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HomeMy WebLinkAboutFIRE LAKE LT E-2Fireloke Lot E2 #051-333-47 ~iUNICIPA]',[TY ()F ANCHOI{A(', Fourth Floor West: 825 L StFeeL Anchoraqe, Alaska 9950 INSPECTION REPORT ON-SITE ~;L:WAOE OISPO.~AL .S "( $'f f /',~, IN% D : [ [N(:III lt,%It'~{ '¢/l{)]ii (lc),ll , fit P/f{ t !C)tJ[{)CAPACIIY/(~'¢--'~q/\f TItf DRAIN [)I'.;[/\N(tl f ROM ION NI A Iq t,1 t C,I l OF I Iq # of Lines I)lhl ,,'\N('.'[ fei l'¢,q_i il [ If'~f.5 IOH Alii A lOP (if Ill f l() t Irll:¢t Gib~{)[ L'All RIAl llt NI Atlt [)btM[ [[ It .... ()R V/If]ltl l~ Log Crib Rings tRJILDIN(.; [OLJI,I[)An/ION Crib Size: Nf Alit 51 . IN /~l}O',/l [II [ AI:',C)Iit'IION /tilt /~ 'W/\f.L Al!! A 5(,~ I I Well Class: Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Material. s: # of Bedrooms: Installer: Remarks: GRE/,~.,:R ANCHORAG[ ARIA BOROUGH DEPfi~THENT OF ENV~RONMFqTAL QU~L[TY 3330 "C" Street ANCHORAGE, ALASKA 99503' Cas e // 3 5~. 7-- 9-- 10-- 12~ 13-- Performed For ~z,~4/~o ~e/o~l~ ~' Dated Performed Legal Description: ,k.~4T~c%~~ ~ Subdivision ~i~m' This Form Reports Soils Leg_ ~. Percolation Test__ Soil Tes( Hust Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics Was Ground Water Encountered? 'If Yes, At What Depth? Date Reading Percolation Rate 6ross Time Net Time Minul:e Proposed Ins~]]-~i-6-d: Seepage Pit Drain Field Depth of Inlet ..... ~_[_ ....... Depth to Bottom o-~--Pit or Trench- COHMENTS:___~:__~.~ ~'-,~-z_ z_,~ ~z~__~r,,/~(~- Test Performed BY._W~/z.~ ~-wm~m~-~m .... Date Cer'Lified BY: PIF'PL. 1CPIN f I... OC:I':I'I 1 t_.E.L~iFIL, !:iE:bd:'IFIRD B I ENEK. FIRE LFIKE SUB MLISHINN MOTEL,. ;'~'.i"12~'8 L..L)'I 5:[ZE 27';'~' 45.54 1;~801::;JO SIJ~UFIRE FEE'T' . tYF'E OF SOIL FIBE;ORBIlON S"r'E;I'EM I$: "fB'.ENCH I"IFI,'.':;:[I"IIJM 1"41JMt3E~I~ UF [3E[;'~OOMS = 4 SOIL, RFI'I I NI] I'HE I~.fLO}.!LJ :[ RED SIZE: OF THE SOIL FII3.',SORF'TION S't'$"I'EM 15: file I....L::N~3'I'FI D:[MEN$10N IS THE LENGTH (IN FEE'T.:, OF' 'T'HE I'f~tENE:H OR DF,'FIINFIEL..L). 'IHE DEPTH OF: FI 'T'RENC:H OR'. I:::':['1' :[S ]'HE: D1S'I'HNE:E DEl'NEE]"4 THE '.':;UP:'.FFiC:E OF 1HIE EiROLIND FIND 1HE BO"I'I'OM OF T'HE EACFIVFI"I'iON (:[N FE:.E'I"). THERE :[5 NO SE'I 14ID'IH FOR TRENCHES. file 13RFIVEL.. DF.:.F'I'I-~ :[E; THE M'[NIMUM DEPTH OF 131~.FIVE'.L.. BETI4EEN THE OU'TF'FIL. L.. I:IN[) '1"HE E,.]'T"iOM OF' I"HE E',>:;CFIVFYf'TON (:[N FEE'T). .................................... F' I:1 Et i--:: Ft (3 E F" IL f:t N -I ILt F' '1" ~ C~ " ..... :[N_,[HLLE.[. FIT THE PERMi'TTEE"S OPTION '~IBJECT TO ']'HE FI F'l:it]k:Fi(JiE FL..HNI I'"IFI'Y BE *' ';: ....... :'", F: OLI..OH I NEi :].. E.:[II"'IEN. FI ..LH.':,.~ ]. OR :[ I i"I~.~F FIPPRO",/E:IL) PLRNT' MFI't' BE INf:";"I"FILI-ED. 2. FI CON'I'INUOL.LS MFIINT'ENFINCE FIGREEMENI" IS I~',EQU:[RED. :[F' ~ MFIIN'T'ENFINC:E FIGIA'.EEMEN'f' :[ii; NO'f' KEPT CUt~RENI' "~OU MI:IV BE REQLIIRED "[O ENLFIRGE THE SOIl .... FIB.E;,OR'.PTJON S't".~;].'EM FIND,'"C~R "r'OU MFI't' BE SUBJECT TO PF.:O%ECU'I"ION. ...................... 1'" L-J (L~ .:,': ~_::? ::::, I r-,I ~; F" E: I-Z: '1" ][. C~ N S !::t F-' IE: R E: t;J IJ BFICKF:[ I..L. :[ Nt3 ;OF FIf.,IY '.:.:,'~'S'T'EM Id :[ THOLJT F I NF:IL :[ NSPECTT ON HND FIPI:'ROVFIL DEF'FIR. T'I~IEN'T' .id :[ LL BE E;UB,] EC'T TO Pf~OE.;EC:UI" :[ ON. ~',fHN ..E'. E, E I HEE. hl FI IdELI... FIND I::lN"d ON-SII'E :,EHHI:iE D:[_,FO_,HL .. r_ I Etl M:[N:[MLII'I [):[" ............... ' .............. ' ,. ............. ,:' ',",:: .... tO0 F'EIEI' FOR'. FI PR'.:[VHI"E HELL (::iR 200 FEET FOE.: FI PL.IEIL:[O I.,.IEI_L LOC:iS FII4'.E REgIUIRE:D FIN[) MiJSI' BE RETUI~'.NED '1"0 T'HE DEPI::IR'T'MEN'T' Id:['I"HZN 7".':0 Gl:: 'T'HE I.,IEI-L COMPLE"I'ION. 01HEI'~.: REQUIF..'E:MENI'S MFI"r' FIPPL"r'. .'E;PECIF:[CFIT':[ON$ liN[:) CONSTRI..IC'fIOI',I FIVFI:[LFIBLE "fO INSUR:E PN'.OPER :[NSTFIL:[.FIT'ION F" E~~: R I~1 ]: 'I" E ;~: F~ :[ R IE: .ES I) I£E: 12:F..2 Ir-1 B E t~.". :3'.:: :."L .. ::.IL.. 9 ] CER'I":[ F"t' 1' HFI1 .,EWER_ FIN[) IdFZLL_ FIS E',E'T' i: I FIM FFIMI:[..IFIR Idll'H 'I'HE REg!UIREfIENT'S FOR ON-SITE c ........ ,c .... ,% F:'O[~t'IH BY THE MLIN i C: I PHI.** I "I"V OF BNCHO~'.RGE. 2'.: I IdlL. L IN$'T'~LL. THE '.S't'STEM IN RCCORDRNCE IdlTH ].HE CODES. UN-:,I 1E. SEIdER ~:' ........ ' .:;: :[ LINI:.:,EE'.SI'FIN[:, 'I"HRi" THE ~ ' ..... _,~STEI1 MRS' REQUIRE ENLRE:GEMEN'T IF' "FHE RES:[[)ENC:E :[S REMODEL..E[) "fO INCI_IJDE MORE T'HRN 4 BE:DROObl%. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DVVELLING Parcel I.D. 051-333-47 1. GENERAL INFORMATION Complete legal description FIRE LAKE LOT E2 Expiration Date: 7- /L//'_// Location (site address) 14614 FIRE LAKE DRIVE, EAGLE RIVER, AK 99577 Current Property owner(s) JOHN & ~ENNIFER HOWARD Day phone Mailing address PO BOX 1020, GROVELAND, FL 34736 Lending agency Mailing address Day phone Real Estate Agent Mailing Address Day phone Un~sso~e~isereques~ COSA willbeheM~DSD~rpi~. 2. NUMBER OF BEDROOMS: 4 3. TYpE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well ~-ubiic Water System TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a pdvate 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 engineer'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 Certificate of On-Site Systems Approval Guidelines for this application,. shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further vedfy that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 04/08/2011 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regUlations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to.subsurface conditions that may notbe Observed from the surface, changes inland use, local soil characteristics, groundWater levels that may fluctuate dUring the' year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a ' ' ~~.'..'. system will function satisfactory for current or future ~~...~....!..,.~...~i~~ !'' i.~"-'ii..:~!~.... occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. DSD SIGNATURE ~:. ~-~ .... Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: '¢ -/ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & WasteWater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: FIRE LAKE LOT E2 Parcel ID: 051-333-47 A. WELL DATA Well type ~ATE.IfA, B, or C provide PWStD # Well Log (Y/N) ~ Date completed 12./26~977 Sanitmy seal (Y/N) ~_ Wires properly prOtected (Y/N) ~ Total depth 125 It. Cased to ~0 It. Casing height (above ground) 1.8 in. FROM WELL LOG AT INSPECTION Date of test 12/26/1977 3/31/201_1 Static water level 20 It. 24 It. Well production 7.0 g.p.m. 1.1.3 g.p.m. WATER SAMPLE RESULTS: Coliform NEC; colonies/100mL Nitrate 5.99 mg/L Arsenic: ND rng/I Date of sample: 3/31_/201_1. Collected by: AzcTezza B. SEPTIC/HOLDING TANK DATA Tank Type/Material S'el~c,/~ibe~ass Date installed 1~978 Tank size 17,~0 gal. Number of Compartments _2 Cleanouts (Y/N) _Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N' High water alarm (Y/N) N Date of pumping 3/31./1.1 Pumper l'Rs C. ABSORPTION FIELD DATA Date installed ~/1.978 Soil rating (g.pld./ft2 or ff2/bdrm) 1.50 System type T~each Length 39 ff. Width --3 ff. Gravel below pipe 8*ff. Total depth 11..4 ff. (Measured 4/5/11) Eft. absorption area 63~ It2 Monitoring tube _Y Depression over field N_N_ Date of adequacy test ;/5/2011. Fluid depth in absorption field before test ~ Elapsed Time: 1.350 min. Final fluid depth Results (Pass/Fail) Pass For 4 bedrooms 32.4 in. Water added 950 gal. New'depth 78 36 in. Absorption rate >= 600+ g.p.d. in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N__lf yes, give date-~- D. LIFT STATION Date installed "Pump on' level at ~ Datum in. E. SEPARATION DISTANCES Size in gallons "Pump off' level at Cycles tested in. Manhole/Access (Y/N) High water alarm level at in. Meets alarm & drcuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot loo'+ Public sewer main ~'+ Sewer/septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding,tank Ice'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line $'+ Absorption field 5'+ Water main 1.0'+ Water service line 1.0'+ Surface water 100'+ Wells on adjacent lots 1.00'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line lO'+ Building foundation 10'+ Water Service line 1.0'+ Surface water 100'+ Curtain drain 50'+ (None Known) COMMENTS Water main 10'+ Driveway, parking/vehicle storage Wells on adjacent lots Z00'+ 10'+ G= Measurements taken show monitoring tube depth to be in the top 6.5'+/- of the effective depth. Septic leachfield is operating in the top one-half of the effective depth. I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name ~KF. NNF. T[-[ M. DUFFO$ Date 4/S/2011. COSA Fee $490.00 Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number (Rev. 11/05) Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # 111105 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot E2 of Fire Lake subdivision. This inspection revealed a nitrate concentration of 5.99 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. SGS Ref.# 1111171001 Client Name ArcTerra Engineering and Surveying Printed Date/Time 04/06/2011 9:35 Project Name/# Fire Lake Lot E2 Collected Date/Time 03/31/2011 13:45 Client Sample ID Fire Lake Lot E2 Received Date/Time 03/31/2011 14:15 Matrix Drinking Water Technical Director Stephen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 03/31/11 04/04/11 NRB Waters Department Total Nitrate/Nitrite-N 5.99 0.100 mg/L SM20 4500NO3-F B (<10) 04/01/11 AYC Microbiolog~f Laboratory E. Coli Total Coliform Negative 1 100mL SM20 9223B A 03/31/11 DLC Negative 1 100mL SM20 9223B A 03/31/11 DLC 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. 051-333-z~7 1. GENERAL INFORMATION Complete !ega. I descript!on, lmt Location (.,site ~ddre, ss o.[ directi~n;),'~ Current PrOperty owner(s) Mailing address Lending agency Mailing address HAA# Expiration Date: 1~1~ P{r~ f.qko Bt, Dan Claugus Day phone PO Box 771971 ~agZe Rtve~ A[ 99577 Day phone Real Estate Agent Mailing Address Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well [] [] [] TYPE OF WASTEWATER DISPOSAL: Individual On-site ~ Individual Holding tank .[--I · Community On-site [] 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 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 oi' 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 vaIidation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of 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. NameofFkm S & S Engineer'lng Address 17034 N. Eagle River Loop Ste. Engineer's Printed Name ~'d//_/,~ [,(,/,/_//',~/~44~. bedrooms. DSD SIGNATURE Approved for t~ Disapproved. Conditional approval for 204 Phone 694-2979 Ea~,le River, AK 99577 Date x -'~ ,, . .~ · C0laK. Wzlh~S ,~ ~ ,~ .. ...... .[%~-- bedrooms, with the following stipulations: Additional Comments Note: The nvell for thls property meets existing State and Municipal Codes. There are nitrates present. It is suggested that periodic testing be performed to insure the wells continned sultabili .ry. Current nitrate concentration is 6.69 rog/1. EPA maximum concentration is 10.0 mg/l. More information on nitrates is available from the On-Site Services Program, at 343-7904. Attachments: HAA Checklist Septic System Advisory Well Fi.ow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: '7 "~ ~ - 0.5" Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907) 343-7904 Legal Description: HEALTH AUTHORITY APPROVAL CHECKLIST' LoT F_..~'~ I~"tcz~ ~ ,%/t~ ParcellD: A. WELL DATA Well type~.VRT~' If A, B, or C provide PWSID # __ Date comp,eted ~Z,,/'~,~,/~-~ Sanitaryseali~N)~'~ Total depth [ 7--.~,I ft. Cased to I~~)f ft. FROM WELL LOG Date of test Static water level ~ f ft. Well production t-~. (~) g.p.m. WATER SAMPLE RESULTS: Well Log(~) Wires properly protected (~N) Casing height (above ground) I ~ ,I in. AT INSPECTION 0 ,,, ~:~~''~ g.p.m. Coliform ~ colonies/100 ml. Nitrate ~,,~,~'mg./I. Arsenic: '~ mg./,. Date of sam pie: ' Z'/I/'*/O~ B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size l'?.~O gal. Number of Compartments Other bacteria __ Collected by: D colonies/100 mL / Date installed Cleanouts (~_/.N) '~ Foundation cleanou~N) ~¢--'~ Depression over tank (Y(~ ~ Date of pumping C. High water alarm (Y~) ~ ABSORPTION FIELD DATA Date installed t /~, Length '~ ~ II Total depth I [ Date of ad~uacy test Fluid depth in absorption field ~fore test ~ Water added ~al. Any rejuvenation treatment (past 12 mo.) ~/~ ~) Soil rating (g.p.d.lft~(~ [.~O System type ff. Width ,.~ I ff. G,rawI below pipe ~ t ft. Eft. absorption area ~'~ ft= Monitoring tu~ ~ Depression over field New depth Absorption rate >= 1~5(~-{- g.p.d. If yes, give date '- D. LIFT STATION Date installed Size in gallons 'Pump on' level at in.~ in. Datum ~ Cycles tested E, SEPARATION DISTANCES High water alarm level at in. Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ~ OO ~- Absorption field on lot I~ I ~ Public sewer main ~ I~ Sewer/septic service line :;2..$ ! ~- On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HCLD;NO TANK ON LOT TO: Building foundation ~ (Jr- Property line .~ I.{ Absorption field Water main /~) I.~ Water service line I~;)/'~'' Surface water Wells on adjacent lots t ~) I'F SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /~.) t ./_ Building foundation ~) I.~_Water main ' JO ~ + Water Service line I~) f.~ Surface water I ~) ('~' Driveway, parking/vehicle storage Curtain drain ~' K-~.~ Wells on adjacent lots ! ~ I'lL 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 lhis date. Engineer's Printed Name / HAA Fee $ Waiver Fee $ Date of Payment Receipt Number (Rev. 12/01) Date of Payment Receipt Number Municipality of Anchorage Development Services Department 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 # 030663 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block , Lot E-2 of Fire Lake subdivision, the well's productivity was determined to be 0.75 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4-bedroom residence is 0.41 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. ASBUILT ..... I HEREBY CERTIFY .THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SI4OULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SCALE~, DRAWN --ME, lARD & ASSOCIATES LAND-SURVEYING 694-08. .~.~-. ........ ,~.o~ ;~." ~".Y+ t. ~'~ '... ..' ~' SCS Ref.# Clleu! Name Project Name/~ Client Sample ID S.m~ple Remarks: 103'/962001 S & $ £ng~.eering LE2. Firelake S/D LE,2. Firelake S/D Dr~klng Wa~er Alt Dates/Times are Ahska Stsndard Time Printed Date/Time 12/17/2003 16:28 Collected Date/Time 12/16/2003 1.5:30 Received DattITIme 12/16/2003 17'.23 Allowable ~ Analysis Resvlts ]~L Units Me.od Contain~ iD L~mlt~ Oste D~e Inlt Wate=s Depa:=t~en~. Nitrate-N 6.69 0.100 mg/L EPA 300.0 B (<=10) 12/17/03 J.rl3 PRELIMINARY - 1" = 50' PIPE LOCATIONS 20' UTILITY EASEMENT 0 0 SITE-PLAN CIRCLE 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.a nchorage.ak, us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ~) ~''1 -33,T -w7 '1. GENERAL INFORMATION Complete legaldescgpfion '. ,.Lbt' E2; Ftrelake Subdivision address 6rdirections) 14614 Fir~ake Dr. Location (site Current Property owner(s) Mailing address Lending agency Dan Claugus PO Box 771971 Day phone 694-4540 EaFle River.AK 99577 ' Day phone Mailing address RealEs~teAgent ' T,'lndn T,~,,,..4.~ I P~'.,-l~.nt'lnl Dayphone 27'i-77q1 Mailing Address Un/ess otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: ' Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: ~] Individual On-site [~  Individual Holding tank Community On-site '. [] ............. [] ......... Public Sewer · [] ........ The Municipality of Anchorage Development Services Depad~'nent (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 ara valid for 90 days from the date of Issue for properties served by a private er 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 ara valid for one year for properties served by Class ^ 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, I verify.that my investigation, based on procedures outlined in the Health Aufhodty Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(am) safe, functional and adequate for ~he number of bedrooms and type of structure indicated heroin. I further verify that based on the information obtained from the Municipality of Anchorage flies and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(am) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. NameofFirm S & S Engineering Address 17034 N. Eagle River Loop Ste. Engineer's Printed Name Robert C. Cowan Phone 204 Eagle River, Date 694-2979 AK 99577 Requesting conditional }{AA due to inaccessibility ...-~-_.-.-.-.-.-.-.-.-.-~., ~. of lot for purposes of monitoring Monitoring tube will be installe~%~OEa~;~n - '~ .' '~Cd .... ~ ~ '.. · · ........ ~prov~ for ~moms. =~ . PROG~M :_ c ~?[~% CE SS01 ~ ~. X Cond~onal approval for 4 ~rooms, ~~g stipulations: Money fn tSe'a~$u~f of $15,000.00 shall ~e p~ace4 wa~tewater' s__ .ys~em', ~.~suafft · to the deSi~n.b~.S & .~-- es~%b~':~ha11-not be 'released until this office has tiven final approval. Placin~ a monitor tube in existin~ drainfield and a successful adequacy test may be accomplished in place of buildini a new wastewater system. AdditionalComments Note: ~e well for this property meets exittinl State and ~uaicip~l Codes. There are nitrates present. It is sugEested that periodic testing be performed to insure the wells continued suitability. Current nitrate concentration is 6.69 me/1. EPA"maximum concentration ~n lO.O me/1. More information on nitrates is available from the On-Site Services ?rogram, at 343-790~. Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory , Supplemental Engineer's Report Well Flow Advisory Other * All work on this conditional shall be accomplished no later than June 15, 2004. By: .~~//. ~'~ OrigMal Certificate Date: Municipality of Anchorage Development Services DePartment Building Safety Division O~-Site Water & Wastewate~ Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.cLanchorage.ak.us (9oz) HEALTH AUTHORITY APPROVAL CHECKLIST WELL DATA Well type~ If A, B, ~ C provide PWSID # Date completed (~_~F_~-~ / ~ ~ Sanitary seal (Y/N) Total depth I'~' ~" fl. Cased to ~"D lt. Well Lng (Y/N) Wires properly protected (Y/N) Casing height (above ground) / ~ s in, FROM WELL LOG Date of test [~,/2~ /~' ,' I Static water level ~ r ft. Well production ~-._. ~ g.p.m. AT INSPECTION O- :~' g.p.m. WATER SAMPLE RESULTS: Coliform (~ celonias/100 mL Arsenic: '-- mod. B. SEPTIC/HOLDING TANK DATA Co Nitrate ~'. (~ f mg./I. Date of sample.'i~L~ ~ bacteria O colonies/100 mi. Coaecled by:. Tank Type/Material ~$ Date inelalled ~ Tank size t~.~"b gal. Number of Compalmeflts ),- Cleanouts (Y/N) Foundation cleanout (Y/N) '~/ Depression over tank (Y/N) ~ High water alarm (y/N). Date o, pumping rz. 141 3 Pumper ,~-~ ABSORPTION FIELD DATA Dale Installed ~ Soil rating (g.p.d./~ Length '~ ~ It. Width '~ ft. Total depth I ( ft. Eft. absorption area ~'~ff= Monitoring tube Results (Pass/Fail) Date of adequacy test / Fluid depth in absorption fiel~/l~efore test in. Elapsed Time: min. /Final fluid depth Any rejuvenation treatment (past 12 mo.) (YIN & type) Water added in. Absor; System type '~/~--¢-,~¢ Gravel below pipe Depression over field For bedrooms g New depth in. )tton rate >= g.p.d. If yes, give date "'"" D. LIFT STATION / Date installed "Pump on" level at__/_ in. / Datum E. SEPARATION DISTANCES Size in gallons 'Pump off" level at in. Cycles tested. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? JR. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/ltf~Me~n on Iol Absorption field on lot Public sewer main AJ / ~,~ :~-w,,r/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOt'D~G TANK ON LOT TO: Building foundation ~ ~ Properly line ~' ~ % Water main ( I~ ~ ~ Water se~ice line t (~) 4. Wells on adjacent lots ~ O~ ~ '¢ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line ~ O ~ . Water main .¢-' Building foundation ~ O ~- Water Service line IO~ Surface water ~ ~3 g:2 Curtain drain/delE K~I o ,.~ ~ Wells on adjacent lots Absorption field ~ ! "" Surface water ~)t~ D~iveway, parking/vehicle storage lOG I0 I,. 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'sPrintedName I~ 0 ~3~,~ ~- ~ ~ Date ! ~ / ~ :7/0 .~ HAAFee $ '~'7 -"e"' '~ Date of Payment Receipt Number (Rev. 12,~01) Waiver Fee $ Date of Payment Receipt Number ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. December 22, 2003 CML ENGINEERS (907) 694-2979 FAX (907) 694-1211 Municipality of Anchorage Department of Health and lluman Services P.O. Box 196650 Anchorage, Alaska 99519 REFERENCE: Lot E2; Firelake Subdivision Request a conditional llealth Authority Approval be issued for thc referenced property. The existing septic system cannot be accurately tested, due to a lack of monitoring tube. Topography of the lot and snow depth/weather conditions do not allow access to the existing leachfield to install a monitoring tube in the septic system. There are no indicators that the existing septic system is in failure. The system has passed prior testing. Because of our request of a conditional I IAA, the following information is provided: Based on soils logs for the referenced and surrounding properties, we estimate the soils in the area to be rated at ~0.8 gpd/fl2. We estimate the cost for a new septic system, including the tank, to be approximately $8500.00. Duc to restricted access to the property for monitoring tube installation, we also cannot access the property for test hole excavation. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/hlm 17034 NORTH EAGLE FINER LOOP * SUrE 204 · EAGLE RIVER, A~S KA 99577 le'~O B El:~f C. COWS. N, RE. FtOBERT A. SHAFEP,, RE, January l9,2004 CMLENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCIIORAGE Department of I lealth and I luman Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot E-2; Firclake Subdivisiou In response to your concerns regarding posslblc placement ora new septic system for the above referenced property, please see the attached site plan for visual reference. We believe there are several obvious places on Ihe lot in u, hich a new seplic system could be installed with the aid ora lift station. One likely location is shown. Request you issue a conditional Il.A.A. immediately based on the previously submitted mitigating circumstances. Ifyon require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/ts 170~4 NORTH F. AGLE RfVER LOOP · SUITE 204 · EAGLE FT~V~P,, ALAS F,A 99577 DESIGN 20' UTILITY EASEMENT SITE-PLAN CIRCLE II 0 II ~ ,,,~1co [.~ © I , ' Municipality of Anchorage Develo~nt Se~tces Depm'tment Soils Log - Percolation Test t,~: /-07' ~-;)._ ' F It~.Lft*c~- g/~ 8- 9* 10- 11. 12- 14- 17.I Date ~ T~a Ret T~ ~ to Waler Nat ~ 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 (~07) 343-7~04 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Bob Cowan Legal description: Fire Lake ~t E-2 The attached paperwork has been reviewed and Is being returned for the following reasons: Original signature or stamp missing on Calculation error in design. ~ Additional soils information needed. Need test hole and contours to confirm en eltemnte · is available. Water monitoring resulta inadequate. Disa'epancy in information .eu.bmitted. Topographic information mlss,ng or inadequate. Incomplete; mi. ssi. ng · ~ Incomplete; mlss,ng Additional adequacy test information needed.  Water sample unacceptable. . Measured/pmpos? distances/dlmens,ons missing. DD Locations of all so,Is, percolation and water monitoring tests not shown. Proposed system too deep for soils information submitted. Well log required. Omission in narrative. .. D[~ Insufficient fill over tank or field. Other. · · Name of reviewer: Self Poet Date: 12-~0-0:~ Please supply the necessary information and re-submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D.# 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) LOT E-2; FIRE LAKE SUBDIVISION Location (address or directions) 14614 Fire Lake Road (b) Property owner Mailing Address (c) Lending Institution Mailing Address Telephone: (home) ~9/~-.~)91 Business 14614 Fire Lake '"'~""~";~'~ Eagle River, AK. 99577 Telephone (d) Real Estate Company and Agent Address Telephone ordered by: Clyde Laws 696-5291 (e) Mail the HAA to the following address: (or check here)l~ if hold for pick up.) List contact person and day phone number below: r S & S ENGINEERING 17034 Eagle Rl~er Loop Road Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Number of bedrooms __,,~'~ Single-Family ~x 3. WATER SUPPLY Individual Well Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site,~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of th is Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone d ~Y'-~ 17034 Eagle Ri~,er Loop Road No. 204 Address ...... ' ............ Date , //, §. DHHS APPROVAL ~pprbved for :_~_Z/ bedrooms by Approved Disapproved Terms of Conditional Approval N'bt,e: Conditional Date The well for this property meets existing State and Municipal Codes. There are nitrates present, however, it is suggested that periodic testing be performed to insure the wells continued suitability. Nitrate concentration is 6.4 mg/1. EPA maximum concentration is 10.0 mg/1. 'I':Vl IL'il The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph $ above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 A. WELL DATA Well Classification RECEIVED Well Log Present ~N) ~.! Date Qompleted MUNICIPALITY OF ANCHORAGE (MOA) Health ,A. uthorlty Approval (HAA) H:^I.u~' OFC'~~ . FEBRUARY 1984 ~:-NIAL ',;] RVJCES OIVI~I(~J3 4744 f~ l~J8~ Legal D~ption: ~ If A, B, C, D.E.C. Approved (Y/N) , \7-/W7 Total Depth ["2.-'~ Cased to ,'~ 14''~ Depth of Grouting Static Water Level '?--'~ Pump Set At Casing Height Above Ground Electrical Wiring in Conduit~.~N) Yield '~,~ "~-' Sanitary Seal on Casing([.~ZN) ""/ Depression Around Wellhead (Y4~I~ t SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ~, c:::~==, ~'-~ ; On Adjoining Lots ~ ~ 1j~ To Nearest Edge of Absorption Field~n Lot ~ ~ I..¢. ; On Adjoining Lots To Nearest Public Sewer Line .~1/~ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot '~'-~ ! Water Sa m pie Collected bY '"~'~ ~'~' ~=I'~ ~~ r"~"l ;Date Water Sample Test Comments B. SEPTIC/HOLDING TANK D~T,~. Date Installed ~/'7~ Size ['Z-~----~c;:~ Standpipes~;~/N) '-/ Air-tight Caps~P/N) Depression over Tank (Y~J:~ Pumping/Maintenance Contact on File (Y/N),,/ Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well \ ~ Ij~ To Building Foundation To.Property Line [ r-~ ~r To Disposal Field To Water Mai~/Service Line To Stream, Pond, ~ake or Major Drainage Course \ ~ J ~"-' No. of Compartments "( Foundation CleanoutCN) /Date Last Pumped \ O ~ '~t --' '~ I'~/'/~ ;for "-- - Temporary Holding Tank Permit (Y/N) 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA / r Soils Rating in Absorption Strata \ ~ ~'"~/~"~" 1-16 Date Installed I /'"~ I Width of Field ~'~ Square Feet of Absortion Area Depression over Field (Y~IS~ Results of Last Adequacy Test Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Presentd[~i:;~l) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ~ ~ ~ To Property Line ~ Jr To Existinrq or Abandoned System on To Building Foundatil~-- 1 ~ - Lot /~ ; On Adjoining Lots TO Water Main/Service Line ~.~::~ t_¥ ~.1//%/ To Cutback (if pfesent) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D, LIFT STATION Dimensions Date Installed Size~s "Pump On" ~~ High Water Alarm Level Tested for Meets MOA Electrical Codes (Y/N) Comments Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date MOA No. S & $ ~NGINEERING 17034 Eagle River Loop Road No. 204 El. ",¢ / / 7o, 0¢ Receipt No, Waiver Fee: $ Date of Payment Receipt No. Date of Payment Amount: $ 72-026 (Rev 7/88) Back Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92.0040440 ANALYSIS REPORT BY SAMPLE for Work Order ~ 17854 Date Report Printed: OCT 30 89 @ 13:47 Client Sample ID:LE-2 FIRE LAKE PWSID :UA Collected OCT 26 89 @ 15:10 hrs. Receivad OCT 2? 89 @ 11:00 hfs. Preserved with :AS REQUIRED Client Name : S & S ENOR Client Acct : SNSENOP P,O,t NONE RECEIVED Req # Ordered By : R.D.J. Analysis Completed :OCT 27 89 Send Reports to: Laboratory Sup~r.vi, eo~.j_,%~EPHEN C. EDE 1)S & S ENGR Released 8y :~ ~. ~ 2) Special Instruct: Chemlab Ref #: 8276 Lab Smpl ID: 3 Matrix: WATER Allowable Parameter Tested Result/Unit8 Method Limits NITRATE-N 6.4 ~/1 EPA 353.2 10 Sample ROUTINE SAMPLE. SAMPLE COLLECTED BY R.D.J. Remarks: 1 Tests Performed ' See Special Instructions Above UA=Unavailable ND= None Detected "See Sample Remarks Above NA= Not Analyzed LT-Less Than, GT=Greater Than MUNICIPALITY OF ANCHORAGE MUNIr:IPAI.iT';' ()F ANCtt¢iF~A(~Ii DEPT. O,' [[~L'['ll ~ {~' ;' FNVIIt(}NM{:N~AI CNGINEEt]ING DiVI~;H.)N [)~0 ~ 1978 REQUEST FOR APPROV/i ~ (:,h INDIVI,)L~At. WATFR AND SEW~R~I!.I~,~~ I, P~IOP~WI'Y OWNER MAII_IN(] A[.]bR,~:o,, ~1~[ ~ ~1~ / ........ ~.- ]r(':~ f~]T: ..... LEGAL DESCRIPTION STREET LOCATION SINGLE F~MI LY Two F iw ~ INDIVIDUAl.* ' AT!-A('.ItWI:I.I {OG, Awelt k~gisr~xtMred fo~ ,:H w<flis i'Ll COMMUNI FY d:~c:: .hum ]g/5, For wells drilled prior to that d~:th ~live .,}1 PUBt. IC UITIL ITY dplh (.:U,Ich lt~] {! Iwtih]hlel) 8, SEWAGE DISPOSAL SYSTEM {~ INDIVIDUAll't)N.FI~I:'' L~ :~ PIJBLIC{ITII.iTY NOTE: THE INSPECTION F:EE MUS'I ACCOMP/XNY FACII RFQUEST BEFORE PROCESSING CAN fie INii 12-0t 0(3/78} DA l ~ I iNslq_ c i'i u :~ I L)A1 [ · 'Ii: OF PIESIDENCIt NUN'If]IER OF I]l-~l)l~OOIVi~ :;ih],~l E FAMILY I , ONE ~ I'HREE ] FIVE [~J ()THER M, UI..'flI~Lt: FAMILY ~ I-WO FOL/R [ ', SIX P?[~MIT IFH~IVI DLIAt. I)EP IH OF WFt t. ~ ',OMMUNI l'Y ................................ : 'i .Wv;I{ I)ISPf)S/NI. SYS fbiM I I'I'liN'll l' NI;MRI I~ ',q iii:: :ti,~l~ Vet [fi(xl L INS!Al I EI~ ' ,',,'~1':. MANU[:ACltliM M ~ - ,vi:Il lo- j J ~I:'Ptl()V [23 FOIl I C('INI.)I I'IONAI APPI'X)VAt_ (h!th'l rnu~;t mx !)mi)mW (:o! lifit:ate) i