HomeMy WebLinkAboutCLEARVIEW LT 13 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LOCATIOJ:~--.. NO. OF BEDROOMS
] W~i$ ~ I AbsorPtion area - I Dwelling ___ o PERI~'I_.T NO.
DISTANCE TO: I ~ )00 I~ ;~ l~'l ~ ' ~ ~ 1
Manufacturer ~ / ~ - ~ Ma~ . No. of ~mpartm~nt~
~ I. . .W~- , .~/~
~' ns I FH O ME ~DE'. Ins ,de len gth WI dth Llqu Id depth
DISTANCE TO [Well Dwelling PERMIT NO.
: I i
Manufacturer ] Material Liquid capacity in gallons
IWel~ ~ ~ .~i Foundatio~ INearestlotli~e PERMI~O~
D,STANCETO: ~ I0~ ~ I ~ ~/~/
No of lines ~ Length pf ~ach line _ TotalJenqth of/ines ~ ~n~iGth -/~[ Dista~ebetween lines
' ~ I ~1 ~ 9~ 114,~ I I,~.~& ~h~ ~/~ '
Top of tile t~ ~i~ish grade/ Material beneath tile ~ .~ ~ Total e~v~b~orption
~ ~ inches ~
Length ~ Width Depth PERMIT NO.
Type of crib Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
lClass Depth Driller Distance to lot line PERMIT NO,
........... Building foundation Sewer line Septic tank Absorption area(s)
OTHER
SOI"L TEST R~TING .__ ,
INSTALLER
REMARKS
APP~ ~ DATE LEGAL
Box 1369, ...~TAR ROU'TE A ANCHORAGE, ALASKA 99502
~,~14-?714
SlX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 9~ ~:~.~.
DRILLED AT THE RATE OF
PER FOOT.
PROPERTY OWNER £~.. ~.t'~¢,~.¢ ~nh~.,4rm. ~f 9-77'3'6'
LOCATION OF WELL SITE
WELL LOG:
¢
CO~F-TI~CLUDES ALL LABOR AND MATERIAL FOR COMPL~ION
~~ OF SAID DRILLING.
/
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF ,~225~. O0
THANK YOU VERY MUCH.
BERNIE CLAUS OF RAMPART DRILLING WORKS
DATE
SERVICE CHARGE 0 F 1~% PER MONTH WILL BE
~SSESSED ON ~
PAST DUE ACCOUNTS.
F'ERMI T NO.
l~LIt-~ I~;: I c;~'RLZT'~" C,F Rt-~E:F
DEPRRTMENT HERLTH RN~ ENVIRONMENTRL HROTECTION
825 'L' STREET, RNCHORRGE, RK. 9950i
264-4720
L4ELL RFIC' I]It-&--SITE SEP]ER
( 8~0~47 )
SRA E:OX 2192 99507
AF'PLICANT ROBERT H JOHNSON
LOC:AT I ON
LEGAL Li-~ CLEARVIEW LJ]T SIZE
T'¢PE OF SOIL ABSORPTION SYSTEM IS' DRRINFIELD
MAXIMUM NUMBER OF BEL':,ROOMS = 4 SOIL RATING (SO FT,--"BR)=
,=, ,,_ t' '~
THE REQUIRED SIZE OF THE SOIL ABSORPTION _~=,TEM IS' ~'-"
[)EF'TH= 7 LEI"'"IGTH=E~N~ GRR%,-"EL C, EF'TH= Z~ ..J L
THE LENGTH DIMENSIOI'.,I IS THE L FEET) OF THE TRENCH OR [:,RAINFIELE:,.
THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THE TREI'-.IC:H P..I I [:,TH I S 5. E1ElO FEET.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFFILL PIPE
AND THE BOTTOM OF THE EXCAVATION ,.':IN FEET).
~:EC_-!LI I D'E[-', SEF'T I C: TRI'~k-'.' S I ZE= -1 25~-_--~ ,3RLLCI[-IS
PERMIT APPLICANT HRS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT [:,IJRING THE
INSTRLLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUM8ER OF RESIDENCES THRT THE WELL WILL SERVE.
TL-IO ,:: '=' ::, I I"-.i_~-F'EC:T I I_-II%iS RRE RE ~_---! U IRE[:,
'-'~"-'nf-I~,'~"' BY
BRCKF ILL I NG 'IF RNY SYSTEM W I THOUT F I NRL INSPECT I ON RND n~'~' r~:_ ~ n- TH I S
DEPARTMENT WILL E:E SUBJECT TO F'ROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL RND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
t00 FEET FOR A PRIVATE WELL OR ±50 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL. .
MINIMUM DISTRNCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET RND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICBTIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F'ERr'I I T E:-(P I RES [)ECEr-IBER %-I , iLr4-SZ-:
I C:ERTIFY THAT
±' I AM FRMILIF~R WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS AS SET
FORTH 8Y THE MUNIC:IPALITY OF ANCHORBAE.
'2: I WILL INSTALL THE SYSTEM IN FtCCORDANC:E WITH THE CODES.
Z~' I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MA'¢ REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELE[:, T~ INCLUDE MORE THAN 4 8EDROCIMS. .~
,.
SOl LS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
DATE PERFORMED:
5
8
--9
10
11
12
13
14
15
16
17
18
19
2O
II i
!
-I
I II
,
III 1
I
iIII
l~ll]llllI
COMMENTS
PERFORMED BY:
SLOPE
SITE PLAN
WAS GROUND WATER ~O S
ENCOUNTERED? L
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
ti."= ~ o
~ i~:~ Io ,~1 .O~
PERCOLATION RATE ! ~:~ (minutes/inch)
TEST RUN BETWEEN +I/3''~. FT AND ~ , ET
CERTIFIED BY: ~~ ~-'~/~
72-008 (6/79)
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. # 01 ~ -;;;)- ~'~ -'~"~, HAA# ~ ~/.~ O~'-(.~,~
GENERAL INFORMATION
Complete legal description
Lo-i-
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
-~OO ~-7~ "~ L2(L~ P~-L Day phone
[~t¢ Il $1,4 o 90~_1N ~__ C_~. i2.C LI~_
'~-,u~ .~-.~-v~A L ~2~-F_..L.OC~,T*k o % Day phone
Agent "T'o"~-~: H, ""~0 ~ "~ ~/~-- Day phOne
aare' -ss " '
Unless Otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: W
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
..-,.. .
NOTE: if community Well system, provide written confirmation from State AOEC atte§t-
...... lng to the legality and status of system. ·
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
',~ :''~ :'~--'' ,-'~;i' ':~?:'~ ~" - ' ~' --~:-~
**.~ :.'w-.'?~: ;~:-:, ~ Holding tank
Community On-site
."~': ...... ~-. ......... '.~'.. Public sewer ~:.' : .-,,
NOTE: :; If communi~ wastewater system, prowde wri~en confirmation from State ADEC
a~esting to the legali~ and status of s~tem.
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 vedfy 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-1~-~ ~u~-~._w_e~ --~-~' Phone~'7c]-~O/~
Address ~_o~ tJ~ / ~-'~,~ ~ 61''0 '~
6. DHHS SIGNATURE
'.~,, Approved for ;;' *~"/ .... bedr°~3ms-
Disapproved,
Conditional approval for
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent_
professional engineer registered in the State of Alaska. The DHHS does this esa courtesyto purchasers of homes.
and their lending institutions in 0rder to satisfy certain federal and state requirements. Employees of DHHS do not
C~'nduct inspections or analyze idata before a certificate is .issued. The Munici of 'is n~
_responsible for err'ors or omissions in the professional
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
A. Well Data
Well type '~
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump level1
/
FROM WELL LOG
Parcel I.D. r'm .~.
If A, B, or C, attach ADEC letter. ADEC water system number ::5~ z-/8 ~ Driller
Date completed
Cased to
g.p.m.
~ Casing height .~ ,t
Wires properly protected (Y/N) ~
/
AT INSPECTION
~. ~ g.p.m.
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot J
Public sewer main l"-////..~
Sewer service line
; On adjacent lots
; On adjacent lots "2'"~
Public sewer manhole/cleanout
Petroleum tank ~ l ~;~
WATER SAMPLE RESULTS:
Coliform ~,~L/
Date of sample: ? Y
Nitrate J. 0~--~ Other bacteria
'[/' /~ ~'( Collected by: -{~ ~"~-~
B. SEPTIC/HOLDING TANK DATA
Date installed ~//~O/~'-~ Tank size /~.. C7 ~ Compartments
Cleanouts (Y/N) ~'// Foundation cleanout (Y/N) ~ Depression (Y/N)
High water alarm (Y/N) ~'///A- Alarm tested (Y/N)
Date of pumping ! 0/~7 l ~' ~ Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot [ O 2-- ~ /~
To property line ~ ~ ~
Surface water/drainage IO (~_-~)
On adjacent lots
Absorption field
Foundation
Water main/service line
CONTINUED ON BACK PAGE
72-026 (3/93)* Front
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)
Manufacturer
Manhole/Access (Y/N)
"Pump off" Level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed ~/~ o/~ _~
Length J I ~,. ~
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (y/N)
System type
Soil rating (GPD/FF)
Width _ ~ Gravel thickness
~/~:~ ~ Cleanout present (Y/N) ~/
I l ltl o,,.[ Results (pass/fail) ~'
After test
Total depth ~ --
Depression over field (Y/N)
for ~/ Bedrooms
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot ) I ~ '~ On adjacent lots
To building foundation L~_,.,~ +
On adjacent lots ~> l ~ Cutbank
Surface water (~..'~
Curtain drain
Property line
To existing or abandoned system on lot
,2-~ ~- -~ ,~ c~ / o/~ ~_ Water main/service line
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect?n~® date of this inspection.
HAA Fee $
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
72-026 (3/93)* Back
zTL
CT&E Ref.#
Client Sample ID
Matrix
ClientName
Ordered By
Project Name
Project~
PWSID
Commercial Testing & Engineering Co.
Environmental Laboratory Services ~jj~r~,~,~jjj~j~j~,~,~,~,~,l
LABORATORY ANALYSIS REPORT
94.4980-]
LOT 13 CLEAR VIEW
WATER
TOBBEN SPURKLAND, P.E.
TOBBEN
UA
WORK Order 82590
Printed Date 09/30/94 ~ 21:12 hrs.
CollectedDate 09/28/94 ~ 15:45 hrs.
Received Date 09/28/94 ~ 17:00 hrs.
Tebhnical Director STEPHEN C. EDE
Released ~....~~ ~~
Sample Remarks: SAMPLE COLLECTED BY: T.S.
Parameter
Qc Allowable Ext. Anal
Results Qual Units Method Limits Date Date Init
Nitrate-N
1.08 mg/L EPA 353.2/300.0 l0 09/30/94 CMR
t
* See Special Instructions Above
** See Sample Remarks Above
U = Undetected, Reportedvalue is the practical quantification limit.
D = Secondary dilulion.
UA = Unavailable
NA = Not Analyzed
LT = Less Than
GT = Greater'l'han
5633 B Street, Anchorage, AK 99518-1600 -- Tel: (907) 562-2343 Fax: (907) 561-5301
ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA
Drinking Water Anal}sis Report for Total Coliform Bacteria
]LEAD .{NSTRUCTI01¥S ON REVERSE SIDE.BEFORE COLLECTING
umc WATER SYSTE / .D. I Ill
mVATE WASa SYSTZ,.M
[] Send Resudxs [] 'Send Invoice
W, ter Sy~ra Sarne~Co~y Name
Phone ~% umber
Commercial Testing & Engineering Co. ;,.
Environmen~tal Laboratory Services
5633 B Street
{ ~' Anchorage, AK 9951 8-1 600
Tel: (907) 562-2343
Fax: (907) 561-5301
~' az :Number
Send Results U1 Send Invoice
Clt'y Smte Zip C,o~e
Month Day Year
ELE TYPE:
outine ./rn Treated Water
epcot
Sample
(for
routine sample ~ Untreated Water
with lab ref. no. )
/ -
El Special Purpose
Time Collected
SA.IVEPLE LOCATION Collected By
PI,~ Priat
TO BE COMPLETED BY LABORATORY
siS shows this Water SAMPLE to be:
atisfactory
Urmadsfactory
Sample over 30 hours old, results may
be unreliable
Sam¢le too long in transit; sample should
not ~e over 48 hours old at examination
to indicate reliable results. Please send
n~w s?_mp!e -da soecial delivery' mail.
SiP 2 ? I%',,
Date Received
Time Received
Analysis Began
Anaiyticz! Methnd: _~a~_.v.C&--_.bra.ne Filter
~ ~O-MUO
* N'amber of colonies/100 mi.
Lab Ref. No. Result* ~nalyst
Sent to A.D.I~.~.-.
Fbks
Jun
Client notified of unsatisfactotD' results:
Phoned Spoke wfth
Faxed
Fa. xed
Date: TL,~c:
Cornlilents;
BACTERIOLOGICAL WATER ANALYSIS RECORD
MMO-.~G Result: Total Coliform
Membrane Filter: Direct Count
E Coli
~,t~ {~6 Colonies/100 mi
COLIFIRM
Verification: LTB BGB
Fecal Coliform ConFlrmatioln
Final Membrane FUter ReSUlts (~
:: 815'P 2 ~ lvv,t
Reported By'J', O3. b~2J~_ate
Colifon'nYlO0 nd
T~e I to OC_)
I~AD"r f~kll: fll:
B ~'~1% I vm ,nm~
-tWO TO
''~ ~~ Member of ,~e SGS Grou, (Soei~,~ G~n~ral, de Surveillance}
ENVIRONME~AL FACILITIES IN A~S~. COLORADO. FLORIDA. ILLINOIS. MARY~ND. NEW JERSEY, OHIO. UTAH. WEST VIRGINIA
TF=
Drink/rig Water Analysis Report for Total Coliform Bacteria
READ INSTRUCTIONS ON REVERSE SLDE BEFORE COLLECTING SAMPLE
Commercial Testing & Engineering Co.
Environmenta! Laboratory Services
5633 B Street
Anchorage, AK 99518-1600
Tel: (907) 562-2343
Fax: (907) 561-5301
MUST BE COM:PLETED BY WATER SUPPLT'FR
BLICWA=R SYSTEM LD. {llllll
RIVATE WATER SYSTEM
iD gend ResuP. s [] Send ~rnvoice
iD Send ResuPs [] Send In~oice
SAMPLE DATE:
Month
R L
E TYPE:
outi~ e
Repeat Sample (for routine sample
~Sth lab ret'. no. )
[] Special Purpose
SA.VfPLE LOCATION
Day. Year
iD Treated Water
Untreated Water
Time Collected
CoUected Bv.~..
PI~ Print
TO BE COMPLETED BY LABORATORY
Analysis shows this Water S~5_M2PLE to be:
fl~' Satisfactory --._ ~
[] Unsatisfactory
El Sample over 30 hours old, results may
be unreliable
[] Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received Zl[~ /
Time Received
Analysis Began
Analytical Method: .~ Membrane Filter
* Number of coton/es/100 wA.
Lab Ref. No- Result*
411012 ~ ~--]
Sent to A.D.E.C. ~ Fbks Jun
Client notified of unsatisfacto~' results:
Phoned Spoke with
Analyst
Date: Time:
Faxed
Faxed
Com.mei1ts:
BACTERIOLOGICAL WATER ANALYSIS RECORD
MMO-M'UG Result: Total Coliform
Membrane Filter: Direct Count ~_
Verification: LTB BGB
Fecal Coliform Cont-u'mation
Final Membrane Filter Results ~
F_ Col;
Colonies/100 mi
COLIFIRM
Coliform/lo0 nd
OB - O~h~r B.t~trla
I~ ~-~1~ Member of the SaS Group (Soci~t~ G~n~rale de Surveillance)
ENVIRONMENTAL FACILITIES IN ALASKA. COLORADO. FLORIDA. ILLINOIS, MARYLAND. NEW JERSEY, OHIO, UTAH. WEST VIRGINIA
Rick Mystrom,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
December 9, 1994
Mr. Tobben Spurkland
6751 W. Dimond Blvd.
Anchorage, AK 99502-3904
Subject: Waiver Request for: Lot 13, Clearview Subdivision
Waiver Approval: # WR940066
Dear Mr. Cowan:
Your request for waiver(s) of the required 100 foot horizontal separation of an
absorption field to surface water drainage has been approved. The approved
separation distance(s) are:
Absorption Field to Surface Water Drainage 93 feet
This waiver approval applies to the existing absorption field to surface water
drainage only. Any future upgrades will require all separation distances be met
or another approval be obtained from this department.
Robert W. Robinson
Civil Engineer
On-Site Services
kb
WR~ W~940066 PID#
Date Received:
Legal Description:
Engineer:
MUNICIPALITY OF ANCHORAG~
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
015-242-52 HA# HA940648 Permit
11-23-94
Lot 13 Clearview Subdivision
Tobben Spurkland
6751 W. Dimond Blvd.
Anchorage, AK 99502-3904
Applicant:
Waiver Requested:
Absorption Field to Surface Water Drainaqe - 93 ft.
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: X Waiver is NOT Granted:
List Conditions or Reasons for above:
Overflow from the standpipe in the absorption field would be
interrupted by Klatt Road before it could reach the creek.
Date:
Rec #:
00516 (7925)
By:
Name of Reviewer
Amount: $ 920.00
Date Paid: 11-23-94
T.SPURKLAND P.E.
6751 W. DIMOND BLVD.
ANCHORAGE, ALASKA 99502-3904
(907) 248-5095
RECEIVED
Municipality of Anchorage
Division of Environmental Health
Department of Health and Social Services
820 L Street
Anchorage, Alaska 99501
November 14, 1994
Subject:
Gentlemen;
REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR
SURFACE WATER TO DRAINFIELD
LOT 13 CLEARVIEW S/D
We are submitting a request for waivers fi.om the separation distances stated in Title 18, Alaska Administrative Code,
Chapter 80.020.
During a HAA inspection of this property we measured 93 feet fi.om the end of the drainfield to the nearest point on
~ small creek flowing on Lot 1 of Arant S/D
This septic system was installed in 1983 and the field notes prepared by a Municipal Inspector makes note of a ditch
90+ feet fi'om the end of the drainfield. No mention is made of flowing water, but the fact that the ditch was noted may
indicate that there was water observed.
The enclosed siteplan was prepared with a surveyed As Built of the property and a rag tape and a slope indicator.
Yours
The direct line between the trench and the creek is 93 feet. Subsurface flow of septic effluent to the creek is prevented
by the presence of Klatt Road. Even if subsurface flow was possible the travel distance and the soil material will
effectively filter the effluent and trap any contaminant. Any surface flow of effluent towards the creek can only happen
if the drainfield completely fails, and causes effluent to surface through the standpipe. The shortest line of travel to
the creek is 120 feet, more or less. In order to reach the creek the effluent must travel across 60 feet of maintained
lawn, then 60 feet more or less in a road ditch that was dry at the time of inspection. It is unlikely that a drainage
pattem along the lawn can be established. The owner of the property will notice the effluent when cutting the grass
and most likely react to the overflow. Also, field observations indicates that overflowing septic effluent will be
absorbed by the ground in a relatively short distance. There are instances where septic effluent have created a
permanent drainage pattern, but in the majority of those cases, groundwater and surface drainage has aggravated the
situation. In this case neither groundwater or surface drainage will aid in promoting surface drainage of septic effluent.
?'-~ .:. :'.: .:' ,, /':~ , -.
T.SPURKLAND P.E.
203 WEST 15TH. AVL~NUE SUITE 203
ANCHORAGE, ALASKA 99502-3904
(907) 279-3916
Fax (907)-276-6013
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC SYSTEM:
SEPTIC SYSTEM ADEQUACY TEST
Lot 13, Clearview
11611 Snowline Circle
Doug Ruckel
Single Family, 4 Bedrooms
Private, On Site
6-? ~'./ · , · :j ,
· .-,.?'~'
FROM ~ICIP~ RECORDS: 4 Bedroom System
T~: ~chorage Tank 1250 Gal. Two Comparts.
ABSORPTION SYSTEM:
ABSORPTION AREA:
SOIL RATING:
INSTALLATION DATE:
WAIVERS GRANTED:
5- Wide Trench
1004 Sq. Ft.
220
8/30/83
None. Ditch/Creek 93 feet from
trench.
DATE OF LAST PUMPING: Anch. Cess Pool 10-07-94
DATE OF TEST: Sept. 29 and Nov. 1, 1994
TEST PROCEDURE: System was inspected and measured. Tank was found with 3.5
feet of cover and with a liquid level of 56 inches.~' trench clean outs ~
Trench cleanouts were six and ei ht feet~___d~eP wit~ 13 and 15 inches
of water. ~600 gallons of clean water was added to the trench without backup.
On October 7, the outlet pipe of the tank was replaced and cleanouts installed.
A week later the system was water jetted.
On November 1, 800 gallons was added to the system. A 2-inch steel monitor was
driven to 2 feet below the trench distribution pipe. There was no water observed
in the cleanouts, and no water in the monitor. After adding 300 gallons of clean
water 11 inches of water was observed in the monitor. The addition of another
500 gallons caused the water level to rise to 25 inches. The water level dropped
rapidly after the water flow was stopped. After 90 minutes the monitor was dry,
indicating that the system was operating satisfactory..
TEST RESULT: This system meets the code requirements of the Health and
Social Services Department of the Municipality of Anchorage.
NOTE: The operational life of all septic systems depends on the local soil
conditions, groundwater levels that may fluctuate during the year, and the water
usage of the family being served by the system. These conditions are outside the
control of the evaluator of this septic system. We can therefore not give any
estimate of how long this system will function satisfactory for current or future
occupants. All septic systems ultimately fail. Some systems last 15-20 years,
others fail after less than 5 years.
I i 2' WIDE CREEK I I I L
ROAD DITCH J ~ BOAD DITCH
NO FLOW KLA TT
S =
TOBBEN SPURKLAND P.E. LOT 13 CLEARVIE~ S/D SEPTIC SYSTEU LAYOUT
20~ W 15TH. AVENUE DATE: NOK 6, 1994
ANCH. AK. 99501 11~11 SNO~LINE CIR.
(907/ 279-~916 DOUG RUCKEL SHEET: 1/I GRID: 2640/2740
WEST 15TH. AVENUE SUITE 203
ANCHORAGE, ALASKA 99502-3904
(907) 279-3916
Fax (907)-276-6013
RESIDENTIAL WELL INSPECTION
LEGAL:
LOCATION:
OWNER:
Lot 13, Clearview S/D
11611 Snowline Circle
Doug Ruckel
TYPE OF WELL: Private, Single Family
WELL LOG AVAILABLE: Yes
INSTALLATION REQUIREMENTS MET: Yes
WAIVERS GRANTED: None Required
WELL YIELD FROM WELL LOG: 20 Gallons per Minute
PUMP YIELD FROM TEST: 6.6 Gallons per Minute
DATE OF INSPECTION: Nov. 1, 1994
TEST PROCEDURE: Well was pumped at a constant rote for two hours. A total of 800 gallons were pumped
without loss of pressure. This well is artesian and access to the well casing is prevented by a mechanical plug..
TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested for E.Coli and total nitrogen on Sept.
28, 1994
E.Coli 0. Other Bacteria 2 Total Nitrogen 1.8 mg/l.
Max. allowable Total Nitrogen 10 mg/l.
No Bacteria Allowed
Well was retested on Nov. 1, 1994.
E. Coli 0 Other Bacteria 0
TEST RESULTS: This well meets the requirements of the Municipality of Anchorage.
THIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE FOR MORE
THAN FOUR HOURS
The Municipal requirement for well flow is 150 gallons of water per bedroom per day. This well exceed this
requirement. The assessment of the condition of the well applies only to the conditions as of the day tested. The flow
rate may change due to subsurface conditions that may not be observed from the surface, and changes in the land use
and other factors that may impact the aquifer feeding the well.
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
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 lOt, block, subdivision, section, township, range)
Location (address or directions)
(b) Property owner ~,~,<,~- ~, ~,~ ~e ~ ~ Telephone' (home)
Mailing Address It~ '~~[;~
(c) Lending Institution ~ ~( ~G~ ~%~ Telephone
Business
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(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
Single-Family,' Number of bedrooms
3. WATER SUPPLY
Individual Well ¢
Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to'th legality and status'.
4. SEWAGE DISPOSAL
On-site ~, Public [] Community [] Holding Tank []
Note:~'f community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72*025 (Rew 7/88) Page I 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 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.
Nameof Firm "~o/',~,~,~''~--, ~/~'~r~"J/'---/~2'~-J-~elephone ~--~7'/'~~ ~ ~
Address ~ Z~--/ ~' ~'~~
~ '/2 .~. ' .C/-J-~~' Engineer s Seal
6. DHHS APPROVAL
Approved for ¢ bedrooms by
Approved ~ __ Disapproved
~,..
Terms of Conditional Approval
~._~/~ _~_~ _~~Date
Conditional
The Municipality of Anchorage Department of H~alth 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.
72-025 (Rev. 7/88) Back Page 2 of 2
A. WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth
MUNICIPALITY OF ANCHORAGE (MOA) ~
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description: L c)-i' 1'5
~ ~ If A, B, C, D.E.C. Approved (Y/N)
"/ Date Completed Y~£/~-~ Yield
Cased to ?~ Depth of Grouting IX////~.
Pump Set At ~o o~
Sanitary Seal on Casing (Y/N) ~'
Depression Around Wellhead (Y/N) ~J
; On Adjoining Lots
; On Adjoining Lots
Static Water Level
Casing Height Above Ground
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
To Nearest Public Sewer Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments t)(/ ~J/ ,'.s
B. SEPTIC/HOLDING TANK DATA
Date Installed ~/~.~ Size
Standpipes (Y/N)
Depression over Tank (Y/N)
· Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
/,2 G~> No. of Compartments
Air-tight Caps (Y/N) ~/' Foundation Cle, anout (Y/N)
IX/ Date Last Pumped
~///~ ;for
Temporary Holding Tank Permit (Y/N) N'//,~.~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well /0 ~-
To Property Line .~,~ ~'
To Water Main/Service Line ? ~"C~
To Stream, Pond, Lake or Major Drainage Course
To Building Foundation
To Disposal Field
Comments
72-026 (Rev, 7/88) Front
Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption St~.~ta
Date Installed ~//¢'¢'
Width of Field
Type of System Design'
Length of Field /1~,.
Depth of Field '7 ~
Square Feet of Absortion Area
Depression over Field (Y/N)
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well
To Building Foundation
Lot /7//~
TO Water Main/Service Line
Gravel Bed Thickness "5'
Statndpipes Present (Y/N)
Date of Last Adequacy Test
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line ~ 1 D
To Existing or Abandoned System on
; On Adjoining Lots "2 /~
_'> ,~r~ To Cutback (if present) !'///,~
Comments
,No
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA,gui.del~.es in effect on the date of this
inspection.
Signed
Company
Date
l ov' z-E5 lq tO
MOA No.
Receipt No.
Amount:
(: ,~? L? ?' . ,., -, ' : . -
Receipt N~. ~ ~~ '
waiver Fee: $
Date of Payment
Engineer's Seal
72-026 (Rev. 7/88) Back Page 2 of 2
b?Sl W. DIHOND
ANCHORASE, ALASKA ~gS02-~g04
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC SYSTEM ADEQUACY TEST
Lot 13, Clearview
11611 Snowline C:i. rcle
R (:) b e.~r t J o fi n s o n
Single Fami
Pr'ivate~ On Site
4 Bedrooms
SEPTIC SYSTEM:
F'F;,'OM MLINiCIPAL F;:ECORDS: 4 Bedr'oom S'ystem
"['ANK: (~nc:horage 'T'ank 1250 Gal. Two Comparts.
ABSORPTION SYSTEM: Shallow Trench
ABSORPTION AREA: 1004 Sq. F't.
SOIL RATING: 22()
INS-r'ALLATION DATE: AUgust 198:3
DATE OF LAST PUMPING:
Anc:l"~. []ess Pool Nov. 29, 199()
DATE OF TEST:
November ~.8, 199(i)
TEST PROCEDURE: System was inspec:ted and measured. Tmank was
~ound with 5.5 ~eet o~ cover and with a liquid depth o~ 47
inches. A monitor tube and a__~.ean out wer"e ~ound ~or the trench.
M(:)nitor was :8 ~eet deep and dr"~, ,cleanout was 6 ~ee"E""~
600 gallons o~ c:lean water was added to the bed while the water
levels in the tank and the monitor tube were monitored. T'he water
level in the tank did not chanc~e~ no water was observed ir"m the
m o n i t (:)r.
TEST RESULT: This system meets the code r'equiremer~ts c::,.6
t. he Health and Social Services Department o~ the Municipa~:[ty o-~:
Ar'mc::hor age.
NOTE The opera'L: i oF)a], t i ~:e o~ al 1 sept. i c: systems depends on the
].oc:al soil. c:ondit, ions, groundwater leve].s thai: may ~luctuat. e
during the year~ and the water usage o~ the ~amily being served
by 'l:he system. 'l'hese cor'lcJitior~s ar"e outside the control o.f the
evalua'Lor c:)f tl"'~:[s septic: system. We can ther'e~:c)re not (aive an'v
estimate of how long this system ~l[ fLtnct:Lon satis~:actory for
c: Ltf' F' e n 'k. o r- ~: t.t'[', t..t r e o c: c LIp a ntz s.
675! W, DIM§ND BLVD.
ANgHORABE, ALASKA 99502-3904
(907) 24B-5095
LEGAL:
RES I DENT I AL WELL INSPECT I ON
[...or 15: Clear'view
LOCATION:
OWNER:
TYPE OF WELL:
11611 Snowline Circle
Robert. J ohr"~son
F'rivate~ Single Family
WELL LOG AVAILABLE: Yes
INSTALLATION REQUIREMENTS MET:Yes
WELL YIELD FROM WELL LOG:
2(]) Gal 1 ohs per Mi nute
PUMP YIELD FROM TEST:
..;- Gal 1 OhS per" Mi F)LI'Le
DATE OF INSPECTION:
November' 28, 1990
TEST PROCEDURE: This is an artesian weii,.U~ When the well cap
was removed, a mec~-a'ill)i'C'~'~i i~-l~g wis +c)und. The above portion o~
the casing was ~rlozen solid. No water level readin(js were ob-
tained. The well was pumped ~or 2 hours at a constant rate o¥ 5
gallons per minute. A total, o~ 600 r~a]l, lons were removed.
TEST FOR E.COLI AND TOTAL NITROGEN: War. er was res'ted ~or E.C,;:)i i
and total nitrogen on 11t2'Zt90
E.Coli 0. Total Nitrogen 1. lmg/1.
Max. allowable Total Nitrogen 10 rog/1.
TEST RESULTS: 'mira ~ ~. S wel il meets the requi r'ements
Municipality c)~ Anchorage..
THIS WELL WILL PRODUCE MORE THAN 5 GALLONS PER MINUTE FOR
THAN FOUR HOURS
MORE
I"he Municipal requirement ~or well ~low is ].5(.') gallons c)~ water
per bedraom per- day. "l"l'~is well exceed this requirement. The
assessmer",'t o¥ the condition o¥ the well applies only to the
c:c~nditions as o.F the day tested. ]'tie ~:l(:)w rate may change due to
subsur-~ace condi~:ions that may not be observed ~rom the sur'~ace,
and changes in the land use and other ~actors that may impac:t the
aqui~:er Yeeding the well. 1.
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
56.33 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343
FEDERAL TAX I.D. #92-0040440
ANALYSIS REPORT EY PARANETER
Client PO! : NONE RECEIVED Req $:
Sample Rec'd : NOV 26 90
Ordered Ey :
REPORTS ADDRESS $1
TOBBEN SPUR~LAND, P.E.
Work Order Ho. : 303?3
Client Account : TOBBENS
Date Report Printed: NOV 29.90~ 10:08
Released By :
REPORTS ADDRESS
6751 W DIMOND
ANCHORAGE, AK. 99502
Special
Instruct:
Chemlab Ref $: 904987
Analysis Completed: NOV 28 90
Matrix :
Parameter :
Lab Sample Client's Sample Limits :
ID Identification Method :
1 LI3 CLEARVIEW POTABLE
2 L13 CLEARVIEW POTABLE
WATER
NITRATE-N
10
EPA 353.2
1.1 n~/1
TOTAL SAMPLE
COLIFORM COLLECTED DATE & TIM
SEE ATTACHED
NOV 26 90 { 11:45 HR
NOV 26 90 @ 11:45 HI{
Report
Remarks:
· See Special Instructions Above
ND= None Detected "See Sample Remarks Above
NA= Not Analyzed LT=Less Than, GT=Greater Than
MUNICIPALITY OF ANCHORAGE
DMSION OF ENVIRONMENTAL HEALTH
DEPARTME~ OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
I. General Information Application Date ~
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions) \
(c) Applicant is (che~ o~) ~nding Institution ~ ; ~r~il~r ~;
8u~r ~; ~her ~ (e~lain);
(d) ~i~ Institution .5~~ I~Y. ~% ~ ~{~ ~lepho~"%c?~:, 5':L.~ -~
(e) Real Estate Co. & Agent
Address
Telephone
2. Type of R~sidence
Single-Family ~
Number of Bedrooms
3. Water Supply
Individual Well
Multi-Family ~--~
Other (describe)
Ccll~unity ~-~ Public
Note: If cu~,,.~nity ~11 system, must have written confirmation fTcr~ the State
Department of Enviro~Ja~ntal Conservation attesting to the legality and status.
Is the ~11 adequate for the number of bedrooms specified in this HAA (Y/N)
4. Sewage Disposal
Onsite ~ff~ Public ~--~ C~,~,~nity ~-~ Holding Tank ~--~
Is the wastewater disposal system adequate f~r the number of bedrcx2ms (Y/N)
[Page 1 of 2]
2-15-84
5. Engineering Firm Providing Inspections, Tests, Data and Information
I certify ~ checked, ~rified, c~ conforn~d to all MOA HAA Guidelir~s
effect on/~~/of th. is inspection.
Signed / ,~'W.)~.-~ Date
Nam~ of Firm
Date f----l.$ ~-/% 4-
in
( ENGINEER SEAL)
6. DHEP Approval
Ap~o~d for ~
Terms of Conditional Approval
The Municipality of Anchorage Department of Health and Environmental Protection does
not guarantee the continued satisfactory perfcrmance of the wate= supply and/or the
wastewater disposal system. This approval indicates that, as of the validation date
shown above, based on the data and information furnished by an engineer registered in
the State of Alaska, the water supply and wastewater disposal system is safe and func-
tional for the number of bedrocms and type of structure indicated.
( DHEP SEAL)
7. Mail t~e HAA to the following address:
KB2/d5/s
[Page 2 of 2]
2-15-84
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Well Log Present (Y/N)
Total Depth ~ ~eT' Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Legal Description: ~.o,7" ~33 c.~.~.~, q~
If A, B, C~ C, D.E.C. Approved(Y/N) ~m
Date Cca~pleted
Pump Set At
~-;~-es~ Yield z~>.
Depth of G~outing ~ ~/- ~"~
Sanitary Seal on Casin9 (Y/N)%~-~
Depression Around Wellhead (Y/N) ~o
Separation Distances f~cm Well:
To Septic/Holding Tank on Lot ioo ~.-~ ~~}~; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot ~z~3 ~ee~7' ; On Adjoining Lots
To Nearest Public Sewer Line ~.//~ To Nearest Public Se~r
Cleanout/Manhole ~//l~ To Nearest se~r Service Line on LOt
C~m~nts
B. SE~IC/HO~I~TANKE~TA
Date Installed % - ? - ~ ~ Size
Standpipes (Y/N) W~ Air-tight Caps (Y/N) ~ s Foundation Cleanout
Deuression over Tank (Y/N) ~o Date Last Pumped 7-{
Pumping~intenance Contract on File (Y/N)Ho ; fo~ ~.~_~
Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances frcm Septic/Holding Tank:
To Water-Supply Well IO0 /-~_.7"' TO Building Foundation
To Property Line 7~' ~_~7~,//~- ;=~7-To Disposal Field /~'
To Water Main/Service Line .~//~ To Stream, Pond, Lake, c~ Major Drainage
Comments
No. of Compartments --~
(Y/N) ~ ~
[Page 1 of 2]
2-15-84
C.' ABSORPTION FIELD DATA
SoilS Rating in Absorption Strata
Date Installed ~ -! - ~/~
Width of Field .~ 3~/~-T~
square Feet of Absorption A~ea ~)
Depression over Field (Y/N)
Results of Last Adequacy Test
Type of System Design
Length of Field . ! t ~. ~ /~d~'7~
Depth of Field ? ~ /~
Grail Bed Thickness~-~;~
Standpipes P~esent (Y/N)
Date of Last Adequacy Test
Separation Distanoe f~cm Absc~ption Field:
To Water-Supply W~ll ilo ~ To ~o~rty Li~ '7f~~
To ~ildi~ F~n~tion c-~; ~ To Existing
Lot ~ ; ~ ~joining ~ts
To Wa~ ~i~vi~ Line ~/~ To ~t~(if pre~nt)
To St~e~ond~ke/~ ~j~ ~aina~
To ~i~way, P~ki~ ~ea, ~ Vehicle St~a~ ~a
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Dime ns ions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
Electrical Codes (Y/~)
Cc~m~nts '/4, / ~
** Check Permtitted Bectrocm Rating AGainst HAA ~quest
I certify that I have checked, verified, o~ eonfc~m~d to all MOA HAA Guidelines in effect
on the dat~ inspection. ~'Wb~
Signed /~/.~-~-~ Date
,.,o,,,,,o.'"
Cc~pany
KB1/d5/s
[Page 2 of 2]
2-15-84