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Home My WebLink AboutGLENN VIEW ESTATES LT 5Glen View Estates Lot 5 #051-521-42 Municipality of Anchorage Page i of 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 N~me: ~O~ ~[~N/~c/ ~5'~ WastewaterSystem: ~New ~Upgrade Address~o P~one: ¢~_ ~¢¢~ No. of%oms: DeepTrench ~ShallowTrench ~Bed ~Mound ~Other Total Depth from original grade: LEGAL DESCRIPTION so,, R~ti.~:O. ¢ ~/S,.~. 7 Lot: ~ BIock:~ ~ ~ubdiv~ion:~)~ Depth to pipe bottom~,from//°rDinal grade: Ft. Gravel dept neath pipe Ft. Township~ Range: Section: Fill added above ori~al grade: Gravel length: Number of liees: Oistance~e~een lines: WELL: :~New ~ Upgrade Gravel width: ~ Ft. / /V/4 Ft. ~lassification (Private, A,B,C): Total Depth: Cased TO: Total absorption area: Pips material: Pump 8et at: Oasin9 HeiSt Above Ground: SEPARATION DISTANCES ~Septic U Ho[ding D S.T.E.P. Number of Compa~ments: Sudace , ~ ~ w~t~ /~% /0o.¢ LIFT STATION ~ LineL°t .~ / ~ ~ i ~ ~ ~ Size in gallons: 1 Manufacturer: ~// Foundation .~/ ~ ~ . i .... "Pump on" level at~~ofl,, level at: High water alarm at: -- Cu~ain ~O,V: ~O~g Pum~¢~ Electrical Inspections pedormed by: ~ Drain Remarks: BENCH MARK Location and Description: I A~umed Elevation: /~0 FI, 17034 Eagle River L~p Road Ne. 2~ E : inspections pedormed b~ace River' Alaska ~577 Dates: 1st //-%D - ¢7 72-813 (Rev. 9/91) MOA 25 PERMIT NO. SW970226 PAGE 2 OF 2 HunicipaLi~.. _y _oF Anchorage DEPARTIVlENT OF HEALTHAND HUiVFAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box 196650 I Anchorage, Ataska 99519-6650 · Telephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5, GLENN VIEW ESTATES STi ST2 ,,~,,,~ FINAL 9 12§0 GAL , S.T. CO1 MT2RC~02n MTldco1 = 94.3' II II I I~' ,co2 = 94.2' [11 ~coi = 87.9' MT2 - 84.~' MT1 = 84.1' NO WATER FOUND 75.1' B.O.H. LOT 4 MT1 ST2 FCO SITE P.I.D. NO. 051-521-42 LOT 5 TRENCH SIDING A B FCO 26.0' 28.6' ST1 47.9' 56.4' ST2 56.6' 43.0' BBL1 58.4' 44.4' DBL2 60.2' 45.6' C01 63.0' 35.5' MT1 62.2' 36,7' C02 129.2' 110.0' MT2 128.6" 108.4' OF WELL I P SCALE l" = 40' ROBERT C. COWAN CE - 8801 DOC eo SULLIVAN WA Yk.:: '% ELLS P.O, I~OX e7027~, CHUI31AK, ALASKA OWNER I~ welt I~ated et approved ~0~it Ioc~tion? ~ ~ No Depth of well: ~ D[~ meter _~(3 ¢ ~inches depth Liner Type: _ ~)&,,,J '"2 Casing Stiukup A~ve Gmu~: ~ Static Water Level (from g~und level): ~..6.~, feet Pumpmg [evef:~tee~ a~eC .h~ ~mping ...... gpm ~eoover Rate: _~ _gpm Me~d of Te)t rig: ~1~ .. W¢l Intake O~ning Ty~; ~n End ~ O~n HOle ~ Scr~n~d; Slab. feet Steppe. ,r~t 0eeh; i~ 0 , ~f~t, to. ~ feet P~ In,kc Dep~: feet Pump ~i[e _bp Brand N~me WeU Di~i~f~ted Upon COmpletion? ~ ~ No AfTENTION; it iS the ret~p~n~ibility of the prope~y owner to ~ubm t a copy oi the ~11 log to tRe proof authed~. Mum¢l~l~ of Anchorage: Depafl~ent of Health & Human ~s and/~ Depsv~n'~ ,[ o? ~:Znvi~n~n~l Con~em~t~n- MetSu Borough: ~pe~nent of Envi~nm~nte. I ~ooo~atton, /dO MUNICIPALITY OF ~uNCHORAGE DEPARTMENT OF HEALTH AND HUMAlq SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970226 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:LEROY ANDERSON OWNER ADDRESS:P.O. BOX 670045 CHUGIAKt AK 99567 PARCEL ID4U~5-?5~ZT2~ 0~/ ~ ~'~/ '~ ~.~ LEGAL DESCRIPTION: T~K1W"S~C'-~0-SW-'COR-NW4- LOT SIZE: 40000 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: DATE ISSUED: 7/31/97 EXPIRATION DATE: 7/31/98 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC'?2) AND DRINKING WATER REGULATIONS (18AAC80) . THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 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 THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: 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 WAS1 EWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, RE. ROBERT A. SFIAFER, RE. July 7, 1997 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 5, Glenn View Subdivision CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Request you issue a permit to drill a well and install a septic system to serve the proposed four bedroom house on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. The monitoring tubes within the test hole has been checked and found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional, information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure MUNICIPALITY OF ANCHORAG,c ENVIRONMENTAL SERVIcEs DIVISION _JUL 09 1997 17034 NORTH EAGLE RIVER LOOP . SUITE 204 . EAGLE RIVER, ALASKA 99577 NOISed _i NV-Icl-3±IS ~ q oZ o [ ¢ o~ / ~ ,09 = ~_~° PERFORMED FOR: LEGAL DESCRIPTION: ~-o 2 4 6 7 8 9 10 11 12 13 14- 15- 16 ~.-~, ©. ~(--, 17- 18- 19- 2O Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: Township, Range, Section: WAS GROUND WATER ENCOUNTERED? / IF YES, AT WHAT I'~ /.~ Oepth to Waler After ,~ /// ?... /¢ ~/ Monitoring? ~ Bate: SLOPE SITE PLAN I Gross Net Depth to Net Reading Date Time Time Water Drop , L, -~-~', - ._-- ~/ '/~,~' _ PERCOLATION RATE TEST RUN BETWEEN /'~¢__ (minutes/tach) PERC HOLE DIAMETER FTAND O. :) FT COMMENTS PERFORMED BY: ' , I f-.- ~ ~ ¢'"'"~"'~"~' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WII~e[_L~,r?EA,~,~qC~t~AL GUIDELINES IN EFFECT ON THIS DATE. DATE: "~ /~ / ~ '7 72-008 (Rev. 4/85} HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & ELOW TEST SITE PLANS ROAD DESIGN SOILTESF PERCOLATION TEST STRUCTURAL & MECNANICAL INSPECTIONS ONSIEE WASTEWATER DISPOSAL SYSTEM DESIGN ncnee zn¢ ROBERTC. COWAN. RE. ROBERT A. SHAFER, RE. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 5, Glenn View Subdivision July 7, 1997 GENERAL: The scope of this project includes the installation of a 1250 gallon septic tank and ~ five foot wide drainfield to serve the proposed four bedroom residence for the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of 'the tank. .Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP . SUITE 204 · EAGLE RIVER, ALASI~, 99577 Page Two Lot 5, Glenn View Subdivision July 7, 1997 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench-to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed--up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. De Monitor tubes shall be of four (4) inch diame'ter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe° This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Lot 5, Glenn View Subdivision July 7, 1997 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: ~y~pe of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the 4t200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever applies. Page Four Lot 5, Glenn View Subdivision July 7, 1997 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above 'to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/OWNER Parcel I,D, ' 051-521-42 1. GENERAL INFORMATION . Complete legal description Municipality of Anchorage '*"' '""'""'!' !i'~ i' Development Services Department :,ii' ~'. i,i~; ~ i"." ' '.' ' · Building Safety Division On-Site Water & Wastewater Pmrjr~m · ' ' · 4700 South Bragaw SL · ~,.~., . - .O. Box .196650 Anchorage, AK99519-6650.,~- .... , .,~ .: ,-~..~,. .... : ,: · , . ,www.ca,ancnorage'aK.us', -.. ...: . . , .... -.. · . ~" ~ '~,'(907133,3-7904' '", ,~'":."~: ~" '' ".'" ' ~ ,~'.':'."' ':' '.. - dE H '"L' ' .... "T""'"'°'A RTIFICATE OF EA TH AO~HbRI Y",&,~PR V k" FOR A SINGLE'F, AMILY DWELLI,NG ,~ ':" .: i.' ..... ' ' ' .. '--. E~(piiati~)~l' Da't~.'7-7-"O / "'* '"" ' GLENN VIEW [$1AIES SUBDIVISION; LOT 5, ' Location (site address or directions) 23323 GLENN HILL. CIRCLE" CHUGIAK,' AK 99567 Current Property owner(s) BRIAN CULHANE Day phor~e ' 336'-~ 702 Mailing address 8618 SAHALEE 0RIVE * ANCHORAGE~ AK 99507 .... Lending agency .... ;"- ' ....... ; 'Dayphone - '.'; ..... _M~iling address . ' ' ': ' · ' Real Estate Agent JOHN WOYTE w/ COLDWELL' BANKER' ~..[~,~, phon~ ~:'- 696-9306 Mailing address 10928. EAGLE RIVER RO~,0" EAGLE RIVER, AK 99'577 Un/ess otherwise requested, HAA will be held by DSD for pickup. 2. NUMBEROF BEDROOMS: 4 3. TYPE OFWATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] · Individual On-site BI Individual Water Storage [] Individual Holding tank [] Community Class Well [] Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Depadment (DSD) 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) 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 pdvate or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a pedod of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B we/Is 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 carb'fied by my seal affixed hereto and ~s of ~he vel/dar/on date shown below, I verify that my Investigation, based on procedures ouffined 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 vedfy that based on the Informafion obtained from the Munlclpali~y of Anchorage files and from my investigation and lnspection, the on-site water supp~, and/or wastewater disposal system is(are) In compliance ~th all applicable Municipal and State codes, ordinances, and regulations in effect at the time of Instal!at/on. NameofFirm ALASKA WATER & WASTE'WATER CONSULTANTS. INC. Phone ,357-6179 Address 6901 DEBARR ROAD. SURE 2B * ANCHORACE. AK 99504. Engineer's Printed Name JEFFREY A. GARNESS. P.E. Date ~-~1 Engineer's Comments: In conducting this evaluation, At444'C, Inc. attempted to pr~fde a thorough, consclen#ous engineering analysis of the system In acco~lance with ADEC and MOA DSD Gu/clef/nee & R~julations. The reputed resulis described the pedermanco of the system undel' the condi#ons encountered at the #me of the tea~ and separation distances measured to readi~, identifiable features. The operationat life of all walls and septic sTstem$ dopend on the Iocal se/is condition, groundwater levels ~at may fluctuate dudng the year, and the water usage of the faml~' being sensed by the s~stem. These conditions are ou~lde the contrel of the evaluator of the system. Satisfacfc~3/ teat results do not guerantse future perlbrmance of the system, nor do they guerantse that there are no hidden defects or encmachmen~ AWWCo Inc. can therefore not provide any wan'andy or fufure eat]mate of how long the ~tem will continue to meet the operational roqutrements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed abe~. Any reliance upon or use of this mpo/t by any other person or l:~Jly is not au~horZzed, nor will lt confer any legal rlght wha~'..~vor. 5. DSD SIGNATURE t~ Approved for L'IL bedrooms. Disapproved. Conditional approval for __ ON-SITE WATERAND :[n= · · · t WASTEWATER bedims, wi~ ~e alowlng snpu~aso~ t. PROG~M .. Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other (~. 12~o) Original Certificate Date: /~ - ~ - 0 I Municipality of Anchorage Development Services Department CO-SIte Water & Waatewater Program 4700 South Bmg~ St P.O. Box 196850 ~ge, AK 99519-6850 Legal Descriplion: HEALTH AUTHORITY APPROVAL CHECKLIST GLENN VIEW ESTATES SUBDMSION; LOT 5 Parcel ID:. 051-521-42 A. WEU. DATA Well type P~.A~; Date completed To~d depth 210 If A, B, or C plovido PW$1D~ N/A We"Log(Y/N) YES 2/5/98 Sanitary seal (Y/N) YES W1ras pmper~y pmt~:t~l (Y/N) YES Casedto 210 lt. Casing helght (above ground) FROM ~ ! LOG AT INSPECTION 2/5/98 5/19/01 165 .lt. 150 ~ 5 g.p~. 4.1 g.p~n. 18+ in. Oate of test Stalb water teval we, produc~m WATER SAMPLE RESULTS: Nitrate 0.587 mg./L. Other becteda 0 colcmies/100 mi. AWWC, INC. Coliform 0 colonies/100 mi. Date of sample: 5/20/01 SEPTIC/HOlDING TANK DATA Number of Compertment~ 2 Depre_~_~__v~_ ov~ tenk (Y/N) NO Pumper Soil rating (~fl~/txlrm) 0.8 W~h 5 .~ Date h~'lalled 11/20-21/97 Cteanout~ (Y/N). YgS Hlgh water alarm (Y/N) N/A JR'a PUMPING Tank size 1250 gal. Foundation cieanout (Y/N) YES o~te of ;~mping 4/4./Ol ABSORPTtON FIELD DATA Date Inslalled 11/20-21/97 Lang~ 78 !~ Ab~xptJon rate NONE KNOWN System type ' TRENCH Gravel below pipe 4 lt. Deprasalon over lbid NO For 4. bedmon~ Newdepth 14. In. 600+ .g.p.d. If yes, give date - Toteldepth *10-11 ~ Eff. abeo~Uonaraa 780 ft~ Monltodngtube YES Oate of adequacy test 5/20/2001 Resul~(Pas~Fall) PASS RuiddepthinabeorpOonflaldbefomtest 0 In. WateraddedlO15gal. F. Japsed Time: 905 min. Final fluid depth 2 In. .'~w rajuvanal~on treath~t (past '~2 mo.) (y/N & type) D. UFT ~TATION F. Date Installed. 81ze In gallons ~ 'Pump on' level at in. 'Pump . High water elmm level at In. ~ Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCE~ SEPARATION DIS'I'ANCE8 FROM WELL ON LOT TO: Sepllo tsnk/liff stallon on lot 100'+ Absorpllon field on lot 100'+ Publlo sewer maln N/A Sewer Isepllo sendce line 25'+ On adJacent lois 100'+ On adjacent lots 100'+ Public sewer manhole/dsenout Holding tatlk N/A N/A SEPARATION DISTANCE8 FROM SEPTIC/HOLDING TANK ON LOT T~. Building foundation 5'+ Property I~e 5'+ Water malo N/A Water 88ndc~ line I0'+ Well~ on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:. Prober~y line lO'+ Water service line 1 o'+ Curtalo drain NONE KNOWN COMMENTS Building foundation 10'+ Sur[ace water 100'+ Wells on adjacent lots. 100'+ ALL SEP11C PIPES ARE CUT OFF AT GRADE. Abseq~Uon field. 5'+ · Smface water. 100'+ Water main N/A Odveway, paddng/vehlcle storage 5o'+ G. ENGINEER'S CERTIFICATIOI~I I ce~ ~hat I have determ~ed through field Inspections and review of Municipal records 6~at ~he above systems are in conformance wi~ MOA HAA guidelines in effect on ~hle date. Date dP. PP~EY A, C.,ARNESS HAA Fee S Date of Payment /~" ~-C~ Recelpt Number Waiver Fee $, Date of Payment Receipt Number ~t~__ CT&E Environmental Servlces Inc. 1011378001 Ag. Water & Wastewatcr Consultants Inc. Glen View Est; L 5 Outside ll/B Glen View Est; L 5 Outside 1t/13 Drinking Water CT&E Rcf.# Client PO# Client Name Printed Date/Time 03/23/2001 12:08 Project Name/# Collected Date/Time 03/20/2001 7:38 Client Sample ID Received Date/Time 03/20/2001 15:10 Matrix Technical Director StephenJL Ede Ordered By -~~ PWSID 0 Released By Sample Rcmm'ks: Allowable Prep Analysis parameter Results PQL Units Method Limits Date Date Init Waters Department Nitrate-N 0.587 0.500 mg/L EPA 300.0 10 max 03/20/01 SCL M£crobiolog~' Laboratory Total Coliform 0 col/100mL SMI8 9222B 03/20/01 KAP Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAl. TN & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING o51-52z-42 GENERAL INFORMATION Complete legal description MAY 27 ]998 MUNICIPALITY OF AN,. ENVIRONM~:NT^L SFRVIC~ ulVl~lON Lot 5; HAA # _~1 Glenn View ~ubdivision Location (site address or directions) NHN Hilltop Drive Chuqiak, AK ,::Property owner Mailing address "Lending agency Mailing address Agent Address M2Ci Construction/Leroy Alderman P.O. Box 670045 Chuqiak, AK Day phone 99567 Day phone 688-3403 Day phone Unless otherwise requested, HAA will be held for pickup. NUi~BER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: xxx If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: xxx 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 ENGINEERING 170:~ I:a e RiYer Lu~,p Address Eagle River, Alaska 99577 ~n~ineer's si~aaturo _ ~/~. ~~' Phone Date ~/~ (, / ¢? ,~' DHHS SIGNATURE ~'/ Approved for /-0 L/' r- Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesyto 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 1¢21 RFCEIVED Municipality of AnChorage DEPAFtTMENT OF HEALTH & HUMAN SERVIC,~Y 2, 7 1998 Environmental Services Division j · ~ A I OF. ' O~b~GE 825L Street, Room 502. Anchorage, Alaska ,V,S,ON Legal Description: Lo 7- Health Authority Approval Checklist ~-- ~.,L~,J/d ¥/¢,.,v' 4¢.5~', ParcelI.D.: 0~'-/ -6~'~k(" 5/~2 A. WELL DATA Well type /o/~ ~ V4./~ If A, B, or C, attach ADEC letter. ADEC water system number Log present ~/N) ~"~ -y Date completed ~ / ~ / ¢) ~ Total depth '~ I O Cased to ~ I 0 Casing height (above ground) Sanitary seal (~YN) ~¢~:-_~' Wires properly protected ~./N) ~' ¢ -J Date of test Static water level Well production FROM WELL LOG AT INSPECTION / g.p.m, g.p.m. WATER SAMPLE RESLILTS: Coliform O Nitrate Date of sample: S~ '//¥/~ ~' B. SEPTIC/HOLDING TANK DATA Date installed II /),1 /0 '7 Tanksize 1"~-6~O Foundation cleanout C/N) 'Y~ ~' Depression (Y/~ Date of Pumping Iv/4 - ~' ~'"~" Pumper -~ C. ABSORPTION FIELD DATA Dateinsta!led If / ~.~ / ~ 7 Length '7 '¢' Width (0, ! Other bacteria 0 S & S ENGINEERING ~7054 Eagie River LoOp ir(cad No, 204 Eagle River~ Alaska 99577 Number of Compartments ~ Cleanouts (~/N) YCJ /,/o High water alarm (Y/~) ,~ O COllected by: Soil rating ~or fF/bdrm) 0 Gravel thiCkness below pipe System type. %,4¢,~ c,¢4 Total depth /o bedrooms Effective absorption area '? ~'0 ¢/- ~-' Monitoring Tube presenterS/N). Y~'J Depression over field (Y~(~ Date of adequacy test P'/~ ~ ~ ~ ~J Results (Pass/Fail) t~ ~'~ Fluid depth in absorption field before ~ Fr~mediately after gal; water added (in.): Fluid depth _~,~_.~f~s)-Mi~ut~s later: Absorption rate = g.p.d. PeroxidCt-~atment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D, LIFT STATION Date installed Manhole/Access (Y/N) "Pump High water alarm level at* ....~~~Datum E. SEPARATION DISTANCES F. Size in gallons "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~ 0 0 -/~ Absorption field on lot /8o -/ Public sewer main /J //4- Sewer/septic service line ~ $- -/ On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station /co ¢ /cO -/-- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation &-- -/- Propertyline ~- -~'- Absorption field / Water main/service line /0 ~ Surface water/drainage /o 0 ¥'Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / ~ '~- Building foundation /D -~ Water main/service line £ Surface water 10 O ~ Driveway, parking/vehicle storage area Curtain drain Wells on adjacent lots / O ¢ ',~ ENGINEER'S CERTIFICATION ab~ , cedify that I have determined thru field inspections and review of Municipal rec~f'the in conformance with MO~ H~uidelines in effect on this date. ~ ? ~ ~ "~'~ Eng neer's Name /~ ~/5 ~-(~ · o ~¢z¢~ are Date of Payment ~=~--~:~"~ /¢ Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number I'rH¥--c:l--l~'~ ll;c:~' L.I~P_ ES] ANCHORAGE ~t~ C T&E Ertvl~onrne. t.,$o rvl~es II lc. 90?$615301 P.03/05 CT&E Ref.# 982276002 Client Name $ & S Engb~eering I~'oj ect Name/# N/A Client Sample ID Lt 5 Glen View Est Matrix Drinking Water Ordered By PWSID 0 Sample Remarks: ~:'inted Date/Time 05/21198 11:08 CgIlected Date/Time 05/14/98 la:07 za,s.celved l;h~teJTtme 05/15/98 11:30 Technical Director: Stephen C. Ede Perameter geoutts Total COilform 0 gftrste-~ 0,100 U attowabLe Prep an~Lysls co[/lOOmL :~]~$ 92, Z7,§ 05/1~;/98 0.100 mg/L !:fA 500.0 11] max 05/17/98 05/17/98