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HomeMy WebLinkAboutRIVERVIEW ESTATES BLK 9 LT 8A Municipality of Anchorage page 1 af 3 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: SW980364 PiDNumber: 050-801 -21 Nam":Taylor Gramkow Wastewater System: [~ New -[2] Upgrade ,~dor~,: ABSORPTION FIELD ~,O. 9ox 196613 A~cho~ag¢,t A[ 9951 Phone; ~ No. of Bedrooms: ~ Oeep Trench ~ShalIow Trench ~ Bed ~ Mound ~ Other J ..Three - LEGAL DESCRIPTION 1.2 G¢o/s~.~,. 7' ... 8A 9 Riverview Est. 3 . ..~,. 4' - ~. 37 . 5 ' ~. WELL: ffi New ~ Upgrade ara~elwidm: 5 I NumOerofli~e~: Private 440 ¢~. 48 ct. 375 so. eL ASTM D3034 PVC Anch. Well & 5/9/98 22' ~. CMN General Cont. ~/~4-29/98 5 · 6 , GPM I, 189 ¢~. 2 ' SEPARATIO N DISTANCES ~ s~ ~ ~o~ c s.~.~.~. ~ ~,,, ~,,~ s~,,~, ~,,, s,~,,u~,, Anchoraqe Tank I 1 ,~00 Well > 100 ' > 100 ' N/A N/A N/A Material: NumUerotCampa~ments: Steel Two Surface >100' >100' N/A N/A N/A LIFT STATION - N/A Lol > 5 ' > 10 ' N/A N/A N/A SiZe in gallons: Line Founda~,on >5 ' >10 ' N/A N/A N/A "Puree on" level a~: "Pump off" level at: High water alarm al: Curtain None on Orain ...... BENCH MARK Remarks: 2" Insulation over Septic '~ Loca,,enan~Oescr,¢n~,: Ground Floor Slab Tank and Drainfield. Assum~ Elevat,en: 100 . 0 Inspections performed by: HEA 0ates:lst ?/3/98 2nd 8/24/98 3~d 8/~9'/98 Department of Health a.~ Human Se..ices appro.al Reviewed and approved by' Oate' /-2~-?~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, AK 99519-6650 343-4744 On-Site Wastewater Disposal System or Well Inspection Report Page 2 of 3 Permit Number SW980364 PID No. 050-801-21 S2 C3 M1 B 21 .9 ~ 23.8 Well 55.5 27.5 /x~ Alternate S ~ S1 S2 ~H ~ / Future ~ ~Garaqe /CI~/A ~ x / x,, <,/- /B ?A~sor~Z~o~ T~enc~ PLAN A_S'_-B_UILT ~ SCALE Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, AK 99519-6650 343-4744 On-Site Wastewater Disposal System or Well Inspection Report Page 3 of 3 Permit Number SW980364 PID No. 050-801-21 r000 = ~ aanl~On 17.9' ~9~ / I / _88,4 ~ 80.0 2" Insulation Drainfield Rock 95.1 37.5' PROFILE AS-BUILT HORIZONTAL SCALE 1" = 10' NO VERTICAL SCALE ANDERS'ON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 ,522-7773 522-6779 (FAX) MEMORANDUM DATE: January 22, 1999 RECEIV[D TO: DanRoth JAN _2.2 1999 FROM: Mike Anderson, P.E. '//~~ Municipality et ^nc~o?go Dept. blealth & Human oervices SUBJECT: Lot 8A, Block 9, Riverview Estates Certificate of Health Authority Approval Attached is the revised Health Authority Approval Checklist which includes the original log for the well drilled on Lot 8A, Block 9, Riverview Estates. The well was completed in July of 1997 by Sullivan Water Wells. It produced only .33 gallons of water per minute. The lot was then sold with the well and the new owners hired Jim Ridgeway to fracture the well to produce more water. According to Ridgeway's test report the xvell now produces 5.6 gallons per minute. The well log is included with the checklist. The checklist now includes the well log data along with the test report data completed by Jim Ridgeway. The well was drilled in its current location rather then that shown on the original permit because of access and the presence of water. The location does not conflict with the septic system on the lot or others in the area. I aln hopeful the Certificate of Itealth Authority Approval can now be completed. Thank you for your help. SUI, WATER WELLS BOX 6';o;";' (:;,d, IGIAK, ALASKAg~!~G? · TELEPHONE 688.2769 ADDRESS DATE. grafted PERMIT NUMBER DEl'TH OF WELL STATIC LEVEL OF WATER DRAW DOWN FT, GALS. PER HR KIND OF CASING _. KIND OF FORMATION: From_~Ft. to~0 Ft ~ J" ~d,4O~.._ From~ FromR0 Ft. toO~Ft, -f~ From. ... From) Ft. h) _'-i" ~.~(~ ~ From ._FI, to.~Ft.~ . (,~&~ From Ft, to__Fo (~ .... ~ from .FI. to ..... Ft <. g ~ . From. Ft. to , __Ft. Fromm_Ft. Fromm. Ft. to~__Ft MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box ~96650, Anchorage, AK 995'19-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 17, 1998 Expiration Date: Sep 17, 1999 Permit Number: SW980364 Legal Description: RIVERVIEW ESTATES BLK 9 LT 8A Design Engineer: 0070 KND Engineering Owner Name: TAYLOR GRAMKOW Owner Address: PO BOX 196613 ANCHORAGE , AK 99519-6613 Parcel ID: 050-801-21 Site Address: Lot Size: 42186 SQ, FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy Private Well [] Water Storage 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ~ ~ Date: Rick Mystrom, Mayor Depad:ment of ealth and - uman Services 825 "L" Street P,O. Box 196650 Anchorage, Alaska 99519-6650 htlp:,,/www ci.anchorage ak.us 343-4744 August 18, 1998 Robert M Caywood dba Cb~ General Contractors PO Box 774042 Eagle River, Alaska 99577 4042 Subject: Lot 8A Block 9 Riverview Estates Subdivision Permit #SW970171~ PID #050-801-21 The subject permit, issued July 3, 1997 by this office for a single family well and/or on-site wastewater system, has expired as of July 3, 1998. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. if you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. if a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office f¢r ::eviaw, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. ~,;hen applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Since.~ely, Ja~es Cro~s, P.E Program Manager On-site Services enc: Copy of Permit cc: KNDEngineering 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 AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970171 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:ALASKA USA FEDERAL OWNER ADDRESS:il517 OLD GLENN HIGHWAY EAGLE RIVER, ALASKA 99577 PAGE 1 OF DATE ISSUED: 7/03/97 ?kt~[ EXPIRATION DATE: 7/03/98 PARCEL ID:05080121 LEGAL DESCRIPTION: RIVERVIEW ESTATES BLK 9 LT 8A LOT SIZE: 42186 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TA~NK / 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 (18i~AC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: DATE: 7-3-77 ,.~NN~ ID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 June 19,1997 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer/well permit - Riverview Estates S/D, Lot 8A, Block 9 Gentlemen: On June 2, 1997, we excavated four new testholes for the subject property. The results of these tests and water monitoring are attached. We propose to install a deep 5' wide trench. Water was monitored in the tesholes from between 7' to 14'. Additional fill will be placed, over the system to provide a minimum of 3' of cover when complete. There are no public or private wells within 200' of our proposed system location except as noted. Although there is a drainage easement located along the southeast property line, there is no water located in the easement nor is it possible for water to follow this alignment due to existing topography. There is neither surface water within 100' nor any curtain drain within 50'. We do not expect that there will be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, ~_ilxf iD Engineering attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test MUNICIPALI'~ OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION JUN 19 1997 RECEIVED WASYEWATER ]]ISPBSAI_ SYSTEH?SITE PLAN R][VERVIEW ESTATES SUBDI¥IS][I]N, BLI]GK 9, LET 8A LET 6 LOT LL ~ VACANT LE]T 7 L~E 8 VACANT L~3T LOT 7 VACANT EXISTING SYS IEM ]]ES~GN CR~IER~A 1. 3 BEDRI]I]NS X 150 GAL./DAY/BEBRBBM : dSO GPB 8. SI]ILS RATiNG~ 3.6,3 bUN/iNCH APPL RATE LP_ GPD/SI 3 450 GPS/I.B GPD/SF ~ 375 SF 4. (375 SF /5'(W)) x 0.50(RF) 37.5'1 5. MIN. DESIGN S~ZE ] IRENCII - 37.5' LBNG x 5' WIDE x d' DEEP 6, I]EPI'H I]F GRAVEL BELI]W PIPE IS 4'. 7. TBTAL DEPTH ~F' SYS'IEH IS 7.0' FRBM BRIGINAL GRADE. NB FES', $. T~E ~NTB TRENCH AT ENg. iNSTALL ]000 GALLBN SEP1 ~C rANK. ~NSULATE TANK W <4' C~VER. 3' INSULATE 1RENCH W[T~ ~" Hg ~UR~AI FBA~ ~F <3' CBVBR. 4 CBNTRAETBR W~II ENSLJRE HAXlNU~ BX SLBPE [NTB SEPTIC raNI<. PREPARED FBR: LEE RAYMI]NB lEE'.% CUSTBH DESIGN 11517 BI_l] GLENN HWY. EAGLE RIVER, AK 99577 (907)694 8565 I<NI] ENGINEERING ~0441 PTARMIGAN BLVD EAGLE RIVER, Al<, 99577 (907)G96 Gill/Fox (907)696 8111 SCALE: 1' = 100' 97056 SI Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCR,*TION:~/~/~'f'~//'(W~/?..~/ Zt/f~'¢ ~O/l~:~''~ Township, Range, Section: '~/~' / 6 7 8 9 10 '11 12 13 14 15 16 17 18 19 20 SLOPE WAS GROUND WATERY~/~ ENCOUNTERED? SITE PLAN IF YES, AT WHAT DEPTH? Depth lo Walor Alter / Monitoring? Date: Gross NeT Depth to Reading Dare Time Time W0[,~,-.~ Drop ./ tmmules/mcr0 PERC HOLE DIAMETER __ PERCOLATION RATE COMMENTS TEST RUN BETWEEN __ FT AND ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON fills DATE FT CERTIFY T HA f THIS TEST WAS PERFORMED IN DATE 72 008 {Rev 4/85) Municipalily o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502 0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRmTtON: SLOPE SITE PLAN ' d~LUI~ WAS GROUND WATER /VO ENCOUNTERED? S IF YES, AT WHAT DEPTH? P E Depth 10 Waler Aller M0niterin0? Dale: 6 7 8 9 10 '11 12 13 i4 15 16 17 18 ]9 20 COMMENTS Gross Net Depth to Reading Date Time Time Wa~e~-~ Drop ,/ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFI,ECT ON TI-IlS DATE TEST RUN BETWEEN F1~AND -- PERCOLATION RATE -- tm,nules/mch) PERC I,IOLE DIAMETER CERTIFY THAT THIS TESf WAS PERFORMED IN Municipalily o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" SireeL Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST SLOPE 1 2 3 4 5 6 7 8 9 10 '11 12 13 14 15 16- 17 18 19 20 WAS GROUND WATER /~ ENCOUNTERED? -~ IF YES. AT WHAT / t E SITE PLAN Gross Net Depth to Net F~eading Date Time Time Water Drop / ~/~/~ z /~7 - ~yz,, -- ~. I,~;'/7 /~,.~n II "'/~z" ;Z V'/" /~'~ /~ ~,~ // W' ~ ~/ . ~ //, /~,% ~¢" ~ ~/" ~1:~ /~/~ // ~ ~ test nun Between /~ et AND --7 FT DATE ~z' ~ . .-~"3 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" S~reet, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFO,MEO ~oR: ,Z.~¢/~mo~a/ SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depih to Wa,er Aller , ~onilorin~)? / .~ 1 2 3 4 5 6 7 8 9 10 '11 12 13 14 15 16 17 18 19 20 Gross Net Oepth to Net Reading Date Time Time Water Drop / ~.-~-¢ 7 /~ :,/5 - 7/,./", - ~. lo:/7 2- ,,,,-, ,'r~ ~ ~& ',, / ~/~" ~ _/~ 'z/ z ~,'~ I~." I ~z" 7 ,/~: z~ z ~ ,'~ //VN "_~ " PERCOLATION RATE /, ~' tmmutesnnch) PERC HOLE DIAMETER TEST RUN SETWEEN ¢''~' FIAND '~' 5 FI CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFEC'I' ON THIS DATE ~ TEST PUMP REPORT - WATERWELt OWNER TA O ADORE88..2040 PAX$ON DRIVE ANC_EIQRAGE AK. ENelNEER _T NYLQ 1%,, GE __Ak4KO3/ WELL LOCAT1ON LOT 8 BLOCK 9 ~RIVERVIEWE~'J'ATES, ' TOTAL DEPTH ....~DEPTH OF CASING__ 48' SCREEN FRbM_NA..TO~ CA,SING 81ZE ~SCREEN DIAMETER ~A SCREEN 8LOT REMARKS,___ PUMP INTAKE DEFTH la~J P~MP 81ZE ~I'HP ~.iRLINE DEP"~t~ ~LE. CTR~NIC STATIC WATER LEVEL 22' AVG. DISCHARGE 5,5 GPM _189' MAX DRAWDOWN PUMP ON ._3:16 TIME 5/9/98 _DATE PUMP OFF _7:15 TIME 5/9/98 DATE DATE TIME In.,OW FLOW WATER .... _. M~n , I%*~ ..:~Evg~--, ~11/98 I;45 OH 6 22' ~D - D~TY 2:~ O~ 64' ~D - D~'rY 3:30 ON 22' 4:45 ~ 64' HST~ - ?00 G~. $/6/98 3:40 ON 26' t3'N I,,4.STI~ ~ t2,AmN O 4 :o0 OFF 65' UN UmTEPmD.-C[Z. AIUNO 5/8./98 4:30 ON 8 29' UNMEI~,RF~ 8:30 OFF 4 109' ~TERED F,N'I'IMA'I~ - I~40OAL 5/9/98 3:16 8700790 8.9 29' 3:26 8709879 8.9 52' 3:36 8709959 8.0 65' 3:46 8710039 8.0 78' 3:56 8710106 6,7 .. 882 4:06 8710181 73 4:16 87),0253 7,2 108' 4:46 S710420 5.6 144' 5;16 8710578 5,3 160' 5:46 8710714 4.5 1';6' 6:16 8710858 4.8 189' 6:46 8711002 4.8 189' 7:16 8711146 4.8 189' TOP OF ~ [23O READ[NO AVl1RADF., 3'O.IRJI~~ ct Municipality of Anchorage ° `G a ra On-Site Water and Wastewater Program (907) 343-7904 5 F T Certificate of On -Site Systems Approval Parcel I.D. 050-801-21 1. GENERAL INFORMATION: Expiration Date: 1 - I ` a © Z72— Complete Z Complete legal description RIVERVIEW ESTATES; BLOCK 9, LOT 8A Location (site address) 7428 RIVER PARK CIRCLE, EAGLE RIVER, AK 99577 Current Property owner(s) RICHARD & JOELLEN RACHOW Day phone 907-750-0008 Mailing address 7428 RIVER PARK CIRCLE, EAGLE RIVER, AK 99577 Real Estate Agent TEAL HELLER Day phone 632-3301 _ 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ S 5�0 Waiver Fee $ _ Date of Payment 5 a 0a 2 Date of Payment Receipt Number 0 La 1/6- Receipt Number, COSA # 03C-2212 ct O Waiver # ME 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, 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: Z_ Inconducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of_.._. . the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future_ The content of this report is for the sole benefit of the person/parry that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for -3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, #AECC884 ���ii� OFjp \�`�``P�\ZY� ON-SIT with the fog �IA�� N D `v m Z001 WASTEcATER z; Jct PROGKAM c; Original Certificate Date: (c>- I -zoz2 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: �+ COSA Checklist 1 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_10.11G-12.doc 90 Legal Description: RIVERVIEW ESTATES; BLOCK 9, LOT 8A If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 711997 Total depth 440 ft Cased to 49'4° ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/11/22 Static water level at beginning of test 28.8 ft. Comments B. TANK DATA Age of tank(s) <24 years Tank type/material STEEL Measured operating fluid level in septic tank 49 ❑ Standpipes/foundation cleanout per record drawing Date of pumping c �1 v / 7- D. ABSORPTION FIELD DATA 5 -WIDE TRENCH Which system tested (date installed) 8/29/98 ❑ ALL standpipes present per record drawing Total measured depth from grade 8.0 ft (max) Measured depth to pipe invert from grade 2.9 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 050-801-21 Structure served by this system 1 Well production at time of test 4.1 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No 0/6-01iform bacteria is Negative Nitrate � -� J`mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG,LTD. Date of Sample 5/12/22 Sequir TATION ❑ aintenance com Age of lift station y Lift station material Adequacy test date 5/11/22 Results (-1 Pass For 3 bedrooms Fluid depth prior to test 22.25 in Water added 686 gal New depth 27.75 in Elapsed time 970 min Final fluid depth 24.25 in Absorption rate 450+ gpd Any rejuvenation treatment (past 12 months) NONE If yes, enter date 163 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Q Yes Community Sewer Manhole/Cleanout > 100' ft If absorption field is under driveway comment below Yes if No ft [, Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25'21 Yes if No ft Absorption Field on Lot > 100' Q Yes if No ft Holding Tank > 100'[]✓ Yes if No ft Neighboring Absorption Fields > 100' ft Animal Containment > 50' Yes if No ft P-11 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5+ ft Surface Water > 100' (✓ Yes if No ft Property Line > 5' Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' ✓ Yes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' El Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' ✓a Yes if No ft F. ENGINEER'S COMMENTS 'MET-SEPARAT'IGN-AT-TIME-GF-INST--AL-L:T-HERE-IS-A-••39'LT-ALI= DEGGRATW-&KEY-STONE RETTAINING-WAL-t_ N 1 A CORNER OF THE TANK MAY BE UNDER THE RETAINING WALL. WALL DOES NOT APPEAR TO BE STRUCTURAL SUPPORT FOR HOUSE/PATIO/DECK. "PER MICHAEL E. ANDERSON, P.E. 1999 HAA - NOT VERIFIED BY GEG. 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. COSA Checklist yellow sheet OSP Je Gorn�ss.•' E 7 �� A7 � pro f essiolo4 #AECC884 Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC221240 Subdivision: Riverview Estates Block 9 lot 8A Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this COSA / property is 24 nears old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank in failure and should be replaced. ISlitrate Advisory Certificate of On -Site Systems Approval # OSC 221240 Subdivision: Riverview Estates Block 9 lot 8A A water sample revealed a nitrate concentration of 6.77 milligrams per liter (mg/Q. 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. 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. 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. 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 050-801-21 NAA# ~:--~'(~:'>l:'tf~'('''' i/-~, 1. GENERAL INFORMATION Complete legal description Lot 8A, Block 9, Riverview Estates Location (site address or directions) River Park Circle Property owner T~aylor Gramkow Day phone. Mailing address P O. Box 196613 Anchoraqe, AK 99519-6613 Lending agency Mailing address Day phone Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Three (3)' Individual well xx× Community well Public water 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. 1191) Fronl 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 Anderson Enqineerinq Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's signature Date. 1/13/99 DHHS SIGNATURE ~ Approved for -~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA Municipality of Anchorage R DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division J/ N 1 4 1999 825 L Street, Room 502 · Anchorage, Alaska 99501 · (90.7) 3~74~44 Munie~paHty of A~cnorage Oept. Health & Human Services Health Authority Approval Checklist Legal Description: Lot 8A, Block 9, Riverview Estates A. WELL DATA Well type Private Log present (Y/N) Y Total depth 4 40 ' Sanitary seal (Y/N) Parcel I.D.: 050-801-21 If A, B, or C, attach ADEC letter. ADEC water system number 5/9/98 Oasing height (above ground) 2 ' Wires properly protected (Y/N) ¥ ATINSPECTION g.p.m, g.p.m. Date completed Cased to ~8 ' FROM WELL LOG 5/9/98 22' 5.6 Nitrate .1 mg/L Other bacteria Collected by: HEA Tank size 1,000 Number of Compartments Two Y Depression (Y/N) N High water alarm (Y/N) PumPer Construction Date of test Static water level Well production WATER SAMPLE RESULTS: 0 Coliform 1 ) 3 / 99 Date of sample: El. SEPTIO/HOLDING TANK DATA Date installed 8 / 24 / 98 Foundation cleanout (Y/N) Date of Pumping New ,: C. ABSORPTION FIELD DATA ~ Date installed 8 / 29 / 98 Length 37.5' , Width , Soil rating (g.p.d./ft2 or fF/bdrTn) 1 . 2 5 ' Gravel thickness below pipe Effective absorption area 375 SF Monitoring Tube present (Y/N). Y Date of adequacy test New Con.qt. Results (Pass/Fail) pass Fluid depth in absorption field before test (in.); Fluid depth (ins) Minutes later:. Peroxide treatment (past 12 months) (Y/N) N/A 72-026 (Rev. 3/96)* Immediately after Absorption rate = If yes, give date ~ Cleanouts (Y/N) Y N Systemtype q'...w~t~ mrench 4 ' Total depth 7 ' __ Depression over field (Y/N) N For mh ~-,~,~ bedrooms gal. water added (in.): g.p.d. D. LIFT STATION - None on Lot Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot > 1 00 ' Absorption field on lot > 1 00 ' Public sewer main N/A Sewer/septic service line > 2, 5 ' F. Property line > 1 0 ' Surface water Curtain drain Size in gallons "Pump on" level at* *Datum On adjacent lots > 1 0 0 ' On adjacent lots > 1 0 0 ' Public sewer manhole/cleanout Lift station N / A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation > 5 ~ Property line > 5 ' Water main/service line > 2 5 ' .Surface water/drainage > 1 0 0 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation > 1 0 ' >100' None on Lot ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections in conformance with MOA HAA guidelines in effect on this date. Signature ~C ~ Engineer's Name Michae[ E. Date 1/11/99 Anderson: P.E. "Pump off" level at* Absorption field > 5 ' Wells on adjacent lots Driveway, parking/vehicle storage area Wells on adjacent lots > 1 0 0 >100' N/A Water main/service line > 25 ' >5' HAA Fee $ ..... Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number SEP-03 98 10:El FROM:FRED D. CHADWICK 907-E57-6395 T0:9075886779 P~GE:01 ~ TEST PUMP REPORT WATERW¢:LL OWNER TAYLOR GRAMKOW .... ADDRESS_2¢40 PAX$ON DRIVE..A_NCHORAGE AK, 99504 ENGINEER TAYLOR GRAMKOW WELL LOCATION LOT 8 aLOEK 9 RIVERVI~W ESTATES TOTAL DEPTH 440 DEPTH OF CASING. 48' SCREEN FROM NA TO CASING SIZE 6" SCREEN DIAMETER NA SCREEN SLOT REMARKS PUMP INTAKE DEPTH 189 ..,PUMP SIZE [ RP AIRLINE DEPTH ~1 ~CTRONIC STATIC WATER LEVEL 22___~.._' AVG. DISCHARGE 5,~6 GPM 189' MAX DRAWDOWN PUMP ON _3:16 TIME $/9/98 DATE PUMP OFF 7:16 TIME 5/9/98 DATE DATI'. ~ PLOW I?LOW WATER 511198 1:45 ON 6 ' 22' UNM~TP. RED- DIRTY 2130 OFF 64' UNIvlET~.D - DmTY 3:30 ON 22' L1Nlvm-tmLLa'D - DIRTY 4:4-~ O~'I= 64' UNM~-i'i~f-~D - DIRTY ES~MATIi - 700 GAL. 5/6/98 3:40 ON 26' UN~ t ¢:00 OFF 65' gSTIMATI~ - 160 OAD 5/8/98 4;30 ON 8 29' UNME~ 8:30 OFF 4 109' UI'fMETEILED gS'Ti'MATg · 1440 GAL- 5/9/98 3:16 8700790 8,9 29' 3:26 8709879 8.9 52' 3:36 8709959 8.0 65' TOP Ot~ Ln, C~R 3:46 8710039 8.0 78' WI!LL LDO IlY,,ADINO 3:56 8710106 6.7 88' ,'.'/liltAO~ TO vm,4:P 4:06 87101al 7.5 98' aUC'HON 4:16 8710253 7.? 108' 4;46 8710420 5.6 144' 5; 16 8710578 5.3 160' 5:46 8710714 4.$ 176' 6:16 8710858 4.8 189' 6:46 8711002 4.8 189' 7:16 8711146 4.8 189' Sate ofAla~.a 2~.~erator CeaxilSc~ '~ dAN ] 4 1999 Munioq)ality ot Anchorag, e Oept. Heaith& Human rCT&E Environmental Services Inc. , ~_ _----_ _---~--_--_--_ - ...... ~Y~615301 P. 05/08 CT&E Ref.# Clien~ Name Proje~ Name/# Client Sample ID Matrix Ordered By PWS[D Sample Remark: 987273004 Anderson Engineering N/A Lot SA, Blk 9 Riverview Fat Drinking Water Client POg Printed Date/Time 12/30/98 11:52 CollectedDate/Time 12/17/98 [3:50 Received Date/Time [2/[7/98 i6:25 Teehnicai Director: Stephen C, Ede ~esutts 0,100 U 0.100 ~/L !. Method EPA 300.0 AL[o~abte Prep AnaLysis Liaits Oate Oate Init 10 max 12/17/98 12/17/g8 SCL RECEIVED JAN '1 4 1959 Health & Human Servicas