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HomeMy WebLinkAboutAUTUMN RIDGE LT 15Autumn Ridge Lot [5 #015-054-18 blunicij~ality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program, 4700 South Rragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 On-Site Wastewater Disposal System and/or Well Inspection Report Pen'nit Number:, SW010486 Nome: MASTERPIECE HOMES c/o KELLY HEITSTUMAN P.O. BOX 775471 * EAGLE RIVER, AK 99577 (907) 884-1234 5 LEGAL DESCRIPTION 15 - AUTUMN RIDGE WELL: · New 0 Upgrade PRIVATE 240 ~ 229,25 Number:. Wastewater System: O Page 1 of 5 o15-i · New [] Upgrade ABSORPTION FIELD IDeep Trench rlSh~llow Trench 13Bed rlUound rlO~her 0.6 ~/s~ ~ 11.5 (MAX) 5.5 (MAX) ~ 8.0 SEE DW~ ~ 80 2.5 ~ 1 1280 m.~ D 3034/ F-810 M-W DRILLING 5/7/2001 201 n. MASTERPIECE HOMES 12/20-21/2001 TANK UNKNOWN ~ UNKNOWN ~L SEPARATION DISTANCES To Septic ~b.o tJon I.Jtt Hokiln~ From Tank ~J Tank St~Uon Well 100'+ 100'+ -- -- Surface Water 100'+ 100'+ -- -- Lot Una 5'+ 10'-t- -- - Foundation 5'+ 10'+ - - Curtain Drain -- NOiNE KNOWq Remarks: · SepU¢ 13 Holding D $.T.E.P. r't O~er r,~k~/~.~ ANCHORAGE TANK 1500 25% STEEL ~ - LIFT STATION BENCH MARK TOP OF WELL HEAD Inspections performed by: AWWC, INC. Dates: 1st 12/20/2001 2nd 12/20/2001 3rd 12/21/2001 Department of Health and I~.uman Services approval. PERUIT NUIdBE:R: SW010486 I AS- BUILT D RAWIN G / / ~'~-~ / / / / ~\\\~ / / / / / / t // / :/ / ^ · ST1 70.56 24.18 / ST2 74.06 34.07 // DBL1 75.98 38.48 DBL2 76.50 39.52 / C01 58.37 25.05 / / MT1 55.12 26.92 "~ / C02 28.81 90.40 / MT'2 24.60 85.77 ALASKA WATER & WASTEWATER pARCEL ID HUMBER: 015-051-04 DRNNF1ELD ii/ CONSULTANTS. INC. PREPARED FOR: PHONE NUMBER: PAGr NUMBFJ~ MASTERPIECE HOMES c/o KELLY HEITSTUldAN 884-12;~4 2 OF 5 LEGAL ~CRIPTION: LOT 15; AUTUMN RIDGE SUBDIVISION AS-BUILT DRAWING OF NEVI WELL AND SEPTIC SYSTEM LOCATION .\ \ NEW 1500 ON.J. ON SEPTIC TANK 2/25/2002 DRAWN BX'.' C.J.G. SCN.~ 1" = 40' P~RMff NUMBER: AS BUILT D RAWlN G pARCI~. ID NUUBER: SW010485 -- 015-051-04 ORDINAL CRAD£ -% ~96,44 FABRIC ~P£ OF - 84,g4 Al ASKA WATER & WASTEWATER CONSULTANTS, INC. PREPARED FOR: PHONr NUMBER: MASTERPIECE HOMES c/o KELLY (907) 884-1234 L[GAL DESGRIPTION: AUTUMN RIDGE SUBDIVISION; LOT 15 1YPE OF WORK: PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM 1/5/2002 Z.T.G. N.T.S. 20F3 ALA$IG WATER WASTEWATER CONSULTANTS, INC. April I, 2002 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref.' Lot 15; Autumn Ridge Subdivision Attn: JeffPoet On 2/28/2002 a on-site sewerAvell submittal comment sheet was given to us. On this comment sheet it was stated that no inspections were called in on the installation of the new septic system. There was a miscommunieation in our office between the field technicians on who called in the inspections and so no inspections were called in. We apologize for this miseommunication, and in the future we will be more cautious about calling in inspections. If you have an )/cstions, P.E., M.S. please contact us at 337-6179. Thank you for your assistance. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Websit¢: akwwc.com 82/2G/2002 1G:82 3453287 M W DRIllING, INa PAGE~? .... M-W D illing, Znc. · P.O. Box l10378eAnchorage, AK 99511e 4.907-3454000 · 907-345-.3287 Fax* Groundwater ~&'ell /ls.Built & £o~ Job No.: 01-141A Permit No.: PendinR P~oj eot No.: N/A Welt Owner: L & H Conalmedon · tIst of Wd/: Teat Well uLegoIDescrlptlon: Lot 15 Autumn Ridge Subdivision- Anchorage ConstTuc~on · HoleDe~ti*: 240" ·Cming$1te: 6" eC~ To: ~9~' eM~: A 53 S~l e ~ M~: Air~ Well Co~l~n- ~ end ~cre~ X Pe~omt~ M~od: ~~ ~: K~k~ & ~: ~.~'- ~9.$'~ 0.1~" $~ T~I~ 5SS: ~93' -240'. T~ & p~ ~: ~' -241' * Grout No~: (I) SKk. Ho. 8 ~i~ ~ules · WtltDodogn~,m M~td: ~drsurse N~: C~. e WeH y~ ~t ~ 98.3 ga~ns ~er m~ (GPM~gaY~ gtr kt~r (C~J for · ~te of eolian: 07 May ~1 ~ !~: Well ~ Depth in feel from lop of casing. 0 TO 2 2 TO 6 6 TO 12 12 TO 20 20 TO 36 36 TO 55 55 TO 62 62 TO 112 112 TO 117 117 TO 134 134 TO 138 138 TO 146 146 TO 157 157 TO 162 162 TO 182 182 TO 195 24 Ao~rs 18 Fcbrumy 2002 De~ib of fOrmntionJ IMnetrated, size of material, Color and hardne~. Casing stickup Silty clay Sandy gravel .. Gravelly silt: brown Sandy~gravel Sandy l~'avel: damp Gravelly silt: brown Gravelly silt: gray Silty sandy gravel: brown Gravelly silt: gray Silty sandy gravel: brown, damp Silty clay: gray Silt, sandy gravel: brown Sandy gravel: damp Silty sandy gravel: brown Clay 02/26/2002 16:82 3453287 N W DRILLING, INC PAGE 03 Depth in Feet from top ol'callnL 195 TO 21'/ TO 220 TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO TO Job No.: 01-141A Permit No.: Ptndin[ Project No.: WeU log Continued Detilb of formations penetrated, size of mBt'rial, cok)~' and hardness. 217 Silty lp'uvch lp'dy 220 Sandy gravel: damp 240 Gravel: coars_e, sandy, water ben~in~ MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Dec 11,2001 Expiration Date: Dec 11, 2002 Permit Number: SW010486 1Legal Description: T12N R3W SEC 15 NE4 PTN Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: Masterpiece Homes c/o KeIly Heistuman Owner Address: PO Box 773471 Eagle River, AK 99577-0000 Parcel ID: 015-0,5-~1~ Site Address: 005400 ABBO'I-I' RD Lot Size: 2214155 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. .~5. The following special provisions~ This permit issued for Autumn Ridge Lot 15 Received By: Issued By: Date: / c~ - //--~-<:~/' Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South 8ragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.a nchorage.ak.us (907) 343-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR ,b, SINGLE FAHILY DWELLING 5--c~-I- c~ ~ Permit Number Property owner(s) MASTERPIECE: HOMES c/o KELLY HEISTUMAN Day phone Mailing address(1) P.O. BOX 773471 * EA(]LF RR/ER. AK Mailing address (2) 884-1234 Zip Code 99577 Legal description (Lot, Block & Sub'd.) LOT 15: AUTUMN RIDGE SUBDIVISION Number of Bedrooms Legal description (Section, Township & Range) Lot Size ~.."~.! C/I 5"6 Acre~ 5 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Well Only Water Storage THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Jacuzzi Water Softening Unit I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. (Signaturc of property owncr or outhorizcd ngcnt) Permit Fees: Date of Payment: Receipt Number:. Waiver Fees: Date of Payment: Receipt Number. ALASI(A WATER & WASTEWATER CONSULTANTS, INC. December 4, 2001 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Proposed Well and Septic System for Lot 15, Autumn Ridge Subdivision To whom it may concern: The proposed 5 bedroom house will be served by an existing well and new septic system. Two soils log we excavated on the property and logged by Michael E. Anderson, P.E. We are proposing that a 1500 gallon septic tank be installed outside the 100 foot well radii and also a deep trench type drainfield be installed around the 30 foot radii of TH-33 & TH-34. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are the logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 0.6 gallons/day/ft2 should be used. The SM soil below the GP/GM strata in TH#33 will serve as a sand filter. 2. TRENCH DESIGN: a. Percolation Rate: <1 & 35 minutes/inch b. Allowable Application Rate: 0.60 gallons/day/ft2 c. Number of Bedrooms: 5 d. Design Flow: 750 gallons per day e. Minimum Absorption Area: 1250 tt2 f. Total Depth: 12 feet (max.) g. Effective Depth: 8 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 80 feet long k. Effective absorption area -- 1280 112 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 6901Debarr Road, Suite 2B Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 4. TOPOGRAPIIY: As can be seen on the attached topography site plan, the average topography in the area of the proposed septic system is a 10% to 20% percent running from approximately northeast to southwest. The trench is to be installed parallel to slope contours. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerely. Preskle~ amess, P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, two soils log, and a 7page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com / / ALASKA WATER & WASTEWATER CONSULTANTS, INC. PRE:PARED FOR PHONv NUMBER: MASTERPIECE HOMES c/o KELLY HEITSTUMAN 884-1254 LOT 15; AUTUMN RIDGE SUBDIVISION SITE PLAN FOR WELL LOCATION AND SEPTIC SYSTEMS I · I /O'm-~ LOT 2o; ~"' I AUTUUN mDG~: S/D Ab'lIJUN RIDGE S/D LOT 16: AUTUUN R~D~£ $/D 12/4/2001 J.L.M. 1" = 100' PAGE: NUMOER: I OF2 I I / / / / / / / / / / / / / / / / / / / / / / / PROPOSED DRA~NFIELDS. EXCAVAT~ A I~E~CH THAT IS 12 k'[ET DEEP BY 2.5 iLL! W~D£ BY ~0 FEEt' LONG. ADD 8 F[['T OF' CLEAN WASHED SEWER DRNNROCK. INSTALL ~F_NCH pARN iF'l: TO N.L SLOPE CONTOURS. (~/ JNOTE: THE CONTRACTOR SHALL HAVE THE NORTHWEST GATE: ALASKA ~,~TER & ~VASTEWATER CONSULTANTS, INC. PREPARED FOR: PHONE NUMBER: PAG~ NUMBE~: MASTERPIECE HOMES c/o KELLY HEITSTUMAN 884-1254 2 OF 2 LOT 15; AUTUMN RIDGE SUBDIVISION DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM 12/4/2001 J.LM. 1" = 40' / / / / / 'IH-32 / / ;-33 0 TH-31 Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Bob Klein Legal Description: Lot 15 Autumn Ridge Subdivision SLOPE I PTIOL 2 3'ESTHOLE NO. 33 GP/GM 6 7 8 9 10 11 12 13 14 15 16 Was Groundwater Encountered? No S If Yes, What Depth? L Depth to Water O After None P Monitoring Date:~ 1/22/00 E Reading Date ~"-t.,~,.,~ C~F'--~--~'v''~ 1 8-Dec 4 5 Date Performed: 1Z/6/99 SITE PLAN "7 Gross Net Depth To Net Time Time Water Drop 1:41 2" 1:43 2 8" 6" 1:44 2" 1:46 2 8" 6" 1:47 2" 1:49 2 8" 6" 17 18 19 Bottom of Hole Perc. LT 1 MinJInch Perc. Hole Diameter: 6" Test Run Between 4 Ft. and 5 Ft, Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A. Harala I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20100 Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Bob Klein Legal Description: Lot 15 Autumn Ridge Subdivision SLOPE I PTIOL 2 3 TESTHOLE NO. 34 GP/GM 4 5 6 8 Was Groundwater 9 SM/GM Encountered? No If Yes, What Depth? 10 Light Depth to Water Tan After Monitoring None 11 Date: 1122/00 Date Performed: SITE PLAN S L O P E 17.J6/99 12 Reading 13 1 2 14 3 4 15 5 6 16 Dale Gross Net Depth To Net Time Time Water Drop 8-Dec 1:46 1.63" 2:16 30 2.5" .88" 2:46 30 3.5" 1" 2:47 2" 3:17 30 2.88" .88" 17 18 19 Bottom of Hole Perc. 35 Min./Inch Perc. Hole Diameter: 6" Test Run Between 4 Ft. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: ~ I, Michael E. Anderson Cedify That This Test Was Performed In Accordance With Ail State and Municipal Guidelines In Effect On This Date: 1/20/00 MUNICIPALITY OF ANCHORA GE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650; Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: May 29, 2001 Expiration Date: May 29, 2002 Permit Number: SW010137 ;Legal Description! '~'12N R3W SEC15 NE4 pTN Design Engineer: 0014 Anderson Engineering Owner Name: LH CONSTRUCTION Owner Address: 5400 ABBOTT ROAD ANCHORAGE, AK 99507-4364 Parcel ID: 015-051-04 Site Address: 005400 ABBOTT RD Lot Size: 2214155 SQ. FT. Total Bedrooms: 0 Permit Bedrooms: 0 This permit is for the construction of: [] Disposal Field r~ septic Tank [-~ Holding Tank [] Privy J-~ Private Well Water Storage Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THIS PERMIT ISSUED FOR AN EXPLORATORY WATER WELL ONLY. UPON COMPLETION OF THE WELL AND SATISFACTORY WATER IS ENCOUNTERED, THE WELL DRILLER SHALL PLACE AN APPROVED SANITARY SEAL ON THE WELL CASING AND NO PITLESS ADAPTOR OR PUMP SHALL BE PLACED IN THE WELL UNTIL A WASTEWATER DISPOSAL SYSTEM HAS BEEN CONSTRUCTED. .~THIS'PERMIT ISSUED. FOR PROPOSED LOT 15 AUTUMN RIDGE SUBD. ' ;' Received By: ~ ~ Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O ! 5' -- 0.,5"'/--. 0~- Permit Number swOlOI;$7 Property owner(s) LH Construction Mailing address (1) 12130 Regency Drive, Suite 201 Eagle River, AK 99654 ~ address (2) ~"~1~)O ~ J~i'O 77- /~O~lp Zip Code Legal description (Lot, Block & Sub'd.) Proposed Lot 15, Autumn Ridqe Subdivision ' Legal description (Section, Township & Range) 7'/Zk/ /~.~t.~ SEE. /,,~'" A/E ~/~. Lot Size 45,704 SF 2, , / THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub SWimming Pool Therapy Pool Acres~. Number of Bedrooms Test Well Day phone 522-1616 Fl'4/ ' [-1 Well Only [] I--I Water Storage [] F-'] Jacuzzi [] r-] Water softening Unit [] I certify that the above information is .correct. I fudher cedify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owneror authorized agent) Permit Fees: Date of Payment: ~)~' C~° (2~)'~ Receipt Number: ~ (Rev. ~2/00) Waiver Fees: Date of Payment: Receipt Number: '7 t THIS PERMIT Brush ,~velopment Information: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Parcel LD. 015--~l~'/~' HAA# ~/Z~ 1. GENERAL INFORMATION Expiration Date: Completelegaldescription AUTUMN RIDGE SUBDMSION; LOT 15 Location (site address or directions) 5400 ABBO'I'I' ROAD * ANCHORAGE, AK 99507 Current Properly owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MASTERPIECE HOMES c/o KELLY H~STUMAN Dayphone 884-1254 P.O. BOX 775471 * EAGLE RIVER,'AK 99577 Day phone Day phone Unlessotherwise ~queste~ HAAw~beheldbyDSD~rp~k~. 2. NUMBER OFBEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil · engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note:Alaska Water and Wastewater Consultants, Inc. shall be paid $ ~ ~-~ '~- at, or p#or I to dosing for the engineering services provided. t 4. STATEMENT OF INSPECTION BY ENGINEER As cerb*fied by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further vedfy 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 ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD. SUITE 2B * ANCHOEAOE. AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 337-6179 Engineer's Comments: In conducting this evaluation. AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The repoded results desctfbed the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being sen/ed by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance cf the system, nor do they guarantee that there are no hidden defects or encroachments. A WWC, Inc. can therefore not previde any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal tfght whatsoever. 5. DSD SIGNATURE ~' Approved for ~ bedrooms. Disapproved. Conditional approval for __ Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms, with the fllowing stipulations: ,,~-.~..' '..~ ~/ ,ON-SITE : WASTEWATER : : ~ ' PROG~M -.... ..... Manitenance Agreements -.yy~ .,,5 Supplemental Engineeds Reo~ Other Original Certificate Date: Legal Description: A. WELL DATA Municipality of Anchorage .o Development Services Department BulMlng ~ltety ONIelofl Water & Wsstewater Program On-Site 4700 South 8mgaw St. P.O. Box 196650 Anchorage, AK 99519-6650 w~w,ct.anc~xage.ak, us (9O7) a43-7904 HEALTH AUTHORITY APPROVAL CHECKLIST AUTUMN RIDGE SUBDNISION; LOT 15 Parcel ID: 015'-'~1~-I ~ Well type PRIVAI~. If A, B, or C provide PWSID~ N/A Date completed 5/7/2001 Santtap/seal (Y/N) YES. Total depth 240. ft. Cased to 229.25 ft. Date of test Static water level 201 Well production q 8 WATER SAMPLE RESULTS: Coliform I~ colonlesJ100 nd. Arsenic: N,/A mg.JL SEPTIC/HOLDING TANK DATA Tank Type/Materiel STEEL FROM WELL LOG 5/7/2001 ff. g.p.m. wen Log (Y/N)YES Wires proper~ protected (Y/N) YES Casing height (above ground) 24+ in. AT INSPECTION Nitrate 0.581 mg./L. / Other bacteria 0 'colonies/100 nd. Date of sample: ?"/le'/~-;,r~cted by:. AWWC, INC. Date installed 12/20-21/2001 Cleanoute (Y/N) YES High water alarm (Y/N) N/A Tank size 1500 gal. Number of Compedmants Foundation cteanout (Y/N) YES Date of pumping NEW ABSORPTION FIELD DATA Date installed 12/2o-21/2001 Soil rating ~lor ft~'edrm) 0.6 length 80 ft. Width 2.5 ft. Totaldedthl2.14 (MAX/ff. Eff. absorpflonarea 1280 fl~ Mo~dtedngtuba YES Date of adequacy test NEW Results (Pass~Fall) - Fluid depltt in absorption field before test - in. Water added - gal. Elapsed T~me: - min. Final fluid depth - in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) 2 Depression over tank (Y/N) NO Pumper pBEL0W FINN- ORAD£1 System type DEEP TRENCH Gravel below pipe 8 ft. Depression over field NO For 5 bedrooms New depth - in. Absorption rate >= - g.p.d. N/A If yes, give date - D, LIFT STATION Date installed 'Pump on" level at in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons "Pump ofF' I~uot et Cycles tested Septic tank/lift station on lot 100'+ '-/~l~.~orption field on lot 100'+ Public sewer main N/A Sewer/septic sewice line 25'+ Manhole/Acr~-- (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 100'+ Public sewer menhole/cleenout Holding tank N/A N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Pmpert~ line 5'+ Water main N/A Water eewice line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water sewice line 10'+ Curtain drain NONE KNOWN COMMENT~ Building foundation 10'+ Surface water 100'+ Wells on adjacent lots 100'+ G. ENGINEER'S CERTIFICATION I certify that I have detem;Ined through field inspections end mv~ew of Municipal recon~s that the above systeme ere in conformance with MOA HAA guidelines in effect on this date. Engineers Printed Name Date ~-/z..~/o, - HAA Fee S ~"~'7~-"~, ~ Dete of Payment ~ - c~. *7'-(D ~ Receipt Number (~)/~ ,~ ~'/ (Rev. 12/01) Absoq~Jon field 5'+ Surface water 100'+ Water main N/A Driveway, parking/vehicle storage Waiver Fee $ Date of Payment Receipt Number 10'+ T. &: E. E "=40' ! / EXISTING FOUNDATION (s~ o~mt) LOT 15 FOUNDATION AS-BUILT AUTUMN 2001 - 143 RIDGE SUBDIVISION LOT 1 5 45.~67 S.F. T. & £. ES~'I'.