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Home My WebLink AboutT12N R3W SEC 24 W2NE4NW4SE4 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~----~0 QI'~ PID Number: ~"~ \ ~L~ _ Name: ~'~/{~..[,-'~-~,~4- ~/~,%/,(~4~/~J' WastewaterSystem: ~New QUpgrade ~'~ /~ ~ ~ ~/ ABSORPTION FIELD Phone:.. INo. of B~oms: ~ Deep Trench ~ShalrowTre~ch ~Bed ~Mound ~Other S~il Rating: Total Depth from original grade: LEGAL DESCRIPTION /~/F~ G~/sq.,t. ~ Lot: Block: Subdivision: Depth to pipe bogom from original rade: Gravel depth beneath pipe Township:, ~ ] R~nge:~ ]Sect[on:.~ Filloadded__ above/,¢loriginal grade: Ft. Gravel lenoX: ~ ' Ft. WELL: D New Q Upgrade~ Grave~ ~ ~ ~ [ Numberof lines: Dista~be[weenlines: Classification (Private, A.B.C): Total Day ~ased To: Total absorption area: Pipe materiak ~ Ft. Ft. /~0~ SQ. Ft. ~ SEPARATION DISTANCES ~Septic D Holding ~ S.T.E.P. TO Septic Absorption Li~ Holding =ublic/Private Manufacturer: Capacity in gallons: From Tank Fie~d Station Tank Sewer Lines ~C~ ~ Material: Number of Compadments: Well ¢ (%~ S,,~¢~W,t~r ¢ ~ LIFT STATION L~:te i~ "~0 ~[A ~/~ F/~ Size in gall°ns: I Manufacturer: Cu~ain Drain ~/~ ~ ~,ectrica, Inspections pedormed by: Remarks: ~ ~c¢~ ~ ~¢ BENCH MARK Location and Description: Assumed ~lovation: ENGINEER'S SEAL ,nspections performed by: /~'~*~ Dates:~:s~~_zne i ~"' ~;'~ "'" ' ' of Health and Human Services approval "~ ~ ' Department 72-013 (1/91) MOA 25 ~ermitNo. ~00~ /,..~' P~,ge '~' Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report 72-013 A (2/91) MOA 25 /,,jo o,' 3 i"I I..i N ! C ]: F' (a L ]: T Y (3 I::: ~.t~ N C H ..) I':;; (~ B ~:~ ..... L. 8Lr(:.:.!~t..~ ,./.~rtchc:r~t:le:'.., · '- 9(;~'51.):i. E) N IE L L F' fii: R N l'i:x .,'ii,:,dr.,'::x:x',i!~: ' '['h:i~.~ !::'c-?r,-:~J.'{' ~ 4 'lc)La). Cap,_.'lcJ. t. yi: 4. i~,.ll!iJ._l..~ l.(:)g mt.u!:?. !:m! ~Ld:i)mS.T..t.~.z,d !,.(::! l"lLtnJ, c::i!:)aI:i-'Ly of Firu::hc)ro.!:]l,x, i}r_.-i, par"Lm~.~nt, o{ ail'l cl I li.Uiia'dq c:i~:. ~ v ! ! ~,~ ;i '~'h :i. t'I (i!;() (:[~tyt~i ~:~ { ~l~! ]. ]. i:::c3ir~p ]. ii:~t J. (:Ici ,, ~'~!::'TEF.: (.)F' F" .[ , ¢-} t.[ ...Y IIONIE,, ..... · .. ':, .,,"'"+~'",, I:::V .. ..~: j¥1Lu"J:i.,::::i.l:ia].j.i:,y i:f (4rlChDraC:[O ,1't(.,)¢ ) and 1. System Design,' 4 bedrooms ~ 150 sE/bdt = 600 sf of effective area Absorption Bed = 600 sf x 1.5 = 900 sf bed area Absorption Bed = 24' x 38' = 912 sf of area 2. Reserve area = 4 bedrooms x 1,500 sf/bdr = 6,000 sf 3. Nearest system 'is B1, L2, Sunny Slopes, > 125'from .this system 4. Ail installation will follow MOA regulations for ma'terials installation methods, and inspections. 5. Well site is approximate. Well driller to confirm minimum 128' seperation from all systems PRIOR TO DRILLING WELL. SEPTIC SYSTEM DESIGN ........ :4,o, (NW + SW + SE)l/4 of SE 1/4 of S24, T12N, R3W DATE PREPARED FOR: May 29, 1990 Acreage Systems 8OALE PREPARED BY: r' = so' Kniefel Engineering ~oA CE 90-030 page 1/2 iZ MOJ P L/XYJ do( I'b' TA-~K (NW + SW + SE)l/4 of SE 114 of S 24, T 12N, R 3w page 212 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: ~ 1 '1 ~,A-,,-,0 ~.,u-/~:St..t~,,,.u~/ 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DATE PERFORI Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEPTH? SITE PLAN Depth lO Water Ar[ertL '~ ~,,~,~/~ i~onilering? '"" Date: ! · Reading Date Dross Net Depth to Net Time Time Water Drop __ (minutes/inch) PERC HOLE DIAMETER __ PERCOLATION RATE TEST RUN E~ETWEEN FT AND FT PERFORMEDS : , CERTI TH^TTHISTE TW^SPERFO. EO,N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: 72-008 (Rev, 4/85) STA~'~ O~' ~LASKA DIVISION OF GEOLOGICAL AND GE0~¥SIC~L"SORVR¥S LOCATION OF WELL BOROUGH SUBDIVISI~ BLOCK SEC DIRECTIONS: , /:.1.:/._'.~ C,',~4> ' . MEASURING POINT: ~top of casing ~ground surface ~Dother BO~HOLE DATA Depth Material type and color ~ From To -~:.? :":~ ~ .' ' O' ' '~,~. [ ~-', ,, i~.. ~ ,~,~ SECTION QTRS CONTRACTOR INFORMATION: /:Ii~ !-ll>.:l.:.,l,/-.~ ~',Avl. i-, , ,':, ,.,,: Registered Business Name Signature of Authorized Representative /--/,:l.. ~ ? %~LL DEPTH: Depth of Depth of casing:d STATIC WATER LEVEL: !.,'.~{ __ te METHOD OE DRILLING{:!':~$r rotary' '~cabletoo! :~6the~:" USE OF WSLL:'~domestic ~irrigation ~mohitor pply ~other: % CASING: Stick-up .,:~__ :ft. WELL INTAKE: [] open end ~ perforated Depths of openmngs:_ ~o . Diam: {{~ . .__in ~screened ~op~n hole ft SCP~EEN TYPE: Diam: in SlottMesh Size: Length: ft Set Between] and ft GRAVEL PACK TYPS: Vol~ne used: .Depth to top: GROUT TYPE: Volume: Depth: from ft tO ft DEVELOPMENT METHOD Duration: '-%. :-, ' ,C YIELD: . PUMPING LEVEL AND {k~'~.~i ~ 7 __ft after. ~ hrs purapLn~ ~ ¢~ gpm INTAKE DEPTH: ft Horsepower: Date Pump Installed WATER CHEMISTRY SANPLE TAKEN? [] yes ~no Well disinfected upon completion? PLEASE MAIL WHITE COPY OF LOG WITHIN 45 DA YS TO: DGGS PO BOX 77-2116 . . EAGLE RIVER, AK. 99577-'~ '.- ~- '-:' PAGE 1 OF 1 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 SYSTEM PERMIT PERMIT NUMBER:SW910076 DESIGN ENGINEER:ROBERT KNIEFEL, P.E. OWNER NAME:COULSON GLEN R & OWNER ADDRESS:3301 STARBOARD LANE ANCHORAGE, ALASKA 99516 DATE ISSUED: 5/01/91 EXPIRATION DATE: 5/01/92 PARCEL ID:01535102 LEGAL DESCRIPTION: T12N R3W SEC 24 W2NE4NW4SE4 LOT SIZE: 217800 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS ATE: E--f ?f 3--I- 71 · /~a'-~ MUNICIPALITY OF ANCHORAGE : ;~ "(~'~.~) DEPARTMENT OF HEALTH & HUMAN SERVICES "'~.~/' Divisior~'0f E~vir0nmental Se~ices ' ' On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-665(3 ~ ' 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 01 5-351-02~ T12N; R3W; 'Sec Parcel I.D. # 1. GENERAL INFORMATION Complete legal description 24; W2 ;NE4t NW4 ~SE4 Location (site address or directions) 11900 Trails End-Rd. Anchorage, AK Prope~yowner Robert & Kelle Stinson Dayphone 868-2133 Mailing address 11900 Trails End Rd. Anchorage, AK 99516 Lending agency Uaili~ address Day phone Agent ,~i Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 ~' 3. TYPE OF WATER SUPPLY: Individual well Community well Public water xx NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. .. . 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer xx NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72~)25 (Rev, 1/91) Front MeAnt21 STATEMENT OF INSPECTION BY ENGINEER As certified by 'ny seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approva~ 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 Phone AI.AIJKA WATER & WA~'TEI/VA~ Address ~ONSULTANT8 6901 DEBARR ROAD, SUITE 2B Engineer's signature AHCHO.m~E.. ~?._%~ ~ Date DHHS SIGNATURE ~ Approved for ~_-__ Disapproved. __ Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending 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. Municipality of Anchorage APR 0~ 199~, DEPARTMENT OF HEALTH & HUMAN SERVICESMuNic~PAUTY o~ ANC~J~/ Environmental Services Division ENVIgONMENTAL$1~RVJC/:(~D~i~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist A. WELL DATA Well type Log present ~'N) Total depth ,-~,~ / Sanitary Seal (~N) /' IfA, B, or C, attach ADEC letter. ADEC water system'number . Date completed Cased to ' ~' / FROM WELL LOG Date of test -.~- ~'/ / Static water level ~/-/ Well production ~-~ ~) Casing height (above ground) Wires properly protected <~.~N) AT INSPECT'iON g.p.m. ,,.~, ? g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: ~/~ I/~ B. SEPTIC/HOLDING TANK DATA Date installed .[1 ~ ~o~-~7 / Tank size Foundation cleanout (~¥N) Date of Pumping C. ABSORPTION FIELD DATA Date installed 1] - ~ - ~// Length ~ ~ Width Effective absorption area~ Date of adequacy test Nitrate · .~* 0~7 Kn~//- Other bacteria Collected by: A~]~r' Depression (Y~ ,/k/ High water alarm (Y/N) Pumper Number of Compadments c~ Cleanouts ~/N) Soil rating (g.p.d./ft~orfF/bdrm)J,-~p~-~ Systemtype ~e~ ~ ! Gravel thickness below pipe ~>..z~ Total depth .~. ~ Monitoring Tube present ~i~) / Depression over field (Y/~) //~ Resu, Fa,) For Fluid depth in absorption field before test (in.); ~ Immediately after7¢¢2 gal. water added (in.): Fluid depth --~ra~_. (ins) M~os later:. ~ ] Absorption rate = ~ + .g.p.d. Peroxide treatment (past 12 months) (Y/~ ~on~n6~m If yes, give date bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm~ ~ze in gallons ~ ~Pump on" level at* ~mp off" level at* *Datum ,,~., ~ Absorption field on lot Public sewer main Sewer/septic service line SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ./C'() '/- /DO ¢- Public sewer manhole/cleanout Lift station On adjacent lots /(.~ 'C-- On adjacent lots/~'o~, ~exJ ¢. o. ~ ~//o~ /d-/8h ~ /,//,4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation //-/. 5' /~ C.O. Property line /~ "/- Absorption field Water main/service line Surface wateddrainage /OO ¢- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /~ ../- Sur[ace water lQ .¢- Curtain drain F. ENGINEER'S CERTIFICATION in conforrna~oe wi~A~ ,,,n:s in effect on this date. Signature L-...--~/~/], [I-, %. Building foundation 149 +- Water main/service line ~' '/- Driveway, parking/vehicle storage area ~ / Wells on adjacent lots /~D 7~ d.~."g' HAAFee $. ~ ~ ~'~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* 0?:40 FROg-¢TE ENVI RON~ENTAL CT&E EAvironme~al Servlo~ Inc. Samp]~ Rem~ks: Client Prin~ed Date/Time 04107/99 10:51 Coll,~t~d Dat~/Tim~ 03131199 13:50 Received ~te/T~l~e 0~/31/00 15:15 T~bni~ Die.or: Slephen C. gAP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmentai Services On-Site Services Section P.O. Box 196650 Anchorage. Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 015-351-02 v H~,~,# 1. GENERAL INFORMATION Complete legal description W2,NE4,NW4~SE4; Sec 24; T12N;R3W Location (site address or directions) 11900 Trails End Rd. Anchorage, AK Property owner Mailing address Shirley Coulson Day phone 346-2225 C/O Jack White Real Estate 3201 "C" St. Anchorage, Lending agency. Day phone Mailin. g address Agent Pam Szender/ Jack white Address Day phone 762-5848 AK. Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Individual welt xx Community well Public water If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: individual on-site Holding tank Community on-site Public sewer NOTE: XX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72~25 (Rev. 1/91) F¢ont MOA 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 flies 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 regt&l~tio.ns iD_eff, ect o_n the date of this inspection. Name of Firm ~an~,, ~1~ Phone ¢~ 7¢ ~/? ~ 7320 East C]~ Ad?ess . _ _~:-ZLh // Enginee¢s signature _~_~7/~ '~ 304 ALASKA WATER & WASTEWATER CONSULTANTS, INC IS TO BE PAID $1100.00 AT CLOSING FOR ENGINEERING SERVICES PERFORMED. DHHS SIGNATURE v~ Approved for Disapproved. bedrooms. Conditional approval for bedrooms, with the following stipulati:-- Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The D H HS 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. Municipality of Anchorage J'~0~ · DEPARTMENT OF HEALTH & HUMAN SERVICE~u~,.~,., .... ~-~ Environmental Services Division .... ~'~,. ~w~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist A. WELL DATA Log present~/N) Total depth ---~ ~ Cased to Sanitary sea~'/N) FROM WELL LOG Date of test .-~'- IfA, B, or C, attach ADEC letter. ADEC water system number Date COmpleted Casing height (above ground) Wires properly/protected(~/N) AT INSPECTION Static water level c~ Well production WATER SAMPLE RESULTS: Coliform Date of sample: //_ Nitrate g.p.m. B. SEPTIC/HOLDING TANK DATA Date installed//- ~' ~'/ Tank size /~'~ Foundation cleanou~/N) ,.~/' Depression (Y/N). ~ Date of Pumping //- ~- ~: ' ~ .,Pumper ~ ~'~ ~::~ C. ABSORPTION FIELD DATA · ~ '~ Date installed //- ;~ ~',/' ,i Soil rating (g.p.d./~ or ft~/bdrm) /~'~ ~-~ Length ~-~& ' .W!dth /od' / Effective absorption area fiD~9~ Date of adequacy test //-/-/- ~ Number of Compartments c:~' Cleanout~N) y High water alarm (Y/N) /~/~ System type Gravel thickness below pipe ~)° ~ Total depth --~' ~ Monitoring Tube present~'/N) ~/~ Depression over field (Y~. /~ Resu, (Pt~ail)P~'~'~' For ~7~ bedrooms Absorption rate = ~/'~'~ '/- q.p.d. If yes, give date Fluid depth in absorption field before test (in.); ~ Immediately after?£~ gal. water added (in.): Fluid depth ~-r~5~-~ (ins) ~ later:. ~ / Peroxide treatment (past 12 months) (Y{~. 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level ~ ' Cycles tested ~ SEPARATIO~N DISTANCES ¢/'"~-- Size in gallons "Pump on" level at* ~ off" level at* *Datum SEPAR/~rlON DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /~0~2 -/- Absorption field on lot Public sewer main Sewer/septic service line c?,:5/¥- On adjacent lots On adjacent lots Public sewer manhole/cleanout Liffstation /(,////:~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation /¢,,5' 7~ c¢, d. Property line /~ '¢- Absorption field /E:) '/- Water main/service line ~ ¢- Surface water/drainage /~ '/-- Wells on adjacent lots /¢~ ¢- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line /~9 ¢- Building foundation /~ -/- Water main/service line Sudace water /~0 ~ Driveway, parking/vehicle storage area Cu~ain drain ~ Wells on adjacent lots /~ F. ENGINEER'S CERTIFICATION d review of Municipal rog~t ~'~ inconfo~a~ w~h~1~uid lines in effocton this date. Engineer's Nam~ ~~ ~' Date Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 N Fax (907) 338-3246 Consulting Engineers November 16, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 FAXED NOV 1 7 1998 Attn: Donna Meats Ref: T12N, R3W, Sec 24, W1/2, NE1/4, NWl/4, SE1/4. 11900 Trails End S/D. Separation distance from septic system to well located on Lot 1, Bk 2, Sunny S/D. Dear Ms. Meats: We made a second site visit to the subject property on 11/16/98 to confirm our previous field measurements between the subject well and septic system. Atter clearing a better pathway through the brash, we were able to get a straight line measurement f~om the edge of the casing to the edge oftha southwest bed clean-out, which was found to be 102.1 feet. This measurement was a slight angle so it is probable that the horizontal distance is closer to 101.5 feet. The pipe is not straight, and angles slightly towards the well. It is unknown what that actual distance is from the pipe to the edge of the bed. In otherwords, an encroachment may, or may not, exist. The only way to be certain would be to expose the bed (with a backhoe), clear the brush on the neighboring lot, and measure the distance. It would cost approximately $400.00 for the excavator and about $150.00 for the engineer to coordinate/inspect this. There would be an additional cost to re-landscape next spring. The homeowner will have to pay this even if it is determined that an encroachment does not exist. Remember, my clients drainfleld existed prior to the well. If it was determined that a waiver is required, my clients would also have to pay for water samples onLot 1, Bk 2, Sunny S/D, and the engineering paperwork to process the waiver. It is my understanding that the file for Lot 1, Bk 2, Sunny S/D would be flagged for future payment of the MOA waiver fee. The water sampling and waiver package would cost my clients an additional $500.00. In short, the total cost, to the innocent party, could reach as much as $1000.00. The reasonable approach, and what I thought was the previously established DHItS policy, would be to flag the file for Lot 1, Bk 2, Sunny S/D, and require them, in the future (when they apply for a health certificate) to provide any documentation deemed necessary by DHItS to prove that an encroachment does not exist. Using this approach, the innocent party is not penalized. Given the fact that there is some uncertainty as to whether an encroachment exists, I am requesting that DI-IHS issue a health certificate for my clients property, and place the burden of proof on the owners of Lot I, Bk 2, Sunny S/D. Thank you for ~our consi~ 'ation in this matter. CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 986534001 AK Water & Wastewater Consultants Inc. Sec 24 T12N R3W W2 NFA NW4 SEA 11900 Trails End Drinking Water 0 Sample Remarks: Client ]FO# PHnte~ )ate/Time 11/06/98 10:47 Collec4:q Date/Time 11/04/98 10:30 Receiw. ~ Date/Time 11/04/98 14:10 Technical Director: Stephen C. Erie Released By ~~ Results POL Units Method Allowable Prep Analysis Limits Date Date Init Iota[ Coliform Nitrate-N 0 col/lOOmL SH18 92Z25 2.83 0.100 mg/L EPA 300~0 11/04/98 rAP 10 max 11/04/98 11/04/98 GCP Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers November 12, 1998 Municipality of Anchorage Department of Health & Human Services Division of Enviromnental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Health Authority Approval for T12N, R3W, Sec 24, WI/2, NE1/4, NWl~4, SE1/4. 11900 Trails End S/D. To whom it may concern: We have tested the well and septic system serving the subject property and found them to be in compliance with MOA standards. It was noted that the southeast bed clean-out is approximately 103 feet (measured through brash and at a slight angle) to the well located on Lot 1, Bk 2, Sunny S/D (11930 Trails End Road). Given the fact that the edge of the bed is closer to the well than the clean-out, and that the horizontal separation distance is less than the angled measurement, it is possible that a slight encroachment exists; however, it would not be possible to positively verify this without exposing the bed and physically finding the edge of it. The well was drilled after the drainfield was installed. If ou have any questions, please call me a 337-6179. ss, P.E., President ParcelI.D. # 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 GENERAL INFORMATION Complete legal description Location (site address or directions) HAA # Property owner 'Mailing address Lending agency Mailing address Day phone ,~L/'.~- 5-,-/'7.~' Day phone Agent Address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well :~ ~ Community well Public water If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 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 ~/erify 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 Es in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm / ~/2,~--~ Address ~ Engineer's signature DHHS SIGNATURE ~ Approved for bedrooms. Date Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date ¢,~,/~'~ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending 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. 72~25 [Rev, 1/91) Bsck MOA ~21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type ~ Log present (Y/N) y Total depth Sanitary seal (Y/N) If A, S. or C, attach ADEC letter. Parcel I.D. ,/ Date of test Static water level Well flow ADEC water system number Date completed ,~' ° I~t~l Driller ,~11 Cased to ~ ,,~ Casing height Wires properly protected (Y/N) /%/ FROM WELL LOG .E ~ I~ ,ql Pump level g.p.m. AT INSPECTION SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank '~',J O VI WATER SAMPLE RESULTS: Coliform / Nitrate Date of sample: ~}//.-';~ '/~' ~?-- ~' / Other bacteria Collected by: ~ ~ ~'~ B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size / ,2 ,t-~-¢~¢ Compartments Foundation cleanout (Y/N) '/ Depression (Y/N) Alarm tested (Y/N) h-///..\ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I To property line Surface water/drainage On adjacent lots Absorption field Foundation Water main/service line t/// 72 026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Manufacturer ManhoJe/Access (Y/N) Vent(Y/N) "Pump on" level at "Pump off" level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed H ,~ I : Length -~ Width I ~ ~otal absorption area 1~)'0 ~ Depression over field (Y/N) ~! Results (pass/fail) ~-'~0~ Soil rating I ~ P ~'~ I:~L Gravel thickness ~ t~ Cleanouts present (Y/N) Date of adequacy test System type Total depth Peroxide treatment (past 12 months) (Y/N) for bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots ,~') 1¢¢.,2 Well0n lot J'l~) ~ To building foundation Onadjacentlots ?~/¢¢P Surface water ~'~ l Curtain drain ~'~/~ Cutbank Property line To existing or abandoned system on lot Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect On the date of this inspection. Signature DateEnginee~'s HAA Fee $ Date of Payment Receipt Number 72*026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number' CHEMICAL &' GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX; (907) 561-5301 ANALYSIS RESULTS for INVOICE ~ 53784 Chemlab Ref $ 92.2147 Sample $ .'L l,fatrix: WATER Client Sample ID ~72 NEg. NWd. BW~ SEC 24 Client Name :TOEBEN SPURKLAHE P.E. PWSID : UA Client Acer :TOBBENS Collected }~ 15 92 @ 09:00 hre, BPO$ : PO~ :NONE RECEIVED Received : I,~Y 15 92 ~ 16:00 hzs Req$ Preserved llzzn AS REQNIRED Ordered By :TOBBEN SPURKLAND Analysis Completed : b~AY 1S 92 Send Reports Laboratory Suparwsor : STEPHEN C. EDZ i)TOBBEN SPURKLANE P.E. Released By~/~t//~'~/C''~~ *~ Parameter Results Unit~ Method Allowable Limits NIT~ATE-~ 2.i ~/1 EPA 353,2 lO Sample HOUTINE SA!@LE COLLECTED BY: IOEBEN SPUP, KLAND. NO TAG FOR THIS SA)~LE Re~mrk~: 1 Test~ Performed See Special Instructzons Above UA~Unavailable ND- None Detected "' See Sample Remarks Above MA= Not Analyzed LT-Less Than GT=Grearez Than ~SGS Member of the SGS Group (SocietY, Gdndrale de Surveillance)