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CHANDELLE ACRES LT 1
Chandelle Acres Lot 1 #051-063-82 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191106 PID Number: 051-063-82 Dwelling: 9 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name Carlton &Violet Norby ABSORPTION FIELD ❑ Deep Trench ❑e Wide Trench ❑ Bed ❑ Mound Site Address 23861 Lennie Circle Chugiak, AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 519-8565 3 1.2 GPD/SF 7.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.0 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot Chandelle Acres 1 Fill added above original grade 0.5 Ft. Gravel length 38 Ft. Township Range Section Gravel width 5.0 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 380 Ftz 1 Ft. Well >100' >1 00' N/A N/A >25 TANK ❑ Septic s❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1,250 Gal. Surface Water >100' > 100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Steel 2 Foundation >101 >10' N/A N/A LIFT STATION Manufacturer Capacity Remarks Anchorage Tank 250 Gal. Alarm location Inside Garage Electrical installed by Power Lighting & Control LLC PIPE MATERIAL House to tank D3034 Tank to drainfield D1785 Installer Northern Excavation Drainfield D1785 CO/MT D3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspdecctiiosn 15t 6/25/19 6/25/19 Location and description 2�a 3`d 4,h Bottom of siding ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp �1�sI& r%,aqt� Conditional Approval: Date (^"...... 49th ..........uun...nn......................... ;MICHAEL E. ANDERSONt� •. No. CE-4381 �u ��'��F•.. Septic System , �61A � Approved®% pp �ti., Date 1 3 j j o•� 10/15/19,•••• Fri D.........•• FE-,S Note: this approval does not include well permit requirements.pR tmev vcte/i i a/ CHANDELLE ACRES, LOT 1 LE NSCIRCLE ENGINEERING PLAN AS -BUILT 0 50 0 bm ME FEET SVt -16.4 25.9 SV2 21.8 32.0 MH 23.5 33.6 MT1 79.8 74.8 MT2 77.4 66.2 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME(minutes)NET TIME(minutes) DEPTH toWATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) CHANDELLE ACRES L1 4/4/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - NONE 6 2 3 051-063-82 VIOLET & CARLTON NORBY 4/8 1 2 3 4 5 6 1' OB GM (SILTY SANDY GRAVEL) 6/25/19 Professional Engineers Stamp: 10/14/19 5:19/5:25 6:15 6.0 1.1 5:26/5:33 6:36 6.0 5:34/5:41 6:40 6.0 5:42/5:49 6:38 6.0 5:50/5:57 6:35 6.0 5:58/6:05 6:40 6.0 6.0/12.0 6.0/12.0 6.0/12.0 6.0/12.0 6.0/12.0 6.0/12.0 BOH TEST HOLE DEEPENED TO 13.5' ON 5/20/19 Test Hole deepened prior to construction to verify lack of groundwater and impermeable lenses. TIVM ONIN[Vi3�J iN3VGSV3 LLJ kinun ot LLJ > 0 Mi 31NN31 (zi,g Dci ggzz >ie) '08nS SIHOIAH 3INNIII 'L 10-1 JO IIJ3N30 :IHI HOJ IN3W30SV3 SS300V A34N3SV3 ),inlin Ot- I 101 om ■ at ff TIVM ONIN[Vi3�J iN3VGSV3 LLJ kinun ot LLJ > 0 Mi 31NN31 (zi,g Dci ggzz >ie) '08nS SIHOIAH 3INNIII 'L 10-1 JO IIJ3N30 :IHI HOJ IN3W30SV3 SS300V A34N3SV3 ),inlin Ot- I 101 om MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http:/Iwww.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191106 Work Type: Septic Upgrade Tax Code Number: 05106382000 Site Legal Address: CHANDELLE ACRES LT 1 G:1460 Site Mailing Address: 23861 LENNIE CIR, Chugiak Owner: NORBY CARLTON D & VIOLET M Design Engineer: FORGE ENGINEERING Effective Date: Expiration Date: Lot Size in Sq Ft Total Bedrooms: 11ec��r V. . w t)eparrniCnr 5/2/2019 5/1/2020 42263 This permit is for the construction of: Q Disposal Field © Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 3 All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under, construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, seated, and heated to prevent freezing Special Provisions: Test hole #1 shall be deepened to at least 13 ft and a 7 -day groundwater reading shall be taken to verify separations to seasonal high groundwater and impermeables. if results require a design change, construction shall stop pending Onsite review and approval of a change order. Please submit results with the change order or inspection report. Received By: Issued By: Date: _6/2116 Date: 5 Z JJ�I MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 051-063-82 Property owner(s) Carlton & Violet Norby Mailing address 23861 Lennie Circle Chugiak, AK 99567 Site address Same Day phone Legal description (Sub'd., Block & Lot) Chandelle Acres, Lot 1 Legal description (Township, Range & Section) Lot Size 42,263 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑x Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade FX_1 ❑ Duplex (D)Multiple Holding Tank El Renewal El Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 56 Waiver Fees: Date of Payment: �J/Sf i `� Date of Payment: Receipt Number: Receipt Number: Permit No. 0/ il(jlo Waiver No. Permit App_.:-: ,�. c� PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) April 15, 2019 MOA Development Services Dept, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Chandelle Acres, Lot 1 – 23861 Lennie Circle Septic System Design and Permit Application Dear On-Site Services Engineer: The absorption trench on the subject lot has failed and must be replaced. We are submitting this design and permit application for the construction of a new septic system. The attached site plan identifies the location of the home and the existing well along with the existing and proposed septic locations. No conflicts exist between the proposed system and any other well or septic system on this or adjacent lots. The ground surface on the lot slopes to the south. There are no slopes greater than 25% within 50 feet downslope of the proposed site. Topographic contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole logs and plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 4-15-19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191106, Rebecca Carroll, 05/02/19 O/E O/E O/E O/E O/E O/E O/E O/EO/E O/E O/E O/E O/E380375390385TH1 10050 0 FEET 1"=50' NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND MT CHANDELLE ACRES, LOT 1 LENNIE CIRCLE 4/15/19 SHED SHED OLD GLENN HIGHWAYCLOVERLEAF ROADWIRE FENCE RETAINING WALL RETAINING WALL 3-BDRM HOME 10' UTILITY EASEMENT10' UT I LITY EAS E M E NT 30' ELECTRIC EASEMENT ACCESS EASEMENT FOR THE BENEFIT OF LOT 1, LENNIE HEIGHTS SUBD (BK. 2756, PG. 642) TH2 38' LONG x 5' WIDE x 4' EFFECTIVE DEPTH ABSORPTION TRENCH EXISTING ABSORPTION TRENCH. ABANDON IN PLACE FOR FUTURE USE. 1,250 GALLON STEP TANK EXISTING SEPTIC TANK NOTE: DECOMMISSION EXISTING SEPTIC TANK PER MOA CODE. NEW TANK MUST BE >10' FROM FOUNDATION AND >5' FROM DECK/STAIR SUPPORTS. EXISTING WELL MT MH SV SV NOTE: TEST HOLE NO. 1 MUST BE DEEPENED TO 13' PRIOR TO CONSTRUCTION TO VERIFY LACK OF IMPERMEABLE SOILS OR BEDROCK. DELIVERY LINE MUST BE MINIMUM 6' DEEP THROUGH EASEMENT. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191106, Rebecca Carroll, 05/02/19 CHANDELLE ACRES, LOT 1 DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: 1-5 MIN/IN APPLICATION RATE: 1.2 GPD/SF 5' WIDE TRENCH SYSTEM 1,250-GAL STEP TANK TYPICAL TRENCH SECTION (NO SCALE) 1" PERFORATED PVC (HOLES DOWN) 30 - 3 16" DIAMETER HOLES @ 1.3' SPACING DRAINFIELD ROCK 5' 6" 6" 2.5' 4' NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY BOTTOM OF TRENCH: 7' BELOW GRADE FLOW LINE ELEVATION: 3.0' BELOW GRADE TOP OF TRENCH: .5' ABOVE GRADE 450 GPD /1.2 GPD/SF /5' WIDE *.5 RED. FACTOR = 37.5 LF TRENCH REQUIRED (38 LF SPECIFIED) 4/15/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191106, Rebecca Carroll, 05/02/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) CHANDELLE ACRES L1 4/4/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - NONE 6 2 3 051-063-82 VIOLET & CARLTON NORBY 4/8 1 2 3 4 5 6 1' OB GM (SILTY SANDY GRAVEL) 4/15/19 Professional Engineers Stamp: 4/15/19 5:19/5:25 6:15 6.0 1.1 5:26/5:33 6:36 6.0 5:34/5:41 6:40 6.0 5:42/5:49 6:38 6.0 5:50/5:57 6:35 6.0 5:58/6:05 6:40 6.0 6.0/12.0 6.0/12.0 6.0/12.0 6.0/12.0 6.0/12.0 6.0/12.0 BOH Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191106, Rebecca Carroll, 05/02/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 2 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) CHANDELLE ACRES L1 4/4/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - - 6 2.5 3.5 051-063-82 VIOLET & CARLTON NORBY 2/21 1 2 3 4 5 6 OB / FILL GM (SILTY SANDY GRAVEL) - Professional Engineers Stamp: 4/15/19 West side of the test hole is a bury site from original construction of lot BOH 6:10/6:20 10 3-4/16 6:21/6:31 2-12/16 6:32/6:42 2-12/16 6:43/6:53 2-11/16 6:54/7:04 2-10/16 7:05/7:15 2-10/16 4.0 / 7-4/16 10 10 10 10 10 4.0 / 6-12/16 4.0 / 6-12/16 4.0 / 6-11/16 4.0 / 6-10/16 4.0 / 6-10/16 3.8 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191106, Rebecca Carroll, 05/02/19 MATANUSKA ELECTRIC ASSOCIATION, INC. LETTER OF NON -OBJECTION May 1, 2019 Carlton and Violet Norby 23861 Lennie Circle Chugiak, AK 99567 Re: Forge Engineering proposed septic design located within Chandelle Acres L1, Plat 79-190, Anchorage Recording District. Dear Carlton and Violet Norby, MEA has no objection to the encroachment of the septic line within the 30 foot electric easement according to the attached drawing, dated 4115119. The depth of the septic line bury, must exceed 60 -inches. 1. The improvement will in no way restrict or limit the current or future ability of MEA to fully enjoy the benefits of the easement for any and all utility purposes that it presently enjoys under the easement. 2. MEA will be held harmless by the landowner from liability for any and all damages or injury to any person or property that may result from the existing and future use of the easement by MEA, its contractors, or assigns. 3. MEA will be held harmless by the landowner for any and all liability arising out of or relating to any use of the easement by others under a Letter of Non -Objection. 4. The landowner will be liable for any damages caused to MEA facilities by the improvement in the easement. 5. The landowner will be responsible for any special construction costs incurred by MEA due to the improvement in the easement. 6. The landowner will assure compliance with all applicable safety codes relating to the improvement in the easement. 7. Use of this letter by the landowner, their successors or assigns will constitute acceptance of these conditions. 8. Alteration of these conditions shall invalidate this letter. 9. This letter is not effective unless it is recorded in the Anchorage Recording District before ownership of the referenced property, is ctianged from the above named landowner. Sincerely Manny Lop Land ServiceVManger STATE OF ALASKA) SS - THIS IS TO CERTIFY that on this 1'91 day of May, 2019, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Manny Lopez SR/WA, MEA Land Services Manager Known to me and to me known to be the individual(s) named in and who executed the foregoing instrument and acknowledged to me that helshelthey signed and sealed the same as a voluntary act and deed for the uses and purposes therein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written Notary Public in and of Alaska My commission expires Return to: MEA, PO Box 2929, Palmer, AK 99645 A cn''��i rt -Ti\\ ti m \ l� mn m z1 Air 7 03 lk \ m �\ �anpn aoo Dom\ �N r- O m \ \ o � � T Z� \ \ s �- mmm o0 oc7ZI F \ mZ mn) \ �`y m �o �= Z �mZai `. jzro of z���z �j� m �rn-� Z z [n - / T Z \T n Z CJ 1 I rn �F / / \ m Q r Zu m Cl) = m 1 l � Cl) O = / m \ n m of \\ r co m = z v o "C7Cf) \ 1 a r m G \ F, z -j Cj) m m ry n m Vrscn \ o U)m Q 4 m o r Q-� \ \�� 1 O p m I�- 1N34�3+7'�J illhNl 01 mm O�mmno m z i W z— m m 0 1� v v n <Z C ❑ V O O A V�./ 3� a3 /� \O�Pi ^ C m O r- \ / Municipality of Anchorage Page '1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report �I 05106382 Permit Number: sWAAA-ftal A��t� PID Number: Name: I Wastewater System: New ❑ Upgrade MM & M Contracting, Inc. Address: ABSORPTION FIELD P. O. Box 670495 Phone: 688-1236 No. of Bedrooms: ❑ Deep Trench Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 6 — 7-'5' -6 GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: 1; Gravel depth beneath pipe �f- 1 Chandelle Acres. 2-- 3. Ft. Ft. Township: Range: Section: Fill added above original grade: Gravel length: 0 Ft. Ft. WELL: New O Upgrade Gravel width: S Number of lines: DistancebetvreenlinFt Ft. Ft. Classification SSPrivate, A,B,C): Total Depth: Cased To: Total absorption area: 170 Pi material:/t577'l 434, rl V 2Tri I Ft. Iti• Z Ft. SO. Ft. Dririllerj `�(/ �y� J0I 11,/a�.Y� 4/k, e, rY� I �s Date Drilled: 9 Static Water Level: Ft. Installer. M M r I moi. Dat installed: 'j 8 —/ ;;13 Yield: Pump Set at: I I Casing Height Above Ground: TANK r 3.0GPM � WK Ft. L Ft. SEPARATION DISTANCES pi optic 0 Holding ❑ S.T.E.P. To Septic Absorption LIN Holding ubilc/Prhtits Manufa rer. �� ` Capacity in gallons: I �G� From Tank Field Station Tank Sewer Lines ► ` well, : Ips % 120 /� �/�/{� / Material: 51 Number of Compartments: Surface I So' > 150 �'�' N1'k y 1y o' LIFT STATION NIA Lot r l /L Size in gallons: Manufacturer. Line I I �/ /Y T �/� Foundation r N /� ///A' � "Pump on" level at: "Pum evel at: High water alarm at: Curtain L I / / / / Pump Mak!!M Electrical Inspections performed by: Drain /V BENCH MARK Remarks: Location and Description, Assumed Elevation: / OO.O S SEAL Inspections performed by: Dates: 1st S Alt n�17r IL ArAwam Department of Health and Human Services approval i� Date: �z Reviewed and approved by: 72-013 (Rev. 9/91) MOA 25 i Permit No. SW 9 5 0 0 81 Page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 a Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Lmni nmw#,i.mnv,• Lot 1 . Chandelle Acres Subd_ am% ru...05106382 . _BPI i ramum S c ump, compartment p 8P2 2 C Clean Out t ST Monitor Tube . ..... . ........04 A B C C1 3.6 P1 10.2 .0 C T 60.9 44.6. _....._ ._............._........ __. , ____..._ ___.._...._......._._ _.._............. _..... 57' x 5'W, ' E.D ,• ; __Alternate _ \7 t � t I 1 ' - 1 PLAN AS—BLT kLC 1" = 201 E. ANDERSON •� / �. ! 4381-E i----------- MEMORANDUM DATE: November 12, 1997 TO: Donna Mears, MOA- DHHS FROM: Mike Anderson, P.E. M SUBJECT: Lot 1, Chandelle Acres Subdivision Certificate of Health Authority Approval RECEIVED NOV 12 1997 Municipality of Anchorage Dept. Health & Human Services The driveway on Lot 1, Chandelle Acres Subdivision has been realigned so the absorption trench does not fall underneath it. A large boulder has been placed near the end of the trench to protect it from vehicular traffic. The as -built has been modified to show the new alignment of the driveway. The alternate site for the absorption trench has been moved parallel to the new trench. Sufficient area is available here and the majority of the alternate trench falls within 30' of Testhole No. 2. The alternate site is also shown on the revised as -built. Permit No. S W 45 oo b I Page 3 Of, 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 a Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Lot 1 , Chandelle Acres Stbd. PID No.: X51063 SZ— SP1 Septic Pump, compartment 1 SP2 2 C Clean Out MT Monitor Tube r.3 V ELEVATION 1" = 10' I. 0 -*.. 0 liIIlIIIIIIIIIIIIIIIIII AS -BLT 1' Ogal . se tic �I Ho 1' Bench Mark: Garage S.O.G.= 100.0 NOTE: Monitor Tube and Clean Out 4 are redessed below grade and.topped with the. typical valve box top section. �PYfIlIPA DOC co. lobe SULLIVAN WATER WELLS P.O. BOX 67t1, M CHUOUM ALASKA 99661 - TELEPHONE 0$11-47611 OWNER OF LAND _ ;� ; 4 sm A J ADDRESS � I 1 L h' ��►t9t.�l c � �.'�l�:r LEGAL DESCRIPTIO Y DATE - Started Ended If P>rIt'MIT NUMBER KIND OF FORMATION: DEPTH OF WELL ,� All STATIC LEVEL OF WATER FT. 1El DRAW DOWN FT. GALS. PER HR -- KIND OF CASING. - From �� Ft. to F!. �, rC / edC, `FT–J t-wC J P From Ft. In Ft. From Ft. to_. 4 —Ft..._lj'� ��'�'�� �`'� - From Ft. to_,"wFt. From '"1 Ft. to e) Ft. ..S O.10 From Ft. to Ft. -From Ft. to Ft.—MU-40 /��� %k+From`_ .._Ft. to —Ft From_ •' - Ft. tFt.�4dFrom�.._Ft. ln., FI From c_ L Pt. ta11; �_Ft. 4 t- _ =-a� ^�C' "Qf From. Ft. to Ft. From'. t Ft. to Ft. ZZCS- ZvA Fror7, . Ff. to Rt. From Ft. to..Ft. From . _.—Ft. to Ft. From Ft. to Ft From' Ft. to Ft. From Ft. to Ft. From—Fl. to Ft. From Ft. to —FI. From–Ft. to Ft• From - Ft. to_ Ft. rom From— From Ft. to Fl. From From Ft. to Ft, n From Ft. to --Ft. From Ft. to Ft. a From Ft. to Ft. From Ft.. to Ft. .oul 22 91 From _ Ft. to Ft. From Ft. to Ft unicipality of Anchorage From Ft. to.: -Ft- From Ft. to`:� MiSCL. INFORMATION: PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE �o JLDJ !7 3(? l DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970074 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:M M & M CONTRACTING INC OWNER ADDRESS:23861 LENNIE CIR CHUGIAK, ALASKA 99567 PARCEL ID:05106382 LEGAL DESCRIPTION: CHANDELLE ACRES LT 1 LOT SIZE: 42263 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 4/25/97 EXPIRATION DATE: 4/25/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED y� A ISSUED BY: ' DATE: DATE: 4 -2S--'/ 7 Mt icipality of Anchorage and Human Services _ Department of Health a � 825 "L" Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor 343-4744 May 20, 1996 M M & M Contracting, Inc. PO Box 670495 Chugiak, Alaska 99567 0495 Subject: Lot 1 Chandelle Acres Subdivision Permit #SW950081, PID #051-063-82 The subject permit, issued May 17, 1995 by this office for a single family well and/or on-site wastewater system, has expired as of May 15, 1996. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. 4sinrely, E. Cross, P.Eam Manager On-site Services enc: Copy of Permit cc: Anderson Engineering MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW950081 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:M M & M CONTRACTING INC OWNER ADDRESS:P.O. BOX 670495 CHUGIAK, ALASKA 99567 PARCEL ID:05106382 LEGAL DESCRIPTION: CHANDELLE ACRES LT 1 LOT SIZE: 42263 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 5/17/95 EXPIRATION DATE: 5/17/96 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: W4j_l4wt E 0"A' ISSUED BY: DATE: 5-h 7 1 1' S' DATE : J-- f 7 - C/f ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, ALASKA 99524 May 10, 1995 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 1, Chandelle Acres Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: We are hereby applying for an onsite septic system permit for Lot 1, Chandelle Acres Subdivision. The location of the new system and the alternate site are shown on the attached site plan. The topography of the lot is also shown on the plan and indicates a west to east slope of approximately 2%. Surface drainage will not be affected by placement of the new system. Soil conditions on the lot are good and will adequately support an onsite septic system. The new well location is also shown on the site plan and is at least 100' from the septic system on Lot 2, Chandelle Acres. If the system is constructed as designed the following statements can be made: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainages pattern will be maintained. Sincerely, ©' t r Michael E. Anderson, P.E. fi u' LOT 1, CHANDELLE ACRES AREA MAP �S PXO TEC.T I 2J 23737 23808 d I � I 2371 23740 236 q� O 23714 23921 23949 W 21887 DR 2384 z� r29642 W d CL I I 23662Y`as<P� 23819 W J J a`y 23832 H W 21811 J� r IDI 23743 �Vl1`P� 2161 r 2 U z B p �� LENN/E HE/G S 3 23717•T 2 .0 H 21751 U I 9 ,FIs c 21750 C S 7R8 23730 2380 m0r Z I 25 t�S0 s s C� 9 �� re LENNIE IR. y w I I J J W M 12 J 21661 /e r 16635 21709 >.S 21721 h N /! rR z /ac 2165 0 21640 I 2 21650 J i� IOG J 21646 . 21705cc 21639 3 21631 9644 W 21636 "PUBBITS" cc 2wW � 21632 21631 21643 21665 E 21675 21624 21619 21625 J `\ 2 /$ 61� TLR /2 21608/3 d 2W,07 / /J TV / 2/ 21524 at 23562 / 23716 21351 21316 21558 21610 21630 21650 21670 5A TLR 21531 SNOWFLOWER LOOP 23554 23616 z 27 21508 21611 21631 21435 23535 23524 42M46 2' 21464 y 21405 621426 ,23 Q 25 I 21448 a 23506 21346 BERNIES r 21424 2' 21430 21407 23431 5 M 21342 V� 21405 gK,E r o $LVE 23466 9530 TEIRS RB J i 21338 Tut 21362 16 23436J REEK Q 21349 r I VD I I/8 6 e 21334. MANOR 23316 21351 /2 21340 I I STp�KNAtISEN 16 23 W 21311 I & I rRAIA IWI re A? 21 a // . A QLD 21248 ¢ /s /r 0 21241 zz Q I T O Z I g0 21249 :3 I l06 I! b _ 23723 �.- =" 3 ar, zO 21219 HOMESTEAD _ / 9 ® �ww Yeses IG,:: ex..-� i_. i,i�C.ersOn `y �d'd ow 5me: nLAM I„ = 4o. JOB SHEET NO. OF [ CALCULATED BY MGA DATE SJ7/QS CHECKED BY DATE PRODUCT 2*1 MMIR SUM) 205-1 (PIM) ®® Mc- Grum. Mm. 01471. To @ow PHONE TOLL FRE t-AOG12MM Lot 1, Chandelle Acres Subdivision DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home Wide Trench System Perc. Rate: 12 Min./Inch 1,000 Gal. Septic Tank Application Rate: .8 GPD/SF 4' Drain Rock Beneath Pipe Reduction Factor: .5 3 Bdrms. X 150 GPD / .8 GPD/SF = 562.5 SF of Absorption Area 562.5 SF / 5' Wide = 113' LF X .5 (Red. Factor) = 57 LF Trench Therefore: Construct a Wide Trench System With One Lateral Totalling 57' in Length. Place 4' of Drainfield Rock Beneath the Lateral. Place Distribution Pipe at 3'-6" Below Ground Surface. Mound Over System To Drain Away. �3 t uTOD .. _... .... ....... __. _ _.__....... _ ^.._..� 1 A ._ _—_....._. �. _...». -_.. ----------- .. ... _..._ ... _. d fi 9 TYPICAL WIDE TRENCH SYSTEM .. (NO SCALE) m w ,� UX2. NOTE: Maintain 4' Vertical Separation From Bottom of Trench to Groundwater Table. Grade Area Around Drainfield to Drain Away From the Trench. �awUZA�. 1ore �3 t uTOD .. _... .... ....... __. _ _.__....... _ ^.._..� 1 A ._ _—_....._. �. _...». -_.. ----------- .. ... _..._ ... _. d fi 9 TYPICAL WIDE TRENCH SYSTEM .. (NO SCALE) m w ,� UX2. NOTE: Maintain 4' Vertical Separation From Bottom of Trench to Groundwater Table. Grade Area Around Drainfield to Drain Away From the Trench. M Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "12' Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST frr PERFORMED FOR: M r" 1 /" 1 Wpirrm fro, G —DATE PERFOR 7 LEGAL DESCRIPTION: LOT ( tw-IAAjDELw AQ%,E Township, Range, Section: SLOPE SITE PLAN _P`r/DL 1 .g 2 0 A 3-, b r 4- 5-1 5 d 6 7 p ,. t � . 8- 9- 10- 11 9 10 11 a 12- 13-, 213 , 14- 15- 16- 4 15 16 0 • 17 18 19 -TEST 14Ot-cr /110, Sn totc WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? lVDA1 Date: Gtr Reading Date Gross Net Time Time Depth to Water Net Drop l41z,8 Z:10 20" PERCOLATION RATE /L (minutesnnch) PERC HOLE DIAMETER TEST RUN BETWEEN 3_ FT AND 4 FT COMMENTSC---S PICC S o kf iy p/'Ll0/L ro EST PERFORMED BY: A *-wca !ER IFY THAT TH� T ST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: i ' IT 72-008 (Rev. 4/85) ;a xa e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST �° a M M M Co y� �- NTRAC,TInI Lt i PERFORMED FOR: DATE PERFORMEb�+ LEGAL DESCRIPTION: LOT Is l..-tAA, DELLE A "tj= Township, Range, Section: _ SLOPE SITE PLAN 1 � �T1OL e 17 BOTTO M Oil= f� 18 19 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? Date Depth to Water 2- 3 3- 4- 45 5 r -e 6- r ` SP 7 7 9- 10- 10 11 11 d. O 12- 213 13- 14 14- 15 151 16 e 17 BOTTO M Oil= f� 18 19 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? Date 20 � g �� PERCOLATION RATE �7S (minutes/inch) PERC HOLE DIAMETER %� TEST RUN BETWEEN J FT AND4 FT � COMMENTS ' ZT Ft's L4 PR''{' Sv1 **-j Paf o lL -m IS CST, PERFORMED BY: A • 144'? -+a � I � "r F &"Z R � IFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: s- o 72-008 (Rev. 4/85) Depth to Water 20 � g �� PERCOLATION RATE �7S (minutes/inch) PERC HOLE DIAMETER %� TEST RUN BETWEEN J FT AND4 FT � COMMENTS ' ZT Ft's L4 PR''{' Sv1 **-j Paf o lL -m IS CST, PERFORMED BY: A • 144'? -+a � I � "r F &"Z R � IFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: s- o 72-008 (Rev. 4/85) ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: Lot 1, Chandelle Acres GENERAL: 1. The scope of this project includes the procurement and installation of a 1,000 gallon septic tank and the construction of a shallow bed drainfield to serve the proposed three bedroom home. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Lot 1, Chandelle Acres May 10, 1995 Page Two 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 5. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts shall be installed between the tank and the drainfield. The first cleanout shall be located on undisturbed soil not more than 10' from the tank. The first cleanout shall be to clean toward the drainfield. The second cleanout shall be to clean toward the tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the bed shall be within 2" of level. The bed shall not be installed on a slope greater than 10%. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any water wells in the area. Lot 1, Chandelle Acres May 10, 1995 Page Three 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trenches must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 seive. Lot 1, Chandelle Acres May 10, 1995 Page Four INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage Development Services Department j Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 www.cf.anchorage.ak.us (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. — r5 —G(Z o HAA#_ C)(DbOI 1. GENERAL INFORMATION Expiration Date: 4 — I C1 — O Complete legal description CHANDELLE ACRES SUBDMSION; LOT 1 Location (site address or directions) 23861 LENNI CIRCLE • CHUGIAK. AK 99567 Current Property owner(s) EDWARD KIDDOO Day phone 688-8660 Mailing address 23861 LENNI CIRCLE • CHUGIAK, AK 99567 Lending agency Day phone Mailing address Real Estate Agent — BONNIE KING w/ KINGS REAL ESTATE Day phone 689-6499 Mailing address KINGS REAL ESTATE • LAKE HILL DR. *EAGLE RNER. AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well N Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of tille (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for Misapplication, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with aq applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines d Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fuctuate 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE _Aeffo� Approved for 3 bedrooms. Disapproved. Phone 337-6179 Date 1 lit ly6 Conditional approval for bedrooms, with the flowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Manitenance Agreements Supplemental Engineer's Reort Other ONSITE WASTEWATER By: Original Certificate Date: —06 (Rw. 17J01) Municipality of Anchorage ' Development Services Department Building Safety Division Onsite Water 6 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: CHANDELLE ACRES SUBDIVISIONLLOT 1, Parcel 10: ��lJ - O A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Date completed 4H997_ Sanitary seal (Y/N) YES. Total depth 113_ft. Cased to 113_ft, FROM WELL LOG Date of test 4/1997 Static water level Well production WATER SAMPLE RESULTS Coliform O oolonies/100 ml. Nitrate o-1 mg./L. Well Log (YM) YES Wires properly protected (Y/N) YES_ Casing height (above ground) 12+ in. AT INSPECTION 12/28/2005_ 71 ft. Other bacteria `_ colonies/100 ml. Arsenic: 5 o mg./L. Date of sample: 12/28/2005., Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Matenal STEEL Date installed 717/97_10/20/97_ Tank size __1000_ gal. Number of Compartments _2_ Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO_ High water alarm (Y/N) NO_ Date of pumping _//(o �0(v_ Pumper JR'S PUMPING C. ABSORPTION FIELD DATA [BELOW EXISTING GRADEI Date installed 717(97_10/?0197 Soil rating (g.p_d.Hfbr R'lbdrtn) 0.8_ System type TRENCH Length 57 ft. Width ft. Gravel below pipe 4 ft. Total depth '7 1_ft. Eft. absorption area 570_ ft' Monitoring tube YES_ Depression over Heid NO_ Date of adequacy test 12/28/2005_ Results (Pass/Fail) PASS_ For -_21 -bedrooms Fluid depth in absorption field before test _36_ in. Water added 765_ gal. New depth ! 16.5_ in. Elapsed Time: 1240 min. Final fluid depth _39_ in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) NONE, KNO_WN__ If yes, give date D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons ManholeJA High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas — SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 51+ Absorption field 51+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingivehicle storage 10'+ Curtain drain AgNUUML Wells on adjacent lots 100'+ F_ COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A GARNESS Date l h -(Jo 6 COSA Feel X430 , -D Date of Payment VI ,�4 01'rt Receipt Number If5w T �r (Rev. 17/01) Waiver Fee $ Date of Payment Receipt Number SGS Refa 1058376001 Client Name Gamess Engineering Group, Ltd. Project Name/# Chandellc Acres Lot 1 Client Sample ID Chandellc Acres Lot 1 Matrix Drinking Water PWSID 0 All Dates/Times are Alaska Standard Time Printed DateMme 01/132006 16:54 Collected Date/time 12/282005 10:00 Received Date/time 12292005 11:00 Technical Director Stephen C. Ede Sample Remarks: 2540C -MS- Sample re -run after hold time. Due to fluctuation in scale, sample was re -run to acquire an accurate weight Peameter Results PQL Univ Method Allowable Container ID Limits Prep Analysis Date Date Init Nitrate -N 0.100 U 0.100 mg/L EPA 3532 B 1229/05 1C Nitrite -N 0.100 U 0.100 mg/L EPA 353.2 B 1229/05 1C Metals Department Hardness as CaCO3 5.00 U 5.00 mg/L SM20 23408 D 12/30/05 01/09/06 SCL Private Individual Analysis Aluminum 20.0 U 20.0 ug/L EP200.8 D 12/30/05 01/09/06 SCL Antimony 1.00 U 1.00 ug/L EP200.8 D (<-6) 12/30/05 01/09/06 SCL Arsenic 5.00 U 5.00 ug/L EP200.8 D (<-50) 12/30/05 01/09/06 SCL Barium 3.00 U 3.00 ug/L EP200.8 D (o-2000) 12/30/05 01/09/06 SCL Cadmium 0.500 U 0.500 ug/L EP200.8 D (o-5) 12/30/05 01/09/06 SCL Calcium 622 500 ug/L EP200.8 D 12/30/05 01/09/06 SCL Chromium 1.000 1.00 ug/L EP200.8 D (o-100) 12/30/05 01/09/06 SCL Copper 1.61 1.00 ug/L EP200.8 D (o-1300) 12/30/05 01/09/06 SCL Iron 250 U 250 ug/L EP200.8 D (o-300) 12/30/05 01/09/06 SCL Lead 0.200 U 0.200 ug/L EP200.8 D (<-15) 12/30/05 01/09/06 SCL Magnesium 661 50.0 ug/L EP200.8 D 12/30/05 01/09/06 SCL Manganese 1.00 U 1.00 ug/L EP200.8 D (<-50) 12/30/05 01/09/06 SCL Phosphorus 200 U 200 ug/L EP200.8 D 12/30/05 01/09/06 SCL Fluoride 0.100 U 0.100 mg/L EPA 300.0 B (o-2) 12/30/05 DSH Chloride 13.2 0.100 mg/L EPA 300.0 B (<-250) 12/30/05 DSII Potassium 500 U 500 ug/L EP200.8 D 12/30/05 01/09/06 SCL Selenium 5.00 U 5.00 ug/L EP200.8 D (o-50) 12/30/05 01/09/06 SCL Sodium 107000 20000 ug/L EP200.8 (<-250000) 12/30/05 01/11/06 SCL Silicon 5670 200 ug/L EP200.8 D 12/30/05 01/09/06 SCL Silver 1.00 U 1.00 ug/L EP200.8 D (o-100) 12/30/05 01/09/06 SCL Thallium I.00U 1.00 ug/L EP200.8 D (<-2) 12/30/05 01/09/06 SCL Sulfate 133 0.100 mg/L EPA 300.0 B (o-250) 12/30/05 DSH SCS ReEM 1058376001 All Datesffimes an Alaska Standard Time Client Name Gamess Engineering Group, Ltd. Printed Dateffime 01/132006 16.54 Project Name/# Chandelle Acres Lot I Collected Dateffime 12282005 10.00 Client Sample ID Chandelle Acres Lot 1 Received Dstelfime 12292005 11:00 hlatrix Drinking Water Technical Director Stephen C. Ede P%VSID 0 ug/L EP200.8 D (<-5000) 12/30/05 01/09/06 Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date t,,;t Private Individual Analysis Total Dissolved Solids 233 10.0 mg/L SM20 2540C B (<-500) 01/11/06 KP Zinc 5.00 U 5.00 ug/L EP200.8 D (<-5000) 12/30/05 01/09/06 SCL Nickel - 2.00 U 2.00 ug/L EP200.8 D (<-100) 12/30/05 01/09/06 SCL IIC03Alkalinity - 206 10.0 mg/L SM202320B C 01/11/06 KP CO3 Alkalinity 10.0 U 10.0 mg/L SM20 2320B C 01/11/06 KP OI[Alkalinity 10.0 U 10.0 mg/L Sh120 2320B C 01/11/06 KP . Conductivity 430 1.00 umhos/cm SM2025JOB C 1229/05 IC PH 8.46 0.100 piIunits EPA 150.1 C (6.5-8.5) 1229/05 AZS Alkalinity 206 10.0 mg/L SM20 2320B C 01/11/06 KP Total Coliform IOB. NoColi coUl00mL SM20 9222B A (o-1) 1229/05 DPT 1 Municipality of Anchorage V16 '� Development Services Department Building Safety Division Onsite Water 8 Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL rFOR A SINGLE FAMILY DWELLING Parcel I.D. in r1 I ` 6 HAA# i 3 1. GENERAL INFORMATION Expiration Date: Complete legal description CHANDELLE ACRES SUBDMSION: LOT 1. Location (site address or directions) 23861 LENNI CIRCLE • CHUGIAK. AK 99567 Current Property owner(s) GEORGE GARRISON Day phone 688-8095 Mailing address 23861 LENNI CIRCLE • CHUGtAX, AK 99567 Lending agency Day phone Mailing address Real Estate Agent LES BAILEY w/ PRUDENTIAL VISTA Day phone 689-6499 Mailing address 16635 comnELD DRIVE •EAGLE RIVER AK. 99577 Unless otherwise requested, HAA wffl be held by DSD for pickup. 2. NUMBEROFBEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual "Well individual On-site ■ Individual -Water Storage ❑ Individual Holding tank ❑ Community Class Weil ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the. State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As cued by my seal affixed hereto and as of the validation data 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 Anchorage riles and from my Investigation and Inspection, the onsite water supply and/or wastewater disposal system Is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name . JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a i hormVh, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational We of all walls and septic systems depend on the tical solis condition, greundwaterlevels that may fluctuate during the year, and the water usage of the family being served by Me system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee shat there are no hidden defects or encroachments. GEG, Ltdd can therefore not provide any warranty orArture estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Phone 337-6179 Date in I I q Conditional approval for bedrooms, with the fllowing sUpulatlons: Attachments: HAA Checklist / Manitenance Agreements •JJ'�J'�/i" ��' Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other By Original �,� �� �t�-�t Original Certificate Date: (Rw. lavV Municipality of Anchorage a...e� �\ • Development Services Department M ': Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bregaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.sk.us (907)343-7904 i HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: CHANDELLE ACRES SUBDIVISION; LOT 1, Parcel 10: oS – 63- 8;2, A WALL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (Y/N) YES Date completed 4/1997 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 113 'ft. Cased to 113 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION 1� Date of test 4/1997 12 04 Static water level 85 ft. 73 ft. Well production 3 g.p.m. 2.43 g.p.m. WATER SAMPLE RESULTS: Collform "S� colonies/100 mi. Nitrate Q,10 mg./L. Other bacteria colonies/100 ml. Arsenic:—mg./L. Date of sampled 1/12/200 Collected by: G.E.G. Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date installed 7/7/97-10/20/97 Tank size 1000 gal Number of Compartments 2 Cleanouts (Y/N) YES c� Foundation deanout (Y/N) —YES Depression over tank (Y/N) NO High water alarm (Y/N) w NU Date of pumping 11/18/2004 Pumper JR'S PUMPING C. ABSORPTION FIELD DATABE t•Wl —oOsnNG GOO Date instailed7p/97-10/20/97Soil rating CENor ftlbdnn) 0_8 System type TRENCH Length 57 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth •7.1 ft. Eff. absorption area 570 ft' Monitoring tube YES ! Depression over field NO Date of adequacy test 11/15/2004 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 30 in. Water added 834 gal New depth43 in. Elapsed Time: 825 min, Final fluid depth 37 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) NONE KNOWN If yes, give date gallons "Pump on' level at _in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements?. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 1001+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 100+ Building foundation 10'+ Water main N/A Water service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 25'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date b( or 4ci ,v HAA Fee $ �' v Date of Payment I I 12o�,�,O,4 Receipt Number mgt (Rev. 12001) Waiver Fee $ Date of Payment Receipt Number y• , iZ •� AS -BUILT + t I hereby cerl0y that I have surveyed the following described, •:•`� ,:. pro erty.T ' .•.. '.' •. (Z,$SAMsvC e•h"'4' Syo.c, ien, 3� 7•/'!'N, f'• f w.� �/..-(r 611L,1 A *O1AP 'A whors a ltecotding precinct, Alaska, and that the Improve. ;� AaN ments NCusted thereon aro within the property lines end du not >✓ (�:' •,..,, �.�'e,es 4stiiS. Get weds or encroach on the proprt lying adacentthereto, that + •�~�r'••N �a�'•: 1S Ner W� �.t^Provements on proprtyying idjacent thereto encroach • �^ •v,lr �� bn t j+remiks Inquest on and that therearc no roadways, "'y'� 49th {' j� SM/ Op tJa IrarumLsion lines at other Visible easements on said property tw • " .....pt, 1, /,y�� ``•. accept as indicated hereon. �• Y Jti ''+ t Dated at Eagle River, Alaska Z.6' dw r.,.. .• .ala ~ yof�Sv_ /�• p7e+n . t •y� • ftp. ECti•5 �•Y•%,,: ROBERT C. [OIINSON r-' . + � SCALE: Registered lend Surveyor No. LS +r +r, +'6i►�i e•..•..•* a4y� Boa 77-0156, Eagle River, Alaska 99577 ,. :4'`s �.�uAlb�•is Phone (907( 694.2543 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-063-82 1. GENERAL INFORMATION qc p .. .r 4 HAA # 02)0�' ` Expiration Date: I — 3 Q —0 L{ - Complete legal description Lot 1; Chandelle Acres Location (site address or directions) 23861 Lennie Cir. Chugiak, AK 99567 Current Propertyowner(s) Michael E]tz Day phone 301-8491 Mailing address same Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by. DSD for pickup. Z 1 2. NUMBER OF BEDROOMS:_ 3. TYPE OF WATER SUPPLY: Individual Well ak Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site ak Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ /0/-7010 3 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional enaineer's work. 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. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S Engineering Phone 694-2979 Address 17034 N Ea 1'p R;vPr Lonn Site_ 704 Eagle River, AK 99577 Engineer's Printed Name Robert C. Cowan Date /01a V/03 OF 1% ROBERT C. COWAN 5. DSD SIGNATURE tt `mac C:-8801 ; 4�, Approved for 3 bedrooms. t+ljl6jl '%.., ;'.'.��: Disapproved. ,,, Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory .�Y�� OFANe ON-SITE %A/ATr:D Akin •. VVA51 tVVAI tK Maintenance Agreements Supplemental Engineer's Report Other By. Original Certificate Date: (Rev 01102) Municipality of Anchorage .•�n ,.� Development Services' Department Building Safety Division < On -Site Water & Wastewater Program ' A TV 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Loi t , C 4`421 2E LL6 /4_4ZJ(QI Pardel ID: 0S`1 •D63 ' 0932?i A WELL DATA Well type If A, B, or C provide PWSID # Date completed Sanitaryseal (YIN) y Total depth -LI 3 ft, cased to 40 ft FROM WELL LOG Date of test 4 c! Static water level "ft Well production 3 g.p.m; Well Log (YIN) _ ' Y Wires property protected (Y/N) Casing height (above ground) - lAt-In. AT INSPECTION Z9 �Es7'b0 3y 8D ft. XA/ /P 0.931 j�uGi�IEG-??AJC_ g.p•m. WATER SAMPLE RESULTS: Coliform O colonies/100 ml. Nitrate 0 mg.A. Other bacteria O colonies/100 ml. Arsenic: mg.A. Date of sample: L07/0 3 Collected by: 15;J!57 &J 1I) moi X14_ B. SEPTIC/HOLDING TANK DATA Tank Type/Material I L SEG Date installed Tank size / 000 gal. Number of Compartments�/ Cleanouts (YIN) y Foundation cleanout (Y/N) _`L Depression over tank (Y/N) N/ High water alarm (Y/N) N/ Date of pumping .Cl/X9/03 Pumper TAN 1 Tol4Y C.' ABSORPTION FIELD DATA Date installed Soil rating (g.p.dJft2 or ft%drm)Q'k System type5ff. T/LC-`RICH Length ft. Width S ft. Gravel below pipe 4 ft. Total depth ft. Eff. absorption area 57�f) ftZ Monitoring tube Depression over field Date of adequacy test O 0 Results (Pass/Feil) P,4 S S For bedrooms Fluid depth in absorption field before test 3 to in. Water added I New depth4Ssn. ,Elapsed Time: min. Final fluid depthSin. / Absorption rate >=_g.p•d. Any rejuvenation treatment (past 12 mo.) (YIN & type) /`r If yes, give date D. LIFT STATION Date installed W R "Pump on" level at in. Datum E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N) "Pump off" level at _ in. High water alarm level at in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lifistation on lot /0o �f Meets alarm 8 circuit requirements? On adjacent lots / 00 /'r - Absorption field on lot /0"0 r On adjacent lots / D O ;- D {- 1 Public sewer main AJ ► Public sewer manhole/cleanout � /- Sewer /septic service line 2 5 �t Holding tank " f SEPARATION DISTANCES FROM SEPTICMOL-DMG TANK ,ON LOT TO: IF Building foundation S r� Property line �f Absorption field Water main N A' Water service tine �� �' Surface water /00 r4- Wells on adjacent lots 1019,' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: rN /F Property line /O f Building foundation 7 Z 5 Water main Water Service line i 0 Surface water 100 'f Driveway, parking/vehicle storage I_ Curtain drain oN Ain j^( Wells on adjacent lots 1t)0'�' F. COMMENTS G. ENGINEER'S CERTIFICATION : '2; - r I certify that I have determined through rield inspections and If ,. ..:•.... review of Municipal records that the above systems are in........ conformance with MOA HAA guidelines in effect on this date. ��, ROBERT C. COWAN c C. Ce "H'J llf`^i�f:� CE -8801 Engineer's Printed Name t�• ^ Date 70o t /j C/,'vc/Y� HAA Fee S 3 1 -- Date of Payment /0/ a" 3 Receipt Number o �r 9 £ Cl f (Rev. 12101) Waiver Fee S Date of Payment Receipt Number Municipality of Anchorage Development Services Department 5� Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Health Authority Approval # 030551 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block Lot 1 of Chandelle Acres subdivision, the well's productivity was determined to be 0.93 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. NI Ole -4 s... LorY r• l.JC.IN k ` -, `• vY`; i ct A;k ' • 1. ( .. .'/• Ori �/.!'•�' ( t.w•.•Id. ea_ ;, moi'` ..`,•h .• �. � I.I , �•� •Y • tour, J/.�.e.. Y. .• � � � 1L may. 1 . vt i .t• . ar by .• . off rs ;..,• logo Wen ,FA .14 1`10. ECU 5 �• ; ,µ•..If ' M1 •f' AS -BUILT I herby certify that I have surveyed the following described, property: Anchorage Recording Precinct, Alaska, and that the Improve- tnenti situated thereon Are within the property lines and do not I wedap or encroach on the property lying adjacent thereto, that 1 t no itnprovemenla on property lying adjacent thereto encroach + on the Prern6ts Inquest on and t at there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. ;. • ,Dated at Eagle River, Alaska teres .ZA day of�� p7oao ROBE C. JOHNSON .i SCALE: Registered Land Surveyor No. 8P0 -LS 3 - 4 o Box 774)456, Eagle River, Alaska 99577 Phone (947) 694-2543 c \ v / •' NI Ole -4 s... LorY r• l.JC.IN k ` -, `• vY`; i ct A;k ' • 1. ( .. .'/• Ori �/.!'•�' ( t.w•.•Id. ea_ ;, moi'` ..`,•h .• �. � I.I , �•� •Y • tour, J/.�.e.. Y. .• � � � 1L may. 1 . vt i .t• . ar by .• . off rs ;..,• logo Wen ,FA .14 1`10. ECU 5 �• ; ,µ•..If ' M1 •f' AS -BUILT I herby certify that I have surveyed the following described, property: Anchorage Recording Precinct, Alaska, and that the Improve- tnenti situated thereon Are within the property lines and do not I wedap or encroach on the property lying adjacent thereto, that 1 t no itnprovemenla on property lying adjacent thereto encroach + on the Prern6ts Inquest on and t at there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. ;. • ,Dated at Eagle River, Alaska teres .ZA day of�� p7oao ROBE C. JOHNSON .i SCALE: Registered Land Surveyor No. 8P0 -LS 3 - 4 o Box 774)456, Eagle River, Alaska 99577 Phone (947) 694-2543 Municipality of Anchorage • Department of Health and Human Services i Division of Environmental Services Mr�j On -Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage. alk. us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FORA SINGLE FAMILY DWELLING Parcel I.D.05—/-063 ,,PL HAA# ,tL/ n_c'z/33 Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 1 ; Chandel Location (site address or directions) 23861 Lennie Circle Current Propertyowner(s) William Petty Mailing address 23861 Lennie Circle, Chugiak Lending agency Mailing address Real Estate Agent Mailing Address Day phone 688-2439 AK 99567 Day phone Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System TYPE OF WASTEWATER DISPOSAL: ❑X Individual On-site ❑ ❑ Individual Holding Tank ❑ Well ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 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 sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. -2925 (Rev. 3VOU 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S&S Engineering Address 17034 North Eagle River Lo Engineer's Printed Name -Robert C . Cowan 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Ste Phone 694-2979 204, Eagle River Date 9/6/200, AK 99577 U'r .. �C....•........- ,�2�c� � 1 ' f FJii tYIL�E.V/ t•. �� -A \ ROBERT C. COWAN �I�Q Oma'- CE•8801 bedrooms, with the following stipulations. Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: 0 Expiration Date 72-025 ne, �1 001' Reissue Date: Municipality of Anchorage RECEIVED • Department of Health and Human Services Division of Environmental Services SEP 0 5 2000 On -Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us MUNICIPALITY OFANCHORAGE (907) 343-4744 ENVIRONMENTAL SERVICES DIVISION HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: )-07- / Cy6rbg- C ACA& S Parcel I.D.: 0 S_ `- 0 Or 3 —YL A. WELL DATA Well type PPIVAT If A, B, or C provide PWSID # Date completed 4 A 7 Sanitary seal 'Yk-J Total depth )1 3 ft Cased to )1,2 ' a ft Date of test Static water level FROM WELL LOG y/97 �;S ft Well production 3 9 -p.m WATER SAMPLE RESULTS: Well Log Y✓L S Wires properly protected y'`/ Casing height (above ground) f 14 in. AT INSPECTION 0610 0 _7S- ft 9 -p.m Coliform 0 colonies/100 ml Nitrate 0. $_ mg/I Other bacteria o colonies/100 ml Date of sample: 9/3/40(3 Collected by: 5 & 5 ENGINEERING B. SEPTIC/HOLDING TANK DATA 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 TankType)Material 'JtA71 � / S7 -,F& c - Date installed "? B)q T,. Tank size / 0 0 o gal Number of Compartments 2 Cleanouts Yif Foundation cleanout YMu- Depression over tank 0*� o High water alarm N D Date of pumping N / n &11 01 Pumper C. ABSORPTION FIELD DATA SNq��a w Date installed I T %9 7 Soil rating g.p.d./ft2 r ft2/bdrm) ©8 System type T44 --c-14 Length __4E'7 ft Width ft Gravel below pipe ft Total depths -') i ft Effective absorption area' 7 0 ft2 Monitoring tube Yt/ Depression over field a o Date of adequacy test $%G ov Results Pass ail) k ,9 s S For 3 bedrooms Fluid depth in absorption field before test 1/ in Elapsed Time: of 0 min Final fluid depth Water added L/ 7 gal. New depth ) 9 in. 3 in Absorption rate >= 9 so g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N 0-6- +ti NO - -1 If yes, give date 72-026 (Rev. 01100)` AEURI;k�1I1dUL6IkiI Date installed Size in gallons ccess "Pump on" level at in "Pump off" in High water alarm level at in Datum _1' Cycles tested Meets alarm & circuit requirements E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot %00 t On adjacent lots % 00 "A Absorption field on lot /0 0 ti- On adjacent lots /00 t Public sewer main r 4 Public sewer manhole/cleanout — /A Sewer /septic service line ,15' Holding tank �J fA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 6 Property line Absorption field Water main / 0 �4- Water service line )o Surface water i Drainage N fA Wells on adjacent lots /00 + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ) b " Building foundation i. a s` Water main !y 19 _ Water Service line /o I Surface water / 00 Driveway, parking/vehicle storage 0 Curtain drain 11 4N k NJ N!✓ Wells on adjacent lots 100 /4 F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and T! �wr review of Municipal records that the above systems are in " ' conformance with MOA HAA guidelines in effect on this date. .1.. 9 1 ROBERT C. COWAN • Engineer's Printed Name R 6l r-, ,s- C , C�wg.� �c�s1.�L CE -8801 Date �I/G A0 HAA Fee $ 5 Ua ^ " Date of Payment 9 Z 7/0--i-) Receipt Number �� �l Sti5 72-026 (Rev. 01/00)' Waiver Fee $ Date of Payment Receipt Number f 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 l.D.# 05106382 HAA# 1. 'GENERAL INFORMATION Complete legal description Lot 1, Chandelle Acres Subdivision Location (site address or directions) Property owner MM&M Contracting Day phone 688-1236 Mailing address P.O Box 670495 Chugiak, AK 99567 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: Three 13 ) 3. TYPE OF WATER SUPPLY: Individual well XX 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. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Anderson Engineering Phone 563-7155 Address Engineer's signature 6. DHHS SIGNATURE v Approved for Disapproved. By: �e� bedrooms. Conditional approval for Additional Comments UITIC Date 10/21/97 PA, own Al 8 bedrooms, with the following stipulations: Date �2" The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (Rev. 1/91) Beck MOA #21 Municipality of Anchorage RECEIVE D DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 4 -47g� 2 2 1997 825 L Street, Room 502 • Anchorage, Alaska 99501 a (907) 344 Municipality of Anchorage Health Authority Approval Checklist Dept. Health & Human Services Legal Description: Lot 1 , Chandelle Acres Parcel I.D.: 051 06382 A. WELL DATA Well type Private Log present (Y/N) _ If A, B, or C, attach ADEC letter. ADEC water system number Y Date completed 4/97 Total depth 112.2' Cased to 1 1 2 .2 ' Sanitary seal (Y/N) Y FROM WELL LOG Date of test 4/97 Static water level 85' Well production 3 g.p.m. WATER SAMPLE RESULTS: Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Coliform 0 Nitrate .1 mg/L Other bacteria Date of sample: 10/13/97 Collected by: Alan Harala B. SEPTIC/HOLDING TANK DATA N Y 2' Date installed 7 18 / 9 7 Tank size 1 .0 0 0 Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) N Date of Pumping New Pumper Construction C. ABSORPTION FIELD DATA Date installed 7/10/97 Soil rating (g.p.d./ft2 or ft2/bdrm) • 8 System type Wide Trench Length 57' Width 51 Gravel thickness below pipe 4 ' Total depth 6 ' - 7 .5 ' Effective absorption area 570 SF Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test New Const. Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test (in.); Immediately after gal. water added (in.): Fluid depth (ins) Minutes later: Absorption rate = g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION None on Lot Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot >100' Absorption field on lot >100' "Pump off" level at* On adjacent lots >100' On adjacent lots >100' Public sewer main Miles Public sewer manhole/cleanout Miles Sewer/septic service line > 90' Lift station None on Lot SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation > 5Property line >51 Absorption field > 5' Water main/service line >20' Surface water/drainage >100' Wells on adjacent lots > 10 0 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line > 10 ' Building foundation 71 Water main/service line >20' Surface water >100' Driveway, parking/vehicle storage area See Letter Curtain drain None on Lot Wells on adjacent lots >100' F. ENGINEER'S CERTIFICATION 1 certify that i have determined thru field inspections and review of Municipal re If t " in conformance with MOA HAA guidelines in effect on this date. •s Signature ; Engineer's Name Michael E. Anderson, P.E. tF, r •. Date I -4/4-2, HAA Fee $ l`� (> Waiver Fee $ Date of Payment 1 C�i a� `11 Date of Payment Receipt Number �;�14A16 Receipt Number 72-026 (Rev. 3/96)* systems are MEMORANDUM DATE: October 21, 1997 TO: Onsite Services Engineer FROM: Mike Anderson, P.E. SUBJECT: Lot 1, Chandelle Acres Subdivision Septic System As -Built A portion of the absorption trench serving Lot 1, Chandelle Acres Subdivision was constructed within 10' of the foundation of the house on the lot. It must be noted, however, the foundation at this location is for the garage and is completely backfilled to the level of the floor slab. There is no crawlspace in this area and no danger of effluent migrating into the foundation. We therefore. request the trench be allowed to encroach within 10' of the foundation at this particular location. The absorption trench also encroaches into the driveway on the lot. The trench is insulated in this area and in no danger of freezing. In addition, both the cleanout and the monitor tube have been encased in cast iron valve boxes for easy access. The lot is crossed by overhead powerlines which limit the area for driveway access. We therefore request the absorption trench be allowed to stay in the driveway area.