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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 !�' �¢ 4 5P• 1 l e OOOO�Jp moi+ G •� O °°'? �� �'r 17�1 .9'oOO 000DOO.G OSTA(�Gi.O OOOd4 G G v .z v Rcbdyt D.:z,Allllrq ' 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 ,J/ N g APF'L, :t: CAN'I: Al..hf,,,~,~. i, IN f (.d, I:::'HONI:~: ." GFIB COIWS I'RI E:;T ]: ON % 360',5 (4RC]:'IC I:}I,.VD AIqCHORA(:~E, /hi'::: 9950:!!; I.li:E~AI.. DI!:SCI::.:iI:::': SLJ:EID:[VI'SION~I F:'F:?RADiSL;,: VAL.LEY LO"f:~ ,:q..I.,I 1( I , I :1 "CJWNSH:rF:': 1 :I.N RANGE,,~ ...,gl 1.01' S I ZIE: 1 i! ,5 (S6!., F:'I,, I]R AL,I' ,:'~E.,..~::: c:, ) ]:. I E}{ ,ill · ],. :[ EAf¥] ~' iAC[I { ], J, CI I' W :i. 'k' Ii th E) I" {~! C1(.1 i I' E.'H~E~Iqt !ill ~' 13P OI]'""S i t 0 s¢~we r' s and we 1:1 s as s<:H'.. Forth by the Mur~:i.c:i.l::n::tl:i.ty ~' Arlchorage (MOA) and '1:.1~,~ S'La'L~ oF Alasl::a,, 2, :[ w:i, ll :i. nsta:l.l 'Ll'~.~, system in acc(:)r'darn:e wJ't..h a11 MOA codes and and :i.,~ compl:Lar~cc~:, NJ.'l;,l'l tl'l(e des:i, gn Cl':['h(~pia c)(' 'N]:L~; perm:i.t,, 3. ]: ~')J.].], adhere 't:,(:~ ali MO~ and Stat,[~ of Alasl.::a r'~.::~qu:Lr~,mer~ts t'[)p t,l'n:,t s~:et back d:i.S'LaHC;E,S t'i"(:;)l~i any e>:J.s'l'.:ing ~t~e],[[, wastel,~ater, d:i. spn~sal system Dr public s(-:~,J(.:mng() sys'LE)m c)Jl '[.J~:i.~ Dr' any adjacent ch' Fieal'by I..IF:T S'FATION ]:El ]:NDTALLIF:D I:N AN AREA COVERED BY MOA BUN..DING (1) KIN I~I.,.IE[;'I'R]:CAI., F'ERM:I:T AND INSI:::'E{CTI ON HUNT BIE OD'IAINED j (2) AS.,.BI, I]:I,TS I',101 I'JE AF:'F:'ROVED N:['THC)U'f AN ELtI::TRI[:AI., INSPECTION RIEF:'ORT; AND (3) THI:i BE D(::INE BY A I..ICI~:IqSED EL,ECTRICIAIq. DA'TE: :: [3F I ON :[ I:: A "I'IIIEIxl W ]: I,,I.. lii!] ,ECTI:? ]:CAL WE)RI< AF'F:'L :1: (:;ANt: bl"lt:" ' :t; SSI IIi:i:D BY Z 07-17 q-, JOB R_ S MOO CHILLPMG 3605 Arctic", Blvd..#.583 !SHEET NO. OF;`27, ­ 7— a Anchorage, AK 99503 CALCULATED BY DATE ASSOCIATES 349-5431 �CHECKED BY nATF �0 � {{{{���� rr��77�� EE;mo�;oO !L JOB lil�,C i0 3605...,AiC'C1C'.B].Vd...1f. 583-�SHEETNO. Z OF T CC ��/�jpa Anchorage, AK .,99503 ASSOCIATES V b"1�� 349-5431 ,CALCULATED BY �Z�S DATE- 319-5431 ATE CHECKED BY DATE 5I✓� I SCALE 7- /7 9D- SCHILLUNG 36,05 Arctic' Blvd. # 583 SHEET No. OF a, Anchorage Ak. 99503 CALCULATED BY 25 DATE 7 ASSOCIATES 349-5431 CHECKED BY DATE SCALE . ....... P 13 'Do. .... ...... . . . ......i.._...._...:...._.. 900 17000p000p oi.,o _....r.__-.__'._..__._._...__...`..._.. . ... ..... . .. . .. ............. R CE' 1411 ..._........._.;i.._._.._; . . ........... . F . ter.... ... . ...... .. . . ...... ........ ....... - . .. ......... ............. .... ....... .......... ... .. ...... ......... ........... r,ll-!+, m Pow ''041 aw. M- 01411 � �{ ��? �p _ . ,JOB Lei / 7 / 4 RArWlSE �"� GI i? � G\ ^3605.: Arctic Blvd: # 583 ISHEETNO.- ¢ OF psi Anchorage, AK99503 jcALcuLaTEo BY �1�5 DATE— CHECKED ATE ASSOCIATES ES 349-5431 CHECKED BY DATE SCALE 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 (FST) DK 13—AJ P7' / ,,z , , s r 1 V , 2 3 1 4- 5 - 6 7 J 8 9 10- 11 0 11 12 13- 14 15 16 pot ®t 17 /C 18- 19- 20 8 1920 7-" /� 5u/L 7 13 Lo &j , M u! S 7- Lb LD S A -&J D Y S 1 L T 7 6 12/+ v c L_ 01 5 % , � <: )A4 51; > / .5-1�- O/S /Z �R/#ti�=Z� 7✓ 514.7-, G2A� w�T t=-3 OF o s • e em'h °®49+ � n ++o+a0000.0000000deoocoo®� f herr D. Sch"ling a Aff A- ° CE - 1411 CCI�� CCCC CCCC WAS GROUND WATER S ENCOUNTERED? �C s L O IF YES, AT WHAT / E DEPTH? CCCCC Date Gross Time Net Time Depth to Water Net Drop CCC C C C1CCCCCCCC'C 3 v Z 4 Z " 1 l.i �.ry,. C1CCCCCCCC'C G• S v. Z / 9� �..h. 30 .i, , C,CCCCCCCC,C O. Z Lf Z -7, Z v . 'L C'CCCCCCCC1C C1C��CCCCCCIC C1C�CCC° CCCIC C___......CCC CCCCCCC�CC Reading Date Gross Time Net Time Depth to Water Net Drop / L, ! z 3 v Z 4 Z " 1 l.i �.ry,. 30.E-�.�. G• S v. Z / 9� �..h. 30 .i, , -2 . o O. Z Lf Z -7, Z v . 'L o 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 2 7-o P .5 13LjJj', �.s7 (o�) 3 4- 5 5 6- 7- 8- 9- 10- 11 7s910 11 / S kz-f 0 Y S/ L_1Y M v 1 5 / --72, JV L %�' Ci - 7- 13 2-4-- L__j 132-LuL„J 5 1Z > ) 0/1312. s 14— , C_12AY, w�T 12 1--i /3 �77z M or - I -w 13 14 OF .1 � 0000voo 16a000000coo�0000e00000eoaa. 17 eon soeao ®ml . @ Robdn D. ScAllhng G' 0 CE- 14q 8 f. 18- 19 8 ►'" �A B°0000coo 9�� 20 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? S U� S L Reading Date Gross Time Net Time Depth to Water Net Drop r� 7- t 2,�/M, O — Sti1,7i/12- 3J min J` 3 V, Z 2- 11 2-v 41 J 3 " /.'"UPI 3J u PERCOLATION RATE 4.2 x/2 = 12 � (minutes/inch) 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� 72-008 (6/79) vG)6189 /077 (\' O;;s i: - . 4)1 • • e o QP �-"I'? i •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