HomeMy WebLinkAboutRABBIT CREEK VIEW & HEIGHTS BLK 1V LT 13Abbit Cr k View iHeights ElInAlm7nam ., �\ MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WATER SUPPLY PERMIT Upgrade Permit Number: SW980274 Legal Description: RABIT CREEK VIEW BILK 1 LT 13 Design Engineer: 70 Owner Name: Northwest Pacific Mortgage Owner Address: 1750 112th Ave NE Suite D249 Bellevue , WA 98004 - Date Issued: Jul 30, 1998 Expiration Date: Jul 30,.1999 Parcel ID: 020-032-43 Site Address: 008201 LEO CIR Lot Size: 88232 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ✓❑ Private Well ❑ Water Storage 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 2A-) Date: �� �� ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 July 14, 1998 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New well permit — Rabbit Creek View S/D, Lot 13, Block 1 Gentlemen: We are requesting approval to install a new well on the referenced property and abandon the existing well in accordance with Municipal and State standards. This project is the culmination of several years of effort to bring the on-site systems into compliance with municipal standards and to finalize the conditional health authority issued in February 22, 1996. As part of the resolution we are submitting the request for a new well. A separate request for approval of separation of the holding tank to open water will be submitted by Tobben Spurkland, P.E. Separation to the surrounding systems and on-site holding tank in addition to the existing fuel tank has been provided. We propose to drill the well southeast of the house and septic area. There are no septic systems within 100' of our proposed well location. Surface water has been surveyed in and is accurately depicted on the attached drawings. We do not expect that there will be any adverse effect on adjacent lots by the development of this well. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, 1214 1D Engineering J Kenneth M. fus, P.E. attachments: On -Site Well and Sewer Application Well Details/Site Plan Plot Plan 12 7N WELL DETAILS/SITE PLAN RABBIT CREEK VIEW S/D BLOCK 1, LOT 13 v4CANT N 314.84' �y`JI 5je w- LOT 14 r �° VACANT 2 -STORY y 4 yA FRAMEy £ ABANDON EXISTING NEL. PER ADEC REGULATIONS. ' kHOUSE CP �: [W✓y} � Ir o WELL �8 LOT 12 1BU9RED BY NOTHING SET W0101 l'. NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. OFA ice, L 's, 1 KENNETH M. S CE -7116 a / r� $ww/ l aid 7 y/g 41Air \ p�OFESSIOT�A1' -AV ,4\ p WELL \� N 77.10.00. W TL \ 8.89 \ Z88.89' 16 \'N POSITIO ABUSNED BY— \ HOIDINC REE \ k DISTANCE FROM BACK —' LOT UNE CORNER. P09TI04 \ W USED TO ESTABLISH CUL— LOT 16 NO NC BSET RADIUS. \; VACANT NOTES 1. SURVEY PERFORMED JUNE 18 THRU XNE 23. 1698 2EASEMENTS OF RECORD OTHER THAN THOSE VOW ON RECORDED PLAT No. 70-133, ARE NOT SHOW HEREON. 3. PARCEL CONTAINS 107.792 2 (88.232) SQUARE FEET. 4, THIS DOCUMENT IS NOT VALID WITHOUT THE ORIONAL SEAL AND SIGNATURE OF ME REGISTERED PROFESSONAL LAND SURVEYOR. S. MIS DOCUMENT IS FOR ME EXCLUSIVE USE OF WE CLIENT. THIS DOCUMENT IS NOT INTENDED OR REPRESENTED TO BE SUITABLE FOR RE -USE BY OMER9 ANY RE -USE BY OMERS WMOUT POSSESON OF ME ORIGINAL DEED NOTES WU. BE AT THEIR SOLE RISK AND 1WTHONT LIABILITY OR LEGAL EXPOSURE TO MYCX NYMAN HAYES. INC.. B.UNLEES INDICATED HEREON, NO CORNER POSITIONS HERE MONUMENTED THIS SURVEY. 7.ME PLAT OF RECORD, PLAT No. 70-133 CONTAINS NUMEROUS MATHEMATICAL ERRORS. LOT 13 RECORD INFpRMAMON DOES NOT CLOSE. ME BOUNDARY SHOWN HEREON WAS DETERMINED BY USING ME FOUND 1/2- REBARS AND ME RECORD INFORMATION TO CREATE A BEST FIT BOUNDARY. PREPARED FOR: MR, LES BEDF❑D NORTHWEST PACIFIC MORTGAGE 1750 112TH NE SUITE D249 BELLEVUE, WA 98004 FIELD BOOKS COMPUTED: O BOUNDARY: TNH DRAWN: EMD STAKING: TNH CHECKED: K M D ASBUILT: TNH DATE' 7/14/98 DWG. FILE: GRID: 3241 ACAD FILE: 97050.DWG JOB No.: 97050 R -49.57' (50') L = 63.11' (62.89') -REBAR USED M ESTAB OE—SAC BULB RADIUS AS PC OF CUL—DE—SAI '7" \ - LEO R = 49.57' (50') CIRCLE L = 49.85' (50.56') LEGEND O FOUND 1/2' REBAR 676.53' FOUND INFORMATION THIS SURVEY (677.98) RECORD INFORMATION PER PLAT No. 70-133 X SEPTIC SYSTEM VENT 0 WATER WELL nuc ELECTRIC PEDESTAL -Q- UTIUTY POLE • WOOD POST WITH ELECTRIC OUTLET —w— OVERHEAD UTIUTY UNES —tX:— OVERHEAD UTILITY CONNECT —•— 6' CHAIN LINK FENCE TREE UNE NE MTN FLOW DITCH UScale: 1'= 100/ PAGE 1 OF 2 ILKLMD ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 DITCH RAttHiiTs i J INTO GRASS WELL DETAILS/SITE PLAN RABBIT CREEK VIEW S/D BLOCK 1, LOT 13 I_t \ KND L0T i VACANT ABANDON EXISTING WELL PER ADEC RE "Z o, 0 34.B' o N 2 -STORY /z $ 'A FRAME HOUSE 34.8' S6 �� 16" CMP w_ BUD;: WOOD BRIDGE BEGIN 1:5' \ N- lrL GRAVELWOOD Q O. "—SHED cP' WELL \ �P 10, W "\ 8'8g') 289.89 \cp POSITIO TABLISHED BY - HOLDING REC p� \ & DISTANCE FROM BACK \\r LOT LINE CORNER, POSITION \ a USED TO ESTABLISH CUL - 4\ OF A TH�* KENN M. DU / CE -7116 a \ pROFESS10' PREPARED FOR: MR. LES BEDF❑D NORTHWEST PACIFIC MORTGAGE 1750 112TH NE SUITE D249 BELLEVUE, WA 98004 FIELD BOOKS COMPUTED: BOUNDARY: TNH DRAWN: EMD STAKING: TNH CHECKED: KMD ASBUILT: TNH DATE' 7 Zl4 98 DWG. FILE: GRID: 3241 ACAD FILE: 97050.DWG JOB No.: 97050 POSITIOESTABLISHED B INTERS CTING THE RECOF BEARIN WITH THE CUL- DE -SA BULB, F NOT HI G SET r \\ \ qy BEGIN t2' NIDE BITCH I E R= 49.57' (50') Cl R, \ L = 49.85 (50.56') \ Scale: 1'= 50' ��j PAGE 2 OF 2 I��1 D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 907)696-6111/FAX (907)696-8111 February 3, 1999 Mr. Tobben Spurkland, P.E. 203 W. 15t' Ave. Anchorage, AK 99501 MAR 15 1999 Municipality of Ancnorage +dept. Health & Human Services RE: Waiver to Open Water — Rabbit Creek View S/D, Lot 13, Block 1 Tobben: Enclosed is a copy of our previous correspondence that was sent to you on September 21,1998. We have not heard back from you, and we need to know the current status of the waiver request you were going to prepare. We are in the process of completing this project and need the waiver request to do so. Please advise us on the status of the waiver request. If you have any questions, please contact us 696-8111/FAX 696-8111. Respectfully, JKND Engineering Brent M. Western Encl.: Previous Letter -09/21/98 CC: Les Bedford Jim Cross, P.E. file Tre" V D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 September 21, 1998 Mr. Tobben Spurkland, P.E. 203 W. 15" Ave. Anchorage, Alaska 99501 Subject: Wavier to Open Water - Rabbit Creek View S/D, Lot 13, Block 1 Tobben: Attached is an as -built survey and the well permit for the referenced lot. Per our discussions you were going to prepare the wavier request for submittal to DHHS and the mortgage company will be picking up the Municipal fee for processing the wavier. To date the well has been drilled and we are preparing to install the water line and close out our permit. This will leave only the wavier request in order to obtain the final HAA. I appreciate your help in resolving this one. If you need any additional information or have any questions please contact me at your earliest convenience. I can be reached at 696-6111/FAX 696-8111. Respectfully submitted, )_K -114D Engineering Duffus, P.E. attachments: Survey As -built Well System Details/Site Plan Mw-deipa]W of Anchorage Department of Health and Human Services 825 "L" Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor September 24, 1996 Merle Jean Muller 8201 Leo Circle Anchorage, Alaska 99516 Subject: Lot 13 Block 1 Rabbit Creek View Subdivision PID #020-032-43 Dear Ms. Muller: At your request, I have reviewed our files on the subject lot searching for information relative to the issuance of a Health Authority Approval Certificate (HAA) by this office on February 22, 1996. A chronological summary of events leading to the issuance of these HAA is as follows: 1. On December 11, 1995 A+ Home Services, Inc. pumped the holding tank. There was no comment or narrative on their invoice covering the work. 2. A requirement of the HAA process is for a site inspection to be made by a registered professional engineer who summarizes the inspection results on the "Health Authority Approval Checklist". Mr. Dee High, P.E., prepared this checklist for the subject HAA (copy attached) on February 6, 1996, which was then submitted to the department attached to the HAA on February 2, 1996. It should be noted that under the Holding Tank Data section of the checklist, Mr. Dee High originally showed none in the high water alarm space and apparently subsequently changed this to yes showing that the alarm was installed on February 19, 1996, two weeks after the HAA was received in the DHHS office. 3. When an engineer affixes his stamp and signature to the HAA and Checklist, he is assuring this office, the owner, and all prospective buyers that the septic system is in compliance with Municipal Regulations and Ordinances. Specifically, AMC 15.65.010.M requires that a holding tank must be water tight. 4. On May 2, 1996, Mr. Tobben Spurkland, P.E., submitted a letter to DHHS (copy attached) which summarized the procedure he used, which led to the conclusion that the existing holding tank was not water tight and needed to be replaced. Should you need any other information concerning the failed holding tank, our files are open for your review between the hours of 7:30 a.m. to 11:30 a.m., Monday through Friday. If there are any further questions, please call our office at 343-4744. Sincerely, Robert W. Robinson Civil Engineer On-site Services 4UNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 A, Anchorage, Alaska 99519-6650 Date: July 3, 1996 To: File From: Robert W. Robinson, Civil Engineer, On-site Services Program Subject: Lot 13 Block I Rabitt Creek View Subdivision Site Inspections At 2:45 p.m. Friday, June 28, 1996, Messrs. James P. Williams and Robert W. Robinson conducted a site inspection of Lot 13 Block I Rabbit Creek View Subdivision. An on-site wastewater disposal system (upgrade) permit was issued on May 21, 1996, permit # SW960080, for the installation of a new 4,000 gallon holding tank replacing a 2,000 gallon holding tank, which was determined to be leaking. The permit contained the following special provision; "prior to installation of the holding tank, install a seal within the well casing (or whatever work is necessary) to prevent any surface water flow from originating within or around the well casing. If, following this work, surface water remains in the depression adjacent to the well, then the holding tank must be placed a minimum of 100 feet from any surface waters. If holding tank is to be installed prior to performing work on well, then the holding tank must ((be) placed at a minimum distance of 100 feet from any surface waters". During the June 28, 1996 site inspection, the following observations were made: I Water was observed standing in the well casing "stick-up" approximately 18" above ground level. 2. Water was observed standing around the outside of the well casing at ground level. 3. A surface seep was observed approximately 15 feet from the well casing discharging into a drainage ditch. 4. Water was observed flowing in the drainage ditch at a flow rate estimated to be 1.5 gallons per minute. This ditch, and water flowing therein was, at the closest point, approximately 45 feet from the holding tank installed on May 23, 1996. 5. A small pond or holding area was observed in the drainage ditch approximately 4 feet wide, 20 feet long, and 2 feet deep approximately 48 feet from the holding tank. 6. A continuous dripping of water was observed visually and audibly entering the holding tank while no water was being generated from the house. 7. The owners stated that the water from this artesian well contained so much silt that it was unusable. The collected a sample in a quart jar and the silt and solid filed approximately 1/4 of the jar with the remaining liquid being extremely cloudy. On Tuesday, July 2, 1996 at 3:45 p.m., Messrs. Jim Cross and Robert W, Robinson conducted a site inspection on the subject lot and the following observations were noted. 1. Water was observed standing in the well casing approximately 4 feet below ground level. 2. No water was observed standing around the outside of the well casing. 3. The surface seep previously noted approximately 15 feet from the well casing was still discharging into the drainage ditch however at a lesser rate. 4. Water was observed flowing in the drainage ditch at a rate estimated to be 0.5 gallons per minute. 5. Continuous dripping was observed, at a rate seemingly less than observed on June 28, 1996, into the holding tank. 6. According to the owners, there is still a problem with high silt content from the well, 7. The owners advised that they would be away for approximately a week in the near future. It was suggested to them to shut off the power to the well during their absence and to determine the level of water in the holding when they leave and again when they return. This information would then be used to determine if there is leakage of surface water into the holding tank. r ®r- cower 407- / �iT ARG-L`�t Li a"W, ,moi l -F 16; / le�Wir- clz�- ' f, V- 0,7 0 G t4ge-W"'s'T 51 -VO lliz 1047NO 4eyr-- / j -31C / i ,r a ---w J LT lq�e-n) ?E- X12) `dA March 11, 1996 Municipality of Anchorage 96-03-12 11:25 RCVD Dept. of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650... ATTENTION: JIM CROSS We recently closed and took possession of a residence loca- ted at 8201 Leo Circle in the Rabbit Creek View Subdivision area. Immediately upon moving in on March 1, 1996, we found the septic hold- ing tank full and frozen and water coming out of the tap so silty that it is unuseable for any purposes. We have spent the last week gathering information and attempt- ing to get these problems resolved. We acquired a copy of the Certifi- cate of Health Authority and saw that the Statement of Inspection By Engineer was completed by Mr. Dee High of DHI Consulting Engineers on Feb. 6, 1996. It has been determined that the septic holding tank is fill- ing up with ground water and that the high water alarm was not funct- ioning as it should have been. We are -still working on determining the problems with the water supply. I spoke with Mr. Jim Williams on March 7th about the pro- blems. He gave me Dee High's phone number. I contacted Mr. High on March 7th following that conversation. Mr. High stated that he did not install the high water alarm that the Municipality required before approval nor did he check it. He acknowledged that the sellers had told him at some point that the holding tank had been repaired recently at least once. He offered no explanation as to the condition of the water. On Monday morning, March 11th, I contacted Dee High again by phone to get more specific information about the work he performed. Mr. High stated that he has been in contact with the sellers and will not provide any further information or answers to our questions. I asked Mr. High if he would be willing to come back out and remedy the situation (i.e. properly install and check the high water alarm, etc.) and he stated he would not without the seller's authorization. We would appreciate any information and assistance you may be able to provide us in this matter. Our phone number is 348-0353. Thanks for your help. Sincerely, Merl Jean Muller 8201 Leo Circle Anchorage, AK 99516 i1 F CblvcLL AP97,n I! 2U IN THE DISTRICT/.%OR COURT FOR THE STATE OF ALASKA AT ANCHORAGE I%A41� Plaintiff(s), VS. Defendant(s). To:/WIt�li Address: CASE NO. SUBPOENA TO APPEAR You are commanded to appear in court to testify as a witness in the above case at: �� i Date and Time: 8:30 �� � � -6 Courtroom: at Date P Sep L OF Th'F­A� P�pl. COVgT Subpoena issued at request of Attorney for Address Telephone If you have any questions, contact the person named above. This subpoena may not be used to order a witness to produce documents, nor may it be used to require a witness to appear for deposition. RETURN I certify that on the date stated below, I served this subpoena on the person to whom it is addressed, . in . Alaska. I left a copy of the subpoena with the person named and also-te day's court attendance. ate and Time of Service Service Fees: Service $ Mileage $ TOTAL $ red mileage anct witness t Si afore If served by other than a peace officer, this return must be notarized. Subscribed and sworn to or affirmed before me on ,19 (SEAL) Clerk of Court, Notary Public or other person authorized to administer oaths. My commission expires CIV -111 ANCH (4/96)(st.3)�2 Civil Rule 45 SUBPOENA TO APPEAR ��� �, 3 � r/ ��i Dist. Ct. Civ. R. II(fl Municipality of Anchorage Page ' of 3 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: S V1g1V&00,-0 PID Number: 02-0 ­03,a " '-' Name: Wastewater System: ❑ New [.Upgrade Address: ABSORPTION FIELD �? �v 1 L-� J G t t2- Phone: No. of Bedrooms: ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 1 'R P>3ri Ct21it.kc, V i E t4 Ft. Ft. Township: Range: Section: Fill added above original grade: Gravel length: Ft. Ft. WELL: ❑ New ❑ Upgrade Gravel width: Number of lines: Distance between lines: Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. SQ. Ft. Driller: Date Drilled: Static Water Level: Installer: A Date installed: ?-f A `t QS. Ft. Yield: Pump Set at: FiHeight Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑ Septic 'XHolding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines AN04 4 1 AMIL o &v-- % Welt' ' i U G, Material: / Number of Compartments: Surface LIFT STATION Water i�� 0ti Lot f Size in gallons: Manufacturer: Line 7!%uU Foundation ! "Pump on" level at: "Pump off" level at: High water alarm at: Curtain Pump Make & Model Electrical Inspections performed by: Drain �1U11 c BENCH MARK Remarks: Q 1 of - e7uI/e T Location and Description: i D D SC IGs MUNICIPALITY OF ANCHORAGE EWIRUTINM SERYIGES Assumed Elevation: v� 1 !9 Ft JUN 18 1991b ENGINEER'S SEAL RKEIVED Inspections performed by: D ! Dates: 1s �3 2nd % Tob I c Department of Health and Human Services approval Reviewed and approved by: Date:` 72-013 (Rev. 9/91) MOA 25 VACANT TRACT B i i LOT 13 ` \ LOT 14 v 2000 GAL. HOLDING TANK i � VACANT R75,00 LEO CIR, LOT 17 VACANT sO 50 0 50 100 150 200 250 300 BENCH MARK: TOP OF DECK SCALE- 1' = 100 FT, ASSUMED ELEV. 100.00 FL TOBBEN SPURKLAND P.E. LOT 13, BLOCK I RABBIT CREEK VIEW HOLDING TANK AS BUILT 203 W 15TH. AVENUE DATE: JUNE 17, 1996 ANCH. AK. 99501 8201 LEO CIRCLE f—% � . MERLE JEAN MULLER SHEET: GRID: 3241 95f RAIN CAP T YP. 6" PUMP ACCE 1 MIN, 4 FEET BURY I" X 10' CONDUIT I" GAL VANIZED L B, DIREC T BURIAL WIRE TO ALARM PANEL 11 90.7 11190.73 \-I,, " PVC CON INV. ELEV. 90.11 HIGH WATER ALARM MERCURY SWITCH FL A T 18, 64' r r r r r r r r r r r rrr.-J,�rrrr,� r 12' .��1 S TANDARD 2000 GAL, HLIL DING TANK ..� ��� . OF... q� qss� ANCHORAGE TANK th�� NO SCALE ..........r4...........................L.�..... TOgjBEN SPURKLAND ' ,�♦�1��� •.•No, CE -2225 •����.Aw BENCH MARK: 11 �� TOP OF DECK /'ROFESS�N�� ASSUMED ELEV. 100.00 FL T❑BBEN SPURKLANDP,E, LOT 13BLOCK 1 RABBIT CREEK VIEW HOLDING TANK AS BUILT ,6751 W, DIM❑ND BLVD. 8201 LEO CIRCLE DATE:JUNE 17, 1996 AN7)aAK, 99502-3904 (c)n7)dR—sMERLE JEAN MULLER nq� SHEETS 313 GRID; 3241 )k C vi Sr PAGE 1 OF 1 ' MUNICIPALITY OF ANCHORAGE LL �pcY\ DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 — ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960080 DESIGN ENGINEER-mnRBEN SPURKLAND, P.E. OWNER NAME: Muller, Mertl� Jean OWNER ADDRESS:8201 LEO CIR ANCHORAGE, ALASKA 99516 PARCEL ID:02003243 LEGAL DESCRIPTION: RABBIT CREEK VIEW BLK 1 LT 13 LOT SIZE: 88232 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONSTRUCTION OF: HOLDING TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 5/21/96 EXPIRATION DATE: 5/21/97 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PRIOR TO INSTALLATION OF THE HOLDING TANK, INSTALL A SEAL WITHIN THE WELL CASING (OR WHATEVER WORK NECECESSARY) TO PREVENT ANY SURFACE WATER FLOW FROM ORIGINATING WITHIN OR AROUND THE WELL CASING. IF, FOLLOWING THIS WORK, SURFACE WATER REMAINS IN THE DEPRESSION ADJACENT TO THE WELL, THEN THE HOLDING TANK MUST BE PLACED A MINIMUM OF 100 FT. FROM ANY SURFACE WATERS. IF HOLDING TANK IS TO BE INSTALLED PRIOR TO PERFORMING WORK ON WELL, THEN THE HOLDING TANK MUST PLACED AT A MINIMUM DISTANCE OF 1 -0'0 -FT. FROM ANY- - SURFACE WATERS. RECEIVED B ISSUED BY: DATE: DATE: 0 CI -D- 1 �7 _' rl��13✓l , iB�� G'r ll6� 'T' 4ot_�6 I N(_7 i /Ntik<, MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On -Site Sewer/Well Permit Application Q(, — ,�� — , NOTE: Application must be filled out completely. SINGLE FAMILY DWELLING �y Parcel Identification Number Property Owner Name - n J_ v -I e i"q u l -e- Y— Day Phone Mailing Address ay�0 i L _e o Y c -0, Zip Code _ Legal Description Le �' I -2� �3 V__ 1? V V —t.r 1 '_" ,on Section Township Range Lot Size RAcres/sq. Ft Inspections will be conducted by: MUNICIPALITY OF ANLrtUKA(.;t n t/ ENVIRONMENTAL SERVICES DIVISION n Number of Bedrooms: r� Approved Engineering Firm A �C� tL1 a Municipality (permit fee included) Does your house contain any of the following: Hot Tub, Swimming Pool, Therapy Pool, Jacuzzi, or Water Softener Unit? If yes, which one? 1996 RECEIVED This application is for: Sewer Only Sewer and Well Sewer Upgrade V_ Well Only I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and in accordance with applicable Municipal codes. Prop y owner/Well Driller Fees: 3 • A) Receipt #_%� �) ` Permit # .2 (Rev 10/86) T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 James Cross P.E. Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: PID 020-032-43 Lot 13, Block 1, Rabbit Creek View Leaking Holding Tank Gentlemen; May 2, 1996 On April 29, 1996 I witnessed A+ Home Services pumping subject holding tank. Before pumping 54 inches of liquid was measured in the tank. After pumping 4.5 inches remained. I tarred off the breaker to the well and sealed the breaker box. The next day 10 inches of liquid was measured in the tank. Municipal records indicate that a 2000 gal Greer tank was installed in 1975. This tank can be a 58 inch diameter or a 76 inch. The 6 inch increase in water depth represents an inflow of 162 or 127 gallons depending on the tank diameter. With the wellpump off most of this water must be infiltration of groundwater. The owners want to replace the tank and request a permit to do so. The attached siteplan shows the location of the existing tank and the well. There are no other wells or surface waters within 200 feet of the tank. The whole lot is muskeg with no possibility for a standard septic system. Yours T. Spur= d P.E. T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 James Williams Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 I Street Anchorage, Alaska 99501 Subject: "Pink Sheet" L13, Bk 1 Rabbit Creek View MAY 2 0 1996 Municilaality of Anchorage Dept. Health & Human Services May 15, 1996 1. The existing holding tank will be replaced with a 2500 gal. tank if this size is available. If not, the size will be 2000 gal. 2. The location of the "drainage ditch" has been added to the site plan. As you can see the "ditch" is a local depression and does not convey water away from the property. 3. The foundation cleanout has ben shown. Yours Tobbe Spurkland P.E. 1 VACANT TRACT B i i LOT --V\ LOT 14 REPLACE EXIS I/vt HOLDING TANK — WITH 2500 GAL OL DING TANK \ some \stancling wo ter �T 12 i LOT 15O LOT 17 � I ', VACANT C Well \' VACANT P TOBBEN SPURKLAND P.E. LOT 13, BLOCK 1 RABBIT CREEK VIEW HOLDING TANK DESIGN 203 W 15TH. AVENUE DATE: MAY 2, 1996 ANCH. AK. 99501 8201 LEO CIRCLE (on7) 97q_;qlF MERLE JEAN HULLER SHEET: VI GRID: 3241 r RAIN CAP T YPICA 6" PUMP ACCES MIN, 4 FEET BURY HIGH WATER ALARM MERCURY SWITCH FL AT 18" 12' -5TANDA RD 2500 GAL, HOLDING TANK ANCHORAGE TANK NO SCALE v .: li '� "a C_:-1'25 I" X 10' CONDUIT I " GAL VANIZED L B, DIREC T BURIAL WIRE TO AL ARM PANEL T 76" if I" PVC CONDUll T❑BBEN SPURKLAND RE, LOT 13, BLOCK 1 RABBIT CREEK VIEW HOLDING TANK DESIGN 6751 W, DIM❑ND BLVD. 8201 LEO CIRCLE DATE: MAY 2 1996 ANCH. AK, 99502-3904 (gn7) a4a—sn9s MERLE JEAN MULLER SHEET: 212 GRID: File No.. 4-1 April 16. 1975 is;r.Ed Nueser Frontier Construction $131. Laurel Street %nrho raige..Alaska. 99504 SUBJECT: Polding Tank On Property Owned Py Virgil Fnglasnd Lot 13, Block 1. Rabbit Creek View Subdivision Dear Mr. 3ueser: The subject property w.is inspected A' r health code requirements and loan approval. As you are &ware. the holding tank wmz covered without inspection due to a rrdsunder standin gr of the Borough Service Are n boundaries. A number of moa- surem nits were taken during ,ny inspection and the tank to well distance is adequate. :rs. Fngland had receipts of tho holding tank purchase and excavating work perforrned. She also wrotf., a statom4,nt as to the cast iron pine being used. In view of the receipts, stnterpf nt5 and €tppar.ynt boundary coni'ufiinn , I am ippv-)ving the Installation. T. hos s wa -r lure and 0nk will not have to be exposed as formerly requested by this de'partry2�nt . Sincerely, Les Buchholz, Z . S . Sanitarian LBIlw cc;, Virgil England FGRE( TER ANCHORAGE AREA BO; )UGH Department of Environmental Quality ��- 3330 C Street Anchorage, Alaska 99503 �/ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME (J% G -I1 N�•�j�wn MAILING ADDRESS23O�(%OI7 J kk � ,S/Ff PHONE LOCATION LEGAL DESCRIPTION k7%_3 CJk IO,�E1c 4 9/d/CYC TANK: DISTANCE I ` NUMBER OF FROM WELL ? 7 r MANUFACTURER ( .T"CFEk MATERIAL >�E� / COMPARTMENTS—/ INSIDE LENGTH _ INSIDE WIDTH LIQUID DEPTH --LIQUID CAPACITY 6f)0 GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER _ OR WIDTH—, LENGTH_, DEPTH LINING MATERIAL CRIB SIZE: DIAMETER TH DISTANCE FROM: WELL TOTAL EF E BUILDING FOUNDATION NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: d ��., i TYPE elllcl) CONSTRUCTION o,k DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC A' SEEPAGE p� FOUNDATION 13 LOT LINE �� SEWER LINE1, TANK /1 SYSTEM /v/� CESSPOOL APPROVED DISTANCES: , OTHER SOURCES DISAPPROVED INSTALLED BY: �n��fE 64S PIPE MATE RIAL:6&6dS% & LOT SLOPE: -_�/au REMARKS: // A, WA //f5/1�� / ,3 '9 5 IARoo { v �lJcl,�c fFi9S E REMARKS DIAGRAM OF SYSTEM a 4�— DATE 'y-ly'7 APPROVED 0 G.A.A.B. U Form No. EQ -031 TN February 21, 1975 Fr-)ntier Cc:nstrut tion 4131 Laurel Road Anchorage, Alaska 99504 ATTENTION: Robert E. Nueser SUBJECT; 'Notice to correct violation: on --site sewer system serving 2-bedrooin . single family dwelling lusted an Lot 13. Bloctk 1. Rabbit Creek View Subdivision Installed without .11orough inspection Dear 4`111r. Nueser: This letter is to serve official notice thet the subject zowvr :system, which was inatalled by Frontier k0onstruction on or about J.:inuary.19, 1975 is in violation of the Greeter Anchorage Areu Surough Cxle of ordinances, Chapter 16, Article 16.45. To prevent legal action :against you by thi:t Departi=tp-nt, the sewer syste;n must be uncover,!d for a Borough inspection within fourteen (14) days from the roneipt of this letter. 1','i: Appreciate your visit to our offfice on January 21, 1975 to discuss this Natter. It you have any question.-. please do not hesitote to contact mr at 274-4561. tendon 142. Sincerely, C. S. a tcKechnie , R.S. Sanitarian CSM/ko cc. Virgil Eni land Al:vska State Bank C rtified . ,,:. 740669 INA '-'RONTIER W,' ISTRUCTINLY!'4 AORCHORAGE, ALASM-A 9950-1 TELEPHONE (907) 274M360 (06 V1 al;, t Date— 19 To Z Address City Ol - q T A T 9: AA F- KI T 11/7 F\. A, -- I L Ol - q T A T 9: AA F- KI T GREATER /ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL OUALiTY PERMIT NO. -T 35,00 7UD09 ROAD POUCH r.65O ANCHORAGE. ALASKA 99.502 TC:.IPNONE 279.817,06 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT � I NAME OF APPLICANT 1/111, rieGXG�'L ---- ---- MAILING ADDRESS -------.--.--. PHONE INSTALLATION LOCATION LEGAL DESCRIPTION V / INSTALLATION OF: TANK TYPE AND SIZE OF FACILITY TO BE SERVED SOIL TEST RESULTS COMPLETION DATE ANTICIPATED r E PIT TO BE INSTALLED BY `�, DRAIN FIELD . OTHER NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL T1 --ST PFR TT nlTb nNF YFAR FINAL IHZPr—CTIOPdt 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEFA ERlITHOUT FINAL Ii°'SPIECTIOM EKY THE HMALTH DEPARTMENT AUTHORITY WILL BE 'SUBJECT TO PROSECUTION. K SIZE -A C, (-)G!`<- TYPES}PPI Or C'ATIC.YP PSEEPAGE AREA SIZE MINIMUM DISTANCES, REQUIREMENTS Fl; DATION TO SEPTIC TANK 5 ft. FOUNDATION TO SEEPAGE PIT 20 ft' . DRAIN FIELD 1.0 ft, SEPTIC TANK TO SEEPAGE PIT WALL 15 ft. SEPTIC TANK 5 fto . SEEPAGE PIT 20 ft- . DRAIN FIELD 10 fte TO NEA EST LOT LINE. Ii((E'r•,:c((= 1 WELL TO SE4'TTCITANK SEEPAGE PIJ , DRAIN FIELD!! ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK 10 fto • SEEPAGE PIT 10 ft„ . DRAIN FIELD 10 ft. . SEPTIC TANK, 25 ft*, SEEPAGE PIT 100 ft- , DRAIN FIELD 50 ft. TO RIVER. LAKE. STREAM. TYPE DIAGRAM OF SYSTEM I P," CAST II PONS SIPilo N SCPTIC PP C V.'ITII AIRTIGHT CRIB I AN 1: i COS CAST / )m CAST IRON - - - - IH70- UNnISTeI:BEB SOIL 511I111;1Ni I Illlrlliuli - - -' - C I required whenever line crosses under drivw ay. hn,rsln IrrL1, i�11'I L:fCfS CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF ---' --' iC"I :'!nL'dL EXCAVATION 5 FEET INTO UNDISTURBED SOIL, 10 PIT- 100' 60 SiA.T11, LINE- 10' 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. 10 TANK- n0" T9 I'll- 120' G^AVEL DACKF'ILL C1-A0'-i!1V2(j11 ! sYa:r, 1 CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I'1111I IC ;,I I -IT - 200' IPC.❑ SCSF.0 `r! u;r •.!+9 S01!rCC OF LPAVEI. rliw LI ;A . ASOU!ID CRIB. ' (CRIB 4' 11'HIN,UH ABOVE- HATER TABI_F.] 4 IIICII SClER CCRSI(JR ARCA. HELLS. . St CI'AGE Pil F,XCAVi,T 1011 BASED DN SOI1. TEST. CAST `BON, IGTO V:!- DISTi!PC.Cn SOIL `\ L I EPTIC A ru; ti.': L L o Grade: 2'.per ;CO' or 1A4'p'r fun: except 10' preen-dini . tank d tha. should I not exceed 7:. 6' per 100 on flat I terrains. -1 4 INCH .CAST IRON SIPIION PIPE / SEEPAGE PIT E CRIB _ GRAVEL BACKFILL OR IHINIHUri I (✓/// LICENSED DESIGNER 20= - -- - t JI. REAPEST LOT LINE. -_ 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDAN WSAID ID CODE.�� DATE ` l � �APPLICAN� SIGNAT7`U�WE 4;tl(l. 64/741 Municipality of Anchorage U On -Site Water and Wastewater Program (907) 343-7904 S � (=T Y Certificate of On -Site Systems Approval Parcel I.D. 020-521-16 1. GENERAL INFORMATION: Expiration Date: 10 _25'_Z-2 Complete legal description RABBIT CREEK VIEW & HEIGHTS; BLOCK 1V, LOT 13A Location (site address) 8201 Leo Circle *Anchorage 99516 Current Property owner(s) Susan Laughton Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Day phone 348-0353 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑X Individual X Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 _ Waiver Fee $ Date of Payment `1 1 a o a a Date of Payment Receipt Number Q 1 1 9 3 Receipt Number COSA # 0 S C- a S i`( 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: Garness Engineerinq Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. D D SIGNATURE System #1 Approved for 2-- bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the Date: ``g 22 o�F CSF �Flyt q {-aj� n z s s. CF Ole 1)11_ro i e s s4on0Go #AECC884 `llllllltl(((f/(� J� ON-SITE o tPu"}- R AND m T WAS J`r PROGFAM C) -- ��J///J�%J)1 � DRi �•,�ll��,ll . Original Certificate Date: 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 Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic A visory Other G �A 1-m-t�—,e i�p(vf id • Legal Description: RABBIT CREEK VIEW & HEIGHTS; BLOCK 1V. LOT 13A Parcel ID: 020-521-16 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system SEE ATTACHED DOCUMENTS A. WELL DATA REGARDING DECOMMISSIONED WELL ❑ Well log is filed with Onsite (or attached) Well production at time of test 0.9+ gpm Date drilled 9123198 Water storage tank volume N/A gallons Total depth 209 ft Well disinfected for coliform test? ❑ Yes on No Cased to. 75.85 ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by GEG, LTD. Date of flow test for COSA 3/7/22 Date of Sample 4/16/22 Static water level at beginning of test ft. Comments ARTESIAN WELL WITH PLUG - SEE ATTACHED WELL LOG - PUMPED 621 GALLONS FROM WELL (209 FEET DEEP) IN 326 MINUTES B. TANK DATA Age of tank(s) 26 years Tank type/material HOLD ST' Measured operating fluid level in septic tank OR Standpipes/foundation cleanout per record drawing Date of pumping HOLDING TANK - SEE ATTACHED PUMPING HISTORY 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, stat depth into effective ❑ Code -required soil cover over fie[ ❑ System presoaked (Required if vacant rester than 30 days prior to date of test) Ga Introduced gallons COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance compl Age of lift stationye Lift station materia Commen . Adequacy test date Results C] Pass For bedrooms Fluid depth; priorst in .00 ;ewter d gal depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) _ If yes, enter date Jeff Garness From: Sterling Anderson <sterling@aplusak.com> Sent: Monday, August 1, 2022 10:01 PM To: Sonja Blewett; Jeff Garness; David Garness Subject: Re: 8201 Leo Circle Float alarm install at 8201 Leo Cir is complete. Interior alarm is on and verified operation. Sincerely, Sterling Anderson A+ Home Services Sterling@aplusak.com (907)268-9674 www.apiusal<.com From: Sonja Blewett <Sonja@garnessengineering.com> Date: Thursday, July 28, 2022 at 2:51 PM To: Jeff Garness <Jeff@garnessengineering.com>, Sterling Anderson <sterling@aplusak.com>, David Garness <David@garnessengineering.com> Subject: RE: 8201 Leo Circle Was this completed? Sonja From: Jeff Garness <Jeff@garnessengineering.com> Sent: Tuesday, July 26, 2022 11:55 AM To: Sonja Blewett <Sonja@garnessengineering.com>; Sterling Anderson <sterling@aplusak.com>; David Garness <David@garnessengineering.com> Subject: RE: 8201 Leo Circle Interior alarm for holding tank. There should be existing wires from the holding tank to inside the house. Jeff From: Sonja Blewett <Sonia@garnessengineering.com> Sent: Tuesday, July 26, 2022 11:47 AM To: Sterling Anderson <sterling@aplusak.com>; Jeff Garness <Jeff@parnessengineering.com>; David Garness <David@garnessengineering.com> Subject: RE: 8201 Leo Circle I cc'd Jeff and David and they can inform you what's needed. 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Z p {D m O p DD C�a3�(D ty = m3 m j�XF�=��.� a-� 3 U m n' Co El G) ro m m Cr, r (D - A < sx 2) 2. a � n. Cj m � -i O - to m `G 'O N (n '� ° tp p fn U) o p: .0 O � m� D0 0 C< CD 0 � y p O N �q �� � m A{ am:� `- < m j C 3' I a CD 77 rto z' o 2 r n s C30 0 Cl; I ' I I j ICr� Im 1C' ECD � CD I3 G7 0 r I CDCD I o C I N p .1 Q CA) I CD o I n 7C ° CP f f ' r ; Seo z CL t CD x O O 0 i to Cl) CD ' CD C. Q O CD 3 0 r ��` 7 7 C)m X06' rn0 Q 62. (nry� M 00 W C CZ C -)Co m _ Cl) v/a^ CD v, IF Q p GZ CD n p CD 77 2 C CD nnom�• C deck r 1 27.3 W 27.3 At `i'0_1115 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 k-.` ?) HAA # t'� �\ � � 1 i 1 7 1. GENERAL INFORMATION Complete legal description Lot 13 dock 1 Rabbit Creek View. Location (site address or directions) _;2C1 Leo Circle Property owner Charles Singltry — Day phone 349-7575 Mailing address Lending agency -w1 hi nnt-on Home P'loroaae Day phone 522-3570 s Mailing address 1199 m nd _.Suite 203 Anchorage, AK 99515 Agent Dan Reyes/HRT Reality Da yPhone 561-2220 Address 341 W. Tudor Rd. St. 103 Anchora e AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water X NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank X Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 77-025 (nn° 1/91) rmr, ' r11 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm DHI Consulting Engineers Phone 344-1385 Address Engineer's signature 6. DHHS SIGNATURE 0 Approved for Disapproved. bedrooms. Date J- 6 " & �,.y,M,P i? *;,:.,V .,s-., lg 1' J' rvs,ak xr� h V ds s -X ,? xxx Conditional approval for two (2) bedrooms, with the following stipulations: Escrow monies to install a seal within the well casing or perform whatever work is necessary to prevent any surface flow from originating in or around well casing. Work is to be performed as soon as it becomes practical (weather permitting) but no later than May 15, 1996. Additional Comments Monies shall remain in escrow until final approval is granted from this Department. 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) Bark MOA 421 W.O. 96251 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • IP I V (90V I 11 VAI& OF ANC.HUrv,Vt Ak ENVIROI\IMENTAL SERVICES DIVISION Health Authority Approval Checklist �'' �� Legal Description: L 1 3 B 1 Rabbit Creek View Parcel I.D.:% A. WELL DATA Well type RES If A. B. or C, attach ADEC letter. ADEC water system number Log present (YIN) jjo .1 Date completed 19 7 5 0 Total depth 5 3 Cased to 5 3 ' O Casing height (above ground) j 1 . 2 ' Sanitary seal (Y/1) Yeses Wires properly protected (Y/1) YeSC20 FROM WELL LOG AT INSPECTION Date of test2 N/A. 1/31/96 Static water level2 IQ/A Artesian Well production N/ Am. 0. 9 5 2 g�P� � g.p.m. WATER SAMPLE RESULTS: Coliform 0 Nitrate 0,1 Other bacteria 0 Date of sample: 21/1 /96 Collected by: Dustin High B. /HOLDING TANK DATA Date installed 19 7 5 y Tank size 2, 0 0 0(DNumber of Compartments 1 O) Cleanouts (Y/N) Y® s Foundation cleanout (Y/N) No Depression (Y/N) No High water alarm (Y/N) A#s � YcS Date of Pumping 12/11 / 95 Ll Pumper A + Home Services C. ABSORPTION FIELD DATA Date Length Width Effective absorption area Soil rating (g.p.d./ft2 or ft2/bdrm) System type Gravel thickness below pipe Total depth Date of adequacy test Results Fluid depth in absorption field before test (in.); Fluid depth (ins.) Minutes later: Peroxide treatment (past 12 months) (Y/N) present(Y/N) Depression over field (Y/N) For Immediately a$tr-,, Absorption rate = If yes, give date gal. water added (in.): p.d. bedrooms D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/1) -Pump.on" level at* "Pump off' level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 10 5 ' ; On adjacent lots 1 1 0 ' +y Absorption field on lot N / A ; On adjacent lots 1 1 0 + Public sewer main None Public sewer manhole/cleanout None Sewer /septic service line None Lift station None SEPARATION DISTANCES FROM 3>/HOLDING TANK ON LOT TO: Building foundation 3 5' roperty line 100'+C74) ' Absorption field N / A /v 14- Q Water main/service line N Surfacewater/drainage None Wells on adjacent lots 1 10 + CZI SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Surface water Water main/service line storage area Curtain drain Wells on adjacent lots \- Property line © DHHS Records:.` \ F. ENGINEER'S CERTIFICATION (DI DHI Records X` Per Owner �A` 1 certify that determinedeefine ections and review of MuntpaLreGorCis fhat the above systems are in conforma ce with IOA HAeffect on this date. Signature Engineer's Name =� ;''�--,E' nee ng,Seal Here Date- �.;: _ HAA Fee $yOD,00 Waiver Fee $ Date of Payment —�0 �U0 Receipt Number b tits 4"� I � - Rev. 8/95 OSS: haa.wk.doc Date of Payment Receipt Number Anr41 17, 107? Virnil FnnlanO lr,l"7 Klatt Station Subiert Lot 11, Dloc'L: 1, R ibbit rreey "i,�w Sub('ivision M-ar 'ar. F n r I in i - MFmhPrs of this nen?rtment' madr. an insr)action of t'ie subject lot on .Anril 1A, 117? to drtermina if on-site sew ne disposal was feasible. From a borinn help made ty 'fir. Les Sawyer, we c,)ul that the watrr tahlo v!as at about 1'" Nr. I�c?v!'fpr RIso stAtr�d thiit h+' ti a(4 bertfl to arI gnat i?; was novn,tvh nreinancr, statns Viii Jul surfact �isvosal Pick's shall not he usc,(4 in honvv clay or )t -',.,r finrr!rvious soil Fnrratic-s or it low. sw;--may arc -as or wherp t.ni, nrnund water luri no ary srasnr, of tic y.Rar will i.;o wit ,i n 1'- '' of t`f' ``ottom of the '`rcncn". Als^, "No seenagQ nit S`!lll eX- tpr- into th,:'- w.i tpr table". nl sc' f t r { that no absor"tion syster may he installed wherr they rercnl=tion rata is loss than l' per Yi ninutr's . For tht: gr rcasors, h,ti must saw that thr., subject rr^?+'rty is not suitable for develQors��nt. with on-si tl-r snwane disf�os.al at t'.i S tilde, . Sincerely, John F. tee, R.S. Senior Environmental Specialist bb 4 ,.gym 14 GREATE�t ANCHORAGE Akc,, BOROUGH Department of Envi ror+n(e+ital Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner: Mailing Address: /bl9? k,"leW- ,.Da y Phone 3. Nane of Buyer: Mailing Address: �Day Phone 4. Name of Lending Institution: ''task. Mailing Address: ��O f„ �(� /�� hone 7S_-7,3 7�y�- 5. Name of Realtor or Agent: Ann � Mailing Address: Phone 6. Legal Description: /�__ /3 g/ Yee! � Location: /SINN 7. Type of Facility to be inspected:,,/� do. Bdrms. 0 � 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served _/_ If individual, depth of well 9. Sewage Disposal System Type o System: Public Utility individual (on-site)/ If Individual, date of installation Aso I'll 41'.. / o) 7 5- 7 6 3-7 lti�4 Pq�CpOAAGE q�� 0 G uw �G��=E9 JAOLLP'Ay \ `96� GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received / 1� Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: ie -,6 Phone: 2. Property Owner: i�,1ti Phone: Mailing Address: 3. Legal Description: ,�� �` /--s`� 4. Location: 5. Type of facility to be inspected -1, ,Q,, z No. of bedrooms . 6. Well Data: A. Type'�� C. Construction 7. Sewage Disposal System: %I"&i`f), "a%' B. Depth D. Bacterial Analysis �, t7 41 -/-7-) A. Installed / %�� B. Installer Atladi C. S_Tank: D. Seep a a Pit: E. Disposal ield: 8. Distances: 1. Size ;),_ : 2. Manufacturer 1. Absorption Area Total length of lines 2. Material A. Well to: S.&Wc tank Iciv _, Absorption area Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Req t for Approval of Individual Sk r & Water Facilities Legal Description Comments Approvedl` "� ,-yl-t�"'1� Disapproved Date 4/ `�'7 - 7 -5 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 EQ -034 (1/74) Date