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HomeMy WebLinkAboutSKYLINE VIEW BLK 1 LT 8 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251207 PID Number: 051-192-47 Dwelling: 2 Single Family (SF) El with ADU R Duplex (D) R Two Single Family Project: El New E Upgrade Name MELANIE S FORD ABSORPTION FIELD - EXISTING R Deep Trench FJ Wide Trench R Bed R Mound Site Address 19370 LUPIN STREET, ANCH El Other Phone Number of Bedrooms Soil Rating depth from original grade 1 4 GPD/SF JTotal Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot SKYLINE VIEW 1 8 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To, Septic Absorption Holding Sewer I Lift Station Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft Ft. Ft. Well 100,+! 25'+ TANK 0 Septic [I S.T.E.P. El Holding 1771 Other Manufacturer INFILTRATOR Capacity 1530 Gal. Surface Water 100'+ Material PLASTIC Number of compartments 2 Lot Line 1 10,+ NA Foundation j 101 LIFT STATION Manufacturer Capacity Gal. Remarks Tank insulated. Alarm location Electrical installed by Tank to PIPE MATERIAL House to tank 3034 drainfield 3034 Installer NORTHERN EXCAVATION Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft ection Is' 7/17/2025 7/18/25 Inspdates: Location and description 7 3 rd 4 th TOP OF MH ON -SITE WATER AND WASTEWATER SECTION APPROVAL A , Conditional Approval: Date AW qW / 11H ----- - - - -------- - -- ------- - - - - -- - - ------- --------- - -- - - ---------- - - ------ - - 0 Septic System Approved - F Date/J Curtis Huffman CE1 .d t A, • "P7/28/25 *AW k OFESSO Note: this approval does not include well permit requirements. (Rev 05/02/18) •;; S 89.59'0 " E 100.05' 10' Utility Esmt t? 10' Utility Esmt -- 20, --- ----- f z_ 0 o � o O r � o F01 Lot 8 l 0 24,851 sq.ft — 0 Gravel M Driveway�� c E::] \ �6 Planter P t Asphalt v cn In 0 Q) - - _ Ow �> I N 89.59'00" W 131.14' 20, Lot . Lot OF AqN . 49 TM •. �0 /NOTES i 30' I 30' 94.... ........ rj Robert 0. Lumpkin • o 1. Bearings and distances are record per referenced plat unless otherwise noted. `� cam•• No, 10459 •� 2. Not all monumentation for this survey may be shown on this document. + `��F•' • .7130/'25. •' 3. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. F�PROfESSIONA�`PNO 4. Plat P-508, recorded Jan 1, 1960 shows radius of 110.08, this survey computed the radius at 108.51'. l 5. Municipality property information shows area is 20,600 sqft, this survey computed the area at 24,851 sqft. \���\��~ IN LEGEND ALASKA REMOTE IMAGINGSurveying Mapping Land Planning LIDAR Found Rebar j/A,��\IMAGING 6239 B Street, Suite 201, Anchorage, Alaska 99518SURVEA�W Well `P'IDRAF IING (907) 519-0339 survey@alaskaremoteimaging.com~QO Cleanout ASBUILT SURVEY OF: SURVEY CERTIFICATION: Alaska Remote Imaging has conducted ❑EM Elec Meter Lot 8, Block 1, a physical survey of the subject property, the improvements EIGM Gas Meter Skyline View (Plat P-508), situated thereon are within the property lines as shown. Anchorage, Alaska EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions PREPARED FOR: WORK ORDER No: DATE: SCALE: ZONING: which do not appear on the Plat used for this survey. Brent Western July 30, 2025 1"=40' CER7 NOTE: Under no circumstances should any data hereon be 25-1084 DRAWN: CHECKED: GRID No: FB BOOK/PAGE: used for construction or for the establishin of property Imes. LL ROL NW1159 173/22 g P P Y PID:051-192-47 PERMIT:OSP251207 FIRST WATER CONSULTING SKYLINE VIEW BLOCK 1, LOT 8 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP251207 Work Type: SepticTank Upgrade Tax Code Number: 05119247000 Site Legal Address: SKYLINE VIEW BLK 1 LT 8 G:1159 Site Mailing Address: 19370 LUPIN ST, Chugiak Owner: FORD MELANIE S Design Engineer: This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 6/25/2025 6/25/2026 20600 ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received B Issued By: Date: 6/25/2025 Date: 6/25/2025 4 MUNICIPALITY Of ANCHORAGE Development Services Department ._ Phone: 907-343-7904 On -Site Water & Wastewater Section Parcel I.D. 051-192-47 Property owner(s) MELANIE S. FORD Mailing address 19370 LUPIN ST, CHUGIAK 99567 Site address 19370 LUPIN ST, CHUGIAK 99567 Legal description SKYLINE VIEW BLK 1 LT 8 Number of Bedrooms 4 Engineering Firm FIRST WATER CONSULTING Building Permit Number Day phone Not Applicable ❑Q APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Absorption Field ❑ Initial ❑ Septic Tank © Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees: 2)1_f Date of Payment: 6 �2A/2,S Permit No. 0�P2�12(%7 Waiver Fees: Date of Payment: Waiver No. Distance: 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! June 21, 2025 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: SKYLINE VIEW BLOCK 1, LOT 8 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install an IM 1530-GAL plastic septic tank per the attached design to serve the existing 4-bedroom residence. No groundwater was noted in the MOA on-site file, but if groundwater is encountered during installation an epoxy coated steel septic tank or other action may be required. This is a very limited area with low tolerance and separations must be maintained. The lot and area are served by private water and any encroaching wells, easements, … must be staked prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251207, Ben Cogger, 06/25/25 FIRST WATER CONSULTING NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK OR EXISTING FIELDS. SKYLINE VIEW BLOCK 1, LOT 8 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251207, Ben Cogger, 06/25/25 O 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 PHONE '~EW MAILING ADDRESS NO. OF BEDROOMS U ~ DISTANCE TO: ~0 ~ ~ ~ ~ ~ Manufacturer ' I Material No, of compartments Liq'capacityingalJ°ns~ IFHOME~DE: Insidelength~ ~ Width ~ ~ Liquid depth Well Dwelling PERMIT NO. Ma,~facturer ~h Material Liquid capacity in gallons ~ DISTANCE TO: Well ~A~ Foundation %~ Nearest lot line ~O PERMITNO. ~ ~O ~ ~ ~_ ~ No. of lines ~ Length of each line ~ Total length of lines¢.~ Trench widtl~ inches Distance between lines ~ OtI inches Total effective absorption~ ~area ~ Top of tile to finish grade ~1 ' O ,1 Materiel beneath tile Length Width Depth PERMIT NO, ~ Type of crib Crib di~e~r Crib depth Total effective absorption area ~ ~ ~11 Buildin~ foundation ~earest lot line m OlSTA~C[ TO: M~~r~st~ ~ ~ Depth Driller Distance to lot line PERMIT NO. '~ ~JO ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIAL¢ ~ ~ SOILTEST RATING 8 5' REMARKS A~~ DATE LEGAL 72-013 (R PERMIT NO. < ?8098? ) tPF'l.. I CRNT .OCRT I ON RRTHUR SFtYLES OLD BEEN HIGHNFt¥ SKYLINE VIEW SUB LOT SIZE 20125 SQUFIRE FEET FYPE OF SOIL RBSORBTION SYSTEM IS: TRENCt'i IR;4Ii'4LIM NUMBER OF' BEDROOMS = 4 SOIL. RRTING (SQ FT,-"BR)= 85 :HE REQUIRED SIZE OF THE SOIl_ ABSORPTION SYSTEM IS: THE LENCiTH DIMENSION IS THE LENGTH ,::IN FEET) OF THE TRENCH OR DRRINF:t:ELD. THE DEPTH OF ~ TRENC:N OF,' PIT IS THE r)ISTRNCE BEI'HEEN THE SURFRCE OF THE GF.'.OUND ~ND THE BOTTOM OF THE E;--',CRVRTION <IN FEET.'.',. THERE IS NO SET HIr.:,TH FOR TRENCHES. THE GR~VEL DEPTft IS THE: MINIMUM DFPTH OF GRRVI~"L BETHEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). :'ERMIT RPPLICPINT t-IFIS THE RESPONSIBILITY TO INFORM THIS DEPFIRTMENT DURII'.,IEi THE [NSTRL. L. RTION INSPECTIONS OF PINY WELLS FlDJRCENT TO THIS PROF'ERTY FIN[:, THE 'IUME:ER OF RESIDENCES TNFIT THE HELl_ HILL ':;ERVE. ~RCKFII".LING OF RNY SYSTEM P.!ITHOUT FINFtl". INSPECTION FIND RPPROVFll.,, BY THIS )EPFIRTMENT WILL BE SUBJECT TO PROSEC. UTIOI"t, IlNIMUM DISTRNCE BETWEEN R WELl.. RND ANY ON-SITE SEHAGE [:,ISPOSRI". SYSTEM IS ~lllO FEET FOR R PRIVRTE WELL.~ OR .50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBL. IC I.,iEl,.I ..... ~ELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~:~3 DRY':S .IF THE WELl_ COMPLETION, )THEM REQUIREMENTS MRY RPF'LY. SPECIFICRTIONS RND CONSTRUCTION DIRGRFtM.S; FIRE ~VRII_RBLE TO INSURE PROPER INSTRL, LRTION. i C'.ERTIFY THRT L: IRM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEI.,IERS RND t.,.IELLS RS SET :ORTH E.:Y THE MUNICIPFILITY OF RNCHORRGE. ]: I WILl_ INSTFJI"..L THE SYSTEM IN RCCORDRNCE WITH TI-IE CODE:S. i:: I UNDERSTRND THR'F THE ON-SITE SEHER SYSTEM MRY REC..!UIRE ENLFIRGEI',IENT IF THE ~:ESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. .:, I Gt'.IED: ~.~ ......................... iSSUED BY .................................................... DRTE ......................................... ',,,'ii:. 2 O Er E GEO,ECHNICAL Er DEVELuPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 6952774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOnG 688-2280 Soils E~ Foundations Land Development Performed for. Name. Mailing Addres : Legal Description:. Depth (feet) Sol) Charactertstic~ o Ground Water Encountered: Yes Proposed Installation: Seepage Pit Comments: No / If yes, what Drain Field~~- · '~' "~' Date: Performed by. -~_~ CHUGIAK, ALASKA... 688-3199 �l W1L��44 DRILLING CO. WE SERVE ALL ALASKA POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567 KODIAK, ALASKA 486-4826 OWNEROF LAND....................................................................................... DEPTH OF WELL....................................................................................... ADDRESS......................�...1...�................................,.�.............................................. /, STATIC LEVEL OF WATER FT................................................................. WELL — SITE .....L....... °'.. .G..� ?.....1.. .,5..Le..�NI .� ;KIRAW DOWN FT........................................................................................ DATE— STARTED...................................................................................... GALS. PER HR . .......................................................................................... DATE— ENDED........................................................................................... KIND OF CASING...................................................................................... KIND OF FORMATION: FROM...................... FT. TO ...................... FT.................................... FROM...................... FT. TO ...................... FT.................................... FROM...................... FT. TO ...................... FT.................................... FROM...................... FT. TO ...................... FT.................................... FROM...................... FT. TO ...................... FT.................................... FROM...................... FT. TO ...................... 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MA • • "Alk�•D_ Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251328 f Parcel ID 051-192-47 Expiration Date: Legal description SKYLINE VIEW BLK 1 LT 8 Site address 19370 LUPIN ST Current property owner(s) FORD MELANIE S X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: ; $ vIIyIIICII I.CItIIIIQIC vauc. —1 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory Arsenic Advisory MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-192-47 Complete legal description SKYLINE VIEW BLOCK 1, LOT 8 Location (site address) 19370 LUPIN STREET, CHUGIAK, AK 99567 Current property owner(s) MELANIE FORD 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: A-1 Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: FN_J Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel FE� Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑O Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ Date of Payment %y�t��� Date of Payment oc COSA # qJ Waiver # COSA Application Apr2025.doc COSA Checklist Legal Description: SKYLINE VIEW BLOCK 1 LOT 8 , Parcel ID: 051-192-47 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 1978 Total depth 184 ft Cased to *UNK ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 5/29/25 Static water level at beginning of test 147 ft. Well production at time of test 4 gpm Water storage tank volume NONE gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate 7.35 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by F Date 05/29/2025 Comments *Log not legible & previous inspections state 40'+. Area has high nitrates. See Sullivan scoping letter. B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NA ❑ Required maintenance completed, if AWWTS Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 10/20/1978 ® ALL standpipes present per record drawing Total measured depth from grade *6_8 ft (max) Measured depth to pipe invert from grade *2.3 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 4_5 ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 05/29/2025 Results E Pass Fluid depth prior to test 3 in Water added 640 gal New fluid depth 18 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 96 in (Mon s' ED) Effective depth used 42 In (Missing ED + Final Fluid Depth) Effective depth remaining 54 in Comments/Deficiencies: Approximate total measured depths from existing grade. *The field existing surface grade goes downhill and the maiority has 3'+ of cover & iust the end has <3' of cover — See owner letter - no known freezing issues. ED per sump lateral invert & appears approximately 3.5' or 42" of ED is missing / not measurable. COSA Checkhst_May2025 copy 2.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Sewer Service/Septic Line > 25' ® Yes if No ft Disposal Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Disposal Fields > 100' Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Sewer Line/Main > 100' ® Yes if No ft ® Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10' ® Yes if No ft Surface Water > 100' ® Yes if No ft Field to Foundation > 10' ® Yes if No ft Wells on Adjacent Lots: Tank to Property Line > 5' ® Yes if No ft Wells > 100' ® Yes if No ft Field to Property Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Main/Service Line > 10' ® Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on -site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer's Printed Name CURTIS HUFFMAN PE Date 08/05/2025 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWC5 .*.•. .TH . ........ �' Curtis Huffman �'F�S,•.. CE 12899108/05/25 ..•+/,'� PROFESS100-WAW COSA Checklist_May2025 copy 2.docx MUNICIPALITY DEVELOPMENT SERVICES DEPARTMENT � �'�` 907-343-7904 I On -Site water and wastewater Section Fax: 343-7997 www.muni.org/onsite --� Nitrate Advisory Certificate of On -Site Systems Approval # OSC251328 Subdivision: SKYLINE VIEW, Block: 1, Lot: 8 A water sample revealed a nitrate concentration of 7.35 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Date: 8/6/25 P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 Brent Western First Water Consulting Services RE: 19370 Lupin St., Chugiak Well Camera Inspection The well is Entirely Cased to a depth of 190’+ with a 3’ Stickup. All welded joints look good with no leaks. The Casing is in good condition with no holes, cracks or leaks. The pitless area appears to be sealed and in good condition. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # , 1, GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address 19370 LupineStreet Chug.~k, AK Erick Borland Day phone 8600 Barney Circle Anchorage, AK 99507 562-7684 (w) 349-7354 (h) Day phone Agent Virginia Kohfield/ REMAX OF EAGLE RIVER Day phone 694-4200 Address 16600 Cent~rfield Drive Eagle River, AK 99577 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well X×X 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: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 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 S & $ ENGINE£RING~...--~ i2u;~4 Eagle Ri'c~Ct~'oop .R6ad No, 204 Address Eagle River, ,~l~i's~ 99,~77 .~- ' Engineer's signature ~~ DHHS SIGNATURE /'//"~ Approved.for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: Date The Municipality of Anchorage Dm~artment 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. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type Log present (~)'N) Parcel I.D. Total depth / ~ ~' Cased to Sanitary seal ~N) '~( If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~. c~ ,] % Driller _--1~'p.¢,~ /~ o Casing height Wires properly protected (~)N) k.( .g.p.m. FROM WELL LOG Date of test Static water level Well flow -'~\ , c, Pump level1 0 ~- SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line AT INSPECTION ; On adjacent lots ; On adjacent tots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: ~ ¢ \~. -%'5 B. SEPTIC/HOLDING TANK DATA Collected by: __ Other bacteria $ & S ENGINEERING l~)~l-Eag~er E~gle River, Alaska 99577 Date installed Cleanouts ~¢~N) High water alarm (Y~) Date of pumping Tank size \'7--~---?c~ Compartments Foundation cleanout (Y/~ ~ Depression (Y/~ Alarm tested (Y/N) ~-~ .-- "~- o ,.. c~ ~ Pumper ....3~¢--. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot _ \ ,._~ '''~ On adjacent lots \ ~ Foundation ,~" To property line \ © ~'¥'- Absorption field ~i~I Water main/service line Surface water/drainage \ ~'~ 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at High water alarm level ~ ¢¢jrdl~'~ te'"'~sted Meets MOA electrical codes (Y/N) S~E FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed _ ~ '~i '~ ~ Length '~"[ \ Total absorption area _ Date of adequacy test. Width Z~;,¢-¢,-~ ~ Cleanout present (~N) _. k/ Water level in absorption field before test z~ ~ Peroxide treatment (past 12 months) (Y(~) ~o~ ¢._ ¢---~,o ~ ~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot t. o ~ t '~ To building foundation ~. On adjacent lots --~ ~ t Surface water \ ~.~ C:~ \ Curtain drain ~-~ /A- E. ENGINEER,S CERTiFiCATiON Soil rating (GPD/FF) ~--~ Gravel thickness System type _ Total depth . Depression ever field (Y4~ ~( for /~ Bedrooms After test If yes, give date On adjacent lots \ o ~ x.V-- Property line To existing or abandoned system on lot. Cutbank ,'~ l/4- Water main/service line Driveway, parking/vehicle storage area Signature $ & Engineers N~j¥~, ' -"~'~~77 I certify that I have checked, verifiea or conformed to ali MOA and HAA gu/de/ines in effect ~n.the dat~e of this inspect/on. Waiver Fee $ Date of Payment Receipt Number HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back APPLIF :NT FILLS OUT UPPER HA' PrbpertyOwner..~ Mailing Address .~..:' Buyer Address 'ONLY Zip Code ,~,.,,~,.~. ~,, Zip Code Phone Realty Co. & Agent Type of Residence ~Single Family ~ Multiple Family No. of Bedroo~4~ ~ Other Phone ? ~/¢/' >~./L~' Phone /-~,'," Water Supply ,," Individual Community ~ Public Utility ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available). Sewer Disposal  I ndividual Public Utility ~ Holding Tank Year Individual Installed:_ / ,~ '~ When Connected Io Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date i/- Inspecler Inepector Inape~lor Inapector Field Notes: ~,~J_ ~) ~ ~ ~ MUNICIPALITY OF ANCHORAGE ( ~PRBOVED BEDROOMS 'CONBITIONS OF APPROVAL ( ) DISAPPROVED ) co..,~,o.,. .~v%. Soils Rating [ Oate,werlnslalled Well To Absorption Area ¢ Well Log Received 'ff~ ? EXCAVATION ROBERTA. SHAFER WORK November 22, 1982 CIVIL ENGINEER 694-2979 Red Carpet/Greatland Realty ATTENTION: Terry Kruger P.O. Box 633 Eagle River, Alaska 99577 A4UNIcPANi¥ OF ANCHo~'AGF_ OFt,/ r~ . ENVIR 3,#, :/', A. .L~ Dear Mr. Nruger, 'Reference: Lot 8~ Block 1: Slcyline View Subdivision A sewer system adequacy 'test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified 'to have a capacity of 1250 gallons in accordance with Municipality records. The absorption trench was tested by a continuous flow of water over a period of 24 hours without any adverse effect on the system. It can be concluded from this 'test that the waste water disposal system serving the two bedroom residence located on 'this property is currently functioning adequately. However, 'this system cannot be guaranteed against subsequent failure. If we may be of further service, please do not h~sitate to call. Si~ly,. cC: Municipality of Anchorage Department of Health and Environmental Protection SR8 196X EAGLE RIVER, ALASKA DA3~r: RECEIVED INSPECTION APPOINTMENTS ~TIME TIME TIME 'NSPECTOR  DEPARTMENT OF HEALTH& ENVIRONMENTAL PROTECTION DEPT. OF I::ALTH & 825 L Street - Anchorage, Alaska 99501 JENVIRONMENI,,:,,L i, ~'TECTION ENVIRONMENTAL SANI'rATION DIVISION FEB 2, ~ I980 Telephone 264-4720 ..ou.s..o.A...OVA. o. DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing, 1, PROPERTY OWNER PROPERTY RESlDEN~ (If different from above) PHONE MAI LING ADDRESS -- 5. LEGAL DESCRIPTION STREET LOCATION 6, TYPE OF RESIDENCE NUMBER OF~SEDRO0~9' I~"SINGLE FAMILY [] One L~K Four [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPELY [~"'1NDI VI DUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) E~ INDIVI DUAL/ON-SITE** [] PUBLIC UTILITY / ~ 7 ~'" YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72-010 (Rev. 6/79) l~J -- THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMS 1, TYPE OF RESIDENCE [] ONE [] THREE [] F~VE [] OTHER [] SINGLE FAMILY [] MULTIPLE FAMILY [] TWO [] FOUR [~3 SIX ~ERMIT NUMBER 2, WATER SUPPLY [] iNDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED ~ ~ERMIT NUMBER 3. SEWAGE DISPOSAL SYSTEM [] INDIVI DUAL/ON -SITE }ATE INSTALLED E~ PUBLIC UTILITY Connection Verified. iNSTALLER [~]SepticTank or ~Holding Tank ._ Size:_~,~'C-) If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK V1ANUFACTURER TOTAL ABSORPTION AREA MATERIAL ~ ~"-'~'~'¢~ ..... Nearest Lot Line Septlc/Ho,dingTank ,Absorption Area ~werLine _~ 4. DISTANCES WELL TO: /~-O -- -- Absorption Area to nearest Lot Line 5. cOMMENTS ~APPROVED FOR _ ~ BEDROOMS [] CONDiTiONAL APPROVAL (letter must accompany certificate) DATE ~ BY -- 72-010 (Rev. 6/79)