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Home My WebLink AboutT15N R1W SEC 18 LT 211 Certified Drilling Log OWNER OF LAND: Stewart Ball ADDRESS: 19317 Spruce Crest Drive Chugiak, AK 99567 LEGAL DESCRIPTION T15N R1W Sec 18 Lot 211 DATE: 2-24-21 PERMIT NUMBER: DATE OF ISSUE: TAX IDENTIFICATION NUMBER Is well located at approved permit location: Yes No Method of Drilling: air rotary cable tool Depth of Well: 144’ Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth feet Liner type 100’ of 4.5” PVC Static Water Level: 23 feet Recovery Rate 4 gpm gph Method of Testing Air Well Intake Opening Type: open end open hole Screened Start feet Stopped Perforations Start feet Stopped Grout Type: Volume: Depth: from feet, to feet Well Disinfected Upon Completion: yes no Method of Disinfection: Chlorine 50 PPM Comments: Bore Hole Data Depth From To 0 80 Exisiting Well 80 110 Sandstone 110 123 Shale 123 127 Coal 127 144 Shale Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. Well Drilling Permit Number: SW Parcel Identification Number: Date of Issue �).5/ - ?31-- 6a Legal Description Property Owner Name & Address 19317 Spruce Crest Drive Chugiak, AK 99567 Stewart Ball -n5m t2W 5Q c 13 L 2 0 Pump Installation Date: 9-1-20 11 Pump Intake Depth Below Top of Well Casing: 70 11 Pump manufacturer's Name: F&W 11 Pump Model: 4F07P053015 I) Pump Size: 1/2 11 Pitless Adapter Burial Depth: 10 Pitless Adapter Installer: Unknown Disinfected Upon Completion? ® yes ❑ no Method of Disinfection: Chlorine 50 PPM II Comments: Pitless Manufacturer: Unknown 11 Pump Installers Name: Sullivan Water Wells feet hp feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE DEl: TMENT OF HEALTH AND HUMAN SERV S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~ ~ ~ ,,~ DISTANCES Address ~ TO SEPTIC ABSORPTION f~-~ '-~ 7 / ~ 2 ~/~ ~,~) ~-22FROM ~ TANK FIELD WELL ~1 I ~ ' /d ~/~ ~ ~ I~ FOUNDATION -- ~/5-- ~ ~/4~ ,~ c,/~ AS-BUILT DIAGRAM (Show locabon Gl well septic sys en , properly lines Ioundahon ~ SEPTIC , ~ HOLDING TYPE OF SYSTEM L-} TRENCH ~ BED ~ W. DRAIN ~ OTHER ~rlgmalFlll addedOradeabove original grade ~ FT ~ FT I WELLS ~ PRIVATE ~,~j D OTHER fldentifV) / REMARKS: O' P. 0~7732:~4 7694.5195 · I I {.I 113 :IFFI' ~ ,..III Ik I ,: ,I ] ) t .... NB CONFLICTING I/ELLS PDt/ER LINE SEC LIN E E~SEMENT ND CFINFLICTING ;,/ELLS 165' WELL AND SEPTIC SITE PLAN LEGAL. LOT Pll, SEC 18~ T15N, Rl~/ OWNER, MRS, PATRICIA CRAIG CnNTRACTDR: N/A EAGLE RIVER ENGINEERING SERVICES PO ]~X 773294 EAGLE RIVER, AK. 99577 694-5195 EASEMENT EXISTING LEACH FIELD NEW LEACH FIELD CLEANDUT -. SCALE~ 1' = 50' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99B01 264-4720 SOILS LOG- PERCOLATION TEST SOILS LOG PERCOLATION TEST 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER S ENCOUNTERED? /t)<9 oL ,~ o,v,'~v c e. ,~' P IFYES, ATWHAT 7 m"~:~,~ ~z) /d'E DEPTH? Gross Net Depth to Net Reading Date Time 'rime Water Drop PERCOLATION RATE ~ (minutes/inchl / -q~ z20,/~ TEST RUN BETWEEN ~/ FT AND /-7////~ , FT PERFORMED BY: 72-008 {6/79) Eagle RJvor Enolneerlnn Rarvlnfl~ P. 0. BOX 773294 Eagle River, AK 99577 694-5195 CERTIFIED BY: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGALDESCRIPTION: Lb7~ ~ I! 7"~/~- /J ,~/t~ ~¢~, ~ DATE PERFORMED; I 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS SLOPE SITE PLAN WAS GROUNDWATER S ENCOUNTERED? fl/O L 0 /'h,,,-,; +,~ ~ ~ P IFYES, ATWHAT 7~'1~2~ 7~ q/ E DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop ~ ', ~:s.~ ,, L/L $,, la//4 PERCOLATION RATE /l./', $- (minutes/inch) TEST RUN BETWEEN '~ ~T AND z~- FT PERFORMED BY: 72-008 (6/79) Eagle Rlvor Engineering Servtcgg P, O. Sox 773294 Eagle River, AK 99577 694-5195 CERTIFIED BY: ,~--- DATE: 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 PHONE [] NEW MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS ~ Absorption area PERMIT NO, ~ DISTANCE TO: ]We~2 Z Manufacturer Material No. of compartments /~00 IF HOME.DE: ~ ~ Well Dwelling PERMIT NO. ~ ~ ~ Manufacturer Material Liquid capacity in gallons ~[ DISTANCE TO: Well ~_ No, of lines/ Length ~°f ~cl~ line Total ~length2' of lines Trench width~ inches Distanc~en Hnes ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot Hne ~ DISTANCE TO: ~ Class Depth Driller Distance to }or line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER SOl L TEST RATING 72-013 (Rev. 3/78) PERMIT NO. ( DEPARTMENT L.' rlERLTH 8ND ENVIRONMENTAL rKOTECTION 825 '"L"' STREET, RNC:HORRGE., AK. 995Ed.. 264-4720 '79~47~ ) RPPL I CBNT LOCRTI ON LEGAl.. EARL ELLIS SPRUCE CREST LRl:t Si8 T~.SN R1W SM LRKERIDGE DR L. OT SIZE 688 228(~ 54450 2.r, 6!LIRRE FEET TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (S6! FT,.."BR)= :1.92] THE REQUIRED SIZE OF THE SOIL ABSORPTION S~r'STEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEE7') OF THE TRENCH OR DRAINF'IELD. THE DEPTFI OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SLIRFRCE OF THE GROUND AND THE BOTTOM OF THE ENCR'¢RTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRR",,'EL DEPTH IS THE MINIMUM DEPTH OF GRR',/EL BETI4EEN THE OUTFAL. L F'IPE AND 'THE BOTTOM OF 'rile E,w, CRVRTION (IN FEET). PERMIT RPPLICRNT HRS THE RESPONSIBILIT'¢ TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RN~' WELLS ADJACENT TO THIS PROPERT'T' AND THE NUMBER OF RESIDENCES THAT TME WELL WILL SERVE. BHCKFILLING OF FIN¥ SYSTEM WITHOUT FINAL INSPECTION 8ND ~PPRO',,,'~L. BV THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETI4EEN FI WELL AND RNY ON-SITE SEWAGE DISPOSAL SYSTEM IS :I.E~EI FEET FOR R PRIVRTE WELL..~ OR i5(~ TO ~OEi FEET FROM R PUBLIC WELl... DEPENDING UPON "FHE TYPE OF PUBLIC WEL. L,. JIHER REQLIIREMENTS MR'¢ FIF'F'L¥. SPECIFICRTIONS AND C. LN_,TEUI.,]IuH DIHL~F. tlM,.., RRE AVAIL. ABLE TO INSURE PROPER INSTALLATION. I CERTIFY THRT l: IRM FRMILIRR WITH ']"HE F.:EOLIIREMENTS FOR ON .,ITE _,EHEE_, RND LIEL,L=, H:, SET FORTM 8¥ THE MUNICIPRLIT¥ OF RNCHORR6E, 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. <: I UNDERSTRND THAT THE ON-SITE .,.EUER :,~_,TEM MR'T' REQJIRE ENLRRBEMENT IF THE RESI[:,ENCE IS REMODELED TC~ INCLUDE MORE THAN ]~ BEDR. OOMS. .......................... RF'PL'I CRNT EBRL ELLIS · ............. ........... O & E ENGI,'~EERING & DEVELOP,wENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 SOIL LOG Earl Ellis 688-2280 Performed for: Name: Tel. No, ~-~ 77 Mailing Address:. LegalDescription: /-.07' ,,~/'/, c~'~'C. /oC)/ 7'"/.5-/~/, /'~/ V',J, Depth (feet) Soil Characteristics 0 2__ 3 5__ 7_ PLOT PLAN PERC. TEST Ground Water Encountered: Yes__ No f If yes, what depth Proposed Installation: Comments: ~//q T'~'/Z. Seepage Pit Drain Field 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 'MAI LING A D D~R ESS~ 'LEGAL DESORIPTION L~ ~11/ TIC~, ~ /W , ~, I~ , ~.~, PHON~ [] UPGRADE LOCATION -~; ?,,~ O ¢ /~ ~ ..~,~- 5 T D ~__, , ~ , /~/~oo=~ DISTANCE TO: IWell /~ ' IAbs°rpti~~rea Dwelling Manufacturer ~ ~ ~ Material Liq capac ty n ga OhS Inside length / ~O IF HOME'DE: Dwelling W~t~ D STANCE TO: Well Manufacturer TO: IlWelI / ~ ~ DISTANCE Length of each line No. of lines ..~ [ ~) · Top of tile to finish grade Length Width Type of crib Crib diameter DISTANCE TO: Class DISTANCE TO: Well Depth Building foundation Foundation Total length of lines Material beneath tile Depth Crib depth Building foundation Driller Material Nearest lot line inches Sewer line NO. OF BEDROOMS PERMIT NO, ?~1o'¢-7 No, of compartments Liquid depth PERMIT NO, Liquid capacity in gallons PERMI..~N~ /4 '~ 7 Distance between lines Total effective absorption area //~ z_ ..~, F~, PERMIT NO. OTHER PIPE MATERIALS ,~ ,/~,o ,~', SOl L TEST RATING INSTALLER ./~C IZ-T ¢.-./'-~'~_F F REMARKS APPROVED 72-013 (Rev,(3/7S) Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Absorption area(s) Septic tank DATE LEGAL DEPT. OF A & L DRILLING COMPANY ECEiVED BOX 97, E~gLE RIVE~,~L~SK~99677 J TELEPHONE696-2688 OWNER OF LAND '~}/ '"'~1 (~ /'~ ~/.~ DE~PTH gV WELL ADDRESS /~f'~A" /)~ ~_~ (,~1(~- ~lo~ t~ STATICLEVELOFWATERFT. LEGALDESCRIPTIO~~ ~/I 'Tl7'~ At~,J S~I~ ~ DRAWDOWNFT. DATE- Started [I/ /1 /7~ Ended ~ t t/t 7 /7~ GALS. PER HR PERMIT NUMBER . 7~ I O ~ -7 KIND OF CASING KIND OF FORMATION: From.__O From From From From *~? h~" Ft. to_ G -/ Ft. From t/? .7 Ft. to 7~ _Ft. From 7~t~ Ft. to ,Co Ft.. From Ft. to.~Ft. From~__Ft to Ft. From Ft. to ~Ft. From Ft. to _Ft. From ~ Ft. to Ft. From _Ft. to.~Ft. From~Ft. to__Ft. From Ft. to Ft. Frmn Ft. to. Ft. From Ft. to~ Ft. From. Ft. to _Ft, ~/~ t~' ~r,,n, ..... Ft. to_ From .Ft. to From__ .Ft. to Ft, From Ft. to Fl r-~ j_.7 Ft to .... Ft. From Ft. to .... Ft. From ~.Ft to .... Ft. From~ Ft. to From ~.Ft. From ~.Ft. to__ Ft. From ~Ft. to. Ft. From Ft. to Ft. From ~.Ft. to.~Ft, From Ft. to Ft. From .Ft. to~Ft .... From~ Ft. to__FL MISCL. INFORMATION: /! ; DRILLER'S NAME ' : / - PERMIT NO. RF'PL I CANT LOCAT I ON LEGAL [:,EF'RRTMENT OF HEALTH AND~EN',,/IRONMENTAI.. F'I:;?.,..WEE:TION ( ........ '"L.'" _.fA[ET, MNL. tlORFIGE., HI .... '.~......,L{~ ~,~ ( 78i047 ) / ".__. __ HLITT&JEFF ~NC P. 0. BX. 2280 WRSS~I_R S. B~RCHNOOD LP. L2:t.l T:tSN R1WSiB SM L. OT SIZE 54C1~0 ~;6H..II::IRE FEE[T TYF:'E OF SOIL RECSOR'BTION SYSTEM IS: TRENCH I"IRXIMUH NUMBER OF' BEDROOMS = :~.~ SOIL RATING (S6! F"T',/BR)= 250 THE REL]!UIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: I::, E: F> T' ~-I'-''= -t :.1... L. E [-~ L~i"f"H == ~1 ,,:I.. 8 El R F~"...' E [ .... E::, E: F> 'T' I-~ == THE LENGTH DIMENS..]ION IS THE LENGTH (IN FEET) OF' ]'HE TRENCH OR [:,RRINFIELD. THE DEPTH OF R TRE:NCH OR F'IT IS THE [:,ISTANCE 8ETNEEN THE SI.JRFRCE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET::,. THERE IS NO SET NIDTH FOR TRENCHE~. THE GRAVEL. DEPTH IS THE MINIMUM [:,EPTH OF GRAVEL BETNEEN THE OUTFFI[..L. PIPE RND TAE E,u~TOfl OF THE EXCRVRTION, (IN FEET::,. PERMIT RF'PLICRN"r HAS THE RESPONSIBILITY TCI INFORM THIS DEPF:IRTF1ENT DURING "FFIE INSTALLATION INSPECTIONS OF ANY NEL. LS ADJACENT 'TO THIS PROF'ERTY AN[:, THE NUMBER OF REESIDENCES THAT TAE NELL NIL. L SERVE. .................. -F I,-~ ,:J '::' :;'"-' ::. I. f-J ~; F:" E:" C: -r I fl2" f"~ :D:; Ft F:;;i: E F;~ E:: ,.'..;:~ El I [,~'~ El.",: []::. ......................... BACKF'II.LING OF ANY SYSTEM NITHOUT FINAL INSPECTION AND RF'PROYAL. E=Y TFItS DEF'FIF.'.Tr. IENT P.IIL. L BE SUBJECT TO PROSECUTION. MINIMUM DIS'I"RNCE BETWEEN A NELL. AND ANY ON-SITE SEWAGE DISPOS-;AL. SYSTEM il.?:u;~ FEET FOR R PRIVATE NEt_L..~ OR ::L5(~4 7'0 2~.3E~ FEET FROM Ft PUBL. IC NELL DEPENDING UPON THE TYPE OF F'UBLIC NIEL. I .... NEt..[. LOG:]; FIRE RE6!LIIRE[:, AND MLIST BE RETURNED TO THE DEPARTMENT NITHIN :!i:E~ DRYS OF '['HE NELL COMPLETION. OTHER REff~.I..IIREMENTS MAY RF'PL.Y. SPECIFICATIONS AND CON'..=;TRUCTION [:,IAGRRMS FI'RE AVAIL~:~BL.E 'FO INSURE PROPER INSTALLATION. I CER'T'IFY THAT i: I AM FAMILIAR NITFI THE REL.:!UIREMENTS FOR ON-"ISITE SEP.IERL:i; RND NELHLS AS :SET FORTH BY THE MUNICIF'ALITY OF RNCHORRGE. 2: I NIL. L. INSTF:fl_L TFIE S9STEM IN ACCORDANCE NITH THE CODES. ]:: I UNDERSTAND THAT THE ON-SITE SENER SYSTEM MRY REQUIRE ENLARGEMENT IF TFIE RESIDENCE 'S REH~ED TO 'NCL. LIDE MORE THAN ; BEDROOMS.' ~..~ ~ ~ ~[ ,~' 9 ............................... O 8' E GEO' Russe#~#ter 694-2774 Soils ~ Foundations Perfomed for: Legal Description: ,DePth (feet) 0 3 9 ~0 '~CHNICAL El- DEVEL SOI~ LOG Name: ~-'~/4 ,,~/~ Mailtng AddresS:.[~'oX /,~ ~//~ ?MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Earl Ellis L.a~d Developme~t Tel. No. & J~2- .2 ~ '7,? I/~, / /9/~,~/D~'~' I~,,,Z, fi, ,x~. ~9J-77 ~e. IE ~ 7-/5',,t/, ,~ /vt,', 5. ,,~. Sotl Characterlsttcs 1] , 12 [4 Ground Water Encountered: Yes /, iiii. No If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments: Performed by: 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 FOR A SINGLE Parcel I.D. 051-231-68 1. GENERAL INFORMATION HEALTH AUTHORITY APPROVAL FAMILY DWELLING Expiration Date: Complete legal description LOT 211; T15Nr Location (site address or directions) 19;317 Current Property owner(s) Mailing address Lending agency Mailing address · Real Estate Agent Mailing address PoO. RlW~ SECTION 18~ sPRucE CREST DRIVE * CHUGIAK~ AK 99577 GARY THOMSON Day phone 688-1054- BOX 770991 * EAGLE RIVER, AK 99577 Day phone DEBBIE PLESSINGER w/ REMAX Day phone 2600 CORDOVA STREET * ANCHORAGE, AK' 99503 276-4429 Unlesso~erwiserequeste~ HAAwillbeheldbyDSD~rp~k~. 2. NUMBER OFBEDROOMS: 5 TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well .~ I Individual On-site I Individual Water Storage [--~ Individual Holding tank r-I Community Class Well . [~] Community On-site Public Water System D Public Sewer , [-I 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 transf(~r 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 ara 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. e STATEMENT OF INSPECTION BY ENGINEER r' ' 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(am) safe, functional and adequate for the number of bedrooms and type of structum indicated herein. ! 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(am) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. OARNESSo P.E. Phone 337-6179 Date Engineer's Comments: In c?nducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, noY do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this-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. DSD SIGNATURE Approved for '~ bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: · ~: WATERAND .: m~ ~ : WAss'~WATER: : .. PROG~M .~.~ Attachments: HAA'Checklist Septic'SyStem Advisory Well Flow Advisory Manitenance Agreements SuPplemental Engineer's Reort Other (Rev. 12/01) Original Cedificate Date: ' Municipality of Anchorage .Development Services Department .... Building Safety Division : · ' ~'" ! ** ' ' ' On-Site Water & Wastewater Program '~* 4700 South Bragaw St. ~,, i!!.! ~ , P.O. Box 196650 Anchorage, AK 99519-6650 ,i, ~ www.ci.anchorage.ak.us '' . (907) 343-7904 ,. 'i HEALTH AUTHORITY APPROVAL CHECKI IST LegaI, D~cription: LOT 211 T15N, RlW; SECTION 18 Parcel ID: A. WELL'DATA Wellt~'~,~i;,.~ PRIVA~ ' ifA, B, orCprovidePWSlD#-N/A ~ ' Well Log (Y/N) YES .... =~i , 11/17/1978 sanitary seal (Y/N) yEs :wires properly, protected (Y/N) YES Date completed 051-231-68 Totaldepth '80 ft. i Cased to .41 ft. Casing heigh!(above ground) 12+ in. ,~I ' ;' ::'!' I !". i: ,! -'~FROM WELL LOG ' ' ' AT INSPECTION Dat~'~ftest : ' ~ il/17/1978 2/20/2004 . Static'water level,i" : 45 ft. ff. · :I ...... 2.75 Well producbon ;" 4 g.p.m..- - . . g.p.m. WATER SAMPLE RESULTS: ColifOml ,i 0, coIonies/loo mi. Nitrate 0.1 ,, mg./L. Other badte¢ia 0 colonies/lO0 mi. ,, i mg Arsenic: :' N/A: ./~.. Date of sample: 2/24/2004 COllected~by:. GEG, Ltd. B. SEPTIC/HOLD:lNG TANK DATA *INSIDE DAYLIGHT'BASEMENT .,, , ~ ,,,11',! i "i ~ 8/26/1979 Ta,hk' ~ype/Material ~ ; STEEL Date installed , ,',h ,i . : ,',, Clean~Ut!(YlN) YES Tank'~'i~ 1000 g~l. :' Number of Compartments 2 , '.,,.' N/A Foundabon cleanobt (Y/N) *YES Depression over t~'nk (Y/N) NO ,High water alarm (Y/N) ; , ;LI ',i ", ' JR'S :'PUMPING Date of pumping - ": 3/4/2004 Pumper C. ABSORPTION FIELD DATA ' I.BELOw EXISTING GRADE I '[ Date: .i.,!l~t~t~lled':i ~.. i 9/28/19873//11/1979 Soil rating (g.p.d./ff': ~'"'or~ 194/192 System t~,pe TRENCH ' "~ ' ' -: 2/5 Length 1' ~ 32~'62 ,'; ft. Width 5/2.5 ft. Gravel below pipe ft. TOtal depth .4.79'.i ft. Eft. absorption area 229/ft= Monitoring tube YES ii Depressioh overfield NO i .,, , , , 620 .i D&te of ~dequacyte~t **2/20/2004 Results (PasS/Fail) ,'PASS 'i . For 3 .bedrooms Fluid depthin absorption field beforetest 0 in. tl ' Wateradded 658'ga1:~ Newdepth 0 in. Elapse'd,,;rime: 0 ':,min. Final fluid ~lei3th 0 in. Absorptioh rate >= 450+ g.p.d. An, y'rejU~/enatiOn treatment (past 12 mo.)(YIN & t~)p~) NONE KNOWN ' If yes, give date - **TESTED 1987 TRENCH D. LIFT STATION' D~te inistalle'd ,p ..... ~,, - .,, ,.- ',~,.,,.,--,,,., ~, .... ... ,,..,,. ,,,.,~,,., ,.,., . ,,ump on level at . :~. 'High ~. ~',~m','~i ~t__ .in. DISTANCES'' i LL bh L 5¥ septic i~h'~li~t"{~ioi~ AOSoi'piic~h'fie'~d' i~ PuOiic s~wei' ifi~in s~i,bi~i-/s~iS~i6 §bNioe lO0,+ N/A -,N/A ~h' g(Jj,~ci~ht i6{s 1'00'+ On adjacent iot'S i OO'+ 'Pu'blic ~W~i' rriai~l~01b/cleah0ut Ho'ldi~ig ~hk ' : N/A foundation P~y iiB~ ~ 5'+ Well~ ~n 'adj~C~h~ i0t~ 1 o0'+ sEp~'~i~N ~I~AN~[ :~OMABSORPTION"~ '; .... ~': ............ FIELD ON"' ............ LOT TO: ASSbi'l~fioh "held 5'+ - S'Ui~JC~ w;at~r. 1 oo,+ W~J{~r iflair~ N/A Driveway, parking/vehicle St0~-;~e. COMMENTS~ ,,: ,- G.. ENGINEER'S CERTIFICATION / Cerfify ,~a} i j~avo ~l~'t'e~Jn)~,-d ihrOug6 Id inspections and 'review of Municipal mcof~s '~hat ~h~ ab~v~ ~y~t&ms are in confo~ance with MOA H~ guidelines in effect on thi~ ~Je. 'Engihee~s'~ri'nt'~'~ JE~'~'~ A. G~RNESS Date ~ [~1/0~ " (Rev. 12/01) · Waivi~? 'Fee ~$ :b~f~ ' '" Of Payment Receipt Nun~6~ Mar. 22. 2004 2'25PM REMAX PROPERTIES Ne. 0485 P.-2 ASBUILT I HEREBY CERTIFY .THAT I-HAVE SURVEYED THE FOLLOWING DESCRIBED .PROPERTY: - . AND THAT NO ENCROACHMENTS I~XIST EXCEPT AS INDICATED, IT IS THE RESPONSIBILITY OF THE OWNE~ TO DETERMINE THE EXISTENCE OF ANY -EASEMENTS, COVENANTS, OR RESTRICTIONS .WHICH DO NOT APPEAR.ON THE RECORDED' ~JBDI- VISION PLAT, UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOE GONSTEUCTION OF FENCE LINES, OR FOR ESTA~LISHIN(.~ B::XJND- ARY LINES. 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 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) LOT 211: T15N, R1W~ Section 18 Location (address or directions) S~PRUCE CREST, E~GLE RIVER (b) Applicant Name PATRICIA CRAIG Telephone: Home 688-2979 Business Applicant Address p,o. ~OX 1387, EAGLE RTv"ER. AK 99577 (c) Applicant is (check one): Lending Institution []; Owner/builder~; Buyer []; Other [] (explain); NA (d) Lending Institution cir./ MORTGAGE COt:LP. Telephone '~7'~-0600 Address P.O, ~OX 874487 ~AGLE RT~R~ AK 99687 (e) Real Estate Company and Agent NA Address ~'~' (f) Teleonone Mail the HAA to the following address: }ql0R PTC~qI~ RY 'RAP, T,~. RTVT~R 'P:N'C, TN~..F. RTNG TYPE OF RESIDENCE Single-Family [~ Multi-Farm, i',y ' Number of Bedrooms Other 3. 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 ENGINEERING FIRM PROVIDING ;PECTIONS, TESTS, FILE SEARCH, DAT, ,~ID INFORMATION ., 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 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 ~AC,~',F,, RT~/~,R ENC, TN'F~,RING SERVICES Telephone 6c)4-~195 Address P.O. ROM 775794; F, AC, T,F, RTVE, R AK 99577 neer~s Se~l DHEP APPROVAL Approved for ~'"~'~"~'.~edrooms by "'~",(~'~"~'~' '~7~''~ Date Approved ~ 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 the_ir 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 [MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: WELL DATA Wel Classification Well Log Present (Y/N) ~ Date Completed '///~'~.,/?-P Yield Total Depth ~c~) / Cased to /'~'/~ ~- "· De,pth of Grouting '""'./'~ Static Water Level ',~" ,,3. g ' /'-~,.~,-,- ~.~. ~';~.--.~ PumpSetAt Casing Height Above Ground /,.2 Sanitary Seal on Casing (Y/N) ? Electrical Wiring ~n Conduit (Y/N) Separauon Distances from Well: To Septic/Holding Tank on Lot If A. B. C. D.E.C. Approved (Y/N) /, ~; ,-<- ¢,,~,,~ ;*-~,,.,'~Z' Depression Around Wellhead (Y/N) /1,5- To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole '~"/~ Water Sarr pie Collected Dy ~:$~ Water Sar¢ pie Test Results : On Adjoining Lots ~/~'~ /6¢ ~ ; On Ac joining Lots Y-/'~ ~ To Nearest Public Sewer To Nearest Sewer Serwce Line on Lot -/;2 5- Comments B. SEPTIC/HOLDING TANK DATA Date Installed / ~ ? ? Standpipes (Y/N) /V Air-tight Caps (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: Tc Water-Supply Wel //~-~'- / To Property Line Z~.~ / To Water Main/Service Line "-/4' / Course /'/~ ' Size ,/~/"~;~,..~'~/ No, of Compartments Y Foundation Cleanoul (Y/N) Date Last Pumped : for '"~.~ Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ~-,3 To Stream. Pond, Lake, or Major Drainage Comments Page I of 2 72-026 11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ,../~'2 ~ /x/~.,,¢ Width of Field :3' / ~,-~ ,'-,~ ( 5'- / ~'~ ~',~,,6_ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test ,~-A/"-~' ~' ~'~ "-v Separation Distance from Absorption Field: To Water-Supply Well /' ~'~ / 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 Type of System Design Length of Field ~ Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line /-~ / To Existing or Abandoned System on ; On Adjoining Lots ~-~ / To Cutbank (if present) ? /-/~ Comments D, LIFT STATION Date Installe(; S~ze ~n Gallons "Pump On" Level at r~gn Water Alarm Level at Tested for Dectrical 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 ** certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Sig ~eo ~~~ Date ~.~z ,~../,~' '2' Company ~/~'".,..",',',',',','~./~_c" MOA No. ~'- Receipt No, ~ ~ 0 0/~00~ ~ Date of Payment ~--3 0--' ~ Amount:$ / 0 ~ 0~0 sSeal Page 2 of 2 72-026 11/84