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HomeMy WebLinkAboutPARK HILLS #2 BLK 3 LT 3Pork Hills lock Lot 17-142 -31 ]UE lg~:z~ A~4 r.l-k~ DRILLIN~ 90-? M-W DRILLING, Inc, P,O. Box H0378 · 103~0 Cid Seward Highway (907) ANCHORAGE, ALAS~ 99511 DRILLING LOG Well Owner.__ Patricia & Victor Kelly. tlseofWell Domestic Location (address of: Township, Range, ~eeLion, if known; or distance main road_ Lot 3 Blk, 3 Parkhills g~2 Sub, NE¼, See 34, T12N, P,3W Size of easing _ Static water level 73 Sereen( ); Perforated ( ' ~.)~ Describe screen or perforation. Well pumping test a~ga~fis :~ ~A~) (minute) for_. 2. .hours with of drawdown from static ~ ~;993 (Corrected 6/23/94) Depth iii feet from -- ground surface 0 .TO. 2 2 .TO 5 ~.& TO. 31 .... To_ A 5 48 97 ].2P; TO Depth of Hole 140 .feet Ca~edto 138.7 feet ft. (!}~zY~:': {below) land surface. Finish of well (check one) open end ( 100,% 5':::i .:;?'. WELL LO{} Gh/~-'~l~'l~ 0f ~i~rmations penetrated, size of material, color and hardness ;.;',. -q .. ~; ,. .... ~ Mrown, silty/sandy x ); ~rilg~ll_, very silty wet PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW920212 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:KELLEY VICTOR E & PATRICIA L OWNER ADDRESS:13340 WESTWIND DR ANCHORAGE, AK 99516 DATE ISSUED: 8/06/92 EXPIRATION DATE: 8/06/93 PARCEL ID:01714231 LEGAL DESCRIPTION: PARK HILLS #2 BLK 3 LT 3 LOT SIZE: 68627 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: DATE: DATE: Municipality of Anchorage Page ,ii 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: ~ W c~ .,'L O.;.Zl/ PID Number: O ! 7 - ) ~ - '~ ) I Name: ~ ~ ~ ~lO~o~ ~ Wastewater System: D New ~'Upgrade Address: 1'7~ F~lz ~ I~s ~-~v~ ABSORPTION FIELD Phone: ~No. of B~ooms: BDeepTrench ~ShallowTrench BBed ~Mound ~Other LEGAL DESCRIPTION so~, Rating: I Total Depth from original grade: Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: i~ ~l ,J Range:~ ~Iisect'°n:~ ~ Fill4a~ded~,.~&l~above/~u/°riginal grade:+ ~/ Ft. Gravel_ length: ~' % Ft. WELL: ~New ~ Upg fade Gravel width: Number of lines: 0~stance between lines: Classification (Private, A,B,C): Total Depth: I Cased To: Total absorptioP area: Pipe material: Date Drilled: : Static Water Level: InstaJler: Date inst~led: Yield: Pump Set at: Casing Height Above Ground: '~ TAN K SEPARATION DISTANCES ~t~ ~ Holding ~ S.T.E.P, TO Septic Absorption LiR Holding ~ublic/Private Manufacturer: Capacity in gallons: F,O~ Tank Field Station Tank S .... Lines ~NC H 'T/~N~ ~& ~' 0 ~ ~ j ~ Material: Number of Oomp~ments: Surface Water &~OI ~qO/ ~Vo' LIFT STATION LineL°t ~ ,~ J ~ ~ ~1~ Size~.~in gallons. Manufacturer:/~ Foundat,o. ~7' ~D / ~0 1 "Pump o." ,e~., ~:. I "Pump off" ,ev~l at: High wa~m at: ~o" I I~" Cu~ain i~ ~O Pump Make & Model E ectr ca nspections ~erformed by: Drain ~ V~" ~ Remarks: BENCH MARK ~'-~ ~¢;~ ~/~'7 Locat,o~ and Description: Poop_  ASSU~ed ElevatioD: ~ ~ Inspections performed by: ~ Dates: 1st_-z/~/f, ~ Department of Healt~ and Human Services approval "~:'~'," ~ ......... ,~' ~ Reviewed and approved by: Date: 4 -/~- ~ .' . ~~ ~5 0 ]%. AC $2.5 Fl' ~ 26X42 MOUND ~ £C 29 i ~ ~ AD ,~o I ~ I I r~ 500 GAL ACREAGE LIF~ FANK BE 43.5 I / / / I I I I iii / / / I / ~ ~ Tn~EN SPU~KLAN~  BENOH MARK: DOOR THRESHOLD ~] ASSU~ED ELEE k~ FL 150 iTOBBEN SPURI<LAND P.E. 205 W 15TN. AVENUE ANCH. AK. 99501 (907) 279-$916 IOT 3, BLOCK3 PARK HILLS s/oil PA TRIC/A KELLY 14700 PARK HILLS DRIVE SEPTIC SYSTEM DES/ON DATE: k/ARCH 26, 1997 SHEET; 2/5 GRID: $057 PAHOSO3~O, Dk/6 017-14c°-$] ': ~. MUNICIPALITY OF ANCHOBAGR., BU~D!NG SAFETY DIVISION 3500 EAST TUBOR ROAD INSBECT!ONS (907' =F~~ ~ ,~.~o-~o~ INFOR~AT ION (907) 786-8~11 NAMe: DICK ~,~,v ADDRESS: 14700 BABK HILLS DR LOT' 3 ="0 .... PHONE ~: 345-6277 . o~=~,. 3 SUBD: ~2 DATE: 7/18/1994 COMMENT: gEIN ~ARLY AS TYPE OF INSPECTION: ELECTRICAL FINAL 0 0 0 0 [~] NO NONCOMBLIANCE OBSERVED [ ] CORRECTIONS ESSENTIAL AS [ ] WILL REEXAMINE AT NEXT INSPECTION EXPLAINED BELOW [ ] DO NOT CONCEAL UNTIL REINSPECTED COMMENTS: E I .¢._.r...--r-r,..¢A-L INSPECTO(': WHeN CORRECTIONS ~RE MADE, PLEASE ~ALL ' '. ' ' ~ .... ~ ~ F~R INSPECTION DO NOT ~EMOVE THIS NOTI~ Municipality of Anchorage Page I 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: E:,LV./,~,?.-O:2.11 PID Number: O I'~- I ~- ~, [ Name: ~ll~. ~c~ ~ ~ Wastewater System: ~ New ~Upgrade Address: ~ ' ~o ~T~ ~v~ ABSORPTION FIELD Phone: JNo. of B~rooms: ~DeepTrench ~ShaUowTrench ~Bed ~und ~Other LEGAL DESCRIPTION Soil Rating: Tota' Depth from orig,~l~rade: J, ~ GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pips bottom from original grade: Gravel depth beneath pipe Township: ~ Range: ~ Section: FlU added above original grade: Gravel ~ength: Number of gheE: Distance between lines: WELL: D New ~ Upgrade Gravel~ ~V Ft. ~ ~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Tota~ absorption area: Pipe material: Ft. Ft. /~ ~ SQ. Ft. ~ ~ . ~O Dril[er: Date Drilled: Static Water Leveh installer: Date in&tailed: Yield: J Pump Set at: J Casing Height Above Ground: ' ~"~ Ft. Ft.TANK SEPARATION DISTANCES ~ti~ ~ Ho~U~ ~ S.T.~.,. To Septic Absorption Lift Holding ~oblic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines A,~,~ ~ ~S ~ eateria~ Number of Compa.ments: Surface Wa~.~ h~ ~ ~ ~ LIFT STATION Lot Size Jn gallons: I Manufacturer: Cu~ain Pump Make & Model ~ Electrical Inspections peMorme~ b~: ~omarks: BENCH MARK ,ENgiNEER'S S~AL. , Inspections performed by: ~ Dates: 1st ~/~ ~ Department of Health and Human Services approval ,~ ...... ,- © , Reviewed and approved by: Date: ~?~": Perm/t'No... ~' ~ ~,2, ~.~ ~ I Page ~* Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES of ..~ ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: PID No.:.. Ol?~ 1~2.-- ~1 '/ ' I D~..!!:r~.:':).~,-'L'.m~:..!r"u!: ,.::,'F i.~,ot,':~l '?.h and So,:: :i. a:L S,::x"v:L n:~x~{. 820 iil S'h?"~'.:'::{.:"?. 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 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920211 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:KELLEY VICTOR E & PATRICIA L OWNER ADDRES$:13340 WESTWIND DR ANCHORAGE, AK 99516 PARCEL ID:01714231 DATE ISSUED: 8/06/92 EXPIRATION DATE: 8/06/93 LEGAL DESCRIPTION: PARK HILLS #2 BLK 3 'LT SEC 34, T12N, R3W, SM LOT SIZE: 68627 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. 2. THE ATTACHED APPROVED DESIGN. 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). THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS PERMIT IS ISSUED FOR THE REPLACEMENT OF AN EXISTING FAILED ABSORPTION SYSTEM. THE REPLACEMENT BED IS TO BE A MOUND PLACED 4' ABOVE THE LEVEL OF THE FAILED BED. THE ENGINEER SHALL VERIFY THAT ADEQUATE SEPARATION EXISTS BETWEEN THE PROPOSED UPGRADE ~ND THE WELL ON LOT 18. RECEIVED BY: ~ ~ 1,,( DATE' ISSUED BY: DATE: SITE PLAN \ I ABSORPTION AREA CALCULATIONS: This lot has an existing absorption bed installed on it (Permit 85-0734) which has failed. Original owner thru another engineer is applying for absorption field upgrade as seperate action. The lot has no other development at this time. This application is for a well permit only. IMPACT ON ADJACENT LOTS: This lot will be served by this private well. The existing and proposed replacement absorption system is located such that there is no impact to any adjacent lot. The well will have no adverse impact on adjacent lots as shown on the site plan. ENGINEER'S SEAL SITE PI.~ DETAILS--PROPOSED WATER ~WELL) SYSTEM ,OT 3, BLOCK 3, PARKHILLS # 2 SUB, NE /4 S3~ T12N PREPARED FOR: VIC KELLY 13340 WESTWIND DR ANCHORAGE, AK, 99516 SCALE: 1" = 100' CONSTRUCTING ENGINEERS3t6-2000 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 DRAWN BY CAL 8/6/92 DRAWING # 92-S1-05~38 LOT 205 W 15th. Awnue~ Suit~ 206 ANCIIORAGE, ALASKA 9950i (907) 279-59i6 SEPTIC SYSTEt~ DESIGN JOHN BERGGREN 'J"h:}. ~i~ ~?~/:~r' J< a?~!. Cl~.ssl:::r' :}. bed made by tl"~ I--Ic~al'kh ABSORPTION AREA CALCULATIONS: This lot has an existing absorption bed installed on it (Permit 85-0734) which has failed. Original owner thru another engineer is applying for absorption field upgrade as seperate action. The lot has no other development at this time. This application is for a well permit only. IMPACT ON ADJACENT LOTS: This lot will be served by this private well. The existing and proposed replacement absorption system is located such that there is no impact to any adjacent lot. The well will have no adverse impact on adjacent lots as shown on the site plan. ENGINEER'S SEAL SITE PLAN DETAILS--PROPOSED WATER ~WELL) SYSTEM ,OT 3, BLOCK 3, PARKHILLS # 2 SUB, NE /4 S3& T12N R PREPARED FOR: VIC KELLY 13340 WESTWIND DR ANCHORAGE, AK, 99516 SCALE: 1" = 100' CONSTRUCTING ENGINEERS346-2000 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 DRAWN ny CAL 8~6~92 DRAWING # 92-81-05-3B O Nonltor 40 1-1/4 inch PVC 1/8 inch holes e t 60 Inches 1-1/4' PVC i500 GAL, STEP Foundo t/on £1een v  Non/tot" /-- Non/tot" 4:, Topsoil 3 Cover / ~ Exist Ground ~ ~////~///////////////////. rz2"/~"~,~.~ r-~ / ~ , ' >:::::::::::::....::..,:::: . 4 FT FZL TE~SAND / ' REVISED ~ESIGN TDBBEN SPURKLAN~ P.E. 675] W. DIMDND BLVD. ANbl AK, 99502-3904 LDF 3 BLLICK 3 PARK HILLS #3 SEC?IDN 34 712N R3~/ J[1HN BERGGREN SEPTi'C SYSTEH ]]ESZGN ~)ATE, ALJ~' ~ 1992 SHEET, i/3 ORZ]~, 3037 1-1/4 inch PV£ 1/4 inch holes a t 48 inche.~ Miro Fi 140 ~ / 1~ inches oF Sep~:ic [~ock /~ Monl-'com 4' Topsoil £' Cover 4 FT FIL TERSAND _1 9 1-1/4' PVC 500 GAL ACREAGE LIFT STATION 1£S0 GAL SEPTIC TANK Monlgom INSULATIDN ~ //////~ REVISEI~ 9ESIGN DF TDBBEN SPURKLANI) P,E, 6751 W, DIMDND BLVD, FNCH, AK, 99502-3904 Lilt 3 J?LD£K 3 PA~K HILLS #3 SECTION 34 Ti£N JOHN BERGGREN SEPTZC SYSTEM AS]]UZLT SEPT, 18, 199£ SH EE T,~,,.~/3 GRI~), 3037 Tom Fink, Mayor Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 February 4, 1993 Tobben Spurkland, P.E. 203 West 15th Avenue Suite 206 Anchorage, Alaska 99501 Re: On-Site Wastewater Disposal System Inspection Report for Lot 3 Block 3 Park Hills Subdivision #2, Sewer Permit Number SW920211, P.I.D. 017-142-31 Dear Mr. Spurkland: In response to your letter-dated January 21, 1993, this office is unable to sign the referenced inspection report until the levels of the; 1) "Pump On"; 2) "Pump Off"; and High Water Alarm are labeled on the form in the designated spaces. An electrical inspection will also be required before final approval can be given to this inspection report. The absorption mound, septic tank, and lift station tank all appear to be constructed pursuant to the design submitted ho this office for a permit issued on Augusfi 6, 1992. When the three items listed in the first paragraph of this letter are completed, this office will sign the subject as-built inspection report. If you have questions regarding the above please call me at 343-4329. Sincerely, Civil Engineer On-Site Services 0SS169 (907) 2~B-50~5 ~ ar]ua¥"v .~'..' :1. 1993 to bu:i. tc; a The owner o'~ t.l z .:~ property ~ Mr'. V:i. [::'t:c)r Kl.:e]. ]. y W:ilth As Built'. submitted 't.o ,/our of.~ice. This As Built: has not: been signed o~'f:; due to t. he 4:act that the residence was not c.'["['l:~t' r .1u::t] .}Fz[] ~('[: th~:~ '['.i ['~(.:{~ ~ and ('l'Ons(aq {¢l:~n't. ]. Y ~ [z:o~,JeJr r~C)l{: I:)eerl i ns'{l:al ]. cad, There has been a chan.}e in the plans :::~e Mr, Kelty, Fie is now marketing] the ].ot~ and is in a aw~:kwar'd situa":iocI concerning the sept. ic syster:. The sepi:ic: sys'Eem is t:here,: but he has no paper- v,:(:)r k show~ ]g that the sep'{:i c system i s a(::(::(.~ptab], e F'lease s:i. gn o-Fl the As Built~ or provide:, Mr'. Ke:,lly with' a merit that '~:he sept:i(:: system is installed ac:cc~r'ct:i, ng % t a t': E, RECEIVED Munic{p[~l[tY 0~ Ano~_ofage Dept. Health & Humeri ~ervices ] unicipality of Anchorage Tom Fink, P.O. BOX 196650 Anchorage, Alaska 99519-6650 Mayor November 11, 1992 Tobben Spurkland, P.E. 203 West 15th Avenue Suite 206 Anchorage, Alaska 99501 Re: On-Site Wastewater Disposal System Inspection Report for Lot 3 Block 3 Park Hills Subdivision #2, Sewer Permit Number SW920211, P.I.D. 017-142-31 Dear Mr. Spurkland: In response to your letter dated November 10, 1992, this office is unable to sign the referenced inspection report until the levels of the; 1) "Pump On"; 2) "Pump Off"; and High Water Alarm are labeled on the form in the designated spaces. An electrical inspection will also be required before final approval can be given to this inspection report. The subject inspection report will be approved by this office when the above mentioned deficiencies are resolved. Daniel ~o ~oth Civil Engineer On-Site Services OSS169 TERRY C. AGLIl~ff! PATRICK M. RODEY RONALD A. OFFRET J. ROBERT WOOI~TEP,, JR. AGLIETII, RODEY & OFFRET ATTORNEYS AT LAW 733 WEST FOURTH AVENUE, SUITE 206 ANCHORAGE, ALASKA 99501 July 14, 1992 RECEIVED JUL 1 6 199 Munimpality of Anchorage Dept. Health & Human Services TELEPHONE (907) 279-8657 TELECOPIER (907) 279-5534 Municipality of Anchorage Department of Health and Human Services On-Site Services Attn: John Smith P.O. Box 196650 Anchorage, Alaska 99519 RE: Lot 3, Block 3, Parkhill Subdivision #2 Sewage system/Victor Kelley Dear Mr. Smith, For your information: Besides my contacts with John Berggren, I've also been in contact with Paul Palmer, Real Estate Broker, to get help motivating the Sandersons to get moving on putting in an adequate, properly permitted system. I gave both Palmer and Berggren the name of Chuck Landers... the Kelley's don't really care who designs or upgrades the septic system so long as they get a properly permitted;functioning septic system promptly. Very truly yours, AGLIETTI, RODEY &/~FFRET · Robert Woofter, Jr. JRW/yms Enclosure: Berggren 7-13-92 letter cc: Victor and Patricia Kelley RECEIVED JUL 1 1992 Agilely. Rodey & ~ July 13, 1992 Acreage Systems P.O. Box 112848 Anchorage, AK 99511 Attn: Ed and Tamara Sanderson Re: Victor Kelley Septic System Lot ~3 Block #3 Park Hills Subdivision #2 Ed and Tamara, Since I'll be out of town for a while after our conversation today, I'm writing you in the need for timeliness in remedial action on the subject lot septic system (re)-approval. As we have discussed, the Kelley's attorney Mr. Woofter, has requested that we work together to provide the necessary current M.O.A. septic (re)-approval to allow the Kelley's to commence construction of their residence on lot #3 by August 1, 1992. · ..... We have agreed that there are probably the existences of mitigating legal circumstances that would possibly allow a substantial argument against any complaint the Kelley's might file. However, all parties have indicated' a serious willingness to prevent a waste of potential remedial funds being squandered in a "fruitless" legal effort. Instead, we have indicated we will contribute to the remedy. As' discussed GEI will commit to an estimated $2,000.00 - $2,500.00 for materials (or actual whichever is less) as a contribution in good faith to get things rolling. Also, as discussed, Acreage' Systems would provide whatever else was needed (in labor, equipment, etc.). We have discussed that Kelley's should also participate, since the system when installed was approved as indicated. Further, it has been discussed that M.0.A. should be aware of their liability (at least to the extent that they would be compelled to speed up their action and (re)-approval.) At this time, we understand that Woofter has contacted M.0.A. (see letter attached) and further, called them later to reemphasize the need for them to expedite the solution to this problem or they could find themselves in court with everyone else. Page 2 of 2 Tamara has said she is awaiting notice from M.O.A. on what to do as an acceptable remedy. It has been over a week since the last contact between all parties has occurred. There are only 3 weeks left to August' 1st. I must urgently remind you that action, is needed, now!! To sit passively by and wait for M.O.A. to give you instructions is not going to solve anything. I strongly suggest that Acreage Systems contacts M.O.A. and the Kelley's as needed to aggressively pursue a timely and cooperative response to allow remedy of this problem before August 1, 1992. I don't want to get into legal matters on this and I know you don't either. However, rest assured that if timely action is not taken (in good faith) and the Kelley's either file suit or return the lot to GEI because of this situation, there will be more heartache and expense by everyone than could be reasonably anticipated by productively applying your expertise toward a remedy satisfactory to allow the renewed approval by M.O.A. I trust you can appreciate the sincerity and general benefit I am trying to convey in this demand for timely and effective action. Please contact me (and the Kelleys) with any and all information you can. I look forward to getting beyond this soon. ggren ~_~resident JB/sf enclosures AGLIETI~I, RODEY & OFFRET ATTORNEYS AT LAW 733 WEST FOURTH AVENUE, SUITE 206 ANCHORAGE, ALASKA 99501 TERRY C. AGLIISITI PATRICK M. RODEY RONALD A. OFFRET J. ROBERT WOOFIIsR, JR. TELEPHONE (907) 279-8657 TELECOPIER (907) 279-5534 June 11, 1992 Municipality of Anchorage Department of Health and Human Services On-Site Services Attn: John Smith P.O. Box 196650 Anchorage, Alaska 99519 RE: Lot 3, Block 3, Parkhill Subdivision #2 Sewage system/Victor Kelley Dear Mr. Smith, Mr. and Mrs. Kelley relied on both the seller's written representation to the effect that "there is a Municipality of Anchorage approved four bedroom septic system on the lot," and a copy of the Municipality's approval of the septic system, in buying the lot. Clearly, they should not be out one penney to upgrade the septic system to the point where a house can be built this summer. I am counsel for Victor and Patricia Kelley, who purchased the above-described residential lot in early 1991. As I discussed with Dan Bolle of your office, the lot's septic system had been installed by Acreage Systems for the former owner, John Berggren, which was critical, since the Kelleys' only reason for buying the lot was to build a home. This year, when it came time to seek a building permit, it turns out that although the Municipality had approved the septic system, no building permit could be issued due to ground water being too high in the subject lot. When I contacted Acreage systems, I was told words to the effect of, "well gosh, [engineer] Bruce Corwin told Acreage how to build it," and Acreage basically denied any responsibility, and suggested that we pursue Corwin. Since Corwin is out of state now, according to my sources, that is simply not cost effective. John Smith June 11, 1992 I understood it from my June 4, 1992, telephone conversation with Dan Bolle, your office is already going after Ed Sanderson of Acreage Systems to get them to put in the right sort of septic system. If I could add a note of urgency to that, the buyers, Mr. and Mrs. Kelley, stand to lose quite a bit of money if they can't move forward with construction of their planned home before August 1, 1992. I would greatly appreciate hearing from you at your earliest possible convenience about the progress of your attempts to motivate Mr. and Mrs. Sanderson, owners of Acreage Systems, to finish the job. I would also appreciate it if you could flush out certain unsubstantiated information I have to the effect that the original test hole data which were part of the sewage system permit application in late December 1985 or perhaps January 1986 failed to mention one of the less permeable soil types which actually occur on the lot. I have discussed this subject briefly with engineer Chuck Landers (694-9098) who evaluated the situation for Mr. and Mrs. Kelley. Given the fact that both of the adjacent lots, all of which were originally part of the same lot, which seller Berggren subdivided, the question arises in me that Acreage Systems , which installed mounded systems in those lots, had to know about soil conditions on this lot. If it assists you in any way, I understand from John Berggren that Acreage Systems had guaranteed the septic system he installed to function whenever a house was built, so long as city code did not change. Can you please enlighten me as to 1) whether relevant portions of the City's building code did change since January 1986 and 2) whether any such changes in the building code would be the case of the current denial of building permit for Mr. and Mrs. Kelley. Let me again please emphasize the urgency of this matter. It is clear to me as real estate lawyer that though it may be difficult to apportion all of the culpability or negligence which is now thwarting the Kelleys' home-building, Acreage Systems, John Berggren, the Municipality of Anchorage and Bruce Corwin all are certainly more responsible than Mr. and Mrs. Kelley themselves, who are totally innocent of any wrongdoing or any negligence. I trust that the four parties set out above will promptly consult with each other and decide who is going to rectify the situation and how. Mr. and Mrs. Kelley hereby give express permission to the Municipality of Anchorage, Acreage Systems, John Berggren, or their agents to enter the property and conduct any necessary ground tests, and/or to put the proper mound system in place, subject to their review. John Smith June 11, 199Z As a lawyer, the only remedies I can offer to Mr. and Mrs. Kelley involve setting the matter before the state court of competent jurisdiction, which would probably arrive at the same conclusions I have so far, but only after considerable expense in legal fees and court costs, not to mention time and opportunity to build lost. In that situation, Mr. and Mrs. Kelley's consequential damages would obviously be quite high. Matters of this sort are clearly better resolved through negotiation and prompt communication than in court. I look forward to your earliest possible response. Very truly yours, JRW/yms /J~. Robert Woofter, 'Jr. CC: Mr. and Mrs. Kelley John Berggren ,,...~ ~.~ ~._~x MUNICIPALITY OF ANCHORAGE ~ ' ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION  ENVIRONMENTAL ENGINEERING DIVISION /l 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ~JOHI~ ~3.~_~r~if~ ~45 ziz~ ~ UPGRADI MAILING ADDRESS LEGAL DESCRIPTION LOCATION ~ ~ ~ ~ ~ ~ O~ ~ ~ ~ /~/~ ~ ~ ~ FNo, OF BEDROOMS JWell J Absorption area Dwelling PERMIT NO, ~ ~ Manufacturer ~ Material No, of compartments Liq, capacity in gallons  IF HOMEMADE: ~ Width 6 ~ ~Owelling O Z ~ Manufacturer ~ Matena ~ ~ty in gallons D - Well Eoundation ~ ~ DISTANCE TO: Nearest Jot Jine PERMIT NO. m Z No. of lines Length of each Jine Total ~ength of lines Trench width Distance between lines Top of tile to finish grade Material beneath tile Total effective absorption area = o FF :G inches ?~ ~' ~T Width Depth ~ ~ PERMIT NO. < ~ Type of crib Crib diameter ~ ~ ~ ~ ~ ~ ~f~rption area ~ ~ ~~ Building foundation Nearest lot line ~ ~ Class Depth ~ Driller Distance to lot line PERMIT NO, ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) PIPE MATERIALS SOIL TEST RATING A DATE .... ~/~ DEPAF('FMENT' OF' HIEAL. T'I..! AND ENV]:REINi¥1ENT'(:,&.. PRC)TECTIEih. I 825 L... STREEIE'T', ANCHORAEiE~, AK 9950 1 264.-'.,~!.720 JOHN BERGGREN I:::', 0,, BOX 4- 1268 A I;.I C I'"10 R A G E, A K 99509 345-'2122 ¥ N1]¥:1t.I :]0 ~)¥~/OHDNV JO MAX ~'~ ........ ~.:,c. D F'd._ L]r I F:,: LO'T: ."/; BLOCK: 3 DEPTH 1'O F:'IF:'E 8[)T'I'0M (F'T'.) GRAVEL DEi:F:"['H (F:'T. TOTAL. DEPTH (F'T.) GF~AVEL WIDTH (F'T,, GRAVEL. L. ENG]"H (1:::']".) GRAVE:I_ VOI...I..Jh'IE (CLJ,, YDS,, ) SOIL RA'FING (S[~,F:']". /BR) 5.0 0,, 5 5.5 · 20.0 38.0 28.2 1,250.0 -~..x- 12.~ I,-d~d'-.. I'IL.>:~ I d,..~vl::: A]" t_1::.~...,::~ I 'T'WO ;( IYF'AR""dEt* 'r':'3 ~ :[ <'L~ ffl -x' · ... .,. ~ <:: li~ .. ]. ,I, <~ ' ': '~' i. ~' c:, r' t. h b y ...... ;' ' ... ~ :..lie:' J LU'J].(..:..pa].:i.t.y O[' ~-ntC. l:LH',~gt::: ~JJLl-I) ar'id t. hE:, St.~At.E, c:)f "' · ,':?..Z ~-gJ. i i iF~:::t.a:[ 1 'Lhe ~' ........ and ir'i comp].iancE, t,gJ.~.J"i thE, d[:~sJ.(:jFi cPit. E, pia O~' t. hiS 3;, I ~J.].i aclher, e t.o all MOA anti Stat. e (:j{' " - .. ..)~ Lk sE?we I" age:, - ' '-'- ~.. aL t. his per'talC is va].id {oi" a ma:x:[mLm~ of' 4 bedr'ooms .-.r. - · ,: (.., d .~. ~. z c ~<:~ ]. p e r' m i 'L. I F A L. :I: F' T '"" "" "" '~ .... o ~'- ~ ~....r,~ I,..INS]"AL.I....ED ]'kl AN ' ~ "" ~"~r~E~-4 COVEI:RED -' ~.¢ ~tC)~-~ BLJ]:LD:I:IqG CODES, ,~1:t,1 (1) AN ELIECTRtCAL. I::'E;F~MIT' AND IN~I"c.C 1L, q MUST BE OBI"AI'IqF'D~ ' :: :""~'""' -L.,_C FI:i~.,A,._ ZNSPEC]"]~oN WZLL NOT BE ~[1 Id..,vE.L) WITHOUT' AN F' ~:: ...... ' '~''~ ,..-,--, .,. ~ ..... ,-:-, ..... , ~ ...... ,..,,._. rd=r'dRT] AND f:':~) 'I"HE ~..t .......... I*..(..,~...WOB'I<:' f'hJc~ BIE D(. t;:. BY A [ ]'FI:::'NSED ,:x :: ....... :,~ ....,. ' .... ' ' . ........ L.~.I_C I*~.,.,.[~-~. ,., ...... ] ~Jl:. ~..~ ]q ~ T -.r-r ,...I. CAN]-: JOHN ]..,E:,:.:[.:F:,::. ,i :~ MU, NIC PAUTY OF ANCHORAGE L ~J ~ DEPT. OF HEALTH & / v TdqV RQNMENTAL PROTECTION ...... [ ~' Municipalily of Anchorage ,~ ~,~-~,,~4J] IiFC 'J r,~ ~ii~PARTMENT OF HEALTH & HUMAN SERVICES ~/Jl//~/~__~//~ ~ 825 L Street, Anchorage, Alaska gg502-0850 R E C E IV E I~°'Ls LOG -- PERCOLATION TEST / / SLOPE SITE PLAN 1 2 3 4 5 6 7 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? I]epth lo Water Alter Monitoring? Date: Reading Date 8 9 10 11 12 13 14 15 16- 17 18 19, 20- Gross Time Net Time Depth to Net Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER ~ .~ ,~, TEST RUN BETWEEN ~ FT AND FT , COMMENTS ~.~" ~/'~ ,-o__~ ,~,~.,.g. ~,~,? ~ ~.~/z. ~. / ~ ~. "- ~HTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELIN[S IN EFFE~N THIS DATE. DATE: /~ --/2 ~ ~ 72-008 (Rev. 4/85) ,er;'/ ;7 J~,~, b ~- 7 .~.~ ~' I. ¢:~ A,~. x' 0O+ I /// / / IE. 6~1' 4 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O~L7-~62-3:~ 1. GENERAL INFORMATION Expiration Date: Complete legal description Park Hills #2 Block 3, Lot 3 Location (site address) ~47oo Park Hills Drive Current Property owner(s) Craig & Heather Tornga Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Dynamic Properties Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. ,NU M BE R OF, 'BEDROOM S: 3;,' TYPE OF WATER SUPPLY: Individual Well ~' · In~lMdua] Water storage Community Cla~'S Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [~ [] Individual Holding Tank [~ [] Community On-site [~ [] Public Sewer r'-] 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 sample results. (Certificates may be reissued for. a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 100217, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 12/27/2010 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe 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 soil condition, ground water 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 system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. 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. 5. DSD SIGNATURE . ~" Approved for L./ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (R,,e,~v?~'i/05)~ .. X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: i//-~ / ) 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: A. WELL DATA Well type Private Date completed Total depth z4o ft. Park Hills #2 Block =}w Lot ~ IfA, B, or C provide PWSID # ~ Sanitary seal (Y/N) Y Cased to ~.~8.7 ft. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform -- o-- colonies/100 mL Arsenic: ~ ug/I B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic I Steel Tank size ~25o gal. Foundation cleanout (Y/N) Y Date of pumping C. ABSORPTION FIELD DATA Date installed Length 42 Total depth 3, ft. ft. g.p.m. Parcel ID: Nitrate O0 ~/'t~'mg/L Date of sample: Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24 AT INSPECTION =.212~_12o~o ,,, 76 ft. , 8.4+ g.p.m. in. Other bacteria -- O--colonies/100 mL Collected by: ~"~ ~--.-% Date installed ~1,.h.c~92 Number of Compartments _~ Depression over tank (Y/N) N Pumper AI'z~~ --c~ Soil rating (g.p.d./~ or ~/bdrm) ~..2 GPDISF Width 26 Cleanouts (Y/N) Y High water alarm (Y/N) Y Eft. absorption area zoo8 ff~ Date of adequacy test ',:~12:~12o.,o ResUlts (Pass/Fail) Fluid depth in absorption field before test _o in. Elapsed Time: 9_q min. Final fluid depth o_ in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N Monitoring tube Y Pass System type Mound Gravel below pipe Depression over field N For _~ bedrooms Water added6oo gal. Absorption rate >= 600+ · If yes, give date New depth_~ in. g.p.d. D. LIFT STATION Date installed 91,.1',992 "Pump on" level at 39_ in. Datum Bottom E. SEPARATION DISTANCES Size in gallons 500 "Pump off" level at x8 in. Cycles tested ~ Manhole/Access (Y/N) Y High water alarm level at ~8 Meets alarm & circuit requirements? Y On adjacent lots xoo+ On adjacent lots xoo+ Public sewer manhole/cleanout ~oo+ Holding tank Manure/animal excrete storage areas xoo+ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot xoo+ Absorption field on lot Public sewer main 75+ Sewer/septic service line 25+ Animal containment areas .. 50+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation xo+ Property line ~o+ Water main xo+ Water service line 25+ Wells on adjacent lots xoo+ Absorption field Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~o+ Water Service line 25+ Curtain drain 50+ COMMENTS Building foundation xo+ Surface water xoo+ Wells on adjacent lots ~oo+ Water main 75+ 'Driveway, parking/vehicle storage ~o+ in. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in · conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone~ P.E. Date COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) ',2/-71:zo',o Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Service~? On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTH.ORITY AISPROVAL FOR A SINGLE FAMILY EJWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Day phone Day phone Lending agenc~ Mailing address ^gent Add ress Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: /7/ 3. TYPE OF WATER SUPPLY: NOTE: Individual well ~ Community well Pub lic water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE O F WASTEWATER DISPOSAL: ,// Individual on-site Holding tank , . Community on-site NOTE: Public sewer 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~Y21 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 Anc. horage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in complianbe with all Municipal and State codes, ordinances, and regulations in effect On the date of this inspe~ion. :.. , \ . Engineer's signature '%('--- ~-~~. Date DHHS SIGNATURE ' ~' Approved for /7~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date · - " The, MunicilSj~lity of'Anchorage Department of Health and Human Services (DHHS) issues Health Authority A'pproval Certific~t,~'based only upon the representations given in paragraph 5 above by an independent profe'smonal on g~h'~ r regmtered In the State of Alaska. The DHHS does th~s as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state roq uirements. Employoes 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 engino~r's work. 72-~25 (Re~. lf91) Back MOA #21 ~ ~ ENVIRONM~:NTA~ ~EI{VICE$ DIVtSION Municipality of Anchorage ~A~{ 'lB 1997 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division ~ E 6 E ~ V E D 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744" Legal Description: A. WELL DATA Well type 'j~.. Log present (Y/N) Health Authority Approval Checklist ~"~ T>,~-~'~ ~.Jc/LL<~ ParcelI.D.: If A, B, or C, attach ADEC letter. ADEC water system number ,,/ Date comp,eted Total depth / Sanitary seal (Y/N) / Date of test Cased to FROM WELL LOG 9 / ~ g.p.m. Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Static water level 7~ Well production g.p.m. WATER SAMPLE RESULTS: Coliform N 0 Date of sample: '~/~2/X,~ Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed / ~'~ Foundation cleanout (Y/N) Date of Pumping Tanksize /2 5~ Number of Compartments ~. Cleanouts (Y/N) ~7/ '? Depression (Y/N) /~ High water alarm (Y/N) /h/ Pumper C. ABSORPTION FIELD DATA Date installed Length /-'/'~-' J~ Width Effective absorption area //'7~ ~ Z"Monitoring Tube present (Y/N) y Date of adequacy test '-~ 7/~7 Results (Pass/Fail) Fluid depth in absorption field before test (in.); ~ / Fluid depth ' I-///' (ins) Minutes later: v'/ Peroxide treatment (past 12 months) (Y/N) Soil rating (g.p.d./ff '~ ~, /~'~ Gravel thickness below pipe . Depression over field (Y/N) __ For Immediately after/o Ogal. water added (in.): Absorption rate = ~' 4~ ~¢-~ g.p.d. If yes, give date System type /W'o o .~ o/ // Total depth ~'4//A .bedrooms ! 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line Size in gallons "Pump on" level at* *Datum On adjacent lots / ~¢ '~/';~-- On adjacent lots I 0¢~ I' i~-~ Public sewer manhole/cleanout ~'¢J~' Lift station / ~/' ~'-~'''' SEPARATION DISTANCES FROM SEPTIC/HOLDINGTANK ON LOTTO: Foundation ";¢ ~ ¢% '~: Property line p ..,,L Absorption field Water main/service line ~ -~' ¢ F~/- Surface water/drainage /~-) '//:-/-Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line /L~ 'P Building foundation ~'-'~ /% ~: Water main/service line Surface water J O~._9 P /~ Driveway, parking/vehicle storage area Curtain drain I"'~/L-~ Wells on adjacent lots i O ~ ENGINEER'S CERTIFICATION .... ,',:: I certify that I have determined thru field inspections and review of Municipal reco/r~, ~}'. '}that ...... theabovo in conformance with MOA HAA guidelines in effect on this date, ~:..,..; ..:: .:: .-,, ,, , Signature '~ ¢~' ?" ....... Date '?~/,' '7 / '~7 ~%1 z.,'/'-Tm .,: HAA Fee Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Free $ Date of Payment Receipt Number T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Dan Roth Municipality of Anchorage Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: HAA and As Built Lot 3, Bk 3 Park Hill #2 Patricia Kelly April 15, 1997 Gentlemen; In response to your" Pink Sheet" dated March 25, 1997, we are submitting a copy o£the electrical inspection report, and revised sheets 1 and 2 of the As Builts. Sheet 1 shows all the required measurements of the lift station, while sheet 2 shows the location of the house and the required swing ties. The sale of this property is scheduled to close on April 18, 1997. Please let me know if an approved HAA can be issued to meet the closing. Yours 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 NAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) 197~2~ 'PA~F-~CL-S ~,~.. .... ' Day phone Lefidin~ aoency ~ '~' Mailing address Agent Day phone Address 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#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 watbr 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 ~./q~ ~-IK/~.~G Phone 42C/L/ Address ~r-~HL~I '~"F~,~GAIA ~P~L-VO ~L~ ~---IvCP~, Engineer's signature DHHS SIGNATURE ~__ Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineeCs work. 72-025 (Rev. 1/91) Back MOA Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription:LoTDBLY-.-~,~P.K_~lL~_$ ~,DD-~-z. ParcelI.D. O1'7 ~ A. Well Data Well type ~-i VA.T~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) "Y Date completed '7 ] I~qS Driller Total depth I "q D ~ Cased to 1 5~ -+ Casing height 2 ' Sanitary seal (Y/N) Y Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test '7 /I~qB Static water level -7 3 ~ ~. ~. Well flow l~- g.p.m. Pump level1 I [ ~ t SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line '+ Z. O0: ; On adjacent lots g.p.m. ; On adjacent lots -~ l 0© ' Public sewer manhole/cleanout -+ zoo ' -~ I DO~ Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed .,INN IqS~, Tank size IZ~-O ~A~ Clean0Ut~- (Y/N) ~ Foundation cleanout (YIN) High~Water ala~,(Y/N), :. '} ~A Alarm tested (Y/N) :..~) .. SEPARATION DISTANCE~.FROM SEPTIC/HOLD NG TANK TO: Well(s) on lot . ~' i.~ ': ' ' On adjacent lots s I To prope~y line 5Z I Absorption field E: Sudace water/drainage Compartments Z Depression (Y/N) Foundation Water main/service line 72.026 (3~3)° Front CONTINUED ON BACK PAGE C. LIFT STATION '~E~.~v~ ~T Date installed ~P~- Size n 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) Y SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot + ~ o©' On adjacent lots + ~ ©O ' Sudace water --r l Do ' D. ABSORPTION FIELD DATA Date installed .Sg'P']- I S (~ Length ~ Z.' Width Soil rating (GPD/FF) I, ;~' Gravel thickness _ Total absorption area ~ Lb O E5 Cleanout present (Y/N) Date of adequacy test.;E~. -~ co~,Fce~e~ ~ ~'-/Results (pass/fail) Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) W/A, for Atter test yes, give date System type I~'~0 //l~°u~qD Total depth + M ~ . Depression over field (Y/N) 1'4 _ Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~- ~ o o To building foundation On adjacent lots Sudace water Curtain drain On adjacent lots 4 I O0 ~ Property line ~O ~ 4 To existing or abandoned system on lot_ Cutbank + [ ~ c~ Water main/service line +5-0~ Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I ce~'fy that I have checked, verified, or conformed to all MOA and HAA guidelines Signature __~__~:~ ' Engineer's Name _.~~, ~. ~)u ~P~ 5,, t~ ~, Da~e ~/ HAA Fee $ ,_~_gJ-Z) Date of Payment Receipt Number_ Waiver Fee $ Date of Payment Receipt Number COMMERClAL TESTING & ENGINEERING CO, ENVIFIONME~NTAL LABORAI"ORY SERVICES Drinking Water Analysis R. cport for Total Coliform Bacteria ~,s_~ a ~,,~r ANCHORAGE, AK 9OSt~ ~ IN6'TRUCTZONg ON ~&gE,?IIJ~'BEFOt~' COLLECTING 5'AMf<~E TEL: (e07} 582.23~3 F~: (~o7} 5z~.530~ i~Ionth Da)' Year SM,.DLE TYPE: . Routine O Treated WaTer Repeat Sample (for routine s~mple n Untreated Water wi~tt lab ref. ~o. __ ) Special Purpose Time Co[Iected S.L,'vf)LE LOCATION ' Collected By /3_ '['0 BE COMPLETED BY LAJSORATORY Anrdysis sho~vs this Water 83A~LE to be; t{~x Satisfactory 12 Unsatiffactory [] Sample over 30 hours old, rerults may be u~eliable [] Sample too long in transit; sample not be over ~-8 hours old at exa.n,J, nadoa to iud/cate reliable results. Please ~end new sample via special deli}cory mMI. Date Received .(../'Z,./ Time Received J! 0 0 Analytical Method; ~, Membr~e Filter .'d ~O-~O Number of colonies/!00 n'd. Lab Ref, No. Resut¢ AuaI.Yst ....... ~ *~.. lJ. t..U. ~nch Fb'kx Jun Client notified of ansatlsfaetoo' results: Phoned Spoke Da,~¢: Time: Faxed Far, cd BACTERIOLOGICAL WATER AXALYSIS 'ZECORD ~O-~I-CIG Result: Total Coliform __ __ __ E, Coil ilt*r Count C-) Colonie~/100 mi M~embrane F _ : Direct' Verification: LTB BGB __ COLIJFER_M Fecal Coliform Confirmation- Fiual Membr~-ne.~er Remlt~ PART ONE OF TWO: C'f&E Ret; # Matrix Commercial Testing & Engineering C°. Environmental LAboratory Services LABORATORY ANALYSIS REPORT 94.3075-1 1,3/3 >ARiKHII,LS (KF~ ,¥) HOS/~I'IlB WA'I'J~,R Clien'cNane BLS & ASSOCIATES, INC WORK Order 79674 Oxdcr~d By CHUCK LANDERS PrinlcdDatc 06/23/94 (¢_,~ I 5;28lu,~. Project Narnc Colt~otcd Date 06/21/94 (¢08;20 hrs, Projec~ Re~eivedDate 06/21194 (~_~ 11:00 lu's. PWSIT.) UA .... TeolmkalDircctor STflPt-IEN C, EDE Released ........................................................................... Qc Allowable Ext. Anal Pfirmaetcr l~,esults Qua,! Units Method Limits Date Date Init Nitrat~N 0. I7 mg/L gPA 353.2/300.0 10 06/22/94 MCE * See Special lnstmctimts Above ** See Sample Remarks Above U = Undetected, Repo~tedvalue is thc practica! c[mnfitication tim[t. . _ D ~ Sec°ndaD' diluti°n' 5633 B Street, Anchorage, AK 99518-1600 -- Tel: (907) 562-2343 Fax: (907) 661-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, ~:LORIDA, ILLINOIS~ rv~-ARYLANO;-NE-VV JERSEY,, O~tlO. UTAH. Wt~ST VIRG gA= Unavailable I',IA = Not A~alyzed Uf = Greater Tn ~ Drinking Water Amalysis Re?orr for Total Coliform Bacteria READ LYSTRUCTIO,.YS 03~ REVERSE SIDE BEFORE COLLECTI'.VG SA3,IPLE NFUST BE CON~LETE~ BY WATER SUTPL~R TO BE CO3,~LETED BY L:&BOP~A.TORY Commercial Testing & Engineering Co. WA R PERMIT Environmental Laboratory Services 5633 8 Street Anchorage, AK 9951 8-1600 Tel: (907) 562-2343 Fax: (907) 561-5301 PUBLIC WATER SYSTE3I I.D. # ~/ pp, IVATE WATER SYSTEM Send ResuRX FI Stmd invoice Month Da5' Year _~w. alysis shov;S d%s Water S_&N-WLE :o be: ,~ Sads~actoT o UnsadsfactoT o Smwm[e over 30 hours old, resu!3 Smmuie too long Lq u-mask; s~p[~ sbtouid not ge over 48 horn% old at ex~mqat:on to mdicara reliable resuks. Pieese send new smmpte via sueda[ de!iveu] mai!. Bate Received Time Received Analysis Began - ~ ~7 ( ' Anab~mal Me ' ~ '- ' thod' ' Membrane Filter ' ' D N~'~O-MU u * Num.ber o f colomes/t 00 mi. Lab Ref. ,.No. Result* Sent to A.D.E.C. ,:~,nck' Fbks Jun Analyst F,~ed Date: ...... TLm. e: Client notified of unsatisfactoO' results: S .&~,,~v LE TTPE: n Treated Water n Routine Fl Repeat Sample (for routine sample Fl Untreated Water w4th lab ret'. no. __ _ - )' O S pedal Purpose Time Collected SA~BLE LOCATION Co~ected By · Phoned Spoke with Date: TLme: Faxed BACTERIOLOGICAL WATER ANALYSIS RECORD t5 Colt _ MMO-MUG Result: Total Coliform ~ Colonies/100 ml Membrane Filter: Direct Count Verification: LTB BGB CO LIFIRM_ Fecal CoLiform Confirmation CoLiformJlO0 ml Final Membrane Filter Results ~ : ,,- ",- -- ~~.~ Member of the SGS Group (Soci~t~ G~nsrale de :3u'veillance) ENVIRONMENTAL FACILITIES IN A~S~, COLORADO, FLOR[OA. ILLINOIS, MARY~ND, NEW J~RS~Y, OHIO, UTAH, WEST VIRGINIA CT&ERef.# Client Sample ID Matrix ClientName Ordered By Project Name Project# PWSl~ Commercial Testing & Engineering Co. Environmental Laboratory Services ~~ LABORATORY ANALYSIS REPORT 94.2085-1 EDDIE BARRETI' GOLDENVIEW PR WATER ANDERSON, MICHAEL WORK Order 78122 Printed Date 05/10/94 ~12:00 hrs. CollectedDate 05/05/94 ~ hrs. Received Date 05/06/94 ~08:30 hrs. UA Technical Director STEPHEN C. EDE Released By: ~ ~. ~ Sample Kc-marks: Parameter Nitrate-N SAMPLE COLLECTED BY: MIKE ANDERSON. QC Results Qual Units 0.10 U mg/L Method EPA 353.2/300.0 Allowable Ext. Anal Limits Date Date Init 10 05~06~94 MCE UA Unavailable · See Special Instructions Above NA = Not Analyzed · * See Sample Remarks Ab ove U = Undetected, Reportedvalue is the practical quantification limit. LT = Less qfhan GT = Greater Than D = Secondary dilution. 5633 B Street, Anchorage, AK 99518-1600 --Tel: (907) 562-2343 Fax: (907} 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA