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HomeMy WebLinkAboutCONIFER HEIGHTS BLK 1 LT 21Onsite File Conifer Heights Block 1 Lot 21 #015-093-55 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 ��- -s f ON-SITE WASTEWATER INSPECTION REPO r "s kt- Permit Number: OSP221122 PID Number: 015-093-55 AA I Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name RANDY BECKER ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 7600 LODGE POLE CT, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot CONIFER HEIGHTS 1 21 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ 100'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water 50'+ 50'+ Material PALSTIC Number of compartments 2 Lot Line 10'+ 10'+ NA Foundation10'+ 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks NEW WELL SEAL & CAN SAMPLES ATTACHED Alarm location Electrical installed by Installer DENALI EXCAVATION PIPE MATERIAL House to tank 3034 d a afield Tank to 3034 Drainfield 3034 Co/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection ection 15` 6/30/22 7/1/22 Location and description 2n 3`d 4`h TOP OF RISER / MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date *: 49 TM .......... . • .. • • • ....... / % " System LApproved- , •.Curtis Huffman�Z ���F�/�••• Date l�Z Date CE 128991 �1 7/29/2022.•�,� QPROFESSO Note: this approval does not include well Permit requirements. kKev ub/uuiu) PID: 015-093-55 PERMIT: OSP221122 _fin S B905613011W 1 09.741 A -C=62.3' B -C=36,0' A -D=63.4' B -D=38.7' A -E=63,1' B -E=39.6' SEPTIC SECTION SCALEi NTS \ CONIFER HEIGHTS BLK 1 LT 21 SUPPORT$ SERVICES: ()F AZ � PREPARED FOR: RANDY BECKER 7600 LODGE POLE CT C * 9 TH* ANCHORAGE, AK 99507 FIRST WATER CONSULTING DATE: 7/29/22 ` tis Huffman / 13030 SUES WAY SURVEY: HOLT 1 CE 128991 DRAANCHORAGE, AK 99516 SCALE: ill = 30, 1 �, 7/29/2022 e'o \FESSIOR�' 907-350-9566 FirstWaterAK@gmail.com SGS Ref.# 1222424001 Client Name First Water Consulting Services (FWCS) Printed Date/"Time 05/31/2022 14:40 Project Name/# Conifer HTS. 131 L21 Collected Date/Time 05/20/2022 11:30 Client Sample II) Spigot Received Date/Time 05/20/2022 12:02 Nlatrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 B (<10) 05/23/22 05/24/22 DSD Waters Department Total Nitrate/Nitrite-N 8.31 0.200 mg/L SM21 450ONO3-F C (<10) 05/28/22 EBH Microbiology Laboratory E. Coli Negative 1 100mL SM21 9223B A 05/20/22 M.A Total Coliform Negative I 100mL SM21 9223B A 05/20/22 M.A Page 2 of 5 LODGE POLE COURT 4 S 89°56'30"W 109.74' MUNICIPALITY OF ANCHORAGE iDn-Site Water & Wastewater Program Flo Bou 19655D 4700 Euro" Road Anchorage, Aleeke 99$198654 PhOno; (90 ) 34:�TMq Fax (907) 343.7$97 htrpWWAW,MUni,argransfte 0nfte Wastewater Disposal System Permit Pe rm it N urabpr, OSP 21122 Work TypA. SepEic.Tank Upgrade Tax Codi§Numl er: 01509355D00 Site Legal Address; CON IPER HEJGHTS ELK 1 LT 21 G:2440 Slte lVailing Address; 7600 LODGE POLIa CT,Anchoraga Owner: B EGKER RANDY E e5ign E nginger, F I R$7 WATE R CO NSU LTI NG This permit it for the o"structien of: EJ Dispersal Field 0 Septic Tank Q HoldIng Tartik O Prig Effective Date: xplratFon fat$; �n4�nr $, 4" r% r� {` ei,.irIinenr EJM.2022 5f20J3 Loi Sipa In Sq Ft: 2,3416 To1ai Bedr ms, 4 0 Pelvale Well Water SkAage All construction shall bo In i ordance with: 1. The attached approved design. 2_ AA requirements speciFk�d is AnCh❑rage Municipal code Chapters 1.5.55 OM 15.55 and the State of Alaska Wastewater Disposal € egvlAans (18AAC72) and Drinking Water Regulations (18AAC80) 3. The w@stevreler K -,Me requires inspections dkinn-9 1110 ilU.LulWLicrF, Tlku engineer shall w0fy the Qeveloprkient Serviaas Cepgrtment per AMC 15.65_ Provix% nolificartion by calling (907) �414W4 (24f7). 4_ From Oat -ober 15 to April 1:5, a s+ub5urface soil absorption syMem under Gonstrm ion during freazing weather shall he either. a. Opened and CMed on Uie same day, or h. Covered. 5ealed, and heated to prLivent Freeing Recelved By: I slued By: 5120!2022 Date= Date; . Development Services Department- Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel 1. D. 015-093-55 Property owner(s) RANDY BECKER Day phone Mailing address 7600 LODGE POLE COURT, ANCHORAGE, AK 99507 Site address 7600 LODGE POLE COURT, ANCHORAGE, AK 99507 Legal description (Sub'd., Block & Lot) CONIFER HTS. B1, L21 Legal description (Township, Range & Section) //�� Lot Size 26416 Sq. Ft. Number of Bedrooms - "I APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank El Upgrade 0 (D) El Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ignature of property owner or authorized agent) Permit/Rush Fees: 2Z e Date of Payment: Receipt Number: (10 q Permit No. 0S)e�22.Z I I Zj' Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMP L LS OSP221122, Rebecca Carroll, 15 DESIGN DETAILS: INSTALL NEW 1250—GAL HDPE 5 --TEP- TANK. MAINTAIN 10'+ FROM FOUNDATION, 200' TO WELLS, 100' TO SURFACE WATER, 5' TO FIELD & DECK SUPPORTS WITH 4' OF COVER OR INSULATION. NSTALL PER AMC 15.65, 15.55, & MASS... TANK BEDDING, SEPARATIONS, MATERIALS,... �v l/ ��. MT �O 100 WELL N, RADIUS o, W c0 i 4'\o -o / H DECOMISSION AND REPLACE EXISTING SEPTIC TANK WITH A NEW 1 2SO GAL HDPE SEPTIC TANK CONIFER HEIGHTS BLK 1 LT 21 PREPARED FOR: RANDY BECKER 7600 LODGE POLE CT ANCHORAGE, AK 99507 DECK NO WELLS WITHIN 100' OF PROPOSED xv\ SEPTIC TANK FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK@gmail.com ASPHALT�1 l/ DRIVEWAY �O ELL 0 N, o, W SINGLE FAMILY 0 FRAME HOUSE Fco � � ti ZA \- 5 1 ©. 54�MUY,a I,HAV9 PERFORM SUPPORT®SERVICES: OF A4,4 �'.� 9 TH . * . DATE: 5/10/2022 rtis Huffman SURVEY: HOLT `f CE 128991 DRAWN: FWCS 5/10/2022 v SCALE: 1 " = 30'' PAGE: 1 OF 1 PRSSIo-t0" 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com May 10, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: CONIFER HEIGHTS BLK 1 LT 21 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1250-gallon HDPE tank per the attached design to serve the existing 4-bedroom residence. The lot and area are served by private wells. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221122, Rebecca Carroll, 05/20/22 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 NAME MAI LING ADDR ESS IPHONE I [] UPGRADE LEGAL DESCRIPTION LOCATION~ We I DISTANCE TO: / (~::;) ]Manufacturer ~.~' Liq'ci~.'~'~g""°ns ,F HOM~UA~: Manufacturer ' Well DISTANCE TO: [ / No. of lines ~ I Length'~cVline Top of tile to finish grade ~ ] Type of crib I AbS°r~t~n ~rea Inside length Dwelling Total le~Yli nee Material beneath tile Depth Crib depth Building foundation Driller Dwelli~;~,~ ~ Mate ri~_.~ Width Material NeaTs~ot~ine Trench ~ inches inches NO. OF B~ROOMS PERMIT NO. No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PER -N 'oO s Distance between lines Total effective absorption area PERIVr[T NO. Total effective absorption area Nearest lot line Distance to lot line PER N 'oO 5 3 Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOl L TEST RATING I NSTA LL~(,,~~ REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78) ' '-.~; ' ' ~'~ 1 . ,: ....'L_ :,TREET., HNL.:HLIRRUE., HI{ ...... PERMZT NO. ( 780053. ) RF'PL. ICRNT DENNI~ BRRNDON PO BOX ~0-655 LOC:RTION L. 21 E, LJUK · CONIFER HTS LEGAL SAME LOT :SIZE 28418 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SO FT/BR)= 123 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: D'EF'T'H= 16 L E I'-II3 TH= 54 EiRA"-~"EL [:-" E P'T H= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE E×CRYRTION (IN FEET). RECaLl I RE[) SEF'T I mi: TRm'4[::: $ I ZE= 1'25;z~ ~3RLL_ Cuf4LE] F'Rm]F=CRm3E F'LRNI" mZmPTIEm[~ R PACKAGE PLANT MAY BE INSTALLED RT THE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: t. EITHER R CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. 2. R CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF R MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND?OR YOU MAY BE SUBJECT TO PROSECUTION. "FL.4Cm ( 2 ) I I'-ISF'EC:T I m_-ml"-.l$ ARE REL---!IJ I F.:E[:. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL 8Y THIS DEPARTMENT N ILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A HELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 288 FEET FOR R PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 20 DAYS OF THE NELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICRTIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'EF-:I~-I I T E:=-::F' I RES DEC:.Er'IBER _~=:1., I CERTIFY THAT t: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND HELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CO[:'ES, 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEMEN"F IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BE[:'ROOMS. :, I liNE[. ' RPPL I CANT DENNI S 8RANDON MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection SOILS LOG 78-01 Performed for Dennis Brandon ~ate Performed Legal Description Lot 21, Block 1, Conifer Heights 1/18/78 o 4 8 lO Red-brown, silty,'sandy gravel (GM) w/boulders to 2 feet. (200 ft'.2/bdrm.) 5'-15' Gray, sandy gravel (G~) w/cobbles to 6 inches (100 ft.2/bdrm.) No water table encountered Total depth - 15 feet AVERAGJ ABSORPTION AREA - 133 ft.2/bdrm. Test Location: 70' South and 60' East of NW lot corner Date Net Time Depth Net Drop Percolation Rate ' minute Performed B CHAMPION DRILLING COblPANY, INC. MUNICIPALITY OF ANCHORAGE 0 Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-093-55-000 Expiration Date: Legal description CONIFER HEIGHTS BLK 1 LT 21 Site address 7600 LODGE POLE CT Anchorage AK 99507 Current property owner(s) BECKER RANDY 11/3/2023 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: $/3/2023 his Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS:' COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory Arsenic Advisory COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section V Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-093-55 Complete legal description CONIFER HEIGHTS BLOCK 1 LOT 21 Location (site address) 7600 LODGE POLE COURT ANCHORAGE, AK 99507 Current property owner(s) RANDY BECKER Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units El Holding Tank ❑ Community S e-pt-icur Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee Waiver Fee $ Date of Payment 71iolZ3 Date of Payment COSA # O S ,� Z 3 2 Waiver # COSA Application 2022.doc COSA Checklist copy.docx COSA Checklist Legal Description: CONIFER HEIGHTS BLK 1 LT 21 Parcel ID: 015-093-55 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled CIRCA Total depth 187+* ft Cased to UNKNOWN ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/5/2022 Static water level at beginning of test 182 ft. Well production at time of test 5+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 7.83 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 7/14/23 Comments __SEE SULLIVAN SCOPING LETTER. *WELL DATE, TOTAL DEPTH & CASING UNKNOWN. B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NA – NEW TANK Required maintenance completed, if AWWTS Comments: HOUSE HAS BEEN UNOCCUPIED AFTER TANK INSTALL C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 1978 ALL standpipes present per record drawing Total measured depth from grade 7.8 ft (max) Measured depth to pipe invert from grade 4.8 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective 3’ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 5/5/2022 Results Pass Fluid depth prior to test 1 in Water added 650 gal New fluid depth 4 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 60 in (MOA 5’ ED) Effective depth used 24 in (Missing ED + Final Fluid Depth) Effective depth (ED) remaining 36 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per measured shots & appears approximately 2’ ED is missing per visual observations in sump, lateral invert in sump, & MOA docs. Tested when occupied no presoak required. COSA Checklist copy.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ 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 N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to 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 Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 7/21/2023 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 7/21/23 Date: 8/2/23 P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259. TO: Brent Western, First Water Consulting Services The well was scoped at 7600 Lodge Pole Court for high nitrates. No issues were found that would contribute to the increasing nitrate levels. -Nitrate Advisory Certificate of On -Site Systems Approval # OSC231249 Subdivision: Conifer Heights, Block: 1, Lot: 21 A water sample revealed a nitrate concentration of 7.83 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you-monifor-the-water-qty a-1ity—Please-see-the-attach ed"Nitrate-F-act-S-h-e-et"-Fo important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www murn org From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the 'well and maintaining good_ separation_ distances between septic_ tank_ leach_ fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Ma�hng Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org 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) 343-79O4 CERTIFICATE OF HEALTH AUTHORITY "' .~ Parcel I.D.. 015-093-55,, APPROVAL FOR A SINGLE FAMILY DWELLING Expi;J~ii;n Date: 7 /4'"O D : ~ ~ "' '-' ' ' CONIFE HEIGHTS SUBDIVISION LOT 1, BLOCK 1 ' . AK ; ':,::" :,'i~:]~;' '.Cur[.ent Property owner(s) ':' 7 DENN S. BRANDON c/o OENE - Day phone 263-7021 - · ' ;. · :;." ,..';' :-'~ -.',Ma ngaddress..-.- .....'.. ~ .' ..... · ..... ..... · ........ ,-. ::~,.: ..ii .... '.. ,.: ~eal E~state Agent ..: '.., ,:, ' ...... Day phone - - ' ~"' ;.-.:~. ':i?,'' 2? ~UMBER OF BEDROOMS: ......'- 3 ....... :, ....~¥.,.,. Individual Water Storage [] . Individual Holding tank [] . i ..... ' ........ , ..... Community Class. Well [] Community On-site [] "... .:i" Public Water System [] · Public Sewer [] ' ,; :' ;.?,i','i.;;i. ~ The Monic~pality of Anchorage De~'elopment Services Department (DSD) Issues Certificates of Health Authority '" :':.','i:?/,""..h'~,pProgal (HAA) ba'sed °nly upon the representat ons 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 propedies served by a single-family on-site wastewater disposal and/or.' '. ' water supply system. DSD also issues HA~s 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. (Cedificates may be reissued for a period of up to one year'with valid water samples.) Cedificates 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.' at, or prlor Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ to closing for the engineering services provided. 4. 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 Health Authority 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 Anchor:age 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 code. s, ordinances, and regulations in effect at the time of installation. -'' [~;.'; ;. Name o~Firm ALASKA WATER & WASTEYtATER 'CONSULTANTS, INC. Phone 337-6179 .'i. ,~'~'~- '7', Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE. AK 99504. ".] .'..- ~. ]~L Engineer's Printed Name · JEFFREY A. O NESS,: P.E. . Date i.... . ..: · -: vl/~ J.':' ~ i '-;; ': In conducb'ng this evaluation; AKWWc, Inc.'a~mpted to provide a thorough ......... . ' - ,';'..: ii;~ :i . systeh~ ufider the cofi~fition's encou~terdd et'the time et the te~t, aha separatibn '~ ' '~."' i~' ': distances measured lo readily identifiable features. The cperational life of all wells and ,~ ./.~'.,; ~.';...~ ~ ' i: ,. ~ there are no hidden defects or encroachmenls. AKWWC, Inc. can therefore not provide ~ .. ~~~.'-,' ~ .~,'. · ~ ~ ::..'~ r -.. ~ operational requiremen, ts of the ADEC or MOA DSD The content of this report is for. ~ i':.: ~' i ,~; ,~. ,,.. :', ~.'. the sole benefit of th'e 'o~n'e~'li~te d ~bove. Any i'eliance upor~ er use &f this report by any ~.~ - :,/ .: -'otherpersonorpartyi~no~authodzed, n&rv,~llitco~feranylegaldghtwhatsoever.. ' ' .. -'~'., , , . ... ~.' . -; ..... -:'- , 5: DSD SIGNATURE ..................... -'" - - Disappro,,;ed · :,":,'.":~ ,'::NOTE: Th~.'W~ll for this property' meets:existing State r.v f;~..'.-.;};:. 'insurg ~he well~ continued suitability. Cur'rent ni.trate concentration isL6.52 mg/1. EPA maximum concentration-is 10.O mg/1. More information is available from the On-Site Program at 343-7904. Attachments: HAA Checklist I~ Septic System Advisory We!l Flow Advisory .. Manitenance Agreements · Supplementa!. Engineer's.Re. or[ Other (Rev. 1Z'01) Original Certificate Date: Municipality of Anchorage DeYelopment Se ices Department Building safety Oivlslon On-SRe Water & wastewater Program 4700 South Bragaw St. P~. Box. 196650 Anchorage, AK g9519-6650 www.cLanchorage,ak.us (907) ~43-7e04 HEALTH: ,6,UTHOR, ITY APPROVAL CHECKLIST Legal Oescrlption: ,CONIFER HEIGHTS SUBDMSIONi LOT 2t, BLOCK 1 Parr, el ID: A. WELL DATA Well tyl~e PRIRATE,. Date completed Total. depth ,~187+' fL Date of test Statlo water level Well production IfA. El; 0rD provide PWSID# N/A .-1978 , 6anitaryseal(Y/N) YES Cased:to ,,,40* fL FROM WELL LOG ~ , g,p.m. ' ,015~095~55 WATER 8AMPLE RESULTS: WeliLog.(Y/N) , ,NO,, wimspmperiypmtected (Y/N) , ,YES Caslnghelght (above ground) , ,60 .... in. AT INSPECTION. ....... ;5/, 9/o5 , , ......5 ........· ........ 5.,8 ,, , g,p,m. Coliform ,.,, 0, ,, colonies/100 mL Nitrate 6.52, mg./L. Arsenic: ,N/A mgA.. Date of sample: 5/~19/200;5 SEPTIC/HOLDING TANK DATA Tank Type/Material ,.., GREER/STEEL ...... Tank size: ~,1250~ gal. Numberof Compartments , 2 ,. .Foundation. cleanout(YIN) ,~, Oepresslonover tank (Y/N) NO Other bacteria ....2 ,, colonles~100 mi. Collected by: ,,, AKWWCt INC.. , Date installed ........ 5/9/1978 Cleanouts (Y/N) . YES (1) High water alarm (Y/N) . Oate of pumping ;5/'19/'200;5. Pumper ABSORPTION FIELD.DATA ~'~IELOW' I~IS'~NO ol~oE'l Oate illstalled . ~/g/~gT8 . S01~ rating (g.p.d~ft~or(~ 1.;55. Length. ,, :, 52 .... ,fL Width ~, 2.66 ff. TotaldePth ,*7.75, ,fL Eft. absOrption, area 520 ft~ Monltoringtube ~ Date of adequacy test .5/19/'200;5, Results (Pass/Fall) PASS, Fluid depth in absorption fieldbefore test , 0 in. Water added 682 gal. Elapsed Time: ,. 0, ,, min. Final fluid depth r~0 in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) , NONE KNOWN · *ME~URED ONLY ;5 FEET IN SUMP. McDONALD,S PUMPING, ........ System.~l~e ..... TRENCH ,, Gmvel~oelow pipe, **5 , ft. Depression over field NO For, 5~, bedrooms New depth , 0, in. ,450+,, ~ g.p.d. If yes, give date , ,, - , D. LIFT STATION Date installed Size in gallons "Pump on" level at in. ~ ~ ~ Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ M anhole/A..~. High water alarm level at Meets alarm & circuit requirements?, On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding lank N//A Absorption field 5'+ Surface water. 100'+ Water main N/A Driveway, parking/vehicle storage 10'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N//A Water service line 10°+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS in, 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 HAA guidelines in effect on this date. Engineer's Prin~t~d Njame JEFFREY A. GARNESS HAA Fee $ ~ Date of Payment ~t' ID'~.~ Receipt Number 55~ (~. ~) Waiver Fee $ Date of Payment Receipt Number SGS Ref.# Client Name Project Name/# Client Sample ID Matrix 1031491001 All Dates/Times nrc Alaska S~andard Time AI~ Water & Wastewater Consultants Inc. Printed Date/Time 03/24/2003 15:$6 Conifer HCs L21, B1 Collect~ Dat~lme 03/19~003 14:30 Conifer H~ ~1, BI Received Dare.line 03/19~003 14:55 Dr~g Water Technical Dir~tor Stephen ~ Ede PWSID 0 Sample Remarks: · Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date Init ~aters Department Nitrate-N 6.52 0.200 m?JL EPA 300.0 (<- I 0) 03/20/03 PLW Microbiology Laboratory Total Coliform 2 OB, No Coli col/100mL SMI$ 9222B 03/19/03 KAP LODGE POLE COURT / / / I I I \ \ S 89°56'30"W 109.'74' DECK ASPHALT DRtVEWAY SINGLE FAMILY FRAME HOUSE 49 '.. SHANE/~ HOLT .: · . LS-6914 .' A~BUILT SURVEY NO CORNERS SET THIS DATE 1' - 3~ I HERESY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 21, BLOCK 1, CONIFER HEIGHTS SUB. ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT THE ~/1SIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VtSISLE ENCROACHMENT~ EXIST OTHER THAN NOTED. DATED AT ANCHORAGE. ALASKA THIS .~gTH DAY OF __APRIL 2003 . HOLT LAND SURVEYING 6086, FB65-54,",~-5-t$ TEL. 345-5513