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Home My WebLink AboutBIRCHWOOD ACRES LT 3 Municipality of Anchorage Page 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: .~/,4J ~2~. O/'/OZ,- PIDNumber: O~/-~-~/-- Name: yUpgrade J~$~P// ~ SAcral4 /v' /coz-4/0£ S Wastewater System: D New Address: /~/~ ~/~ ~ ~ ~?~ ABSORPTION FIELD Phone: ~ No. of Bedrooms: ~ ~ - ~/~~ ~ ~ Deep Trench ~hallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION so, Rating~ Total Depth fromqriginal grade: O, ~ GPD/Sq. Ft. LOt: BIOok: Subdivision: Depth to pi~ bottom from original grade: Gravel depth beneath pipe Township'. /~ IRange'. /~ ISection: /~ Filladdedaboveorlginalgrade:o_, Ft. Gravellength: WELL: D New ~¢/~ Upg rude Gravel d~:~¢~?~ Number of lines: I Distance ~tw, n lines: ~ ~ Ft. ~ I /0 Ft. Classification (Private. A,B,C): Total Depth: ~: Total absorption area: Pipe material: Driller: ~~ ~ate Drilled: Static Water Level:Ft. I~ ~,~1, ~,~{~ D~7~ SEPARATION DISTANCES ~eptic D Holding D S,T.E.P. To Septic Absorption Lift Holding ~Private Manufacturer: Capacity tn gallons: From Tank Field Station Tank Sewer Lines ~/~t ~ ~ ~ , j~ Material:( - Number of C~padments: Surface Water P/4 ~//4 A/j/ W// W~ LIFT STATION Line ~- / Remarks: BENCH MARK ~ ~ Location and Description: Assumed Elevation: /] %,.~ , ~ <, ~ . . /:::00c,uO~' . ~' - ' ' .......... - , r,:: Inspections performed by: ~H~/H~ Dates: 1st ~ ~//g~ ~':', *~ ~' '" t~, ':~.~ ~"~' ' ......... ~ :'. Department of Health and Hum ices approval ~:?~'~':-,, -, ~', ~"~'~.... . ':-...~-:'" Reviewed and approved by: ~-~~' -. Date: //'Z/~ -/ 72-013 (1/91) MOA 25 Permit No. SW 920402 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: BirchwoodAcres, Lot. 3 PID No.: 051-231-42 94.5' SWING A - C B - C A - D B - D A - E B - E A - F B - F A - G B - G A - H B - H A - I /% - J B - J NEW 1250 GAL TANK 4 TIES; = 65.6' ' = 30,8' = 788' = 38,9' 297,01 V/ 10' UTILITY EASEHENT LOT 3~ ~WELLS 20,2' 297,01 10' UTILITY EASEMENT U/ EXISTING TANK ~ CRIB ABANDONED 74.6' 40.6' 76,3' 42.6' 109,5' 80.0' 107,1' 770' 118.9' 93.~' 117.2' 90,8' }LEVATIBNS NOT TU SCALE) ¢~ SW CORNER []~ PORCH SLAB --ASSUMED ELE~ = 100.00' r,1 (,/I T 0 GWT 8 85,8' B3,8' SCALE 1' : 50' z · - MONITOR TUBE o SEWER CLEANOUT -¢ WELL LEACHFIELD EASEMENT I ENGINEER'S SEAL x.-~,¢*~'' ,,, ,,f, ~ ,'. ...~ ,;~ d:~ cdt , ~'?.:;' , ( %/ ~'~; g ..... =..; ?','%T, ~" ,' ?. I ~',,:x ~.~ ~'~,~ ~ ' ~ ' 72-013 A (2/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920402 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:CLAIR RICHARD D & PATRICIA A OWNER ADDRESS:2183 BARRETT AVE SAN JOSE CA 95124 PAGE 1 OF 1 DATE ISSUED:12/03/92 ~/~ EXPIRATION DATE:12/03/93 PARCEL ID:05123142 LEGAL DESCRIPTION: BIRCHWOOD ACRES LT 3 LOT SIZE: 41594 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: ~O Louis Butera, P.E. Registered Civil Engineer November 10, 1992 John Smith, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAl. SERVICES DIVISION Re: Birchwood Acres Lot 3 Narrative RECEIVED Dear Mr. Smith: The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: The area has large lots allowing sufficient room for septic sites. Immediate neighboring septic systems are all +30' distance. Reserve space is adequate, due to absorption capacity and well location. This is the second system on this lot. Drainage will not be effected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 694-5195 · Fax (907) 694-3297 / NEIGHBOR'S WELL +100~ / TH 1 NEW 1000 TANK 297,01 4' CAST IRBN PIPE 10' UTILITY EASEMENT LOT 3 WELLS 'REWORK TO GRAVITY FEED 297,01 10' UTILITY EASEMENT EXISTING TANK & ~ CRIB NEIGHBOR'S TO DE WELL +100' AI)ANDONEI) LOT 4 ~ NO SURFACE WATER COURSES +100' NO KNOWN CURTAIN DRAINS :SEPTIC :SITE PLAN LEGAL: LOT 5 BIRCHWOOD ACRES OWNER: RICHARD 84 PATRICIA CLAIR CONTRACTOR: N/A JOB # 92-0581 DATE' 11/10/921 SCALE 1" = 60' EAGLE RIVER ENGINEERING SERVICES A P.O. Box 772,294 EAGLE RIVER, AK. 99577 (90~) 694-5195 FAX: (907) 694-3297 SEPTICS +100' - TEST HOLE - MONITOR TUBE - SEWER CLEANOUT - WELL - PROPOSED LEACHFIELD EASEMENT SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: LOT 3 BIRCHWOOD ACRES 2. 3. 4. 5. 6. 7. 8. TANK GENERAL The well and septic plan are for a single family residence only. The drawing and or site plan shall be a part of this specification. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage requirements. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 1. The existing tank is to be pumped and abandoned in place to MOA code. 2. New 1,000 gallon tank is to be provided to current code with cleanout at house foundation. DRAINFIELD 1. The bottom of the drainfield shall be level, plus or minus 1.5". The leach pipe shall be level within ~A". 2. The total depth of the drainfield excavation is not to exceed 7' at any point. 3. The sewer line is to replace the existing sewer line that leads to the existing tank. 4. The drainfield gravel is to be covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the drainfield is to be finish graded to prevent ponding of surface water runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 6' GRAVEL DEPTH DRAINFIELD LENGTH = 5' DRAINFIELD WIDTH = 5' SOIL RATING = 0.8 GPD/ft2 BEDROOM CAPACITY = 3 SEPTIC TANK SIZE -- 1,000 gallon Twenty-four (24) hours notice required for all inspections. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: Township, Range, Section: ~-/J-JV COMMENTS ~'-/"/ SITE PLAN 1 I I III .,I I II'*'~h-' II I 111 I SLOPE WAS GROUND WATER ENCOUNTERED? sl IF YES, AT WHAT / L~ DEPTH? E Depth to Water After ,, // Monitoring? Dale: ?°1'"'-~/'~'t- Gross Net Depth to Net Reading Date Time Time Water Drop i ,, .~:/¢ /., .,....... ?'-~- ~ / '",~,, PERCOLATION RATE TEST RUN BETWEEN {minutes/inch) PERC HOLE DIAMETER ET AND ;2, ~ FT PERFORMED BY: ~, ~/~ ~', I ~~""~--~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /~d/i/¢,~ 72-008 (Rev. 4/85) JOB Birchwood Acres Lot 3 92-058 EAGLE RIVER ENGINEERING SERVICES S,EET No. oF P. O. Box 773294 EAGLE RIVER, ALASKA 99577 CALCULATED BY ]',=[1,= DATE Phone 694-5195 CHECKED BY DATE SCALE SOil'absOCtion' rate ~ 9 minlineh~ 0:8 iGPDlft~ (trench) Kequired abSo~tion area = 450 0i8 = 562~.5 square feet ~"5i'~d~'tren~hlength ~ 562:5 squge feet ~ 5' = i13" x OiT(t~aeti6hfacto~) ~ 79''~ ~ Louis, A. CE-6736 Louis Butera, P.E. Registered Civil Engineer June 11, 1992 John Smith Municipality of Anchorage Dept. of Health & Human Services 825 L Street Anchorage, AK 999502 Re: Birchwood Acres, Lot 3 RECEIVED ,JUN 1 2 1992 Municipality of Anchorage Dept. Health & Human Services Dear Mr. Smith: We are requesting a determination of acceptability for Health Authority Approval on the above referenced private water system. The septic system does not meet adequacy and is scheduled to be upgraded. Prior to an upgrade, the owner would like to determine if his well is adequate to meet HAA standards. The well flow is 0.5 GPM and water quality samples for bacteria and Nitrates are acceptable. The question is the turbidity of the well water. This is the second well on this lot. The water contains a fine suspended silt which increases in c~.gntent a~ the well isp~umped and drawn down. There is a sand filtration system installed with Oocculent..and backwas~ During our four hour well flow test the water was initially clear and then became increasingly silty. After 26 days we returned to the site to determine the clarity after pumping for a limited time span. The clarity of the water was measured for a 41 minute time span flowing at 1.5 GPM. Turbidity amounts are measured at 28 NTU at 41 minutes. I would consider the water to be drinkable at 28 NTU, but that is my own opinion. There is no standard level of acceptable turbidity for a private well. Turbidity levels are usually a concern when utilizing surface water with a chlorination system. Would this system be acceptable for HAA with a notational letter on the well? If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 694-5195 · Fax (907) 694-3297 Louis Bulor~, P.E. Registered Civil Engineer June 11, 1992 Rick Clair HC 78, Box 2336 Chugiak, AK 99577 Re: Birchwood Acres, Lot 3 Dear Mr. Clair: At your request we have taken samples of your well water, and conducted turbidity testing at intervals of 7, 20, 30, and 41 minutes while running the kitchen sink at its maximum flow rate of 1.5 GPM. During this time the water reached a turbidity level of 28 (see attached lab analysis), and maintained this turbidity level for 41 minutes at which time the water was shut off. It was indicated that after this period of time the water will become increasingly turbid as the water filtering system becomes overloaded. The turbidity is caused from a fine silt that is present in the water well and becomes more pronounced as pumping is continued. I believe it is also affected by the water drawdown level that causes increased fines to enter the well as it is draw down over an extended pumping period. You have in place a small sand filter system with limited capacity to filter and backwash. Acceptable turbidity levels are difficult to define for a private well system. Turbidity is not normally a concern unless there is a public water system, and the turbidity affects a chlorination process, or prevents accurate coliform sampling. In the case of a public water system the maximum level is designated at 5 NTU because of the above concerns. Acceptable turbidity in a private non-chlorinated system may be judged by the person utilizing the system and their particular tolerance level for clarity of water. More advanced treatment systems can be installed and measures taken to limit water use. While an expensive option, I would consider a water holding tank so that the well can pump intermittently at a slow flow rate into a large tank. This will limit the drawdown effect on the well. Any. potential buyer or lender on the property should be made aware of the turbidity problem utilizing a disclosure statement. It may be possible to obtain a Health Authority Approval on the water system based on these turbidity tests with a notational letter on the well turbidity attached. We will forward a request to the Municipality for a determination on this. Iq} l~..x 7~:l'.!ql · l",;~t!h' Riv{,r. ^laska !1!)577 · 'lNepl .ne (907) 6q,1-51!15 · Fax 19117) Page 2, Birchwood Acres, Lot 3 June 11, 1992 If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. cc: Municipality of Anchorage ~'" JUH 09 '92 0~:4~ HORTHERH TESTIHG, AHCHORAGE P.4/5 NORTHERN TESTING LABORATORIESi INC. FAIRBANKS, ALASKA 99701 (907) 456-3116 FAX 456-3125 3330 INDUSTRIAL AVENUE (907) 277-8378 * FAX 274-9645 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 90503 '.w. agle River Engineer£ng Repo~ Date: 06/09/92 =P.O, Box ?73294 !Eagle Kiver AK 99577 Attnt LoUis Butera Our Lab #: Your Sample ID: sample Matrix: commentez Al17804 Lot 3 Birohwood Acres ? Min. Water Method Parameter EPA 180.1 Turbidity SPA 353.3 Nitrate-N units NTU Date Arrived~ 06/05/92 Date sampledt 06/04/92 ~ime Sampledt Collected By~ LB MD~ = Method De~ectiOn Limit Flag Definitions B - Below Regula=or¥ Min. H - Above Regula=ory Max. E ~ Below De~ec~ion Limi[ Est£ma~ed Value Date Result Flag HDL Analyzed 21.00 0.20 06/05/92 0.1 06/0S/92 Microbiology Supervisor 3Ubl 09 '9~ 09:47 HORTHERH TESTIHG, RHCHORRGE P. 1/5 NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 4.~6-3118 · FAX 456-312,~ 250{~ FAIRBANKS STREET ANCHORAGE, ALASKA '39503 (907) 277-8378 * FAX 274.9645 Rep~t Da~e~ 06/09/92 P.O. BOx 773294 Eagle River AK 99577 !Attn~ Louis Butera Ou= Lab #~ Your Sample Al17801 Lot 3 B£rehwood Acres 20 NLn. wa=er !Method Parameter 'EPA 180.1 Turbidity Date Arrived~ 06/0~/92 Date ~ampledt 06/04/92 TLme Sampled~ 1030 NTU MDL ~ Method Detection Flag Definitions H ~ Above Regulatory Max. E ~ Below Detection Limit Estimated Value : Result Flag MDL Analyzed 26.00 0,20 0~/0S/92 ~LcgobLolog~, Supa~viao~ ' ' JUN 0~ '92 0~:47 HORIHERH TESTIHg/ AHCHORAGE P.2/5 NORTHERN TESTING LABORATORIES, INC, 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 · FAX 456-3125 250B FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 · FAX 274-9645 ~agle River ~ngineering Box 773294 Zagle River AK 99579 !Attnt' Louis Butera =Our Lab #= You= sample iDz iSamp[e Matrix~ :Method Parameter EPA 180.1 Turbidity Al17802 ~ob 3 Birchwood Acrea 30 Min. Water ~eport Date= 06/09/92 Da~e Arrivedt 06/05/92 Date.Sampledt 06/04/92 Time sampledt 1040 collected Byt LB DtDL ~ Method Deteotion Limit Flag Defi~itions 8 - Below Regulatory Min. ~ ~ Above Regulatory Max. E = Below Detection Limit Estimated Value' Date Flag MDL ' Analyzed 0.20 o~/o~/~ Re[~or~ed By: Susan C. Tifental Microbiology Supervisor :Ea~le River Engineering P.O. Box 773294 .~agle River AK 99577 Louis Butera JUH 09 '92 09:48 HORTHERH TESTIHG, AHCHORAGE '" P.3/5 NORTHERN TESTING LABORATORIES INC :33:30 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 997'01 (907) 456,3116 , FAX 456.8125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 9960:3 (907) 277~8378 - FAX 274-9645 Report Date; 0:6/~g/92 Date Arrivedz 06/05/92 Date Sampled: 06/04/92 Time Sampled; 1051 colleot~d By: LB ~Our Lab #~ :Location/Project: You~ Sample ID; .sample Matrix; Al17803 LOt 3 Bi~chwood Ac~ee 41 Min. Water iMehod Parameter .EPA 180.1 Turbidity MDL = Method Detection Limit Flag Definitions B = ~elow Reg.u~a~ory Min~ H = Above Regulatory Max. E = Below De=so, ion ~imit Es=ima%ed Value Units Result Flag mmmmmmm mmm m m W --~ NTU 28,00 MDL Analyzed 0,20 o6/o5/92 Miczobiology Supervisor MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # 051-231-42 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Birchwood Acres, Lot 3 Location (site address or directions) 18713 Birchwood Loop Road, Chugiak Property owner Joseph & Sabina Nicolaides Day phone 694-5195 (msg) Mailing address . 18713 Birchwood Loop Road, Chugiak, AK 99567 Lending agency Mailing address Agent Address 11411 Old Glenn Hwy., Eagle River, Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well × Community well Public water NOTE: City Mortgage/Ann Picard Day phone 277-0745 121 w. Fireweed Lane #120, Anchorage, AK 99503 Great Land Realty/Cindy Lindblom Day phone 694-9125 AK 99577 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: x If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ~21 ~# VOJq ~a.I] (~6/~ '^ea) ~i~0-~z '~po~ sjeeu!Sua I~UO!SSejmd eql u! SUO!SS!LUO JO s~oJ~e ~oj elq!suodseJ lou s! elSeJoqouv jo /~l!l~d!o!unlhl eq.L 'penss! s! a~o!J!lJeO ~ eJojaq ~l~p eZ~l~Ue Jo sUO!loedsu! lonpuoo lOU op SHHQ jo see/~OldLU~l 'slueLue~!nbe~ el~ls pu~ leJepeJ U!~lJaO ~Js!les ol ~epJo u! suo!lnlp, su! §u!puel J!eql pu~ sawoq jo sJesl~qoJnd ol ~S@lJnoo 8 sE s!ql s@op SHHQ eq_L '~lSl~lV jo elglS aqi u! pGJG1S!~GJ JGSU!~UG I~UO!SSejoJd ~uepuedepu! u~ ~q e^oq~ (3 qd~JlS~d u! ue^!15 suo!l~lues@JdeJ eql uodn ~lUO pes~q sel~o!J!lJeO I~^mdd¥ ~,poqln¥ qll~eH senss! (SHHQ) seo!AJeS U~LUnH pu~ qlll~eH jo lUeLUlJ~deQ eB~Joqouv ,to ~l!lBd!o!unlAI ¢-~ p¥O~//d O'~' '7 '7~?./Vi ~___~d% SlUeLUUJO0 leUO!l!ppv :suo!lelndp, s fiU!MOIIOJ eql q),!M 'StUOOJpeq 'SLUOOJpeq JOJ IBAoJdd1~ leUO!l!puoo 'pe^oJddes!C] JOJ peAoJddv --~' ]l:ln/~fNDIS SHHO '9 LL§66 ~ '.Xa^T8 @'[Bg.q '~6~.ELL xc~ 'O'cI sseJppv ~6I;-~69 euoqd SOOT,A. XOS 5UT.XOouTBu,q .z@.'XT8 oTf~,q tU.q..4 jo etU~N · uo!loedsu! s!ql ,to el~p eql uo loejje u! suo!leln§eJ pue 'seou~u!pJo 'sepoo el~lS pue ledp!unlAI lie ql!~ eou~!ldLUOO u! s! Luels,~S lesOds!p Jele~else~ Jo/puc ~lddns Jele~ el!s-uo eq), 'uop, oedsu! pue UO!le§p, se^u!/~LU LUOJ~ pu~ Sel!~ eB~Joqouv ,to ~l!l~dp!unR LuoJ,t peu!elqo UO!IE~LUJOJU! eql uo peseq leql/~Jpe^ Jeqlan,t I 'u!eJeq peleo!pu! eJnlonJls ~o ed/4 puc suJompeq jo JeqLunu eql Joj elenbepe pu~ leUOp, ounj 'ejes s! uJelSXS I~sods!p JeleMelS~ ~lddns Je],e~ el!S-UO eql leql s~oqs uop,~o!ldd~ le^oJddv/4poqlnv q~,l~eH S!ql ,to uop, eBBse^u! ALU leql/[JpGA I 'MOleq UMOLIS el~p UO!I~p!IeA eql Jo s~ pu~ oleJeq pex!jJ~ I~es ALu Xq Pe!tBJeo sv t:I=~=~NIIDN=~ Aa NOIJ. O~IdSNI 40 .LN=~IN~J.V.LS Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~/~-~/+U.13OO ,4C.,~-~., /--~7'~.~ Parcel I.D. ¢5/- Z-S/- /-/-Z- A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed /2/V/~/V/.)/~/,,/ Driller Cased to ~ /-/'~ I Casing height Wires properly protected (Y/N) Date of test Static water level Well flow FROM WELL~ g.p.m. Pump level SEPARATION DISTANCES~ROM WELL TO: Septic/l'u~dAwg tank on lot ,/~/ / Absorption field on lot //'~2 / Public sewer main /'//~ P..ubl. ie sewer service Ii ne ; On adjacent lots / ; On adjacent lots ~ /~)~ Public sewer manhole/cleanout ~'J/,g Petroleum tank ,A/OAJg ??4 CN T WATER SAMPLE RESULTS: Coliform ~ Date of sample: 0~'/¢~//?Z Nitrate ~ /~¢/-3 L- Other bacteria O ¢~'~/?.~ Collected by: B. SEPTIC/HeL-BtN~ TANK DATA Date installed ~q/tg//~g / / Cleanouts (Y/N) ~/£ High water alarm (Y/N) Date of pumping /~/~ ~ Tank size Compartments Foundation cleanout (Y/N) )/g'~ Depression (Y/N) /,,//~1 Alarm tested (Y/N) /~'//// SEPARATION DISTANCES FROM SEPTIC/HOL-DhNG TANK TO: Well(s) on lot / ~ / / "~ On adjacent lots 7~ /DO ¢ Foundation To property line "~ 5- ? Absorption field ~ / Water raa~/service line Surface water/drainage /~//~ 7'/o 72~026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electriC___ SEPARAT!~~ANCE FROM LIFT STATION TO: J On We~J~o/? lot adjacent lots Manufacturer / "Pump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed (~ ?/D// Length ~0 / Width Total absorption area ~'- 2 / S.~, Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating ~. <~ ~?~/fl ~ System type Gravel thickness .2 ' Total depth Cleanouts present (Y/N) Date of adequacy test /~//,f for ~ bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot //W / To building foundation On adjacent lots ~' -~'' Surface water ~//~ Curtain drain /,,//,,4 On adjacent lots /'MOO / Property line To ~ abandoned system on lot Cutbank /V/~r Water ra~¢.;, Jservice line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. HAA Fee $ Waiver Fee: $ Date of Payment Date of Payment Receipt Number Receipt Number 72-026 (Rev, 3/91) Back MOA 21 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING -42 HAA # ¥-~ ~ c't ~(~,(~ '-~,'L't GENERAL INFORMATION Complete legal description BirchwoodAcres, Lot 3 T15N R1W Section 18 Location (site address ordirections) 18713 Birchwood Loop, Chugiak Property owneRichard & Patricia Clair Mailing address 2183 Barett Avenue, San Jose, CA Lending agency Ann Picard/City Mortgage Mailing address Agent Address 11411 Old Glenn Hwy., Eagle River, AK Unless otherwise requested, HAA will be held for pickup. Day phone 95124 (408) 559-8660 Rick Day phone 277-0745 121 w. Fireweed An. Suite 120, Anchorage, AK 99503 Cindy Lin~olom/Great Land Realty Day phone 694-9125 99577 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: ........ Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. .... .4_,___ T_YP E_ O_F~AS_TEWA_T E R_D I S P.O SAL: Individual on-site X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ¢t21 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 Eagle River Engineering Services Phone 694-5195 Address P.O. Box 773294, Eaqle River, AK 99577 Engineer's signature * Approval of this system is conditional on construction of new leachfield in 1993 as per permit #SW920402. DHHS SIGNATURE ~ Approved for bedrooms. Disapproved. ~ Conditional approval for bedrooms, with the following stipulations: ,,. '. _ ,. .... ..' :_. -.,.:;"~ t~_,~~ ?~' ~'.~.,/.y' d?~,~ ~ ~/-,-~c /~.,-~/~" Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending ~nstitutio~s ir] Order tO ~atis~f~r~in ied~a~ a-r~-s-ta~-r~q~]~r;~-m-e~i~. 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 fRev 1/91) Back MOA WATER WELL ADVISQRY HEALTH AUTHORITY APPROVAL NO. /~//~ During a recent Health Authority Approval on-site inspection and test~of the potab~ water supply well on Lot , .~ Block of ~/~7~,,~/-/'~C? o/~C"~&;b. Subdivision, the well's productivity was determined to be ~"~ .5' gallons per minute. The minimum well productivity required by this department (AMC 15.55) for a ~ bedroom residence is C ~/ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of noncritical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. ~-J / / · - +:: ,, ,.. / , x.7 / .,, .. . .x :.~,.. ,,-,...k-.. CITY MORTGAGE C O R P O R A T I O N January 19, 1993 Mr. Robby Robbins Municipality of Anchorage Dept. of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED dAN 21 199a MUmmpah[y of Anchorage Oept. Hearth & Human Services Re: Lot 3, Birchwood Acres Dear Mr. Robbins: Upon conditional approval from DEC of the current on-site sewage disposal system on the above-referenced property, City Mortgage Corporation will be prepared to escrow sufficient funds to cover the replacement of said system. Three bids have been obtained and two times the highest bid will be escrowed along with the cost of final DEC acceptance of the new system. Thank you for your assistance in this matter. Should you have any further questions in this matter, please do not hesitate to contact our office. Sincerely, f /~/~/ Mary ~ee Hillier Senior Vice President MLH:amp P.O. Box 92810 · ANCHORAGE, ALASKA 99509-2810 · (907) 277-0700 · FAX 277-0804 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type P.,~. 1/,//~7'~ If A, B, or C, attach ADEC letter. Log present (Y/N) /~ Total depth ~ /-/- 0 / Sanitary seal (Y/N) Y ~ 5 ADEC water system number Date completed /)/V~'~/D/,O/,-/ Driller Cased to ~-/-/0 / Casing height Wires properly protected (Y/N) Date of test Static water level Well flow Pump level FROM WELL SEPARATION DISTANCES FROM WELL TO: Septic/hoMin~j tank on lot Al~sorpbon field on lot g.p.m. Public sewer main /"///4 Sewer service line 7" ~'~ j AT INSPECTION g.p.rq~ ~ r~ >zn ~o ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank ~IDO t Other bacteria B. SEPTIC/HOL-BING TANK DATA (;~ ~E.,c~pG,,~i_Z;~ - Date installed Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size Compartments Foundation cleanout (Y/N) Depression (Y/N) Alarm tested (Y/N) Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots Foundation To property line Absorption field Water main/service line Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons !~ _ i i Manhole/Ac~ Vent (Y/N) __ __ "Pump on" level at _..~..--'~ "Pump off" level at High water alarm level /~ I~:~. ~ Cycles tested Moots MOA electrical ~.~'~ SEPARAT~CE FROM LIFT STATION TO: Wel..~J~t On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Soil rating System type Length Width Gravel thickness Total depth Total absorption area Cleanouts present (Y/N) Depression over field (Y/N) Date of adequacy test Results (pass/fail) for bedrooms Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION'FIELD TO: Well on lot -/-/_/)(~) / On adjacent lots f-/~ ) Property line //0 / To building foundation 7/' ~-~::~) ! To existing or abandoned system on lot -J"'/~ '/ On adjacent lots ? 30 Cutbank /~/,z~. Waterc~qservice line ../.. /~:) 3 Surface water /k///~ Driveway, parking/vehicle storage area /~ 4 Curtain drain /~J//~ If yes, give date E. ENGINEER'S CERTIFICATION Signature Engineer's Name Date /////~ I certify that I have checked, verified, or conformed to all MOA and H,AA gu, idelines/p effect.on thDdat~ o.f this inspection. * Approval of this system is conditional on construction o~new ±eacn~le±o in 1993 as per permit #SW92-402. ~':~ ' I~, "".Z . ': ,'~ / ' ,'g?,~...4 : :,,. : t , ::, .'~ ~,~ ~,'~ ~. ,, ~::/"5 '~ C? HAA Fee $ /7 Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 NORTHERN TESTING LABORATORIES, INC. (907) 277-8378 , FAX 274-9645 Eagle River Engineering P.O. Box 773294 Eagle River AK 99577 Attn: Louis Butera Report Dates 06/09/92 Date Arrived: 06/05/92 Date Sampled: 06/04/92 Time Sampled: 1016 Collected By: LB Our Lab #: Location/Project: Your Sample ID: Sample Matrix: Comments: Al17804 Lot 3 Birchwood Acres 7 Min. Water Method Parameter Units MDL = Method Detection Limit Flag Definitions B ~ Below Regulatory Min. H = Above Regulatory Max. E = Below Detection Limit Estimated Value Date Result Flag MDL Analyzed EPA 180.1 Turbidity EPA 353.3 Nitrate-N NTU mg/1 21.00 0.20 06/05/92 <MDL 0.1 06/05/92