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HomeMy WebLinkAboutSIEFKER #3 TR 5 LT 9 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 MAILING ADDRESS DISTANCE TO: Manufacturer I Liq, capacity in gallons · ,//)/) ¢~) I IF HOMEMADE; DISTANCE TO: Iwell Manufaaturar Absorption area Dwelling We, i ' Mataria,,5:¢1 Inside length W dth PERMIT NO, No, of compartments Liquid depth DISTANCE TO: [ Wel.~ No. of lines i Le4th of each line ~ ~ ~ ~ Top of tile to ~nish ' grade.~ fi ., ,. Jl Length Width' ~ Crib diameter Class De~th DISTA~C~ TO: Buildin~ foundation Dwelling PERMIT NO, J Material Liquid capacity in gallons .Foundation /, Nearest )o.t line >2;2 Total length,of lines Trench vyidth Zf ~.) .~"~,- inches Material beneath tile ~¢2 inches Depth PERMIT NO Distance between lines Total effective absorption~rea PERMIT NO. Crib depth Total effective absorption area Building foundation Nearest lot line Driller Sewer line OTHER PIPE MATERIALS PERMIT NO, Absorption area(s) SOIL TEST RATING INSTALLER REMARKS / ' '1 I I APPROV ED/~ / ~ DATE LEGAL 72-013 (Rev, 3/78) .-,., [)Ei;I:::'I:::II:;121"HF~I'-,I'rl' Ol::: H[:".ZF:ILTtl FIN[::, ~!3;:2]!:~i L 'Ji!;Tl':::l~[i~:"l"., I:ll'.,lC:Hl::ll:;i:l::ll.*~ili~b F:It'::: ;:2 ~!~; q.-... C:::~ tPql ......... :~i!!i;; bE '"'tt'" EiZ E!iii;; l~!!iZ: 114 IEFZ IF;~: .!ii'z: [.,,..lt E'C L.... ti ........ IF::::" Eh}:: 1t~: li'ql ::ltl -T" ::: '~:! ,'"' :: ::: ,-'" ::: ~:l. F' C H'T'FIC T I:::'HON[~: ' L..CIT: 9 I'::FIf',l(3 I!!!: ' :3:1.'.! E:LIL')I'.': I-=:' · TFJ:F:C':T f5 ~Permit #: 82100]. January 3]., 1983 TO: Permit: Applicant Subject: Lob 9 Tract 5 Siefker Subdivision A permit issued by this department for an individual well and/or on-site sewer systera has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-.site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office Sincerely Sewer and Water Program enc: Copy of Permit MUNICIPALITY OF ANCHORAGE Department = Health and Environmental rotection 825 ._ Street, Anchorage, AK. ~.501 264=4720 * * * HANDWRITTEN PERMIT * * 2'ermit ~\~C%i ~ ON-SITE SEWER PERMIT Applicant: . ~.~ ./c~ .'L..~_.C.~Ca_ Mailing Address: ~ocation: Phone Nu~er: ~] Legal Description: L C/ ~/. FL~ . ~ ,,~,'.~/~-~-~'% ~ Lot Size: Typ~ of Soil ~sorption System Is: Trench: .~(' Drainfield: Seepage Bed: Holding Tank Maxim~ N~ber of Bedrooms: <~ Soil Rating(sq ft/br) DEPTH The Required Size of the Soil Absorption System Is: ~ .LENGTH "-=<-; . 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 = /~V~ 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 department 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 fs 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. O~her requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 2 * * * 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 understand that the on-site sewer system may require enlargement if  r~°bms' , the residence is remodeled to include more th 3 be~ SWP/024(1/81) & ENGINEERS, INC. 7125 OLD SEWARD HWY. ANCHORAGE, ALASKA 99503 549 -6561 SOILS LOG 'PERCOLATION TEST ',~L/~ L3 LOG' F'ERCOLATION TEST PERFORMED FOR: LEGAl DESCRIPTION 1 2 3 4 5 6 7 8 9 10 12 1S 17 18 ~0 COMMENTS PERFORMED BY: 12-008 [6/79) /--/ WAS GROUND WATER ENCOUNTERED~ IF YES, ATWHAT DEPTH) Readin9 Date Gross Time TEST RUN BETWEEN SLOPE ~ ~ SITE PLAN Ne( Depth [0 Nel Time Water Drop DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone; (907) Address: 274-2533 November 26, 1984 NHAWTHORNE - ENGINEERING 7127 Old Seward Highway Anchorage, Alaska 99502 SUBJECT: Waiver Horizontal Separation between Well and Septic Tank ~ .c and We'll to Leach Field on Lot 9, Tract 5, Siefker S/D ~' Anchorage (8521-WA-071).~,/l;.j .... Dear Mr. Hawthorne: ~,~:~ The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 98 feet and well to leach field to 99 feet on the subject property for a 3 bedroom single family residence only. Sincerely, Bruce E. Erickson District Engineer BEE/dd May 21, 1984 M. Keith Bandt Alaska Department of Health and Environmental Protection 825 L Street Anchorage, AK 99501 Re: Lot 9, Tract 5, Siefker Subdivision Rick Purcella - Owner Dear Kelth, Reference our conversation on the above property this date. A prelim- 'inary sketch is enclosed. Sincerely, Neil Hawthorne Separation distance waivers are requested for the following 1. Septic tank to building foundatic~n - Measured - 9 ~t. 2. Septic tank to .... '~:~:--- "~C~ absor tion t " · -~: ..... - ...... ~ .... p rencn ~asured - 2 ft. (5 ft. to perforated pipe) 3. Absorbtion trench sidewall to lot line - ~asured - 6 ft. 5. Clean out to well - ~asured -J~2ft. All ' ' cast i with bolted full circle clamps. ~lplng Thank you for your time. mbv WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF' NATURAL R£SOURE$ Division of Geological ~ Geophysical Surveys SeclJon No. .. Sur f~r.a .. Top BoHom Malarial Type 4. WELL DEPTH: [final) 5. TE OF COMPLETION ...... o' ~-~:-.,- ..... ~_,.~_ _ 7. USE: ~"l~maltlc [] Public Supply [~ Indu,h¥ E~] )rrigallon [] Recharge [] CommldcoI [] Test Well [] Other; __ d,.m..~ '" ,,. 'o.ZF'? ,,.o.p,h w..~,., /_-Z.__,,,.,,,. -- diam. in. l0 ft. Oeplh SIl~kup~ fl, 9, FINISH OF WELL:' T,p,: ~/~_~,//~Z,~ Baakfllllng ~__ . GrOvel pack [] Above or ~'~'~ow land ~urlool Dote II. PUMPING LEVEL below land _~ fl,' ofl;'~ hr,, pumplng~ ~g,p.m, MolerloI; ~ Nlot Cement ~ Other: IS. PUMp: (if available) HP Lenglh of Drop Pipe ..... fl. capacity [] Subm. [] d,f [] Cenlrlficol [] Olh,r I'1. REMARKS: PINK-Driller, CANARY.Cuiiomlr NIdAW~r~)~NE ,, ENGINPb.'RIN(~' Old Seward ~EI~o Ot~ ENVIIRONMENT/J, IL (:OI~SERV~TIION BILL SHEFFIELD, GOVERNOR ?blephone: ~07) 274--2533 Address: 437 g. Street Su±te 200 Anchorage, AK 99501 January 31, 1984 [t. tk~,.~J: ho-c ne-Engl nee riag A~chorage, A~< 99502 Dear Sir: Subject: Waiver to Well to Septic System for Lots 9 & 10, Tract 5, Siefker Subdivision The Departmeut has reviewed the Plat Plan, water sample results and Engineering Report dated December 29, 1983 for the subject Lots and here- by waivers the Class "C" well to septic tank horizontal separation to 110 feet and the well to leachfield horizontal separation to 120 feet. This waiver is for a 3 bedroom, single family residence on Lot 9 ONLY. Sincerely, Bruce E. Erickson Environmental Engineer ~ L /q f, t ,S /ff o w / /v' C.. o F w~:--.L; , I "= DIEII*T. OF ENVII~ON~IENTAL ~;ONSIEIIIVATION $OUTHC£1VTnAL REGIOtVAI_ OFFICE October 2, 1979 336 Dena%l -truest MacKay Bldg., Room 12 Anchorage, A%aska 995C (907) 274-5527 P.O. Box 1207 [] Soldotna, Alaska 99669 (907) 262-5210 P.O. Box 1064 [] Wasilla, Alaska 99687 (907) 376-5038 Lynn Lindquist Dept. of Health"and Environmental Protection 825 L Street Anchorage, Alaska 99501 MUNICIPALITY OF ANc DEPT OF,.- HORAG~ -- '"'~M~NfAL PROTECTION OCT 2 3 1979 RECEIVED Subject: Lot 10, Tract 5, Siefker Subdivision Dear Ms. Lindquist: This department has no objection to'the proposed sepa- ration of 111 feet between the well and upgraded onsite sewer system serving the subject lot. Sincerely, James O. Start Environmental Enginee~ imc ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 CERTIFIED MAIL RETURN RECEIPT REQUESTED March 17, 1986 BILL SHEFFIELD, GOVERNOR 274-2533 Mr, Marcus Methonen //~"~ PO Box 520454 Big Lake, Alaska 99652 SUBJECT: Monitoring Non-compliance, Class A Public Water System Siefl<er Subdivision PWSID #212988 Dear Sir: Our records indicate the consistent failure of your operator to perform required routine bacteriological monitoring for the subject water supply. This failure occurred both before and after repeated warnings from our Oepartment, As per our previous notice, we are turning your case over to the District Attorney's Office for prosecution. You are entitled to an interview, to explain extenuating circumstances, should there be any. 'I have set the date of intervieu ?or March 27, 1986 at 1:30 PM. Please notify me if that date and time is inconvenient or if you choose not to attend. JFH:pkk ./~James F. Hayden Anchorage/Western District Supervisor Anclxorage POUCH 6-650 AN(. )RAGE, ALASKA 99502-0650 (907)264-4461 TONY KNOWLES, MA YOR OFFICE OF THE OMBUDSMAN FINAL COMPLAINT SUMMARY Case No.: 85-58 Case Closed/Final Complaint Summary Completed: August 11, 1986 Complaint or Concern: The complainants assert that the Municipality has the respon- -~bility to ensure that a community well, which is their only viable source of water, be maintained as such. Case Description: The plat for the complainant's subdivision was recorded on April 14, ~970. Comments on the approval memorandum dated October 15, 1965, noted that Lots 1 through 7 were very small for individual sewer and water systems but that soil con- ditions were acceptable. Public sewer and water service were not available. On May 4, 1970, an application was filed with the Alaska Department of Health and Welfare (ADHW), for approval of a semi-public water system to serve ten lots from an existing well. ADHW approved the water system in a letter dated July 21, 1970. On September 27, 1982, the Municipality issued an on-site sewer permit for Lot 9 of the subdivision. There was a question of whether this septic system was an encroachment on the community well located on Lot 10. This issue was resolved by the January 31, 1984 letter from the Alaska Department of Environmental Conservation (DEC), in which waived the separation distance between the well and the septic tank to one hundred and twenty feet and the separation between the well and the leachfield to one hundred and twenty feet. Findings: Unjustified. There can be little doubt that when the subdivision plat was approved that all parties agreed that the source of water would be the community well situated on Lot 10. Lots were too small for individual on-site wells. After individual wells, the only other option besides community wells would have been public water which is still economically not viable. Nonetheless, even though municipal approval of the plat was based on the assumption of water availability from the well on Lot 10, the Municipality did not guarantee it would protect or preserve access to the well for all lots. Individuals who purchase lots' such as those in this subdivision have a responsibility to enter real estate negotiations fully aware that the water is provided through a private arrangement enforced via the court system. Recommendations: The Municipality should impose regulations as strict as possible to help insure that all parties understand before they purchase real estate on community systems the limit of governmental responsibility for such systems. Results: The Program Manager for On-Site Services at the Municipality commented that eT~-~-office had received many complaints about this well, mainly because it is not a ~n well and can barely supply the lots now connected. She repeated that commu- nity wells are outside Municipal jurisdiction but stated that she found efforts to force the delivery of non-existent water ludicrous. (Throughout the long investigation of this complaint, there was no mention of water supply shortages or other similar problems with the well.) Most importantly however, she stated that the ordinance had been amended to require that new plats served by privately owned public water systems provide well flow information and certification from DEC. ab/bcs21 CC: 'Michael 'Mills, Ombudsman Jewel Jones, Director, Health and Human Services Complainant !'i F'EF:I'I I T NO' [:,FITE I'_---,SUED: [::,IEI::'FIF:TI'IENT OF' I.IEI::ILTH FIND EI-,I',,,'IF::OI',II'IEZNI'FiL F'F:OTEC:I'IOi',! ',E:25 [_ :'STREET., FINL-:HO[;;:I::IGE., FII<: 995E1± 264--..47;~E1 I..EGFd_ I>ESCR I F' ' L. OT SIZE: HFI;:':; E',EE:,E:OEd,I%: SUE:I:, I ',,,' I S I ON: '_:, I EFKEF..' L::ECTIOi.4: ;2t TOHI'.4E;HIP: :L2N J.:!?,47_-'.:. ,::Sg!. FT. C,F: F]C:RES> LOT: '9 RFff',IGE: 3:1,.I E:LnC:K: TRFIK:T 5 LISTED E:ELOI,I FIRE T~...~: FdZ.,Tff"li..I,--: A',,'A'rl AFd F TI-I 'd'" I1"4 DEL:;IGNING 'T'I-IUI~: SEF'TIF: :.S'¢S T EH. I~':HOOSE T E:,EF'TH TO F'ZF'E BOT GRFI',/EL E:,EF'TFI ,::FT. ") GF4:FI',,,'EL H]:E.,TH ,:;FT. (' /.fj,~.~bA./ ~L'~'- .~ ,"~' '/ \4'(:' "(3 '-(--h~. ' ~.~ GF:I.X,,,'EL LEI'.4GTH ,::F'r , ,, ; , , GI~:FI',,,'EI... ',,,'-dJ.l'lE ,:'F:I ...... -f'Ft!',ll,:: S,]:ZE '::GFIL'.S> ., SOiL RFdTING '::Sg!. F' ' "" ..... /.s...,,.,~:,,,,. ,:}_:~.:,) '" ' ' ' ~' 1,," ' ' *"~"~"~'~'~"'.' ....... X.:.&,.,.¢..~ ~',..,, ,4.' /'.'v.., ..:./ ,.:, ,,......,,.,,_..,:.; . _ :1. I FIH FF:IHILII .'.'; -..., .~ ~:4~'"/' /'¢~'~ ¢//x2' :: ,9:; FIS SET FORTH B'T' THI ......... Z ........... , 'tLFISKFt. 2. I HTLL ZNSTFILL THE Z;'¢STEll IN F:IF:F:FIF.'.E:,FII'.,ICE kIITH FILL f"ll_-II:~ CODE:F ¢.'~' F:'.EGIJLFI'I'IL-~NS, FINE:, tN CEII'"tF:i.]ZF]NCE [,l~[ I'H THE E:,ES'rGH CR:[-FERfFt OF THIS F'ERMT]:. 2.. .[ I,.IZLL. FtE:,HE~:E 'Tf"l FI', L ,',IOFi I::'d',lE:, '---,TFITE OF FILFISKF-t I~'.EL.-.flJIREI,IENTS FAR THE SET E',F. iC:K E.,ZSTFli.4C.E:S FF;:OI,I FIN¥ E',:...',I'_r,T:[NG HELL, kIFiS, TEHFi]"ER E:,TSF'FiSFIL .:~-:TEII'-' "-' ' FiR PI_IE'.LTL-: SENEF..'.RGE '-'?/:::"TT'EI'I ON THIS EP I':IN"F FIE:,J'FtL-:ENT FiR N'EFIRE~'-r' LAT. 4.. I IJNE:,ERSTFIND TI.II:IT 'H-..IZS F'EI~'.HIT :IS ',,,'I::ILIE., FAR FI hlI':tY, IHLIH OF 2: E:EE:,RC,-$1S FtNC, RN'-r' ENLI':II~:GEI'IE'NT H I I...L F?ELC. U_ I RE F:IH FIE:,E:, I TI ONFIL F'Et~'.M Z T. '.IF FI LIFT STFITIOI'.,I I'_--', II",IS'TFIt_L.E[:, IN FIN FIF::F_"FI F:EI',,,'ERE[:, EA- HOR E:IJILE:,ING C:I'-[:,ES, ELEI-:TF~:IF:FiL HORI::: HI..I'ST bE [:,ONE B'¢ FI LIF:ENSED ELEFTF'II_-:IFIN. ISSUED BY DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 November 22, 1985 Mr. Robert Talmage 3640 Cleo Street Anchorage, Alaska 99516 SUBJECT: SieCker Subdivision, Anchorage, Alaska Dear Hr. Talmage BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 The Sie?ker Subdivision is considered a Class 8 Public Water System. En?orcement procedures have started ?or ?ailure to sample as required. Sincerely, District Supervisor JFH/msm ATTACHMENT: MEMORANDUM TO: THE RECORD FROM: Dan Schubert,P.E. State of Alaska DATE:27 March 1987 FILE NO.: TELEPHONE NO.: SUBJECT: Siefiker S/D A call was received this date from Keith Kelton asking additional questions concerning Siefiker S/D. Several conversations with Dick Farnell had occurred earlier in the week. Specifically a subdivision resident, Mr. Talmadge had called Keith and stated: 1. "1983 regulations" stated that a Class A water system meant a system desiqned to serve ... 25 persons. ~ The original submittal was for a 40 resident development. 2. Was the DA aware of this and the plans when the case for bacti monitoring non-compliance was dropped? I advised that reference to the regulations was probably to the wastewater regs, and that this is used for plan review purposes. For monitoring, the DW definition of 25 residents has always been used. Further, that the DA was aware because as-builts and the number of lots served was provided as part of the case preparation (see files for details). It was requested that I call Mr. Talmadge, relay the above and advise that DEC would take water samples. I discussed the above with Mr. Talmadge by telephone on this date and advised that, again, for plan review purposes, a system may be classified as a Class A to ensure adequate separation distances but that for purposes of monitoring, classification is based on population served (ie 25 full-time residents). This is consistent with the federal Safe Drinking Water Act, with the exception that federal law indicates a number of service connections (15) to avoid having to take a census or relying on the owner/operator for population data, or causing confusion (as in this instance). Mr. Talmadge pointed out that a waiver of separation distance for an individual well was granted by DEC, with the understanding that monthly bacti samples (as for a Class A system) would be taken. The enforcement sequence was initiated for bacti monitoring non-compliance consistent with the enforcement-compliance strategy document. Jim Hayden was requested by the DA to take a census and interview the owner. Based on the results, the DA, Jim Hayden, and all concerned concurred that for purposes of monitoring, this system is a Class C. Talmadge indicated that a more important point was that the system owner did not recognize a water service agreement, that he may disconnect service, and the system pumphouse was in poor condition. I stated that there exists no regulatory requirement to provide water with the exception of PUC regulations which do not apply in this case. Our usual response in cases such as this it that it thus becomes a civil matter between the owner/operator and consumers. I indicated that the district office has been directed to take one set of water samples and reiterated that a clear distinction must be made in the classification of water systems insofar as relates to plan reviews and as to monitoring compliance. The submittal indicates that it was designed for 40 individuals, thus Class A stipulations on plan review should/would have applied. For purposes of monitoring requirements, it will be considered Class C until such time that the population exceeds 25. Monitoring is recommended, but not required. The files show that this issue has been a recurring one for several years, and that the affected S/D residents have expressed dissatisfaction with DEC's action or inaction. Under the details described and indications from the file, it is probable that a search warrant would be likely in order to perform a sanitary survey, should Juneau so decide this is necessary. cc: ADEC- Juneau Bill Lamoreaux AWDO Mr. Talmadge PLANNING October ~1, 1969 l) S-I~'~ ~, l/&c&tLon of' La~er/d~ Drive ~nd, 1, m~d Subdlvisi~ of 6.73 ac~s in ~he S~t 1/4, N~ 1/~, Section 14, TI2N, R4~, S,I[., Alukaa to bo delivered C~bell ~e l~lshts~ M~tlon ~o. 8 ~d ~ts IA and 2A~ C~bell lklRhts ~dition 1to, I , '~r,~h~est; of the inte~ection of 100th Aven~ and Victor ~a~ · '~iMI, (T~.N~ ~d llayes for Saved _Ale), ~is ~q~st is fsi the vmcmtt~ of ~ t~o h~d~d (200) f~t lon~ st~ street, ~e tt~et ~ befo~ the ~ssi~ for a pa~ial vacati~ ~d ~plat S,ptf~r 17, 1~69. at ~hich tim the ~q~t was denied. ~is p~sent ~qvast la fo~ the vacati~ of ~e entJ~ steer. ~e st~et ~as ori~ir, sllg interned to be extended Into ~ adjacent ~divided p~ent ~velo~at pl~s ~r the p~e~y do not lncl~ ~ extension of thts stye:. staff recomends greeting FINAl. approval ,',~Ject to: Grantin8 o~ utility easements V 2} $~1715 - Resubdivislon o£ Tract ~, Sle~er S~divisi~ ~o, 3, ~nlnq 4.S52 ac~'a :, In the ~a 1/4, Section 21, Tl~a ~!, 8.IL. ~M~a~ to be ~sl~ated ~ts I th~u~ 11 (located no~h of 1~ ~omd ~d aest of Jer~ St~o~) . PIMI. ~o~ CLJohnso~_ for~ .....ii.etd II. ~d O~iel,. L, }~d~), ~o eb~eetlye of this pla~ is to subdivide a $ acro:~ract into 11 residential ?ti, 111o ~.l&I contoms to ~l e~stlnI ed ~ticiPated Ii.et pattern in the ma ~d ~tI ~e S~vi~l~ ~lati~i. ,~lte etaff raco~-~a~ ~rantinR Pl,~t. ~pproval o~Ject to: 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 9 of Tract 5; Siefker Subdivision #3 Location (site address or directions) Property owner Mailing address Rick Purcella 3701 E. 121st. 3701 E. 121st Avenue Anchoraqer AK Day phone Anchorage, AK 344-4554 Lending agency Mailin. g address. Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further 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 com ordinances, and regulations in effect on the date of Name of Firm .~ask¢, %Vate,~r ~; ~¢~,st~w8 Engineer's signature .A~~ ~ )liance with all Municipal and State codes, lis inspection. Phone ~,~2'7-/~/7~ Date_ ALASKA WATER & WASTEWATER CONSULTANTS INC IS TO BE PAID -~ AT CLOSING FOR ENGINEERING SERVICES PERFORMED. DHHS SIGNATURE ~ Approved for -'~/-l/~ ~.~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: 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 DH HS does this as a COd rtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is' not responsible for errors or omissions in the professional engineer's work. 72-025 (Re~. 1/91) Back MOA ~ Municipality of Anchorage 0C'I i ,;~ 'J~}95 ~//~ DEPARTMENT OF HEALTH & HUMAN SERVI'G~8P^, ,, -'. Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 o (907) 343-4744 Health AuthoritY Approval Checklist LegalDescription: /_,~¢-/' ¢ 7"~-.. ,_~', ~'~-/'/¢,-~ -¢¢~ ParcelI.D.: g:)/~'- ;~=.-,/.5' A. WELL DATA Well type Log present (Y/N) Total dePth Sanitary seal (Y/N) Cased to Date of test Static water level Well production 'WATER SAMPLE RESULTS: Coliform ~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed "~ "~ '¢- ~' '¢ Z ?'" Casing height (above ground) FROM WELL LOG Wires properly protected (Y/N) AT INSPECTION Y % g.p.m. 'Z. [ -~' Nitrate ,, ¢--- I 'qr- r~10¢. Other bacteria ~ Collected by: Number of Compartments ~,) Depression (Y/N) ,N) High water alarm (Y/N) Ac//:) Pumper Date of sample: / B. SEPTIC/HOLDING TANK DATA Date installed //- /~"'~¢ Tanksize //~,o Foundation cleanout (Y/N) Date of Pumping / g.p.m. C, ABSORPTION FIELD DATA Date installed /¢ ~ ! 4, _Ez/, Soil rating (g.p.d./fF or fF/bdrm) ~5' Length z~/o / Width :~ / Gravel thickness below pipe Effective absorption area ,Ztr Eft) ~¢?-' Monitoring Tube present (Y/N) ¢ Date of adequacy test / ~ ~ ~'.- '~ 2' Results (Pass/Fail) /'¢4 5 ,~, Fluid depth in absorption field before test (in.); 2-':) Fluid depth ~t),¢ (ins) Minutes later: z-/:D Peroxide treatment (past 12 months) (Y/N) /%/ System type ,,-~¢.~ -~g'"'~', :~ Total depth ~ I _.__.~ . Depression over field (Y/N) AJ For --~ bedrooms Immediately after~')'2,flal, water added (in.): Absorption rate /,/~ .,L- = g.p.d. / If yes. give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/~~ ~igh~rm level a tCyc. res tested * "Pump.,~atumOn" E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / Absorption field on lot Public sewer main On adjacent lots On adjacent lots Public sewer manhole/cleanout f~ /~o Sewer/septic service line ?.- 5' / * Lift station A,/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation / ~' ~ Property line .5' v Absorption field /~ / ~ 7'~ i. wws?. Water main/service line ¢'~/¢' Surface water/drainage /~'o/+ Wells on adjacent lots t lot ~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Building foundation 1°/4- Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots \~::;~ ~ '~ Property line Surface water Curtain drain F, ENGINEER'S CERTIFICATI,ON ~/ rec.or~ ~.~ are I certi~ that l h~~ ed~¢ fie{d inspections and review of Municipal S igninC°nf°rma~ewith~ature ~ ~/.~ ~J~~sineffect°nthisdate'~ . Engineer's Name ~~ 4' ~¢ HAAFee $ ~ /~ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number DEPT. OF ENVIRONMENTAL CONSERVATION BILL .~WEFFIELD, {~oz} 274-2533 437 E. Street Suite 200 A~chorage, AK 99501 January 31, 1984 N. Hawthorne-Engineering 7127 Old Seward Highway Anchorage, AK 99502 Dear Sir: Subject: Waiver to Well to Septic System for Lots 9 & 10, Tract Siefker Subdivision The Department has reviewed the Plat Plan, water sample results and Engineering Report dated December 29, 1983 for the subject Lots and here- by waivers the Class "C'[ well to septic tank horizontal separation to 110 feet and the well to leachfield horizontal separation to 120 feet. Thz~ waiver is for a 3 bedroom, single family residence on Lot 9 ONLY. Sincerely, Environmental Engineer BEE/msm DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL ~I£EFIELD~ GOVERNOR Telephone: (907) Address: 274-2533 November 26, 1984 NHAWTHORNE - ENGINEERING 7127 Old Seward Highway Anchorage, Alaska 99502 SUBJECT: Waiver Horizontal and Well to Leach Anchorage Dear Mr. Hawthorne: Separation between Well and Septic Tank l~'~'-" Field on Lot 9, Tract 5, Siefker S/D ~-' The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 98 feet and well to leach field to 99 feet on the subject property for a 3 bedroom single family residence only. Sincerely, Bruce E. Erickson District Engineer BEE/dd May 21,' 1984 M. Keith Bandt Alaska Department of Health and Environmental Protection 825 L Street Anchorage, AK 99501 Re: Lot 9, Tract 5, Siefker Subdivision Rick Purcella - Owner Dear Ketth, Reference our conversation on the above property this date. A prelim- 'inary sketch is enclosed. Separation distance waivers are requested for the following ite, ms. 1. Septic tank to building foundation - Measured- 9 ft. {y~.~ 2. Septic tank to L_,.];._j-,<:::;-~t~_-::.~'~ absorDtion trench sidewall -0~ Measured - 2 ft. (5 ft. to perforated pipe) 4. Depth of gravel below pipe - 5 ft. instead of 3.5 ftC' 5. Clean out to well - Measured-JZ/ft. All' piping cast iron~,~'~/~?/~ with bolted full circle clamps. .._? /',~ ~ ~', ' ~-'~n( Sincerely, Heil Hawthorne Thank you for your time. mbv C!CT-1~-19.9~ 11 ~56 CT~,E ESI AIqCHORAI.]E ~=t~ CT&l~EnvlronmentalSer~lces C,T&E ReL # 985788001 Cltent Name AK Water & W~tewatet' Consultaat~ Inc. ~oJ~t Name/~ Lt 5 Lt 9 8ie~er No. ~4 Client S~ple ID 3701 E. l~lst Matrix Dri~g Water Ordere~ By PWS~ 0 Client POi ~lnted Date/Time I0/12i98 11:19 COllectedDate/T~e 10/05/98 09:31 R~elv~Date~ime 10/05198 11:55 Technical Director: gtephen C, Ede ~H18 9~22~ 10/05/98 ~P EPA 300,0 10 r~x 10/0~/98 10/0~/g8 GOP