HomeMy WebLinkAboutPREUSS #4 BLK 7 LT 2 Municipality of Anchorage Page ' DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~'b.) ~,C~ 0 15~} PID Number: C)~O-- Name: .~ ~ ~./q~ E~,~ Wastewater System: ~New ~ Upgrade Address: ~~ ~;~~ ~ ~e~j~il ABSORPTION FIELD Phone:~ '7~'-~/~7 . No. of Bedrooms:~ ~ Deep Trench D Shallow Trench DBed DMound DOther LEGAL DESCRIPTION So,lRating: 0~6' GPD/Sq. Ft. Total Depthfromoriginalgrad~:), Lot: ~ Block:7 Subdiv~ion: -- Depth to pipe bo.om from original grade: Gravel depth beneath pipe~ ~ Township: IRange: ISection: Filladdedaboveoriginalgrade:o.&~ -- ~ Ft. Gravellength: WELL: U New C Upg Gravelw~dth: ~' Ft. I~t Ft. lassification(Private, A,B,C); ~ Cased To: Total absorption are~ Pipe materiah Driller: ~ Date Drilled: Static Water Level:Ft. Inst.:/~''~xC~Ti~J~ /, Date installed:; ~/ Yie,d: ~ I ,um~ S,~ at: C~,~n, Hei,~*bov~ ~o,,d: TAN K ~ GPM I Ft. Ft. SEPARATION DISTANCES ~Septic D Ho~ding ~ S.T.E.P. TO Septic Absorption Lift Holding Public/Private Manufacturer: ~ ~ Capacity in gallons: From Tank Field Station Tank Sewer Lines ~~ {~ [~[~ Material: ~/ Number of Compa~ments: ~ Wel~ .... SudaCewater ~0'~ ~O~t~ L~Fm STATION Line .~0~ ~ Size in gallo~s: Manufacturer: Gu~ainDrain '~ ~ ~ ~ ~0~ ~ ~ ~ ~ ~ Electrical Inspoction~ p*~orm~d ~y: Remarks: ~Pt'r,o,~'~c ~.~ c r~r7 BENCH MARK Location and Description: ~0~ ~ ~10~4 E.Ob ~iv~r Loop ~o~d, N~, ~ ~.._~..],;~..~,,,,.~...~,~ ..... ~nspections pe~ormed by: ~.m~.r,~k.~ ..... Dates: ~st ~-1 ~_~o/ ~-~..~ ~ ~t~ Department of Health and Human Se~ices approval · ,~:,.%.. Reviewed and approved by~~ ~ ~~ate: ~' ~ '~? ',~,.,c;;,_ 72-013 (Rev. 9/91) MOA 25 ~'~,EMIT '~0. SW990150 PAGE 2 . Mun~i._cip.~_~iC.y__o.F Anchor'~Qe DEPARTHEN/ oh H~AL/H AND HUI~AN SERVICES ENVIRONMENTAL SERVICES DIVISION p,FI, Box 196650 oAnchoea©e, Alaska 99519-6650eTeleohone, 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~.~.aAL LOT 2, BLOCK 7, PREUSS S/D #4 P.I.D. NO. 050-572-38 LOT 1 II LOT 6 I I ' I I ~> ~ LOT 7 o lO0' k/ELL R~DIUS_~. [~~[ I ~ I I LOT 8 ~ I ~~/.,.~...,~...: I I PERMIT NO. SW990150 PAGE 5 OF 5 Hunicip, 9Li~. y_o. F Anchoroee DEPARTMENT OF HP_AL/H AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,E], Box 196650 ®Anchorage, AL~sk~ 99519-6650·Te[ephone, 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAL LOT 2, BLOCK 7, PREUSS S/D #4 P.I.~}. NO. 050-572-58 ST1 ST2 /FINAL 100.9' --~ "NEW "~-~4 1000 GAL SEPTIC .0' TANK GRADE A B FCO 8.0' 24.0' ST1 37.0' 35.5' ST2 43.0' 40.0' DBL1 44.5' 41.0' DBL2 45.5' 42.0' DV 47.5' 44.0' C01 27.5' 50.0' C02 80.5' 73.0' MT1 28.0' 49.5' MT2 78.5' 71.5' MT3 95.0' 71.0' COl=lO0.1' 2= 1015'. FINAL GRADE MT1 =88.5' MT2=88.6' C01 =94.0' CO2=94.0' · NO WATER FOUND 82.5' B.O.H. ~f-,V~, ............. :."... L%~ ~ ~ ~ ROBERT C. COWAN /,~ ~ LEGAL DESCRIPTION: ~r2; ~¢/K ~;~/s~Township, Range, Section: SLOPE SITE PLAN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 2 3 4 8 10 It 12 ~3 14 17 20 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ..,..,./ OL DEPTH? p E Deplh to Waler A,er .../ /~//,~/~ Monitoring? Date: Gross Net Depth to Net Reading Date Time Time Water Drop ,/,c/9+ o - - .30 3o~m 7'/4" I V4" PERCOLATION RATE ~- ~Z TEST RUN BETWEEN 5 __ (minutes/inch) PERC HOLE DIAMETER _ FT AND "7Z- FT 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 18, 1999 Expiration Date: Jun 17, 2000 Permit Number: SW990150 Legal Description: PREUSS CfA BLK 7 LT 2 Design Engineer: 0003 S & S Engineering Owner Name: Marsha Buck Owner Address: 8445 KIMBERLY STREET JUNEAU , AK 99801-9161 Parcel ID: 050-572-38 Site Address: 010227 WERN LN Lot Size: 19600 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field r~ SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL PERCOLATION TEST/SOILS TEST AT THE WEST END OF THE PROPOSED ABSORPTION TRENCH. Received BV~'-"~'-'---'- Issued By: 825 "L" Street Rick Mystrom. P.O. Box 196650 Anchorage. Alaska 99519-6650 Mayor http://www.ci.anchorage.ak.us June 21, 1999 Robert C Cowan, PE S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 2 Block 7 Preuss #4 Waiver Request #WR990033 Parcel ID #050-572-38 SW990150 Dear Mr. Cowan: Your request for a waiver of the required 10 feet horizontal separation from the on-site wastewater disposal system to property line has been approved. The approved separation distance is 1.0 feet. This separation waiver pertains to the new leachfield and north property line.. This waiver approval applies to the existing on-sitewastewater disposal system to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~[,>~(h~%[~ PID~ 050-572-38 HA~ Date Received: June 9, 1999 Legal Description: Lot 2 Block 7 Preuss #4 Engineer: Applicant: Robert C Cowan, PE, S & S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River, Alaska 99577 Marsha Buck Wai, ver Requested: leachfield (new) Lot line waiver of 1 foot from the north property line to the Criteria: 1. Geology: Points: A. Water Table B. Soil sorption c. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: ~F~ f~6/~f£~ ~£~ Date: ~--/~-?~ By: /~ Amount: $ 115o00 Rec ~: 04919/5212 Name of Reviewer Date Paid: 6-9-99 HEALTH ALffHORITY APPROVN_S SEWER &WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERINGSTUDIES ANOREPORTS WELLINSPECTION &FLOWTEST SITE PLANS ROAD DESIGN SOILTEST PEROOLATION TEST STRUOTUFiAL& MECHANICAL INSPECTION~ ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, P.E. June 7, 1999 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 2, Block 7, Preuss Subdivision Request you issue a permit to install a septic system to serve the existing three bedroom dwelling on the refere.,n, ced prope~,r~; One test hole was excavated and percolation tests performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation, 5-28-99 water was not found. After seven days of ground water monitoring the monitoring tube was dry. We do not anticipate any adverse effects on neighboring wells, septic systems, reserye areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/bjj Enclosure JUN 09 1999 ,v~uNICIPALITY OF ANCHORAGE :~qViRONMENTAL SERVICES DIVISION 17034 NORTH EAGLE RIVER LOOP ~ SUITE 204 * EAGLE RIVER. ALASKA 99577 ~O 1" = 40' DESIGN SITE-PLAN SCALE ' .... ' ~0' UTZL~TY EASEBENT }0' UTZL~TY EASBHENT Municipality of Anchorage. DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 2 3 ~.~ 4 7 g 10 13 14 15 17 18- 19- 20- ..... Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT ~ O DEPTH? p E Depth to Water After, Monitoring? .},.~ y Date: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE o~ '7 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ? FT COMMENTS PERFORMED BY: '~70~4 Eag;e ~iver Loop [~oad No. 2~ I ,_ . CERTIFY THAT THiS TEST WAS PERFORMED IN ACCORDANCE WIF~~O~AL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ /~ / ~ 72-008 (Rev. 4/85) . 't? . MAI LING ADDRESS LEGAL DESCRIPTION I DISTANCE TO: ~./6 'T ~ ~ I Manufacturer ~ "Liq/a~ ~ ~allons IF HOMEMADE W dth ~ ~ ~ Manufacturer /C I I ~ ~ Top of ti e ~ finish grade I Length Width ~ ~ Type of crib Crib diamet~ / ~ Well ~ ~ DISTANCE TO: ~ ~ D~STANCE TO Building foundation ~'~/ MUNICIPALITY OF ANCFIORAGE '~._..: 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 Inside length Dwelling I Material FO u nd. ation~:~ /~.~ Total le3t~h ~line,~,/. Trenc.~width t( · -- "- I ~-~ O inches Material beneath.tile ~ Depth Crib depth Building foundation Driller Sewer Hne Septic tank OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS APPROV, ED / / / // l/ ~', 72-013 (Rev. 3178] DATE LEGAL NO, OF BEDROOMS No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERiVLLTNQ. ~ d ' ~,~ ~ D i st a'n c e b~e o?~ n~s/~. Total effective a'b~sorption, area/' Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Absorption area(s) ~ & S Eng/neering PERMIT NO. DEPARTMENT ' HEALTH AND ENVIRONMENTAL OTECTION ,=,.=.._, STREET., RNCHORAQE., AK. '-99~.¢.,'1 264-4720 ( 8r"104_-',.'i ) APPLICANT LOCATION LEGAL ERIC:KSON¢S BACKHOE EAGLE RIVER L2 B? PRUESS SR BOX D0~0 CHUGIAK LOT SIZE 688-3280 22000 SQURRE FEET TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [)EF'T~-I= :L ~--~ LF~-~L3TH= 5~:-] ~3 F..' R '-.." E L C¢EPTH= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES.- THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVRTE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE T~PE OF PUBLIC WELL MINIMUM DISTRNCE FROM A PRIVRTE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS RRE RVRILRBLE TO INSURE PROPER INSTALLATION. F'EF:~"I I: T E:=-::F' '~' F:EL--]. [:.ECE~'-IE:EF:~: _---:-"- ::L .. I CERTIFY THAT t: I RM FRMILtRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I HILL INSTALL THE SYSTEM IN RCCORDRNCE WITH THE CODES: 3:: I UNDERSTFIND THAT THE ON-SITE SEWER S'¢STEM MRY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. .......... PERFORMED FOR:_ .LEGAL DESCRIPTION:-__ 1 2 3 4 5 7- 8 9 .~....~10" 11 12 13 14 15- 16- 17- 18 19 2O COMMENTS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-S50. Anchorage. Alaska 99502 276-222~' · , SOILS LOG -- PERCOLATION TEsT Rob~:r t A. No. 1457-~ SLOPE 72-003 {7/76) PERCOLATION TEST DATE PERFORMED: "~ ' · ) ENCOUNTERED? O~ IF YES. AT WHAT Gross Net Depth to Net Reading Date Time Time Water Drop ~ERCOLATION RATE TEST RUN BE~EEN ~ FT AND KIND OF FORMATION: From Ft.' to From Ft. to `-� Ft. Ft. 'to From �= t Ft. to� Ft.'to Ft. ✓ From ° ' Ft. to L� Q Ft. ` From 2`` Ft. to Ft. Ft From Ft. to f is ` Ft. From " � Ft. to r.- 9k Ft. r* r -1 r From L •la Ft. to 0I I Ft. V From i'. ? i Ft. to • Ft. v 4 ; From I`Q. Ft. to _03 Ft. a4 Ft. to From - Ft. to Ft. to Ft. /vi t X E From -'i '� Ft. to a Ft. From "> Ft. to } ? Ft. {75 From 2 j. Ft. to--a/—Ft. S ri From Ft. to Ft. From 91 Ft. to q�I0 Ft. From 7i,-.1 Ft. to - u a Ft. From Ft. to Ft. t. to Ft. t. to Ft. From Ft. to Ft From Ft.' to Ft. From Ft. 'to Ft.' �= t From Ft.'to Ft: From Ft. to Ft 41JFrom ,u Ft. to Ft From Ft. to Ft. From Ft. 'to Ft. -' From Ft. to Ft. C4 41 From Ft.'to Ft. From Ft.-to—Ft. From Ft. to Ft. From Ft. to Ft. �^ —�-- From Ft. to Ft. ' From Ft_ to Ft t. to Ft. t. to Ft. From Ft. to Ft Certificate of On -Site Systems Approval Parcel I.D. 050-572-38 Legal description PREUSS #4 BLK 7 LT 2 Site address 10227 WREN LN Eagle River AK Current property owner(s) O'ROURKE Expiration Date: 4/11 /2025 X The On -site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: c Original Certificate Date: 5/24/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 {���jj �{'" {� ,(9; fir+ F'J��� L7 � G �i"�r" p ez��. ¢7 PA L e �5:.� Y �+�� E-^ ANCHORAGE ryL � .l Development Services Department w Rhone: 907-34-3-7904 On -Site Water & Wastewater Section � � Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-572-38 Complete legal description PREUSS #4; BLOCK 7, LOT 2 Location (site address) 10227 WREN LANE, EAGLE RIVER, AK 99577 Current property owners) HUNTER O'ROURKE 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 1-254-368-0861 3. TYPE OF WATER SUPPLY: a Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age <25 - See advisory if steel older than ZO years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed H Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $`, Waiver Fee $ Date of Payment S/2.0 17-4- Date of Payment COSA #%C? 46 l I Lo�' Waiver # sec � p0835C� COSA Application June 2022 DA 5-/ 1( /? "` COSA Checklist Legal Description: PREUSS #4; BLOCK 7, LOT 2 Parcel ID: 050-572-38 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA 9 Well log is filed with Onsite (or attached) Well production at time of test *3•6 gpm Date drilled 9/18/1980 Total depth 397 ft Water storage tank volume N/A gallons Cased to LINK ft Well disinfected for coliform test? ME Sanitary seal is functioning correctly 0 Coliform bacteria is Negative UNKNOWN M■ Wires are properly protected Nitrate mg/L ■N Nitrate less than MRL (ND) Casing height (above ground) 18+ in. Arsenic ug/L 0■ Arsenic less than MRL (ND) Date of flow test for COSA 4/23/2024 Collected by ARCTERRA CONSULTING Static water level at beginning of test **354.3 ft Date 4/11/2024 Comments *WELL FLOW TEST PERFORMED BY ARCTERRA CONSULTING (SEE ATTACHED REPORT). **GEG STATIC WATER LEVEL ON 5/16/2024. B. TANK DATA T STATION Measured operating fluid level in septic tank 515750" ❑ Require tenance Date of pumping 4/22/2024 Age of lift station ❑ Required maintenance completed, if AWWTS Lift station al Comments: D. ABSORPTION FIELD DATA *DATA BELOW IS FOR 1980 DRAINFIELD. Which system tested (date installed) *8/29/1980 Adequacy test date *5/10/2024 W ALL standpipes present per record drawing Total measured depth from grade *10.7 ft (max) Measured depth to pipe invert from grade *5.7 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. X Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 965 gallons 5/10/2024 date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Results Pass Fluid depth prior to test *39 in Water added 944 gal New fluid depth *41.5 in Elapsed time 120 min Final fluid depth *26.5 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) *60 in Effective depth used *26.5 in Effective depth remaining *33.5 in Comments/Deficiencies: *TESTED 1980 DRAINFIELD. PER ARCTERRA REPORT, 1980 DRAINFIELD WAS IN USE UNTIL 4/16/2024. PERFORMED 965 GALLON PRESOAK ON 5110/2024. PRIOR TO PRESOAK, TRENCH HAD 4.5" OF LIQUID IN IT, COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ❑i Yes if No ft FM1 Yes if No ft Neighboring Tank > 100' ❑■ Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' QYes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50, Q Yes if No ft ❑i Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑■ Yes if No ft ❑■ Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' R Yes if No ft Tank to Property Line > 5' ❑■ Yes if No ft Field to Property Line > 10' ❑ Yes if No *51 ft Water Main > 10' FC Yes if No ft Water Service Line > 10' [j] Yes if No ft F. ENGINEER'S COMMENTS Wells on Adjacent Lots: Private Wells > 100' 51 Yes if No Community Wells > 200' 0 Yes if No If tank or field is under driveway comment below *V LOT LINE WAIVER GRANTED FOR 1999 DRAINFIELD. 1999 TRENCH IS IN FAILURE. PER ARM SEPTIC SERVICES, THE DOUBLE CLEANOUTS WERE WERE REPLACED AND SPUTTER STANDPIPE STAIGHTENED OUT AND THE 1980 DRAINFIELD LINE WAS EXCAVATED, JETTED ALL THE WAY BACK TO THE SPLITTER, AND REPAIRED. THE ENITRE SEWER LINE FROM SPLITTER TO THE 1980 DRAINFIELD CLEANOUT WAS CAMERAED AND FOUND TO BE FUNCTIONAL. ft ft G. CERTIFICATION & 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, indicates that the on -site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineering Group LTD. (GEG) Phone 907-337-6179 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 �obo���0 practices. The reported results describe the condition of the system/s on the date/s of the evaluation. to identifiable features. Hidden defects or encroachments may o O F 0� o C op Separation distances were measured readily life septic systems depend o • S Q exist that were not identified during the evaluation. The operational of all wells and levels (that may fluctuate . upon a variety of variables, including (but not limited to) soil conditions, groundwater the of the family utilizing during the year), quality of construction (materials and workmanship), and water usage the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not 0• • . • • •I• r • • -• • • . • • guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding 1 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 J frey rness:' QQ ' 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 . CE 795 I Q s 7 ��G �4rP�Pf (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. • LICENSE4 aprofess,c) ���Op�o�o COSA Checklist —June 2022 #AECC8U MUNICIPALITY F ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT `I i '� 907-343-7904 On -Site Water and Wastewater Section �R Fax: 343-7997 www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 2 Y 11 Y g Subdivision: Preuss #4 Block 7 Lot 2 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this COSA / property iS Uyears old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16-year-old septic tank. 04 RCPTER�� ARc T irmRA CONSULTING INC 20441 Ptarmigan Blvd Eagle River, AK 99577 Office (907) 868-3791 Fax (907) 868-3793 April 29, 2024 Hunter O'Rourke 10227 Wren Lane Eagle River, AK 99577 RE: PREUSS SUBD. #4 BLOCK 7 LOT 2 ON -SITE WELL & SEPTIC SYSTEM INSPECTION Per your request, we have inspected the on -site water and wastewater systems of the above referenced 3-bedroom property. This investigation was based on observations of the day in which the septic adequacy and well flow tests were performed and according to available Municipality of Anchorage (MOA) record documents. This is to certify that as of the date of this letter, the subject on -site well appears to meet or exceed minimum state and municipal requirements. The on -site septic system field failed to absorb the required volume of water to meet minimum MOA requirements for a COSA. Record on -site wastewater documents were found at the Municipality of Anchorage (MOA). Those records show the septic system consists of a 1000-gallon steel septic tank with a diverter valve between two separate septic trenches: trench 91 is 63' long x 5' wide x 3.0' effective depth per MOA records and was approved in 1983, while trench 92 is 69' long x 2.5' wide x 5.5' effective depth (with available monitoring of 5.25') was installed in 1999. The tank effluent was directed to the 1983 held when we made our first inspection on 4/ 16/24 and we found effluent standing in the post tank cleanouts. Although the original design and subsequent COSA in 1985 showed a CO/MT during our inspection we found no visible pipes for the 1983 trench which would allow us to conduct an adequacy test. Based on these observations on April 16" we switched the diverter, thereby diverting effluent to the 1999 field. We did not observe a drop in the post tank cleanouts at that time. This may indicate that settlement has occurred post tank and before the diverter. On April 161" we measured 50" of effluent in the 1999 trench out of a measured total of 63" in the monitoring tube. On 4/23/24 we conducted an adequacy test of the 1999 trench where we added the required amount of 450 gallons of water into the field and the water level increased in the monitoring tube to 64" which was above the lateral distribution pipe. Upon inspection 24 hours later the water level in Preuss #4 Blk 7 Lot 2 April 29, 2024 Page 2 of 2 this field measured 60" and had not returned to pre -test levels, thus failing to absorb the required amount of water for this system. A well flow test was conducted at the same time of the septic adequacy test. The well produced a constant flow of 3.6 gallons per minute, which is well above state standards, The wellhead stickup was 27" from grade, with a seal and conduit. Water samples were drawn and submitted to SGS Laboratory for bacteriological, nitrate and arsenic levels. The results of this water analysis states either `non -detect' or negative and are attached. Therefore the water quality meets or exceeds MOA /State requirements. 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 in land 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 cannot give any estimate of how long a system will function satisfactorily for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. If after review of these records you or any of the underwriters have any questions regarding the adequacy of these systems or the methods and/or procedures employed during our inspection or evaluation, please feel free to contact me at (907) 696-6111, Fax (907) 868-3793. Respectfully, 1 r ArcTerra Consulting, Inc. Kenneth M. Duffus, P.E. Attachments: Water Analysis (SGS) Invoice Y KENNETH 01 t W N ". 1 waft c/a�1 j Q < uJ W W N w LL .J i° ` '� •• O iUJ ,,► `'> - Q 1: : • • ` - 0- cry + 0 i .. toe Wx x'ji `� j U a< v aco lee 11 �' j1.1 0 Z 0 d � � M 0 0 z z x c NOW Zj 1 ,64 0•C-4 LLI-- W ia... C) ---:: 0 - 6........ ...... z .. ............. w-........ . = ::::: t' cn o M '0 b w 0 a.oDaF- L"L (0 0 m o Z €� w U) z C Li::: LL - �, o'y, W _ -'m=w' © C) 'S©CC) <ui zap- ,< i t : ,r% FENCE __ X M 0LL cn H C? w w D U- 0 U) w ........... c) C) 0 1............ .......-/� 0 -j Z Z V?0 ------------------ ............. GL 00 (n LZ 0 U) j.- 0 i CSC) LAC �?F-C ¢0�� 0 no§0/a x�> '<C) C6 Dw>-wz U w Ca L-"' )►-U_W®QW,Q¢,> LL��0=L) �� d�F-wzt� u ;-!'Q©W¢w w Z w� )F- wwwxx h�W 00c/> W ZDU- LL© 1 1 w Z Pz a W© z w=WW�W> ©. 2 cl)0 <C.) �CL ma c/J z5wW w Da.wU) Z 2W-i —, 0 F � ¢Qm0 GE @� Municipality of Anchorage ° U On -Site Water and Wastewater Program s (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-572-38 _ Expiration Date: ZZ 1. GENERAL INFORMATION Complete legal description Preuss #4 Block 7 Lot 2 Location (site address) 10227 Wren Ln. Eagle River, AK _ Current Property owner(s) Stacy Sandoval Day phone Mailing address Real Estate Agent 10227 Wren Ln. Eagle River, AK 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class _ Well ❑ Public Water System ❑ Waiver/Variance request for: 3 ___ Day phone TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ S5 0 _ Waiver Fee $ Date of Payment 3� /2z Date of Payment Receipt Number O�75()r, Receipt Number COSA # 0 S C-)") 1 (0 ( (a Waiver # istance: 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 _ARCTERRA CONSULTING,_ INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 _ Engineer's Printed Name KENNETH M. DUFFUS _ . _ Date 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 �.., encroachments, deficiencies or discrepancies exist. Ul ;1L,<fv\, AIK I n T E -f 6. DSD SIGNATURE System #1 Approved for �__ bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: — -- ANC/-/" - ON_S �1D J� R o G� P C_ 0)))))111 Original Certificate Date: 3 _0 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 X Septic System Advisory Well Flow Advisory _ COSA blue sheet -10-10-12 doc Nitrate Advisory Arsenic Advisory Other S,ec �drJisivwi' Legal Description: Pruess #4 Block 7 Lot 2 Parcel ID: 050-572-38 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA IN Well log is filed with Onsite (or attached) Well production at time of test 3.0 gpm Date drilled 9/18/80 Water storage tank volume gallons Total depth 397 ft Well disinfected for coliform test? ❑ Yes No Cased to 40+* ft 0 Coliform bacteria is Negative Sanitary seal is functioning correctly Nitrate mg/L 11 Nitrate less than MRL (ND) Wires are properly protected Arsenic ug/L PE Arsenic less than MRL (ND) Casing height (above ground) 30 in. Collected by Arcterra Consulting Date of flow test for COSA 2/18/22 Date of Sample 2/11/22 Static water level at beginning of test 368 ft. Comments *Per 1999 COSA B. TANK DATA Age of tank(s) 6/18/99 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 49" 10 Standpipes/foundation cleanout per record drawing Date of pumping 2/14/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 6/18/99 IN ALL standpipes present per record drawing Total measured depth from grade 13.25 ft (max) Measured depth to pipe invert from grade 8 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 5.25 STATION ❑ Requir aintenance completed Age of lift station years Lift station material Comments: Adequacy test date 2/18/22 Results FV_1 Pass For 3 bedrooms Fluid depth prior to test 43 in Water added 450 gal New depth 53 in Elapsed time 1440 min 11 Code -required soil cover over field Final fluid depth 43 in System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced 2000 gallons If yes, enter date Com ments/Deficiencies: COSA Checklist yellow sheet 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' ® Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ® Yes if No ft [7j Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25'0 Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ft ® Yes if No ft _ Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® 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' 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' ® Yes if No ft - Water Main > 10' ® 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' 0 Yes if No ft If absorption field is under driveway'comment below Property Line > 10' ❑ Yes if No 5+* 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' ® Yes if No ft F. ENGINEER'S COMMENTS *Per 6/18/99 Inspection Report G. ENGINEER'S CERTIFICATION I certify that / 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 Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC 221066 Subdivision: Preuss #4 Block 7 Lot 2 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this COSA / property is 23 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank. Madiq Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A S NGLE F^M LV DWELUNG 1. GENERAL INFORMATION Complet~;'legal description ~- Location (site address or directions) ,/(~ ~- ~-- ~ /'1//~G'/u/ / · Property owner · Mailing address ...... Day phone rending agency Mailing address ' :' Day phone Agent C/~/0 Y Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Day phone ~'~ ~4¢¢'~ Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev. 1/91) Front MOA~21 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 furtherverify 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. Nameof ¢ phone Address 17034 Eagle River Loop Road No, 204 Eagle River, Alaska~957~~.~/~"-'--~ Engineer's signature ~L~-¢ ~ Date '~ / A ?/fi c~' DHHS SIGNATURE Approved for -i'"H,gEE bedrooms. Disapproved. Conditional approval for bedrooms, with th-e following stipulations: Additional Comments 'fA'llifli 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 DH H8 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. 72-025 (Rev, 1/91 ) Back MOA a~21 Do LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on'~Pump off" level at* High water alarm level at* ~ *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 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 SEPTIC/HOLDING TANK ON LOT TO: / Foundation 3 a'" Property line ~' ~ Absorption field Water main/service line ! 0 -F Sudace water/drainage / O ~) q- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line ~ '~~c$~o°~ :~) Building foundation '~ $- water main/service line Sudace water / o '0 '-,~ Driveway, parking/vehicle storage area ~- o '~- Curtain drain A/~ ~ ~.. /~ ,~ ~ ~ ~J Wells on adjacent lots / 0 0 % ENGINEER'S CERTIFICATION I certifythatl have determined thru field inspections and review of Municipal in conformance with MO~ H~ouidoO~gs in effect on this date. Engineer's Name ~6&~T ~ ~o~ Date "~ ~ ~/~7/~ ?Y')O., oO HAA Fee $ Date of Payment Receipt Number ~O~(~ Waiver Fee'S Date of Payment Receipt Number 72-026 (Rev. 3/96)* Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN'SERVICES JUL ~y Environmental Services Division ,~UNICIPALITY OF ANCHOR 825 L Street, Room 502 · Anchorage, Alaska 99501 - (9~gq~o~zl~4mu~c~s Health Authority Approval Checklist LegalDescription: )-o'V~ /~L-oc~c 7 I /°'P':~s-'~ ~/-/ ParcelI.D.: OS-'0 --~7;)-- ~,~g A. WELL DATA Well type J3/~ v At-~ Log present (~YN) 7 ~.- --[ Total depth '~ q 7 Sanitary seal (~N) "7' £J Date of test Static water level Well production if A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to ~/0 -~ Casing height (above ground) Wires properly protected (.~/N) ,/ Y~f WATER SAMPLE RESULTS: FROM WELL LOG AT INSPECTION 'a. 7 Coliform 0 Nitrate Date of sample: '7/~ ~ ~l~) B. SEPTIC/HOLDING TANK DATA Date installed (-,/~'~/ff¢) Tanksize /ooo C. ABSORPTION FIELD DATA Date installed ~ //¢ / q (~ Collected by: Other bacteria 0 $ & S ENGINEERING i7034 Eagle River Loop Road No, 204 Eagle River, Alaska 99577 Number of Compartments ',,'Z Cleanouts (~/N))'~'3 Foundation cleanout (~/N) ~ J Depression (Y/~ Date of Pumping' ~/fi - ~ ~'~J Pumper - High water alarm (Y~) w O · Soil rating ~or fF/bdrm) O. (;' System type Length- ~ q ~ ' ' " Width ~ /:' Gravel thickness below pipe '¢' ~/~ / Total depth///,'' Effective absorption area 75-9 ~r t. Monitoring Tube present ~',1). ¥~ Depression over field (Y~ Date of adequacy test/V/,,~ _- ,,L)£',-/ Results (~ / For Fluid depth in absorption field befo~ / Immediately after gal. water added (in.): Fluid depth ~s later: Absorption rate = g.p.d. Peroxide tre..~_~erff (past 12 months) (Y/N) If yes, give date bedrooms 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRON}~NTAL HEALTH DEPARTMENT OF HE~kLTH AND ENVIRONmeNTAL PROTECTION APPLICATION FOR ~ ~MEALTIt AUTHORITY APPROVAL CERTIFICATE General Information Application Date / (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name (<"?,/~,/"'(' "7-,~, Applicants Address ?/-~ - :../ (c) Applicant is (check one) Lending Institution Buyer ~ ; Other ~ (explain); (d) Lending Institution ~ / ~ Telephone Telephone - 1tome Business Address (e) Real Estate Co. & Agent__ (f) Telephone Mail the HAA to the following address: 2. Type of Residence Single-Family~ Number of Bedrooms Mul~i~Family~--~ Other (describe) [Page 1 of 2] 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 the legality and status. 4. ~ ,, \llll/ i// OnsltePnblic EZ2q. olding Tan. Note: Id community well system, m'~s$ ~,gVO Sz~ttten confirmation from the State Department of Environmental Conservat~ ~attes~lng to the legality and status. 5. En__gineering Firm Providing Inspections, Tests, File Search, Data and Informati~n ~ As certified by my seal affixed hereto and as of the validation date sho~m below, verify that my investigation of this Health Authority Approval shows that the on-sft~ water supply and/or wmstewater 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 Mnnicipality of Anchorage files and from my investigation and inspection, the on-si~e water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tious in effect ou the date of this inspection. Telephone Approved for~ bedrooms B Approved //~'/ Disapproved~ ~onditioual Terms of Conditional Approval CAUTION THE bfdNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISS'JES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN LN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIObL%f ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEF DOES THIS AS A COURTESY TO PURCHASERS OF HOblES A_ND THEIR LENDING INSTITUTIONS //~ ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQULRE- bIENTSo EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED° T~E MLD~ICIPALI~f OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK° RR4/ej/D18 ii, [Page 2 of 2] 7-19-84 ALASKA e[1OIROFImeIITAL COFITROL IF1C. GENE TOBEY SRA BOX 5415 EAGLE RIVER ALASKA 99577 SELLER-GENE TOBEY GENE TOBEY SRA BOX 5415 EAGLE RIVER ALASKA 99577 APRIL 4 1985 50016 LEGAL:PRUESS SUBDIVISION BLOCK 7 LOT 2 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-4/2/85 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 580 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 449 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 4/3/85 · FLOW TEST ON WELL WELL FLOW DATE-4/2/85 THE WELL FLOW RATE WAS 3 GPM FOR 1.5 HOURS. THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME. 1200 [Uesl 33rd Aucnu¢, ~ait¢ ~ ° Anchoraqe, Alaska 99503 · (907] 276-1361 ~'-~"MUNICIPALiTY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH & HEALTH ~AUT['{ORITY APPROVAL (HAA) [NVIRONMENTAL PROTECTION - F Ru Y 1984 pp, 5 g85 Date Completed Pump Set At Well Classification ~¢.~ Well Log P~esent Total Depth ,~f ~'¢/. Cased to Static Water Level Casing Height Above Ground~r~'~ ''~/ Electrical Wiring in Condui%/~) Separation Distances fram ~1~: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Legal Description:[~'~:~<J~g~-,-~ W If A, B, ~ C, D.E.C. ~p=o~d(Y~) ~pth of ~outing Sanit~ ~al on ~sing ) ~ession ~ound ~l~ead (Y~ ; O~ Adjoining Lots ,~//773 ? ~-- TO Newest ~blic ~ Line C lean~t~a~ole Wate~ S~le Test ~'ult, Standpipes ~/N) Ai~-tight Caps Depression over Tank (Y~)) Date Last Pumped No. of Cc~,%~artments '-~ Foundation Cleanout (Y~) Pumping/Maintenance Contract on File (Y/N)I,.:!k ; for (~ ~ Holding Tar~k High-Water Alarm (Y/N) t%li~'~ Temporary Holdipz~ Tar~k Per~t (Y/N)fu/~ l~/ Separation Distances fram SePtic/Holding Tank: To Water-Supply Well To Property Line To Water Maip~Service course ~ ~ ~ / To Building Foundation 1~1 j~' To Disposal Field ~! To S~eam, Pond, Lake, c~ Major Drainage [Page 1 of 2] Receipt 9 Date Paid: Amount: 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date .Installed Width of Field Type of System Design Length of Field Depth of Field Square Feet of Absorption A~ea ~'<~'_% © c/ Standpipes P~esent .~/N) Depression over Field (~ Date of Last Ad, qume7 Test -- Results of Last Adequacy Test ~.~eD- ~ ~o-~- ~' //.~'~'" Separation Distance f~Gn A~so~ption Field: To Water-Supply Well ? ]'-(~! ~ To P~operty Line /0 ~- TO Building Foundation ~Tf/ ~ To Existing or' Abandoned System cn Lot ~J lJ,~ ; On Adjoining Lots . ../--~/ To Water Main/Service Line .~-~/~,-- To Cutbank( if present) /3//% "'' TO St~eam/Pond/Lake/c~ Majo~ D~ainage Course '~'l O O ( To D~iveway, Pa~king A~ea, c~ Vehicle Stc~age A~ea /(~/ ~ LI~ STATI~ ~ Date I~talled · ~~ns "~ ~" ~1 at ~ / ~ ~f" ~vel at____ High ~ter ~ ~vel ~t~/ Ve'~t (Y~) Tested fo~ / ~ing Cycles ~ing Adeq~ ~st. ~ets ~A Elec~ical ~ Counts ** Check Permitted Bedroom Rating A~ainst HAA R~quest I certify that I have checked, verified, or confound to all MOA HAA Guidelines in effect on the date ~ this inspection. Signed 1~ ~ Date ~/~ Company KB1/d5/s [Page 2 of 2] 2-15-84 · DATE RECEIVED ~ INSPECTION APPOINTMENTS 07---,/~ ~ TIME ': !TIME ,. ~ J~J /~ (,~ TIME ENVIRONMENTAL SANITATION DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DI REOTION8: Complete all parts on page 1. Incomplete reques~ will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE BAILI~Q ABBRE88 PROPERTY RESIDENT (If different from above) PHONE 2, BUYER PHONE MAILING ADDRESS 3. LE~DI~G I~STfTUTIO~ MAI LING ADDRESS MAILING ADDREgS 5. LEGAL DESCRIPTION ,Z ,r 7 , l, c ,( 7 STREET LOCATION 6, TYPE OF RESIDENCE JX~' SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [~ Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* COMMUNITY [] PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) .~ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY EZ] ONE [~] THREE [] FIVE EZ] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED PERMIT NUMBER 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE DATE INSTALLED ' ~ ' ~",O E~]PUBLIC UTILITY ~.~'~c.~ ~..Z~ , Connection Verified INSTALLER []Septic Tank or [] Holding Tank ~/'~_.(~:A,.r~-~ - Size: I 0(~0 If Tank is homemade SOILS RATING give dimensions: I ~' TYPE OF TANK MANUFACTURER TQTAL ABSORPTIO~ AREA MATERIAL 4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: I Absorption Area to nearest Lot Line 5. COMMENTS E~] APPROVED FOR BEDROOMS [~' CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79)