The URL can be used to link to this page

Home My WebLink AboutT12N R4W SEC 10 LT 18 N2 Municipality of Anchorage Page I of 'Z, DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ,~Jfl ~o~-~,-'( PID Number: o ! l -- I ~.l - I '7 Name: ~ u ~.,~, ~t ~ c o Wastewater System: D New ~--~"~-pgrad-~ Address: ABSORPTION FIELD Phone: ~Z --OS3 I IN°'°fB~r°°ms: U Deep Trench UShallowTrench~ UMound UOther Total Depth from original grade: LEGAL DESCRIPTION Soilaating: O.~ GPD/Sq. Ft. ~,1~ ~,0~ I I Fill added above original grade: Grave~ length: I WELL: E~[~ew ~ Upgrade ~rave~width: Numar of lines: Di~n~lin~: Cla~ification~ I~(Private' A,B,C): Total~Depth: Ft. Casedz~To: Ft. Total absorption~o~area: Se. Ft. Pipe~material:~.~ ~a~ ~ Date Drilled: Static Water Level: Ins~ll~r: Date installed: Yield:J Pump Set at: ~sing Height A~ve Ground: TANK SEPARATION DISTANCES ~sep.o a ,o,~na ~ TO Septi¢ Abso~tion Li~ Holding ~ubllo/Private Man f~cturer: Capaci~ in gallons: From Tank Field Station Tank I Sewer Lines ~0~ T~; J~oo su~ac~ LIFT STATION Lot Size in gall°ns: I Manufacturer: ~ "Pump on' level at: "Pump o~' level at: High water alarm at: Remarks: ~ ~o~ ~k~e~ ~T~D~ BENCH MARK Depaflment of Health an~ H~an Se~ices approval ~;-'~,~ ,,, ..- ~' Reviewed and approved by: Date:/' 7-~ ~~ 72-013 (Rev. 9/91) MOA 25 PERMIT N[JMBER: SW980467 AS-BUILT DRAWING I PRESSURIZED BED / / I --ALTERNAFE SI'FE 42 PVC LiNE INSIDE A 20~ LONG 6" PVC WHERE IT CROSSES THE WATER SERVICE LINE. NO JOINTS WITHIN 10' OF THE WATER %NEW 1500 GALLON % S.F.E.P. ROAD F~ASEMENT PARCEL ID NUMBER: 011-161-17 A B C ST1 65.5 71.1 -- MT3 -- 84.5 93.0 MT4 -- 97.5 --- i TO MT4 = 12.9 MT5 £0 MT1 59.5 MT3 TO MT2 60.1 MT4 TO MT1 59 9 MT4 TO MT2 95!i7 TO MT2 ALASKA WATER AND WASTEWATF. R CONSULTANTS, INC. 6gOI DEBARR ROAD. SUITE 2B. ANCHORAGE. AK. 99504 PHONE: (907) 537-6179/FAX: (907) 338-3246 LEGAL DESCR{PTION; T12N, R4W, SECTION 10, NORTH 1/2 OF LOT 18 I~PE OF WORK: AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: BOB BAER 272-0571/274-9616 DRAWN BY: SCALE: PAGE: 12/30/98 A.C.G. 1 = 40' 2 OF 3 -7953 NOf¢~ ~XCAVAi~P A5 N~C~55~ fO ~ 5~P/d~b ~lb5. ~Ng OP P~P W~ MO~P .fo ~ ~QUI~P fO ~H NO~ ~NP O~ P~ PO~ A 5~g/O~L LAYer, L~V~LING NO ~OUNPWAT~R POUNP ~'~' P~T P~LOW P~P P~TOM NO P~PROCK eO~Ng 6~ P~BC P~LOW P~ P~TOM 6a01 DE~R~ ROAO, SUITE 2B. ANCHO~GE, ~. 99504 PHONE: (907) 557-6179/F~: (907) 558-5246 T12N, ~4W, SECTION 10, NO,TN 1/2 OF LOT la ~ ................................. ~PE OF WORK: DETAIL OF EXCAVATION OF NEW BED [ ............................ :'"'~ PREPAREO FOR: PHONE NUMBER: 272-0571/274-9616 ~o~ ~,~ ~, .. ............. .~ ~"~:,2/ao/,~ I~''''N ~: I~: I~'' A.C.G. N.T.S. 5 OF Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B N Anchorage ~ Alaska 99504 Phone (907) 337-6179 N Fax (907) 338-3246 Consulting Engineers December 3, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 FAXED DEC 0 3 1998 RECEIVED JAN 5 1999 Municipality of Ancr~ora~e Dept. Health & Human Services Subject: T12N, R4W, Sec 10, Lot 18, North 1/2. 8500 Emerald Street. To whom it may cencen~ A design package has been submitted to your department for an upgrade of the septic system serving the subject property. As can be seen looking at the site plan, the well is approximately 30 feet fi.om the house. The location of the water service line is unknown, but it probably runs in a straight line to where is stubs up in the basement. Regardless of its route, it undoubtedly runs underneath the proposed sewer service line. Given the short length of the water service line, it is reasonable to assume that it is one piece (has no joints). Since it is not possible to maintain the 10 foot horizontal separation between the water service line and the sewer service line, we are proposing to encase all of the sewer service joints, within 10 feet of the foundation, in concrete. If you find this to be an acceptable solution, please note it as a special provision on the permit. If you have any questions, phase contact me at 337-6179. Thank you for your assistance. :lvffre],/~. Ga iess, P.E., M.S. Presiflen~ / / Rick Mystrom, Mayor Municipality of Anchorag¢ Department of Health and Human Services 825 "Lr' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage ak.us January7, 1999 Jeff Garness, PE Alaska Water & Wastewater Consultants, Inc. 690i De Barr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for T12N R4W Section 10 N2 Lot 18 Waiver Request #WR980097 Parcel ID #011-161-17 HA990004, SW980647 Dear Mr. Garness: Your request for a waiver of the required 100 feet horizontal separation from the S.T.E.P. tank to private well has been approved. The approved separation distance is 81.0 feet. This waiver approval applies to the existing S.T.E.P. 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 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Wa'iver Review Worksheet WR# WR980097 PID~ 011-161-17 HA~ Permit ~ Date Received: November 20, ]998 Legal Description: T12N R4W Section 10 N½ Lot 18 Engineer: 3eff Garness, PE, Alaska Water & Wastewater Consultants. Inc. 7320 East Chester Heights Circler Anchorage, Alaska 99504 Applicant: Juli Simco Waiver Requested: New S.T.E.P. tank to the private.well 8~ feat. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: 5~ ~/~/~ Rec %: 04623/7241 Amount: $ 625.00 Name of Reviewer Date Paid: Nov 20, 1998 WRIVER REQUEST FoR d~)~LoT ~,EZL To P~OPO$~P ~.T.E~ T,~,V/~ OF I 4~' £4- 4.3 2,0 2.2 January 25, 1978 Jim Frye Emerald St. WELL LOG 0 ft. to 35 ft, 35 ft. to 58 ft. 58 ft. to 59 ft. 59 ft. to 100 ft. 100 ft,to 100.5 100.6 to i04 ft. 10~,ft. 203 ft. 204 ft, to 220 ft. 228 ft. to 228 ft. 228 ft. ~o 230 ft. 230 ft. to 234 ft. 234.ft. to 244 ft, 2~$ ft, to 265 ft, 265 ft, Silty sand clay water bearing sand.., bails dry finee sand,., weeps water clean water bearing sand and gravel ~0 ft. water., bailed at 15 gpm Unable to clear up fine materials bottom heaved in 20 ft. dirty wet sand heaves 30 ft. 6" of medium gravel and sand., very tight, bottom stable, bails dry at a gpm can perforate clay dirty silt with trace of gravel clay ddirty fine sand with some gravel clay clay and gravel olean water bearing sand and fine gravel Static 55 ft. drawdown ~o 150 ft. at 10 GPH TEST PUI~PED 42 HOURS continuou~ oumping clear and clean Don Dwi !;gins FEB 8 I".5~0 WELl. LOG 2 TO 3 3 'ro 18 ! $ T(' ._z, 3 43 1'o 105 _ ]05 'ro 125 16o 'ro 2~0 230 '1'o ~38 . Sand grav?l Sand Sticky clay: gray . ..................................... Damp silty sand .................................. Bllue clay ................................. Oo Alaska Water & Wastewater ConSultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers December 3, 1998 FAXED DEc 0 3 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: T12N, R4W, Sec 10, Lot 18, North 1/2. 8500 Emerald Street. To whom it may concern: A design package has been submitted to your department for an upgrade of the septic system serving the subject property. As can be seen looking at the site plan, the well is approximately 30 feet from the house. The location of the water service line is unknown, but it probably runs in a straight line to where is stubs up in the basement. Regardless of its route, it undoubtedly runs underneath the proposed sewer service line. Given the short length of the water service line, it is reasonable to assume that it is one piece (has no joints). Since it is not possible to maintain the 10 foot horizontal separation between the water service line and the sewer service line, we are proposing to encase all of the sewer service joints, within 10 feet of the foundation, in concrete. If you find this to be an acceptable solution, please note it as a special provision on the permit. If you have any questions,~p?~ase contact me at 337-6179. Thank you for your assistance. Presiflerlt CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 985516001 AK Water & Wastewater Consultants Inc. 8500 Emerald St. 8500 Emerald St. Drinking Water 0 Sample Remarks: Client PO# Printed Date/Time 10/01/98 11:23 Collected Date/Time 09/23/98 12:10 Received Date/Time 09/23/98 12:40 Technical Director: Stephen C. Ede Released By ~ Results PQL Units Allowable Prep Analysis Method Limits Date Date Init Total Coliform Nitrate-N 0 col/lOOmk $M18 9222B 0.391 0.100 mg/L EPA 300.0 10 max 09/23/98 K~AP 09/23/98 09/23/98 GCP MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Dec 11, 1998 Expiration Date: Dec 11, 1999 Permit Number: SW980467 Legal Description: T12N R4W SEC 10 LT 18 N2 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Julia Simco Owner Address: 3701 E TUDOR ROAD #206 ANCHORAGE , AK 99507-0000 Parcel ID: 01%16%17 Site Address: 008500 EMERALD ST Lot Size: 49268 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ~/~J/~,U./~_ '~ Issued By: ,.o= Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B. Anchorage, AK. 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 November 19, 1998 Municipality of Anchorage Department of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for the North 1/2 of Lot 18, Section 10, T12N, R4W. To whom it may concern: 1. GENERAL: The existing 2 bedroom home is served by a private septic system and well. The existing septic system is undocumented and approximately 25 ft. from the existing well. Consequently, the sgptic system must be upgraded prior to the sale of the house. We have been instructed to design a four bedroom septic system. One test hole was excavated to the southwest of the existing septic system. The soils are sttmmarized as follows. 2. SOIL CONDITIONS: The test hole was excavated to a depth of 14 feet. There was less than 1 ft. of organiqs, and the soiig to a depth of 7 ft., was a dense ML material that was visually rated impermeable. At a depth of 7 ft. the soils changed dramatically to a loose, sloughing SW material with some SP lenses. No groundwater was encountered. One percolation test was performed at a deptla of 8.0 to 8.5 ft. The pere. hole was filled 2 times and drained out each time in less than 2 minutes, giving a percolation rate of less than I minute/inch. The intent is to place the bottom of the bed at the deepest level allowable for.the depth of the test hole, thus staying beneath the tight soils above the 7 ft. depth. It ~s4~ur opinion that the insitu sand will act as a 3. DRAINFIELD: We are'proposing to install'one 60 ft. longiby 15'ft: wide'bed: It'witt be'8 fi: deep withun effective'depth of 6 inches: This'corresponds to an'absorption area of 900 ft2i or'an- appi?ation rate of 0:67'g~d/fi2 :iasstmdng'600 'gpd total flow): SURFACE' WATER: There are no ~surface waters within 100'feet' ofthe proposed'upgrade. 5; TOPOGRAPHY:. The 'ground where the proposed bed is to,go-has 'a 5%' or less slope 'to the. east. There.are ho.concerns regardingthe slepe 'of tbe terrain: 6. WAIVER FROM WELL TO NEW S.T.E.P. TANK: Given the location of the well and the topography of the 10t, the new bed w~ have to be located uphill fi:om the house, necessitating the need for a lift station. The new S.T.E.P. tank will be approximately 80' from the well, near the southeast corner oftbe lot. A waiver will be required. The existing, well is, undocumented. An inspection was performed by Anchorage Well & Pump Service, and it was determined that the well is 267 feet deep and cased to the same depth. The static water level on 11/19/98 was 72 feet below the top of the casing, The existing septic tank is only about 25 fi. away fi:om the well and the drainfield is estimated to be about 50 fi. away. Recent water samples indicated nitrate levels of 0.39 mg/1 and no bacteria was present. It is believed that the existing encroachment has existed since the mid-1950's. The fact that this encroachment has existed for so long, and has yet to adversely impact the well, is evidence that the installation of a new septic tank, 80 feet fi:om the well, has virtually no risk of contamination associated with it. I,n short, we are only improvingthe existing situation. We were unable to find well logs for any of the adjacent properties for purposes of evaluating the geological profile; however, given the facts presented, this evaluation is moot. The topography is such that if the STEP tank were to overflow, wastewater would migrate directly downhill to the road right-of-way where it would be noticed. It is physically impossible for wastewater overflowing fi:om the tank to migrate towards the well. Based upon the aforementioned facts and the long_ history associated' with the existing encroachment, it is my opinion that there is virtually no health risk associated with granting the subject waiver (80 feet from well to STEP tank). 7. CLOSING: IfYou~/~e any questions, please call me a 337-6179 or 244-9612. ~ rness, P.E., M.S. / Lo'r l, VANDENER Ld LOT 2, VANDENER o LOT 3, VANDENER Ld LOT 4-, ~ VANDENER NOR'Ill 1/2 OF LOT 17, T12N, R4W, SEC 10. PRIVAIE WELl_ & SEPTIC. WELL. ON WEST END OF LOT. EXISTING 2 HOUSE (TO BE TO A 4 8DRM HOUSE IN I'HE FUTURE) RESERVE CREEK-/ LOT 10, ~12N, R4W, SEC 10 LOT 9, T12N, R4W, SEC 10 NORTH 1/2 OF LOT 19, T12N, R4W, SEC 10 SOUTH 1/2 OF LOF 17, T12N, R~W, SEC 10 UNDB/ELOPED PROPOSED SEPTIC SYSTEM (SEE DESIGN, PAGE 2 OF 2) SOUI'H 1/2 OF LOT 18, T12N, R4W, SEC 10 UNDEVELOPED WEST 86'd~ AVENUE '~NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH LOT LINE, THE ROAD EASEMENT, AND THE 60' WELL CONSTRUC lION. RADIUS FLAGGED BY A REGISFEREO LAND SURVEYOR PRIOR TO ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 29. ANCHORAGE, N(. 99504 PHONE: (907) 337-§17g/FAX: (907) 338-324-6 DESCRIPTION: NORTH 1/2 OF LOT 18, SECTION 10, TOWNSHIP 12N, RANGE 4W OF WORK: SITE PLAN PREPAREO FOR: BOB BAER PHONE NUMBER: 272-0571/274-0016 )RAN'IN BY: A,C.G, 1 = 100' 1 OF 3 SOUTH 1/2 OF LOT 19, T12N, R4-W, SEC 10 :-7953 .,' HOUSE (T -- U IN THE FUTURE / / ~'-EXISTINg , RESERVE STE~ ' WELL J PAGE ~ OF 3). ~1 I I I N ~ . A~ ..~/ 1) 7HE CONTRACTO~ SHALL HAVE FHE SOUTH 1 1/4" HDPE UNE PROPOSED 1500 LOT LINE,THE 80' WELL ~DIUS, ~D THE ROAD BURIED A MINIMUM GALLON S.T.E.P. TANK ~ J 2) EXISaNG SE~IC TANK AND FIELD SHALL BE FOUND AND ABANDONED ~ FILLING WITH SOIL. 3) S~tER LINE FROM HOUSE TO S.T.E.P. TANK SOUTH 1/2 OF LOT 18, ~ I MUST BE GRATER 7HAH 25' FROM WELL T12N, R4W, SEC 10 UNDEVELOPED LEGAL DESCRIPTION: PHONE: (907) 3~7-6179/F~: (907) 33B-~246 NORTH 1/2 OF LOT 18. SECTION 10, TOWNSHIP 12N, RANGE 4W ...................... DESIGN OF SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: 272-0571/274-9616 ~. DATE: 1 2/8/98 D~WN BY: SCALE: PAGE: A.C.G. 1 = 50' 2 OF 5 ROUSE (TO Bc UPGRADED /~ / / l'O A 4- BEDROOM HOUSE SEPHG ROAD ~E~ oP~l~ocx (SEE O~A~L. ~ I I I I ~ ,~/ ~ ~ ~ ~ / *NOTES: 1 1/4" HDPE LIRE- PROPOSED 1500 1) 7HE CONTRACTOR SHALt. HAVE THE SOUTH BURIED A MINIMUM GAl LON S.T.E.P. TANK ~ J LO7 LINE,TRE 80' WELL ~DIgS, AND THE ROAE OF 3 FE~ DEEP. ~SEMENT F~GGED BY A REGISFERED ~ND SU~V~OR PRLOR TO CONSTRUCTION. 2) EX~STING SEPTIC TAN~ AND FIELD SHALL BE FOUND AND ABANDONED BY FILLING WiTH SOIL. ~) Se,'¢ER LiNE F~OM HOUSE TO s.'r.E.P. TAN~ SOUTH 1/2 OF LOT 18, M. U~%~E GRATER TNAN 25' FROM WELL 112N, R4W, SEC 10 UNDEVELOPED A~S~ WA~R A~ WAS~WA~R CONS~TANTS, ~C. PHONE: (907) 337-6179/F~: (907) 33B-3246 LEGAL DESCRIPTION: NORTH 1/2 OF LOT 18, SECTION 10, TOWNSHIP 12N, RANGE 4W f"H-k't//;? ....... ~'"';" I .............. :....E DESIGN OF SEPTIC SYSTEM UPGRADE BOB BAER 272-0571/274-9616 M'r O]IIII t ...... MfoJ Il/4'l ~4 4~ HOL~5 ] VIF//////////////IkJ klk×///××/// ××//4k'J ~a[ l/IF/////// ///////IP'] -0'07 A5~6 P~O}'}(XiE '¥i(iF, W ~vc 5c~. 40 AIASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 9EBARR ROAD, SUITE .32. ANCHORAGE, AR. 99504 PHONE: (907) 337-6179/FAR: (gO7) 338-3246 LEGAL DESCRIPTION: NORTH 1/2 OF LOT 18, SECTION 10, TOWNSHIP 12N, RANGE 4W DETAIL OF PROPOSED BED BOB BAER 272-0571/274-9616 BY: SCALE: PAGE: 11/12/98 A.C.G. N.T.S. 5 OF 3 DEPTH TO DATE GROUNDWATER DRY 10/30/9B DRY 11/6/9~ AL&SKA WATER &: WASTEWATER CONSULTANTS, INC. ..ONE LO(;(g°')...-.~_ PERCOLATION'g · F^X (go.)..8-a.46 f~" '2/J JSOIL TESTJ ~'/ -z.'u/~ LEGAL DESCRIPTION: NORTH 1/2 OF LOT lB. SEC 10. T12N, R4W ~ ........ '~/' ~/"~,, ........... PERFORMED FOR: BOB BAER ~1 ...~.,~.~../IC.~.. ............. DATE PERFORMED: ,0/30/,8 G4 I:sT .oc ........ DEPTH ~ (~"~) ~ SOIL C~SSIFICATiONS } I VERY DENSE. ~ ~ :~,GP ML J [ 7~ VISUA~Y ~TED ,~ ~ P ii~;i GM CL . ~ SM OH l ' ~ sc [ 7 DEPTH TO DATE + ~ GROUNDWATER, ~H/~I X SW ~ ~ ~1~1~ : w/ sP L~SES. ~ P~N WELL GRADED ........ "= I00 ~ L lO SAND W/ FINE SAND LENSES. 11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 12 ( D~INED OUT ~CH TIME IN LESS THAN 2 MINUTES. ~ B.O.H. 15~ ....... 16 17 19 ~RCO~TION ~TE <1 (HIN./INCH) =ERC. HOLE DIA. 6 (INCHES) 20 ~ TEST RUN BETWEEN 8.~ ~. ~,~ ~_ 5 FT. THIS WAS PERFORMEp ~ ACCORDANCE WiTH ALL S~A~'k J.ICIP~GUIDELINES IN EFFECT ON THIS DAT~. DAT~: Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage.ak.us December 15, 1998 Jeff Gamess, P.E. Alaska Water & Wastewater Consultants, Inc. 6901 De Barr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for T12N R4W Section 10 Lot 18 N2 Waiver Request #WR980097 Parcel ID #011 161 17 SW980467 Dear Mr. Garness: Your request for a waiver of the required 100 feet horizontal separation from the S.T.E.P. tank to private well has been approved. The approved separation distance is 80.0 feet. This waiver approval applies to the existing S.T.E.P. 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 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-Site Water Quality Program MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorege, Alasks 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 011 -1 61 -1 7 HAA # '~. ¢---'~\¢"/"'f-; 1. GENERAL INFORMATION Complete legal description North ½ of Lot 18; Sec. 10; T12N; R4W Location (site address or directions) Property owner Mailing address Lending agency Mailing address. Simco Estate C/O Totem Realty 8500 Emerald St. Anchorage, AK Day phone 724 E. 15th Ave. Anchoraqe, Day phone AK 99501 Agent Bob Baer/ Totem Realty Day phone 272-0571 Address 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well ×× Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site xx Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Fronl MOA P21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms / and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in com~l'iance with all Municipal and State codes, ordinances, and regulations in effect on the date o~tr~is inspection. Name of FirmAlaska Water & Wastew~/i~ons. InCphone 337-6179 Address 6901 Debar~/~/ ;/c~? ~c o /ge, / AK 99504 ALASKA Water & Wastewater Consultants Inc. is to be paid $3195.00 at closing for engineering services performed. DHHS SIGNATURE ',~ Approved for ~- Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 DH HS 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-O25(Rev. 1/91) Back MOAI~;~I P, ECEIVED Municipality of AnchorageSERViCES ,/AN 0,5 1998 DEPARTMENT OF HEALTH & HUMAN MUNICIPALITy OF ;Ni~CE;OD~ Environmental Services Division ENV RO ENr, 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) ~L~:~ ~v~SlON Health AUthority Approval Checklist Legal Description: /~.~'~ A. WELL DATA Well type ~P., Log present Total depth ~ Lo~'16;, .~c~-~o~ [0,; ParcelI.D.: ' ~)11-JGI-I-I If A, B, or C, attach ADEC letter. ADEC water system number ~ o Date completed ~,~o~ 'i-o ' I'~ ~H' Cased to Casing height (above ground) Wires properly protected (~R.) Sanitary seal ~t) '~' Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform i~ Date of sample: ?/Z.,~/~ FROM WELL LOG AT INSPECTION "g.'p.m. g.p.m. Nitrate ,)~'/ Other bacteria Collected by: ~. u-). u~ · ~. ,, B. SEPTIC/HOLDiNG TANK DATA Date installed IZ/~/~ Tanksize Foundation cleanout ~ ~-~ Date of Pumping ~ ~u.3 Pumper -- C. ABSORPTION FIELD DATA Length (~O Width Effective absorption area ff~o i~ Date of adequacy test ~-~ ~-~-~ Fluid depth in absorption field before test (in.); Fluid depth --'----- (ins) Minutes later: ~5;eo Number of Compartments ,7.. Cleanouts(~t).__ Depression (~ ~o High water alarm I~YI~ Y=<- Soil rating ~o~) o.'7 I~' ~ Gravel thickness below pipe Monitoring Tube present ~ ~/,=< Depression over field ~ __ Results (Pass/Fail) . For ~ ~ Immediately after ~ gal. water added (in.): ~'~ Absorption rate = q.p.d. System type ~"~ Total depth bedrooms Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access([~ High water alarm level at* Cycles tested ~ ~ ~ E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum "Pump off" level at* F, Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line SEPARATION E)ISTANCES FROM WELL ON LOT TO: joo~- On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station -~ ~o~ ~A~4P.e._ SEPARATION DISTANCES FROM SEPTIC/H~B[a~I~,~TANK ON LOTTO: Foundation ~ O ' ~ ~ 4. -- Property line 12_ Absorption field Water main/service line I d~+ Surface water/drainage Ioo~+ Wells on adjacent lots Iio' +__ iol-~ 17_.~t+_ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain 1~5 I+----. Bu di0g foundation 8~= ~ Water main/service line } co ~ -I- Driveway, parking/vehicle storage area ~o,.u J Wells on adjacent lots Io~+ ENGINEER'S CERTIFICATION½ I certify that Ip~ tt in conformarl'ce i Signature _~ ~/~ Engineer's NaZ Date ield inspections ~lines in effect on this date. Date of Payment Receipt Number _) 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number