HomeMy WebLinkAboutPARK HILLS #1 BLK 1 LT 10 · Municipality of Anchorage Page J__[~ of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage. Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~c~'=l ~"° °°~ PID Number: o~-'l -I~ - ~- Name: et~, ~st~eo,~%'r'( Wastewater System:D New ~ Upgrade ~ Address: ~ ABSORPTION FIELD I No, of Bedrooms: Phone: ~&~ -- ~ ~ ~ Deep Trench ~ Shallow Trench ~Bed ~ Mound ~ Other LEGAL DESCRIPTION so, Rating: O.~ GPD/Sq. Ft. Total Depth ~.~'fr°m original_ ~tgrade: Lot: Block: Subdiv~ion: Depth to pipe boEom from original grade: Gravel depth beneath pipe Township:~ I Range: ~ Section: ~ Fill added above~ ~°riginal~. ~grade: Ft. Gravel length: ~ Ft. I WELL: s~,~ ~ New D Upgra~ Gravel width: Number of lines: Distance baleen lines: I ~ Ft. ~ ~ ' ~ Ft. Classification~A~(Private, A,B,C): ~ ~Ft. Cased To: Ft. Total absorption area:~ O0 SQ. Ft. Pipe material:~o ~ ~ Driller: ~ Date Drilled: Static Water Level:Ft. Installer:~T,E~ ~oas Date installed: G Y~ GPM Pump Set at: Ft. Casing Height Above Ground:Ft. TANK- SEPARATION DISTANCES ~ Septic D Holding ~S.T.E.P. To Septic Absorption Lift Holding Public/PrivatE Manufacturer: Capacityin gallons: From Tank Field Station Tank Sewer Lines ~ ~ ~ O~ ~ ~ J ~ O O Number of Compadments: Sudace ~ LIFT STATION Water Ioo~+ Iool~ I°o~ Lot Sizeingallons: Manufacturer: O a~ ~N ~ o ~ ~ "Pump on' level at: "Pump off" level at: High water alarm at: Curtain Pump Make & Model ~ Electrical Inspections pedormed by: Remarks: G~,~,~ W~T~,,~ ~r~ ~ ~ BENCH MARK ~ Location and Description: Inspections performed by:,,, 'Ne IN E EtoN' Dates: 1st 5-z6-~',~7', 17034 Eagle River Loop Road, No. 2~ 2nd. ~'z~ -~ ~ ' Eagle River; Alaska ~577 ~¢~ & - I~ - q L CE ,:8801 Department of Hea~ an~ Human~e~ices approval ~. '~. ~t' ,.... Reviewed and approved b ~ ate: ~ ~2 7-¢~ "~ ~ '~';~ 72-013 (Rev. 9/91) MOA 25 Permit No'. SW960004 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LOT 10, BLOCK 1, PARK HILLS S/D //1 017-142-12 Legal Description: PID No.:  .~.-- ~ /--CURTAIN DRAIN / '~- . ~ INSTALLED 1' .~ _~--J' ~ N-' EXis] lNG SYST~LM~-~'?/¢~', ~¢~'%%~,- ~NE ~ PRES¢~R~ ~ BED ~ ~G ~ '~ '' ~ LOT 1 0 ' ~Y~,, ~ ~'~ , -- "' · ~~>~~-- MH 29' FD 51' gg .~' ;¢'~ ;~::~ ~:' 4o, ¢5' - : .. , :'~ ; ,~i:5 77.5 90.5' sc~ ,"=~o' ~ ~~ ;' ' ~T4 81.5' 97.5~ 9vn' ~ / :9v.v' ~'~% ....'%~ ~ ~ 98.2' ]ROUND WATER ~OUND ~2~13 A (Rev. 9/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960004 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DASHO LEONARD J & CYNTHIA ANN OWNER ADDRESS:14411 RIVERTON CT ANCHORAGE, ALASKA 99516 PARCEL ID:01714212 DATE ISSUED: 1/08/96 EXPIRATION DATE: 1/08/97 LEGAL DESCRIPTION: PARK HILLS #1 BLK 1 LT 10 LOT SIZE: 41936 (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 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. ~IyI~E~GINEERS R [ C E 1 ( 6u-2979 FAX (907) 694-1211 HEALTH AUTHORIF( APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE W/',S TEWATE R DISPOSAL SYSTEM DESIGN December 8, 1995 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Mumc po.I ,y o[ Anchorage Dept. Health & I-hJn~an Services Lot 10, Block 1, Park Hills Subdivision Request you issue a permit to upgrade the septic system serving the existing four bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation water was encountered at 14 feet in the test hole and after seven day ground water monitoring, water was found at ~ feet. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. Attached is the revised upgrade design. A curtain drain has been installed uphill from the proposed leachfield bed and ground water has subsided from the 6 to 8 foot level to ~ feet below grade. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. Rcc/gk Enclosure 17034 NORTH EAGLE RIVER LOOP ' SUITE 204 . EAGLE RIVER, ALASKA 99577 = 50' SITE PLAN UPGRADE , 80ALE .// ~ / ~u ~?~ ~ * ~o ~-, - r-° ,.? ~,~ a, ~u)>cnz ~k, zmo kg, ~,-'u~ 4'¢ ~, ¢>m°_._d,, ~'~oo · %o ~. m ~z .... / ~ ~ ~ o -_o o o<>zz o~q .~'~.., ~ ,.~. ..... :., . ... I DETAIL PROFILE "N.T.S. , SCALE r~OU F o£ Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 625 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR:P[~ I'I Hu,,.~¢ l~Ou, rY ~ ~/o ;~,l[~ ~..~-~-~ C ,3. LEGAL DESCRIPTION: LOT I0 (J~'~: / DATE PE~FOaM~D: Township, Range, Section: I 2 3 4 5 6 7 8-- 9 10 11 12 13 14- 15- 17 ~8 10- 20- COMMENTS ./ ~-~R4 yeL was GROUND WATER ENCOUNTERED? / L iF YES, AT WHAT ~ ~-/ 0 DEPTH? p E Bonilering? SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop i~_1;~/~- "'~: 3 q ~ -7 %.,. ._ ~ '~s' I ~,~ ~ ~ ~/~" ~: 3c ~ '/~ ~ ~/~" PERCOLATION RATE q (minutes/inch) PERC HOLE DIAMETER ~' /'' TEST RUN BETWEEN__~ FT AND __'t"/ FT PERFORMED BY'&$ ENGINEERING , ~7/ - ~-"'~ CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River L~p Road No. 2~ I ~ /io /Cl ~ ACCORDANCE WI~HA~~ ~PAL GUIDELINES IN EFFECT ON THiS DATE. DATE: 72-008 (Rev. 4/85) ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 10, Block 1, Park Hills Subd. %1 December 8, 1995 GENERAL: 1. e o e Se The scope of this project includes the installation of a 500 gallon wastewater S.T.E.P. system (septic tank) and a pressurized absorption bed to serve the four bedroom residence located on the referenced property. The existing 1250 gallon septic tank is to be excavated to verify its integrity. If the integrity of the existing septic tank is poor the existing septic tank is to be excavated, pumped, crushed, and abandoned completely and a new 1500 gallon S.T.E.P. system is to be installed in its place (do not install the 500 gallon S.T.E.P. system). The existing leachfield is to be abandoned such that it may be used in the future. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 10, Block 1, Park Hills S/D #1 December 8, 1995 SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. J The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Se Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. e Septic tanks installed with less than 4 ft. of cover shall be insulated. Se A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. e Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: mw Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavati6n shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. e If a sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. Sewer rock shall be placed uniformly throughout the entire bed. The distribution piping is to be of PVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel depth below the distribution pipes shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. Page Three Lot 10, Block 1, Park Hills S/D ~1 December 8, 1995 0 Se e The distribution piping must be as shown on the design. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Silt barrier material must be installed between the final gravel layer and the native soil backfill, unless insulatio~ is used, then the silt barrier should be installed over the insulation. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed at the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. The monitoring tube should not extend below the bottom of the gravel surface. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. e The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid e Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal)° Page Four Lot 10, Block 1, Park Hills S/D #1 December 8, 1995 e Septic tank inlets and outlets shall be fitted with watertight couplings.(Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail ~leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the ~200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. ® The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. Page Five Lot 10, Block 1, Park Hills S/D ~1 December 8, 1995 The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER 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 [~EW MAILING ADDRESS -'7 ! ~ 5~ o1~ $~,',,~/%_ ~,~W_ LEGAL DESCRIPTION LOCATION ~ / D,STANCETO: Iweg 140 Absir~°/narea Manufacturer Liq ' IF HOMEMADE: Well DISTANCE TO: ~j/.~ Manufacturer Dwe ng 'Foundation Dwelling Material(. ¢ Material Nearest lot Ii. ne Tren_~d~t h D[STANCETO: Well I ~%~'~1 No, of lines ' Length of each r :tile to inish, gra~ii ~,¢~,q Length Width Type of crib Well DISTANCE TO: Class Depth tile ~.~1¢ ~1~.~ ~ inches DISTANCE TO: Building Sewer line OTHER PIPE MATERIALS NO, OF BEDROOMS PE~{MIT NO, No, of co%rtments Liq~d ~h PERMIT NO, Liquid capacity in gallons PERMIT Dista nc~et~¥veen lines Crib depth I Total effective absorptic Building foundation I Nearest lot line ¢'0, Driller Distance to lot line NO. ¢z¢ Septic tank ~o ~.~ SOIL TEST RATING INSTA/LLER REMARKS APPR~)V E/~ DATE LEGAL 72-0~3 (Rev. 3/78) C:~ ll'",,.fl ....... ~!Ei~: LE 'T' fE!E: ED; fEE: !b,~ lEE: ,~::;?'. ;D,~:. !p~,~ EiE: IL.... ~ ¢tPPL..I C(4NT: D(3UGLJqS 5; NE(~L lEACH ):hl¢~ CONSTIRLJCT]: ON ~i~DDRESS~ 2:521 ~3AtqE{URY CONTF~CT F'HDNE = :5~7:-- 17:1.:5 LEGAL. I)IEi.:;CF~ :[ F' :: ...c [::. ~ L. QT ST'~' ''~ RANGIE: I c:e~'tiCy that: {cm'LIq by 'kh6~, ~4t.u"~.c:~.t]a.].:i.'ky c3( [.~r'lcl"~t:)p¢~(~.~ (HOA) .ar'id and ir'i c:cm~p,l:~ar}c:e (,~J.'ILH 'l. he des:~gF~ cpJ.'k, er'J.~ c:)(, 'EhJ. s "cc:: ,'UNIC[~ALIIY Ok ANCHUNA6E ~ Department'~) Health and Environmental'~motection , 825 L Street, Anchorage, AK. 99501 264-4720 ' ~'>~ * * * HANDWRITTEN PERMIT * * * Permit # 0~ WELL AN~ ON-SITE SEWER PERMIT ApPlicant: ~)~./.~g .X ~/6~/' ~ /~,~&'~ai'ling Address: ~$~/ ~4~ Location: ~/O ~ / /~'/~ ~ Phone Number: ~J~- /~/~ Legal Description: ~ -~y-- /~J - /~ ~ 6~) Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed:/-'- Holding Tank: Maximum Number of Bedrooms: .~-~_ Soil Rating(sq.ft/br) /~ The Required Size of the Soil Absorption System Is: DEPTH _~c~ f LENGTH ~ r ~r .... GRAVEL DEPTH ~:~ WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~,.~X:2) GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this departmen~ will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs. are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 t-* * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3)( /I una~standz[/~//~/A ~//that the on-site include mor~ ~: be~s. /t~e re~i~e~c~srem~ed to sewer system may require e~argement if Signea.~//~_,/~,,~F(~//X~ \.~__ Issued ~pp~I~nt ~ Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -~ PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5- 8 10- 11 12 13- MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIO~ JUt RECEIVED' 14- 15- 18- 19- 20- COMMENTS 'THIS 72-008 (6/79) DATE PER.ORMED: u~//~ SLOPE WAS GROUND WATER ~e.~ SL ENCOUNTERED? O P E IF YES, AT WHAT ~ I DEPTH? 7 PLAN I Gross Net Depth to Net Reading Date Time Time Water Drop , ,, _ - nYq ]-z._ .2~ TEST RUN BETWEEN ? FT AND (minutes/inch) WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological ~ GeophysicBISurv~ys LOCATION OF WELL Borough 'ANCE AND DIRECI'ION'~=ROM ROAD I Street Address and Area of Well WELL LOG {please cam; Drilling Permit NO. A.D.L. No. Material Type /./ ?.USE: Domeltic ~ Public Supply ~ Other: di~m. _in. to ft. Depth Stlckup__ft. Set between - ft. and ft. Backfilling Gravel pack I0, STATIC WATER LEVEL: ~Above Or ~ Below Ion~ surface Date II. PUMPING LEVEL belaw land surface and YIELD I~.GROUTING Well Groufed: ~ Ye. ~No 15. Wrier Temperature _e ~ F ~ C WATER WELL CONTRACTOR'S Authorized 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 ©i '7-) ~/' ~ -- ~ ~. HAA# H/) 1. GENERAL INFORMATION Complete legal description z.~ T lo G,.~c ,~ i /-~,V,~< Location (site address or directions) o Property owner Mailing address Lending agency Mailing address Day phone Agent4c'4''( ~ /~'~'"~'~4.e,¢- /J4'"-~v,/,~-,~,: ~.~,,r~. (~- Day phone Address '~'~ / "c" .c~_.~,¢~ 7- , ~-~., r,2 -~ ~ / Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well 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: 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 =~! 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, l furtherverifythat 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 S & s ENGINEERING 17034 Eagle River Loop Road No. 204 Address E~le I~iver: Al~b~ qq~77 Engineer's signature Phone DHHS SIGNATURE ./~' Approved for ¢ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date _ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~25 (Rev. 1191) Back MOA ¢Zl Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 3J~3~4~f VED 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) LegalDescription: £o ~ /O Municipality of Anchora e Health Authority Approval Checklist Oept. Health & Human Se~t~ceee Parcel I.D.: ~ I '7 '- I 6/ 3- - ) ~. A. WELL DATA Well type P/~ t Log present Total depth Sanitary seal Date completed Cased to If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) / Wires properly protected (~/N) Y g 3' Date of test FROM WELL LOG /o/y- / Static water level 0 Well production '-~ 0 WATER SAMPLE RESULTS: Coliform O Nitrate Date of sample: ~ / ? [ ~/C B. SE~HOLDING TANK DATA Date installed G / t 7 [ q (,., Tank sizel ! $'~0 ~0 AT INSPECTION g.p.m. ~ ~ ~ g.p.m. Collected by: Other bacteria C ,:: 5 & $ ENGINEEEING i/-0$,i Eagie River Loop Road No, 204, Eagle Ri~er~ Alaska 99577 NumberofCompartments ~ Cleanouts{~/N) ~V£$ High water alarm (~/N) Y~ 5 Foundation cleanout (~)N) ¥'~ 5 Depression (Yff~ __ Date ofPmnping ~//~ --'~v,~ ~ Pmnper C. ABSORPTION FIELD DATA Date installed 6//7 / a) l~ Length (o 0 Width / Soil rating ~or flOgodrm) O~ 7 System type. ff £ O Gravel thickness below pipe 0, ~ Total depth ~/ ! Effective absorption area ~ O O Monitoring Tube present(~/N) ¥~J~ Depression over field (y/~ Date of adequacy test iv/4 - ~2 ~ Results (Pass/Fail) For ,,~edrooms Fluid depth in absorption field before test (in.); I dod (in.): Potent (past 12 months) (Y/N) If yes, give date D. LIFT STATION Date installed C / I 7 / 6/ Manhole/Access (~/N) ¥~; $' High water alarm level at* Cycles tested 3 E. SEPARATION DISTANCES Size in gallons "hlmp on" level at*. t,/;z "Pump o: *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: ~olding tank on lot Absorption field on lot Public sewer main level at* /~0 r4- ] oo -~' On adjacent lots / o O ~- ; On adjacent lots ~/'~ Public sewer manhole/cleanout / J0 0 4- Lift station Sewer/septic service line SEPARATION DISTANCES FROM/~OLDING TANK ON LOT TO: Building foundation ~- o / ~ Property line ~' ~ '1 Absorption field Water main/service line ~-,,q-'/4- Surface water/drainage. /0 0 '4~ Wells on adjacent )ts )too r4 'ice line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / ~ Property Line ~5' '~ Water maln/s~ Building foundation Surface water Cumin drain Driveway, parking/vehicle storage area Wells on adjacent lots ? o 0 /4- F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records in conformance with MOA HAA guidelipes in effect on this date. Signature "~t// Engineer's Name t~0g~ Date ' are HAA Fee $ Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number 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 1. GENERAL INFORMATION Complete legal description Lot 10; Block 1; Park Hx~ls Subdivision #1 Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Clair PHH/Homequity 3201 "C" Street 14411Rive~ton Anchorage, AK C/O Jack W 'hite Co. Day phone 563-5500 Suite 200 Anchoraqe, AK 99503 Barbara R~Tse. y/ Jack White, Co. Address 3201 "C" Street Suite, 201 A~.e. hn~-?, Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 ',.~ TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: Day phone Day phone AK 563-5500 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: 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 flies and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm $ & S ENGINEERING Phone ~ ~ ~' - 3 ~) ? 5 ]7034 Eagle River Loop Road No. 204 Address Eagle River~ Alaska 99577' Request you issue, a Conditional Health Authority Approual to upgrade the. septic systezn no later than July 31, 1996 contingent on ground water o By: DHHS SIGNATURE Approved for Disapproved. /~ Conditional approval for bedrooms. ROBERT C. CO'.Va'I - (i CE -88©I .', Additional Comments bedrooms, with the following stipulations: TO [~E ?Lft(~p I~ ~£(.Rok¢ To Arcn~Pz/~N THE ~¢0¢~ 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 satisf,/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. ?2*025(Rev. 1/91) I~ack MOA~F21 Legal Description: LO'F- ~0 Mumclpallty of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage Alaska 99501e (907) 343-4744 Health Authority Approval Checklist ~'~ g Z~ / ~ ~t~c5 ¢ ParcelI.D.: A. WELL DATA Well type ?R Log present Total depth If A, B, or C, attach ADEC letter. ADEC water system number '- Date completed / o /.~ / g ?' Cased to q 0 Casing height (above ground) I Sanitary seal (~q'4) ~'/~Y Wires properly protected (~/N) Yt' J Date of test 0 Static water level Well production WATER ~AIvlPLE RESULTS: Coliform O Date of sample: 71. / 7 / 9 6, B. ~OLDING TANK DATA Date installed FROM WELL LOG Nitrate O. ~c~ 1o] 5t~J Tanksize 1>8~O AT INSPECTION Collected by: Other bacteria S & S ENGINEERING 17034 Earlle River Loop Road Eagle River, Alaska Number of Compartments ~-' Cleanouts (~/N). ~'~ 5 Foundation cleanout (~q) ¥ ~5 Depression (Yffl~ N' O High water alarm (Y/N) Date of Pumpit~g ).,/}.'3)q (,, Pumper ]3r~ to/°"4 C. ABSORPTION gmLD DATA Date installed l 0 / ~ t./ Soilrating (g.p.d./ft2o~ t~od~-3 }"7~' Systemtype t;~:gO Length g~O Width ~_ c~ Gravel thickness below pipe O..5~ Total depth Effective absorption area tq0o Oa,-C) Monitoring Tube present ~(,~/N) ¥'~J' Depression over field (y/r~ Date of adequacy test a,//I '6/q ~ Results~ail) · /oh ~5 For i) bedrooms Fluid depth in absorption field before test (in.); 13~¥ Immediately after2o09 gal. water added (in.): "7 Fluid depth I (ins.) Minutes later: ) 3 o ;~ Absorption rate = (.vO 0 '+ g.p.d. Peroxide treatment (past 12 months) (Y/N) /~',o.-o ~ t<,,. o ~.,,-' If yes, give date D. LIFT STATION Date installed Manhole/Access (Y,q',l) High water alarm level at* Size in gallons "?ump on' level at* ,._-----~"~ump ofF' level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ~Septi.cj/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line 10o 100 -3- Ou adjacent lots ; On adjacent lots Public sewer manhole/cleanont Lift station SEPARATION DISTANCES FROM]~E~I~PrtOLDING TANK ON LOT TO: Building foundatim~ D o v- Water main/service line ~0 (-F Property line 21. 5- --~ Absorption field Surfacewater/drainage /oo '4 Wellson adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~ o 4- Water main/service line Sarface water ! o o Cmtain drain ~O Driveway, parking/vehicle storage area 7g-o Wells on adjacent lots ] o o 4- Property line 4 I0 ~ F. ENGINEER'S CERTIFICATION l certiJ_) that lhave determined thru field inspections and review of Municipal records ~~: are in conJbrmance wit~ M~A IIA,~ guid~es in efJbct on this date. HAAFee $ ;~ff) ~ [~ Waiver Fees ReceiptNamber /~ F6'¢~fl Receipt Number Rev. 8~95 OSS: haa.wk.doc ROBERT C. COWAN, RE, ROBERTA. SHAFER, RE. HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECT[ON ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE pLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN February 15, 1996 Municipality of Anchorage DEPARTMENT OF HEALTH AND. HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 RECEIVED FEB 16 1996 Municipality of Anchorage [)ept, Health & Human Services REFERENCE: Lot 10 Block 1 Park Hills Subdivision Request you issue a conditional Health Authority Approval on the referenced property. A septic adequacy test verified the existing system is presently absorbing in excess of the required 600 gallons per day and appears to pose no health problems. The property has a history of shallow groundwater. A curtain drain was installed in November of 1995. It is anticipated the curtain drain will be a permanent solution to the shallow groundwater. However, in the event the groundwater encroaches on the septic system during spring break-up, the system will need to be upgraded. Groundwater monitoring will be performed during the spring of 1996. The septic system will be upgraded no later than July of 1996, if needed. If we may be of further service, please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES_ :i: 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 1. GENERAL INFORMATION Complete legal description ~ot 10, B[ock 1, Park H±[[s Subd. Location (site address or directions) 14411 PJ. ve~con Ct., (o£f of ~bb±t Creek) Property owner Mailing address Lending agency Mailing address Agent Address Leonard & Cynthia Dasho 14411 Riverton Ct., Anchorage, Day phone 345-2101 AK 99516 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 4 NUMBER OF SEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: lng to the legality and status of system. If community well system, provide written confirmation from State ADEC attest- Individual on-site Holding ta"nk ~ Community on-site '"~ Public sewer _ If communi~ wastewater system, provide wri~en confirmation from State ADEC.-: X 72-025 (Rev. 1/91) Front MOA#21 NOTE: 4. TYPE OF WASTEWATER DISPOSAL: 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 Environmental Management,., Inc. Address 206 E. FireweeCCLane, _Suite t61, Phone 272-9336 Anchorage, AK 99503 DHHS SIGNATURE ~ Approved for ¢ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments ' " 7'" ', '7 ' ", .' .., f;;,,: '~ ,..~,. \~-,T. he MuniCipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority '~,,*~pproval ~ertifice[~§' based only upon the representations given in paragraph 5 above by an independent Prot~ss!on,al 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. 724)25(Rev. 1/91) Back MOAt/21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 10, Block 1-, Park Hills SVb~arcel I.D. Sec. 34, T 12N, R3W A. Well Data Well type Private If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Yes Date completed 10/5/84 Driller Alpine Drilling Total depth 105 ' Cased to 97 ' Casing height 12" Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes FROM WELL LOG AT INSPECTION Date of test 10/5/84 t~/22/94 Static water level 0 ' ;)4 ' Well flow 5 g.p.m. 6.25 Pump level1 99' 99' SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 137 ' ; On adjacent lots 1 Absorption field on lot 130 ' ; On adjacent lots 100 Public sewer main N/A Public sewer manhole/cleanout Sewer service line N/A Petroleum tank WATER SAMPLE RESULTS: Coliform 0 colonies Date of sample: 11/17/94 B. SEPTIC/HOLDING TANK DATA Nitrate 0.70 r~q/1 Other bacteria 0 colonies Collected by: Tobin Spurkland ( see attached Residential Date installed 10-17-84 Tank size 1250 gal Compartments 2 Cleanouts (Y/N) yes Foundation cleanout (Y/N) ?es Depression (Y/N) High water alarm (Y/N) -N/A Alarm tested (Y/N) N/A Date of pumping 11-29-94 Pumper Isaccs Pumping Serivce SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 137' To property line Surface water/drainage On adjacent lots 100 ' + Foundation 20 ' 80 ' Absorption field 1 ?. 5 ' Water: main/service line N/A None observed 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LiFT STATION TO: Well on lot On adjacent lets Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed 10/17/84 Length 56' Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) 178£t2/bdr Width 24 ' Gravel thickness 6" 1344 ft2 Cleanout present (Y/N) 12/10/94 Results (pass/fail) I .$~ No Yes pass System type Bed Total depth '~' Depression over field (Y/N) for 4 After test ~. fl" If yes, give date No Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 130' To building foundation 40 ' On adjacent lots 100 ' + Surface water None observed Curtain drain None observed On adjacent lots 100' + Property line 25' To existing or abandoned system on lot_ N/A Cutbank N,/A Water main/service line Driveway, parking/vehicle storage area 40 ' E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or~onformed to all MOA and HAA Signature ~ ~_~~ t Engi~;~-"'~s~ame %/~/~L-} ~A'~p'-~Z4,.~) HAA Fee $ ,~//~' Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number ; of this ¢nspection. 72-026 (3/93)* Back WEST 15TH. AVENUE SUITE 203 ANCHORAGE, ALASKA 99502-3904 (907) 279-3916 Fax (907)-276-6013 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: Lot 10 Block 1 Park Hills S/D 14411 Riverton Court Lcn Dasho TYPE OF WELL: Private, Single Family WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET: Yes WAIVERS GRANTED: None Required WELL YIELD FROM WELL LOG: 5 Gallons per Minute PUMP YIELD FROM TEST: 6.25 Gallons per Minute DATE OF INSPECTION: November 22, 1994 TEST PROCEDURE: Well was pumped at a constant rate while the drawdown was monitored with an acoustic probe. At the beginning of the test water level was found at less than 24 feet below top of casing. At a pumping rate of 6.25 gallons per minute the water level dropped to 98 feet af[er 48 minutes of pumping. A total of 300 gallons were pumped. The well recovered to 29 feet in 30 minutes, indicating a recovery rate of 3.45 gallons per minute. TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested for E.Coli and total nitrogen on November 17, 1994. E.Coli 0. Other Bacteria 0 Total Nitrogen 0.70 mg/l. Max. allowable Total Nitrogen 10 rog/1. No Bacteria Allowed TEST RESULTS: This well meets the requirements of the Municipality of Anchorage. THIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE FOR MORE THAN FOUR HOURS The Municipal requirement for well flow is 150 gallons of water per bedroom per day. This well exceed this requirement, The assessment of the condition of the well applies only to thc conditions as of the day tested. The flow rate may change due to subsurface conditions that may not be observed fi.om the surface, and ~,~..h~ ge~.~ the land use and other factors that may impact the aquifer feeding the well. ~,~ ;. ..... ,.~ -,,~, I~COR?ORAT~D April 17, 1995 Jim Cross Municipality of Anchorage (MOA) Department of Health and Human Services On-Site Services Anchorage, AK 99501 Re: Lot 10, Block 1 Park Hills S/D Mr. Cross, Attached please find a field data sheet showing total volumes of water input into to absorption field located on the above referenced property. In addition a copy from" In Situ Testing of On-Site Sewer Systems" by Leroy C. Reid, Jr. PhD. has been attached for your reference. Environmental Management, Inc. (EMI) uses this document as a guidance for testing of systems for Health Authority Approval Certificate applications. It is EMI professional opinion that there was not a significant rise in the water level in the system'. Under MOA Health Authority Approval guidelines only 600 gallons are needed to be added to teSt the system. There was a total rise of only 1.5 inches after the addition of 600 gallons. At the time of testing this system passed the adequacy test and appeared to be functioning at the design level. If there are any questions please call me at 272-9336. .-::.?John SicSpson, P.E. 206 E. FIREWEED LANE, SUITE 201 · ANCHORAGE, AK 99503-2703 CONSULTING (907) 272-9336 o FAX (907) 272-4159 · TRAINING (907) 272-8852 ° FAX (907) 272-0319 '1 SEPTIC S~'STEM I~F STA,~;E T~ME L TOTAL F'.Oi T.SPURKLAND P.E. 203 WEST 15TH. AVENUE SUITE 203 ANCHORAGE, ALASKA 99502-3904 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM ADEQUACY TEST LEGA~: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: Lot 10, Block 1, Park Hills S/~D 14411 Riverton Court Len Dasho Single Family, 4 Bedrooms Private, On Site FROM MLrNICIP~_L RECORDS: 4 Bedroom System TANK: Greer Steel i250 Gal. Two Comparts. ABSORPTION SYSTEM: ABSORPTION AREA: SOIL EATING: INSTALLkTION DATE: WAIVERS GRANTED: Bed 1344 Sq. Ft. 178 Oct. 17, 1984 None Required DATE OF LAST PUMPING: 1993 Isaacs DATE OF TEST: November 22, 1994 TEST PROCEDURE: System was inspected and measured. Tank was found with 1.5 feet of cover and with a liquid level of 53 inches. Bed clean out was 3.5 f~et deep with 4 inches of liquid. Bed monitor tube was 4 feet deep witk 13 inches of water. 130 gallons were added to the bed. This caused'the water level in the tank to rise 3 inches and the level in the bed to rise 4 inches. Based on these observations it was concluded that the bed was surcharged and not in compliance with the Municipal regulations. TEST RESULT: This system does not meet the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE: 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 a~y estimate of how long this system will function satisfactory for current or future occupants. All septic systems ultimately fail. Some systems last..15-20 years, others fail after less than 5 years. T.SPURKLAND P.E. 203 WEST 15TH. AVENUE SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Mr. Len Dasho 14411 Riverton Court Anchorage Alaska 99516 November 23, 1994 Dear Mr. Dasho; Per a request from PHH Homequity I inspected the septic system serving you property on November 22, 1994. I regret to inform you that my inspection showed that the septic system would not pass a Ivlunicipal adequacy test. The system became surcharged after the addition of 130 gallons of water. The attached test report describes my test and observations. This system was installed in 1984. It is a b .e4:[ system with gravity feed. My experience tells me that most septic systems of this kina require an upgrade after less than 10 years of use. I have encountered systems that are failing after as few as 5 years. The Municipal Rewalations requires that the replacement system is designed by a registered engineer, and that the design is b/sed on soil data obtained from the location where the system will be installed. To obtain this soil data a testhole must be excavated to a depth of 16 feet or more, this testhole must be monitored for at least 7 days to show that ground water is not present. A percolation test is required to indicate what the soil rating should be. Municipal approval of the proposed system must be obtained, the proposed system must be installed by a certified contractor, and finally the installation must be inspected by an engineer, and certified as builds submitted to the Muni. The time required to obtain the permit may be as long as 30 days. Winter construction is possible, but additional cost, above the cost of spring or summer construction, must be expected· The gravel pits may be closed periodically making the availability of sand and gravel uncertain. I do not install systems, but I can assist you in obtaining three or more quotes to install what I specify, t prefer that you pick one of the suggested contractors and I will take care of the rest. My fee for the described services will be between $1500 and $1750. Muni fees are a total of $ 620, and the cost of installing the system will be between $13-15,000, depending on the size of the system and how much landscaping will be required. Feel free to contact me at any time. Tobben Spt~kland P.E. 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 GENERAL INFORMATION' Complete' legal description Lot 10, Block 1, Park Hills Subd. Location (site address or directions) 14411 [~_Lve_t~on Ct., (off of Pc_.bbbit Property owner L~ona~d & C%mtbia Dasho Day phone 345-2101 Mailing address 14411 ~vert:on Cc., Ancboraqe, A~ 99516 Lending agency Day phone M, ailing address Agent · Individual on-site Holding tank Community on-site Day phone Unless otherwise requested, HA& will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OFWATER SUPPLY: , '- individual well X ' Community well ...... :' ' ...... Public water NO'~E: "' If community well system, provide written confirr~ation from State ADEC attest- .... lng to the legality and status of system. ' .............. ,~-'",,:,....' .'~';,.),..(,/~ 4. TYPE OI~ W'ASTEWATER DISPOSAL: ~' ~,," ,' -! X ' '"?" "-; ?.-~ · -"i., Public sewer :: ' NOTE: .If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 informat on obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or westewater disposal system is in compliance .with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. :..*, Name of ~nn Environmental Management,, Inc. Phone 272-9336 Address 206 E. Firewc~r~ne, ~uite/~ Anchorage,. AK 99503 · 6. DHHS SIGNATURE ppr(~ved.fOr ':'. edl:~O );.,.-.- :~'.. Conditional approval for b~rooms, with the following stipulations: Additional Comments .. ~..: . . ' ..~..' [',_. ~.~ 'cr.:.-"1.. 'C-Z,' ¢¢ D ~.~'~he ~ni~pali~ of'~c~o~ge Depa~ent of Health and Human Se~ic~ (DHHS) i~u~ Health Authod~ -.'~pproval Ce~ific~' bas~ only upon t~e representations given in pa~g~ph 5 above by an independent .... pr0fe~ onal eng~n~r reg~ster~ in the State °f Al~k~ ~e DHHS d°~ this as a c°u~esyt° purch~e~ °f h°mes and thei~ lending institutions in order to ~ti~ ce~ain f~e~l and s~te ~uJrements. Employ~ of DHHS do not conduct inspections or anal~e data before ~ ce~Jfi~te is i~ued. The Municipeli~ of Ancho~ge is not responsible for erro~ or omi~ions in the profe~ional engin~¢s wo~. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 10, Block 1, Park Hills SvbCsrcel I.D. Sec. 34, T ]2N, ~3W A. Well Data Well type Private Log present (Y/N) Yes Total depth 105 ' Sanitary seal (Y/N) Yes Date of test Static water level Well flow Pump level1 If A, B, or C, attach ADEC letter. AOEC water system number. Date completed 10/5/84 Ddller A.Lp~'~e Drilling Cased to 97 ' Casing height Wires propedy protected (Y/N) Yes FROM WELL LOG AT INSPECTION 10/5/84 %~t/22/94 O.' 24' 5 g.p.m. 6.25 99' -- .g.p.m. SEPARATION DISTANCES FROM WELL TO:. Septic/holding tank on lot 137 ' Absorption field on lot 130' Public sewer m~in N/A Sewer service line N/A .; On adiacent lots 100f+ ; On adjacent lots 100 ' + Public sewer manholelcteanout N/A Petroleum tank N/A WATER SAMPLE RESULTS: Coliform 0 colonies Date of sample: 11/i7/94 B. SEPTIC/HOLDING TANK DATA Date installed 10-17-84 Cleanouts O'/N) yes High water alarm (Y/N) Date of pumping I 1-29-94 Nitrate 0.70 rfc/! Other bacteda 0 colonies Collected by: Tcb~ Scur.~(~ ~nd ·. ( see_ attac2ued Residentiafu Wel~/~s~_~-~) Tank size 1250 ~ral Foundation cteanout (Y/N) Compartments 2 Depression (Y/N) Alarm tested (Y/N) N/A Pumper rsaccs ~amoin~ Serivce SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 137' To proDere/line Surface water/drainage 72-026 (3/93)' Front On adiacent lots 100'+ 80' Absorption field ]7.5' ,>]one cbs~rveQ Foundation 20 Water main/service line CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots N/A Surface water D. ABSORPTION FIELD DATA Date installed 10/17/84 L.enCh 56' W~dth 24' Total absorption area 1 ;~44 f:-? CIeanout present (Y/N) Date of adequacy test 12/10/94 Results (pass/fall) Water leval in absorption field before test i. ~". Peroxide treatment (past 12 months) (y/N) No Soil rating (GPD/FF) 178ft2/bC~r System type Bec]. Gravel thickness ,6" Total depth Yes Depression over field cass for 4 After test ~'. ¢1" If yes, give date No Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 130 ' To building foundation 40' On adjacent lots 10O ' -~ None observed Surface water On adjacent lots 100'+ Property line 75' To existing or abandoned system on lot N/A Cu~ank ,~,/~ Water main/service line Driveway, parkingNehicle storage area 40 ' Curtain drain None observed F_ ENGINEER'S CERTIFICATION I cern'fy that I have checked, verified, or conformed to afl MOA Signatur~ ?L-- .._.. .... ..~.. ~ ' and HAA guidelines in e~ ~.~_ , .~.,of this inspection. ,~-x ~ .., ' .... ,,~.~ . ~ .- % John Earl Smeson z'~.t HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number WEST 15TH. AVENUE SUITE 203 ANCHORAGE, ALASKA 99502-3~04 (907) 279-3916 Fax (907)476-6013 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: Lot I0 Block 1 Park Hills $/D 14411 R. iverton Court Len Dasho TYPE OF WELL: Privatei Single Family WELL LOG AVAIl,ABLE: Yes INSTALLATION REQUIREMENTS M]ET: Yes Wz4_rVERS GI~41NTED: None Required WELL YIELD FROM WELL LOG: 5 Gallons per Minute PUM~P YIELD FROM TEST: 6~-5 Gallons per Minute DATE OF INSPECTION: November Z% 1994 TEST PROCEDURE: ' Well was tamped at a eommut ram while the drawdowu was mon/ta:~d with an. acotm:ic probe. At the beginning of the test water level was found at less th~u 24 feet below top of cas{ng. At a pumping ram of 6.25 gallons per minute the war. er level dropped to 98 f~t after 48 minutes of pumping. A total of 300 gallons were pmmped. The well recovered to 29 feet in 30 minutes, indicating a recovery rate of 3.45 gallons per minute. TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested for E.Coli and total nia'ogen on November 17, 1994. E.Coli 0. Other Bacteria 0 Total Nitrogen 0.70 rog/1. Max. allowable Total Niu'ogen I0 mg/h No Bacxeria Allowed TEST RESULTS: This well meets the requirements of the Municipality of.Anchorage. TI:tIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINITTE FOR MORE, TI:tAN FOUR HOURS Tho Municipal requirement for well flow is 150 gallons of water per bedroom per day. This well exceed this requirement. The assessment of the condition of the well applies only to the conditions as of the day texted_ The flow rate may change due to subsurface conditions thsl may not be observed from the surface, md 9hu.nges ~U the laud use and other factom that may impact the aquifer feeding the wetl- ~- .~' ;- ,.., '. >"::: . -.. ~. : -.;'-: ~.:.: .. i :. ~I .... ~.._~9.~c,.cwx~.. '- ENMRO,~f~L MANAG~A4~qT INCORPORATED March 20, 1995 Bonnie Mehner lack White Co. 3201 C St. Ste. 100 Anchorage, AK 99503 Re: Lot 10, Block 1, Park Hills S/D (14411 Riverton Court) Ms. Mehner: : The Municipality of Anchorage (MOA) requires that an on site waste water system pass an adequacy test prior to issuance of a Health Authority Approval (HAA.). The. MOA Department of Health and' Human Services HAA Guidelines. state" ...-a measured volume of water, based on 150 gallons, per lpedroom, is' injected into the absorption field... The field must be able tO absorb that. volume of water during a twenty four hour period." Environmental Management. Inc. (EMI) uses, as a standard protocol, the rule: 150 gallons per bedroom per day multiplied by 1.5 will be added to the field without the level of water in the field rising more than 12 inches and the level must be below the perforated lateral pipe. This is above and beyond the MOA guideline requirements and is used as a standard in the industry. On December 10, 1994, EMI performed an adequacy test on the absorption field located at the above address. A total of 925 gallons of water was allowed to flow into the field at a rate of 5 gallons per minute for 185 minutes (3 hours 5 minutes). Prior to starting the test the water level in the absorption field was measured to be 1.5 inches in depth. During the addition of water, the rise in the level of the water in the field was monitored at regular intervals. Once 925. gallons of water were added, the final level, of water in the field was measured to be 5.0 inches in depth. Thus the..addifion'of 925 gallons resulted in a total rise' of 3.5 'inches. ''The home at the above location is a four .bedroom single family residence. The perforated-.lateral pipe is located at a.depth of 6 inches above the bottom 206 E. FIREWEED LANE, SUITE 201 ' ANCHORAGE~ AK 99503-2703 CONSULTING (907) 272-9336 - FAX (907) 272-4159 · TRAINING (907) 272-8852 · FAX (907) 272-0319 of the field. With the addition of 925 gallons, a rise of 3.5 inches and a constant rate of input at 5 gallons per minute for 185 minutes, this system easily passed the adequacs' test on December 10, 1994. EM3[ feels at the time of the test the system was performing well to its design specifications and within MOA guidelines. From our experience in perfoi,-,ing MOA adequacy teats this system demonstrated typically of a normally functioning system and the test was completed without any noticeable problems. If there axe any questions please call me at 272-9336. ' Re,~/ctf Ily .....,~ /~,;:iohn Simpsoi~, P.E. ~/" 206 E. FIREWEED LANE, SUITE 201 · ANCHORAGE, AK 99503-2703 CONSULTING {907) 272-9336 · FAX (907) 272-4159 · TRAINING (907) 272.8852 ,, FAX (907) 272.0~19 CERTIFICATION OF HEALTH AUTHORITY APPROVAL This is to certify that the on-site well and/or septic system inspection report for the property located at IHH ii ~l,/~f'Jror', ~'t". and shown on the attached fecrn has been prepared and reviewed by a registered professional engineer. Findings in this certification represent the conditions found at the site atthe particular time of the site inspection and are the result of services rendered within the scope authorized by the client. Changes due to natural processes and human activity will affect the conditions described herein. EMI prepared these tasks in a manner consistent with the level of skill 'ordinarily exercised by members of the profession currently practicing under similar conditions. No warranty, express or implied, beyond exercise of reasonable care and professional diligence, is made. The engineer and Environmental Management, Inc., are not responsible for any claims by third par[les for personal injury or economic loss alleged to arise out of this wetl and/or septic system inspect[on. ENVIRONMENTAL MANAGEMENT, iNC. hn S.j~son, P E e President Date EMI 5%Stan's Stu~Mfsc. Off[ce Wcr~\HeaRh APP Oisclafmer ~MUNICIPALIT¥ OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPAKTMENT OF ~.ALTH AND ENVIRONMENTAL PROTECYION APPLICATION FOR ~%LTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date April 5, 1985 (a) Legal Description (include lot, block, subdivision, section, township, range) Park Hills Subdivision Lot 10 Block 1 Sec 34 T12N R3W Location (address or directions) 14411 Riverton Court, off Goldenview Dr. c/o GEOLAB Applicants Name Kachina Construction Telephone - Home Business 344-8042 Applicants Address~/o GEOLAB 1131 E. 76th Avenue, Anchorage, AK 99502 (c) Applicant is (check one) Lending Institution Bnyer,[12/; Other C2lI<e plain>; (d) Lending Institution Alaska Mutual Bank Ad~ ss Owner/builder~; Telephone (e) Real Estate Co. & Agent Heritage Homes Address (f) Telephone Mail the HAA to the following address: c/o GEOLAB 1131 E. 76th Avenue ~101 Anchorage, Alaska 99502 2. ~ype of Residence Single-Family~ Number of Bedrooms Individual Multi-Family~ 4 Other (describe) Community~ Public~--~ Note: If community well system, must have written confirmation from the Sgate Department of Environmental Conservation attesting to the legality and status. OnsiteX~_~ Publico Comm~mity~--q 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] 5o Engineering Firm Providing Inspectioms~ Tests File Search~ Data and Information e 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 om-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 Manicipality of Anchorage files and from my investigation and inspection, the om-site water supply and/or wastewatar disposal system is in compliance with a~l Ma~nicipal and State codes~ ordinances~ and regula- tions in effect on the date of this inspection. Name of Firm GEOLAB Telephone 344-8042 Address .... '1131 E. 76th Avenue ~101, Anchorage, ~-~,~f~'~ka Date.___ _ April ~, 1985 ~_ , , '// ~.~1~ .~ ,~ ~ ~ ' .: ~ . . ~ , Approved _ "~ Disapproved ~ ConiSton' ' -' ~"'~ Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF hIEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT~ ATIONS GIVEN IN PAi~GRAPM 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. ~ DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES A2ID THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE~ MENTSo 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° (DHEP SEAL) RR4/eJ/D18 [Page 2 of 2] 7-19-84 April ! 6, 1985 ~07-344-8042 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTE(... flON RECEIVED Municipality of Anchorage Department of Health & Environmental Protection 825 "L" Street Anchorage, Alaska Reference: Engineers Stamp for Thomas R. Smith Gentlemen: On March :30, 1985, the office of Thomas R. Smith burned, resulting in the loss of his professional engineers stamp. Please accept his signature without the stamp until such time as the stamp can be replaced. Since Mr. Smith has been doing business with the Municipality for years, he is surely no stranger to you. If you need supporting evidence such as newspaper clippings or police reports, we will furnish them on your request. Please process the Health Authority Approval for Park Hills Subdivision Lot 10, Block I without any further delay. This HAA has languished In the "Hold" We were not notified that the HAA was being held for basket for ten days. Mr. Smith's stamp. David A. Stanley, P.6. ' / President °~oLo?q.-.~.~LC°"su*~'"'"'~ ___.._~~~ ~ ~,,~.~ , ~ ~,~ ~o,,;,, A. WELL DATA '~'~'IMUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: Well Classification Individual Well Log Present (Y/N) Yes Total Depth 105 ' Cased to Static Water Level 0' Casing Height Above Ground 12" Electrical Wiring in Conduit (Y/N) Yes Separation Distances f~om Well: To Septic/Holding Tank on Lot 140' To Nearest Edge of Absorption Field on Lot 135' To Nearest Public Sewer Line NA Cleancut/Manhole NA Water Sample Collected By Water Sample Test P~sults C~t~nts DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION: Date Completed 97' Lot 1 Block 10 Sec 34 T12N R3W If A, B, Or C, D.E.C. Approved(Y/N) NA 10/5/84 Yield 5 gpm Depth of G~outing. None Pump Set At 99' Sanitary Seal on Casing (Y/N)Ye: Depression Around Wellhead (Y/N)No ; On A~joining Lots 100'+ ; On Adjoining Lots 100'+ To Nearest Public Sewer To Nearest Sewer Service Line on LOt NA D. Stanley ; Date 4/4/85 B. SEPTIC/HOLDING TANK DATA Date Installed 10/17/84 Size 1250 gal NO. of Ccmpartments 2 Standpipes (Y/N) Yes Air-tight Caps (Y/N) Yes Foundation Cleanout (Y/N) Yes Depression over Tank (Y/N) No Date Last Pumped NA new system Pumping/Maintenance Contract on File (Y/N) NA ; for Holding Tank High-Water Alarm (Y/N)NA Temporary Holding Tank Permit (Y/N)NA Separation Distances frcm Septic/Holding Tank: To Water-Supply Well 140' To Property Line 85' To ~ater Main/Se=vice Line Course NA NA To Building Foundation 25' To Disposal Field 19' To Stream, Pond, rake, c~ Major Drainage Couik~nts Receipt % Date Paid: Amo un t: [Page 1 of 2] 2-15-84 Soils Rating in Absorption Strata 178sq.ft.BR Type of System Design bed Date .Installed 10/17/84 Length of Field 56 ' Width of Field 24' Depth of Field 3'-4' below final qrade~ after ' 1 ~ading Square Feet of Absorption A~ea 1344' Standpipes Present (Y/N) Depression over Field (Y/N) No Date of Last Adeql/acy Test NA new system Results of Last Adequacy Test NA Separation Distance from A~sorption Field:. To Water-Supply Wall 135' To Property Lir~ 10' To Building Foundation 41' To Existing or Abandoned System on Lot NA ; On Adjoining Lots 100'+ To Water Main/Service Line NA TO Cutbank(if present) NA To Stream/Pond/Lake/c~ Major D~ainage Course NA To Driveway, Parking Area, c~ Vehicle Storage A~ea 31' Co~'m~nts D. LIFT STATION Date Installed NA Size in Gallons "P~mp On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Din~nsions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Counts ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA Signed ~/~_~~ Date ~/~- Company GEOLAB MOA No. ST85-007 KB1/d5/s [Page 2 of 2] HAA Guidel~s in effect 2-15-84