HomeMy WebLinkAboutPARADISE VALLEY BLK 4 LT 17Paradise Valley
Lot 17
Block 4
#020-411-25
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES (~.C~- ~//-~,,~
~d~ ~oit/~AN K FIELD WELL
P~one(s) ~ Permit NO. No. of Be ms WELL
L°[ ~ Block Subdivision
Townsigp, Range, Section
AS-BUILT DIAGRAM (Show location ol well, septic system, property Unes, [oundaUon,
TANKS
~ SEPTIC ~ HOLmNG
ManufacLurer Capacity in gallons
Materia~ No. of Compa~ments .
TYPE OF SYSTEM
~ TRENCH ~ BED ~ W. DRAIN ~ OT~ -
Depth to pipe bottom from Total depth ~rom orJgina~
original g~ade FT F1
Fill added above original grade
FT FT ·
Number of lines Soil ~U~ P,pe m~teria, ~ ~ ._
WELLS )~-
~ PRIVATE ~ OTU~e~/
/ FT
REMARKS:
/,
I / · [~A ~ ce~ify thai Ih[s inspecll0n was peH0rmed acc0rdiao 10 all
/
72-013 (3/85)
4.
, ,' ' 'l/,'l,i:!:i,r'ig
J
ALASKA eF1UIROFImeI TAL cOr TROL SeRUICeS, II'lC.
~nqinecrinq 8 ~nuironmenlal $1udies
P. O. Box 240668
Anchorage, AK 99524-0668
(907) 279-5553
October 18, 1989
Municipality of Anchorage
Department of Health & Human Services
826 L Street, Fifth Floor
Anchorage, AK 99501
ATTN: Susan Oswald
RE: Lot 11, Block 4, Paradise Valley
Dear Susan:
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
OCT 2 0 'i989
RECEIVED
I talked to both Mark and his father, Howard Johnson, about
the alleged streams you and Dan saw. It is very difficult
to believe that a stream has originated on this lot.
Mr. Johnson gave me a sketch of a drain system installed to
prevent water from reaching the crawl space in his house,
It is about 6 feet deep. The photographs lie took during
construction show a double sided Miradrain starting near the
well and running to the edges of the house, From there,
there is solid pipe located as sketched, The 'two drains
apex uear the well and terminate at the low area near tile
culvert in the southwest corner of the lot, A rock fill
with drain pipe and Mirafai runs to tile north.
The lot to the west (Lot 15) has a bed system located in the
northwest corner of the lot. The soils between the
northwest corner of the lot and the curtain drain on Lot 17
is impermeable blue clay.
1412 Web'l; 331~ch 3,venue · &nchol~&q6, 3'l&sk& 99503 · (907) 279-5553
Mr. Johnson and Mark both acknowledge that there is water
ruuning o~ the neighbor's lot onto their lot. In light of
the fact that this is a recerd rainfall year, that is
understaadable. But hardly can it be called a stream. The
stream that crossed these lots was diverted south off these
three lots years ago when the road was rebuilt along the
east side of the sabdivision. This lot is lower than the
lots to tile
be expected.
years that I
tight vessel.
ditch that
north and east, so drainage unto this lot would
I have not seen anything within the past 2
would ca]l a stream. A holding tank is a water
It is doubtful if it would pollute a yard
is 4-5 feet above it.
Therefore, the delay in issuing a permit for the holding
tank is tantamount to reckle:~s endangerment of public
health.
The existing septic tank, albeit plugged, is, by your own
words, a potential bealtb hazard,
I strongly recommend that
issued most expeditiously.
LCR/sr
a permit for a holding tank be
Sincerely yours,
President
Duane Mark Sew J
LS-6918
AS-BUILT NO CORNERS SET THIS
for the use of
lending institutions showing the relation
ship of existing s~ructures and platted
easements and lot lines. It is not to
used for posi~ionin~ additional struc-
tures or fencelines.
'l hereby cerLl~y that I have performed · Mortagee's
be ~ction of me ~oUow~g d~i~ prope~y:
, LO~ 17, BI~, 4, Paradise Valley
~d.
/ / '- _.:
Anch~rsge l~cording Precinct, ~k~ and th·t the lmprov~-
men~ s~tua~ ~e~ ~ wi!bin ~e pro~y ~es snd do
not overlmp or en~oa~ on the ~y IDn~ ad~acent ~er~
~ ~at no ~p~vemen~ on p~ lying ~ja~nt ~e~o
· en~oa~ cn ~e pre~s ~ que~on ~d ~t th~ are no
roadways, ~ion lines or oth~ t'~ible e~mcn~ on
sud proper~ ex.pt ~ tn~ h~m ~
Dawd at ~ch~ag% ~a ' . ' [
The information hereon is for the use of
lendinq institutions showinq the relation
ship of existinq structures and platted
easements and lot lines. It is not to be
used for positionin'q additional struc-
tures or feneelines.
AS-BUILT NO CORNERS SET THIS DATE,3)//~C~C/~'7
"I hereby ccrtlt'y that I have ~o~ a Mo~ag~'~ ~.
l~ction of ~e [o~ow~g d~i~ prope~y:
Lot 17, Bi~, 4: Paradise Valley __
S~d.
~ch~.~e ~co~ng ~ednc~ ~ and ~at ~ ]mp~v~
not overlap or en~oa~ on ~he ~p~y Imng adJacen~ ~er~
m, ~at no ~p~vemen~ on p~ lying ~j~nt ~ego
en~oa~ on ~e pre~ ~ question ~d ~% ~h~ ~re no
roadways, ~ion line~ or oth~ v~sibl~ e~men~ oa
~d proper~ ex~pt u ln~ h~m I
.'.'S~QARD & ASSOCIATES'LAND SURV~NG"
l$ - 69 ] 8
o o
for the use of
The information hereon is
lending institutions showing the relation
ship of existing structures a~d platted
easements and lot lines. It zs not to be
used for positioniffq additional struc-
tures or fencelines.
AS-BUILT NO CORNERS SET THIS DATE
'I hereby certLt~ t.~.t I have perJormed a Mortagee'j
s~ction of ~e ~o~ow~g d~cri~ prope~y:
Lot 17, Pl~, 4: paradise Valley
men~ sttua~ th~e~ ~ wi~ ~e pro~y ~el and do
not overlap er en~os~ on the ~p~y l~ng adjacent ~er~
en~oa~ on ~e pre~ ~ ques~en
roadwayl. ~ion ]~ne~ or
a~d proper~ ex.pt ~ in~ h~
, Dasd at ~chorag~ ~ukl '
~il ~6 d~of ,~ne
. .
· '.'SEWARD & ASSOCIATES'LAND SURV ING
The information hereon is for the use of
lending institutions showing the relation
ship of existinq structures and platted
easements and lot lines. It is not to be
used for positionin~ additional struc-
tures or fencelines.
L
I I h~eby certify that I have peHor'med · Mor~agee's in.
~,pection of the following described property:
Lot 17, Bi~, 4, Paradise
Subd o
Anchorage Recording prucinct~.A~k~, and that ~ fmp~v~
men~ situa~ th~e~ ~ wi~ ~e pro~y ~e~ and do
not overlap or en~oa~ on the ~y {~ng adjacent ~er~
~ ~at no ~np~vemen~ on p~ lying ~jm~nt
en~oa~ on ~o pre~s ~ ques~on ~d ~t th~ rare no
roadways, ~ion lines or oth~ visible e~mcn~ ou
s~d propurt7 ex~p~ ~ t~ h~m I
Dasd at ~chora~ ~a '
· i~ 26 d~ot ~Une Ig 87. ' ,I .'
-.'.'SEWARD ~ ASSOClATES'LANB
," i
ALASKA I~IIUIROnmeFITAL CONTROL IFIL
$~RUICe$,
. ~n~ineerinq f~ ~nubonmenM Studies
TO ~ DEPT. OF HEALTH &
~ OCT 2 ~i989 DATE
Tom Fink,
Mayor
mxicip lity of A xchorage
Department of Health and Human Services
825 "L' Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
September 26, 1989
Mark Johnson
6511 Italy Circle
Anchorage, Alaska
99516
Re: Upgrade of On-site Wastewater Disposal System
Lot 17, Block 4 Paradise Valley
Dear Mr. Johnson:
Our records indicate that earlier this year you purchased a
house located on the subject lot. Our records also indicate
that you purchased the house "as is" from H.U.D. and that you
were made aware of the inadequate on-site wastewater disposal
system at the time you purchased the house.
We understand that you have retained the services of Dr.. Leroy
Reid, P.E. to design a new on-site wastewater disposal system
which will function in accordance with AMC 15.65 - Wasteweter
Disposal Regulations. We also understand that Dr'. Reid has
proposed the installation of an innovative peat mound system on
your lot.
The Department of Health & Human Services (DHHS) supports the
concept of installing and testing ,experimental and innovative
wastewater disposal systems. However, the Alaska Department of
Environmental Conservation (ADEC) has not yet issued a permit
for discharge of effluent treated by a peat mound system. DHHS
can not issue a permit for installation of the peat mound system
until ADEC issues a discharge permit.
In order to avoid problems associated with winter construction,
it is very important that you take immediate corrective action
which will provide a permanent solution to the deficiencies in
your on-site wastewater disposal system.
Therefore, please be advised that by October 15, 1989 you must
complete one of the following corrective measures:
Install a holding tank system which meets or exceeds the
requirements specified in AMC 15.65.090 - Holding Tanks.
Install an innovative system such as peat mound system which
meets or exceeds the requirements of AMC 15.65 - Wastewater
Disposal Regulations and all discharge requirements mandated
by the Alaska Department of Environmental Conservation
(ADEC).
"Kids Are Our Future"
Mark Johnson
September 26, 1989
Page Two
If you do proceed with the installation of a holding tank, it
will not preclude you from pursuing the installation of an
innovative system at a later date.
If you have any questions or concerns about the requirements for
upgrading your system, please contact our office at 343-4744.
For your information, we have enclosed a copy of AMC 15.65 -
Wastewater Disposal Regulations.
Sincerely,~
~th, P.E.
Program Manager, On-site Services
cc: Lee Browning, P.E., Manager
Environmental Services Division
Leroy C. Reid, Phd, P.E.
Alaska Environmental Control Services,
Inc.
Tom Fink,
Mayor
Department of Health and Human Services
825 "L" Street
P,O. Bo× 196650 Anchorage, Alaska 99519-6650
September 21, 1989
Bill H. Lamoreaux, Regional Supervisor
State of Alaska
Department of E~vironmental Conservation
Southcentral Regional Office
3601 "C" Street, Suite 1334
Anchorage, Alaska 99503
Re: Wastewate~ D~posal Permit Application 8921-DB010
.
Dear Mr. ba~ore~ux.
In response to your letter dated August 28, 1989, the Department
of Health and Human Services (DHHS) has reviewed the subject
wastewater disposal permit application.
DHHS supports the design, installation and testing of innovative
on-site wastewater disposal systems. The permit application
specifies the use of a peat mound system to treat septic tank
effluent prior to discharge to groundwater. DHHS considers the
peat mound system to be an innovative form of on-site wastewater
treatment. Accordingly, installation and testing of the system
will be specifically governed by AMC 15.65.110, Innovative
Systems. For your reference, a copy of this code section is
attached.
DHHS supports issuance of the wastewater disposal
you require additional information please contact
343-4744.
permit. If
John Smith at
Sincerely,
Lee Brownihg,
Manage r,
Environmental Services
cc: John Smith, P.E., Program Manager, On-site Services
"Kids Are Our Future"
DEPT. 017 ENVIRONMENTAL CONSERVATi[ON
SOUTHCENTRAL REGIOHAL OFFICE
3601 C ST., SUITE 1334
ANCHOPJkGE, AK 99503
.STEVE COWPER, GOVERNOR
(907)563-6529
August 28, 1989
Lee Browning
Manager, Environmental Services Division
Department of Health & Human Services
P.O. Box ].96650
Anchorage, AK 99519-6650
Dear b~r. Browning:
RE: Paradise Valley
8921-DB010
MUNIOPAL,TY OF ANCHORAGE
ENV[R~,NMEN'rAL SERVICES DIVISION
SEP 5 1989
RECEIVED
The Department of Environmental Conservation has received an
application for a Wastewater Disposal Permit, from H. & Z. Johnson
for the discharge of a maximum of 300 gallons/day of treated
domestic wastewater from a peat mound system to the groundwater to
be located at Lot 17, Block 4, Paradise Valley Subdivision.
Anchorage, AK. A copy of this application is enclosed for your
review and comment.
We request that you and your staff review the application and
submit your comments to the Southcentral Regional Office, 3601 C
Street, Suite 1334, Anchorage, Alaska 99503, within 34 days from
the date of this letter, so that they may be given full
consideration in our review process. Request for additional
information must be received within 25 days from the date of this
letter. Should you have any question regarding this matter, please
contact Julie Howe, at the above address, or telephone (907)563-
6529.
Thank you for your consideration in this matter.
Sincerely,
Regional Supervisor
BHL :JH: r ts
EMCLOSURE
STEVE COWPER, GOVERNOR
~. O~ ~NV~RON~NT~L ~ONSERVATiON
3601 C ST., SUITE 3.334
ANCHOraGE, AIR 99503
(907)563-6529
Mark Dalton
Hunicipality of Anchorage
P.O. Box 6-650
Anchorage, AK 99502
Dear 2.!r. Dalton:
RE: Paradise Valley
8921-DB010
August
28, 1909
The Department of Environmental Conservation has received an
application for a Wastewater Disposal Permit, from M. & z. Johnson
for the discharge of a maximum of 300 gallons/day of treated
domestic wastewater from a peat mound system to the groundwater to
be located at Lot 17, Block 4, Paradise Valley Subdivision.
Anchorage, AK. A.copy of this application is enclosed for your
review and comment.
We request that you and your staff review the application and
submit your comments to the Southcentral Regional Office, 3601 C
Street, Suite 1334, Anchorage, Alaska 99503, within 34 days from
the date of this letter, so that they may be given full
consideration in our review process. RequesB for additional
information must be received within 25 days from the date of this
letter. Should you have any question regarding this matter, please
contact Julie Howe, at the above address, or telephone (907)563-
6529.
Thank you for your consideration in this matter.
Sincerely,
Regional Supervisor
EIIL:JH:rts
ENCLOSURE
°,~~ ~nqincerincI F~ ~nuironmmtul Studies
June 20, 1989
Alaska i}epartment_ of Environmental
Western Dietrict/Anchorage
3601 C Street, Suite 322
Anchorage, Ak 99503
A'FTN: Julie A. Howe, Environmental Engineer
RE: Lot 17, Block 4, Paradise Valley
Conservation
R£CEIv D
,JUN 2I 1989
'ANCHORAGE/W~TE
l ,S l lCT OFFicE
Dear Mrs. Howe:
Attached is the application 'for the wastewater permit for an
on-sitl=. system using milled peat. I have enclosed the
signed application, the letter from Lee Browning~ of tbe
Municipality of Anchorage, and my attached letters and
designs. Also included is a background sta'~ement on the lot
and what had been previously attempted there.
To support the application for a peat system I have included
a report filed by the Department o9 Natural Sciences, Alaska
1:'acidic University to the Municipality of Anchorage in 1989.
I believe that from the research~ mas~ of the parameters
with which we weald be can~ereed with going in~a the
groundwa{er are far beLt~r titan what a normal septic system
would pL.t~ out. If yOU will refer to Tables i and 2, you
will see under Operatien Analyses, the total removals a? all
the ma'~erials. The Septic. Tank Data is the effluent of the
sep'hic tank~ aod the F'ea~ Mound Data is ~he di'f'feren~
parameters we've measure~ coming ~ut o'f the pea~ mound.
These two tables give you approximately one year's operating
data. Since that time~ we've had another year's da~a and it
has continued al~n~ the same lines. The Suspended Solids we
were hi,ting were considerably higber because 09 the ~ype of
subdrain material used ta collect water for research. ~'hat
is explained in the repo'rt. One a'f the things we did note
was that there seems to be channelling occurring that
periodically gives us high bacterial COL~n~s. We 9eel that
using a combination of khe sand bed underneath the peat,
and milled peat instead of natural peat, it will give us a
bet:ret media that sbould keep the bacteria counts near zero.
Ii'] the c:lesign section profile you will see that I have a
mor~itoring system wi~ich goes into the soil underneath the
water level. We found in the research that i't is better to
have a well there sa that we can pump out tl~e day before we
collect samples. The water" collected ~:ram this point would
be right at 'hhe surface of the peat and the underlying soil,
Before hest. ir~g, a pump would be used ho pump OLtt the water
141U ~J6~ 33~6 &venue · &ncho~zq6, ~Lzskz 99503 · (907)
and then al lew new water to accumulate and then pul i a
sample.
I be].ieve the parameter that would be of interest in this
~,,~c)uld be coliform bacteria. I ~.~c)u].d recommend quarterly
eampling for one year and annually thereafter. If the
celif(:)r'm are ne~c getting out of the system and ;i. nt~ the
Icest wells then I believe t. he peat system efficiency is far
greater than that o'f a septic system. "Fhe discharge in,ia
the ground water' would be well within ~he standards for
surface discharge. Please note the nitrate' r'emovals. Our
e'~ficiency in nitrahe removal is much higher than that of a
septic sysllem.
Fly wife's master's thesis explains this in more detail,
llowever, i~: will not be available unEil lief committee at
Alaska Pacific University releases it. The method by which
the system werks appears to be physical-chemical. The acid
~r'om the peat kills the bacteria. So as long as
channelization does net occur then the bacteria can't
survive arid pass through the system.
Researcl;l.,indJ. cates that for- renewal of a peat system all yeu
need to do is flush it with water by putting a garden
sprinl.::;Ler em the meund and spraying the mound surface with
~,~ater. This rinsing has a rejuvenating effect on the.
system.
If you have ne objections~ please issue a Letter of
Non-Objection to me so that I ran go ahead and submit
design back to the Municipality of Anchorage to get a
to conetr'uc'b,
permit
I'f you have any questions, please
let me know.
Sincerely yours,
Fh~e~'iden t
LCR/sr
Xe
Be
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
APPLICATION FOR WASTEWATER DISPOSAL PERMIT
In accordance with Alaska Statutes, Title 46, "Water, Air, and Environ-
mental Conservation", Chapter 03, Section 46.03.100, and rules and regu-
lations promulgated thereunder, the following application is made:
ZOELEA JOHNSON
(name of applicant)
6511 ITALY CIRCLE 345-7208
(address and phone number of applicant)
ANCNORAGE~ AK 99516
C. TYPE OF INDUSTRY/OPERATION: 2 BEDROOM HOME
D. LOCATION OF WASTE DISCHARGING FACILITY:
General; 6511 ITALY CIRCLE
Legal: LOT 17~ BLOCK 4, PARADISE VALLEY
E. LOCATION OF WASTE DISCHARGING POINTIS):
General: 6511 ITALY CIRCLE
Legal: LOT 17, BLOCK 4, PARADISE VALLEY
F. WASTE DISCHARGE VOLUME:
Maximum (gallons/day) 300
Daily Average
(gallons/day): 80
DOMESTIC INDUSTRIAL
WASTEWATER WASTEWATER COOLING WATER
NOHE NONE
G. RAW WATER SUPPLY: Source: WELL
NONE NONE
Volume 80-300 gallons/day
H. NAME OF RECEIVING ~ATER./TYPE OF RECEIVING AREA: GROUHD WATER UHDER PEAT SOILS
APPLICATION FOR WASTEWATER DISPOSAL PERMIT Page 2
I. DESCRIPTION OF SOURCFS:
Give a detailed description of the sources of all industrial/domestic
wastes within your facility. Include a schematic flow diagram showing
the sources of all wastes, and their flow pattern. Submit this informa-
tion with your application as Exhibit 1.
J. WASTEWATER TREATMENT:
Describe waste treatment practices used on this discharge with a brief
narrative. (i.e. primary, secondary, cooling, oil/water separator, etc.)
Include the disposal method for any sludge generated by the treatment
system. Submit this information with your application as Exhibit 2.
CHARACTERISTICS OF WASTE FLOW: Describe in detail the chemical and physi-
~a! properties o~ the e~luent to be discharged to State waters (includ-
ing but not limited to temperature, pH, dissolved oxygen, color, total
dissolved solids, suspended solids, BOD5, COD, oils, phenol, heavy metals,.
chlorinated hydrocarbons, biocides, acidity, alkalinity, etc. Also in-
clude a description of sampling and analytic methods used to derive this
information. Submit this information with your application as Exhibit 3.
L. PLANT OPERATION:
Average: 365
Days per Year
Maximum: _365
M. RAW MATERIAL AND CHEMICALS USED IN PROCESSES:
Brand Name
Chemical, Scientific or
Actual Name
Quantity Used per Day*
Average Maximum
NO,NE i'I/A N/A N/A
APPLICATION FOR WASTEWATER DISPOSAL PERMIT Page 3
N. PRODUCTION:
I tern
Quantity Produced per Day*
Average Maximum
~'I/A I'I/A
* Please specify units. For example: Tons per day, pounds per day,
barrels per day, etc.
O. SEASONAL VARIATION:
Explain any seasonal variation in waste discharge volumes, plant opera-
tions, raw materials, and chemicals used in processes, and/or production.
LITTLE TO NO VARIATIOH
P. SYSTEM PLAN APPROVAL:
Submit engineering plans for systems not previously approved by the De-
partment as Exhibit 4.
Q. ADDITIONAL INFORMATION: ·
Include any additional information or comments as necessary to clarify
this application as Exhibit 5.
The information given on this application is complete and accurate to
the best of my knowledge.
19 JUHE 1989
Date
SignatUzr~oE LEA' d ZN SON
Printed Name
PROPERTY OWNER
Title
Coastal Proj t Questionnaire and Ce..fication Statement
.Please answer all questions. Include maps or plan drawin-s wi-'- .....
. . . ~ re. yoUr pact, et. An
mcoffa?~t~ queat~onnal~ may be returned and will delay the re,new of your packet.
APPLICANT INFORMATION
Name of A~licam
City
PRO~ ~O~ON
Sta~ Zip Code
Zip Cod~
1. Provide a brief description of your project and ALI: assoc!~L,_'d facilities (car~taker facilities, etc.):
~ ~ed~o~ ~o~¢
Starting Dam for Project A-'~c/st/~2 , Ending Dat~ for Project
PROJECT LOCATION
I. Please give location of project. (Include near~st comm~mity or identifiable b(xly of land or water.)
Town.~p //m Rsnie.?!O Meeahn~/ S~c~oo // Alktu~Pam USOS~,l,..
2. Is the project on:
S~ Land, F __,d~l_ Land PdvaZ Land i'~Municipai Land
3. Project i$ located in which l~gi~o of tho state (s~e attached
. CURRlavr APPROVALS
1. D~? you eun~nfl, y have any S.tam er federal ~arovals for this l~oj~O..If vas. ule~s~ list 1
t~ote: approval means permit ce any ~ form of autlmelzafiou-.) Liat state rovtow ID#, if any.~--a' below. I~ [~N°
,FEDERAL APPROVAl.8
1. Will you be placing alxuctu~s ~' fills in any of the following: ~ water~, Y= ~o
I~ Ye.s,, have you appli .ed .f. or or do you intend to apply for a U.S. Army Corps of. Engineers v= So
(COE) pcTmit? Plea~ indica~ at right and give dat~ of submittal [] []
2. Have you apl~lied for or eta you inmnd to apply for a U.S. Eaviro-~aental Protection Agency
National Pollution Dis~ ge ~iminarlon System (NPDES) per .~ Please indicat~ at right and
give date of submittal . (Note: For information regarding the need for a NPDES
permit, contact E. PA at 271-5083.)
Yea No
3. Have you app..l~, fro' ~' da you intend to apply for permitS from any other federal agency? Ye, No
If yes, please list below. [] []
Agency Approval Tyl~ D~_ate submitted (or intend to submit)
DEPARTMENT OF NATUZ~L R~OURCES APPROVALS
No
1. IS the proposed project on state-owned land or will you need to cross state lands for access? r~
Pto~: In ~a,~n t~ ~ ~ v4vhm~, th~ .~,,!,, ~ j~..,~i~ ~ ~ l~d ~ ~ ~ Mgk
wat~ lin~ oI' ~trem'nt. rive~, halt~, and mean hightidt lint ~av,~,d for thret rnil~.
2. Is any portion of your project placed below th~ ordinary high water line of a stream, river,
lake, or meaa high water line of a ~ater body? [] [~
3. Will you be dt~lging? If yes, location of dr~dging is: [] []
Town-~i? Ranffe M~idian Section
. Location of disposal sit~ for dredged rr~r,~"ials (~scribe):
gect~m ,
Ye~ No
4. WILl you be filling with ro~k, $aad or gravel? If yes, azl~unO .. [] []
e Location of source: Tow~,~ Range Mmklim~ See. tim
· Location of fill site: Tow~q~ip Range M~idhn Sectkm
5. Do you plan to use any of the following stat~.owned resources? Timber
Ye~ No
* W'dl you be harvesting d~her from 10 or more acr~? If ye~, amount?. [] []
· Location of source:Town~ip ., ·
. If yes, wire material?
, Location of source:Town~ip
6. Are you plannin~ m u~ any fx~h wamr?
* Ifye~,amoem(~tlemlx~rd~y)? ,:~,~ o
7. WUI you be building or altering a dam?
8. Do you plan to drill a geoth~al well?
9. Will you be exploring for or exu'acting coal?
10. Will you be exploring for or exwacting mineral~ on sr.~-owned land?
11. Will you be exploring for or extracting off and gas on s~.~:-owned 1.ncl?
12. WLll you I~ ~nvcsdgat~ ~r removing historical or archa~ologi .~sources
on start--owned land?
13. Will the project be located in a unit of the Alaska State Park System?
~.f yo.u. a .nsw_ered NO to. all..questt .o~_in this ~c~i~ y. ou_do n. ot need an approval from
ne AI~SKII IJep~lrml~nt o1' Naturll Ke~ourc~s (DNK). Continue to the next section.
Iff.. yo.u answered YI~$ to ANY questfom in this section, c~atnct DNR to identify and
ootmn necessary application form~
Based on your discussion with DIOR, please list (below) the approval type needed and date submitted.
A4~prov.m Type Dau~ Submi.,.a (m- intmd to ,u{xnh)
Y~ No
~b, ve you pa~d the filing fees ~quL.-ed for t~e DNR permits?
· ~ you are not applying for DNR petmks, Lndkate reason below:
~ a. (DNR contact) told me on
approvals o~ permits were required on this project.
b. Ot~.:
Ye~ No
(date) that no DN-R
DEPARTMENT OF FISH AND GAME APPROVAL,q
1..Will you be we~l~lg bi n sl~enm- tiv .et: ot lake? (This includes wodc in running w. atm' Or on I~
~ce, within the a~ive floedp~ on mantu, the face of the banks, o~ the sn'e. am tideia,~L~ down'--'
to mean low tide.)
Name of stream or rivet: Name of lake:
Will you be doing any of the following:
b) Ustng the water? []
¢) Diver~ng or altering the n~tntl Channel s~nm? []
d) nlock~n{ o~ dammin{ tl~.stt~,-= (~trily e~ permanently)? []
e) C~n~tn{ the wa~ flow e~ the water channel? . []
0 Pumplng water out of the sn~.am e~ lake? []
g) Inu'oducin.g silt, InveL rock, peuuleum'ptoducts, debris, chemicals ar wastes
any type into fie wam~
n) Constructing a web.
o) Other in-su~m structure not mentioned above?
2. Is your project located in a designated State Game Refuge, Critical Habitat Area, or State Game
Sanctuary?
3. Does your l~'Ojeet include the construction and operation of a salmon hatchery?
4. Docs your project affect or is it related to a previously l~'mitted salmon hatchery?
5. Does your project include the construction of a shellfish or sea vegetabl~ farm?
If you answered NO to ifil questions in this section, you do n~ m~,i o,, o......,., ~..~-.
the Alask~ Department of Fish ~nd Gatoe (DFG). (~onlinue to the next section.
Ii* you answered YES to any of the questions under I or 2, contact the Regional DFG
Habitat Division Office for fnformatlon and application form~
If you answered YES to qu.estions 3, 4 or $, contact the DFG Private Nonprofit Hatchery
Office at the F.ILE.D. divi~ton headquarter~ for information ~nd appllczflml form~
Based on your discussion wi~h DF, G, plcas~ list (below) the approval type needed and date submitted.
.s~,,~at T.~ I~ Sul~ni~l (mr tn~nd m sxd~ait)
Y~s No
Ye~ No
It' you are not applying for permits, indicate mason below:
----- a., 03Fa contact) told me on
approvals or permits wen required on this project.
b. Other:.
.D, EPARTMENT OF ENVIRONMENTAL CONSERVATION API~OVALR
(date) that no DFG
1. Will a ~sc?rge of wastewater ~ industrial et commercial operations eccu~
(See #2. m Federal Approvals" section) .
2. Do you intend to consu'u~ or modi~ any pan of a wastewater (sewage or ~z~yw~ter)
disposal system?
3. ff yes, will me discharge be 500 glxl or greater?
4. Do you expect to request, a mixing zone fo~ your proposed project?
ff so, ptea~ cemact 1~ to discuss tn~ ~quired un(ret 18 AAC 70.032.
· _ . pmje? ~.mlt.in d~i~.l~ ~.distx~..of fill '.m wetlands
tn wat~,ways't {~.o~e,. your appucauon ~or this ncUvity to the Cz~rps of Ensineers will also
serve as your appucatton to
6. W~..ill y?.ur .project ~sult '.m ~e d~. v. elo.p..m~nt of..a cun~nfly unp~mittcd facility for the
msposai O! oon~sllc or moustnai solio waste!
7. W'fll your project require the application of oil or pesticides to the surface of the land?
8. Will yo~ project gene
· ak emissions ~ the following:
. a) Diesel ~nerators totn!!ng mom than 10,000 bp?
b) Otis' fo~l fuel-ff~d decn'i¢ generator, fiamace, or boiler totaling grea~r
~ 10,000 bp, ~ 9,000 kwh, or 100,000,000 bm/hr?
c) A~halt plant?. . ·
d) ~'lch~efatof btl~ ~ thnn 1000 lbs, ~
9. Will you be altm'inff a public wa~' system?
approval from the Ahska Uepartmen rmumntai Cons~vaflon (DEC). Pl~se
eonrbme to the next section.
If yo~ answered YES to any ~f these questions (see ~ Note), ~ntnc~ the DEC Re#onal
Offi~ fo~ inform~on and application forms.
If you ~ t~ ~!ying for permlu, indlc~e ~ below:
· '~ '~" I~ 011' ' (
---= n. ~ ' (DEC co~tnct) told
..~.approvals (~ permits we~ requi~d on ~it pmje~. .; ...... "~ ,,'"-
(d~m) ~ no DEC
To complet~ your pa~tet., please attac.h your stat~ permit nppUeatloua and eopie~ of
yoor federal permit applications to this qut~tionubz
Tom Fink,
Mayor
June 9,
lvlurticipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
1989
Leroy C. Reid, Jr., PhD, P.E., DEE
Alaska Environmental Control Services,
1412 West 33rd Avenue
Anchorage, Alaska 99503
I~IC .
Re: Proposal For Installation Of A Peat Mound Drainfield On Lot
17 Block 4 Paradise Valley Subdivision
This office is supportive of your proposal to install a peat
mound drainfield for septic tan][ effluent as an alternative in
lieu of a holding tank. Hopefully, the peat systems may one day
demonstrate through performance that they should be elevated to
the status of an approved standard system.
We understood your letter of May 31 to say that your clients
were willing to incur the costs of installing this alternative
system, even at the risk of having to convert it to a holding
tank at a later date. It was not clear to us as to your
expectations regarding performance testing of the peat system.
While an approved testing program will be necessary, we do not
have resources available to participate in the testing or costs
thereof.
After reviewing the peat mound design submitted with your
letter, our impression is that a permit for the discharge of the
effluent from the peat mound through course sand, then through
insitu peat into ground water, will be required from the Alaska
Department of Environmental Conservation prior to our office
issuing a permit for construction.
We request that you strike the last sentence in the draft
agreement that was included with your letter and replace it with
the following: "It is also understood that we will provide for
the costs associated to test and evaluate the system to the
Municipality's satisfaction."
If you have any questions regarding the above please contact
this office at 343-4065.
Sincerely,
, P E., Man 9er ion
Envi ro~meint a ~vis
cc: John Smith, P.E.,Program Manager, On-Site Services
ALASKA
FIUIROI'ImeI'ITAL COFITROL
~nqin¢¢rin~I ~, (~nui~onmcnlal Studies
S RUIC S, II1C.
MUNICI?AHI'Y O~ ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
JUN 2 1989
,:., J. 989
RECEIVED
MuniczJ, pality a'l~ AnchcJrage
Depar"l".ment o'f Heal'Eh & Human
825 L S'Ereet
Ancl"tarage, AK 99501
ATTN: I...ee Brawr'lil'lg~ F'E
Manager c)'t: IZnvirc~r~mental Services
Here is alett, er I had ~r±t'~'.en to Jol'~r'~ SmJ.'l.:l'~, I Ul"lderstand
J'le cqi:L:L be c]i] vac:&'t'[:i(:Jl'l
kl'~C:)wledg~able abOUt the pBa'~ sys'LselllS~ t,JC)L.ild you p:Lease
rev:Lew the ].e'[:'~zer arid
glad ~c:) drop by and di~uss
TI"IE~I]R you roi'" yc:JLIr" ass:Lstanc:e ·
,'~j,I'IE:~F"(5~:j.y yCJL,Irs ~,
I..e~roy C. Re.i.d,
F'IID~, F'E, DE!:E
P i" e ~i ~ J. cd (~.] r 'l t
L.(] f'~ / !r~. r'
1412 W6,~ 33I~b ~vellue · AnchoRAGe, AlAskA 99503 · (907) 279-5553
ALASKA e IUIROnmEI1TAL CO[1TROL
S I UICI S, II'lC.
Municipality et' Anchorage
Depart':ment o'f Health & Fluman Serv:i. ces
825 L Street
Anchc)rage, AK 99501
ATTN: John Smith, I:'rogram Manager"
On-s:i. te Services
RE: I...ot 17, Block 4, F'aradise Valley
Dear" Mr. Smith:
Or'l Aucjust 9, 1988, I per'rearmed an ir~spectier~ of the lcrb arid
sewer systenl fer the U.S. Depar"t:ment e'f HeLisirig ar'id Urban
Development (HLH}). 'Fhe en-.-site system~ as instal:Led, d:i.d
no'E meet 'Lhe MOA requiremente. 14UD elected t.c~ sell the
At'bathed is tile background data erl this lot ar'id sewer"
system. The attached repor't recemmends this s:i. te as a
possible place 9er a peat bed, the design of which makes use
o'f the resulLs e'f tl"le research project. Tl'le design is
a t t. ac bed ,,
This let appears 'L:o be a prime candidat, e 'for a peat system.
"l'l"le 'frent of the lot is fill mater:Lal ever the i]a'tlJ, v(~ soils.
There :i.s 3+ 'feet: c)'f peat ever ~,~hic:l'~ the sandt;ill for' the
system would be placed. 'The water level was a't: 8 feet beh;)~J
gl"c:H.tl]d sLtrface avb the pea'~-silt inter'face.
The owners of the :.or-, Mark and Zoelea Johnsorl, are wfi. lling
· t_c3 pay for the design arid insta].latic}n ef the more ac;Ivan(ed
sysstem. "l"h(:.~ a]l. sc~ ur'ld~er'star]d that i'f this system
pr-c:H]erly 'func'b:i.c~n a~nd can't be repaired or rel:)].aced that
Ehey will install a hob:ling tank at tl'~eil" exl:)e~'H~e.
general, the design mcldi'fil::a'~iens over t. he .Bird (:;reel..: al-id
bbit Creek ,.'~ys~tems are as 'fc:)llows:
Coarse sar'id lay(~:r is used te breal:: the capillar'y
a'Ltr"actier~ of 'Lhe 13ea'L-'"soil irrt:er"fac:e.
'['he bed ].oading fi.s higher. (:]anadiar~ resear"ch
il"ldic:ates that if 1c~lfl:i.l'~gI iS teo low the~ the peat
dl-'J.(es~:, E:hallnels develop and bacter'ia passes ilvL~
the e'f'f].uent. Our" loadZng factor is 1.',¢~ gl:)dps'f
which J.s equiva].ent te 100 sq 'f'L/bedr"eom.
:3.
"l-I'le d:Lstr'ibutier'l pipes are closer spaced en ~i] fooT:
centers tc:l §ive a mere uni'fer"m loadir'lg of ¢.~ewage.
It is a gravi't:y f].ew system ±ns't:ead crf a li'f'l:
s t.a t. i en.
· 1412 West 331~b Avel]u6 · AncilOl~Zq6, AlASka 9950~ s (907) 279-555S
"rl"le lc)ca'L'ior'~ of 'C'he monitoring wells are shmwn
'~hl.:) dra~Jil'lg. These ~elZs ~.].]. be Ltsed '[o (]olle(:'~
da'tla c)n 'L~he '~lc)w of the wa~er' '~l"lrc)ugh the peat
sc)i I.
I have attached a cmpy of the pre)posed agreement with '[he
J(?)hnsons. Does J.t meet with your approval?
Please ],et me I.:;r'lc)w which rou'~e the MOA wou].d like to
At that time I w;Lll submit the prc~per papers for either the
permit fmr a peat. system ()r a ho].ding tar]l<, ir'l the interim,
I would recommend that the existing 1000 ga].lon '~iank be
sealed and used as a holding tank until final design
approva].s are c(~]mpleted and a permit is issued.
systems, tI?e.MOA sl"lc)u'.l.d include i:.he tel. search in i~LI/MOA
I'f you have ~]l'iy qt.~, ~].D~ '.~'[ me ~::l"lO~y.
I,..CR/sr'
We, Mark and Zoelea ,]c~hnsen, unders'~and that /:he peat bed
that J.s pr(:~pesed for treating the septic tank e~'fluent fc~r
c~ur house located on Lot 17, Block 4~ F'aradise Valley, is
exper'imental. As .'L'~ is an experimental system, i~: may
work as expect, ed. In this case, the Municipality of
Anch~:~rage may require us 'L:o abandon this syet. em. ]['f that
the case, tl"lerl a holding tank will be required t.o be
install, ed at our expense. There are no warranties,
expressed (~r implied~ by either Alaska Environmen'Eal Cont. ral
Services, Inc., ~)r the Municipal:Lty of Anchorage.
:'/
.:.. ,.,
~,~,,... ... ~ , ~ , , , .. ~'~',~
· ' , '. · ,:t~~ ~. ~.. '" '.
~BUILT NO CO~NERS SET ~IS DATE
· ~e ~n~o~a~on ~e~eo~ zs ~oT ~e use o~
ex~s~~ ~ ~ s~I~c~res a~(~ Dla~ 'l h~eby ce~l~ ~t I have ~o~ed ·
ship
Of
eas~ents and lo~ lines, It is ~ot ~o be
used for positionin~ additional s~ruc- Lot 17, Ri~, % paradise Valley __
%u~es or fencelines.
~ch~uge ~co~ing ~ecinc~ ~, and ~%~
'"'%. ' . ,. men~ ~llUa~ [here~ ~ WJ~ the pro~
' · en~oa~ on ~e prenfl~c~ ~ que~on ~d ~mt th~ are no
, ' r- roadway%, ~ion line% or other vt~ibl~ e~men~ on
~ , --z, ~- . ~ Dasd at ~choragN ~ka ' [
- ,
';¥:.~..' ..,'~O...J--:.:~.¢'55;~7 ~z.'~ .'4.". ".'SEU~B ~ XSSoClATES'L~NB S~RV~I
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEET NO. OF
CALCULATED BY DATE
CHECKED BY DATE_
$CAL~
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
(ENGINEER'S SEAL)
PERFORMED FOR: ~//'P / '
LEGAL DESCRIPTION.~/'~ /-'~' ''
DATE PERFORMED:
· Township, Range, Section: ~.×/:/ ~.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Oeplh Io Waler Aller
Monitoring?
SLOPE SITE PLAN
Oate:
'-~ Y
-Cc
Reading Date Gross Net Depth to Net
Time Time Water Orep
PERCOLATION RATE __ (mmutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN __ FTAND FT
PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EEFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Tom Fink,
Mayor
Municipality of Anc orage
Department of Health and Human Services
825 "L" Street
P,O. Box 196650 Anchorage, Alaska 99519-6650
February 23, 1989
Mr. Paul O. Johnson
Chief Property Officer
H. U. D.
Anchorage Office, Region X
605 West 4th Avenue, Suite 081
Anchorage, Alaska 99501-2231
Subject:
Paradise Valley, Blk 4, Lot 17
P.I.D. 02041125
Dear Mr. Johnson:
I appreciated our telephone conversation regarding the above
property. Thank you for the subsequent clarifying letter you
sent as well.
Based on the information contained in your letter of February
21, 1989, this department will nullify our previous enforce-
ment letter. We will require no action on the part of your
office.
Again, thanks for your cooperation .
Sincerely,
Susan Oswalt
On-Site Services
/SO147
U.S, Departnmnt u, Housing and Urban Development
Anchorage Office, Region X
Housing Division t ,],.i~
Property Disposition Branch I(t'4
605 West 4th Ave., Suite 081
Anchorage, AK 99501-2231
~un±eipality of Anchorage
Attention: Ms. Susan Oswalt
P. O. Box 196650
Anchorage, Alaska 99519-6650
SUBJECT: 111-031427-203, 6511 Italy Circle
Dear Ms. Oswalt:
This letter will confimn our telephone conversation wherein we
explained to you the U. S. Department of Housing and Urban Development's
marketing of the subject property.
The subject property is not currently occupied, nor will it be
occupied at any time HUD has title. Further, it is completely
winterized, and all water pipes have been drained, and no water is hooked
up. This wil] ensure absolutely no usage of the septic system.
The Area Management Broker for the subject property has been
requested to put a copy of the engineering report in the house, so any
prospective purchaser will be immediately aware of the septic problem.
Further, any inquiries that come to our office from real estate agents or
other interested purchasers have been answered with the explanation of
the septic problems. Let me assure you HUD is taking every precaution to
ensure any interested purchaser is made aware of the problems.
If you have questions, or need further information, please contact
Vivian Gayton, of my staff, at 271-2792.
cc: Associated Brokers
Sincerely,
ief Property Officer
MUNICIPALITY OF ANCHOP, AGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
FEB 9:3 1989
RECEIVED
Tom Fink,
Mayor
Municipality of An,
Department of Health and Huma
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 9
February 9, 1989
Secretary of H. U. D.
701 C Street
Box 64
Anchorage, Alaska 99513
Subject: Lot 17~ Blk 4, Paradise Valley
Parcel I. D. 02041125
Gentlemen:
P 126 633 152~,
RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
(See Reverse)
~ Se to
§tecretary of H.U.D.
~tr$~ndN~ Street Box 64
~.0., State and ZIP Code
~ Anchoraqe, Alaska 995.3
~ Postage l,$
,~ Certified Fee
Special Delivery Fee
RestNcted Delivery Fee
Return Receipt Showing
to whom and Date Delivered
~ Date, and Address ol Delivery
u."~ TOTALPostageandFees
~ Postmark or Date
kS 2-9-89 Sent
Several months ago this office notified you of a violation on
the above lot. At that time a ditch had been cut through the
sewer system, exposing gravel, insulation and sewage. The ditch
drainage then flowed to the street ditch on Italy Circle.
Subsequently, we worked with Leroy Reid of Alaska Environmental
Control Services as he verified discrepancies in the original
installation. Dr. Reid was also able to determine that the only
possible solution to the problem was the installation of a
holding tank.
At the time of the first certified notification to H. U. D., I
was contacted by Ed Tolley and assured that the system would be
brought into compliance in a timely fashion. It appears that
this is not the case.
This lot is now being offered for sale by H. U. D. on an "As is,
cash only" basis, and has been advertised in at least one local
paper. I have personally spoken with one individual who was
interested in purchase of the home, and he was unaware of the
problems with the sewer system.
Secretary of H. U. D.
Page 2
You are again notified of a violation of AMC 15.65.020A, B, and
C, which pertains to the proper disposal of sewage. You are
further ordered to bring this system into full compliance within
fourteen (14) days of this date. You will need to have an
Alaskan registered civil engineer prepare a site plan and submit
an application for a permit prior to the installation. Failure
to comply with this order will result in legal action against
H. U. D. or any person who allows or permits this violation to
continue. This department will also take legal action against
any person who utilizes this sewer system prior to system
corrections.
If you have any questions about this notice, please contact me
at 343-4744 or 343-4718.
Sincerely,
Susan Oswalt
On-Site Services
/126
DOMESTIC RETURN RECEIPT
ALASKA erlUiROrlmerlTAL COI TROL SeRUlCeS, II'lC.
J~nclincerir~i ~, J~nuironm~ntaJ StucJies
August 9, 1988
Mr, Ed Tolley
Marston Property Management
4105 Turnagain Blvd.
Anchorage, AK. 99503
RE: Paradise Valley Snbdivisi~i Block 4, Lot 17
Dear Ed: ........
On August 8, 1988, Jn the presence of Monte Acheson, we exposed the sewer system
for this lot. The asbu!lt showed it to be e bed. What we found was e bed that
was approximately ~he dimensions shown on the attached drawing: ~5 feet on the
south line, 28 on the east, 17 on the north, and approximately 80-31 feet on the
west sewer line. The system is located about 5 feet from the lot line, At the
southwest corner of tile system there was maybe a foot to 18 inches of dirt and
then insulation, and then the pipe, with total rock under the pipe maybe 3-4
inches et the maximum. There was approximately 6 inches of sand under the rock.
The snnd was a blue grey, very fine and co~]tained septage. Underneath that was
a mottled wet silt for 2 feet. In the 80-81 foot length of the system it
dropped appro×imate]y one foot. It appears that pert of the system was in fill,
and ms the fill settled the entire sewer system settled. Oil the northeast corner
of the system, there was the insulation and then maybe an inch of rock and then
maybe an inch of rock under the pipe, S~!!{cf~.under the system in the
northeast corner was a mottled blue grey silt.
As constructed, the system did not meet the Municipality of Anchorage code. Tile
soils underneath the system would not be acceptable for on-site systems. Some
years in the past AECS had done a testhole very near where this is, and at that
time, we found that the soils would not perk. A copy of the test is attached.
We looked at the possibility of installing e system in the front yard of the
house. We dug a test hole there. From zero to 2,5 feet was a silty sandy
gravel fill. Underneath that, from 2.5 feet to ? feet was a mixture of peat and
roots. It was hard to tell if that was fill, but I believe as DY best educated
guess, this looked to be natural swampy peat type vegetation. Between 7 and 8
feet the soils were a grey and red silt, highly plastic, mottled. '
At this time, I think that a holding tank is the only reasonable thing that can
be installed on that lot. There is research being done on the use of peat
systems. Bowever, I doubt that the research has progressed far enough at this
time to be able to consider using a peat system on this lot. Bowever, in the
future if these systems are approved, this would be a prime lot to install a
peat system. The Municipality of Anchorage is looking for an additional site
for a peat system for future testing. I suspect that this would be an ideal lot
for that to be used. The peat that we saw was relatively dry, well-drained
peat, so a system should well work there. I am not sure that HUD would be
interested in taking a gamble on this.
If you have any questions, be sure to let me know.
Sincerely,
Lero~6'C. Reld, Jr., PhD, PE
President
MUNICIPALITY OF ANCHORAGE
MEMORANDUM
DATE: August 8, 1988
TO: File; Lot 17 Blk.4 Paradise Valley
FROM: D.N.Bolles. On-site Services
SUBJECT: Absorption bed installation.
On August 8, Susan Oswalt received a phone complaint from Lee
Reid, P.E., concerning the absorption bed constructed on the
subject lot. The septic system had been installed on 7/10/85 by
CHB Construction and inspected by Robert D. Schilling P.E.,
CE-1411.
At 3:20 pm I arrived on site and met with Mr. Reid. The entire
west edge and a 6' portion of the east edge of the absorption
bed had been exposed. The following are the observations made
at that time.
It was apparent that fill was placed under the south half of the
bed. This fill may exceed 4' in depth at the southern extremity
and contains sticks, roots and other organic matter. Per AMC
15.65.040 (G)3 all fill must be approved by the department,
which this was not and would not have been due to the organic
content. The bed was not level as required by AMC 15.65.065
(H). This, however, may be due to compression of organics in
the fill section. Also not all of the native organics had been
removed under the north half of the bed.
The ground water table, at the time of my visit, was 2.5' below
the bottom of the bed, in violation of AMC 15.65.020 (C)6. It
can be expected that this level will rise during the high water
cycle, September through November.
Gravel depth below the distribution pipe is less than the
minimum 6" required under AMC 15.65.075 (E). The average depth
appears to be less than 3". The gravel layer also does not
extend beyond the edge of the distribution pipe as required
under AMC 15.65.075 (F). The as-built by Mr. Schilling shows 3'
of gravel extending beyond the distribution pipe.
The apparent bed size is 15'x 28'= 420 sq.ft.; the as-built
details a 20'x26'= 520sq.ft. bed area.
This investigation has revealed that this lot cannot support
on-site wastewater disposal system. It will, therefore, be
necessary to install a holding tank as the only means of
wastewa~er disposal.
an
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
12OO. West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEET NO, OF
ALASKA enUIRO[lmeI1TAL cOnTROL SeRUICe$, II1C.
~n~in~griOCl § ~nuironmtnl~l
July 14, 1988
Ed Tolley
Marston Properties
4105 Turnagain Blvd.
Anchorage, AK. 99501
Re: Paradise Valley Subdivision, Block 4, Lot 17
6511 Italy Circle
Dear Ed:
On July 13, 1988, I visited the above mentioned lot to determine what needs to
be done, Below is the information which I have prepared.
1. The system needs to be dug up so that we can determine exactly how close
to the lot line it is. The recent survey, that you ordered, indicates that the
system may be on the lot line or slightly aver on the neighbor's lot We need
to check that. '
2. Since the system is within l0 feet to the lot line, we will have to get
a lot line waiver from the MOA,
g. The existing drainage ditch that runs through the sewer system must be
abandoned, We will need to have a grading plan for the lot, which essentially
takes all water to the east and then down the east tot line. A swale behind the
house can be built to accomplish the drainage, If you looked at the house to the
immediate west of this one, you would see what I am talking about. We jnst
finished ~ grading plan there.
4. There is water in the crawl space under the house. Because of the
location of the sewer system and the fact that a footer drain would be downslope
of the system, it would probably be illegal'. I would recommend that a small
ditch be dug around the inside of the house. The drain would come under the
footer and flow through a pipe down to an outfall near the road. This ditch
would be the one which is to the south west corner of the lot. I also recommend
that several inches of gravel be placed under the visqueen in the basement.
That would allow water that comes through the silt to travel to the collection
ditches.
5. It looks like the culvert under the driveway is over on the lot to the
east. It needs to be moved. I understand that there was a discussion between
the o~mer of lot 16, and 15 about draining water that was puddled on the corner
of lot 15, across lot 16 In the same area that we are talking about putting
drainage. It might be advantagous if all three lots cooperated on the drainage.
6. tn addition there will have to be a well flow test, an adequacy test,
and a health authority done for the lot.
If you have any questions, please let me know.
Sincerely,
Leroy C. Reid Jr., PhD, PE
President
1200 LUcs~ 33rd Aucnu¢. $ui1¢ B .Anchoroq¢. Aloska 99503.[907] 561-5040
Tom Fink,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
~1988
343-4744
Secretary of H.U.D.
701 E Street
Box 64
Anchorage, Alaska 99513
Certification Number
P 126 633 103
Return Receipt Reques~l(~
Subject: Lot 17 Block 4 Paradise Valley Subdivision
PID 020-411-25
Gentlemen:
On June 13, 1988, I investigated a complaint on Lot 18 Block 4
Paradise Valley Subdivision. While there I noticed a drainage
ditch which runs near the property line between Lot 17 and
Lot 16. This ditch drains water from a pond behind the house
to the ditch on Italy Circle. Unfortunately, the ditch has
been cut through the shallow absorption bed on your lot.
Please be advised that having raw sewage on the ground and
draining sewage into a ditch are violations of AMC 15.65.020(C) o
It will be necessary to arrange for evaluation and repair of
this sewer system prior to the time the house is re-occupied.
In addition, this office will.hot approve any Health Authority
Certificate until the system is ~n full compliahce.
I would gladly discuss this problem with a representative from
your office. You may call me at 343-4744.
PS Fo,rm 3811, July 1983 DOMEST C RE, TORN, RECEIPT
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
PHONE
NAME
~_~ CL_ ~ ~J _% 7'J~_~,~ ~7 o/,J []UPGRADE
MAILING ADDRESS
EGAL DESCRIPTION
LOCATION NO, OF BEDROOMS
Well ~ Absorption are~ / / Dwelling
DISTANCE TO:I /o~--
Manufacturer ~:~/~- ~-~'--/~. Material
L q. capacity in gallons Inside length Width
/
/Z..~-O We[IIF HOMEMADE: I ~ iling
DISTANCE TO:
Material ~
~ ] Foundation~ / Nearest lot line,~,~.~ / ·
Total length of lines
~:~o / Trench width
Material beneath tile
I _.~4~---~ ~.~¢-I~. ~ inches
DISTANCE TO: IWell /O4~,~ /
Length of each line
No. of lines ~ I ~ ·
) of tile to finish grade ~- i
DISTANCE T~'~wetl
DISTANCE TO~'~uilding foundation
Depth
Crib depth
Building foundation
Driller
Sewer line
Total effective absorption
Nearest lot line
Distance to lot llne
Septic tank
PERMIT NO. ~:~ 0_~ ~:? ~
No. of compartments
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO. ~,-~ ~
Distance between lines
Total effective absorption area
PERMIT NO.
area
OTHER
SOIL TEST RATING
NSTALLER
REMARKS
APPROVED
DATE
LEGAL
72-013 (Rev. 3~78)
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
~ ,t-~ ~. C_o *~J S, 7'J2~C4 C~-I O ~,j PHONE [~J EW
~---- ~ 7~ ~ UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOMS
IWell IAbsor~tionare; , Dwelling PERMITNO.~,O~
~ ~ DISTANCE TO: /OO ~ ~. ~ ~
~ ~ Manufacturer
~ ~ ~/~ Material No. of compartments
Liq. capacity/~oin galrons IF HOME,DE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
=_~O Z ~ Manufacturer / Material Liquid capacity in gallons
~ Well Foundation Nearest Jot line ~/ PERMITNO. ~b ~
~ DISTANCE TO: /O~.~/ ~ /
~ ND. of lines ~ Length of each line Total lengthoflines Trench width ~ Distance between lines
~ -- ~ Top of tile to finish grade ~ I Material beneath tile Total effective absorption area
~ ~ ~oc~ ~ inches ~ ~/
~ Length Width Depth PERMIT NO.
~ Type of crib C~ Crib depth Total effective absorption area
~ DISTANCE ~ Well Building foundation Nearest lot line
~ Class Dep~ Driller Distance to lot line PERMIT NO.
~ DISTANCE TO/ ~lding foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS 4~, GoW~ ~ ~ ~S~ ~3~
~1~ ~ /- ~ .... P' ~ ~/'7' :~' ~'~
APPROVED ~ ~ ~,~ ~"~-~ ' DATE LEGAL
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
ESIN EW
G /-f /3 �'US7-J2 Ue- j /0 Q
34.>-�u7c`,'3
❑UPGRADE
MAILING ADDRESS
C/o 3('vs
LEGAL DESCRIPTION O
L o+ 1-7 131 v c.K 4 P-,t_r4_L, 5 e 0'r—k-9
LOCATION
NO. OF BEDROOM
r" V)
7_
DISTANCE TO:
Well
/vv ,
Absorption area
,
Dwelling
r
PERMIT NO.
v Y
o�
3/
63!5 o3 &9
F- z
a Q
wF
Manufacturer
Material
STrZ L
No. of compartments
Z
Cn
Liq. capacity in gallons
Z S0
Inside length
IF HOMEMADE:
Width
Liquid depth
z
DISTANCE TO:
Well Dwelling
PERMIT NO.
2 z F
Manufacturer
Material
Liquid capacity in gallons
w =
DISTANCE TO:
Well
/�� r
Foundation
1 -7
Nearest lot line ,
PERMIT NO.
cs s p -S 3 tf
J u. Z
Z
No. of lines
3
Length of each line
Total length of lines
Trench width
Distance between lines r
LU
zio
l o v e
/ 6' .iRahes-
5
ccI-
Top of tile to finish grade
Material beneath the
Total
�
4
S ewtr Y'vci(� G inches
effective absorption area
,� / v o �
Length
Width
Depth
PERMIT NO.
w
C7
Q F-
w°
Type of crib
Crib diameter
Crib depth
Total effective absorption area
LU
Cn
DISTANCE TO:
Wel
Building foundation
Nearest lot line
Class
Depth
_Driller
Distance to lot line
PERMIT NO.
J
W
�
DISTANCE TO:
Buil . oundation
Sewer line
Septic tank
Absorption area(s)
OTHER
7e, /
PIPE MATERIALS
F7
4 ^
0
SOIL TEST RATING
1 7v Q` /P>/2
o a
INSTALLER
41 tr 1 G
REMARKS
1
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5P• 1 l e
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moi+ G •� O °°'? �� �'r
17�1
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APPROVED DATE LEGAL
i.
72-0i3 imev.308)
Date Drilled~ 8-10-85
Static Water Level 18 feet
Draw Down N/A feet
WELL LOG
Lot Blk. 4
Paradise Valley
Gallons Per Minute
Total Feet of Casing
64
Type Material Drilled~
0 feet to
54 feet to
64 feet to
to
to
to
54 Grey Clay
64 Brw, Clay
149 B~drock w/water
Hefty Drilling
S.R.A. Box 1553 K
Anchorage,Alaska
99507
MuNiCipALiTY O~ ANCHORAGE
D~PT. OF H~ALTH &
[NViRObIM~NTAL pROI'ECTION
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I< SOILS LOG
MUNICIPALITY OF ANCHORAGE
• afe DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
825 L. Street, Anchorage, Alaska 99501 264-4720 TEST
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: Cf773 Capt/ 577�t �L7-i u.�J DATE PERFORMED: %—
LEGAL DESCRIPTION: -,-oj /%, i3L-K
P SLOPE SITE PLAN
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ENCOUNTERED? �C s L
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IF YES, AT WHAT / E
DEPTH?
CCCCC
Date
Gross
Time
Net
Time
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Water
Net
Drop
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Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
/
L,
! z
3 v
Z
4
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PERCOLATION RATE 3/k/2 / 2• 5— (minutes/inch)
TEST RUN BETWEEN 4- FT AND FT
COMMENTS 5o1L5 12-A-Ttr—D i4T /70 ��3/Z — /f��/� G�o�cn�lDc✓7�Tc:%2 !./cL /2=4�k1�r=
'UKAJ04;/-) /ick
PERFORMED BY: /2 57,71(, CERTIFIED BY:_j�%.�, ._�tJy DATE:
72-008 (6/79)
X SOILS LOG
MUNICIPALITY OF ANCHORAGE,
• �.e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Sk PERCOLATION
825 L. Street, Anchorage, Alaska 99501 264-4720 TEST
SOILS LOG — PERCOLATION TEST 72F-57' //-�«: ti = Z
PERFORMED FOR: H7 t 3 /iJS ecC/ ueJ DATE PERFORMED:
LEGAL DESCRIPTION: Lvj /7. /�L� ¢ p/I-7� Q/S�= v LLL- SL,QD
SLOPE SITE PLAN
A I) K )3 I vu /D 7-
2
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5
5
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8-
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10-
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WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
S
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Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
r�
7-
t 2,�/M,
O
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TEST RUN BETWEEN 4 FT AND FT
COMMENTS 3 u 1 L 5 H -r
PERFORMED BY: /� 5 .7�in_" CERTIFIED BY: 2Z��, DATE: -7-%-'C9�
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•11 c Municipality of Anchor.�� eAPR 0 62018 V,,6",,. tic.:,.._
,,
On-Site Water and Wastewater Progra .
(907) 343-7904 w fS A
S A CTY
Ali O 9Ch
CERTIFICATE OF ON-SITE SYSTEMS AP' = 3\7
Parcel I.D. 020.411-25 Expiration Date: 7-/ 3 - 1I?
1. GENERAL INFORMATION
Complete legal description PARADISE VALLEY BLOCK 4, LOT 17
Location (site address) 6511 ITALY CIRCLE,ANCHORAGE,AK 99516
Current Property owner(s) JOHN PAUL STOKKE Day phone
Mailing address 6511 ITALY CIRCLE,ANCHORAGE,AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 2
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual ❑
Individual Well ® Holding Tank El
Individual Water Storage ❑ Community ❑
Community Class_Well ❑ Public Sewer ❑
Public Water System ❑
WaiverNariance request for: Distance:
Received by: , i a� Date: 7/I7/1
COSA to be released to the engineer,unless otherwfill?ste
Ad by the engineer.
COSA Fee $ 5?c, Waiver Fee $
Date of Payment '-i i—it Date of Payment
Receipt Number b3.--)`j.;b Receipt Number
COSA# Cl-JC 1,811.900 Waiver#
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,
based on procedures outlined in the Certificate of On-Site Systems 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. 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(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ARCTERRA CONSULTING,INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 4/5/2018
THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineers Comments: This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested.
The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface,changes inland use,
local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the
system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function
satisfactory for current or future occupants or can ArcTerra guarantee that no unseen
encroachments,deficiencies or discrepancies exist. , OF AL
•
6. DSD SIGNATURE
9111 ''`
�/ �_-�
/`' System #1 Approved for bedrooms. I - Aram
System #2 Approved for bedrooms. , "fry 7L: ;� /
Ay
Disapproved. \ ''t•FF•ss o0'
Conditional approval for bedrooms, with the following stipulations:
SRP\5\ OF,q
ON-SITED,
WATER AND s'
WASTEWATER o
.
PROGRAM ,
pc,
/T S.-R\I1C�.
t=-‘; Original Certificate Date: 1--/ 13 `
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10.10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of_
Structure served by this system ,
Certificate of On-Site Systems Approval Checklist
Legal Description: PARADISE VALLEY BLOCK 4, LOT 17 Parcel ID: 020-411-25
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID#_ Well Log (Y/N)Y
Date completed 8/10/1985 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y
Total depth 149 ft. Cased to 64 ft. Casing height(above ground) 24 in.
FROM WELL LOG AT INSPECTION
Date of test 8/10/1985 3.28-2018
Static water level 18 ft. 24 ft.
Well production 0.5 g.p.m. 1.08 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 5.95 mg/L
Arsenic: ND ug/L Date of sample: 3/28/18 Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material HOLDING TANK 1 STEEL Date installed 11/13/1989
Tank size 3500 gal. Number of Compartments 1 Cleanouts(Y/N)Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) Y
Date of pumping 2/25/2018 Pumper A+HOME SERVICES
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type
Length ft. Width ft. Gravel below pipe ft.
Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field
Date of adequacy test Results(Pass/Fail) For bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access(Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 85'
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway,parking/vehicle storage 10'+
Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+
F. COMMENTS
Steel holding tank is 29 years of age.
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date. OF AZ.4 \
Ar Engineer's Printed Name KENNETH M.DUFFUS / �� �1-'
Date 4/5/2018 * 49TH
COSA canary sheet_2-6-15.doc ` KENNETH M.
%
°F'F,s'iOT+w
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 141 907-343-7904
On-Site Water and Wastewater Section \ Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC181136
Subdivision: Paradise, Block: 4, Lot: 17
A water sample revealed a nitrate concentration of 5.95 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.0. Box 196650* Anchorage,Alaska 99519-6650 *www.muni.org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen,which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids,and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mailing Address: P.0.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org
MUNICfPALITY 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. # 4~.O ~'// - "8-,5~ HAA# ,Li/-~(
1. GENERAL INFORMATION
Completelegaldescription /.-of IT, C foc ~' '~, P~z ~'~fcX,.~ ~ L/,~ / I ¢~.
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
~ '~'~ ¢"~ ~'~/¢~/~ Day phone
V
/~¢ ~ /~¢~¢~ Day phone
~ / -
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
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
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seaJ 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. ] further verify that based on the information obtained from
the Municipality of Anchorage flies and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all ivlunicipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Engineer's signature
Phone
Date
DHHS SIGNATURE
Approved for ~
__. Disapproved.
Conditional approval for
Note:
bedrooms.
bedrooms, with the following stipulations:
The well for this property meets existing State and Municipal Codes.
There are nitrates present. It is suggested that periodic testing be
performed to insure the wells continued suitability. Current nitrate
concentration is 5.6 mg/1. EPA maximum concentration is 10.0 mg/1.
DHHS, 343-4744.
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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 engineeCs work.
RECEIVED
Municipality of Anchorage APR 18 2000
DEPARTMENT OF HEALTH & HUMAN SERVI~^m.
Environmental Services Division 'vIP~'klMENI'AL SERVK'F
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Legal Description:
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Health Authority Approval Checklist
IfA, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to ~' 5"
FROM WELL LOG
Date of test
Static water level I b' '
Well production
WATER SAMPLE RESULTS:
Coliform 0 c¢,(~n~_.r
Date of sample:
B. SEPTI~ANK DATA
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
'~./'
o. 5- g.p.m, ~, I
g.p.m.
Nitrate ~, ~d' ,m~/'.,~' Other bacteria /,/o,~¢_ ~"~/~,--~f
Collected by: /~/~'.~/=,,,~ ~"'¢/~ -c'~'c
Date installed II /
Foundation cleanout (Y/N)
Date of Pumping
ABSORPTION FIELD DATA
Date installed
Length _~Width
Effective absorption area
Date of adequacy test
Fluid depth in absorption field before test (in,);
Depression (Y/N)
Tank size ,~$~o0~ / Number of Compartments ) Cleanouts (Y/N) ¥'
~ High water alarm (Y/N) Y'
System type
Total depth
__ Depression over field (Y/N) __
For
gal. water added (in.):
bedrooms
Fluid depth (ins) Min'utes later:
Peroxide treatment (past 12 months) (Y/N)
72-026 (Rev. 3/96)*
Absorption rate =
If yes, give date
g.p,d.
Pumper ~,~,~ ~.~
Soil rating (g.p.d./ft~ or ft~/bdrm)
Gravel thickness below pipe
Monitoring Tube present (Y/N)
Results (Pass/Fail)
Immediately after
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
HAA# ~\ ¢~/c'tC~-('%, q ~t,.~
1. GENERAL INFORMATION
Complete legal description
Lot 17: Block 4; Paradise Valley Subdivision
Location (site address or directions) 651] Th~ly ¢.ir'cle, Anchorage, Alaska
Property owner
Mailing address
Ma~ureen Raleiqh Day phone 272-2025
6511 Italy Circle, Anchorage, Alaska 99516
Lending agency
Mailing address
Day phone
Agent Day phone
Address
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Unless otherwise requested, HAA will be held for pickup.
NOTE:
Individual well
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
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.
Name of Firm s & s ~,~.iGIN~ERING
'J7034 ~.agie E~vur L~ ,~.C:~ ~.~C. 204 Phone
Address Eagla River, Abska 99577
Engineer's signature
Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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.
(~ Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDescription: ~/~?JADI~ V~I..C~/Z./JZ/"~.,,I././~,]5. c.I Parcell,D, /~
A. WELL DATA
Well type
Log present (~N)
Total depth
Sanitary seal (~N)
If A, B, or C, attach ADEC letter.
Date completed
Casedto ~L./' ~-
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/~'lding tank on lot, 8~''y_
Absorption field on lot
Public sewer main
Sewer service line
ADEC water system number
8-/O-(~S Driller /J~'~---Ty
Casing height ~/~'~
Wires properly protected CN)
g.p.m.
; On adjacent lots /f~O''~
; On adjacent lots /¢~)
Public sewer manhole/cleanout A~'/,~
Petroleum tank ,//?0,tu~ /~'UOCJ/v/
WATER SAMPLE RESULTS:
Coliform (~ Nitrate
Date of sample: /O [t(:,/?2.
Collected by:
Other bacteria ('~
B. SEPTIC/HOLDING TANKDATA
Date installed
Cleanouts ~N)
water alarm ~N)
High
Date of pumping
Tank size ~)O OPt'f-- Compartments
Foundation cleanout (:~,7,N) ~'/~5~ i:::>~k Depression
Alarm tested ~N) ~%?EO
/0/~0/¢~ Pumper ~& ~/~
SEPARATION DISTANCES FROMa. E~T~, ,~/HOLDING TANK TO:
Well(s) on lot ~;~ I'F
To property line ~O ~4'
Surface water/drainage
On adjacent lots l00f~' Foundation ¢:~O /+
Absorption field AJ/,gr Water main/service line .'~ 0 t./
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
D~e~f/~- Manufacturer
Size in gallons ~ Manhole/Access (Y/N)
Vent (Y/N) "P~ at "Pump off" level at
High water alarm level~ Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots . Surface water -'"---.
D. ABSORPTION FIELD DATA
Soil rating System type
Width Gravel thickness Total depth
Total absorption area ~-~'~........~ Cleanouts present (Y/N)
Depression over field (Y/N) Date of adequacy test
Results (pass/fail) ~ bedrooms
Peroxide treatment (past 12 months) (Y/N) Ifye~
SEPARATION ~)ISTANCE FROM ABSORPTION FIELD TO:
To existing or abandoned system on lot
On adjacent lots Cutba"~ Water main/service line
Surface water D riv~e
Curtain drain
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature
$ & $ ENGINEERING
Engineer's Name
Date
ROGER J.
No. 821!
HAA Fee $ /
Date of Payment \
Receipt Number '~\\
72-026 (Rev. 3/91 ) Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99516 TELEPHONE (907) 562-2343
ANALYSIS RESULTS for INVOICE ~ 59746
Chemlab Ref.# 92,5814 Rample ~ 3 Matrix:
FAX: (907) 561-5301
WATER
Client Sample ID
PWSID
Collected
Received
Pr@served with
L17 B4 PARADISE VALLEY S/D
UA
OCT 16 92 @ 15:35
OCT 16 92 @ 16:40 hrs.
AS REQUIRED
Client Name :S ~ S ENGINEERING
Client Acer :SDSENGP
BPO# :
Req# :
Ordered By :R. SHAEER
PO# :NONE RECEIVED
Analysis Completed : OCT 19 92
Laboratory Super~E~llED C. EDE
Released By : ~~~
Send Reports to:
I)S ~ S ENGINEERING
n)
Parameter Results Units Method Allowable Llmite
NITRATE-N 3,0 mg/1 EPA 353.2/300.0 LO
Sample ROUTINE SAMPLE COLLECTED BY: J.W.
1 Te~ts Performed See Special Instructions Above UA-Unavailable
ND- None Detected "See Sample Remark~ Above
NA~ Not Analyzed LT-Less Than, GT-Greater Than
~SSS Member of the SGS Group (Soci~t~ GOn~rale de Surveillance)
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D, #.
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include 10t, block, subdivision, section, township, range)
Location (address or d ~ections~ . E?
(b) Property ~¢ner .~ ~¢~. ,d ¢/.¢2~ Telephone: (home)
.. :,. -;,'¢
(c) Lending Institutibn ' .
Telephone
Business
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(e)
Mail the HAA to the following address: (or check here..~, if hold for pick up,)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single-Family,,~ Number of bedrooms
3. WATER SUPPLY
Individual Well,l~' Community [] Public []
Note: If community well system, must have written confirmation from the S!ate Department of Environmental
Conservation attesting to th legality ~nd status.'
4. SEWAGE DISPOSAL
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. 7/88) Page 1 of 2
· ~oi~eB~d
' '~/6~ O'OT sT uoT~z~u~uoa
p~nuT~UOO S,lT~ eq~ ~xnSUT o~ p~mzo~d ~q 6UT~Sa~toTpOT~d
p~gs~BBns sT ~I 'guasa~d sag~%Tu a~ a~aq& 'sapo~ T~dTbTunw pup.
· a~S 6uT~sTxa s~aam X~ado~d STq~ ~o~ II~ aqA :a~ON
le^o]ddvleuo!%!pu00~os~l
leuo!l!puoo
'~Jot~
suo!ss!u~o ~o sJo~4e JO; elq!suodseJ ~ou s! e6,Joqouv ;o X~,!l~d!o!u nw eH.L 'penss! s! m,~o!j!14eo e @Jo;eq ~lep ezXl~ue Jo
suoRoedsu! lonpuoo iou op SHHQ ~o seaXoIdLu~ 'sluauJe~!nbe] ale,s pue I~ep@~ u!e]JeO X~s!~.s o~, Jep~o u! suo!]mRsu!
6u!puel ~!eq~ pu~ seuJoq ~o sj@s~qoJnd o~ ,~selJno9 ~ si] S!LI~ seop SHHQ eH.I. 'e)lselV ~o
j@eu!bue ii]uo!ssejoJd ~uepuedepu! ue/,q e^oq~ ~ qdeJ6eJed u! ue^!5 suo!l~uaseJde~
le^oJdd¥ Al!Joq],n¥ q~l~eH senss! ($HHQ) sao!^JeS u~uJnH pue q~leeH jo ~u@uJ],J~dec] ebeJoqou¥ jo X~!l~d!o!unpI @q.L
,., leUOR!puoo
(~ MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA)
IpALITY OF~E'~)K'~[-q~T - FEBRUARY 1984
ENVIRONMENTAL SERVICES DIVI$1q~I3-4744
JUN 2 8 1990 Legal Description: ~,/~
~/./A) /"~.~/4 ,%//
RECEIVED
Date Completed
A. WELL DATA
Well Classification
Well Log Present ~/~)
Total Depth /~' Cased to ~' ~/'
Static Water Level ~ /
Casing Height Above Ground ,~ /
Electrical Wiring in Conduit U(4~',/N)
SEPARATION DISTANCES FROM WELL:
To Septic/H,old__~g Tartan Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by /., /~.~
Water Sample Test Results ~-'¢ ,'
../
Comments
If A, B, C, D.E.C. Approved (Y/N)
~"/,. ~,/¢¢"5~' Yield .~"~,,"¢
Depth of Grouting ~4'~,/,¢--~.~,~-~J~l.
Pump Set At
Sanitary Seal on Casing (¢~N)
Depression Around Wellhead (Y/~
To Nearest Public Sewer Cleanout/Manhole
; D.to
.w,¢-,-~/-¢,..' S~.
; On Adjoining Lots
; On Adjoining Lots
B. SEPTIC/HOLDING TANK DATA
Date Installed I//'2/,E¢/ Size
Standpipes~,f~) Air-tight Caps ~',1)
Depression over Tank (Y~))
Pumping/Maintenance Contact on File{~)
Holding Tank High-Water Alarm ~) ~"~
No. of Compartments //
_ Foundation Cleanout~'~/N)
Date Last Pumped ¢/.¢tO
; for
~ Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well '~J~ /
To Property Line ~' '¢ /
To Water Main/Service Line .~ E.F /
To Stream, Pond, Lake or Major Drainage Course ~ ?J' /
Comments_CA,)~,o (,z,.,,~¢. ¢o -).¢.t¢ /
¢' 4,' /¢/~,,., ¢~-,'¢,~.d ~ h,c
To Building Foundation
To Disposal Field AJ.//~
72-026 (Rev. 7/8§) 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)
Type of System Design
Length of Field
./
Depth of Field /
Gravel Bed Thickness ~i
Statndpipe~Present (Y/N)
Date of.L<~ist Adequacy Test
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIE/!.!.!.LD~':
To Water-Supply Well ./ To Property Line
To Building Foundation ~j~..) ~--'/ To Existing or
Abandoned
System
on
Lot -/ //~' ; On Adjoining Lots
To Water Main/Service Line ¢ To Cutback (if present)
To Stream, Pond, Lake, ~C. '~ajor Drainage
Course
To Driveway, Parkin. g/Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N! ....
Comments
Dimensions
Manhole/Access (Y/N)
"Pump O. ff~-I::~-el at
~-- Vent (Y/N)
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection.
Signed
Company Engineer's Seal
Date
MOA No.
Receipt No.
Date of Payment
Amount: $
72-026 {Rev. 7188) Back
Receipt No
Waiver Fee: $
Date of Payment
Page 2 of 2
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET · ANCHORAGE,ALASKA 99518 · TELEPHONE (907)562-2343
FEDERAL TAX I.D. #92-0040440
ANALYSIS REPORT BY MAHPLE for Work Order ~ 22579
Date Report Printed: JUN 21 90 0 13:50
Client Sample ID:Li? B4 PARADISE VALLEY
PWSID :UA
Collected JUN 19 90
Received JUN 19 90 0 16:00 h~.
Preserved with :AS REQUIRED
Client Name : A E C S
Client Acer : ANECSRP
P.O.# NONE RECEIVED
Req #
Ordered By : L. REID
Analysis Completed :JUN 20 90 Send Reports to:
Laboratory Superviso~.~TgPNgN C. ED~ I)A g C S
Spomial
Instruct:
Chemlab Re£ ~: 901954 Lab Smpl ID: 1 ~atrix: WA~ER
Allowable
Parameter Tested Result Unit~ Method Limits
NITRATE-N 5.7 mR/1 EPA 353.2 10
Sample ROUTINE SANPLE.
Remarks: SABLE COLLECTED BY L. REID.
i Tests Performed ' See Special Instructions Above UA-Unavailable
ND~ None Detected "See Sample Remarks Above
NA- Not Analyzed LT-Lees Than, GT=G~oater Than
~¢IUNICIPAI. I'rY 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 FACILFf'Y
264-4720
Application Date _
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Applicant Name ~//'~.~¢~4F/e~ Telephone; Home ,~5-~2~ Business .~¢~¢~_
(c) Applicant is (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain);
(d) Lending Institution g¢',4/'/7-,¢'~ /E, ,¢~//~' ..¢'z~',,¢ Telephone
Address_ ~;L¢~;~ ~. ;.~6 ~L ,.4!-~?, ,"~AJ~.~/. ____
(e) Real Estate Company and Agent -'~"--
Address
Telephone
(f)
Mail the I-tAA to the following address:
TYPE OF RESIDENCE
Single-FamilyJ~ Multi-Family []
Number of Bedroorns
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¢~' 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(11/84)
ENGINEERING FIRM PROVIDII,,,.~ INSPECTIONS, TESTS, FILE SEARCH, Dt~A AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that rny investigation of this Health
Authority Approval shows that tile on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated hereie. 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 Muaicipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm
Address
Date ....
Engineer's Seal
DHEP APPROVAL
Approved for -f'~'~ ~;;~:') bedrooms by ~.&~)O¢- ..... ,x/~' '~¢7~-¢'*~'--'~--~ Date
Approved /""~ ~- Disa~'~4ved ~' Con~ nal
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 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
72-025 (I 1/84)
MUNICIPALITY OF ANCHORAGE (MO/~j
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: '~"
WELL DATA
Well Classification
Well Log Present (Y/N) Y
Total Depth /~-'~ ~ Cased to
Static Water Level /~i'
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To~olding Tank on Lot
To Nearest Edge of Absorption Field on Lot
If A. B, C, D.E.C. Approved (Y/N)
Date Completed ~-/~ '~'-~' Yield
Depth of Grouting '"-'-
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Line ,""'-- To Nearest Public Sewer
Cleanout/Manhole ~ To Nearest Sewer Service Line on Lot ~
Water Sample Collected by ,~2. D. -~,,~,,44.2,~J~ ; Date /Z-_q'-,~E"
Water Sample Test Results ~ 4. 7' / $.~'.~l,c~'o/'~ ~'
Comments
OLDING TANK DATA
Date Installed '~-¢-~ ~'
Standpipes (Y/N) Y"
Depression over Tank (Y/N) AC/
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N) ~
Distances fro Sep~ic~flolding Tank:
Separation ~
Size ?~-5'c~ ~-~,,,~'. No. of Compartments ~
Foundation Cleanout (Y/N) Y
Date Last Pumped ~
; for
Temporary Holding Tank Permit (Y/N) ~
Air-tight Gaps (Y/N)
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
To Building Foundation /~¢ ' ~' z
To Disposal Field '~ ·
To Stream, Pond, Lake, or Major Drainage
Page I of 2
72-026{11/84)
Dat. In~t~ed ~
~,~. · .Lot ~ ~ ~ ~ , - ToEx~sllng~Abah~
?.:' ~.'" To Wafer Ma n/~,. / ; On Adj~ning [els ~/oe" * ' · ' ' , . ~ ~
' _ To Cutbank (if print} ~ ,:=:
:'~.- (:. To 8trO~m/PondlLake/or Maior Drainago ~ur~
1o
.:: . ~i~wa_,y Parkin=n Area, or Vehicle Storage Area ~ ' ~ - ' .,.'
· D: ' UFT STATION
: Dale Installed _.
~ze in Gallons ~
.,'. 'Pump On" Level al ~
~: High Waler Alarm Level at ~
· Te~ted Io~ __
: Electrical Code~/Y/N) __
COmment~ __
Manhole/Access (Y/N)
- "Pump elf' Level al
Venl (Y/N)
Pumping Cycles during Adequ.~cy.?~il .~eet
Check Pefm~tled Bedroom Rating Agama/HAA Request *,
'~ ""' ~'--.' ~' ..-~";--"<:,...~,.o.~,o.,~,o., ..,. ....... ·
c~ ......'~-;.. ~_--:::-~- .a,e_ ~_.~,,,- ,~ ~
....... -uA ~o. ~~_~ ,',. ~'.'
E ng,nee~'s Sea,/
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed "7-/o - ~' 5-
Width of Field ~"
Square Feet of Absorption 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 Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments -~-~-.~ ~ ~ ,
Type of System Design .~,4.0/21,~'I~'.D
Length of Field ~-&, '
Depth of Field 4L i
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) '"'---
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical 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 **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Company''~/z~/x,'~ '~t ,''~ s c~ · ''~ MOA No. ~ ~- -/~
Receipt No.
Date of Payment
Amount: $
Engineer's Seal
WELL DATA
MUNICIPALITY OF ANCHORAGE (MO~
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
MUNICIPALII¥ OF ANCHO~,AOE
DEPT. OF HEALTH
ENVIRONMENTAL pI~OTECTIOI~
oaf; 1
Legal Description:
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
Well Classification ~ ¢.lv)~r'-"~' ~- If A, B, C, D.E,C. Approved (Y/N)
Well Log Present (Y/N) ~/~ Date Completed ~"/'~'' ~ ~ Yield
Total Depth /~.~ ~ Cased to ~ ~/~ I Depth of Grouting
· Pump Set At
~. '-¢ / Sanitary Seal on Casing (Y/N)
~ Depression Around Wellhead (Y/N)
ToC?ptic~Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
~ ; On Adjoining Lots
Ioo~ ; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on
,.~, ~. ~,~.J,~ t I , ,,~ ;Date
Comments
B.
~HOLDING TANK DATA
Date Installed "7- R-,¢~'~ Size I'z-~ ~-. No. of Compartments
Standpipes (Y/N) 'T''¢ Air-tight Caps (Y/N)
Depression over Tank (Y/N) .~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N) /P/-//,//r
Separation Distances frorr~epti~Holding Tank:
To Water-Supply Well / oo
To Property Line .-%.~_ t
~ Foundation Cleanout (Y/N) /t.....,
Date Last Pumped
~ ; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Water Main/Service Line
Course
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed '7~/ o - ,~ .5'- Length of Field ~ :z~ t
Width of Field /A, / Depth of Field ~ t
Gravel Bed Thickness f t
Standpipes Present (Y/N)
Date of Last Adequacy Test
Square Feet of Absorption Area ~t
Depression over Field (Y/N) /t,ff
Results of Last Adequacy Test ~
Separation Distance from Absorption Field:
To Water-Supply Well ] ~ o '
To Building Foundation 1%' ~
Lot ~
To Water Main/Service Line .'-'---
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments ~.~.
Type of System Design
Y
To Property Line I I
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present) '~
D. LIFT STATION /~//~
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical 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 **
Page 2 of 2
72 026 (11/84)
I certify that.,.,.~__l have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Sign ed,~.~_l;~-~~ Date
Company ~,//,~ /
Date of Payment
Amount: $ ~? 0 0 Engineer's Seal