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HomeMy WebLinkAboutCHRISTOFFERSEN LT 23AChristoff I1 Lot 23A #051 - 103 - 47  Municipality of Anchorage Development Services Department :=: ~:= = Building Safety Division Or~SIte Water & Wastewater Program. 4700 8curb Bragaw SL www.cLancflomge.ak.us (g07) 343-7g04 On-51te Wastewater Disposal System end/or Well Inspection Report Permit Number:. SW0100:~I PI0 Number. 051--105--47 FRED AND DARLENE OAYTON WastewaterSystem: [] New II Upgrode e.o. Box 6705s9 · CHU¢~AK. AK 99567 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 688-2442/279-$411 4 irlDeep Trench · Shollow Trench [] Bed []Mound []Other Te~a~ I)~u~ fr~m ees~n~ ~Se: LEGAL DESCRIPTION ~' "~ 0.6 ~/~ 23^ - CHRISTOFFERSEN 4' MAXIMUbl - - - 0.5-3.§ rL 100 (2 O §0')fL 5 ~r~ ~ 1000 ~.~ D 3034/ F-810 ~ EAGLE MTN. EXC. 3/19-22/2001 Tonk SteUon Toni[ ~ U,~ ANCHORAGE TANK 1250 Well I00'+ 100'+ - -- 25'+ STEEL 2 ..~o~k.: ~E Ex.stoNe SE~C TANK WAS CO~PL~'n. EY BENCH MARK REMOVED, CRUSHED, AND BURIED ON SITE. BOTI'OM OF GARAGE DOOR THRESHOLD Inspections perfomed by: AWWC. INC. Dates: 1st 3/19/2001 t'l": ..... 6th 3,/22/2001 SWO 100~ 1 -- 051-103-47 k~ / / / / ~ / /_ _ _HOMEST~D__ ROAD __x~W '/ ~ ~ ' e · , I C01 -- 42.2 ~5.1 ~ : J ~[N~ ~ ~ ~ -- ~1/ co; I / I / I I / / ~S~ WATER & WASTEWATER CONSULTA~S, INC. ~ FRED AND DARLENE GABON 688-2442/279-5411 2 OF CHRISTOFF[RS[N SUBDIVISION; LOT 23A AS-BUILT OF SEPTIC SYSTEM UPGRADE SWO10031 -- 051-103-47 fiNAL GRADE ~ 100.96 70P OF T~K AT~ = : ~TOP O~ T~g AT I~ OF BUNG~ N~ 1250 GALLON SEPTIC TANK ~ oF SUN~ AT AT IN~ - 94.91 O~ ~ 94.66 ~S~ WATER & ~STEWATER ~ FRED AND DARLENE GABON 688-2442/279-5411 3 OF 3 CHRISTOFFERSEN SUBDIVISION; LOT 25A ..'"' PROFILE AS-BUILT OF SEPTIC SYSTEM UPGRADE MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Mar 16, 2001 Expiration Date: Mar 16, 2002 Permit Number: SW010031 Legal Description: ~_~STOFFER~EN t¥ ~,~ ....... -~ Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: FRED & DARLENE GAYTON OwnerAddress: PO BOX670589 Total Bedrooms: 4 CHUGIAK, AK 99567-0589 Parcel ID: 051-103-47 Site Address: 022324 HOMESTEAD RD Lot Size: 44914 SQ. FT. Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ~ Issued By:, Date: Date:, Municipality of Anchorage Development Services Department Building Safety Dlvl~lon On-Site Water & Wastewater Program 4700 South Bmgaw St. P.O. Box 196850 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (9o7) 343-79o4 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0,51-103-47 Permit Number Property owner(s) FRED AND DARLENE (;AYTON Day phone - - Mailing address (1) 22324 HOMESTEAD ROAD * CHUGIAK. AK Mailing address (2) Legal description (Lot, Block & Sub'd.) 7Jp Code LOT 23~A CHRISTOFFERSEN SUBDMSION 99567- 0~'8~ Legal description (Section, Township & Range) Lot Size ,,, ~ 44, ~1~ THIS APPLICATION I$ FOR: Sewer Only Sewer and Well Sewer Upgrade Number of Bedrooms Well Only Water Storage THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Jam ,'-', ! ~E] Water Softening Unit I certify that the above Information is correct. I further certEy that this application is being made for a Single Family Dwelling and Is In accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTSf INC. Permit Fees:. ,.'.~ o~) Date of Payment: Receipt Number, Waiver Fees; Date of Payment: Receipt Number. ALASKA WATER & WASTEWATER CONSULTANTS, INC. March 15, 2001 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Septic Upgrade Design for Lot 23A, Christoffersen Subdivision To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system consists of a 1250 gallon septic tank and a deep trench type drainfield. The existing drainfield is in a state of failure and must be upgraded prior to the sale of the house. A test hole was excavated west/northwest of the existing septic system. The proposed septic system will be designed around the 30 foot radius of this test hole. We are proposing that a new 1250 gallon septic tank and a two 5-wide drainfields be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 0.6 gallons~day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 17.1 minutes/inch b. Allowable Application Rate: 0.6 gallons/day/fl2 e. Number ofBedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 1,000 ft2 f. Total Depth: 8 feet (max.- on uphill side) g. Effective Depth: .4 feet h. Width: 5 feet i. Reduction Factor: 0.50 i. Minimum Length: 2 ~ 50 feet long,each (100 feet total length) j Effective absorption area-- 1,000 fl~ 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached design drawing, the average topography of this property is a 5 to 15 percent running from approximately east/southeast to west/northwest; in short, there are no slope concerns. The trenches are to be installed parallel to slope contours. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Presi ,amess, P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a soils log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com (SECTION 4. Tr% RIW) ~:3 I I HOMEreD ROAD ./~. IL ........ .... ~ 23B; ~R~rr~NS~ S/D ~ / ~T 37; S~N g. tl~N, RIW ~T ~; SE~ON g, TISN. R1W J I / / CONSULTANTS. INC, SITE P~N FOR SEPTIC SYSTEM UPGRADE \"' \ HOMESTEAD ROAD ~ .~ / /Z':'.'~ .......... .~.~.- ~s~ ~m~ i LONG ~H (1~' FE~ TOT~ ~H). I I 0 : ~. ~N~ mmC~ ~ ~ ilJ ~ J// / ~ :~ ' ~ ~N8 I ' I ~~/ j.~ ~Hous~ ' I '~'~i ~llL~ ~ ~ ' I , ' , I NO~: ~E CO~OR S~L ~ ~E 100 FOOT WE~ ~IUS SO~H/SO~WE~ OF ~E PROPOSED SEP~C ~EM ~D THE J NO~ PROPE~ UNE F~GGED ~ A REGI~ERED ~D SU~OR j PRIOR TO CON~U~ON. J ~S~ ~TER & ~STEWATER CONSULTANTS, INC. FRED AND DARLENE OA~ON 688-24421279-5411 2 OF 2 CHEISTOFFEESEN SUBBIVISION; LOT 23A DESIGN OF SEPTIC SYSTEM UPGRADE ALASKA WATER & WASTEWATER CONSULTANTS, INC, ISOIL LOG~' - PERCOLATION TESTJ IFC, AL DESCRIPTION: CHRISTO;-i-~A'SEN SUBDMSION; LOT 23A -- -- PERFORMED FOR: FRED AND DARLENE: GAYTON DATE: 5,/8/2OOl JTEST HOLE GM/SM (HARDPAN) GW GP GM GC SW SP SM SC I ORG ML CL OL MH CH OH DEPTH TO GROUNDWATER DATE DRY 3/8/2001 13.0' 3/15/20011 (SEE DESIGN, PAGE 2 OF 2) DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) ,3/8/2001 1 4:09 6' 2 4:39 ,30 4-I/4' 1-,3/4' 3 4:39 6' 4 5:09 30 4-I/4' 1 -`3/4" 5 5:09 6' 6 5:39 `30 4-1/4' 1-3/4' PERCOLATION RATE 17 (HIN,/INCH) PERC. HOLE DIA. 6' (INCHES) TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. COMMENTS: PERC-HOIF WAS PRE-SOAKED FOR 4+ HOURS PERFORMED BY ALASKA WATER & WAsiEWATER I, JEFFREY A. GARNESS. CERTIFY THAT THIS W~S I~ERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL OUIDEUNES IN EFFECT ON THIS DATE: .~/1~'/01 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 [] UPGRADE LEGAL DESCRIPTION Well .._.. /' Absorptj. oj~arei~ DISTANCE TO: I Manufacturer~ , [Uq/~~,,on, ,F HOME.DE: Inside ?ngth _ DISTANCETO' [Well / / IDwetling Manufacturer Well DISTANCE TO: I ~O '~O {No. oflines / ILengtho~- Z Totallengt~nes Type of crib I Crib diameter Cr~ deCth DISTANCE TO Well · ~.ildi~ f~dstion ~1 - . Bepth Briller DISTANCE TO ] Builaing foundation Sewer line OTHER PIPE MATERIALS so,. INSTAOLE~ REMARKS I Dwelli20 / Width.__.._..~ Material Neares~tf~ e, Trench w,~t~.~ NO. Of BEDROOMS No. of compar~nts Liquid depth PERMIT NO. Liquid capacity in gallons inches G O L~mches Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Septic tank Absorption area(s) ? APPROVED ~"~ ~ ~-~ _~ ~ ~ i I~1 ~--~ ~ I J~'~ L~ DATE , .., ~B 196X . , ~H. 69~2979 ~ ~ 72-013 (Rev. 3/78) ' '~ ..... GAL! ' fi' DOG Co. cilia SULLIVAN WATER WELLS O. BOX 272, CHUGIAK, ALASKA 99567 ·r TELEPH.ONE 688-2759 DATE - Started Ended PERMIT NUMBER .... ., DEPTH OF WELL co, q S"~X~_ 3 STATIC LEVEL OF WATER DRAW DOWN FT. GALS. PER HR KIND OF CASING KIND OF FORMATION: From" '0 Ft. t° Fro~';" ~3 Ft. to Ft. <~' c~ ¥, ~ (~,-'ff,4c~c-"e.. Ft. Ft. From ~c~' Ft. tO From ZIL 3 Ft. to From ~ Ft. to"75" From__ Ft. to From 7..~ Ft. to~-'~'~ Fro~ e'? Ft. to / From /~)-,'<c/ Ft. to From,: 7.3 it. to ! From Ft. to From Ft. to From Ft. to From . Ft. to From__Ft. to From Ft. to From__.Ft. to From From - From Ft. Ft Ft Ft. Ft. From From Ft. to Ft.. Ft. to -Ft. Ft. to Ft. to Ft. to Fir From Ft. to Ft. From FLto Ft. From Ft. to Ft. From__Ft. to Ft. From Ft. to Ft. From Ft. to__Ft. From Ft. to Ft. From Ft. to .Ft. From Ft. to Ft. From Ft. to - Ft. From__Ft. to. Ft. From Ft. to Ft. MISCL. INFORMATION: DRILLER'S NAME PERM I T NO: DATE I .... UED. 84082 t 09/26/84 APPL I CAN]': ADDRESS: CONTACT F'HONE: C/O S & S ENG'G. 7 C'S CONSTRUCTION SRB 196X EAGLE RIVER, Al.::; 9957'7 694--29'?9 LEGAL. DI=-.SCR ! P: LOT SIZE: MAX £~.D SUBDIVISION: NA SECTION: 9 TOWNSHIP: :t5N 2.48A (SQ.FT. OR ACRES) 4 LO]': '~'~ '~ .... ..... BLOL;t....: NA ,~AN~.E, :LW I..isted below are 'Lhe optic)ns avai. lable to yoLt in designing your' septic system. Choose the option that. best Fits y©u.p site. '1- IF~~. E r',,.," (.Z: ~-II ]E,': E D P~,~. I], ~;: A ][ ~ DEPTH TO PIPE BL')T'¥OM (FT.) GRAVEL DEF'TH (FT.) TOTAL DEPTH (FT.) GRAi~EL WIDTH (I--T.) GRAVEL LENGTH (FT.) GRAVEL VOLUME (CU.YDS.) TANK SIZE (GALS) SOIL RATING (SQ.F]'. /BR) .:::) (NOT LSXCEEDING '~5 /, FT, EACH) TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. I am familiar wi'Lb the requirements fer' on--site sewers and wells as set. Forth by the Municipality oF Anchorage (MOA) and tJqe State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design cpitepia o¢ this pepmit. 3. I wil]. adhere to all MOA and St. ate of Alasl.::a requirements For the set back distances From any existing well, wastewater disposal syst. em of public sewepage system on 't..his or any adjac:eFit or near'by lot. 4, I unders'f, and that this per'mit is valid For a maximum of 4 bedrooms and any enlargement will F'eqLtiPe ar'i additi,~nal permit.. IF A LIFT STATION Im.., INSTALL. ED IN AN ARc:~-., ............. MOA BUT[...DT,~R.,. ll-l,r_h.,(1;, ,AN ,:T_., .... "-'m'rc'"!CAl-,~-,., I='ERMIT ,AND INSPECTION MUST BF OBTAINED; .,_, Alll ........ [, NITHOUT AN EI_ECTRICAL. :If ......... T ..,,,, F'.,..F.,I-,T,.. AND ¢'~;,..., THE ELI:.L, TRI~,AL_ WORK ~,,C~T BE DONE BY A ~_.IU~..Iq,~,-:D EELECTRICIAN. c- l (.".'] tq E D --,:- F L. I .~ .ANT: ]'cF::~ JE:D- BY C/O S &: S tL~",IG'G,, 7 C'S COI*,I~;TF<UCTI. Otq ........................................................................ ......... ............... Itl SOILS LOG ,/~% MUNICIPALITY OF ANCHORAGE ? e~!~i DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~~/ 1125 L. Street° Art~.,~o~age, Alaska ~501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR:__~~f DATE PERFORMED: PERCOLATION TEST LEGAL DESCRIPTION: 1 SLOPE SiTE PLAN 3 6 7 8 9 - ' 10 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER ENCOUNTERED? , IF YES, AT WHAT " ,*~ DEPTH? p ERCOLATION RATE ,,, ' TEST RUN BET'WEEN COMMENTS ~-'-~-~'.?~ ~~/- Gross Net Depth to Net R~ading Date Time Time Water Drop ~",~ I z ~:os p.. ~o ~ II ~ ~ ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: ~'7-- ~.. ' 3,~ LEGAL DESCRIPTION: [J:'- C~ t',/,(._. 1 2 3 4 5 6 7 8 9 10 11 12 ['~ o-~ 13 14 15 16 17 '~/c7'? SLOPE SITE PLAN 72-008 (6/79) WAS GROUND WATER j'~ I~ ENCOUNTERED? ~-~ O P E IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop I ~,-z.-~3 ~,35 p .... 7~ ------ q ¢.'z.~ ? /0 /35' _7_ _ PERCOLATION RATE '~d_~) (minutes/inch) TEST RUN BETWEEN ~ ~ FT ~ FT CERTIFIE ~ _ // / × Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & 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 FAHILY DWELLING Parcel I.D. 051-103-47 1. GENERAL INFORMATION Expiration Date: Complete legal description CHRISTOFFERSEN SUBDIVISION; LOT 23A, Location (site address or directions) 22324 HOMESTEAD DRIVE * CHUGIAK~ AK 99567 Current Property owner(s) Mailing address Lending agency TOM & MARIE IRELAND Day phone 688-1221 22324- HOMESTEAD DRIVE "' CHUGIAK, AK 99567 Day phone Mailing address Real Estate Agent Mailing address DAN FERRELL w/ PRUDENTIAL VISTA Dayphone 689-1808- 16635 CENTERFIELD DRIVE * EAGLE RIVER, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for propedies 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. Municipality of Anchorage Development Services Department BufldlnO ~fatY On-Site Water & Wastewater Program 4100 ~ou~ Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Legal Description: A. WELL DATA Wail type Date completed HEALTH AUTHORITY APPROVAL CHECKLIST CHRISTOFFERSEN SUBDNISIONi LOT 2,.~A~ Parcel ID: 051-105-47 If A, B, or C provide PWSID~ N/A Well Log (Y/N) YES 10/1984 Sanitmy seal (Y/N) YES Wires properly protected (Y/N) YES Totaldepth 180,9 ft. Casedto 180.9 fi. FROM WELL LOG 10/1984 159 ff. 15 g.p.m. Date of test Static water level Well production WATER ,SAMPLE RESUL'F~: Nitrate O'~1 (~mg./L. Date of sample: 4/8/2002 Depression over tank (Y/N) NO Pumper Casing height (above ground) AT INSPECTION /1/2OOl 156 ff. Coliform ~ colonies/lO0 mi. Arsenic: N/A mg./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Matertal STEEL Tanksize 1250 gal. NumbarofCompa~tments .. Foundation cleanout (Y/N) YES. Date of pumping 4/9/2002 C. ABSORPTION FIELD DATA 6.5 g.p.m. 12+ in. Other bacteria Lcolonies/100 nfl. Collected by: AKWWC~ INC. Date installed 3/19-22/2001 Cleanouts (Y/N) YE~ High water alarm (Y/N) N/A JR'S PUMPING **LESS THAN 2 YEARS OLD System type TRENCH Gravel below pipe 4 Depression over field ~ Fo~ Date installed 2/19-22~col Soil rating ~or ft~lxIm'~) 0.6 Length100 (20 80'~lt. Width 5 ft. Toteldepth *7.e-ll.2ft. Eff. absoq:)tlonaroal000 ft~ Monltoringtuba YES Date of adequacy test **NEW Results (Pass/Fail) - Fluid depth in absoq~tion field baforo test - in. Water added - gal. Elapsed Time: - min. Final fluid depth - in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) - New depth If yes, give date NO 4 bedrooms g.p.d. m HOMESTEAD ROAD 3~z3~e~J~ ~JiLT ~o.-.~$ o ~ ..... __.. ~.~ -- =~ · . ~, '*~'~- ......... ~.-~~ , , 9~ ~ R~ ~l~the~! 23B ! · ',.-, 'Municipality of Anchorage Development Sentices Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL p.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 'CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. O51 - 103-47 ¶, GENERAL INFORMATION Expiration Date: 0 1~31t3~' Complete legal description CHRISTOFFERSEN SUBDMSION; LOT 23A Location (slta address or diracfions) 22324 HOMESTEAD DRIVE * CHU01AK, AK Current Propertyowiler(s) FRED AND DARLENE GAYTON Dayphone 688-2442 Mailing address Lendingagency P.O. BOX 670589 * CHUGIAK, AK 99567 Dayphone Mailing address Real Estate Agent LYNN SWANSON w,/ PRUDENTIAL VISTA Dayphone 689-1803 Mailing address 16635 CENTERF1ELD DRIVE * EAGLE RIVER, AK 99577 Un/ass o~herwlae requested, HAA will be he/d by DSD forplckup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Indivldual Well Indivldual Water Storage Community Class Well Public Water System TYPE OF WASTE'WATER DISPOSAL: ~F1 Individual On-slta Individual Holdin .g, tank ~  Community On-site [] Public Sewer Fl The Munlclpality of Anchorage Development SaUces Department (DSD) Issues Cer'dficetes 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) for properties served by a single family on-sita wastawatar disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Cert§cates of Health Authority Approval are valid for 90 days from the date of Issue for propertes served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certficatos may be reissued for a period of up to one year with valid water samples.) Certficates are vaIid for one year for properties served by Class A er B wells or a public water system. The Municipality of Anchorage Is not rasponsibie for errors or omissions In the professional engineer's work. Note:Alaska Water and Wastewater Consultan~s, In~ shall be pald $2,820.OO at, or prior I to closing for the engineering seMces provided. I 4. STATEMENT OF INSPECTION BY ENGINEER As ce~fied by my seal affixed hereto and as cf the validab'on date shown below, I verify that my Investigation, based on procedures outlined In the Health Autho#~y ~oproval Guidelines for this application, shows that the on-site water supply and/or wsstewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and ~ of structure indicated herein. I further verify that based on the information obtained from the Munldpality ef Anchorage files and from my Invesb'gation and Inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance v, fth all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm ALASKA WATER &: WAST-----------------EWATER CONSULTANTS. INC. Phone · Address 6901 DEBAER ROAD. SUITE 2B * ANCHORAGE. AK 99504- Engineers Pdnted Name JEFFREY A. GARNESS. P.E. Date 337-6179 Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provfde a thorough, conscientious engineering ana~Jls of the s~tom in accordance with ADEC and MOA DSD Guidelines & Re~ju/ations. The repotted results described the I~efformance of the system under the condi~ons encountered at the ~frne of the test, and separation dis~ances measured to readily IdonEliebIs features. The oparet/onal life of all vmlls and septic sysfams depend on tho local sells condYJon, groundwater levels that may fluctuate dudng the year, and tho water usage of tho family being se/red by Jhe s~torn. These conditions are ou~side the con~l of the evaluator of the ~Tstsrn. Satisfactory test results do not guarantee fuIure pedorrnance of the system, nor do they guarantee that there are no hidden defoe"ts or encroachments. AWWC, Inc. can theref~ not provfde any wamanty or future est/mate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this repart Is f~r the sole benefit of the owner listed above. Any reliance upon or uce of this report by any other person or party Is not authorized, nor will it confer any legal right wha~ver. 5. DSD SIGNATURE Approvedfor Disapproved. /'~ . bedrooms. Conditional approval for __ Attachments: HAA Checklist Septic System Advisory Well Flow Advisory ~,. Manitenance Agreements Supplemental Engineer's Reort Other O~ginal Ce~f~cate Date: '~ - ~ ''~- ~) / Municipality of Anchorage Development Services Department Bu~xllng Safely DivlMm On-~lte Water & WastBwater Pmgflmt 4700 Soulh Omgew St. P.O. Box 196650 Anchorage, AK 99519-6650 Legal Descdpfion: A. WELL DATA Well type PRNATE Date completed 10/84 TOrN deplh 180.9 lt. HEALTH AUTHORITY APPROVAL CHECKLIST CHRISTOFFERSEN SUBDM$1ON; LOT 2~A Parcel ID: 051-105-47 If A, B, or ¢ pm~cle PWSlD~ N/A Date of test Stetl¢ water level 159 Well production 15 WATER SAMPLE RESULTS: Coliform 0 colonies/lO0 mi. Date of ~ample: 2/23/2001 B. SEPTIC/HOLDING TANK DATA FROM WELL LOG 10/1984 g.p.m. Well Log (Y/N) ~ propedy protected (Y/N) Casing halght (atxwe ground) AT INSPECTION 3/1/2001 156 ft. 6.5 g.p.m. 18+ In. Nllrate 0.789 mgJL. bacteria 0 colonies/lO0 mi. S ENGINEERING Tank 'Fjpe/Materlal Tank size 1250 gal. Foundation c~eanout (Y/N) YES Date of pumping NEW C. ABSORPTION FIELD DATA Date Installed 3/19-22/01 Length 100 (2 O 50)fl. STEEL Number of Compatlmante 2 Depression over tenk (y/N) NO Pumper. 6oll raung ~ ~redn'n) 0.6 Date hlalalled ,3/19-22/2001 Oeanoute (Y/N) YES Hlgh water ~ (Y/N) Width 5 ft. Totaldeplh ?.a-~ It. Eff. absorpffonaraalO00 It" Monlteringtube YES Date of adequacy test NEW Results (Pass/Fall) - Fluid depth In absorpfio~ field before test - In. Water added - gal. Elapsed Time: - min. Flmll fiuid depth - In. Absorption rate Any raJuvanaUon tma~ant (mst 12 mo.) (Y/N & type) System type 5-WIDE TRENCHES Gravel below pipe 4 ft. Deprasalon over field. NO For 4 bedrooms New deplh - In. - g.p.d. - If yes, give date - D. LIFT 8'rATION Oate installed Size In geilon~ ~ Cycles tested Meets alam~ & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 6epfie tenk/lllt station on lot 100'+ Absorpfion field on lot 100'+ Public sewar main N/A Sewer Iseplb service fine 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N,/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Absorption field Surface water. Bulidlng foundafion 5'+ Property line 5'+ Water main N/^ Water sewlce line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Bulidlng foundation 10'+ Surface water 100'+ Wells on adjacent lois. lOO'+ Property llne 10'+ Water sen/Ice line 10'+ Curtaln drain NONE KNOWN F. COMMENTS ,5'+ 100'+ Water main N/A Odveway, paddng/vehlclestorage lo'+ G. ENGINEER'8 CERTIFICATION I certify that I have determined t/rough field ir~ons end revfew of Municipal records that the above systems ere In conformance wfth MOA HAA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date ~.~~//~ Ol HAAFee$ 0°.0 Date of Payment ~ -c~-4::) I Waiver Fee $ Oate 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Christoffersen, Lot 23A T15N R1W Sec.9 Location (site address or directions) 22324 Homestead PropertY owner peg_cjy Coyle Day phone 688-3933 Mailing address P.O. Box 671548, Chugiak, AK 99567 Lending agency N/A Mailing address Day phone Agent Kathy Geraci/Great Land Realty Address 11411 Old Glenn Hwy'., Eaqle River, Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 ~ TYPE OF WATER SUPPLY: NOTE: Day phone 694-9125 AK 99577'} Individual well x Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site × Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Eagle River Engineering Services Phone 694-5]95 Address P.O. Box 773294, Eagle River, AK 99577 Engineer's signature D?,~,~SlGNATURE Approved for / ~edrooms. Disapproved. Conditional approval for Date bedrooms, with the following stipulations: Additional Comments Date 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. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~-"~'~:~ ¢'~ ~-,4,,-,.? ~/',~,.-.r~,,, S,,/,,/, Parcel I.D. A. WELL DATA Well type Log present (Y/N) Total depth /,P/' Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. Date completed Cased to /,Vz ' Wires properly protected (Y/N) ADEC water system number /~//g"¥ Driller Casing height ~- FROM WELL LOG Date of test Static water level /5"~ Well flow Pump level ~ ~"~'" g.p.m. AT INSPECTION ?//...~. ,..,.~/~/ MMNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION AU( - }. 1991 ~"..r" g.p.m. .-,.,,,- RECEIVED SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /~J-' / Absorption field on lot ,/-?'~ / Public sewer main ~CN~b~ic sewer service line °c"2 ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout -""/-'~ Petroleum tank '~'~'~'e WATER SAMPLE RESULTS: Coliform / Date of sample: Nitrate 4~ ,¢' '"'~ Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed /~*,')'*' ~*~ x~-~6"l Tank size Cleanouts(Y/N) ~F High water alarm (Y/N) Date of pumping Compartments Foundation cleanout (Y/N) .~' Depression (Y/N) Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /~ .c'" On adjacent lots ~-" '" ~ ' To property line ~'~ / Absorption field /~. ' Surface water/drainage Foundation Water main/service line 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA cq Date installed /',r~-~ tc:~'~-~ Length .~'~ ' Width -7~" Total absorption area ~'~'~ '~ Depression over field,Y/N) ~ Results (pass/fail) ,F'~~-cr Peroxide treatment (past 12 months) ((~ Soil rating ..~.'~.r- ~/~ System type Gravel thickness -~- / Totaldepth Cleanouts present (Y/N) ?/ Date of adequacy test ~/_z for ~'~ bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /-~ To building foundation On adjacent lots Surface water On adjacent lots ,'"'/",~ / Property line ,/'~" / To existing or abandoned system on lot Cutbank '"',/'~ Water main/service line Driveway, parking/vehicle storage area Curtain drain ,~',~,,e E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature ~ Engineer's Name HAA Fee $ / Date of Payment Receipt Number c.~ c~._~ ..~ ~ "" Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 EagLe River Engineering Services A 11940 Business Blvd, SuiLe JJ205 P.O. Box 775294 694-5195 Eagle River, Ak. 99577 Fax 694--3297 Owner: ~~ DaLe: Tvpe of ~esL: ~ Well Flow Test ~ Septic ~est Only ~Well · Septic Test ~ Other: Meter Monitor Well Tank GPM PSI Remarks Time Reading Level Level Level MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF W~.ALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date ~ & E E:-~GINEERIN~ Applicants Address SRB (c) Applicant is (check one) ue~ institution ~ ; ~er/builder ~ ; Buyer ~ ; Other ~ (~plain); (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) ~e HAA to the following address: 2. Type of Residence Single-Family~ ~umber of Bedrooms 3. Water Supply Multi-Family ~--~ Other (describe) Individual Well~ Community~--~ Public~-~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite/~ Public ~-~ Community ~-~ Holding Tank ~--~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. En~ineerin~ 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 om-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. 6. DHEP Approval B A~proved for bedrooas Approved /~' Disapproved __ Co Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 Well Classificatio.~~/~ ~ Well Log P~esent Total Depth / ~ ' Cased to Static Water 'Level / ~-~ Casing Height Above Ground 2 Elect~ica! Witting in Conduit Separation Distances f~cm Well: To Septic/%~(~a~ank o~ Lot To Nearest Edge of Absc~ption Field on Lot To Nearest Public Sewer Line C leancut/Manhole Water Sample Collected By Water Sample Test Results C~t,,'ents MUNICIPALITY OF ANCHORAGE (MOA) an o TY PP OVAL CHECKLIST - FEBRUARY 1984 Legal Description: /- z3' ,rz3-,,J If A, B, cr C, D.E.C. Approved(Y/N) Date Cc~p~ leted O -I/" Pump Set At Depth of G~outing ~ . Sanitary Seal on Casing0~) Depression A~ound Wellhead (¥~.)~ ; On Adjoining ~Lots ~/L'"~ .,,L / ~o ' ; On Adjoining Lots /C~D '~ TO Nearest Public Se~er To Nearest sewer Service Line on Lot ~ / B. SEPTIC/~TANK DATA Date Insta~ ,_1~/~ ~ Size /".~"~ Standpipe s (~/W) _ Air-tight Caps ~) Depression over Tank ~ Date Last~umped Pumping/Maintenance Contract on File (Y~/~% ; for Holding Tank High-Water Alarm (y/N)~C/~ Temporary Holding Tank Permit Separation Distances f~cm septic/Holding Tank: To Water-Supply Well To Property Line To Water ~m~/Se~i~e Line Cou~ se Con'lN~nts No. cf Compartments ~ Foundation Cleanout (Y~) To Building Foundation To Disposal Field ¢ TO Stream, Pond, Lake, /D Major D~ainage Receipt $ Date Paid: Amount: c{~ [Page 1 of 2] 2-15-84 ABSORPTION FIELD DA. TA Soils Rating in Absorption Strata Date .Installed / O/~ g/- Width of. F~.e:ld .._~O ~ Square Feet of Absorption A=ea Depression over Field (Y~_~ Results of Last '~de'quacy Test ~'2~/~ Type of System Design ~..~6 Length of Field ~(? Depth of Field ~ / Gravel Bed Thickness Standpipes l:~'e.~ nt ~ Date of Last Adequacy Test Separation Distance frcm A~sorption Field: To Water-Supply Well /~c~ · To P~operty Line //~ To Building Foundation "~ r To Existing or Abandoned System cn Lot /~, ~ /.3 ~ ; On Adjoining Lots ~ ~ To Wate~ Masm%/Service Line ~4~ ' ~- To Cutback(if present) To Stream/Pond/Lake/o= Majo= Drainage Course /-~ ~ ~ To D=iveway, Parking Area, o= Vehicle Storage Area ~O Ccmrents /~ o ~ ~_ D. LIFT STATION Date Installed Size in Gallons "Pump On" Ievel at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) 2i_nl"~sOff'' Level at Vent (Y/N) C clm ing Adequacy Test. Con~ents ** Check Permitted Bedroon Rating Against HAA Request ** I certify tha.~ve checked, verified, or confcz~ed to all MOA HAA Guidelines in effect on the s igne Date m/d5/s [Page 2 of 2] 2-15-84 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Health Division CASE REVIEW WORKSHEET CASE NUMBER: $-8027 DATE RECEIVED: February 21, 1985 COMMENTS DUE BY: March 8, 1985 SUBDIVISION OR PROJECT TITLE: T15N R1W Section (Christoffersen) 9 Lots 23A, 23B(Lot 23) ( ) PUBLIC WATER AVAILABLE ( PUBLIC SEWER AVAILABLE ( ) COMMUNITY WATER AVAILABLE COMMENTS: , ~.,--'*~ : "'" "' ,~ ' ,7. ;' ,~:; ,', ,.', ~ ~ ~ 71-014 (Rev. 5/83)