HomeMy WebLinkAboutPROSPECT HEIGHTS #4 BLK 2 LT 4Prospect Heights
Lot 4
Block 2
#015-091-57
Municipality of Anchorage Page 1 of --jL -
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: Stn(, Rq� l ��i PID Number: OIS-091 -S
Name:
Wastewater System: X New ❑ Upgrade
Me:Gillivavy Dgivid Ewing
Address;Si
FIELD
of a11916ABSORPTION
Phone:
No. of Bedrooms:
5
p Deep Trench ❑ Shallow Trench ;d Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
O GPD/Sq. . Ft.
T. S
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
'-2 PY04perf1 Ll
21 Ft.
4,1 Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
I Ft.
49 Ft.
WELL: Df New ❑ Upgrade
Gravel Aeptp: widtfh,
Number oflines:
3
Distance between lines:
I
is, Ft.
Ft.
Classification (Private, A,B,C):
Total Depth:
CasedTo:.20
Total absorption area:
Pipe material:
Private
0 Ft.
Ft.
775' SG. Ft.
y
I. O 10
Driller:
Date Drilled:
Static Water Level:
Installer:
Date installed:
A n DYI
12-2.-11
IS Ft.
Hag In& ie
3-7-00
Yield:
Pump Sol at:
Casing Height Above Ground:
TANK
4 GPM
Ft.
oZ Ft.
SEPARATION
DISTANCES
Kseptic ❑ Holding 9S.T.E.P.
To
septic
Absorption
Litt
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
n a
2000
Material:
Number of Compartments:
Well
I'
Il),I
31
S
2. f thifl
Surface
Water
!
t 100
f 0
f 10
,
t 100
LIFT STATION
Lot
Size in gallons:
Manufacturer:
1
Line
+10 1
+10 r
1fr
01.2000
hnchopgA
/
"Pump on" level at:"
Pump off' level at: High water alarm at:
Foundation
$
211
811
0
"1'
3T11
Curtain
Pump Make 8 Model
I Electrical Inspections performed by:
M.O.P.Ids 64"1`'1 1464
Drain
054:-0S- b
ec
Remarks: pye5,SUi2ed slesfem IA " 14terals
BENCH MARK
Y94 b I 34•" s aeih ttirfti iii e
Location and Description:
e
shialdi FiResY Won
-Assumetl Elevation:
clegnouts at ends mairked Yeb4r.
1'/!✓GQe� Sui/ C/�cr 3r TY'a/ o✓C✓ �iC/.�
p��o. eaoeeeaB���
.4 IN
Inspections by: Ride Dates: lst 3-400
� - e•••• �
performed ika�le
2nd 3 - 1-00Louts
A.
♦ Gr •STSG a G
� ��
3- 10-00
�,be e.•
Department of Health and Human Services approval�ao
Reviewed and approved by: 2 44i Date: 7-/i-0 D
72-013 (1/91) MOA 25
Permit No. SW990162
Page a of 3
Municipality of Anchorage
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
Legal Description: Lot 4 Block 2, Prospect Heights Sub. #4 PID No.: 015-091-57
1 "=60' ?
/
/
/
/
/
/
/
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S
Swinq Ties
moo
Won
0E®
FA
LOT 4
Gahan
'i STING
JILGING
BED
DETAIL
S �
A�A9.
F
15 BS
�O AI
TH
® Leach
n Bea
e
7—i/4' Piping
.:RAVEL aRW moo.
ry /
,yOp GVv
7-5-00
ENGINEER'S SEA
lz� ooa�Op�4
ti^ OF A
/ O�Cij�PTH.
/ .... 49 —
" PVC
Permit No. SW990162
Page _? of 3
Municipality of Anchorage
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
Legal Description: Lot 4, Block 2, Prospect Heights Sub. #4 PID No.: 015-091-57
ELEVATIONS n T2 °i Ve"
ASV = 102.97 ti
(NOT TO SCALE) N
ORIGINAL
GROUND I
LEVEL AT.
V-3' I00E0 M 100.3
\ m
u \
e.5• U 3.3• GVT
92.3
TANK 88.9
90.1 0.0 98.3 98.3
\97.8
7-5-00
ENGINEER'S SEAL
'N%
4
ooP�r .. Q.... A•....!, p
49 TH
Oa � r
LOUIS A. BUTERA.
c wO
QO ST•. CE -6736 .•
Fp .Fl3
o
4����0000 0��0
07-10-2000 03:57AM FROM E.R. Engineering Svcs. TO ON SITE P.01
r .u. .r�n� rv-urlr,.xCR 4u, rfRRVC IYU. C40tlH.Yh JUA. .1. PJ GFJCI l•2 :li*W"1 F:k I
of 1 jWSPECTrwlJV jRFP0A'ZT
4 W �
MUNICIPALITY OF ANCHORAGE—Bu .exAP11Ci= SaFk,ix
4700 SOLMI RUAC `17> 57RE . AiV(."fi.�OR G"n s'#k..UKA►
JI)SPE4 9:VO,P4, rarest (907) 34.t-8340 (3c�Tj 3 i -k s5 ilirp'Ui�M,477CJPe� (,F07/ . .3.�21F
RDARFSS: 9Q"'G7 1A1.r`i GiF�•[..I....E 7� iTE:
t1a` MOCK: -Z� .S°71T:
CC)1?11dF_A'7
tu-
PWSJT.�C'?FU�:• "J� lx1'"t G {_ S ff ��-, !� r : oil i-1 +iia t.-•
No nartscnnpilarxxeiwaewad- EJL: w•vmse�3CfY274I83CxD!&�lSus'J@iper r :; ".;.�,; nlrpa+;mco.
i
J11ICfia'X(LL'G4Y!E+YE L7C:Si:WSin-'li:liF CJ UG7WSiC�`Wi LS17e7i K:."•1EL5�Y+'x:Ifk 4 i:.i..:..rL!!y.toreJ. S4VC4L7•7ffi'rb i)03�iv.•j.
lNEPECAW&R.- tFill
9 t
{( it
on Tzf�
NrfdEs'Nt=l)1CIC/SQ.�YE7JY.�A.(P,!„+r4'fli�)dS..t'iiER.Nh,f'r�f_!, tdtffl:�',S?'Kl,t74.4fV
i
FFOM : JOHH HAGPIEIER CO. PHONE NC. : 248643.1 Apr. 10 2000 08:59PM P2
Fran : ALP11E ZRiLL 345 0202 Ap.'09.2000 09:59 PM P0i
Municipality of Anchorage
Department of Health and Human Services
els V street
p.P.60><ang85D Anohor�e,AlaskaDD§t9-[i85D
�Qft �� Mtp�Mr+uw.a.pnplaags.ak_us
t1kgN
Permit Number., #S W 9901 Date of issue: B -2Z parcel IdentHication Numbert 016-04
Daae &rarsted: �?Cxmv
-DeftZempleted. JZ1419 Is well located at appmvod permit lmation? Yea No
Legal Descrlptproseecf HUNS 44 WIZ11
k4
Prop" Owne& Address: OaHd MCGNUv&ty
9950 SkkmfLn
Borehole Dam:
Depth 011)
Method of Drilling ® air rotary M cable tool
Soil Type, Titidka W-& Water Strata
Ron) To
Casing type: steel
Slick -Up
0 2
Wall T'ltickness .2b inches
org& w & 6M
2 4
Diameter; A inchas Depth: RQ feet
gravelly -i9
4 if
Liner Ty pe:
viam0 er: inches Depth: — feet
padlock
11 207
---
Casing stickup Above groand: 2 feet
Static water level (from ground level): J3-fce1
Pumping levek_Mfeot after
2 hoes pumpitrg $ Spot
Recovery Rate; ft gprn
Method of Testing; aL2
Well Intake Opening Type:
El Upon End 9 Open Hole
Scfawmd Start _ feet Stopped fbct
(] Pcrforstions Start foot Stopped fea
(: rout Type: bentantre # R Volume:
Depth: start — feet Stopped _ feet
pumps Intake Depth — feet
Pump size _ by Brand Name
Well Disinfested Upon Completion? ® Yes Q No
Method of Disinfwaion. clQ„/ot�tdblefs
Comments:
Well Drips!: Alp" DrOUng & EntoMfftes
P. 4. Box 110498
Anehoraga AK 99511
Alwatlotl: ?heseiFrtsiflerslnitfpfcvidoswait logto the property owner wMln.30 days of oompletionand the prapeAy
nuronr nr rho ,unit rtrtlinr shall �pmriRa n ,ttnN Inn t� rb. Ilrnl nfltraifh R I�..mw*, Rm,;nnc ...:rbin Ftl de..� ..f rmmni.d��+�
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
I �lS�� - t L f"1
3 /q BOO @ 0.'W -Pyr
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Renewal
Permit Number: SW990162
Date Issued: Jun 29, 1999
Expiration Date: Jun 28, 2000
Parcel ID: 015-091-57
Legal Description: PROSPECT HEIGHTS #4 BLK 2 LT 4
Design Engineer: 0024 Eagle River Engineering Services Site Address: 009950 SIDOROF LN
Owner Name: John Hagmeier Company Lot Size: 101085 SQ. FT.
Owner Address: 2204 Cleveland Avenue #201 Total Bedrooms: 5 Permit Bedrooms: 5
Anchorage , AK 99517-0000
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ 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:
Issued By:
Date: 6�
Date: to - 2 % -'77 %
1104 COPY
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW980195 DATE ISSUED: 6/22/98
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE: 6/22/99
OWNER NAME:MCGILLIVARY DAVID EWING
OWNER ADDRESS:9950 SIDOROF LN
ANCHORAGE, ALASKA 99516
PARCEL ID:01509157
LEGAL DESCRIPTION:
PROSPECT HEIGHTS #4 BLK 2 LT 4
LOT SIZE: 101085 (SQ. FT.)
NUMBER OF BEDROOMS: 5 THIS PERMIT: 5
THIS PERMIT IS FOR. THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. 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 SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
S. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED ]
ISSUED BY
DATE: 1 �L!
DATE: 6-22-
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
June 8, 1998
Jim Cross, P.E.
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Prospect Heights 44 Lot 4 Blk 2
Narrative & Permit Application
Dear Mr. Cross:
The proposed well and septic system 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 major consideration in our design.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\1997\98-015 NAR.DOC
Eagle River Engineering ,Services
Louis Butera, P.B.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Prospect Heights #4 Lot 4 Blk 2
6/8/98
A. GENERAL
1. The well & septic plan is for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the Feld by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet
Municipality of Anchorage requirements.
6. It is the responsibility of the 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 WITH LIFT STATION
I. The septic tank shall be an Anchorage Tank 2000 gallon septic tank with integral OSI lift station
pump model OSI-05-20-HHF.
2. A building department inspection report shall be provided to the engineer verifying lift station wiring
to all applicable codes.
C. BED
1. The bed is to follow the natural land contour to maintain uniform total depth of the bed bottom.
2. The bottom of the bed shall be level, plus or minus 1.5".
3. The total depth of the gravel layer is not to exceed 2.5' at any point. If Necessary use pit run gravel to
level bed.
4. The effluent line is to be a 1-1/4" PVC line with 1/8" holes drilled 34" OC within the leachfield,
placed face up with orifice shields placed over holes. Line from tank to field is to be 1-1/4" HDPE.
5. The bed gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed
over the bed. Mounded side slopes not to exceed 3:1.
7. 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:
BOTTOM OF GRAVEL LAYER = 2.5' BELOW GRADE'
GRAVEL THICKNESS = 6" under pipe, 2" over pipe
BED LENGTH= 63' BED WIDTH= 15'
SOIL RATING = 0.8 GPD/ft2 BEDROOM CAPACITY= 5
SEPTIC TANK = 2000 gallon with lift station
EFFLUENT PIPE = 1-1/4" PVC with 1/8" holes oriented up with orifice shields spaced at 34" OC.
1-1/4" HDPE from tank to field.
Twenty-four (24) hours notice required for all inspections.
11997198-015 spec. doc
Note:
Lotlines should be located by
a licensed Surveyor.
/o /
TH 2
Lot 4 sg
TH 1
WELL & SEPTIC
BED
DETAIL
2 PVC
Manifold
q4C,
Q
4Y 16
x
\ Lot 3
TH
TH 4 ^�+
x_2000 gal tank
�w/Ifft station
PROP
HOUSE
/O �
O
PROP
WELL
WELL/SEPTIC SITE PLAN
I CCAI • Prncnnni W- ;nk+c -ISA I A P9
/WELL & SEPTIC
+100'
ULILN I : Hagmler l;onstructlon
CONTRACTOR: N A
JOB## 98-015 1 DATE: 6/8/98 FSCALE 1 " = 60'
EAGLE RIVER ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, AK. 99577
(907) 694-5995 FAX: (907) 694-329
OF No
* 9 LH-* *'
........................
..a'+* ...=............... .
�i. •� LOUIS A. BUTERA
�d`j, •. CE -6736
+100'
0
- TEST HOLE
•
- MONITOR TUBE
0
- SEWER CLEANOUT
-0
- WELL
- EASEMENT
- PROPOSED LEACHFIELD
- EXISTING LEACHFIELD
NO
SURFACE WATER
NO
KNOWN CURTAIN DRAINS
BED
DETAIL
2 PVC
Manifold
q4C,
Q
4Y 16
x
\ Lot 3
TH
TH 4 ^�+
x_2000 gal tank
�w/Ifft station
PROP
HOUSE
/O �
O
PROP
WELL
WELL/SEPTIC SITE PLAN
I CCAI • Prncnnni W- ;nk+c -ISA I A P9
/WELL & SEPTIC
+100'
ULILN I : Hagmler l;onstructlon
CONTRACTOR: N A
JOB## 98-015 1 DATE: 6/8/98 FSCALE 1 " = 60'
EAGLE RIVER ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, AK. 99577
(907) 694-5995 FAX: (907) 694-329
OF No
* 9 LH-* *'
........................
..a'+* ...=............... .
�i. •� LOUIS A. BUTERA
�d`j, •. CE -6736
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES. Project No.: 98-015
Calculated By: LB
Date: 6/8/98
Legal: Prospect Heights #4 Lot 4 Blk 2
Single Family 5 Bedroom Dwelling
Bed Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom =
Percolation rate =
Wastewater application rate =
Required absorption area =
Bed width (W) =
Gravel depth (D) =
TEST HOLE 384
750 gallons
1.7 minutes per inch
0.8 gallons per day per square foot
938 square feet
15 feet
0.5 feet
Required length = Required absorption area / Bed width
Required length = 63 feet
Total Excavation Depth = 2.5 feet
2.5'total depth, if necessary useswpit run to level bed
�,• ggTH� '•v*
I ..... ..................
•.LOUIS A. BUTERA,"4�T
�•, CE -6736 •,• Q
0�
PRO FESSIONPo"
98-015 cal.xls 12:22 PM6/8/98
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
Job #: 98-015
Legal: Prospect Heights #4 Lot 4 Elk 2
Date: 6/8/98
Press. Effluent Lateral:
Assume 5' head at orfice
25 GPM flow rate
.42 GPM per 1/8" office
25 /.42 = 67 orifices
Pipe Length 189
Spacing = length/#of offices
2.82 feet
Spacing = 33.9 inches
��.O� A�gs4�
�.. 49TH '•.v,
............-. - �, .............
5 A. BU TERA.:
CE -6736
•'.. �d
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907)694- 5195
ERES Project No.: 98-015
Calculated By: LB
Date: 6/8/98
Legal: Prospect Heights #4 Lot 4 Blk 2
Single Family 5 Bedroom Dwelling
TEST HOLE 1&2
Shallow Trench Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom =
Percolation rate =
Wastewater application rate =
Required absorption area =
Trench width (W) =
Gravel depth (D) =
750 gallons
2.1 minutes per inch
1.2 gallons per day per square foot
625 square feet
5 feet
1 feet
Required length = Shallow trench factor' Required absorption area / W
Shallow trench factor = 0.88
Total Excavation Depth = 4.0 feet
Required length = 109 feet
:` 49TH '-X
LOUIS A. BUTERA; O
CE -6736 V�DO
�p�PROFESS10NPa� Fuels/
98-015 cal res.xls 12:15 PM6/8/98
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 ••L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: (IA mj'/' C1 7/'u G. Tibr-i DATE PER
//�`f zy 62
LEGAL DESCRIPTION: JI gVPLT TJ owns Ip, ange, ec on:
I n.c
Tyq DEPTH
I � L FFFT
2
v'
3 L
4 �t
5
6
7
8 v
9-
10-
11 10 11
12
13-
14-
15-
16-
17
314151617
18
19
20
COMMENTS
TS, dr1q.,,cs
WAS GROUND WATER
ENCOUNTERED? AGF
IF YES, AT WHAT v
DEPTH? O
Depth to Water After _ z�
Maniloring7 8 Dale:
SITE PLAN
Louis A. Buten
CE -6736
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop 1
i
Y-iv-�Iy f4: z
3Z /s„
2
1-A7 .
S ;„
y/ 7 /c
/!Y!
39 r(i6
v 3r
,,, "
4 '11d
7 7/
r 31
9 I/
/
4i 7Ily
Z 1//.
PERCOLATION RATE 2- (minutes/inch) PERC HOLE DIAMETER 6
TEST RUN BETWEEN 3 FT AND FT
PERFORMED BY:✓���f I V " ` CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
/'W491H 0
e Municipality of Anchorage •.. .. ............
`�.�...
DEPARTMENT OF HEALTH &HUMAN SERVICES Louls A.Butera ; a,
825 "L" Street, Anchorage, Alaska 99502-0650 ® '• CE -6736 F °
t��zff
SOILS LOG — PERCOLATION TEST �!: R�t�•...w•t'�� .
PERFORMED FOR: YIA//$41'c 'L/o/HfTlcc,�rLTr,n.-. DATE PERFORMED: Y—/47-98
LEGAL DESCRIPTION: OlQ�T ryrS �/ L l 6{ Township, Range, Section:
2
yr °'
3
4
5 ()c 0
6 ' G w son7,��..� y
to 164'1
oil (� l we -05 e7 iF-X
-7o�
TS
9-
10
1146 ,/
12
Date Gross
Time
NetDepth
Time
to Net
TWater Drop rMe1
13-
3
14-
14151617
15-
16-
l y
L!
17
J
18
19
y
ly
20
T' -
0 3 0
COMMENTS
SLOPE
WAS GROUND WATER
ENCOUNTERED? <-
IF YES, AT WHAT
/ DEPTH?
Depth to Water Alter
/ l\
Monitoring? S,3 Dale:
VLAN
Reading
Date Gross
Time
NetDepth
Time
to Net
TWater Drop rMe1
lc
Z
l y
L!
r,
J
y
ly
6
T' -
0 3 0
141;y
s
la
PERCOLATION RATE 1.6 (minutevinch) PERC HOLE DIAMETER 6 e
TEST RUN BETWEEN Z'S FT AND 3•5— FT
PERFORMED BY: `SFS' 1 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)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
�1 SOULS LOG — PERCOLATION TEST
PERFORMED FOR: (lVx4jer LlNSTerLT ce.-`
U
N
Louts A.Butera s
CE -6736 s
DATE PERFORMED: Y—Yy—YB
LEGAL DESCRIPTION: "?'ar e ---T- ryTS � / 1- I 6� Township, Range, Section:
P-iSLOPE SITE PLAN
EETf 0/'4Ni GS
1
O,6 Cl� i1IMd% I IOOi�EE
2
3
4
I�
5 G 'O
6 D '' G W t✓i Th f<Ns�
7 D' G•�s�, lro--H
8 O,
10 ] c�i/oct \
11
12
13
14
15
16
17
18
19
AS GROUND WATER I/
ENCOUNTERED? �
S
IF YES, AT WHAT /lI%J L
O
DEPTH? p
E
Depth to Water Aller
Monitoring? P!Y Date:
Reading Date Gross Net
Time Time
Depth to
Water
Net
Drop,,,,,.,,
I Y-rv-?Y 1r'
Zs- s a
Is: 3
20
PERCOLATION RATE V7 (minutes/inch) PERC HOLE DIAMETER G '
TEST RUN BETWEEN Z FT AND 3 FT
COMMENTS
PERFORMED BY: I ��"� - CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: •�' •� �� ���
72-008 (Rev. 4/85)
•q qy • w•w•s.•
Municipality of Anchorage
DEPARTMENT OF HEALTH 8, HUMAN SERVICES ""{ a"""'""'L"'••
825 "L" Street, Anchorage, Alaska 99502-0650 ��: Louis A. Butters j
CE -6736 ��uu''
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: A/JMie.,/` 11't✓Ttc,�r G.T�Jor-t ^� DATE PERFORMED:
LEGAL DESCRIPTION:.E&/ no�T // �/ L / 6/ Township, Range, Section:
T SLOPE SITE PLAN
Tff y aFP � o'v r—TTS—T
1
o'
2 r
r
3 - 6
4 .
5
6
7 ()
9
10
11
12
13
14
15
16
17
18
19
20
TSr. 7 .1
'�?"/, s.Iry
wiTly %y,,/
,�ioTlor
\ WAS GROUNDWATER
ENCOUNTERED?
IF YES, AT WHAT y�
DEPTH?
Depth to Water After
Monitoring? Date:
Reading
Date
Gross
Time
Net
Time
Depth to Net
Water Dropr� ""
I
Y -19-r"
Is. Z 3
Z S 3rr
2
it z 8
2 1 I�
9
1 -25-
ry
10
z z 16
fs 3S
zs
Y
ts: O
Z Z s
PERCOLATION RATE �' (minutes/Inch) PERC HOLE DIAMETER
TEST RUN BETWEEN Z FT AND 3 FT
COMMENTS
PERFORMED BY: �fc�E.J' I ���'� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
i8
72-008 (Rev. 4/85)
fa&",
Municipality of Anchorage
e4
• -� Development. Services Department
Building Safety Division��
On -Site Water and Wastewater Program
4700 South Bragaw St. s "
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 DWELLINGIA
Parcel I.D. 1 /2 - c�Xi/ - s
1. GEN ERALINFORMATIO'N
Complete legal description',
HAA #__
Expiration Date:
Location (site address or directions) 99s -o
Current Property owners) 7l �s ,y, ,s A�aee ,i Day phone 3y5- - -Z ,3 3Co
Mailing address
Lending agency Day phone
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
Day phone
2. NUMBER OF BEDROOMS:
�3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
0
Individual Water Storage
❑ Individual Holding tank
❑
Community Class Well
❑ Community On-site
❑
Public Water System
❑ 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 sample results. (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
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 ZC--x.,r
Address /asci S '
Engineer's Printed Name �ti� Pir /soo
5. DSD SIGNATURE
Approved for __G bedrooms.
Disapproved.
Phone
Conditional approval for bedrooms, with the following stipulations:
�.Ig1dM31SbM
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other j4%AAT`t..'
Original Certificate Date: /qtllw
By:
(Fev.01/02)
P
`DeV
horage
PG€iuBp
p 9v
6partmant
s,"E,y.
q�g /D /diy
colomes/100 mL Nitrate• 3 j Mg./I. Other "bacteria lcoloniesl100rri1.
mg /I Date of sampCe: 7m a�/cP y Collecfed
. _ ., " g- YG"
44,
„,
la '�'�°- qq Date mstaCled ,3/9/oe '
11
SSp raattingd / z or ft'/bdrm) d S System type �o
Width /a ft Gravel below pipe o : ft,
absorption arrelrEr ft Monitoring tube ,yam Depression over field ,va
ResuttS as Fail
�n,.-.����•,,�_�z,��.� ).For L bedrooms
before test �i in. (Nater a�dec7��'�gal New depth�?1 in
Final fluid depthqq� m Absorption rate ? X60
1Y IUUIIUOLIU--
main ��d' Water service line `idSurface water tine'
on adjacent lots 1'i0o
„�,,. °.:.
RATION' DI''S-rANCE FROQABSORPTION FIELD ON LOTTO
rty line id Building foundation` " %9 ' Water main*
Service line /� Surface water fr 9a 'x Driveway, paCrig[vehicle sf6rag6' 5'd '
n dram 4 60' j _ Wells on adjacent lots
'M 1,
z ✓ e t re d: v �., p ';, �
� ° �...����.��m.,. �,f"�k�?"��y=�§xt r .�. �'��c »� ^,.*%;.,�evia Ste« r...»'..'•,
91NEEI2'S"CE2Tl IC%d ICON '... °, .. �wMVbZ.o r
fy"tliat'1'havei3eermined jh`rough`fie`Id inspeotwns and
...
N of Mun clpal records that the above systems are in
rmance with MOA HAA guidelines m effect on this WOOL
date,., "WOOD "
'� CFIftl3TOPHE�t R. j�•
•. r. _� a. .d4 -rv.o. � ,. a ... -
f fit( Date of Payment
��'.77,
Receipt Number _
Municipality of Anchorage
Development Services Department
Building Safety Division a
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
Nitrate Advisory
Health Authority Approval # 040529
During a recent Health Authority Approval on-site inspection and test of the
potable water supply well on Block 2, Lot 4 of Prospect Heights #4
subdivision, a nitrate concentration of 6.39 milligrams per liter (mg/L) was
reported for the property's water well sample. The Environmental
Protection Agency (EPA) maximum contaminant level (MCL) is 10.0 mg/L.
Although the subject water well sample is less than the MCL, it is suggested
that periodic testing be performed to insure the wells continued suitability.
More information on nitrates is available from the On -Site Water and
Wastewater Program, at 343-7904.
This advisory must be attached to all copies of the subject Health Authority
Approval.
Sep 24 04j 09:50a
The Ramsey Team (907)261-7555
83-296
PROSPECT HEIGHTS SUED. NO. 4
LOT 4, BLOCK 2
A IOT.OB5 S.F.
BUILDING DETAIL
1"m20•
GASTALDI LAND SURVEYING
JEFF A. GASTALDL R.L.S.
II 4725 WEST SSTH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 249-5454
RPID PATE
2N1/2541 4/18/2004
F.B. JOB NO.
00-03 PHS442
I
/
/
/
/
LOT 4
.'r
omnxc
(SEE�Yl1�
Y
-10/ G�
p.2
HEREDY CERTIFY THAT I INVE SURyEym THE .. .'sSs1pW,•
RDPE CHL EPIM 5T M AND THAT NO AS INDICATED. .�*.It .2t.. 4( .f
IS THE RESPONSIBIMY Off THE OWNER TO yP49L1 ••5'�•0� 1 11=50�
ETERMINE THE EXISTENCE OF ANY
FASEMMIS, �. ..............
OVENANTS OR RESTRICTIONS WHICH DO NOT
PPEAR ON THE RECOROEp Su ON PIAT. .. ••••••
0 a ft...
NOER NO CWCUMSTANCES SHOULD ANY DATA ♦
MON BE USED FOR CONSTRUCOON OR FOR 0 '••.
TABUSHIN(i BOUNDARY OR FENCE UNES.
ANCHORAGE RECORDING DISTRICT, AUSKA
NOTE: NO CORNERS SET THIS DATE
NOTE: NO CORNERS SET THIS DATE
8-04 08:54AM FROWCUE E51, SOS ENV SERVICES
1046478001
Engle River Engineering
'N Prospect His #41.4, B2
In Prospect Hts #4 EA, H2
Drinking Water
9075615301
T -4T5 P.01/O1 F-300
All DatesITlmes are Alasha Standard Time
Printed DatelTime
10/08/2004 9:45
Collected Date/Time
10/01/2004 12:37
Received DatelTime
10/011200413:04
Techaleal Director
Stephen C. Ede
Released H1/}�(
_
(] -k3 '/iJ
Pei e`a Resubs PQL We Memad Cenainm 11)Aru,,,;ple D.M AM a Init
:Ia,ka Department
[r to -N 6.39 0.100 mg/f. EPA 300.0 R 0101
'obiology Laboratory
Stat Colifotm 0 coUl00mL SM209222B A (c I)
MUM JJB
10/01104 DKC
{
• •;
............................. .............................
.................................
....•..................... I..—.............—..t...
Water AneMla Racord:
9nrdMAPEC:
BacUrioloalcel
era:
MMnlalla IRA) aau
ANC Fen NN
An.h.b Beans,
10� L/ NNO
Tea tbrdam
Oen•'
SII
Analyce t�,r
E. t.ea
&mw Own:
AmIsneM Where
M6MaMNa MTM aPAYLTa:
Phoned [] rand[]
laeaceunl: P --r.
CamaYlnanL
oaanaro'
Membrane Filter
MMD -MUG (PIA)
verNknaun:
me...a {tea,
apalawim,
[W Satisfactory
rare e m { vc
❑ UnsaGefactory
ilae•Tw fNaa.uaNaas,
ported Dy
r
DamRime: u
f/ fl 011-om.a....m
Form d FW- 0053 17H7103
O MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # _ HAA # 111)0�
e1S-0>I -S�
1. GENERAL INFORMATION
Complete legal description Lu u 01Jk r iws p �t tle %a I
Location (site address or directions) V9 hnu %h 7 N; ilftgy:' r i'
Property ownerilly"= I vv i?:a s -i// a Day phone —f
Mailing address
Lending
Agent
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
S
X
Day phone
Day phone
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site X
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attestina to the legality and status of system.
72-025 (Rev. 1/91) Front MOA 421
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 compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Eagle River Engineering Services�-
Name of Firm Box 773294, FagleRiver, AK 5Y,"3Phone
Address
Engineer's signature �� " Date 7"i - o ° —
6. DHHS SIGNATURE
Approved for bedrooms.
0
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Note: The well for this property meets existing State and Municipal CQdps.
There are nitrates present. It is suggested that periodic testing be
performed to insure the wells continued suitability. Current nitrate
concentration is 6.97 mg/l. EPA maximum concentration is 1.0.0 mg/1.
More informat'orl On 11tLraues ts avattabte from Lite On -sire Services Program,
aflirir"
Date 7-//- 6 6
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 orderto satisfy certain federal and state requirements. Employeesof DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is riot
-gsponsible for errors or omissions in the professional engineer's work.
15 (Rev. 191) Back MOA e21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division 16
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
Health Authority Approval Checklist
Legal Description:Lof4 512c, lnt 1&Q-5peciFleicitils *rf Parcel l.D.:015-0%L57
A. WELL DATA
Well type Pr i Vpie If A, B, or C, attach ADEC letter. ADEC water system number IVDA
Log present (Y/N)
Total depth 207
Sanitary seal (Y/N)
Date of test
Static water level
Well production
Datecompleted 12-2-99
Cased to .20 ( x� Casing height (above ground)
Wires properly protected (Y/N)
FROM WELL LOG AT INSPECTION
-.2-`19 /V//i New wall
WATER SAMPLE RESULTS:
Recovd fvom well Ica
g.p.m. g.p.m.
Coliform i Nitrate IM "/c Other bacteria __
Date of sample: 4-29-00 Collected by: En a i h e e Y
B. SEPTIC/HOLDING TANK DATA
Date installed 3-9-00 Tank size 2000 Number of Compartments I— Cleanouts (Y/N) yo 5
Foundation cleanout (Y/N) Ye 5 Depression (Y/N) 1 0 High water alarm (Y/N) /Y/v9
Date of Pumping Me Pumper
C. ABSORPTION FIELD DATA
Date installed 1-q-00 Soil rating (g.p.d./ft2 or ft2/bdrm) V 0.5 System type bed
Length k. ` Width 15 / Gravel thickness below pipe h N Total depth 2. 5
Effective absorption area 173 r Monitoring Tube present (Y/N) Yes Depression over field (Y/N)V�
Date of adequacy test N/A Results (Pass/Fail) -
—
For bedrooms
Fluid depth in absorption field before test (in.); Immediately after= gal. water added (in.):-
Fluid
in.):_Fluid depth - (ins) Minutes later: Absorption rate = g.p.d.
Peroxide treatment (past 12 months) (YIN) N0 If yes, give date -
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed _3-9-60 Size in gallons 2000
Manhole/Access (Y/N) Yes "Pump on" level at* rho q "Pump off' level at* B S"
High water alarm level at* f.5 11 *Datum NoyP. van 1t ba ltom
Cycles tested AIM - /Ve ui
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot 1131 On adjacent lots +100
Absorption field on lot 1121 On adjacent lots �_Oo l
Public sewer main A//A Public sewer manhole/cleanout 1V/19
Sewer /septic service line + 2r Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation 8,/ Property line e `i l Absorption field 10
Water main/service line +101 Surface water/drainage 4,100/ Wells on adjacent lots 4 100 1
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line 161 Building foundation 191 Water main/service line I - I o 1 _
Surface water A//A + 160 ' Driveway, parking/vehicle storage area *61 _
Curtain drain N//I Wells on adjacent lots P 100'
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal records t •t;
in conformance wi OA HAA guidelines in effect on this date. 046
__ a
Signature i A491H
Engineer's Name Louis A, Bafeya - �•" !•� •
d�. -4ouls A. SU
Date 7-l0=00 ®�'v%'1�,� CE,8736
HAA Fee
Date of Payment
Receipt Number _
72.026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
are
06-30-00 14:37 FROM -CTE ENVIRONMENTAL
CT&E Ref 14
1003355001
Client Name
Eagle River Engiaeering
Project Name/#
Prospect His
Client Sample ID
Lot 4 Elk 2
Matrix
Drinking Water
Ordered Ey
PWS1D
0
Parameter
waters OCPaftmenr
Nitrate -N
5615301 T-858 P.01/02 F-150
Client PM
Printed DatefTime
066012000 14:32
Collected Daterrime
06/2$11000 8:05
Received Datefrime
06728/2OW $:50
Technical Airector
Stephen C. Ede
Released By AJA e Al 10 1 A.
RenuM PCL units Method
6.97 0.500 mW/L EPA 300.0
At LaraME Prep Analysis
Lf MTS Dare Dare Lnir
(c10) 0612&/00 SCS
Ni CfoGiolo9y LziParaLafy
TaraL mllfonn
0 ca1110qu_ smifi 92220 06/28/00 KAP