HomeMy WebLinkAboutMCMAHON #2 BLK 9 LT 4
GRE .,:R ANCHORAGE AREA BORt, JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE I ~ ~ NUMBER OF
FROM WELL J (~ ~ MANUFACTURER MATERIAL COMPARTMENTS
INSIDE WIDTH LIQUID DEPTH
INSIDE LENGTH
LIQUID CAPACITY//'''~Jr'b GALLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL i(~~''~''//f' FOUNDATION
NUMBER OF LINES J DISTANCE BETWEEN LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
NEAREST LOT LINE
TOTAL LENGTH
OF LINES
TRENCH WIDTH__ IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE
IN. ABOVE TILE IN.
'~j
BUILDING NEAREST
FOUNDATION__ LOT LINE_
CESSPOOL
, OTHER SOURCES
APPROVED
DISAPPROVED
NEAREST SEPTIC
SEWER LINE__, TANK__
DEPTH
SEEPAGE
SYSTEM
DISTANCE FROM:
REMARKS
DISTANCES:
INSTALLED BY: '~2-"~
SEWER LINE DEPTH:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
DATE¢~ APPROVED--~--~~ ~G.A.A.B.
Form EQ-032
(��r=a-
F DMUN
914 East 78th Avenue
ANCHORAGE, ALASKA
344-9242
COMPLETE
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,
GREATER ANCtlOkAGE AP, EA BOROUG,.
Department of Environmental Quality
3330 "C" Street
Anchorage, Alaska 99503
SOILS I,O(1 - I)EROI,ATION TEST
Legal Description:__z~_4_
This form reports: Soils log ,,
Percolation test
Depth
Feet
4-
12-
13 -
14 -
Was ground water encountered?
If yes, at what depth? ..................
Reading
Date
Gross Time
Net Time tDepth~ to Water Net Pro[)
Percolation Fit--e- ............... ~l~ut~ ......
/-'h-Proposed installation: Seepage Pit
Depth of Inlet . Depth
COMMENTS:
Drain Field
t or trench
., , Municipality of Anchorage
On-Site Water and Wastewater Program a
(907) 343-7904 12.
Certificate of On Site Systems Approval
Parcel I.D. 017-362-11 Expiration Date: J 2 -/
1. GENERAL INFORMATION
Complete legal description McMahon #2 Block 9 Lot 4
Location (site address) 3636 Taiga Dr.
Current Property owner(s) Michael Donegan Day phone
Mailing address 3636 Taiga Dr. Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
El 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 Q Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received b : Date: _� o i LA . __41aji/Ii=L //.ZC��/
COSA to be release. to the engineer,unless otherwise requested by the ngineer.
COSA Fee $ S2 ,0 Waiver Fee $
Date of Payment 5\D-4) f 7 Date of Payment
Receipt Number o`6715G\ Receipt Number
COSA# , C,1-1 PAO Waiver#
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.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak, 99510
Engineer's Printed Name Steven R Pannone Date 8/24/2017
OF Al.: kk
40'4)7- •It" Oi
6. DSD SIGNATURE tO°' 41 �" "
System #1 Approved for '3 bedrooms •• S�everi •aririorie •81 "
System #2 Approved for _ bedrooms � 0 CE—... . ',
r
Disapproved ��k `�?OFE551C0\
Conditional approval for bedrooms, with the following stipulations:
OF AI ,
rct7.:
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ON-s AGam'
WATER uo
z
W AS"TEW p,-CER 9
.-c2 EROGRAM c ..
By: Original Certificate Date: R
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 X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet2: • ..
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system '
Certificate of On-Site Systems Approval Checklist
Legal Description: McMahon #2 Block 9 Lot 4 _ Parcel ID 017-362-11
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed 1977 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y
Total depth 81 ft Cased to 81 ft Casing height (above ground) 18 in.
FROM WELL LOG AT INSPECTION
Date of test 1977 7/25/2017
Static water level 35 ft. 55 ft.
Well production 5-10 g.pm 9.0 g p m
WATER SAMPLE RESULTS:
Coliform Nf,4 colonies/100 mL Nitrate 1 °' l� mg/L
Arsenic N ug/L Date of sample. $/1 51201 7 Collected by' PES
`/
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 3/12/1977
Tank size 1 250 gal. Number of Compartments 2 Cleanouts (YIN) Y
Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (YIN) N/A
Date of pumping 7/24/2017 Pumper Northland Pump
C. ABSORPTION FIELD DATA
Date installed
3/12/1977 Soil rating (g.p.d./ft2 or ft2/bdrm) 150 GPD/SF System type TRENCH
Length 40 ft. Width 3 ft. Gravel below pipe 8 ft.
J i
Total depth J�y� ftQ Eff absorption area 640 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 7/25/2017 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0 in Water added 455 gal New depth 4 in.
Elapsed Time: 1440 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d.
N
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm& circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO: � �
Septic tank/lift station on lot 100+ On adjacent lots y' ���
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. OMMENTS - � "
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4 ?ev NA;1/4per ( er p
___ ' put-k- v-a. I s 0/040 i � .
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�1` _�`--f!� T- r I 0.\\ Ik
G. ENGINEER'S CERTIFICATION ..+7 0 Ac.ellkk,
/ certify that I have determined through field inspections and 'rrr�.tP `'. ••1
review of Municipal records that the above systems are in 0*; , • I._ i\ •,*
conformance with MOA COSA guidelines in effect on this date. I • ••• •viii. ••••
Engineer's Printed Name Steven Pannone j ••Sven .•.•nnone
•• •• /
eo8/24/2017 l;o/y., CE-8149 .&'f
Date (
� .,
COSA canary sheet_2-6-15.doc
Municipality of Anchorage 4'
•;t Development Services Department
Building Safety Division "'W''d
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC 171390
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 9, Lot 4 of
McMahon 'subdivision. This inspection revealed a nitrate concentration of
10.6 milligrams per liter (mg/L) was reported for the property's well water
sample. 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.
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.
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panengak.com
September 12, 2017
Subject: McMahon S/D No. 2 Block 9, Lot 4, Lot 29D
Response top COSA Comments
I am writing this letter under protest as the COSA for the sale of this property is being held hostage until
"further explanation of the test procedure be explained" as requested by the reviewer Ms. Deborah
Wockenfuss.
Under protest, the test, which was performed by a licensed Civil Engineer in the State of Alaska with over
30 years' experience is further explained as follows:
• The monitor tube extends three feet into an eight foot effective depth drain field.
• The monitor tube was dry at the beginning of the test
• 455 gallons of water was added to the system.
• At 109 gallons, water was observed in the bottom of the monitor tube.
• The remaining 346 gallons of water added caused a rise of four inches in the monitor tube. (That's
86.5 gallons of water per inch of rise.)
• The system was monitored for 15 minutes after the water was turned off and a drop of 1/2 inch was
noted. (That's 43.25 gallons in 0.25 hours which when math is performed equates to 173 gallons
per hour, or 4,152 gallons in 24 hours.)
• The system was checked again at 24 hours (1440 minutes) and the system was dry again.
• This system is able to absorb greater than 450 gallons per day.
I hope this further explanation satisfies your questions.
1111P 1100
Tom) .kNNc rt)ter
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
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.% OF`% 1 AS BUILT NO CORNERS SET THIS DATE
AUF
~ ��• • • • AL,'5 1 a I hereby certify that I have performed a Mortgagee's inspection
•� �P••• 'f' of the following described property: LOT 4. BLOCK 9.
C• 49th .i\ •;9 I McMAHON SUBDIVISION. SECOND ADDITION
�� � Anchorage Recording Precinct,Alaska,and that the
/ i4:•'tom•`y••• • • / improvements situated thereon are within the property lines
V.Fred Walatko :1 / and do not overlap or encroach on the property lying
s • or adjacent thereto,that no improvements on the property lying
r�•• 3255 – S •• s — adjacent thereto encroach on the premises in question and
,, o . • ,O%iv that there are no roadways.transmission lines or other
a 1'ssiow - ! visible easements on said property except as indicated
%,�``�� hereon.
SCALE: 1"= 40 Dated at Anchorage,Alaska
this 4th day of AUGUST ,2017
EASEMENTS OF RECORD,OTHER THAN
THOSE SHOWN ON THE RECORDED FRED WALATKA 8 ASSOCIATES
PLAT ARE NOT SHOWN HEREONEngineers and Surveyors
UNLESS OTHERWISE NOTED FB 17-10, pg 2 BE (907-248-1666)
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. # ~) \-~ - ~t~ ~ ~ ~ \ HAA #
1. GENERAL INFORMATION
Complete legal description ~,~) '~ l.~ ,. '~ ~ ~ ~t~ ~
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
Day phone
Day phone
Day phone
Unless otherwise requested, HAA Will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
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.
NameofFirm '~ ~_F,j.,c~,~.~.,~.(,,~-7 "~.~i- Phone ,~7~--~'~[~
Address ~ '~ ~/ 15~ ~'1 ~ ~'
Engineer's signature
DHHS SIGNATURE
Approved'for
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
By:
AdditionalComments No.te: ~he well for this property meets existing
State and Municipal Co~es. There are nitrates present. It is
suqgested that a periodic testinq be performed to insure the wells
continued suitability. Nitrate concentration is 5.12 mg/1. EPA
~axim,lm C~nC~e~n~ i~ ln,~- mg/].
/
Th~ 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
profess;onal 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:
Parcel I.D. 0 / Y~ ~ -~ ' //
A. Well Data
Well type ~--
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Cased to
-/
If A, B, or C, attach ADEC letter. ADEC water system number ~'//A
Date completed !~'7'~ Driller
~ t Casing height
FROM WELL LOG
I 77
Date of test
Static water level
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot J J 0 +'
Absorption field on lot I ~..~ ~'
Public sewer main J~'/f~
Sewer service line .~ ~' 0
Wires properly protected (Y/N) "/ ~ --
AT INSPECTION
g.p.m, b,, ~'~ g.p.m.
.; On adjacent.lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~' ,
Date of sample:
Nitrate
~'~' i ~ Other bacteria
Collected by: ~ ~ ,
B. SEPTIC/HOLDING TANK DATA
Date installed '~/Z~/'?'7
Cleanouts (Y/N) y
High water alarm (Y/N)
Date of pumping
Tank size i 5'~- .~' O Compartments
Foundation cleanout (Y/N) y Depression (Y/N)
~'~//~ Alarm tested (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot J ! 0 ~'
To property line
Surface water/drainage
On adjacent lots
Absorption field
Foundation
Water main/service line
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
"Pump on" level at
High water alarm level
Meets MOA electrical codes (Y/N)
Manufacturer
Manhole/Access (Y/N)
"Pump off" Level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed ~ ~/7'7
Length L/~) Width /_~
Total absorption area ~¢ I.~( 0
Date of adequacy test ,,/~::)/~,.~-,i.
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
Soil rating (GPD/F¢) J-~C2 System type '~'~
Gravel thickness (-¢'~ Total depth
Cleanout present (Y/N) ~// Depression over field (Y/N) /%./
Results (pass/fail) ~ for L~ Bedrooms
After test
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot I ~
To building foundation
On adjacent lots ~'
Surface water ~
Curtain drain ~ i
On adjacent lots '~ /¢'~¢ Property line
To existing or abandoned system on lot
Cutbank N 0 v/-6. Water main/service line
Driveway, parking/vehicle storage area ~'
E, ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in e¢~ct On tt~b date of this inspection.
HAAFee$ /~,0
Date of Payment ,/~".~-4~.~ '~
Receipt Number ¢'~'--~(--)¢
Waiver Fee $
Date of Payment
Receipt Number
72-026 (3/93)* BBck
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264~4720
7))
Application Date J ~'~']/~'~'
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Applicant Name ('z~,~.-~. t~/~,~bVLP.]~ Telephone: Home ,~ ~/~'--0 ,~.~"~ Business
Applicant Address
(c) Applicant is (check one): Lending Institution []; Owner/bi,Co,er ~i~; Buyer []; Other [] (explain);
(d) Lending Institution J~¢14~"4C=JC'. ¢--.P--C-,~f Telephone ,~! - ~l/'q-~'O , -:'
Address f~.~ '/¢.~J ~,~..4)'oc4-J .~4~'~ /O'~
(e) Real Estate Company and Agent "~ i~
Address
Telephone
(f) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single-Family ~ Multi-Family [] Other
Number of Bedrooms ~
WATER SUPPLY
Individual Well~ Community [] Public []
Note: If communityf'' well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite~' Public [] Community [] Holding Tank []
/
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal a~fixed hereto and as of the validation date shown below, I verify that my investigation of this Heatth
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional'and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage flies and from my investigation and inspection,~ the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes ordinances, and regulations in effect on
the
date
of
this
Name of Firm /?, , Telephone
Engineer's Seal
'%,
DH.. Ap.ROVA,
Approved for "~°~'"' L~"~'.~ bedrooms bY ~ ,4~-. "~~ Date
APproved ~ '' Disapproved Conditional
Terms of Conditional Approva
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: L ~::)7'
WELL DATA
Well Classification
Well Log Present (Y/N)
Total Depth ~!~ ! Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments ¢
If A, B, C, D.E.C. Approved (Y/N)
Date Completed I ~"7 ? Yield
8 ! Depth of Grouting rh/o ~,1
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
l ~.0 + ; On Adjoining Lots
t~o.,,,/~' To Nearest Public Sewer
~oN ~-. To Nearest Sewer Service Line on Lot
~ c~. ; Date
~/~¢¢,-,4 1777
lZto q'
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N)
Depression over Tank (Y/N)
Size
Air-tight Caps (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
No. of Compartments '~
Foundation Cleanout (Y/N)
Date Last Pumped lZ/~_/~:,
"F'~'//-~ ;for
Temporary Holding Tank Permit (Y/N) 1~'/',,~
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
Ilo+
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
MUNICIPAl rrY n~ ak,,",~,", ....
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
4
RECEIVED
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed Z4/,~ '-2
Width of Field
Square Feet of Absorption Area &' ~ ~
Depression over Field (Y/N) N
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well ! ;20 ~u
To Building Foundation 20 ~
Lot ~/N~ ¢ ~4 6_-
To Water Main/Service Line .~ / U~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present) N
z/o -/-
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked verified~ or conformed to ail MOA and
Signed '~--~-~ Date I%/V/~ HAAguidelinesineffectonthedateofthisinspection.
Company MOA No.
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
Engineer's Seal
P.O. BOX 196650
ANCHORAGE, ALASKA 99519-6650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
December 8, 1986
Tobben Spurkland, P.E.
203 West 15th, C Suite 203
Anchorage, Alaska 99501
Subject: Lot 4 Block 9 Mc Mahon Subdivision
Waiver Request WR86-168
Dear Mr. Spurkland:
Your request for a waiver of the 100 foot separation required
between the well on the subject lot and the leachfield on the
adjacent lot (Lot 9 Block 7 Mc Mahon Subdivision) has been
granted. This distance has been waived to 88 feet. This
reinstates a waiver that was previously issued by this
Department.
This waiver is valid for the existing well and septic system on
the affected lots. Upgrades of these facilities must meet all
applicable code requirements. This waiver is valid for the
existing four bedroom single family dwelling only.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
CONSULTING ENGINEER ~ ~ ~ ANCHORAGE, ALASKA 99501
TELEPHONE: [907) 279-3916
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 6-6650
ANCHORAGE, ALASKA 99501
DECEMBER 4, 1986
MUNICIPALITY OF ANCHOJ~(3E
DEPT. OF HEALTH &
EN'./I ~ONM~.NTAL PROTECTION
DEC ,d., 1986
SUBJECT:
REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR
PRIVATE WELL. LOT 4, BLOCK 9, MCMAHON
Gentlemen;
We are submitting a request for waivers from the separation
distances stated in Title 18, Alaska Administrative Code Chapter
80.020
The well in question is located 88 feet from the end of the
leachfield on Lot 9, Block 7, McMahon. This leachfield is
running perpendicular to the street, 12 feet of the trench is
therefore within the protective radius of the well.
The Municipal Health Department issued a waiver, signed by Joseph
S. Blair, on February 10, 1977, when the Department was made
aware of this non-conformance. It is my understanding that
waivers issued in the past is not honored by the Department.
Therefore this request for an up-dated waiver.
Tobbe~ Spurkland P~E.
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-3915
LEGAL:
SEPTIC
S YS TEM: ADEQUACY
LOT 4, BLOCK 9, McMAHON
TEST
LOCATION:
OWNER:
3636 TAIGA
CARLA WARNER
RESIDENCE:
SINGLE FAMILY, FOUR BEDROOMS
WELL:
SEPTIC SYSTEM:
PRIVATE, ON SITE
FROM MUNICIPAL RECORDS:
TANK: GREER STEEL, TWO COMP. 1250 GAL.
ABSORPTION SYSTEM: TRENCH
ABSORPTION AREA: 640 SQ.FT.
SOIL RATING: i150
INSTALLATION DATE: MARCH 1977
DATE OF PUMPING: DECEMBER 2, 1986. ROTO ROOTER
DATE OF TEST:
DECEMBER 3, 1986
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND
WITH 7 FEET OF COVER AND EMPTY. CLEAN OUT TO
TRENCH WAS 7 FEET DEEP AND DRY. 6-INCH SUMP WAS 10 FEET DEEP AND
DRY. SUMP IS NOT PERFORATED, TRENCH PIPE CAN BE SEEN THREE FEET
OFF BOTTOM.
900 GALLONS OF CLEAN WATER WAS ADDED TO THE SUMP. WATER
LEVEL ROSE THREE FEET AND REMAINED AT THAT LEVEL. NO WATER
ENTERED THE TANK.
TEST RESULT:
THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of
how long the system will continue to,meet the operational requi-
rements of ~.~.~h~/~unicipality and State.
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-3916
RESIDENTIAL
WELL
INSPECTION
LEGAL:
LOCATION:
LOT 4, BLOCK 9, McMAHON
3636 TAIGA
OWNER:
CARLA WARNER
TYPE OF WELL:
SINGLE FAMILY
WELL LOG AVAILABLE:
INSTALLATION REQUIREMENTS MET:
SYSTEM. WAIVER
1977.
YES
NO. TOO CLOSE TO NEIGHBORS SEPTIC
GRANTED BY MUNICIPALITY IN
WELL· YIELD FROM WELL LOG:
pUMp YIELD:
· DATE OF INSPECTION:·.
5-10 GALLONS PER MINUTE
7 GALLONs PER MINUTE
DECEMBER 3, 1986
TEST PROCEDURE: ~ WELL WAS PUMPED AT A CONSTANT RATE OF 7
GALLONS' pER MINUTE WHILE THE DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE
DRAWDOWN STABILIZED. STATIC WATER LEVEL WAS FOUND 61 FEET BELOW
TOP OF CASING. WHEN PUMPED AT 7 GPM WATER LEVEL DROPPED TO 66
FEET AND STAYED AT THAT LEVEL. RECOVERY WAS INSTANTANEOUS.. A
TOTAL OF 900 GALLONS WERE PUMPED.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON
DECEMBER 3, 1986 . TEST WAS NEGATIVE.
TEST RESULT: THIS : WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is 150 gallons of water
per bedroom per 24 hours.This well surpasses this requirement.
The assessment of the condition of this well applies only to the
conditions as of this date. The flow rate of the well may change
due to subsurface conditions that may not be observed from the
surface, and changes in land use and other factors that may
impact the conditions of the aquifer feeding the well.
.........
~' . ~ . ~, ;'~
DEPT. OF ~::" T'~ ~- ......
MUNICIPALITY OF ANCHORAGE ENVIROh',,!;'.ENTAL ::. ,:. :CTION
..~__~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
) 925 L Street- Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10} days for processing.
I PHONE
P.OPERTYOWNER//?g Y 055
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
MAILING ADDRESS'
3. LENDING INSTITUTION I PHONE
MAI LING ADDRESS
4. REALTOR/AGENT PHONE
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE
SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF BEDROOMS
[] One [] Four
[] Two [] Five
~- Three [] Six
[] Other
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
8. SEWAGE DISPOSAL SYSTEM
:~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well Icg is required for all wells drilled
since June 1975. For wells drilled prior t~)thpt date, give well
depth (attach log if available.) DI( ~ ~//J/~ - (/J~.
**If individual/on-site, give installation date ~"~" -7 7
!f s;'stem is c':sr two (2} ;'e-~rs e!d ~ -~deq'-'-~c;· test !s requ!rcd.
by this Deportment.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
iNSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
~ INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
1~ INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified
INSTALLER
El]Septic Tank or •Holding Tank
Size: I~'~) If Tank is homemade SOILSRA~ING
give dimensions: /~L-~,
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
[] APPROVED FOR BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
~]~-~DISAPP ROV ED
DATE BY {Title) / /
LEGAL D~SCRIPTION
72-010 (Rev. 3/78)
1st Inspection: Time
Date
Inspector
4~ .... --,-~-,~/-~,MUNICIPALITY OF ANCHORAGE~
%" :~DEPARTMENY,'~,r HEAE¥1~.~AND, ~NVI.RONMENYAL ?ROTEC'~'I,ON-
. '~. 8,25 I, str~et~ Anc~oraqe, Alaska 995,01
279-2511~ e×t. 224, 225
Date Received: March 23, 1977
2nd Inspection: Time
Date
Inspector
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request: Alaska Bank of Commerce
Mailing Address: Pouch 7-012 99510 Phone: 279-5641
2. Property Owner: wilbur Dittbrender
Mailing Address; Star Route A Bpx 476-Y
Phone: 349'2235
Legal Description: Lot 4 BloCk'9 Mc Mahon SUbdivision ~2
4. Single Family Residence: (x) Number of Bedrooms: 2 ~
Multiple Family Residence: ( ) Number of Bedrooms:
e
Well Data: Type Individual
Construction ~
Depth
Bacterial Analysis
Well Log Filed ( )
On-site system (x)
Sewage Disposal System:
~/Permit # Installed '/? 7 7 ' Installer ~,~__?/~-~,
Septic Tank Size i~0 Manufacturer ~~
Absorption Area'~ Soils Rate /~--'~ Material
Public Utility ( )
Distances: Well to Septic Tank /~D /
to Sewer Lines Nearest Lot Line
to Absorption Area
Absorption Area to Nearest Lot Line
',Request' for".Approval of Individual~:.Sewer and Water Facilities · ·
Legal Description: Lot 4 Block 9 Mc Mahon Subdivision %2
Colnnlent s:
Affadavit Attached: (')
Disapproved:
Letter At.tached: ( )
Date:
Department Worksheet:
~' MUNICIPAL/?/ OF
.'; ..... ,,*' ~--. MUNICIPALITY OF ANCHORAGF'-..~ Pr. PT. O,. t', :~.',':~:;'. i .
:' ~"'xkx. J.' De artmen'~ of Health and Enviro~entc ']~'~%~'~dn'~C'~c'~lON-' .: :'
~ ~ ' .p
,/ ~ :' '825 L S%reet, ~chorage, Alaska 99501
- ,,:~~ . 279-2511, e~t. 224, 225 ~.~,,i.2 3 1,~/I . .
:~ ~/~ues% ~0r Approval of individual Sewer and W~C~~es
Mailing_ Address: ~~~ ~ ~.¢~~
/
2~Name of Buyer~~ ~
Mailing Address: ~ ~~ - ~ho~e:~
Mailing Address: ~~ -- ~/~ r~ Ph°ne:~ ~,~
4. Realtor/Agent: ~~,~ ~~
5. Legal D~scr~p~on:~~ ~ ~ ~~_.~~~
Re~donce: ~ Number o~ Bodrooms:
Family
/
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply: * Individual Well ~ ) Public/Community System ( )
If Individual Well, well depth /
If Communiay System, name of system~ ~~~
·
Sewage Disposal System: On-site Syste Public~ System ( )
If On-site System, date of installatio~r~/~/ ~j
~NOTE:
A well log is required on ALL wells drilled since 6/75.
/
3/77