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Home My WebLink AboutT12N R3W SEC 33 LT 223BName Lot Block rownship, Range, Section SEPTIC MUNiCIPALiTY OF ANCHORAGE D P^RTME.T Or HEA'T, A.D HUM^. SE.WCES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT../ DISTANCES SEPTIC TANK WELL Pe,mil No. NO, ol Sedrooms WELL LEGAl. DESCRIPTION LOT LINE Subdivision FOUNDATION TANKS ~'-E-E. Mo'r~ X HOLDING AS-BUILT DIAGRAM {Show location of wml, septic system, propedy lines, foundation, driveway, water bodies, etc.) Material TYPE OF SYSTEM [] TRENCH [] BED Depth to pipe botlom from original grade Fill added above original grade [] W [] OTHER inal grade Gravel aleph benealh pipe SQ FT Soa rating Pipe material SO FI WELLS [] PRIVATE Classification (A,B,C) REMARKS: [] OTHER fldentlfv} Total Depth FT Cased to Date Inslalled: Inspections Performed by; 4¢*~- '~O ~l]&~J "~ Date: Municipal ,nd State ,uidelines in effect on ,.~ ¢//~/~'¢ Heallh ,.,admen, Approv:~/~ Date: 72-013 (3/85) :O::i' !::.:, ! !! :..!,:!c! :' & associates,inc. Consulting Engineers 1000 E. Dimond Blvd. · Suite 205 · Anchorage, Alaska 99515 · (907) 522-1311 January 11, 1990 Municipality of Anchorage Department of Health & Human Services On-Site Services Department 825 L. Street, Fifth Floor Anchorage, Alaska 99501 SUBJECT: CONSTRUCTION OF NEW REPLACEMENT HOLDING TANK SEWER SYSTEM LOT 223B, BLM LOT 223, S33, T12N, R3W, S.M. Gentlemen: We performed an inspection of the subject property on December 28, 1990 and, based on the information obtained on-site and information obtained through S & S Engineer's inspection, we recommend that a holding tank be installed rather than any attempt to upgrade or replace the sewer system. Our application for a permit is attached. Should you have any questions, please ~et us know. Very t/~uly y~rs, ./'~uce ,~'. ¢orwin, P.E. Pres ~.~en?' BJC/lb attachments L~G£ND Prlmqry m~nument reooverad Iron l~pe and/or r~a{~ recovered 6/8 '~ ~ 0 ~ taba~ #et this survey I hereby cowl/fy that on accurate ~urvey o! the fo/lowing de$orlbed property- WO~ ~ada on ~/Z~/~¢. and that the Imp~wm~nl~ situated thereon ar~ wMhln th~ propa~y Iln~ and do not o~rlap or en~oa~h ~n t~m propmrly I~ng ad)'ao~t tha~ t~t no Improv~m~n~ ~ p~p~rly lying ad]ooent ~wato ~nc~aoh on th~ pr~ml~ In ~estZon and that thmr~ are no toa~ transmission Ilna~ ~ other vl~lbl~ ~a~m~nt~ ~ ~atd propmr~ ~oapt a~ Indloatmd h~reon. ~tod at ~ohoraga~ Alaska~ thi~doy, of tHE£TNO. I of / CORWIN ~ ASSOCIATES lO00 ~, 0~0~0 B~VO, SUITE 205 ANCHORAGE, ALASKA 99515 (907) 582-1311 CORWIN & ASSOCIATES, INC. 1000 E. Dimond Blvd. Suite 205 ANCHORAGE, ALASKA 99515 (907) 522.1311 FAX (907) 349-2236 JOB SHEET NO. CALCULATEO BY. CHECKED BY SCALE OF Nov~mb¢~ 14, 1989 ROBERT SMAFER, ~OGER SHAFER CIVIL ENGINEER8 FAX ~94,1311 APP~OVAL~ EQILTJET Mr. Tom Bl~k¢ JACK ~)HITE COMPANY Su, i~e 100 Anchorage, M_~ka 9950~ Lot ~$BI S~e. tion $$~ TI~Ni R$~ SM 15445 Kreit~ Str~, Anchorage, Al~s~ · Oe~r Mr. 2nd 6ewer approu~.~ On Nov~b~r ?, 1989 wz ui6i~ ~he 6it~ to p~r~oe.~ t~6t6. Flow t~s~ ~ve i~o~d r~o~d, p~or ~ ob~n~ an approu~ on the ~. If ~OOm ~e ~i~d in ~ n~ ~o~o~, a ~n dr~n r~ng be~n~ the WAItl WATER 0~I~$Ak OCS~°a 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 1990 P.O.Bo[ 196615 ~EFERENC~: Lo~ 22~B, Sec. ~, TIgN, RSW, $.M. 15445 /~ei~Str¢~, Anchorage, Alaaka A ~e~ ho~e ~ ~v~ on ~h~ ~6t 6id~ of ~h~ property, ap~ f~om ~he ~x~ ho~. (Se~ log ~d.) Unfor~Y we ~n~o~r~ a ~ch~d.) WitCh ~ hol~ w~ found modernly poor so~ i~~ ~Oan~r ~P~h~ at 6~5 ~f~. I~ app~6 tk~ ~is~ng r~omm~n~ ~x~va~ng ~h~ plping an~ ~ ro~ wizen th~ ~is~ng A6 ~6~6e~ in our l~r da~d Nov~b~r ~4, 1989 ~o Tom BCa~ ....... ~'- ...... ~d~ w~ r~r,~r~ abando~ of Z~ potion of wo~d'b~ r~p~ed wi~h ~ 4" 6o~a rye. (MOA), ~ , . .......... ~ +1.~. ~ve ~u~n ve~u~ 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Sac, J~nuar~ ~, 1990 I~ ~hould a~o 6¢ no~d th~ when a n~w wc~l i~ d~d o~id~ of ~h& road Th~ naxt 6~p in ~ proj~ i~ ~o aon~tru~ ~ d~ig~ of th~ proposed upg~d~ and ob~n ~ ob~ntl for th~ If w~ may b~ of further 4~rvlc~, ~ if ~o~ ~h ~ to p~oc~d ~h ~h~ d~ign SHAFE~, DEPARTMENT OF HEALTH & HUMAN SERVICES 825 %" Street, Ancl~ofage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6- 7 8 9 lO 11 12 13 14- 16- 16- 17 18 Township, Range, Section: ~"~ ~LOPI~ .... $1T~ PL~,N Depth tO Wlilr M0~liloriflg? ........ PER~(~)LA'~ ON RATE , immmem~ncnj PERC HOLE DIAMETER I ~ES~ RUN BETWEEN ,, ~7 AND ,F~ ~ ..... . ~~ ~ ~ ~~~ · ~7 ~ ' -~Z~ - ..... /,/ / ~// CERTiFy THAT ~15 TEreSA6 P~FORMEO IN Munlelpa~lty el Anch~r&oe DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 3 4 6 ? 8 g- 10 11 12 13 16 17 18 19- 20 Towns hip, Range, section;"T'~. P ~LOPE SITE IPLAN IF ¥E$, AT WHAT ~ DEPTH? MonitorlflO? MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection Pouch 6-650, Anchorage, AK 99502 264- 4744 Permit No: Date Issued: ~ -- 2 ~ ~ ~O Applicant: F~Y ~ Legal Description: S/D: On-site ~Water Permit HANDWRITTEN Section: ~ Township: Lot size: 4q, fOe (sq. Ft. Lot: '~2~ ~ Block: -- /2 ~ Range: ~ W Lot Location: Max Bedrooms: De~h to pipe b~tom(ft.) Gra 1 depth ( t.) Oravelklen~th (ft.} So~ r~~. ft./hr) ~..c_!~~ ~gc~t~~ e -- i~'~) I certify that: ' 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage(MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for the maximum number of bedroom~ stated above, and any enlargement or modification will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; '(2) AS-BUILTS WILL AND (3) THE NOT BE APPROVED ~%HOUT AN ELECTRICAL INSPECTION REPORT; ELECTRICAL WOR~//MU~T BE DONE ~Y ~ LICENSED ELECTRICIAN. y' - - SWP/024 rev.1/85 vt oo ~/ · o? 0oo °H 0 WELL LOG Date Drilled: Static Water Level ~! feet Draw Down feet Gallons Per Minute" /':'~ ' Total Feet of ,Type Ma_t_e_r~.al Drille~d.: HEFTY DRILLING 3M0 AKULA DRIVE 'ANCHORAGE, AK 9951§ (907) 345-0593 ' MUNICIPALITY OF ANCHOI)JS, GI~ DEPT. OF HEALTH & ENVIRONMENTAL pROTE, CflON RECEIVED MUNICIPALITY OF ANCHORAGE DE :ITMENT OF HEALTH AND HUMAN SER..ES Environmental Health Division 825 "L" Street, Anchorage, Alaske 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Nan~e DISTANCES ~"~'f~'~ 'J-/'~'"~/" J')'¢'~"/~ /~ SEPTIC ABSORPTION AS-BUILT DIAGRAM (Show Iocahon O~ well, septic system property hnes, ~oundahon, '~ Z ~ /~,~ /.~ '~ ~ '~ dr~veway, waterbod~es, etc) TANKS ~ S[PTIC TYPE OF SYSTEM ~TRENCH ~ BED ~ W. DRAIN ~ OTHER r'~a~e~mengt h Grave~ wmdth REMARKS: Scale: ~'~ ENGINEER'S SEAL Health Depadmen, Approval: // 72-013 (3/85) PERFORMED FOR: Munlclpallly of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATIONTEST LEGAL DESCRIPTION: 1 2 3 4 5 6 7-- 8 9- 10- 11 13 14 15 16 17 18 19 2O ~'~J~ ~O~M~M ENT8 WAS GROUND WATER ENCOUNTERED? Township, Range, Section: "7"7'~,./ ,~.$/,~ _~e-"'~%..~.~' SLOPE SITE PLAN S IF YES, AT WHAT OL DEPTH? PE nepth to Waer After ~/~ ~/' ~-Z~?-~? Monitoring? '~'"' ' Dele: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE -- (minutes/inch) PERC HOLE DIAMETER -- TEST RUN BETWEEN -- FT AND FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /-~--t ~' ! 72-008 Rev. 4/85 PERFORMED FOR: LEGAL DESCRIPTION: 4 5 6 7 8 9 10 11 12- 13- 14- 16- 17- 18,- Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN 825 .... 2O SLOPE SITE ELAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Aller ~/~,,/ Monilorlno? ur--/ Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN __ (minutes/inch) PERC HOLE DIAMETER __ FT AND FT COMMENTS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-o08 (Rev. 4/85) ALASKA ENVIR~DNMENTAL CONTROL SERVICF' INC. 1200 West 33rd Avenue Suite B ANCHORAGE, ALASKA 99503 Phone 561-5040 SHEET NO CALCULATED BY E ~)B~ ~'H CHECKED BY OF DATE ~ Or UNIFIED SYSTEM ASTM D-2487 LOT 223B SAMPLE IDENTITY 18 FEET DEEP PASSING ~200 SIEVE: 2.30% PASSING ~ 40 SIEVE: 70.10% PASSING ~ 10 SIEVE: 93.00% PASSING ~ 4 SIEVE: 94.50% PASSING 1/2 IN SIEVE: 97.10% PASSING 3/4 IN SIEVE: 99.30% PASSING 1 INCH SIEVE: 100.00% PASSING 2 INCH SIEVE: 100.00% PASSING 3 INCH SIEVE: 100.00% D10 IS 0.14 MM, D30 IS 0.24 MM. D60 IS 0.38 MM. THE LIQUID LIMIT IS UNKNOWN THE PLASTIC LIMIT IS UNKNOWN THE PLASTICITY INDEX IS UNENOW~ CU = 2.71 CC = 1.083 RETAINED: 67.80% RETAINED: 22.90% RETAINED: 1.50% RETAINED: 2.60% RETAINED: 2.20% RETAINED: 0.70% RETAINED: 0.00% RETAINED: 0.00% RETAINED: 0.00% THE SOILS ARE COARSE GRAINED SANDY SOILS THE SOILS ARE POORLY GRADED SAND.(SP) LOT 223B TESTHOLE - SAMPLE DEPTH = 18 PEET PERCENT PASSING ~200 SIEVE 2.3 PERCENT PASSING #100 SIEVE '15.1 PERCENT PASSING # 60 SIEVE 36.8 PERCENT PASSING # 40 SIEVE 70.1 PERCENT PASSING # 20 SIEVE 86.8 PERCENT PASSING # 10 SIEVE 93.0 PERCENT PASSING # 4 SIEVE 94.5 PERCENT PASSING 1/2 IN SIEVE 97.1 PERCENT PASSING 3/4 £N SIEVE 99.3 PERCENT PASSING 1 INCH SIEVE 100.0 PERCEN~ PASSING 2 INCH SIEVE 100.0 PERCENT PASSING 3 INCH SIEVE 100.0 ALASKA I~FIUIROFImeFITAL CORTROL 5ERUICI~S, Legal Deecription , Sample Depth i_~/ D D Comments TES~ HOLE NO._, ? Date.,. Repo:ted to, Plotted ~' /~/~Che~ked by ~oproved by, GRAVEl; FINE POUt ~-650 ANCHORAGE, AI_ASKA 99502-0650 (907) 264-41 'i 1 TONY I(NOWLES, MA YOn DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Permit ~: 840076 January 31, 1985 TO: Permit Applicant SUBJECT: Township: 12N Range: 3W Section: 33 Lot: 223B Block: NA A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Departraent for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as-built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4720° Sincerely, Keith B. Bandt, SupeYv±$or Environmental Engineering Progrem KEB/].jw enc: Copy of Permit SWP/057 DEPARTMENT OF HEAL1 H ~_ ~..~,v~,~_'~;~Z~i~/'~lON ENVIRONMENTAL l;i',lu.~; ~- 825 LSt~e~ ~nchora~, Al~a ~501 T.lephone 2~72~ oN.SITE SEWAGE DISPuSAL SYSTE~ AND/OR WELL iNSPEC',. ~N REPORT , NEW ~ UPGRADE C , ~DDRESS )ESCRIPTIC DCATION DISTANCE TO: DISTANCE TO: DISTANCE TO: Well crib rib diameter DISTANCE TO: DISTANCE TO: OTHER Material of compartments foundation line MIT NO. cspacit¥ in gallons inches Nearest lot line 1stance to [oi line NO. ,;eptic tank Absorption 'lNG ARKS DATE LEGAL ::' '" HTI=ICT F'i II:::lhE!:: t:::1 tr,! I:::: I I I:::1 ~2. I:::1 (:!i I !!., 3 d' !!!!;'' 3 :ii!: 2 ! I.:::I!::[TI3.. .:. 1..I .I. OF:I:= I.OCH 3: C F:'T. EFII:'.':H ::' ]: I::E!:I::~:'T':[I:::'Y 't'1 Il=Fl': ' :t.. :[ I':lt'i t:::'Oi;:Ttl E',Y 't'IIIZ HI..IH:~:C:i:;='I:::II..:!:TY ;;i:. :[ I,.l:[l.l. FINi:::' ::!i:.Z H:I:I.I.. F:il:::,l'Ii!i:i:;i:Ei: TO f:t[...I... HOFI FtHC' STFITE!: OF' F:IIJ::ISI'::F:I RE:QLI:I:F~F~:I"I[~:HTS FOI:;~'. 'f'HIE S~;E:'T' BRCI<: i:::' :!: STI:::it",IE:t;~::i!; l:::'f:~:OH I:::II'-,fY E:::':; :[ :~i;'f' :t: I",!G I.,.!IZI...I .... I,.IFIS~;TEI,JFITIZI;: I::, :[ :~i;PEv_:.;f::IL.. SYS:;"I'EH OF:'.' PUF3L. ]: I::: :~IEI,.IE!:Fi:F1GFi: :Ti;YS'Ft'Ef't OH TH:I::E; (::d:;~: FINY F:I[;,..:i'F:IE:EI'qT ]:::il*i: I'-,IE'::F:II:;;'.E:Y L.OT. ,':t..:1: f.tHt:::,EI:~:STFIN[;' TI~IFIT -t'H :t:'-":i I:::'IZI;i:H :t: '1' 3: :!~; 'v'i:::l[...:l: E:' F'OI:;;'. FI I'"IF]',":: :t:l'ql..ll'l Ol:::' ::::: 13EI:::'F;'.OOH:i~; Rl",ll:::' tiNY Ii:l'.,tl.l::tF;i:(:!ilEl'll!i!:i",l'i" H:II...I. :1;1:::' FI i...~:FT :Ei;'l"l=lT:i:l::)i",! i'HE:N ':: ! ::' f:ti'-,! 1":t .[i:1::::"i't:;: :[ I::::1::it... l:::'l:;i:F:l'l :i: "1" FII",IE:, :1: I",I:ii:;PI3:.;T ]: 01",1 I"iLJ'_"~;T E:IE OBTFI :[ I",IEE:'.; (: 2 ;' I'"'JS--'E:U ]: L.T':'ii; t,.I :( I..[. HCFi' FIlE I::II:::'F:'I:;i:O',,,'IE[::' H :!: T'I t01..IT I::ii",! EL..Ei:CTI-;~: !: Cl=li. ): I'q::~;I::'E:E: I" :t: ON I:,~:EF'Oi:;;'.T.= I:IN[::~ ':: 3: ::~ THE ........ :!i; :[ t::ii i",t [ii: [::' , ...~'["::', ./~ :'.: ....... ~.: ¢"':'~.-_...L.~,~-¢,~.~.-.¢. ....... ~:-%~i:-~ ................................................................. F,I:::'F:'I..:I:,::::F,i".,",': F,I..i"IE, i",,[::,., :,:H,:::. :~ /,,~¢ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 3 4 5 6 7 8 SLOPE SITE PLAN 10 11 12 13 14 15 16- 17 18 19- 20- iWAS GROUND WATER !ENCOUNTERED? ~V~..; DEPTH? O P E Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) CERTIFIED BY: DATE: 72-008 (6/79) Department off Health and Environmental Protection £nvlronmental Engineering Division 825 L Street Anchorage~ Alaska 99501 Suly 26, 1984 Attn: Mr. Kennedy This letter substantiates our conversation on 3une 21, 1984 regarding the placement of Lot 22}B~ Sec. ~, T12N~ R~W located on Kaita1 Street offl Lock Leman Road on hold pending resolution of several issues. The first and second inspections were conducted by me with subsequent approval of the septic system as per the design furnished by the Municipality. Sines then persistent water in the absorption field and other, related issues need resolution before we continue forth with your processing the permit. Please place a hold on the On-Site Sewage Disposal System Report conducted on 50 April and 4 Hay~ 1984 until further notice. I will keep you informed oF developments. Boyd J, Brown Almond, incorporated PO Box 11-22~7 Anchorage, Alaska 26 3uly, 198~ Sir: Please note that I have put a hold on the first and second inspections of your septic system 1costed on Lot 223 8, Sec. ~ T12N, R3W located on Keitel Street off Lock Lumen Road pending resolution of several potentially major problems. On at least four separate occasions over a span of at least one month ~he~e has existed s~andin9 wate~ in the no,th end of the absorption field. This condition will cause the system [o fail shortly ef~e~ becomes in use, The curtain drain around the septic system is ~ithin 5 feet of the south end of the absorption field, i~ concerned that this is sufficient separation to prevent filtration of effluent into the curtain drain thereby making it, in essenee~ a ps~t of the d~sinage field. Because of the curtain d~ain condition~ I have fu~the~ concern the wste~ well system may not have the ~equi~ed separation f~om the septic system. th of the north standpipe is about 8 feet and the p~esently, the dep · ....... 1~ d inconsistency which south is about 6 feet~hete is s,, ~..~._ine did not exist du~ing ~ond inspection. as been ~aeed into the ground according to While your sy~te~ h f~-~a~e~, otolonged standing water end othe[ Municipality aesign~ ..... ~--~ [ -~,,e that the system would not, conditions noted above lead me~to u=~-~- · - - "the tn j~s ptesent cond~t~on~be a~ceptab~e to the [n=ent Municipality end Sta~ ~ p~ase con~ If y~ h~e ~ questions. STATE OF ALASKA DEPARTMF~T OF NATURAL RESOURES Division o. ~ologicol ~ GeophysicolSurveys I0. ~TATIC .WATER LEVEL: fl, ofllt htl. pumping ~ ~,p,m. 12.gROUTING Will Grouted: ~ YII ~ NO I~, PUMP: (If available) HP 15. Water T~mp*tolut~ o ~ F ~ C 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 ' . 1.~ GENERAL INFORMATION Comp!ete'!egal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Location (site address Or directions) P, r0perty owner · Mailing address'. Lehding' agency.. Mailing address Day phone '-3 ~ ~-. - ',~ g~) Day phone Address Unless otherwise requested, HAA will be held for pickup.., 2. NUMBER OF BEDROOMS: : " :3, : TYPE OF WATER SUPPLY: Individual well · X '~.':.' ' 'r · . -- . :''"r. C0mmumtywell .r.,, ' .- ' ' r__ NOTE: If community ~vell SYstem, provide writtbn confirmation ·from State ADEC attest- the legality ..... . · ing to and status ofsysterq,,:!/ 4. TYPE OFWASTEWATER DISPOSAL: . , .... :.Individual.on-site` ., ___ Community on-site ,. Public sewer ~ ' '" NOTE: If community Wastewater system, provide Written confirmation from State ADEC attesting to the legality and status of s~/stem. 72-025(Rev. 1/91) Front MOA#21 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, tl~e 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 ' 17034 Ea_~!e River Loop Road No. 204 Phone Eagle River, Alasl~a 99577 ~. , . ., . .,.. Address,. . . Engineer's signature DHHS/SIGNATURE.~.~ Approved for' ~--'~ bedrooms. " Disapproved ' Conditional approval for" bedrooms; with. the following stipulations: !.~'.~ . ~ .. ,..~, ...- ~ . · Additional Comments Date ' The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health A. uthodty 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 DHHS do not conduct inspections or analyze data before a certificate is issued, The Municipality of Anchorage is not responsible for errors or ~)missions in the professional engineer's work, KLCEI¥ L, Municipality of Anchorage NOV 1 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIPALIYY OF ANCHOR,~ 825 L Street, Room 502. Anchorage, Alaska 99501. (9~0~R~,~-~z~erv~ces Health Authority Approval Checklist LegalDescription:J~o~ ~'~31~, ~,cTJo,,/3'~ 'Tl&~,~ ~':~ ParcelI.D.: Ol~ A. WELL DATA Welltype ~/'4~V.~'~',[-- IfA, B, orC, attach ADEC letter. ADEC water system number Log present (~q) k/,¢:. 5~ bate completed (,o / 3o/ ~/ Total depth Sanitary seal ,~,.)N) I00 / Cased to / 0 O Casing height (above ground) Wires properly protected (~1) FROM WELL LOG AT INSPECTION g.p.m. ~.0 Date of test St'atic water level Well production g.p.m. WATER SAMPLE RESULTS: Coliform O Nitrate Date of sample: I~ //o / ~/~l E. DA 'A Date installed G R o Tank s ze Foundation cleanout ~) V¢~ Depression (Y~ Date of Pu~ping )~ //0/~'¢1 Pumper I ~c ~ ~ ~ 5'- Other bacteria ca Collected by: _ $ & $ ENGINEERING 17034 Ea[:,¢e River Loop Road No. 204 Eagle River, Alaska 99577 ~ Number of Compartments I Cleanouts(~/N).__ /~J d High water alarm ~/N) ',/~_ 5' ,V/~ j' C. ABSORPTION FIELD DATA ~4 oL.~ ~,,/6._ Date installed Soil rating (g.p.d./fF or ft2/bdrm) Length Width Gravel thickness be~ Total depth Effective absorption area __ __ Monitoring Tub~.er4t"(Y/N) Depression over field (Y/N) Date of adequacy test ~_~.~el~Pass/Fail) _ For bedrooms Fluid depth in absorpt~ere'"-test (in.); immediately after gal. water added (in.): ~i~nt (past 12 mont.`''/' (ins)Min~tsi~/atN;r: AbSllryl;ingri;;eda~e g,p.d. 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* ...-~~level at*---~ C y c I e,%t e..,ste ~'----~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot N / 4 Public sewer main N//~ Sewer/septic service line ~) ~' ~ On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation S- ~-~ ~ Property line ~ -¢- Absorption field Water main/service line )0 w- Surface water/drainage ) 08 -¢-- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building Curta~ Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and rev, ew of Mun,c,pal recor, cj~.t~a~.t.~.~..~.~tems are ...... ,~'.'~3 . ........... ~!:'" "~ /n conformance w/th MQA HAA guidelines/n effect on this date. Ennineer s Name i.o~ :r . o [¢lt g . HAAFee $_ Z--~£'F-z'' Date o, Payment Receipt Number --~'4~ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 1et, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone: (home) ,/~ Business Telephone Telephone f (e) Mail the HAA to the following address: (or check here , ~[~f hold for pick up.) List contact person and day phone number below: Single-Family ~ Number of bedrooms 3. WATER SUPPLY J Individual Well ~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. SEWAGE D IS/P~AL ~ 4. On-site ~ 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. 72-025 (Rev. 7188) Page 1 of 2 ~ ~.o ~ e§~d '~iJO~ 8,,leeu!6ue leUO!SSejoJd eql u! SUO!SS!LUO JO 8JoJJe Jo~ eiq!euodseJ ~ou 8! e88Joqou¥ jo/~!led!o!unlAI eqJ. 'penes! 8! el~o!,qIJeo ~ eJojeq e~p ez,~18ue Jo suo!loedsu! ~onpuoo ~ou op SHHQ jo sea,~oldu~3 's~ueuJeJ!nbeJ a~e~,s pu~ leJepaj u!e~Jao ,~.s[~ee o~, JepJo u! §u!puel J!eq~ pu~ se~uoq jo sJeseqoJnd o~ ,~selJnoo ~ s~ s!q~, seop SHHQ eq.L '~s~lV jo e~eiS eq~, u! peJe~sCeJ Jeeu!6ue I~uo!sse,~oJd ~uepuedepu! ue ,~q e^oq~ ~; qde~§eJed u! ue^!6 suop, e~uaeeJdaJ eq~, uodn ,~lUO peseq peleo!J!Jeo Ca^o..ldd¥ X~.poq~.n¥ q.tleeH sense! (SHHQ) seor^.mS U'aLUnH pue q~.leeH Jo ~,ueuJ~.mdeQ e6e.ioqou¥ J.o X~lledfo!unlAI eq..L leUO¢.!puoo le^o~dd¥ leUO!~.!puoo J.o sw~ej. pe^o.~ddes!a ../~. pe^o.ldd¥ ,~q stuoo~pe~'~ot pe^o~dd¥ 'IYAOtJddY SHHO '9 lees s,.~eeu!eu'=l ,o <,~ ~ MUNICIPALITY OF ANCHORAGE (MOA) ~ ~ ~,,,~'" (?~,~ ~,. Health Authority Approval (HAA) ,,/a~,~'~, ~ ¢ _ ~X v 343-4744 ~ ¢ Legal Description: ~ ~Z~¢ ~ %~j~, ~ A. WELL DATA Well Classification ~ /~/~ If A, B. C, D.E.C. Approved (Y/N) ~/~ Total Depth /Z Cased to /~¢:2 Depth of Grouting ~"~/,/~ Static Water Level ~/ / Pump Set At Yield Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Sanitary Seal on Casing (Y/N) ,~ Depression Around Wellhead (Y/N) ~ SEPARATION DISTANCES FROM WELL: / To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line /¢"J/,'Z:IL To Nearest Sewer Service Line on Lot Water Sample Collected by /~/'"L2C,.6 ; On Adjoining Lots /f'-)//¢~' :;~' ;On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Water Sample Test Results Comments ~ /-~::9~'~/~' / Date Installed 2~./~./¢g/;~.)Size .~oo,~,-~,~/'_g',¥,~No. of Compartments / Standpipes (Y/N) ~/ Air-tight Caps (Y/N) Z// Foundation Cleanout (Y/N) Depression over Tank (Y/N) /L'/ Date Last Pumped Pumping/Maintenance Contact on File (Y/N) '~'/,//'~ ; for Holding Tank High-Water Alarm (Y/N) Y/~/~/¢'/~/~¢ Temporary Holding Tank Permit (Y/N) / SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ~ / '7 ~) To Building Foundation To Property Line '~' ¢:'./'/_2 To Disposal Field To Water Main/Service Line -~/~ / To Stream, Pond, Lake or Major Drainage Course Comments 72-026 (Rev 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test 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 £ To Driveway, Parking Area, or Vehicl6 Comments Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Present To Pre Line Test ; On Adjoi Lots To Existing or Abandoned System on To Cutback (if present) D, LIFT STATION Date installed Size in Gallons "Pump On" Level at __ High Water Alarm Leve Tested for Meets MOA Elect Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test, **Check Permitt~_ Bedroom R.~g Against HAA Request** I certify that I//h/a~/~/ )eck/ed/ve.9~ied, or conformed to all MOA and inspection./////~/ Signed / /////~-~ MOA No. Receipt No. Date of Payment Amount: $ 72-028 (Rev 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 in effect on the date of this Engineer's Seal CHEMICAL & GEOLOGIC LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SANPLR for Work Order ~ 20756 Date Repozt Pzinted: APR 3 90 @ 09:03 Client Sample ID:GOVT. LOT 223B 15445 KREITRL PWSID :UA Collected APR 2 90 @ 13=00 h=s. Received APR 2 90 @ 13:20 h~s. P~eserv~d wzth :AS REQUIRED Client Name : CORWIN R ASSOC Client Acct : CORWINP P.O.~ NONE RECEIVED geq ~ O~de~ed By : BRUCE CORWIN Analysis Co)~leted :APE 2 90 Send Reports to: Laboratory Superf½s~,/STE?EN C. EDE 1)CORWIN & ASSOC Released By : ~~. ~_~ 2) Special Instzuct; Chemlab ge£ ~: 900701 Lab Smpl ID: I Matzix: WATER Allowable Pararnete~ Tested Result Units Method Limits NITRATE-N ND(O.IO) mR/1 EPA 353.2 lO Sample ROUTINE 3AWPLE Remarks: SAI4PLE COLLECTED BY BJC. Tests Performed ' See Special Instructions Above UA=Unavailable None Detected "See Sample Remarks Above }lot Analyzed LT=Less Than, GT=Greater Than CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 a Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER D PUBLIC WATER SYSTEM I.D.# [[]"/PRIVATE WATER SYSTEM Phone No. / Mailing Address city SAMPLE DATE: Mo. Day Year Zip Code RoLE TYPE: urine [] Chock Sample (for routine with lab ref. no. [] Special Purpose sample Treated Water Untreated Water SAMPLE NO, 1 LOCATION Time Collected Collected By '. I I TO BE COMPLETED BY LABORATORY x~sYSiS shows this Water SAMPLE to be: atisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send ~luw [~ampl,~ vie, .pecial delivery mall. Oa,o.eceived _ Time Received I ~ %~ Analytical Method: Membrane Filter * No. of colonies/100 mi. PO,O?oI ~ Result* Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLF BACTERIOLOGICAL WATER ANALYSIS RECORD Membrane Filter: Direct Count Verttlcatlon: LTB Final Membrane Filter Results Reported ByL,~.~ ~ TNTC = Too Numberous To Count OB = Other Bacteria BGB Collforrn/lOOml PART ONE OF TWO REMAINDER TO FOLLOW 'b O' I h~reb~ ced/fy that an accurate mue. v o! th, follow/n~ descrlbod prop~ty- was ~ad~ on /2/~/~ and that/he Impmwm~nts situated thereon am w#hln /ha prop~y Iin~s and do not o~rlap or ~oroaoh on l~ prop~r/y /~n~ adj'ac~t theme, t~t no Im~owm~n~ ~ pmp~y lying adjacent ~r~to ~ncmaoh on th~ premiss In ~#1o~ and thai 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, secuon, township, range) Lo~ation (add~'es's~or,directions) ~rr , (b)', Applic,ant Name ;, A.p. plican, t Address Telephone: Home ..~'/5"- 5~ 7~' Business (c~:~ &pplidafit i~.(check on~)j,~nding Institution ~; Owner/builder~: Buyer ~; Other ~ (explain}; (d) Lendingln'stitutio0';~ ~ ~~ Teleph0ne r (e)AddressReal Estate Company and Agent ~ ~ Tolephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family.~ Multi-Family [] Number of Bedrooms ~' Other WATER SUPPLY Individual Well~f. Community [] Public [] Note; If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite'~l~ Public [] Community [] Holding Tank [] Ngte: 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 72-025 (tl/84) 'NJOM S,Je@U!6U8 IBUO!SSeJOJd eql u! suoJssFuo JO sJoJ~e JOJ elq!suodsaJ )ou s! e§~Joqouv Jo Xl!lBd!o!un~ eq..L 'penss! s! @leoU.!Pao ~ eJo~eq elBp eZ~leUe Jo suo!loedsu[ lonpuoo ~,ou op cl'qHO ~.o seeXoldm~ 'S:lUeLUeJ!nbeJ e)~:lS guB IB.lepeJ U!B:H9O .~JS!.l~S o], JepJo u! suo!1n:Hlsu! 6u!puel J!eql pub se~uou Jo sJeseqoJnd o~: ~se:Hnoo e se s!ql saop cF:U-IQ eqJ. i~uo!ssDjoJd lUgDugdgpuj u~ ~a 9AOql~ ~ qdeJ§eJed u! ue^~6 suo!i~iuasgJdgJ eql uodn ~l~lOS p@sBq 9aJ8o!J!]Jgo IB^oJddv ~l!Joq)nv qll~eH senss! {cl'qHQ} uo!loelOJcl ,m. ueuJuoJ!^u~ oue q:~l~eFI jo lueu~:p~dea e6BJoqouv ~.o Xl!led!oun~l NOIlr~'O .g f .,.~UNIClPALITY OF ANCHORAGE (MOA) ~,~ F¢.C'?~ ~'i i~,I~.EAETH AUTHORITY APPROVAL (HAA) ,.~\vh~\~' ~ ;~',~-~ CHECKLIST- FEBRUARY 1984 ~,¢~ ~ ~' ~ 264-4720 .,~ , ~ Legal Descnpbon. WELL DATA ~ ~ ~_..~.. ' ~ Well Classification ~/V~%E If A, B, C, D,E,C, Approved (Y/N) Well Log Present,N) Date Completed ~O-~ Yield Total Depth /,¢O Cased to Static Water Level I~1 ~'~,,, ! · Casing Height Above Ground Electrical Wiring in Conduit ~)N) Separation Distances from Well: ~o Septic/Holding Tank on Lot /~.d Depth of Grouting Pump Set At Sanitary Seal on Casing~N) Depression Around Wellhead (YI~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ,/¢~/ · ; On Adjoining Lots To Nearest Public Sewer Line W'/~ To Nearest Public Sewer Cleanout/Manhole ,,*~/~ To Nearest Sewer Service Line on Lot Water Sample Collected by ~41&~*'-~'~ ~'¢' /~/~"~ ; Date Water Sample Test Results Comments II~ ~J~. ~'~o~,~ B. SEPTIC/HOLDING TANK DATA Date Installed ~ - ~'"¢ ~'¢ Size Standpipes ~)N) Air-tight Caps Depression over Tank (Y~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course No. of Compartments Foundation Cleanout~N) Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 o! 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field / /cb Square Feet of Absorption Area Depression over Field (Y/(~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /0'¢4 · · To Building Foundation Lot ~' ~ · TO Water Main/Service Line /O 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 CN) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots ,/¢ ~' To Cutbank (if present) ~J/,~ Comments D. LIFT STATION High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ~'~'~ __ Vent (Y/N) P~"~u m '.~Adeq uacy Test. Meets M CA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I ha?~hec~ed, vej'ified, or conlormed to all MOA and HAA guidelines in effect on the date of this inspection, Signed ~/$'/P'//ll-, ~j/.~_~ Date /~ ~/'~ Company ~fi MOA No. Receipt No. ~') ~' ~)~ ~ ~?' Amount: $ (~, ~O Page 2 of 2 72-026(11/84) A. WELL DATA MUNZCIPALITY OF ~NC~ORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MUNICIPALLY/ OF /, C ORACF Legal Description: Well Classification Well Log P~esent ~/N) Total Depth. /OO' Cased to Static Water Level ~ ' PureD Set At Casing Height Above Ground Electrical Wiring in Conduit ~/N) Separation Distances ~om Well: To Septic/Holding Tank on Lot To Nearest Edge of Absor~ption Field on To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected By Ware= Sample Test Results Date C~gleted If A, B, c~ C, D.E.C. App=oved(Y/N) Depth of G~outing. Sanitary Seal on Casing Depression A~ound Wellhead (Y/~ ; On A~joining Lots ~rlOo ; On Adjoining Lots (~rloo ~ To Nearest Public Sewer To ~est ~ ~vi~ Li~ on ~t ~1oo ~ B. SEPTIC/HOLDING TANK DATA Date Installed g ~ ~% Size /OOO ~/~C No. of Ccmpa~ta~nts Stan~i~s ~) ~ e~ Ai~-tight Caps ~) ~e5 Foun~tion Cleanout ~p~ession o~ Ta~ (Y~ ~O ~te ~st P~d P~ing~intenan~ ~n~a~ ~ File (Y~) ~ ; fo~ Holding Ta~ High-Wate~ ~a~ (Y~) ~% ~ Holdi~ Tank ~t (Y~) ~p~ation Distan~s ~ ~ptic~olding Tank: To Water-Supply ~11 ~ ~lq I To ~ilding Foundation 7' To ~o~ty Li~ ~ 3 ~ ' To Dis~sal Field To ~ter ~inJ~vi~ Li~ ~ too' To S~e~, ~nd, ~e, ~ ~jo~ ~aina~ Receipt 9 Date Paid: Amount: [Pa~e 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date .Installed ~ Ju~ Width of Field Square Feet of Absorption A~ea Depression over Field (Y~> Results of Last Adequacy Test Separation Distance from1 Absorption Field: To T~ate~-Supl~lY Well ~/~ ~q' To P~operty Line ;~9~~- Type of System Design Length of Field ~ q I Depth of Field ~ ' Gravel Bed Thickr~ss ~ ~5-~~ Standpipes P~esent Date of Last Adequacy Test To Building Foundation 'Y i ~, q ' Lot A~A ; On Adjoining Lots ~-? ZOo To Water Main/Service Line To Cutbank(if present) To Stream/Pond/Lake/or Majo= D~ainage Course. ~% ! C;O ' To D~iveway, Parkinc3 Area, or Vehicle Stora~ Area To Existing or' Abandoned System on D. '~I~FT STATION Date Si?~ in Gallons~ "Pump On" Level at Dimensions Manhole/Access (Y/N) ~-.~....~ "Pump Off" Level at High Water Alarm Level at , ,A Vent (Y/N) Tested for Pumping~e~+s ~ing Adequacy Electrical Codes(Y/N) ~ Con~nents Test. M~ets MOA . ** Check Permitted Bedroc]n Rating Ac3ainst HAA Pequest certify that I have checked, ~.rified, o~' c~nfomr~d to all MOA HAA Guidelinss in effect on the date__ .~ s~k~ns~Pe, cn~of this '.~nspecticn. Signed ~~~ ~ _ Date Company ~fCc; MOA No. [Pa~ 2 of 2] 2-15-84 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) T12N R3W Section 33 Lot 223B Location (address or directions) Kreitel off Dora Avenue and LocLoman (b) Applicant Name A~.mond, Inc. Telephone: Home 345-3821 Business 345-7742 Applicant Address PO Box 112247 Anchorage~ Alaska 99511 (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [~x Multi-Family [] Number of Bedrooms three(3) Other 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~l~x 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 72-025 (1~/84} ENGINEERING FIRM PROVID ~ INSPECTIONS, TESTS, FILE SEARCH, E s. AND 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 end/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 Telephone Address Date Engineer's Seal DHEP APPROVAL Approved for Approved bedrooms by Disapproved * XXXXXXXXXXXXYConditional Date April 9, 1986 Terms of Conditional Approval *Disapproved due to failure to comply with conditions set forth March 6, 1985. 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 their 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-o2s m/84) ALASKA iiUIRoi m I TAL COI TROL SeRulC $, IRC, ~nqJn¢¢rJnq 6 ~nuJronrnc,~lol June 7, 1985 Department of Health and Human Services 825 L Street 4th Floor Anchorage, Alaska 99501 Attn: Susan Oswald Subject: T12N R3W Section 33 Lot 2~3B On May 23, 1985, two water monitor tubes were installed, each to a depth of 15 feet, on the subject property. This was in agreement with the "conditionals" on the Health Authority approval of March 16, 1985. The monitor tubes were installed as stated; that is, one on the "upstream" and one on the "downstream" side of the curtain drain. At the time of installation, water was not present in either location. On May 29, 1985, the monitor tubes were rechecked and found to contain no water. If this office can be of further assistance~ please contact us at 561-5040. Sincerely, P r e ~s~iz~n t 1200 UJcsl 33r~ Aucnu¢, Suite [~ ,,, Anchorage, Alaska 99503 ,(907) 561-5040 ALASKA H,IUIRO~P~e~TAL CONTROL Se,,JICeS, I~C. LOT TH 3 4 5 6 7- 8 9 10 11 12 13 15 16 17 18 19 20 SupplemenLaJ So~ls InformaLion, LOl' TH 1 3 4 5 6 ? 11 11 12 13 14 14 15 15 16 16 17 17 18 18 19 - 19 20 - 20 LOT TH 1 2 3 4 5 6 7 8 9 lO 11 12 13 14 15 16 17 18 19- 20- MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information (a) Legal Description (include lot, bloek, subdivision, section, township, range) (e) Real Estate Co. & Agent Address Telephone Location (address'or directions) , {~R¢~T~L oF~_Qo~ ~1)~ ~ doc I-.OW3AjxI (b) Applicants Name ~L~o~D ~C /~ <~Zelephone - ~ome /Business Applicants ~dres~_ ~0 ~0~ I I,%~7 ~CHOa~= ~K 9q ~11 (c) Appliaa. t is (check one) Lending Institution ~ ; ~ner/builder ~; (f) Mail the HAA to the following address: 2. _Type of Residence Single-Family ~ Multi-Family Number of Bedrooms 3 Other (describe) 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] 5. Engineering Firm Providing Inspections~ Tests~, File Search~ Data and 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 safes 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 %mter 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 Address ~'LOO~O Date Telephone DHEP Approval Approved ~ Disa Conditional Terms ofz Conditional Approva~y /°/I~-~t/~'~ /9~.~', /d~-,ez.g- RR4/eJ/D18 ~ [Page 2 of 2] THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES BEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY .a2q INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCILRSERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. T}~ MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. ALASKA ENVIRONMENTAL CONTROL SERVI( ., INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO OF CHECKED BY DATE / SCALE. / / / / ~o ALASKA e dlROIlm IqTAL CO[1TROL SeRulCe$, I[1C. Enqineefinq ~, ~nuironmentol $1udie$ February 27, 1985 Mr. Robbie Robinson Department of Health & Environmental Protection 825 L. Street Anchorage, Ak. 99501 Lot 223B, T12N, R3W, Section 33 Dear Mr. We are in the process of sorting out the absorption field and curtain drain on the subject lot. We have exposed the curtain drain and the absorption field and have found problems with both. We will address each problem separately and then provide a set of recommendations to bring the system up to Municipal and State codes. Upon exposure of the curtain drain & absorption field (See Attachment 1) we found: a) The curtain drain is at 3.5' below ground level with SB-2 pipe embedded in a foot of gravel. b) The top of the absorption field is at 4' below ground level with 24" of gravel under the perforated pipe. c) The curtain drain and absorption field are separated by at least 7 feet of undisturbed soils. A diagram of the curtain drain and absorption field profile along with flow network are provided (Attachment 2). The flow network indicates that any cross connection will be from the curtain drain to the absorption field and not vise versa. There is only a short length of the curtain drain which is as close as 7 feet. Most of the curtain drain is from 9-20 feet away from the absorption field. The curtain drain at the south end of the trench was severed and plugged. During the exposure of the absorption field (See Attachment 1), we found the trench to be installed in silty gravel (GM) material. No sign of fine sand and gravel (SP) or sandy gravel (GP) was found as indicated on the soil log used to obtain the permit. (See Attachment 3) However, upon examination of the original soils test hole location, it was found to be between the septic tank and the house foundation, approximately 18 feet from the nearest edge of the absorption field. (See Attachment 4.) 1200 LUest 33r(~ Auenue, Suil~ [~, Anchoraq~, Alas~o 99503,(907) 561-5040 Based upon our observation of the soils encountered during exposure of the system, we accomplished a 2 day adequacy test on 2/25 and 2/26/85. On the first day, we introduced 1179 gallons of water into the system to completely flood it. On the second day, 24 hours later, we introduced 344 gallons into the system to fill it up to the same level as the previous day. Based upon this test, we conclude the system is capable of absorbing 344 gallons of water per day. This is not sufficient for a 3 bedroom house. (See Attachment 5, Adequacy test results). The location of the standpipes/cleanouts on the absorption system, curtain drain outfalls and curtain drain location along the south lot line were carefully measured. These were then plotted on the as-built survey done by Landtech, 7/11/84. (See Attachment 4). This shows a portion of the curtain drain along the south lot line to be off the lot. Further, the south end of the trench is about 4.5 feet from the south lot line. We have prepared an absorption field upgrade proposal. The upgrade is predicated upon what the existing system was capable of absorbing. Using the equation cited Q = 5/~per the 1979 Manual of Septic System Practices. We calculated the soils to be rated at 299 sqft per bedroom uncorrected. Using a corrected soils rating of 380 sqft/bedroom, the system requires an additional 655 sqft of absorption area. (See attachment 6). Verbal statements were obtained from Dan Morrison, Foreman for the general contractor and owner of the lot. He stated that: a) During excavation of the trench, ground w~-~s---~ "observed to be coming into the trench through a thin seam in the east side 3 feet below the surface b) The excavator installed the curtain drain at the 3 foot level to cut off the groundwater. The curtain drain was not designed by an engineer and is improperly installed. Further, no method of monitoring the curtain drain effectiveness was provided. The engineer Mr. Bound Brownfield, PE 3895-E, who inspected the installation of the absorption field cited persistant standing water in the north end of the trench as reason for withdrawing his approval of the septic system. (See attachment 7) We require your assistance in resolving this matter. Please evaluate the following recommendation: 1) The curtain drain should be accepted as-built. The southern leg has been cutoff and plugged as indicated on Attachment 4. While the curtain drain is close to the absorption field, it is installed above the field and should not cross connect. 2) Monitors should be installed upslope from above the curtain drain and just below the curtain drain to determine its effectiveness in draining the ground water away from the system. 3) After breakup, the data should be evaluated and the curtain drain be improved as necessary to make it effective. 4) A waiver should be granted for the southern end of the absorption field to lot line separation. 5) ~- A conditional approval of the wastewater disposal system ~.--for a temporary perzod should be granted. This period should not be less 90 days from thzs date 6) The water levels in the system should be monitored regularly until after break up. If the systems begins to fail the outlet of the septic tank should be plugged and the septic tank pumped, as needed, until the absorption field is upgraded. 7) A soils and percolation test should be accomplished. Absorption ~ield should be added as necessary to bring the system up to total needed capacity. If you have any questions, don~t hesitate to contact me at 561-5040. Sincerely, Approved by: Pre~ PhD PE Ronald E. Godden Operation Manager Environmental Engineer Attachments: 1. Lee Memo 2. Curtain Drain profile 3. Site plan on Landtech As-built survey 4. Adequacy test results 5. Absorption field upgrade 6. Brownfield package ALASKA e,,UIROrlmEDTAL COF1TROL SE?[,tUICe$, IFIC. ~n§ifl~erir~§ 6 ~nUirOnrnenlal $1udies 2/26/27/85 ALMOND INC P O BOX 112247 ANCHORAGE AK 99511 SELLER - JIM FEJES BUYER - SUBDIVISION - T12N R3W BLOCK - SEC33 LOT - 223B ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 485 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 344 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1179 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT. ACCEPTABLE FOR A HOME OF 3 BEDROOMS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF~1000?IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. ]200 UJ¢$1 33rd Aucntt~, ~tlJl¢ B $ Art~llor~1§8, Al~skQ 995o~o(9o?) 561-5040 .mz /r~, oo G ALASKA ENVIRONI~?- NTAL CONTROL SERVICE iNC. 12OO West 33rd Avenue Suite B ANCHORAGE, ALASKA 99503 Phone 561-5040 SHEET NO, OF. CALCULATEDSY. ~ G~)~' ~'~ CHECKED BY SCALE !; ~0 ALASKA ei dlROI1Ffl F1TAL COI1TROL SeRuICeS, IIlC. TO: RON SUBJECT: FIELD TRIP TO LOT 223B, T12N, R3W, SECTION 33, ALMOND INC.'S HOME OFF OF LOC LOMAN On February 16, 1985 at approximately l:00pm Alan Wien and I visited the subject lot to inspect the testholes done by Jack Hill for Almond Inc. Immediately adjacent to the standpipe at the north end of the system was a testhole which was 12 feet deep and approximately 18 feet long. Nowhere along that system did we find evidence of a curtain drain or disturbed soil except ~he soil immediately adjacent to the system. The soils appeared to be GM type material down to the full 12 foot depth. I did not notice any sand or gravels as outlined in the soils log. Also, the exact location of the soil test should be determined by field measurements from the telephone pole referenced in Jim Green's soil test. The hole at the south end of the curtain drain was right at end of the standpipe. The curtain drain was approximately 7 feet from the sewer system. The system was 4 foot from the top of the ground to the top of the gravel. The curtain drain was 3.5 feet from the top of the ground to the top of the drain. Therefore, it appears that the curtain drain is very shallow. It consisted of slightly less of a foot of gravel with SB2 drain pipe imbedded in the gravel and then engineering cloth on the top. At the south end of the system the curtain drain appears to be 9 foot to the east of the sewer system. Also, the soils at the south end of the sewer system did not appear to be representative of the testhole. Soils were silty, sandy, gravels to silts. The distance from the standpipe to what appears to be the south lot line appears to be 10 feet. The testhole to the south is approximately 9 foot deep. In neither hole was water noticed. The existing curtain drain goes right down the lot line. It was severed by the backhoe immediately south of the sewer system and plugged. Recommendations: It is recommended that the exact location of Jim Green's testhole be obtained by measuring from the referenced telephone pole and off setting to the south. It would appear that this testhole would be very close to were the septic tank is located. I would like this confirmed. Because of the variation in soils I feel that an adequacy test should be run on this system. My recommendations are that the system be filled up with water; preferably warm water because the frost level appears to be right at the top of the sewer system. Since the curtain drain is approximately one half of a foot above the sewer system I would recommend that you contact the 1200 Lgesl 33r~1 Aucnu¢, Suite ~;. Anchoroq¢, Alosko 99503 ,(907) 561-5040 Municipality to see if they are amenable to allowing the curtain drain to be within 20 foot of the system. The next item is if the Municipality will not allow the sewer system to be within 20 feet of the curtain drain even though is of higher elevation then the sewer system. I recommend that Almond get bids and try to set up the changing of the curtain drain as a conditional of the house sale. Let us go ahead and get the adequacy test and the health authority because it appears that the system is approximately 10 foot from the lot line. Signed by: -~HEMICAL & GL..LOGICAL LABORATORIES ~F ALASKA, INC. T.ELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL GUNTER 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: I.D. NO. (*) See h on back city Slate MO. Day Yesr Zip Code SAMPLE TYPE: ...J~'R~utlne [3 Check Sample (for routine sample with lab ref. no. [] Special Purpose ! [3 Treated Water ...E~,-UntreatedWater SAMPLE NO. LOCATION I I 4 I Time Collected Collected By I TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfectory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results, Please send new sample via special delivery mail. Time Received Analytical Method: [] Fermentation Tube ~ Membrane Filter Lab Ref. No. Result* Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Rev, 1983 BACTERIOLOGICAl. WATER ANALYSIS RECORD Membrane Filtec Direct Count Collformll00ml Verification: LTB Final Membrane Filter Results Reported By ~~~'"- '~ /"" Date · ( Time: TNTC = Too Numerous To Count BGB. Collformll00ml ALASKA ENVIRONMENTAL CONTROL SERVICE' 'NC. 1200 west 33rd Avenue ouite B ANCHORAGE, ALASKA 99503 Phone 561.5040 SHEET NO C^LCUL^TEODV ~., G~*~eO CHECKED BY SC^LE }',J T 5 OF DATE