HomeMy WebLinkAboutBROADWATER HEIGHTS TR D BLK 1 LT 10 Municipality of Anchorage
Community Development Department Page 1 of 2
On-Site Water and 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: OSP171023 PID Number: 050-131-23 [' New 0 Upgrade
Name:
SMALL ABSORPTION FIELD
ROBERT
Address ❑✓ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
11730 BROADWATER DR ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
3 0•8GPD/SF 9 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 2.0 Ft. 7•0Ft.
BROADWATER HEIGHTS TR D 1 10 Fill added above original grade Gravel length
Township Range Section —1.0 Ft. 55 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 2.5Ft. Ft.
TO Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches
From Tank Field Tank Line 770 Ft2 1 Ft.
Well 109.5 83.8 N/A N/A 50+ TANK p Septic 0 S.T.E.P. ❑Holding 0 Other
Manufacturer Capacity
Surface Water 100+ 100+ N/A N/A ANCHORAGE 1250Ga1.
Material Number of compartments
Lot Line 18.3 7.8 N/A N/A STEEL 2
NA LIFT STATION
Foundation 37.9 39.2 N/A N/A
Manufacturer Capacity
Curtain Drain 50+ 50+ N/A N/A Gal.
Pump on level at Pump off level at High water alarm at
Remarks
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 drainfield
tod 3034
Installer
JR'S SEPTIC Drainfield 3034 CO/MT 3034
Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 699ft
Inspection 15' 05/26/17 nd Location and description
dates: 2 05/30/17
3r° 05/30/17 4th HOUSE TRIM
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp
OF
Conditional Approval: Date
1F •
• .e,�li
01
V
\C .
64b••t't'e.veri•f . •15annoraei
f+ g4• C 8149 0%
ti . c C ..
Approved +� Date 1—S1 4P i> 4
\\.\\\.4
Inspection Report_1-1-12.doc
s.
DESIGN PARAMETERS ABBREVIATIONS
PRIMARY/RESERVE SEPTIC SYSTEM \ TH TEST HOLE
NO. BEDROOM: 3 (450 gpd) i / (P) PROPOSED
TANK SIZE: 1250g OG (E) EXISTING
PERC RATE: 6-15 MPI -AA -
LOT VACANT /1\ CO CLEAN OUT NO.
SOIL RATING: 0.8 GPO/SFMT MONITOR TUBE NO.
AREA RQD: 750 SF .---NO WELLS OR SEPTICS �M.
SYS. TYPE: DEEP TRENCH- 7.0'ED \ TYP TYPICAL
MIN LENGTH: 54.0 LF
Nom -- 9 I \ \ = R
\USED: I \ \ \ , , _
55 LFx2.5'Wx7.0' E.D., 9.0' TD / I ) ..
"
TOTAL AREA: 770 SF \ �/ \\�
/ / /
\ 1>. \ N \ (4, „,
\\/
.„
z,4•
. ,‘ ., ,r� WELL (E) • , , 1 O
\\\\,,. . 0. ..
/ 1I .. . . ,.
7o9 cs)
UPGRADED DRAIN FIELD !°
• 695 1 ��
55LF x 2.5W x 7.0'ED x 9.0 TD / • • / • O
INSTALL RIGID INSULATION OR FILL , r 3BR I A
TO CREATE MINIMUM OF 3' OF COVER i • SFD DRIVEWA'ABANDONED 1250G TANK E
INSTALLED MT AND CO AT EACH END f .. QQ1
- ,� _ \ I 109.5 (E) 4- PER MOA CODE
690 ° INSTALLED 1250G TANK(
���, I I • 83`8 � „V,� � W/ DCO AFTER TANK
\�,
\\665 \79 l •\ •,• ` -Ji \
\ \ `'m , ___.
_ 1 e Si I
-\N
�/ N \ .\,6;.
�Geo _ � �� - � � � � 2b Cc��
-\
2r/ 675 � --GB_ 141 IN _x 7.: . \C' �L.
LOT VACANT \� - �� '"'�-� \ L
NO WELLS OR SEPTICS W�W N \ ` _ � _ , ` N TH2-1 9�
�� TH(PES)\'(O&E GEO•T€CI UCAL)
DRAIN FIELD (E) IN FAILURE _ N N N N N
REMOVED AND REPLACED OVER-EXCAVATION NN N
N
/ WITH CLEAN FILL 7• - \N N -N . `\ \ �q\1�
` — A C D
SEPTIC AREA-\ NO WELL ON LOT7 Ti 39.3 48.60
TH1-1979 C1 54.7 57.5
1 (0&E GEOTECHNICAL) C2 ,v 34.5 41.0
/ ,.
z
05t- > > 5
R
0 3 0 0 ,,,0 W
CO W
0 W m0� i5
L,0 v 0 0 FILTER FABRIC K 'o
- - -- Z - DRAIN ROCK 6"ABOVE PIPE INV o
OG.EL. 701 _-- 8 0Z
0 m 4"0 DRAIN PIPE a 0
-
4.0 27.8.1. F.G.E.L. 691
0.G.E.L. 690 T}-1-PES
—r Z O.G.E.L. 692 OR/
—
OC 688
/ 12509 SEPTIC GP/
696.4 TANK 688
9.0 SP 687
PROFILE 6962 7.0I688 SM!
SCALE 1'•10
681 _ _
I 55 { \681 -�rA74.5
•o cawe..rt
��T ��+ �T LLC arae/1'
NOTES: PANNONE TIG SVC, LLC ���``\\\\� Date
RECORD DRAWING ,. ,s ,OF A�gslk 1/8/2018
P.O. BOX 100217 ANCHORAGE, AK 99510 �,sP. ' t 11 Scale
PHONE (907) 272-8218 FAX (907) 272-8211 All* \',
��; *�0, 1"=50'
/ ,\`�\) •• 0 P.I.D. NO
BROADWATER HEIGHTS, TRACT D, BLOCK 1, LOT ! � -# Qa131-23
Steven f . 'Ponnone PERMIT NO.
ROBERT SMALL /
DRAWN BY: ACP 4 �F.•. CE 8149 •(Z-ii- O
11730 BROADWATER HEIGHTS 141s (���\4� OSP171023
SP1
EAGLE RIVER, AK 1 •''t��
PLAN l\\\\"`=�`— 2 OF 3
SOILS LOG - PERCOLATION TEST
TEST HOLE 1
0�' TE PLAN F
SLOPE / , • 695 �
<'\ O
1 OR ORGANICS / i /• 1 3BR ,\\ t` i'/‘
/ / 1
2 GP/ SILTY GRAVEL / 1 SFD DRIVEWAY \
3 SP AND SAND 1 (E) PDQ
ao \ 11.411r°°... \
4 • � p.\
\ • \
5 \ �
,.5------
6 sfio -'\ - Ill 5 �c��
TH ` N \- -- - -
\ \ \` •-.. 740* +, ��G\��FL
7 `675\ —GB, = /G. ss..,
\J ., .
•8 N
W W _ ^ N TH2-1 79�
9 — "---,<,
.(0&E GEOTT€CI Cp
\ \ TH(PES) •-•\ N t
10 N
11 SMSW/ \ — \ \N N �1 1
13
WAS GROUND WATER SLOPE
14 ENCOUNTERED? N
15 IF YES,AT WHAT TH
BOH DEPTH? -NA
DATE PERFORMED:05/19/17
DEPTH TO WATER AFTER
MONITORING? -NA
DATE: 06/06/17
WATER
READING DATE NET TIME LEVEL NET DROP
READING
1 05/19/17 --- 3.50 ---
2 30 MIN 8.06 4.56
3 --- 3.50 ---
4 30 MIN 7.85 4.35
5 --- 3.50 ---
6 30 MIN 7.88 4.33
PEROLATION RATE 6.9(min/inch)PERC HOLE DIAMETER 6 inches
TEST RUN BETWEEN 5 FT AND 6 FT
COMMENTS: Test hole excavated by JRs SEPTIC
PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTESPANNONE �T LLC `�����\\ Dote
RECORD DRAWING. PANNONE ENG SVC, SOF A�q�l 1/8/2018
P.O. BOX 102954 ANCHORAGE, AK 99510 r • : 1-4-10A l
PHONE (907) 272-8218 FAX (907) 272-8211 /eg,Q „4 . 7y Scale
off*:49TH /\ .*/ NTS
••• •••. 141).. .. .. 0 P.I.D. NO
BROADWATER HEIGHTS, TRACT D, BLOCK 1, LOT 11- Steven R. �Onnome 150-131-23
ROBERT SMALL E 8149 -e-;,-, PERMIT NO.
11730 BROADWATER HEIGHTS �� Fix. � � OSP171023
EAGLE RIVER, AK �O1N t , '= Sheet
SOILS LOG 1�\\\\"`_� 3 OF 3
DESIGN PARAMETERS ABBREVIATONS
PRIMARY/RESERVE SEPTIC SYSTEM / \ `,,TH TEST 'OLE 1
NO. BEDROOM: 3 (450 gpd) / (P) PRaPOSED
TANK SIZE: 1250g (E) ISTING
PERC RATE: 6-15 MPI -AA -
SOIL RATING: 0.8 GPD/SF
SF LOT VACANT 4\ `, CO CLEAN OUT NO.
AREA RQD: 750 SF ----NO WELLS OR SEPTICS -"----, MT MONITOR TUBE NO.
SYS. TYPE: DEEP TRENCH- 7.0'ED9 TYP TYPICAL V
MIN LENGTH: 54.0 LF V
moi - I \ \ Ti , x S
USED: / \ \ \ � i
55 LFx2.5'Wx7.0' E.D., 9.0' TD / I
; W
TOTAL AREA: 770 SF / \ // )(.
. ti
/ 1
/ WELL E ( •x') 10 , �� ••
v� S I / I I • / 7 1S`
UPGRADED DRAIN FIELD // • 69s ��� /
55LFx2.5Wx7.0'EDx9.0'TD ! / O
INSTALL RIGID INSULATION OR FILL /! 4 i 3BR I A
c�` /
TO CREATE MINIMUM OF 3' OF COVER / I
INSTALLED MT AND CO AT EACH END / SFD Q$ DRIVEWA'ABANDONED 1250G TANK(E)
-\
N /,. 109.5 (E 4- PER MOA CODE
\� ���\ 16�° • 83.8 ° '- _ W/ DCO ADF125OG TER TANKNK( )
q<(-/ I t 685 ` •` ��� ' .<:"S �� \
\_ 1_07.9 �9�I • �/+:
I \\,.-
,, \--, - 44 s____1, , -; , 0.,,,-/,‘0,„),0-s
20' \/, \X675 x-7.: \
LOT VACANT •Y\� - ' _\G'\ .. /.� ti
NO WELLS OR SEPTICS W�W ` _ - - TH2-179
/ • - � TH-(P)N N.(O&E GE T€CI CAL)
!� DRAIN FIELD (E) IN FAIL ARE (PES)
REMOVED AND REPLACED OVER-EXCAV• ION /
WITH CLEAN' FILL N N \ N NI "1\
` - A C D
SEPTIC AREA� (0&E GEOTECHNICAL)NO WELL ON OT Ti 39.3 48.60
1 TH1-1979 Cl 54.7 57.5 •
C2 34.5 41.0
z
O� t 7 7, ,_ j
QO 8 O O w0 W
ozaZ z W
OW y� W W 7W ~ n r•
i 0 C C 0 o 0 0 0 FILTER FABRIC c. o
OG.EL. 701 w z DRAIN ROCK 6"ABOVE PIPE INV 2
z
4"0 DRAIN PIPE f
4.02 _.R.l, F.G.E.L. 691
O.G.E.L. 692 O.G.E.L. 690 TH—PES
-----
•_r '—I—__ OR/
OC
/ 1250 g SEPTIC OC 688
596.4 TANK 688 /
696,2 7.0
0
9.0 SP 687
PROFILE 668 Sw!
SM
SCALE 1'•10
681
I 55 681 �i
pal.74.5
avoai,.
NOTES: ������xv, Dote
RECORD DRAWING PANNONE ENG SVC, LLC -OF A/gkl 1/e 2018
P.O. BOX 100217 ANCHORAGE, AK 99510 r 'c. 9 $
PHONE (907) 272-8218 FAX (907) 272-8211 /egoP �4,..t.5,1# Scale
:1*.. 49 •.*l0 1"=50'
P.I.D. NO
BROADWATER HEIGHTS, TRACT D, BLOCK 1, LOT 10 '1� ' n_n050-131-23
ROBERT SMALL A Steven R. oo�ae PERMIT NO.
DRAWN BY: ACP O r�,•, C 8149 .•�j OSP171023
11730 BROADWATER HEIGHTS rIIcs .'•CiI•rj.-�,� Sheet
PLAN EAGLE RIVER, AK 1k PROFESSION-4 2 OF 2
\\��x�
Carroll, Rebecca M.
From: Steve Pannone <Steve@panengak.com>
Sent: Wednesday, January 31, 2018 1:50 PM
To: Carroll, Rebecca M.
Cc: Joseph Lawendowski
Subject: RE: BROADWATER HEIGHTS TR D BLK 1 LT 10
Yea, I got it. The existing system was abandoned and removed surrounding the new system out ten feet, but JR's left the
Old Clean-out pipe at the end of the abandoned trench...Don't ask me why, but its there. It's the last part of the old
system still in place.
Steven R. Pannone, P.E.
Pannone Engineering Services, LLC
907.272.8218
907.272.8211 fax
Please Check Out the NEW www.panengak.com
Agents/Clients can order tests online, check status and email staff
PES give our Active Military/retired Vets a 5% discount on Engineering services.
From: Carroll, Rebecca M. [mailto:CarrollRM@ci.anchorage.ak.us]
Sent:Wednesday,January 31, 2018 12:28 PM
To:Steve Pannone <Steve@panengak.com>; Pannone Customer Service<Customersvc@panengak.com>
Subject: BROADWATER HEIGHTS TR D BLK 1 LT 10
Steve, not sure if Tim e-mailed you this comment, so I am sending it so you have it ASAP.
M4— ctilQf SCA14 tir stm/k-t,
e z'iook.tt^-c2)( o\-) 0 (
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
MAILING ADD
II~'I~EW
I--]UPGRADE
LEGAL DESCRIPTION
LOCATION
]~ell P' narea Dwel ng
DISTANCE TO: qO [ ~
Manufacturer ~ ~ ~.~ ~idth
InsMe length
~iq. ca~acitg IF
~oll ~ollin~
Length of each line ~otal length of linCs~rench width~
Top of tile to finish grade Material beneath tile
ten,th ~idth ~e~th
3rib diameter ~~ib depth
Building foundation ~ Sewer line ~_ &~ Septic tank
DISTANCE TO: _~ ~
No, of oomp(~ments
Liquid depth
PERMIT NO.
- ~Werf~tlons
PERMIT NO...79 ~.~ ~ L~ (4::)
Total effecti~a~s~tfon area
PERMIT NO,
-~a~re~ .,Loij~ffective absorption area
IPERMIT N O.,_~
Absorption
OTHER
PIPE MATERIALS
LEGAL
DATE
t'"lt:::!;:':: :[ t"ILtJ't NlJJ"I['!iJE!!iI:;i: ()1::;' li!i:tFl":,l:;'O 'Tll'"t'!!! :::' ,.:J.
"l"~..ll~i!: L..i}ii:l'.~Ci'i'H [::, :[ f'tEZN:!!i; :[ ON :[ S THE L...I~i~N(:!i'T'H ,:: I I'.,t I:::IEET ) ElF -l" !...I Fi!: 'l"Fi:Ib'_'i'-$Z:H OF;i: !)F;i:I:::1:1: I'.,!F::' :[ Ii.'".;L..[:,.
"f' !,',l l!.;.': DE?TH OF I:::! TF;i:IEhlE:H Ot:;i: F::'IT :l;:ii!; 'l['J'"lJ].;.': D_Tt!!..';TF!i'.,IE:[~; BI:iL'I"HEE]:I',I 'THE :~!;l. jt:;~:j::;'l:::l(:.':t~i!; i:;iF '?'HIE
r.;iil:;¢r(7.H_fl'.~[:, I::I1',11)'T'HI!!i; E:OT'l"(;Zii,! OF:' TI".It~:T-. IE;:.;jE:F:i',/iSl"I";[OI'-,I ,:;];t'.]
'I"Ht~E;F;?IE X :i!!; bio SE'T' H ]: D'I"H F::'OFR
'I"HE GF;;:I:.:I',/EZl .... [)fEF::'TH :[:!i!; 'I"HIE h~];P.,l];l',~l..l~,l [)ti.:.';F:'TH O1:::' I}iF;;:!:::l¥[i!;J. E~E'I"I,.tEi;I~!i;N THE: Ot..rl"t:::'l:::it...L.
f::l.l',JD Tl...lt~i!; Ei r:' T T ;;; !"1 (;)F::' 'i"HEi; [!i;::.:;C:!:::l',/l::l'l" ;[ r;)i'-,. ,:; ]; i",l F:'FiiLliii;T ).
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::L 5 I?f T 0 2~i:.~l?.~ l:::l!E;liE; T F R O i"1 I:::1 I:::'lJ!f!i:!.... ;!; E: !.,.tIE L..I .... D E: F:' E t',tD ;!; !',1G l.J J;::' ()i'.,! T H fE l" "r' F::' !:i!; 0 F PI..lt}!ill... ;1; C I.,.tt:i!;!.... I.
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i:::I","1::1 ;[ Lt:::lli?,f....l!i[ 'T'O ]; N'.ili;I...l.r.;?.E PF;;:CIPI~if;i: 1' I'.,t::?FI:::ILI...F!T ] CIl'.,I.
;I; C:!ERT ;1: F'./ 't"HFIT
:1.: ;[ I::1i',1 f::'l:::!l','!];I..~.];!:::l~;?. H]iTH THE I:;~:IE(;!I...I]:!:;?.[EI','IIEI',IT:'~!; FOR Ol'.,l..-.:!i!;]]"l"t:ii;
FEII:;?.TH l~ii?'r' 'T'HI}ii; I"11...11',1 ]; C: ;I; F'I:::II... ;I; T'-r' O!:::' f::II",IE;HEU::.':I::I(;iiE:;.
;.';!:: ;l; l,.t ;I; M .... ]; I"4STFILI... THtE '.!?'r'li:i;'l"!!'Zh'l ;!; N I::IE:E:EU:;i:!')I:::II",IE:E H
}i;: ;[ l...fl',l[:,f~ii:lF~:S'T'f::ll',ll)/ '~"HF::iT THE (;) t",! ""' S ;[ T IE '.:~;~;t.,.!E!;B: S"r'IE;TIEi'"! l'If::l"r'
t:;?. E :iii; ;I; f)EI",ICI:i!: :1; :i~; I:';~:l"~;:,!;;:,l!:i;l~.~",r'.~ :I:I'.,I(%..UB',E//HOI:;i:E THF:i!',I
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/
'::: ..... :" ::: .... : .................................... ,,~;:;i;-i .........................
;I; :iii;'.:i!; I...I Ii!!; t;;:, F: 'r' ....~ ~. '-"~'~'~-'-~---~ '"':' I:::1 'T' ::'
0,8- E
Russell Oyster
694 2774
Soils El' Foundations
GEC, ,'ECHNICAL 8 DEVELOPMENT
th~ !~). I.hiv~:.-. '.:.~1 . I ,l!lh~ t'hw,. AIm.k,t !ltl!)//
694 2774 (,' 688 2280
Performed for: Name:
Hal]tng Address:
Legal Description: Z o~ /L~ i
Depth (feet)
/-/~ /._ /.--
0
5
6
7
8
9
11
12
14.,
15
Z6
SOIL LOG
/-40L E
~ot1 Ch~rqctertstlc~
CO.
Ead E/lis
Land Development
Tel. No. ~;,?,,z/:~. ,_~Z 7~'
//rs. .~ a~.
GrOund Water Encountered: Yes /
Proposed Installation: Seepage Ptt~
Comments:
If yes, what depth
Drain Field,,
Performed by:
- ~' .n.. ' CHuGiAYb,/ALAsKA
' WE SERVE ALL ALASKA
· . . POST OFFICE SOX 42 -- CHUGIAK, ALASKA 99'567
OWNER OF ~ ~LAND ~*~'I,~-'~:~ r~,~ ·
!.
"ADDRESS 'lq 0 ~ ','~tv, e Pa,-
.... ~..m~ ,r...2..~ ...... Sky. ..................................................
,, WELL - SITE. 2,Y~..~,. ~......B...'I...,B,~.. ~.0,.w,;a.t o.~......ql,; ~...~a~¢ ................
- ST,U/rED ...L.p..e...b.e...m.~.e.~...t..~.,B...t, ............ : .............................
DATE
r~ATE - ENr~ED .......... .Ee.k,....6..,....t.9.~ ...............................................
KODIAK, ALASKA
4864826
KIND OF FORMATION:
Fr. TO ....... .3_, ........ FT. ~:U2. ........................
45 /' h'm Blue clay
FROM ....................Fr. TO ........ELl .............................................
FROM ...................... Fr. TO ......~. ............... FY ....................................
FROM ....................... Fr. TO ....................... Fr .................. ~ ...............
FROM ....................... FT. TO ........................ FY .................................
FROM ....................... Fr. TO ........................ FT .................................
FROM ....................... FT. TO ..................... ~.. FT .................................
FROM ....................... ~'T. TO .....,:i ............... FT .................................
FROM ....................... FT. TO ........................ FT .................................
FROM .......... .: .......... FT. TO ........................ Fi' .................................
FROM ....................... FT. TO ........................ Fr .................................
FROM ...................... , FT. TO ...................... ~ Fr .................................
FROM ...........~ ........... Fr. TO ........................ FT .................................
FROM ....................... FT. TO .............~ ......... FT ....................... .L ........
FROM ....................... FT. TO ........................ Fr .................................
MISCL INFORMATION:
"Caseing at 66 f{. rockfrom there on."
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
ROBERTSHAFER, P E
ROGERSHAFER, P E
February 11, 1993
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
RECEIVED
FEB 1 1 199i)
Mu,.Hc~p~l~[yotAnchorage
Oept. Health&HumanServices
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Attention: Dan Roth
P.O. Box 196650
Anchorage, Alaska 99519-6650
Reference: Lot 10, Block 1, Broadwater Heights Subdivision
Dear Dan,
This letter is to inform you the well located within the
utility easement on the referenced property has been
abandoned. The abandonment was performed by Dean
Construction on February 10, 1993. The well casing was cut
off at approximately 6" below the ground surface, and the
well was filled with sand to approximately 5 ft. from the
surface. The remaining 5 ft. of casing was filled with
concrete.
Please call me if you have any questions.
Sincerely,
ROGER J. SHAFER. P.E.
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
I31K INCH WATER WELL DRILLED AND CASED OUt TO THE DEPTH OF .....
DRILLED AT THE RATE OF
;:.~". PR~OpERTY OWNER
:';"LOCATION OF WELL SITE,
DRILLER '
I179,00 PER fOOT.
JO0
7o,t.z~ 'Ca~;L o~ ~),~d, Utd/rg: 250 X ~19.00 S4750.00 Jla
INCLUDES. ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING,-
;.;WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF $47.~0.00
THANK YOU VERY MUCH. .,'.
BERNIE CLAUS OF RAMPART DRILLING WORKS
DATE ' R~:,ld.~ 26,~, 1979
am
MUNICIPALITY OF ANCHORAGE
"p A�4
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050-131-23
1. GENERAL INFORMATION
Expiration Date: CI -2 q -2
Z
Complete legal description BROADWATER HEIGHTS TRACT D, BLOCK 1 LOT 10
Location (site address) 11730 BROADWATER DRIVE EAGLE RIVER, AK 99577
Current property owner(s)
Mailing address
Real estate agent
ODIE ANN BREWER
Day phone
11730 BROADWATER DRIVE, EAGLE RIVER, AK 99577
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
phone
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5 5 0
Date of Payment 6 Z 1,51,2 0'Q a
Receipt Number 70 516 L/
COSA # SC a � 8
Date:
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 6/14/22
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. 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 in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
�Qk,��
these various and dynamic characteristics and are outside the control of the evaluator of the •�fG
well and septic system. Therefore, any estimate of how long a system will function satisfactory %: • •~..
for current or future occupants or guarantee that no unseen encroachments, deficiencies or fig•• •.9 �j
discrepancies exist can be given by First Water Consulting & FWCS ' *• lli , , • , ,.;*
: .. Vim_
6. DSD SIGNATURE Curtis Huffman
System #1 Approved for bedrooms ��+�Fc�s •, CE 128991 •.T�.�
System #2 Approved for bedrooms �i1,F�pROF SSIONP���—"
Disapproved
Conditional approval for bedrooms, with the following stipulations:
ON -St
TE
o
=- g3 WASTLyilATED
0 1'ROGRgM
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BY Original Certificate Date: _2 L? 22
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
r
Legal Description: BROADWATER HEIGHTS TRACT D LOT 10 Parcel ID: 050-131-23
If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system
A. WELL DATA
® Well log is filed with Onsite (or attached) Well production at time of test 1.3 gpm
Date drilled 2/6/1982 Water storage tank volume 500 gallons(GREER PLASTIC)
Total depth 400 ft Well disinfected for coliform test? ❑ Yes ® No
Cased to 66 ft ® Coliform bacteria is Negative
® Sanitary seal is functioning correctly Nitrate 3.33 mg/L ❑ Nitrate less than MRL (ND)
® Wires are properly protected Arsenic ug/L ® Arsenic less than MRL (ND)
Casing height (above ground) 18+ in.
Date of flow test for COSA 6/10/22 Collected by
F`
�=
Static water level at beginning of test 206 ft. Date of Sample 6/10/22
Comments 2 GREER WATER STORAGE TANKS WITH PRODUCTION APPROXIMATELY 1.3 GPM.
B. TANK DATA
Age of tanks) 5 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 51"
® Standpipes/foundation cleanout per record drawing
Date of pumping 6/9/22
D. ABSORPTION FIELD DATA
Which system tested (date installed) 7/17/22
® ALL standpipes present per record drawing
Total measured depth from grade 13ft (max)
Measured depth to pipe invert from grade 6 ft (min)
❑ N/A — pressurized field
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Adequacy test date 6/10/22
Results ID Pass For 4 bedrooms
Fluid depth prior to test 23 in
Water added 600 gal
New depth 23 in
® Monitor tubes go to bottom of effective. If not, state Elapsed time <5 min
depth into effective MOA IR SHOWS 7'ED
® Code -required soil cover over field Final fluid depth 23 in
❑ System presoaked Absorption rate 600 and-
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N
date of test)
Gallons introduced gallons If yes, enter date
Comments/Deficiencies: E MT/CO AT GRADE W/ SAME ELEVATIONS. W MT/CO DRY. Fes,,
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No
Neighboring Absorption Fields > 100'
Water Service Line > 10'
® Yes
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ®Yes
if No
ft
® Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100' ® Yes if No
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100' ® Yes if No
Water Main > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No _
Water Service Line > 10'
® 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'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
w, A
l certify that l have determined through field inspections and review Qom.
of Municipal records that the above systems are in conformance •: ���
with MOA COSA guidelines in effect on this date. / : • . TM . , • •': ��
Curtis Huffman
r� �°F'• CE 128991 r+'
bi17/2 �.-A41.�
Oft_ OFESSt
ft
ft
ft
ft
ft
ft
ft
ft
18910 0
Municipality of Anchorage
On-Site Water and Wastewater Program 1 :
(907) 343-7904 d JAN 0 9 ', F Eli
certificate of On-Site Systems Approval `4 •
f3
1 . 9L °' a
Parcel I.D. 050-081 72 Expiration Date: / •
1. GENERAL INFORMATION
Complete legal description Broadwater Heights Tr D Block 1 Lot 10
Location (site address) 11730 Broadwater Dr.
Current Property owner(s) Robert Small Day phone
Mailing address 313 7th St. Apt. 1 Juneau, AK 99801
Real Estate Agent Day phone
2. TYPE OF DWELLING:
O Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by ),/ • I / Date9/1, a/ /I 8
COSA to be released to the engineer,unless otherwise requested by the a eineer.
COSA Fee $ Av. Waiver Fee $
Date of Payment 1 1 I[ig. Date of Payment
Receipt Number Q(04�"(G Receipt Number
COSA# OS J8 100B Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined
in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply
and/or wastewater disposal system is(are)in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at
the time of installation.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we ca not provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole'b%nefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 1/9/2018
Agkk
l
•
•
6. DSD SIGNATURE 0 W • y�
l'- System #1 Approved for 2 bedrooms >' --•.S'ceven R. 'annone: /
�• CE-8149• • &�
System #2 Approved for bedrooms �� 4)•. "�
Disapproved !'k \?O`k
Conditional approval for bedrooms, with the following stipulations: •
•�c\( OF A 4O
ON-SITE
WATER AND
WASTEWATER o
PROGRAM
SER
By: FZe Original Certificate Date: I J
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
<. . ;
COSA Checklist X Nitrate Advisory,. , ;
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet' '- c
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Broadwater Heights Tr D Block 1 Lot 10 Parcel ID: 050-081-72
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed 2/6/1982 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 400 ft. Cased to 66 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 2/6/1982 1/4/2018
Static water level 330 ft 47.6 ft
Well production 20 GPH gpm 2.4 g p m
WATER SAMPLE RESULTS:
Coliform t\LQ,Q colonies/100 mL Nitrate 2.01 mg/L
Arsenic i t7 ug/L Date of sample: 1/4/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 7/17/2017
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A
NEW Pumper N/A
Date of pumping
C. ABSORPTION FIELD DATA
Date installed
7/17/2017 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 GPD/SF System type Deep Trench
Length 55 ft. Width 2.5 ft. Gravel below pipe 7 ft.
Total depth 9 ft. Eff. absorption area 137.5 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NEW Results (Pass/Fail) For 3 bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
geoO
G. ENGINEER'S CERTIFICATION .cl- F`\�
O Aqkkk
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in re*:• . ! • \ . '9 ��f
conformance with MOA COSA guidelines in effect on this date. ;I � r
EnEngineer's Printed Name Steven Pannone
g ••:Steven 13. Pannone•
Date
1/9/2018 6,?:..• CE-8149• �"
COSA canary sheet_2-6-15.doc
\ \ 8468T
30
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Lot 9 \ G "y0
(t\ \ AA
.�` Shed ' \ o0 \1:14‘
�6�� cl�pl \ �/' ��0
_.,.....---"'"--
.,a �0° cD ��L
411 1 f6, 30.0 I deck 21'
10'x 20' Water Well Easement Well 2 Story Frame \
(Book 2370,page 183) / House with 20.3 \ tcP
deck M Basement ce, Carport N dt e" \
\------------- 30.0 20.3 \
IIIUIIIIIII DoH n \ \\
L12.4J CO
Deck \ (§)
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Ret.wall ° \
0%
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,\o //
Off'
Lot 20 sQ Septic vent(typ) s \
/ "c''--'3,o, ,\Noo
F o
/ ���01 ,OO� y Pic'°t�aseme�t
000 XZ
,,..01 Lot 11
Lot 19
AS-BUILT NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
.,0\ ‘\ of the following described property: LOT 10, BLOCK 1,
a"
� OF •AL_%\ BROADWATFR HFIGHTS SUBD . TRACT D
�••• •S- /, Anchorage RecordingPrecinct,Alaska,and that the
• 49th �\ ••9 improvements situated thereon are within the property lines
2.{�' d and do not overlap or encroach on the property lying
_� �/ 0 - adjacent thereto,that no improvements on the property lying
(/y cva adjacent thereto encroach on the premises in question and
f •.Fred WoI a tka,ao / that there are no roadways,transmission lines or other
�: • . �, visible easements on said property except as indicated
siF,•• 3255 — S ••• s)e• ,� hereon.
SCALE: 1"= 30' /l 1Fo •'• • . o'' "' Dated at Anchorage,Alaska
EASEMENTS OF RECORD,OTHER THAN I 'PitFEssIoNA�•�P`� this 18th day of January ,2018.
THOSE SHOWN ON THE RECORDED \\`-S.% FRED WALATKA&ASSOCIATES,L.L.C.
PLAT ARE NOT SHOWN HEREON Engineers and Surveyors
UNLESS OTHERWISE NOTED. Seward, FB 18-1, pg 16 BE 907-248-1666
MUNICIPALITY Of ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
Lot I0; Block I; Broadwater H~i,qhts
Location (site address or directions) 11730 Broad~at~ D~/ve
Property owner
Mailing address
Lending agency
Mailing address
Conno~cThomas
11730 Baoadwa~ D~.u~r
Day phone
Eagle. Riv~; Ak.
Day phone
694-9446
99577
Agent Cindy Wilson DON McKENZIE REAL ESTATE Day phone
Address Old Glenn Highway; Eagle River, Alaska 99577
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
694-9035
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
XX
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Engineer's signature
17334 Eaglo River Loop Road No. 204
Phone
Date '~ - ~ o- ~'Z..
DHHS
SIGNATURE
Approved for .~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
~L~ ,P. ~:/~c.~" LUA-~-P.. L~JA~tv'~--P...,
By: 4 ~ ~4(q '~'t"t I'T]nL Date
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
WATER WELL ADVISQRY
HEALTH AUTHORITY APPROVAL NO.
During a recent Health Authority Approval on-site inspection and
test of the potable water supply well on Lot /o Block /
of ~ D ~f~~-~- F~/a~cs Subdivision, the well's productivity
was determined to be O~ gallons per minute. The minimum well
productivity required by this department (AMC 15.55) for
a ~ bedroom residence is O.~l gallons per minute.
Although the subject well currently exceeds this minimum
requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of
noncritical water uses such as washing cars and watering lawns
and gardens may be required.
This advisory must be attached to all copies of the subject
Health Authority Approval.
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~ t~:~ ~'...~...~--. I
Parcel I.D.
A. WELL DATA
Well type~""~'t'Z-\~/'~'~[~-~ If A, B, or C, attach ADEC letter.
Log present ~)/N) ",// Date completed
Total depth ~--~ Cased to (4~,l... I
Sanitary seal ~:~) ~
ADEC water system number '"'---"
'~.-~,. ~'Z.. Driller ~/'-~ ~k~lL.L.l,~-~'t~
"1'% ~ Casing height \'7.-~
Wires properly protectedf~)r, ~/
FROM WELL LOG
Date of test ~.
Static water level
Well flow
Pump level
AT INSPECTI~_ _,~ ~
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot ~ ~ 'P
Absorption field on lot ~ i' (V~V'~-I~)
; On adjacent lots
; On adjacent lots
Public sewer main
Sewer service line
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~ Nitrate
Date of sample:
Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed ~ c,/~,~
Cleanout~/N) y
High water alarm (Y/N)
Tank size \"~-0 Compartments
Foundation cleanout (?~) i~ Depression
Alarm tested (Y/N) ·
Date of pumping
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot ~ c-°~
.To property line
Absorption field
Surface water/drainage
Foundation
Water main/service line
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Manufacturer
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed ~,'="/'1
f
Length ~¢3¢~¢ Width
Total absorption area
Soil rating
Gravel thickness
Cleanouts present2~N)
Depression over field (Y.d~) ~-~'
Results ~l~;i~/fail) · ~~S
Peroxide treatment (past 12 months) (Y~j:;' 1~:2~:.
System type"~~4'
Total depth ~,~ !
¥
bedrooms
Date of adequacy test
for ~
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
f
Wellonlot '~.1 ~..~?2~,Z~lV~_3'~ On adjacent lots
To building foundation
~ ~.~sting or abandoned system on lot
On adjacent lots ~'~¢=' ~ '~ Cutbank Water main/service line
Surface water
Curtain drain
'~' ~ ~~'~¢-'~'~--'~)Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
S & S ENGINEERING
~ . 17034 Earl, River Loop Road
~ignature ............
Engineer s Name ~~
Date ~- ~0-- ~ ~
HAA Fee $ / 7~),
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $
Date of Payment '~-*'L/~, ~ '~__
Receipt Nu
m ber
unicipality of Anchorage
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
February 3, 1993
Roger Shafer, P. E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Subject:
Waiver Request for Lot 10 Block 1 Tract D Broadwater Heights
Waiver Request #WR920055, PID ~050-131-23
Dear Mr. Shafer:
Your request for a waiver(s) of the required 100 foot horizontal
separation of a septic system to the surface water has been
approved. The approved separation distance(s) are leachfied to
surface water of 94 feet.
This waiver approval applies to the existing septic system to
surface water separation only. Any future upgrade to the septic
system will require all separation distances be met or another
approval from this department. Should the operation of the
subject wastewater disposal system cause any contamination or
degradation of the subject surface water, this waiver will
become void.
S~ere ly,
Daniel J. Roth
Civil Engineer
On-site Services
Concur: ~ /
On-site Services
ljm:~5
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
ROBERT SHAFER, P.E
ROGERSHAFER. PE.
September 10, 1992
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
Muni~pality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anch. orage, Alaska 99519-6650
REFERENCE:
RECEIVED
SEP 1 5 1992
Municipality of Anchorage
Dept. Health & Human Services
Lot I0; Block l;~Broadwater H~ights Subdivision;
Request you issue the attached Health Authority Approval and grant a
waiver for the horizontal separation distance between the septic
system serving the referenced property and a small stream at
approximately ~4 ft.
The stream is very small. At this time the flow of the stream is very
minimal, however, it is suspected to increase considerable during
snowme~t and rainfall events.
As can be seen from the attached annotated as-built survey for the
property, due to topography, there is little to no chance the stream
can be contaminated by the referenced septic system..
If you have any questions or require additional information for your
review, please contact us..
Sincerely,
ROGER J. SHAFER, P.E.
RJS/gm
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
S & S ENGINEERING
17034 Eagle River Loop Road No. 204
Eagle River, Alaska 99577
Flow is not Guaranteed
Subsequent Var;atlons.
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
June 24, 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
S~TE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
Cindy Wilson
DON McKENZIE REAL ESTATE
13135 Old Glenn Highway #100
Eagle River, Alaska 99577
REFERENCE: Lot I01 Block I; Broadwat~r H~ights Subdivision;
Dear Cindy,
At your request an adequacy t~st was p~rformed on the septic system
serving the referenced property on June 23, 1992. Water was added to
the system while water level m~asurements w~re taken from the
monitoring tube within the l~achfield. From this t~st we found the
system to be functioning adequately for a ~ bedroom house. However,
the system cannot be guaranteed against subsequent failure.
During our site visit we found a small stream on (or near) the
property. This stream is approximately 95 ft. from the septic
l~achfield as opposed to the 100 ft. required by State Regulations.
Prior to obtaining a Health Authority Approval, a waiver for the lesser
separation distance will need to be obtained.
During the septic adequacy t~t a flow rate was performed on the well
serving the property. (The 2nd well n~ar the road do~s not appear to
be in use.) The static water level was measured at 30 ft. from the top
of the casing. A meter was connected to the system and the flow turned
on full. The water level was then drawn down to the pump where the
flow rate was initially measured at 5.1 gallons per minute (GPM).
However, throughou~ the test this flow rate decreased to less than I
GPM when the pump had to be shut off and a series of recovery t~sts
p~rformed. At the end of 4 hours of use the flow rate from the w~ll
had still not stabilized. This type of continu~y decreasing w~llis
common for the area. The flow rate may continue to decrease for
several hours after which the flow rate may eventu~ly stab~ze. At
this point we recommend a prolonged s~i~ of recovery tests over a 24
hour p~riod to obtain a true and ace. urg,,te w~ll flow rate. The last
recovery test we performed showed a flow rate of 40 gallons per hour
(GPH).
Water sampl~ were taken from the well and t~ted-for coliform bacteria
and nitrate. The r~It~ were satisfactory.
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
Pa~e Two
Lot 10~ Block I~ Broadwat~r He~ght~ Subdivi6ion;
June 24, 1992
Attached pl~as~ find an invoic~ for th~ work p~rform~d thu~ far.
i~ a cost ~stimat~ for th~ re~aining
C~rtificate:
I. 24 Hour w~ll flow te~ting
2. Application for strgam to septic
waiv~ (THIS I~IF AS-BUILT WITH/STREAM
LOCATION IS PROVIDED)
3. Municipal Wa~er Fee
4. Municipal Certificate Fee
TOTAL =
If we may be of further s~rvice, plgase contact us.
Sincerely,
ROGER J.
The following
ne¢~66ar~ to obtain a Heo. lth
300.00
150.00
590.00
170.00
$1,210.00
/" = $0'
SCALE
SITE PLAN
uult MCI<,LN/Ib KbHL b%;I. TEL:907-696-6900 Oct 02,92 10:1{; No.O01 P.02
, ! -- p · Health & Fluman Services
FOLLOWING DESCRIBED PROPERTY, Lot 10, , 1".= 30~''
Block 1, Broad~ater Hei¢[e SU~iviston ,. DATE, '--
AND ~AT NO EN~HMENT~ EXIS' ~C~, A~ '
~ ~ ~..,.~ T.~ ~sT~:E .OF.~Y'...! SMD,'., ..
WHI~ ~'NOT ~PEAR ~ THE, RE~ RD~' ~aO]-,:' .
',
~ DATA:H~N BE US~,F'OR C0~S~U~iON: ,31-66
DON HcKENZIE R£RL EST.
. . . ~, ;¢.j
12:19 No.O0~ P.O5
ENSI'AR Nmtuml Oas Oompmny
A DI\'I,'31ON OF SEA~UI.L ENERGy' ¢..OFIPORATi(gN
P.O. Box 190288
Ar'10hor:"l~;~., A%!A8 99519-0288
(907) 277.,5551
November 24, 1992
Don Mokenzie
Don Mckenzie Real Estates
13135 Old Glenn H~y, Suite
~a~le R~Ve~"Xla~ka, 99~77
TO W~OM IT MAY CONCERN:
ENSTAR Natural ~as Company ha~ no obje~tion to the Well that
encroaohes J. nt ~ the utility easement on Lot 10 Block 1
B~oadwatez. MeJ~ts SubdivJ. slon.
If you have any questions
Very truly yours,
ENSTAR Nattlral ~as Company
Dave Titus
For Dan We~tervelt
Right-of-Way Agent
DW/yh
.S_T_.A..~MENT OF NO.~OB.1ECT;ON FOR E~CROAC:BM£NT
WITH/N UTILITY EASEMENT
Matanuska Electric Assoc.[ation, lnc, (ME^) has no objection with the location of
a.--...wa~..wel~..ca&~rm th~n the utility ~asement
. ~,~ ,
Lot 10, Block 1 BROADWATER HE
~.., , . [G,.[a SUBDI¥ISION accordin§ to
Plat No, 70-~,~, Anchorage Recording gistr~ct, Third Judicial
District, State of Alaska
This non-objection is conditioned by the ~HpuletJon that M£A will be held
harmless from any ,~nd ;all dema~e~ to the encroachment that may result from the
exJstJn~ and ~uture use o.¢ sa.;d easememt.
by:
Electric Association, ..!n_c.__
Genera! M~-t~§~ ori~h~S-R~pr~senta~'ive
December 28, 1992
Ddte .....
MEA ACKNOWLEDGEMENT
STATE OF ALASKA
THIRD 3UDICIAL. DISTRICT
ss.
The foregoing agreement ','as acknowledged before me this
day of ~_2~ec.~.mber .......... , 19..~Z_, by _ ~:,vi,~ ~_--i.n~al.~. ................. ·
28th
, ot~F~;'"'~[Jb.jh.- ~t6£"t~'~T'ST&e o~' Alaska
My commission expires: _$ :?.qz_ ,~ ~
333.1/121~.1
D~N McKENZiE ~ERL EST.
Feb 0l, 93
12:29 N0.003 P.02
Thom.$ Fl. Mlnnt=h
Pre~i~lent/C,E.O.
NON-O~CJ~(:TION TO F..ASEMENT ~'.N('.'ROAO;.~E. NT DOCU~.NT
By this docurr~ent, Matanuzka TeleDkone Association, Znc.,
that it has no objecti:n to the placement of tl~e following
encroachment within tbs platted utility easement located on
described as_ Lot Ten (10),_. Blo~k One _(1) Bro~w~t~r ~e~.~hTs
Svst~ ~ , ....... ~ _; ~._~ ,e~, anu ~n~ergroun~ Water -
_~ .... , -- ~ ~n~e~ or ~ove Ground Se9tic S ste~ c .
~. ~ Structure, f. -- Other~ Y , · ~ Fence,
Please be ad',ise~ that should MatanT~ska Telephone A~ociatio~,
need to upgr.Tde, maintain, and or replace buried or aerial
teleco~unicatloas facilitiem within the platted utility easement,
it will be allowed to ~o so. Any repairs th~2 may be re~ired
the encroac~ent described above, as a result of utility
construction will' be borne by the proDerty owner of record.
PLEASE NOTE= This document iR, in no way, an agreement to vacate
any portion of thc platted utility easement, and should not be
i~terpreted as such by buyer~, governmental agencias,, lenders,
owners, Realtors, ~itle companies, a~d or
SPECIAL CONDITIONS=.~E NOTE: MTA HAS Bt{EN ADVI.. ,
CA_,.NG 12 THREE ],,~i. ES CJTHIN rH ......... --- .;
This docum¢~: must b~ recorded. Matanuska Telephone A~=ociation,
Inc., will r~ccrd the original docu:~ant. Upon the return of the
recorded docum~nt copieo will be sent 2o the Grantee(s). An
As-Built is retained with the original document¢ a~
T~lephon~ Association, Inc. 's Plant Se~'iccs Building Palmer,
Alaska. '
Page one of Two
DON MCKENZIE RERL EST. TEL:907-696-69,:,:
12:19 No.O05 P.O5
Easement Encroaohmcmt DocUment/MTA
Page 2
~z~i~ ~ ~-" ~- P~ '-.~.'~ ~ ~z~,--~ ~ .............
Bernadette
Date: January I1 1993.
S~a:m of Alaska, personally appeared B~ADE~E ZI~E~, to me '
19~, before me the undersigned, a No~a~ F~lic in and f~r ~%he --
Per~onaliy known and to me k~own to be the individual de~crtbe~ in
a~d who executed the foregoing and ac~owledged t~ me that she
stgne4 and sea.led the sa~e freely and voluntari!y for the uses and
pu~o~es therein mentioned.
' · .-~ day and year in thi~ qeStlf:cate first above
written o /. . .
.. NOTARY PUBLIC for
My commi~io. ~xgires:_
~ yrrlC" ~O~ 3550 ~~
~.mer, Alaska 996~5-3550 '~'"~--~ ..: ' ~..~. J' *~9;~H~, :.~,'%'~.~'
Please Return To:
Bernadette
Real Estate and Properties
Matan~ska Telephon~ Association, /nc.
Post Office Box 3550
Palmer, Alaska 99645-3550
BZ/EEDNOFOR.N02
Land Title ~'EL:56,1-,~$70 Feb O1 9."..,
8~LLi,,;R ADDRgS.~:
' , 1'. o. ~oz 210485
Anchorage, AK 99521
TRUSTEE'S DEED
This ind,?ntv.~'e made thim 272h day o~ Canuary, 1993, between
GOTten Zerbetz as trustee of the Estste of Harry P. MoClure and
Deborah A. M~Clure, husband ~nd wife, l~ereinafter "Seller",
Timothy P. G~eydanus and Sarsh A. Greydanu-, husbam~ and Wife,
h~einafter -PurGh~ser", witnes[;t~th, tllat:
Whereas th~ ~.Ionorable Donald MacDonald, IV, U.~;. Bankruptcy
JUdge i,~ and for ~be District of Alaska, at Anchorage, ordered on
the 21st d~y of D~oembe=, 1993, that =h~ seller was autho~ize~ to
~ell to the buyer ~he b~loW described real property:
LOT NINE (9), ~LOCN ONE (1), Of
TRACT D, BROADWATER HEIGHTS
SUSDIVISION, according to the
official pla~ t)mreof, filed under
Pla~ No. 71-297, records of
Anchorage Recording Distri~t, Third
Judicial DiStr~ct, State of
Now, therefore, };.now ye, .that I, Gordon Ze~be. tz, trustee by
a~d au=hor.%ty in me v~t~d, ~ aforesaid, .and
virtue Of ~he power
tn consideration of tbs mum of Slx thousand five hundred al%d nO/100
Dollars ($6,500.00), to ~ue paid by thz buyer, the reoetp~ wllereof
i~ heI'e~y ac~nowled~-sd, do h~reby g~ant, ~argain, sell and convey
~nto ~he buyer, their heirs and assigns, forever,
whioh deb~O~(s), ~{a~ry P. McClure and Deberah a. McClur~, husband
and wife, had on OCtober 30, 1987 (dS~ of filing), in
of LOt 9, ~lock I of Tract D, ~z'oadw~ter Heights Subdivi~on, Plat
No. T1-297, ~Orage Recording District, Third judicial DistriCt,
Sta~e of Alaska, toee~h~r wi~h' all and ~ingular th~ t~Demen~,
hereditame~ts, and ~ppur~enanoes'.th~reUnto b~1ongin~, or
apps~taining~ ,and th~ reversion and revisions,
remai~ders~ rentS, issues, an~ profit~ thereof.
To have and to hold the s~id abc're-.bargained p~emi$os, with
the appur=enan=~s, ,~pd every 9art thereof, unto the puroha~er(s),
behoof for~ver~ a~ fully and absolutely a~ the selle~ oan and ough~
~ do pursuan'~ to ~he sta~te and authority a~ a~ore~nid.
This =ale im without any representation or warranty by Seller.
IN WITNESS WHEREOF, I, as such trustee, have hereunto set
hand this 27th day of January, 1993.
~~ Estat~ of MoClur,..
SUBSCRIBED AND SWO~ TO c in ~nd for
day of, Janllary, 3993. ~ ,...
the ~tate Of Alaska thi~ ~_ ~ ;~ ~~. ,.;.~; ........ ;.-.
, State of Alaska
'. . .. ..~ .... ,-'~.7: ·
~v co~m~ion Expires. hZ :,?~_ ;,. .,
DDN MCKEN2IE RE~L EST. TEL:?,2?_~96_F:gO0 . Feb 0i,9~
Land TItle TEL::-.5!-~876 Fe~, O1 9~
005 P. 06
,1993,
by an4 between Timothy p. and Sarah A. ~reyd&~m of 11730
Sroadwater, ~agle River, Alaska 99577
m~ Sarah A. ~royda~s of 1~.730 Broadwate~, Eagle RlVOr, Alaska
99577
WITNES$~T~:
WHEREAS, the Grantor is the owner in fee simj~le of the
following ~escribed r~al property, to wit:
Lot Nine (9), ~1ock One (2), Broadwate~
~e~.~ht~ ~lbd~vi~i~n, aec()r~ing to the official
plat fil~d under ~lat No. 71-297, book~ and
reco~d~ of the Anohorage Recordin~g District,
Tht~'d Judicial District~ State of Alaska.
(hereinafter "Lot 9 "}; and
WHEREAS, Grar~tee is the owner in fee simple of the
a~otning parcel of land to Lot ~ as describo~ below, to witr
Lo~ T~D (10), Block On- ~1%. Broadwater
Heights SubdiSi~ion, accor~n~ %~' thm official
plat filed under Plat. No. ?1-~97, books and
Third Judlo~al DiEt~iot, State of Ala=ka.
(hereinafte~ "Lot 10"); and
WHeReAS, Grantee ownar cf Lot 10 ~s desireu~ of enjoying
the u~e of a oerta!n ~ortlon of Grantor~= l~3nd, LO~ 9, fo~ the sole
~ '
Durpose of u~J.n~ and maintain~.ng o ~i~ate water well; and
WHEREAs, Grantor has agreed in oonsideratlon of Ten an~
NO/lO0 Dollar~ ($1o.00} a~ other good and valuable con~i~eration,
reoeipt of which i~ hereby auknowlr-dged to grant to Grantee an
easement ~ole!y for said defined p'~rpose and for no other;
10312
DON McKENZIE RE~L EST T_,L ~
Land Title Tgu:S61-~$?6
Feb 01,93
Feb 01 93
12:19 No.O03 P.07
10:13 No.O0? P.04
NO~:, THEREFORE, this grantwitn~seth that Grantor hereby
grants unto Grantee, ~heir heirs and assigns, full and free ~ight
and authority to use the following described Dortion of Grantor's
land, ~olely for purDosae heretofore m%ntioned:
A ten (10) foot by twenty (~0) foot easement
appurtenant to and located on Lot Nine (9) and
more particularly described as follows:
~egiMning at the most easterly
9, proceed $ 54'00'00,,.W, 8~.00 feet along the
O~ B~GIN~I~G; thence S'D4'OO'00" ~, 20.00 feet
~o a point; thence N D6'O0'O0" W, 10.00 fee~
to a po£n~! thence N 54'00'00" E, 20.00 fee=
to a point; thence S'36'00'00" E, 10.00 feet
to the TRUE POINT o? BEGINNING, ~ald point
be:~ng the TRUe; POINT O~ ENDING of this
easement. This wel~ ~ccess easement contains
200 ~quare feet, ~ore of
It is further .covenanted and agreed by the parties
hereto, for thebes, elves, 'their heirs, exeo~tors, &dministrator~,
personal repre~entatives and assigns, that ~hould the well, pump,
or water lines at any time whil~ in uss be in need of maintenance,
repai~ or replacement in the ~ame !ocatton, the same shall be
maintained, repaired, rebuilt or redrJ.lled au the so!~ expense of
the Grantee, their heirs, ~xecutoTs, adminlst~ators, personal
repre~entatives, ur a~sign$; ~nd the sra:~tor as~ume~ no i~ab~lity
other than due diligence in protectin~ the i~provement~ within the
ea~.sm~nt fro~ harm and h~eby covenan= ~hat they w111 continuously
kee9 said well a~d rights of access granted herein unencumbered ~o
aS tO allow Grantee free use ~nd aocess to the water w~ll du~inu
the term of this Agreement.
DON McKENZIE REF~L EST. TEL:907-696-69%:.q
Land Title TEL.~61-4875.:,.
Feb 01,93
Fei, 01 93
12:19 No.O0~ P.08
10:14 No.O0? P.05
Grantee may /'rom tame to tim6, removo brueh, shrubbery,
soill ~nd/or excavate to r~pair or tn~tall w~ter iine~; in the
a~urse of maintaining or improving the existing well. Grantee
area to substantially the san~e conditions which ex,st at the t~me
any work oomm~nce~ w/th the ~nderstan4ing no trees exist o~ Will be
placed' within the easement area.
IN WZTN~SS W~{EREOP the Grantor ~nd Grantee have hereunto
set their hands on the day and year f~t written above.
AFI'Ek RECO~'~ING R E?.'L'XN TO:
Sarah A, 'Greyd~nus ....
"~rantor"
sarah A; Greyd~Dus
"Grantee"
STATE OF ALASEA )
) ~S.
Third Judicial r.istrict
THIS 2g 2'0 CERTIFY that on this ~. ~ay of
1999, before me, =he unde~igned, a Notary ~ublic~ln and
Alaska, De~ona!!y appeared Timothy P. ~rey~anus and Sarah A.
Greyda~us, Grantor, ~o me known and );:nown %o m~ to be the
individuals named in and who e~cuted the fozegoing instl'ument and
they aoknowledged to me that they signed the s~me freely
voluntarily for the uses ~nd ~urpo~e~ %herein ~ated.
10312
DDN McKENZIE RERL EST. TEL:90?-69L::--69C.~O
Land Title 'TEL ;561 -4876
Feb 01,93
Feb 01 95
12:22 No.O03 P.09
i0:14 h~o.O0? P,06
this certificate first above written.
STATE OF A~S~ ...~ '/,' --
~tvtd~al~ named in an~ who e~e~uted the foregoin~ t~trument and
they ~oknowle~ged to me that they si~ned the same freely and
voluntarily for the uze~ and Pu~Doses therein stated.
WITRZSS my hand ~nd official seal the day an~,,,;year in
this Certificate first above written. . ,,,
AN¢t'iORAe,,F.. R£:C, DISTRICT
REQUEST£D BY
LTC
"93 J,qN 89
10912
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date June 10 ? 1986
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lotl0~ Block 1~ Broadwater Heights
Location (address or directions)
Broadwater Drive
T14N~ R2W~Sec.1
(b) Applicant NameConnie Thomas Telephone: Home 694-9446 Business n/a
Applicant Address 117~0 Broadwater Drive, Eagle River, AK 99577
(c) Applicant is (check one)'. Lending Institution []; Owner/builder []; Buyer []; Other [] (explain);
(d) Lending Institution United Bank of ALaska
Address pouch 7059, Anchorage, AK
(e) Real Estate Company and Agent I
Address
Telephone
9951O
276-i9il
Telephone
(f) Mail the HAA to the following address:
pickup by en_~ineer
TYPE OF RESIDENCE
Single-FamilY [] Multi-Family []
Number of Bedrooms 4
Other
WATER SUPPLY
Individual Well [] Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite [~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
ENGINEERING FIRM PROVIDIN . iNSPECTIONS, TESTS, FILE SEARCH, D~.,4 AND INFORMATION
A'~* certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage 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 ~f~ct on
the date of this inspection, *W±th wavier approval well to leachfield dfst. of
Name of Firm
Address
Date
EAGLE
I'IIVEM
EAGLE RIVER, AK 99577
P. 0. BOX 773294
694-5195
Telephone
Engineer's Seal
DHEP APPROVAL
Approved for
Approved /"'"~""
bedrooms by .,'~'~.~"'~'-'~
Disapproved
Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MOAi
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: j~_9
MUNICIPALITY OF ANCHORAGE.
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
WELL DATA
Well Classification ~:~-,'~/q Y'c~' If A, B, C, D.E.C. APproved (Y/N)
Well Log Present (Y/N) /)/ Date Completed /c~ &, ~;,, /)&.~ Yield
Total Depth z/'O~)" Cased to ~" ¢ ~
z~O. Depth of Grouting /~' /4
Static Water Level '~/ / /5~/o,-~ 7~,p ~ ~ ~,r,,~,_~ Pump Set At c~3-
Casing Height Above Ground ~ z Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) ~' Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot 7//
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Line /'M'//,'~ To Nearest Public Sewer
Cleanout/Manhole //././,,4 To Nearest Sewer Service Line on Lot ~'~2J- /
Water Sample Collected by ~-'~_~/-¢ ~"~ ,~F...,$/.~,~ ,-/~$ __; Date ,-~,//'~'~//"~'¢'
Water Sample Test Results ~ / ,'J ~ ~ ~ ~v ~ ~ d;~/~ ~ ~ c'o,~t ~
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ,,/'~ ~
To Property Line
To Water Main/Service Line '/~z~
Course ,///.~
Size /'P~'~.~4 L No. of Compartments ~-
Air-tight'Caps (Y/N) ,/V Foundation Cleanout (Y/N) /M
Date Last Pumped ~/,//~/
; for ~
Temporary Holding Tank Permit (Y/N) ,'¢/./~
To Building Foundation ~- /
To Disposal Field :~ / ~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field ~- /
Square Feet of Absorption Area
Depression over Field (Y/N) ,/L/
Results of Last Adequacy Test .~/-,~' '~", c/'~'~.~.
Separation Distance from Absorption Field:
To Water-Supply Well 7/
To Building Foundation -~
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
¢d//~'/'C Type of System Design
Length of Field /¢4~/ '/
Depth of Field // ' ~/
Gravel Bed Thickness ~ /
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line /6
To Existing or Abandoned System on
· On Adjoining Lots ~'~ /
To Cutbank (if present)
Comments
LIFT STATI O N/¢./~
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed~~''~ Date ~/~/~ *with wavier approval well to
Company ~-~/ / MOA No. ' leachfield separation dist.
Receipt No.
Date of Payment
Amount'. $
Page 2 of 2
72-026 (11/84)
Engineer's Seal
EAGLE RIVER ENGINEERING SERVICES
June 6, 1986
Lou Butera P.E.
P.O. Box 773294
Eagle River, Alaska 99577
Telephone (907) 694-5195
Mr. Steve Morris
Civil Engineer, On-site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
REF: Lot 10, Block 1, Broadwater Heights
Dear Mr. Morris:
On behalf of my client, Mrs. Connie Thomas, I am submitting the
information necessary for your determination of a wavier of separation
distance, well to leachfield, to ?1' for the above referenced lot.
The septic system absorbtion rate has been tested and found
adequate for a 4 bedroom use. The leachfield was installed in 1979 by
Hamilton construction and was inspected and approved by the Municipal-
ity at that time, as per the inspection report enclosed. At that time
the well nerving this lot was located at 82' from the septic tank.
This well has been temporarily abandoned in favor of the new well
drilled 2/6/82. It was discovered as part of our health approval
investigation that the new well is located ?1 horizontal feet from the
existing leachfield. A request for wavier is being submitted as there
is sufficient evidence to warrant wavier approval.
The enclosed well log shows that the well draws from a bedrock
confined aquifer at a depth of 66-400'. Based on the well log the
casing is continuous to 66 ' where it is seated into bedrock. The
surface topography is such that any seepage would be directed away from
the well location toward a 45% slope to the west. The septic
leachfield is actually located on a bench along this slope with the
well head located 12 vertical feet above the top of the leach trench.
It is evident that the bedrock depth varies significantly from East to
West sides of the lot. A soil log enclosed shows bedrock at 8' on the
east end of the lot with no bedrock encountered at the site of the
leachfield. The subsurface soil is a GW-GP type with a perc. rating of
140. Judging by the well logs and my past knowledge of the area the
soil type changes from a good sand and gravel to a silty clay at depths
greater than 20-25'. This would act as a filter to septic leachate
traveling downward through the soil. The 1982 well log also shows the
presence of a protective blue clay layer from 45-65' depth. Previous
studies of the area have shown that the bedrock plane is steeply
sloping in this area,(ref:L1, B1, Birch Hill Est. #1). A water sample
for coliform bacteria was satisfactory. The area in question has a low
~opulation density. .,/
~pa~e ~. L10, B1, Broadwater Heights
If there are any questions or if additional information is required
please feel free to contact me at 694-5195.
Sincerely,
Lou Butera, P.E.
Encl: HAA application
soil log
inspection report
well logs
EAGLE RIV:
ENGINEERING SERVICES INC.
P. o. Box 773294
EAGLE RIVER, ALASKA 99577
Phone 694-5195
SHEET NO.
CALCULATED BY
CHECKED BY
SCALE ~/" '~¢
OF
DATE
~?~ ~ ~-~,~
.... i..To sh.ow:distances as note.d
~position d.o not attempt to
.. i dista~nces .not shown.
and relative
scale any
\
\
PRODUCT 204-1 ~ Inc, G~oton, Mass. 01471
EAGLE RIVER ENGINEERING
SERVICES
Lou Butera P.E.
P.O. Box 773294
Eagle River, Alaska 99577
Telephone (907) 694-5195
June 30, 1986
Mr. Steve Morris
Civil Engineer, On-site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, Alaska 99519
REF: Lot 10, Blk 1, Broadwater Heights, Tract D
Dear Mr. Morris,
MUNICIPALITy OF ANCHORA~
DEPT. off H
~NVIRONM~ ~' .... EALTH &
~'~rAL PROTECTION
'J !.;' ;~.1 ,3' 0 ~
RECEIVED
We have investigated your concern with bedrock slope and its effect
on the septic system runoff and waiver approval for the above-referenced
lot. The enclosed well~gs and soil logs are the result of a file search
of available information in the general area. Information was obtained
for lots 1 and 2 of Seidler Subdivision that show bedrock at 34' and 17'
respectively. Soil logs for both lots show no indication of bedrock.
As the land surface slopes steeply in the westerly direction, one could
assume that the bedrock surface slopes at the same relative degree as
the land surface. I would also assume that the bedrock indicated for
test hole #1, lot 10, Blk 1, Broadwater Heights, at a depth of 8' could
be an isolated bed outcrop. A plot of the lots showing their relative
locations has been included.
If there are any questions, or if additional information is required,
please feel free to contact me at 694-5195.
Sincerely,
Lou Butera, P.E.
Encl: Soil logs
Well logs
Subdivision map
unicipa y
of
nchora ¢
P.O. E~ ,196650
ANCHORAGE, ALASKA 99519-6650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
July 1, 1986
Lou Butera, P.E.
Eagle River, Engineering Services
P.O. Box 773294
Eagle River, Alaska 99577
Subject: Lot 10 Block 1Broadwater Heights Subdivision
Waiver Request, WR86-080
Dear Mr. Butera:
This department has approved your request for a waiver for the subject lot.
This department concurs with your assertion that sloping bedrock and layers
subsurface silts and clays will adequately protect the well from septic
leachate contamination.
The 100 foot separation between the well and leachfield on the subject
lot has been waived to 71 feet. This waiver is valid for the existing
~well and septic system only. Any upgrades or modifications must meet
separation distance requirements.
Sincerely,
Civil Engineer
On-site Services
SSM/ljw
~il. 1 DATE RECEIVED
INSPECTION APPOINTMENTS ~
TIME ~' TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF HrLALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTL:II~P, ONMEN1'AL F,::OTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION JAN 2 3 I981
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPE,R;~YOWNER I PHONE
MAI LING ADDR E88
PROPERTY R ESI DENT (I f different from above) PHONE
2. BUYER PHONE
MAILING ADDRESS
3. LENDING INSTITUTION PHONE
MAI LING ADDR ESS
4. REALTOR/AGENT //~ J PHONE'
MAI LIN~ ADDRESS
5. LEGAL DESCRIPTION
STREET LOCATION
TYPE OF RESIDENCE
C~~ SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[] One [] Four
[] Two [] Five
~ Three [] Six
[] Other
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
8, SEWAGE DISPOSAL SYSTEM
[~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give wel
depth (attach log if available,)
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 IRev, 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] IN DIVI DUAL/ON -SITE
r-q PUBLIC UTILITY
Connection Verified
I-qSeptic Tank or [] Holding Tank
Size: ! ~"- ~ If Tank is homemade
give dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [] SiX
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
MANUFACTURER
./
MATERIAL
i Septic/Holding Tank IAbsorption Area [Sewer Line
[] OTHER
JNearest Lot Line
DATE
~ED FO R...~
BEDROOMS
CONDITIONAL APPROVAL (letter must accompany certificate)
72-010 (Rev. 6/79)
~ MUNtCIPALITYOFANCHORAGE _ DEP"r. 0/; -.',..TI] &
~ -~ DEPARTMENTOFHEALTH&ENVIRONMENTALPROTF~NMENTAL PRCTECTION
~~ 826 L Street 'Anch°rage' Alaska '501
,, l[~)) ENvIRI~NMENTAL ENGINEERING DIVISION .S~.P
DIRECTIONS: Complete all parts on page 1, Incomplete requ.~ Will not be proud. Please allow ten (10) days for processing.
PnOPEATY HESlDEN~ ( f d ffer~ro~ ~b~) .... {' P N
r, ' ......... H NE
2, BUYER ~ P O
'~A(LING ADDRESS
~.LENOlNOINSTITUTION . / · I PHONE
t
[] Four- ' [] Other
[] One
~ SINGLE FAMILY ' ,
7'~ I~ Two [] Five
[] MULTIPLE FAMtLy ~ ~ Three [] Six
WATER SUPPL
' f~' INDIVI DUAL* * ATTACH WELL LOG. A welt tog is requ]redfor all wells drilled
' [] COMMUNITY ' since June 1975. For wells drilled prior to that date, give well
" -.[] PUBLIC UTILITY , 'depth (attach Iogif available.) ' ' '
8, SEWAGE DISPOSAL SYSTEM -- ' ,. - ' - ....
J~ INDIVIDUA L/bN SITE** If ,ndlv,dual/on-site, g ve instal ation date~ j~/~l;~,~
If system is over two (2) years old an adequacy test.ls required
[] ' PUBLIC UTILITY ' -by this Department. '
fNOTE:' THE INSPECTION FEEMUSTACCOMPAN¥,, EACH REQU~T BEFORE PROCESSING CAN BE INITIATED. '
............ "-
THIS SIDE FOR OFFICIAL USE ONLY
I NSPECTION APPOINTMENTS
DATE RECEIVED
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2, WATER SUPPLY
[] INDIVIDUAL
[] COMMUNIT~Y
[] PUBLIC UTILITY
Connection Verified
3, SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[]SeptiC Tank or [] Holding Tank
Size: I'f Tank is homemade
give dimensions:
NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE [] OTHER
[] TWO [] FOUR [] SiX
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOl LS RATING
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
'Septic/Holding Tank -IAbsorption Area
ISewer Line J Nearest L~t Line
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
[] CONDITIONAL APPROVAL (letter must acgb~an¥ certificate)
[~;;~--OISAPPROV E D ~
~ ( ~ ~ ~ BY (Title)'
LEGAL DESCRIPTION
72-010 (Rev. 3/78)