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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 12 LT 4Mountian PaPk Estates Block ! 2 Lot 4 #017-441-18 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191371 PID Number: 017-441-18 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New *Upgrade Name KRISTA ROSEN ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ound Site Address 12641 ALPINE DRIVE *ANCHORAGE, AK 99516 El Other Phone Number of Bedrooms Soil Rating Total original grade depth 907-440-3115 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot MOUNTAIN PARK ESTATES; BLOCK 12, LOT 4 Fill added above original gr Ft. Gravel length Ft. Township Range Section - Gravel width Ft. Beds.. Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well *85'+ TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER TANK Capacity 1250 Gal. Surface water 100'+ Material Number of compartments Lot Line 51+ NA HDPE 2 Foundation 10'+ LIFT STATION Manufacturer Capacity Remarks OLD TANK DECOMMISSIONED PER UPC Gal. PER CONTRACTOR *OSV191083 Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 drainfield Tank to D3034 Installer A+ HOME SERVICES Drainfield D3034/EXISTING CO/MTD3034 Inspector TIM ECKLUND AND DAVID GARNESS BENCH MARK (Assumed elevation) 97.75 ft Inspection n 1M 9/13/2019 - Location and description dates: nd 2 TOP OF MH 3`d _ 4"' _ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer s S mp �o6oOp 0 ....��� Conditional Approval: Date "' 95�� o T'�Q�D p............ ........... �... ....f .................. Septic Sys r `— A OQ 9. CE 79 3 O° Approved- Date eo. � Fo Note: this approval does not include well permit requirements. P #AECC884000o\o�\ (Rev 05/02/18) PERMIT NUMBER: PARCEL ID NUMBER: OSP191371 RECORD DRAWING 017-441-18 A I B DBL1 25.8 30.9 DBL2 27.1 31.1 MH 35.4 32.2 ST1 39.8 33.8 DBL3 41.1 33.9 DBL4 42.2 34.2 DBL5 82.6 49.8 DBL6 83.9 51.1 MT1 81.7 49.9 r-------- - - - - I SEPTIC AR!�D MOUNTAIN PARK ESTATES; BLOCK 12, LOT 3 -ASSUMED LOCATION OF DRAINFIELD PER MOA RECORD AND AS -BUILT SURVEY; DOUBLE CLEANOUTS INSTALLED PRIOR TO DRAINFIELD AND NEW MT1 INSTALLED AT WEST END OF FIELD \� DBL5& T1 'r_ I1 -- ds DgCK j S /y EXISTING 3 \\ BEDROOM 91j /L9 HOUSE BL3&4 I q 2 Of T1 / DBL1&? NEW 1000 GALLON HDPE GREER TANK 85' WELL WAIVER REQUEST \ \ \ MOUNTAIN PARK ESTATES; BLOCK 12, LOT 5 \ � 1 GARNESS ENGINEERING GROUP, Ltd ENGINEERING,-, SALES � CONSULTING :_- _ - - --- - - 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507 -PHONE (907) 3376179 -FAX (907) 33&3246 - WEBSITE: w gamessengineenng.cam PREPARED FOR: PHONE NUMBER: PAGE NUMBER: KRISTA ROSEN 907-440-3115 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: 12641 ALPINE DRIVE *ANCHORAGE, AK 99516 D.J.G. TYPE OF WORK: DATE: SEPTIC TANK RECORD DRAWINGS 9/19/2019 I - Z w w w Lu J F- 0 *w AV * : . * •♦ .. .... ........ ......... , ••• • ........... . 0 # �; JreyA. Garness e•W i Is,fit/ i ## 9E 7953)je7 Air LICENSE/1�;; EVS! � #AECC884 / PERMIT NUMBER: PARCEL ID NUMBER: -441-18 OSP191371 RECORD DRAWING 017 TOP OF MANHOLE = 97.75 FINAL GRADE = 97.54-97.67 MH ST2 2" INSULATION PER CONTRACTOR TOP OF TANK AT INTLET = 95.30 TOP OF TANK AT OUTLET = 95.29 NEW 1000 INVERT OF BUNG AT INLET = 94.59 GALLON Fi.D.P.E. INVERT OF BUNG AT OUTLET =94.47 SEPTIC TANK VA GARNESS ENGINEERING GROUP, Ltd .....:.......... .... __ - _ _ _ --_ _-_ 1 ENGINEERING -) SALES 3 CONSULTING = - ---- 0 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE, AK 99507' PHONE (907) 337E179 -FAX (907)33"246 ' WEBSITE: wriw.ga.es gin nng.... ...... •. ............... •„ ... ....... ...... , 0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: �0 •• J rey arSS .' ■ KRISTA ROSEN 907-440-3115 3 OF 3�j�'i •• + C -795 _AV LEGAL DESCRIPTION: DRAWN BY: ## ,•�i���� MOUNTAIN PARK ESTATES; BLOCK 12, LOT 4 D.J.G. •��� pRpF.... TYPE OF WORK: DATE: LICENSE SEPTIC TANK PROFILE 9/19/2019 #AECC 84 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 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191371 Work Type: SepticTank Upgrade Tax Code Number: 01744118000 Site Legal Address: MOUNTAIN PARK ESTATES BLK 12 LT 4 G:2838 Site Mailing Address: 12641 ALPINE DR, Anchorage Owner: MILLER KRISTA AILEEN Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms q // -31, q llcpa rtment v 8/22/2019 8/21/2020 22577 ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 ove , 01 (,Je,Q.,Q VtOl Received By: r Issued By: Lq� Z /9 Date: i Date: 3 Municipality of Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section * x x x VARIAT®TCE/W.A.IVER REVIEW x x x x Waiver#: OSV191083 COSA#: Permit#:OSP191371 PID#: 017-441-18 Legal Description: Mountain Park Estates Block 12 Lot 4 Engineer: Garness Engineering Group Applicant: Krista Rosen Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 85.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation.distances be met or another approval from this department. ■ .......... ■ ■ ............. ■ ■ ............................. ■ ■ ................... 1 Waiver is Granted: X Waiver is not Granted: Date: Approved by: QX404 Name of Reviewer .............................................................................. 1 **** VARIAN C E1IVAIVE R REVIEW **** MUNICIPALITY OF, Community Development Department Development Services On -Site Water & Wastewater Program Parcel I.D. 017441-18 Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Property owner(s) KRISTA ROSEN Day phone 907-440-3115 Mailing address 12641 APLINE DRIVE *ANCHORAGE, AK 99516 Site address 12641 APLINE DRIVE *ANCHORAGE, AK 99516 Legal description (Sub'd, Block & Lot) MOUNTAIN PARK ESTATES; BLOCK 12, LOT 4 Legal description (Township, Section & Range) Lot Size APPLICATION IS FOR: ( ® all that apply) Absorption Field ❑ Septic Tank N Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Sq.Ft. Number of Bedrooms 3 APPLICATION IS AN: Initial ❑ Upgrade N Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: TYPE OF DEWELLING: Single Family (SF) N (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) MtA �� C_ � W2 Distance: ? 5 " Cc# 1 I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Zs• oo Waiver Fees: Date of Payment: 0812-1111 Date of Payment: 13 1 Receipt Number: 0841001 Receipt Number: 09 � 59' t� Permit No. OSp is l 3q I Waiver No. O SU R 1 OV3 (Rev. 01 /11) GARN ESS ENGINEERING GROUP9 Ltd ___-___ __-__ -- - -=.-- ENGINEERING SALES CONSULTING August 15, 2019 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Mountain Park Estates; Block 12, Lot 4 To whom it may concern: The subject lot is served by a private well and septic system. The existing septic tank is steel and was installed in 1980 (39 years old). Per MOA. memorandum, steel septic tanks over 30 years old must be physically inspected and/or replaced. Based upon this fact, we are proposing to replace the existing septic tank. We are proposing to decommission the existing steel septic tank and install a new 1000 -gallon HDPE Greer tank rated for 10' burial. See attached design drawings for tank location and other MOA requirements. We are 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. E., M. S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com GARNESS ENGINEERING GROUP9 Ltd _-- - ENGINEERING SALES CONSULTING September 13, 2019 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Mountain Park Estates; Block 12, Lot 4 — Well Waiver Request To whom it may concern: During the installation of the proposed septic tank, the contractor noted that the proposed tank location outside of the well radius would not permit adequate fall from the septic tank to the existing drainfield. Additionally, the existing 1982 trench had not been decommissioned as stated in the MOA records. We are proposing to abandon the trench segment in place and ensure a dirt plug is installed between the existing bed and trench. We are also requesting an 85 well waiver (well to tank). Justifications for granting this waiver are as follows: • The existing septic tank is steel and encroaches on the well. We are proposing to install a HDPE septic tank rated for 10' burial. • Water samples were pulled on 8/27/2019, nitrates were 2.19 mg/L and coliform bacterial was negative. • The existing trench encroaches on the well and was abandoned in place per MOA records; however, per A+ home services, the trench is still in use. We are proposing to decommission this trench. This will prohibit primary treated effluent form being discharged inside the 100' well radius, further improving the protection of the well/aquifer. We are 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. SEP 1 2019 3 v C� ti lZ,CUO!68Lc3 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com SGS Ref.# 1194957001 LOQ Units Client Name Garness Engineering Group, Ltd (GEG) Printed Datefrime 09/11/2019 14:14 Project Name/9 12641 Alpine Dr Anchorage AK Collected Date/Time 08/27/2019 12:52 Client Sample ID 12641 Alpine Dr Anchorage AK Received Date/Time 08/27/2019 14:17 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks Parameter Results LOQ Units Method Container ID Allowable Limits Prep Analysis Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 B (<10) 09/03/19 09/06/19 BMZ Waters Department Total Nitrate/Nitrite-N 2.19 0.200 mg/L SM21 450ONO3-F C (<10) 08/28/19 EWW Microbiology Laboratory E. Coli Negative 1 100mL SM21 9223B A 08/27/19 A.L Total Coliform Negative 1 100mL SM21 9223B A 08/27/19 A.L GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED �9 s INSTALL DIRT PLUG EXISTING 3 BEDROOM HOUSE NOTE: THE CONTRACTOR CSEAREICASHALL THE 1 00'WELL RADII D FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. MOUNTAIN PARK ESTATES; BLOCK 12, LOT 3 ASSUMED LOCATION OF DRAINFIELD PER MOA RECORD AND AS -BUILT SURVEY _1 DgCK EXISTING SEPTIC TANK TO BE HAULED OFFSITE; INSTALL NEW 1000 GALLON HDPE GREER TANK; \ INSTALL DOUBLE CLEANOUTS BEFORE AND AFTER; \ MUST BE INSTALLED 5' FROM DECK POST 85' WELL WAIVER REQUEST MOUNTAIN PARK ESTATES; BLOCK 12, LOT 5 \ 1 N � I 1"=40' LJI k I/ 00 Ag _.lwjF d —y 7, GARNESS ENGINEERING GROUP, Ltd 0;*' 9 .. ENGINEERING � SALES CONSULTING, _ - 0 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE, AK 99507 -PHONE (907)337 -6179 -FAX (907)338-3246-WEBSITE:www.gamessengineenng.com 0•• ••••• • • •••••••••••• • ••••••• •••0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0, � •• J Game s : W i KRISTA ROSEN 907-440-3115 2 OF 2 ♦j� E- ' _AV ♦J'J'• PROJECT/LEGAL DESCRIPTION: DRAWN BY:♦♦ F `3 �• ,. �� MOUNTAIN PARK ESTATES; BLOCK 12, LOT 4 D.J.G. ♦ •''' •.•• �+���jjj�, �� TYPE OF WORK: DATE: LICENSE ,1�1�S``._� • DESIGN OF SEPTIC TANK UPGRADE - REVISED WITH WAIVER REQUEST 9/13/2019 #AECC884 I% lak —INSTALL NEW SEWER LINE / TO BE INSULATED WHEN 12 WHERE COVER DOES NOT EXISTING SEPTIC TANK TO BE HAULED OFFSITE; INSTALL NEW 1000 GALLON HDPE GREER TANK; \ INSTALL DOUBLE CLEANOUTS BEFORE AND AFTER; \ MUST BE INSTALLED 5' FROM DECK POST 85' WELL WAIVER REQUEST MOUNTAIN PARK ESTATES; BLOCK 12, LOT 5 \ 1 N � I 1"=40' LJI k I/ 00 Ag _.lwjF d —y 7, GARNESS ENGINEERING GROUP, Ltd 0;*' 9 .. ENGINEERING � SALES CONSULTING, _ - 0 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE, AK 99507 -PHONE (907)337 -6179 -FAX (907)338-3246-WEBSITE:www.gamessengineenng.com 0•• ••••• • • •••••••••••• • ••••••• •••0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0, � •• J Game s : W i KRISTA ROSEN 907-440-3115 2 OF 2 ♦j� E- ' _AV ♦J'J'• PROJECT/LEGAL DESCRIPTION: DRAWN BY:♦♦ F `3 �• ,. �� MOUNTAIN PARK ESTATES; BLOCK 12, LOT 4 D.J.G. ♦ •''' •.•• �+���jjj�, �� TYPE OF WORK: DATE: LICENSE ,1�1�S``._� • DESIGN OF SEPTIC TANK UPGRADE - REVISED WITH WAIVER REQUEST 9/13/2019 #AECC884 I% lak —INSTALL NEW SEWER LINE i W TO BE INSULATED WHEN 12 WHERE COVER DOES NOT I UU) EXCEED 3 FEET i WW J F- 7 ASSUMED LOCATION OF ; EXISTING TRENCH TO BE COMIIIISSIONED PER UPC EXISTING SEPTIC TANK TO BE HAULED OFFSITE; INSTALL NEW 1000 GALLON HDPE GREER TANK; \ INSTALL DOUBLE CLEANOUTS BEFORE AND AFTER; \ MUST BE INSTALLED 5' FROM DECK POST 85' WELL WAIVER REQUEST MOUNTAIN PARK ESTATES; BLOCK 12, LOT 5 \ 1 N � I 1"=40' LJI k I/ 00 Ag _.lwjF d —y 7, GARNESS ENGINEERING GROUP, Ltd 0;*' 9 .. ENGINEERING � SALES CONSULTING, _ - 0 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE, AK 99507 -PHONE (907)337 -6179 -FAX (907)338-3246-WEBSITE:www.gamessengineenng.com 0•• ••••• • • •••••••••••• • ••••••• •••0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0, � •• J Game s : W i KRISTA ROSEN 907-440-3115 2 OF 2 ♦j� E- ' _AV ♦J'J'• PROJECT/LEGAL DESCRIPTION: DRAWN BY:♦♦ F `3 �• ,. �� MOUNTAIN PARK ESTATES; BLOCK 12, LOT 4 D.J.G. ♦ •''' •.•• �+���jjj�, �� TYPE OF WORK: DATE: LICENSE ,1�1�S``._� • DESIGN OF SEPTIC TANK UPGRADE - REVISED WITH WAIVER REQUEST 9/13/2019 #AECC884 I% lak MUNICIPALITY Of: ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYS'rEM AND/OR WELL INSPECTION REPORT Nar. o DISTANCES .~.~dressF~ ~ J ~"~e~ /~.~~V/ ~ SEPTICTANK ABSORPTIONFiELD WELL ' ~hone(s)~ ~. ~ Permit NO.¢~ '7¢. ~O' Bedrooms. WELLLOT LINE LEGAL eESCRIPTION Township, Range, Section AS-BUILT DIAGR~ ,M {Show tocahon el well, seplic system, property hnes, Ioundahon, S~; ~¢ .F/~ _ d ..... ay, waterboOloS, etc.) TAN KS Material ~ No. of Co~padments TYPE OF SYSTEM ~TRENCH BED ~ W. DRAIN ~ OTHER t, .... ~-. Depth 1o pipe bottom from Total depth I/om original grade ~ ' °r'ginal grade ¢ /~ ~T ~ / F~ Pill added above onglnal grade Gravel depth beneath p~pe G~vel length Gravel width / FT /4 FT Distance between Imnes Number of lines J Soil rat*ng Pmpe ma[erial ' ' WELLS r ~ OTHER (I · ~,~e ~ PRIVATE Installer ~ )ale hlstalled: REMARKS: ~ ~// ~ ~,~/ ~t~ ~ ~-~t~. Scale:lnspections~,~Pedormed by: ENGINEE~'SSEAL I~ t~O ], ~ ceflily Ihat this inspe~ion was peflormed according to ag ~ ' Health Depedmenl Approval' Date 72-d13 i3/851 ALASKA eFIUIROFIITI FITAL COFITROL SeRUICeS, IFIC. ~nqinemnq ~, Enuironmento} SIuclies P. O. Box 240668 Anchorage, At( 99524-0668 (90'7) 279- 5553 *** FAX (907) 276 8706 June 25, 19!)0 Department of Health & llulllan Services Municipality of Anchorage 825 L Street, Fifth Floor Anchorage, AI( 9950] RE: Lot 4, Block 12, Mountain Park Estates In 1982, when this system was instal]ed, the lot corner was misidentified by one of the parties. When tire lot was resurveyed in 1990 the bed was found to be on Lot 3. The actual lot corner was 30 feet south of this corner. That placed about two thirds of the bed on the wrong lot. A ne~q soils test was .lade during the period when the ground 3was st:ill ~et. The 1990 percolation test was identical to the 1982 test resu] ts. The aew system w:ill be l0 feet from the lot line and in the location which it was intended to be located. The old system wi] 1 be scavenged for cover. Used rock wi ] 1 be baried on Lot 4. Part of the new bed will be closer than 10 feet frola the old bed. As the old bed is still functional , the closeness should have ne detriment:al affec[. 'to move the new bed farther away will cause some old trees to be cut. I think it is unnecessary, in vfew of Lhe fact that the bed working. Please allow this variance. LCR/sr -I 4 ! 9 W6gC 33P.(~ ,.~vF..nu6 ~I,-cNncho,~aQ6; ¢Nlafka 996~ · (9071 279-5553 ALASKA E F UIROIIlTIE I1TAL COIqTROL SeRUICCS, IBC. ~nqineefinq f~ ~nuironmcnt~l Studies SPECIFICATIONS FOR BED WASTEWATER TREATMENT SYSTEM LEGAL DESCRIPTION: LOT 4, BLOCK 12, MOUNTAIN PARK ESTATES 1.0 GENERAL 1 1 The Drawings, sheets 1 through 5, shall be part of this specification. 1 2 All materials and workmanship shall meet the requirements of the Municipality of Anchorage, Department of Health & Human Services (DHHS) , the conditions of the permit, and all applicable rules and regulations currently in effect. 1 3 Ail excavations and depths are advisory, and are to be verified or modified in the field by the Engineer or inspecting agency. 1 4 It is the responsibility of the property owner or insta]ier to adhere to approved design for the installation, to maintain the specified separation distances and to have the appropriate inspections. 1 5 It is the responsibility of the property owner or installer to report to the engineer any observed conditions which would put the system in violation of state or Municipal regulations. 1 6 If the installation is not inspected by an AECS engineer, AECS will not be responsible for the installed system. An engineer at AECS should be consulted prior to construction, to determine the number of inspections that will be required and to explain what these inspections will involve. 2.0 SEPTIC TANK 2.1 If there is an existing septic tank it ]nay be used if it meets the capacity requirement for the residence. The structural integrity of the tank must be verified, 2.2 The septic tank shall be a UPC-approved two-compartment tank, constructed of 12 gauge steel with bitumastic coating and set level on undisturbed soil. If the tank is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. 1412 W6SE 33RO Avenue · Ancho~qe. Alaska 99503 · (907) 279-5553 2.3 2.4 2,5 2,6 2.7 The septic tank shall be a minimum of 5 feet from the house foundation, and a minimum of 5 feet from the absorption area. The septic tank and bed shall be a minimum of 300 feet from any private well or body Qf water, 150 feet from Class "C" wells, and 200 feet from Class "A" or "B" wells, unless otherwise specified. Less than the required separation distance must have prior approval or waiver by DHHS or Alaska Department of Environmental Conservation (ADEC) . Piping shall be fitted with a mechanical watertight calder coupling on the outlet and inlet of the septic tank. Piping shall be 4 inch solid PVC ASTM D-3034 or cast iron, sloped a minimum of 1/4 inch per lineal foot on the inlet side and 1/8 inch per foot on the outlet side, If the piping is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation, Cleanouts shall be installed as designated and capped with air-tight rain caps (Jim Caps or equivalent), and extend a minimum of 1 foot above ground level. If a lift station is required it shall be a combination lift station septic tank per Anchorage Tank and Welding, Inc. design. Specifications and design drawings are on file with the municipality and the engineer. 3.0 SEEPAGE BED 3.1 The gravel for the bed shall be 0.5 to 2.5 inch, screened rock with less than 3 percent passing the No, 200 sieve, All substitutes must have prior DHHS approval. 3.2 The bottom of the excavation shall be level and raked with the backhoe blade to ensure that the bottom has not been compacted during excavation. 3.3 Sand, for leveling, shall have a size distribution which meets the requirements of MOA code 15,65,077. 3,4 The distribution pipe shall be perforated 4 inch rigid PVC with a minimum crush strength of 1500 3 5 3 6 3 7 3.8 pounds and shall meet the approval of DHHS for use as drainfield pipe. All pipes shall be laid level, and spaced according to the drawings. Monitor standpipes shall be placed as shown in the drawings. They shall be 4 inch rigid PVC ASTM D-3034, or cast iron. The section shown with holes may be either drilled 0.5 inch holes on 6 inch centers on opposing sides of the pipe, or a section of regular perforated sewer pipe may be clamped to the solid section with a no-hub coupling or solvent joint. The perforated section of the monitor tube shall be located in gravel only. The portion of pipe above the sewer rock shall be solid. A rubber raincap (Jim Cap or equivalent) shall be placed over the top of the pipe. Filter fabric is required. The side slope of the mound shall be slope 1 foot vertical to 3 feet horizontal. The bed shall be planted with a white clover and red fescue mix, or with Kentucky bluegrass. 4.0 INSPECTIONS 4 1 This bed will require a minimum of three inspections. The first inspection will be of the open excavation, to assure that the system is installed in the proper soil strata, correct depth and meet minimum specified design parameters. 4 2 The second inspection will be after placement of gravel, monitor standpipes, and distribution pipe, to verify proper installation and position of pipes prior to backfill. 4 3 The third inspection will be after final backfill grading and seeding to ensure that adequate soil cover has been provided over the bed. 4.4 The inspection of the septic tank or lift station installation can be incorporated with any one of the above listed inspections. 4.5 The lift station will require either an MOA electrical inspection or certification by a licensed electrician depending on whether the building code applies to this part of the city. ALASKA ENVIRONMENTAL CONTROL. SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 S,EET,O. / OF 5' CHECKED BY DATE-- SCALE / ": JO / ii, I ro, ~ : D r- , ,r e I/3~ / [o¥£ . B,;r-, ~/d Parcel I. D.017-441-18 Municipality ®f Anchorage On -Site Water and Wastewater Program 3 4 7 '9 (907) 343-7904 70 Certificate of On -Site Systems 1. GENERAL INFORMATION: ExpirX'�,_ ate - 'z 9 9 Complete legal description Mountain Park Estates; Block 12, Lot 4 Location (site address) 12641 Alpine Drive *Anchorage, AK 99516 Current Property owner(s) Krista Rosen Day phone 907-440-3115 Mailing address Real Estate Agent 2. TYPE OF DWELLING: Z Single Family (w/wo, ADLI) Fj Duplex Fj Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: .3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual N Individual Water Storage 1-1 Holding Tank 0 Community Class Well 0 Community 0 Public Water System 0 Public Sewer 0 Waiver/Variance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. IGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Y OF '/4#AECC884 ON-SITEr WATER AND m o WASTEWATER o Conditional approval for bedrooms, with the �"wir�� ts. NZ .� v Original Certificate Date: ' 2 The Municipality of Anchorage 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: MOUNTAIN PARK ESTATES; BLOCK 12, LOT 4 Parcel ID: 017-441-18 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 0.31 gpm Date drilled/124/1880 Water storage tank volume NO gallons Total depth 360 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to 360(?) ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate AALI mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 12+ in. Collected by GEG Date of flow test for COSA 4/30/18 Date of Sample 8/27/19 Static water level at beginning of test 162.6 ft Comments *ACCURACY OF PRODUCTION IS LIMITED BY ACCURACY OF THE "TIME" READINGS; THEREFORE 0.31 IS APPROXIMATE B. TANK DATA Age of tank(s) NEW years Tank type/material HDPE Measured operating fluid level in septic tank NIA ON Standpipes/foundation cleanout per record drawing Date of pumping N/A D. ABSORPTION FIELD DATA Which system tested (date installed) 7/23/90 ❑ ALL standpipes present per record drawing Total measured depth from grade 4 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ON Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced N/A gallons Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance come, Age of lift station rs Lift station mate Adequacy test date 4/30/18 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 500 gal New depth 5 in Elapsed time 120 min Final fluid depth 1 in Absorption rate 450+ and Any rejuvenation treatment (past 12 months) If yes, enter date N/A N/A K, E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' *85 + Community Sewer Manhole/Cleanout > 100' ft ❑ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' R] Yes if No ft Neighboring Absorption Fields > 100' Surface Water > 100' 0 Animal Containment > 50' ❑✓ Yes if No ft ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [Z] Yes if No ft Q Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *OSV191083, DRAINFIELD IS 10'+ TO CURTAIN DRAIN/S PER 1990 RECORD DRAWING G. ENGINEER'S CERTIFICATION I 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. COSA Checklist yellow sheet #AECC884 Well Nater Advisory Certificate of On -Site Systems Approval # OSC191444 Subdivision: Mountain Park Estates, Block: 12, Lot: 4 This well's productivity was determined to be .31 gallons per minute. The minimum well productivity required under (AMC 15.55) for a .31 -bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently Meets this minimum requirement, the production capacity can fluctuate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. 000 3.EC.00 00 N _ PERFORMED FOR: LEGAL DESCRIPTION: COMMENTS -~¢'. ~[~F ~.~(~N~EER'S SEAL) ~,~/' / ~ '.~'~ Municipality of Anchorage ¢~/ 49~. s'*.t H MAN 825 "L" Street, Anchorage, Alaska 99502-0650 ~~ ~ Township, Range, Section: ~/~ ~ ~, SLOPE .SITE PLAN WAS GROUND WATER ENCOUNTERED7 IEJ' t, S IF YES, AT WHAT ,.?..~.,- ~ DEPTH? p E §epth lo Water Alter .onit,ring? ~'"; Data: ~'/~/~' Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE,/¢~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ '~'~-. FT AND ,.~.O FT PERFORMED BY: ,,Z. , /~¢_, n/ I ~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TH~S DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ~,~/ ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet-Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME IPHONE MAI LI~J..G ADDRESS LEGAL DESCRIPTION tDrer city in gallons r / .J Absorption area DISTANCE TO: Manufacturer Well Inside length Dwelling Material Width Meteria] I Well I/~v'-'~l I Foundation -' . DISTANCE TO: -f'Len ,~h of Z~e~cn -- L~ No, of lines ~, L.~_ j,~, ~.~, _ linel-~' Total length of lines Trench wi~ of tile to finish grade~/ j Material b~th tile inches ~ UPGRADE NO. OF BEDROOM% PERMIT NO, Liquid depth Type of crib DISTANCE TO: Class DISTANCE TO: Building founaation Sewer line OTHER PIPE M~ERIALS SOIL TEST RATING Crib diameter Well Depth 1fl5 / 6c roo¢ INSTALLER Crib depth Building foundation Driller Total effective absorption area Nearest lot line ' Distance to lot line Septic tank PERMIT N""~, Absorption area(s) qPPROVED £f z DATE LEGAL Distance between lines Lc' ~ effective absorDzJon area Liquid capacity in gallons -~RMIT NO. PERMIT NO. 0 NAME- , . MAILIN~G ADDRESS LEGAL DESCfilPTION 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 Absorption area NO, OF BEDROOMS,3 Inside length LOCATION -- - - -- - J Well I / D STANCE TO: ~. Z' hManu facturer ~ ]Liq capacitvingalons [ ' I IF HOMEMADE: DISTANCE TO: [Well Dwellieg PERMIT NO. FoLmdation Total length of lines Material beneath tile DISTANCE TO: No, of lines~! L~e. ngt hj/~;..~r}' ?f'~l. each~.~" line I~'~ Top of tile to finish grade ~.t Depth Width Type of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: Depth Driller Sewer line Building foundation [] NEW [~z~ UPGRADE Class Dwelling Material Trench wicl~~ inches inches DISTANCE TO; ~ERMIT NO. Liquid depth P~,~I '[ NO. 0 .5.5 Distance between lines Total effective absorELtjon area PERMIT NO. Total effective absorption area Nearest lot line Distance to Io[ line Septic tank PERMIT NO, Absorption area(s) OTHER PIPE MAr~ERIALS SOIL TEST RATING INSTALLER ~EMARKS APPROVED j,O Z F't DATE LEGAL MUNICIPALITY OF ANCHORAGE Department f Health and Environmenta Protection 825 Street A~chorage, AK. ~9501 ? 264-4720 * * * HANDWRITTEN PERMIT * * * ~ermit ~ ~ ~ ~ WE~=AN~8~R ON-SITE SEWER PERMIT ~'~/~'~ kpplicant: Mailing Address: ~CD, A~~A Phone Nuraber: ~ ~ Lot Size: location: Legal Description: ,, 1 -d' ?h ~ype of Soil ~sorption System Is: Trench: ~ Drainfield: Seepage Bed: Holding Tank: ~ Soil Rating (sq. ft/br) ~axim~ N~ber of Bedrooms: ~ . ~ The Required Size of ~he Soil ~sorption System Is' DEPTH .LEN6TH 6RAVEL DEPTH WIDTH The length dimension is the length(in feet) of ~he trench or drainfiela. The depth of & trench or pit is the distance between the surface of tne ground and the bottom of tne excavation(in feet). There is :o set width for trenches. The gravel depth is the minim~ de,tn of gr~val between the outfall pipe and the bottoz of the excavation(in feet). ~ ~ REQUIRED SEPTIC(HOLDING) TANK SIZE = 6ALLONS ~ ermit applicant has the responsibility to inform this department during the nstallation inspections of any wells adjacent to this property and the number f residences that the well will serve. TWO(2) INSPECTIONS ARE REaUIRED ackfilling of any system without final inspection and approval by this department 'ill be subject to prosecution. :in:um dista:ce between a well and any on-site sewage disposal system is lO0 feet 'or a private well or 150 to 200 feet from a public well depending upon the type ,f public well. Minim~ distance from a private well to a private sewer line .s 25 feet and to a co,unity sewer line is 75 feet. Well logs are required ;nd ~st be returned to this department within 30 days of the well completion. )ther requirements may apply. Specifications and construction diagrams are ~vailable to insure proper installation. ~ ~ ~ PERMIT EXPIRES DECEMBER :~, ~ g 8 2 ~ ~ ~ I certify that: (1) I ~ f~iliar with the requirements for on-site sewers and wells as set forth by the ~unicipality of Anchorage. (2) I will install the system in accordance with codes. (3) Z understand that the on-site sewer system may require enlargement if i~cl~de more tha 3 bedroom. the<:_~ re~idence,is~ -"1 ~' remodeled to ~/.~ - ~ Date: . t. .~ ,'~ S~TP/024 (1/81) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 025 L. Stroot, Anchor,:liD, Alauk~ 99501 264-4720 SOILS LOG - PERCOLATION TEST '1 2 3 4 5 6 7 8 9 ...... DATE PERFORMED: SLOPE SOILS LOG Pt:[~QOLATION .... .. SITE PLA~ ............................. 10 11 12 ]3 14 15 WAS Gt~OUNI) WA'rEM //~ ENCOUNTERED? (~ ~. O IF YES, AT WHAT E DEPTH? Roading Date Gross Not Depth to Not 'rime Time Wat~,r DroD 16 1 9 2O z C, I~oid, J No. ,?ERCOL^TION []ATE TEST I]UN BE"I'WEF:N ......... FT AND COMMENTS PIEItFORMEI) B¥:__~...~J_ C['"FITIFIED BY: 72-008 (miautes/inchJ FT DATE: 7---C2'2~ .~1~ ,' MAILING ADDRESS LEGAL DE~.~CRIPTION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMF. NTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Manufacturer NO. OF BEO~O~,~ Foundation ~4 Material beneatt~ ti~e Depth Crib depth Building foundation Driller Sewer lina No, of compartmen.~,s,~ Liquid depth PERMIT NO. Material Liquid capacity in gallons ~ERMIT iN 0.~ ~ I Nearest lot ~ / Trench .t~Jdt h ~-'1 inches ~,(~ inches ~ [ ~ Well/ _ I D STANOETO: / XJ6r! AJ' ~ ~ z I No. of hnes ~ ~ Lengt~,~ egcb hne ~ '~ IT°p°ftilet° finish grade ~ I ~/~en~th Width ~ P~ I ~~ ~ diameter ~ DISTANCE TO: ~ ~ D ISTANC~ TT B u ,~din9 f~undat~o,~ Total effective abSOlptiol~ area PERMIT NO, Nearest lot line Distance to lot line Septic tank Absorption area(s) OTHER PIPE MAT F.,~ IA LS SOIL TEST RATING LEGAL SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF_ DRILLED AT THE RATE: OF .. ,.,~'J.0.00 PER FOOT. PROPERTY OWNER WELL. LOG: 0 ..... 26' MUNICiPALiTY OF ANCHORAGE-. 'C~IL)N 7o,t.~. coa.t o./'. 2)a. Mfl~.hW.: ,74000.00 c~o czg..ze.e¢ .9/~ .;,e.C toe.t.. COST' INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING, ;/4000.00 WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF __ THANK YOU VERY MUCH, OATF__L'a_~uCu. o,C_ 2.4.&':, 79Z¢0 BERNIE CILAUS OF RAMPART DRILLING WORKS F'EF~'.M i l" NO. F'PL iF:FINT DFtHI.. COI',IST'RUCT 1: ON I IqC OCI'T'IT I O~",t FILF' I IqE FII',![:' BE'v'EF.'.L'T' EGFIL Lq' B,,~ MT RSRk: ESTRTES YF'E CIF SOIL FIE:SORPTION S'¢STEH IS: TRENCFI il'vll ILJl ~".U JL IL_': .JL I1'-'" II'";ql L- JL 1t "'~"' LJI U-- ~-II 11"-41 Il,._:: IF'dl L.w Ih< If--Il s..:~ DEF'f-:tRTMENT F HEf'~LI"H FINE:, EN'v' I ROi',IMENTFIL r 'OTECT I I"_'IN :32.5 "L STF.':EET., FINCHORFIGE., FIK. 'DS ...... 264--4.720 ,:; 800389 LOT SIZE IR::.:; i MUM NLIME:ER OF BEE,PF.ZU'"I'F:; = SOIL RATING ,::Si:.! FT,.'E,F.',= t65 HE REQUIRE[:, SiZE OF TI4E SOIL. RDSCIRPTION SYSTEM IS: :::" E; F' 'lF t-dl ==:..ff5 L. E 1'4 C:~ "IF I-I = :~.." ~-'-: ,3 ~r? F! %,.' E b [:. EE F" qF ~-II ~= THE L. ENGTH [:,iHEi"~ISiOI',I :I:S THE LENGTH (IIq F'EET> OF THE TF::ENCH OR [:,RF~INFIELD. I"HE [:,EPTFI OF FI TRENCH OF.': F'iT iS THE [:'ISTFINCE BETWEEi"~ THE SURFRCE OF THE GI';':OUi"~[." FINE:' THE BOTI"OM OF' 'THE E;.':CRVR'I"IOi",I (IN FEEl">. 'f'HERE IS NO SET WI[:'TH F'OR TREI".ICHES. TFIE GRFt'v'EL [:,EF'TH IS THE HINIMUM [:'Ef:'TH OF GF.'.FIVEL BETWEEN THE OUTFFILL F'IF'E FIN[:, I"HE BOTTOM OF THE E::-::CFI',,~FITZON (IN FEET). :~: I-:E rtL--,.! LJ ][ IF~: IF_:.: [:, :-~; E F' 'IF I C7.: l- R f-.~ !.::: S ][ Z g == ::L ~:) [Zl nZff IlS I:a g L_ ~ERHiT FIF'PLiCFINT HRS THE RESI::'ONSZBILiT'¢ TO INFORM 'f'HZS DEF'RRTMENT DURING THE :htSTRLL..RTiON INSPECTIONS OF RN'¢ WELLS RDJFICE:NT TO THIS PROPERT'¢ FIND THE IUI','IBER OF RESIDENCES THWT' THE WELL WiLL SEF.:',/E. i:FIC:KFILLZNG OF FIN"r' S'¢STEM WITHOUT FZNFIL INSPECTION FIND RPPRO',/RL B'¢ THIS :,EF'FIRTMENT WILL BE SUBJECT TO PF.'.OSECUTION. 'IINIMUM E:,ISTRNCE BETHEEN Fl WELL RNE:, FIN'¢ ON-SITE SEHI~GE DISPOSRL SYSTEM iS .00 I--EET FOR FI F'RI',/FITE WELL OR t50 TO 200 FEET FROM R PUBLIC WELL DEPENDING !F'OI'.,I THE T'¢F'E OF F'UBt. iC: WELL IZNZf"IUM [.',ZSTFtNC:E FROH R PF.:I'v'FITE HELL TO R PRi',,,'FI'FE SEWER LiNE ZS 25 FEET rOR COMMUNIT'¢ SEHEF.: LiNE IS 75 FEEl". )THER RE[:.!LIIREIqENTS MFt'¢ RF'F'L'¢. SPEE:];.FICRTZONS RND CONSTRLICTION DZRGRRMS RF..'E :IVf-:IZLRBL. E TO iNSURE PROPER INSTFILLFITION. [ (]ER]'IF'Y THR'I' L: i RM FRMILIFIR WITH THE REQUIREMENTS FOR CmN-SITE SEWERS AND WELLS RS; '::;ET :OR'Hq B'T' TFIE MUNICiPRLIT'¢ OF RNCHORRGE. .!': i I.,IILL iNSTFILL THE S'¢STEM IN RCCORE:,RNCE WITH THE CODES. · ]:: I UNDERSTFIN[:' 'f'HFIT THE ON-SITE SEWER SYSTEM MR'¢ REQUIRE ENLRRGEMENT IF' THE ;;:ESI[:,ENC:E IS REI','IC[,ELEE)TO INF:LIJ[:,E i'.IDRE 'I"HRN 2: E:I--DROOMS. /~l('~.~._J(_..(~ ~;i GI'.,IEE:,: ...................................................................... c~¢, FIF'F'L. ICFINT ['4qFIL CONSTF'.UCTION iNC L - '-':/' ,-- ,-* / / ~-¢"~ ,,' ~ ,~'V, .,~, " ",' , 'M',~ ~,' /4"/]./'7: SOILS LOG MUNICIPALI'rY OF ANCHORAGE ~ PERCOLATION DEPARTMEN]' OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch ~-1350, Anchorage, Alaska 99502 276-222'g TEST SOILS LOG - PERCOLATION TEST PERFORMED FOR: Da. hi CoTtstruotion DATE PERFORMED: August 11, 1980 LEGAL DESCRIPTION: Lot 4 Block ].2 Mountain Park Estates Subdivision 1 2 3 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS PERFORMED BY: ' ORGANIC WITH ROOTS GRAVELLY SANDY SILT WITH COBBLES SILTY SANDY GRAVEL SANDY SILT WATER ENCOUNTERED SLOPE SITE PLAN WAS GROUND WATER S~_.i ....... ! ...... ENCOUNTERED? Yes L 0 E IF YES, AT WHAT i . - DEPTH? 9.0' --'~ ~ ' ~.-,~-~:'~'-'"'~-~-"~' ~ Gross Net Depth to Net Reading Date Time Time Water Drop 8-11-8( 2:03 20 10.50" 0 2:13 30 11.50" 1.0" 2: 23 40 12.25' 1.75" · 2: 33 50 13,50 3.00" 2:43 60 14,50" 4.0" min PERCOLATION RATE 10 1~ (minutes/inch) TEST RUN BETWEEN 2-1/2 FT AND 4-1/2 . FT 72 008 (71761 SPECIFICATIONS FO~I ELEVATED UF]i) ALTERNATIVE WASTEWATER TREATMENT SYSTEM.~ LOT q~ ~i,OCK 12, MO~JNTAIN PARK ESTATES 1 .0 GENERA[, ],i TIlE DRAWINGS, SI1EETS 1 TttRU 4, SHAI,L BE A PART OF THIS SPECIFICATION 1.2 AL1, MATERIALS AND WORKM~SIlIP SNALL MEET Tile REQUIREMENTS.OF ANCHORAGE DEP~ITMENT OF liEALTH AND ENViRONMENTAl, PROTECTION PERMIT. 1.3 ALI, EXCAVATIONS AND !)EPTHS ARE ADVISORY AND ~E TO BE VERIVIED OR MODIFfED 1N 'FILE FIELD BY THE ENGINEER. 1.4 I'r Is THE RESPONSiBILiTY OE TIlE OWNER 'FO Ot~TAIN ALL NECESSARY PERMITS OR EASEMENTS, 2.0 TIlE LIFT STATION 2.1 THE STOCK MATERIAL FOR TIlE LiFT STATION Si~Li,, BE EITHER CALV~qlZED STEEL (AS'I'M A'-4444-76), OR ALUMINUM CULVERT, C~ABLE OF BURIAL TO ]0 FI'. 2.2 THE 24" PIPE FOR THE LIFT STATION SItALL HAVE A WEI, DED WATER TIGHT BOTTOM OF 'FILE SAME THICKNESS AND COMPOSITION A.S TIlE CULVERT, 2.3 ALL PENETRATIONS OF THE LIFT STATIiON SHALL BE WELDED AND WATER TIGHT. AI,L WEI,DS SHAI,L BE CLEANED OF SLAG, WEI,DS ON GALVANIZED STEEL WILL BE SPRAYED WITH ZiNC RICIt PAINT OR COATED WiTI1 BITUMASTIC. 'rile BOTTOM 2' OF TUE INTERIOR SHALL BE COATED WITft I{ITUMAS'rlC PAINT. 2.4 THE TOP CAP StlAI,L BE RAIN TIGHT ~D SECURELY FASTENED 'WITH SCREWS. 2.5 AI,L ELECTRiCAl, FITTINGS ~D CONNECTIONS IN 'FILE I, iFT STATION SNAI,L MEET T[iE REQUIREMENTS FOR A WATER TIGHT SERVICE. 2.6 THERE SHALL BE A H!Gtt LEVEL ALARM SET AT TUE LEVEL OF THE SOIL PIPE FROM THE SEPTIC TANK. THE BUZZER SItALL BE LOCATED NEAR TIiE ELECTRICAl, CONTROL PANEL OR IN A LOCATION DESIGNATED BY THE IIOMEOWNER. 2.7 TliE SUt~ PUMP StlALI., BE CAPABLE DF DELIVERING 10 (;P~i AT A HEAD OF 20 FEET. 2.8 THE SUMP PUMP SaALL BE SUSPENDED NOT LESS THAN 6 iNCttES OFF TIlE BOTTOH OF TIlE I, IFT `STATION WITH A CHAIN OR NYLON LINE. 3,0 SEEPAGE BED 3,1 TIlE GRAVEL FOR THE BED SIIAI,L [U~ SGREENEO TO TIlE SIZES INDICATED. 3.2 THE SAND SHALL [[AVE AN EFFE6TiqE;S]ZE OF 0.4 TO 0.6 AND A UNIFORMITY COEFFICIENT OF NOT MORE TtlAN 4. 3,3 TIlE BERM AROUND THE SEEPAGE:BED ,SHALL BE CONSTROC'IED OE IMPERHEAitLE MATERIAL, AND ON A SLOPE OF 1 EOOT VERTICAL PER 2.5 FOOT itORIZONTAL. 3.4 THE BOTTOM r~F THE EXCAVATION StIALI, BE RAKED WiTII THE BACKNOE BLADE TO INSURE THAT TIlE BOTTOM [lAS NOT BEEN COHPACTED DURING KXCAVATION. THE BO'rTOM ELEVATION StiALI, BE PLUS OR MINUS 2", 3.5 ~I OBSERVATION PIPE SIIALL BE PLACED AS SHOWN IN THE DRAWINGS. IT SHALL BE RIGID PVC, AaTM 3033 D-3034. THE SECTION SIIOWN WITII HOI,ES MAY BE EITHER DRILLED 0.5" ttOLES @ 6 iNCH (]ENTERS ON OPPOSITE SIDES OF THE PIPE OR A SECTION OF PERFORATED SEWER PIPE MAY BE CLAMPED TO THE SOLID SEI]TION WITH A NO }tUB COIJPLING OR SOLVENT JOINT. A RUBBER RAIN-CAP (JIMCAP OR EQUAL) SHALL BE PLACED ON THE TOP OF THE PIPE. 3.6 IF INSULATION IS REQUIRED TIlE INSIJLATION SHALL BE DOW EXTRUDED BLUE STYROFOAM INSULATION BOARD 01.2 TIlE TIIICKNESS SHOWN ON THE DRAWINGS. 3.7 THE TOP AND SIDES OF Tile liED SItALL BE PLANTED WiTIt A WHITE CLOVER AND RED FESCUE MIX. 3°8 THE SEPTIC TANK OR BED MUST NO'£ BEE CLOSER THAN 100 FEET FROM THE CREEK. 4.0 PRESSURE SEWER 4.1 THE PRESSURE SEWER SHALL BE 2 INCIt POLYETHYLENE OR PVC PIPE BURIED TO THE DEPTH OF 5 FEET FROM TIlE LIFT STATION TO THE CENTER OF TIlE BED 5°0 CURTAIN DRAIN 5.1 THE PIPE FOR TIlE CURTAIN DRAIN SHALL BE RIGID PVC PERFORATED PIPEE ASTM D 3350 LO6K2B. 5.2 'J'~tE ROCK FILL SUALL BE 1/2" -- 2 1/2" WASItED GRAVEL. 5.3 TIlE ENGINEERING FABRIC SHALL BE TYPAR, MIRAFI OR FIBERTEX. 5.4 THE SLOPE OF THE DRAIN SHALL NOT BE LESS TllAN 0.45 FT/iO0 FT. 5.5 THE CURAT!N DRAIN SHALL NOT BE PLACED CLOSER TITAN 20 FT TO ANY SOiL ABSORPTON SYSTEM. CONTROL SEEVr-S, INC, 1220 West 25th ,enue ANCltORAGE, ALASKA 99503 Phono 276-1361 CONTEOL SERVIC[ INCo 1220 West 25th Avenue ANCHORAGE, ALASKA 99503 Phono 276-1561 /) R ? Y: L :, Z ~.~' D/i-.~ P/Il r'.~..;-I~i,~.~ r~l'~VlffUl~lIVli~l~ I AL CONTROL SERV~""~i, INC. 1220 West 25th..,enue ANCHORAGE, ALASKA 99503 Phone 276-1361 25r 'CONTROL SERVIC INC. ~220 West 25th ANCHORAGE, ALASKA 99503 Phone 276-1361 NOTE S 1, URE-iHANE FOAIq SHOULD L;E: APPLlf!D 8EL.OW GROUND SUi~f--ACE Al A THICKNE]SS 0F'1 I~CH, 2, COAT 80TTOM 2 FEET INSIDE WITH t~I'I-UHASTIC PAINT. 3, USE JI,~"OR ~'FL_EXISLE t~,OSE TO FIT F)UMf~. 4,. SEE SPECIF'ICAI"ION~ FOR F' E E T LIF:"I'- o 1/\! ...METAL_ CAP WITH /'" 2."UFtE'FHANE FOAH "' NC}P[: ..... ~ I AL.L AROUND CIqAINOR N,L~N. "]~ ~'~x PUHP POWER CORD-- ~- Ox : i-' 4 s'rEFt NIPPLE-- t I /~ ......1 ~ FLEX HOSE ::>>.,. .&... %~J~ F IL.LEI :El [) . ~.. ~¢~,~ %'~ ~ m , ~r:~,,,~,~ / ,-.'~,~ n-lu _ ~-"]~i CtiECI( VALVE ~,,.~"~7"~ .... ~// r [~ t: ............. I / ~:S~ ......... 5UHP PUMP Augu;;t t~, 19B0 SRA [~0× 78 AnChorage, ALtention: Don ,O~dtl MUNICIPALITY OF ANCH©RAgE DEPT, ©F ]; .LiH & AUG [i o 198(3 P~r-k Estates S.t.~bdivision, A'£ your Peque~,t of Augu~;t Ilt 1980, R&M ¢;omsuftants conducted a subsut'- accomp~ishm~ wi~h ~ b~c. kho~:~, 7he log hoh~ wa~ e~(~vated tO a depth of ~'t ',4J'L'/i h / ?>.', f -,d Municipality of Anchorage Development Services Department CERTIFICATE Building Safety Division On-Site Water & Wastewater Program P.O. BoX 196650 Anchorage, AK 99519-6650 v~v.m u ni.org/onsit~ (@07) 343-7~04 OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-441-18 1. GENERAL INFORMATION Expiration Date: ' ~ - / 7 '~'// / Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MOUNTAIN PARK ESTATES; BLOCK 12, LOT 4 12641 ALPINE DRIVE *ANCHORAGE~ AK 995]6 MICHELLE LEBLANC Day phone 555-5958 12641 ALPINE DRIVE *ANCHORAGE~ AK '99516 Day phone DETTE OWENS W/ KELLER WILLIAMS Day phone 440-2515 101 W. BENSON BLVD. SUITE 505 *ANCHORAGE, AK 9950.3 UnlesS otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 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 pr0perties.served by a private 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. 4~ STATEMENT OF iNSPECTiON BY ENGINEER As cePdfied by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, s.hows that *.he 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 furt,ffer verify that based on the information obtained ~rom the Municipality of Anchorage Nes 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 GARNESS ENGINEERING GROUP, Ltd. Phone 557-6179 Address ,3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA 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 septicsystemsdependonthelocalsoilscondition, groundwaterlevelsthatmay fluctuate during the year, and the water usage of the family being se~ed by the system. These conditions are outside the control of the evaluator of the system. Satisfacto~ test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, L TD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirementsoftheADECorMOADSD. Thecontentofthisrepodisfor the sole benefit of the owner listed above. Any reliance upon or use of this roper by any other person or pa~y is not authorized, nor will it confer any legal right whatsoever. DSD SIGNATURE v Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulatio,,~ ~. Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Adv.sory (Rev. 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Legal Description: MOUNTAIN PARK ESTATES; BLOCK i12, LOT 4 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# Date completed 8/,,24/,80 Sanitary seal (Y/N). YES Total depth 360 ft. Cased to 178 ft. FROM WELL LOG Date of test 8/24/80 Static water level 145 fi. Well production 2.1 g.p.m. WATER SAMPLE RESULTS: Coliform O colonies/100 mi. Nitrate 1,61 mg./L. Other bacteda Arsenic: ND ug./L. Date of sample: 3/1/11 Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/,STEEL Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 3/,8/,11 Pumper. ABSORPTION FIELD DATA I'BE:LOW EXISTING GRADEI Date installed 7/23/90 Soil rating (g.p.d./ft2o~ 175 Length 50 ft. Width 1 6 .ft. Total depth *3.83 ft. Eft. absorption area 800 ft2 Monitoring tube YES Date of adequacy test 5/,4/,11 Results (Pass/Fail) PASS Fluid depth in absorption field before test. 3.5 in. Water added 460 gal. Elapsed Time: 320 min. Final fluid depth 4 in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN CHECKLIST Parcel ID: . 017-441-18 Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground~~in. AT INSPECTION 3/,4/,11 168 ft. 0.37 g.p.m. 0 colonies/100 mi. GEG, Ltd. Date installed 8/18/,80 Cleanouts (Y/N) YES High water alarm (Y/N) N/,A ONE STOP SERVICES System type BED Gravel below pipe 0.5 ft. Depression over field NO For 3 bedrooms New depth 7 in. 450+ g.p.d. If yes, give date - D. LIFT STATION Date installed "Pump on" level at Datum J E. in. Size in gallons Manhole/Access~ ~ "Pump off" level__at.-------fl'~'-~-. High water alarm level at Cycles tested. Meets alarm & circuit requirements? SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: '95'+ Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas 50'+ .in. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/'A Manure/animal excrete storage areas N/'A 100'+ Building foundation Water main Wells on adjacent lots SEPARATION DISTANCES FRoM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property line 5'+ N,/A Water service line. 10'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main Water service line 10'+ Curtain drain 50'+ PER REID COMMENTS *WAIVER GRANTED IN 1990. Surface water 100'-I- 1990. Wells on adjacent lots Absorption field 5'+ Surface water, 100'+ 10'+ N/'A Driveway, parking/vehicle storage 100'+ G. ENGINEER'S CERTIFICATION I 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. Engineer's Printed Name JEFFREY A. GARNESS Date ~)l~/)l COSA Fee $ ~C[~) -- Date of Payment Receipt Number (~ (Rev. 11/05) Waiver Fee $. Date of Payment Receipt Number Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci. anchorage, ak.us (907) 343-7904 Water Well Advisory Certificate of On-Site Systems Approval (COSA) # 111069 During a recent COSA on-site inspection and test of the potable water supply well on Block 12, Lot 4 of Mountain Park Estates subdivision, the well's productivity was determined to be 0.37 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3-bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. 2011-03-14 14:47 AAROW PUMP & '®'ELL 18882806416 >> Fax P 1/1 Aarow Pump & Well Service, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 · Fax (907) 333-8976 Eagle River: (907) 622-9335 NO- 08925 CUSTOMER ! JOB SITE ,'¢/,m',,,e I QUANTITY ..... D.E,,SCHi~TiON .......... PRIGE AMOUNT LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR 'WORK ORDERED BY DATE COMP, TOTAL -- __. LABOR Thank You SIGNATURE (i Hereby Acknowledge the Salisfaetory 6ompletion of the Above Described Work and agree that if above work is not paid for in 90 days I agree 1o allow Aarow Pump & Well ,~e~v)ce, L,L,C, the right to remora unpaid for oquipmcnt and charge lot labor already performed & labUl [u f~lll~Jv~ uflpald for equipment,) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1,5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS, 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.muni.orglonsite (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-441-18 1. GENERAL INFORMATION Complete legal description Expiration Date: Mountain Park Estates, BIk 12, Lot4 Location (site address or directions) 12641 Alpine Drive. Anchorage Current Property owner(s) Llnda Chang-Edwards Day phone Mailing address 12641 Alpine Dr., Anchorage. AK 99516 Lending agency Mailing address Day phone Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site I--I Public Sewer . [] The Municipality of Anchorage Development Services Department (DSD) Issues Ceraficates 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 time (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 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 emissions in the professional engineer's wonk. 4. STATEMENT OF INSPECTION BY ENGINEER As certified 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 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 Watkins Engineering. Inc. Address P.O. Box 110443, Anchorage, AK 99511-0443 Engineer's Pdnted Name Cindy W. Ellis Phone 349-1851 Date, ~-Z#'~)~ 5. DSD SIGNATURE Approved for ,-~ Disapproved. Conditional approval for bedrooms. '..... CE-,o,,, ~'. .......... bedrooms, with the fo,owing -.upu~at~ons: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other (R~v. 01R)2) Original Certificate Date: ..5' - o -0.5' Municipality of Anchorage Development Services Department 8ut~ng Safety Division On.Slta Water & Wastewatar Program 4700 8outh Oragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.munLorg/onelta (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Mountain Par~ Estates, BIo(~ 12, Lot 4 Parcel ID:. 017-441-18 A. WEII DATA Well type ifA, B, otC provide I:WVSID # - Well Log (Y/N) Y Data completed Sanitary seat (Y/N) Y VV]res properly protectad (Y/N) Y Total depth 360 It. ~ to 178 It. Casing height (above ground) 12 in. FROM W~=I I LOG ATINSPECTION Date of test 8/24/80 6/17/05 Static water level 145 It. 172 It. Well p,-c~luctlon 2.1 g.p.m. 0,33 g.p.m. WATERf~4~LE RESULTS: Coliform 0 .ccdonlas/100 mi. /Usenic: IdA mg./l. B. SEPTIC/HOMNNG TANK DATA Tank Type/Mataflel ~ Nib'ate 1.04 mg.A. Date of sample: Other bacteria 0 colonids/100 mi. ~Ofler:terl by: Watklns Engtneedng, Inc. Tank size ,1000 gal. Number of Compartments 2 FoundaUon deanout (Y/N) ~ Depression over tank (Y/N) N Data of pumping 6/17/05 Pumper Isaac's Pumping C. AB$ORPI'ION FIELD DATA Datainstafled 7/23/90 6oli rating (g.p.d./it2orit2rodrm) 175 Len~ ~0 ~ Width 16 It. Total depth 2.6 ft. Eft. absoq)tlon area 800 ~ Morn'toting tube Y Date of adequacy test 6/17/05 Results (Pass/Fell) PASS Fluid depth in abeo~3flon field before test 3.0 in. Water added 601 gal. Elapsed Time: 234 min. final fluid depth s~5 in. A.y rejuvenation treatment (past 12 mo.) (Y/N & t~e) No Date installed 6/18/80 Cleanouta (Y/N) Y 1 High water alarm (Y/N) System type bed Gravel below pipe 0.5 It. Depression over field N For 3 bedrooms Now depth 6.5 in. Abeoq~ rate >- 450 g.p.d. If yes, give data D. LIFT STATION Date Installed. NA 'Pump on" level at. In. Datum E. SEPARATION DISTANCES Size in galions "Pump off' level at. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lilt ata~on on lot ~ (wal~r In 1990) A~on field on int 120 Manhole/Access (Y/N) High water slaim level at Meets ~larm & c~ mqu/reme~s?, Public sewer maIn .100+ Sewer/septic sen4ce line ?0+ On edjscent lots. 100+ On adjacent lots too+ Public sewer manhole/oleaneut 100+ Holding tank .NA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10* Water main 100+ Wells on adjacent lots 100+ Water .Service line ~o* Curtain drain _so+ ~ L. Re~ tg;o F. COMMENTS Property line .IO* Water service line 40+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line. 10 Building foundation ..~+ Surface water Wells on adjacent lois, fiX)+ Ab~n field. 1 0+ Surface water 100+ Water main 100+ Dmsway, pae~n~m~,~e mrage ..6p+ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspect~ns and review of Munldpe/ mcerds that the above sj~tems ere in conformance with MOA HAA guidelines in efi~ct on this date. Engineers Printed Name, Cindy W. Ellis Date 8/24/05 Date of Payment ~ Receipt Number (Rev. 12./01) Waiver Fee $., Date of Paymem. Receipt Number EIIII CE. loa;? Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci .anchorage.ak .us (907) 343-7904 Water Well Advisory, Health Authority Approval # 050416 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 12, Lot 4 of Mountain Park Estates subdivision, the well's productivity was determined to be 0.33 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3-bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. ASBUlLT-NO CORNERS SET THIS CATE. SEWARD & ASSOCIATES LAND SURVEYING 69~,-0~2' I HEREBY CERTIFY .THAT I HAVE SURVEYEC THE SCALE, _'"~?~._~,'~"~'~',~C ~ ~/~ DATE, ~ / ' E~EMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT ~PEAR ON THE RE~D~ ~BDI- VISION P~T. UND~ NO ClROUMSTANCES S~ FB: ~-~7 _ ~ .. ...... .. . ~Y DATA H~EON BE USED FOR CONSTRU~ION OF FENCE LIN~, OR FOR E~LISHING ~ND- - DRAWN~ - ARY LINES. . ~/ ~%~ ' Parcel I.D.# MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 1'96650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING rlCIPALITY OF ~,NCHORAGE NMENTAL $~RVICE,S DIVISION JUL 2 6 1996 RECEIVED 1. GENERAL INFORMATION Complete legal description Lot 4; e.~.oc,'~ 12; ~' ' ' ;"' -* "~"''~ Location (site address or directions) Property owner Mailing address Lending agency Mailing address 2c,t 1 :,..,..px_~'~.e griv;? 12641 /,Zpi~.:(' D;~,".v¢ ,.;,~Lch. o.'zaq e ¢ AK Day phone Day phone Agent Jac% Blair/ ?,e/,~a;c Proper.feCes Address Day phone ,..,'~r:7-0159 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. ordinances, and regulations in effect on the date of this inspection. Name of Firm S & $ ENGINEERING -' '~7~54 E,~I~ R;,~, L,,,,~ ~,,~a~ N,,. 2.8.4 Address Eagle River, Alaska 99577 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, Approved for 3 Disapproved. Conditional approval for bedrooms. DHHS SIGNATURE Phone bedrooms, with the following stipulations: Additional Comments Date ~-/E" -,/0~-'''- 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 DH HS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1191) Back MOA #21 Municipality of Anchorage Environmental Services Division ·.~v~/~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744~/UL Health Authority Approval Checklist ~CE! t/ED Parcel I.D.: ~ / '7 - ~/~/-/ A. WELL DATA Well type Log present (~/N) Total depth Sanitary seal If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to l '-/~ 8f~ Casing height (above ground) Wires properly protected ~/N) Date of test Static water level Well production FROM WELL LOG I'~ ~'o AT INSPECTION / ' ? / ' ¢~ '/' g.p.m. ~)" ¢q- g.p.m. WATER SAMPLE RESULTS: Coliform O Nitrate Date of sample: rS / ~ f~ / ~ ~' Collected by: B. ~HOLDING TANK DATA Date installed ~//~///¢~0 Tank size. ¢--2 L ~/t~',/~ ~, Foundation cleanout (Y/N)~/¢ '¢4'~'~'~¢/* ~/~epression ~'~,~ Date of Pum'~ing S-/~I/Ci(¢ Pumper ! C. ABSORPTION FIELD DATA Date ineta,ed '7 :, Soil rating (g.p.d./ft' Length. ~'-' O Width EffectiVe absorption area ~ o o Date of adequacy test.' (o / 7- Other bacteria d S & S ENGINEERING 1~'0;~4 Eagle ;iv,,' L.c.,.;p Rc=~ H"-. 204 Eagle River, Alaska 99577 Number of Compartments ;;L Cleanouts ¢,)N).__ )¢Z~ High water alarm (Y~,~ ,),j o / '7 ~ System type }~ Gravel thickness below pipe 0, '-¢' Total depth Monitoring Tube present (~,7/N) ~£,¢Depression over field (Y/(~ Results~Fail) p ,4-,~ For Fluid depth in absorption field before test (in.); /~/ _ Immediately after t/~-~/gal, water added (in.): Fluid depth ~ ~ ~¥ (ins) Minutes later: ~" //¥ Absorption rate = ~-) ~;"'~ 4- g.p.d. Peroxide treatment (past 12 months) (Y/N) /v ~ ,¢ ~ ~v ~ ~,w If yes, give date '~' bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed r Size in gallons High water alarm level at* ~ *Datum Cycles ie:C[e--~- E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ~holding tank on lot ~ ~'- / PO '-'/- Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM{S~,..~HOLDING TANK ON LOTTO: / ~ Foundation ~O Property line I0 '-? Absorption field Water main/service line ~ 5- y' Surface water/drainage / ¢ o Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line / ~ , Building foundation &~ o Water main/service line Surface water / 00 Driveway, parking/vehicle storage area "¢ ~'~ ~c ~4,v ~. ~ Wells on adjacent lots 1o~ Curtain drain ENGINEER'S CERTIFIcATIoN in conformance with MOA NAA .quideli~es in effect on this date ,¢ .,~ _ ..f _~/ , ,~-¢..~ .,,,,-- X',.,,.,~ ,¢. ~. . ~ A -'".,~ Signature ~/~ ~ ~~ ~:, ~ %~ ' Engineer's Name [(O ¢~ ~ (, ( ¢ ~4/¢ HAAFee $ ~.,, ~t~ of Receipt Number O(~//2 ~'~//"~ ~ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE M E M 0 R A N D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO.~0~/6 During a recent Heaztn ~u=horlty A~prova! on-site inspection and test of t~e potable water supply well on Lot ~ Bloc]< /~ .. of ~/,~ ~R~ ~f~5 Subdivision, the well's productivity was determined to be .~ gallons per minute. The minimum well productivity required by this Department (.AMC 15.55) for a ~ bedroom residence is .~/ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. <~ CLIENT: ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. i-~EALT H AUTHORITY APPROVALS SEWER & WATER MAIN E~TENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN WELL RECOVERY TEST DATA CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 WELL LOCATION (legal): TEST DATE: -/ / ~ $¢ / WELL DEPTH: 13(~o CASING DEPTH: ~/ TESTED BY: WELL DRILLER: DATE DRILLED: TEST PROCEDURE: 1) Draw water down to pump, 2) Shut pump off 15-60 min. -record time -record meter reading 3) Turn pump on. Drawdown, 4) Shut pump off. -record time -record meter reading 5) Calculate gal./min, recovery. TEST DATA: START TIME: MISC DATA: Casing Height: Sanitary Seal? Wires in Conduit? Grading O.K.? Pump Depth: Samples Taken? Date: STATIC WATER LEVEL: / 6 / TRIAL II,PuMP II TIME II II GAL/MIN. OFF OFF OFF 2 ON OFF /~,~0~,~ OFF o . OFF OFF OFF OFF 5 ON OFF RESULTS: WELL CURRENTLY PRODUCES: FLOW RA'TE NOT GUARANTEED--SUBSEQUENT VARIATIONS CAN OCCUR. 17034 NORTH EAGLE RIVER LOOP ° SUITE 204 ' EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE Department o! Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcell. D.#_~'~.--~_ L~,- \O~ HAA# ~'\~'/ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 4; Bloc~ 12; Mountain Parr Estates Location (address or directions) 12641 Alpine Drive N08), (b) Property owner -F~.&d ~ ~ry ~cw,L*..~-,~c~m.£&~ Telephone: (home) 256-7506 Mailing Address _ S~n Jose, (c) Lending Institution Telephone Business Mailing Address (d) Real Estate Company and Agent _ ERA Address-- ?70? ¢~mhc. ZZ .%,¢i~ ~¢00 A~o~, Telephone _ ~7~-~77~ (e) Mail the HAA to the following address: (or check here ~if hold for pick up.) List contact person and day phone number below: ATTN~ E~Jo F~a~bgJ~ $ & $ ENGINEERING 17034-E:.3!c R~e~J,~~tl.4- Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Family E~X Number of bedrooms 3. WATER SUPPLY Individual Well,~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site [~X Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. ;'/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, l verify that my investigation of this Health Authority Approval 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. Telephone ~/~z/g'._--~. ~2 ~' Name of Firms & 5 5.N~NF?~ING 17034 Eagle Ri~er Loop Road No. 204 Address .... ~... &l.¢k&99577 Date 6. DHHS APPROVAL Approved for ~ Approved ~ Disapproved _ Conditional Date Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services(DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph S 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 DHHSdo 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 eng'neer s work, 72-025 (Rev. 7/88) 13acx Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) UNK::i PALIG'HE~,I~,q/~r= E B R U A R Y 1984 1ENvIRONM~NTA~ SrzRVlC£S ~'¢,JG 2 ]- 1~)90 Legal Description: A. DATA R E C E I V E i) Well Classification I I~-~¢) \ N/ ~ ~ Well Log Present(~:::~N)/~ Date Completed \ ~ Total Depth''''"~;'~' Cased to /~ ~ Depth of Grouting ! Static Water Level / (.r~ ~ Pump Set At If A, B, C, D.E.C. Approved (Y/N) /'-- Yield "~..-¢:~ 4~ 1~ Casing Height Above Ground Electrical Wiring in Conduit(CC)N) SEPARATION DISTANCES FROM WELL: -Fo Septic/Holding Tank on Lot -Fo Nearest Edge of Absorption Field or) Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments 'uh'¢ ~ Sanitary Seal on Casing4:~C:N) "¢ Depression Around Wellhead (Y,/~ eJ I ;On Adjoining Lots \ ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ~/f~ ~ ~ % ~' ; Date ~ -I~f"'-~'[ B. SEPTIC/HOLDING TANK DATA Date Installed~='' ~ ~' E~ Size Standpipesd~N) ~ Depression over Tank (Y¢_.I~-~ Pumping/Maintenance Contact on File (Y/N) / Holding Tank High-Water Alarm (Y/N) ~/'~ Air-tight No. of Compartments ~ Foundation Cleanout ~(:~N) /l~,Date Last Pumped ¢ t ;for Temporary Holding Tank Permit (Y/N) t4/,~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well 5~ 4::~ To Building Foundation '1-o Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments To Disposal Field 72-026 (Rev. 7/88) Fronl Page 1 of 2 ~"~ '=~/I~¢,.~- Type of System Design C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed '"7-'~-'¢~- ~c::~ Width of Field ~l~=,~ Length of Field Depth of Field Gravel Bed Thickness ~,~" Square Feet of Absortion Area ~ ~ Statndpipes Present Depression over Field (Y¢.I~;]~ r-.& Date of Last Adequacy Test Results of Last Adequacy Test ~,~t/~ ~-.~ ~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well / To Building Foundation / Lot ~ ~ To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ~ I To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutback (if present) Comments D. LIFT STATION Date~ ,,S, ize:l .n_ G~I,.,o, T~-._~ Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ~__ Vent (Y/N) ~"'--~'---.~L.mping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect inspection. S 8, S p;i',iGIN~.ERING Signed 17034, ha{lie i~iver Looi3 ~Oa~ NO~ ~ Company E=91a River, Alaska 99577 Receipt No. Date of Payment Amount: $ 72-026 (Rev 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 BSTREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT BY SAWPLE for Work Order ! 26385 Date Repext Printed: AUG 16 90 @ 09:57 Client Sample ID:L4 EL2 NTN PARK EST. PWSID :UA Collected AUG 14 90 ~ lO:O0 hrs. Received AUG 14 90 @ 10:45 hrs. Preserved with :AS REQUIRED Client Name : $ ~ 8 ENGINEERING Client Acct: SNSENGP P.O.$ NONE RECEIVED Req ~ Ordered By : R, SHAEER Analysis Completed :AUG 15 90 Send Repoxts to: Laboratory Suporvi~o~ :DTEPHEN C. EDE l)S & S ENGINEERING Relea, ed Er: 2) Special FAX RESULTS UPON CO~LETION TO 694-1211. Irmtzuet: Chemlab Ref $: 903021 Lab Smpl ID: 1 Natxix: WATER Allowable Parameter Teated Result Units Method Limits NITRATE-N 0.72 ~/1 EPA 353.2 10 Sample ROUTINE SA~LE~ Remarks: SAMPLE COLLECTED BY RES, Testa Performed ' See Special Instructions Above UA-Unavailable None Detected *' See Sample Rezmrks Above Not Analyzed LT-Leas Than, GT~Greater Than Tom Fink, Mayor unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O, Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 28, 1990 Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 4 Block 12 Mountain Park Estates S/D Waiver Request ~WR900030, PID ~017-44t-18 HA900347 Dear Mr. Shafer: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 95 feet from private well to septic tank. 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 G. Roth Civil Engineer On-site Services Con ur: ~~ Program Manage On-site Services ljm:#6 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN August 21, 1990 ROBERT SHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION RECE!vEE) Mu~ci~ality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 4; Block 12; Mountain Park Estates Request you issue the attached Health Authority Approval and grant a waiver for the horizontal separation distance between the private well and the septic tank located on the referenced property at a distance of 95 ft. The septic tank was installed in August of 1980 while the well was drilled subsequent to the septic tank installation. The septic leachfield was upgraded in August 1982 and then again in July 1990, however, the location of the septic tank was unchanged. A risk analysis was performed using the State of Alaska, Department of Environmental Conservation Separation Distance Waiver Guidelines. Our resets are as follows: A. WATER TABLE: From the well log for the referenced property, water was first encountered at 178 ft. deep. This ~eaves a separation distance b~tween the septic tank and the water table of approximately 170 ft. = 7.4pts. B. SOIL SORPTION: From the soils log used in the most recent upgrade of the leachfield the receiving soils below the leachfield are silts with fine sand mixed (ML). From the well log there appears to be ~ayers of differing sodas separating the septic tank and the water table. Most of these soils appear to have a fair clay content. Use "clay and sand", however, there is a silty receiving soil with gravel included. = 4.0 pts. C. PERMEABILITY: With the soils as described above use "silt or sandy clay".= 2.0pts. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Lot 4; Block 12; Mountain Park Estates August 21, 1990 D. WATER TABLE GRADIENT: Since this well draws water from within the bedrock, the slope of the bedrock should be used as the hydraulic gradient. In examining well logs from surrounding properties it appears the bedrock tends to follow the contour of the land. In this case, the land slopes slightly from the septic tank toward the well at approximately 5%. However, in assuming the worse case, use 60% = 0 pts. E. HORIZONTAL SEPARATION: The horizont~ separation between the septic tank and the well is 95ft. = 2.8pts. TOTAL POINTS = 16.2 Therefore, d~ appears that "No bacterialogical pollution possible, but chemical pollution possible but unlikely from household chemicals." Other mitigating factors involved which support the issuance of the waiver are as follows: I. Only the septic tank is within the 100 ft. protective well radius. Generally speaking, septic tanks should not be considered a "continuous" source of contamination as would a leachfield. 2. The well log shows several layers of soil including a "Hardpan" which would detour the migration of septic effluent from the septic tank to the drinking water aquifer. 3. The house is located between the septic tank and the well (perhaps explaining the encroachment due to difficulties in measurement). This would alleviate any surface overflow from the septic tank from reaching the well casing. It is our opinion that the horizontal separation distance prescribed by 18AAC72.021 is not required in this case. Attached for your review are the following documents: A. A site plan developed by Leroy C. Reid, Jr., P.E. showing the well to septic tank separation distance encroachment. B. Satisfactory coliform bacteria and nitrate analysis results taken from the referenced well. C. A copy of the soil log used in the recent design of the leachfield upgrade. Page Three Lot 4; Block 12; Mountain Park Estates August 21, 1990 D. A copy of the well log for the referenced well. If you have any questions, or if you require additional information for your review, please contact us. S/gm APPLIC ~IT FILLS OUT UPPER HAL 3NLY Prop. srly Owner Buyer Phone Lending Institution Address ("r2't Realty CO. & Agent Address Zip Code Zip Code Street Locati~ (--~. ./} ~ ~ "-'"' ' ~ '~ 'rype of Residence - // ' ~ 1~_ Single Family .--/, [] Multiple Family No. of Bedrooms E] Other Zip Code Phone Phone Water Supply  .i Individual ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach Icg if available). [] Public Utility Sewer Disposal - h'~dividual Public Utility [] Holding Tank Year Individual Installed: ~,/'("~ When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Date Date Date Date Inspector Inspector Inspector Inspector.-,,, Field Notes: ~'_~ MUNICIPALI~ ANCHORAGE OF CCT 7 !982 ('~ ) APPROVED BEDROOMS "CONDITIONS OF APPROVAL ( ) .~SA.PROWD ( ) CONDIT[ONA~ AP~OVAL' DATEI 0 ~J I~ Soils Rating Date ~wer Installed Well To Absorption Ares Well Log Received ~ ~ Well to Tank Septic T~k Size 72-023 (3182) NIUNICIPALITY OF ANCNORAGE ENVIRONMENTAL ENGINEERING DIVISION DEPT. C? : :, & Telephone 264-4720 ENVIRONM~t,i i,.: ,2CTION REQUEST FOR APPROVAL OF INDIVIDUAL. WATER AND SEWE~.'. ,~A~31LI;~hF~S DIRECTIONS: Complete all parts on Pa9e 1. Incomplete requests will not bo processed. Please allow t0nR0~i~s~rlp~q[~]i~ MAILING ADDRESS PROPERTY RESIDENT {If different from above) 2, BUYER MAILING ADDRESS 3. LENDINGINSTIT~UTION ,,. ,/~ I PHONE MAIUNG ADDRESS 4. REAL~OR/AG ENT MAILING ADDRESS ....... 5, LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE --NUMBER OF OEDROOMS " [~ SINGLE FAMILY [] MULTIPLE FAbll LY WATER SUPPLY [~] One ~J Four ,r_~ Two [-_-] Five ,~.~q, Three [.._~ Six [7_~ Other INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY · ATTACH WELL LOG. A well log is lequi~ed for all ,/:ells drilled since June 1975. For wells drilled prior to that date, give well (iepth (attach log if available.) 8, SEWAGE DISPOSAL SYSTEM ~-~' INDIVIDUAL/ON-SITE'* [~] PUBLIC LJ'rl LITY **If individual/on-site, give instaltation date ., If system is over two (2) years old an adeqLJacy test is required by this Del'~artmenl. NOTE: TlaE INSPECTION FEE MUST ACCOMPANY EACH REQ(JEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78)