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HomeMy WebLinkAboutKNIK HEIGHTS BLK A LT 9 DEl-,. ~TMENT OF HEALTH AND HUMAN SER¥...~..,S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT P~'mil N~) - v' Phonels) ' ~qo of Bb,~o'ms LEGAL DESCRIPTION Lot I~ Block A Subd ....... ~r~[~ Township. Range, Section 'TIZN TANKS [] SEPTIC [] HOLDING Manulactuler CapaclW in gallons ~'~ (~,~'~/Z%..-/~'~ NO. of Compartments Material TYPE OF SYSTEM [] BED [] W. DRAIN [] Depth to pipe bottom from Tolal depth lrom original grade orlgl/laig[ade 5.5 ET ¢' ~ Et Fdl added above original grade Gravel depth beneath pipe /0 FT ~,~ FT length ,ravel width Total absorphon a~ea Distance beJween lines Pipe material [~PRIVATE [] OTHER (Identilv) Classdicauon (A,B,CI Total Depth FT Cased to Date Installed: FT REMARKS: DISTANCES WELL LOT LINE SEPTIC TANK ABSORPTION FIELD IgC~` WELL FOUNDATION 4',/0 / ~-,/d / /'/0 ' AS-BUILT DIAGRAM (Show Iocat,on ol wea, s~ptic system, propecW hnes, JoundF~JlOD, driveway, water bodies, etc ) Scale: jl~ T 5 Ins~oe~tions Pedorme~by: Date: Municipal and State guidelines in effect 0n this date: Health Depadment Approval: Date: 72-013 (3/85~ ENGINEER'S SEAL Ccrvdn CE-5283 'T'HOMAS L.., DEtL. IE :1.;~74 :L IR ]:I}GEWOOD DR I VE AIqCHORAGE, AK 995:L6 786-- 1230 LOT: 9 RANGE: 3W BLOCK: A I cel-t.:Lfy tl"iat.; . . fortl"~ by the Muri:i. cilz~a].itY c:,f Arlc:hoPa(.~e (Mt]A) and the Sttate of Alaska, ? :[ will. insta].], the systein J.n acc:cH'dance ~f.~i'Lh all MOA codes and pegu].at:i.c)rls~ arid iri c:ofilp].iar'ice with the design cPiter'ia of this 3,, ]: w:i.:!.1 adhere to all MOA and S't.a'Le (:~f A].aska r'ec!uiPc~ments for the set bacl< d:LEFL~'&t"ic:es f'Poln any existir't~l t,,*e;Ll~ was'kewater' disposal, system ol" pt.ib].~.c se:,~AtePac;!e system on this (::~I" any adjacent ot neaPby lcd'.,. ....... [A...L.......t., ]:N AIq AR!EA F]]',/F'RE'T) BY MOA BItli f)'fNrq ,.. I AT ..... N 1 ,..~'r , c,"' :~ t:: ~ .................. I F' A I..,. I F"I" ::- ....r ~' · ' c~ ........................... . '" ' '"'"V n q ", c :, ~*~ '" ~s ] F'~E:~ (l) AN F:'I E:'C'.TF~ A PERMIT A,4 ........ E ,.., I .[ ;,. MUST NOT BE AF:'PF:~DVED *, '[ Tt'-'IOUT ¢...fl,~ .... , t ....... rr',T ""Zt,~ INSPECTION REPORT~ AND ]"HE F:[FC'TRICA WORK MUST BE DC)NE~BY A LICENSED ELECTRICIAN,, ....... ;-.;..-;. ................. ............................................................... AF'PI..,.~E;ANT: 'i'~[~1~ I ..... LE].LE l%- Municipality of Anchorage DEPARTM~.NT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 2 oL- 3 4 5 6 7 8 DATE PERFORI To¥,nship, Raogo, Section: T/2/~ ~ ~g¢/ SLOPE SITE PLAN WAS GROUND WATER 10 ENCOUNTERED? . . S L 11 IF YES, AT WHAT O DEPTH? P 12 E 13 16- 17 18 19 Oepth to Water,er Monitoring? Gross Net Oep'th to Net Readin9Date Time Time Water Drop / //:~¢/ //:~/~/.'/.~ /o - ~/,,./? ./~ ;z //.'/~/.-z3/0 ,sC/,'-/8 · /~ .6 I/.'zs/ :55/¢ · bo/. 5'0 . lO ~ /I.'3._~ I :V3 /o ¢~/. ~/ ,o? 5 II.'~8/,5~ /e ,6o/.sl b u.,~//z.'o~/o .~0/, ~( .09 20 PERCOLATION RATE //~' ~ (minutes/inchJ PERC HOLE DIAMETER ,EsT RuN BET,W/EEN ff, O FTAND ¢ ~ FT -- 72-008 (Rev. 4/85J Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2o DATE PERFORMED: Township, Range, Section: SLOPE WAS GROUND WATER &~ ENCOUNTERED? ]~ ~ S IF YES, AT WHAT ~ DEPTH? p E Oepth to Water ,~lter,/ Monitoring? SITE PLAN Bate: Gross Net Depth to __ Reading Date Time Time Water - PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETW.E~N FT AND FT ii J/' U ~ ~ ~ CERTIFY THAT~IS T~ST WAS PERFORMED IN ACCORDANCE WITH ALL S'ATE AND MUN'CIPAL G U[DELIN~ ~ ' ~ DATE DATE' ~/~ EFFE N THIS . . 72-008 (Rev. 4/85) O M DATE SIGNED MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES WAIVER REVIEW WORKSHEET DATE RECEIVED: July 1, 1986 LEGAL: Lot 9 BLock A Knik Heights Subdivision ENGINEER: Corwin & Associates, Inc. 4790 Business Park Boulevard,~8-D Suite 1 Anchorage, Alaska 99503 APPLICANT: Acreage Systems, Inc. EX86-195 WAIVER REQUESTED: CRITERIA: 1) Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 2) Special Conditions: TOTAL: 3) Other: WAIVER IS: granted, with conditions listed below: ~ot granted for reasons listed below: DATE: BY: NAME ~ ~¢.%~,~ ~']E~ % '~-': .¢~ DRAWN BY' SYSTEMS INDICATED IS NOT EXACT. DETEEMINED ByUSE OF CLOTH TAPE A~ & associates,inc. Consulting Engineers 4790 Business Park Blvd. · Bldg. D · Suite One · Anchorage, Alaska 99503 · (907) 561-6151 July 14, 1986 Municipality of Anchorage Department of Health and Environmental Protection 825 "L" Street Anchorage, Alaska 99501 Iv[UiqiCIPALITY OF ANCHOoAQ DEPT. OF HEALT ENVIRON r_~.,~.. H & M;~L PROTECTioN RECEIVED SUBJECT: KNIK HEIGHTS SUBDIVISION, LOT 9, BLOCK A To Whom It May Concern: During excavation it was discovered that the approved receiving strata (SW) was not continuous. The material uncovered had a higher silt content (GM) although lines of well-graded sand were noted throughout. A perc test was performed in the GM material resulting in a 192 sqare feet per bedroom rating; this was adjusted in the field to 225 square feet per bedroom due to the depth of excavation and increasing density of the soils. (See soils information.) Because of the inconsistency of the SW layer and a reduction of available area due to property line constraints, the configuration of the system was changed from a shallow bed to a deep trench. Two (2) parallel trenches were installed with total absorption area totalling 902 sq. ft. (See As-Built/Inspection Report.) The septic tank was exposed to ensure watertightness and was verified to have high integrity. It is a 1,250 gallon steel tank without stubs to allow for placement of caui~er couplings. The existing seals on both inlet and outlet were inspected and no evidence of leakage was observed. To make doubly, doubly sure it didn't leak, the excavator added a resinated mortar around the seals. The new system meets or exceeds all the requirements set forth for new installations and the tank is watertight: therefore, we request that the waiver be granted and the system upgrade approved. Very truly yours, CORWIN & ASSOCIATES, INC. Laura Ogar Environmental Engineer LO/d Municipality of Anchorage MEMORANDUM DATE: TO: FROM: SUBJECT: July 17, 1986 File Civil Engineer, On-site Services Lot 9 Block A Knik Heights Subdivision The separation distance between the septic tank and well on the subject property has been waived to 94 feet. The tank was inspected and found to be in satisfactory condition and watertight by Laura Ogar of Corwin and Associates on July 14, 1986. Stephen S. Morr°s Civil Engineer On-site Services SSM/ljw A'-" NCHORAGE AREA BoR'OdGH 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM II/' ~7~LC.~C~~iNG ~.~ ¢~.-- //C~--~/..~ ~ ! SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER INSIDE WIDTH MATE RIAL LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY__ GALLONS. DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE TOTAL LENGTH OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE IN. WELL: TYPE _ BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE __ OTHER SOURCES DISAPPROVED NEAREST SEWER LINE__ DEPTH SEPTIC SEEPAGE TANK , SYSTEM REMARKS DISTANCE FROM: DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: O ' G&.LB. -- Form EQ-032 GREATer ANCHORAGE AREA BorOUgh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 ! SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. , "/b INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED SEEPAGE PIT DRAIN FIELD TO BE INSTALLED bY NOTE: THIG PERI'IT iS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. TANK SiZE TYPE SEEPAGE AREA SIZE TYPE ~ -- ~7~'~ ~'/~-~'~ SEPTIC I MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM CAST irON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT , DRAIN fIELD SEPTIC TANK TO SEEPAGE PIT WALL sePtiC TANK , SEEPAGe Pit , DRAIN FIELD TO NEAreST LOT Line. WELL TO SEPTIC TANK SEEPAGE PIT DRAin FIELD ALSO CONSIDEr AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD . SEPTIC TANK, , SEEPAGE PIT ., DRAIN FIELD TO RIVER, LAKE, STREAM. EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUgh REGULATIONS REGARDING INSTALLATION. ] CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA~]BoRoUGH ORDINANCE NO. 2B-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ~ /~ ~/ bK ANLHUKAbI: AKI-A UU' UbH Department of Environmental Quality 3330 C Street ¢' Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL LOCATION MAILING ADDRESS ~J'//'~'~ ~:~/' '¢/'"?/' PHONE,~ ~/":/~,:,~ ~2~ LEGAL DESCRIPTION// ~w'~/Z .w~//~///..,~//._C SEPTIC TANK: DISTANCE FROM WELL.~g//~'~ MANUFACTURER INSIDE LENGTH INSIDE WIDTH MATERIAL NUMBER OF COMPARTMENTS LIQUID DEPTH -- .LIQUID CAPACITY GALLONS. SEEPAGE Pit: NUMBER OF PITS / DIAMETER ~4// OR WIDTH ~4:2, LENGTH -~4 DEPTH LINING MATERIAL/--Z:;~.,-CCC/I/'~J~IB SIZE: DIAMETER ~ DEPTH ~ DISTANCE FROM: BUILDING FOUNDATION 2d/~NEAREST LOT LINE'~,~. TOTAL EFFECTIVE WELL ABSORPTION AREA (WALL_AREA) ~f~ SQ. FT. ADDITIONAL ABSORPTION · " WELL: TYPE .~~ CONSTRUCTION BUILDING NEAREST FOUNDATION_ LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED NEAREST SEWER LINE REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM D ISTA N C ES: ~f~//d~d-~/~/ INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: ~//~/ Form No. E0-031 DIAGRAM OF SYSTEM DATE ,~'~/Z/~ ¢./¢~ APPROVED G.A.A.B. GREATe:R ANCHORAGE: AREA E~OROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 ! SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO, INSTALLATION OF: SEPTIC TANK /' SEEPAGE Pit-- ~ . DRAIN FIELD __ . OTHER FINANCED THROUGH TO BE ~NSTALLED BY SO~L TEST RESULTS u~~/~ NOTE: THiS PERMIT iS NOT VALID WITHOUT PHONE FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FI~_~AL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINII~IUM DISTANCE.~, REQUIREMENTS DIAGRAM Of SY~TE~/~ FOUNDATION TO SEPTIC TANK ~/ / CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF FOUNDATION TO SEEPAGE PIT ~ ., DRAIN FIELD SEPTIC TANK TO SEEPAge PIT WALL SEPTIC TANK , SEEPAGE P~T . DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK _~-~..~ . SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATSR MAIN TO SEPTIC TANK . SEEPAGE PIT DRAIN PIELD TO RIVER, LAKE, STREAM. EXCAVATION 5 FEET INTO UNDISTURBED SOIL. GRAVEL ~A~KFILL :~ :~.,,,,,/~ 3330 "C" Street ~"~/~'~' ~.// Anchorage, A1 as ka 99503 SOILS LOG - PEROLATiON TEST Performed for Glacie~ Excavating Legal Description: Lot 9, Block A '~i~-~He~ghts This form reports: Soils log 6~DAr~R ANC,M, ORAG~ AR~A BOROUGH Date Performed o/~o/?~ Percolation test Depth Feet Inlet to Seepage Pit Silty Sand ( SM 8- i3 15' BOTTOM OF TEST HOLE Was ground water encountered? yes, at what depth? Reading Date Gross Time Net T~:me Depth to Water I Net Drop -Proposed installa~-~,-:---~-ge Pit Yes Drain Field ....................... ',X:i~til of Inlet...._~.~________~ __ _ __,_~_.____. Dept~--t-~"~-o'~-t~--~]>it or trej~ci, .......... _ __ CO.,,~,~TS. No bedrock or water table encountered. Pa rformed By: Jg~_~_~k ............ Certi fi ed By :~n~p~.~&~ .......... ~a se: 6/2 Test Lab l.{ay 29, 1974 Veteran's Administration 429 "D" Street Anchorage, Alaska SUBJ,.CT: Knik I!eights SuSdtviston, Lot 9: B~ock A Ge~l emen~ The sub,feet lot appears to be of sufficient size to acco~odate Indivi(lual w~ll anti on-site sewer system. Related soil test in the area indicates a se~er system S i ncerely ~ Les ~uchholz, R,S., Environmental Control Officer LD/ko MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-032-27-000 Expiration Date: Legal description KNIK HEIGHTS BLK A LT 9 Site address 4805 FAIRMONT RD Anchorage AK 99516 Current property owner(s) HOEFFLER FAMILY TRUST 10/21/2025 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: M Original Certificate Date: 11/14/2024 his Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-032-27 Complete legal description KNIK HEIGHTS BK A LOT 9 Location (site address) 4805 FAIRMONT RD ANCH AK Current property owner(s) HOEFFLER FAMILY TRUST 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY:❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel X Plastic ❑ Concrete ❑ Fiberglass Age 11 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑■ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ ST Date of Payment COSA # DS C-�- Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist Legal Description: KNIK HEIGHTS A LOT 9 ParcellD: 017-032-27 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA N Well log is filed with Onsite (or attached) Date drilled 7/9/74 Total depth 150 ft Cased to 148 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 10/21/24 Static water level at beginning of test 32 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 522' Date of pumping 10/21/24 ❑ Required maintenance completed, if AWWt-S Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/14/86 N ALL standpipes present per record drawing Total measured depth from grade 9.2 ft (max) Measured depth to pipe invert from grade 5.7 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. 0 Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: 1986 TRENCH TESTED. COSA Checklist June 2022 Well production at time of test 4+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No N Coliform bacteria is Negative Nitrate 1.91 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L X Arsenic less than MRL (ND) Collected by MNA Date 10/21/24 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 10/21/24 Results Q Pass Fluid depth prior to test 24 in Water added 600+ gal New fluid depth 34 in Elapsed time 1440 min Final fluid depth 24 in Absorption rate 600+ and FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 66 in Effective depth used 24 in Effective depth remaining 42 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' 7Yes if No '80 ft Neighboring Tank > 100' R] Yes if No _ ft Absorption Field on Lot > 100' [' Yes if No ft Neighboring Absorption Fields > 100' Ri Yes if No _ ft Community Sewer Manhole/Cleanout > 100' ❑� Yes if No _ ft Private Sewer/Septic Line > 25' Q Yes if No _ ft Holding Tank > 100' QQ Yes if No ft Animal Containment > 50' Q Yes if No_ ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No _ ft 0 Yes if No _ ft ❑ N/A— Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No_ ft Surface Water > 100' 9 Yes if No _ ft Tank to Property Line > 5' Q Yes if No_ ft Wells on Adjacent Lots: Field to Property Line > 10' 9 Yes if No _ ft Private Wells > 100' C' Yes if No ft Water Main > 10' Water Service Line > 10' 0 Yes if No _ ft Q Yes if No ft F. ENGINEER'S COMMENTS "SEE MOA WEAVER OSP121138 Community Wells > 200' Q Yes if No ft If tank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. 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Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFIC,~TE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 01 7-032-27 1. GENERAL INFORMATION Complete'legal description HAA # Knik Height Subdivision; Lot 9; Block A; Location (site address or directions) 1 2741 Ridgewood Road Property owner Mailing address Charles and Linda Haase Day phone 345-9449 12741RidgeWood Road Anchorage, AK 99516 Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: XXX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WAS;rEWATER DISPOSAL: Individual on-site NOTE: Holding tank Community on-site Public sewer XXX 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 _ __~_A.~KA WATER & WASI~ATEi~ Address Engineer's signature DHHS SIGNATURE X Approved for 4 Disapproved. Conditional approval for bedrooms. Phone ~:~ 7¢~/7~ Date 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-o25(Rev. 1/91) Back MOAiY21 t'~.,L, LI v Lb' Municipality of Anchorage DEPARTMENT OF HEALTH & .... HUMAN SERVICER~ONiCiPALiTY o1: ANCHU..~_.~.~lNJll Environmental Re,ices Division E~IRONME~ALSERVICES 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: Iz, N~y. ~e,c.~'rs ._~orh=~o~l Parcel I.D.: ~)1-/ - o~ -2. 7 A. WELL DATA Well type ¢~.JA-'¢~ Log present (Y~ ~o Total depth I ~l I _p Sanitary seal (~N) ~5 Date completed Cased to z+OLF IfA, B, or C, attach ADEC etter. ADEC water system number Casing height (above ground) Wires properly prote~:ted (~N) Date of test Static water level Well production FROM WELL LOG ~ g.p.m. AT INSPECTION WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate O.-'/B~- ~,l.~./g Other bacteria Collected by: /~. ua. uJ. 4::. ~, I ~44.. B. SEPTIC/HOLDING TANK DATA Date installed '-7/~/-/~ Tank size. Foundation cleanout (~'N) "fa -~ Date of Pumping I/~/,~'~ 12.¢O Number of Compartments J Cleanouts ~/N)__ Depression (Y~IL /'~ O High water alarm (Yd~) ~ o Pumper g.p.m. ~.~oo~ If yes, give date Peroxide treatment (past 12 months) 72-026 (Rev. 3/96)~' C. ABSORPTION FIELD.DATA ,~/~ h~ ~/. _~, Date installed ~ -//l~l/~,(=. Soil rating ~ or~ ~ ~A ~System type ~' Length~ q~'~ x~' Widt~ ~.o' Gravel thickness below pipe~ ~.g' Total depth ~ Effective absorption area ~ ~oz ¢ Monitoring Tube present O~ les Depression over field ~ Dateo, adequacy test '/'~-'~/f15 Results~) ~eA~ For ~ bedrooms Fluid depth in absorption field before test (in.); ~¢~ Immediately after CZE gal. water added (in.): Fluid depth ~¢~ (ins) Minutes later: I%%o Absorption rate = ~°O+ .g.p.d. LIFT STATION Date if'rsta[tp,_~ ~ Manhole/Access (Y/N) ~t* "Pump off" level at* High w~~*Datum ~ C yete'~ tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~ '~ Absorption field on lot -~ ~O~-~ Public sewer main ~/~ Sewer/septic service line ~' ~ 1' On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: .5~ Foundation +: Property line JO Absorption field Water main/service line ~1+ Surfacewateddrainage loct 4- Wells on adjacent lots ]~oI SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line lo Building foundation I o [-~ Water main/service line Surface water I co~ + Driveway, parking/vehicle storage area O [ Curtain drain ~4o¢e: ' // "'~'''''' : ENGINEERS CERTIFICATION I ce~ify that l h~t~/~/~¢~N¢~ inspections and review of Municipal r¢~"~~¢~s are in conforma~h p~¢/H/¢ ~/deli~es in effect on this date. Signature ~M//1Fl L~/ Engineer's Name HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number Rick Mystrom, Mayor Mtmicipality of Anchorage Department of Health and Human Services 825 "U' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www,ci.anchorage.ak.us March 22, 1999 JeffGarness, PE Alaska Water & Wastewater Consultants, Inc. 6901 De Barr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Lot 9 Block A Knik Heights Subdivision Waiver Request #WR990011 Parcel ID #017-032-27 HAA# HA990059 Dear Mr. Garness: Your request for a waiver of the required 100 feet horizontal separation from the on-site wastewater disposal system to private well has been approved. The approved separation distance is 80.0 feet. This is a waiver from any portion of the septic sytsem; the septic tank and the absorption field. This waiver approval applies to the existing on-site wastewater disposal system to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet wR~[~\~/~%~{~£~l PID~ 017-032-27 HA#~L~~ Permit Date Received: February 12, 1999 Legal Description: Lot 9 Block A Knik Heights Subdivision Engineer: Jeff Garness, P.E., Alaska Water & Wastewater Consultants, Inc. 6901 De Barr Road, Suite 2B, Anchorage, Alaska. 99504 Applicant: Charles & Linda Haase Waiver Requested: Waiver of 80' from the private w&ll to any portion of the septic system; septic tank and absorption area. Criteria: 1. Geology: Points; A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other~: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: Date: ~ - Z2- f ~ By: ~f~/ Name of Reviewer Rec ~: 04502/0865 Amount: $ 920.00 Date Paid: 2-12-99 ! 7./ ~0 4..5-w Zo2 18.5' Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B - Anchorage - Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers February 10,1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Attention: Dan Roth Reef: Waiver Request and Health Authority Approval for Kink Heights Subdivision, Lot 9, Block A, WELL AND SEPTIC TESTING: The existing 4 bedroom house is served by a private welt and septic system. On January 14, t999, we went to the referenced property to perform a welt flow test and a septic adequacy test. On our site visit, we found that the septic system consisted of a 1250 gallon septic tank, three drainfields and a crib. The two dminfield in the southwest corner of the property were installed on 7/16/86 and the other drainfield/crib were installed prior to "1977". Attached is the well flow and adequacy test data. As can be seen from this data, the 7/16/86 drainfields do not pass for a four bedroom house*, however the crib does pass for four bedrooms with no water ever showing up in the 8" sump of the drainfield extending from the crib. A diverter valve has been installed and set open to the crib only. The well flow test shows that the well produces in excess of 5 gallons per minute. WAIVER REQUEST: Attached are a site plan, a detail drawing and a topography site plan showing the encroachment that exists. As can be seen on the detail drawing the well encroaches upon the septic system at several points. We request that your department issue a 80 foot separation distance waiver f~m the well to any portion of the septic system serving the referenced property. Justification for the waiver is as follows: · As can be seen on the topography site plan, the ground surface elevation in the area of the septic system is lower than the ground surface elevation by the welt, so that if any effluent were to surface, it will flow away from the well. · The location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the-problem corrected. · Recent water samples indicated that the nitrate levels were 0;782 mg/L and no .bacteria was found (see attached results). · Attached are also some neighboring well logs. As can be seen from the well logs, there is thick clay and/or hardpan layers that have served .to protect the aquifer from any contamination. Based upon these factors, it is our opinion that there is a minimal risk for the granting of this waiver. One other situation we would like to address is the neighboring septic system to the north of the referenced property. The exact location ofthe neighboring septic system is unknown at this time not allowing us to verify the separation distances have been met. According to the inspection report, there are no standpipes in the septic tank or draintield. We have been able to find one standpipe for the entire septic system and believe this to be a pre-tank cleanout which is shown on the inspection report (see attached inspection report). The septic inspection report for Lot t0, Block A, is so vague that it is of little value. We'attempted to obtain an as-built survey for tot 10, Block A (through Pacific Northwest Title), but there was none on record. The septic upgrade design for Lot 9, Block A (Corwin & Assoc., t986) showsthe septic system on Lot 10, Block A, as being greater than t00 feet t~om the welt on-Lot 9, Block A. The welt serving the referenced property was drilled in "1974" and the neighboring septic system was installed in "t979". in other words, the well should be "grandfathered" if any encroachment does exist. With the granting of the waiver, we also request that .you issue a Health Authority Approval, If you have any questions, please contact me at 337-6179, or 244-9612. assistarlce. ~//~ Sincer 1 ~ Jeffi:¢/d~ ess, P.E., M.S. Presid~n L] Thank you for your KNIIK H ldFrF5 5LIIPPtVBIONI, l..0I' 9, IPLOCK A, 1/14/99 ~ ~ C01 C02 MEASUREMENTS: MT1 CR~B CO/MT_ 152-1/2" - TOP TO BOTTOM 1,~7" - 'tOP TO BOTTOM 89'" - TOP TO LIQUID LEVEL 112" - TOP TO LIQUID LEVEL DBL1 HAD 3" OF STANDING WATER DBL2 HAD 4-1/2" OF STANDING WATER B" - STICK UP 1" - STICK UP DBL5 & DBL4- WERE DRY C01 HAD 2" OF STANDING WATER MT2 _B" SUMP C02 WAS DRY 151-1/2" - TOP TO BOTTOM 8" SUMP REMAINED DRY FOR ENTIRETY OF TEST 152-1/2" - TOP TO BOTTOM 108~ - TOP TO LIQUID LEVEL DRY - TOP TO LIQUID LEVEL 7" - STICK UP 29" - STICK UP WELL FLOW TEST AND SEPTIC ADEQUACY TEST DATA TIME: METER: GALLONS: S.W.L. MT1 MT2 CRIB MT2~ CRIBZ~ G.P.M. 11:56 12940 50 151.0' - 5,u 12:03 12977 37/67 TOTAL - 12:23 15085 108/'195 TOTAL 131.5' 978-8!/'2" - +6"/'10.5" TOTAL 5.4- 12:53 13245 160/'335 TOTAL 131.0' " - +9.5"/20' TOTAL 5,3 1:10 13336 91/'446 TOTAL 131.0' 84-" - +4."124" TOTAL ,__ 5.4 LIQUID ~_EVEL AT THE TOP 01~' DISTRiBUTIQN IN C02. - - - - STOPPED FLOW INTO C02 AND STARTED INTR!pUCiNG WATE~R INTO CRIB'S C~_O~O ~MT 1:15 13336 (CRIB ONLY') 131.0' 89" - 112" - 5.5 1:45 13503 84/167 TOTAL .... 110" +2" 5.6 2:45 13845 342/509 TOTAL - - 98" - +2.5"/16.5"+12"/14" TOTALToTAL 5.75'7 3:05 13960 115/624- TOTAL INTO SEPTIC - . -__ _ - - S'OPPED FLOW OF W,-,,ER95-1/2'' ?,OMMENTS: WATER WAS. FIRST ADDED TO MT2 UNTIL FILLED TO TOP OF DISTRIBUTION LINE. WATER WAS THAN ADDED TO CRIB. CRIB ABSORBED MORE THAN 600+ GALLONS/DAY AND THE WELL PRODUCED IN EXCESS OF 5 GALLONS/MINUTE. ! LOT 6, BLg~13~-~'''i-. ~ LOT 11, BLOCK A I j LOT 6, BLOCK A KNIK HE~FFTS S/D '<0 KNIK HEIGHTS S/D I t KNIK HEIGHTS S/D / / I I , '~o~ 7 ~ LOT 10, BLOCK A ~ KNIK HEIGHTS S/D f ~ LOT 7, BLOCK A LOT 7, BLOCK B ,/ //~ ~ j ~ KNIK HEIGHTS S/D KNIK HEIGHTS S/D / / [ X~ J L I , I . I~*1 ~/i t I LOT 8, BLOCK B / J k / J I ~ SE~O' / 1 I KNIK HEIGHTS ~~__ ~/- ~ BEDROOM J J FAIRMONT ROAD t I LOT 1, BLOCK G LOT 18, BLOCK H j [ LOT 1, BLOCK H KNIK HEIGHTS S/D j KNIK HEIGHTS S/D j j KNIK HEIGHTS J j ~ J L ' I I ( ~ LOT 2, BLOCK H LOT 2, BLOCK G , LOT 17, BLOCK H KNIK HEIGHTS S/D ~ KNIK HEIGHTS S/D ~ I KNIK HEIGHTS S/Bi ~ I // ~S~ ~A~ ~ ~AS~A~ CONS~T~S, ~C. ~ ~ 6901 D~RR RO~, SUITE 2B. ~CHO~GE. ~, 9950¢ KNIK HEIGHTS SUBDIVISION, LOT 9, BLOCK A . . ;~ ......... : .... ,~.~ ~.~ ..... ) ........ SITE P~N FOR WAIVER REQUEST '~.. '~flre]/~.G~s~:' CHARLES HAASE S45-g449 ~1~e .. .... DAT~:2/10/99 J A.C.G./J.L,M. 1 = 100' I OF 2 '~0~ \x PROPEmY..EUEVED TO a - ~N -"L--LOCATION OF NEICHBORING CLEANOUT (FOUNDATION CLEANOUT),'~ ~ / SEPTIC SYS~M IS UNKNOWN, i ~ mT ms BEU~EB TO BE IN / / I FAIRMONT ROAD I ~S~A WA~ A~ W~WA~ CONS~T~S, ~C. ~~J 6901 DE'RE ROAD. SUffE 2B. ~CHO~GE. ~. 99504 WAIVER REQUEST FOR WELL TO SEPTIC sySTEM CHARLES HAASE 345-9449 Q~;~'.... ....' .~ OATE:2/10/99 m A.C.G./J.L.M. I = 40' 2 OF 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 017-032-27 HAA# ~Gqq 1. GENERAL INFORMATION Complete'legal description Lot 9; Block A; KnikT~Heights Subdivision Location (site address or directions) 12741Ridgewood Road Anchorage, AK Property owner Mailing address Charles & Linda Haase Dayphone 345-9449 12741Ridgewood Rd. Anchorage, AK 99516 Lending agency Mailin. g address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 4 NUMBER OF BEDROOMS: 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. 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. 72-025 (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 verifythat 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 ALASKA WA' ER & W~"WATER 3~ ? ~ ~/7~' ~U Phone Address A~'~ ~ ~Rc~UITE2B Date , . Engineer's signature /~1~0~¢ Alaska Water Wastewater Consulta qts, Shall be PAID or prior to, closing for the Engineering Services Provide DHHS SIGNATURE ~ Approved for ~-~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: 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. 72-025 (Rev. 1/91) BaCk MOA ~ Municipality of Anchorage R F C E IV F ~--~ DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division JUL 1 5 199! 825 L Street, Room 502. Anchorage, Alaska 99501 · (907)lV~7a~t4y et Anchorage Dept. Health & Human Services Health Authority Approval Checklist Legal Description: ~Z~ !~ . ._ -~ \l~[~'~arcel I.D.: A. WELL DATA Log present (Y~) Total depth I ~ / i 4-- Cased to Sanitary seal (~/N) FROM WELL LOG If A, B, or C, attach ADEC letter. ADEC water system number Date completed L./(~ ',Jr-- Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION /~/~ ~/~'~/Z- Other bacteria Collected by: Date of test Static water level Well production ~ g.p.m. WATER SAMPLE RESULTS: Coliform °~-~ Nitrate Date of sample: ~o~'/~ ~ SEPTIC/HOLDING TANK DATA Date installed '7/&/7 Tank size i ~:~-5~ g.p.m. Number of Compartments __ Cleanouts~/N) ~'~OS Foundation cleanout (Y~) y Depression (Y/~_~ ~ High water alarm (YN~ Date of Pumping I/!¢-t!C~C~ Pumper ~)O.¢"~-.~.J('Jd/')~.-~ tD(L/~it//~ ABSORPTION FIELD DATA Date inSta ~(~ Soil rating (~ or~/~~ (4~j) System type 0~Jb/~5 Lengt~.'~ ~7" Width) ~.~ Gravel thickness below pip~ ~, 5 Tota[depth~ ~z' ~ Effective absorption area~ ~O~. ¢ Monitoring Tube present~/N)~ Depression over field (Y~ /~ Date ofadequacytest '~q-t%/~ Result~Fa,l) ~ For d bedrooms Fluid depth in absorption field before test (in.); ~ ~ Immediately affer~ gal. water added (in.): ~ ~, 5-/' Fluid depth ~" (ins) Minutes later:~ ~ Absorption rate = ~ '¢ .g.p.d. Peroxide treatment (past 12 months) ~ ~ If yes, give date 72-026 (Rev. 3/96)* ~ .-Tr¢~& ~ / ~~ ~Oe ~ ~-~ ~~ Date installed ~. ~e in gallons Manhole/Access (Y/N) ~evel at* "Pump off" level at* High w * *Datum .~tested E. SEPARATION DISTANCES vuP.¢tSooll SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot ¢ ~(3' + Public sewer main ~ /0,-- Public sewer manhole/cleanout Sewer/septic service line ,,~--,_,~ '"~ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ / + Prope~y line / 0 "¢ Absorption field Water main/se~ice line ~' ~ Sudace water/drainage ~00/~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line )0~'-r · Building foundation /~) '~ Water main/service line Surface water /~) ~) / '1~ Driveway, parking/vehicle storage area Curtain drain )~ 0/'~ /~/-)0 ~//~ Wells on adjacent lots /~--) ~ / ''i~ ENGINEER'S CERTIFICATION i ce i y t ,at inc°nf°rmafcewit7~ si . tur Engineer's Name teld inspections and review of Municipal ~lines in effect on this date. HAA Fee $ /'~ 'LLL¢ Date of Payment ~,4 Receipt Number Waiver Fee $ , ,/'¥'%.LC',q,4~'l~e of Payment Receipt Number 72-026 (Rev. 3/96)* the followi · TYPE OF system s n compliance with all date' of this inspeCtiOn, i: :::: ::: ;: codes ordnances; and regtJ at 0ns n effect on ~roved [y Of Anchorage Department of Health and Environmental Proteclion (DHEP),issues ,pproval certificates based solely upon ti · , , .... ...... 'Auth°rity MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: WELL DATA Well Classification Well Log Present (Y/N) Total Depth Static Water Level l Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Y' Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole N, Water Sample Collected by Water Sample Test Results Comments /,/~ I1' ~'¢'~'¢~'¢ IfA, B, C, D.E.C. Approved (Y/N) ~ Date Completed I,¢ '? ¢ Yield _'~ Cased to rp, 1 3t' Depth of Grouting Pump Set At ~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots '~' (OO ~'~ ; On Adjoining Lots '~ (OO To Nearest Public Sewer To Nearest Sewer Service Line on Lot ;Date ~'[l~'/ ~'" B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line ~ ,~'O ' To Water Main/Service Line Course .~, too ~ No. of Compartments . Foundation Cleanout (Y/N) IV Date Last Pumped ;for t,h~', &l,,~', Temporary Holding Tank Permit (Y/N), To Building Foundation To Disposal Field Air-tight Caps (Y/N) To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Datelnstale ' ~ ~ Width of Field ~ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Depth of Field (~.¢~._.~ .~..> ~____~r)~ ~ rC'~/~Gravel Bed Thickness ~ 7~O '/' '~'~¢n~j~ Standpipes Present (Y/N) ~ ~ Date of Last Adequacy Test O"'/[~ /~O'" CA'¢"¢¢) Separation Distance from Absorption Field: To Water-Supply Well ~ 7 ~ ~loc/'/') TO Property Line ~,¢' To Building Foundation TO Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments C~,~ ' LIFT STATION ; On Adjoining Lots ~)' ~' To Cutbank (if present) To Existing or Abandoned System on Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test, Meets MOA Electrical Codes (Y/N) Comments ItUiq;CIP/,,LtTY OF ANCHORAG~ Dl:'ld. OF HEt,LTH & ~|qVIP, ONM~N~'AL I~ROTFCT!ON ** 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 ¢'J'""""~ ¢ ~ Date ~/~0/~' Company FIe~ ~ ~U~ MOA NO. Receipt No. ¢-/,./_~-(, Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal NOR'i iERN TESTING LABURATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 907-479-3115 6957 OLD SEWARD HIGHWAY, SUITE 101 ANCHORAGE, ALASKA 99618 907-349-8623 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT [] PUBLIC WATER SYSTEM I.D. Cf [] PRIVATE WATER SYSTEM Mailing Addreyt ! State SAMPLE DATE: ~' I~ ~0~ Phone 3 ¢~5- - I.~,5'-,,,,z''' Mo. Day Year Purchase Order No. SAMPLE TYPE: [~ Routine [] Special Purpose [] Check Sample (for original contaminated Zip Code [] Treated Water ~ Untreated Water sample with lab reference no. Sample NO. 2 3 4 7 8 @ 10 Location Collected Collected by Signature of Representative FOR LABORATORY USE ONLY CASH CHARGE TO BE COMPLETED BY LABORATORY Received at: [~nch. [] Fbks. Date Received Time Received Next Sample Due COMMENTS: SATISFACTORY UNSATISFACTORY RESAMPLE OTHER BACTERIA TOO NUMEROUS TO COUNT U R OB TNTC Direct Verification Count LSB BGB Final Result* Comments ~al ~oliform Colonies per 100 mis. Time. BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 Department o¢ Public Works Municipality o¢ Anchorage ATTN: Susan K. Metcal¢ PO 8ox 196650 Anchorage, Alaska 99519-6650 J u n e 26, 1986 MUNICIPALITY OF ANC"HORA(BI~ DEPT. OF HEALTH & I,:NVIRONMENTAL PROTECTIO~ 'JUN .5 0 198d RECEIVED SUBJECT: KNIK HEIGHTS SUBDIVISION DRAINAGE PLAN Anchocage, Alaska 8621-DA-093 Dear Ms. Metcal¢: In reFerence to the subject subdivision, our department has received numerous inquiries From individuals on the identified drainage problem in this area. Knouing your department's involvement, ue have tried to reFer these individuals to your oFFice For any additional inFormation, but many have come back to us indicating problems in contacting knouledgeable personnel. We therefore request a wri'tten response as to the status o¢ uhat is presently and in the Future being done to resolve this drainage problem. We ~ould appreciate receiving your response as soon as possible so that ue may be able to better help these homeouners in the Future. IF you have any questions, please contact me at our Anchorage/- Western District oFFice. Sincerely, MPL:pkk cc: Bill Lamoreaux, DEC MOA/DHHS Michael P. Lewis Environmental Engineer D/~'~'R ECEIV ED ~ ' ~"~-' INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALI~ OF ANCHORAGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DFPT 825 L Street - Anchorage, Alaska 99501 E~VIR(Dj ~L' :i,.,,L_; ,O. LOTION ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~~,~ Ol RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER I PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) ' PHONE 2, BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION ' / ~ PHONE MAILIN~ ADDRESS ' , '~ d ~ 4. R~R/AGENT t~ ~' ~ ' PHONE MAI LING ADDR~S STREET LOCATION/.~ ~ , 6. TYPE OF RESIDENCE ~ NUMBER OF~BEDROOMS ~ SINGLE FAMILY ~ One ~ Four ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six [] Other 7. WATER SUPPLY J~[] COMMUNITyINDIVIDUAL* I (:~.(~.j. ~. <:* ~.h~'~ATTACH WELL LOG I A well log is required for all wells drilled ~ since June 1975 For wells drilled prior to that date, give well [] PUBLIC UTI LITY ' '* depth (attach log if available.) ~/~ ;~ ~ i L~ ~/ ~_~- 8. SEWAGE DISPOSAL SYSTEM ' · ""~" ' : J;~ INDIVIDUAL/ON-SITE** YEAR ON-SITE SYST'EM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY ' 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE E~ FiVE E~ OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL )EPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED PERMIT NUMBER 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER []Septic Tank or [] Holdin§ Tank Size: I...'~° If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/H°lding Tank IAbs°rpti°n Area ISewer Line I Nearest L°t Line Absorption Area to nearest Lot Line [] APPROVED FOR BEDROOMS ./~ [~J-CONDITION'AL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79) CHEMICAL & GEolOGICAL LABORATORIES t~.., ALASKA, INC. ~. Drinkin t An I sis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER I.D. NO, Water System Name Phone No. Mailing Address City Stat~ Zio Code Mo, Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water [] Untreated Water TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to De: IT'(Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indica[e reliable results, Please send new sample. Date Received .... Time Received "~ Analytical Method: [] Fermentation Tube [:::]~ Membrane Filter SAMPLE NO. 4 I LOCATION Time Collected Lab Ref. No. Result* Analyst Collected By I/'?;/ *No. of coronies/lO0 mi oF NO. of Posl[IVe READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 Rev. 19?8 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collecte~l Source. Data Received Time Recalv~l Presumptive 10mi /0mi 10mi 10mi 1Omi Z,0ml 0.1mi 24 Hours 48 H(~urs Confirmatory . 24 Hours 48 Hours - EMB Broth 24 hours~ Broth 48 hours: Multiple Tuba Report= 10mi Tubas Positive/Total lOml Portions Membrane Filter: Direct Count. Collform/lOOml Var[flcatlof~: L.TB BGB_ Final Membrane Filter Results Collform/lOOml Reported By Data . Time: a,m. December 15, ].982 Margaret Carlson% SRA Box 1692 C Anchorage, AK 99507 Subject: Lot 9 Block A Knik Heights Sub. Approval for the _ndlvldual sewer and water facilities cannot be granted until the following items have been comptetec~: review. e:~e~o The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. '/~ The septic tank pumped with a receipt submitted to this departmen-t. o A four (4) inch cleanout needs to be installed to the sep- tic tank. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, RP250/p/EIt Enclosure Robert C. Pratt Associate Environmental Specialist ALASKA EiiOIRonmenTAL CONTROL sem oice$, Inc. ~n§ineerin§ 6 ~nuironmcnM $1udics 12/9/82 GENERAL ELECTRIC MORTGAGE COMPANY/ATTN AJ 401 E NORTHERN LIGHTS SUITE 210 ANCHORAGE AK 99503 SELLER - MARGARET CARLSON & DENNIS MILLER SUBDIVISION-KNIK HEIGHTS BLOCK-A LOT-9 BUYER-TOM DEILE ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 780 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 993 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 4 BEDROOM HOUSE. 1250 IS ADEQUATE FOR 1200 L~¢st 33rd Aucmt¢, Suil~ ~ · Anchore§~, Alasb 99503 · (907) 276-136l ISAACS PUMPING SERVICE (Norm Tibbetts, Owner) 6218 Quinhagak Street ANCHORAGE, ALASKA 99507 DATE INVOICE NUMBER / DESCRIPTION I CHARGES ] CREDITS BALANCE BALANCE FORWARD J~'~ ISAACS PUMPING SERVICE PlANY LAST AMOUNT THIS COLUMN GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR ,4..- 1. Approval requested by: ~ /~ ~C~'/~, Phone: Mailing Address: z/'~/~ 2. Property Owner: ~ Phone: Mailing Address: 3. Legal Description: 4. Location: ~--t-/~.~' ,~-z~-,'~-~~-- ~$~~~z 5. Type of facility to be inspected/~-/. ~- No. of.bedrooms 6. Well Data: A. Type ~.---- ~ C. Construction ~,~/~/~ Sewage Disposal System: A, Installed C. Septic Tank: D. Seepage Pit: E. Disposal Field: B. Depth /~/. D. Bacterial Analysis /~ B. Installer ~'~c~ 1. Size /-~2~.~./ 2. Manufacturer 1. Absorption Area ~x~/ 2. Material Total length of lines o Distances: A. Well to: Septic tank /~m x~z, Absorption area /~ ~, Sewer Lines~3'~'? Nearest lot line /~ ~ , Other contamination /-/~/~,'~ B. Foundation to septic tank .~' /~, Absorption area C. Absorption area to nearest lot line ,~) z~ EQ-034 (1/74) Page 1 of two pages Pag,e '2 of two pages - Re~est for Approval of Individual ~__?~er & Water Facilities &'egal Description ~ o/'- 7'~___~c'/c>-~ x© /~>/~ ~"~"~'~ Comments Approved '~]~]~. ~---..~-.:~.,~_.~..-~ Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (l/74) I2 — 'Z:7 M -W DRILLING, Inc. -P. O. Box 4-1224 . 1310C International Airport Road Iq L'i � BAD C (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner Dennison Construction Location (address of: Township, Range, Section, if known; or distance main road i,9, b c- b, Knik Hts ubdiv se of Well LD1i tols9 Size of casing --5 Depth of Hole 10 feet Cased to LL feet Static water level lo ft, (IiboQ) (below) land surface. Finish of well (check one) open end Screen ( ); Perforated (. ).. Describe screen or perforatio*► I.7one Well pumping test at--5--gallons per (hour) (minute) for F lours with 10 ft. of drawdown from static level. Date of completion -�° JI)1 V 1071+ WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness C O —TO - 1 1 TO�-Silty r: ravel 1C TO Silt 21 TO 5 Saar► "2 TO 71 Gr+lyelly sand 71 TO 11 511 11, TO 140 clay 142 TO TO TO TO T�TO TO TO .TO , 2 — STATE STATE OF ALASKA 10159 DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING, LAND & WATER Alaska Hydrologic Survey WATER WELL LOG Revised 08/18/2016 Drilling Started: / / Completed: 7 / 9 / 1974 Pump Install: Cit /Boron hSubdivision Block Lot Property Owner Name & Address TOM D E I L E Municipality of Anchorage KNIK HEIGHTS L09 Well location: Latitude Longitude Meridian S Township 012N Range 003W Section 27 , SW 1/4 of SE 1/4 of NE 1/4 of NW 1/4 BOREHOLE DATA: (from ground surface) Drilling method: it rotary, able tool[Other Suggest T.M. Hanna's hydrogeologic classification system' Well use:❑Public supply,❑ Domestic, ❑Reinjection,❑Hydrofracking https://my.ngwa.org/NC Prod uct?id=a 185000000BYub3AAD ❑Commercial,❑Observation/Monitoring,❑Test/Exploratory,❑Cooling, ❑Irrigation/Agriculture,OGrounding,❑Recharge/Aquifer Storage, ❑Heating,❑Geothermal Exploration, []Other Fluids used: Depth From To Depth of hole: 150 ft Casing stickup: ft Casing type: Casing thickness: inches Casing diameter: inches Casing depth: ft Liner type: Depth: ft Diameter: inches Note: Well intake opening type: 0 Open end, pen hole, ■ Other Screen type: , Screen mesh size: Screen start: ft, Screen stop: ft, Perforated Des ElNo Perforation description: Perf from: It, Perf to: ft, Perf from: ft, Perf to: ft Gravel packed❑Yes ONo Gravel start: ft , Gravel stop: ft Note: Static water (from top of casing): ft on / / Artesian well El Pumping level & yield: feet after hours at gpm Method of testing: Development method: Duration: Recovery rate: gpm Grout type: Volume Depth: From ft, To ft Include description or sketch of well location (include road names, buildings, etc.): Final pump intake depth: ft Model: Pump size: hp Brand name: Was well disinfected upon completion? LJ Yes L!J No Method of disinfection: Was water quality tested?ElYes n■ No Water quality parameters tested: Well driller name: WAYNE,WESTBERG........................................................ Company name: M.W DRILLING............................................................ Mailing address:.PO,BOX 110378............................................................ City: ANCHORAGE State: AK Zip: 99511 Phone number: 907 945 - 3287 AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a copy of the well log be submitted to the Department of Natural Driller's signature: Resources within 45 days of well completion. Well logs may be submitted using the online well log reporting system available at: Date: Anchorage Municipal Code 15.55.060(1) and North Pole Ordinance 13.32.030(D) require that a copy of this well log be submitted to the Development Services Department/City https:/Idnr.alaska.-gov/welts/ within 30 days of well completion. OR email electronic well logs to City Permit Number: Date of Issue: —/—/ dnr.water.reports (a-�alaska.gov Parcel Identification Number: 'Guide for Using the Hydrogeologic Classification System for Logging Water Well Boreholes by Thomas M. Hanna NGWA Press