HomeMy WebLinkAboutBONNIE VIEW LT 6Bonnie Vi w
Lot 6
#017-422-15
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 ~,,~
www.ci.anchorage.ak.us (907) 343-7904 Page
On-Site Wastewater Disposal System and/or Well Inspection Report
PID Number: 017--422--15
Name:
GENE HECKLER Wastewater System: [] New [] Upgrade
Address:
12641 NEHER RIDGE DRIVE * ANCHORAGE, AK. 99516 ABSORPTION FIELD
No. of Bedrooms:.~ Deep r'lot~
Ph°ne:(,907)' ' 257-0116 [] Trench [] Shallow Trench E] Bed []Mound
LEGAL
DESCRIPTION
-- GPD/Sq. Ft.J -- -- Ft.
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Grovel depth ~d~th pipe:
6 BONNIE VIEW - Ft.J -- Ft.
Township: Range: Section: Fill added above original grade: ~ length:
Gravel width: ~ Number of lines: Distance between lines:
WELL: [] New [] Upgrade --~ Ft. -- -- Ft.
Classification (Private. kB.C): Total Dep~.tb~/ Cased TO:(BEDROCK) Total absorption cre~',/ Pipe material:
__ ~-- Ft. -- rt. / -- SQ. Ft. --
Driller: __~~ Date Drilled: Static Water Level:/Installe~/''~ Date installed:
TAN
K
GPM -- Ft. -- Ft.
SEPARATION DISTANCES · Septic [] Holding [] S.T.E.P. [] Other
T~To Septic Absorption Lift Holding Public/Private Manufacturen Capacity in gallons:
Tank Reid Station Tank Sewer Lines GREER OR ANCHORAGE TANK 1500
Material: Number of compartments:
Well 100'+ - - - 25'+ STEEL 2
.... LIFT STATION
Surface
Water
lOO'+
Size in gallons: Manufacturer:. /
Lot Line 5'+ .... _
'Pump on' level ct: ~ot: High water alarm ct:
Foundation *UNKNOWN ' -- -- -- -- _~_ _
Curtain Drain ' NONE KNOWN . Pump~ Electrical Inspections performed by:
I I
,~ -
Remarks: BENCH MARK
Location and Description:
SEPTIC TANK INSTALLED IN 1986, FOUND TO NORTH END OF GARAGE SLAB AT FRAME
BE OF GOOD INTEGRITY VERIFIED BY G.E.G. Ltd.
ON 7/28/2004. *, .... d Elevation: 1 00.00 Ft.
ENGINEER'S SEAL
· 4.9' FROM CO TO FOUNDATION. EXACT DISTANCE UNKNOWN.
DOCUMENTATION OF EXISTING SEPTIC TANK (REVISED 6/27/2011) ~"--/'"~:""~ ....//' .'i"'/'¢:" '"~.k~.~
Inspections performed by: GEG, Ltd. Dates: ~st 7/27/2004 t~........:~.;i~?. .......
3rd ¢~ ~ '..~/effr ~,~/A Garn~ss.'
V,-'~ ~' " '
Development Services Department¢ Approval ~l[~% ¢,.~' '":" :/...~/~.-/./,~r
~,~ 'Otess~U"
AS- BUILT D RAWlN G ~^~°~'o,~-~-,, '~ ~:
I
I
I
IIt REVISED 6/2011
I BONNIE VIEW S/D
I
/ EXISTING DRAINFIELD
/ I / 1500 GALLON
t // / ~,,~ ~
'.. ..i.., .... ~., ..... ~ ~EDROO~
~:'..';...: . '. · .-~ ~ HOUSE
~~...~..~:i ... '.:-' ".:' 'L:.'" .".' :' .":' ""-"".: ;-~ ....'~ .:, ~.';t..,,'.-': ~ ~
.;': ~. ".,;'. "-'-;;.....'.~'~o :-, '. . ...-. .
[ 2" STEEL MONITORING ST1 .5
I ~ - TUBE INSTALLED ON ST2'~ 15.75
I \ 7/12/o4. BY
DISCOVERY DRILLING.
~'- THE MONITORING TUBE/SUMP?
44.5
A B
ST1 6.5 42
ST2\ 15.75 44.5
THAT was SHOWN ON OLD INSPECTION
LOT 7,
REPORT NO LONGER EXISTS. BONNIE VIEW S/D
I
I
I
DATE:
GARNESS ENGINEERING OROUP, Ltd. SOA~[:
CONSULTANTS & GEN,RAL CONTRACTORS
BONNIE VIEW SUBDIVISION; LOT 6, (907) 257-0116 2 OF
~.~ .~c.~. ~k~"' '~t*~.1'"''~~
~PE OF WORK: ~k~rofessiO~
AS-BUILT DRAWING OF EXISTING SEPTIC TANK (REVISED)
NOTE: TANK WAS EXPOSED
AND INSULATION WAS FOUND
ST 1 ST2
TOP OF TANK AT ~
EXISTING 1500 GALLON
INVERT OF BUNG SEPTIC TANK INVERT OF BUNG AT
AT INL~ = 97.04~ ~ OUTL~ = 96.90
(CALCU~TED)
(CALCU~TED) ~
EL~ATION ~ ~
SHOT OF BOSOM OF/ EL~ATION SHOT OF
TANK AT = 92.79J BOSOM OF TANK AT
= 92.82
, 7/28/2004 ~r
GARNESS ENGINEERING GROUR . R.A.L. ' ", ' ' "~+'~
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ..........
BONNIE VIEW SUBDIVISION; LOT 6 ~
PROFILE AS-BUILT OF EXISTING SEPTIC TANK '%%~
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-S TE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date issued: Sep 09, 2004
Expiration Date: Sep 09, 2005
Permit Number: SW040379
Legal Description: BONNIE VIEW LT 6
Design Engineer: 0855 Garness Engineering Group, LTD
Owner Name: GENE HECKLER
Owner Address: 12641 NEHER RIDGE DR
ANCHORAGE, AK 99516-3319
Parcel ID: 017-422-15
Site Address: 012641 NEHER RIDGE DR
Lot Size: 33000 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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 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.
Date:
Received By:
Issued By: ~ Date: ~/e//~
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P,O. Box 196550 Anchorage, AK 99519-6650
www.ci.anchorage .ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
Permit Number SW
Property owner(s) ~
Mailing address (1} ~;~,(~. ~')¢_~'r,
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
Lot Size .~").'~;~L"'~("") Acres~ Number of Bedrooms
Day phone
Zip Code
THIS APPLICATION IS FOR:
Sewer Only []
Sewer and Well []
Sewer Upgrade []
THIS PROPERTY CONTAINS:
Hot Tub []
Swimming Pool []
Therapy Pool []
Well Only []
Water Storage []
Jacuzzi
Water Softening Unit
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Date of Payment: (~/ "7/O q
Receipt Number: ~ '-/~;z'~'"~_ i
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
& MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
flPHONE LJ UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
~ ~ ~o~Nte Vv~
LOCATION NO. OF BEDROOMS
Well I Abso~on ar Dwelling ~,/_ PERMIT NO.
m<~ Z Manufacturer ~ ~¢¢~ Materiag Ve~ ( No. of com<tments
~ ~ Liq. capacity in gallons Inside length Width Liquid depth
[~-0 IF HOMEMADE:
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
~Z
O Z ~ Manufacturer Material Liquid capacity in gallons
~.~= DISTANCE TO: ~o~Well t~ ~'~ Foundation ~O ~ Nearest lot line ~_ / P~.
~ ~~ No. of lines Length o~ each line Total length of lines Trench width Distance between lines
~ ~ Top of ti~e to finish grade Material beneath tile Total effective absorption area
Length Width D0pth PERMIT NO.
~ ~ Tvpe of crib Crib diameter Crib depth Total effective absorption area
m Well ~uilding foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TQ: Building foundation ~ Sewer line Septic tank Absorption area(s)
OTHER
c "
SOIL TEST RATING
INSTALLER
REMARKS
APPROVED DATE LEGAL
72-013 (Rev. 3/78)
PERM
DEF'F~RTMENT ._,-' HEFfLTH FIN[:, EN'v'I RO,NMENTFIL. ~-:ROTEC'1' I ON
825 "L." STREET., RNCHORFffGE, FIK.
264-4'720
< 82019E;
!::IPF'L. t E:FI.NT
LOC.':FIT I ON
L. f.:".' G E~ L
CHRRLES EE. HECKLEF.:
L6 BONNIE VIEN
t S:.~4 0 PR"FT'EF.%ON
LOT SIZE
TYF'E OF SOIL I::IBSOF.:F"T!ON SYSTEM IS: DRRINFIELD
MI:~XIHUH NUMBER OF:' BEDROOMS =- 4
sO l L RFIT ! NG ,.'; SQ F'T',.-"E~R :-', = 2E:ID
THE REQIJtRE[> SiZEE OP" THE: SO! L. F!BSORF'TION SYSTEM I:5:
THE LENGTH C, IMENSiON IS TFIE LENGTH <IN FEET;:, OF 'THE; 'TRENCH OR DRFtlNFIEL. E:,.
]"HE DEPTH OF R TF..'ENCH OR I::'];T .'[:L:; ']"HE DZSTFtNCE E:E'Tf.,.!EEEf.,! THE SURFRCE OF' THE
GROUN[.', RND THE BOTTOH OF' THE E::'::CFfVRTION <IN FEET>.
'I"HE '"'P'-",'"' .
.~r,n,,~_.. E:'EF'TH IE; 'THE; MINIMLIM [:'EPTH E}F GF,:FI',?EL E:E",r'HFEN THE; OLrl"F"FILJ_ PIPE
FIN[;:, THE BOTTOM OF' THE EXCRVRTION ,'.; ZN FEE'T'>.
IF.'-".: E E;::_, L.3 ]E FY: E] [::, ;L::Z; E: F::" 'T Z: C: -F' i::~ P,,I ~-::'.' .rE; :it ;.:":&". EE == ::It_ 2: ."..~'; AE~ ~Z~ F::~ L. L. (;,.-.~ ~..41
PERMIT FtPF'Lt CANT HRS TI.YE; RESPONE;IE:IL ! TY "rE) INFORM '!"HI S [:,EF'FtRTMENT [:,URING THE
INE;TRLLF~TION tNSF'ECTZON':S OF' RNY f,.IELLS Ft[:,JFtCEN'T TO THZS PROF'ERT'Y FIND THE
NUMBER OF RESI[:,ENCES.; 'THAT THE HEL. L HIL. L SEF..'VE.
E:RCKFILL!NG OF' FIN. Y SYE;TEM H!T'HOUT FtNRL !NSPEE:T!ON RN[:, RPF'ROVRL. E:Y THIS
DEPF!RTMEN"r' HILL. BE: SUB..IECT TO F'F..'.O:E;E]CUTt
MINIMUM [:,!:..T, TRNCEE BE'I"HEEEN Fl WELL. FINE:, ANY ON-:~ITE SEHRGE D!SF'OE;FfL. :!i;'T'f.:¢TEM
:I. EE F'EE:T F(]R Fl.F'RI ,,,,._¢¥rr: HELl ..... '"iF."-I!=¢~. ........ TO 2fF.¢~.~ FEET.. ,¢'rY"~M ....... F~ F'LIE:L..IC t,.IEL. L [:,EPENIT.:,]JNf'k
UPON "['FIE 'TYF'E OF' F"UE:LIC NELL..
M!t'.,IIMUH D!STRNCE F'ROM F:I f:'F.:IVRTE NELL TO R PR!VFFi'E SEHER LINE iS 25 FEET
TO R COMHUNITY SE!,qER L. INE I:E; T'"'5 FEE:T,
I.,.IiEL. L. LOGS RRE: F.:EQUIF.'.'ED RN[:, HUST BE F-/ETURNE[:, TO 'T'HE [>EF'RR"r'MEN'T' Ni"THZN ]:E~ DRYS
OF THE NEL. L. COb!PL..ETlON.
OTHE:F..': REQUIREMENTE; I'!RY RF:'PLY. SF'E:CIFiCRTIONS FiND CONE;TF:UC'TION E:,IF~GF.:.RMS
FF,,'FI.I: LRBLE TO INSURE PF..:OF'EF.: Z NSTFd_LEYT I ON.
I C.:ERTIFY THFf'F
i: I FIM F'RMILIFtR H!TH THE RE:QUIREEMENTS F"OR ON-SIT'E SEHERS RND HELLS !:~S SET
FOF::TH BY THE MUNIC!F'RL ITY OF F~NCHOF::F!GE.
2: I NILL.. INtL:;TRL. L TH.E SYSTEM IN RCCORE:,F',NCE HI'TH THE CODES.
]:: I UN[:,EF.:S'f'F4ND THF!T THE ON-.SITE SEI.,.!EER SYE;TEM MR'.P REL.]UtRE ENLFIRGEMEN"F IF:' THE
RESt I.':,ENCE i:E; F.':E:MOE:,ELE:E:, TO IN(.'.':L. UE:,E MORE THFIN 4 E:EE:,ROOHS.
SOILS LOG "' :
4
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
"l
WAS GROUND WATER
ENCOUNTERED?
I
PERCOLATION
TEST
DATE PERFORMED: L~.,._, /~'~'~Z
SITE PLAN
S
L
O
P
E
PERFORMED BY: ~/
Reading Date Gross Net Depth to Net
Time Time Water Drop
9 ~; ~ ~ I0 ~i~ I, ~. O, O~
PERCOLATION RATE ?Z- (minutes/inch)
g FTAND ? FT
.7~../~(~ST RUN BETWEEN
72-008 (6/79)
INVOICE NO.
1421
MUNICIPALITY OF ANCHORAGE
[~F'T Cc '.C".':"'t ~'
ENVhL ..;it I, /-,.; .O F ;: I
SOLD TO
STREET & NO.
CITY CITY
C-'~STOMER'S ORDER ~-- SAL£sMAN TERMS VIA F.C~.B.' '
~Pb-iZA T~-LY HA~P .........
7H 736
INVOICE
APPLI¢ 'NT FILLS OUT UPPER ' ONLY
Proper.h, Owner
Mailing
Buyer
/7~/~,,~ (~, /.:2~. Zip Code
Phone
Ad, ress
Zip Code
Lending Institution
Realty Co. & Agent
Phone
Phone
Address
Zip Code
Legal Description
Street LOcation
Type of Residence
.[~ngle Family
[] Multiple Family
[] Other
No. of Bedrooms 2
WSer S pPlY
.J,~ndivldual
[] Community
[] Public Utility
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
For wells drilled prior to that date. give well depth (attach log If available).
Sewer D~isposal
~ndividual
[] Public Utility
[] Holding Tank
Year Individual Installed: .,~
When Connected to Public Utlilty:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time f,.~L~ Time 0~_0 ~"~
Date Date Date Date ~ ~
Insp~tor Insp~tor Insp~tor Insp~tor ~
'' ' -- ~UNICIPAU~ OF ANCHORAGE
( ) CONDITIONAL APPROVAL* ~ --~ -- ~ ~ -- 8 ~
DATE ~ ~ ~ ~ ~ ~ ~ ~
BY:
Soils Rating Date ~wer Installed Well To Absorption Area ~ Well Log Received
72-023 (3182)
September 23, 1982
Herzog Construction
P.O. 10-237
Anchorage, ~ 99511
Subject: Lot 6 Bonnie View Sub.
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
The top of the well casing sealed with a sanitary seal so
that it is water tight.
The depression or pit around the well casing needs to be
filled with impervious type soil so that it slopes away
from the well casing.
" Exposed electrical wires to the well head are in violation
of the ~unicipality of Anchorage codes and must be encased
in conduit.
0 The water analysis report needs to be submitted to this
office from the Chem Lab, 5633 B Street, for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
RP192/p/EH
Robert C. Pratt
Associat8 Environmental Specialist
CERTIFICATE
' FOR A
Municipality of Anchorage
Development Services Department
Building Safe~/Division
On-Site Water & Wastewater Program
4700 Eimore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
OF ON-SITE SYSTEMS APPROVAL
SINGLE FAMILY DWELLING
Parcel I.D. 017-422-15
1. GENERAL INFORMATION
O
COSA# O ('-~ (~
Expiration Date:
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
M~iii'r~ address
BONNIE VIEW S/D; LOT 6
12641 NEHER RIDGE DRIVE * ANCHORAGE~ AK * 99516
RALPH & CAROLYN CHEEK Day phone
12641 NEHER RIDGE DRIVE * ANCHORAGE~ AK * 99516
Day phone
BRIAN BRODERICK W/ PRUDENTIAL Day phone 227-7671
5801 CENTERPOINT DRIVE, #200 * ANCHORAGE~ AK * 99505
:Unless ethe~'e .requested, COSA will be held by DSD for pickup.
NUMBER OF BEDROOMS: 5
3. TYPE OF WATER SUPPLY:
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 []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEkr,'ENT OF INSPECTION BY ENG!NEE~
As certified by my seai affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of Qn-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater o'ic~osa! ~/stem is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further veKfy that based on the
infom~ation obtained from the Municipafity of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compfiance with afl applicable Municipal
and State codes, ordinances, and regulations in effect at the time of fl~staflation.
Name of Firm. GARNESS ENGINEERING GROUP, Ltd.
Phone 357-6179
Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date
o
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 MOA
DSD 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 daft 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 dhow 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 listed above. Any reliance upon or use of this repoR by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
DSD SIGNATURE
___L_~,/Approved for 3
bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Attachments:
Septic System Advisory
Well Fiow Advisory
~,~, at~ ,~,dv;~u~ y Other
By:_ __~_z~
(Rev. 11/05)
ArsePiC Advisory
Maintenance Agreements
Supplemental Engineer's Report
Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
CERTIFICATE
OF ON-Sll( ? MS APPROVAL CHECKLIST
Legal Description:
BONNIE VIEW S/D; LOT 6
Parcel ID: 017-422-15
A. WELL DATA
Well type PRIVATE
Date completed
Total depth 227
*BEDROCK @ 21.5', PER WELL LOG.
9/1982
ff.
If A,' B, or C provide PWSlD# N/A
Sanitary seal (Y/N) YES
Cased to *50.5 ft.
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
YES
YES
12+ in.
Date of test
FROM WELL LOG
9/1982
AT INSPECTION
6/22/2011
Static water level
UNKNOWN ft.
24 .ft.
Well production
1.0 g.p.m.
5.52 g.p.m.
WATER SAMPLE RESULTS:
Coliform (~ colonies/lO0 mi.
Arsenic: I'J~D ug./L.
Nitrate
Date of sample: 6/22/2011
Collected by: GEG, Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL
15"o0
Tank size ..1-eOO-+--flal. Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
Date of pumping ~ 1~ 0 /l ~ Pumper ~,,~,~
Date installed * 1986
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A
C. ABSORPTION FIELD DATA
Date installed 8/9/1982
Length f~ + 81)
TOTAL ft.
Total depth '6.7/8.0ft. Eft. absorption area 1415 ft2 Monitoring tube YES
Date of adequacy test *'6/23/2011 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 25 in. Water added 600 gal.
Elapsed Time: 120 min. Final fluid depth 29.5 in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date
**HOUSE WAS VACANT AT TIME OF TEST. DRAINFIELD WAS PRE-SOAKED ON 6/22/2011 WITH 2155
GALLONS OF WATER. PRE-SOAKED AND TESTED SOUTH TRENCH ONLY. NOTE: MT FOR NORTH TRENCH
WAS CRACKED SUB-GRADE. MT EXTENDS BELOW THE CRACK TO A TOTAL DEPTH OF 6.7' BELOW GRADE.
TOTAL DEPTH CAN NOT BE VERIFIED BECAUSE OF POSSIBLE SOIL INTRUSION.
[*BELOW EXISTING GRADEI
Soil rating (g.p.d./ft2or~ 280 System type DUAL WIDE TRENCH
Width 5 ft. Gravel below pipe 4 ft.
Depression over field NO
For 3 bedrooms
New depth .31 in.
600+ g.p.d.
D. LIFT STATION
Date installed
"Pump on" level at in.
Datum ~
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Size in gallons Manhole/Access (Y/__~_) ~
"Pump off" leve~.-~ High water alarm level at
Cycles tested, Meets alarm & circuit requirements?
100'+
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25%
Animal containment areas, 50%
in.
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/'A
100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation *4.9' FROM CO Property line. 5'+
Water main N/A Water service line 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Absorption fie d, 5'+
Surface water 100'+
Property line 10'+
Water service line 10'+
Curtain drain NONE KNOWN
COMMENTS
*PER 2004 GEG H.A.A.
Building foundation. 10'+
Surface water 100'+
Wells on adjacent lots 100'+
Water main N,/A
Driveway, parking/vehicle storage
I'-F
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 Print~l N~me JEFFREY A. GARNESS
Date 7/~/II
COSA Fee $
Date of Payment
Receipt Number
(Rev. 11/05)
ness..'
Waiver Fee $
Date of Payment,
Receipt Number,
Municipality o.f Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-79O4
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel i.D. 017--422--15 HAA# ~)q
Expiration Date:
1. GENERAL INFORMATION
Complete legal description BONNIE VIEW SUBDMSION; LOT 6
Location (site address or directions) 12641 NEHER RIDGE DR * ANCHORAGE! AK 99516
Current Property owner(s) GENE HECKLER Day phone (AGENT~ 257-0116
Mailing address
Le. nding agency
P.O. BOX 1432 * KOIL~uUE~ AK 99752
._ Day phone
Mailing address
Real Estate Agent
Mailing address
CAROL BUTLER W,/ REMAX PROPERTIES Day phone
2600 CORDOVA STREET * ANCHORAGE, AK 99505
257-0116
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBEROF BEDROOMS: 3
TYPE OF WASTEWATER DISPOSAL:
3. TYPE OF WATER SUPPLY:
Individual Well [] Individual On-site []
Individual Water Storage [] IndividUal Holding tank []
Community Class_ _Well [] Community On-site []
Public Water System [] Public Sewer []
The Municipality of Anchorage Development services DePartment (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional Civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of iSSue for properties served by a private or Class C well and may
be reissued with new water samples. (certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown be/ow, I vedfy that my
investigation, based on procedures out#ned in the Health Authority 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 vedfy that based on the
information obtained from the Municipality of Anchorage fi/es 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 (~ARNESS ENGINEERING 0ROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUR'E 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Phone ,7,37-6179
Date ~/?0///0~//
!
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thor°Ugh,
conscientious engineedng analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the ~
system under the conditi°ns enc°untered 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 sen/ed by the system.
These conditions are outside the control Of the evaluator of the system. Satisfactory te~t
results do not guarantee future performance of the system, nor do they guarantee that --
there are no hidden defects or encreachments. 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 listed above. Any reliance upon or use of this report by any
other person or party is not authodzed, nor will it confer any legal rtght whatsoever.
5. DSD SIGNATURE
Approved for .~ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the fllowing stipulations:
Note: The well for this property meets existing State and Municipal Codes. There are nitrates
present. It is suggested that periodic testing be performed to insure the wells continued suitability.
Current nitrate concentration is 5.76 mg/l. EPA maximum concentration is 10.0 mg/l. More
information on nitrates is available from the On-Site Services Program, at 343-7904.
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
By:
Manitenance Agreements
Supplemental Engineer's Reort
Other
Original Certificate Date:
ITIM■ I,kY
Developrr
'- On -Si
v
dbr x.+ww OSx, �
r�45W a^:ze .
par{ment
q
3A STY
��ram
DW rviAN Well
IVGC IS (11 f`P[�
in
yLb '
` N/A
42.25 in
Size in gallons
Cycles tested
High water alarm level at
Meets alarm & circuit uirements?
in.
ot
fO0'+
On; acent lots 100'+
100'+
e Holding tank N/A
~roPerty line 5 + ~bsorpt~on field 5'+
N/A · '
Water service hne 10 .*- Sur[ace water 100'+
+
Building foundation 10'+ Water ma~n.
above systems are in
this datel
Waiver Fee $
Receipt Number
17 04 04:10p Bu%ler & Walden 8072761584
~'~ ~ I "' ~ s~
E
Anchoroge Recording PreCi~ct~
SURVEY CERTIFICATION LEGEND
' I hereby ~f~ t~ I hooe Surveyed the ~r~erty shown
h~,o~ th~ ~he improvements sit~ thereon ore w~hln ~he proP- o