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HomeMy WebLinkAboutT15N R1W SEC 8 LT 146 Municipality of Anchorage Page [ _of ~ DEPARTMFNT 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: D:_/,,l~ c~'-~Bq ~ PIE) Number: ~.F//~/~ Name: ~ ~ ~/.. ~ Wastewater System: E]New ~pgrade ¢~.~.? / ABSORPTION FIELD Ph°ne:~o~_ ~- ~-~ N°' or,rooms: O Deep Trench O Shallow Trench ~ed E) Mound O Other LEGAL DESCRIPTION s°' Rating; ).~GPD/Sq Ft Total Depth2,from~original grade: -- Lot: Block: Subdivision: Depth t0 pmpe bottom Dom original grade: Or~vel depth beneath pipe Number el lines: I 0isl~nce beIween lines: WELL: ~' ~r~ ,~ Q New ~ Upgrade Gravel width: /~ Fl ~I ~' ~ Cl~ss~lion (Private. A,B.C): Total Deplh: Cased TO: Total absorpt,on area: Pipe ma[eriah Yield: % asmg He~ghlAbove Ground: SEPARATION DISTANCES ~eptic ~] Holding ~ S.T.E P. Frorn Tank F~eld SlalmOn Tank Sewer Lmnes ~ ~ '~ /~P ~" / Well )10 /// ~ ~/ ~/' Material: ~& Number°lC°mpartmenls: ~ Surface ~lOg ¢'/~g ~ {/¢~ W.t~r ~_ LIFT STATION Foundation [ ~ / ~[ /~ "Pump on" Iovol al: "~ump o*~'~ le~et a~: ator alarm at: CurtainDrain ~ ~ / J //~ Pump Make¢ &Nodel ] Electrical Inspections performed dy: Remarks: 2 ' ~/¢~¢ ~ Z~¢ BENCH MARK Assumed Elevation: /~, ~ Department of Health and Human Services approwfl e~,'~,~ .... Reviewed and approved by: , Date: ~/'[~ ~ '" '?'"'""' 72-013 (Rev 9/91) MOA 25 oF ~ Permit No, SW970349 Page 2 Municipcdity oF Anchormge 9EPARTMENT ElF HEALTH AN]3 HUMAN §ERVIC£S ENVIRE]NHENTAL SERVICES ]]IV[S[E]N P.O, Box 196650. Anchorage, Ataska 99519-6650 .Tetephone: 343-4744 On-Si te Wastewcten Disposal System and/on Weir Inspection Repont Legal Descpip'tion:LDT 146 T15N R1W SEC, 8 PID No,: 05115413 1§X73' .... EAS~UENT TARIKA AVENUE ELEVATIDNS (NE]T TD SCALE) 89. 7 ,'SWING T1¢_5 A-B = 57.~' ~-C = 25.2' A-D == :5-0 = SCALP- 1"= 60' ENGINEER'S SEAL ]PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 A~NCHORAGE, ALASICA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970349 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:PERKINS GARY L & BILLI J OWNER ADDRESS:P.O. BOX 670263 CHUGIAK, ALASKA 99567 DATE ISSUED:10/03/97 EXPIRATION DATE:10/03/98 PARCEL ID:051154t3 LEGAL DESCRIPTION: T15N R1W SEC 8 LT 146 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. 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 (iSAAC80). THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE S/LME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: DATE:__ ,/0' ~*~7 DATE: /~---a .~.~ ~'y Eagle River Engineering Services Louis Butera, P.I~. P.O. Bo× 77329'} (907) 694~-S195 Eagle i~iver, ~ 99577-329'[ (907) 69z3-3297 fax August 21, 1997 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lot 146 T15N, R1W, Sec: 8 Narrative & Permit Application Dear Mr. Cross: The' proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are: all +30' distance. 3. Reserve space is adequate, due to absorption capacity. 4.. Drainage will not be affected and is not a maj or consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. MUNICIPALI fy OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION 1997 RECEIV[D \1997\NARRAT~2.DOC Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax LEGAL: SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM Lot 146 T15N, RIW, Sec 8 8/21/97 A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specificatioa. 3. All materials and workmanship shall ~neet the Anchorage Department of Health and State Department of Euvironmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in tbe field by the engineer. 5. All excawitions aud depths are advisory and are to be verified in tbe field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation require~nents. 6. It is the responsibility of tile owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled. B. SEPTIC TANK 1. Septic tank sball be a minimum of 1500 gallons and be of MOA approved design C. BED 1. The bottmn of each level designated in the bed excavation shall be level, pins or minus 1.5". 2. The bed is to be excavated to a depth not to exceed 6' at any point, this is the depth to the bottom of the sand filter. A 2' layer of ADEC approved filter sand is to be placed below the sewer rock. 3. A 1' layer of sewer rock is to be placed at a depth of 4' below grotmd surface over the sand filter. 4. Tile effluent lines within the bed gravel shall be at mid deptb in tile gravel and laid level within 0.0Y. 5. The bed gravel is to be covered witb typar fabric material. 6. Soil or co~nbination of soil and extruded board insulation to a deptb of 3' or equivalent is to be placed over the leachfield. 7. The area over the bed is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 6' btm of sand BED LENGTIt = 72' SOIL RAT1NG - 0.7 GPD/Fl5 SEPTIC TANK S1ZE = 1500 gal GRAVEL DEPTH = 6" under pipe, 2" over pipe BED WIDTH = 15' BEDROOM CAPACITY = 5 DEPTH TO BOTTOM OF SEWER ROCK = 4' Twenty-four (24) hours notice required roi' all inspections. \1997\97-049b-spc.doc EAGLE RIVER ENGINEERING SEF ,VICES P.O, Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No,: 97-049 Calculated By: I.B Date: 8/21/97 Legal: Lot 146 Single Family $ Bedroom Dwelling TEST HOLE '1 Bed Design Bed Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 750 gallons Percolation rate = <1 minutes per inch Wastewater application rate = 0.7 gallons per day per square foot Required absorption area = 1071 square feet Bed width (VV) = 15 feet Gravel depth (D) = 1 feet Required length = Required absorption area / Bed width Required length = 1071 / 15 Required length = 72 feet Total Excavation Dept = 4.0 feet 6.0 feet Bottom of Gravel Bottom of Sand Layer ~xletlng house to be removed when new home completed. NO SURFACE WATER NO KNOWN CURTAIN DRAINS _eL _T_ARIK A A~/E~UE ~ec~ Detc~¢~ WELL/SEPTIC SITE LEOAL: LOT 146 T15N RlW Sec 8 OWNER: PERKINS CONTRACTOR: N A JOE3~ 97-049 DATE: 8/26/97I SCALE PLAN 1" =60' EAGLE RIVER ENGfNEERING SERWCES AP.O. Box 773£94 EAGLE RIVER, AK. 99577 (90'7.) S94-SI9S FAX: (90'7) 694-329'7 TEST HOLE MONITOR TUBE SEWER CLEANOUT WELL EASEMENT PROPOSED LEACHFIELD EXISTING LEACHFIELD PERFORMr!D FOR;2~ ~,'~ ~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 5 6 7 9 9 19 11 12 13 14 16 19 17 18 19 29 - Township, Range, Section: SLOPE SITI= PLAN WAS GROUND WATER ENCOUNTERED? --kC- ~. . IF YES, AT WHAT ~' O DEPTH? ~ p E Depth to Walar Alter ,. M0nilorinD? ~'-/ _Dale: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~)f ~' (minutes/inchJ PERC HOLE[ DIAMETER TEST RUN BETWEEN Z"7/'~:) F'rAND ~-"1 FT COMMENTS PERFORMED BY: /'~'~'~' I'~'~ '~'~'"'~' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE[: ,~'-- ~- ~'' '- ~ ) 72-008 (Rev. 4/85) LAND USE AGREEMENT BETVqEEN MUNICIPALITY OF ANCHORAGE Date: Legal Description: Physical Address: October 1, 1997 Lot 146, T15N R1W Section 8 20919 Tm'ika Avenue, Chugiak, Alaska Gary and Billi Perkins attest that they eu'e the owners of the subject lot which is zoned R-6. Mr. and Mrs. Perkins cm'rently live in a cabin on the subject lot and wishes to build a permanent residence. ivh.. and Mrs. Perkins wish to continue to live in the cab!n tempormfly while working on the new structure. It is their intention to demolish the existing cabin upon completion of the permanent residence. The Perkin's request is hereby granted, subject to the following conditions: 1. Mr. and Mrs. Perkins shall obtain a valid Land Use permit and subnfit to annual inspections to verify compliance with Title 21 emd this agreement. 2. No residential occupancy of both the cabin and the proposed residence is allowed at the same time. The cabin cannot be occupied by any persons other than the Perkin's. 3. The cabin will be demolished by July 1, 1998 and prior to occupancy of the proposed residence. There shall be no exceptions to these requirements.. This agreement shall be made part of Land Use permit # M_unicip ality of Anchorage~ Steven M. Ellis, Code Eq~lS,~fcement Manager SUBSCRIBED AND SWORN TO before me this .6~tt~r~rrr Date: October 1, 1997 Notary Public in and for Alaska Land Use Agreement October 1, 1997 Lot 146, T15N R1W Section 8 Page 2 Owner: Gary t1 er'k~s SUBSCRIBED AND SWORN TO before me this / ~ day of C~7.bb~ t" ,i 997 Notary Public in ,and for Alaska ~ My CouLmission Expires:_ ~[~/~C))J'~) SUBSCRIBED AND SWORN TO before me this ~ day of -C)~-P-4' ,1997 NOTARY PUBLIC My Cormnission Expires: MARILYN BITNBY. My Commission ~xpires .... De~.~ber 6,, 200~x' Mlerno To: MOA-DHHS Attention: Jim Cross From: Gary Perkins Date: September 19, 1997 Re: Septic system construction I will be constructing my own septic system and feel I am qualified as I am a general contractor and have my own equipmen, t. I am knowledgable in it's use and in installing a septic system. Gary Perkins Page 1 MUNICIPALITY OF ANCHORAGE 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. 051-501-14 1. GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: j(_3cq_/ f Sleepy Hollow #1, Block 2, Lot 3 23745 Sleepy Circle, Chugiak, AK Current property owner(s) Mailing address Real estate agent Samuel & Brittany Busch Lindquist Day phone 907-406-0959 25343 Homestead Road, Chugiak, AK 99567 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic El Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 656 Waiver Fee $ Date of PaymentLgL1 Date of Payment Receipt Number Receipt Number COSA # osed13,80 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 Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 8/14/19 6. DSD SIGNATURE XSystem #1 Approved for <I bedrooms M System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: `�illEEiilt°, Original Certificate Date: D G 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 Checklist blue sheet Legal Description: Sleepy Hollow #1, Block 2, Lot 3 . If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 4/26/89 Total depth 400 ft Cased to 96.4 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '24 in. Date of flow test for COSA 8/6/19 Static water level at beginning of test 118 ft. Comments B. TANK DATA Age of tank(s) 5 years Tank type/material Septic / Steel Measured operating fluid level in septic tank 51 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 8/19/19 D. ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) 10/21/14 ❑ ALL standpipes present per record drawing Total measured depth from grade 14.7 ft (max) Measured depth to pipe invert from grade 5.9 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: -System remained in use during test period. COSA Checklist yellow sheet Parcel ID: 051-501-14 Structure served by this system Well production at time of test 0.35 gpm Water storage tank volume 300 gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate 7.09 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 8/6/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 8/13/19 Results F✓ Pass For 4 bedrooms Fluid depth prior to test 16 in Water added 1450 gal New depth 37 in Elapsed time 1440 min Final fluid depth 28 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) If yes, enter date No 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' F/ Yes if No Community Sewer Manhole/Cleanout > 100' ✓0 Yes if No ft Q Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' F-/1 Yes if No ft Absorption Field on Lot > 100' FV -1 Yes if No ft Holding Tank > 100' FV� Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' El Yes if No ft Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' P/1 Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F/ Yes if No ft Surface Water > 100' ®✓ Yes if No ft Property Line > 5'✓0 Yes if No ft Wells on Adjacent Lots: Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ✓� Yes if No ft Water Main > 10' ED Yes if No ft Community Wells > 200' F71 Yes if No ft Water Service Line > 10' F71 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' 21 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'✓Q Yes if No ft Private Wells > 100' R✓ Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' ✓1 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION OF'� L� I certify that 1 have determined through field inspections and review�'\P.•'` of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. �'• �' to . r....... ..4a .........kry...a i.3a.o to �saassa°aslalaaaaaaa.aasitaie40Pff��i""t����b.•.•4.(aiAa �sy A N4ICHAEL E. ANDERSON e • LL L No. CE -4381 8/14/1 aepcSS���� COSA Checklist yellow sheet i j� ".......... �_ FL LOT � -55't 0" 10 UTILITY EASEMENT _Y-- `-- 1 / ;0 6.0'X1 1-8, Co LAT ,'A COVERED ENTRY I70.500 s.f. i WELL-� o� 4 PR07EC71VE RADIUS o t 84.7 1 n . 2 STORY . BALCONY "IRES4D� CE r �q . g LOT 6 '-2.0' CANT -: 1.0' CANT SEPi7C PIPES L' 12.2'x 10.2'Dl- LOT SHEDN 8i'S 4 . r r PLOT PLAN AS BUILT X SCALE 1" - 50' GRID NW 1160 Project No. 14-198 Long & Associates, 1nC. 11500 Daryl Avenue, Anchorage, Alaska 99515--30+49 907) 522-6476 Phone ,a©p� Registered Land Surveyors 907) 522-4625 Fox � kan*langsurvey.com / jonathanOlangsurvsy com ��(, � � A C I hereby certify that t have surveyed the following described property. LOT 3, BLOCK 2," SLEEPY HOLLOW #1 (PLAT 73-8r4)rte* :• 49 •� Anchorage Recording District, Alaska, and that the improvements situated thereon are ... .......... within the property limas and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent therefc encroach on the surveyed .. premises and that there are no roadways, transmission linea or other visible KQifi G. ; 'l' easements on said property except as indicated hereon. t 1%(14 - Dated this the lcDay of _ _ ��caa7,n,�n, , '7�at�r, of Anchorage, Alaska ''-52D If is the responsibility of the owner to determine the existence of any easements, s�01*0 covenants, or restrictions which do not appear on the recorded subdivision plat. 1 � r Q a r Q � 0 z 0.0' r r ! r LOT � -55't 0" 10 UTILITY EASEMENT _Y-- `-- 1 / ;0 6.0'X1 1-8, Co LAT ,'A COVERED ENTRY I70.500 s.f. i WELL-� o� 4 PR07EC71VE RADIUS o t 84.7 1 n . 2 STORY . BALCONY "IRES4D� CE r �q . g LOT 6 '-2.0' CANT -: 1.0' CANT SEPi7C PIPES L' 12.2'x 10.2'Dl- LOT SHEDN 8i'S 4 . r r PLOT PLAN AS BUILT X SCALE 1" - 50' GRID NW 1160 Project No. 14-198 Long & Associates, 1nC. 11500 Daryl Avenue, Anchorage, Alaska 99515--30+49 907) 522-6476 Phone ,a©p� Registered Land Surveyors 907) 522-4625 Fox � kan*langsurvey.com / jonathanOlangsurvsy com ��(, � � A C I hereby certify that t have surveyed the following described property. LOT 3, BLOCK 2," SLEEPY HOLLOW #1 (PLAT 73-8r4)rte* :• 49 •� Anchorage Recording District, Alaska, and that the improvements situated thereon are ... .......... within the property limas and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent therefc encroach on the surveyed .. premises and that there are no roadways, transmission linea or other visible KQifi G. ; 'l' easements on said property except as indicated hereon. t 1%(14 - Dated this the lcDay of _ _ ��caa7,n,�n, , '7�at�r, of Anchorage, Alaska ''-52D If is the responsibility of the owner to determine the existence of any easements, s�01*0 covenants, or restrictions which do not appear on the recorded subdivision plat. Well Water advisory Certificate of On -Site Systems Approval # OSC191380 Subdivision: Sleepy Hollow #1, Block: 2, Lot: 3 This well's productivity was determined to be .35 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 4 -bedroom residence is .41 gallons per minute or 150 gallons per day per bedroom. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Nitrate Advisory Certificate of On -Site Systems Approval # osc191380 Subdivision: Sleepy Hollow #1 B2 L3 A water sample revealed a nitrate concentration of 7.09 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.