HomeMy WebLinkAboutBIRCH TREE ESTATES BLK 2 LT 12Birch Tree
Lot 12
Block 2
#017-141-37
i 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
LEGAL DESCRIPTION --
LOCATION NO. OF BEDROOMS
j Well Absorptron area Dwelling PERMIT NO.
O DISTANCE TO: ~o~ I
~ Manufacturer ~ ~ Material . No, of compartments
'Liq. capacity in gallons Inside length Width Liquid depth
/ ~O IF HOMEMADE:
~ DISTANCE TO: Well Dwelling PERMIT NO.
~ Well Foundation Nearest lot line PERMIT NO.
~ DISTANCE TO:
~ ~ ~ No. of lines Length of each line ~ Total-length of lines Trench width Distance between lines
~ ~ ~ Top of tile to finish grade / Material beneath tile I effective absorption area
Length ~ Width Depth 'PER~IT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TQ:
~ Class Depth Driller Distance to lot Pine PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
¢~ /*~.-01 /O-lo,r/
72-013 (Rev. 3t7~
~,540 ^KUI.A, OR~VE
AN.CH0,RAGE, AK
(907) 345.-0593
Locollon
Type
Top
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL*RESOURE$
OJvJglon of 0eologJcal.& Geophysl¢ol Surveys
Town.hip NJ'-] Rgnge. 'E~l Meridian
sm
0 Irrlgallon 0 Recharge ' 0 Commltlc~
0 Te*I Well ~ Olhlrl ~
I0. STATIC WATER LEVEl. __~-~_~ ~
0Above or [--]eelow land'lurtaae Dale
16, WATER WELL CONTRACTOR'S CERTIFICATION:
IZ.GROUT!NO Well Grouled: ~Ye~ [] Ne
' Oc
LOG
Static Water Level ,~-~ feet
Gallons Per Minute
Draw Down feet
Total Feet of U~stng
Type Material Drilled:
0 feet to
~ to
~.0 to
76) to
to
to
Hefty Drilling
S.R.A. Box 1553 H
Anchorage,Alaska
99507
MUNICIPALITY OF ANCHORAGE
DFPT O~ qE,'";.T ~ ,~,
F'EF:r'.1I 'T' NO.
f:fF:'F'L.. :[ C Ff!",FI-
LOC FI'I" Z 0 N
LE(:iiFIL.
EJF::UCE LONG 3'?82 I.,JEZT Eh::!.TH. ..¢~',,,'E
Ii'.-': F:t S T :,1.. 4'7 T H Fl'v' E.
LOT ::L2 BLK ;Nit BIRCH 'TREE EZ-f'. L. OT' ZIZE
'T'?PE OF .'.::!;(:IZL RE:SOF.:F::'"f'tON S'¢:5'TEH I:5: TF.:EENCI.-!
MRXi'ML!t'q NUME:ER OF !i~:E__.:,l:;::EtCd',l'='._:; ..... 7_::
.'==;OIL. RFITING ,::Z(;:! FT,.."E~Ri: .... 225
THE I:~:F}.')]:!U t RED :~..:, I ZE OF THE .'.:..:;01L FIE,'E;ORF'T i OI'.,I $'¢STEM :[ :5:
TF!E LENGTH DiHENSION IE; THE: LENGTH ,:: ]:N F'EET::, OF TFIE !"F:'.ENCH OR DRFt.I. NF'IEL.[:,.
THE DEPTH OF FI TRENC:H OF: F'IT I::='.'; THE D IE;TF1NCE: BETk!EEN THE :E;URF'F!CIE OF THE
0]ROUI'-,I[:, RND THE E',OT'T'OM Cd::' THE E',:.::CRb'FITION (IN FEET>.
THERE IS h!O %ET FI I[':,]"H F'OF,' TRENCHE'E;.
THE: GRR',,,'E:'!... [:,EF'TH !.'L:; THE M INIMLIH [)EPTH ('_'iF GF.:Ff',/EL E',ETHEEN THE OL.rT'F]=!LL.. F:'IPE
FIN[:, THE BOTTOM OF THE E',:,';CFt',,,'FITtC~N ": IN FEE:T::'.
P[.:.:RH ! T F!F'PL. I CRt',H" FIRS THE RE'E;F'ONE; ! E: I L I 'T"~' TO ! NFOF.:H 'TH I S [:,EPFIRTHENT' [:,UR t NG THE
I N:.:?r'FILLFtT' I ON Z NSPECT.t:. OI'.,E:; OF FIN'.;.' WEL..I....'L=, F:I[:,JFICENT TO TH I :.::!; PROF'ERT'T' FIN[:, THE
NL!HBER OF F.'.E$I[:,ENCE:E; THRT THE: I.,.IEL. L .[4ILL :.'+.';ERVE.
i:3FICKFI !..L I NG OF F:tN'¢ :5'~-'S".f"Er'I 1.,.t I THOL.rt" F' I f'-,IFtL ! NSF'EC'T'I ON R!'.,ID FI, PPRO',,,'f::IL. E',? ]"H :1: E'.';
[:,EF'RRTI"IENT t41 L.L. BE: I).'.:;UEL.TE".CT TO PROL:.;ECL.Fr :[ 01'-,t.
M Z !',t I HL.II'"! [:, I STFINCE BET!-4EEN Fl I.,.tELL .¢:~I",!D FI!",l"r' ON"'"S I "rE SEWFIEiE
::I..(~E! FEET !::'OF.: FI F'F::I',,/RTE !.,.!EL..L OR ::I..5E~ TO 2(i:.~E~ FEET FF.':OH .FI PUBLIC HELL. DEPENDIHG
UF:'ON THE TYPE OF F:'LIE~L..IC !.,.!ELL:
M t N l MUM D I STFfNCE FROM F:I F'R I VI::I'I"E: I.,.!ELL TO R PR I 'v'FITE S;E].,.IER t.... I NE I E.:, ;?5 FEET t::tHD
TO FI COHI"!LtNIT'T' SEt.,.IEF.: LINE: I% 7'5 FEET.
HELL. LOEiS FIRE RE(.:.!UIRED RNE:, MUST BE RETURNE:D TO THE [':,EPPtF:THENT 1.,.fZ'rHiN
C!F THE NELL COHPLETION.
OTFIER. RE('..:!U I RIEi',.1ENT::=., r,lR'¢ FIPF'L.Y. SPEC I F I CFrT t ONS F~I'.,I[:, CONSTRIJCT I ON E:, I F!GRFd',IEi; FIRE
RVFI I LFtE',LE TO I NSLJRE F'ROPER I N'.:.:;TF!LL. FI]" l' ON.
I C:ERT I F"r' 'T'F!FIT
d..: ! FIH F'FIMILIRR HI'TH 'T'HE !=::E:6!UIREMEi'q'T'::5 FE;R ON-ZITE: ':_:,E!.,.IER:E; FINP l.,.IELL..:iii; FIS SET
FOR]"H E','¢ THE HI...l?-,t I C I F'RL. ! T¥ OF F!NCHORFIC-iE.
2: I t.,.t ILL I NE;TF!LL. THE '}.:';:¢STEM I N FtC:COR[:,FtNE:E t.q I TH THE CODE:'=:;.
3: I LINDERSTFIND THFrT' ]"HE ON-SITE ::=;ENEF.'. S'~.'STEM MR"r' RE(;!LI!RE EI",tLt:~F::GEHENT IF' THE
F.':EE; I [:,E!",ICE ! E; RE:MO[:,EL.E[:, TO I NCLU[:,E HORE THFIN 3 BEDROOM:.:.!;.
, ~.::,e.N [ F f I0.
t ~ /
PERMIT NO.
DEF'ARTMENT '.,r HEALTH ANC' ENVIRONMENTFIL ..:OTECTION
25:LE, E. TUDOF.'. RC'... ANCHORAGE, AK. ~'950','-'
276-222t
i-,l EZ L L_ R I"-,i E) C~ I%1 -- E; I 'f E :E; E: I~-.l ET.T;Z F~..". F:' E'~ ~'.' ~'-'l i: 'T
,:: 76F=02. ::,
RPF'LICRNT
LOCATION
LEGAL
OFF 147TH ST
82 L12 BIRCH TREE EST.
BOX Z-':26-A SRFt
L. OT SIZE
25000 SQUARE FEET
TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH
MAXIMUM NUP1BER OF' BEC, ROOMS = 4 SOIL RATING ,::S(;! FT'/BR)=
THE REQUIRE[) SIZE OF THE SOIL FIBSORPTION SYSTEM IS:
:I.::L5
[:. G: P' T' #-I = i 2 L E I'-,i ,]ii T' t--I = 2 9 ,_3 F~: Fi %-" E L E:, E F' -r t4 == :~.":':
THE LENGTH [:, I MENS I ON IS THE LENGTH (IN FEE'f') OF 'THE TRENC:H OR DRFilNFIEL. D.
THE DEPTH OF R TRENCH OR PIT IS THE [:,ISTRNC:E 8ETL4EEN THE SURFACE OF' TFIE
GROUND AND THE BOT'f'OM OF THE EXCAVATION ,:;IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS; THE MINIMUM DEPTH OF GRA',,,'EL. E:E'f'WEEN THE OUTFAI_/.. F'IPE
AN[:, 'file BOTTOM OF THE EXCAVATION (IN FEE'f').
'"l"' I...i Cu ,:: 2:: :::, I I-,il :S. F' E C: T ][ I:i i¢.-~j 7:; F--I F-: E F-: EE ,--.:! I_) ]I' tf~: E:_ IE:.
BACKFILLING OF FtNY SYSTEM WITHOUT FZNFIL ZNSF'ECTION AND FtPPRO',/AL BY THIS
DEPARTMENT WILL BE SUBJECT 'f'O PROSECUTION.
bllNII'"IUM DISTANCE BETWEEN Ft WEL. L AND FINY ON-SITE SEWAGE DISPOSAL. SYSTEM IS
:L00 FEET FOR A PRIVATE WELL OR 20¢1 FEET FOR A PUBLIC: WELL.
WELL LOGS ARE RE,.T.!UIRED FIND MUST 8E RETURNE[:, 'fEi THE DEPARTMENT 1.4IT1-~II'4 ]i:0 DRYS
OF "['HE WELL COMPLETION.
SPECiFICA]"IONS AND CONSTRUCTI ON DIFIGRRMS ARE Ft',.,'R II_ABLE TO INSURE PF.:'.OF'ER
I NSTALLRT I ON.
I CERTIFY THAT
l: I AM FAMILIAR WITH THE RE(:.!UIREMENTS FOR ON-SITE SEWERS AND I,.IELL..S AS SET
FORTH BY THE MUNICIF'ALITY OF FINCHORAGE.
':2: I WILL INSTALL THE SYSTEM IN ACCORDANCE P. IITH THE CODES;.
ii:: I UN[:'ERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLFIF..".GEMENT IF' THE
sRESIDENCEIGNED I~EMI:IDELE[:, TO CNC~I[:,E/~LA _MORE THAN 4 E:EE:,F.'.CIEIMS.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
~SOI LS LOG
~RCOLATION
TEST
PERFORMED FOR:
LEGAL DESCR,PT,ON:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS J'~'~- e ~q~'-
PERFORMED BY:
IK2
SLOPE
SITE PLAN
WAS GROUND WATER
P
E
IF YES, AT WHAT
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
~ /~' 3."/ 6 ('~ /'~
PERCOLATION RATE L~' ~ (m nutes/ nch)
TEST RUN BETWEEN ~ ~ FT AND FT
CERTIFIED BY: [) DATE:
72-008 (6/79)
Parcel I.D. 0/7
Municipality of Anchorage
Department of Health and Human Services
Division of Environmental Services
On-Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-4744
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Expiration Date:
GENERAL INFORMATION
Complete legal description
Lo"['
Location (site address or directions)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Day phone
Day phone
Real Estate Agent I~,",-,? '~f'~':,- , Dayphone
Mailing Address
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
~], Individual On-site []
[] Individual Holding Tank []
[] Community On-site []
[] Public Sewer []
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of
Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent
professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are
required for the transfer of title (except between spouses) on properties served by a single family on-site
wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners.
Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by
a private or Class C well and may be reissued with new water sample results less than 30 days old. 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.
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 Health Authority Approval Guidelines for the Health Authority Approval
application show 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 fifes and from my investigation and inspection, the on-
site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
NameofFirm ~7~;~-~,~ ~..¥ ~,_i~2 I'~.~--- Phone
Address ~8 '~ ~ /~-~ /~ ~ ~
Engineer's Printed Name ~ ~ ~ ~'~ ~ ~ ~ ~ Date
DHHS SIGNATURE
Approved for ,_"~ bedrooms.
Disapproved.
Conditional approval for
ENGINEER'S
bedrooms, with the following stipulations.
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Expiration Date: / - ~. LC - (.0 /
Original Certificate Date:
Reissue Date:
"' Municipality of Anchorage _ V
Department of Health and Human Servicea~E C E !
Division of Environmental Services
On-Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650 OCT I I 2000
www. oi.anchorage.ak.us
(907) 343-4744 MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SEBVICES DIVISION
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDescription: J,,., ~L I,'p_, B't(!~.., ~,,~-~./.~",r----.~
Parcel I.D.: ~/7-1¥/- ~, ?
A. WELL DATA
Well type ~,
Date completed
Total depth /~-~ ft Cased to
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
¢ colonies/100 mi
Coliform
Date of sample:f
IfA, B, or C provide PWSID # __
Sanitary seal ~//
Well Log ')/
Wires properly protected
Casing height.(above ground) ~"~ in.
AT INSPECTION
ft ft
g.p.m g.p.m
Nitrate N[ [.) mg/I Other bacteria I colonies/100 mi
Collected by: ~.~
Foundation cleanout
Number of Compartments ,2.
Depression over tank /~ High water alarm
Pumper
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ~'o_~ ~'~ / ~-e-(
Date installed /~)-I :~ - ¢¢ / Tank size ~o g-e gal
Cleanouts ¢ '"/
Date of pumping
C. ABSORPTION FIELD DATA
Date installed /~
Length ~'~ ft Width zT/ ft Gravel below pipe ~, ft
Total depth c~ fl~l~'ffective" absorption area//~£ ft2 Monitoring tube y
Date of adequacy test ~'/2-//,~' Results (Pass/Fail) '""~
Fluid depth in absorption field before test ~,¢ .- in
Elapsed Time: ~-~ min Final fluid depth ~ ~ ~ in
Any rejuvenation treatment (past 12 mo.) (YIN & type)
Soil rating (g~e-:ddft2 or ft2/bdrm) ,;1~¢ ~ System type '~"'4..z4~/t'
Depression over field
For ~b"' bedrooms
Water added/~¢0 gal. New depth ~7
in.
Absorption rate >= /-/5' Og.p.d.
If yes, give date __
72-026 (Rev. 01/00)*
LIFT STATION
Date installed
"Pump on" level at
Datum
in
E. SEPARATION DISTANCES
Size in gallons/,,,/~'
"Pump off'/~el at __ in
Cyc,,~ested
Manhole/Access
High water alarm level at __ in
Meets alarm & circuit requirements
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot tt 0
Absorption field on lot I
Public sewer main
Sewer/septic service line 1 042
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation /'.t~ Property line I 0 ~/' Absorption field
Water main ~ ~//A Water service line ,¢-5 Surface water
Drainage
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Properly line . ~0 '/'
Water Service line ),~'-
Curtain drain ~ )¢'
COMMENTS
Building foundation ,¢-.g Water main t',l/,,~
Surface water ]',1 I o Driveway, parking/vehicle storage
Wells on adjacent lots q~+ L.~ 2,.%
G. ENGINEER'S CERTIFICATION J¢'"'~"~" ' ;':' ' ': ·
I cedify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name
Date
HAA Fee $
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 01/00)*
George P. Wuerch,
Mayor
Municipality of Anchorage
Department of Health and Human Services
$25 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
http://www.ci.anchorage.ak.us
343-4744
October 25, 2000
Kenneth L. & Carolyn Ann Pratt
5215 East 147th Avenue
Anchorage, Alaska 99516-4250
Re: Separation Encroachment of Water Well to Wastewater Disposal System,
Lot 23 Block 1 Birch Tree Estates, P.I.N. 017-141-15
Dear Mr. & Mrs. Pratt:
The property described as Lot 12 Block 2 Bimh Tree Estates recently had the on-
site wastewater disposal system and water well evaluated to obtain a Certificate
of Health Authority Approval. The engineer performing the evaluation discovered
that the wastewater disposal system serving the home on this property is being
encroached upon by the water well serving the home on Lot 23 Block 1 Birch
Tree Estates. According to our records you are the owner of this property. The
existing separation is 90 feet from your water well to Lot 12's wastewater
disposal system. The required separation is 100 feet. This is a violation of
Chapter 15.65 of the Anchorage Municipal Code of On-Site Wastewater Disposal
Systems.
The wastewater system on Lot 12 was constructed in October 13, 1981. The
water well on your property was constructed in May 14, 1991. This makes it your
responsibility to either move the water well in question to achieve the required
100 feet horizontal separation or apply for a separation encroachment waiver
from this office.
Anchorage Municipal Code chapter 15.65.033 requires that all single family
homes within the Municipality of Anchorage served by a wastewater disposal
system and/or a water well shall obtain a Certificate of Health Authority Approval
from the Department of Health & Human Services prior to the transferring of title.
Your property is not eligible to obtain this Certificate of Health Authority Approval
until the separation encroachment between your water well and Lot 12's
wastewater disposal system has been resolved.
If you have questions of the above, please contact me at 343-4761.
Daniel J. Roth
Civil Engineer
On-Site Services Program
George P. Wuerch,
Mayor
Municipality of Anchorage
Department of Health and Human Services
625 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
http://www.ci.anchorage.ak.us
October 23, 2000
Tobben Spurkland, PE
203 W. 15th Ave., Suite #203
Anchorage, AK 99501
Subject:
Waiver Request for Birch Tree Estates, Lot 12, Block 2
Waiver Request #WR000091
Parcel ID #017-141-37
HA000513
Dear Mr. Spurkland:
Your request for a waiver of the required 100 feet horizontal separation from the
on-site wastewater disposal system on the subject property, to the private well located
on lot 23, block 1 of Birch Tree Estates, has been approved. The approved separation
distance is 90.0 feet.
This waiver approval applies to the existing on-sitewastewaterdisposal system to
private well separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Water Quality Program
""~ ~' MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On-Site Services
Waiver Review Worksheet
WR#: WR000091 PID#: 017-141-37 HA#: HA000513
Date Received: October '19, 2000
Legal Description: Birch Tree Estates, Lot 12, Block 2
Permit:
Engineer: Tobben Spurkland, PE
203 W. 15th Ave., #203, Anchorage, AK 99501
Applicant: Bruce Lamm
Waiver Requested: 90 foot waiver between septic system on subject lot to well on lot 23, BIock~
t of Birch Tree Estates.
Criteria: 1. Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Points:
Total:
2. Special Conditions:
3, Other:
Waiver is Granted: ,~
List Conditions or Reasons for above: ~'EE
Waiver is not Granted:
Date: /0 -23 --dO By:
Name of Reviewer
Rec#: 0000 Amount: None Date Paid: n/a
~Earte s~'¢r£t'l ~,~; co~vsr~uer~o I~., Ivau. IfSI, TIZ~ ;at~ r~
T~
Z:O
16:28 FROM-CTE ENVIRONMENTAL
5615301
CT&E Environmental Services Inc.
Laboratory Division
200 W. Potter Drive
Anchorage, AK 99518
Tel: (907) 562-2343
Fax: (907) 561-6301
T-783 P.O1/02
F-826
CT&E Ref. #:
Client Name:
Project Name:
Client Sample iD:
Matrix:
PWSID
1006527001
Tobben Spurkland
n/a
23/1 BTE
Drinking Water
n/a
Sample Remarks:
Client PO//: n/a
Printed Date/Time: 10/20/00 16:20
Collected Date/Time: 10/18/00 10:30
Received Date/Time: 10118/00 10:55
Technical Director: Stephen Ede
Released
Parameter
Results PQL Units
Allowable Prep Analysis
Method Limits Date Date Init
Total Coliform (MF) 0 col/100 mi
Nitrate 0.5 U 0.5 mg/L
SM9222B 10/18/00 KAP
EPA 300 10.0 10/18/00 SCL
10-28-00 16:28 FROM-CTE ENVIRONMENTAL 5615301 T-783 P.02/02 F-826
CT&E Environmental Services Inc.
~,~ Laboratory Division ~'J~e'~-~¢~~~~~
Drinking Water Analysis Report for Total Coliform Bacteria
READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE
PUBLIC WATER SYSTEM
PRIVATE WATER SYSTEM
Send Results ~1 Send Invoice
MUST BE COMPLETED BY WATER SUPPLIER
'Send Results ~ Send Invoice
200 W, Potter Drive
Anchora~le, AK 99518-1605
Tek 1907) 562-2343
Fax: (907! 661-5301
TO SE CQMPLETED BY LAB~
Analysis shows this Water SAMPLE to be:
atisfactery
!_ ~ Sampleover 30 hours o1~. RecuRs may be unreliabte.
L~ Sample too long in transit. Sample should not be over
48 hfs eld for anaJysis to indicale reliable results.
Please send a new sample via special delivery maiL/ /
Date Received. / ~/7(7L'~ ~
Tir e Reee ed:
Analytical Method:
~Membrane Filter
MMO-MUG
SAMPLE DATE:
SAMPLE TYPE:
':outine
epeat Sample -
(refer to lab no,.,
: ~pecial Purpose
Location Collected fremont_
i"[ Treated Water
._~Untreated Water
Time Collected
ColJected:
MMO-MUG Result:
Membrane Filter:
Verification; LTl]
Fecal Coliform Confirmation:
Final Membrane Filter Results:
Repelled By:
~omments:
100B ?
Result* Analyst
Sent to ADEC: ANC FBK JUN [~
Date: Time: -- Fax
Client notified of unsatisfactory results:
Date: Time:
BACTERIOLOGICAL WATER ANAYSIS RECORD
Total Coliform E. Coil
Direct Count Q.../"'-~ Coloniesll00ml
BGB COLIFORM
Coliform/100ml
Member of tile SGS Group (Soci~t~ G~norale de Surveillance)
T. SPURKLAND P.E.
203 W. 15th. AVE. SUITE 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
Municipality of Anchorage
Department of Health and Social Services
825 L Street
Anchorage, Alaska 99501
October I8, 2000
Subject: Waiver Request Lot 12 Block 2 Birch Tree Estate
PID 017-141-37
Gentlemen;
We are applying for a waiver of the separation distance required between the septic system serving this lot and the well
on Lot 23, Block 1, Birch Tree Estate. The septic tank stand pipe is located approximately 94 feet from the well. The
inlet end of the drain field is probably the same distance from thc well. There are no markers (standpipes) defining the
start of the trench. We request a waiver to 90 feet for both tho tank and the drain field. The submitted siteplan,
prepared by S&S Engineering shows the approximate location of the stand pipes of the septic system and the location
of the well.
The septic system was installed in 1981, the well was drilled in 1991. Obviously the well is in violation of the
Municipal Code, not the septic system. Due to the fact that the owner of this lot is transferring tittle of the property,
he is forced to request this waiver.
Copies of well logs from this lot and fi.om Lots 22, 23, and 24 of Block 2 can be utilized to evaluate the contamination
potential. The static water levels in the wells are reported as boeing 50 feet more or less below ground surface. Total
well depthd are 100 feet or more. Well yields are from 6 gpm to 10 gpm. There are several thick layers of hard pan
or clay reprted.
The justifications for granting this waivers are:
1. Water samples taken October 18, 2000 show a concentration of of Nitrates. This is within expected
background levels. No bacterial contamination was detected.
2. The well logs show several impervious layers between the surface and the intakes of the wells.
3. The ground surface is level or slopes away from the well. Overland flow of surface contaminants originating
at the septic system location will flow away from the well.
Yours _, ~ i
~ sP~~~ujfkland P.E.
0
0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND EI~iVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date ',-) ~
GENERAL INFORMATION
(a)
(b)
(c)
Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Applicant Name ~g~_ Lc~,,,.. u~ Telephone: Home
Applicant Address
Applicant is (check one): Lending Institution []; Owner/build'~rE~; Buyer []; Other [] (explain);
(d) Lending Institution ___/~,'~¢'
Address ,~,"2 [)
(e) Real Estate Company and Agent
Address
Telephone ,~-~ ~ ,5~ ~-~/)
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family I~ Multi-Family []
Number of Bedrooms ~
Other
WATER SUPPLY
Individual Well I:~ 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: I[ 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 PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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.
Nameof Firm /~&,.~.'-~'~,~'r'v~. ~,.-zr-- Telephone
Address ~ ) ~ ~ 0 5 /-'/rd ~ . .
Date ')~h~ '~c~ /~
~ATER ~ELL NOTE: This Health Authority Approval inspection merely
certifies that the subject ~ater ~ell produced ~50 gallon~ pe~
bedroom per day and that certified laboratory tests sho~ed no
presence of coliform bacteria in a sample of that ~ater. No ~arantee
o~ certification is expressed or implied concerning the long term
adequacy or safety of the ~ate~ supply,
ON-SITE SEWAGE DISPOSAL SYSTEM NOTE: This Health Authority Approval
inspection merely certifies that the subject on-site sewage disposal
system accepted at least 150 gallons of water per bedroom per day
as determined by methods approved by the Municipality of Anchorage
Department of Health and Human Services. No warantee or
certification is expressed or implied concerning the long term
adequacy of the on-site sewage.disposal system. Construction data
reported on buried system components is from MOA files and was
not verified during this inspection.
DHEP APPROVAL
Approved for t//"~t'~ eOrooms by
~.~p _p_r_ _o_ y~e_..cl, '"~ Disapproved
Terms of Conditional Approval
Conditional
Date
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 $ 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 (11/84)
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description:
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
Well Log Present (Y/N) ~Vf~,--~ Date Completed .~', ~-~' ' ~ ~, Yield/..
Total Depth ~.,-~"" * Cased to ~'--~--/ Depth of Grouting _~,'~'~/·"~' "~
Static Water Level ..,~"~_,"
Casing Height Above Ground ,/~ ~'
Electrical Wiring in Conduit (Y/N) ~/~--~,..~
Separation Distances from Well:
To Septic/Holding Tank on Lot /,~¢~.~" /
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line ,,4,"/~
Cleanout/Manhole
Water Sample Collected by '~J~'~,,~
Water Sample Test Results
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
· On Adjoining Lots
" , · On Adjoining Lots /~:D' '"'
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot ~ · '~'
; Date ~--~
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed ,/~¢)-/$' .~/
Standpipes (Y/N) ~/~-.,~ Air-tight Caps (Y/N)
Depression over Tank (Y/N) ~ (~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line ~,.~'~'/
To Water Main/Service Line ~;~1~" ~'
Course ,~/,~
Size ~ No. of Compartments ~
Foundation Cleanout (Y/N)
Date Last Pumped ~,-,~- ~'~.-.~
'for
Temporary Holding Tank Permit (Y/N) ,,~
To Building Foundation
To Disposal Field ~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11/84)
ABSORPTION FIELD DATA ,/~
Soils Rating in Absorption Strata
Date Installed /,~ -/~' -~' /
Width of Field ~7/~t~
Square Feet of Absorption Area _~.~,_~
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well f/al")
To Building Foundation
Lot ,~v",~,,,e'~,
To Water Main/Service Line ~
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness _
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Par_king Area, or Vehicle Storage Area
Comments ~:~,4YAt,~ ,~,4~.~ ~',,f~,~$~-~-__5 ,~',<~J ~---'~',~.
To Property Line ,/<:~/
To Existing or Abandoned System on
' On Adjoining Lots _/',~ * '~
To Cutbank (if present)
LIFT STATIOI¥~~.
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted.Bedr/oom Rating Against HAA Request **
I certify tha, tA~e//~h'~cXed,ye/ified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed Y~////~ Date ~ /,2,. ~ /<~(~ '.
Company //~,~J ~,.ov-~_ ~,~"MOA No.
Receipt No. 3 ff(~"""~ "~
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
!
APPLI(' ~IT FILLS OUT UPPER HAL 3NLY
Property Owrer Phone
Mailing Address .,.~-,.,b C ~ L A ~ ~ ZipC°de (~~ :~(/..~/~'~
Buyer
Realt~ Co, ~ A~n~ i,,/,.' /, ~,-- ,~ [~> i} ~ ~ ~" ~> Phone
Address .~ 4 /~ ,,~* ~ Z. C ~n / ~ ~} ~ <-, ZipCode
S,re., Loca.~ /~/
Type of Resi~nce
~. Single Family
Multiple Family No. of Bedroo~
~ Other
Water Supply
.~lndividual ~ ~ ~ ~t~ ~ ~'~ i~' ATTACH WELL LOG. A w~l Icg is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach Icg if available).
~ Public Utility
S~we, ~o., /
'~ Individual Year Indiv~ual Installed: ·
~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED.
Time Time Time Time
...~/~/~ r .~_~ ~ ,...- ~ Date Date
_ D at e ~/~,- (-,,N"~ ~
Inspector ~ Insp~tor Insp~tor Inspirer
( ~PPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) DISAP~OVED
( ) CONDITIONAL APPROVAL*
DATE ~{ g ~ ~
BY:~ ~
Soils Rating Date ~wer Installed Well To Absorption Area IOff~ Well Log
Received
72-023 (31~[2)
October 3, 1977
#76802
Judy Sehm
Box 326-A Star Route A
Anchorage, Alaska 99507
Subject~ Permit Expiration
Dear Ms. Sehm:
A .permit issued by this department for well and/or on-site
sewer installation on Lot 12 Block 2 Birch Tree Estates
Subdivision has expired since the issu~-~ e~'~d's~°ne'
(1) year.
In the event you still plan to install the well and/or on-
site sewer system, a new permit is required. The original
soil test may be used to obtain a current permit.
If the well has been drilled, a well log should be sent
to this department to document the installation date.
If you have any questions regarding the above matter, please
do not hesitate to contact this office immediately at 264-
4720.
Sincerely,
Les N. Buchholz, R.S.
Sanitarian
June 3, 1976
4.1
4040 "B" STREET,
ANCHORAGE, ALASKA 99503
PHONE: 907-279-2581
'May 25, 1976
W.O. 17683
Grip 3037
Yukon Realty
4619 Spenard Rd.
~Anchorage, AK 99503
Subject: Subsurface Investigation - Ldts 11,12,13, Blk 2
Birch Tree Estates
Gentlemen:
Transmitted herein in accordance with your instructions are
the results of the above referenced investigation as performed
by us on May 19 and 20, 1976. The scope of this project is
investigation for suitability of an on-site sewerage system.
Included in this transmittal are:
Vicinity Map
T~-~s~ ........ ~ ' Sketch
Test Hole Log's
Explanatory InformaYion
Figure 1
F~ ~ure 2
Table A
Sheets ~-3
The exploration was conducted using a Nodwell mounted· Mobile
Drill model B-50 drill rig with a continuous flight solid
stem auger. The rig is owned and operated by Denali Drilling
Inc. Drilling was supervised, the test holes logged and
percolation test performed by Mr. Terry Barber, geologist
with Alaska Testlab.
The test holes were placed at the approximate location shown
on Figure 2. The logs of these test holes are included as
Table A of this report. In interpreting the logs it would
be helpful to utilize the explanatory information contained
in sheets 1 to 3 of this report.
When dri].ling was completed, a 3/4" slotted PVC pipe was
inserted in each hole to aid in determining the free water
level. For the percolation test, the test hole was filled
with wster and ].eft overnight to saturate. The next day,
~he hole was refilled with water and the drop in the water
].eve]. carefully monitozed over the next 60 minutes.
This procedure i.s not. a standardized percolation test.,
howevcr, w'e understand that the Anchorage Department of
Env'kronmental Quality prefers tests performed in this manner
to evaluate a site for a propos~a on-site sewerage system.
Yukon Realty
May 25, 1976
Page 2
Using the above test, the observed 'minimum percolation rates
were as follows:
Lot 11
Lot 12
Lot 13
min./inch
4_.~./inch
min./inch
No water table was observed during drilling, but it should
be noted that the free water level normally fluctuates
seasonally and with precipitation.
We hope this report meets your present needs. If we can be
of further service, please feel free to contact us.
Yours very truly,
Approved:
Melvin R. Nichols,' CE
Laboratory Supervisor
ALASKA TESTLAB
R. Mark Hansen
Attachments
Lot 12, ~Blk 2
Test Hole No. 2
Depth in Feet
From To
0.0 2.0
2.0 9'.0
9.0 13.5
13.5 16.0
TABLE A
Date: 5/19/76
Logged: T.B.
WO# 17683
SOIL DESCRIPTION
F-4, brown Gravelly Sand~ Silt (ML), damp, NP
F-2, light brown'Silty Sand, (SM), dry to damp,
layers of gravel and occasional cobbles.
F-l, brown Silty Sandy Gravel (GM), damp, has
layering of gravel Snd silty sand.
F-4, grey Gravelly Sandy Silt, (ML), wet, NP.
Bottom of Test Hole:
Frost Line:
Free Water Level:
SA.
NO. Depth
1 2.5
2 5.0
3 10.0
M%
16.0 ft.
None observed
None observed
Type of Dry
Sample Streng'th
G
G
Unified
SM
SM
GM
Remarks:
1)
2)
3)
'4)
Type 0f Sample, G=Grab
General Information, see Sheet 1
Frost & Textural ClassificatJ. on, see Sheet 2
Unified Classification, see Sheet 3.