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HomeMy WebLinkAboutLANG LT 2Lang Lot 2 #015-273-57 } Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5W9-7oz3 0 PID Number: 0I5 -" 2-1.�r57 Name: Wastewater System: �6 New E] Upgrade Address: o goy 9R 51 ABSORPTION FIELD Phone:n 4^ _ 33 / 4 bDESCRIPTION No. of Bedrooms: peep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL Soil Rating: Q Total Depth from originalgrade: �m .f U GPD/Sq. Ft. Lot: 2— Block: Subdivksion: G_ Depth to pipe bottom from original rade: 'Tn �. Gravel depth bQn$ath pipe 66 I� /• �i 9 Ft. Ft. Township: Range: Sectio Fill added above original grade, ' Gravel length: r +Ft. / IS' T . o 4.4- ' Ft. WELL: )k New E7 Upgrade Gravel width: 2 /� Number of lines: Distarn Jce tweenlin Ft. F /} Ft. Classification (Private, A,B,C): Q.XNJ4QT4 - Total Depth: I8-7 Ft. Cased To: 1 l6"7 Ft. Total absorption area: lb ZO + SQ. Ft. Pipe material: 9)3034 �j 61b Driller: Aup) Ir11✓ Date rilled: 2. �8 Static Water Level: 142 F,. Installer: V-tr4CAID Date installed: /5r9I- 9 i 9 Yield: Pump Set at: Casing Height Above Ground: u TANK 10 GPM / Ft. * Ft. SEPARATION DISTANCES t%Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: 1 Z50 From Tank Field Station Tank Sewer Lines 4 ,4 C 64 Well' + t fig # l08`_ ItMateria�l=.��� Number oCompartments: Surface « 100 4- fJ 1 4 NJA loo LIFT STATION Water loo _ Lot gb Z� ra fJJAN R �li„ Size in gallons: ufacturer: Line Foundation �'� I# —1.31 * N I A "Pump on" level at: " P o vel at: High water alarm at: Curtain t) 1p Pump Model Electrical Inspections performed b . Drain Remarks: BENCH MARK 'k4A.�1 - tA_a APplel 141X10%1 Location and Description: -IrDP or- d6ractlERE PAD 0( i�7 6PD/F-r Z wvAtca SvPPorKt Ura L..aT�-j PcD�snrn. l� st "I—H,EL" Cof2.1 Assumed Elevation: or= tori- 100.00 Fu ENC]] NKR S �. of �e O� i kyr 4r i ei. �0 t tiS �' .1A ,0 .," ...•� Y... Inspections performed by: Dates: 1s Wag�r�w 2nd 2/ Fkffr A. Ga•1ra�s � Department of Health and Human Services approval 4 ° �^ Reviewed and approved by: Date: mrd 72-013 (Rev. 9/91) MOA 25 ATOF.C.0 =5 B TO F.C.O, = 20 A TO Sl = 13.8 B TO Sl = 23.5 A TO S2 = 22 B TO S2 = 29 A TO CO2 = 93.5 B TO CO2 = 102 A TO MT = 68 B TO MT = 81 A TO COI = 45.1 C TO C01 52.4 T TEST HOLE H2 LOCATI PERMIT IkSW970230 PID, 015-273-57 DOUBLE 1250 GALLON SEPTIC INCH DIA, PVC, LOPED AT 1/4 INCH 'ER FOOT MIN, OUNDATION C/O - JANer _ C I E lRck c TEST HOLE FOR 'THE ORIGINAL DESIGN, AS—BUILT DWG: WELL & SEPTIC SYSTEM: LOT Z, LANG S/D PREPARED FOR: GRAHAM HOMES PREPARED BYi ALASKA WATER & WASTEWATER DATE: 5/31/98 DRAWN: GARNESS SCALE: V = 30' WELL ON LOT 3, LANG OF A .. Q A of e Gar ss, ��s CE 7953 Qorf pI'Dfessi°°°ate SW970230 PIDi 015-273-57 GROUND ELEV. OVER TRENCH IS 99.6 TO 100.3 MINIMUM COVER = 5.3 FEET 3I3 AS -BUILT DRAWING Ln c� �d [SEPTIC UPGRADE: LOT 2, LANG S/D (PREPARED FOR, GRAHAM HOMES (ALASKA WATER & WASTEWATER GROUND OVER TANK = 101.0 TO 101.2 COVER = 5.6 FEET. TOP OF TANK = 95.4 NEW 1250 GALLON SEPTIC TANK. INLET INVERT = 94,89, OUTLET INVERT = 94.65, —FOR LOCATION OF M.T SEE PLAN DRAWING ILTER FABRIC OVER DRAINROCK DATE: 5/31/98 ' DWN; GARNESS 4 INCH DIA., ASTM F810, PERFORATED PIPE A. INVERT OF DRAINPIPE = 93.95 B. BOTTOM OF TRENCH = 87.9 DRAINROCK DEPTH = 6 FEET C. TOTAL DEPTH BELOW O.G = 7.6' (NORTH END) TO 8.9' (SOUTH END). D. TRENCH LENGTH = 85+ FEET E. TOTAL ADSORPTION AREA = 1020+ SO. FT, THERE WAS NO BEDROCK, IMPERMEABLE SOIL, OR GROUNDWATER TO A DEPTH of AT LEAST 16.5 FEET BELOW ORIGINAL GRADE PER THE 9/8/97 TEST HOLE BY JEFF GARNESS, P.E. THE WAS APPROXIMATELY 2.6 FEET OF FILL. AT THE NORTH END OF THE TRENCH EXCAVATION AND 3.9 FEET AT THE SOUTH END OF THE EXCAVATION, SCALE, NTS .•Q...... A J f A. ss; —7953 Gv� s ' Q dp�0fassiosD�,© �DOOnQ�aQcy FROM . GRAH.RH HOhIES PHnHE HO. . 9017 522 465,5 11.=_y, , ..w'. I. ,.-,aYY�. ,rei..1'.Yt++•1; e' nL4'll_ STATE DP ALASKA DEPARTMENT OF NATURAL. RESPUR(;ES OIVI$K)N GF MINING & WATER MGIAT WATER WELL RECORD LOCATION OF WELL CONTRACTOR INFORMATION ���> .l /Gi f.�.::/.r r ry / '%r<.. .. 1'• S�V .'1 'Pti-.T..��e F Date REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: UNK/01VISION OF MINING St WATIR MGM'L 3801 4 St, Suite 8017 ANCHORAGE AK 99503.6935 Phone (907)762.2532,Fax 1907)562-1384 711:41 Y>gc;o BOROUGH aU1101VIKION LOT CLOCK . 99CTIONOTRS SECTION TOWh'BN,P PAN6E M R(OtAN N EE LOCATION/$RETCH: WELL OWNER! DEPTHS MEASURED FROM:12casing ❑ground WELL DEPTH: DATE OF top suiiane`I r / COMPLETION 60ASHOL.IE DATA: Depth Depth of holo; r ' .. it Depth of rasing;_ ;� %_ft Materlal Type and Color From To 'Awl t7EPTH TO 8 PATIC yVATFR DIEL: !� s' ��f•t Lelow kop of casing Cl ground surtace Data: f'��E..�r$.e3wt METHOD OF f)R1l,LIPlG: U..,r7ir rota+y cable tool .. t; ,% G• other..®..,,..- /� .� :_ �<,'z•r.� ¢r f,°� f I USE OF WELL: domestic irrigation monitor C. publiQ uUpply ± Ijrn '.Pel. /4 CASING Si1CK. Utas, f 7_ it, Ri im: 0 in to f�'4'--•l' ,. - ,..F'...w. l�'r s, !,^° .' .�=•- :Casing type ,:-r,�� m to ,�� ' l v s` •r fn�A F� ,, y �/, y WELL INTAKE OPENING TYPE: E] open end O scri-@ud ;/ G perforated Dwell hole Depths of openings: to it / - .: �I 1 ° ; .e, c . t , •t17 'd k� r _ . .. SCREEN TYPE . Warn; _ in. - Slot/Mesh Size,{t � GRAVEL PACK TYPE _e Volume Usad Dip n to top p qi 'ROUT TYPE Depth: from �. it .0 ft DEVELOPMFN'r METHOD: Duration: PUMPING; LEVEL AND YIELD: I t after �5 _..._ hrs Lumping, C W)W 9 v PUMP INTAKE [SEPTAL: _ _ it Hatef pe+ver: �y _ WELL DISINFECTInD UPON COMPLETION? .S -YES EI NO CONTRACTOR INFORMATION ���> .l /Gi f.�.::/.r r ry / '%r<.. .. 1'• S�V .'1 'Pti-.T..��e F Date REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: UNK/01VISION OF MINING St WATIR MGM'L 3801 4 St, Suite 8017 ANCHORAGE AK 99503.6935 Phone (907)762.2532,Fax 1907)562-1384 711:41 Y>gc;o 05-28--1989-0 10:31AM FROM LORI/MARY .'V IIF.n'rt TO 93383246 P. P-12 v: 25.00' C0'96', NORTH r�Otr.#7,oi0 S 3 _ .�S3 •2 >p pl ,CIL _ I • � rwa • V I i 1 1 I l.0 I -04 a i S. I •ar'at, r qpm 4nf 1�• 751 �T]� ' NG r1 Tyr ` 1 (NTS) •S tin 00y I •Qp' wsj+ •tI, Ca 40 •v I �of flo 5r, 1�yt ,�r�� 6`fn• 1 T 1 I f^ a d T, do E. EAI p Alaska Water & w a s tewal t er 7320 East Chester Heights Circle — Anchorage — Alaska 99504 Phone (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers December 11, 1997 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 -- _� Attn: Laura Montgomery Subject: Status of Well & Septic System documentation for Lots 2 & 3, Lang S/D. Permits were issued to Install the subject wells and septic systems. Lot 2 is SW970230 and Lot 3 is SW970090. Both lots were undeveloped and new homes are being built. The septic systems have been installed, however there are deficiencies with the Lot 3 installation that have yet to be corrected. The wells have yet to be drilled, and the developer has yet to order the as -built surveys. After the deficiencies have been corrected on Lot 3, the wells are drilled (and I can verify the separation distances to the septic systems), and the as -built surveys are completed (so I can determine separation distances to the lot line) I will complete the as -built packages and submit them to DHHS for review and approval. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. Sincerely, Jeffrey Qj1M arjs, P.E.,-� b i Princina/1 /I . I QNMENTAI. SERVICES DIVISK_ DEC i i 199 RECEIVED PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970230 DATE ISSUED: 7/31/97 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES EXPIRATION DATE: 7/31/98 OWNER NAME:LANG HERBERT C & JANET LEE OWNER ADDRESS: PARCEL 'ID:01527357 LEGAL DESCRIPTION: LANG LT 2 LOT SIZE: 49915 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE 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: L RECEIVED BY: �c�---�--n DATE: s ISSUED BY: le g, a_-e_,eA41kt�i� DATE: 07 <31' �/� _ PAGE 1 OF 1 T MUNICIPALITY OF ANCHORAGE r� DEPARTMENT OF HEALTH AND HUMAN SERVICES - P.O. BOX 1.96650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER'SW970230 DATE ISSUED: 7/31/97 DESIGN ENGINEER'ALASKA WATER & WASTEWATER SERVICES EXPIRATION DATE: 7/31/98..-.. OWNER NAME: T(fqHERBERT C' & JANET LEE OWNER PARCEL TD:.0152735�7, t . LEGAL DESCRIPTION. LANG LT. 2 SOT SIZE: 49915 (SQ. FT.) + , NUMBER OF BEDROOMS 3 THIS PERMIT: 3 THIS PERMIT ISS FOR,THE CONSTRUCTION OF: DISPOSAL FIELD%SEPTIC-TANK / WELL SYSTEM l "� ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: ,z THE ATTACHED APPROVED DESIGN. 2. ALL REQUIiFMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 1565.AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS".'(1-'8AAC72) AND DRINKING WATER REGULATIONS (18AAC80). N� 3. THE ENGIER;'"MUST'.NOTIFY DHHS AT LEAST 2 HOURS PRIOR:!TCS�E&CI4I'NSPECTION. PROVIDE NOTIFICATION BY CALLING;343-9744'( 2.4 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) i. FROM OCTOBER;-15;TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER''MUSTf BE -',EITHER: A.-OPENED,ANDJ:CLOSED ON THE SAME DAY B. COVEREDpSEA'LED'AND HEATED TO PREVENT FREEZING 5. THE POLLOWING''S.PECIAL PROVISIONS. SPECIAL PROVISIONS If, RECEIVED ;BY. f. , DATE: - �� �2- 3k ISSUED BY: 6[� Cxu%'yhGG�K DATE: ty 1. ) 41F Q��t s� p�.slb�•I Alaska wa celr & wastewater 8471 Brookridge Drive — Anchorage -- Alaska 99504 (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers September 15, 1997 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 �e tr,n IS j� �dd ErA en"n e o aE::>a aanao... �+1 y A. Gayness �lpOrO 'aar nq nen°� �.. Ref REVISED DESIGN PACKAGE: Well & Septic System for Lot 2, Lang S/D. To whom it may concern: A permit was issued by your department, on 8/4/97, for the subject installation. Since that time the contractor has decided to install a 4 bedroom septic system, and reroute the driveway. These changes made it necessary to move the proposed trenches outside the 30 foot radius of the initial test hole. As a result, we dug another test hole further to the north (see the site plan for TH location). The soil profile in this area did not have the "fill" that was encountered in the original test hole. Comments regarding the revised design are summarized as follows: 1. SOILS: Attached is a copy of the new soils log. The soils perked at 8 minutes per inch, but overall visually appeared to be in the .6 gpd/ft2. The primary and reserve systems fit within the 30 foot radius of the new TH. There was no water in the test hole on 9/8/97, and 9/13/97. The original TH (18' deep) established that groundwater is not an issue in this area. 2. TRENCH DESIGN: a. Percolation Rate: 8 minutes/inch. b. Allowable Application Rate: .6 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 1000 ft2 f Effective Depth: 9 feet g. Reduction Factor = N/A h. Width: 2 feet minimum i Minimum Length: 56 feet j Effective absorption area = 1008 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The lot is generally flat from north to south, and slopes gently downward, from east to west. A considerable amount of fill has been hauled into the west end of the lot (see the old test hole log) in the vicinity of the west (primary) trench. It appears that the original topography in this area was generally flat. The intent is to use the bottom of the test hole monitoring tube as a benchmark for establishing the maximum depth of the primary trench. The bottom of the trench will be at least 6 feet above the bottom of the test hole. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Thank you for your assistance. OMALLEY ROAD SEPTIC SYSTEM / ROPOSED WELL LOT IA, SECTION 21, T12N, R3W, S.M, COUNTRYSIDE CONDOMINIUMS. THERE i IS NO WELL ON THIS LOT. ALL OF THE STRUCTURES ARE SERVED BY COM- MUNITY SEPTIC SYSTEMS, THE SEPTIC SYSTEMS ARE GREATER THAN 40 FEET LO'T 1, LAND S/D FROM THE WEST PROPERTY LINE. IN PRIVATE WELL& SHORT, THERE ARE NO ENCROACHMENT SEPTIC SYSTEM, �CONCERNS. NO SEPARATION DISTANCE CONCERNS 4 LOT 5, LAND S/D UNDEVELOPED 0 LOT 4, LAND S/D. UNDEVELOPED, TH RADIUS NOTEI THIS IS NOT A SURVEY. THE LOCATION OF ALL WELLS, SEPTIC SYSTEMS, AND STRUCTURES IS APPROXIMATE. THE CONTRACTOR SHALL VERIFY THE SEPARATION DISTANCE FROM THE SEPTIC SYSTEM UPGRADE TO ALL WELLS ON ADJACENT LOTS. CLASS 'A' WELL SERVING LOTS IA, & ID, SECTION 21, T12N, R3W, S.M. 10936 ELMORE ROAD. COUNTRYSIDE CONDO- MINIUMS, REQUEST TO ADEC FOR CLASSIFICATION AS CLASS 'C' WELL WAS APPROVED 1/11/95. REVISED DESIGN FOR WELL & SEPTIC SYSTEM+ LOT 2, LANG S/D, PREPARED F❑R+ GRAHAM HOMES PREPARED DY1 ALASKA WATER & WASTEWATER DATE; 9/15/97 DRAWN: GARNESS SCALE+ I' = 100' J` .. . ... ....7 'i�. CJ9TT1899,� E-7953 oG NIPW k -v Prof 0661000\ a C/.❑ MT TEST HOLE #2 PRIMARY TRENCH 56 FEET LONG. RESERVE T 56 FEET NEW 1250 GALLON SEPTIC TANK. BURIAL RATING SHALL BE COMPATIBLE WITH ACTUAL BURIAL DEPTH OF TANK, 4 INCH DIA. PVC, J�SL❑PED AT 1/4 INCH / PER F❑OT MIN. DOUBLE C/ OUNDATION C/❑ r C/❑ ANfT LCE CIRCLE pROpp SFd 9 �` dFdROO^/ �TI ST�LE FOR THE ❑ IGINAL DESIGN. / REVISED) DESIGN FOR WELL & SEPTIC SYSTEM1 LOT 2, LANG S/D PREPARED F❑R1 GRAHAM HOMES PREPARED BY1 ALASKA WATER & WASTEWATER .. DATE: 9/15/97 7F GARNESS SCALE: 1' = 30' e ■ PROPOSED WELL % PROPOSED LOCATION FOR NEIGBH❑RING WELL 0 A' J f e A. a r �ne s s.,. " —7953 ' �4Q� 4..• . Qr°''e ......... F.°A> �Q a'OrofessW'G° ` Op��p4o� TOTAL TRENCH LENGTH = 56 'FEET. TOTAL ABSORPTION AREA — 1000 SQUARE FEET (MIN.). MAX. TOTAL DEPTH = 13' L • 2 FEET MIN. TRENCH DETAIL: LOT 2, LANG SID PREPARED FOR: GRAHAM HOMES ® BACKFILL WITH NATIVE SOIL AND MOUND. TOPSOIL AND RESEEDING SHALL BE THE RE- SPONSIBILITY OF THE HOMEOWNER. BUYER AND SELLER SHALL NEGOTIATE. FILTER FABRIC SILT BARRIER. PROVIDE 2 INCHES OF BOARD INSULATION IF SOIL COVER IS LESS THAN 3 FEET, INSULATION SHALL COVER THE ENTIRE WITH OF THE TRENCH. 4 INCH DIA. PERFORATED PIPE, WITH HOLES DOWN. SHALL BE LEVEL WITHIN .01 FEET. PLACE 2 INCHES OF DRAINROCK OVER TOP OF PIPE. TOP OF DRAINROCK SHALL BE AT THE SAME ELEVATION OVER THE ENTIRE TRENCH WIDTH. MONITORING TUBE (TYP). PERFORATED IN DRAINROCK. NOTE: 1. TRENCHES SHALL RUN PARALLEL TO THE SLOPE CONTOURS. 2. FOR LOCATION OF MONITORING TUBE, SEE SITE PLAN. 3. CONSTRUCTION PRACTICES, AND MATERIAL SPECIFICATIONS SHALL COMPLLY WITH ANCHORAGE MUNICIPAL CODE 15.65, °WASTE- WATER DISPOSAL REGULATIONS % 4. INSTALLATION SHALL COMPLY WITH SPECIAL PROVISIONS AS NOTED ON THE SEWER PERMIT. 5. SMEARED BOTTOM AND SIDEWALLS SHALL. BE RAKED. 6. DRAINROCK SHALL BE SCREENED PER M.O.A. SPECIFICATIONS. DIRTY DRAINROCK WILL BE REJECTED. ALASKA WATER & WASTEWATER SERVICES _DATE: 9/15/97 I DWN: GARNESS I SCALE: NTS (® Municipallty of Anchorage �.� DEPARTMENT OF HEALTH & HUMAN SERVICES ^ 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST / 1 " C_� \a�M Ii`t�s PERFORMED FOR: DATE P '"" ,'`" r. r. >•Y LEGAL DESCRIPTION:_ L -O' k Ljcw S (p Township, Range, Section:r1fl �— �S-LOPES rTTSITE PLANJ I FSR ,iaS ���!f I I I I I I I . I I 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 S WAS GROUND WATER b ENCOUNTERED? S IF YES, AT WHAT /4 0 DEPTH? P _ E Depth to Water Aller IJ,A „� Monitoring? Date: I Reading Date Gross Time Net Time Depth to Water Net Drop /v ZQ to 3 3op A,� `FU p 0 0 y ° — �• PERCOLATION RATE --B—'o (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN �' � FT AND g 0 FT COMMENTS V I S iJG--t (J y A-PRa q • 6 &I'D F PERFORMED BY: \ Jl� Lam'" E I .<1� ` S CERTIFY THAT TH S TE T WAS PERFORMED IN SU L,&, 1 OS L -J ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Alaska Water & Wastewater J NAGE 8471 Brookridge Drive — Anchorage — Alaska 99504NVIRONMENTAL SERVICES DIVISION (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers JUL. 24 1997 July 22, 1997 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well & Septic System for Lot 2, Lang S/D. To whom it may concern: hn C E VED OF IIA, � p� eR> aoaA9 nP E1 10 0 o a vn ®9H®.098 P 9a9. 9 BOa On. Pq OOP°a° °V9 f e A. Garne$s �f The subject property is currently undeveloped. Graham Homes is proposing to build a 3 bedroom house on the site, which will require the installation of a well and a septic system. Comments regarding the proposed systems are summarized as follows: 1. SOILS: Attached is a copy of the soils logs prepared by Anderson Engineering (Mike Anderson, P.E.). The soils on this lot perked at 21.8 minutes per inch. This corresponds to a trench application rate of .6 gpd/ft2. The primary and reserve systems fit within the 30 foot radius of the TH. There was no water in the test hole on 7/31/96, 8/10/96, and 7/21/97. 2. TRENCH DESIGN: a. Percolation Rate: 21.8 minutes/inch. b. Allowable Application Rate: .6 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 750 ft2 f. Effective Depth: 4.5 feet g. Reduction Factor = N/A h. Width: 2 feet minimum i Minimum Length: 84 feet j Effective absorption area = 756 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The lot is generally flat from north to south, and slopes gently downward, from east to west. A considerable amount of fill has been hauled into the west end of the lot (see test hole log) in the vicinity of the new trenches. It appears that the original topography in this area was generally flat. The new trenches will be installed below the fill, which is approximately 7 feet thick. There are no slope concerns associated with this installation. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Thank you for your assistance. Sincerely, Jeffrey#./GV#ss, RF;,,,pGI.S. OMALLEY ROAD i ROPOSED SEPTIC SYSTEM _(-PROF -� asl// LOT 1, LAND S/D I PRIVATE WELL& SEPTIC SYSTEM, NOSEPARATION DISTANCE CONCERNS AN �. er ee �IR�ce LOT 5, LAND S/D UNDEVELOPED 0 0 LOT 4, LAND S/D. UNDEVELOPED, TH RADIUS WELL LOT lA, SECTION 21, T12N, R3W, S,M, COUNTRYSIDE CONDOMINIUMS, THERE IS NO WELL ON THIS LOT. ALL OF THE STRUCTURES ARE SERVED BY COM- MUNITY SEPTIC SYSTEMS. THE SEPTIC SYSTEMS ARE GREATER THAN 40 FEET FROM THE WEST PROPERTY LINE, IN SHORT, THERE ARE NO ENCROACHMENT' CONCERNS. NOTEI THIS IS NOT A SURVEY. THE LOCATION OF ALL WELLS, SEPTIC SYSTEMS, AND STRUCTURES IS APPROXIMATE:. THE CONTRACTOR SHALL VERIFY THE SEPARATION IIISTANCE FROM THE SEPTIC SYSTEM UPGRADE TO ALL WELLS ON ADJACENT LOTS. WELL & SEPTIC SYSTEM, LOT 2, LANG S/D, 1 PREPARED FOR: GRAHAM HOMES PREPARED BY; ALASKA WATER & WASTEWATER DATE; 7/21/97 DRAWN; GARNESS SCALE. V = 100` CLASS 'A' WELL SERVING LOTS IA, & 1B, SECTION 21, 112N, R3W, S.M, 10936 ELMORE ROAD. COUNTRYSIDE CONDO- MINIUMS, REQUEST TO ADEC FOR CLASSIFICATION AS CLASS 'C' WELL WAS APPROVED 1/11/95, �F A uv ..L4� T'.. .1...: Jj ` —7953 0 �'OrofOBslo�O\ `.� r ZABEL FLOW SPLITTE PRIMARY TRE 42 FOOT LONG RESERVE 42 FOOT LONG EACH, DOUBLE C/ C/o — . J"/TT — C.lRCLf NEW 1000 GALLON SEPTIC TANK, BURIAL RAPING SHALL BE COMPATIBLE WITH ACTUAL BURIAL DEPTH OF TANK. 4 INCH PVC (D3034) %SLOPED AT 1/4 INCH/FT, MIN. / OUNDATION C/O MTi 'y ;� PROPOSED 3 BEDROOM i f ' —TEST LOCATION WELL & SEPTIC SYSTEMi LUT 2, LANG S/D PREPARED FOR, GRAHAM HOMES PREPARED BY, ALASKA WATER & WASTEWATER DATE) 7/21/97 DRAWN: GARNESS SCALES 1' = 30' PROPOSED WELL emu PROPOSED LOCATION FOR NEIGBHORING WELL Y OF A' r ... ff A. G ®ss: �J —7953 TOTAL TRENCH LENGTH = 84 FEET. TOTAL ABSORPTION AREA = 750 SQUARE FEET (MIN.). N wi — Q uj J ti J Jca uj Lu wT a° Q O uj m O w wtu� 4w W O Cc h 0¢caLu v mU.Jro 2 FEET MIN. 'TRENCH DETAIL: LOT 2, LANG SID PREPARED FOR: GRAHAM HOMES BACKFILL WITH NATIVE SOIL AND MOUND. Ala Pjp_�ID FILTER FABRIC SILT BARRIER. PROVIDE 2 INCHES OF BOARD INSULATION IF SOIL COVER IS LESS THAN 3 FEET. INSULATION SHALL COVER THE ENTIRE WITH OF THE TRENCH. 4 INCH DIA. PERFORATED PIPE, WITH HOLES DOWN. SHALL BE LEVEL WITHIN .01 FEET. PLACE 2 INCHES OF DRAINROCK OVER TOP OF PIPE. TOP OF DRAINROCK SHALL BE AT THE SAME ELEVA77ON OVER THE ENTIRE TRENCH WIDTH. MONITORING TUBE (TYP). PERFORATED IN DRAINROCK. NOTE. 1. TRENCHES SHALL RUN PARALLEL TO THE SLOPE CONTOURS. 2. FOR LOCATION OF MONITORING TUBE, SEE SITE PLAN. 3. CONSTRUCTION PRACTICES, AND MATERIAL SPECIFICATIONS SHALL COMPLLY WITH ANCHORAGE MUNICIPAL CODE 15.65, "WASTE- WATER DISPOSAL REGULATIONS % 4. INSTALLATION SHALL COMPLY WITH SPECIAL PROVISIONS AS NOTED ON THE SEWER PERMIT. 5. SMEARED BOTTOM AND SIDEWALLS SHALL BE RAKED. 6. DRAINROCK SHALL BE SCREENED PER M.O.A. SPECIFICATIONS. DIRTY DRAINROCK WILL BE REJECTED. ALASKA WATER & WASTEWATER SERVICES DATE: 7/21/97 1 UWN: GARNESS I SCALE: NTS OF A *' B000ae 0rp Ei (i too 6008 A t e . 1 a a 1000 haven e.n oea U � e A. Garners ' ^ ° ne.0p100„ E-7953 C`" /C 6661 Municipality of Anchorage E*-4 DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: G5"PAM 4Mm-S DATE PERFOAMED% 3) `� r' �, Z e r.iG Sufi. Township, Range, Section:_ SLOPE _ LEGAL DESCRIPTION: SITE PLAN DEPTH (FEET) 2 / I— ILL r " I ATL—"Fri JLI, 3 5 6- 7 7 8 ° 9- 12- 12 A' V GM 13- 14 3 14 6d i 15- 16 5 16 �c d•, 17 0 18 19 -� I-0—TrNine N9. 1 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? No, Depth to Water After Mnnilnrinn? After pate: 7 9L S L O P E Reading Date Gross Time Not Time Depth to Water Net Drop r*! 6717ql, iz: r9: 3n 10 7k Z. 1r': 49.30 3d 4 rt 3 4 N1,0 /Z -So In ql�I• 4 b 1:50 TO �b Z:z1 .30 47% !a� q + :.0 1.w?o '�` T11! 3 o 30 `i 1 31b 20 z�. PERCOLATION RATE __— (minutes/inch) FERC HOLE DIAMETER ®a TEST RUN BETWEEN _ 9 FT AND 10 FT Ts; N D r,E 1 �R.�s oAr�sD p2r o rL "rD ?Er7 co 4A"rr 0 N �� $'- COMMENTS � � ()4•�--� IS TEST WAS PERFORMED IN PERFORMED BY: CERTIFY THAT THIS ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) -tss�a�Cz Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-273-57 Expiration Date: 1. GENERAL INFORMATION Complete legal description LANG LOT 2 Location (site address) 4001 JANET LEE CIRCLE *ANCHORAGE, AK Current Property owner(s) Mailing address Real Estate Agent ED & ROBERTA DARBY Day phone 230-2000 4001 JANET LEE CIRCLE *ANCHORAGE, AK BRIAN BRODERICK W/ PRUDENTIAL Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: 273-7262 TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well Community On-site ❑ Public Water System Public Sewer ❑ Received by:/ ~ / Date: COSA to be released to the engineer, unless otherwise requested bytfie engineer. COSA Fee Date of Payment Receipt Number COSA # 1 3 Waiver Fee $ Date of Payment Receipt Number Waiver # rr- v` );r " /1 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 timT of installation. ) Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 + ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD_ attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MQA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The op era tional life of all wells and septic systems depend on the local soils condition, 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 evaluptor of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to most the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for bedrooms. Phone 337-6179 Date )0 1,611,3 System #2 Approved for bedrooms. \\\�Q \I � F ryV'r`5 Disapproved. ` 2 ON-S4TE y J Conditional approval for bedrooms, with the following stipulations g WATER AND -v WASTEWATER PROGRAM By: (/�!�–�/ L / 3 Original Certificate Date: — 3 Theunicipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11105) If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: LANG LOT 2 Parcel ID: 015-273-57 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 2/98 Sanitary seal (Y/N) YES Wires properly protected (YIN) YES Total depth 187 ft. Cased to 187 ft. Casing height (above ground) 18+ in. FROM WELL LOG Date of test 2/98 Static water level 142 ft. AT INSPECTION 4/20/13 136 ft. - Well`production 10 9.p.m. 5.78 g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate •Vomg./L. Collected by: GEG. Ltd. Arsenic: Nb ug./L. Date of sample: 9/27/2013 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 9/15-16/97 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 4/30/2013 Pumper ISAACS PUMPING C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 9/15-16/97 Soil rating (g.p.dfft or /bdrm 0_8 System type TRENCH Length 85 ft. Width 2 ft. Gravel below pipe 6 ft. Total depth *11.83 ft. Eff. absorption area 1020 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 4/20/13 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 22 in. Water added 640 gal. New depth 30 in. Elapsed Time: 120 min. Final fluid depth 27 in. Absorption rate >= 600+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date )eb/13 (Rev. 11/05) Municipality of Anchorage Community Development Department Development Services Division 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 # 131159 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 2 of Lang subdivision. This inspection revealed a nitrate concentration of 7.06 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. Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-273-57 Expiration Date: 1. GENERAL INFORMATION Complete legal description LANG LOT 2 Location (site address) 4001 JANET LEE CIRCLE *ANCHORAGE. AK Current Property owner(s) ED & ROBERTA DARBY Day phone 230-2000 Mailing address 4001 JANET LEE CIRCLE *ANCHORAGE. AK Real Estate Agent BRIAN BRODERICK W/ PRUDENTIAL Day phone 273-7262 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ QD,o Date of Paymenta�<3 Receipt Number COSA# 05Gl3G�b� Date: :S Waiver Fee $ _ Date of Paymen Receipt Number 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. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSO Guidelines & Regulations. The reported results described 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 soils condition, 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner fisted above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date 14 3 bedrooms, with the following stipulations: tOE(IAIVC411� G ON-SITE WATER AND WASTEWATER Original Certificate Date: The '1v1(inicipafity VAXk. orage Develop,emt 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 o omissions in the professional engineer's work. 7. ATTCHMENTS: / COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11/05) If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: LANG LOT 2 Parcel ID: 015-273-57 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 2/98 Sanitary seal (YIN) YES Total depth 187 ft. Cased to 187 ft. FROM WELL LOG Date of test 2/98 Static water level 142 ft, Well Log (YIN) YES Wires properly protected (Y/N) YES Casing height (above ground) 18+ in. AT INSPECTION 4/20/13 136 ft, Well production 10 g.p,m, 5.78 g_p,m, WATER SAMPLE RESULTS: Coliform C) colonies/100 ml. Nitrate s• 3 ymg./L. Collected by: GEG. Ltd. Arsenic: mug./L. Date of sample: 4/22/13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 9/15-16/97 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 3v 3 Pumper 1 Sc, a c S V�� mpt?'Ig C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 9/15-16/97 Soil rating (g.p.d./ft2or /bdrm 0.8 System type TRENCH Length 85 ft. Width 2 ft. Gravel below pipe 6 ft. Total depth * 11.83 ft. Eff. absorption area 1020 ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/20/13 Results (Pass/Fail) PASS Fluid depth in absorption field before test 22 in. Water added 640 gal. Elapsed Time: 120 min. Final fluid depth 27 in. Absorption rate >= For 4 bedrooms New depth 30 in. 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date - D. LIFT STATION Date installed "Pump on" level at in. E. SEPARATION DISTANCES Size in gallons "Pump oft" Manhole/Access water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout N/A Holding tank Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, paridng/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I cePoly that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 01 113 (Rev. 11/05) Municipality of Anchorage Community Development Department Development Services Division 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 # 131159 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 2 of Lang subdivision. This inspection revealed a nitrate concentration of 5.34 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. MUNICIPALITY OF ANCHORAGE pa DEPARTMENT OF HEALTH & EIUMAN SERVICES �! Division of Environmental Services '� 1 (1 On -Site Services Section JUN 0 1 1998 P.O Box 196650 Anchorage, Alaska 99519-6650 343-4744 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ' Parcel I.D. # t� ~ ):-13 -- HAA # _AA !2�SS `1 � 12 1. GENERAL INFORMATION Complete legal description La' i 2, LAA S �Q Location (site address or directions) Jl;— �ft2CC Property owner L.Le.�-�-t* t� Day phonei`�3�� s Mailing address Lending agency Day phone -� Mailing address— Agent ddress Agent c cls- ltill-4 ucto ( l Gl P, D y phone -7� Z — _386 Address _ Unless otherwise requested, MAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3.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. 4. 'HYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank _ Community on-site _ Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOA#21 - - - 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my .investigation' of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site 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 is inspection. Name of FirmPhone 1-76i Alaska Address 7320A_5_1;C s r s irci Engineer's signature chara S Date %ale Wa—­j, F__r2_ Ph-;��..,F14 Ce)N a.eIt ft awtva.� _ "V 7 ' ChifTYtOi ♦. w 00 7953 6. DHHS SIGNATURE t' nAa'Qpo�,« �. Approved for FO U bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date G Z7 q - g g e 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 orderto 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#21 - - I\L%..LI v LU JUN 0 1 1998 +.r Municipality of Anchorage MUNICIPALITY OF ANCHMGE DEPARTMENT OF HEALTH& HLIMANE8 VC994sERVICESDIVIsION Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist 54- Legal Description: 1-o T Z -e L4,1 C" � /6 Parcel I.D.:_ �✓' A 73 A. WELL DATA Well typeV i ' _ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Z 9 Total depth IS -7 Cased to 1 g7 Casing height (above ground) Sanitary seal (Y/N) `j ES Wires properly protected (Y/N) _ % f' FS FROM WELL LOG AT INSPECTION Date of test �/ q 6 Static water level 14--z Well production to g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform �j/ Nitrate 1`o4 rk § Other bacteria Date of sample: 151h,1r98 Collected by: 14 LUw `� CW B. SEPTIC/HOLDING TANK DATA 199 Date installed ��_ Tank size 1250 Number of Compartments Cleanouts (Y/N) Foundation cleanout (WN) _ Depression (Y/N) N High water alarm (Y/N) _ N14 '2 LL Date of Pumping N 5L� Pumper NUJ -2 C. ABSORPTION FIELD DATA Date installed q q+ Soil rating (g.p.d./ftz or ft2/bdrm) System type 's Length y 5 + Width Zf + Gravel thickness below pipe ! Total depth � (`7 "rO Effective absorption area I 0 O + Monitoring Tube present (Y/N)_�_ Depression over field (Y/N) _0 Results (Pass/Fail) For bedrooms Fluid depth in absorption field before a �;. Immediately after_ gal. water added (in.): Fluid depth (ins) Minutes later Absorptionnrr tB _g.p.d. Peroxide treatment (past 12 months) (Y/N) _`, If yes, give date — 72-026 (Rev. 3/96)* D. LIFT STATION Date Manhole/Access (Y/N) High water alarm E. SEPARATION DISTANCES Size level at* "Pump off' level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot �dV ff- On adjacent lots IDD f+, Absorption field on lot6U On adjacent lots jCyff- Public sewer main MjAA Public sewer manhole/cleanout rJ r Sewer /septic service line 2 ~' '1" Lift station N r4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation t,,�� t Property line �r'I Absorption field Ju tlove' PvT-' Water main/service line IQ "t- Surface water/drainage I OOr4- Wells on adjacent lots amu` 43UP.LJ e. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line la + Building foundation 10 l`4- Water main/service line to (+ r r�, Surface water Driveway, parking/vehicle storage area t avr Pv ' Curtain drain N A Wells on adjacent lots t f ugac, 4- F. ENGINEER'S CERTIFICATION n f_.a�p��®®s I certify that I in conforman spections and review of Municipal in effect on this date. Signature k--� Engineer's Name % / ` Date HAA Fee $ Date of Payment Z Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number F AC Q;.x rn, r��1 cx�• 2C 3 e . 7953 tate MAY -2/-1999 19:44 CTE ESI AlgCHORAGE CTs[ Environmental Services Inc. u r. siis�ini�ei�t�v�l►iw.rw� ChemLab Ref. +1: 98.2430-1 Client Name: AK Water & Wastewater Services Project Namer We Client Semple ID: L2 Lange $/0 Matrix: Drinking Water PWGID n/a 90756/57,0= P.02:07 Client PD#: nla Printed Datefrime: 6/24/9818:00 Collootsd Datafrime: 5/20198 15:45 Received Datefrlme: 6122/98 09:55 Technical Director: Stephen E=de Released By; Semple Remarks: Allowable Prop Analysis Parameter Resuitc PQL Units Method Limits Date Date Init Total Coliform (MF) 0 0011100 ml SM9222B 6/22/98 TMW Nitrate 1.040 0.1 mg/L EPA 300 10.0 6/22198 RMV