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Home My WebLink AboutPROSPECT HEIGHTS #1 TR A2 O Municipality of Anchorage t Development Services Department .... Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 5 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW040024 PID Number:. 01 5--091 --,34 tame:MARK AND NANCY JONES Wastewater System: [] New · UPgrade Address: 9901 SCHUSS DRIVE * ANCHORAGE, AK 99516 ABSORPTION FIELD No. of Bedrooms: Ph°ne:(907~ 346--3284 4 I Deep Trench [] Shallow Trench r'l Bed nMound r'lOther Soft Rating: Total [~pth from original grade: LEGAL DESCRIPTION ~.2 ~... 9.5-11.0 Block: Lot: Subdivision: DepLh [o pipe bo~)m lmm o~ginol grade: Orovel depfl~ ben~3th pipe: - TRACT A-2 PROSPECT HEIGHTS #1 5.0 MAX ~ 8.03 rL Township: Range: Sec[ion: RII added obev~ original grade: Omv~l - - - SEE DWG. ~ 36 WELL: [] New [] Upgrade 2.5 ~. 1I - Cla~lflcatJ~ (P~mtl, AB,C): Total D?,.p. Iba'/'~ Gaeed To: Total obe~rpU~n cr~o: Pipe ......~ ~. rL 576 s~.n. D 3034/ F-810 n. AKWWC, INC. 1-23/2004 SEPARATION DISTANCES ,s,ptic nHo~m, nS.T.E.P, nO~h,r To Septic Absorption Eft Holding 'ub,c/Pn~t. I~nufodur~. C=lmc~V In :From ~ Tank Field Staten Tank S. wor Un. ANCHORAGE TANK 1250 Materiel: Numbs' of we, 1 oo'+ 1 oo% - - 25'+ STEEL 2 S~,ace Wotar ~00'+ ~00'+ - - - LIFT STATION Lot Use 5'+ 10'+ - - - 'Pump on' level or: Foundation §'+ 10'+ -- -- -- Curtoln Drain N~NE KNOW~ - Remorks: BENCH MARK OLD SEPTIC TANK COMPLETELY ABANDONED PER UPC TOP OF ELECTRICAL METER BOX OLD DRAINFIELD COMPLETELY ABANDONED ENGINEER'S SEA~ Inspections performed by: AKWWC, INC. Dates: 1st 2/21/2003 ,..,- · -(.---I. J~"~: 3rd 2/23/2003 ' ~ ' Development Serv!ces Department .Approval I1~1~o~..... .....¢~,~,~ R~viewed and approved by: ~ ~: AS- BUILT D RAWIN G ~°~ '~ ~: SW040024 015-091 -,:34 r r c.J.O. ..... CONSULTANTS, INC. ;, , ~ .... ~ ..... --1. I J. i ......... ':....v~ AS-BUILT DRAWING OF SEPTIC SYSlEM UPGRADE · A B ST1 45.70 38.01 ST2 51,89 42.98 DBL1 53.84 44.30 DBL2 54,75 45,09 C01 105,43 104,85 MT1 105,60 105,59 C02 132,49 138,70 MT2 ;132,18 137,87 PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER: SW040024 015-091-34 FINAL GRADE _ 111.71-112.71 TH#1 ST1 ST2 . TOP OF TANKAT INLET = 107.21 /00UPF TANK 07 18 NEW 1250 GALLON INVERT OF BUNGSEPTIC TANK INVERT OF BUNG AT AT INLET = 106.6 I OUTLET = 106.36 FINAL GRADE = MT CO 102.53 (AVG.) r ORIGINAL GRADE = 101.50-103.00 FABRIC INVERT OF PIPE = 100.03 (AVG.) BOTTOM OF TRENCH = 92.00 (AVG.) LL -.Z— RELATIVE ELEVATION OF BOTTOM OF TEST HOLE = 85.50 (TEST HOLE DRY) DATE: 2/24/2004 4oQ DRAWN BY: J ALASKA WATER & WASTE, W C.J.G.ATER p/� •'" 4 T 70,CONSULTANTS, SCALE' INC., — 40' D 3701 E. TUDOR ROAD, SUITE 101 . ANCHORAGE, AK 99507 ' PHONE (907)337-6179 ` FAX (907)338-3246 — O '•• PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARK AND NANCY JONES (907) 346-3284 2 OF 3 QO ff ey 04 9s •, - Ga ness 953 �Q LEGAL DESCRIPTION: PROSPECT HEIGHTS SUBDIVISION #1; TRACT A-2 �c a a o �Q�ed ro f e siono\ o0 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE ../// TRACT A-1 UTILITY S B9'752'22'%/ SINGLE FAMILY FRAHE HOUSE O VELL 299,20 AS-BUILT SURVEY SCALE: 1" = 40' THE INFORMATION HEREON IS POR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFUCTS EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADI STRUCTURES OR FENCEUNES. EASEMENq'S OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PRO[: ~R LOCATE STRUCTURES. ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS. I HEREBY CERTIFY THAT I HAVE PERFORMED A MDRTOAGEE°S INSPECTION DF THE FOLLOWING DESCRIBED PROPERTY, TRACT A-E, PROSPECT HEIGHTS ADD'N. ND. I ~ETWEEN ITIJ~t3RAGE RECORDING DISTRICT, ALASKA AND T THE VISIBLE IMPROVENENTS SITUATED THEREO WITHIN THE PROPERTY LINES AND THAT ND VIS ENCROACHMENTS EXIST OTHER THAN NOTED. RT~'A'~J~.I~T ANCHDRAGEo ALASKA THIS __24TH .... DAY OF .FEBRUARY ............ 2004 ..... HOLT LAND SURVEY[NO 9266, FBHt-Io3 TEL. 345-5513 MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Feb 20, 2004 Expiration Date: Feb 19, 2005 Permit Number: SW040024 Legal Description: Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: Mark & Nancy Jones Owner Address: 9901 Schuess Drive ANCHORAGE, AK 99561- Parcel ID: 015-091-34 Site Address: 009901 SCHUSS DR Lot Size: 43560 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: r~ Disposal Field r~ SepticTank [] Holding Tank [] Privy r-~ 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Parcel I.D. Municipality, of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 w,wv.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT 'APPLICATION FOR A SINGLE FAHILY DWELLING ,~----~ I '"" "~ W Permit Number Property owner(s) MARK &: NANCY JONE;$ Day phone 346-3284 Mailing address (1) 9901 SCHUES$ DRIVE Mailing address (2) Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size q'~ THIS APPLICATION IS FOR: Sewer Only r-] Sewer and Well Sewer Upgrade [] Acres/~ *ANCHORAGE. AK 99.,561 PROSPECT HEIGHTS SUBDIVISION N/A Number of Bedrooms Zip Code 99501 #1; TRACT A-2 4 Well Only Water Storage ' BI, THIS PROPERTY CONTAINS: Hot Tub El Jacuzzi [-1 Swimming Pool D Water Softening Unit El Therapy Pool El I certify that the above information is correct. I fudher certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS~ INC. Permit Fees: ,~' Date of Payment: Receipt Number: '~~t~-- q'(O ~'~ Waiver Fees:. Date of Payment: fl~'J'¢/ q~"~-~ S---~ Receipt Number: ALASI A WATER & WASTEWATER Jr','.' ....... ~ ...... CONSULTANTS, INC. ""'"~ .... ""'"" February 17, 2004 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Proposed Septic System for Prospect Heights Subdivision #1; Tract A-2 To whom it may concern: The proposed 4 bedroom house is served by a private well and septic system. The existing septic system is in the state of failure and must be upgraded. A test hole was excavated north of the septic system. We are proposing that a new 1250 gallon septic tank and a deep trench type drainfield be installed. The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 1.2 gallons/day/ft2 should be used, and that the insitu sandy soils ~ 15-17.5 feet will act as a sand filter. 2. TRENCH DESIGN: a. Percolation Rate: <1 minutes/inch b. Proposed Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 500 ft2 f. Total Depth: 11 feet (max.) g. Effective Depth: 8 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 35.feet long k. Effective absorption area = 560 ft2 3. SURFACE WATERS: There are no surface water within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography in the area of the proposed drainfield is a 10 -15 percent slope running from east to 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com west. In short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. assistance. SincerelI If you have any questions, please contact us at 337-6179. Thank you for your , P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soils log, and a 7page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com ......... CONSULTANTS. INC.~ MARK & TRACY CRAIG 346-3284' /J '"-~ ": " ~ ~PROPOSED DRNNFIELD EXCAVATE A ~ J / \ '."_' !~. ~ MAXIMUM BY 2.5 FEET WIDE BY ,35 ~.. J / \ '.".']'.t: Cc~'~ FEET LONG. ADD 8 FEET OF CLEAN ...... CONSULTANTS, INC.- ---.~ 1" = 40' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: '""" i ................ MARK & NANCY JONES $46-5284 2 OF 2 , ss..: PROSPECT HIGHTS SUBDIVISION #1; TRACT A-2 DESIGN FOR PROPOSED SEPTIC SYSTEM UPGRADE ..... - ~ CONSULTANTS, INC. ,-,----.=.--.,= E 101 * N~CHORAGE* AK. 99507 · PHONE: (907)337-6579 · FAX: (907)338-3; i · WEB$1TE: ok SOIL LOG - PERCOLATION TEST ION: PROS~PECT HEIGHTS SUBDIVISION; TRACT A-2~ ,,: MARK & NANCY JONES DATE: 2/12/2004 ORGANICS ' - ~:-' - ---.-. CONSULTANTS, INC..,.---...-.-..---.-,i-- ,., 3701 E. IUDOR ROAD, SUITE 101 · ANCHORAGE, AK. 99507 · PHONE: (907)337-6579 · FAX: (907)338-3245 · WEB$1TE: okw~coco~ LEGAL DESCRIPTION: PERFORMED FOR: ITEST HOLE #1I GW TO GW-GM GM ' SOILCLASSIFICATIONS GW GP GM GC SW SP SM SC DEPTH TO GROUNDWATER DATE DRY 2/12/2004 DRY 2/19/2004 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST-RUN BETWEEN 5 FT. AND 6 FT. A FOUR HOUR PRESOAK WAS PERFORMED: [] YES · NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: KELLY HEITSTUMAN COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS /C)ERF/ORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ~-_/1~ Ir~Z~.. Heat MUNICIPALITY OF ANCHORAGE 'h and Environmental Prote('~'~on Fourth Floor West 825 L Street Anchorage, Alaska 99501 279-2511, x 224, 225 ................. -i-N "P'EcTION REPORT ON-SiTE SEWAGE DISPOSAL. SYSTEM SEPTIC TANK: DISTANCE I ~.~..~ .4 /) '--/J-- NUMBER OF [~. FROM WELL./~)-~- ....... MANUFACTURER~ _MA'fF RIAL_/~~ . .COMPARTMITNTS ......... INSIDE LENGTH ........ INSIDE WIDTH .... LIQUID ()FPTH ........ t ICiUID CAPACITY/~GA, LLONS. TILE DRAIN FIELD: ]OTAL LENGTI-t ¢ /~ OF I. NE /--7/".~' ~: '/~"~1(,/0,I FOUNDATION/J/)T['-" N[.AREST 10[ LINt~ /~ /-/-'- DISTANCE f-ROM W,I ............... · / ABSORPTIOFI *,REA .... ~'>'&~ SQ. FT. LENGTH OF EACH LINE / L)Em~tO~ FILTER SEEPAGE PIT: DIAMETER ..... OR WIDTH ....... ~,_~ FNGTH, , .... , DEPTI4 Log Crib Rings BUll. DING FOUNDATION__. Crib Size: DIAMETER .... DEPfPl .... DISTANCE FROM: WELL ............. TOT,AL EFFECTIVE NEAREST LOt LINE ...... ABSORPTION AREA (WALL AREA} ......... SQ, Fi. Wello Well Di--~t~ce To: Lot Line/d+ Bldg: /~1~ Sewer Line: /¢7-~ Pipe Materials' ~ of Bedrooms: Remarks: 'i i;?i:';;?',!!;:H O1:,i' i::';! 'i ;i:i:i, 'i'i"i~; i;:';(:~i;'i'l":d',i~;:i':; E',iE'i"i.'.iiiii;ii'i;H 'I'HE ::::! l?i'::'t::;~l'":i::: :::' i:::',i';;l¢"i!;ii"i t'liz:' ii'i~i; :;'::'::':t:::i¥t:::~i' (;Ii"4 ':;;(i",! i:':'l:~?'T;:'. i.'.! i: i;::" hi i':'!;;d';i; T :;' ;:'i"!' i'" i:'i::i;i'::"'i"l ;i;i:; 'ii'l(::[ 4ti",i;i:?'iiii"i i.;'ii¥:::'Ti! I;')i::' ':i:;':::¢,,,'i::l !:'~:i::['i"i.,.l~!!;i!i¥,l 'i"hiiE " TF:'::I I iii':, ii-.if::' f-;:;;:-:;i :1:':t;,.¢ :::i" 'i l';ii",i ," ;i i",! .::: ":'i::;'i' ':' .:--"IEATER ANCHORAGE AREA BOROUGH~-~ HEALTii DEPA~;T:.!ENT :. 'CASE 327 EAGLE STREET ' ' ' ~CHORAGE. ALASKA· 99501 . LeKal ~sc~pslon, ~o~ Block S~di~ision ~--~ Soil Chaz, act ez, istics %las G~ound Watem Encountered? If Yes,' A~:. What: Readlng Date Gross Time Location Sketch Net Time Depth To H?O Drop Proposed Instal~Seepage Piz ~-", Drain Field Depth Of Inlet .~ Depth To Bottom Of COMME~ ~o: ~"r ¥-~' -- _ ,. - .... / ~it Or Tmencn Test ?erforme~ ~:.~ MUNICIPALITY INCH f�04\ Development Services Department =_ s Phone: 907-343-7904 On -Site Water & Wastewater Section--^ Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-091-34 1. GENERAL INFORMATION Expiration Date: 0 2 ozc) Complete legal description Prospect Heights #1 Tract A2 Location (site address) 9901 Schuss Drive Anchorage, AK Current property owner(s) Federal Home Loan Mortgage Corp. Day phone 907-229-8993 Mailing address 500 Plano Parkway, Carrollton, TX 75910 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: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑Q Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6.60 Date of Payment Receipt Number 2.63x60 f COSA# 05G2012CV-k Waiver Fee $ Date of Payment Receipt Number 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Civil Engineering Phone 522-7773 Address 1399 W. 34th, Suite 100 Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 6/30/20 410'. OF 44 too G 6. DSD SIGNATURE C , A �'®.......'.................................... System #1 roved .. y pp for bedrooms A MICHAEL E. ANDERSONgum 00. ff 0, - - X O. CE-4381_�® System #2 Approved for bedrooms �p r�F•'••. 6/30/20 .••''��® Disapproved 4� flap®®S®�1®®®� Conditional approval for bedrooms, with the following stipulations: `j ON-SITE TEvyATER o J pROGF J A- IN 0))))))))111 By: !ii/ Original Certificate Date: Z—w7_0 The Municipality of Anchors 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 Checklist blue sheet COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: will be submitted when they become available. Previous results dated 3/28/14 and 1/22/04 were ND. Prospect Heights #1, Tract A2 015-091-34 1.0 ~1977*NA 400* >40* ** >18 Forge Egineering 6/22/20 180 6/23/20 *Data taken from previously issued COSAs found in MOA file. ** Arsenic results pending and 16 Septic/Steel 50 7/1/20 - AK Quality Septic NA DeepTrench 2/21/04 6/22/20 4 11.1 0 3.1 2625 15.5 1440 0 >600 No 2000 ✔ 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 Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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 Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft F. ENGINEER’S COMMENTS G. ENGINEER’S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 7/1/20 ✔✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ See letter regarding well flow test. ✔ Received Date/Time 06/23/2020 16:45 06/23/2020 13:20Collected Date/Time 1202856001 Matrix SGS Ref.# Client Sample ID Prospect Heights #1 TR A-2 Client Name Project Name/# Printed Date/Time 07/10/2020 14:16Forge Engineering Inc. Technical Director Stephen C. Ede Prospect Heights #1 TR A-2 Drinking Water Sample Remarks: Parameter Results LOQ Units Method Allowable Limits Prep Date Analysis Date InitContainer ID Metals by ICP/MS ACF07/09/20EP200.8ug/LArsenic 06/24/20ND5.00 (<10)B Waters Department EWW06/24/20SM21 4500NO3-Fmg/LTotal Nitrate/Nitrite-N ND 0.200 (<10)C Microbiology Laboratory A.A06/23/20SM21 9223B100mLE. Coli Negative 1 A A.A06/23/20SM21 9223B100mLTotal Coliform Negative 1 A Page 2 of 5 / O / O i i DR\ 00, lb 5 i i i C - �i i r OF qCq�;.4p 49 TH* °y SHANE A. HOLT io LS -6914 _ ..... ae o • DECK of -- SINGLE /-- SINGLE FAMILY HOUSE DECK M 10' UTILLTVEASEMENT S 89°52'22"W 299.20 TRACT A-1 sQ,o 00, 7cJ�J WELL IN, AS-BU/LT SURVEY I" =401 NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY TRACTA2, PROSPECTHEIGHT51 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN EXIST OTHER THAN NOTED. HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE DATED AT ANCHORAGE,ALASKA THIS 12 TH DAY OF PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. JUNE , 2020 ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. LAND SURVEYING HOLT HOLT9 09 GROVER DRIVE ANCHORAGE,AK 99507 0 ti l tV J 2 e ti . 00 �, O P • OF qCq�;.4p 49 TH* °y SHANE A. HOLT io LS -6914 _ ..... ae o • DECK of -- SINGLE /-- SINGLE FAMILY HOUSE DECK M 10' UTILLTVEASEMENT S 89°52'22"W 299.20 TRACT A-1 sQ,o 00, 7cJ�J WELL IN, AS-BU/LT SURVEY I" =401 NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY TRACTA2, PROSPECTHEIGHT51 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN EXIST OTHER THAN NOTED. HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE DATED AT ANCHORAGE,ALASKA THIS 12 TH DAY OF PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. JUNE , 2020 ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. LAND SURVEYING HOLT HOLT9 09 GROVER DRIVE ANCHORAGE,AK 99507 Municipality' of Anchorage · .,.,, ~, Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. .~;~ . p.o. Box 196650 Anchorage, AK 99519-6650www.cLanchorage.ak.us(907) 343-7904 ' ~~~___~ CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-091-54 1. GENERAL INFORMATION 0 0 0 0 Expiration Date: j-~- ~ (z:) - O ,~' Complete legal description PROSPECT HEIGHTS SUBDIVISION #1; TRACT A-2 . Location (site address or directions) 9901 SCHUSS DRIVE * ANCHORAGEt AK 99516 Current Property owner(s) MARK Mailing address 9901 Lending agency AND NANCY JONES Day phone 346-3284 SCHUSS DRIVE * ANCHORAGE, AK 99516 Day phone Mailing address Real Estate Agent Mailing address TRACY CRAIG w/ DYNAMIC PROPERTIES Day phone 5111'"C" STREET * ANCHORAGE, AK 99503 261-7510 Unless otherwise requested, HAA will be held by DSD for pickup. 2. 'NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage r-I Community Class Well [--1 Public Water System D TYPE OF WASTEWATER' DISPOSAL: Individual On-site [] Individua! Holding tank [-'1 Community On-site D Public Sewer D The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system, DSD also issues HAAs upon request to homeowners, Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples,) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work, II pr )d .WATER SAMPI RESULTS: :', :;."L" I,' 0 coloniesllO0 mi. Coliform '0 ~, ~!l:colonies/100 mi. A~)selnic: .~iN/Ai:[~g.~L! · . ' ~ .D.,a,t~e. 0fsamp!e: 1/22/2004. iColle,,c}~d.~y:" : AKWWC, INC. SEP~TICiHOLDING 'rANK DATA :Il. i::?.,. :!l'~i i t:;;: :.. : , .! ~:!. i! : - .' ' '..',- ,~!,.'.~, .~i,i. . , t: ~:.~,,~ ';I .i-~,' . - ' ..... 2 21'23 2004- T~,~Tv,,~_/M~t~.nalJ I..t...., · STEEUii': .~'; ',i.. ~ =..: . . Date installed . / / Tank s~ze' 1250,,ga!.. . :Number o.f C0mpartm, ,egt. s ! ~ :.: ' i cleano. ,uts,,(Y/N) . . YES ....... ,,~ ,.. ....... , , ._.__.__~i.-- ,i~~ i ~ ' ' - , ' ':, ~ , . : ' ,., ........ ,., . . ; ..... , ...... ......... .: (:j~datidh clealn~'uJ(Y/N) YES DepresJsi6n:over !a, nk (~Y(N)~ NO ~. H,gh .w.a~er alarm (Y/N) ! N/A Date of pumpng I: ~.: J; NEW :' ~umper ';' ~[~J t' Ii ' ' " l :',H. ,' , :;.,, i : I. ' I;i q~, t -~ ' ':'~ ' i ~I 't: I'' n ~ , ,! ~ .. ,, ,' · ~ r~ .... , , , ~' ;t. ,] ~. : ABSORPTIONFIELD!DATA ' ' ,;J, I!I**BELOW,FINAEGRADEI i !: ",'i=',,i?.]: ':i;, ;' ' !1~ ,,,I,~, l,,I/I,,/l, . '-jj!~,.;r~;",j;?. j2:'! ' ~,~!'::.,i ,.' 'TRENCH Da{e installed '~ Soil rating.[q.p;d./tOo,r;ftlbdrm) ~; : :.:i:~,. ~ystemizype "' ,~,~-,,'-"~ .... ' .,,,' I. "r~ · . ' , I ~[!i' ',~'' .,' i.I''' ~ ' ;t,:' ~ ' .,i J .~':'"'~il '" ~ ~,,I!!.~;. 'I ' ~:~ '~ :':. ' "' ' · .8 .fl Length ..... ft. . . ! ~. ..: ..,~. . . , . ~J~I .:.~.,,.,,.,~1:~t .,ll,,ili .... ! ~: :,.~': .;'; ': -'~ ~i ~'~ · ' T, ota~ depth -'"o-s. ~I" Eff. absorpt,on ~,fia :,ST~ ~. Hp, n t.or,ng t~.be ,Y. EE ,,, ~ ~epress,on over fie~d NO Date of adenga','~'tbst .!ti NEW' - :i i Resu ts (Pass/Frei) ..... ,~, i' '~, . ' For: 4 bedrooms i', - i i,ii, ~.i ,~' ' ' ' ' E ';;' i I !! !~ ,: ' : ~ :i ,,j '. ": ' E uid depth in absorption field before test ~',- ~,' m.. ! [ = i Watre, r added - ,-gal. ! ,, .~. , New depth ~,- .,,', ",. , ~ il',' ' ~,~, , , [ ' 'L ;',',~i, '; ;" ~, . ;'. J"' ~"~';'!!. i : Eia[~sedTime. l';"-r min. - Final fluid .depth ; ~- '.'. m. ~? ~!~ . I ,ADSOr ~on, raJe>=~._..~- ._g.p.u. ,! . . ',~ ................ J.''. ..... ..,. .: .... .,,,,,, ,I,,, . .f,I,,,, ........ , , ., .... l . - An~rejuv, enat~n~re~ment(past12mo.)~/~&~tYP~?): '":: ;' ,-, :, 4... ,ry~s,g,vedate · ..... ' ' ' · ' '' ~ i ~ ~ ~ :; :~ ' :' J . ' ' : I r . i ; : i ~ t. , Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anehorage.ak.us (907) 343-7904 Water Well Advisory. Health Authority Approval # 040060 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block , Lot Tract A-2 of Prospect Heights #1 subdivision, the well's productivity was determined to be 0.44 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4-bedroom residence is 0.416 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. ;907 5615301 2/ 3 2--24--04;10:04AM; G5 ReLY ;lient Name 'rolect Name/# :iient Sample ID ~atrlx 1O40426001 AK Water & Wastewater Consultants Inc. Prospect Hts S/D Tract 2 A-2 Prospect Hts SfD Tract 2 A-2 Drinking Water 'WSID 0 All Dates/Times are Alaska Standard Time Printed Date/Time 01/27/2004 12:48 Collected Date/Time 01/22/2004 14:05 TR:cC~inviZID;:ree~c~/ ~. 0slt~%04E~:37 ample Remarks: Allowable Prep Analysis ammeter R~sults PQL Units Method ConUiner ID Limits Date Date Ink raters Department Nitmte-N 0.406 0.100 mg/L EPA 300.0 0 !/22/04 .].lB [icrobiology Laboratory Toul Coliform col/lOOmL SM18 9222B A (<=1} 01/22/04 DKC 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 SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) ~z~ I ,_C, C..~ Property owner Mailing address Lending agency Mailing address. Day phone Agent 5i~-~ '~ ~ ,' .~ ('~.-5 Address ~[,,~'~ o~ Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water N,,OTE: NOTE: Day phone ~.~ 7-- (_..O1/~ 7 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 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 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. NameofFirm '~ ,--~,,,,,t,~[~__ ~'~.~-- Phone.~-~_&~./~ Address ~0 ~, cC./ / ,~-~ '~¢~-o ~ Engineer's signature "~ D~ SIGNATURE Approved for ~---~'~'"- ~//~/~ bedrooms. Disapproved. Conditional approval for 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 a, independent prore=sional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is 'issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91 ) Back MOA ~1 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~',co.c-{~- /5.- 3.__ A. Well Data Well type Log present (Y/N) Total. depth Sanitary seal (Y/N) Parcel I.D. O/,~'- -- o If A, B, or C, attach ADEC letter. ADEC water system number Date completed t ~"/'-/ Driller Cased to ~--,~-, ~z_ Casing height "/ Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~'o ~' L/~',.~-,,-') Absorption field on lot 9o ( U~,.,,- ~ g.p.m. AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer main Sewer serVice line WATER SAMPLE RESULTS: Coliform Date of sample: ~ll B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) ~/' High water alarm (Y/N) Date of pumping Nitrate Public sewer manhole/cleanout Petroleum tank >,1 I ,c) ! .. ~ ~ Other bacteria Collected by: MUNICIPALITY OF ANCI.IOP, Ar~I~ [,~,",'IRONMENTAL $1:RVIC~$ DIVISION Tank size /,2.. ~'4:~ Compartments Foundation cleanout (Y/N) /5/ Depression (Y/N) f'///,~ Alarm tested (Y/N) /"//,~- Pumper I/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: g.p.m. RECEIVED Well(s) on lot ~O On adjacent lots ~/0'-O Foundation /,...~ To property line ,~/C' Absorption field .-~ .Water main/serVice line Surface water/drainage 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons_ Vent (Y/N) "Pump on" level at. High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: On adjacent lots Well on lot_ Manufacturer Manhole/Access (Y/N)_ "Pump off" Level at .Cycles tested Surface water_ D. ABSORPTION FIELD DATA Date installed ~//~-~'/I.,~_ .Soil rating (GPD/Ftc) -- Length _ /7~) Width __ ~ Gravel thickness. Total absorption area __ ~/~ Cleanout present (Y/N) __ y Results (pass/fail) ~-~ Date of adequacy test _ Water level in absorption field before test Peroxide treatment (past 12 months) (y/N) ._System type "~',<,~,,c~ _ / /,, ~ .Total depth __~/~. Depression over field (y/N) '~{ for j Bedrooms After test ~' O .~lf yes, give date _ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot_ To building foundation On adjacent lots ;> Surface water_ ~ Curtain drain On adjacent lots. '7 ! u--c> Property line __ '~1 To existing or abandoned system on lot _ Cutbank i'~/,z~ 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 iu'effect~n the date of this inspection. Date HAA Fee $ ,-~0 ¢~' Date of Payment //~0 ~-~ Receipt Number ~-~O 5- 5/~'zT/ / Waiver Fee $ Date of Payment Receipt Number COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY SERVICES Chemlab Ref.~ Client Sample ID :TRACT A2 Matrix :WATER PROSPECT REPORT of' ANALYSIS Client Name :TOBBEN SPURMLAND, Ordered By :TOBBEN SPURKLAND Project Name : Project~ PWSID :UA Sample Remarks: ROUTINE SAMP[,E COLLECTED BY: T.S. 5633 B STREET ANCHORAGE. AK 99518 TEL: (907J 562-2343 FAX: (907) 561-5301 WORK Order : 71~417 Report Completed : 11/22/93 Co.llecteO :11/18/93 @ 13:00 [Irs. Received :11/18/93 @ ~3:20 hrs, Technical Di~ector:STEPliE~ C. EDE . QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date !nit Nitrahe.-N 1.64 mg/L }LPA 953.2/300.0 I0 11/19 LLi.t ~. .......... .--y ......... = ..... ==== ..... = .............. ======.-.=======.~ ===================== .... ~' Se~ Special Instructions Above ** i~,ee Sample Remarks Above UA = Unavailable NA = No't Analyzed U = Unde'tected, Reported value is the practica], quantification ].imit,, LT = Less Than D =~ Secondary di].u'kion. GT = Greater Than ~SQS Member of the SGS Group (SocJ~,~ G~n~ra,e de Surveillance) ENVIRONMENTAL SERVICES iN ALASKA, COLORADO, UTAH. ILLINOhq 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 Parcel I.D. GENERAL INFORMATION · Complete legal description "J-'~-(" /~?---/ ~)}).,c~'~'p~r,-T5 I,.~1-1~. -~ { Location (site add~'ess or directions)f~'~.t ~'C ~,~.~ S. ~) ¢"~ ~ · " . .:.,,. .'..~..?,,. Property °Wne[ Mailing address Lending agency: Maiiipg address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3o TYPE OF WATER SUPPLY.:' Individual well Day phone Day phone Day phone Community well w 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 ~21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that rn~ 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 regu latio ns in effect on the date of this inspection. Name of Firm ~ l,J t ~ Address ~ 2-1 I"~\ ~, -~-~ Engineer's signature Phone' DHHS SIGNATURE X Approved for' ¢ D~sapB. r.¢ved. .Conditio~nal approval ior bedrooms. bedrooms, with the following stipulations: Additional Comments By: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91 ) Back MOA ¢Y21 Legal Description: A, WELL DATA Well type ~ Log present (Y/N) Total depth ~' ~ ! Sanitary seal (Y/N) Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST If A, B, or C, attach ADEC letter. ADEC water system number hJ/m ~1, o Date completed Iq'/"/~' 7) Driller /'J IA Cased to ~l, ,~J I~. Casing height Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL LC~ AT INSPECTION ffZ..' l, I g.p.m. [, O SEPARATION DISTANCES FROM WELL TO: I Septic/holding tank on lot --/ Absorption field on lot Public sewer main g.p.m. Public sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Nitrate 7 I ~o Petroleum tank ~_.~ ~ L/ Other bacteria Collected by: ~'~./0 t~. /1~ B. SEPTIC/HOLDING TANK DATA Date installed ~/'~ ~ Cleanouts (Y/N) ' High water.alarm (Y/N) Tank size Foundation cleanout (Y/N) ,A~/~'~ Alarm tested (Y/N) Date of pumping SEPARATION'DISTANC~S-FROM SEPT C/HOLD NG TANK TO: Well(s) on Io~: ~ To property line ~ Absorption field Surface wateddrainage Compartments ~ Depression (Y/N) Foundation Water main/service line /6 72-026 Rev. 3/91)Front MOA21 CONTINUED ON BACK PAGE C.~ATION Datein~ / Manufacturer ~ ~ ~ /M~hoIiIAcce's(YIN),,~~' ~ieZn%i(ny~l)l°ns "Pu~ /'~J~ff level at High water alarm level ~~ Cycles tested Meets MOA electrical co~~ SEPARA~ FROM LIFT STATION TO: ~J~'"'~ On adjacent lots Surface w~ D, ABSORPTION FIELD DATA Date installed ~ "~"~ ''-~ ~ Soil rating ~3'~" System type ~T~ Length Width Total absorption area ~;"'! Depression over field (Y/N) Results (pass/fail) ~ Gravel thickness /~..,~ ,I Cleanouts present (Y/N) Date of adequacy test for ~" Peroxide treatment (past 12 months) (Y/N) Total depth -7..0 ~&.¢u~ ~J If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~ ~) I On adjacent lots [ '~ O Property line To building foundation ~-",-~'/ To existing or abandoned system on lot /J/~1 On adjacent lots ,~ t/A Cutbank kg' //~ Water main/service line Surface water ~J'OlO~ OJ~'~4,~/~c~) Driveway, parking/vehicle storage area ~'"'~ Curtain drain 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. HAA Fee $ Date of Payment Receipt Number -- -- ' '" Signature Engineer'SDate Nameo ~ - ~, ~ Waiver Fee'. $ ,~ ~-~ -~ ~ Date of Payment ~ Receipt Number NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE 2505 FAIRBANKS ST. FAIRBANKS, ALASKA 99701 ANCHORAGE, ALASKA 99503 907-456-3116 907-277-8378 Kniefel Engineering 8441 Miles Court Anchorage AK 99504 Attn: Robert Kniefel Our Lab #: Al11364 Location/Project: - Your Sample ID: 9891 Schuss Sample Matrix: Water Comments: Report Date: 06/20/91 Date Arrived: 06/18/91 Date Sampled: 06/18/91 Time Sampled: 0850 Collected By: SM Flag Definitions U = Below Detection Limit DL Stated in Result B = Below Regulatory Min. H = Above Regulatory Max. E = Below Detection Limit Estimated Value Date Method Parameter Units Result Flag Analyzed 418 C Nitrate-N mg/1 0.4 06/19/91 Reported By: William E. Buchan Anchorage Operations Manager Parcel I.D. # MUNICIPALITY OF ANCHORAGE ~ Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) '7",'-¢-*c1" ,4-- p,,-o-.rp.-c.b lY- .-q /D .,4¢JJ ¢¢ ! Location (address or directions) (b) Property owner ~,¢r-~,C'~.-- Mailing Address ~:¢! ~'c (c) Lending Institution ~o~¢~J~ Mailing Address ~ ~ ~ (d) Real Estate Company and Agent Telephone: (home) Business /'~¢~/"~ Telephone ~ ~ -~ e2 (e) Mail the HAA to the following address: (or check here ~, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Number of bedrooms Single-Family I~ 3. WATER SUPPLY Individual Well I~. ,¢ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site I~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirn~ation'from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88} Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, 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 ~nd 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 _.~(¢z ~-/-~_~___~"~C~, c~/' ~'~/c..f'~ Telephone Address-- Date -- /~C;// ~/' 6. DHHS APPROVAL Approved for ~ Approved/~'.-- __ .bedroomsby'~~~'. ~,~"'~Date~f · Disapproved _ Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional.engineer's work. Page 2 of 2 72-025 (Rev. 7/88) Back A. WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARy 1'984 343-4744 Legal Description: '7'¢"~zC.f" Well Log_Pre_sent (Y/N) _~_~ Date Completed ~ t~ Total Depth 3,'-~~ Cased to ff~ Depth of Grouting Static Water Level ~' , Pump Set At If A, B, C, D.E.C. Approved (Y/N) Yield 1, Casing Height Above Ground I~' Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL; To Septic/Holding Tank on Lot _. To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by _ 7': F', Water Sample Test Results Comments ~v¢~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) /v ; on Adjoining Lots ~' /¢~ c,o, ;On Adjoin'lng Lots .. ;> ¢0o ' To Nearest Public Sewer Cleanout/Manhole ¢> ; Date B. SEPTIC/HOLDING TANK DATA Date Installed ~/~g[ 77 Size Standpipes (Y/N) ~' ~_1) Depression over Tank (Y/N) . I E.~Z?(~[ No. of Compartments Air-tight Caps (Y/N). Y Pumping/Maintenance Contact on File (Y/N) At,,~, Holding Tank High-Water Alarm (Y/N) N./¢. Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well 7,~ .,~n~m C.O. Foundation Cleanout (Y/N) Date Last Pumped ¥! ~-¢/' ~ ; for To Property Line. ,~¢' To Water Main/Service Line. To Building Foundation To Disposal Field TO Stream, Pond, Lake or Major Drainage Course Comments_ 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ / 8,?-/' 7' ? Width of Field Square Feet of Absortion Area_ Depression over Field (Y/N) Results of Last Adequacy Test ~-~¢-¢-~/'¢- sEpARATiON DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well _ <]O' ~__.~¢o/-' c, ~,. To Property Line Type of System Design Length of Field _ ___~,3' ¢ Depth of Field ~O t Gravel Bed Thickness ~ O// _ Statndpipes Present (Y/N) Date of Last Adequacy Test To Building Foundation Lot _ /~./I. To Existing or Abandoned System on ; On Adjoining Lots ~ 3'¢ · To Water Main/Service Line _ ;='--~z'-' To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course - To Driveway, Parking .Area. or Vehicle Storage Area Comments ~¢4,v,~ ~ ~.~,£O~_/'r~ D. LIFT STATION Date installed "Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dimensions Manhole/Access (Y/N) . "Pump Off" Level at _ _ Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments **Check Permitted Bedroom Rating Against HAA Request** all M°A and HAA guidelines in effect on the date of this I certify that I have checked, verified, or conformed to inspection. . ~ ~ ..... ~.~ ~';X: 49TH p% % % engineer's Seal Company - ~ ~C~{ ~ ~ ~"' ~'~ ~ % THEODO~ ~. t~OORE MOA No. ~ - 0~ ~ ~ ,, ~ ~ V.~- ~ ~-3o89 Receipt No. ~///~ ~ ~ Hecelp~ ~u .... ~ Date of Payment_ ~-~ ~ Waiver Fee: $ ~ ,~ ~ ~ Amount: $ /2~ ~ Date of Payment -- Page 2 of 2 72-026 IRev. 7/88) Back Tom Fink, Mayor unicipality of Anchorage. Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 May 4, 1989 Theodore F. Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for ~ract.A-2.~rospect Heights Addn #1 Waiver Request #WR890020, 'HA .890149, PTD #015-091-34 Dear Mr. Moore: Your request for waiver of the required 100 foot separation of the components of a septic system to a private well have been approved. The approved separation distances is 77 feet from septic tank to well and 90 feet from absorption field to well. 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 Program C~ & EN~ON~NT~ ENG~EE~G * 'ENERGY CONSERVA~ON & ~YS~ T~ODO~ F. MOORE, P.E. 14530 ECHO ST. Pa: (9o7) s4s-lsss April 24, 1989 ~CHORAGE, ~KA 99516 M.O.A. Dep't. of Health and Human Services P.O. Box 6650 Anchorage, AK 99519 Dear Sirs: By means of this letter we are requesting waivers of the required 100 separation distance between the well and septic system components down to 77 feet for the septic tank and 90 feet for the soil absorption trench on Tract A-2 of Prospect Heights S/D, Addition #1, located at 9861 Schuss Drive. A copy of a property as-built survey, marked up to show additional improvements, is enclosed as well as copies of pertinent Health Department documents. We have been unable to obtain a copy of the driller's log for this well, but the owner reports that it was drilled in 1977 and has a total depth of 359 feet. On April 18 I conducted a yield test of the well. The static water level was 92 feet below the top of the casing, and no water was heard entering the well from above that level. Steady pumping of 438 gallons over a 72 minute period caused the water level in the well to be drawn down to the pump intake at 336 feet. The measured recovery rate near maximum drawdown was 1.1 gallons per minute, which is adequate for a 4 bedroom residence. The recovery rate slowed as the water depth in the well increased, indicating that the source of the water is an aquifer near the bottom of the well. Water samples taken on March 28 were satisfactory, showing 0 coliform bacteria per 100 mi., and 1.2 mg/l of nitrate-N. The driller's log for a well completed in 1979 on Tract A-1, approximately 150 feet north of the subject well is enclosed. The reported information for this well appears to have a good correlation with the measurements made on the subject well, (i.e. the total depth is reported to be 375 feet, the static water level is 90 feet, and the yield is 1.5 gpm}. This log reports a clean gravel down to 33 feet underlain by a dry sandy gravel containing 25 % clay down to 74 feet with no sign of water at the bedrock interface. Beneath 74 feet is bedrock with a small amount of water production at 126 feet, and the remainder at 285 feet or deeper. This indicates that the aquifer is artesian and confined by imper, meable bedrock, which should effectively eliminate any possibility of contamination finding its way down from above. According to the as-built drawing, the wastewater disposal system was installed in 1977, and consists of a 1250 gallon, two-compartment fiberglass septic tank followed by 43 lineal feet of soil absorption trench containing 6 feet of gravel. On April 18 I tested the system's adequacy by adding 612 gallons of water directly into the trench, while monitoring fluid levels in the trench and septic tank. This amount of water caused the fluid level in the trench to rise almost 20 inches, but it did then reabsorb at an adequate rate for a 4 bedroom residence. In reviewing the Health Department file, I noted that in addition to the Municipal inspector overlooking the separation distance discrepancies, he also approved the placement of sewer gravel to a total depth of 10 feet, which is the same depth as the original test hole. In order to determine whether the system has the necessary 4 foot vertical separation from groundwater I arranged for a new test hole to be excavated to a depth of 14.5 feet and a monitor tube installed. I have thus been able to confirm that any groundwater is at a depth greater than 14.5 feet. The topography of the immediate site slopes to the west at 5 to 10 percent, While the overall trend over a broader area is an average slope to the west of 13%. Thus, should the septic system fail causing effluent to surface, there is no possibility of this effluent flowing along the ground surface to the vicinity of the well casing. It is only logical to assume that the slope of the bedrock surface and the aquifer roughly parallels the ground surface. Following is my analysis of how the points should be awarded when using the D.E.C. waiver analysis guidelines. Distance to water table: Use distance from bottom of system to bedrock surface = 64' 5.5 pt Soil Sorption: (23'xl.5 +41'x2.5)/64 2.1 pt Permeability: (23'xl.0 + 41'xl.5)64 1.3 pt Water table gradient: +13% average slope 6.1 pt Horizontal separation: 90' for trench 2.6 pt Total: 17.6 pt The D.E.C. waiver analysis guidelines specify that only the soil above the bedrock be counted in assigning points, which I would agree is appropriate where there is a likelihood that the well draws water from this vicinity. In this case, however, both the log and the Held observations indicate that no water production occurs in this zone. For the soil sorption and permeability calculations I treated the upper material as a silty sandy gravel rather than a clean gravel. This is based on my observations while the test hole was being excavated for the monitor tube. The fact that the bedrock creates an impermeable barrier confining the aquifer is not reflected in the above calculations. Based on the above observations and measurements, it is my professional opinion that the requested waiver can safely be granted without concern as to contamination of the well from the septic system. Please give me a call ~f you have any questions on this report. Sincerely, Ted Moore, P.E. ! TYP _ ~ A~-.BU(~T- ~0 CO~NERS S~ ~ PCOT PLaN , AS*DUILT -LOT ~URVEY -TOPOGRAPHY ~ LOT $URV[Y ~ RECERTIFIC~TION ~S-BUI~T- NO CORNERS II m/he responsibility ~ ihs builder or ~net~ prior lo ' ~O/tl~fuclion~ tO verify proposed buildin~ grode relative I~ fmBhed 9rede and uliliiy co.clicks and lo delermine ~e e~lslence Of any eosemeMs, covenants ~ restrictions ~hich do' not 'appear ~ the recorded subdivision plot. ~ot__S. urvey Cert ificoli ,~. . hereby cerllfy Ihot I hove ;urveyed the ploperb' shown 'h~re~ ore within the a~ indleoted hereon, ~e&ament~ of record, Dthor thoh ~ho~e shown pn the ~ecorded plot, .... ..... . ...... v ,; SYMBOLS ~-~ O- W~D FENCE L~' ASPHALT __~ ~"x L CHAIN LINK FEND~. ~ CONCRETE NOTE, "~hces are.~showh'[~"their approximate LEGEND locations only. h'U6 & tack-found [] set iran rebar -found set · iran pipe -found ~ scl 0 brass coo '-found ~ set G alum. cap -found ~ set ~ ]"~50~ ,.~ PreBo~ed by E/VCH- M,4RK /NC. Profe£sionol and Survey, ors O~ own by' WAH Surveyed: ] 2-1-86 Oo~s Oraw., 12-1-86 'L~ g a I Oc',erl~la., ..... Chocked by: R~3' Odd, 2441 I w'°'86- 236 Tract ProsT~¢!ot,lte~qh{:s AddJ. t:~o;} ~]