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HomeMy WebLinkAboutMOUNTAIN AIR ESTATES #1 BLK 7 LT 1's Mountain Air Estates #1 Block 7 Lot 1 #017-171-12 .MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION --` ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE I V-NEW mt�,,�C11'1. r I f °�[�3,. ❑ UPGRADE MAILINGADDRESS� ^� LEGAL DESCRIPTION / LOCATION P1, NO.OF BEDROOMS DISTANCE TO: Well( Absorgg area DOw@��n PERMIT NO. 2x / !� i IZQ w F Manufacturer �Q2 Mate ri No. of comp a3r mants 2. Li . capacity in gallons IF HOMEMADE: Inside length Width Liquid depth_ 0 _ O DISTANCE TO: Well Dwelling PERMIT NO. J Uz SF Manufacturer Material Liquid capacity in gallons DISTANCE TO: Well Foundatio �2, Nearest lot line PERMIT NO. LU D/ 4-1a J LL Z No. of lines' Length of ea line Total length of Ines Trench width Distance between lines F-2w inches '— Top of tile to finish grade Material beneath file / Total effective absol n area inches Length Width Depth PERMIT NO. w a F- Type of crib Crib diameter Crib depth Total effective absorption area w� U.] DISTANCE TO: Well Building foundation Nearest lot line Class Opth Driller Dist ace lot line PERMIT NO. J UAIL�il U.1 DISTANCE TO: uildi foundation Sewer line Septic to j Absorption area(s) Cl L OTHER PIPE MATERIALS r2drLCIO 634 SOIL TEST RATING to -- INSTALLER S• � REMARKS i toIf 1 K exl- APPROVV/}ED DATE LEGAL 72-013 (Rev. 3/76) rip I FYF— I—r-nip 13 M—AP$§_ rte'U �. DEPARTMENT HEALTH titJD EfJ'+IrtiFdptENTAL CiTECT'IOPd / ci-s I. 825 'L-` STREET, ANCHORAGE, AF:. 99501 264-4720 PERMIT NO. 1 820648 ; APPLICANT MILTON MELLOTT SRA BOX 449M 9950 LOCATION _ LEGAL LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEMSYSTEMIS: TRENCHR:nU m6m -7_a7_�a MAXIMUM NUMBER OF BEDROOMS = SOIL RATING (_O F'T/BR:)= 125 It,_i. AKA vTHE REQUIRED SIZE OF THE -OIL. ABSORPTION RPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCEBETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE Q NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THEYMINIMUMDEPTH- OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET), F?EE B_ d I.-_4 l FZ E= Ern E_ FOO T In X._ FAtA AFA L_ L_ CD tA rev PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS !=ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- —Ft4 Ce - c_ . _.n - I "_ F ` E=7 e:_' -y- I e.-11°-49 = F:= F*' E=— F-" E= "A U 11 F;�= E=_' Gn — BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS -- DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AY'D ANY ON–SITE 'SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC: WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. - - MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE i_ 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET OTHER REQUIREMENT= MAY APPLY. SPECIFICATIONS AND CON`_-:TRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER: INSTALLATION. F0000.00 I 'T- F07>001 I iT' FG S ° E E0 Cl E0 bl E E0 FR = "_ wL "A 43:12 I CERTIFY THAT 1: i AM FAMILIAR WITH THE REQUIREMENTS FOR ON–SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALIT`r' OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES,. < I UNDERSTAND THAT THE ON --ITE =EWER: SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO IINCLUDE MORE THAN 3 BEDROOMS;. SIGNED: ----- A '. ffiT - F'PLI�_ P� T rONMELD � ;'#. 0 ISISSUEDB'r'-- –�-- — - – --------- C>ATE– ContracEngineers & Associates • SOILS LOG ` 212 st International Airport Rd. Suite 204 ANCHORAGE, ALASKA 99502 /� "\� _ ❑ PERCOLATION 1I(` (907) 278.3773 -TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR: �' (�' t' LOT DATE PERFORMED:, LEGAL DESCRIPTION: Lv / '6 {'"` A44+ At- I DEPTH SLOPE SITE PLAN - (FEET) 1 O2& V1 2 6 s E 7 iTr roe 4- 5 5 Gn - 5d (S w) 7 vL j3L?DILrnit� WFL 8 --9 10- 11 WAS GROUND WATER pfo S �u ENCOUNTERED? �'�/ 72 S/ -SA (SM) o IF YES, AT WHAT E DEPTH? 13 14- 15- Date OF AE®�I Net Time. Depth to Water Net Drop P 16- 618alph a� 17- 18 -Ralph t. .. lokelo >dpf.•'. NO, 1993.[ Q•i F�.� ar �•S �`R, �Or`ESS1�N�a► Reading Date Gross Time Net Time. Depth to Water Net Drop P a� ,^ pr I PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: 0,4A/v J /Ile e e 071 CERTIFIED BY: __ DATE:_02// ENKINSVELL DRILLING P.O. BOX 3.142 ECB ANCHORAGE, AK 99501 PHONE 34»-3J92 5 June 1c'78 D R I L L E R I S WELL LOG Mium CUSTOMER MT M.,llott SRA Box. 1582 Anchore.p.,e, d' LOCATION —Lt 1, Block 7, Mountain A;r Estates (C££ Rabbit Creek F.a) SIZE 6" DEPTH 118 CASING DEPTH 118, GROUTING DEPTH HA YIELD 15 STATIC WATER LEVEL 381 HdvJ TESTED AIT PUMP INSTALLED No TYPE FORMATIONS ENCOUNTERED AND APPROPRIATE DEPTHS 1, TO 48 S�,r.., gravel, clay water seepate Pt 27£t 48 TO 75 ?LE "Tan, r-rav -lav occassicnal bo+.zlder 75 TO 115 send, leese gravel, occassional boulder water 1_2 F --r, 115 TO 125 sand, gravel, water TO TO TO TO TO TO TO TO � ' `^^- �-'��-�- �v� MUNICIPHLITY E ���- � ~`~ ' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 /L/ STREET/ ANCHORAGE, HK 99501 264-4720 L_ �I=- F;P.'M 1 -r PERMIT NO. ( 770994 ) APPLICANT SRH BOX 1582 ANCHORAGE 99507 ]49~I]70 LOCATION SNOWFLHKE Uf7= LEGAL L1 87 MT HIR EST #1 LOT SIZE 36980 SQUARE FEET MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F� I -E Ve M I -IF E: X F� I FZ F=!E; E> F= f-- [-= M E? F= FP_ �:JL , �SN _7 _p 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. SIGNED MILTON MELLOTT 0 r�CIL Municipality of AnchorageOn-Site Water and Wastewater Program(907) 343-7904CERTIFICATE OF ON-SITE SYSTEMS APPR Parcell.D. 017-171-12 Expiration Date: 1. GENERAL INFORMATION Complete legal description MOUNTAIN AIR ESTATES #1 BLOCK 7, LOT 1 Location (site address) 15271 SNOWFLAKE DRIVE, ANCHORAGE, AK 99516 Current Property owner(s) RICHARD & WAKAE MACLEAN Day phone Mailing address 651 NW 77TH STREET, SEATTLE, WA 98117 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance Received by: Date: COSA to be released to the engineer, unless otherwise requested by the. engineer. - COSA Fee $ 52-�o — Waiver Fee $ Date of Payment 1C)/30 Date of Payment Receipt Number {ibg / -j b Receipt Number COSA# �C16t(Poq Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As ce le bbyy 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. 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 10/19/2015 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to. the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future+�\ occupants or can ArcTerra guarantee that no unseen �- OFAZ encroachments; deficiencies or discrepancies exist. / lL4. 111 6. DSD SIGNATURE V System #1 Approved for 'a bedrooms. System #2 Approved for bedrooms. Disapproved. 9 KENNETHj1l_ d[;NLiS / 7tl P�FESStpN� Conditional approval for bedrooms, with the following stipulations: A By: Original Certificate Date: The Municipality of Anchors a 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 Septic System Advisory Well Flow Advisory COSA We sheet 10-10-12.dw Nitrate Advisory Arsenic Advisory Other 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: MOUNTAIN AIR ESTATES #1 BLOCK 7, LOT 1 Parcel ID: 017.171.12 A. WELL DATA Well type PRVT Date completed 615/1978 Total depth 125 ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 118 ft. FROM WELL LOG 61511978 ft. WATER SAfMP�LE RESULTS: Coliform /1/C1G colonies/100 mL Nitrate AID mg/L Arsenic: 1Vb ug/L Date of sample: 10.19.2015 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC ISTEEL Tank size 1000 gal. Number of Compartments 2 Well Log (WN) Y Wires properly protected (YIN) Y Casing height (above ground) 12+ in. AT INSPECTION 10.19.2015 ft. 9.p -m. Collected by: ARCTERRA Date installed 7/2611982 Cieanouts(Y/N) Foundation cleanout (Y/N)*4r1 Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 10.19.2015 Pumper One -Stop Pumping C. ABSORPTION FIELD DATA Date installed 7/2611982 Soil rating (g.p.d./ft2 or ft2/bdrm) 125 System type DE& TRENCH Length 33 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 10.6 ft. (Measured 1/30114) Eff. absorption area 396 ft2 Monitoring tribe Y Depression over field N Date of adequacy test 10.19.2015 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth -0, in. Elapsed Time: 1 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off" level at —in. Cycles tested WELL ON LOT TO: 8.4,- Septic •wSeptic tank/lift station on lot 4004- 4,091w) Absorption field on lot 1004 Public sewer main 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout 100'+ Holding tank Manure/animal excrete storage areas 1004 Building foundation 5'+ Property line 54 Absorption field 51+ Water main 10'+ Water service line 101+ Surface water 1004 Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main 104 Water Service line 101+ Surface water. 1001+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONEKNOWN) Wells on adjacent lots 1004 F. COMMENTS .# Fe -0. 1tvS1n£ CR.4wb SBACE - s -w, 641&C. Ovalt 9.T. G. ENGINEER'S CERTIFICATION ! certify that I 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. �► OF Engineers Printed Name KENNETH M. DUFFUS Date 10.19.2015 - f 4TH COSA canary sheet_2-6-15.doc - xEr tasmr[a in. MUNICIPALITY OF ANCHORAGE Community Development Department Right of Way Section Development Services Division Phone: 907-343-8240 Fax: 907-343-8250 Mayor Dan Sullivan May 13, 2011 Milton and Ana Mellott 5501 Ridgeview Drive Anchorage, AK 99515 RE: Encroachment: Well, Stairs and Deck in Utility Easement Mountain Air Estates #1 Subdivision, BIock 7, Lot 1, Grid SW3139,15271 Snowflake Drive The Right of Way Division has reviewed a request for a letter of non -objection to an existing well, stairs and deck, which encroach approximately 5' into the 10' Utility Easement. On the as -built survey dated March 7, 2011 (Fred Walatka & Associates), submitted with the request, the petitioner has shown the encroachments. This letter of non -objection is issued with stipulations, and by using it the petitioner is agreeing to the following: 1. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or injury to any person as a result of the encroachments. 2. All applicable codes and regulations will be observed and maintained within the easement. 3. This letter of non -objection will in no way preclude MOA from full use and enjoyment of its rights within any portion of the easement. 4. Additional and extraordinary costs incurred during any future required construction, repair or reconstruction of MOA improvements to accommodate any or all of the encroachments shall be paid by the property owner. 5. Maintain letters of non -objection from the following utilities: ❑ Anchorage Water & Wastewater Utility 0 Alaska Communications Systems ® Chugach Electric Association, Inc. ❑ Matanuska Telephone Association ❑ Matanuska EIectric Association, hie. ® Enstar Natural Gas Company ❑ Municipal Light & Power ® GCI Cable of Alaska ❑ Eyecom (Girdwood Cable TV) ❑ No letters required All letters of non -objection should be retained in your permanent files. If you have any questions, please call me at 343-8240. Sincerely, Concur kFr st,Jrf Way Supervisor Property Owner(s) Mailing Address: P.O. Box 196650 - Anchorage, Alaska 99599-6650 • http:/Iwww.muii.org 71 F- LOr M co o£ I mw �S,L� ' HIMON O N m Sip saw ':oj 0 LL F1�°� z o% O O S�. z t O0. Q � \ CA N Y � m �0£ m m 'o of v C� U- O N o 0 0 fi N N o _ cli N mw �S,L� ' HIMON 0 M n Lij U U) ti6'81£ HINON N O J WSLE HiNON 0l/G41 1N3W3Stl3 A nun,OL 0617L£ M, OOZOXON S L S28 0 w N O n- o o a OF aZ ww 0 w w Q w ow =U A Q w O Z FW - Q E saw ':oj �A LL F1�°� z o% O O S�. z t O0. Q � \ CA O 2 \ OE �0£ of v 0 M n Lij U U) ti6'81£ HINON N O J WSLE HiNON 0l/G41 1N3W3Stl3 A nun,OL 0617L£ M, OOZOXON S L S28 0 w N O n- o o a OF aZ ww 0 w w Q w ow =U A Q w O Z FW - Q F - z W 2 W Q W W U Z z Z W F - z W CO r _J F- W w m N a a Z W Q ~ w w0z 0 OUR d UJ_ w Z w~O of o LL Z N=Z w Go w mwQ Q0to t W F- saw ':oj z LL F1�°� z o% O O �/ z t m Q F - z W 2 W Q W W U Z z Z W F - z W CO r _J F- W w m N a a Z W Q ~ w w0z 0 OUR d UJ_ w Z w~O of o LL Z N=Z w Go w mwQ Q0to t W F- LS, Municipality of Anchorage p& s • Development Services Department Building Safety Division 4 On -Site Water and Wastewater Program 5. F, r 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING ssUe- Parcel I.D. COSA # 0SC.10 /1,6 Expiration Date: 8131// 1. GENERAL INFORMAT16N Complete legal description Mouniain irir i..514ho "j Blctk 7 Z44 Location (site address) 15211 Snou flab2, Pr'i✓e Curre;rat Property owner(s) _ 'Pe-fe lf?cl/o# Day phone 3Y,6-7-700 Mailing'adof.gsas r, 55ol %.'ra%t✓rea. a -,,Ig, 444 a7,4g , A 41516 Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. Day phone Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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. 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address Engineer's Printed Name 5. DSD SIGNATURE _L.1' Approved for 3 bedrooms. Disapproved. Conditional approval for Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Phone ; H-39 I,(- Date b Date /I RS PURKLAND:� bedrooms, with the following stipulations: Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other_ By: Original Certificate Date: G (Rev 11/05) Municipality of Anchorage 4 G` ' 'rt Development Services Department ' Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: _ Mown Iain Air 2fn 6o ['dock } Lo{ 1 Parcel ID: Ott A. WELL DATA Well typefri vd4Et If A, B, or C provide PWSID # — Well Log (Y/N) Y Date completed 5 f4me 1111 Sanitary seal (Y/N) i Wires properly protected (Y/N) y Total depth 125 ft, Cased to i�ft. Casing height (above ground) 17 + in. FROM WELL LOG AT INSPECTION Date of test June 5 ill 2010 Static water level 38' ft. 3Y ft. Well production 15 g.p.m. 51/ g.p.m. WATER SAMPLE RESULTS: Coliform -4—colonies/100 mL Nitrate 0 mg/L Other bacteria -y-4-1— colonies/100 mL Arsenic: A/D ug/L date of sample: ±V701D Collected by: L41-5 Jaur kil cinA B. SEPTIC/HOLDING TANK DATA TankType/Material G_ruA /5 fee, Date installed Tank size 1000 gal Number of Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) _1_ Depression over tank (YIN) /^i High water alarm (Y/N) IV Date of pumping 7 1z Z010 Pumper A v Nome. ,Seri Ce S C. ABSORPTION FIELD DATA Date installed 2b Ik L Soil rating (g.p.d./ft2 oriGDO I, z5 System type peen T'enck Length 33 ft. Width 3 ft. Gravel below pipe G Total depth 95 ft. Eff. absorption area '34b ft2 Monitoring tube Depression over field �[ Date of adequacy test 11811010 Results (Pass/Fail) Pam For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth O in. Elapsed Time: — min. Final fluid depth 0 in. Absorption rate >= q50 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) A%nt know. If yes, give date D. LIFT STATION Date installed "Pump on" level ain. Datum E. SEPARATION DISTANCES Size in gallons anhole/Access (Y/N) "Pump off" level at in. High water alarm level in. Cycles test Meets alarm 8 Geuftreiquirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot r(( �* Absorption field on lot ►► On adjacent lots ICD?+ On adjacent lots t0a t Public sewer main AILA Public sewer manhole/cleanout N/A Sewer /septic service line ZS 1+ Holding tank NrA 1 r Animal containment areas 50 +' Manurelanimal excrete storage areas 100 t SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 1 r 1 Building foundation S r Property line 5 + Absorption field 5 + Water main Al [A Water service line 10` t- Surface water IOD + Wells on adjacent lots 100 + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10 + Building foundation 10'+ Water main 6�A i Water Service line 10 t Surface water ICO fi Driveway, parking/vehide storage _ Curtain drain N, O, Wells on adjacent lots 1M+ F. COMMENTS See L✓oi✓eA, G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and h' +f review of Municipal records that the above systems are in : 49T ?' 00 conformance with MOA COSA guidelines in effect on this date. ....._� 10 Engineer's Printed Name _ r<A25 NS wr lood a UFKLAND;' j Date $'N/7010 I tt{1 00 i ',11���'dccnNP��� •► COSA Fee 91000Waiver Fee $ Date of Payment tJ 2010 Date of Payment Receipt Number. Receipt Number (Rev. 11105) ikr SPHTNalmd .{ ` Environmental Consulting and Design August 31, 2010 Municipality of Anchorage Development Services Department Building Safety Division On Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519 Subject: WAVIER REVISION MOUNTAIN AIR ESTATES BLOCK 7 LOT 1 15271 SNOWFLAKE DRIVE Ladies and Gentlemen: During the COSA review process it was discovered that the existing well to septic tank separation distance is approximately 91 feet. An existing waiver for the well and septic tank states the separation distance is 93 feet (the measured distance between the nearest septic tank stand pipe and the well casing). The justification for granting the original waiver remains valid. Water quality samples were collected on July 9t", 2010. Neither total coliform, nor nitrate nitrogen were detected in the water sample, indicating that the well is not being contaminated by the septic tank. Please revise the waiver for 90 feet of separation. If you have any questions or need additional information, please give me a call at 279-3916. Sincerely, Lars Spurkland, P.E. Spurkland Engineering 203 West 15"' Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net <f G' !/T rz r7 i �.._J c'c,R. ♦ '� F jl—`�-a 11.'Icfl 7v eo" A ,'r4rvf- .;t? jU r 7f,.�r,i ! r' ose,, l,4 o'�uEz TR�iz t f.�EJ NSGGL � `a <f G' !/T rz r7 i �.._J c'c,R. ♦ '� F jl—`�-a 11.'Icfl 7v eo" A ,3,t -� -17110 MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMANSERVICES 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. # n1-1 - 11 \ - \;Q HAA# 11`fy\ 1. GENERAL INFORMATION Complete legal description L0T / QLO k 7 /'Ir e)le Za7,49rES Location (site address or directions) /S271 S/UDGJ.� AC-_ 2/UE IVAIQio&k , Property owner Mailing address Day phone 271- 29/0 Lending agency RCFIAI"CL. 1?k41,5A GCU Day phone .S--63' 4SZ7 Mailing address er7 lox Agent /✓o✓E - Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 �' 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOAM21 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. Name of Firm S/fL// ".retIf a 7f 5 Phone 34� ,694 7 Address _ Engineer's signature 6. DHHS SIGNATURE JL Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments M_ 1/ITir Date 7— 2- 7— 9 ¢ 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. 72-M(Rev1191) Beck MOAV1 ® Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:_QTl % i% li-fjkhet Parcel I.D. A. Well Data Well type P✓T If A, B, or C, attach ADEC letter. ADEC water system number AM Log present (Y/N) y Date completed -5-Tu,-)e '78 Driller J�, Iw GikLL DRILL. Total depth /25 Cased to 118, Casing height /3" Sanitary seal (YIN) Wires properly protected (Y/N) /% FROM WELL LOG AT INSPECTION Date of test _ S.%d61/E '73 -52,44e '%Q MUNICIPALITY OF ANCHORAGE Static water level 3$ SD' ENVIRONMENTAL SERVICES DIVISION Well flow /Vor/fr"0 0E4) g.p.m. 6.03 g.p;m' j )994 Pump levelt IV; 7- AE 464awls - aR RTE ! � C I � / C n SEPARATION DISTANCES FROM WELL TO: L V G tl Septic/holding tank on lot 93 CWA/dER E2-3I2(�82} On adjacent lots /37(CALcuGATEO� Absorption field on lot /00 ' C,5c,oceo Faom4g-9&z On adjacent lots /Sd� (CALc 4 r&T Public sewer main /VOA/!' Public sewer manhole/cleanout Sewer service line D 'FRom WACAE ZIAIC Cw1rtrPetroleum tank MOA/E /3646. WATER SAMPLE RESULTS: Coliform 0 Nitrate CNlDL Other bacteria Date of sample: 428.94 Collected by: S, ACA&I-cc B. SEPTIC/HOLDING TANK DATA � Date installed .Tiny /96 2 Q Tank size - G © 4460A/ Compartments Z Cleanouts (Y/N) y Foundation cleanout (Y/N) /✓ Depression (Y/N) High water alar (Y/N) /l//) Alarm tested (Y/N) NA Date of pumping 4-19-124 Pumper ZSAACS 101i177PIAIA SdC SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots /92 (P4Q-Z)) Foundation 30 To property line /4 (W as-AwLa Absorption field /$ S5' Water main/service line 8,3'kAZE I IA Surface water/drainage /VOTLJ/A/Y FDU.VD Iy/T71GU /90: ENoe5- OcV4, 72.Ozs(3W)•F=t CONTINUED ON BACK PAGE C. LIFT STATION NA Size in Vent(Y/N) High water alarm level Meets MOA electrical codes (Y/N) at SEPARATION DISTANCE FROM LIFT STATION TO: Well on D. ABSORPTION FIELD DATA Manufacturer (Y/N) "Pump off' Level at tested On adjacent lots Surface water Date installed TuC.Y rt� Z 0 Soil rating (GPD/Ft?) 125 © System type %CA1641 Length 33 0 Width 0 3 Gravel thickness to Total depth 0. 4' Total absorption area .330 0 Cleanout present (Y/N) Y Depression over field (YIN) A_ Date of adequacy test Z3Avz/L 94 Results (pass/faiQ P4 -5s for 2 Bedrooms Water level in absorption field before test O After test O Peroxide treatment (past 12 months) (Y/N) /U If yes, give date SVA SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot AM On adjacent lots A72 ' CAAf&D) Property line AS%SURVEY SH To building foundation 40 �Sf�Pr . To existing or abandoned system on lot MME On adjacent lots 60 � Cutbank /VAOAIZ Water main/service line & ' wNr?r [i uEcAircxr Surface water /dvNE FOUN4 by/TNny/OO Driveway, parking/vehicle storage area D , awiuE ASLSSEs oVE2 �AA?r 0.1cr SY.Sr'T; H. Curtain drain /UD.UE A'.t/Ok/A/, / TAACIV FRom 1"04 rrrEs E. ENGINEER'S CERTIFICATION I certify that t have checked, verified, or conformed to all MOA and HAA guidelines in effect.oathe,d , rof this inspection cj HAA Fee $ - �60 Date of Payment 9 l Q Receipt Number 's % I)� L Z 72-026(3!93)' Back Waiver Fee $ Date of Payment Receipt Number. t.,ra Signature Engineer's Name S77-05_ hAIS6Zr� o s+� ease ab Date ., '�" iaoa k8t- "( cj HAA Fee $ - �60 Date of Payment 9 l Q Receipt Number 's % I)� L Z 72-026(3!93)' Back Waiver Fee $ Date of Payment Receipt Number. � z >I b � Y y 11 N m Q c /�,1, ',z;,G, �' --� - {1/7/1 OG f�G� o+ lZ N1 �O/V ,C?7oao/'� 0 >I b 11 N m Q c O �� u h A04) G0 N- 0O U E N O v N U W 44 w • W � 0 0 .01 d G a a v (Zi N r N0 Nu c ,c 10o 0.cu0 m pm 0 MCN -H C�jm Ilk1N ` d N O O N 7 N >r U E W v O N O N W U N •M > I� h • W ro W F N N o W90 -Ho, 0 u N Z o� +A+ CL v ro G e x kt aN 0m r 0 0�w v X • a> >, G W W 4J 0 0 N >r O 'O 'O ti Nm 4roc'9i'00 P� +.0+ W.H x wu mai C3r 0 0v C. CA Ca C d MUV O u N m bW O Z W v C C v p G m m U v 0 O=M a, 1 .c 0 y ti y m u0i N A N X H,> roaj .� D 4Ui •O A 'O .. 4 xOm 0 Munic0ilpality of AncArage Department of Health and Human Services RR }; 825 "L" Street X�X P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 27, 1994 Steven Henslee, P.E. SKLH Consultants PO Box 110261 Anchorage, Alaska 99511 Subject: Waiver Request for Lot 1 Block 7 Mountain Air Estates #1 Waiver Request #WR940036, PID #017-171-12, HA940235 Dear Mr. Henslee: 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 of 93 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 DJR/ljm �eJGived 0.>11enL+e� �o p,0/JrO�� Gl � r`r Se�Grati'or� oG ci0 %e+ween the, fGn Gv a will �Jer bars �purklar<a( r�uesf �i�l aJ )fM 5 I • Wq/VEll flEQu 41f 7 MDuIvTAIu 19IR E'SrgTfs WAIVER R Fq OEST NUMBER WR `140036 WAIVER REQUEST FO.P 0A/-4or WEL, 77 S6PT/c rgA,k of 93 FEET. -56P7'1e OAm - iNE 5ueT,F!% SEIoT/c ri9N/C Cv/vs7-/Pa1cTI`_p /A. T"L y' 1962. TNIs 7-6ux 4 /if C0A/f7-Rw(r£P LITH 1,uVER7-f ON TI -!f mlixr-o"r&_T � CLI TO 4 r/L1zE wj,9.7-ER 7-16HT CvuPLI1v6S, tkE INSPECTOR Ar THE T1r1E of /usr?LCAT/oA1 64LIE fE/P14/tf/ai THE EXC6VY4T01? rO 1Nf T,gLL rl-et 7-/4yK 14 ro BS / FR a. r/-/£' 1i JE it QuaSrfOA/. IT LI,/rS 1Nf7-,,q-LCIEp y,? F-EET Fleo,•a ;-",- LELL_ TAt W F_LL IS Lbcit TED OAN rH-' f/4me /}NPR ax /ti nT£ CU.S/Ta"R t3f1N6 SL1614rLi LOw6IQ /N ELEv�r/v v (* 2/>. rxedF HOurE /T °OA/fTRxcTEp T/ETw EE,v TIKE WSLG 1 f�PT/f Thn+K 1'" 4kFS ri a,v. WELL p1gT-A- 7-kE kvL�tc /A. QuEfrlaa L.. /3s IlR/cLgp IA/ J-CfA/E 9978. rl-e rarer/ OEPTM If 12r PEST L-i7i-/ rleE b,)g7-eR BENR/NG 6.Yyve4 LAeo"�T6>P�p/ 115' FEIET, lV .9 TER C..Y}S /}L fo S.v l UuwT6/P60 /4T %.S- F6 ST 14 t Uo sE' fl9. ? 6RA✓ltc 7-;14 6T pvwnl rurt,- wArsR nr l/3-FO'C7 1 5 (!/t Ff?I'M 4B 7v 75 ' /f 1yv /riNsR �rEROLf GA'/rY CLny cL /rfr SQ GRAVEL t CLny gDove T12/47 r0TKE6M&LZ4,.eQ fu/PIF/4fE. T1GE S�1or/c Thn/r 13 C vNs Tnu c rEd LN Solt rl-[/97 I'eAcy 6r /CS �r IAv1iA iitis rrvE oer 5-01L 61uef F_XcercL F�r T .SArF..LEw-T To L..orSTEI..-mr61Q /� At- It, r I✓ {F L L T //- ✓✓ crrTi-� NO .,p TRATEs 0 CGL ft, T7 c r r4 rfi R t rr= �e< . s .rr ori•,, 3 e ', • y -o ' /•I.piCsrli.c [, r�r� ,A,& f}i/u/PIER /S <Un-F/NEO FI?Orr SN/t �igef !'a e -T/9.0 /.I-isri e.ri. %I 2 coa' 0 S. o f R. O. E. C. S. R k". 6" Lvn 84 Ar 7S ' NCu N,,.rb•PE4 SEpl,c TH.•q- Gstry = a7 )4.✓r� (67/6 = S/ (67/2*(>3=2.� TABLE 6RtP1,f ,7- 6017,6 �S %HwK 1.07ELL 67' F X ts.-7 — 120 N -.26i - v>= /.74 I-IG17rZoaTgE SEPHr��9-Tiu,v x=.7V-2 ( 0A/C"-r IGN 6l7,v-ur vit� t? / 2.7 /7.4 ( ,.J(?_o1Llcc) '1�L SKLH Consultants 1700 Vashon Circle Anchorage, AK 99515 {907} 344-7096 14 June 1994 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, AK 99519-6650 Re: Mt. Air Estates Add. #1, Lot 1, Block 7 Separation Distance Waiver Request. (9402) Dear Mr. Roth: Although an informal waiver for a distance less than that set out in 18 AAC 80 for an existing private water supply well and an on -lot wastewater disposal system was granted for this property in 1982, the purpose of this letter is to formally request the existing separation distance be allowed to remain. This request is made in accordance with Municipality of Anchorage Code Chapter 15.65 Wastewater Disposal Regulations, Section 15.65.140 Separation Distance Waivers. As an informal separation waiver was previously granted for this property, the review fee for this request will not be required per personal communication with your Department. Attached to and part of this request is the following: A. Satisfactory bacteriological and chemical test results for a representative well water sample collected by SKLH Consultants from the existing potable water well. B. Available well logs of the adjoining properties. Lot 2 Block 7 and Lot 3 Block 4. There is no adjoining development west of this property. C. An as -built survey of the property showing the well location and the distance between the well and septic tank cleanout serving the first compartment of the septic tank. D. A site map showing the spatial relationship between the subject lot's septic and well and the approximate Mr. Dan Roth, MOA/DHHS Lot 1 Block 7 Mt. Air Estates 21 Well Waiver Request. WO 9402 June 23, 1994 Page 2 location of the wells located on adjoining lots. Contour lines have also been shown for the immediate area around the subject property. E. A list of all adjoining property owners with addresses and telephone numbers. As shown on the attached as -built, the well is located approximately 94 feet from the edge of the septic tank. (Per the surveyor the well is 95 feet to the septic tank cleanout. A one foot adjustment has been made for the distance from the cleanout to the edge of the septic tank.) The owner, Mr. Milton Mellott, requests a variance to allow the existing separation distance remain as is rather than to relocate the existing well or septic tank to meet the minimum 100 -ft separation distance required by state regulations. The subject well presently serves a three-bedroom (3) single family dwelling. The well consists of a covered six-inch (6 -in.) diameter steel casing. The casing extends greater than 12 inches above the surrounding ground surface. As shown in the submitted well log, the well is cased to 118 feet. The site surface drainage characteristics are good. Justification for this variance is based upon the existing geological conditions, the small percent of reduction in the separation distance requested, the lot density, the type of potential source of contamination, and, most importantly, the length of time the conditions have been in eff'ec't without existing evidence to indicate chemical or bacteriological contamination of the subject well or of adjacent wells. Although there are no special construction techniques which have been incorporated in the original installation which would mitigate potential adverse affects associated with a lesser separation distance, there are other considerations which should be taken into account. Please consider that: The amount of variance requested is small. The conditions as they now exist provide approximately 94 percent of the minimum required separation distance. The owner is requesting only 6 percent of the required separation distance be waived. The lot density of 12,327 sf/bedroom is greater than 10,000 sf/bedroom. The source of contamination addressed by this variance request is not a continuous contamination source such as a leach field. Mr. Dan Roth, MOA/DHHS Lot 1 Block 7 Mt. Air Estates 31 Well Waiver Request. WO 9402 June 23, 1994 Page 3 The conditions have been in existence for more than 12 years without any evidence of contamination to the well. This is supported by the satisfactory results of the attached bacteriological and chemical water tests. The geological conditions, per the well log, indicate that although the upper reaches of the subsurface lithography .reveals the presence of a rapidly draining coarse grained substratum, the aquifer from which this well draws water is protected by a relatively impervious stratum of hardpan and grey clay. In addition, notice that due to this impervious confining layer this particular aquifer is a confined aquifer. The hydrostatic head raises the static water level in this well above the aquifer elevation. A review of the submitted well logs also shows the presence of a confining impervious layer of clay in these wells and a high static water level. Due to the positive water pressure on the aquifer, the water supply for these wells is naturally protected from contaminates migrating due to gravitational forces alone, as in the case of domestic wastewater from a leaking septic tank. Although no elevations of the static water level were measured at the surrounding wells, it is possible to draw some inferences from the focal topography and from the well logs relating to the direction of subsurface water flow. Due to the surface topography sloping towards the southwest towards Little Rabbit Creek, which is a topographic low, and combining the aquifer elevations shown in the well logs, it is logical to suspect Little Rabbit Creek as an area of groundwater discharge. As an area of groundwater discharge, the direction of flow of the underlying aquifer would be towards the south and southwest. Consequently, contaminate flow in the aquifer would be in the direction of the groundwater flow, away from the neighboring wells. Based upon the above information and, more importantly the satisfactory water tests, it is the opinion of SKLH Consultants that the requested waiver be granted. The names and addresses of the adjoining property owners are provided below. Lot 2, Block 7 - Frank Tadda 15261 Snowflake Drive Anchorage, AK 99516 345-0429 Lot 3, Block 4 - Keith Morberg 15200 Mesa Place Anchorage, AK 99516 345-1491 Mr. Dan Roth, MOA/DHHS Lot 1 Block 7 Mt. Air Estates 41 Well Waiver Request. WO 9402 June 23, 1994 Sincerely, 5i en C. Hen d ee, P.E. Attachments. Per text. cc: File SKLH Consultants 94021406 Page 4 r.. Stevan P/iiensl" U/1604 � �'ROf ra�l0�� ���• . 374. 90 ft. T Y D m Smo °�� ` a mx r � O O � i N m cn m X cn S c N a MESA PLACE ft. �o ° 30 ft. � mO r m w m o m d' ME m p M omZ m O --4 o o m »o y W n — S D N N F X O m