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US SURVEY 3215 & 3215A T10N R1W SEC 5
Onsite File Uiomb Aomb Amok 0% 1 � & zo zourvey s e. o ION RIW ec 5 tZAtm Lois ins wa �syj 2-7-4NICIPALITY OF ANCHORAGEr Hee n and Environmental Prote' �n Fourth Floor West 825 L Street Anchorage, Alaska 99501 279-2511, x 224, 225 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME J1-.Z&fr "'1 11++ LOCATION 1�� &Ln- Se-Loh-Pa1141 y LEGAL DESCRIPTION MAILING ADDRESS c; R. S o -X ion- i nalam I (DNRtW PHONE {0S3-aa43 S S U • S. Su/NARAI Sal S" SEPTIC TANK: DISTANCE FROM WELL L INSIDE LENGTH MANUFACTURER 5t-^"" MATERIAL P INSIDE WIDTH LIQUID DEPTH NUMBER OF osS COMPARTMENTS LIQUID CAPACITY IOEVGALLONS. TILE DRAIN FIELD: 5lnlat(C"CSILr+tt✓iCad) y I 1 _ I DISTANCE FROM WELL 5 I 0 FOUNDATION_ La NEAREST LOT LINE a'S OF LINE _ 1 ! DISTANCE BETWEEN LINES /•,S TRENCH WIDTH toQ IN I � LENGTH OF EACH L INF A ) a'C DEPTH OF FILTER DEPTH: MATERIAL BENEATH TILE IN ABOVE TILE z— IN TOTAL LENGTH 5v # of Lines 3 ABSORPTION AREA Q- ()C] 54 FT TOP OF TILE TO FINISH GRADE TOTAL EFFECTIVE 1 L SEEPAGE PIT: DIAMETER OR WIDTH _ LENGTH_—, DEPTH _ Log Crib Rings Crib Sizer, BUILDING FOUNDATION DI AM ETER___DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) _ SQ FT NEAREST LOT LINE Well \\ Class: hd Depth: Well Distance To: Lot Line 20 Bldg: ` o' -F Sewer Line: or.A. Pipe Materials: (A)luj'u # of Bedrooms: O, Installer: j ,v, pV4 Ca ) Remarks:r Qtl �Ooraim oil DATE 77 APPROVED I r T L 71 : • a _(_.L_ ' I +. - ---- ID 3 i id — - —. -- rya'"' --- -t ;1 - • h A lam -J n- DATE 77 APPROVED N 1 /_ I F" I -Y f.i 11 - °'e" 1_I A-' 1=A t-4 P_ I -A P=1 "MA /_a DEPARTMENT «' 'HEiL.TH AND ENVIRONMENTAL r '0 -1, -"\TION 02 'L- STREET, ANCHORAGE, AK. 279-2511 SLI fl — Y ._`_. E_. Sr; EA. -.1 A= E-! E_" E'er Imo: M.1: ...I.. FERMI T NO. APPLIDAN T J. ZAPOTOSKY B?;. _:';'02 1PNDIFIN LOCATION •,1PNDIFfN 3 gig LEGAL IS NR1WS5, US. ' SURVEY -3 LOT SI4E TYPE 01 SOIL ABSORBTION_ SYSTEM .I_ .', C:RHIWIELD k,56& boat oh' to 6.. SOIL RATING '::SC. 1 -.'BR,,= 100h1H;Il'•IAJhT PdL It'IE:ER'- L �F BEDROOMS - • r� TEE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS : = /'H A.., = LCI :i_ A*' FA 'V i Et F" 14it=igcic1 St;AUARE=; FE.E. I THE- LEh4I3TH DIHENSIAAN::If: THE LENGTH-11Ta-FEET 11 SHE - -TRENCH OR LR:AINI-1ELD. THE DEPTH UT.- -EITR:IENL:H UR N'IT- IS THE DISTANCE BETWEEN THE SURFACE OF SHE GROUND AND THE BO'1 Tom OF :THE E?<:CAV'AT ION ( IN FEET). THE TRENCH WIDTH EOR'..1FHTP•aftIELL:'1 IS 3 FEET THE GRAVEL DEPTH 1S; THE. MINIMUM DEPTH OF GRAVEL BETWEEN THE . OUTF-'ALL'PIPE - ANC' THE BOTTOM. OF THE EXCAVATION C. IN FEET): A : ILA A -A N;! A_:a =. E=° t Y 1.: �.- f -A = i / 4 s ci Fu Y._ E. Or -4 Fl /_ FC FA EE F L t r-,6 F E=" 11E -L' C3 r4 A PACKAGE PLANT; MAY BE. INSTALLED AT THE PERM I TEE''_ OPTION SUBJECT TO THE FOLLOW INU ri-ANDITIONS : _ . 1. EITHER H - t;LH 1- OR IF • NSF APPROVED U -PLAN T - MAY -BE .I INS I HL:LF L' H TCUNT INLILIIIt-MAINi'ENHNI:E-AGREEI'IENT,.IS: REWIRED. IF A MAINTENAPaI'E AGREEMENT 1S NOT KEPT CURRENT YOU t'1FI'T BE REQUIRED TO- ENLARGE. PHE: SOIL - ABSOR:F'TION SYSIEI'I AND/OR YUU MAY BE SUBJECT- TO -PROtiECU11UPa. • E &°-E C/ c: - > .1L F -i . n Ad A . E 13®1_1 L> _ -_ _ BACKFILLING OF ANY SYSTEM WITHOUT- FINAL INSPECT ION AND APPROVAL_ BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY OP•d--SITE- SEWAGE- DISF'AJSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 213E1 FEET FOR --A PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION L"•DIHGRAMS: ARE -- AVAILABLE TO INSURE PROPER INSTALLATION. A-=" IE.. t°b I _.A_. E :' F" L fr: E L e E-: t°1 B E IER 1 CERT IF'r' THAT 1: 1 AM FAN ILIHR WITH THE REQUIREMENTS• FOR ON-SITE FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE. SYSTEM IN ACCORDANCE WI N— THE AMIDES. 1 UNDERSTAND THAT THE ON -SI TE SEWER SYSTEM TEM MAY" REQUIRE ENLARGEMENT' IF THE RES IDENi E IS REMODELED TO INCLUDE MORE THAN BEDROOMS: • SEWERS- AND WELLS _. SET S:iGNELi:_---/ - ------ HE I C:f a1PO TCIS•KY ISSUED E:'r'���_�- _ DATE. k % e 4PT.oirs pe / •Ve-e,f�MF aat I /one S FCC 7,w3 at V_. Ei • • • ;.!:: A " • . *'l. I V M -W DRILLING, INC. . • Well Owner SfoLleph Xnpatosky DRILLING LOG • • :•;( : ;..: Use of Well Do) • Location (address of; Township, Range, Section, if known; or distance main road U. S . Survey 3215 • Size of casing 6" Depth of Hole 5° feet Cased to 50.9 feet . • . • •• . Static water levelft. jaillys) ..4elow) land surface. Finish of well (check one) open end • .... .. Screen ( .); Perforated ( • . '. ).. ( Describe screen or perforation ...N/k : _ II.., • • - . .• • . Well pt. raping test at j.2 -..gallOns.iei. Ilifiiii) (minute) for hours with_i_t° 0% ft of drawdown from static level: ;,:;- • :,.:•,.'; 7/8/77 • -.J ..: ' .:- •*• Date of com- pletion • .. • .,. . • : ! : WELL LOG Depth In feet from ground •-••,Irlace Give details niformations penetrated, size of material, color and hardness 0 TO 2 •Ping,:.4tiekup 2 3 TO' 3 TO 4 1.0s6,zravel 3.Z3 Saticly • gravel 25 • To 35 :trairel, wet 1.:6o.6�:.reva: 40 t • • • ' - TO 40 TO 50 .water'it • • . . • - • ....• • • • . TO TO TO TO TO TO kiNVW,f1 Certifici1 Contractor .CcrtiScate Ws. 814 Ez t(1 2 -STATE Well Owner M -W DRILLING, INC.' o`1 -`w DRILLING LOG dph ._apai,osky Use of Well j'E'`' Location (address of: Township, Range, Section, if known; or distance main road 11.S. Survey 3215 Size of casing " Depth of Hole feet Cased to 50•9 feet Static water level 15 ft. :(4j age) (below) land surface. Finish of well (check one) open end ( ); Screen ( ); Perforated ( ). Describe screen or perforation_ .l_ fts Well pumping test at 12 gallons per (h`olii() (minute) for i' hours with 1___ ft of drawdown from static level. Date of completion 7/0/ WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO 2 Casing; stial up /.. TO ., Organ tc TO Loose gravel TO ;.o gravel Lf>TO tj Silty gravel, tet 25 TO 5 Loose c:xave1 TO 40 Loose sandy grave wet 40 TO };I Bandy ... gravel, water lJZaf /fiq TO TO TO TO TO TO TO l N\, ATA. catefipa ContractorJ"!3 Certificate iaos. 8I4 2 - STATE 4 I C :1: F.1=0 /""CL T- °T" co If= FIFA C.-5.1-4 CD F: i=i Cs FE ,_ CPAF:TMENT qi;i HL._ _ TH AND ENVIRONMENTAL. RIT J C;T ION 825 'F S•1REET) ANCHORAGE_ AK:. 99 1 279-2511 W E_ L__ E_ F L E F-` rl R -r PERMIJ Na 77673 ) 1 1 1 653 824. APPLICANT �.APOT'i_iS,k;4 .T _:F:L.I:f}', :�.'!'4�Ir� INDIAN LOCATION SEWFIRD HWY LEGAL U. 5 SURVEY 312 /49/Vi:/a/,.�' 6 LCIT SIZE j_o4_1&it_i SQUARE FEET MINIMUM DISTANCE BETWEEN H WELL. AND ANY ON-SITE SEWAGE DISPOSAL_ SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 2009 FEET FOR A PUBLIC WELL. WELL. LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. EITHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. Fa E_F:L-i x ...L._ E.: -:1= 1: Lam' LE: = c.EE®_:FEL'1 E3EEL' ' - _y_ . :L_"I T CERTIFY THAT 1: T HM FAMILIAR WITH THE REQUIREMENTS FOR [JN -SITE :EWERS AND WELLS AS. SET FORTH BY THE MIINICIPAL.ITY OF ANCHORAGE. 2:I WILL INSTALL. THE SYSTEM IN ACCORDANCE WITH THE CODE=. AFIEk!ICAN1 / FPOTOSKY _r _--DATE t'-/ $ ?-? Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 090-031-07 1. GENERAL INFORMATION Complete legal description HAA# Expiration Date: /;/ ?/03 U.S. SURVEY 3215 & 3215A; T1ON, R1W, SECTION 5 Location (site address or directions) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address OLD JOHNS ROAD & SEWARD HIGHWAY MARK & CATHY AMES C/0 GEORGE McCOY W/ PRUDENTIAL J. W.6 Imo- l') IC j ft 3 Ste; -rvcok, 4 zgs")4o Day phone ' Day phone 727-7444 PRUDENTIAL JACK WHITE, GIRDWOOD Day phone 227-0583 3201 C. STREET, SUITE 200* ANCHORAGEAK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System • 2 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer • The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE rZ Approved for bedrooms. Disapproved. Conditional approval for Attachments: HM Checklist Septic System Advisory Well Flow Advisory Date 1/303 bedrooms, with the filowing stipulations: rttttl.t(U(fff//j,�i k,..Y OF giy�,y��. WATERON ; AND m TE WASTEWATER • PROGRAM • Manitenance Agreements Supplemental Engineer's Reort Other . •• •• \ • • % llE}Ijj))111 Original Certificate Date• Y//.4 Legal Description: A. WELL DATA Well type PRIVA1E Municipality of Anchorage Development Services Department Building safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519.6650 www.ctanchorage.ak.us (907) 343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST U.S.S._ 3215 & 3215A, Parcel ID: 090-031-07 If A, 8, or C provide PWSID# IVA Well Log (YIN) YES Date completed 7/8/1977 Sanitary seal (YM) YES Wires properly protected (Y/N) YES Total depth 50 ft. Cased to 50.9 ft. Casing height (above ground) 12+ in. AT INSPECTION 6/13/2003 FROM WELL LOG Date of test 7/8/1977 Static water level 15 ft. Well production 12 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Arsenic:. N/A mg./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material FIBERGLASS Tank size 1000 gal Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (WN) Date of pumping 6/12/2003 Pumper 23 ft. 7.13 9 P.m. Nitrate 0.692 mg./L. Other bacteria 0 colonies/100 mi. Date of sample: 6/13/2003 Collected by: C. ABSORPTION FIELD DATA Date installed AKWWC, INC. 8/30/1977 Cleanouts (WN) YES NO High water alarm (Y/N) N/A CHUGACH PUMPING Date installed 8/30/1977 Soil rating (g.p.dJftso Length 50 ft. Width 5 100 System type TRENCH ft. Gravel below pipe 0.5 ft. Total depth 3.0+ ft. Eff. absorption area 250 fe Monitoring tube YES Depression over field NO Date of adequacy test 6/13/2003 Results (Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test 0 in. Water added 2140gal. New depth 0 in. Elapsed Time: 10 min. Final fluid depth 0 in. Absorption rate >= 300+ g p d Any rejuvenation treatment (past 12 mo.) (WN & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed "Pump on" level at in. Datu E. SEPARATION DISTANCES Size in gallons Manhole/A "Pump off" in High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot •90'+ On adjacent lots Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5.-1- Water '+Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 100'+ Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS * 65 / -Ivp ruvy < G. ENGINEER'S CERTIFICATION vet__ r L. 'Y'T I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printe Name Date 7/3 02 JEFFREY A. GARNESS A. G -7953 rorsaswo o HAA Fee $_1 t , Date of Payment 7 • '7 ' O E' Receipt Number 354 105 (Rev. 12(01) Waiver Fee $ 800 • a Date of Payment 11'1 ' 0 7", Receipt Number -3g lo3 7/16/2003 Municipality of Anchorage Mark Begich, Mayor Building Safety Division I'.O. Box 196650 • 4700 Bragaw Street Anchorage, Alaska 99519.6650 • (907) 343.8301 • Fax (907) 343-8200 littp://www.muni.org Jeff Garness Alaska Water Waste Water Consultants Subject: Waiver Request for Us Survey 3215 & 3215A; T1 ON, RI W, Section 5 Waiver Request #WR030055 Parcel ID #090-031-07 HAA#030313 Dear Jeff Garness: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to private well has been approved. The approved separation distance is 90.0 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Joy=. all Civ ineer On -Site Vater & Wastewater Program Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WR#: 030055 PID#: 090-031-07 HA#:930313 Permit#: Date Received: 7/7/03 Legal Description: T10N R1 W Sec 5 US Survey 3215 8 3215A Engineer. ,teff Garness Alaska Water Waste Water Consultants Applicant: Mark & Cathy Ames Waiver Requested: 90 foot well to septic tank seoeration distance Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: Total: Waiver Is Granted: Waiver Is not Granted: List Conditions or Reasons for above: Date: 41 /r, IDT By: £..K14-1/ Name of Reviewer Rec#: 38105 Amount: $$49 Date Paid: 7/16/2003 MUNICIPALITY OF ANCHORAGE Building Safety Division MEMORANDUM Op'iw ...*. 01uaraaV:n - -- < DATE: July 17, 2003 TO: File FROM: Joe Goodall Engineer 11, On -Site Water Wastewater Program SUBJ: U.S. Survey 3215 & 3215A T10N, R1 W Section 5 Jeff Garness of AWWC, Inc. submitted a HAA for U.S. Survey 3215 & 3215A T10N, R1 W, Section 5. As part of the HAA there was a waiver request for: -a 90' on -lot well to on -lot septic tank separation distance. -a 65' on -lot well to the privy on U.S.S. 4456. I was authorized by Jim Cross (On-site manager) to grant the 90' waiver from well to septic tank. The separation waiver guidelines outlined by the D.E.C. include a point system to determine the risk of well contamination. The total points calculated was 10.84, which is less than the required 16 point minimum. The waiver point system is only a guide provided by the D.E.C., but numbers of 16 or less for a continuous source of contamination such as leachfield should not be waived, unless other mediating measures are noted or special construction techniques which can mitigate some of the gelogical concerns are taken. The following are some of the other mediating measures or facts that were provided by Jeff Garness: -"the lot is sloping away from the well. the well is slightly uphill from the septic system and if the septic system were to overflow, it appears that the effluent would not travel toward the well head" -"the location of the septic system is in a very visible area so that the effluent were to surface, it would be noticed and the problem corrected." So based on the above mediating factors Jim Cross and Dan Roth after discussions with Jeff Garness from AWWC, Inc approved and gave me authorization to grant the 90' well to septic tank waiver. It was determined by the Jim Cross (On-site Manager) to not grant the waiver for the 65' on -lot well to the privy on U.S.S. 4456 separation distance. The privy that is located on U.S.S. 4456 was found to be be undocumented and was illegally constructed. Therefore, our department can not grant a 65' well to privy separation distance waiver if the system is illegally installed. The people currently living on U.S.S. 4456 are leasing the property from the Bureau of Land Management. In conclusion, our department will grant a waiver for the 90' well to septic tank separation distance and will approve the Health Authority Approval. However there will be no waiver for the 65' well to privy. The On-site Water and Wastewater Program will inform the BLM of a violation of the illegal, undocumented privy located on U.S.S. 4456. S ft-. D. F. C. S. D. W• 40=1 S. C . R. o kJATEa TAME ER A wt 44- 77sr 3 I 10, 57.737k. wI7EZ LFuccL. @_ Z3 fee. -Mt Ft 1 pepfti o(' TR-eNGF/ FRoM N/7F} cFleck/.Y . prtou;ded R7 Tc:44 6nrtrvejt 2sC.{l2n-;vcc( fo _L_ -7c= 31. IC SOIL Sof+8TioAl 67;). z C -.) y •'#"(j).(° •p*9.. .1. • ii + .o(o _ •3S' PEv,r+ER g; I iTy -\ 8 •2 0 .24 C1 7o) 1 2?o ) 1.3 • ss + • 13 = ALASKA WATER & WASTEWATER Jule 1.2003 Municipality of Anchorage Department of Health & Human Services Division. of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 CONSULTANTS, INC. Ref: Waiver Request and Health Authority Approval for U.S.S. 3215 & 3215A The existing 2 -bedroom house is served by a private well and septic system. During our site evaluation for the purpose of obtaining a Health Authority Approval we identified the following encroachments: • 90 feet from the well to the septic tank on the subject property. • 65 feet from the well to the privy on U.S.S. 4456 We are requesting waivers for these encroachment based upon the following facts: • The lot is sloping away from the well. The well is slightly uphill from the septic system and if the septic system vas to overflow, it appears that the effluent would not travel toward the well head. • '1 he location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. • There is a travel trailer on Lot 4456 that may be periodically used. Per the property owner, the privy is not in use at this time. It is our assumption that this encroachment has existed for over 25 years and there has been no adverse impact on the well water quality (based upon the recent water sampling data). • The existing septic tank is made of fiberglass; therefore, it will not rust through and leak, as would a steel septic tank. The cti-er path of contamination is subsurface migration wastewater should the tank begin to leak because of a fra::ure in the fiberglass. As can be seen on the attached well log, the aquifer is relatively shallow with approximately 50 feet of loose, sandy gravel. We believe that the aquifer is running north to south in the porous soil, which will serve to prohibit drainfield effluent from migrating towards the well. Recent water sample results indicated nitrate levels of 0.692 mg/L and no coliform bacteria. This encroachment has existed for almost 26 years with no adverse impac to the well water. Based upon the aforementioned facts, it appears that there is minimal risk associated with the 9 * f et separation distance waiver. Ify^n have .ny Since{e1 s, please contact us at 337-6179. Thank you for your assistance. -1-61(1.ey Pre •i , M.S. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179Fax: (907) 338-3246 Website: akwwc.com INDIAN VALLEY ALASKA S/D; LOT 14, U.S.S. 4456 INDIAN VALLEY ALASKA S/D; LOT 13, DUSTING 2 BEDROOM NOUSE ALASKA WATER & WASTEWATER �----- ----- CONSULTANTS, INC. PREPARED FGR MARK & CATHY AMES PHONE NUMBER: 727-7444 GATE 6/26/2003 DRAWN BY: C.J.G. LEGAL DESCRIPTIO'J: U.S.S. 3215 & 3215A PAGE NUMBER: 1 OF 1 TYPE OF WORK: SITE PLAN FOR WAIVER PACKAGE ALA SKA WATER & WASTEWATER ��.,.. - .._.. . CONSULTANTS, INC.-----'.••.,.'.' 3701 E. TUD07 RCS), SUITE 101 • ANCHORAGE. AK 00507 • PHONE (9071337.6170 • FAX (007)338.3766 1YPE OF WO" K: DETA11. DRAWING FOR WAIVER PACKAGE MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date /41F6045— (a) LtFEB 5—(a) Legal Description (include lot, block, subdivision, section, township, range) (A.S.S Ft 32/r 3zirA 716n1 elk) sec. r U S sua.usy 312s Location (address or directions) Red �° 1003AN 1-4-S1ALASIC4 -1-4-S1LN EsfaC-'C0lL-U.001RNCac:ecGetflbe`a,ciaS?Roq�OMezywh, �. e (b) Applicants Name ;� al GSt inti 2Apo �� SkYTelephone n HomeCS' d'^ 7913-B �i9T Business S(t3^3/Li/ Applicants Address S(2,' 60 8702. JNO24ry 4t ggrNU (c) Applicant is (check one) Lending Institution r®1 ;.Oumer/buildcr Buyer ; Other( ! (explain); (d) Lending Institution Address Telephone (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: CSL S t 1 ( 1G-- � z 0 © 71,L0)--t-L-1 <;c Lam. 2. Type of Residence Single—Family r5Z Multi—Family Other (describe) Number of Bedrooms 41 A 3. Water Supply Individual Well P4. Community ET 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 t A Holding Tank FT 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] r^•^\ 'Do toitVisecr kS5 7i?mr F'32.1S'4 /n ineerin. Firm Providing Ins.ections Tests File Search Data and Information As certified by my seal affixed hereto and as of the validation date shown below, t 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 regula- tions in effect on the date of this inspection. Name of Firm AECS Address 12 Od W 3$d aaly ��O�Ofy`�pO�ooee2eoo, Date o Telephone S621- S-0 N O W 04A6% 4t <MS -03 '' uo 12ereo.he.o Cc") D7970NA( 4ppaoJaC nu t do one-off-FocLow2Yuy: 1� obtia:in Wcaidtere. L=tow 400-CWrits r oN OTSY4mie WCILc-SE{(l13C 3An K q3.5! coo; ria o.qa� Eli, SEAL ) DEEP Approval L /a/now-9-c Approved Lor /cc'o jz- Approved Disapproved 2) MOJC seri-ae c ruc t0 owes -TAW /OoEtEfzo.tWeLt.• ISO: frM4s4 9.a31 -all well wiRt j:w".' v4Rd IKSi�n. / A.HD F IIRaemntf P. 1 to 2 W -4_.c.o-4-.� ,c c.t %t Date 0"VMS-- Conditional VM - Conditional X Terms of Conditional Approval„ Y%t45 AA/Li-et / v2Gf. 6 -C1 -4-11-6-1.-e-/ 72- ,-'u ! /s i C -O ' zl«t-e- ti.i_--r-/c [' CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DEEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DEEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DREP 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. (DEEP SEAL) RR4/ej/018 [Page 2 of 2] 7-19-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: I /ytoES NICIPALITY OF ANC.'ORAG DEPT. OF HEALTH ENVIRONMENTAL FEB 15 1985 Well Classification -c,tite- Well Log Present//7) Total Depth $j), q ' Static Water Level USS-4,1S2iCct3ats— If A, B, or C, D.E.C. Approved(Y/N) 4)4 Date Completed If(61/47 Yield60 Cased to car' Depth of Grouting/Vdforcu /,?,3'7�® Pump Set At gr(on WF / AI ?,15 Sanitary Seal on Casing 41/N) Casing Height Above Ground Electrical Wiring in Conduit (Y, Separation Distances from Well: Depression Around Wtillhead Y To Septic/Holding Tank on Lot , On Adjoining Lots /00 / To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots 106/ - To Nearest Public Sewer Line �� To Nearest Public Sewer Cleancut/Manhole OA -- To Nearest Sewer Service Line on Lot 4i4f Water Sample Collected By L„Npi ; Date oVe`- Water Sample Test Results 54t,•s P' Ie}cae5 n / Ca�e:ents (p(1,y-L,,,,,,i r /Ina:1 e .1-e, _e z -n4.0.1/ ,?Inc.-/ J(fl / 1)(t L zv ./1. ef. “^_aL . g La's/PIO-gt-:.., � (fa,,- z-t-e-'Pso4. 7!1 s - -Cu -rLJPY'/JJ isct' i/Z2 N-0,1tii/ r ev Nie -g to y B. SEPTIC/HOLDING TANK DATA Date Installed /a 6/7'7 Size's /000 . No. of Comtpartments 2 Standpipes ,f'YY,7/N) Air -tight Caps fY7/N) Foundation Cleanout Depression over Tank (Y/J Date Last Pumped Pumping/Maintenance Contract on File (Y/N)144 ; for it)//4- /' Holding Tank High -Water Alarm LY/N) , �i( Temporary Holding Tank Permit (Y/1141 Separation Distances from Septic/Holding Tank: To Water -Supply 4311(P q315- 1 70' To Building Foundation X8, 3 To Disposal Field /0 To Property Lire `/'/0°` To Water Main/Service Line A)41- To Stream, Pond, Lake, or Major Drainage Course )70a i ConanentsO/91eei.Qct-seri 0 „4,ay�� 2r/rST tn�-4,ein-aaLa) 4'S•-.a.(:,bt DikeP Rs-3uu.7, X--SO-77 Stio.,'s /o0: -)P giw D(4eP Z 3o-7) ,fsDu.I} Receipt # ,2150(111-3 Date Paid: Amount LLC,QU [Page 1 of 2] 2-15-84 T/0 N ,e/ea C. ABSORPTION FIELD D tL. S 3z,5"-iteats4 Soils Rating in Absorption Strata Date Installed Width of Field /0 4/ Type of System Design Sul/dQ� Length of Field ?JACO' rr` 5 Depth of Field dE7.5'-- Gravel Bed Thickness O,C Square ..-_, r'°,_O Standpipes Presence (Ye a//2/,mac Depression over Field (Y/0 Date of -Last Adequacy Test Results of Last Adequacy 'lest Pada'f Drre,/7ee620, Separation Distance from Absorption Field: To Water -Supply 14e11 11(1 To Building Foundation Lot tQA To Water Main/Service Line To Property Line 4-77 0247' To Existing or Abandoned System cn ; On Adjoining Lots 53a / To Cutbank(if present) //j0-' 0 To Stream/Pond/take/or Major Drainage Course WD/0 To Driveway, Parking Area, or Vehicle Storage Area 470/0 Conments0p2a4z,„7_,,l% corns ,4206, /i/�� * ffWetA 014eP d-.30"774se4•i% D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) W41 -- Comments Dimensions rya Manhole/Access (Y/N) Yi/A_ 144/ "Pump Off" Level at 141/4 Vent (Y/N) 'v4 Pumping Cycles during Adequacy Test. Meets MOA ** ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to all on the date of this inspection. Signed Company Date (yFEh$S- 4tc5 MOA No. SS-oty KB1/d5/s kiecomimeHp Cou•cfi %,'utu( Approua ( mesh: 0 1M6ue Septic TANCC +c, 6-Y/00' ('aowt Well z)Aepu;v co»c(u,"toA wQ0 poww.s,Ayipl� '3) 144404-‘owu( '(i QVUUVIC[ We(( fo Iiw t"ci44 DCIM5SIoN Aaouv wall H-61in• [Page 2 of 2] MOA HAA Guidelines in effect ., et, QG. LC. Reid, Jr, No. 2261.E ® F e- "t'c PROfCsas-0 ®©�C 2-15-84 ALASKA bilUIROnCYICnTAL COf1TROL sCkICes, Inc. Engineering & £nuironmental Studies February 14, 1985 Keith Bandt Municipality of Anchorage Department of Health & Environmental Protection 825 L. Street Anchorage, Alaska 99501 Subject: T10N, R3W, Section 5 U.S. Survey 312 Dear Keith: We performed a Health Authority Application on the subject lot on 2/12/85. The 8/30/77 inspection report on-site sewage disposal system (attachment) states the septic tank is 100 ft. from the well. Further, the inspection report shows the absorption field to be 110 ft. from the well. Unfortunately, the inspection report shows little resemblance to the actual construction on the lot. Attachment 2 is a scale drawing of what we found on the lot. While it is not an exact survey, it is sufficiently cross - tied together to be reasonably accurate. These measurements show the septic tank cleanout is 93.5 ftfrom the well. Further, the location of the absorption field is suspect and may also be within the 100' radius of the well. At the time of construction, monitor pipe and clean outs were not required in the field. Therefore, we are unable to determine the exact location of the field. We are submitting the Health Authority with a recommended conditional approval. Our recommendations are that either a waver for separation of the septic tank to the well be submitted and approval obtained or the septic tank be moved. These recommendations both have problems. They are: a) The waiver will not be likely to be approved unless the septic tank integrity is verified and caulder couplings are installed on the inlet and outlet. Digging around a fiberglass septic tank to verify integrity and install couplings will in all likelihood damage the tank and destroy it's integrity. b) Attempts to move a fiberglass septic tank will result in the same fate as above. It will likely get damaged. Unfortunately, the current homeowner must close on the sale of the house or supposedly be held in contempt of court: Therefore, we need to have your office approve the conditional with a stipulation that if the septic tank is dug up in any manner, it will be replaced. This is the safest alternative. 1200 Test 33rd Auenue, Suite B • Anchorage, Alaska 99503• (907) 561-5040 Due to the shallow well (50 ft) and coarse gravel exists between ground level and the water bearing strata, any damage to the septic tank could result in contamination of the well. If you have any questions, please do not hesitate to call. Environmental Engineer Approved by: 2-1 l l f r ° . _ . • 4 60 -N-& gw,2L--w-a - A.A.e, cwt. -a citLt -rr moL.,_‘,-c.r j Lam-. ,eLs,—) yt,-'- /c.t G-e:� A 1:14e ce.J P c - (45) ALASKA ENVIRONMEF L CONTROL SERVIr'S, 6.C. 1200 West 33rd Aver_.; Suitel3 ANCHORAGE, ALASKA 99503 Phone 561-5040 JOB u`SS SHEET NO CALCULATED BY CHECKED BY SCALE (- DA -1 OF DATE ///f/® "r DATE PRODUCT 204-1 (IV EJ Inc . Won. Ws 01471. ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 March 4, 1985 Th 274-2533 Mr. Ron Godden Alaska Environmental Control Services, Inc. 1200 W. 33rd Avenue, Suite B Anchorage, Alaska 99503 SUBJECT: --Temporary Waiver Horizontal Separation between Well and Septic Tank, USS 3215, 3215A, T1ON, RMW, Section 5, US Survey 312, Indian, Alaska (8521 -WA -110) Dear kir. Godden: The Department has reviewed the subject waiver request and hereby tempo- rarily waives for 120 days the horizontal separation between the well, and septic tank to 93.5 feet on thesubject.property for a 2 bedroom single family residence only. This temporary waiver is contingent upon the proposed work to alleviate the situation as described in your February 21, 1985 letter, same subject. SWE/msm Sincerely, Steve W. En District Engineer