) y AT INSPECTION ( P~.~., a..~ ,3 y g.p.m _ Nitrate ? J- , ~/{L Collected by: Other bacteria Date installed 7'-.?/' Tanksize /~'~ Number of Compartments ~ Cleanouts~N) ~' Foundation cleanout,, - ~ . ,,.,, (~/. . ~ Depression (Y~ ,~ High water alarm [Y/N) % / Date of~u~ping' ~'~'~:~,. umpor ~. ~ ~ ABSq~TION-FIELD DATA'...~'~ _ C. Date~nstalledz.. -~ ~p~rating (g.p.d./,~orft~/bdrm) /~ r Systemtype ~ Length '~., ' Width:. ~: E~ Gravel thickness below pipe ~ Total depth ~/D ' Effecti;e'ab;orption area '3 ~ ~ Monitoring Tube proson~)~ Depress,on over fiemd rY~ ~ Date of adequacy tes( ~J ~- 1 2 Result~Faim) ~J' For ~ bedrooms Fluid depth in absorption field before test (in,); ~ Immediately after~gal, water added (in.):~ Fluid depth ~ ~ . (ins) Minutes later: '~ ~ Absorption rate = ~ ~ g.p.d. Peroxide treatment (past 12 months) (~ ~ ~e~ If yes, give date ~ 72-026 {Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* ~ at* *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~"-O / c- Absorption field on lot I O,~ I t~ Public sewer main f)/~ Sewer/septic service line ,~ ~ On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~ ? ~ Property line ;;/0 I ~-' Absorption field Water main/service line Surface wateddrainage / ,~ a I~Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line / o I ,C Building foundation Surface water / o ~ Water main/service line Curtain drain /o /'¢- ~//Driveway, parking/vehicle storage area .~/,/'¢ Wells on adjacent lots / /4- HAA Fee $ '~ L~Z) ' Z')Z) Date of Payment '-7/'Z :?/'?7 ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recor~t~t~,..~...~.'~ems are in conformance with MQA HAA guidelines Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE MEMORANDUM WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. ~f~.~QD~l~) During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot ~TA ~ ~& !~; TI~! ~ S~, the well's productivity was determined to be 2/~ gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 bedroom residence is 0.~| 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 ~f the subject Health Authority Approval. M-W Drilling, Inc. P,O. Box 116378, Anchorage, Alaska 00511 (907) 048-4000 Faxt 345-3287 luly 22. 1997 Yr, To~ Iaperiale P O Box 672049 Chuglak, Alaska 99567-2~49 RE, 18126 Birch Tree S/reel Dear Yr. Imperial. el I would like to relate the relult~ of' hydrofrae:inS the'well on he above described property, Tho pertinent statistics of your well areJ Total depth of well 175 teetl static water level 99 feel, pump set at 170 feet from top of the casing to intake of tho pump. After completion of hydrofraclng and ilushing the veil on 17 {uly ~997 we installed a pump and began to test pump the well at 18~0 hours. The pump ran continuously until aaee hours on 18 July 1997. The flow rate was stabilized at'slightly more than 31,1 of a gallon per minute with a pumping level of 166 feet fro~ top of cailn~. The pump was sbu! of/ at 0845 hours and recovery zeadin{s were taken for 15 ~lmute,. The well recovery (t.e. the water level came up the well bore) at a rate et 314 of a gallon per ~tnute. Plea{e find enclosed Our invoice for the above mentioned work. If Y6u have any f~rlher quesllo~ t~ tills regard, please do not hesitate to contact our office. ~tncerely, ~ayne B, ~estberg, ~j~- President  ~.~* Lynn SWanson are OUr h~'ln~,~./ ~t~, CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 973368001 S & S E~gineering L 197ASec. 18 T15N RIW L 197hSec. 18 T15N RIW Drinking Water 0 Sample Remarks: Client PO# Printed Date/Time 07/02/97 13:45 Collected Date/Time 06/25/97 16:30 Received Date/Time 06/27/97 08:35 Technical Director: Stephen C. Ede Results PQL Units Method Attouable Prep Anatysis Limits Date Date Init Nitrate-N 0.100 U 0.100 mg/L SM18 4500-NO3F 10 max 06/27/97 JRJ Total Coliform 0 col/lOOmL SM18 9222B 06/27/97 TMW . . / C,'TH Pm MUN c PALITY OF ANCHORAGE DEPT. DEPARTMENT OF HEALTH & ~NVIRONMEN'FAL PROTEC~IROh'''' ~'.~L 825 L Street - Anchorage, Alaska 99501 g ENVIRONMENTAL ENGINEERING DIVISION REQU .'"'ST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS; Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1, PROPERT~Y WNER ¢ MAILIN-G ADORE~S J ' pROPET~TY RESI DENT (if d!fferent from above) PHONE PHONE MAILING ADDRESS STREET LOCATIO . ~ [] One [] Four ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other WATER SUPP ~Y 7. ~DIVIDUAL* [] COMMUNITY PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well. depth (attach Icg if available.) '?~)~ ,/ 7L5'' 8. SEWAGE D~L SYSTEM [~'~N DI VI DUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation dateI, If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONL DATE RECEIVED INSPECT] ON APPel NTMENTS TIME TiME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~ .-. '~ ~ Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: ]~L'~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER 57'. TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELLi TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~APPROVED FOR ~.~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev, 3/78)