Press Alt + R to read the document text or Alt + P to download or print.

No preview available

The URL can be used to link to this page

Home My WebLink AboutPTARMIGAN LT 2Ptarmigan Lot 2 #067-311-03 Municipality of Anchorage Page —L_of 2� DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: o/ Z,9 PIU Number: p1036,2 35 Name. ! Wastewater System: ,,ff New ❑ Upgrade Address: SQ(J/ Llrcf.0 /.(Jr//O � ��, �",�� ABSORPTION FIELD r.3 — Phone:8 3 A 9 No. of Bedrooms n: I p - z y / c� -` ,f�ueep Trench ❑Shallow Trench ❑ Bed El Mound ❑Other LEGAL DESCRIPTION_ -- Soil Rating: o. 8 Total Depth from original grade: /,!�) GPD/Sq. Ft __— Lot. Block: _ Subdivision: / II Depth to pipe bottom from original grade. Gravel depthbeneathpipe �/° 3-0 Ft. 0 —_Ft. Township Range Section: Fill added above original grade: rt,SY• Gravel length: O Ft. —� —---- WELL: New ❑Upgrade Gravel width: 3. O Number of lines: Distance between lines. / I Ft 11/14 Ft. Classification (Private. It B.C). Tom l Depth'. Cased To. Total absorption area: Pipe material. _g -/v i %'GPI✓ATE 9-/ Ft, P/ Ft. %lra SO. Ft. Driller: Date Drilled. /0-].1-9i Sialic Water Level: Installer. CX 97-6a Date installed 3�fl, ✓t-1 WH —_ -- Yield: Pump Set at: I Casing Height Above Ground: TANK r'2 GPM I uN Ft a Ft. SEPARATION DISTANCES o/septic El Holding ❑S.T.E.P. To Septic Absorption Lia Holding Pubtic.Pnvale Manufacturer. /� —�" AN�' Capacity in gallons: From Tank Field Station Tank Sewer Lines /�/✓J� %SSU _ Well /VA A —J-__ NA ------- Material:Numbed/ �T��/ Compartments: —L--- Surfac--- ' LIFT STATION /V4 moo' Water Lot Line / O / i /� v 6 Sizam4aLIQnManufacturer — Foundation .. "Pump on" level at: "Pump oft" ,Ie9eFaL High water alarm at: Curtain, /� T Pump Make 8 Model Electrical Inspections performed by: Drain _ "— -- ------ BENCH MARK Remarks_ Location and Description- Assumed Elevation: f/ FL o eiet� ��0�44'� 'eaeOEgf" UB n_ — —_ by: E�� S Dates: 1st"B- 7 SY.nlhPn 04trivn - � =�� s, Inspections performed w.As eoun n+n nuu.....uu.gv.::a s Y) Y 2nd /v'/$—�_ U` �"t. Louis A. ;ader� ea - 'tf�°'tie CL:' .e r Department of Health and Human Services approvalff`,'•&. -6736 gGO.PIr114NL•. by: Date: /z ZzZ W Reviewed and approved 72-013 (neo 9/91) MOA 25 Perth t No. SW970120 Page 2 OF 2_ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650• Anchorage, Alaska 99519-6650 •Telephone: 343-4744 On -Site Wastewater Disposal System and/or Welt Inspection Report Legal Descri pti on: Ptar 1i qan Lot 2 PID No.: 05036235 PTARMIGAN BLVD -- Wh' _L5_ _ SWING TIES ®TRI frWELL A -C = 103.5' B -C = 99.3' A -D = 94.2' B -D = 88.6' -WELL Septic Area LOT I UNDEVELOPED L�1 DRIVE N ® (Reserve Q� Area a ® - TEST HOLE 8MONITOR TUBE 1250 GAL 1,V o - SEWER CLEANOUT 3'tiSA 0- - WELL -- EASEMENT D ®TN3 -10 - LEACHFIELD o a�SEµVE PaEA -- ` 5 WELELL SCALE I"=60' -100' ttrttL 4 —/j9-7 /1e✓ n/37s� "W D ENGINEER'S SEAL 07b' 090000p�0 ELEVATIONS n ALUM. CAP, SE LOT COR o OF A 4^�0 (NOT TO SCALE) v ASSUMED ELEV = 99.31 -° Q�P.•.•.......• a� p ORIGINAL I * GROUND LEVEL O .: 49TH' AT. O ......... 98.9 u H O✓ 5 D> O (lull 3, Q ........... . Q ND DWT OO �'•. LOUIS A. BUTERA : 4�T O rANe B2'° Q f'. CE -6736 ��p� 96.3 6.1 95.9 ` 95.9 `D8.9 0'�4 OQP ESSk by }}�� VAN }�� oec co. rare p,O. BOX 670272, CHIIGIAK, ALASKA 99567 a TELEPHONE 600.2769 OWNER OF t1WD_Baan mLE a fEHo-ri-j ADDRCSS - % 'lLu<Cr _ � ✓Z Y -- LEGAL DESCRIPTION__? Ji•'I7 Q Mi✓E A o spa PFIRMITNUMi3atmA ic7 i Date of issue-PAL-4-- TAX ssueLPAL-- TAX INDENTIFICATION NUMBER.0 5-0 .f 6 a' .i 5) _ /z6.j{Su U Is well Ionated at approved permit location? 73i Yhs IO No j�`gau Method of Drilling: rotary (- cable tool Depth of well: Casing Type S�MLFA—Wall Thickness .i � _inches Diameter -A—_inohes, depth-4�M—�feet Lmer'Type: Casing Stickup Ahoye Ground: ,_C___—reel ,Mr round level _�;,-- feet Static Water Level (from g : ) pumping level:__ feetafter___hrs. pumping--9P'u Recover Rate:--%(R--gpm Method of Testing:Y---- Weli Intake Opening'i'ype: CJ Open End f3 Open Hole I- Screened; Start_�� feet Stopped feet 915erferations Start __ feet Stopped_ &D feet Grout Type: &M to 4olurno �r�d�% — Depth: from_ (j�—feat, to _ feet Pump Intake Depth: Pump size.- __.__hP SrandNanle_ -- Well Disinfected Upon Completion? Ales 1-1 No Method of Disinfection: C RoRrrJ+L'�._ �1 1�%-- Comments! Comments: / M4NOV4lyyt M nicipality of Anchorage — Health h&I lum@n Services -- Driller's Name ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Departmont of Health & Hunian Services andler Department of Environmental Conservation. WGU Borough: Department of Environmental Conservotloh. TO'd 889 S'T79M NElVN NVAI-1-1AS 14V 61::©T IZJA L.6—TE-130 110 C v !. a c riov�5 icjh�)1 -7 II wM Ik P� PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAI, SYSTEM PERMIT PERMIT NUMBER:SW970120 DATE ISSUED: 6/04/97 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE: 6/04/98 OWNER NAME:KIEHL CYRIL & LOIS OWNER ADDRESS:7920 CRANBERRY STREET ANCHORAGE, ALASKA 99502 PARCEL ID:05036235 LEGAL DESCRIPTION: PTARMIGAN LT 2 LOT SIZE: 43996 (SQ. FT.) NUMBER OF BEDROOMS: 4THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: j RECEIVED ISSUED BY:`��/- p/t 0 Iv -1V-97 (PT�l DATE: DATE: ( i N, OZ✓'�u 0 A s'i Ti p, /I Eagle River Engineering services Louis Bute m, P.F. P.O. Box 773294 (907) 694-5195 tel Eagle Rivcr, AK 99577-3294 (907) 694-3297 fax August 11, 1997 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Ptarmigan Lot 2 Narrative & Permit Application Dear Mr. Cross: The proposed well and septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \1997\96-034-NAR.Doc — — — PTARMIC AI 139,E 15' UTT ELLS NTH1 PROP05E WELL LOT 1 UNDEVELOPED I NO SURFACE WATER NO KNOWN CURTAIN DRAWS PROP DRNe GARAGE BLVD PROP HOU5E FF=99.0' 1250 GAL TANK N � /� U YRe CH s ®TH/:3 +10' ¢'WELL Septic Mea a� Re m urea RNc ' - TEST HOLE 5 s - MONITOR TUBE �Lo} $ WELL 0 _ SEWER CLEANOUT +100' WELL - EASEMENT - PROPOSED LEACHFIELD --- EXISTING LEACHFIELD WELL_ SEPTIC SDTE PLAIN LEGAL:PTARMIGAN LOT 2 _OWNER: STECKEL CONTRACTOR:N A _ _JOB# 96-034�DATE: 10�4�7 SCALE 1 = 60' EAGLE RIVER ENGINEERING SERVICE'S P.O. Box 773294 j EAGLE,' RIVER, AK. 99577 v (907) 694--5995 FAX: (907) 694-3297 OF 49 Tei. o �� c '• LOUIS A. BUTERA s '•• CE -6736 .• �?� OQFPFo • • ...... °' Jo O��EEUuoc��o�oo� 5ept;c Vent --- -� P MIG BLVD ----- Wh' 15' D P.g52mtK ®TH1 WELL PROP SED WWELL I O ~ Iro 0 LOT 1 UNDEVELOPED Irn PROP u DRNE i z aea �lmROP0USD E" l I1IReSeN¢ 37.5' . FF=99.0' Area GARAGE ? N 4, 1 NK GAL TANK N 4 tR 5+!0' p•E5E1?Vel- �� — TEST HOLE Lot 5 • — MONITOR TUBE (WELL 0 — SEWER CLEANOUT +ILO'¢ — WELL NO SURFACE WATER-- PROPOSED LEACHFIELD — EASEMENT = '"'5�6"W -- — NO KNOWN CURTAIN DRAINS wh' EXISTING LEACHFIELD W E L L S_E P T I C SM--- T E P LAN e.•��e,� LEGAL: PTARMIGAN LOT 2 ..�OF OWNER: STECKEL MCI)�Q,• CONTRACTOR: N/A _ 5* -49TH /� * �0� i.......,�. �.:....... JOB# 96-034 DATE: 7—/7—/97 SCALE 1" = 60" 0"' — F,AGLE RIVER ENGINEERING SERVICES p �, c^c ••• LOUIS A. BUTERA P.O. Box 773294 �,; •.••CE -6736 ••.•��==ir EAGLE (90'7) 9RIVER,5195 FAX.•5(907) 694-3297 �111I1\Fy�W��'� yl. r d o,�q.;1,3i d. � "J lClY 6" " •Y� M � li b Municipality of Anchorage 1 DEPARTMEN'r OF HEALTH & HUMAN SERVICES <t�" Louis A. 8urera qui 825 "L" Street, Anchorage, Alaska 99502-0650 CE -6736 .' 4N 'V SOILS LOG -- PERCOLATION TEST �r�I1�.'•.YW_.__•"';w°�'" PERFORMED FOR: .5 r�C^ b7 DATE PERFORMED:_ - Y_'> LEGAL DESCRI ^l� - Net Time i[YE Pit l: EET 1 2 3 Q 4 6 7 8 9 0 .-,� 10 Q- _L11 s4ndy or9en?'c_s 6M, hl _5ancd - __ _ ConlenT7 Pry �rowa'9rcy _ -5p wi Th lN�r. bo77oa� 17 - I PT7'o • 4 �f -51Y 18- 19- 20- COMMENTS 81920COMMENTS Township, Range, Section: SLOPE H Ja SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHATL _ DEPTH? IVA- p g' E Depth to Water All r Monitoring? %-� Dale: Reading Date Gross Time - Net Time Depth to Water Net Drop - -6— 3•'D<� � odd ., 3 ; za 7! %e �• S i•.3z 7s is - 31 42. .'y2. low. 762 3 PERCOLATION RATE ; _ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN G FT AND 7—FT PERFORMED BY: 1�; t & A C I _ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72.008 (Rev. 4i85) - Eagle Diver Engineering ,Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle Riven, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: 5/13/97 A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled. B. SEPTIC TANK 1. Septic tank shall be a minimum of 1250 gallons and be a MOA approved design.. C. TRENCH 1. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. 2. The bottom of the trench shall be level, plus or minus 1.5". 3. The total depth of the trench excavation is not to exceed 10' at any point. 4. The effluent line within the trench shall be laid level within 0.03'. 5. The trench gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 7. The area over the trench is to be finish graded to prevent ponding of surface water runoff 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 10' GRAVEL DEPTH = 7' under pipe, 2" over pipe TRENCH LENGTH = 54' TRENCH WIDTH= 3' SOIL RATING = 0.8 GPD/ft5 BEDROOM CAPACITY = 4 SEPTIC TANK = 1250 Twenty-four (24) hours notice required for all inspections. \1997\96-034-spadoe EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 96-034 Calculated By: LB Date: 5/7/97 Legal: Ptarmigan Lot 2 Single Family 4 Bedroom Dwelling Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = Percolation rate = Wastewater application rate = Required absorption area = Trench width (W) = Gravel depth (D) = TEST HOLE 3 600 gallons 12.3 minutes per inch 0.8 gallons per day per square foot 750 square feet 3 feet 7 feet Required length = Required absorption area / 2 / D Required length = 750 / 2 / 7 Required length = 54 feet Total Excavation Depth = 10.0 feet 6 49 TH '•� �.............. •LOUIS A. BUTERA� P'•, CE -6736 •,• Q TF��'••..... OS 1�4p�PROFESS1oNPo� Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muhl.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _ 067-311-05 COSA# L / q 03 68 1. GENERAL INFORMATION Expiration Date: /_ 1 J _1 0 Complete legal description PTARMIGAN S/D: LOT 2 Location (site address) 20442 PTARMIGAN BLVD * EAGLE RIVER. AK • 99577 Current Property owner(s) MARK SIMEON Day phone Mailing address Lending agency Mailing address 20442 PTARMIGAN BLVD • EAGLE RIVER. AK • 99577 Day phone 748-3930 Real Estate Agent KATHERINE DEHOOP W/ EXIT REALTY Day phone 622=3948 Mailing address 19132 TRAIL BAY DRIVE ' EAGLE RIVER, AK • 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the 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 riles 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 6 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE y Approved for bedrooms. Disapproved. Phone 337-6179 Date Conditional approval for bedrooms, with the fllowing stipulations: Attachments: / COSA Checklisty Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ARM 10.) q OF `iA1yC . ; ONSITE • '�ci"s WATER AND WASTEWATER PROGRAM o Original Certificate Date: / (Rm 11105) Municipality of Anchorage N. 1 Development Services Department Building Safety Divisiond On -Site Water 8 Wastewater Program Nc1/ . 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: PTARMIGAN S/D; LOT 2 Parcel ID: D 67 -3//–O -S A. WELL DATA Well type MATE If A. B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 10/22/1997 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 81 ft. Cased to 81 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 10/22/1997 9/23/2009 Static water level 47 ft. 44 ft. Well production 12 g.p.m. 5.7 — 9 -p.m -WATER SAMPLE RESULTS: Coliform �0 colonies/100 ml. Nitrate �mg./L. Other bacteria U colonies/100 ml. �I Arsenic: � • v ug./L. Date of sample: 9/23/2009 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date Installed 10/18/1997 Tank size 1250 gal. Number of Compartments 2 Cleanouts1(Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping � � U Pumper i 41 �S C. ABSORPTION FIELD DATA E ow EXISTING ORAD Date installed 10/18/1997 Soil rating .p.d./ r tt'/bdnn) 0_8 System type TRENCH Length 54 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth • 10.75 ft. Eff. absorption area 750 ft' Monitoring tube YES Depression over field NO Date of adequacy test 9/23/2009 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test DRY in. Water added 600 gal. New depth4in. Elapsed Time: 110 min. Final fluid depth3- in. Absorption rate >= 600+ g.p.d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date – *LAST 280 GALLONS CAUSED ONLY 1" RISE. D. LIFT STATION Date installed Size In gallons "Pump on" level at in. "Pump offleve E. SEPARATION DISTANCES Manhole/Access water alarm level Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM 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 N/A Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 1 o'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 109+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 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. Engineer's Printed Name JEFFREY A. GARNESS Date (0 1 C11 Del COSA Fee $ Li CIO Date of Payment lo - /9 -0q Receipt Number 0 14 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage • �'` Development Services Department j Building Safety Division On -Site Water and Wastewater Program ' 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 090368 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot of Ptarmigan subdivision. This inspection revealed a nitrate concentration of 7.86 milligrams per liter (mg/L) was reported for the property's well water sample. 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. f PTARMIGAN BLVD — ` s.n: _ i • •• l ••GRAYeL A. ' 7 site, 42C "wx j 7e r I X ' 145 L I e YMt3 1 Or At 00 illi • E9L�` `;y LEGEND: . ••• .... .7sr rouho �,,..��. 3/60 Nei.*g • IOUM A. 1y7t:RA ••••• L23• vu -o t 'S� 147b' "W ANO.TA= C ^'anae,;ei l� RrtC� MOOD otos i 117M stANDFMM o CAQL.E RI I 1 s10tk ' WAT" u + VER ACEs ASBU/LT SURVEY """ ' 10421 VFW v.ranine MAY ' eks ~77 oww`R; STECKEL f VAX• e30nA1.ce+t:trs DESCRIPTION. PTARNIGa+I LOT 2 GDO•/7sl��"4411: 96.034 ; utyR0, Diet I he .•s surveyed the foil f 96.034A6.Dw Wb hl� q mew Aiestto, orld th.t r o sneroo" P100ertr. PTA(• OOM 0 s whet tl.eat to eeterel;ns tM es.s e`oe of ontts exist e,, t os bp; pak LOT 2 IlVson be used coplam Ns fe0oresd subdivision Diet saZd:mt I! 4 eonstrtietlen et fence lines. U^ ne elrc msloncea should , or for eetebh2h;nq boundary Ines, -Is-ci . OAC' MUNICIPALITY 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 �/y Parcel I.D. # 050-•362-35 H A A # -/# 6 y 0 L 1. GENERAL INFORMATION Complete legal description Ptarmigan Subdivision; Lot 2 Location (site address or directions) 20442 Ptarmigan Blvd. Property owner Richard Steckel Day phone 696-6279 Mailing address 20442 Ptarmigan Blvd. Eagle River, AK 99577 Lending agency -- — Mailing address -- Agent -- Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL.: Individual on-site XX 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(Rov.1/91) Front MOAN21 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 compl' ce with all Municipal and State codes, ordinances, and regulations in effect or the date of y- 'spection. Name of Firm Address 2B Engineer's signature 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Phone X37-"7�1 Date Conditional approval for bedrooms, with the following stipulations: Note: The well for this property meets existing State and Municipal Codes. here are nitrates present. It is suggested that periodic testing be- erformed to.insure the wells continued suitability. Current nitrate oncentration is 8.75 me/1 EPA maximum concentration is 10.0 mg/1. ore information on nitrates is available from the On-site Services Program, 1HHS, 343-4744. Additional Comments IN 4t1T1t7 Date 1-4-00 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. 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. 72-025(Rev.1M) sack MOAN21 Municipality of Anchorage J� Q DEPARTMENT OF HEALTH & HUMAN SEi11f�Q&ES o3 2000 Environmental Services DivisiJ-NV/RcAzW"41/�yorA 825 L Street, Room 502 • Anchorage, Alaska 99501 • (90��°�40 t4W'AcF E,g 0 1V S,/ON Health Authority Approval Checklist Legal Description: PTARMIGAN SUBDIVISION; LOT 2 Parcel I.D.:_ 050-362-35 _ A. WELL DATA Well type _ PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N) YES Date completed i9./"-197- Total depth _ Sanitary seal (Y/N) Date of test Static water level Well production 81' Cased to 81 YES FROM WELL LOG 10/22/97 47' 12 Casing height (above ground) _ 2'+ Wires properly protected (Y/N)_ YES AT INSPECTION NES g.p.m. g. p. m. WATER SAMPLE RESULTS: Coliform 4 Nitrate mgtOther bacteria_ Date of sample: 12/22/99 __Collected by: B. SEPTIC/HOLDING TANK DATA A,W.W,C., INC. Date installed _I0/1_8/97 Tank size _ 1250 Number of Compartments 2 Cleanouts (Y/N) YES_ Foundation cleanout (Y/N) YES Depression Date of Pumping _ /L 3/ Pumper `k.46S' C. ABSORPTION FIELD DATA (Y/N) NO _ p 4-+6. High water alarm (Y/N) N/A Date installed _ 10 18 97 _ Soil rating (g.p.d./ft2 or ft2/bdrm) . 0.9 _ System type TRENCH Length 54' Width _ 3' _ Gravel thickness below pipe 7' _ Total depth _ 0'--1 11 Effective absorption area _ 750 _ Monitoring Tube present (Y/N)YES Depression over field (Y/N) NO _ * Date of adequacy test NEW Results (Pass/Fail) For Fluid depth in absorption field before test (in.); - Immediately after - gal. water added (in.): — Fluid depth =s_ (ins) Minutes later: - Absorption rate = - _g,p.d. Peroxide treatment (past 12 months) (Y/N) NONE KNOWN If yes, give date 72-026(Rev.3/96)' NouS� L✓oT" OGcv7iEp r/v.nL ro/9� IOFB D. LIFT STATION ' Date installed Manhole/Access (Y/N) High water alarm level at* S';e in gal N 1� "Pum vel at* *Datum "Pump off" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation .9'+ Property line 5'+ Absorption field Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line t0,+ Building foundation 10' Water main/service line Surface water 1001+ Driveway, parking/vehicle storage area Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. ENGINEER'S CERTIFICATION 1A 1 certify that I havld719tm fi ru field inspections and review of Municipal in confor ance w h, �j/{ goid�lines in effect on this date. Engineer's Nai Date I ld HAA Fee $( Waiver Fee $ Date of Payment 1I,3'O(7/ _ l Date of Payment � Receipt Number 2J� ��"/ J Receipt Number 72-026 (Rev. 3/96)* A. —7953 are WHEN RECORDED MAIL. TO: �7 Richard Steckel n68522 9980C30 AS 9131 �,,/ ANCHORAOf, 1�' REGOESTED BY *CIADING DIS RICA; N11r'Qq OWNERS NOTICE OF COMPLETION NOTICE IS HEREBY GIVEN, pursuant to A.S. 34.35.07(d) that; Name ddre owner, lessee or other of the following described real property: of he Lot 2, PTARMIGAN SUBDIVISION, according to the official Plat thereof, filed under Plat No. 95.55, records of the Anchorage Recording District, Third Judicial District, State of Alaska. That on the _ day of 19g8_, work was completed on the construction —_-- --- of (construction, improvement, or particular improvement) the building (or particular building) located thereon by Richard Steckel (name) — the original contractor. That Notice of intent to Record this Notice of Completion was given to all persons having given Notice of Right to Lien or asserted a Stop Lending Notice on the abovementioned property at least five days before the recording of this document. --- Signed: -- chard Steckol (owner, lessee or other agent) STATE 01= ALASKA } } ss: ZHIRD _ JUDICIAL DISTRICT } Richard Steckel —_— -- -- being first duly sworn, (owner, lessee or other agent) under oath, deposes and says: I have read the foregoing Notice of Completion, know the contents thereof, all and sing r, and the statements contalned therein are true as I verily believe. — — Signed: ---- R' hard Steckel (owner, lessee or other agent) —�_day of SUBSCRIBED and SWORN to before me this � --- OFFICIAL SEAL STATE OF ALASKA SHERRI L. KELLY NOTARY PUBLIC iry public fo Alask � / My commission expire . �! 1—� "MMARY OF BUILDING INSPECTIO. o ORIGINAL For .Site -Built Construction Owner of record:_ RrcziARl� smrxr•F ---p—n --�J,- .� Legal description:__ -=-2 PTARMACAN 3, Z . r GSL „ �- oa lin de recording district) L Site address:—CLia -2iaA �' 9-(-� + -- - �Dp Two caracation is issued pursuant to the raqukements of AK Statute 18.66.300 and AHFC's rsgulatlons 15 AAC 150.030. The Electrical Inspection may be completed by an inspector qualified under the International Association of Electrical Inpnctors. An Architect or Engineer may only perform inspections for a project or phone of construction conducted In a community with a population of 5,500 or lass that in not connected by road or rail to Anchorage or Fairbanks. Use of altenute methods, such as videos, must have PRIOR WRITTEN APPROVAL of Alaska Housing Finance Corporation. By my signature below I certify 1 have the current, applicable certifications of authority. I am not personally or financially related to the builder, seller, buyer, realtor, or her interested party for this project, other than as a fee inspector, �y 11 D PLAN 9E'PAOVAL: � �`_ 0821553-55 �d DAVID R OWl'sNS - Name Maine Print) _ emra � � n ®n� ��90 x1 66 D e T— a/ail 2) ASO r. U W LY. C`J Bi ) Lr) CO CD aO �) io a. Q Name Framing: fNpnsasembMd Name IPloaae Print) Items to be completed: A 0821553-55 c2,L3Je?d IC6o r1 66 `-' 21553.55 08 Date ' / � • IC80 #166 MEClJANICALs met• '3/2 .& approptotefy stamped wkh the /C80 xsdng nu obsr.l r"-- 0821553-55 ,j 0821553-55 • icso T66 To be Completed Noma (Please Print)) S a[ure ��T-- • ICBG M 166 Date 6) SNALAEMVAL 0821553.55 _ QAZajt olgENS� / Name Mason Ring Signature ' ICBO xx 166 Date • Or, If applicable, Electrician, Architect or Engineer State Registration Number. By my aEgnatt8e below 1 hereby certify that the required inspections have been completed and that the puliding motto or excaada the standards set fort,Wunder AS 18.68.300 and 15 AAC 160.030. 1 also certify that any preataeembled wall pWtNs are currently liste&wlC8 l to In wledge there hes been no action taken to rescind the IC80 approval. VY - ',,Builder's SignatureDate�� Suilder's Name��J� L Builder's License #---_---- (if applipable) ��✓7 Name of Business /{,//�/ AAA.... City, $tete_ .. SZ'` = Before me, a Notary Public in and for the State of Alaska, foregoing document of his/her own free will. the My fomnllFjSion expires: Recorder: Index by legal, owner, and buBdor #PUR-102 Rev. 05/87 MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# �)b o3G) 3, - HAA # A 1. GENERAL INFORMATION Complete legal description PAOr%I: Gu �� S 1 b�%'v:sioh ZIT 3. Location (site address or directions) Property owner A;�h�,%�.� Stegel I L�'ry // '��"�y°� Day phone �/�7 -QHS�9 Mailing address, '2-C 61q) �1,0�0 Com../e —T X'ive, .' Lending agency -Se`177_1e �'�'t -' s -e Day phone `/° !- s6 ' - end Mailing address eg v,/ `s� Agent 1s, b,' �u, a /fes Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER Of: BEDROOMS: 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. 1191) Front MOA #21 S. 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 Ha le v -s -r- — Phone Address P.O. Boa 773294, Eagle g;,er, AK 99577.3294 Engineer's signature— Date /° %k 6. DHHS SIGNATURE r `/ Approved for S GU%- bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Note: The well for this property meets existing State and Municipal Codes. Tharp nrp nifrnfpq prAgent.. Tt is sl=asted that periodic testing be performed to insure the wells continued suitability. Current nitrate eaneentratien is 9.92 mg,11- EPA ma�4mum is 19 0 mg/1— More information on nitrates is available from the On-site Services Program, Additional Comments By: atm Date 10 'ZY �K 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. 72-02501w. 1/91) Back MOA R21 Krlvv Municipality of Anchorage „ DEPARTMENT OF HEALTH & HUMAN SERVICES p�T� Environmental Services Division " 825 L Street,,Room 502. • Anchorage, Alaska 99501 • (907)'Mj4` 44 (r5 oivi (7 Health Authority Approval Checklist Legal Description: ! ��PrN/c7� v1�__ �ub• T _ Parcel I.D.: DSII 36 3 S^ A. WELL DATA Well type � r/'Vcr Te If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) 5 Date completed /0 - - — `i % Total depth �I � --Cased to w �T Casing height (above ground) Sanitary seal (Y/N) Date of test Static water level Well production FROM WELL LOG g.p.m. WATER SAMPLE RESULTS: !2-,V// Wires properly protected (Y/N) /_- AT INSPECTION yew ivy-// /" 13/ Other bacteria _ 74 Date of sample: /1.� -• ,a C, -- V k Collected by: B. SEPTIC/HOLDING TANK DATA g.p.m. ColiformNitrate -'e `% a Date installed 10-10'_q% Tank size�s Number of Compartments Cleanouts (Y/N)�s Foundation cleanout (Y/N) _rcs _ Depression (Y/N)/1%_ High water alarm (Y/N) Date of PumpingZ—/P w✓ _ Pumper _ IVII C. ABSORPTION FIELD DATA 7 Date installed. / 8- _ Soil rating (g.p.d./ft2 or ft2/bdrm) O, 8 _ System type L>`�/� TeHch Length S y �� / Width _ Gravel thickness below pipe _� 0 ' Total depth _ l U, � Effective absorption area %5 D �' _ Monitoring Tube present (Y/N)_& Depression over field (Y/N) . No Date of adequacy test. yL" 9"ew Results (Pass/Fail) _ 41 For _ IV -4 bedrooms Fluid depth in absorption field before test (in.); _ /1/j Immediately afters%gal. water added (in.): _ Fluid depth NA - (ins) Minutes later: N'4— Absorption rate = 111'4 _g.p.d. Peroxide treatment (past 12 months) (Y/N) IV4 _ If yes, give date _ A,1'4 72-026 (Rev. 3/96)* D. LIFT STATION IA// Date installed Manhole/Access (Y/N) High water alarm E. SEPARATION DISTANCES Size on" level at* *Datum "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot On adjacent lots /eqD Absorption field on lot � y D ' On adjacent lots -f /DD Public sewer main /�� — Public sewer manhole/cleanout ^/U4 Sewer /septic service line OS Lift station — /L /I/ i SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation /s Property line 6o Absorption field Water main/service line N0- Surface water/drainage Wells on adjacent lots ids SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line % ' Building foundation -3s-,Water main/service line - 2 Surface water /UO - Driveway, parking/vehicle storage area rw _ Curtain drain F. ENGINEER'S CERTIFICATION Wells on adjacent lots r/fid i certify that 1 have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. Signature Engineer's Name Lr�h l �ti a Date to - a d* O O HAA Fee $ C3 DD r Date of Payment 10 Receipt Number o�4 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number R�stems are \ Is A. Butera CE -6736 : ��®