HomeMy WebLinkAboutPREUSS #4 BLK 7 LT 9 Municipality of Anchorage Page / of ~'- '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: ,-~/'V' ~/~'~/~ PID Number: 050- 5~Z- ..z./_,..~, Name:/Z~.~7,/~/~,/~) ff~/57"~5/~' ~ ~WCL~ ~/WW Wastewater System: ~ New ~pgrade Address: yY~ ABSORPTION FIELD Phone:~_~/~ ~ ~ No. of B~rooms:, ~beep Trench D Shallow Trench D Bed D Mound D Other Total Depth from original grade: LEGAL DESCRIPTION soil Rating: ~, ~ GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe  ~ Section: Fill added above original grade~ , Gravel length: Township: /~1 Range: / ~I ~ ~ -- I Ft. ~ / Ft. ~/5~--V~ New ~ u a ' 'pgra-e Gravel depth: ~/~ Ft. Number of lines:~ Distance ~n lines:~ Ft. WELL: Classification (Private, A,B,C): Total Depth: Case~[o:~~-~ Total absorption area: Pipe material: ~.~F~ Ft. ~ SQ. Ft. ~ ~3~ Driller: ~ate Drilled: Static Water Level: Installer: Date installed - /0 & / ~/ GPM [ Ft.I Ft. SEPARATION DISTANCES ~ Se.t~c ~/~r/~/~ ,o~n~ ~ To Septic Absorption Lift Holding ~Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ Well ~/~ ~ fi~/~ ~/~ ~ / / Material:~/ Number°f C°mpadments: Surface Water ~//~ ~/~ Nh ~/~ ~/~ LIFT STATION,, ~ Lot ~ ~ Size in gallons: ] Manufacturer: I Foundation "Pump on" level a~off" level at: High water alarm at: 4&' 70' ~/~ /t//A W/~ ~el~ I El.tr[~, ,~pections pedormed by: Remarks: BENCH MARK Location and Description: IAssumed Elevati°n?~ , ~ ENOINEER~S.~AL Inspections performed by: ~A/~/W~/~ Dates:lst /Ph~./¢/ 2nd )O/l~hl ¢~ ~; ~~:.~- Department of Health~d Human S~ryices approval ':~'.;:. ....... < .... , ,. ,,.,.:~.~':~"'~.~ Reviewed and approved by: Date:/~/ ~':' '" '~' 72-013 (1/91) MOA 25 Permit No. ~'~ ?/~ -~/,~ Page .-~ of ~ Municipality of Anchorage 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 PID No.: ~J'o - 5' ~ ~. - 5'2 1"=30' ELEVATIONS (NBT Td sCALE) tTANK EX[STING 3 BE HOUSE 46' EXISTING SEPTIC TANK - 16g,S4 21' LEACHF[EI ii !iLEACHFLELI)i []· __ ~ i o - : ~ ASSUNED iELEV = 100,00' i ~0 i ! i ! '~ ENGINEER'S SEAL j GROUND NO GROUND ~/ATER i ENCOUNTERED TD 7=9.5' TEST BOLE MONITOR TUBE SEWEF~ CLEANOUT WELL~ LEACHFIELO 72-013 A (2/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910318 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:DISTASIO RAYMOND & OWNER ADDRESS:10134 RONALD PL EAGLE RIVER, ALASKA 99577 DATE ISSUED:10/04X91 EXPIRATION DATE:10/04/92 PARCEL ID:05057243 LEGAL DESCRIPTION: PREUSS #4 BLK 7 LT 9 LOT SIZE: 19600 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY:,-~ ISSUED BY: DATE: DATE:/~--~ -- ~,/ Tom Fink, Mayor N unicipality Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 4, 1991 Lou Butera, P. E. Eagle River Engineering Services PO Box 773294 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 9 Block 7 Preuss Subdivision ~4 Waiver Request #WR910043, PID ~050-572-43 Dear Mr. Butera: Your request for waiver of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance is 75 feet from the private well to the septic tank and 80 feet from the private well to the leachfield. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services Concur: On-site Services ljm:~6 Louis Bulera, P.E. Registered Civil Engineer September 12, 1991 I~UNICIPALITY OF ^NCt,IOIt.4~I~ ~NviRON~ENTAL SEIL~/ICE$ Dl¥t§t~ SEPt 3 1~91 RECEIVED John Smith, P.E. Municipality of Anchorage On-Site Services 825 L Street Anchorage, AK 99504 Re: Lot 9 Block 7, Preuss//4 Waiver Request Dear Mr. Smith, On behalf of my client, Mr. Raymond Distasio, we are submitting a request for waiver of horizontal separation distance for the above referenced three bedroom residence. The home is being sold and passed septic adequacy test for only two bedroom capacity requiring a one bedroom upgrade. The request is for a waiver of well to septic leachfield distance of 80' and well to tank of 75' to allow upgrade and possibly a future reserve area. The separation distance was waived previously in 1986, however, the waiver states that an upgrade invalidates the waiver. Therefore we are applying for a renewal. The original system was installed in 1976 as a deep trench system. The system was installed and inspected with the inspection report showing a note that well to tank distance as 75' approved by the MOA in 1976. A waiver request was approved in 1986 allowing 75' to the septic tank and 92' to the absorption field. Both components of the septic system carry equal potential risk and are evaluated by the same methods as was established in 1986. Nothing has changed and we are not requesting an increase in bedroom capacity, therefore the physical evidence should support approval of our waiver request. Soil characteristics in the area are well documented and are fairly consistent. The immediate subsurface soil is a dense sandy gravel down to the typical test hole depths of 13-16'. No ground water levels were shown on any of the file records researched, and deep trench systems are typical. These are attached for your review. Well logs show that the local aquifer is very deep 375-500' and is overlain by many layers of sandy silt, hardpan, clay and cemented gravel. Static water levels are also very deep. The on-site well has a static level of 351' with 1' of drawdown at 5 GPM. This would indicate a very well protected aquifer with a minimal drawdown cone. Potential leachate travel through the soil to water source at 375' would be very unlikely. Well levels taken at neighbor's wells show a possible gradient to the South away from }hO. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 694-5195 · Fax (907) 694-3297 P~e2, Lot 9 Block 7, Preuss//4 Waiver Request the well and flat gradient continuing to the South. The surface gradient would indicate aquifer recharge from the mountains to the North. The well is located up gradient from the septic system so surface flow is directed away from the well. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. 09/12/91 bP~Lb l~lVb~ ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 SHEET NO. OF CALCULATED BY L .B DATE CHECKED BY DATE SCALE i Wate~T~bl~ i i i i i i'"BOtt~m Of sePti~tank/leach '~ i i statidw~terilevel i i ~: ~ i 331'i i i i i i i { i i i i i i i i i ...... i i Dig~eeito Water ~ble~ ..... ~ 351~ 13 ~ ~'"'SbiiS6~ti6h~ ~ ~ ~ [..~......From. w~lll0g:~ ~ ~ ..... ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .... ....... ...... ......... ....... ~... ~ ~- -~ } ~- ~ ~ ~ ~ ...... ......... ..... ........ ~ ~ ~ ~ c0bbiegmvel(1.0) ~ 25~.50 } silty gravel ~ (2.5~ ~ ~ ~ } ~ ~ ~ .... ~ .~ .... ~ ~ ~ ~ ~' &"1~0:365 &2i5"} { ......... } { ...... ~ ~ ~ ........ ~ ....... } ] ...... ..................... ...... ........... } .......... ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~'~ ~ ~ ..... ....... .... ...... ........... ....... ~" ~oint'vflae a'"'"2~4~ ? .......... ~ mm~i.t~ ~.~ ....... ~ .~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ........ ~ ~ ~ ~ ....... ........ ..~ ~ ~ samdasso~tion ~ ~ ~ ~. Water Table Gradient ] ~ = ~.. ~ [... .Point Vfluq ~..?.........~ } ........ · '~ ~ H0fi~0nh1 s~ati6n~' ~ ~ ~ 8o'~ { ~ ~ ~ ~ ~ ~ ~ Point vflu~ '~ ~ ........ SHEET NO. OF CALCULATED BY DATE ENGINEERING SERVICES P. O. Box 773294- EAGLE RIVER, ALASKA 99577 Phone 694-5195 DATE SCALE i iii iii ...... ...... i;iii ............ ......... _~, ~ ~ ...... ~ ........... } ..... ~ ...... ~ ~ ~ ~ } .......... ~ ....... ~ ~ ~ .......... ~ ..... } ..... ~ ........... ~. ......... ~ ~ ....... ~. ~ ~ ~ ~ ~ } } [ ~ ~ ....... ............ " / ~1~ SEPTIC · / X+lO0' Jl X/ELL / X 33' FRaM LBT o_ \ HOUSE q,.. ~--Lj(/) ~ ~- PR,/]pFISED ~ ~ -- ~~ i~:~ LEACHFIELD X ~\ ADDITION--, +S~EoPoT'IC//~'/' ~ ~EX~N~ANK %k / ]! PR-IVATE i ~ E EX ~ScTHIFNiGE L D V [] - TEST HOLE · - MONITOR TUBE o - SEWER CLEANOUT + - WELL ::::H:::::- PROPOSED LEACHFIELD NO KNOWN CURTAIN DRAINS EASEMENT SEPTIC SITE PLAN ..a. BLOCK .7, PREUSS SUB. ,_~4- ~w~ LEGAL: LOT OWNER: DISTASIO & WINN ~'. CONTRACTOR: JOB # 91-11tj DATE: 09/12/911 SCALE 1" - 50' EAGLE RIVE~ ENGINEERING SE~V/CES ~,o,~ EACLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O SLOPE SITE PLAN ~)EPTH (F~ ////// ~/~' ~ . EN ~ IF DE / / S GROUND WATER ENCOUNTERED? YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ;OLATION RATE o~'' /7/ (minutes/inch) TEST RUN BETWEEN ~', FT AND o"'5~ FT COMMENTS PERFORMED BY: 72-OO8 (6/79) Eagle River Engineering Services P. 0. -"-;× 773£~.4 Eagle River, AK 99577 69~-5195 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 525 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: ~d//~/ SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 DEPTH / ~. E~ DE 13- GROUND WATER S OUNTERED? /k/~ L O P IF YES, AT WHAT /¢~z..~ ;¢'.~ E DEPTH? 15- 16 17 18 19 20 Gross Net Depth to Net Reading Date Time Time Water Drop "' /'~ ' PERCOLATION RATE fi" zT/ (minutes/inch) TEST RUN BETWEEN ~ FT AND 6"5~ FT COMMENTS PERFORMED BY: 72-008 (6/79) bagle River Engineering Services P. 0. Box 773294 EagJe River, AK 99577 694-5195 CE.T,P,EDB¥, .ATE: LEGAL: SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LOT 9, BLOCK 7, PREUSS//4 Ao GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified or modified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. TRENCH 1. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. 2. The bottom of the trench shall be level, plus or minus 1.5". 3. The total depth of the trench excavation is not to exceed 12.5' at any point. 4. The effluent line is to be connected into the existing leach line to allow effluent overflow to the upgrade leachfield. 5. The trench gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation'to a depth of 4' or equivalent is to be placed over the leachfield. 7. The area over the trench is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 125' GRAVEL DEPTH = 6' TRENCH LENGTH = 21' TRENCH WIDTH = 3' SOIL RATING = 0.6 GPD/FT2 BEDROOM CAPACITY = 1 upgrade to 3 total SEPTIC TANK SIZE = 1,000 GALLONS Twenty-four (24) hours notice required for all innpections. Calculations 1 Bedroom Upgrade to 3 Bedroom Total 150 GPD = 250 S.F. required trench area 0.6 Trench length = 250 12 21' with 6' of gravel z GREA.,.ER ANCHORAGE AREA Depsrtment of EnvironmentsI Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER ~' ~'/~--- MATERIAL INSIDE WIDTH LIQUID DEPTH NUMBEROr COMPARTMENTS LIQUID C A PAC I TY/~:P~GA LLON$. TILE DRAIN FIELD: DISTANCE FROM WELL ~ ~J~.. FOUNDATION NUMBER OF LINES ~ DISTANCE BETWEEN LINES ABSORPTION AREA ~'6 DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH NEAREST LOT LINE ~"'~ .OF LINES TRENCH WIDTH "~'IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE ~;~ O ''~ '~ ,,~ ~ ~,~-~ DEPTH OF FILTER ~'7 MATERIAL BENEATH TILE IN. ABOVE TILE IN. WELL: TYPE CONSTRUCTION DEPTH BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE__, SEWER LINE__ TANK , SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: ,NSTALLED B¥: "('*' SEWER LINE DEPTH: PIPE MATERIAL' LOT SLOPE: REMARKS: Form DIAGRAM OF SYSTEM PERMIT NO. FIPPL iCFINT ~ LOCFITION DFIYID FIVE & RONFILD PL. LEGAL L9 E:,--' PRELISS SUBD ~4 TYF'E OF SOIL. AB'SORSTION SYSTEM IS: TRENCH DEPFIRTMENTL-..:~? HEFILTH RND ENVIRONMENTR~, /ROTEC:TI01'..f 25~6 E. TUDOR RD., RNCHORRGE, AK. ~S~5Ef7 276-2221 ( 768~2 ) GEN DEL E. R. LOT SIZE flH,.,IMLM N IME:ER OF BEDROrIF'IS = 3: SOIL RATING ,::SQ F F,..'E,E.. = -/'HE REQLIIF.'.E[:, SIZE OF THE SOIL FtE'--,F~F."F'TION_ _ :.,-'"-.:,TEI"I I S.,: ±:~6:,E~E SQURF.':E F'EET THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR [:,RRINF:IELD. THE DEPTH OF R 'TRENE:H OR PIT IS THE DISTANCE BETWEEN "I"HE SURFFICE OF THE GROUND AND THE BOTTOM OF ;'HE EXCRVFITIOI",I (IN FEET). 'THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTPI IS THE MINIMUM DEPTH OF GRAVEL BETWEEN ]"HE OLITFFtLL F'IPE FIND THE 80TTOM OF THE E',:.::CAVFITION (IN FEET))),. F--: E ,_-]-, LI ]: F-: E E:, S E F" T :I C: T R ~'-.i F::: S ][ ;~: IE == d_ (::, ,;', ,.:.:.~ ,Z;~ ¢-~ L_'L.. ,]} rp~ T ~--I C, ,:"..=_"-':' .":, I P-,t z. F E _-T :[ C, t'-.~ :-_--; Ft F-: E F-: E,_:;.-] L~ Z ~-~. E. [.- ...... B Y E:RC:KFILLING OF FINY SYSTEM WITHOUT FINRL INSPECTION AN[:, HFFF.. ,HL THIL:; E EFHF..TMENT WILL E:E SUBJECT TO PROSECLITION. MINIMUM [:,ISTRNCE' BETWEEN R NELL. RND RN"r' ON-SITE SEWAGE DtSPOSFIL SYSTEM IS 'iF10 FEET FOR R PRIVFI'T'E WELL OR 2EIE1 FEET FOR R PLIBL. IC WELL SF'ECIFICRTIONS RND CONSTRUCTION DIRGRFIMS ARE RVAtLRE:LE TO INSURE PROPER INSTALLATION. P E F-: It-.1 'Ir ]- %." IIR L :I [:, F' C, F.: C, I'-.t E "-¢' E Il=ti Fe.' F" F--': C, tt--'f Z S; S Il_., E'~ I CERTIFY THAT J.: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE E;EHERS RN[:' WELLS RS SET FORTH BY THE MUNIC'IPRLITY OF ANCHORAGE. 2: I [,JILL. INSTALL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ~:: I UNDERSTAND THRT THE ON-SITE SEWER SYSTEM MAY REQUIRE; ENLARGEMENT IF' THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3: BEDROOMS. ~PPLIC~NT BILL FOREH~N ISSUE[:, Performed for GREATER ANCtlORAGE AREA BOROUGh-: Department of EnvironmenLal Qua]ity 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG -' PEROLATION TEST l'his form reports: Soils log xx(_ Percolation test Depth Feet 6- 7- 10 - 11 ~ 12 - 13 - 14 - Was ground water encountered? If yes, at what depth? Reading Da t e Gross Time Percolation rate minute-. Net Time Depth to Water Net Drop ,Proposed installaiT~-n: Seepage Pit Drain Field Depth of Inlet . Depth 't6'~i-t-~xCi)it o~ trenci~ ,~' - -' -~ '>-/AS. ': / EQ-040 (6/74) ANCHORAGE. Lo~tiofl (sddress of: Town~hfp. Rtnfe, Section, STATE (907) 27i ANCHORAGE, ,~,~..~ It/5 DRILLINO Well Owner I~ y Eurst ._ Location (address of: Township, Range, Section, L~, ~!k 7, dreur~ ~oh~ SLze of casing ~ . ,,Depth of/Hole Static water level ; =~' ft. (~bove) Screen ( ); Perforate~-' Describe screen or perforation Well pumping test at ).r gallons per (h;6hf) of drawdown from static level. .lNG, Inc. tefnatior~] Airport \.._..rid 461 ] .AS K,A 99509 known; or distance main road ¥ c I)£~ Use of Well ~7~ feet Cased to :?: feet (below) land surface. Finish of we]] (check one) open end ( 3. i,one (minUte) for ~ hours with :.' "' Date of completion ] ~ .... 7Z WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 2 -- STATE / • Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 ` " ti= CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050--572-43 Expiration Date: 11-1 LI-1 7 1. GENERAL INFORMATION Complete legal description PREUSS#4 SUBD. BLK 7, LOT 9 Location (site address) 10134 RONALD PLACE CHUGACH AK Current Property owner(s) Day phone Mailing address SAME Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) -3. • NUMBER OF BEDROOMS: • 3 • 4. TYPE OF WATER SUPPLY: • TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class A Well ® Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: ___VA5-14 - Received by: /A Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee S LP Waiver Fee $ Date of Payment N-7 17 c,J( W 2-149 Date of Payment Receipt Number Receipt Number COSA# d5C r 7/ 3'10 Waiver# 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 MIKE N ANDERSON. P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE v. Date 8/5/17 ",.. c .e .',// ^o . ., , . u ate.',.' 6. DSD SIGNATURE v. � SCIV .5,. .� s- e if...,-.,•. CF 9459 *.,..,:`�. X System #1 Approved for _ bedrooms. �`�.�.•.• . . System #2 Approved for bedrooms. oto -ncrriro, _`a'" r', Disapproved. Conditional approval for bedrooms, with the following stipulations: P / '. sir \— y r;n1 ... . 40 • .. , —, u, / �`�,,1.t Y uec,cly1 - : � ON-SITE �. VIJA I-ER VVAS1E,,IJA AND �; ER 1 ' . )� PROGRAM .c By: _ _ =- ice _ Original Certificate Date: E— itM 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10.10.12 doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system _ Certificate of On-Site Systems Approval Checklist Legal Description: PREUS #4 SUBD. BLK 7, LOT 9 Parcel ID: 1150--572-43 A. WELL DATA Well type PRIVTE If A. B. or C provide PWSID Well Log (Y/N) Y Date completed_6-1974 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y Total depth 375 ft. Cased to 373 ft. Casing height (above ground) 15 FROM WELL LOG AT INSPECTION Date of test 6-1-1974 8.1.17 Static water level 358 ft. 344 ft. Well production 5 g.p.m. 4+ g.p.m. WATER SAMPLE RESULTS Coliform NEG colonies/100 mL Nitrate ND _ mg/L Arsenic: ND ug/L Date of sample: 8-1.17 Collected by. MNA , B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC I STEEL Date installed 12-1976 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) NA Date of pumping 8.9.17 Pumper Alaska Quality Pumping C. ABSORPTION FIELD DATA - Date installed 12176&10191 Soil rating (sf/bedroom) 150 SFJ(J System type TRENCH Length 30+21' ft. Width 3.0 ft. Gravel below pipe 6 &7' ft Total depth 13&12.6 ft. Eff. absorption area Mit' Monitoring tube Y Depression over field N Date of adequacy test 8/712017 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth ii____mt_bs-o p field before test 52 in Water added 500+ gal New depth 69 in Elapsed Timly . n. Final fluid dept L-D Absorption rate >= 450+ g.p.d Any rejuvenation treatment (past 12 mo.) (Y/N & type) UNKNOWN If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in.High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements'? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 75' * On adjacent lots 100'+ Absorption field on lot 80' • On adjacent lots 100'+ Public sewer main NA Public sewer manhole/cleanout Sewer/septic service line 25'+ Holding tank Animal containment areas 100'+ Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5' Property line 5'+ Absorption field 5'+ Water main 100'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots WAIVERS IN THE MOA FILE ABSORPTION FIELD ON LOT TO: Property line 2'+ Building foundation 10'+ Water main NA Water Service line 104 Surface water 100'+ Driveway. parking/vehicle storage 20'+ Curtain drain 50'+(None Knownl Wells on adjacent lots 1004 F. COMMENTS t+JR '&, O77 eq 00Li.3 G. ENGINEER'S CERTIFICATION � tawv$A I certify that I have determined through field inspections and `� '•• •. tt review of Municipal records that the above systems are in ;v j conformance with MOA COSA guidelines in effect on this date. • 7H • E 49 Engineer's Printed Name 111KE N. ANDERSON. 1'F. !••;• •,84W7:441104,44. 0 rl A;MICHAEL N. ANDERSON ." / Date 813/2017 #.J;. CE-4769 69 ..,Z, COSA canary sheet 2-6-15.doc Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA # MAY 22 1997 RECEIVED 1. GENERAL INFORMATION Complete legal description LOcation (site address or directions) Mailing address Lending agency Mailing address Agent Address Day phone Day phone e Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: -~"' RECEIVED TYPE OF WATER SUPPLY: Individual well Community well MAY 2 2 1997 Municipality of Anchorage Dept, Health & Human Services Public water NOTE: 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 Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA~f21 5, STATEMENT OF INSPECTION BY ENGINEER. Engineer's signature As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address ~P~'~ Date ~-. D~k/~S SIGNATURE Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date __ Od'/Od/c~ ~z-' 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 satis~ 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. 1191) Back MOA ~1 Legal Description: A. WELL DATA MUNICIPALiTy 0t~ A , Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES ,.-.. Environ mental Services Division 825L Street, Room 502. Anchorage, Alaska 99501. (907)3~/~--~' VE~ Health Authority Approval Checklist Parcel I.D.: ¢~'~ -~-/-~ "'J-/ Well type Log present (Y/N) Y' Total depth -~-'~'.¢..'-~ If A, B, or C, attach ADEC letter. ADEC water system number Sanitary seal (Y/N) FROM WELL LOG Date completed ~/"'~ :~/' Cased to ~ ?t/~:/, Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Date of test Static water level Well production g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed Foundation cleanout (Y/N) Date of Pumping ~/~/'~ / Nitrate Collected by: Tanksize /~'~';g~-- Number of Compartments -~ Cleanouts (Y/N) Depression (Y/N) ~ High water alarm (Y/N) C. ABSORPTION FIELD DATA , ~'/, ~/?~: ~-~,-~'?~..~.~ .......... Date installed -:/;' ~-./? / Soil rating (g.p.d./fF or ft2/bdrm): ~ ~/:/,~S¥~te'~ type, Length ' / :,,r/ Width /,~'~: Gravel thickness below pipe Y/~,~,,~ar'depth Effective absorption area ~-'~~t-~ ~onitoring Tube present/Y/N) ~' Depression over field (YIN) ,4--? Date of adequacy test /4',d/ /~,'~ zff'¢/ Results (Pass/Fail) -'~--~" For -/ bedrooms Fluid depth in absorption field before test (in.); -Z','2~/~ Immediately after ~?~'~-~ gal. water added (in.): Fluid depth -¢'/,~:~- ~' (ins) Minutes later: /"J~ Absorption rate = ~¢~ g.p.d. Peroxide treatment (past 12 months) (Y/N) .,c/ If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cyete~ SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Size in gallons "Pump on" level at* ~ *E~atum _..---~P~el at* RECEIVED MAY ?_ Z 1997 !~ Ml~l~i~lr~li/y of Anchorage @~, t'l~lth & Human Services On adjacent lots /=~ ~/~ Absorption field on lot Public sewer main Sewer/septic service line '"::'-;'¢ On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~y'~-,~z. Property line Water main/service line -~'~/'~z-/..Surface water/drainage SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line ,¢---,z-~ Building foundation Surface water /c/,~ Curtain drain ,c,'~,~,~- ,,~_,:~ ,~,~ ,,~ ~'~..~ ENGINEER'S CERTIFICATION Absorption field /'¢ Wells on adjacent lots Water main/service line .,~a- Driveway, parking/vehicle storage area Wells on adjacent lots I certify that I have determined thru field inspections and review in conformance with MOA HAA guidelines in effect on this date. Signature "l~;'~(.(_.~-:--~', I(/'-~-~.,-~zC,-/~ Engineer's Name ~ ~-k~ I~ ~ ']U F ~c",, I~;~ Date ~ · Z [ , ~ ~ HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number :' ~ MUNICIPALITY OF ANCHORAGE I~.-¢~:~"(~.~) DEPARTMENT OF HEALTH & HUMAN SERVICES ('~.~.~ · ,¢ ~'*~ X~2~Y/ Division of Environmental Services ~ ~ ¢ On-S~te Serwces Section ~ ~ ~ ~ P.O. Box 196650 Anchorage, Alaska 99519-6650 ~ ~ ~ ~.~ 343-4744 ¢' ~ ~ ~O ~ . ~¢,.,. ~ .,~ 0~ ~¢~9 CERTIFICATE OF HEALTH AUTHORITY ,~x¢~¢~' APPROVAL FOR A SINGLE FAMILY DWELLING 1, GENERAL INFORMATION Complete legal description P=euss fi4, Lot 9, Biock 7 Ti4N R1N Section 8 Location (site address or directions) Property owner Mailing address 10134 Ronald Place, Eagle River Raymond Distasio & Pamela WinnDay-phone 563-3149 10134 Ronald Place, Eagle River, AK 99577 Ext4 Lending agency GMAC/Sue Gallion Day phone 562-2181 Mailing address 460 W. Tudor Rd., Ancho~aqe, AK 99503 Agent N/A Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ~ TYPE OF WATER SUPPLY: Individual well x Community well Public water NOTE: 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 Public sewer NOTE: If community wastewater system, provide writtps.confi.r, mation from State ADEC attesting to the legality and status of system. X 72-025 (Rev. 1/91) Front MOA #21 STATEiVlENT OF INSPECTION BY ENGINEER As certified by my seal affixed here[o 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/orwastewater disposal system is safe, functional and adequate forme number of bedrooms and type of structure indicated herein. I further verify that based on thehformation 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. NameofFirm Eagle River Engineering Service~hone 694-5195 Address P.O. Box 773294, Eagle River, AK 99577 Engineer's signature ~,~~- Date /o.// DHHS SIGNATURE _/"*,~,,,~_ Approved for Z~/,'<-'~-'_~) Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does th is 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 ce(tificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professi~'nal engineer's work. 72-025 (Rev 1/911 Back MOAi121  Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 0C'" 'i931 I;~)!3~icip~,~]'t,y,o,f Anchorage ~HeaI~1~ & Human Services 7-/z,,/,// ,'E//~J~ .5~E. <?' Parcel I.D. A. WELL DATA Total depth. Well type ,/'~/P)b'~'~' If A, B, or C, attach ADEC letter. ADEC water system number . . Log present (Y/N) ~'~5 Date completed ~2~,/-,~Z¢ Driller ? '~ '~ ~ Cased to Sanitary seal (Y/N) Date of test Static water level Well flow Pump level FROM WELL' LOG ! ~'?-~ Casing height 1~'~ Wires properly protected (Y/N) g.p.m. AT INSPECTION / - .MUN!CJPALi;I'Y OF ANCHOEAGE ¢ 2//~/~r~VI~.ONMENTAt- S~RVICES DIVISION OCT 1 8 991 ' EIVED SEPARATION DISTANCES FROM WELL TO: Septic/he!ding-tank on lot Absorption field on lot Public sewer main Sewer service line ~ ~/ ~'~ ;Onadjacentlots ~'~ / ~ ; On adjacent lots Public sewer manhole/cleanout Petroleum tank -//oo WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: 0~//~/~/ <~ <. ~' -~ ~/L Other bacteria ~' / Collected by: r-./,,/~ /~/~'~/'~ S. SEPTIC/HOL-BtN~ TANK DATA Date installed /~./2. y~O Tank size ~ ~ ~1~ Compartments ~, Cleanouts (Y/N) )/ (~ / Foundation cleanout (Y/N) Y Depression (Y/N) High water alarm (Y/N) /,////"~ Alarm tested (Y/Hi ' ./~//'~ Date of pumping /~)//~,/~/ Pumper ~/~ ~ SEPARATION DISTANCES FROM SEPTIC/HOEENNC~TANK TO: Well(s) on lot ~ ~ tT'~n adjacent lots ! To property line / ~ Absorption field Surface water/drainage x Foundation Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on"l v I at High water alarm level ~.~~ Cycles tested Meets MOA electrical~ SEPARATION~"T~NCE FROM LIFT'STATtON TO: Well~ocr~ot On adjacent lots Manufacturer.----'"'"'"""-' Man (Y/N) ~ "Pump off" level at Surface water D. ABSORPTION FIELD DATA Date insta~lPe~p'4¢~ IO///~J¢/ Soil rating ¢. ~ Cp~¢z System type /~¢P ~~ ~O~ / ~ ~, Length ~// Width~o ~ ~ ~Gravel thickness ~ / Total depth /~. ~ Total absorption area Cleanouts present (Y/N) Depression over field (Y/N) ~ "~' Date of adequacy test ~/¢ z./? / Results (pass/fail) ~/ Peroxide treatment (past 12 months) (Y/N) for --~ bedrooms If yes, give date __ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot ~ To building foundation On adjacent lots Surface water Curtain drain /"///4 Property line__ To existing or a.ba,q4te4:~ system on lot _ Cutbank /~,//¢ Water main/service line Driveway, parking/vehicle storage area ~) E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date 1,¢ - HAA Fee $ ,/'~L~ d~' Date of Payment /~¢~' / c¢ Receipt Number o.3 ~/ ~ E" 72-028 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number A Eagle River Engineering Services 11940 Business Blvd, Suite //205 'P.O. Box 773294 Eagle River, Ak. 99577 694-5195 Fax 694-3297 Legal: )-,, r ~ /~//r 7 ~ Date: Owner: lType of test: [] Well Flow TeSt [] Septic 'fast Only l~ Well & Septic Test [] Other:_ Time ii;/~ I1: Meter Reading Level Well Tank GPM PSI LeVel Level 6%o Remarks ; DepL Health &Human Services MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECT{ON DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) .~o~ or directions) ~ ~'~&~1~m~(~): Le~din~ Institution ~; Owner/builder ~; ~er ~; Other D (explain); r~ ~- ./ (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: /,, '~./ ', <' /,? .~' , . 2. '~YPE OF RESIDENCE Single-Family ~' Multi-Family [] ~,, Number of'Bedrooms Other WATER S. UPPLY 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..'. SEWAGE DISPOSAL .,,v/,. Onsite ~ Public [] Community [] Holding Tank [] 'Note: If community well system, must have written con. firmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ,ENGINEERING FIRM PROVIDIN~'G"I~NSPECTIONS, TESTS, FILE SEARCH, DA ~i'A"AND INFORMATION As cedified by my seal affixed hereto and as of the validation date shown below, I 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 fudher 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, o~dinances, and regu!~tions in effect on the date of this inspection. Name of Firm ~E~5, / ~- Telephone Address 12o TE Date DHEP APPROVAL . ' I ~ Approved for C'_ gbedrooms bye-- Approved Disapproved Conditional Terms of Conditional Approval Date CAUTION, The Muncipality of' Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025' (! ~/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MO)~"- .....,=r~l/M. PP'OTE~TiO~ HEALTH AUTHORITY APPROVAL (HAA) JOt\l© ,j CHECKLIST - FEBRUARY 1984 Legal Description: Well Classification /~/~/.D I f///P¢/~-~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (DN)- Date Completed - I *-)f-//%/'~--~; '7 ¢ Yield Total Depth_ ,~'Z'~ Cased to_ ~3'~---~ 3,5"/, Z " Static Water Level Casing Height Above Ground _ Electrical Wiring in Conduit (~N) Separation Distances from Well: To Septic/Holding T~nk on Lot 7;~' / To Nearest Edge of Absorption Field on Lot _ To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ~ -,12 Depth of Grouting Pump Set At Sanitary Seal on Casing ~N) Depression Around Wellhead (Y~ ; On Adjoining Lots 92_ / ' On Adjoining Lots I O0 /i_/ /SF To Nearest Public Sewer ~ To Nearest Sewer Service Line on Lot - ;Date . B. SEPTIC/HOLDING TANK DATA Date Installed _ J~-/~ ~/7~ Standpipes CN) - Depression over Tank (Y/~ Size. Air-tight Caps ~N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~ /~/'//'~ Separation Distances from Septic/Holding Tank: To Water-Supply Well _ ~"~' To Property Line No. of Compartments Foundation Cleanout ~/N) Date Last Pumped /V//~- ;for_ Temporary Holding Tank Permit (Y/N) To Building Foundation t/,~- / To Disposal Field '7~,~- / To Stream, Pond, Lake, or ~ajor Drainage 72-026[11184) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed "Z./2. 7/,~,~, Width of Field .~ / Square Feet of Absorption Area Depression over Field (Y/~) Results of Last Adequacy Test Type of System Design Length of Field Depth of Field . Gravel Bed Thickness 7 Standpipes Present (~N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well (~.7~ /' ? To Building Foundation '~/ Lot /~/'//IT- To Water Main/Service Line /V/,~- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line '~- To Existing or Abandoned System on ; On Adjoining Lots . ~'~0 / To Cutbank (if present) _ ioo/¢-- D. LIFT STATION Date Installed Dimensions ~ Size in Gallons Manhole/A~j High Water Alarm Level at Vent (Y/N) Tested for Electrical Codes (Y/N) Comments J Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I hecferphecked, verified,.or conformed to all M. OA and HAA guidelines in effect on Signed ~ Date Company ~';1~[~.~__'~_ //'~LI"7. MOA No Receipt No. %~Gq~ ~ Date of Payment ~- ~ Amount: $ ~ ~ the date of this inspection. ] unicipal Yof Anchorage P.O. BO~ 196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES June 17, 1986 Jeff Kaitchuck Alaska Environmental Control Services, Inc. 1200 West 33 Avenue, Suite B Anchorage, Alaska 99503 Subject: Lot 9 Block 7 Preuss Subdivision Waiver Request, WR86-072 Dear Mr. Kaitchuck: Your request for waivers of the required 100 foot separation between the well and septic system components has been granted. The existing separation to the well is 75 feet from the septic tank and 92 feet from the closest part of the absorption trench. These waivers are valid for the existing septic system only. Any upgrade of the system will invalidate this waiver. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw ALASKA B"TrdlROFlmerlTAL COIqTROL Seh lCe$. IFIC. ~n§ineerin§ 8- I~noironmental Studies STEVE DAVIS SR1 BOX 5512 EAGLE RIVER ALASKA 99577 SELLER-SAME JUNE 2 1986 STEVE DAVIS SR1 BOX 5512 EAGLE RIVER ALASKA 99577 60191 LEGAL:PREUSS BLOCK 7 LOT 9 ADEQUACY TEST FOR SEWER SYSTEM ADEQUACY TEST DATE-MAY 27 1986 THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA 0P 460 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 717 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. sEPTIc TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON MAY 20 1986 . THIS REPORT DOES NOT VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. PLOW TEST ON WELL WELL FLOW DATE-MAY 27 1986 A FLOW TEST WAS PERFORMED ON THE WELL. 717 GALLONS OF WATER WAS PUMPED AT A RATE OF 5.12 GPM OVER A DURATION OF 1.5 HOURS. THE DRAWDOWN WAS .7 ' WITH A RECOVERY TIME OF 10 MINUTES AND THE STATIC WATER LEVEL WAS 351.2 FEET. THE WELL IS ADEQUATE FOR THIS S BEDROOM HOME. 1200 UJest 33r¢1 Auenue, Suite [~, Anchoroqe, Alaska 99503 ,,(907) 561-50/40 ALASKA e,-HLIIBoI meFITAL COF/TROL Sei dlCe$, II3C. J~ncljncerin§ $ I~nuJronmcnlaI $1udics May 30, 1986 Municipality of Anchorage Department of Health and Human Services 825 L. Street Anchorage, Alaska 99501 RE: Preuss Subdivision Block 7, Lot 9 The above referenced lot consists of a S-bedroom single family dwelling served with a on-site individual well and sewage disposal system. The well was completed June 1, 1974 and the sewage disposal system was installed December 27, 1976. On May 6, 1986 we performed a Health Authority inspection on the subject lot and found that the septic tank is 75 feet from the well and the closest edge of the absorption area is 92 feet from the well. The well is 375 feet deep, cased to 373 feet and has a static water level of 351.2 feet. Relative height of the bottom of the septic tank is 8.55 feet below the ground around the well head. On the Municipality of Anchorage inspection report completed December 27, 1976 by Joe Blair, MOA, it is noted that the distance from the well to the septic tank is 75 feet and the distance from the well to absorption area is 92 feet. At that time the regulation stated that both the septic tank and the absorption area must be 100 feet from the well. The water sample taken on May 6, 1986 is free of coliform bacteria. We feel that the location of the well in relation to the septic system will not promote a health hazard. Therefore ~e reqhesi;'that you-grant~;'a~waiver for the separation distances from the well to the septic tank and absorption area to 75 feet and 92 feet respectively. If you have any questions please feel free to contact this office. Sincerely, Jeffrey Kaitchuck Engineering Techuician ApproQed ~ucnu¢. Suite [~, Anch0ra§¢, J~laska 99503 o(907) 561-5040 1200 West 33rd Avenue, Suite B - ANCHORAGE, ALASKA 99503 CALCULATED BY ~'~ T ~ (907) 561-5040 CHECKED BY ~O^LE 1'%20~ OF DATE GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "c" Street, Anchorage, Alaska 99503 274-4561 Date Received December 20, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF Buchholz INDIVIDUAL SEWER & WATER FACILITIES FOR 12-20-76 Monday 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: Cony. Alaska Mutual Savings Bank Post Office Box 1068 99577 Bill Foreman Phone: Phone: General Delivery Eagle River 99577 Lot 9 Block 7 Preuss Subdivision 4. Location: 5. Type of facility to be inspected Single Family 6. Well Data: A. Type Individual C. Construction 7. Sewage Disposal System: A. Installed C. Septic Tank: 1. D. Seepage Pit: 1. E. Disposal Field: 8. Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line No. of bedrooms 3 B. Depth 375' D. Bacterial Analysis Satisfactory On-site system 1976 B. Installer R.B. Woods Size 1,000 2. Manufacturer Absorption Area 460 sq. ' 2. Material Total length of lines Greer , Absorption area , Other contamination , Sewer Lines , Absorption area EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re( ~t for Approval of Individual S ~r & Water Facilities Legal Description Lot 9 Block 7 Preu~$ Comments Approved ~]~/~/~_~ Disapproved Date ~ Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES VA FHA CONV 1. Type of Inspection: CMRO 2. Property Owner: ~// ~~-~'"'-~'-'~ ~ Mailing Address: ~ , , ~ Day Phone: 3. Name of Buyer:~~~ Mailing Address: Day Phone:. 4. Name of Lending Institution: ~/~~' Mailing Address: ~~~~/~~ phone: 5. Name of Realtor or Agent: Mailing Address: Phone: Legal Description: ~~--_---~ L ocat,on 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: No. Bdrms. ~ Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site] If Individual, date of installation 72-003(3/76)