HomeMy WebLinkAboutPARK HILLS #1 BLK 1 LT 2Onsite File
' Municipality of Anchorage Page
'" DEPARTMENT OF HEALTH AND HUMAN SERVICES
".. ENVIRONMENTAL SERVICES DIVISION
· 'i. P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
' On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: S~J cl~ O ~ 13 PID Number:
Name: "-~.,, ~'~ ~~ 5~ Wastewater System: D New. ~Upgrade
Address: - -
_?~~ ~~ ABSORPTION FIELD
Phone: ~-- ~ ~.~ Nc. or,rooms: ~ Deep Trench ~ShaHowTrench DBed DMound ~Other
Total DeDth from original grade:/
LEGAL DESCRIPTION Sol, Rating: ~ GPD/Sq. Ft. :
Subdiv~on: , Depth to p~p~bottom from ordinal grade: Grave~ depth beneath pipe
Lot: ~ Block:[ ~ [~lL~5 ~ ~ ~ TO · ~'Oq~ Ft. * ~ Ft~
Township:, ~ I Range~ I Section:~ Fil] added. ~ab°ve~ 4°riginal+ grade: Ft. Gravel length: ~ f~ Ft.
~ Gravel wi~hj ~ i , Numberff lines: Distance ~e~een lines:
~ New ~ Upgrade / ~7, O Ft, ~(A Ft~
Classlfic6flon (Privat~ /T~al~Ft ~sed To: Ft. Total absorption~o~area: SQ. Ft Pipe
~ Static Water Level: installer:' Date installed:
Driller: Ft. ~000 ~ ~
SEPARATION DISTANCES ~ Septic ~ Holding ~.T.E.P.
'.~O Septic Absorption Lift Holding ~Private Manufacturer: Capacity in gallons:
From ': - Tank Field Station Tank 8ewerLines ~ ~ . ~/~
Suffa~ I I
Water' ~OO~ I~ ~ lo0 ~ lO0 ~ LIFT STATION
Lot ~/~ / t.~ ~ S~ze in gallons: Manufactu
Line j O ~O ~ '+ .~ ~- '~'
Foundatio, ~t~ ~ ~1~ ~ "Pump on" level at:~ ~1 ~'~off" level at:
CudainDraih: ' ~ ~ ~ ~ Pumpo~Make & Model Electrical Inspections performed by:
Remarks: BENCH MARK _
I Assumed Elevation:
I00 · O0
Depa~ment of Hea~ and H~man SeNices approval
72-013 (Rev. g/gl)MOA 25
S~/970313
C/O
TOWARDS FOUNDATION~
AS-BUILT DWG,
'; ~._ B TO FOUNDATION C/O : 9.5 C To CO1 = 38
· i,' -~.~ ] A TI'; FOUNDATION C/O 29.5
'."" ~:'-.'~ / A TU MH1 : 88,5 C TD CD2 = 34
~ ~ ...' ~Z. ~ B TD MH1 = 43,3 9 TO CO8 = 59
~<]' '~ / A TO NH8 : 33.8 C TO SAMPLE PORT = 33
'~ l"'.":~'~, lB T~ NH8 : 37.7 ~ TD ~AMPLE P~RT 36
~ELL
EXISTING 4
BEDROOM HOUSE
M~
SAMPLE
DOUBLE
DOUBLE
TANK WITH RECIRC-
ING TRICKLING FILTER,
TANK DESIGN
FOR BEDROOMS, --
UPGRAI]E~ LOT 8~ BK 1, PARK HILLS
TRENCH
NORTH SECTION
5'x17'×7'×17t
SOUTH SECTION
5,5'x17'×6,5'×17'.
TOTAL AREA =
804 SQ, FT,
FILTER
ANCH, TANK
DESIGN,
PREPARED FOR~
PREPARED BY~
DATE~ 10/3/97
HAL & CONNIE SNO~/
ALASKA WATER & ~/ASTE~/ATER
I]RAWN: GARNESS SCALE~ 1' = 30'
F- GROUND = 103,0+. COVER .................. +
__ / lIVER FILTER = 2'
2,5
SLOTTED PV£ PIPE WITH 2 INCHES / /--SAMPLING PORT
OF DRAINROOK OVER THE T~P <MIN.>-~ / / '
SEE
PLAN
~ \ ~F // INLET TD PORT ~ FOR LOCATION'
ND~E 5HE UPFLDW ~~ ~ X -- '
INSULATED ON SIDES ~ITH 2' URETHANE / ~ ~ -]?; INSULATION AND FA2RIC
AND DN TOP VITH 4 INCHES DF ~LUEBDARD,: / ~ ~ T:~
..... / I / / J ~, TDTAL A~SBRPTIDN AREA = ~84 SD, FT.
~A::~X"~%~j -p~X~"bAT'g~ / / / D, BDTTDM EXCAVATION : 97,B TO 9B,~5
IN STEP TANK PREVENTS ~ACK- / ~ ~ ....
~.m.~ TD TANK ~ / / E, TaP DF SAND : 99,13
...... / / F. INVERT OF DRAINPIPE = 9~,~ ,
~ 5 FEET MIN DF ANCHORAGE ~ ~T~TI ?DBTDD
~k~" '~ ............ ~.~ ~. INFILTRATOR CHAMBER (12 INCHES TALL)
MIN, DF 2 INCHES DF DRAINRD:K, BOTTOM
DF laX TD ]DTTDM DF ~LDCK PEA IS
APPRDX, 15 INCHES,
aROUND ELEV, :
COVER : 4 FEET+
4 IN~LINE FROM
94,77, DRBP FROM 6/D TB TANK =
65 FEET. SLBPE : 1.1X
ND
UPFLO~ FILTER, CHEEK VALVE IN LIFT
DATE: 10/3/97 DWN~ GARNESS SCALE: NTS
STA P.T.TIMF.: ' ~
PAGE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW970313
DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES
OWNER NAME:SNOW HAROLD E JR &
OWNER ADDRESS:14531 WOODHAVEN CIR
ANCHORAGE, ALASKA 99516
DATE ISSUED: 9/12/97
EXPIRATION DATE:
PARCEL ID:01714205
LEGAL DESCRIPTION:
PARK HILLS #1 BLK 1 LT 2
LOT SIZE: 46229 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AMD 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18~qAC72) AND DRINKING WATER REGULATIONS (18AACS0) .
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
. ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
1 OF
9/12/98
SPECIAL PROVISIONS:
THIS PERMIT IS ISSUED FOR THE CONSTRUCTION OF AN INNOVATIVE
RECIRCULATING TRICKLING UPFLOW FILTER SYSTEM. AS A
CONDITION OF THIS PERMIT, THE OWNER SHALL MAKE ARPJkNGEMENTS
FOR THE SYSTEM TO BE SAMPLED ONCE A MONTH FOR A MINIMUM OF
12 CONSECUTIVE MONTHS AFTER BEING PUT IN USE. THE ATTACHED
PROPERTY OWNER AGREEMENTS BECOME A PART OF THIS PERMIT
RECEIVED BY: [~ ~.
DATE:
DATE: ?-/2 -?7
W elr & W tew ter
8471 Brookridge Drive ~ Anchorage ~ Alaska 99504
Phone (907} 337-6179 ~ Fax (907} 338-3246
Consulting Engineers
September 9, 1997
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic System Upgrade for Lot 2 Bk 1, Park Hills S/D. REcIRCULATING UPFLOW
FII,TER (RUF) SYSTEM
To whom it may concern:
1. GENERAL: The existing 4 bedroom home is served by a private well and septic system. The
drainfield will not pass an adequacy test at this time, and an upgrade must be performed prior to
the sale of the house. Given the location of the structure, the old trench, the protective well
radius', and the topography, the area available for the new drainfield is very limited; The area to
the north of the well radius supposedly has some glaciation in the spring, which discouraged us
from siting the new system in that vicinity. Given the site restrictions, the only suitable area
appears to be to the southeast of the house.
Because of the space constraints, and the soil/groundwater conditions, we are proposing to install
a Recirculating Upflow Filter (RUF) system, designed by Orenco Systems, Inc., and marketed by
Anchorage Tank. The specifics regarding the design are summarized as follows:
2. SOIL CONDITIONS: A test hole was dug to a depth of 11 feet. Below a depth of
approximately 4.5 feet, the soil appeared to be bonded and very tight. A perk test at 11.0 feet
indicated that no water was absorbed in 30 minutes. In short, it is impermeable: At a depth of
4.5 feet the soil perked at 27 minutes per inch. On 9/9/97 groundwater was encountered at a
depth of 8.5 feet below grade.
3. DRAINFIELD: The intent is to install a Recirculating Upflow Filter (RUF) system that will
allow the use of a small drainfield in the area of the TH. The size of the drainfield will be based
upon the previously established criteria for the RUF systems, which dictates that soils percolating
between 1 & 30 minutes per inch have an allowable application rate of 4 gpd/ft2. Given this
application rate, the system (4 bedroom house, 600 gpd) will require a drainfield area of 150 ft2.
This corresponds to a 5 foot wide trench that is 30 feet long. To be conservative, we are going to
install a 5 foot wide trench that is 40 feet long (200 ft2).
4. ORENCO PACKAGE SYSTEM: The STEP tank with the trickling and upflow filters will
be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. Since you are
familiar with the operation of the system I won't elaborate. As with their standard STEP tank, it
is equipped with a high water alarm per M.O.A requirements.
5. SURFACE WATER: There are no surface waters within 100 feet of the proposed septic
system upgrades.
6. TOPOGRAPHY: Attached is a copy of the as-built survey, which gives numerous elevation
shots over the lot. Also, on the 30 scale site plan, I have identified the general location of the
cutbank which is to the south of the existing drainfield. To the southwest of the proposed trench,
the lot slopes downward at approximately 10% to 15%.
7. CLOSING: Clearly, this property has numerous site restrictions which limit the potential .for
septic system upgrades~ The suitability of this design will be limited by the soil/groundwater
conditions at the proposed trench site. I am open to any suggestions from your department that
would be an improvement to the proposed system. I am unaware of any negative impacts that
this installation would ~rc ~ose on adjacent wells, or septic systems. If you have any questions,
please call me a 337-617!
Sincerely,
Jeffrey]/
Principfii
244-9612, or on my digital pager at 1-800-481-1162.
ess, P.E., M.S.
LOT 6, BK 1~
PARK HILLS,
PVT. WELL &
SEPTIC.
LOT 8, BKI,
PARK HILLS
LOT I, BK 8, PARK HILLS,
PVT, ~/ELL AN]) SEPTIC
LOT 1,
PARK
LOCATION
OF ])RAINFIEL])
UNDEVELOPED LAND
NOTEj THIS IS NOT A SURVEY, THE LOCATION DF ALL WELLS, SEPTIC SYSTEMS,
AND STRUCTURES IS APPROXIMATE. THE CONTRACTOR SHALL VERIFY THE SEPARATION
])ISTANCE FROM THE SEPTIC SYSTEM UPGRADE TO ALL WELLS ON ADJACENT LOTS.
SEPTIC UPGRADE,
PREPARED FOR,
PREPARED BY,
DATE~ 9/8/97
LOT 8~ t~K 1~ PARK HILLS S/D
HAL & CONNIE SNOW
ALASKA WATER & WASTEWATER
DRAWN: GARNESS SCALE, 1' = 100'
NOTE~ THE CONTRACTOR SHALL HAVE THE WELL RADIUS,
AND THE PROPERTY LINES FLAGGED IN THE VICINITY OF
THE SEPTIC UPGRADE, Dy A REGISTERED LAND SURVEYOR.
NEW C/~
EXISTING 4
]~EDRBBM HOUSE
INCH
SAMPLE
INCH/FT MIN.
TRENCH TO
TOP OF CUTBANk
TANK WITH RECIRC-
ULATING TRICKLING FILTER.
PER ANCH TANK DESIGN
]R FOUR BEDROOMS. --
SEPTIC UPGRADE~ LrlT 8, BK 1, PARK HILLS
PREPARED FOR: HAL 8, CONNIE SNB~/
PREPARED ]~Y~ ALASKA ~/ATER & ~/ASTE~/ATER
SLOPE
SLOPE
FILTER
;RANCH, TANK
)ESlGN,
TRENCH
DATE: 9/9/97 DRA~/N~ GARNESS SCALE: 1" = 30'
/\lOVER TOP OF FILTER, / DRAINROOK FROM TOP oF 'PLUCK PEA, TD
2 INCHES OVER TOP DF SLOTTED PVC PIPE,
~ . ..' . '.. '..'".. ~//,,~//~,/,.~ ......
~ ; '..' :.."
~ND GRAVELS ']~LOCK PEA NEW 2000 GALLON STEP TANK, 4 INCH DIA. PVC
WITH RECIRCULATINO TRICKLING FROM HOUSE.
~-INFILTRATDR CHAM~ER (l:::' INCHES TAL~) / FILTER. PER ANCHORAGE TANK DESIGN.
DN ~DTTDN DF TANK IS COVERED WITH/ SET TANK LEVEL
MIN. DF 2 INCHES OF DRAINRDCK. 3DTTOM /
DF 'DDX TD iIDTTDM OF /tLDCK PEA IS
APPROX.
15
INCHES.
/ 1,25 INCH PVC PRESSURE LINE
FROM STEP TANK. CHECK VALVE
NDTE~ THE UPFLD~ CHAM~ER SHALL ~E INSULATED ~ITH ~ IN STEP TANK PREVENTS ~ACK-
DF SPRAYED URETHANE, ~Y ANCHORAGE TANK,
FLOW TD TANK. MIN ~URIAL DEPTH
DF ~ FEET, AND ~ INCHES DF INSULA-
TION ~DARD (~ FEET WIDE) OVER THE
TOP DF THE PIPE~ FOR EFFECTIVE
~URIAL DEPTH DF e FEET.
TOPSOIL AND RESEEDING TO BE THE RESPONSIBILITY DF THE ~UYER.
TOPSOIL & RESEEDING / FOR LD~ATIDN DF M.T SEE PLAN DRAWING
TD ~E DONE IN THE ~
SPRING DF 19~e.~ ~ ~ INCH PVC, 6 INCHE~ DF DRAINRDCK ~ELD~ PIPE.
/
[ F FILTER FABRIC OVER DRAINRDCK
/ / AND 2 INCHES DF INSULATION,
/
/
~~ A. TRENCH LENGTH ~ 40+ FEET
~ ~, TDTAL ABSDRPTIDN AREA = ~+ SO. FT.
I
EXCAVATE DRGANI~ L~Y~R AND FILL BA~K UP TD ~ITHIN
,~ F~ET DF DRIGINAL GRADE ~ITH LA~E DTI~ GRAVEL,
THI~ ~ILL ENSURE A 4' ~EPARATIDN TD IMPERMA~LE
SEPTIC UPGRADE, LOT ~, ~K l, PARK HILLS S/D, . ......... :...
PREPARED FDR~ HAL & CONNIE SNOW
ALASKA WATER & WASTEWATER
" ~,." ....... "L~*~
DATE~ 9/9/97 DWN, GARNESS SCALE: NTS
PERFORMED FOR~
LEGAL DESCRIPTION:
1
7
9
10~
11
12
13
14
15
16.
17
18
19
20
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMI
Township, Range, Section:
WAS GROUND WATER
ENCOUNTERED?
SLOPE SITE PLAN
[:),A~k,,A- o,, ,uw Ne~?1'
S
IF YES, AT WHAT O
DEPTH? p~
Depth to Water A,er ~.~-- ~/.~
Monitoring? Date:, ,
Reading Date Gross Net Depth to Net
Time Time Water Drop
I.
PERCOLATION RATE__ ~ [' ~) (minutes/inch) PERC HOLE DIAMETER
PERFORMED BY; d~c:~O~c~.~.~J~-~~t_~r.. ~ I ~ ~kJ~k/E'~s CERTIFY THAT T~S T~ST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
9'£,
R/ck Mystrom,
Mayor
Municipality of Anchorage
Departmentof Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
http://www.ci.anchorage.ak.us
Dear Homeowner/Prospective Buyer:
The on-site wastewater disposal system you are purehasing/installing is an "alternative" wastewater
disposal system. This system, known as a "Recirculating/Upflow Filter Septic System", is undergoing
testing within the Municipality of Anchorage under the Alternative System section of the Wastewater
Disposal Regulations (AMC 15.65). There am certain risks involved with the ownership of one of these
systems:
The technology used in this system has been shown to be effective in other areas. The system is
currently undergoing a two year testing period in Anchorage under the guidance of the Department
of Health and Human Services (DHHS) and the State of Alaska Department of Environmental
Conservation (ADEC) to determine its effectiveness in a subamtic environment.
The system for this property may have received vertical separation distance waivers from both
State of Alaska and Anchorage Municipal Codes to both ground water and bedrock. These
waivers were granted due to the system's expected performance within the site conditions on this
property. If the test results do not support these waivers, modification or replacement of this
system may be required.
If this system fails to meet the requirements set for it to become a standard, code approved
wastewater disposal system, it may have to be removed and replaced by either a holding tank or (ff
possible) other wastewater disposal system that meets Municipality of Anchorage requirements.
The cost of any conversions required to meet code requirements will be the responsibility of the
homeowner at the time of conversion.
I (we) certify that I (we) have read the above statements and am (are) aware of the risks outlined. I (we)
also certify that I (we) am (are) in the process of purchasing (property legal description):
(Purchaser Name) _
(Purchaser Signature)
(Purchaser Name)
(Purchaser Signature)
Notarize Here
SUBSCRIBED AND SWORN TO THIS
12Ttl DAY OF SEPTEMBER, 1997.
E MOORE
NOTARY PUBLIC IN AND FOR ALASKA
MY COMMISSION EXPIRES: 9-9-2000
PROPERTY OWNER AGREEMENT
FOR THE 'MAINTENANCE OF AN
ON-SITE WASTEWATER DISPOSAL
SYSTEM
This agreement, dated ' :':~-r~4g~ 99'-/, is made between the Municipality of
Anchorage Department of Health and Human Services (DHHS) and the property
owner(s) of:
This agreement is made for the purpose of maintaining an on-site wastewater disposal
system on the subject property.
The property owners agree to the following:
Allow the Municipalit3, of Anchorage the perpetual right of entry to the properb, during
normal working hours, to allow for effluent sampling or evaluating the general state of
repair or function of the system.
Submit to the Municipality of Anchorage, on an annual basis, an inspection and
operation statement from a registered professional engineer. This inspection and
operation statement shall verify that the engineer has inspected all effluent and air
pumps, timers, and alarms, and that any deficiencies have been repaired and that the
system is functioning as designed.
(Signature)
(Printed Name)
SUBSCRIBED AND SWORN TO THIS
12TH DAY OF SEPTEMBER, 1997.
MOORE(Notarize Her~
NOTARY PUBLIC IN AND FOR ALASKA
MY COMMISSION EXPIRES: 9-9-2000
(Signature)
(Printed Name)
MUNICIPALITY OF ANCHORAGE `\_,
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
' ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264.4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME - --
PHONE
-r
NEW
❑ UPGRADE
MAILING ADDRESS --- - -
LEGAL DESCRIPTION `—
A S I-- I
LOCATION
C� s o(— (AN Vd P cit.)
NO. OF BEDRTS
V Y
Well Absorption are j
DISTANCE TO:
Dwelling
_
PERMIT NO.L� ��
wWQ
~
Manufacturer
Material
No. of compartry�nts
Liq. cap cii allons IF HOMEMADE: Inside length_��
Width i
Liquid depth
z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
0z F
Manufacturer
Material
Liquid capacity in gallons
w =
DISTANCE T0:
Wel( `—
T r
Foundatn
Nearest lot line
PERMIT
J Z w
F — x
No. of lines 1
Length of e ch- qf
Total length of in s
��
Trench wid h •j-
inches
Distance between lines
f
Top of tile to finish gradeI )
Material beneath tile
T I effective absorption area
rinches
��
w
Length
Width
Depth
PERMIT NO.
0
4 F
wa
Type of crib
Crib diameter
Crib depth
Total effective absorption area
w
W
DISTANCE TO:
Well
Building foundation
-
Nearest lot line
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
O
OTHER
PIPE MATERIALS
PUC— 1_.
SOIL TEST RATING
INSTALLER
REMARKS
_/I
t c �rc?-tiw tr- eA,_c ,_
j2
n
APPROVED DATE LEGAL
f � r
J ucck 1
� ~ WT U 149 :11 17"-1=1 1=1 Q 1: Vis" 41) F77 K MAI C -117) Q oil 42a�
DEPHRTMITU: HEHLTH HND ENVIRO�MENTHL���OTECTIO� ' U
STREETHNCHORHGE' HK. 99501 ~
^`
` 2�4-4720
�
PERMIT NO. ( 820464 )
HPPLICHNT HMC INC PO BOX 4�2882 ]45~581]
LOCHTIONI
LESHL 1 2B: -L FIE:ET
TYPE OF SOIL HBSORPTION SYSTEM IS: TRENCH
MH�IMUM
NUMBER OF SOIL RF! TING (SCA FT/EA f;!)�z ;;L��'�
THE SIZE OF THE SOIL HBSORPTIOH SYSTEM I��
/06-1 �
ED; 1=2 FQ1~---= FEE8�-Y ^9--q C,:�l 1141 i=w M K ���W, lIm-%.� ~�
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD
THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE
8ROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET)
THERE IS NO SET WIDTH FOR TRENCHES
THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETHEEN THE OUTFHLL PIPE
HND THE GOTTOM OF THE EXCHVHTION (IN FEET).
��9-J! 1 F:! EE: E".:- 11-11 1: W K aE:
PER|1IT HPPLICHNT HHS THE RESPONSIBILITY TO I�FORM THI5 DEP8RTPIE
NT DURING THE
INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS PROPERTY RND THE
NUMBER OF RESIDENCES TINT THE WELL k!1[ -[-
G. �,
ILL�03�, IF tcj! 01 K 1=1 FV EREE.'
BHCKFILLING OF HNY SYSTEM WITHOUT FINHL INSPECTION HND HPPROVHL BY THIS
DEPHRTME-NT WILL BE SUBJECT TO PROSECUTIQN
MINIMUM DISTHNCE BETWEEN H WELL HND HNY ON --SITE SEWHGE DISPOSHL SYSTEM IS
100 FEKETT FOR H PRIYHTE WELL OR 130 TO 200 FEET FROM H PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTHNCE FROM H PRIVHTE NELL TO H PRIVHTE LINE IS: 25 FEET HND
TO H COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS HRE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN 30 DHYS
C)F THE". WELL COMPL�TION
OTHER REQUIREMENTS MHY HPPLY HRE
RYHILHBLE TO INSURE PROPER INSTHLLHTION�
��M 1: K 1 MEMEZ ��Q M M W EEL sol ��. ME!
I CERTIFY THf3T
V I HM FHMILIHR WMH THE REQUIREMEINTS FOR OY--!^SITE SENERS HND WELLS HS SET
FORTH BY THE MUNICIPHLITY OF HNCHORHGE
2: I WILL INSTHLL THE SYSTEM IN HCCOREHNCE WITH THE COMM.
]� I 0VDERSTHND THHT THE ON ---ITE SEWER SYSTEM MIF THE
REMDENCE IS REMMELED TO INCLUDE MORE THHN 4 BEDROQMIR
SIGNED4
ISS�ED BY�.����.����~-^.��� ...... <[.a��.-..... V40
MUNICIPALITY OF ANCHORAGE�'
o DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
825 L. Street, Anchorage, Alaska 99501 264-4720 TEST
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: PAr(e- PIL-S &c4lyIsI ori DATE PERFORMED: 3 -Z2- Fez
LEGAL DESCRIPTIO'(:_ %ST WOLF_ 41 2 6),
DEPTH - SLOPE SITE PLAN
10-
14-
15-
16-
17
_4F F FTI
1� Nurnu s
1
WAS GROUND WATER S
Froz EfJ +p 2_
11
.
3
13rowN7 A4o,sr
4
G ►i
N •yard 6 I'L_L I -) j
s O
RA&AOOM Cob6tes
12
6-
7
IF YES, AT WHAT E
8
9
DEPTH?
L6j. Cobble. or o -t
13-
3
18-
819
q' r
10-
14-
15-
16-
17
14151617
Gross
Time
Net
Time
WAS GROUND WATER S
Net
Drop
11
.
ENCOUNTERED?L
s O
12
P
IF YES, AT WHAT E
DEPTH?
13-
3
18-
819
Reading
14151617
Gross
Time
Net
Time
Depth to
Water
Net
Drop
18-
819
19-
,)n
PERFORMED BY:
72-008 (6/79)
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND FT
CERTIFIED BY:
DA
>
2
3
5
6—
8
9
10
COM
Et�
L4;
4`rnZGaJ id; C°
r
�p.bw Gr or' I
Mo-it�Y
WFr-� DrilsLin 3
12w�.tooir, Cobble S
NArd V f!!�L! n q
P
SLOPE
SITE PLAN
PERFORMED BY: —
CERTIFIED BY:
-� DATE:
p
r- ... ANCHOPAGC_
S
(907) 20 'i 11
TON?'N '
DEPAR"i.MENT OF I EALTFI AND ENVIRONMENTAL PROTECT IO J
(Permit #: 820737
January 31, 1983
TO: Permit Applicant
Subject: Lot 2 Block 1 Park Hill Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely
Q �
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
B
I
��`����...
~ `~ �EPHRTMENT � /HEHLTH HND ENYIRn�H�NTHL\` !QT�CTION
825 '�STREET' HNCHnRRGEHK99501 ��
264^�720
` AN EVE L. L. 101 As Fly 61, 141�l"E., AT ERE u A ERE SY FINE205,100 1 1,
PERMIT | NO ( 8207]7 ".�
/
� APPLICHNT HMC INC PO BOX 4~2882 99509 ]45-58M..'
LOCHTION
� LEGHL L2B1 PHRKHILL LOT SlZE FEET
TYPE OF SOIL H8SURPTIOH SYSTEM IS: DRHINFIELD
� MHXI�UM ��M�E� OF BB}�GOMS � 4 SOIL RHTING (SQ FT/E3 Fz 100
THE REQUIRED SIZE OF THE SOIL HBSGRPTIUN S�STEM IS�
1=E U 112, EE F" V 41� �
THE LENGTH FEET) OF THE TRENCH OR DRSINFIELD
THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF THE
GROUND HND THE BOTTGM SF THE EXCHVHTION (It! FEETA
1- F-1 EVE "T- to? K 141 p! � M 9 lf --1 1: !! �
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRHYEL BETWE,EN THE F'11 FIE
HND THE BOTTOM OF THE EXCHVHTION (IN FEET).
lot &A � -A K Tot WET 131! Ji- r- L'.
PERMIT HPPLIWANT HAS THE RESPOf|SIBlLITY TO INFORM THIS IF) EPHRTMENT THE
INSTHLLATION INSPECTIONS OF HMY WELLS HDJHCENT TO THIS PROPERTY HND THE
NUMBER OF RESIDENCE5 THHT THE WELL WILL SERVE.
�� ��� ���������7�������� ���� ����������� ~_~~
BRCKFILLIN8 OF STY SYSTEM WITHOUT FINAL INSPECTION HND HPF 1IR0VHL BY THIS
DEPHRTMENT WILL BE SUBJECT TO PROSECUTIO�-
MINIMUM DISTHWE BETWEEN H WELL HND ANY VA -SITE SE@HGE DISPOSHL SYSTEM IS
AS? FEET FOR H PRIVHTE NEL[ OR 150 TQ 200 FEET FROM H PUBLIC WELL DEPENDING
�PON THE TYPE OF PUBLIC WELL
� MINIMUM DISTHNCE FROM H PRIYHTE WELL TO H FIFO IVHTE SEWER LINE IS 25 FEET ND
TO H COMMUNITY SEWE� LINE IS 75 FEET.
� WELL LOGS ARE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT /(ITHIN ]0 DHYS
� OF THE |�ELL COMPLETION
OTHE� REQUIREMENTS WAY FKq`L\! SPECIFICHTIONS HND CONSTRUCTION DIHGRHM5 HRE
HKHILHBLE TO INSURE PROPER INSTHLLHTION.
`
�U 117 K two FINES- J-��
I CERTIFY THRT
U I HM MMILIHR WITH THE REQUIREMENTS FOR ON`SITE SENERS HND WELLS �S SET
FOR% BY THE !ORHGE.
2: I WILL IIIJSTHLL THE SYSTEM IM HCCORDHNCE WITH THE CODES
]� I UNDERSTHND THRT THE ON^SITE SEWER SYSTEM MHY IF THE
RE5IDENCE IS REMODELED TO INCLUDE MORE THAN 4 GEDROOMS.
SIGNED���
�F1 113 11 N T�
�
ISSUED BY ��^ ~Jr
., �� �
-MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
n� SOILS LOG - PERCOLATION TEST
PERFORMED FOR: 64<- 141 SL, 6G4I U I S t o nl DATE PERFORMED: 3-22- 9-2-LEGAL DESCRIPTION: 'Te Sr LIOL- Z
SLOPE SITE PLAN
DEPTH
1 FrozE'i +o Z�
2
5'Lry SarJOy cjfA�EL
3 r3fowN7 Mo,sr _
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
PERFORMED BY:
72-008 (6/79)
NArd brZIL(„tf) !
RAnlporvi Cobbles
Lg-Cobble or Ooi lder ap
9' i84ru5At_
WAS GROUND WATER , S
ENCOUNTERED? L
D
P
E
IF YES, AT WHAT
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE
TEST RUN BETWEEN
CERTIFIED BY:
FT AND
(minutes/inch)
— FT
DATE:_j��g
15
MUNICIPALITY OF ANCHORAGE`f '
®' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
O PERCOLATION
TEST
PERFORMED FOR: PAS F -Ir S DATE PERFORMED: 3 -22 -
LEGAL
-22 -LEGAL DESCRIPTION: Te51 f4w-E z o-+ lO o -Froj 5+oxte-
SLOPE SITE PLAN
DEPTH
Jrr z:t-- 'tvS
�
1 raZE wl -co Zs
S1 t, T'LlSA Mt 0V
2 3 w - -r„t'j ,
rnolsr
3 HArJ Dr1`L trig
4 R1^^1poM Cobbles
a® 6
�M
7
12
13
14
15
771
A.
15
17
uArd l�ri�t:tr�q
Sc�'k I 1 o- (0 - 5
51t_r,.j S alupy grAVe LWAS GROUNDWATER S
TAN 1 M01ST- - O ENCOUNTERED?\_ e �j 0
s 11q 1�+17 nti of St' P
J
* More o�rAvp1., y h..n1 IF YES, AT WHAT r E
trJdtg..>,}PS DEPTH? �5 Z
18 '51 �-r 'l 5A,,>04 q r A 0 L-
19-
Reading
r19
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
O
O
5('0`2.
r
y
1: Z
I:Z9
0'2 1 34
r
I : y
5l017L &0 Y
r
3'0
58
20`
;'j'tJ PERCOLATION RATE - (minutes/inch)
` TEST RUN BETWEEN / FT AND FT
COMMENTS hpp+k oG Pipe- 1/2 rr C `r .��0JP rr6U nGr
PERFORMED BY: - CERTIFIED BY: DATE:_
16
72-008 (6/791 -
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Surveys
Drilling Permit No.
OCATION OF WELL (Please complete either to, lb or 10.) A.D. L. No.
qIr5 section I
121 Borough vision L Block qtr5. Section No. large Meridian
Subdivision at 1/4 Township No I R;�� E [T]
:If
—of W
f
TD DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL:
Address
9
Street Address and Area of Well Location
Feet Below
2- WELL LOG
4. WELL DEPTH: (final)
I
5 . DATE OF COMPLETION
Surface
1 ..
1 .1 -.
Material Type Top Bottom
6. O'Coble toot Rotary ®Driven Doug
Auger Jetted ®Bored ❑Other
"a) I.,
7. USE: E] Domestic E] Public Supply ❑ Industry
0 Irrigation Recharge ❑ commerical
To Other:
of Well
I I
1 C r;
8. CASING: Threaded O�'Welded
in. to 0 ft. Depth Weight ight tbs./ft.
diam.—in. to ft. Depth Stickup ft.
9. FINISH OF WELL:
Type: Diameter:
Slot/Mesh Size: Length
Set between ft. and ft.
Backfilling Gravel pack
10. STATIC WATER LEVEL: ft.
0 Above or;Q Below land surface Date
Equipment used!'
I I . PUMPING LEVEL below land surface and YIELD
ft. after hrs. pumping Q. P. M.
ft. after hrs. pumping g.p.m.
rn
—Y 12>
12, GROUTING Well Grouted: I E] Yes [] No
Vol
Material; Neat Cement [3 Other:
G M
13, PUMP: (if available) HP
Length of Drop Pipe ft. capacity g. p.m.
::-4 "o
0 Subm. Jet Centrifical E] Other
LQ
!3: 14. REMARKS:
16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature —0 F C
This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief;
1 11 11_ I 'k
r j!A
Registered Business Name Contract License Number
y:1
L
Address: G v J.- � I ,',
Date:
Signed
_4
Authorized Represents live
Form 02-WWR (11/81) Copy Distribution: WHITE -State DGGS, PINK -Driller, CANARY -Customer
0
APPLI, IT FILLS OUT UPPER FIA, ONLY
Property Owner /1`(J
Time
Address ��) - — 'x
FeMailing
Zip Code
Buyer
Address
Zip Code
Lending Institution �//6) 7�
Phone
Address -
Zip Code
Realty Co. & Agent
Inspector
Phone
Address
Zip Code
Legal Description //
Field Notes:
Street Location ( -
j
Type of Residence
[Y8ingle Family 2
❑ Multiple Family No. of Bedrooms
PROTECTIOR
❑ Other
Water Suyply
Q-tfiaividual
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
❑ Community
For wells drilled prior to that date, give well depth (attach log if available).
❑ Public Utility
( q) APPROVED BEDROOMS
Sewer Deposal-
dividual
Year �N,
❑ Public Utility
Individual Installed:
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
Date
Date
Date
Date
lo --
Inspector
Inspector
Inspector
Inspector
Field Notes:
OF ANICHORAGF
MUNICIPALITY
CEPT. OF HFP, Tli is
PROTECTIOR
t
ENV IRO\)J=iJTAL
kT;f
RECEIVED
( q) APPROVED BEDROOMS
`CONDITIONS OF APPROVAL
( ) DISAPPROVED
_
( ) CONDITIONAL A PROVAL'
DATE
BY:
(
Soils Rating
Date Sewer Installed
Well To Absorption Area / O v
Well Log Received - .-
�Qyp
5;— 2—.Y` 'V
I Well to Tank / 6-1)
Septic Tank Size i, 5e)
Municipality of Anchoragle
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Etmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEIVlS APPROVAL
FOR A SINGLE FAMILY DWELLING
O
Parcel I.D. 017-142-05
1. GENERAL INFORMATION
COSA# 0
Expiration Date:
Complete legal description
PARK HILLS S/D #1; BLOCK 1, LOT 2
Location (site address) 14531 WOODHAVEN CIRCLE * ANCHORAGE, AK * 99516
Current PropertY owner(s) KELLY & NATALIE BAY
Day phone C/O AGENT
Mailing address
9158 ARLON STREET, #3145 * ANCHORAGE~ AK * 99507
Lending agency
Day phone
Mailing address
Real Estate Agent PEGGY FRENCH W/ REMAX
Day phone 242-6121
~.i,; ~a, ilingaddress 110 W. 58TH AVENUE, #100 *
Unless other~)i~e_requested, COSA will be held by DSD for pickup.
BEDROOMS: 4
ANCHORAGE, AK * 99505
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well · Individual On-site ·
Individual Water Storage [] Individual Holding tank []
Community Class Well [] Community On-site []
Public Water System [] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4,. STATEMENT OF !NSPECT]ON BY ENG!NEER
As certified by my seal affixed hereto and as of the validation date shown below, ! verify' that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shov,/s that the on-site water supply and/or wastewater disposal &vstem is (are) safe, functiona! and adequate
for the number of bedrooms and type o~ s,., u,,u, ~ ¢,,u,c¢t~d he, ~n. ! further verify that based on the
. .ol rn~.un obtained. u~ ~ ~ u ~ ~v*u~ .~..fHol~"./ O* ~ ~.ho, og~ ~;!es aRd . ,~,,,¢"'~"~ ,,u,~'~ l,~, ves~.Igat~on~,~'!,~ .;'~o~:~'"'H"~,..~.. ~-'-"' ,, .h~
on-site water supply and/or wastewater disposal system is(are) in compliance wit.h afl appficable Municipal
and State codes, ordinances, and regulations in effect at t,ffe time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 557-6179
Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.Eo Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this rePort is for
the sole beneN of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
DSD SIGNATURE
'//'"~ Approved for
Disapproved,
bedrooms.
Conditional approval for
bedroomsl with the following stipulations:
ll~Ci I ~11'-i ~ ~
COSA ~hec~hst
Septic System Advisory
Well Flow Advisory
~,:;u ate ,~uv~ury
(Rev, 11/05)
Arsenic Adviso~¢
Maintenance Agreements
Supplemental Engineer's Report
Other
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Legal Description: PARK HILLS S/D #1; BLOCK 1, LOT 2
WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 6/'27/1983 Sanitary seal (Y/N) YES
Total depth 95 ft. Cased to 78 ft.
FROM WELL LOG
Date of test 6/27/1983
Static water level 15 .ft.
Well production 4 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi. Nitrate 3.57 mg./L.
Arsenic: ND ug./L. Date of sample: 6/13/2011
CHECKLIST
Parcel ID: 017-14-2-05
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
6/13/2011
23 ff.
1.9 g.p.m.
YES
YES
12+ .in.
Collected by: GEG, Ltd.
SEPTIC/HOLDING TANK DATA
Tank Type/Material *S.T.E.P./STEEL
Tank size. 2000 gal. Number of Compartments__
Foundation cleanout (Y/N) YES
Date of pumping -
ABSORPTION FIELD DATA
Date installed 9/27/1997
Length 34- ff.
Total depth *3.8 ff.
Date of adequacy test
2
Depression over tank (Y/N) __
Pumper.
*RECIRCULATING TRICKLING FILTER SYSTEM.
Date installed 9/27/1997
Cleanouts (Y/N) YES
NO High water alarm (Y/N) YES
A+ HOME SERVICES
I'BELOW EXISTING GRADE]
Soil rating ~or ft2/bdrm) 4.0
Width 6 .ff.
System type SHALLOW TRENCH
Gravel below pipe 0.5 ft.
Depression over field NO
For 4- bedrooms
Fluid depth in absorption field before test 0 in. Wateradded 640 gal. New depth 0 in.
Elapsed Time: - min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date -
NOTE: DRAINFIELD IS INSULATED. 24" SOIL COVER ACHIEVED.
Eft. absorption area 204. ft2 Monitoring tube YES
6/13/2011 Results (Pass/Fail) PASS
D. LIFT STATION *SEE
Date installed 9/26/1997
"Pump on" level at TIMER in.
Datum BOTTOM OF TANK
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
ATTACHED
Size in gallons 2000
"Pump off" level atTIMER in.
Cycles tested, *
100'+
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'+
Animal containment areas, 50'+
A+ HOME SERVICES INSPECTION REPORT.
Manhole/Access (Y/N) YES
High water alarm level at 56
Meets alarm & circuit requirements?
YES
in.
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main N/A Water service line. 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation, 10'+
Water service line 10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
COMMENTS
Absorption field 5'+
Surface water. 100'+
Water main N/A
Driveway, parking/vehicle storage 10'+
G. ENGINEER'S CERTIFICATION
/ 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
Engineer's Prin}ed Name
Date
JEFFREY A. GARNESS
COSA Fee $
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
.-X~-" ".-...'..~]k
Lot ~ , e,ock. / °"-....~' ...
' /Vo. / '
' ·· '~.* ' .... '"'~ ~.' I
04.~[_SURVEY CERTIFICAT~ON o~bor.,..
LEGEND
~o I~~ ~ ..... ~-~ ~op~ eM fh~ ~ '2: ~ hub ~ rock
~ Prepared
~'~ JO3 7 ~. No. 0~-0/~,
TOTAL P.01
A+ Home Services, inc.
!nspeetions
-~,~k :y~o: ................... .0.1~ ........... -~.~-°:-~'~-': ....
Phone Numbm': ......
Timer Setting ....................................................................
Air ]Flow ~.._55_: ...........................................
Elapsed Time_~_3~ff/
Event Counter
Date & Time
,//
Problem: ........ .~._.,_a..~L ~-.
INVOICE# ~9779
A+ HOME SERVICES , INC.
CUSTOMER
7501 E. 140th Avenue
Anchorage.~ Alaska 99516
345-1.890
14531 Woo~lh~,~ C/rcle
A~horage, AK {)9516
Lot
Block
DATE
DESCRI PTI ON AMOUNT
* . ,... '~ ~ TOTAL
, '"' ': illrr~ '
aEC%ns ""':":" ':"' :'"'"'"
Gallons ~Septic~ LeachAma ~H°ldingTank z standpipes (O'~m,
E~ PROBLEM AREA -- CALL FOR MORE INFORMATION
GooDS TO BE DONE AGAIN IN 6 MONTHS
d Shape ~ Sludge buildup on bottom
[] Jim cap missing or [~ Cut standpipe to 1' above ground
needs replacing
Floater on top
Needs Septictrine
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
THIS MEMORANDUM OF UNDERSTAN-DING made and entered into as of this
I kDDayof ~L,~.rl cT.,. of201L, bY andbetween Cx;,--~./q L;,[{~,."~ c~
herein the "OWNER,"' and the Municipality of Anchora. dge, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
pm-ties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality'
grants permission to Owner to utilize and operate an Advanced Wastewater
as located
Treatment System (AWWTS), described j/~t~lkJO_rq trc>c ?~C S 5
at ~ 5 [ ~ 1 L '~-- , Anchorage, Alaska.
2. Definitions.
A. Alteration. An>, change to the design or function of an AWWTS that
Includes the installation or removal of any parts, components or pieces not
included in the original construction perm. it and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
p~xrsuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On-Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
These approvals certify that the systems are adequate tbr the homes that
they support and meet the codes that were in place at the time of system
construction.
Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
D, Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included in
the original design which would allow the AWWTS to continue to
perform as designed.
E, Permit (Construction) An On-Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65~
F. Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality~ that
allows the Owner to operate an AWWTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit~, the
requirements of the On-Site Wastewater System Construction Permit and
all relevant provisions of AMC 15~65
3. Fee~ Ovmer shall pay to Municipality an annual fee of_ ~
($ (~.00)~ payable on or before the issuance of the operating permit and annually
thereafter, The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed s~stem.
4. Term, The term of this Memorandum of Understanding shall be for the life of the
AWWTS.
The term begins on the date of approval by the Municipali~~ of the installed system and
shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On-Site approval is issued to
the new owner or transferee of the property.
5. Alterations, Installation and Removal of Additional Equipment~ Owner agrees
not to make any alterations, removal of parts or additions to the AWWTS without a
Construction Permit from the Municipali~~.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereo£ at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustrnent(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws. regulations,
rules and orders for the AWWTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AWWTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AWWTS
Operating Permit is: ~ ~-~ce_~ ./~ .....'...~'~..-~' ca.--*
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
D~ Owner agrees that only maintenance, repair personnel ce~ified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test. and inspect the
AWWIS upon 24 hours written notice.
F. Owner agrees that any- sale or transfer of title of the property will not occur
without a new Certificate of On-Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AWWTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AWWTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
nor in any way effect the validity of(he Memorandum of Understanding or any part
hereof~ or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the same
formality of this Memorandum of Understanding was executed and such writing shall
be attached to this Memorandum of Understanding as an amendment.
B. For the pmTposes of any amendment modification or change to the temns and
conditions of this contract, 'the only authorized representatives of the parties are:
Anchorage: Purchasing Officer
C. Any attempt to amen& modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void,
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding,
10. Severabili~', Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
OWNER: ~ -
By~a~ .~, ,_~__' By:
Title:
Date: Ja~?~ } ! Date:
STATE OF ALASKA )
) SS.
THIRd) JUDICIAL DISTRICT )
MUNICIPALITY:
The foregO~ instrumep~as aqtflnowledged before me th_i~ t~y o~~~_~,
My Co~issio~'expires: ~~
c o
Municipality of Anchorage
-�1 Development Services Department
Building Safety Division
\, On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
' www.muni.orglonsite
(�
R L) %R)
(907) 343-7904
V ri• CERTIFICATE
I!
100
OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0 11 - U5 COSH# 6L6d(09 -
1. GENERAL INFORMATION Expiration Date: & - 2- L -11"_ Q8
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
PARK HILLS Al BLOCK 1 LOT 2
14531 WOODHAVEN CIRCLE *ANCHORAGE AK
JANE AHERN Day phone 947-0246
14531 WOODHAVEN CIRCLE 'ANCHORAGE AK
Day phone
KATHERINE DONAHUE W/ PRUDENTIAL Day phone 244-6939
3801 CENTERPOINT DR #200 *ANCHORAGE AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
0
❑
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, baseqpj&ocedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that th %r supply and/or wastewater disposal system is (are) safe, functional and adequate
for the ooms and type of structure indicated herein. 1 further verify that based
informah ined from the Municipality of Anchorage riles and from my investigation and in i
on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Munito
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm
GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 I
Engineers Printed Name JEFFREY A. GARNESS, P.E. Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines 8 Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the solo benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
WASTEWATER
PROGRAM
Conditional approval for
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
bedrooms, with the fllowing stipulations:
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
By, i/ Original Certificate Date:
(Ra. 1105)
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: PARK HILLS #1, BLOCK 1, LOT 2 Parcel ID:O�%'���
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 6/27/1983 Sanitary seal (YIN) YES
Total depth 95 ft. Cased to 78 ft.
FROM WELL LOG
Date of test 6/27/1983
Static water level 13 ft.
Well production 4 g.p.m.
WATER SAMPLE RESULTS:
Coliform U colonies/100 mL Nitrate- r , r — mg./L.
Arsenic: f ~ ug./L.
B. SEPTIC/HOLDING TANK DATA
Well Log (YIN) YES
Wires properly protected (YIN) YES
Casing height (above ground) 12+ in.
AT INSPECTION
2/29/2008
kllk.
Other bacteria n colonies/100 ml.
Tank Type/Material SEPTIC/STEEL Date installed 9/27/1997
Tank size "2000 gal Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A
Date of pumping 3/3/2008 Pumper A+
C. ABSORPTION FIELD DATA tBELOW EXISTING GRADE
Date installed 9/27/1997 Soil rating .p.d./ r ft'/bdrm) 4_0 System type SHALLOW TRENCH
Length 34 ft. Width 6 ft. Gravel below pipe 0.5 ft,
Total depth 6.3 ft. Eff. absorption area 204 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 2/29/2008 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test E in. Water added 601 gal. New depth Sin.
Elapsed Time: E min. Final fluid depth 3 in. Absorption rate >= 600+ g.p,d,
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
D. LIFT STATION *SEE ATTACHED INSPECTION REPORT FROM A+ HOMES
Date installed 9/26/1997 Size in gallons 1500 Manhole/Access (YIN) YES
"Pump on" level at TIMER in. "Pump off" level at TIMER in. High water alarm level at 56 In.
Datum B.O.T Cycles tested ' Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankilift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main
Public sewer manholetcleanout N/A
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5t+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
10'+
Building foundation
10'+
Water main N/A
Water service line
10'+
Surface water
100'+
Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
OF'101
G. ENGINEER'S CERTIFICATION po`� L 9
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 0
date. If y G ness.,
Engineer's Printed Name JEFFREY A. GARNESS QQ�4 C - 3
I lDU Ore^° 3�Z 0�6o4vP
Date
COSA Fee I U w —/? �
Date of Payment -4h,4&8 J'f q Cg
Receipt Number
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
r
L
AAROw PUMP & WEU SERVICE, LLC
P.O. Box 110496
Anchorage. AK 99511
Office: (907) 346-9355 • Fax (907) 333-8976
Eagle Rlver: (907) 622.9335
70:3383246
P.1
MUM
N° 07992
1 1 JOB SITE
Niner k a
ag1-1-69-39
J Lei 7_ <"u mac -
ICEDATE
WELL DEPTH
aWL
CHLORINATED
PUMP DEPTH
V j—
.,EpRSDN
l ct L1
QUANTITY
DESCRIPTION
PRICE
AMOUNT
B c
OU P CclelQa
LABOR
HOURS
RATE
AMOUNT
TOTAL MATERIAL
TOTAL LABOR
WORK ORDERED BY
DATE COMP.
TOTAL
LABOR
PAY THIS AMOUNT
Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that 11 above work Is not paid for In 00 days I agree to allow Aarow,
Pump a Well Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed A labor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.6% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
III
tilR-5-2008 06:27A FROM:
2
■ i NORTHLAND PUMPING SERVICE, INC.
t�■ Your Professional Septic Pumping Service Company
7501 E. 140th Avenue
ANCHORAGE, ALASKA 99516
(907) 344-7146 • FAX (907) 868.6770
TO
Gayness Egineering Croup
3701 E. TudorRoad, #101
Anchorage,AR 99507
IGHM:'
70:3383246
v0.1t
I
Pump Septic & lift for adequacy test at 14531 Woodhaven Cimle
1f1V01G� 'ice OPPtCr
2000 gal ons-
?vw
I
�2`6-a o s Holding Tank j"j PROBLEM AREA - CALL FOR MORE We
P: lei
•
19601
$115.00
-%A'60 NEEDS TO BE DONE AGAIN IN 6 MONTHS
Septic Standpipes Good Shape [] Sludge huildup on bottom [-I Floater on top
Lj Jim cap missing or LJ Cyn stardpipe to 1' above ground U Needs Septictrine
Lcach Area _Time needs replacing
■l:R-24-2008 11:25A FROM:
i■
i
70:3383246 P:1e1
A+ Herne %Sjery;ces, Inc.
insnPot•ions
_r
Tank'lypc:_ 11jiiy._v.
Name:_ a r y Ys $ _
7Q
Address: — �te
Phone Numb!2002f1�t cit__• __ _
Inspection # _
0.00
Timer Setting A , C
Air How.—
Elapsed 'Time
Event Counter
Date c� Time _
Problem: ri,P 6�r .•.. FYD�,� pinsL. Cis .
Parcel I.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
(907) 3434744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
017-142-05
1. GENERAL INFORMATION -~ /
Complete legal description PARK HrLL$ SUeDIVlS~ON: LOT 2. BLOCK 1
Location (site address or directions) 145~1 WOOD HAVEN CIR.
Property owner
Mailing address
Lending agency
Mailing address
Agent MARY O. FOX w/REMAX
Address 2600 CORDOVA
DREW HEMBLING Day phone
14531 WOOD HAVEN CIR. ANCHORAGE. AK. 99516
Day phone
265-4107
Day phone 276-2761
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE: If community weft system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site xxx
Holding Tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
lng to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21 Computer Version
Note: Alaska Water and Wastewater Consultants, Inc. shaft be paid $1,000.00 at,
or prior to, closing for the engineering services provided.
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 an-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 fudher 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 Munic and State codes, ordinances, and regulations in effect
on the date of this inspection. .~.,/
Name of Firm_ALASKA WATER ~IiA~/E'~/¢//' .rER CONSULTANTS, INC. Phone (907~ 337-6'179
Address 6901DEBARR~OAI~,~{'f/E;C--B/A CHORAGE, ALASKA 99504 . /¢, ___
Engineer's Signature L-,, -.-,, , ~UtL~ .~-~ ~ Date *t~'__. ____
In conducting this evaluation, AWWC, ,¢c. ¢tt~pted to'"~ ,vide a thorough, conscientious enginee' rin'g analysis of the
system in accordance with ADEC and lCfOA DIrlHS Guidelines & Regulations. The reported results described the
performance of the system under the conditions encountered at the time of fhe test, and separation distances
measured to readily identifiable features. The operational life of all wells and septic systems depend
on the local soils condition, ground water levels that may fluctuate during the year, and the water
usage of the family being sea/ed by the system. These conditions are outside the control of
the evaluator of the system. Satisfactory test results do not guarantee future performance
of the system, nor do they guarantee that there are no hidden defects or encroachments.
AW1/VC, Inc. can therefore not provide any warranty for future estimate of how long the
system will continue to meet the operational requirements of the ADEC or MOA DHHS.
The content of this report is for the sole benefit of the owner listed above. Any
reliance upon or use of this report by any other person or party is not authorized,
nor will it confer any legal right whatsoever.
6. DHHS SIGNATURE
/~ Approved for J'7L
Disapproved
Conditional approval for
bedrooms
bedrooms, with the following stipulations:
Additional Comments
By: (")~,~./~--~ ~ .~ .- /,{_/', /~::::~_~'~ Date ~' - ~-/- ~) o
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 #21 Computer Version
Legal Description:
A. WELL DATA
Well Type PRIVATE
Log present (Y/N)
Total depth 95'
Sanitary seal (Y/N)
Municipality of Anchorage AU
DEPARTMENT OF HEALTH & HUMAN SERVICES
Health Authority Approval Checklist
PARK HILLS SUBDIVISION; LOT 2; BK 1 Parcel I.D.:
If A, B, or C, attach ADEC letter. ADEC water system number
Y£S Date completed
Cased to 78'
YES
017-142-05
FROM WELL LOG
Date of test 6/27/83
Static water level 13'
Well production 4
WATER SAMPLE RESULTS:
Coliform 0 Nitrate
Date of sample: 7/18/2000
6/27/85
Oasing height (above ground)
Wires properly protected (Y/N)
AT INSPEOTION
7/18/00
N/A
12"+
YES
23'
g.p.m. 2.5 g.p.m.
2.53 mq/L Other bacteria 0
Collected by: A.W.W.C., INC.
*PER LOWELL McNU'Fr W/,~ANCH.TANK. 1500 GALLON STAMPED ON TANK.
B. SEPTIC/HOLDING TANK DATA TH S S A INNOVATIVB'I~'FCC~T-E~ SYSTEM W/ A TRICKLING FILTER.
Date installed 9/27/1997 Tank size *2000 Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression (Y/N) NO High water alarm (Y/N) YES
Date of Pumping 6/22/2000
C. ABSORPTION FIELD DATA
Date installed 9/27/1997
Length 34' Width
Pumper A+ HOME SERVICES
Soil rating (~Lp.d./~or
ft2/bdrm).
4
Gravel thickness below pipe 0.5' Total depth
Effective absorption area 204- SQ.FT. Monitoring Tube present (Y/N) YES Depression over field (y/N)
Date of adequacy test 7/18/2000 Results (Pass/Fail) PASS For. 4
Fluid depth in absorption field before test (in,); . 0 Immediately after 653 gal. water added (in.): __
Fluid depth 0 (ins) Minutes later: 0 Absorption rate = 600+
Peroxide treatment (past 12 months) (Y/N) NONE KNOWN If yes, give date -
72-026 (Rev. 3/96)* Computer Version
System type SHALLOW TRENCH
4'
NO
Bedrooms
0
D. LIFT STATION
Date installed 9/26/1997
Manhole/Access (Y/N) YES
High water alarm level at* 56'%
Cycles tested 3
Size in gallons 1500
"Pump on" level at* TIMER "Pump off' level at*
*Datum BOTt-OM OF TANK
Septic/holding tank on lot
Absorption field on lot_
Public sewer main.
Sewer/septic service line
E, SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
100'+
100'+
N/^
25'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+ Property line 5'+
Water main/service line 10% Surface water/drainage 100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
On adjacent lots 100'+
On adjacent lots 100'4-
Public sewer manhole/cleanout N/A ....
Lift station __ 100%
Absorption field
Wells on adjacent lots
5'+
100'+
10'+
Property line 10'+ Building foundation, 10'+ Water main/service line
Surface water 100% Driveway, parking/vehicle storage area 1 o'+
Cudain drain NONE KNOWN Wells on adjacent lots 100'+
I certiry that l C~-~o/~n/~/~ field inspections and review
of Municipa/ /~ecord~ ~p~t/fh~b s systems are in confo~ance
with MOA ~ ~ on this date.
Signature ~ ~
Enginee~sNa~ JEFFR~ A. ~ARNESS
Date
HAA Fee $ ~ 09'0
Date
of
Payment
Receipt Number ~
72-026 (Rev. 3/96)* Computer Version
Waiver Fee $
Date of Payment
Receipt Number
PROPERTY OWNER MAINTENANCE AGREEMENT
ON-SITE WASTEWATER DISPOSAL SYSTEM
This agreement, dated ~c~(°kxad4~ t'5' , 20oQ is made between the Municipality of
Anchor~,age Department of Hea'l~h and Human Services !DHHS) and the property owner(s) of
ctr/< t-4 ?ll. do/ /oe./c / .
This agreement is made for the purpose of maintaining an on-site wastewater disposal system
on the subject property..
The property owner(s) agree to the following:
The property owner(s) will have an annual inspection of the system performed by a registered
professional engineer. This inspection shall verify that all effluent and air pumps, timers, and
alarms are functioning as designed. Any deficiencies shall be corrected and the engineer's
statement that the system is functioring as desi~gned shall be filed annually with the DHHS.
l~roperty Owner ~e ~ Property Owner Name
(Notarize Here)
,?,
State of
Judicial Dkstrict %,~ SS.
ye~ ~o~ ~ before me, ~e ~dersi~ned no~
~ublic, perso~ly appe~:
· e person(s) whose n~e(s) is/~e subsoiled to
wi~ i~ent ~d ~owl~ged ~at he/she/~ey
ex~uted ~e s~e for ~e p~oses
con~ed.
In witness whereof, I hereunto set my hand and
ofl~al seal. ~
Noty4y Public (signature),
(Notary's prated
My co~ission expires:
HOME SERVICES, INC..
7501 E. 140th Avenue
Anchorage, Alaska 99516
345- 1890
CUSTOMER
Pmchorag¢ Tank & Welding, Inc.
2700 PorcupLn¢
__.~~ 99501
Lot --.
__. DESCRIPTION
14531 'W'oodhaven Circle
~Drcw Hcmbling 348.8948
REMARKS
Gallons Septic __ Leach Area __ Holding Tank
[] PROBLEM AREA -- CALL FOR MORE INFORMATION
[] NEEDS TO BE DONE AGAIN IN 6 MONTHS
[] Good Shape [] sludge buildup on bottom
[] Jim cap missing or [] Cut standpipe to 1' above ground
needs replacing
invoice= # 13740
AMOUNT
$3( .00
..... Standpipes __ Time
[] Floater on top
[] Needs Septictrine
:.' tNvOtCF-. # 15 4 i'8 ii
~sERV1CES, IN(,.
7501 E. 140th Avenue
Anchorafle, Alaska 99516
345 - 1890
CUSTOMER
· Drow H~mblh~g
~ 14531 Woodhavcn
~ 995~5~
Lot
DATE ~
6-15-99 tall Carbon Fihcr
DESCRIPTION
I .345-8948 263-4107
DreW' ! do{J~le ch.~cked w'il~A~;hor~ge-Ta~k and th~-~y sa::', ::': were
~onstb ........... ~ ............. BEV - --
REMARKS
__ Gallons __ Septic __ Leach Area __ Holding Tank
TOTAL
AMOUNT
__ Standpipes __ Time
[] PROBLEM AREA -- CALL FOR MORE INFORMATION
[] NEEDS TO BE DONE AGAIN IN 6 MONTHS
[] Good Shape [] sludge buildup on bottom
[] Jim cap missing or [] Cut standpipe to 1' above ground
needs replacing
[] Floater on top
[] Needs Septictrine
HOME SERVICES, IN(;.
7501 E. 140th Avenue
Anchorage, Alaska 99516
345- 1890
CUSTOMER
..... 14531 Woodhawn Ckcl~
Lot --
Imp~tion of Scplic Syst~'m
DESCRIPTION
· ~MOUNT
REMARKS
__ Gallons __ Septic
Leach Area .... Holding Tank
[] PROBLEM AREA -- CALL FOR MORE INFORMATION
[] NEEDS TO BE DONE AGAIN IN 6 MONTHS
i~ Good Shape [] sludge buildup on bottom
Fl Jim cap missing or [] Cut standpipe to 1' above ground
needs replacing
.. _ Standpipes __ Time
[ J Floater on top
[] Needs Septictrine
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # (3 t'-'~ '-- I z:~f'~--O
1. GENERAL INFORMATION
Complete legal description
HAA #
Location (site address or directions) j~c~-~ i L~c>o~).LS~,/' ~LtP__~_~{~
Property owner
Mailing address
Day phone
Lending agency
Mailing address
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~c'
TYPE OF WATER SUPPLY:
Individual well '~
Community well
Public water
NOTE:
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: 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 ail Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Engineer's signature
Alaska Water &
/
Phone
Date
DHHS SIGNATURE
· ~ Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments The new owner of this property shall be responsible for making
arrangements with an approved person to sample effluent from the wastewater
system far a maximum of 12 consecutive months.
Date ./~) -/~ - ~7 7
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) E~ack MOA #21
Municipality of Anchorage OCT 0 8 ]997
DEPARTMENT OF HEALTH & HUMAN SERVICF-q
Environmental Services Division 'J~E C E .J V
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Legal Description:
Health Authority Approval Checklist
·
~_. I._j ~ bYtL,L,~, Parcel I.D.:
A. WELL DATA
Total depth
Sanitary seal (Y/N)
Well type ~)~--' If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) '~ ~ ¢ Date completed ~/,2///8 ,~
/
C~'~" Ca§ed to '-7 ~ Casing height (above ground)
Wires properly protected (Y/N)
Date of test
/
Static water level /
Well production
WATER SAMPLE RESULTS:
Coliform
Date of sample: '~///~-
FROM WELL LOG AT INSPECTION.
/
g.p.m. /° ~ + g.p.m.
Nitrate 1 · ,ac g rw,~f./.V. Other bacteria
Collected by:
B. SE-F'TIC/I:CLD;NG TAN;~DATA ~'."F'. E-. P
Date installed ~/2-")./¢'/'~'' Tanksize
Foundation cleanout (Y/N)
Number of Compartments ~ Cleanouts (Y/N) ~/~J
Depression (Y/N) ~D High water alarm (Y/N) '~-~-~
Date of Pumping ~--~,-~J
C. ABSORPTION FIELD DATA
Date installed
I
Length ~z¥. Width
Effective absorption area
Pumper /~
Soil rating (g.p.d./ft2 odtC./bdrerl) '¢¢
~'J~'_"~2 Gravel thickness below pipe
Monitoring Tube present (Y/N) %~
System type %Lt/~t.(--o~
~ ~ Total depth
Depression over field (Y/N)
/'~~ Results (Pass/Fail) For ~.------~'-"--'-"~oms
n.; ~al. water added (in.): _
'(.~ ,'~ Fluid depth in absorption~~lY ~
72-026 (Rev. 3/96)*
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at*
*Datum
"Pump off" level at* "T'7~ ~
Absorption field on lot
Public sewer main
Sewer/septic service line
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot j O-'/ /~
!
On adjacent lots
I DOrY-
On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation ,~/:4- Property line ,'~fO t+ Absorption field '~O/.~
Water main/service line [E)I~ Surface water/drainage lOC14'' Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTiON FIELD ON LOTTO:
Properly line
Surface water
Curtain drain
I
Building foundation '..~'~ '~ Water main/service line ~ O/'+
Driveway, parking/vehicle storage area
fl/_..~OuJ P Wells on adjacent lots ~ fO0 t4-
ENGINEER'S CERTIFIC. ATIO~'t~ !~
I certify that I hav. e~Jet~]ne inspections and review of Municipal records
in c~nformanc~witt~C~/~el.~in~_ect on this date.
Signature ~aLr~e~~---
Engineer's ,/~' ~---~-~
Date / o/~__~-
HAA Fee $_- ,~ ~-¢' ' ~
Date of Payment
Receipt Number ',~,%,S~¢~- ~'~ ¢~'~ ~
/
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
FHUM : HLHSKH WHISH & WHSILWHIEK HHUNt NU. 9b I.i363246 Aug. 26 1997 81:54PM P1
c �-)- � AQ -C)5
Alaska Water &. Wastewater
8471 Brookridge Drive — Anchorage — Alaska 99504
;Phone (907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
August 22, 1997 o / F •p°������ y
O as 9� v • e••P. •.•e vvo
pe • .a•%. e•p.
Hal & Connie Snow �'c�j o r y A. G s p ,
14531 Woodhaven Circle ��� E.7953 • �..�,
Anchorage, Alaska 99516 �4 �Fo a�"" p•h• �'�
Subject: Septic System Evaluatio FJot 2, Bk 1, Park Hills SID_
Dear Mr_ & Mrs. Snow:
Per your request, we performed an adequacy test on your septic system, 30 days after it was
Terra -lifted by Alaska Drainfield Restoration. Prior to starting the adequacy test, the liquid level
was 5.5 inches below the invert of the drainpipe. Water was added to the clean-out at an average
rate of 4.59 gallons per minute for 68 minutes (312 gallons), This caused the water level in the
field to rise 6.5 inches, which corresponds to 48 gallons per inch. The water level was just above
the drainpipe invert. Four hours later the level had dropped approximately 1 inch, indicating an
absorption rate of 12 gallons per hour, or 288 gallons per day. Based upon this data, the
absorption field does not meet the M.O.A absorption requirements for a 4 bedroom house, which
is 600 gallons per day. In short, the Terralift process failed to rejuvenate the septic system to the
extent necessary to pass an adequacy test. If you have any questions, please contact me at
337-6179, 244-961q, or on my digital pager at 1-800-481-1162.
Sincerely,
Jeffrey
, M.S.
A77 --r 3
e
0 rf c i T -IF—
• Cti2oSs
t�
Q Fes, Com- .
" At[ s]ka Water & Wastewater
September 18, 1997
Hal & Connie Snow
14531 Woodhaven Circle
Anchorage, Alaska 99516
8471 iBrookridge Drive ~ Anchorage ~ Alaska 99504
Phone (907) 337-6179 - Fax (907) 338-3246
Consulting Engineers
Subject: Well Adequacy Test. Lot 2, Bk 1, Park Hills S/D.
Dear Mr. & Mrs. Snow:
WELL ADEQUACY TEST: Per your request we performed the subject well adequacy test.
The static water level on 7/19/97 was 25 feet below the top of the casing (BTC). After initial
trying to run the test, and finding that the a water softener was restricting the flow, we restarted
the test, with a water level of 50 feet BTC. Approximately 252 gallons was pumped during this
period (78 minutes). The level in the casing dropped from 25 feet, down to 81 feet, and
recovered to 50 feet, during this time. Of the 252 gallons pumped, approximately 37 gallons
came from storage in the casing, and 215 gallons came from well recharge. This corresponds to
2.76 gallons per minute. The test was then restarted, with the water level at 50 feet BTC.
Water was pumped from the well at an average rate of 3.14 gpm for a total of 98.5 minutes
(309.5 gallons). This caused the level to drop 40 feet, to a depth of 90 feet BTC (at the pump).
Of the 309.5-gallons pumped, approximately 59.2 gallons came from storage in the 'casing, and
250 gallons came from well recharge. This corresponds to 2.54 gallons per minute. The pump
was then shut off (because it was cavitating) and the well was allowed to recover for
approximately 12 minutes. An additional 82 gallons was then pumped from the well over a period
of 24 minutes (3.42 gallons per minute), after which the water level was 90 feet BTC (at the
pump intake). The recovery was then monitored for 28 minutes, during which time the level rose
from 90 feet BTC to 54.5 feet BTC. This corresponds to a recovery rate of 1.88 gallons per
minute.
In summary, over a period of 4 hours, 643 gallons was pumped from the well. Approximately 44
gallons came from storage in the casing, and 599 gallons came from well production. This
corresponds to a recharge of 2.5 gallons per minute. Based upon the aforementioned data, it can
be concluded that the well meets the M.O.A requirements for a 4 bedroom house (.425 gallons
per minutes.
MUNICIPALITY OF ANCHORAGE \i
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date A9r_t i Zi, I QgG
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Le)T 2. Bk 1, 2ARV 14ILL Pin 141 SEc3y,%tel, 231✓
Location (address or directions)
(b) Applicant Name
Applicant Address
Telephone: Home
Business
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer; Other ❑ (explain);
(d) Lending Institution n1011,FI-ett Vt#w6. Telephone
Address ?01. WA 0IA& 4
(e) Real Estate Company and Agent ac,eL W kII442 �� . 77.
Address
Telephone
(f) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single -Family Multi -Family ❑ Other
Number of Bedrooms _-
3. WATER SUPPLY
Individual Well 9 Community ❑ Public ❑
yy VV
d
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite 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 72-025 (1v84)
5. ENGINEERING FIRM PROVI& ; : INSPECTIONS, TESTS, FILE SEARCH, L -. ,,A AND INFORMATION
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 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. 3
Name of Firm ! di0% c`I �N V YIC P t' Telephone 027 9 41,6
Address
Date
4220f
. d OF dt I.
A
i';� ', rsH �` � Engineer's Seal
d 4 r _._ .. .. 9
�•�.�••o2225-E
luck 25, 1971 ,
6. DHEP APPROVAL ��J�
Approved for f"""r `""'`'aDate
bedrooms by
�`" ���'�
Approved G_�_ Disapproved
Terms of Conditional Approval
Conditional
dhep
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal
A. WELL DATA
Well Classification R" If A, B, C, D.E.0. Approved (Y/N)
Well Log Present (Y/N) Date Completed 4P/X-7 + / 8- 1
Total Depth q.5 Cased to -7-9 Depth of Grouting
Static Water Level < Pump Set At
Casing Height Above Ground —
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot t (
To Nearest Public Sewer Line NaWE To Nearest Public Sewer
Cleanout/Manhole m0 0i To earest Sewer Service Line on Lot
; Date 14/z&Jr4►
Sanitary Seal
Depression
ENVIRONMENTAL PIU
asing (Y/N) —
Wellhead (Y/N)
"On Adjoining Lots !+
Adjoining Lots ��+0
Water Sample Collected by
Water Sample Test Results
Comments
B. SEPTIC/H"" STAN ATA
Date Installed a
Standpipes (Y/N)
De ression over Tank (Y/N)
er(aso No. of Compartments r (Ia
Air -tight Caps (Y/N) Foundation Cleanout (Y/N) y
V Date Last Pumped AIA
Pumping/Maintenance Contract on File (Y/N) for N��+
Holding Tank High -Water Alarm (Y/N) NA Temporary Holding Tank Permit (Y/N) NfA
Separation Distances from Septic/Holding Tank
To Water -Supply Well q3 To Building Foundation
To Property Line IV To Disposal Field }
To Water Main/Service Line > To Stream, Pond, Lake, or Major Drainage
Course
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 160 Type of System Design ��L7 Y �2NG1
Date Installed A. t� 119A Length of Field 47
Width of Field 5 t=7- Depth of Field _ 7 f,
Gravel Bed Thickness 3e a; /= _�_
Square Feet of Absorption Area `(0 Zo Standpipes Present (Y/N) Y I`+
Depression over Field (Y/N) .�rDate of Last
v-Last Adequacy Test y/Za �6
Results of Last Adequacy Test ��A+s f �Y ro5e.G YwlextM5
Separation Distance from Absorption Field:
To Water -Supply Well (f C`7 To Property Line
To Building Foundation 35 To Existing or Abandoned System on
Lot N C) NEE ; On Adjoining Lots 7 IOU
To Water Main/Service Line f 0 To Cutbank (if present) 115+
To Stream/Pond/Lake/or Major Drainage Course fel o*4
To Driveway, Parking Area, or Vehicle Storage Area 950
Comments
D. LIFT STATION NOri
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
** Check Permitted Bedroom Rating Against HAA Request **
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
I certify that l have checked, verified, r conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed Date
Company
Receipt No. J�� D, -6c
Date of Payment
Amount: $ �
Page 2 of 2
72-026 (1 ti84)
MOA No.
Engineer's Seal
t;. T! i
J•enu 5ssa.a
2225-E
JUN`i 250 1971 >
03 W. 15th
"C" SUITE 203
vbli D 2 V �!.t!"'�hW�7!lVUVl p �p�p i 2 ANCHORAGE, EALASKA 99501
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
R E S I D E N T I A L W E L L I N S P E C T I O N
LEGAL: LOT 2, BLOCK 1, PARK HILL ADD. #1
LOCATION: 114531 HILLHAVEN CIRCLE
OWNER: HAROLD HILL
TYPE OF WELL:
WELL LOG AVAILABLE:
INSTALLATION REQUIREMENTS MET:
WELL YIELD FROM WELL LOG:
WELL YIELD FROM WELL TEST
PUMP YIELD:
DATE OF INSPECTION:
SINGLE FAMILY
YES
NO. SEPARATION DISTANCE TO SEPTIC
TANK IS 93 FEET. 100 FEET REQUIRED
4 GALLONS PER MINUTE
3.6 GALLONS PER MINUTE
8.2 GALLONS PER MINUTE
APRIL 28, 1986
TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 8.2
GALLONS PER MINUTE WHILE THE DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE. STATIC WATERLEVEL WAS FOUND TO
BE LESS THAN 25 FEET BELOW TOP OF CASING. AFTER 45 MINUTES OF
PUMPING THE THE WELL WAS ALLOWED TO RECHARGE FOR 15 MINUTES. THE
WELL WAS THEN PUMPED FOR ANOTHER 15 MINUTES. THE POWER WAS THEN
SHUT OF AND THE RECOVERY OF THE WELL MONITORED FOR 15 MINUTES.
THE WATERLEVEL ROSE 35 FEET IN 14 MINUTES AND 20 SEC.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON
APRIL 29, 1986. TEST WAS NEGATIVE.
TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE, WITH THE EXCEPTION OF THE SEPARATION
DISTANCE TO THE SEPTIC TANK. A WAIVER HAS BEEN REQUESTED.
The Municipal requirement for well flow is 150 gallons of water
per bedroom per 24 hours.This well surpasses this requirement.
The assessment of the condition of this well applies only to the
conditions as of this date. The flow rate of the well may change
due to subsurface conditions that may not be observed from the
surface, and changes in land use and other factors that may
impact:-t.he conditions of the aquifer feeding the well.
f-
No. •2225-E>F
''3017. JUiV- 2�. 1971
03 W. 15th
"C" SUITE 203
v0 G m wL)hR[L ; AbV p® v �j 2 ANCHORAGE, EALASKA 99501
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
S E P T I C S Y S T E M A D E Q U A C Y T E S T
— — — — — — — — — — — — — — — — — — — — — — — —
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WATER SYSTEM:
SEPTIC SYSTEM
DATE OF PUMPING
DATE OF TEST:
TEST PROCEDURE:
(
._
2 ,.,.
2 1-E s
il,71
LOT 2, BLOCK 1, PARK HILL ADDITION # 1
14531 HILLHAVEN CIRCLE
HOWARD HILL
SINGLE FAMILY, FOUR BEDROOMS
ON SITE WELL
FROM MUNICIPAL RECORDS:
TANK: GREER STEEL, TWO COMP.
1250 GAL.
ABSORPTION SYSTEM: TRENCH
ABSORPTION AREA: 620 SQ. FT.
SOIL RATING: 100
INSTALLATION DATE: AUGUST 1982
APRIL 29, 1986. ANCHORAGE CESSPOOL PUMPING,
APRIL 28, 1986.
SYSTEM WAS INSPECTED AND MEASURED. DRAINFIELD
SUMP WAS FOUND 6 FEET DEEP AND DRY. NO
WATERMARKS. TANK WAS BURIED 3 FEET. LIQUID
DEPTH IN TANK WAS 49 INCHES. 450 GALLONS OF
WATER WERE ADDED TO THE DRAINFIELD. THE
WATERLEVEL IN THE TANK WAS MONOTORED. THE
ADDITION OF THIS WATER DID NOT INCREASE THE
LIQUID DEPTH IN THE TANK. TWO INCHES OF WATER
SHOWED UP IN THE SUMP.
TEST FESV7L:T: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
' I
Munlcipailty
of
Anchorage
May 13, 1986
P.O. UwX 196650
ANCHORAGE, ALASKA 99519-6650
(907 ) 264-4111
TONY KNOWLES,
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
Tobben Spurkland, P.E.
203 West 15th Avenue "C" Suite
Anchorage, Alaska 99501
Subject: Lot 2 Block 1 Park Hills Subdivision #1
Waiver Request - WR86-057
Dear Mr. Spurkland:
Your request for a waiver of the required horizontal separation distance
between the septic tank and well on ther subject property has been granted.
The 100 foot separation requirement has been waived to 93 feet in this
case.
This waiver is valid for the existing four bedroom single family dwelling
only.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
SSM/ljw
03 W. 15th AVE "C" SUITE 203
.7699 18N V U�l�9 �a�a 2 ANCHORAGE, ALASKA 99501
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
MUNICIPALITY OF ANCHORAGE APRIL 29, 1986
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 6-6650
ANCHORAGE, ALASKA 99501
SUBJECT: REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR
PRIVATE WELL.
LOT 2, BLOCK 1, PARK HILL ADD. #1
Gentlemen;
We are submitting a request for waivers from the separation
distances stated in Title 18, Alaska Administrative Code Chapter
80.020
This submittal follows the format outlined in a Memorandum dated
January 3, 1985 on the subject of "Separation Distance Waiver
Guidelines for SCRO", prepared by Mr. Bruce Erickson, District
Office Coordinator. State of Alaska, Department of Environmental
Conservation.
This Memorandum outlines a procedure to be used in the evaluation
of waiver requests by assigning number values to geological
features addressed in the waiver request. In this request I have
followed this procedure and assigned values to the pertinent
features as follows:
1. Vertical Distance Between Sewage System and Ground Water.
From well log prepared by Foss Drilling, AA 0758. Water at
44 feet.
Point value assigned 4.5
2. Soil Absorption.
From well log. Hard till between 0 and 44 feet.
Point value assigned 3.5
3. Permability:
The material described in the well logs has a percolation
rate larger than 50 min/inch.
Point value assigned 3.0
4. Water Table Gradient.
This is a confined aquifer with 20 feet of pressure head. At
maximum drawdown the gradient of the water table will be 0%. At
less than maximum drawdown the gradient will be positive.
Point value assigned
1
3.0
-Tobben Spurkland P.E.
Waiver Request
Lot 2, Block 1, Park Hill #1
April 29, 1986
page 2
..i
5. Horizontal Separation
From well to septic tank 93 ft.
Point values assigned For septic tank 2.75
TOTAL POINTS
For septic tank 16.75
This total shows that this system is almost sure to be free from
any form of contamination from household sewage.
Cast iron was used in the construction of the system. Septic tank
has water tight couplings. Water sample taken during the
operation of the system have not shown any contamination.
I request that a waiver be issued for this property.
Yours
Ts
Tobbe Spurkland P.E.
fi F
e ao<.
ja "t f^
�'.e�, aooaaoe ee "e
��. , e• a •• et4
2225-E
%°• JUNE 25e 1971• r
E•..� .e.v ne e°• ����Ry
