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BROADWATER HEIGHTS BLK 3 LT 27
Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite - (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number. OSP191466 050-081-67 PID Number. El New El Upgrade Name: ERIC & KRYSTLE QUINTANA ABSORPTION FIELD Address: ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 12116 SWEETWATER CIRCLE, EAGLE RIVER, AK 99577 ❑ Other Phone: No. of Bedrooms: Soil Rating: Total Depth from original grado: 952-9116 3 GPD/Sq. FL FL LEGAL DESCRIPTION Depth to pipe invert from criginal grade: Gravel depth beneath pipe FL FL Subdivision: Block: Lot: Fill added above original grade: Grave BROADWATER HEIGHTS 3 27 GFL Township: — Range: Section: Gravel width: Beds Number of lines: Distance between lines: SEPARATION DISTANCES FL Fl. Total absorption Number of trenches: Dist between benches: TO Septic Absorption Lift Holding Public/PrivateFrom Tank Field Station Tank Sewer Lines SD. FL FL Well 100'+ _ 25'+ TANK M Septic ❑ S.T.E.P. ❑Holding ❑ Other Manufacturer. Capacity. Surface Water 100'+ z - - GREER TANK 1000 Gel. Lot Line 51+ X _ - Material: Number of compartments: Lu NIA HDPE 2 Foundation 10'+ _ LIFT STATION Curtain Drain NONE KNOWN Manufacturer. c Gel. Remarks: 'Pump on'levol at: 'Pump ofl lovelah High water alarm ah Pump Mako 8 Model• Electrical Inspections performed by PIPE MATERIAL C,\M-t:,j House to tank D3034 Tank to D3034 / Installer drainfield NORTHERN EXCAVATING Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) Inspection 95.65 FL Dates: 1st 11/16/2019 2nd Location and Description: 3rd - 4th TOP OF MANHOLE (MH1) ENGINEER'S SEAL Community Development Department ApprovalOF "444 Ar ®®aeesne Conditional approval: Date: �:'. ••••4 IA yood •; d .�.. ..5..3 .. ........... s ricy as n® CE9� _© m F .� .... Approve t^- Date:? 20 Z LI EN 1®®r°'°ROFESS��P®®® #AECC884 ®� Inspection Report 1-1-12.doc PERMIT OSPI91466: RECORD DRAWING OSP191466 A B NOTE: THE EXISTING DRAINFIELDS WERE FOUND TO NOT HAVE I ENOUGH COVER OVER THEM. DURING THE INSTALLATION OF THE DBL1 98.3 1 67.1 NEW MONITORING TUBES, THE CONTRACTOR ADDED DBL2 i 98.9 68.0 I ADDITIONAL FILL (FROM ONSITE) AND ADDED FILL TO THE MIDDLE MH1 100.3 70.0 OF TRENCHES (APPROX. 12'-15' SOUTH OF NEW MTS) AND TO I STI 103.3 74.4 THE NORTH ENDS OF THE DRAINFIELDS. TRENCHES NOW HAVE DBL3 104.0 75.5 2'+ OF COVER EXCEPT FOR SOUTH END OF EAST (UPPER) i DBL4 104.8 76.6 TRENCH. SEE OWNER STATEMENT ABOUT NO FREEZING ISSUES. I i ( C01 136.1 119.1 DURING THE TANK INSPECTION WHILE TOP OF TRENCHES MT1 128.0 121.2 WHERE EXPOSED. INSULATION WAS OBSERVED OVER PORTIONS ' CO2 131.7 123.3 OF DRAINFIELDS OBSERVED BY GEG CONSULTANT, JODY MAUS. ICO3 152.1 133.1 MT2 141.7 136.0 -j- I C04 141.4 147.2 MT3 139.9 1142.4 / MT1 MT2 ( I � 1 T.D. 58.5" 54" I ¢ I / A L.L. DRY DRY S.U. 14.5" 17.5" MEAS, FROM 11/20/19 i F I I I 1 EXISTING MONITORING TUBE ' (MT3). BELIEVE MT EXTEND _ TO BOTTOM OF SAND FILTER. USED THIS MT FOR I EXISTING \I TESTING. REMAINED DRY I FOUNDATION\ I 1 THOUGH ENTIRE TEST, AND PRE -TANK i \ CLEANOUTS NEW MONITORING TUBE HE I \OD N (MT1). INSTALLED SO U - NEW MONITORING TUBE • 1 BOTTOM OF MT IS 6" °3 BOTTOM OF MT IDS 60 BELOW INVERT OF DISTRIBUTION LINE °D F �0 0 0 0 fn m BELOW INVERT OF DISTRIBUTION LINE- I I I I I �I I 1 I I I I I I 1 o INSTALLED DOUBLE ' oo CLEANOUTS I (DBL3 & OBL4)- EXISTING WNFIELDS NEW 1000 GALLON HDPE GREER TANK - NOTE: OLD SEPTIC TANK WAS EXCAVATED, PUMPED, AND DISPOSED OFFSITE PER CONTRACTOR / DOUBLI CLEANOL (OBL1 & Df PARCEL ID NUMBER: 050-081-67 -EXISTING WELL WITH BOULDER BARRIERS * a ....6' ENGINEERING, SALES .� CONSULTING 0.� , 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507' PHONE (907) 337-6179 -FAX (907) 33&3246' `h£BSITE. vA w.gamessengineenng.mm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 (n ERIC QUINTANA 907-952-9116 2 OF 3 ®®Gi°: PROJECT/LEGAL DESCRIPTION: DRAWN BY: BROADWATER HEIGHTS; BLOCK 3, LOT 27 J..L.M. ®®® TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC TANK UPGRADE 12/2/2019 #LICENSE AECC884 �I� firr;A___i!frne;S:r O -793 lw .� � �,�.•' Fes® oil n PERMIT OSPINUMBER: RECORD ®'..yA� A ��NG PARCEL ID 050-081-67 BER: OSP191466 � � DRAWING TOP OF TANK @ INLET = 93.2; INVERT OF BUNG @ INLET = 92.58- TOP OF MH LID = 95.65 --\FINAL GRADE = 95.45-95.51 GREER 1000 GALLON HDPE TANK •2" OF INSULATION PER CONTRACTOR -TOP OF TANK @ OUTLET = 93.23 -INVERT OF BUNG @ OUTLET = 92.43 A S Eli LTg Ltd �• == ENGINEERING -SALES, -CONSULTING —_ 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 - PHONE (907) 337.6179 • FAX (907) 338-3246 • WEBSITE: www.namessenatneetina.eom PREPARED FOR: ERIC QUINTANA PHONE NUMBER: 952-9116 PROJECT/LEGAL DESCRIPTION: BROADWATER HEIGHTS S/D; BLOCK 3, LOT 27 TYPE OF WORK: � RECORD DRAWING OF SEPTIC TANK UPGRADE PAGE NUMBER: 3OF3 DRAWN BY- J.L.M. DATE: 11/25/2019 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191466 Work Type: SepticTank Upgrade Tax Code Number: 05008167000 Site Legal Address: BROADWATER HEIGHTS BLK 3 LT 27 G:0253 Site Mailing Address: 12116 SWEETWATER CIR, Eagle River Owner: QUINTANA ERIC & KRYSTLE M Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date Expiration Date: G r. t.)E �8 CtI1]C(Ft Lot Size in Sq Ft: Total Bedrooms: 10/17/2019 10/16/2020 40612 ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing L2. cial Provisions: -built survey of existing systems is missing multiple septic standpipes that were shown on the record ings. If standpipes are missing, they need to be replaced. The updated as -built survey submitted to close he permit shall show all septic standpipes. ease note, prior to issuance of a COSA, the well located in the driveway will need to be protected from age by vehicles. Received B Issued By: B) Date: J JUi Date: 10 17 MUNICIPALITY OF ANCHORAGE Community Development Department Development Services On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 050-081-67 Phone: 907. Fax: 907 - 56789� ;nnA /7 Property owner(s) ERIC QUINTANA Day phone 907-952-9116 Mailing address 12116 SWEETWATER CIRCLE *EAGLE RIVER, AK 99577 Site address 12116 SWEETWATER CIRCLE *EAGLE RIVER, AK 99577 Legal description (Sub'd, Block & Lot) BROADWATER HEIGHTS; BLOCK 3, LOT 27 Legal description (Township, Section & Range) Lot Size Sq.Ft. APPLICATION IS FOR: 3 (Nall that apply) APPLICATION IS AN: Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ 8L 95 Number of Bedrooms 3 APPLICATION IS AN: TYPE OF DEWELLING: Initial ❑ Single Family (SF) Upgrade ® (w/wo ADU) Renewal ElDuplex (D) . EJ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: N/A Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 12-S 2 - 00 Waiver Fees: Date of Payment: L/ / I I l l -1 Date of Payment: Receipt Number: (y S Receipt Number: Permit No. OsP tCIIA O Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd -- , ENGINEERING SALES CONSULTING -:- --_ October 8, 2019 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Broadwater Heights; Block 3, Lot 27 To whom it may concern: The subject lot is served by a private well and septic system. Per MOA records, the existing septic tank is approximately 30 years old. Per MOA memorandum, a septic tank of this age must be physically inspected and/or replaced prior to COSA approval. Based upon this fact, we are proposing to replace the septic tank. We are proposing to decommission the existing septic tank per UPC and install a new 1000 -gallon HDPE Greer tank rated for 10' burial. See attached design drawings for tank location and other MOA requirements. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. 3. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com / N jl LOT 19, BLOCK 3; BROADWATER HEIGHTS S/D I Ii SCALE: i I 1"=100' j I I � I I I I I I I- I I LOT 18A, BLOCK 3; I I I BROADWATER HEIGHTS S/D I I� I 1D II I \ LOT 4, TRACT H; I BROADWATER HEIGHTS S/D 1 W ) J � I I W I LOT 3, -FI; BROADWATER GHT \ �-A I 1\�PTIC I LOT 26, BLOCK 3; / (7 \ -,AR EA BROADWATER HEIGHTS S/D / \�/{.1� \ \ � I _ s 1� ` \\kOT 2,SHGHTS H; \ \ \ BROADWATES//-- �✓moi SEPTIC -A-A AR SEPT AREA \\ \ LOT 1, TR CT H; \ \ BROADWATE TS S/D \ \ LOT 4A, BLOCK 3; \\ \\ 1 1BROARWATER HEIGHTS S/DEPTIC ARE //l\ \\ \\\\ `AREA ILOT 5A, LOCK 3;/ \ Py0 `I L 3,13LOC BR DWATER EIGHIIS S/D \ \\ \• �G� I BROAD ERR H IGHTS S/ I LOT ldA, BLOCK 3; \ I I I\\ BROADWAITER HEIGH�T$J4 �\ LOT 7, BLOCK 3; I 11 \ BROADWATER HEIGHTS SI 1 I LOT 15, BLOCK 3; 1 I BROADWATER HEIGHTS S/D BLOCK 3; D \� BROADWATER HEIGHTS S/D GARNESS ENGINEERING GROUP, Ltd _� ENGINEERING o SALES,; CONSULTING .D, SUITE 101 ' ANCHORAGE, AK 99507' PHONE (907) 337-6179' FAX (907) 338 -3246 -WEE PREPARED FOR: ERIC QUNTANA PHONE NUMBER: 952-9116 PROJECT/LEGAL DESCRIPTION: BROADWATER HEIGHTS S/D; BLOCK 3, LOT 27 TYPE OF WORK: �, SITE PLAN FOR SEPTIC TANK UPGRADE PAGE NUMBER: 1 OF 2 DRAWN BY: J.L.M. DATE: 10/9/2019 OF ,.......... ....... ., i o �':... e• ....carne ...' i LICENSE 11k1jklilk � •••• #AECC884 / GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. BY PROCEEDING NOTE: THE CONTRACTOR SHALL FORWARD WITH THIS INSTALLATION, THE 1 HAVE ALL WELL RADII AND SOUTH ENGINEER, WELL DRILLER, CONTRACTOR AND LOT LINEFLAGGED BY A PROPERTY OWNER AGREE THAT THEY HAVE REGISTERED LAND SURVEYOR READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. PRIOR TO CONSTRUCTION. NOTE: ACCESS TO PROPERTY IS LIMITED DUE TO STEEP SLOPES / , 1 t it m 1 / ��-A 1 1 m EXISTING 3 I � I I / I ' 1 LOT 26, BLOCK 3; / BROADWATER HEIGHTS S/D I I i i 1 ' I �I I O I 1 i 0 J = I Z I w F W I W, 09 ¢, �¢ I wI o _ w 1 F— II I I TH WERE I I REPORTED TO BE A ELL IN THIS AREA; GEG FIELD TE I CH COULD NOT FIND WELL \ �I Ii 1, 1p -qO((iS �SvP I IFEXISTING DRAINFIELD (STALL FUNCTIONAL MT ON EAST TRENCH; NOT PRESENT DURING GEG INSPECTION EXISTING SEPTIC TANK TO BE DECOMMISSIONED PER UPC oo � PROPOSED 1000 GALLON HDPE GREEK TANK; INSTALL DOUBLE CLEANOUTS BEFORE AND AFTER TANK LOT 4A, BLOCK 3; BROADWATER HEIGHTS,' GARNESS ENGINEERING GROUP, Ltd — J ENGINEERING o SALES o CONSULTING -- 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE. AK 99507' PHONE (907) 337-6179 • FAX (907) 338-3246' WEBSITE: www.gamessengineedng.com PREPARED FOR: ERIC QUINTANA PHONE NUMBER: 907-952-9116 PROJECT/LEGAL DESCRIPTION: BROADWATER HEIGHTS; BLOCK 3, LOT 27 TYPE OF WORK: �- DESIGN OF SEPTIC TANK UPGRADE PAGE NUMBER: 20F2 DRAWN BY: D.J.G. DATE: 10/9/2019 1w ........ LICENSE , #AECC884 1"=4U' i 1 �SvP I IFEXISTING DRAINFIELD (STALL FUNCTIONAL MT ON EAST TRENCH; NOT PRESENT DURING GEG INSPECTION EXISTING SEPTIC TANK TO BE DECOMMISSIONED PER UPC oo � PROPOSED 1000 GALLON HDPE GREEK TANK; INSTALL DOUBLE CLEANOUTS BEFORE AND AFTER TANK LOT 4A, BLOCK 3; BROADWATER HEIGHTS,' GARNESS ENGINEERING GROUP, Ltd — J ENGINEERING o SALES o CONSULTING -- 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE. AK 99507' PHONE (907) 337-6179 • FAX (907) 338-3246' WEBSITE: www.gamessengineedng.com PREPARED FOR: ERIC QUINTANA PHONE NUMBER: 907-952-9116 PROJECT/LEGAL DESCRIPTION: BROADWATER HEIGHTS; BLOCK 3, LOT 27 TYPE OF WORK: �- DESIGN OF SEPTIC TANK UPGRADE PAGE NUMBER: 20F2 DRAWN BY: D.J.G. DATE: 10/9/2019 1w ........ LICENSE , #AECC884 1"=4U' r -nmc Omz Xco omx Dm0 W0r- x0 :r0 zzc WA -1 Oz= cou, pwo xc00 -<U3C x 0 Z m Mm mA cpm XK mZ 0� W O °m z O 0o�m -lo X00 Std O 0CY Zcmn 0w = z < -G m z m--0 020 To O Q7 �ZZ� CCD)o m m -1 oho -nc 0cz my wX � S c Z D -i C 00 m Z cn �mZ �m �-i 0 Fn- cnm00 -i m M rn rn U) 0> -Dip QO L1 = < IT! 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O Q7 v> Orn * m W z� 0 n om m� Cl) n W � S m O>< 0< M �C/) m rn z m r- 0 0 A v mm m r' I o � o Z / a � I A o Ctj � N P O Q7 o m a 6 m� s L Ir 1SZ W I i CD m m --i D m x _n I n r m 1 I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES 7 Environmental Health Division 0 Ye -- 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ~ 1~c~5[I (~,~:~0 &""IL-T?~OC/~ ,OM SEPTIC ABSORPTION Address ' ' ~0 WELL ~ TANK FIELD Phone(s) WELL [~,~ [~'~ , ,~ 57~ ~O~OGI -" LOTLINE I0 Y I0 LEGAL DESCRIPTION t L°t2~ I L~r-o~dt~ ~c ~~ FOUNDATION ' ' Township, Range, Secti;n ' A~-BUILT DIAGRA~ {Show location ol well, septic system, prope~y lines, foundation, Yi~ ~ ', ~Z~ : ~8C ~ driveway, water bodies, etc.) TANKS N Manufacturer Capacity in ga,ons ~;~,~ ~a(erial ' No, of Compa~ments~ ~ ~ TYPE OF SYSTEM ~¢ ~ ~ T,ENC. ~ SEe ~ W. O,A,N ~ OTHE, ~ originaIDeptht°pipeb°tt°mfr°mgrade Total depth from or[ginal grade, ~ ~).. . Fill added above original grade Gravel dept~ beneath pipe ~, ~r.~,,.m~/j ~.~e,w,~, ~ ~ ~5 .~ ~ ET ~ FT Number of lines J Soil rating Pipe material ~ PRIVATE ~ OTHER (Identify) ,~t~ Installe~ ' ' Date Installed: , Scale: ~ ~ ~ ENGINEER'S SEAL , Eagl. River. Ai..ka 97~77 ~c~ly~i~nspeai0n was pefl0rmed acc0rding to all Health Depa.ment Approval:' Date://- 72-013 (3/85) OWNER OF LAND ADDRESS LEGAL DESCRIPTION Z 0~7 DATE i- Started PERMIT NUMBER ( er ifiei Drilliag by DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759 Ended //? / / DEl'TH OF WELL ~ (D STATIC LEVEL OF WATER /~OT'I~RAW DOWN FT, GALS, PER HR ~O KIND OF FORMATION: From. 0 Ft. to From /~"O Ft. to.. From.../q,O Ft. to From --~OOFt. to From.. Ft. to From.~_~ Ft. to From_~__~Ft. to From~Ft. to From 4~..t~ Ft. From Ft. From Ft. · From Ft. to From. Ft. to Ft From , Ft. to Ft. From~Ft. to Ft. From Ft. to Ft. From ~_ Ft. to_~t. From Ft. t o.~~. From ~ Ft. to. Ft. From ~ Fl. to Ft. From. Ft. to Ft- From ~ Ft, to Ft. From ~ Ft, to Ft. From~Ft. to Ft. (~/{~:~.'xJ ~y" From From From ~ From From From Ft. to Ft. to Ft. to Ft. to .... Ft. to Ft. to ~Ft. to Ft. to Ft. to ~Ft. Ft. Ft. Ft. Ft FEB 4 19S1 D~pt. Heat~h & Hum~, $~Fvice,$ ~Ft. ~Ft. Ft~ MISCL. INFORMATION: B 1 ac: k .,: I t",t~i!Yl"(':~l....l .... I:::'I!i!tF:~: l!!!:l'dE) ]: I',IIEER~3 DI'~:~.!~ ]: GI\I !, N ',!: TH C)F:'"f' :[ C)I\I 'l"[) t.J~E IL) :1: RliEC:T ]i) '.[ ~!i~"J"J':;.'. ]'. '~i,'.'~l...]']" ]'. 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(,,,,"~!!~1.4 F,;~ U (::~ ~zl U SCALE I ~ ~ ~ / / / Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 so,cs - PERFORMED FOR:~~/' ~~~ ~ DATE PER LEGAL DESCRIPTION'. ~ ~ ~~~ownship, Ra ge, Section: ¢~ ~ SLOPE SITE PLAN A -. /_2_ 7 WAS GROUND 10 ENCOUNTERED? 11 r DEPTH? 12 E Depth t°WaterAller !'~7 Date: ~/~/~?F 1 3 M0nit0rinD? / / / ~/ Gross Net Depth to Net Reading Date Time Time Water Drop , ~ 14 15 16 17 18 19 2O PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ ~- TEST RUN BET_WEEN ,,~ FT,.AND F'T · oo~.~ ~ 0/2 ~ ~.~ z'..- ~'~.~4 .... ~ ~'Oe_~. ~z ':~, ~/ s · s ~o,.~ _ T ,~/~- ~' PERFORMED BY: ~n~ ~..la Ri~ L~ Road No. 2~// ~/ CERTIFY THAT T~IS T~ST WAS PERFORMED iN 72-008 (Rev. 4/85) 825 MUNICIPALITY OF ANCHORAGE Health and Environmenta~ ~otection Street, Anchorage, AK. ~J301 264-4720 PERMIT * * * SEWER PERMIT Mailing Address: Location: .~'"/~///~'7 ~ ,~//-~ Phone Number: Legal Description: - Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: ~ Holding T~Z Maximum Number of Bedrooms: Soil Rating(sq.ft/br) -- The Required Size of the Soil Absorption System DEPTH q-~ ! LENGTH ~0 ! / / 6'~P"~a~r GRAVEL DEPTH-- ~-'--./- NIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). REQUIRED SEPTIC(HOLDING) TANK SIZE = /~"'~"P~-J' GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. ' * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER ~1~ 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site'sewers and wells as set forth by the Municipality of Anchorage. (2) I wi/~Ainstall the system in accordance with codes. (3) I ~de~W~d t~a~ the on-site sewer system may require enlargement if ~ ~~~//~~f~odeled to include more that.3 bedrooms. / _ Date: ~---~/~- [& ' I SWP/024 (1/81) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: 6-- 7- 8S I 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS PERFORMED BY: 72-008 (6/79) SLOPE SITE PLAN WAS G.O ND ATER ENCOUNTERED? IF YES, AT WHAT DEPTH? T'U {:5 ~ L~ ~s A. No. 1 "Pk]. 694-2979 Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ~f/~ TEST RUN BETWEEN ND ~ FT CERTIFIED~ (minutes/inch) GC 8 ® Municipality of Anchorage ° P On -Site Water and Wastewater Program (907) 343-7904 s T Certificate of On -Site Systems Approval Parcel I.D. 050-081-67 1. GENERAL INFORMATION: Expiration Date: d I— LI- 2- o Z o Complete legal description BROADWATER HEIGHT S/D: BLOCK 3 LOT 27 Location (site address) 12116 SWEETWATER CIRCLE, EAGLE RIVER, AK 99577 Current Property owner(s) ERIC QUINTANA Day phone 907-952-9116 Mailing address Real Estate Agent 12116 SWEETWATER CIRCLE, EAGLE RIVER, AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3- 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ H 12. 1) Waiver Fee $ Date of Payment O 7 W I zn o Date of Payment r Receipt Number 61' 55G Receipt Number COSA # 05G2013�69 Waiver 4 AA 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure, indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) . Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 3 G Z In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for `" j,:: ooOF oQ000�o4 0 49 LH �.. -7 ..1.�...!..... ..... :Jef Iey .......... S.: CE -795 • e� Grp' _rofessiol o #AECC884 bedrooms P��ZY tOF bedrooms ON-SITE c WATER AND bedrooms, with the foil!,::, igt$i +iii ATER 0 PROGkAM Pj Original Certificate Date: g' q— zo-ay 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 Septic System Advisory Well Flow Advisory COSA blue sheet_70.10-12.doc Nitrate Advisory Arsenic Advisory Other 11 Legal Description: BROADWATER HEIGHTS S/D; BLOCK 3, LOT 27 Parcel ID: 050-081-67 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA � > o b`- torr - Gas �tarrJ�"' L t ❑ Well log is filed with Onsite (or attached) Date drilled SUNK Total depth 460 ft Cased to UNK ft �3 ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 10/3r19 Static water level at beginning of test 28.1 ft. Comments *DEEPEND ON 1/1991 B. TANK DATA j Age of tank(s) NEW years sr� Tank type/material HDPE t t ' Measured operating fluid level in septic tank NEW J ❑ Standpipes/foundation cleanout per record drawing Date of pumping NEW �n l� D. ABSORPTION FIELD DATA DUAL 5-WIDES Well production at time of test 4+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate 5.57 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 7/15/20 :N■U31�'��C�I► maintenance completed Age of lift stati years Lift station material Which system tested (date installed) srlaias Adequacy test date 1013/19 ❑ ALL standpipes present per recor drawing Results ❑✓ Pass For 3 bedrooms LTotal measured depth from grade 57prior + Fluid depth prior to test *0 in Measured depth to pipe invert from grin) Water added 604 gal ❑ N/A — pressurized field New depth *0 in ❑ Monitor tubes go to bottom of effece Elapsed time 0 min depth into effective ❑ Code -required soil cover over fieldFinal fluid depth *0 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 Any rejuvenation treatment (past 12 months) N/A date of test) N/A Gallons introduced N/A allons If es, enter date Comments/Deficiencie. TESTED WEST TRENCH ONLY. EXISTING MT BELEIVED TO EXTEND TO BOTTOM OF SAND FILTER. ----------------- THIS MT REMAINED DRY TRHOUGHOUT ENTIRE TEST. A NEW FIITROIN�7U� INSTALLED IN EACH TRENCH DURING INSTALLATION OF NEW SEPTIC TANK (AFTER THE SEPTIC ADEQUACY TEST). DRAINROCK APPEARED TO BE CLEAN WITH NO INDICATION OF BIOMATT PER GEG CONSULTANT, JODY MAUS. NEW MT'S WERE INSTALLED SO THE BOTTOMS OF THE MT'S ARE 6" LOWER THAN THE INVERT OF THE DISTRIBUTION LINES (PER THE CONTRACTOR). DRAINFIELDS WERE ALSO FOUND SHY ON COVER. CONTRACTOR ADDED FILL FOUND ONSITE TO ADD TO DRAINFIELD AREA TO INSURE 2 FEET OF COVER, EXCEPT FOR A SMALL PORTION ON THE SOUTHEND OF THE DRAINFIELD. INSULATION WAS OBSERVED BY GEG CONSULTANT DURING INSTALLATION OF NEW MTS. NO FREEZING ISSUES PER OWNER (SEE ATTACHED EMAIL STATEMENT). OTH CAVEAT - PER ROBERT C COWAN, P.E. RECORD DRAWING FOR LOT 2, BLOCK H; BROADWATER HEIGHTS, THE THE DRAINFIELD FOR LOT 2 I OVER 1001+ FROM THE WELL FOR THIS PROPERTY (LOT 27), AND THE SEPTIC E. SEPARATION DISTANCES SYSTEM FOR LOT 3, BLOCK H; BROADWATER HEIGHTS IS UNDOCUMENTED AND THE SEPTIC TANK WAS SHOWN -116' FROM THE FOR THIS PROPERTY (LOT 27). PREVIOUS HAA'S AND COSA ALSO SHOW THE WELL FOR LOT 27 IS 100' FROM NEIGHBORING SEPTIC TANKS AND DRAINFIELDS. From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' Q Yes if No ft M Yes if No ft Neighboring Tank > 100' F1 Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Q Yes if No ft Holding Tank > 100' El Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' P1 Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q Yes if No ft P/1 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q Yes if No ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: 0 Yes Absorption Field > 5' Q Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' El Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' F� Yes if No ft If absorption field is under driveway comment below Property Line > 10' M Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' M Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS **WITH CAVEAT - 100' PROTECTIVE WELL RADIUS FOR WELL ON BROADWATER HTS, B3, L18 IS SHOWN ON AS -BUILT SURVEY. BURIED PORTION OF DRAINFIELD MAY ENCROACH SLIGHTLY ON THE SUBJECT WELL. oo600pp G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review o of Municipal records that the above systems are in conformance with p0 ) off: gT •�� MOA COSA guidelines in effect on this date. 0, • ..: , . , , . , - • , ; • _ • �0 o� ........... .13 o -•Je Irre Gorness.: 49 •z � ,c�4 COSA Checklist yellow sheet�g4eaPSL�o& ,� ofesst o #AECC884 �D�OODOc' D,o www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC 201369 Subdivision: Broadwater Heights Block 3 lot 7 A water sample revealed a nitrate concentration of 5.57 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. r 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. 7 "Mailing Address P O Box 196650 *Anchorage, Alaska499519 6650 *www muni org � m w c mD-i omz oz= m> (mpmm x 000T9 o m W -nO xDo c cc vZ o -i cn 0 55 CMm �O =o0 �C)z W -n Z G)zK m -I0 Gm o O OC> Z(n O;u x -hoz G-Cz ZD z m -1m 020 mo A ;u�zr" 000 m o -n0 o�cz w� -i c m c m rnb -i s \\\\\\NN>>> o �ZO m Cl)-rn�i a m 1STrrri -Di O Dw Z� m m'� -10 �Om �o; w.\v i D c (n �n Cn m0 m> 00 'N s-+ ; 'Oi (� rnD m [ zZ if m aim me rnz n O -I m A z ? m rr� Fy' a r lr r -n �� n=m0 �m cn 27.4' Cl) 32.0' __a, C N I�1 � S DzCO ~ m co 5.5' U) 0 3: 01 =mm G) O z< G)c) to �� m m m °_ zo-um �� U1 M 9.7' 14.ctl rn G) D u)m00 w � Umi- ; 2 m;u n O m� co O o m= 0 y m -4 mZzG) Z-4 o- r C) cxCOco� my(� OD rnm N Zzi m c o> >0 (n Z -i -i O < `2 H D ZO0�' 05 m -n o Z ..A{ 3 m(D to in m 0 m N = O W _A f ; � � -i m 20 0m0Z 0 < cAz0 'D G) m � s cn m3: O 0o m> z 8 R: N a HOZ' O�Z �L9 �-" •P 4 0 z m (n N m / m O i p / �o� c R� 0 yCO �,li:i co Co / .9Z 0 -�- 27.4' Cl) 32.0' __a, in n P N 5.5' 0" = O o ms o o ;u �� m M U1 M 9.7' 14.ctl -] N rn 5.7' 10.6' ._. .. r:: •: U� ow n 1 24.0' c y N m 2 Z° i mM, CA o� / // m� O rn o o D D t m m m x C) ,"D C7 r m I I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Bo 196650 Anchorage, Alaska ~!9519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 1. GENERAL INFORMATION .' Complete.legal description HAA # ~ ~ ~.~ ~)-~ \'-~ .~:'.';.'5!.~'~r . ,., :* Lot 27; 'Blo'~k"~$;' B .o~d~r H~ights Location (site address or directions) ' Prope~ty'owne;--'" "' Eagl~ River ..~;'~.~,~[~ng..~ddress P.0. Box 770210 Lending agency ~?'Ma!ling address 12116 Swe~ter Eagle. RZv~: AK "~ DaYphone "694-5797 Eaqle River, AK 99577 Day phone :.NOTE: If community Well system, provide Wri~en confirmation from SM'~e ADEc attest- :{~" ~ ?::.~:~./:) lng t°'th~"~eg~lity'~nd statuSOfsystem,''. ~ . ~': ~::' :~ ':~: :..::?'~::.?~ · :~[:~TYPE OF.WASTEWATER DISPOSAL: ;'?/~ ?':: :: :;:~J;~(:':~:'.,~; '~;~.~ ':~;;'~5~' ~?~'~ . , ': : : : ' NOTE:.. If community wastewater system, provide Wri~en confirmation, from State ADEC : ,a~eS~h~" to' the Iity of yste '- lega and status s m. 72~ (R~. 1~1) Front MOA ~1 , STATEMENT OF INSPECTION BY ENGINEER : As certified by my seal affixed hereto and .,as of the validation date shown below, !verif7 that my investigation of this Health AuthOrity ApP?oval 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. '- : $ & S ENGINEERING Name of Firm ' ' Engineeessignat~'re' ~~ ~' ~ - Phone Date The MunicipalitY of An~h0ra~i~-'6ep~ent of Health and Human Services (DHHS) issues' Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certa!n 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-{]25(Rev. 1/91) Back MOAit21 -,, ..-~.: ,.~ ~ ~- :: :~::, : ~ · ... .. .... : .... _ ......... Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division Health Authority Approval Checklist egal Descnptmn ~ ~t ~ ~ ~~~, Parcel I.D.: A. ~LL DATA Well ~e ~,kt ~ If A. B. or C. attach ~EC letter. ~EC water system numDer Log present (~) Total depth Sanitary seal Date completed [-'~1 I Cased to It,' fl..g-.Casing height (above ground) lZ.a4~ Wires properly protected t~q) ~ FROM WELL LOG AT INSPECTION Date of test 35-/ II-/ Static water level Well production WATER SAMPLE RESULTS: g.p.m. Coliform -~ Date of sample: I l/gL./a~ B. SEPTIC/HOLDING TANK DATA Nitrate 1.3"/ Other bacteria Collected by: S & S ENGINEERING 1/O:t4 angle ktver Loop ROad No. 204 Eagle Kiver, Alaska 99577 Date installed 9 -~ I g - ~ 9 Tank size / oo o Number of Compartments 7..- Cleanouts (~lq) Founda.t~ion cleanout ~) ,f Depression (Y/I~ d High water alarm (Y~12i> Dat'e of Pumping I I- b,~ 9 Y Pumper _7"-~ ~ raja/ ABSORPTION FIELD DATA Date installed q - / $'- 0 5 Length 76. e Width Effective absorption area ,382. Date of adequacy test Soil rating (g.p.d./ft: or ft2/bdrm) [2"a~/~ System type 6'- ' Gravel thickness below pipe O, ¢' Total depth /"/ Monitoring Tube presentl~Iqq) ~ Depression over field !/.~ t ~ 5 6"- Result~Fail) t~$ For 3 bedrooms Fluid depth in absorption field before test (in.); C..3 Immediately after ?,8o gal. water added (in.): Fluid depth O (ins.) Minutes later: ,-' " Aosorpuon rate = ¢5'3 4- g.p.d. Peroxide treatment (past 12 months) (Ytl~ Afa~f~-/~/aca~)Ifyes, give date ~ ~ D. LIFr STATION Date installed Size in gallons Manhole/Access (Y/N) .... H~ *Datum C~cles tested "Pump off' level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Io c~ ~ ~ · On adjacent lots Absorption field on lot ~.~c~ ~J~ ; On adjacent lots Public sewer main ~[p- Public sewer manhole/cleanout Sewer/septic service line "z~ tl~ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~ t ~ Property line \ ~ x 3r Absorption field Water main/service line \ I> ~ & Surface water/drainage ~oo t4~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~ 7~ \ Water main/service line Surface water Driveway. parking/vehicle storage area Curtain drain ]p~ Wells on adjacent lots \ c>c:> Property. line F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records ~ ~l~ are in conformance with MO~I I:[AA pdtjdelines m effect on this date. j : I~.~,,~,,~,,~, ~ ~_ Signature '" Date ......................................................................................................... HAA Fee $ ~ O~ ~ Waiver Fee $ ,eceipt Number 2¢ ;ff C~) Receipt Number Rev. 8/95 OSS: haa.wk.doc CT&E Environmental Services Inc. Laboratorv Division ................ -- Laboratory Analysis Report WATER L2V BLK3 BROADWAT~R ~TS $ & ~ ENGINEERING R. COWAN UA WORK Order 194R~ Prfnted Date 11/09/95 ® 1~:15 hrs. ColleCted Da~e 11/02/95 ~ 11:30 hrs, Received Dabs 11/0~/95 G 13~55 hrs. Te~hni~al Director STEP~N c. EDD ::,~,,l~p,]e Remarks~ SAMPLE COLL~,CT~,D BY: RAY, QC AlloWable Exc. Anal Results Qual Unibe Method Limits Dace Dace Inlt 1,34 m~/L EPA 351.2 10. 11/06/95 CMR See 8pe~ial I~l~t.rucbioll~ ~bove UA = Ul~available See Samp,],e Rema~k,$ Above UI~detected, Reported value is bhe praccieal qua/iclfication limit- LT -- Less Than ~T = G~'eater Than $ e condat'y dllutlotl. 200 W. Potter Drive, A,eho,~e. AK ~9B18-1805 -- Tel: (907) 562-2343.~ax: (90~) 5~1-5301 ,~,.~,,,o~, ~Z~ll tTIF~ IN Al ARKA. CAI IFORNIA, FLORIDA. I~LINO~. ~ARYLANO, MICHIGAN. MISSOURt N~ JERSEY. OHIO. WEST ViRGINiA 6PS'ON ~IE~P69L~6 ~ ~NIISBI 3UID~3WWO3 9~:9I G6/60/I~ MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING (¢'~3(~') - ~)~- (o"~ HAA# ~--~'~"~©~ / (7~(~"~.(~) 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Lot 27; Block 3; BROADWATER HEIGHTS SUBDIVISION: Location (address or directions) Swe6twatcr Circle (b) Property owner Mailing Address (c) Lending Institution Mailing Address Car~ Disotell P,0.Box 770210 Telephone'(home) River. Alaska 99577 Telephone Business (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here'S, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING i7054 Eag;e River Leap Road Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Family (~(x. Number of bedrooms 5 ''~ 3. WATER SUPPLY Individual Well I~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ~( 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. 72-025 (Rev. 7/88) Page 1 of 2 · ~JoM s,~eeu!Buo leuo!ssejoJd oql u! suo!ss!mo Jo sjol iE) Joj elq!suodsoJ lou s! o6eJoqouv Jo X1! led!o!unlAl eq[ 'penss! s! oleo!J!lJoo e eJojoq elep ezlleue Jo suo!loodsu! lonpuoo lou op SHHQ jo seeloldmEI 'sluome~!nbeJ elels pue leJop@J u!elJeo XJsIles oh Jap Jo u! suo!inl!lSU! 6u!puol ~!eql pue semoq jo sJoseqoJnd ol tSelJnoo e se s!ql soop SHHC1 oqI 'e~s~lV jo OlelS eql u! peJels!6eJ Joeu!lSue leUO!Sse~oJd luopuodopu! ue iq e^oqe ~i qde~§e~ed u! ue^!B suo!lelueseJdoJ oql uodn AlUO peseq poleoUpoo le^oJddv tlpoqln¥ qlleoH senss! (SH HQ) seo!^Jo$ uemnH pue qlleeH jo luoml~edoo oBmoqouv jo tl!led!o!unlgl oqI alPC] ~ A. WELL DATA Well Classification \ Well Log Present ~N) ~ Date Completed Total Depth"~t Cased to Static Water Level MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) IV E ['I~HECKLIST - FEBRUARY 1984 "~ ' ',',~ ~ ~; ' Of An,o',-~o"ago DepL Health & Human Services Casing Height Above Ground Electrical Wiring in Conduit ~f~)'N) 343-4744 Legal Description: ~_~ ~"/ ~L~---,. ~ If A, B, C, D.E.C. Approved (Y/N) I~//~ ! Pump Set At Sanitary Seal on CasingdC~N) routing ¥ SEPARATION DISTANCES FROM WELL: To Septic/~g Tank on Lot I 6:~ Pr Depression Around Wellhead (Y,~ ; On Adjoining Lots To Nearest Edge of Absorption Fief/4//,~n Lot ~ ~ A-- ;On Adjoining Lots ~:::~Ipr/ To Nearest Public Sewer Line I~ __ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service ki[e~n Lot Water Sample Collected by ~---~ ~L---'t'I(A~I"~I~."~. ;Date Water Sample Test Results '~,~'~"~~~-~ ~ ~ Comments B. SEPTIC/HOLDING TANK DATA Date Instal"~eed ~ "' ~"~ Size Standpipes~/N) "f Depression over Tank (Y/~ Pumping/Maintenance Contact on File (Y/N),.1/ Holding Tank High-Water Alarm (Y/N) No. of Compartments ~-- Ai r-t i~,,,~ t Caps~CP'/N) Foundation, Cleanoj~t ((-~N) Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Water-Supply Well To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course . Comments ~/~ ~)~ O~.-0~)d-~) 1~-'-/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: \ ~14' To Building Foundation \ (::)1 ~ To Disposal Field '' f 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field /~-~ "/~:/~ Type of System Design I 'i~- E~'~ Length of Field Depth of Field Square Feet of Absortion Area ~ ~:~'~-- ~avel Bed Thickness Statndpipes Present ~;~N) Depression over Field (Y~ t~./ , D/ate of Last Adequacy Test Results of Last Adequacy Test ~ ~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well / ~;~C;'I~ To Property Line I To Building Foundation1 ~'~f To Existing or Abandoned System on Lot ¢'/~' ;On Adjoining Lots '~:::::>t Jr' To Water Main/Service Line /C~ ! ')- To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course I c:t:~l Jr- To Driveway, Parking Area, or Vehicle Storage Area I Comments D. LIFT STATION Date tn~~ Dimensions Size in Gallons '""--.~_ Manhole/Access (Y/N) On" Level at ~ "Pump Off" Level at "Pump High Water Alarm Level at ~ Vent (Y/N) _ Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~ Comments ~ **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date MOA No. ~ ¢ ¢,.2 ~- (.2 ¢ .~ r's st~af Receipt No. Date of Payment Amount: $ 72-026 (Rev, 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST Mr. Carl Disotel P.O. Box 770210 Eagle River, Alaska 99577 February 7, 1991 ROBERT SHAFER, P,E. ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 RF EIVED 7 I9'31 [V~ ;' !r;~i:,-q:h,,. r,'i/\ '~,cli;);'ac..e REFERENCE: Lot 27; Block 3; BROADWATER HEIGHTS SUBDIVISION Sweetwater Circle, Eagle River, Alaska Dear Carl, At your request a well flow test was performed on the well serving the referenced property on February 6, 1991. The static water 6evel was measured within the well at 60 feet below the top of the casing. The water was turned on full and the water level drawn down to the pump at 459 feet in 98 minutes. At that time the pump was shut off and the water level allowed to recover for 30 minutes. The pump was then turned on and the water level was drawn down to the pump again while the q~antity of water pumped was measured. This test was performed three times with consistent results. From this test it was determined the referenced well currently produces 32 gallons per hour. This flow rate is not guaranteed, subsequent variations can occur. If you have any questions or if we may be of further service, please si~Contaet us. ~DJ/ss PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 LAB I~STRUCTIONS for RUSHorder # 31083 Dmte Re~ort Printed: FEB ! 91 @ 12'~ Client Sample ID:L2? B3 BROADWATEB HTS PW$ID :UA Collected ,3AN 30 ql @ 11:00 hrs. Received JAN 30 91 ~ 16:25 hrs, Preserved with :AS REQUIRED Client Name : 3 & S ENGINEERING Client Acct : 3NSENGF BPO # PO# NONE RECEIVED Rea # Ordered By : R. SHAFER ~hemLab Ref. # :g10330 Analysis Completed : Laboratory Supervisor :STEPHEN C. EDE Released By : Send Reports to: 1) 2) 3) Sample SAMPLE COLLECTED BY: Remarks: :heml ab C1 lent Parameter ~a~ole# Samole Description Matrix; To Test Hethod Units Result ~ ...... ~i-~,~ ~OADWATER HTS .... 120005-TOTAL COLIFORM ................... col/lO0 ml ~ Tests to be Performed per Dept, 0 0 0 I 0 0 ": 0 0 EPTox GC Metal Micro O/G GiIs Water Ref Bill End of Samole# 2 Lab Instructions on RUSHorder# 31683 ENO O~ ALL LAB INSTRUCTION~ for R~Horder # ~1683 Tests for. this Samo!e, LAB INSTRUCTIONS ~or RUSHorder # 31683 Date Reoort Printed: FEB Client Sample ID:L27 83 BROADWATER HTS PWSID :UA Collected JAN 30 91 @ 11:00 hrs. Received JAN 30 91 @ 16:25 hrs. Preserved with :AS REQUIRED Client Name : S & S ENGINEERING Client Acct : SNSENGP BPO # PO# NONE RECEIVED Req # Ordered By : R. SHAFER Send Reports Lo: ChemLab Ref.,.#:910330 Analysis Completed : ~1--~,~ 1) Laboratory Supervisor :STEPHEN C. EDE Released By : Samole ROUTINE SAMPLE COLLECTED BY: RAY Remarks: Cheml ab Cl ient Parameter Sample# Samo!e Description Matrix To Test Method Units Result Tests, to be Performed per Dept. 0 0 0 0 0 0 t 0 0 EPTox 8C Metal Micro O/G Oils Water Ref Bill End of Sample# 1 Lab Instructions on RUSHorder# 31683 1 Tests for this Sample.