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Home My WebLink AboutLAKE HILL ACRES #1 LT 29Loke Hill Acres Lo1' 29 #051-052-34 Municipality of Anchorage Page 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: ~--~P C/:~dz~:::)~:? RID Number: ~2~1 N~¢~ ~. ~ ~~ ~ ~, Wastewater System: D New ~Upgrade , Addres : i~~ ~~ ~. ~~ ABSORPTION FIELD Phone: ~.~ No.o~rooms:__ , ~eepTrench ~ Shallow Trench ~Bed ~Mound ~Other LEGAL DESCRIPTION SoilR~ting: ~'~GPD/Sq. Ft. Total Depth from original grad~ Lot: ~ Block: / ~Subdivisi°n:~ ~ Depth to pipe bottom from original~gra~: Ft. Gravel depth beneath pipe ~/ Ft. Township: Range: Section: Fill added above original grade: Gravel length: ~L I/ Ft. ~/ FI. WELL: ~ New ~ Upgrade Gravelwidth: ~ZFt. Number of lines:l Dsanceb~weenlines:~ Ft. lassific&tion(Private, A,B,C): ~ Total Depth: Cased To: Total absorption area: Pipe material: ~ Driller: ~ate Drilled: Static Water Level:Installer: Date installe¢: Yield: Pump Set at: ~ Casing Height Above Ground: TAN K GPM Ft. Ft. SEPARATmON DmSTANCES ~ept[~~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank S .... Lines ~ ~ Well ~ ~f~ ~ ~ ~1 Material: NumberofCompartments: Surface Water I ~ ~ ~ ~ ~ LIFT STATION Lot Size in gallons: Manufacturer: ~ "Pump on" le~mp off" level at: High water alarm at: Foundation ~ I ~¢~ ~ Cur,~in ~,~¢~ f~¢~O~., .~od~, ~,~t.ca,,.~p~ctio...~.,or.,~d~.: Drain Remarks: BENCH MARK Location and Description; I ~ ENGINEER'S SEAL Inspections performed by' 170~4 ~,gl, ~ivcr Joe ioa~, ~lst~l~ ~ ¢ ¢~'/ ' Eagle .wet, Ala,ka ~S~ 2nd~ ~:L~¢ ~~2 Department of Heal,a? Human. Services approval ., Reviewed and approved by: Date:~-/~-~ "~? 72-013 (Rev. 9/91) MOA 25 Permit No. $W9S0006 Page a of a 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 Well Inspection Report LAKE HILL ACRES SUBDIVISION, Legal Description: BLOCK 1, LOT 29 ~IDNo.: 05105234 CO1 . 9~,~ EXIST, ~. 1260 GAL ~.-r.,. FINAL WELL HOUSE MT C04 lo,Jo GAL SEPTIC TANK 96.6' TRENCH '~WELL 72-013 A fRev. 9/911 MOA 25 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST I 2 3 4- 5 6 7 8 9 SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18 19- WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT ~ - O DEPTH? P E I~o~it~ring? Gross Net Depth to Net Reading Date Time Time Water Drop PERFORMED ~a4 Eagle River L~R~a~ Eagle River, Ala~a ACCORDANCE WITH ALL STATE AND MUNtCIPAL GUIDE~FECT ON THIS DATE. DATE: 72-~8 (Rev. 4/~) 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 WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930006 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:THENO STEVEN M & SHELLY OWNER ADDRESS:24428 REESE RD CHUGIAK, ALASKA 99567 DATE ISSUED: 2/12/93 EXPIRATION DATE: 2/12/94 PARCEL ID:05105234 LEGAL DESCRIPTION: LAKE HILL ACRES #1 LT 29 LOT SIZE: 15000 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 343-4329 OR 343-4681 AFTER BUSINESS HOURS 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: DURING CONSTRUCTION OF THE PROPOSED ABSORPTION FIELD AN ADDITIONAL SOILS TEST SHALL BE PERFORMED BY THE ENGINEER AND SEVEN (7) DAYS WATER MONITORING TO A MINIMUM DEPTH OF 14 FEET. RECEIVED BY: ~~ ' DATE: ROBERT SHAFER, P.E. ROGER SHAFER, P.E. 3,1993 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIETEST PERCOI~,TION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN M~nicipality of Anchorage D~partment of H~alth and Human S~rvices P.O.. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 29; -~; Lake Hill Acres~I A Conditional Health Authority Approval (HAA} was issued on March I, 1993, for the referenced property.. All work r~quir~d for the Conditional H~ h~ b~n compl~d. A~ach~d is th~ On-s~ Wast~at~r D~pos~ Syst~ and/or Insp~on R~port for yo~ approve. W~ r~qu~st you ~su~ a Fin~ H~th A~ho~y Approv~ for th~ r~f~r~nc~d prop~y. If yo~ ~v~ any qu~o~ or r~q~r~ any ad~on~ info~a~on, pl~as~ co~a~ S/' 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Tom Fink, Mayor /Viun ( :pahty of Anck. rag¢ Department o! Hea th and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 February 19, 1993 Roger Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Re: Waiver Request for Lot 29 Block 1 Lake Hill Acres #1 Waiver Request #WR930001, PID #051-052-34, SW930006 Dear Mr. Shafer: Your request for waiver of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance is 87 feet from the well on lot 32 to the proposed absorption trench 6n the subject lot. The waiver requests for; 1) proposed absorption field to foundation, 5 feet, 2) proposed absorption field to existing absorption field, 5 feet, and 3) proposed absorption field to property line, 5 feet have also been granted approval. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-Site Services Manager On-Site Services OSS#196 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR% WR930001 PID# 051-052-34 HA% Permit % Date Received: January 4, 1993 Legal Description: Lot 29 Block 1 Lake Hill Acres Subdivision Engineer: Roger Shafer, P. E,. S & S Engineering 17034 Eagle River Loop Road, Suite 204, Eagle River 99577 Applicant: Steve/Shelly Theno Waiver Requested: ~-Ut Zg--w~3~l to scptie ~a~k- 90 re=L; Lct 29 wall ~D~pl-opo ' . ~1~ on Lot 30 to p~Jed~l'~fi~ld' ~cn Lot ~--9~-9~ fcct+ well on Lot 32 to proposed leachfield 87 feet; Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: Points: 3. Other: Waiver is Granted: ~>~ Waiver is NOT Granted: List Conditions or Reasons for above: Date: By: N~la~F~e viewer Rec #: 24359/5508 Amount: $ 590.00 Date Paid: 1-4-93 RoNALD E. A,'CSAMIT ST. RU'. ]~OX 9~2a g.AGLE RIVER ~iLASKA 99577 Tom Fink, Mayor Municipality oI Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 January 29, 1993 Timothy J. & Sandra M. Mortimer P.O. Box 672155 Chugiak, Alaska 99567-2155 Subject: Waiver from a Private Well to a Proposed Septic System Lot 29 Block 1 Lake Hill Acres #1 Subdivision, P.I.D. #051-052-34 Dear Mr. & Mrs. Mortimer: The property owners of the subject lot immediately to the east of your property, Lot 30 Lake Hill Acres #1, have made application to this office for a permit %o upgrade their on-site wastewater disposal system. The absorption quality of the existing absorption field is inadequate. As part of the permit application the property.owners and their engineer have requested this office to waive the required 100 foot separation between the septic tank and proposed absorption field on their lot to your well, reducing the separation distance to 90 and 95 feet respectively. There is a rigid set of requirements that must be satisfied in order for such a waiver to be granted. These requirements were met and an on-site inspection conducted to provide further assurance that granting the waiver would not have an adverse affect upon your well. The waiver, WR930001, will be granted on February 12, 1993. If there are any questions or objections regarding this matter, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-site Services #182 Tom Fink, Mayor unicipality .oI Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 January 29, 1993 Ronald E. Aksamit & Eva Loken 9123 Hiland Road Eagle River, Alaska 99577-9411 Subject: Waiver from a Private Well to a Proposed Septic System Lot 29 Block 1 Lake Hill Acres #1 Subdivision, P.I.D. #051-052-34 Dear Mr. Aksamit a Ms. Loken: The property owners of the subject lot immediately to the north of your property, Lot 32 Lake Hill Acres #1, have made application to this office for a permit to upgrade their on-site wastewater disposal system. The absorption quality of the existing absorption field is inadequate. As part of the permit application the property owners and their engineer have requested this office to waive the required 100 foot separation between the proposed absorption field on their lot to your well, reducing the separation distance to 80 feet. There is a rigid set of requirements that must be satisfied in order for such a waiver to be granted. These requirements were met and an on'site inspection conducted to provide further assurance that granting the waiver would not have an adverse affect upon your well. The waiver, WR930001, will be granted on February 12, 1993. If there are any questions or objections regarding this matter, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-site Services #182 x=.~+ 7 4, ¢ /.2 ~ 0 g~cK fly~dA~ ROBERTSHAFER, PE ROGER SHAFER. P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 29; Block 1; Lake Hill Acres Request you issue a permit to upgrade the septic system serving the referenced property and grant the following separation distance waivers: 1. The distance between the well on the referenced property and the existing septic tank at 90' 2. The distance between the well on the referenced property and the proposed leachfield at 89'. 3. The distance between the well on the adjacent Lot 30 and the proposed leachfield at 95'. 4. The distance between the well on the adjacent Lot 32 and the proposed leachfield at 80' The original septic system for the referenced property was installed in 1978. At this time the well was not installed. Subsequent to that date, the well was drilled, apparently too close to the existing septic tank. In October, 1989, a one bedroom upgrade was permitted and installed for the septic system. In March of this year we performed an adequacy test on the septic system for Health Authority ,Approval purposes. The results of the adequacy test indicate the system is only functioning adequately for a 1 bedroom capacity. Therefor, we are requesting a two bedroom upgrade. The proposed upgrade design is based upon the soils test performed for the 1989 upgrade. This soils rating is 20 min/inch and is consistent with soils tests we have performed in the area. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Lot 29; Block 1; Lake Hill Acres, In developing a site plan for the septic upgrade, we found there does not exist a location on the property to add onto the existing leachfield without encroaching upon the protective radii for several wells. This situation was further complicated by the well on Lot 32 being used to serve two homes giving a Class "C" rating requiring a 150' protective radius. Since the well on Lot 32 has never been approved to serve two homes (in fact, records implicitly state that it cannot serve two homes), the smaller mobile home on Lot 32 has been vacated. The water supply to the mobile home has been shut off by way of a valve located within the larger home on the property. The owners of Lot 32, have been notified that use of the well to serve two homes is a violation of State Regulations. For the following reasons we feel the requested waivers may be granted and the proposed septic upgrade permitted: Wells in the area (as with the referenced wells) are relatively deep at 189' to 228'. All well logs found show several layers of soil above the aquifer (presumably unconfined). The soil layers appear to consist of poorly permeable clays and "hardpan". This stratification of poorly permeable soils would help to alleviate the migration of septic effluent toward the aquifer. o As can be seen from the attached data sheets for flow tests we have performed in the area, the typical drawdown for these wells with existing pumps is very minimal ranging from 0' to 2'. This small drawdown would form only a minor hydraulic gradient toward the wells when they are in use. Therefor, use of the wells would not "draw" the effluent toward the aquifer. Unfortunately, the proposed septic upgrade is at a slightly higher elevation than the subject wells. However, in viewing the topographical map for the area, the general slope of the land is to the west. Since subsurface flows tend to follow the same flow patterns that topographical information suggests, the migration of septic effluent would be to the west, perpendicular to, and between the wells for which the waivers are requested. e The soil log used in the upgrade design (as with several soil logs for the area) show the effluent receiving soils to have a reasonably high silt content. These silty receiving soils would have a purification effect on the effluent as it migrates from the leachfield through the soils. Water samples taken from the subject wells show no bacteria or nitrates present. Thus, with several years of use of septic systems in the area, the aquifer appears to be still uninfluenced by septic systems. For the reasons listed above, we feel the requested waivers may be granted and request a permit be issued for the upgrade of the referenced septic system. Page Three Lot 29; Block 1; Lake Hill Acres, #1 If you have any questions or require additional information for your review, please contact us. Sincerely, ROGER J. SHAFER, P.E. RJS/tv Attachments I'= 40' J. SCALE I /{5 I"=40' SCALE J ~ I I ,R~A ~ ~,9_9 0 338.0 358.5 o 405.4 359.5 545.5 ~41.0 339.0 343,0 537.5 C 33Z5 525.0 314.5 L 322.0 360.5 367.5 347.5 55Z0 546.5 I 345.5 339.0 · Post-It'"' 'brand fax transmi~a[, .memo 7671 1 . # o: p~f~** · ~ ~ ~: ~ C~, ..... ~.~ ~~. .... _ TANKS ~ ~EPTIC ~ FIOLD~NQ TYPE OF SYSTEM ~TRENCH ~ B£D ~ W, DRAIN [~ OTHER 0 ~T~ tr. +ret= , -- '._ L_ ......... ?F.,_r..~~q WELLS PRIVATE OTHER dden.-%'t D.~OF ANCHORAGE rH AND HUMAN SERVICES 1 Health Dlvt~lon ~ska 99502, Telephone 264-47~0 ~I AND/OR WELL INSPECTION REPORT DISTANCES TAN~. k F!ECO WI;U. ~BU~LT DIAGRAM ~ow :~no~ of well ~pu~ Sy~om. p~c~ IJnae."tO~A~ltlon, i I , ! CE - 7760 MunlcipaJity ef Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG .-.- PERCOLATION TEST 1 2 3 4 6 7 9 10 11 13 14, 15- 16- 17 18 19 20 WAS GROUNO WATER £NCOIJ NTEJ-~,ED? $ IF YES, AT WHAT D~PTH? p ~13tlt ta W~' k~r , Time Water Oro~ 17034 Eagle River Loop Road ROBERTA. SHAFER Eagle River, Alaska 99577 CIVIL ENGINEER 694-2979 LOCATIONOFWELL(Legal Description): ~'~"~ '~L--'l~/-~ I L.~ WELL DEPTH: l~__.. FT. CASING: 4~::>' ~ FT. DATE DRILLING COMPLETED: ,~.~=...-Z.. STATIC WATER LEVEL {Top of Casing): DATE OF TEST: '~'"~"'~"' ~:~'~ SCREEN: FT. DATE: ~ '~? - fl~ CLOCK ELAPSED TIME SINCE DEPTH TO DRAWDOWN! PUMPING TIME PUMPING STARTED/ WATER, FT. RECOVERY RATE, GPM REMARKS STOPPED, MIN. 15 25 30 35 40 45 55 90 150 180 (3 hours) 210 ~. ~0 240(4 hours) RECOVERY t 0 0 5 10 15 20 25 30 35 PROJECT: .} ROBERTA. SHAFER CIVIL ENGINEER 694-2979 LOCATION OF WELL (Legal Description): ~-~:~ WELL DEPTH: ____0~~'' FT. CASING: DATE DRILLING COMPLETED: ~:?~¢Z'-~' STATIC WATER LEVEL (Top of Casing): DRILLER: _FT. DATE: SCREEN: ELAPSED TIME SINCE DEPTH TO DRAWDOW N/ PUMPING CLOCK PUMPING STARTED/ WATER, FT. RECOVERY RATE, GPM REMARKS TiME STOPPED, MiN. 35 ~ I 40 45 50 55 ~': 60 (1 hour) 90 120 (2 hours) 150 ~.,,, .,;. I 180 (3 hours) ';~'"~ ~ 240 (4 hours) RECOVERY 20 25 Flew is not Guaraiffeed Subsequent Variations Can Occur. / t ' ' -~, ' ~ ~.. ~ / Eagle River, Alaska99577 ~o~ct: ~ / LOCATION OF WELL (Legal Description): W~LLDEPT.: ~ FT, DATE DRILLING COMPLETED: STATIC WATER LEVEL (Top of Casing): ROBERTA. SHAFER CIVIL ENGINEER 694-2979 DATE OF TEST: \ ~ FT. SCREEN: I FT. DATE: CLOCK ELAPSED TIME SINCE DEPTH TO DRAWDOWN/ PUMPING PUMPING STARTED/ WATER, FT. RECOVERY RATE, GPM REMARKS TIME STOPPED, MIN. /'~,'- ~20 ~, O \ ~"'~ (swl) 0 0 Start 15 20 25 30 35 40 45 50 120(2 hours) 150 ~~ ~'~ 210 f ~ ~,~ ...... ~,,, RECOVERY ~ ',~- .~, .~. ~0 20 25 30 35 Commenls: Flow is not Guaranteed SuJ~sequenf Variations Can Occur. PROJECT: LOCATION OF WELL (Legal Description): ROBERTA. SHAFER CIVIL ENGINEER 694-2979 WELL DEPTH: [.)~' FT. CASING: ,~,~ I.,~ FT. SCREEN: DATE DRILLING COMPLETED: O~-'~ DRILLER: O ~ I STATIC WATER LEVEL (Top of Casing): / ~ FT. DATE: ~' ~'~C~ CLOCK ELAPSED TIME SINCE DEPTH TO DRAWDOWNI PUMPING TIME PUMPING STARTED/ WATER, FT. RECOVERY RATE, GPM REMARKS STOPPED, MIN. 25 30 120{2 hours) RECOVERY 10 15 20 25 30 35 Comments: Flow h not Guaranteed Subsequent Variations Can Occur, CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 AHALISIS RESULTS for INVOICE # 52074 Chemlab Ref.~ 92.1084 Sample # I ~atrix: WATER FAX: (907) 561-5301 Client Sample ID PWSID Collected Received Preserved wtth L29 BL1 LAKE HILL ACRES S/D. UA MAR 19 92 @ 14:30 bxs. ~ 20 92 @ 14:45 h~s. AS REQUIRED Client Name Client Acct BPOt Req~ Ordered By POt :HONE RECEIVED Analysis Completed : MAR 23 92 Send Reports to: Laboratory Supervisor : STEPHEN C. EDE 1)S ~ S ENGINEERIN~ Released Ey : /~~ 2) Parameter Results Units Method Mlo~able Limits NITRATE-N ND(O.iO) ~g/1 EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: RAY. Remarks: 1 Tests Performed * See Special Instructions Above UA=Unavailable ND= None Detected "See Sample Re~arks Above HA- Not Analyzed LT-Less Than, GT-Greater Than -G-~ Member of the SGS Group (Soci~t~ GGnGrale de Surveillance) CItEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PRIVATE WATER SYSTEM Mailing Address Ph~e No. $ & $ ENGINEERING 17o~. Ea_nle River Loop P. oa¢] No. 20~ Eagle River, Alas[ca 99577 C~y Mo. Day SAMPLE TYPE: ~ Routine [] Check Sample (for routine sample with lab ref. no. ) [] Special Purpose State Zip Code Year [] Treated Water [] Untreated Water SAMPLE No. LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Time Received /q~ ¢% Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ref. No. 924O84 I I I Result* Analys/t/ A .D .E.C. READ INSTRUCTIONS BACTERIOLOGICAL WATER ANALYSIS RECORD BEFORE COLLECTING SAMPLE Membrane Filter: Direct Count Verification: LSB BGB Fecal Coliform Confirmation Final Membrane Filter Results~ ~ Reported By '~'/~ [.'. U; (',/~~'~ Date ~ / PART Of~E OF TWO: REMAINDER TO FOLLOW TNTC = Too Numerous To Count OB = Other Bacteria Coliform/100 mi Coliform/100 mi CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA99518 TELEPHONE (907) 562-2343 FAX:(907) 561-5301 ANALYSIS RESULTS for INVOICE ) 55972 Chemlab Ref.~ 92.3527 Sample [ 3 Matrix: WATER Client Sample ID : L30 Bi LAKE HILL ACRES PWSID : UA Collected : JUL 15 92 @ 16:00 hrs. Received : JUL 16 92 ~ 13:30 hrs. Pxese~ved with : AS REQUIRED Client Name :S & S ENGINEERING Client Acct :SNSENGP BPO# : Req# : Ordered By :R. SHAFER PO~ :NONE RECEIVED Analysis Completed : 3UL 20 92 Send Reports to: 1)$ ~ S ENGINEERING Paramete~ Results Units Method Allowable Llmlts NITRATE-N ND[O.IO) ~/1 EPA 353.2 10 Sample ROUYINE SAMPLE COLLECTED BY: RAY. Remarks: 1 Teets Performed ' See Special Instzuctions Above UA=Unavailable ND- None Detected '* See Sample Remarks Above NA~ Not Analyzed LT-Less Than, GT-Gzeater Than Member of the SGS Group (Soci~tO GOn~rale de Surveillance) CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER CI PUBLIC WATER SYSTEM I.D. # I I I I I I I ~...PRIVATE WATER SYSTEM Name Phone No. Mailing Address City Zip Code Mo. Day Year SAMPLE TYPE: ~L-Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water [] Untreated Water SAMPLE No. LOCATION nl i Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Time Received // Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* .A,~naly~t A .D .E .C.~.~~ BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter: Direct Count O Coliform/100 mi BEFORE COLLECTING SAMPLE TNTC = TOO Numer OB = Other Bacteril Verification: LSB BGB Fecal Coliform Confirmation Final Membrane FIIter~, stults Reported By /tl~ PART ONE OF TWO REMAINDER TO FOLLOW Coliform/100 mi Oa,e 7' /7 Time: //,-~'"~ a.m. p.m. CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALYSIS RESULTS for INVOICE $ 55972 Chemlab Ref.$ 92.3527 Sample $ 1 Matrix: WATER Client Sample ID ?WSID Collected Received Preserved with L32 Bi LAKE HILL ACRES UA 3UL 15 92 @ 16:15 h~s. JUL 16 92 @ 13:30 h~s. : AS REQUIRED Analysis Completed : JUL 20 92 Laboratory 8uper~s~3N ~. EDE Released By : ~~/~ ~ Client Name :S & S ENGINEERING Client Aect :SNSENGP EPO# : Req~ : O~dexed By :R. SHAFER Send Reports to: I)S & S ENGINEERING 2) POS :NONE RECEIVED Parameter Results Units Method Allowable Limits NITRATE-N ND(O.iO) r~/1 EPA 353.2 10 Sample ROUTINE SABLE COLLECTED BY: RAY. Remarks: 1 Tests ?e~fo~mad ' See Special Instructions Above UA-Unavailable ND= None Detected "See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT=Gzeatez Than Member of the SGS Group (Soci~t~ G~n~rale de Surveillance) CHEMICAL & GEOLOGICAL I, LABORATORY A DIVISION OF COMMERCIAL TESTING & I~NGINEERING CO. TELEPHONE (907) 562-2343 { 5633 B Street Anchorage. AIasl<a 99518 Drinking Water Analysis Report for Total Coliform' Bacteria TO BE COMPLETED BY WATER SUPPLIER PRIVATE WATER SYSTEM Name Pho~o No. Mai~ing Address c~y Mo. . Day SAMPLE TYPE: ~ Routine [] Check Sample (for routine sample with lab ref. no. ) [] Special Purpose Slate Z~p Code Year [] Treated Water [] Untreated Water SAMPLE No. LOCATION I Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: "1~ S. atisfactory [] Unsatisfactory [] Sa[~ple too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Oa,..e~ived 7//~,/~?z_ Time Received /,_g.gb Analytical Method: Membrane Filter No. of colonies/100 mL Lab Ref. No. Result* I ~l:z~5~~ ~ I ~ I ~ A.D.E.C. READ INSTRUCTIONS Membrane Filter: Direct Count Verification: LSB BEFORE Fecal Coliform Confirmation COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD Coliform/lO0 mi BGB TNTC = Too Numerous To OB = Other Bacteria Final Membrane Filter Results Reported By PART ONE OF TWO REMAINDER TO l=nl~ Date Time: Coliform/100 mi 7./?. ?~ a,mo MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division (~ _~ / -f(-~J ~-- -'~ q 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Na,~e DISTANCES :~ ~(~'~'v/~C> FROM~ SEPTIC ABSORPTION WELL Address TAN~ FIELD Township. Range, Section T~¢H j [~t~, ~%%¢ driveway,AS'GUiLT DIAGRAM (Show location of well, septic system, propo.y tines, 'ounOatiOn.water boO,os, etc., Manulacturer Capacity in galions ~ ~~ Material ' NO. gl Compa~ments Depth to pipe bottom from Total depth from origin~l grade /~. ~/. -~ ~ ~, Fill added above original grade Gravel depth beneath pipe / / Gravel length Gravel width ~ -- ~ '~~ Instalter ~Og ~, WELLS ~.~ ~C~ ~ PRIVATE ~ OTHER IId~nlifv) Classification (A.B.C) Total Depth I Cased to ~ ~ ~ ~ ~ r -- ~ ~ , Instalte~ Date Installed: REMARKS: ~ ~ ~ ~/ ~ inspections Pedorm~d by: ) ~.~ ~ ~-~ Municipal and State guidelines in elle~n~his date: IoJ¢l J~q ;~)¢ "~?,%.., ,, CE- 7760 Health Depadment ,pproval= ( ' Date:; ~TY-- 72 "q,' .......... Par'ce]. :1: (::i ~ Lcd'.. L. ega:l.: Subd:i¥isicln: L~KE HILL ACRES :~;I. ~;i:F:,i:::t :i./]ri ',~ 3d:, Tc3Wlrl~Bh ::,.p ',', :LSN Range:, Lot. S:i.z~:!.! 1~.;i(:.'--00 (s(::j~ {t., or' ac:r'es) Max )Br~;~dr'r;)cm~s: 'Tl'~:i.s F:'(.:~mm:i.t: ! T'ot. al C,apacit. y',~ 3 B 1 c:lc k: - :i: I',I!i!N"ALL.. F:'IEI::;'. li::N('::; I i',II:ii].EF;..'S AT'TACHii!::D AF:'F:'RE.',"ViED DIES ]: GN ,, NOT I I:::'Y [)HI'tS PR ]: i3R TO Ii:ACH :1: NSI:::'EC'T 1 ON ,, V!EF:R I F:'Y IE X I ST :I: NG SI}E:I:::'T :[ C "l'Alql< ' S ):lq'II~'.E'~R:[ I"Y,, IEXCAVA'I :l:(:)lq MtJSt' BE O!::'EI~.iiED ANi.) CLOSED :t:N (:)hie DAY iE!_SEt CC)VEFd~/D RND I'IE(.:JTIZD IF:' MEI':'] OF:'EN I:::i]l::~ HO!::!IE "i"H(.~N C)NE ]'!"'i:iS F:'ERFi):f E:XF':[Ft'.ES ON :1.;~::/3!/8V,, ! F:'¥ ]]"iA"i' r, a/il .familiar' ~,,~:i.t. iq t.h,'.e reci;...',ir",'~am,'..~:,.'"rLs {oP (::ii"i.-E~:i.t(.~:.) si-'_'.),v,~[:(,rs and ~,,.,;.::~:l. ls as i,::,r-th i:::,y the h'h. tn;i. cipa:Lit, y o',"' Ar'ichl::ipage (MOA) arid tl"ic.) St. ate o',"' Alaska,, wi Il install t.l"ua sys'J.'c~lni :i.n ac:c:cmdance ~.,~:i.t. ln a].l I"IOA c:clde)s and requ:l.a'L ~td"id J.i'] i:::l:ifilj:):[.:i.~;~.['li:::i.':;, l,,.~:i.'~..l"i t. he d~sasign crit. e[':[a c,f 'l'..h:i. ss ~/-.i:i.:l. 1 a,:::ll"m:re t.c~ ail I"I[)A ar'id St. at.e i:ii Alaska r'6:qLt:i. Peiiisr'lt% {oP '(i"ic.::, set back ~i;Lar'il:::e:,s i Pc:m] ¢i[]y (?).( :i. st :i. I']g !,.,.~(a ]. ]. ~, v,~a~i!FL(.;,vca'i.'.i.~)r (:J i sr::,cisa 1 system oi" pub i :i. c !~].(.::;,N(.:.:?i"<::~i~l(~.~ ~iys'~'..(.:.'(,m or'¢ t.his (::)!' arw ad.:jaci.:.:.)nt or nearl::)y !cit. t.u~ch):.H'"st, arlci t. hat. t. his pe'.~:,Pi'iiit. :i.s raj. id ior a m~;~x:i, mum {::~' i l::0..:,dr'.ooms,~ ]. " ' ..... c ' - a adc, .~. ~k.i~mlal I:~e.mm:i.t.,, MOUNTAIN ENGINEERING 10251 CRF:STVlF:W F:AST EAGLF= RIVER. ALASKA 99577 (907] 696-1700 (SOO] 479-0101 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Ataska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~---~ ~/~"~"~f-J~ LEGAL DESCRIPTION: , .. -c~¢'~( L..c~ ~-1 (~([/-\ -' Township, Range, Section: "]-I~-/'"J/ J~l~,/ 5~::~ 5 6 7 8 9 10 11 13 14 15 16 17 18 19 20 SLOPE SITE PLAN WASGROUNDWATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? P E Depth to Water Alter,, monitoring? k/O'J~ ~_ Date: Gross Net Depth to Net Reading Date Time Time Water Drop ~ ). ~.o~ ~ ~;.~ /~7/,5" ~/~'~ 6~ ~S, oe /~.' ~ ~ 'iz'~ ~ PERCOLATION RATE __ TEST RUN BETWEEN -- COMMENTS (minutes/inch) PERC HOLE DIAMETER __ PERFORMED BY: ~4 ~:/~ ~'~F~/~ I ~'~J /~?- ;~- ~f~'~'~'~'~J CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: I !' fl 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 NA PHONE [] UPGRADE LEGAL DESCRIPTION LOCATION , ~ ~ NO. OF BEDROOMS Well Absorption area Dwelli~ PERMIT NO. ~Z< Manufacturer~.~ Mater~--d~/. _ - N°' °' °°mpartment' ~ ~ Inside length Width Liquid depth ~,' BISTANCETO: ..I, ~/~ Dwelling PERMITNO. ~ = ~ Manufacturer--z Material Liquid capacity in gallons ~ Well Found~n¢~ Neares~i~ ~ PERMI~ NO. ~ DISTANCE TO: , . ~~ ~ tile t "n--rade '~O ~ ~ ~, ~ inches Total ~f. fecti, ve No. of lines / Length of each line Total length of.li~es Trench width 0ist~ce bet~en lines ~ ~ Top of~ ~g, Material beneath tile absorption a Length I Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ¢ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, ~ ¢~¢ ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER ~,. Pi PIPE MATERIALS SOILTEST RATING ~ { ~ INSTALLER~ ~ ~ APP~VED DATE LEGAL 1'40. D[EF'FIF:'.'THENT /:" -'d[EALTH P','ND ENV :[ I:~:ONI"IEIqTF:IL. ~':'.'r:":YTE:C]" 1' ON :.:.:;,:.'i~i ":.?, ' I" F:: [!'] [~'J T ., FINC!"'IC~f~:Fir:JDL, FIK. F::EE3ERT .:::,H i ....1 ..r:,,.'. NORTH L2~9 L.t:IKI:~ H 'Iq-.-IF F::EQI...III;~:EE:, :E;I;.;:".E qF THE: ~E;OIL. HE,.,Ur4. F t.f'.,1 :,r::,-tEI1 I THE L..ENGTI--! [::, I i"IEN:B l ON 1:5 THE LENGTH ( I I",1 FEET :." OF THE TRENCH OF,' E'.,I:;i:FI:[ I'-,If.:' Z EL.D. THE [::,EPTH OF Fl TREIqC:H OR F'IT I'.'_::; THE:". [.':,I'~'_:;'I"FINCE: BE"f'HE:IEht THE :~J;LtI~::i:::i::~CE; OF' 'THE Gt:;~!OLIN[::, FIN[) 'THE [~OTTOM OF TH!:E E',:.:;CF:I'v'F:FF l O1",1 ,:: I N FEET ::'. 'T'HEF=:[E I2; IqO ::];ET I.,.IIE:,TH F'OI'(: TF.'.[:{NCHEE;. THE'] GB'.FtV[EL. [.':'EF:'TH Z':'.:i; THE FtlNiHU.i"I DEPTH O.F: GRFf',/EL E:ET[,.IEI~;N ']'HI:J~: OIJT!":'I:::IL.L. F'IPE!: F:tI'.,f[::, TFIE [3OTTEff"I OF' 'TH[E E::.:',CF:I',/I::IT Z ON ,:.' I f.,I F'[-::E:T :.',. F:'ERHI'T' FIF'F'L. IE:FtNT HFI!'; TH[E f.E:':,l ...l~z,I,::,.LIl TO INI:::O[:;:H TI-.tI::!; DEPF:IF;:THENT f',III:?'rNG "f'FIE ]: I'.,IS:;'TFiI._ LI::tT ]; OI'.,t )] N'.'~;F:'EXYI" I I.]~t'.,l~:~; OF I::lN"r' HE:LJ.2.".:; FtDJ'I::IC:ENT TEl TH Z :i!!; I I:.. F I:: I:;. I ¢ F:!ND TH[ii: I"4 HE ER Cfi:: I:RE::.:; t Lq, ENCEE; THFIT THE k!EKL.: H t L.L :.:~'ER','E::. E',R(:::!'::;FIL. LING OF Fll',l"r' :, z, lr:.tl HITHOIJT FINFIL .!i'.l':!iF't!.:'rcTIClt'.4 FII'.,IE:, RPI:::'F.:C¢,,,'FII... [",r I)EPF:IRTi-,'IEh!T .[41 L.L E:[E 'j( LIELTEE:T 'T'O F'[;::: '::.J [-..]I'/:t. IT ]' H i i',! !' HUH E:, I STF!i'.,fE:E BETklEEhl FI HELL. FINE:, Ri',l'.,.' ON-."¢ I 'T'E ~!;EHRGE E:, I L::;PEdi!;F:IL. :!i;"r'?FEH I :~i;. - :'LOE~ FE[ET FOR FI PIq:I'v'F:tTE: HELL.~ OR :!!:SEI 'FEi ;;:"E~O FLEET F:ROf't FI PUBLIC HEL.L E:,EF'ENDZNG LIF:'C)N 'THL:: 'F"r'F'E OF:' PUBL. IF: I.,.I[:J:L.I .... HEL. L. LOEiE; RRE F::EQUIRE!') FIN[::' i"llJ?l." [:'i:E RE:'I"URN[.:.'E:' TO THE: E:'EPRRTHEi",Ff' HI"FH:[N ]!i:~;i!l [)F:I"r'L:; OF THE HELL E:OHF:'LET:[ON. Ii)"fr'HI:EF..' I::;:EQU l REf'IENT~; hIR"r' FIF'PL.'¢. '.ii;F:'EZC 1' F' I CRT l ONE; FIND COiq?t'RLtCT i Oiq E:' ! FIGI:;i:FIM'.::] t::'IF~:E FI',/FI I L.F~BLE TO Z N:SUI::~'.E F'I:.-:'.OF'EP:: ]: N:!i;TFILL. FfiT Z I CIEt:;i:T I I::'? 'THFIT 1: t FIM FRM]:t..IFtFi: H!TH THE REQIJ]:REt"tENTS FOR FORTH [3"¢ THE I"IUN I C I PF'IL I T"r' Cfi:' ;;:J:: :t: HILL :[I',I~!;TFI!_L THr£ S'¢?FIEFt IN FICE:ORDF:tF,IC::E HITH ~!"HE CODE:5. ]-:: I Ui'.,IE:,ER2:;'I"F:Ii'.,ff)THFIT THE Oi'.;,-~.~;ITE ::~;[EHEF~: S'¢':};TEH f'lF:i"r' RE(;:!UIF;i:E I:EI'.,!L~F:IF~:GE::MENT IF' THE I:;::tE~:: I [:,E!qC:E I S R[CHODEL. ED '1"O I NCL..U[:,E HOf:?.E THFtN ]: ..................................................... 'erformed FBr .eaal ~escrintion: /ot29 Block Fhis Form Renorts Soils loq .yp.~ 2204 Clevelancl ~,neho~:age, Alaska 99503' Date Performed 8/4/78 Percolation Test Penth Feet Soil Characteristics Peat / Reddish Silt Brown Gravelly Sand with occasional Cobbles B0H Was Ground Water Encountered? 1~ Yes, At what Depth? NO Readinq Date Gross Time .% Percolation late .Hi nute Proposed ]ostallatlon: Net Time Seenaoe Pit E-F! I "' ~ i ) .J Depth to H20 Drain Field Net Dro Deoth of Inlet Depth To Bottom Of Pit Or Trench =A~ENTS:_ 150 Sq. Ft, dralnage__area required per_heddrenm- . Oate:~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St, P,O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage,ak.us (907) 343-7904 CERTIFICATE Of HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051.052-34 1. Expiration Date: ] ~.- / ;~. -~3 / GENERAL INFORMATION Complete legal description I~ake Hilt Acres #1, Lot 29 Location (site address or directions) 24428 Reese Rd., Chuqiak, AK 99567 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, NAA will be held by DSD for pickup, 2. NUMBER OF BEDROOMS: 3 Day phone Day phone Mike Ciaramltaro - RE/MAX of E.R. Day phone 694-4200 16600 Centedield Dr,, #201. Eaole River, AK 995'7? 3. TYPE OF WATER SUPPLY: Individual Well individual Water Storage Community Class .__ Well Public Water System [] [] [] [] TYPE OF WASTE-WATER DISPOSAL: Individual On-site [] Individual Holding tank [] - Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Cedificates of Health Authority Approval (HAP,) 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) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. 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 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 Health Authority 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 ail applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm END Enqineerinq Phone 696-6111 Address 20441 Ptarmiqan Blvd. Eagle River, AK. 99577 Engineer's Printed Name Kenneth M. Duffus Date 09/051200t ;.4,t-,,...,..,,,q'.~, k. ~'~J.-' ~ '*,'I~ I/~ENGINEER S ~..j,,,':.;............,,....,,,,. ~ ST~t.~? 5. DSD SIGNATURE ~~///7~'~.~-" Approved for bedrooms, c=,,,, ~ · Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: NM Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date, Municipality of Anchorage Development Services Department Bul)dln9 Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 w~vw.cl.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Lake Hill Acres 81. Lot 29 Legal De~ption: A. WELL DATA Well type Drivate Date completed ¶97'/+l- Total depth t80'+ ft. If A, B, or C provide PWSID ~ Sanitary seal (Y/N) Y Cased to 40'+ fl. FROM WELL LOG Parcel ID: 0~1-052.34 Date of test Static water level ft. Well production g.p.m WATER SAMPLE RESULTS: Coliform 9 colonies/100 mi. Date of sample: I)9104/200t B. SEPTIC/HOLDING TANK DATA Tank Type/Material ADoeam to be ateel Date installed 08/1978 Tank size 1250 gal. Well Log (Y/N) N Wires properly protected (Y/N) y Casing height (above ground) 1]" AT iNSPECTION 09/04/200t unknmvn (182~* ft. 6.0 g.p.m. Nib'ate 9,[i mgJt. Collected by: KND Enalneerlna Other bacteria J_ colonies/10Oml Number of Compartments Cleanouts Y_._Foundation cleanout y__Depmssian over tank NHIgh water alarm NA Date Of pumping 89/03/2001 Pumper C. ABSORPTION FIELD DATA Date installed 05/18/1993 Soil rating (g.p.d./ff2 or ft2/bdrm) 0.6 Length I}:} fl. Width ~ fl. Gravel below pipe 4' ft. Total depth 8 It. Eft. absorption araa 504 ftz Monitoring tube Y Depression over field N Date of adequacy test 09/IN~1 Results (Pass/Fall) Pass For 4 bedrooms Fluid depth in absorption field before test *O in. Water added 450 gal. Elapsed Time: 144~ min. Final fluid depth O in. Any rejuvenation treatment (past 12 mo.) (YiN & type) fl System type New depth ~_ in. Absorption rate >= 4[iQ g.p.d. If yes, give date ED UFT STATION Date installed 'Pump on' level at __ in. Datum SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot ~ Public sewer main Sewer/septic service line 25'+ Size in gallons Manhole/Access (Y/N) 'Pump off' level at __ in. High water alarm level at Cycles tested Meets alarm & circuit requirements? · in. On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank tQO'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~'* Property line Ii'+ Water main lQ'+ Water service line IQ'+ Wells on adjacent lots 1QQ'+ Absorption field Surface water ~QQ°+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *~' Building foundation tQ'* Water Senace line lQ'+ Surface water IQQ'* Curtain drain [iQ'+ Wells on adjacent lots 1QQ'+ F. COMMENTS Water main Driveway, parking/veld(de storage 25'+ G. ENGINEER'S CERTIFICATION m~ew of Munidpal m~s ~at ~e a~ s~tems am in ~n~anm ~ MOA ~ guidelines in effe~ on ~is date. HAA Fee $300 Date of Payment 09110/2001 Receipt Number . (Ray. 1~00) Waiver Fee $ Date of Payment Receipt Number 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 AUTHORI-FY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# 051-052-34 HAA# HA930094 1. GENERAL INFORMATION Complete legal description Lot 29 Lake Hill Acres Location (site address or directions) 24428 Reese Road Property owner Mailing address Lending agency Mailing address Steve & Shelly HC 80 Box 1530 Theno Dayphone 688-2459 Chuqiak, Alaska 99567 Day phone Agent Cindy Wilson % Mc Kenzie Real Estate Day phone 694-9035. Address Eagle River, Alaska 99577 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unlessotherwiserequested, HAA willbeheldforpickup. three (3) NOTE: Individual well xxxxxx 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 xxxxxxx 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. 72-025 (Rev. 1/91) Front MOA ~21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, 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 Enqineerinq~~--~ Phone 694-2979 Address 17034 Eagle Rive~ooop ~ad, Suite 204, Eagle River, Alaska Engineer's signature Date 99577 DHHS SIGNATURE ~"~" ''''~ ~ Approved for -~ bedrooms. Disapproved. Conditional approval for 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. 72~)25 (Rev. 1/91) Back MOA#21 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# 1. GENERAL INFORMATION Complete legal description Lot 29; Block I; Lak6 Hill Acres Subdivision;~l Location (site address or directions) 24428 R6~s~ Road' Property owner Mailing address Lending agency Mailing address St~v¢ & Shell~ Thcno HC 80 Box 1530 Chugiak~ Day phone Alaska 99567 Day phone 688-2459 Agent Cindy Wilson McKENZIE REAL ESTATE Day phone Address Old Glenn HZgb~ay: Eagl~ Riv~% Ak. 99577 Unless otherw~e requeste~ HAA willbe held forpickup. NUMBER OF BEDROOMS: $ %' TYPE OF WATER SUPPLY: NOTE: 694-9035 NOTE: TYPE OF WASTEWATER DISPOSAL: 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. Individual well Xx Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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 & $ ENGINEERING 17034 Eagle River Loop Road Address Eagle M,.,er~Alask_- 9?577 Fngineer's signature Phone Date DHHS SIGNATURE Approved for Disapproved. bedrooms. Conditional approval for -~ bedrooms, with the following stipulations: 7-0 Additional Comments Date i 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~)25 (Rev. 1/91) Back MOA ~21 Log present (Y)~::) Totaldepth L)~, - Sanitary seal. N) Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~.--~¢~1- "~--~ ~, t Parcel, I.D. WELL DATA Well type ~'~1~--~/'-~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed \ ~t ~ '7 ~ Driller. Cased to ~ J~ Casing height Wires properly protected~N) y Date of test Static water level AT INSPECTION FROM WELL LOG / Well flow g.p.m, z~¢, 7 Jo' Pump level ~)~' · SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot \ '~:>~:~ ~J~ Public sewer main SeWer service line ~-~ On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank g.D.r~.~ o P WATER SAMPLE RESULTS: Coliform ~' Nitrate · f,.~ I~T~, ~'¢),/~5 ~-~/ Other bacteria Date of sample: '~-~'~'~ Collected by: ~;~ ~ ~/~--- B. SEPTIC/HOLDING TANK DATA Date installed ~/'7E~ Cleanouts4¢F~N) High water alarm (Y/N) Date of pumping Tank size /¢ ~'-O Compartments ~' Foundation cleanout,~N) '~ Depression (Y~j~ ~ - Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: ! Well(s) on lot ~[ 0 ~/~v~ On adjacentlots To property line ~ C:p~ J~ Absorption field Surface water/drainage \ c:~rT~ I A-~ Foundation Water main/service line · CONTINUED ON BACK PAGE 72-026 (Rev. 7/91) Front C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at 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 Date installed \ ¢['7 ~; Le ng t h -~'2'~' ' ~r-'¢¢,F~,-/- Width Total absorption area Depression over field (YI~]~ Results (pass,~[~l:~ "~ L~ Peroxide treatment (past 12 months) Soil rating .Gravelthickness ~'.~L.' ,~ System type. Total depth Cleanouts present4~flN) Date of adequacy test for SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~ c;~.~ On adjacent lots ~ ~ bedrooms If yes, give date ~ ~2- I~. _Property line To building foundation On adjacent lots ¢~"¢~¢ Cutbank Surface water [ c~)/ Curtain drain /'J ~ /'J ¢:::: ,E-cdo¢~ ~"J' To e~<isting or abandoned system on lot /4 /~_ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION ~ ~o~. ~/~ ~d~ I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date 5 & S ):;NGINEERING 17024 Eagle l;~iver Looi~ I~oad No, ~0~ HAAFee$ /7~) ~ Date of Payme.t Receipt Number ~-~//,~ ~ ~ 7 '~ ./ Waiver Fee: $ Date of Payment Receipt Number CHEMICA£ & GEOLOG. ICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGtNEERI~IG CO. 5653 ~ STREET ANCHO,~AGE, ALASKA 99516 TELEPHONE (907) 60~-2343 FAX: (~07) 5~t-~301 CMlect*d ~02/2~/9~ t i$~iO lue, O~srsd ~y ~ ~ Ord,~ ~emrk.~ MUNICIPAUTY OF ANCHORAGE ) DEPARTMENTOEHEALTH&ENVIRONMENTALPROTEDTION DEPT. OF i!TALTH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ?,~.(?~ L.CTION ENVIRONMENTAL ENGINEERING DIVISION MAR 1 Telephone 264-4720 - REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~C~I.JIVE~D DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE Pnb~.r~, Zwicker (De-nise - bom~ mn.q~, nr ~.4m~ - j~]~_, o~]lh G$8-30Gfl MAILING ADDRESS ' -P,0. Box PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE SteYen a~cl_ SheZle,7 ~2:heno 277-'1080 MAILING ADDRESS ~27 ~. qG'b~ 9c)~0~ 3. LENDING INSTITUTION PHONE Un±ted Ban~ 0~' Alaska 27G-~9q'l MAILING ADDRESS 2G00 Den&].i Street 4, REALTOR/AGENT I PHONE ~ou Wood (G~acier Realty)J 2?6-8500 MAILING ADDRESS 72'] L Street 5. LEGALDESCRIPTION Lot 29 ~ake Hill Acres Sub. '~'/ STREET LOCATION Reese Street 6. TYPE OF RESIDENCE [~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY ~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. Awell log is required for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date I(~'~ ~ If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TiME DATE DATE DATE INSPECTOR I NSPECTOFI INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS "~ SINGLE FAMILY [] ONE ~ THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY COMMUNITY DRILLED DATE [] PUBLIC UTILITY Connection Verified __ LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER -[~] INDIViDUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER '~]Septic Tank or [] Holding Tank Size: I~r~). If Tank is homemade SOILS RATING give dirnensions: \~((~ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISI'ANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [Z.~-~APPROVED FOR .~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78)