HomeMy WebLinkAboutBROADWATER HEIGHTS BLK 2 LT 1Broadwater
Height
Block
Lot I
#015-081-2'8
Municipality of Anchorage Page l 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: '~l~ ~'~. ~l 4::::)4:~ PID Number: ~ ~::::~4:~ ~ ~ ~
N~~ ~. ~ ~b~ ~~%~ Wastewater System: u New ~Upgrade
Address:
I~~ ~. ~ ~~V~, ~:- ABSORPTION FIELD
No. of Bedrooms'
Phone~ ~ ~ ~. ~ ~ Deep Trench ~ Shallow Trench ~ed ~ Mound ~ Other
Total Depth from original grade:
LEGAL DESCRIPTION So,~ Rating: D.~ GPD/S~. Ft. l
Block: ~ Subdivision: ~ Depth to pipe bottom from original grade: ~ Gravel depth beneath
Lot: ~ ~ ,~~--~~ ~, O'~:~.~F,. p'peo'~ Ft.
Township: ~ Range: I Section: Fill added above original grade: Gravel length:
WELL: ~ New D Upgrade Gra~e~ ~c=~h:~ ,~1[[/ ~/ Ft. N~ber~of ,,e~: . I D~ce betwee,
~ Ft.
or.r:
Yield: I Pump Set at: I Casing Height Above Ground:
~.u F~. ~.TANK
SEPARATION DISTANCES ~Sep~ic ~ Holding ~ S.T.E.P.
To Septic Absorption Lift Holding Public/PrivateManufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~~ ~ ~
WaR [~ J~ ~ ~ ~ ~ Materia~:~~ Namber~of Co~pa~tme,ts:
s~rf~ce {~'+ ~+ ~ LIFT STATION
Water ~
Lot [~' [~/ Size in gallons: I Manufacturer:
Line ~' ~
Foundation ~/ ~1 __ ~ ~- "Pump on" level at: ~el at: I H,~, wat~r*,r~ a,:
CurtainDrain ~ ~ ~ ~[C,~' ~ Pump Uake~ Electrical lnspections performed by:
Remarks: ~)~ ~ ~~ ~ BENCH MARK
Location and Description:
,,,
Inspections performed b~~~l ~~l~ates: 1st ~~~
"""
Department of Heal es~ppr~l .~
Reviewed and approved by:~~~/~~e:_ ~Z~ _ . '(~OFEss'~
72-013 (1/91) MOA 25
Permit ,o. '~ V,..Iq '~,-~ [ ~) Page ~ of ~
Municipality of Anchorage
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
Legal Description:"~~~-~:::~ ~"~l~-'~;"~l~--~'~,~..~ ] PID NO.:
N~
N
;I-IAFER
72-013 A (2/91)MOA25
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 WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920100
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:BOSTLEY ARCH D &
OWNER ADDRESS:12131 W SKY LINE DR
EAGLE RIVER, AK 99577
DATE ISSUED: 5/22/92
EXPIRATION DATE: 5/22/93
PARCEL ID:05008128
LEGAL DESCRIPTION: BROADWATER HEIGHTS BLK
1
2 LT
LOT SIZE: 27887 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT:
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK 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 (iSAACS0).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
DURING CONSTRUCTION OF THE BED AN ADDITIONAL TEST HOLE WILL
BE DUG AT THE SOUTH END OF THE BED TO CONFIRM SIX FEET OF
SEPARATION FROM BEDROCK. INSTALLATION OF THIS UPGRADE SYSTEM
MUST CONFORM TO THE APPROV_~D REVISED ENGINEER'S DESIGN DATED
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
May 14, 1992
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, Alaska 99501
REFERENCE: Broadwater Heights Subdivision, Block 2, Lot 1
Request you issue a permit to upgrade the septic system
serving the referenced property.
A test hole was excavated and a percolation test performed in
the area of the proposed upgrade. Bedrock was encountered at
eight feet. Attached is the proposed upgrade design.
We do not anticipate any adverse effects on neighboring
properties by the installation of the proposed septic upgrade.
If you have any questions or require additional information
for your review, please contact us.
Sincerely,
ROGER J. ~HAFER, P.E.
RJS/lsu
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
PERFORMED FOR:
LEGAL D ESCR I PTION :;[;~/~
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
-'~, ~ ~ Township, Range, Section:
SLOPE
t
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? ----------- p
E
Depth to Water AIt~/.er ,
Monitoring?
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
W~ ~ " ~'1+" ~'1~"
~ ~: ~ ~. ,, ~ '/~" ~,/>,'
PERCOLATION RATE ~L (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN "~ FT AND ~ FT
PERFORMED BY: ~,~ ,,~ A ~ ~.1~ o ~,,~,,,,/~,¢,~,,~ ~m ~/'~.~-c E~]G~H~G I f~i~~
ACCORDANCE WITH ~~'~U~~~I~IN EFFECT ON THIS DATE~
Eagle River, Alaska YY~ll
72-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
/" = $0'
SCALE
JUPGRADE
I
SCALE
DETAIL
rillin6
by
DOC 12o. d~a
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759
OWNER OF LAND
ADDRESS /~ 13./
LEGAL DESCRIPTIoN~/07' ./ ~L.S~ _~.
DATE - Started Ended
PERMIT NUMBER
DEl'TH OF WELL L?. 0 0
STATIC LEVEL OF WATER F'IL
DRAW DOWN FT.
GALS. PER HR
KIND OF CASING
7o
From ~).q_Ft. toJGg Ft.
From3~ ~ Ft. to~O Ft.
From Ft. to Ft. F//'~fizC..T"$a~' ~''
KIND OF FORMATION:
From ~0 Ft. to G~ Ft.
From t~ Ft. to ~] ,, Ft.
From ~ Ft. to/~ Ft.
From /~, Ft. to .~l~ Ft. d~_~4~t3eJ~ t/~t~_f~/~fO~J.l~ From ~7~0 Ft. to
From~AFt. to ~ Ft. ~.SVO~ ~/ Q~From Ft. to Ft,
From Ft. to . Ft. ~~ From ~ Ft. to . Ft.
From~Ft. to-~ Ft. ~~TO~ From Ft. to
From ~ F,.,o ~/F,.~E~~ ~/ ~ ~g ~
From~Ft. to__Ft.
F~om~/ Ft.,o ~Ft.~~~ ~rom.~F,.,o
From Ft. to Ft. ~J - l~ ~ I From~Ft. to.~Ft
From ~ ,. Ft. to ~ ~ Ft.,:~C~ From Ft. to__Ft,
From Ft. to__Ft.
From~e~Ft. to~ Ft. ~gEE~~ Fg~~Ft.,o Ft.
From~D Ft. to ~[ Ft.~9~~ ~/ ~~ From Ft. to .... Ft.
MISCL. INFORMATION:
'
DRILLER'S NAME
/< £ e~ V~_~~
! hr:,'eby certify that I have surx,'yert th,
de~,¢'rib,'d ,p:'ope,'ly: LoT 1~ ffl~cr'~
Anchorage l{ecurding lhecincL Ala:ka, and
lines alld (lo i~ot overlnu or encroach on lh~,
lying adjacent thereto, that no impr~lverm,:,ls
ertv 5' lg nt intent Ihcreto eh;rtl ch on lhe l~l'{'[ll' '~'~
unes or other visible easemonts on said pt~,pcrtv
as indicated hereon.
Dated at Eagle liN, er, Alaska
7
~L ~ , lieM~tered I.and Sm've~',~r N6. ~80-1~q
~ Phone 094-2543
k~cCRAR'i' ROAD 60'
0.80'
GRAVEL DRIVE
WELL
BARN
FENCED
AREA
3ARAGE
PIT
Guy Greer, RLS No. 8033
P.O. Box 110555
Anchorage, Alaska 99511
DWELLING
SCALE:
1 "=50'
I
10'X25' ANCHOR
EASEMENT
AS-BUILT
I hereby certify that I have surveyed the following described
propert~ Lot 1, Block 2, Broadwater Heights Subd., E1/2
SE1/4. Sec. 1, T14N, R2W, Seward Merldlan, Anchorage
Recording District, Alaska and that no encroachments
exist except as indicated. It Is the responsibility of the
owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the
recorded subdlvlslon plat. Under no circumstances should
any data hereon be used for construction or for
establishing boundary or fence lines. Dated: March 17, 1991
RECEIVED
MAR 9 1992,
Municipality at Anchorage
Dept, Health & Human Services
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTIONK'~7'
DATE - Started
PERMIT NUMBER
by
DOC Co. dba
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759
DEl'TH OF WELL
!
/4oa
STATIC LEVEL OF WATER F'F. 7 0
~; /: ~ b, 4O(AJ,d' ,:,:~r~ DRAW DOWN FT.
·
Ended ? //:~/ GALS. PER HR /
KIND OF CASING g-,'~ ~ () ~
KIND OF FORMATION:
From ~ Ft. to -,.;x Ft.
From ~ Ft. to q ,..Ft.
From ¢ Ft. to /6 Ft.
From /(~ Ft. to ~'~ Ft.
From ~'<-~ Et. to ~._~3- Ft.
From__Ft. to .Ft.
From.4~ Ft. to~ Ft.
From ~'~C? Ft. to ~[ .Ft.
From~ J Ft. to ,~? Ft.
From ~-.~ .Ft. to .~ Ft.
From . Ft. to Ft.
From :~'~, Ft. to [ 7~ Ft..
From [q~ Et. to ,:x,,,~ Ft.
From ";~ ~L Ft. to '~ ':~'Ft.
From ~ff~ Ft. to ' t.
From ': Ft. to J'bi~ Ft.
From
From
From
From
From
.... t (~)~' From,
From ~
From
From
From ~
. . Ft. to
.. Ft. to,,? ~"~
Ft. to
Ft. to
Ft. to~ Ft
Ft. to__ Ft.
~Ft. to Ft.
Ft. to~Ft.
~Ft. to~Ft.
....From
From Ft.. to
From __Ft. to__
~u/ q~
. From Ft. to.__
l
Ft. to__Ft.
~,...M'OP!~patity of Anchorage
Ft. tooihl~lq~fillh & ~uman Services
Ft. to Ft.
Ft.
Ft.
Ft
MISCL. INFORMATION:
GR rER ANCHORAGE AREA BOROL' ~!
DI~..~FITMENT OF ENVIFIONMENTAL 0.UALI,. -
3~i00 TUDOFI ROAD ANCHOFIAGI::, ALASKA 99~07 27~-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
ADDRESS
LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY ,/'~o ¢:> E") GALLO'NS.
, NUMBER OF /'
MATERIAL ..~;~Z~z.--~LZ,,"~JT~ ~C~o/~'~-~_~ COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH DEPTH ..
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PIT:'
OUTSIDE DIAMETER OR WIDTH , LENGTH , DEPTH ~''
~"~.'¢¢,,,-L/~' · .,.,/'~:;;;:~'~'~ ,/'~/-/1/~'~--~¢ DISTANCE FROM WELL. .,,,~.,~.~¢',,,,¢~zr.;,...//-~:2 , BUILDING FOUNDATION~~:'
/~ / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ ~'~'.~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL FOUNDATION 0 NEAREST LOT LINE
NUMBER OF LINES CE BETWEEN LINES TRENCH WIDTH
ABSORP SQ. FT. LENGTH OF EACH LINE ~ //~'~
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
. IN. ABOVE TILE~
WELL:
~',~--~,,~'~¢~'~ -.'~f'~/z/'''~''~r ' ' / DISTANCE FROM ,_-.-- WATER ~
TYPE -~,~.~--/z~z--~'~ , DEPTH , BUILDING FOUNDATION. SAMPLE_
NEAREST / SEPTIC SEEPAGE -.---- ,..._..-
LOT LINE ~ SEWER LINE , TANK ~ SYSTEM , CESSPQOI.
DIAGRAM OF SYSTEM
, NEAREST
OTHER
, SOURCES ~.
DATE
,.v,,,-v::p. c~c',-.c ~ IF' ----ZZ'--- ,I /--~ / _~-- I I
.... -~..--~ ~----~*"~. ~ .... .r-~. '.: ...... .--/--~,~ ...... .~ ...... ~ ~--
~ ~-~ ..... ,? ' ~, .~ , , '?- --...:---,~,-,,~- --'-s-- -
. . ~-~ :,,-. ~ .~'Y ~ ~' ~
~ .
'rN,~..CT 'B,' I t
GAAB-HD-I
GR rER ANCHORAGE AREA BOROt' H
Db.-.~RTMENT OF ENVIRONMENTAL QUALI,.
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
.ADDRESS '¢"~ ' .x~',~.. ¢7~.~.' "~ PHONE__
LEGAL DESCRIPTION .~( ~ ~~/~~' ~/~'/
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY /~ ~? cC) GALLONS.
. . ~:?r~-~. ' _ . NUMBER OF
MATERIAL f~----,,~----~J~ ~ ~/J2/~:'~--'~'~Y~T--COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH
LIQUID
DEPTH __
SEEPAGE SYSTEM:
NUMBER OF PITS
LINING MATERIAL
NEAREST LOT LINE__
SEEPAGE PIT:
/ __OUTSIDE DIAMETER OR WIDTH , LENGTH /~-"~ , DEPTH
~:o/d'~.-. ~,,-~. ~'//,4/~-~_: DISTANCE FRO~ WELL~ ~~~ _. BUiLDiNG FOUNDAT~ON~'
/~ / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ ~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL.
FOUNDATION
NEAREST LOT LINE
NUMBER OF LINES ..,.~'// '~
__ DISTANCE BETWEEN LINES .TRENCH WIDTH
ABSORPT~ SQ. FT. LENGTH OF EACH LINE ~ ~ f~'"/
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL: "~'~'~'~"zm'-~-J'~'~/'~"'~?-~'- DISTANCE FROM WATER
TYPE _,~,.~-.-j z._-.~-z--~- D E PTH ~ "-'-'-
BUILDING FOUNDATION.._ SAMPLE
NEAREST SEPTIC SEEPAGE ~
LOT LINE / SEWER LINE / , TANK / SYSTEM__ , CESSPOOL
NEAREST
OTHER
, SOURCES__
DISTANCES:
DIAGRAM OF SYSTEM
F-,
I
June 6, 1977
Frederick P. Case
Box 676
~ag~& River, Alaska
99577
Subject~ Permit Expiration
Dear ~r. Case:
A permit issued by this department for well and/or on-site
sewer installation on ~L~.,~ I Bl_o~.~k~2.~ Broadw&ter.~{eights Subd*vision
has expired since the iss~'~'~ exceeds one (1)
In the event you still plan to install the well and/or on-site
sewer system, a new permit is required. The original soil test
may be used to obtain a current permit.
If the well has been drilled, a well log should be sent to
this department to document the installation date.
If you have any questions regarding the above matter, please
do not hesitate to contact this office immediately at 279-2511,
extension 224 or
Sincerely,
Les N. Buchholz, R.S.
Sanitarian
LNB.lJh
Gte, .;R ANCHORAGE Area Bo,
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE Z74-4561
JGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERM,T NO.
,NSTALLAT,ON-OCAT,ON /O/c,
INSTALLATION Of: SEPTIC TANK SEEPAGE PIT
TYPE AND SIZE OF FACILITY TO BE SERVED
OTHER
FINANCED THROUGH
DRAIN FIELD
TO BE INSTALLED BY'/. F
COMPLETION
DATE
ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLIN~ OF Y SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL B~ SUBJECT TO PROSECUTION.
~F~ I ELD
DRAIN
, DRAI~ FIELD
TYPE
DIAGRAM OF SYSTEM
SEPTIC TANk SiZE /~ ~ TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALl
SEPTIC TANK , SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PIT
SEPTIC TANK, , SEEPAGE PIT
TO RIVER, LAKE. STREAM.
., DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL,
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
LICENSED DESIGNER
J I
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE
FORM NO. EQ-01 6
P.,,;:,~ic s~:.<n~ and ....
' ¢ *~' sari sfac-
'?:?')ly ~.,~, ..,i ~:u;:flic, ..... ...... ~,' is avail, ;¢:d',~..
a well dr~t!':d on e't,.n,::r o'F the ,*,"*','~¢," lots should provide
Si~cerely, '
EFiV t ronm~t,~'l Special i st, Sr.
.,REATEr,~ A~.:~,HORA¢= AREA
Department of Env~ronmenta
Date Received
INDIVIDUAl. !~}..:¢IE~ & WATER FACILITIES
FO?
Number of Bedrooms:
D, f~acteria ] Analvsis
C. Septic Tank: 1.
D. Seepage Pit: 1.
f. Disposal Field:
8. Distances:
A. Well To:
B. Foundation to S~ot:ic Tank /~ ¢ ""
.... ,. ~, AbSorotion Area
C, Absorption Area to Nearest Lot Line~ ~ /
Septic Tar, k_.~ ...... , Absorption Area.=__/ ~ 0 , Sewer Lines
2equest for Approval of ~' 'v!dua! Sewer & Water Facflit~.e'
Page Two
9. Comments.'
Ap~'~ovs~ Va~id for One Yaar
te~ Anchoraqe Area" ,
.. 4oroJqh, 9e~a'rf, ment ?f Env~.~m~e~MT.a~ Quality
D!AGi~AN',. O? SYSTE~,~
I certify that the information contained in this request for approval to be a true
and accurate representation of i:he subject sewer and water :facilities located at:
Signed Date
Municipality of Anchorage
Mark Begich, Mayor
Building Safety Division
P.O. Box 196650 ·/~700 Bragaw Strcct
Anchorage, AlaSka 99519-6650 · (907) 343-8301o Fmc (907) 343-8200
httI~://www.muni.org
4~22/2004
JeffA. Garness, P.E.
Garness Engineering Group, Ltd.
3701 E Tudor Rd, Ste 101
Anchorage, AK 99504
Subject:
Waiver Request for Broadwater Heights Block 2 Lot 1
Waiver Request #WR040021
Parcel ID #050-081-28
HAA# 040169
Dear Jeff Gamess:
Your request for a waiver of the required 100 feet horizontal separation from the
absorption field and septic tank to private well has been approved. The approved
separation distance is 90.0 feet. A 90 foot waiver for well on Broadwater Heights Tract H
Lot to septic field on subject lot. A 97 foot waiver from septic tank and well#1 on subject
lot. And a 95 foot waiver from septic field and well#2 on subject lot
This waiver approval applies to the existing absorption fieldandseptictank to
private well separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
On-Site Water & Wastewater Program
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastcwater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
~nvw.ci.anchorage.ak. us
(907) 343-7904
Waiver Review Worksheet
HAg: 040169 Permit:
WR#: 040021 PID#: 060-081-28
Date Received: 5111104
Legal Description: Broadwater Heiqhts Block 2 Lot 1
Engineer: Garness En.qineerin.q Group, Ltd.
3701 E Tudor Road, Suite 101
Applicant: Ronald & Freda Norquist
Waiver Requested: 90 foot waiver from the Septic Tank to the Well
Criteria: Geology
, A. WaterTable
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E, Horizontal Separation
Total:
Points:
Waiver is Granted: .~,/' Waiver is not Granted:
List Conditions or Reasons for above:
Name of Reviewer
Rec#: 51861 Amount: $1150.00 Date Paid: $/1112004
' ' z~- '~ /$'" "/r= . G 2. b
GARNESS .ENGINEERING GROUP, Ltd.
~.~,~ ........ ~-~ CONSULTANTS & GENERAL CONTRACTORS
April 26, 2004
Municipality of Anchorage
Development Service Department
Building Safety Division
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Waiver Request and Health Authority Approval for Broadwater Heights S/D, Lot 1, Block 2
Gamess Engineering Group (GEG) completed a well and septic system adequacy test for the above
· subject property. During the test, it was noted that separation distances to two wells were not adequate.
Per bur field measur, ements, it is just over 100 feet from the center of the well on the subject property to
the center of Monitoring Tube 2 located at the end of the trench. Given the bed ~vidth ranges from 11
feet to 25 feet and Monitoring Tub~ 2 is on the edge of the drain rock, it is reasonable to request a
separation distance of 95 feet from the septic system to the 1991 well. The septic system on the subject
property encroaches upon the well located on Lot 2, Tract H just over 100 feet. GEG is requesting a 90-
foot waiver for the septic tank to the neighboring well. The well was drilled on August 2, 1998. Drinking
water samples were taken from both wells serving Lot 1, Block 2 and the well serving Lot 2, Tract H.
The analytical results are shown in the table below:
Sample ID
L1, B2 Broadwater Heights S/D,
Well #I, 1991 well
Nitrate (mgJl)
1.77
Total Coliform (col/1 O0 mi)
0
iL1, B2 Broadwater Heights S/D, 1.94 I OB, No coliform
Well #2, 1971 well
L2, Tract H Broadwater Heights 0.465 0
S/D
Municipality Maximum 10 10
Contaminant Levels
The drinking water sample results are attached for your reference. The following items are justification
for the ~vaivers:
The on-site drainfield is downhill from the on-property xvells and if the septic system was to
overflow, effluent will not travel toward the wellhead.
The septic system on the subject Property is uphill from the well located on Lot 2, Block H; however,
there is an MOA road right-of-way (West Skyline) that separates the well and septic system. There
are road ditches, which would intercept any migrating effluent and prohibit the direct flow of
wastewater from the septic system to the well.
3701 iEast Tudor Road, Suite 101 * Anchorage, Alaska 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com
The location of the septic system is in a very visible area so that if any effluent was to'surface, it
~vould be noticed and the problem corrected.
· Recent water sample results indicated nitrate levels as high as iii~J~4 ~tL~' an~ ~ioi~6![?c~r~'.~a~i~iial
Based upon this water quality data, it appears the encroachment, which has existed for over 10 years,
has had no significant adverse impact on the groundwater quality.
· Attached are drilling logs for the subject well and wells from several adjacent properties. Bedrock
was encountered as shallow as 6 feet and as deep as 16 feetJ The presence of shallow bedrock is
generally not favorable; however, the water sampling data indicates there has been no significant
adverse impact.
Based upon the aforementioned facts, it appears that there is minimal risk associated with granting the
following waivers:
· Well #1 on Broadwater Heights, Lot 1, Block 2 to the septic tank on the same property: 97 feet
· Well #2 on Broadwater Heights, Lot 1, Block 2 to the drainfield on the same property: 95 feet
· Well on Broadwater Heights, Lot 2, Bloc'k/Tract H to the drainfield on Broadwater Heights, Lot
1, Block 2:90 feet.
We are also requesti~.g
questions, please c~
S' ,
hat your department issue a Health Authority Approval.
s at 337-6179. Thank you for your assistance.
If you have any
3701 iEast Tudor Road, Suite 101 * Anchorage, Alaska 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: garnessengineering.com
' I/ ./ /'~
BROADWATER Hr'IGHTS /--LJI ,...---
I / I ~., I/~... ×'",,. ~** "'<,
~ k'°°'"'~''' k 'l~ .....
/ "3',
GAYNESS ENGINEEalNG GaOUg Ltd.
370~ E, TUDO~ ROAD, SUITE ~ ' ANCNO~AGE, AK ~507 ' PHONE (~07~37-b~7~ ' FAX (~07)3~8-3~Ab
PREP~ ~R: PHONE NUMBS: P~B NUMBS: .............
FREDA & RONALD NORQUIST 696-1997 1 OF 2
BROADWATER HEIGHTS SUBDIVISION; LOT 1, BLOCK 2 -~h[~._ ....~ ....... .-~
SITE P~N FOR WAIVER REQUESTS
4--23--04; 3: 18PM; ;907 5615301 # 5/ 9
:GS ReL#
:lient Name
?roject Name/#
.~lient Sample ID
tlatrlx
1041882004
Garncss Engineering Group, Ltd.
Various
Broadwater Heights S/D L2, BH
Drinking Water
'WSID 0
:ample Remarks:
All Dates/Times are Alaska Standard Time
Printed Date/Time 04/23/2004 12:18
Collected Date/Time 04/21/2004 8:25
Received Date/Time 04/21/2004 12:20
Technical Director ~..Stephen_C//Ede
Allowable Prep Analysis
'arameter Results PQL Units Method Container ID Limits Date Date Init
~ate~s Department
Nitrate-N 0.465 0.100 mg/L EPA, ~00.0
B (<=10) 04;21104 SJB
~¢robiology
Total Coliform
0 col/100mL SMI8 9222B A (<=1) · 04/21104 DPT '
4--23--04; 3:18PM;
;907 5615301 # 9/
SGS/CT&E ENV!RONMEN. TAL SERVICES '
Drinking water Analysis Report for Total Coliform Bacteria'
READ INSTRUCTIONS ON REVERSE SIDE BEFORE.COlLECTING SAMPLE
MUST BE COMPLETED BY WATER SUPPUER . .
[] Pueuc WATER S'r~r~a
SAMPLE COLLECTION: ·
Time: ~:'2.~' . ~ PM ~.~.
T~ns~d
to ~b e~' ~ Same as ~lle~ ~he~
200 W..I:~TrER DRIVE
ANCHORAGE, ALASKA 99518'
Tel: 907-562-2343. .. ..
Fax: 907-561-5301'
[-I. Routine [] Treated.Water
:
[] Repeat Sample . [] Untreated Water..
(refer to lab no.,, .'
r-I Special Purpose ·
SAMPLE TYPE:
! nE COMP. LETED BY LAI~ORATORY
Sample Receivln,q:
nme:
Temp:
I~llvery Method: C~.'
P'~'~ed Name
Results ma)- be unmfllable
[] 4~ Hour W~v~'
RIJSH ..~AMPLE. . '
MMO-MUG (P/A) RESULTS:
Analyst.: - E. C~..'
Analytical Method:
[] Membrane Filter
· r"-I ' MMO-MUG (P/A)
MEMBRANE FILTER RESULTS:
Dire~ Count' · (~
Verification:
4--20--04; 4:14PM: ;907 5615301 # 2/ 7
GS Ref.#
:llent Name
'roJect Name/#
:lient Sample ID
Iatrix
1O41769OO1
Gamess Engineering Group, Ltd.
Various
L1, B2, BroadwaterHeights S/D -- ] ~.ff / "~-~J',-
Drinking Water
WSID 0
ample Remarks:
All Date~Tlmes are Alaska Standard Time
Printed Date/Time 04/20/2004 8:56
' Collected Date/Time 04/14/2004 17:25
Received Date/Time 04/15/2004 11:10
Allowable Prep Analysis
meter Results PQL Units Method Container ID Limits ' Date Date Init
'aters Department
Nitrate-N
1.77 0.100 mg/L EPA 300.0 B (<=I0) 04115104 JJB
'~ crobiology Laboratory
Total Coliform
col/100mL SMIg 9222B A ('<=1)
04/15/04 DKC
4--20--04; 4:14PM;
SGSICT&E ENVIRONME .NTAL SERVICES
Drinking Water Analysis Report for T6tal Coliform Bacteria·
READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING raAMPLE
MUST BE COMPLETED ElY WATER SUPPUER
[-I PUBUC WATER b'YSTEM ID~ __ __' __
[~RIV~'~ WATER SYSTEM
SAMPLE COLLECTION:
~ ~b ay: D Same as mlled~ ~e~
; 907 .~6 I 530 I # 5/
2~ W. ~O~R DR~
~CHO~GE, ~S~ ~518' '
: Tel: ~7~2-~3. ..
F~ ~7-~1-5~1
SAMPLE -p/pr:- ·
[] RouUne [] Treated.Water
[] Repeat Sample [] Untreated Water . '
. (refer to lab no. ' .)
[] Special Purpose ·
'O BE COMPLETED BY LABORATORY
Sample Rece|vinq:
Date:
· 'time: l
t .,,,..
Temp:
· [--1 Sample over 30 hours ekl;
Results may be tJnmflable
;
Phone
RIJSH SAI~PI_E. .
. .Dellvenj Method: "Fa~. #:
A/~alytJcal Method:
[] ·Membrane Filter
· [--~ MMO-MUG (P/A)
eport&d By,'.
Total Cordomc
MEMBRANE FILTER RESULTS: '. D .. Faxed E~
"~- ~.~B:. ' ~] Satisfa~
. ~ [ .EC~ ~ .Unsatisfa~o~
Date~me: I . (~ ~ ~ -~ .,
. .: ~o~, ~-oos3 1~wo3
4--20--04; 4: 14PM; ;907 5615301 # 4/ 7
CS Ref.#
:lient Name
'roject Name/#
:lient Sample 1D
~[atrix
1041769003
Gamess Engineering Group, Ltd.
Various
L1, B2, Broadwater Heights S/D
Drinking Water
0
amplc Rcmarks:
Ali Dates/Times are Alaska Standard Time
Printed Date/Time 04/'20/2004 8:56
Collected Date/Time 04/14/2004 12:30
Received Date/Time 04/15/2004 11:10
Technical Director ~...=..~ ~el~.
Allowable Prep Analysis
arameter Results PQL Units Method Container ID Limits Date Date Init
raters Department
Nitrate-N
1.94 0.I00 mg/L EPA 300.0 B {'<=10) O4115/04
~UB
~crobiology Laboratory
Total Coliform
I OB,No Coli
col/lOOmL SMI$ 9222B
A (<=I'}
04/15/04 'DKC
4--20--04: 4:14PM;
SGS/CT&E ENV!RONMENTAL SERvicEs
Drinking Water Analysis Report for Total Coliform Bacteria'
READ INSTRUCTIONS ON REVERSE SIDE BEFORI[ COLLECTING
MUST 13E COMPLETED BY WATER SUPPUER
'D Pu6uc WA~. SWr~M ~
[~PRIV. AT~ WATER SYSTEM
" r-J. SendResu~ 0 'Sefldlmolee'
907 5~1~301 # 7/
~..~,~t\-
200 W. PO~R DR~
~NCHO~G~ ~S~ ~518'
Tel; ~7-~-2~3. .
F~ ~7-~1-5~1
1041769
SAMPLE COLLECTION:
Tmns~
SAMPLE TYPE:
.~.0ut~rle [] Treated.Water
[] Repeat Sample. E] Untreated Water '
(refer to lab no. ' .)
[] Special Purpose
0 BE COMPLETED BY LABORATORY
Sample Receivinq:
Time:
Temp:
Delivery MethYl.:
Commeflts:
· [] Sample over 30 ~ old;
Result~ may be m~dlable
[] 48 Ho~ W~v~r
RIJSH.~AMPLE. .
Phone t
kl~l. O-MUG (P/A) RI[SUITS: FBK JI~N ·
AhalytJcalMethod: MEMBI~J~NEFILTEREESULTS: IPho~ r--! , Faxed r--I '
'Membrane Fllter Vedrx=uon: ' ISpoke
MMO'MUG (P/A) ' ': CTB: .
"'~'-- :~.6~a:. ' [] Satisfactc~ry
.b.c.,=. { Ec; []. Unsatisfactory "
· : Form # .FW. 0053 12/17103
DATE'- Started
PERM IT NUMBER
by
DOC Co. clt:)a
SULLIVAN WATER WELLS
P.O. BOX670272, CHUGIAK, ALASKA99567 · TELEPHONE688-2759
KIND OF.FORMATION:
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MISCL. INFORMATION:
a,~/ Tor,~ ~"'
DOC Co. ~
SULLIVAN WATER WELLS
P.O. BOX !170272, CHUOIAK, ALASKA 99567. TELEPHONE 688-2759
OWNER OF LAND ~$~"/"/~"ZL L~O~J5 'j"" BORe HOLE DATA
_ DEPTH
ADDRESS_ PO 8OJ( .'7 7 o a /-'-.. /2 .,0., To
T~ INDENTIFICATION NUMBER 050~146 .
,~od of Drilling: ~r rota~ . g cable tool.
CasingType J'V~eL WallThickness.j.~0 inches ~~ ~_~OC~ ~.r
,meter__ .~ ~ inches, depth A 0 ~ I/ feet - -
Casing Stic~p Above Ground: ~ feet
Static Water Level (from grou~ level): / ~ feet
Pumping level: _feet afle~.hrs, pumping gpm
cowr Rate: ~ O ~ ~ ~ --
Well Intake Opening Ty~: ~ O~n End ~ Hole
. ~ Screen~; Sta~ ~eet Stopped ~eet
~ Pedorations Sta~ feet Stop~d feet
De pth:. from ~ ..... feet, to, ~ feet
Pump Intake Depth: ..... feet
Well Disinfected Upo~ completion?' ~e~ ~ No
thodofDislnfection:~,~' ~ ~ 'DEC 3 1'1998
..... - - Municlp~li~ Oi Anchorage
;omment,: ~/~Z Dept. Heaith & Hum""
Driller's Name_ ~ ~
ATTENTION: It is the resp0nsibllity of the property owner to submit a copy of the well log to the proper authority. Municipality
. of Anchorage: Deparlment of Health & Human Services and/or Department of Environmental Conservatlon..MatSu Borough:
Department of Environmental Conservation,
.
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DRILLER'S NAME __/.~., ./ ': ...... "---'-"' __
~:.'.'..,'.:.~z ,-- LOG OF DRILLING by A 6, L DRILLING COMPANY
· , .. t~ --
OWNER OF LAND ~ ...........................................................
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:.(.:: '"(.:.!.:.. .:. . ::.. -.:
· · ;'i. DRILLER'S
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050-081-28
GENERAL INFORMATION
Complete legal description
Location (site address)
COSA# OSC 05'5-
ExpiratiOn Date: ,~,T_ 2~''~-//
BROADWATER ~IGHTs; LOT 1, BLOCK Z
12131 W SKYLINE DRIVE, EAGLE RIVER, AK 99577
Current Property owner(s) CARRINGTON MORTGAGE LOAN TRUST Day phOne
Mailing address
Lending agency
Mailing address
1610 E ST ABDREWS PL #B150, SANTA ANA, CA 92705
Day phone
Real Estate Agent
Mailing Address
SHAYLENE ERNISSE - PRU
Day phone
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF.BEDROOMS:
3. TYPE OF wATER SUPPLY:
Individual Well :"
· Individual Water Storage
Community Class Well
Public Water System
4
TYPE OF WASTEWATER ,DISPOSAL:
[] Individual On-site
[] ' Individual Holding Tank
[] Community On-site E~
[] 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 sample results. (Certificates may be reissued for a pedod 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 below, I vedfy 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 vedfy 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 ARCTERRA CONSULTING, INC. Phone 868-3792
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 02/22/2011
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The
assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow
and absorption rates may change due to sUbsurface COnditions that may not be observed from the surface,
changeS inland use, local soil characteristics, groundwater levels that may fluctuate: during the Year and the
water usage of the family being served by the system. The operational life of all well and septic systems are
subject to these various and dynamic characteristics and are outside the control of the
evaluator of the well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
DSD SIGNATURE
V"" Approved for
Disapproved.
bedrooms.
Conditional approval for
bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
/J'/~~ Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: BROADWATER HEIGHTS; LOT 1~ BLOCK
A. WELL DATA *To Bedrock
Well type PRIVATE IfA, B, or C provide PWSID #
Sanitary seal (Y/N) Y__
*20 ft.
Date completed 1971 & 1F)1
Total depth JL?,JZ~k~L0~ff. Cased to
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform NEC; colonies/100mL Nitrate 0.596
Arsenic: ND .rng/I Date of sample: 2/1_1/201_1
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Parcel ID: 050-081-28
Well Log (Y/N) _Y
Wires properly protected (Y/N) Y__
Casing height (above ground) 15 & 30 .in.
AT INSPECTION
unk- 3/91 2/11/2011
unk - 70 ft. 38 & 39 lt.
unk - 3.75 g.p.m. .2.5 & 0.99 g.p.m.,
__ mg/L
Collected by:. ArcTerra
Date installed $/25/1992 Tank size 1250 gal.
Number of Compartments g Cleanouts (Y/N) __Y Foundation cleanout (Y/N) Y Depression over tank (Y/N)
High water alarm (Y/N) N Date of pumping 2/10/2011 Pumper 1Rs
C. ABSORPTION FIELD DATA
Date installed 5/25/1992 Soil rating (g.P.d./ft2 or ft2/bdrm) 0.8
Length 43 ft. Width 11'-25 ff. Gravel below pipe 0.,5 ft.
Eft. absorption area 791 ~ Monitoring tube Y
Date of adequacy test 2/11/2011'
Fluid depth in absorption field before test 0 in. Water added 850 gal. New depth __
Elapsed Time: 1260 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N__lf yes, give date
System type Bed
Total depth _4 lt. (Measured 2/11/11 )
Depression over field N__
Results (Pass/Fail) Pass For 4 bedrooms
5 in.
D. LIFT STATION
Date installed
"Pump on" level at
Datum
in.
E. SEPARATION DISTANCES
Size in gallons
"Pump off" level at ~
Cycles tested
in.
Manhole/Access (Y/N).
High water alarm level at in.
Meets alarm & drcuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot **97' & 100'+
Absorption field on lot 100'+ / **95'+
Public sewer main 75'+
Sewer/septic serVice line 25'+
Animal containment areas 50'+
On adjacent lots 100'+ / 100'+
On adjacent lots 100'+ / 100'+
Public sewer manhole/cleanout lO0'+
Holding tank IOIY+
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 10'+ 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 10'+
Water SerVice line 10'+ Surface water
Curtain drain 50'+ (None Known)
COMMENTS
100'+
Driveway, parking/vehicle storage 10'+
Wells on adjacent lots **90'+
*Vacant system surcharged up to the latterals prior to tesi4n~. **#WR0400ZI
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 K~.NNI~TT-I M. DtJ'FFUs
Date 02/22/2011
COSA Fee $490.00
Date of Payment
Receipt Number
(Rev. 11/05)
,
Waiver Fee $
Date of Payment
Receipt Number
SG,S
SGS ReL# 1110497001
Client Name ArcTerra Engineering and Surveying Printed Date/Time 02/17/2011 10:32
Project Name/# Broadwater Hts B2 L1 Collected Date/Time 02/11/2011 13:30
Client Sample ID Broadwater Hts B2 Ll Received Date/Time 02/11/2011 14:25
Matrix Drinking Water Technical Director Stephen C. Ede
Sample Remarks:
4500NO3-F - Total Nitrate/Nitrite - MS recovery is outside of QC criteria. Refer to LCS for accuracy requirements.
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals by ICP/MS
Arsenic ND 5.00 ug/L EP200.8 C (<10) 02/14/11 02/16/11 NRB
Waters Department
Total Nitrate/Nitrite-N 0.596 0.100 mg/L SM20 4500NO3-F B (<10) 02/11/11 AYC
Microbiology Laboratory
E. Coli Negative I 100mL SM20 9223B A 02/11/11 DLC
Total Coliform Negative I 100mL SM20 9223B A 02/1l/11 DLC
8357 M
SCALE:
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON
10' X 25' Anchor
Fb 11-1, pg 18-'J7, G.Gmer
o we~
Weft
LOT 1
Wo~
LOT 2
LOT 8
Note: Surface features including asphalt
and concrete sidewalks are approximate
due to snow and ice.
NO CORNERS ~ET THIS DATE
oremfO~owlngda~dbedpmp~. LOT t_ BLOCK 2.
BROADWATI~R HEIGHTS RHRnlvI~ION
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.enchorage,ak.us
(907) 343-79O4
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-081-.~
GENERAL INFORMATION
Expiration Date:
Completelegaldescription BROADWATER HEIGHTS SUBDIVISION; LOT 1~ BLOCK 2
Location (site address or directions) 12131 WEST SKYLINE DRIVE * EAGLE RIVER, AK * 99577
Current Property owner(s)
Mailing address
Landing agency
Mailing address
' Real Estate Agent
Mailing address
RONALD & FREDA NORQUIST Day phone 696-1997
12131 WEST SKYLINE DRIVE * EAGLE RIVER, AK * 99577
Day phone
F.S.B.O. Day phone
Unless othe~vise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
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 pdvate 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 below, I vedfy that my
investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(am) safe, functional and adequate
for the number of bedrooms and ~ype of structure indicated hemin. I further verify that based on the
information obtained from the Municipality of Anchorage tiles and from my invesb'gation and inspection, the
on-site water supply and/or wastewater disposal system is(am) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm CARNESS ENGINEERING CROUP. Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Pdnted Name JEFFREY A. CARNESS, P.E.
Phone
Date
337-6179
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in eccordance with ADEC and MOA
DSD Guidelines & Regulations. The rraported resulls described the performance of the
system under the conditions encountered at the b'rne of the tost, 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 dudng the year, and the water usage of the family being sen/ed by the system.
These conditions ara outside the control of the evalualor of the system. Satisfaclo~y 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 provfde
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 repori by any
other person or pady Is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
[.,"/' Approved for L/L bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
.
ON-SITE
~: WATFR AND :
- · WASTEWAIER ·
Maintenance Agreements ~j~ ~.,
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Supplemental Engineer's Report
Other
Original Certificate Date:
Municipality of Anchorage
Development Services Department
Bm'ldlng Safety Division
On-81te Water & Wsstewater Program
4700 South Bragaw St.
P.O. Box lg6850 An=ge, AK ~51~61L50
www.ci.anchorage ~k.u~
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: BROADWATER HEIGHTS SUBDMSION~ LO]' 11 BLOCK 2 Parcel ID:
A. WELL DATA ~I'O BEDROCK
050-081-28
Well ~ PervA~ If A, B, or C provide PWSID# N/A
9/1971 & .
Date completed 3/91 Sanitary seal (Y/N) YES
220+/
Total depth 400 ff. Cased to *20 ft.
Date of test
FROM WELL LOG
UNK & 3/91
Static water level UNK & 70 ft.
Well producfion UNK & 5,75 g.p.m.
WATER SAMPLE RESULTS:
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 31 in.
AT INSPECTION
4-/1 /2004. & -4-/21/2004.
54' & ** 14. ft.
0.17 & **0.98 g.p.m.
**WELL HYDROFRACTURED AND TESTED BY
ANCHORAGE PUMP & WELL SERVICE.
Coliform O IO
Arsenic: N/A mgJL.
SEPTIC/HOLDING TANK DATA
Tank Type/Material
colonies/100 mi. Nitrate o.I/'/o~mg./L.
Tank size 1250 gal.
Foundation cleanout (Y/N) YES
Date of pumping 4/7/2005
ABSORPTION FIELD DATA
Date of sample: 4./11/2005 Collected by:
STEEL Date installed
Other bacteria O [ O colonies/100 mi.
GEG, Ltd.
Number of Compartments 2
Depression over tank (Y/N) NO
Pumper,
5/23-25/1992
YES
System type BED
Gravel below pipe 0.5' ff.
Depression over field NO
For 4 bedrooms
New deplh 6.5/5in.
600+ g.p.d.
If yes, give date -
Date installedS/23-25/1 g925oll rating ~Or ft~odrm) 0.8
Leng~ 4.3 .ff. Width 11 '-25' fl.
Totaldepth 2.6-4..0ft. Eff. absoq~tlonarea 791 ft~ Monitoriogtube YES
Date of adequacy test '4./14,/2004 Results (Pass/Fstl) PASS
Fluid deplh in absoq~tion field before test 6.5/5 in. Water added 677 gal.
Elapsed Time: 375 min. Final fluid depth 6.5/3 in. Absorption rate >=
Any rejuvenation treatment (past 12 mo,) (Y/N & ty~e) NONE KNOWN
*N20 O 2/3 INCHES ON 4./13/2005.
Cleanouts (Y/N)
High water alarm (Y/N)
dR's PUMPING
./A
D. LIFT STATION --
Date installed :ize in gallons ~
~ Cycles tested Meats alarm & c~rcuit requirements?.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELLS ON LOT TO:
Septic tank/lift station on lot .97'&:100'+ On adjacent lots
Ab~on field on lot 100'+/'95'+
Public sewer main N/A
Sewer/septic service line 25'+/25'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absoq~tion field
Water main N/A Water service line 10'+ Surface water
Wells on adjacent lots . 100'+
100'+/100'+
On adjacent lots 100'+/100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
5'+
100'+
10'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Propen~/' line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway. parking~ehicte storage
Curtain drain NONE: KNOWN Wells on adjacent lots. *90'+
F. COMMENTS
*WNVER GRANTED ~WR040021
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems ere in
conformance with MOA HAA guidelines in effect on this date.
JEFFREY A. GARNESS
Enginear*s Pdnted Name
,~ Fee $
'~.~'~'"'Date of Payment
Receipt Number
(;~v. 12/ol)
Waiver Fee $
Date of Payment
Receipt Number
\ ¢!¢. . ...
wi~h RON'S CENERAL un~ ~o ckcumstonc~s ~ld ~y d~l~ her~ be used f~ HUB ·
S~ANA SURVEYS INC. ~'~"~'~'~"~'*~'~'"~"'""~"~'~'"-~'~- """
440LAND.sT ~ CONSTRUCTION~ENSON BL~.SUR~YORS-PLANNERS-ENGINEERS~ 103 (fax) 561-6626 AS~UILT O~ ~a~ oEs~Pn~: ~*~ ~[L-
%;--...
~o~, ~L~s~ ~o~ (~o~) ~-~o~ LOT 1, BLOCK 2,
..,.~,,-.- _,~ BROADWATER HEIGHTS SUBD.
O~SL1 3 ... I ,..w ~
GS Re£#
.~lent Name
'roJeet Namd~
.'llcnt Sample ID
,~atrh
1051854002
Garness Engineering Group, Lid.
Various
Brdwater H~.s S/D LI B2 HWall
D~nk!ng Water
Ail Dates/limes are Alaska S~audard Time
Printed Date/Time 04/19/2005 16:!9
Collected Date/Time 04/11/2005 8'.25
Recdved Date/Time 04/I 1/2005 12:30
Technical Director Stephen C, Ede
.nrn~le Remarks:
EP300 - Sample rerun out~idc of hold to confirm original concentration. Concontradon conf'u-ms.
Remits I~L Units Me~xi
Allowablc p~p Analysis
Coutnin~r ID I.~mi~ Dat~ D~to Init
Nitrate-N
2.80 0.100 rng/L EPA 300.0 B (<-I0)
04/11/05 CAM
lic:cobioloc~' Labo=atorv
Total Coliform
coVl00mL SM20 9222B A
04/11/05 TLF
'SG$ICT&E ENVIRONMEI':ITAL SERVICES ·
· Drinking W~ter Analysis R~port for Total Coliform Bacteda'
MUST BE COMPLE i,-D BY WATER SUPPLIER ' . :
r"l ;,tmuc WAI'ER ~STE~ ~ .
r-i S~d Rel~m
ANCHORAGE, ALASKA 99518
Tel: 907-562-2343 .- ..
Fax: 907-561-~01
· 1051'854-2A-"
04-20-0i~5:24PM FROI~-CT&E ESl. ScS ENV SERVICES 90?5615301
.' 'Rtl~ SG$iCT&E ENVIRONMENTAL SERVICES ·
Drinking Wate~ AnalYsis Report for Total Colifomi Bacteria
MUST B~ COMPL~ ~ ,-D BY WATER SUPPL.)ER
T-497 P.O1/OI F-473
· 20OW, PuIIt=RDRNE · .
ANCHORAGE, ALASKA 99518
TM: gOT.562-2345
Fax: g07-561-5301
,.. L
1:
' ~acterleleelcal Water analwh~ Record:
"-Membrane Filter
MMO-MuG (P/A)
'r-1 Uno.factory'
.Form # FW- e053 17./1T~3
2/ 8
~ Ref.#
~;mt Name
YoJect Nam~
lient Sample ID
1051854001
Garness 'En§ineering Group, Ltd.
Verlous
BmadwnterH~'ts 5/D Lot I Bk2
Drinking Watcr
AH Dates/Times are Alas '~a Standard Time
lerinted DatelTime 04/19/2005 16:19
Collected Date/Time 04/11/2005 8:30
Received Date/'X'lme 04/11/2005 12:30
Te~hnfcal Director Ste~hen C. Ede
tmvle Remarks:
EP300 - Sample rerun outsldc of hold to confirm original conccntration. Concentration confm'as.
Allowable Prcp Analysis
u~meter Resuhs PQL Units Mcthod Co~talner ID L~mi~ D~te Datc
Xnit
N~at~N
0,100U 0.100 mg/L £PA 300.0 B
04/11/05 CAM
icrobiolo~v Laboratorv
Total Coliform 0 col/100mL SM20 9222B A (~1) 04/11/05 TLF
SGS/CT&E ENVIRONMENTAL SERVI S ·
· Drinking W~'ter Analysis R~port for Total Coli[orm Bacterial'
READ I~'RU'~IONS C~I REVER~£ SIDE BE~eOKE (~XIECTING SAMPLE
MU~T BE COMPI.~ I ~n BY WATER SUPPLIER
,,~ Roue'ne '
~ow. e'o'~ DRZW
ANCHORAGE, ALASKA g~18
I BE COMP. LETED BY LABORATORY
I-I Repeat Sample' .. [] Untxeated Water :'
(ref*r to lab ne. ' .... )
I-I Special Purpose. :.
' 'Membrane F~ter
MMO-MUO (P/A)
.'~..=---- { Ec:. ,/ "l--I.Unsatlsfactory
Date/Time:
F~ P ~ 0053 . 12/17/O3
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
Parcel I.D.
1. GENERAL INFORMATION
CERTIFICA'TE OF HEALTH AUTHORITY 'APPROVAL
FOR A SINGLE FAMILY DWELLING
l Cf
Expiration Date: /¢i~¥
Complete legal description
Location (site address or directions)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
BROADWATER HEIGHTS SUBDMSION; LOT 1~ BLOCK 2
12131 WEST SKYLINE DRIVE * EAGLE RIVER~ AK * 99577
RONALD &: FREDA NORQUIST Day phone 696-1997
12131 WEST 'SKYUNE DRIVE * EAGLE RIVER~ AK * 99577
Day phone
F.S.B.O. Day phone
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
"IndividuaIWell [] Individual On-site []
Individual Water Storage D Individual Holding tank D
Community Class Well E~ Community on-site r'-]
Public Water System D Public Sewer D
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 dale 'shown below, ! vedfy that my
investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application,
shows that the on-site water supply and/or was~ewafer 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 was~ewater 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.
Phone.
Date
337-6179
.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 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 ~he system, nor do they guarantee that
there ara 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 r~port 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.
5. DSD sIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms. : ,- 6,~ t~,\~';,
· ~'~ ~".. .....
bedrooms, with the fllowing stipulat~on~ ~ ON-SITE
~: WATER AND
~ · PROG~M
~, ~(~ ..... ~%~ '
Attachments: HAA Checklist
Septic System Advisory
Well Flow Advisory
Manitenance Agroements
Supplemental Engineer's Reort
Other : -'
(Rev. 12/01)
Original Certificate Date:
! Development SerVices Department.
Building Safet~ DiVision
' ' On-Site Water & Wastewater Program
.:~ I ~ 4700 South Bragaw St.
ii' !;~'~ ' P.O. Box 196650 Anchorage, AK 99519-6650 . ·
t: . www.ci.anchorage.ak.us
,, ' ,. (907) 343-7904 .... .' '.
,. . w,
, HEALTH AUTHORITY
· ; ; :l~ .,, "; ' ' ; ;i :- ~ '
Legal D~scription: BROADWATER HEIGHTS SUBDIVISION; LOT .1, BLOCK 2 Parcel ID: ~-081
A. WELL DATA '*TO BEDROCK- ' '
"" ~;. ' ~ ,1
Well type PRIVATE ]; If A, B, otc provide PWSID# ,, N//A Well Log (Y/N) YES
; : ,~' 9/197,1 &
D~te'F-,Sr~pleted ' S/'91 Sanitary se~l (Y/N) ';'ES Wires properly protected (Y/N) YES
· ' ;:' i .220+/ ' ~ 12+/
T(~tal' d~)th 400 ftl ! Cased t°, ' "20 ~. i Casing height (above ground) Sl in.
, !~ '.,t- ;' '~I FRoM WELL LOG' - : AT INSPECTION
! '::' ': 3//91 4/14//2004 & *'4//21/2004
DateOftest UNK :& . . .~: ,. ,
. . i;~ ',: .... : : · .
Static Water level UNK &: 70 , :.fi.. . 54 ~ *'14 , ,ff.
Weilproduction ' UNK & '3.75 '~ g.p.m. ~ . 0.17 &: **0.98 g.p.m.
i; .. ,: t! **WELL 'HYDROFRACTURED 'AND TESTED BY .ARRIDW-PUMP &: WELL SERVICE.
wA'I~ER SAMPLE RESULTS: ' : ..
'l;: ! , -I: 1,94,/.
colif(~rmi.' 0//0 'colon'ies/100 mi. Nitrate 1.77 mg.IL. : Other bacteria, 1//0 colonies/100 mi.
"'" i'l': f i,N/A 'mgjL.. ~ Date of sample: 4//14/2004 Collected by: GE(?, Ltd.
Arsenic:
B, SEPTIC/HOLDING TANK DATA
Tank:'rype/Material ~ ~t ~STEEL/'SEPTIC ~ Date installed 5//23-25/1992
,.'-',=;il;' ' ' 'i
.' ;I~; ~-_
Tank's~ze 1250 gal. ~ NumberofCompartm~nts. 2 Cleanouts (Y/N) YES
.:. !r i{, ' :t '~ ': '
Foun~lation,. cleanout (Y/.N,) ,YES Depression over tank (Y/N), NO High water alarm (Y/N) N/A
_ .. 'Dante, ~. ;' i: ' ",;.,~'umping' .... 4/t;~:4/'2004 Pumper iUcDONALD'S PU~PINO
C. ABSORPTION FIELD DATA ";~*BELOW EXlSqlNG CP. ADE]
......... ~,,I; . , 1'.. : "
: ~' ' ' ' ~r:
Date mstalled5//23-25/'1992Soil rating~ ~t:/bdrm) 0.8 .. System type' BED
Le,ngth I.- ' 43 : fl;i · 'Width i. i 11;-25'. ': 'i fti Gravel below pipe 0.5' ft.
Total'ddPth 2.6-4.0 ft.!Eft.abSorptiOn ama:791' ~t~ ! Monitodn~ tube YES ' Depression over field NO
Dale ~f adequacy test .;4:,/14//2004 . : ;Results !(Pass/Fail). PAss For- 4 bedrooms
Fluid depth ~n ab$orpbon field before test 6.5/5 in: : Water added 677 gal. New depth 6.5/5in.
Elapsed Time: .375 min,' 'Final fluid dePth 6.5/.3in.. ' ; Absorption rate >= 600+ g.p.d.
Any' r~juvenation.: , treatment (past 12 mo.) (YIN & type) NONE I KNOWN If yes, give date -
LIFT STATION ' " .'
Date installed '·. -,Sizein gallons~ ,,~
"Pump on" level at in. Pump o~ ~n.. High water alarm level at
Datum Cycles tested Meets alarm & circuit requirements%
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELLS ON LOT TO:
:. Septic tank/lift station on lot' '97'&100'+' On adjacent lots' 100'+/100'+
!' ~' AbSorption field on let 100'+/.95'+: . ~ ..' on adjacent lots 100'+/100'+
Public Sewer main N/A Public sewer manhole/cleanout
_ SeWer/septic service line 25'+/25'+ : Holding tank
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 LOTTO:
Property line ' .10'+' 'Building foundation 10'+ .Water main N/Al/
Water service line 10'+ Surface water '100'+ Driveway, parking/vehicle stora'ge
~ L' Curtain drain NONE KNOWN ~Wells on adjacent lots
F.'. COMMENTS " .~ ""
· *SEE ATrACHED WAIVER PACKAGE
in.
G.:. ENGINEER'S 'CERTIFICATION '
/. cerf#y that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name JEFFREY A. GARNESS
Date: c~ ·
Waiver Fee $
:Date of Payment
"~.' Receipt Number
P.O. Box 196650 * 4700 Bragaw Strcct
Anchoragc, Alaska 99519-6650 · (907) 3-~3-8301 · Fax (907) 343-8200
http://www.muni.org
4~22/2004
JeffA. Garness, P.E.
Gamess Engineering Group, Ltd.
3701 E Tudor Rd, Ste 101
Anchorage, AK 99504
Subject:
Waiver Request for Broadwater Heights Block 2 Lot 1
Waiver Request #WR040021
Parcel ID #050-081-28
HAA# 040169
Dear Jeff Garness:
Your request for a waiver of the required 100 feet horizontal separation from the
absorption field and septic tank to private well has been approved. The approved
separation distance is 90.0 feet. A 90 foot waiver for well on Broadwater Heights Tract H
Lot to septic field on subject lot. A 97 foot waiver from septic tank and well#1 on subject
lot. And a 95 foot waiver from septic field and well#2 on subject lot
This waiver approval applies to the existing absorption fieldandseptictank to
private well separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
On-Site Water & Wastewater Program
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
w~vw. ci.anchorage.ak.us
(907) 343-7904
Waiver Review Worksheet
WR#: 040021 PID#: 050-081-28 HA#: 040169
Date Received: 5/11104
Legal Description: Broadwater Heiqhts Block 2 Lot 1
Engineer: Garness En.qineerin.q Group, Ltd.
3701 E Tudor Road, Suite 101
Applicant: Ronald & Freda Norquist
Permit~:
Waiver Requested: 90 foot waiver from the Septic Tan I
Criteria: Geology
· A. WaterTable
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Points:
mmmmmmmm~mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm~mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm!
Waiver is Granted: .v'"' Waiver is not Granted:
List Conditions or Reasons for above:
Date: ~'"/t~/oq By:,
Name of Reviewer
Rec#: 51861 Amount: $1150.00 Date Paid: 511112004
fro I~T5
2.b
GARNESS ENGINEER G GROUP, Ltd.
i~.,~ ............ ~" ~ ....... CONSULTANTS & GENERAL CONTRACTORS~.~.~.~.....~ ...... ~,~
April 26, 2004
Municipality of Anchorage
Development Service Department
Building Safety Division
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Reft Waiver Request and Health Authority Approval for Broadwater Heights S/D, Lot 1, Block 2
Garness Engineering Group (GEG) completed a well and septic system adequacy test for the above
· subject property. During the test, it was noted that separation distances to two wells were not adequate.
Per bur field measurements, it is just over 100 feet from the center of the well on the subject property to
the center of Monitoring Tube 2 located at the end of the trench. Given the bed width ranges from 11
feet to 25 feet and Monitoring Tube 2 is on the edge of the drain rock, it is reasonable to request a
separation distance of 95 feet from the septic system to the 1991 well. The septic system on the subject
property encroaches upon the well located on Lot 2, Tract H just over 100 feet. GEG is requesting a 90-
foot waiver for the septic tank to the neighboring well. The well was drilled on August 2, 1998. Drinking
water samples were taken from both xvells serving Lot 1, Block 2 and the ~vell serving Lot 2, Tract H.
The analytical results are shown in the table below:
Sample ID
L1, B2 Broadwater Heights S/D,
Well #1, 1991 well
Nitrate (mai)
1.77
Total Coliform (col/100 mi)
0
L1, B2 Broadwater Heights S/D, 1.94 1 OB, No coliform
Well #2, 1971 well
L2, Tract H Broadwater Heights 0.465 0
S/D
Municipality Maximum 10 10
Contaminant Levels
The drinking water sample results are attached for your reference. The following items are justification
for the waivers:
The on-site drainfield is downhill from the on-property wells and if the septic system was to
overflow, effluent will not travel toward the wellhead.
The septic system on the subject Property is uphill from the well located on Lot 2, Block H; however,
there is an MOA road right-of-way (West Skyline) that separates the well and septic system. There
are road ditches, which would intercept any migrating effluent and prohibit the direct flow of
wastewater from the septic system to the well.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: garnessengineering.com
· The location of the septic system is in a very visible area so that if any effluent was to'surface, it
~vould be noticed and the problem corrected.
· Recent water sample results indicated nitrate levels as high as
Based upon this water quality data, it appears the encroachment, which has existed for over i 0 years,
has had no significant adverse impact on the groundwater quality.
· Attached are drilling logs for the subject well and wells :from several adjacent properties. Bedrock
xvas encountered as shallow as 6 feet and as deep as 16 feet. The presence of shallow bedrock is
generally not favorable; however, the water sampling data indicates there has been no signifiean~
adverse impact.
Based upon the aforementioned facts, it appears that there is minimal risk associated with granting the
following waivers:
· Well #1 on Broadwater Heights, Lot 1, iBloek 2 to the septic tank on the same property: 97 feet
· Well #2 on Broadwater Heights, Lot 1, Block 2 to the drainfield on the same property: 95 feet
1W, eBllo°c~. ~f°~0dWfeaet~.r Heights, L°t 2, Bl°ek/Tract H to the drainfield on Broad,rater Heights, Lot
We are also requesti~,g/t~at your department issue a Health Authority Approval. If you have any
questions, please con~t ls at 337-6179. Thank you for your assistance.
Pres~d ' ,ss, S.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507
Ph: (907) 337-6179 * Fax: (907)338-3246 * Website: garnessengineering.com
,~r. :: ~-.,:-~. 4/19/2004
....................... ~'. ~,~,,~, ~p.r ....... ...:,~
FRE~A ~ RO~ALO ~OR~IST 696-1997 1 OF 2
BEOADWATEE HEIGHTS SUBDIVISION; LOT 1, BLOCK 2
SITE P~N FOR WAIVER REQUESTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P,O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
Lot I; Block 2; Broadwater H~ights
Location (site address or directions)
12131 W~st Skyline Drive
Property owner D~an & Altha Bos~J~/ Day phone ' 694-2925
Mailing address 12131 W. Skq~ne Drive Ea~le River, A~. ?9577
Lending agency
Day phone
Mailing address
Agent B~,~an Broderick VISTA REAL ESTATE
BETTER HOMES & GARDENS
Address 6~1 ~_x~t D~'_m_nnd B~_;,d.
Anchorage, Alaska 99515
Unless otherwise requested, HAA will be held for pickup·
Day phone 344-9(~03
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-
. i.ng, to the legality and status of system. ,
4. TYPE OF WASTEWATER DISPOSAL:
In~tividual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system. ,
72-025 (Rev. 1/91) Front MOA #21
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 this inspection.
Name of Firm
Address
Engineer's signature
DHHS SIGNATURE
Approved for
17034 Eagle River Loop Road No. 204
Phone
bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By:
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev, 1/91) Back MOA #21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Desc ri ptio n~~.~.~..-~'~l~---
A. WELL DATA
Well typ~,~//3~z.~--~ If A, B, or C, attach ADEC letter.
Parcel I.D.
ADEC water system number
Log p rese n_t..(~/N) y
Total depth ~¢ ~4:~ /
Sanitary seal(~/N) y
Date completed :;~1 q ~ Driller '~LI L~L.-{ V'~'~
Cased to
.Casing height ~ '~-"+'
Wires properly protectec~N) Y
Date of test
Static water level
Well flow
Pump level
FROM WELL LOG
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer service line
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
~--~. ~,.[~c4.UOoliform I : ~ ' ' Nitrate
~--~. I,J~L.c. Date of sample: f-'34~,./ t~Z.-i tct,¢t,~---
:~.~ I"v~/~ Other bacteria
Collected by: ~'~ ~ ~ ~-4~.[ ~
SEPTIC/HOLDING TANK DATA
Date installed ~l'~"'~J~'~'' Tank size [ ~) ~---t~'/-~'~ Compartments
Cleanout (~N)y Foundation cleanout~ y Depression (Y~
High water alarm (Y/N) I'~ l ~ Alarm tested (Y/N) ~'J/~
Date of pumpi,ng N.~-~'~ '"'¢'4k1-.-~ ~- Pumper b3/.it~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot l (P~ 1 On adjacent lots
TO propertY line ~ z~ I Absorption field
Surface water/d rai nage ~ 4:~:~ I ~
Foundation
Water main/service line
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C, LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical coj~s (Y/N)
SEPARATION~ANCE.FROM LIFT STATION TO:
Well on Io-r' On adjacent lots
4Vran hole/Access (,~/N)
"Pump on" le at~'''~ Pump off" level at
~ Cycles tested
Surface water
D. ABSORPTION FIELD DATA
Date installed ~j ~-~ I ~:~''~/~-~
Length ~/~ Width /
Total absorption area ~ ~ [ ~
Depression over field (Y~_~____~ ~
Results (pass/fail) ~ / ~
Peroxide treatment (past 12 months) (Y~_~ I~
Soil rating
System type
Gravel thickness .
Cleanouts present,.~N)
Date of adequacy test
for
Total depth
If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
I
Well on lot
To building foundation
On adjacent lots ~ ~--P-
Surface water [ ~)4:::D ~-Jr-'
Curtain drain
E. ENGINEER'S CERTIFICATION
On adjacent lots J ~ ~ I Property line
'~/ To existing or abandoned system on lot
Cutbank ~.--~1' ~ Water main/service line
Driveway, parking/vehic e storage area
I
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
S & S ENGINEERING
7034 Eagle River Loop Road No. 204
Signature
Engineer's Name
Date
Ea,.~;~e ~iver, Alaska 99577
HAA Fee $ /
Date of Payment "'~' :~ ' ~ -~
Receipt Number ~~ i 1~~'~
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number
S & S ENGINEERING
17034 Eagle River Loop Road No. 204
Eagle River, A~aska 99577
17034 Eagle Eiver Loop
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
ANALYSIS RESULTS £o= INVOICE t 53675
Che~ab Re£.t 92.2070 Sample t 1 ~atzix:
FAX: (907) 561-5301
Client Sample ID : NORTH ~LL L1 B2
?WSID : UA
Collected : MAY 12 92 ~ 14:30
Received : )dAY 12 92 ~ 16:30
Pzese~ved with : AS REQUIRED
BROADWATER NS.
Client Name :S & S ENGINEERING
Client Acct :SNSENG?
BPO{ :
Reql :
Ordered By :R. SHARER
POt :NONE RECEIVED
Analysis Completed : MAY 13 92
Laboratory SupeLvi~EPHEN_C. EDE.
Released By : ~~j ~
Send Repozts to:
1)S & S ENGINEERING
Pazametez Results Units Method Allowable Limits
NITRATE-N 4.7 m~/1 EPA 353.2 10
Sample ROUTINE SAMPLE COLLECTED BY: R.J.S.
1 ~ests Pe~fo~aed ' See Special Inetzuction~ Above UA-Unavailable
ND- None Detected *" See Sample Rena~ks Above
NA- Not Analyzed LT-Less Than, GT-G~eate~ Than
Member of the SGS Group (Societal G(~ndrale de Surveillance)
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
ANALYSIS RESULTS for INVOICE t $3675
Cha~ab Ref.t 92.2070 Sample # $ Matrix:
FAX: (907) 561-5301
Client Sample ID : SOU~H WELL L1 B2 BROADWATER HTS.
?WSID : UA
Collected : ld~Y 12 92 ~ 13:10
Received : ~Y 12 92 e 16:30
Presexved with : AS
Client Name :S & S ENGINEERING
Client Acct :SNSENG?
BPOt
Ordered By
POt :NONE RECEIVED
Analysis Completed : ~Y 13 92
Reports to:
S ENGINEERING
Parameter Results Un, ts Method Allowable Limits
NITRATE-N 3.5 n~/1 EPA 353.2
Sample ROUTINE SAMPLE COLLECTED BY: R.J.S.
Remarks:
1 Tests Performed ' See Special Instructions Above UA-Unavailable
ND- None Detected ** See Sample Remarks Above
HA- Not Analyzed LT-Les8 Than, GT-Greater Than
~SGS Member of the SGS Group (Soci~t¢ G~n~rale de Surveillance)
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