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Home My WebLink AboutGLENN VIEW ESTATES LT 20Glenn View Estates Lot 20 #051-521-57 Municipality of Anchorage Page / 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 Name: , ~r~ ~ Wastewaler System: ~ _New ~ Upgrade Addres~o~ ~ ~¢ /~¢~ ~ ABSORPTION FIELD Phone: Z¢~_~ No. olBedrooms:~ ~ Deep Trench ~ShallowTrerlch ~Bed ~Mound U Other Total Deplh from original grade: LEGAL DESCRIPTION S°ilRating: /, ~ GPD/Sq. Ft. Lot: ~ Block~/~-~'~Subdiv~i°n: ~ Depth to pipe bottom from~l~original grade: Ft. Gravel depth beneath pip~ I FI ~ Number of lines: Distance between lines: WELL: ~ New ~ Upgrade Gravel width: % FI / ~ Ft. Classilicat~ (~rivate.~.B.C): Total Depth: Cased TO: Total absorption area: Pipe material: ~ ~O Driller: --, ti , I // DateDrilldd: SlalicWaterLevel: Yield: Pump Set at: C~-asing Heighl Above Ground: . /g GPM ~¢~n Ft. ~ Ft. TANK SEPARATION DISTANCES ~s~p~i~ ~ Holding ~ ST.E.P. TO Seplic Absorption Lib Holding Public/Private Manufacturer: Capacity in gallons: Prom Tan, Fietd si.rich Tank Sewer Lin,s ~ ~ WeI,' /¢0'¢ /¢0~ -- -- Z:~Material: ~ ~O / Number of Compadments: Surface Water /¢0 /o0% - - - LIFT S'rATION LO, __ Sizein gallons: ~Jturer: /' alarm Ele~l Inspections~r reed by: Remarks~¢ ~¢M~ ~/~ ~5 ,¢ ~ BENCH MARK Location and Description: ~,%/ ~ ~/. ~ Assumed Elevation: Inspections pedormed by: ~ ~~f~ Dates: 1st ~"'".?~~J~ Department of Health and Human Services a~fdval '~'l¢~e~",~¢~'~z* .. ~¢ ~ Reviewed and approved by , ~ ~~Date /0-&~- ~., ~~ 72~013 (Rev 9/91) MOA 25 AS-SUILT SYSTEM DBTAILS/SITE PLAN Permiq; SW980063 LE1T 20, GLENN VIEW ESTATES S/D PID~051 5al-57 Lot 19 S89°51'i8'W 418,98 co X?~HBT " PRBPBSED RESE ~ ("1 TIt ~$981~ ~/~/~/~.~/5/~ 0 ~ ~ ~'~AC g~ELL ~ % iO'~EQUESTI ................. ~m~?~-~'¢-~-,x~- .... -~ .......... ~ ..................... - ~ ~)26 B-C:54,0~ ~~ ~ ~ ~ ..... A-D=32,7' ~ d, r~ .... ~ FINAL GRADE ~ = ............ ~ ........... ~ T~ S-B=67'5' ~ /I SEPTIC '~ ~~ER RSCK ~-~=loo,~' ~ ~ ~ ~,~ I ~J4~ C~ ~ TURNER CONST, CO,, INC, Tt , P,O, BOX 3489 ~ ' / PALMER, ALASKA 99645 ~ C~-S~ ~ou~,~*~: LANG o~*~"x: KMD ~~8s1OS¢ ~ AS,,U,,,: LANG UA,E: 9/16/98 EAGLE RIVER, AK 99577-5736 P. 01 ADDR~S~ ~ LEGAL DESCRIPTION T~ INDENTIFICATION NUMBER ~1 Method of Drilling: t ~r rota~ ~ ~abla t~l Depth of well: ~/ Casing ~ ~Wall Thickness., ~ inches Liner Type: _~,~ Caring S[ickup Above Ground: ~ feet Stat~ ~ter Level (from ground level): ~ f~l Pumping level: feel afle~ .__hfs, PUmping. . g~m R~ver Rate: ~gpm Method of Teating: _~ Well Intake Opening Type: ~ End ~ eden Hole' E~ Screened; Staff ~feet Stopped~eet 0 Pedorat,on~ St~ Depth: f~~feel, Pump Inlake Depth: Pump ~lze ~ .bp Bland Na~e... Weft Disin[ected Upon Cempletion? ~ommenls: -" HOLE DATA ATTENTION: It is the responsibility of the property owner to ~ubmll a ~py o! Ihe well ~og tO the proper authority. Municipalily oi' Anchorage: Department of Health & Human Services and/or Dapartmenl of E~vironmental Conservation, MatSu BorOUgh: Department of Environmel3lal Conservation. PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980063 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:ARCTIC DEVCO INC OWNER ADDRESS:P.O. BOX 3489 PALMER, ALASKA 99645 DATE ISSUED: 4/14/98 EXPIRATION DATE: 4/14/99 PARCEL ID:05152157 LEGAL DESCRIPTION: GLENN VIEW ESTATES LT 20 LOT SIZE: 68887 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS ISSUED BY:~J~~. J-~N D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 March 26, 1998 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer/well permit - Glenn View S/D, Lot 20 Gentlemen: The owner has requested we proceed forward to obtain a well and septic permit on the subject lot. There is one previous testhole which was dug during the preliminary plat process. This hole was not suitably located and we have excavated another hole. We have designed our system utilizing the testhole we excavated for the four bedroom house which is proposed for this lot. The results of the existing test and water monitoring are attached. W~ propose to install a 5' wide deep trench. The original testhole indicated no water, and we did not find any water during our monitoring. Additional fill will be placed over the system to provide a minimum of 3' of cover when complete. There are no public or private wells within 200' of our proposed system location except as noted. There is neither surface water within 100' nor any curtain drain within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696.-8111. Respectfully submitted, ~'lxl ~ Engineering~ ff ennet M. u us, . . attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test 8 19 AS-BUILT 80,00 153,86 60 ¢J 153,86 SYSTEM DETAILS/SITE PLAN LnT aO, GLENN VIEW F-STATES S/D LOT :].8 b// 151,09 TH ERE¢89°51'IB'W 418,54 PROPOSED PRIMARY SYSTEM I_BT 19 389°51'18'~/ 418,98 LOT 20 TH #98-1 LOT 13 S89'51'10'W 294,19 LOT t8 K D VACANT ND PUDLIC WELLS WITHIN 800' OF PROPOSE3 SYSTEM, NB PRIVATE WELLS WITHIN 200' DF PROPOSED SYSTEH EXCEPT AS NOTED, NB SEPTIC SYSTEMS WITHIN 200' OF PRBPDSED WELL EXCEPT AS NOTED, 1 a DESIGN DETAILS 4 B])RM X 150 GPD = 600 GPD 500 GPD/1,8 GP3 PER SQ, FT, = 500 SQ, FT (500/(5')) X 0,5(RF) (4.0' GRAVEL) = 50 FT, TRENCH Toto, t depth oP system Is 6,0' Prom origino( 9r'o, de, Toto, t depth oP gpo, vet beLow distribution pipe is 4.0' , NBTES~ 1. USE i850 GALLON SEPTZC TANK, INSULATE TANK IF <4' COVER. P, INSULATE TRENCHES WTTH 2' HI) 3URIAL FOAM,, 3, CONTRACTOR WILL ENSURE HAXINUH PZ SLOPE 1NTB SEPTIC TANK, 4, AI)I)TTIBNAL FILL ~/ILL 3E ADI)E3 OVER SYSTEH TB ACHIEVE HTN, 3' COVER fF REQUIREI), PREPARED FBR~ REX TURNER TURNER CF1NST. CH., INC, P.B, DBX 3489 PALMER, ALASKA 99645 ENGINEERING- .'~'~D'~!~^R~i ~ ........?_~-*J~i ~K.M.p__ ....... ST^XlNG; I.ANG CHECK£D: KMD 20441 PTAItMIGAN BLVI). ~,AGLL ~WL~, AE 995??-8?36 AcAo,:,cm98033.[)WG ¢oa,o.: 98033 ~9072696-6111/FKX q907)696-811.1 Municipalil¥ of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST SLOPE SITE PLAN 4p 1£" 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER ENCOUNTERED? s IF YES, AT WHAT ~ (~ DEPTH? p E COMMENTS Monitoring? ~ Date:. Gross Net Depth to Net Reading Date Time Time Water Drop / ~?y-?,¢ //,' ~ ~- /~ ,' ~. //. y l:,.,.,,',-~ 1'; ~-h~ / ?~ ~ -~ //,/IZ ~- /:4" ~- //:'17 '~ ,-.,'., P "~,.'/ "¢:' PERCOLATION RATE ..,~, ~'-" 'L tmmulesnnch) PERC HOLE DIAMETER ~:~ TEST RUN BETWEEN '~,~- FTAND.~::2'-5'--FT / ! ACCORDANCE WITH ALL STAT NDMUNi L GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-0~8 (Rev, 4/85) MUNMPAU TY OF ANCHORAGE Development Services Department .. Phone: 907-343-7904 On -Site Water & Wasten�ater Section �� Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 05152157 1. GENERAL INFORMATION Expiration Date: 31, 0, � Complete legal description Glenn View Estates L20 Location (site address) 20411 Chapel Dr Current property owner(s) Mailing address Day phone Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic M Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6S0 Waiver Fee $ Date of Payment l t l3eh I Date of Payment T Receipt Number 046 t9 G Receipt Number COSA # 0.5 (' 21 1 �; q I Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal systern is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 745-8200 Date f1G A , Z2I, Conditional approval for bedrooms, with the following stipulations: ON-SITE W ri u\'ATER oz PROGF AM \cA \\,o 1 By: Original Certificate Date:,3 aUo2 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist . X Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory X Arsenic Advisory Other wwisorvt X COSA Checklist Legal Description: Glenn View Estates L20 Parcel ID: 05152157 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 7/98 Total depth 193 ft Cased to 192.5 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 11MW202, Static water level at beginning of test 153 ft. Comments B. TANK DATA Age of tank(s) 19'e years Tank type/material Measured operating fluid level in septic tank 4" ❑ Standpipes/foundation cleanout per record drawing Date of pumping 10/2/2021 D. ABSORPTION FIELD DATA shallow trench Which system tested (date installed) 5/98 ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade 34 -ft (min) ❑ N/A — pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced .__. gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 6.9 gpm Water storage tank volume na gallons Well disinfected for coliform test? ❑ Yes ❑✓ No R"Coliform bacteria is Negative Nitrate Mll( mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by PIE Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 111M2021 Results [DPass For 4 bedrooms Fluid depth prior to test ~-0" in Water added 600+ gal New depth <P in Elapsed time / ZjC> min Final fluid depth Q in Absorption rate 600+ and Any rejuvenation treatment (past 12 months) If yes, enter date '-"—° E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' P/1 Yes Community Sewer Manhole/Cleanout > 100' p✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' ✓V Yes if No ft Private Sewer/Septic Line > 25' ✓0 Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' 0✓ Yes if No ft Neighboring Absorption Fields > 100' F71 Yes if No ft Water Main > 10' Animal Containment > 50' C]✓ Yes if No ft M✓ Yes if No ft F,/1 Yes if No ft Water Service Line > 10' F� Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' P/1 Yes if No ft Surface Water > 100' El Yes if No ft Property Line > 5' F/I Yes if No ft Wells on Adjacent Lots: ✓/ Absorption Field > 5' if No Yes if No ft Private Wells > 100' F71 Yes if No ft Water Main > 10' ft Yes if No ft Community Wells > 200' F,/1 Yes if No ft Water Service Line > 10' F� Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓/ Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Service Line > 10' F/ Yes if No ft Community Wells > 200' p✓ Yes if No ft Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. —2 l C t se) COSA Checklist yellow sheet Steve... R. Panno.n CE 8149 Al Aw MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Septic Tank Advisory Certificate of On‐Site Systems Approval # OSC211691 Subdivision: Glenn View Estates, Lot: 20 The septic tank for this property is 23 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Nitrate Advisory Certificate of On‐Site Systems Approval # OSC211691 Subdivision: Glenn View Estates, Lot: 20 A water sample revealed a nitrate concentration of 6.48 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached “Nitrate Fact Sheet” for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as “blue baby” disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a medi a with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several “wet chemical” methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive “screening test”, and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.d,anchorage,ak.us (907) 343-79O4 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 051-521-57 1, GENERAL INFORMATION Expiration Date: Complete legal description CLENN ViEW ESTATES SUBDMSION; LOT 20, Location (site address or directions) 20411 CHAPEL DRIVE * CHUGIAK, AK 99567 Current Property owner(s) Mailing address Lending agency RICHARD & DIANNE SCHUSTER Day phone 20411 CHAPEL DRIVE * CHUGIAK~ AK 99567 Day phone 688-2077 Mailing address Real Estate Agent Mailing address DIXIE DIXON w/ REk4AX PROPERTIES Day phone 2600 CORDOVA STREET * ANCHORAGE~ AK 99503 257-0127 Unlesso~envisemqueste~ HAAw~beheldbyDSD~rpickup. 2, NUMBEROFBEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Indiv!dual On-site Individual Holding tank Community On-site Public Sewer The Municipality of A~chorage Development Services Deparlment (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given tn 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 prepe~es served by a single family on-site wastewater disposal and/or water supply system. DSD also issues ~ 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. Note: Alaska Water and Wastewater Consultants, In~ shall be paid $¥;~)~7,0~at, or prior to dosing for the engineering sen/fces provfded. 4. STATEMENT OF INSPECTION BY ENGINEER As cerlified by my seal affixed hereto andas of the validation date shown below, I verily that my investigation, based on procedures outlined in the Health AuthoriO/ Approval Guidelines for this application, shows that the on-site water supp~/ and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of st/ucture Indicated herein. I further vedly that based on the information obtained from the Municil~allly of Anchorage files and from my investigation and inspec~on, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Flr'm ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. 'Address 6961 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504- Engineer's Printed Name JEFFRD¢ A. (~ARNESS, P.E. Phone 357-6179 Date '? ~ Z.:/~'l~ Engineer's Comments: ' In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering ana~s~s of the system in accordance with ADEC and MOA DSD Guldetinea & Regulations. The reported resu~ deac,'fbed the pedermance of the system under the conditions encountered at the time of the test, and separation disl~nees measurecl to readi~, /dentil/able features. The operational life of all wells and septic systems depend on the local cells condition, groundwater levels that may fluctuate dudng the yea~, and the v, ater usage of the fami~ being served by the s~/stom. These conditions are outside the control of the evaluator of the system. Sa~sfactoty test results do not guarantee future porfermance of the system, nor do they guarantee that there are no hldEon defects or encroachment& AWWC, Inc. can t]~erefore not provide any warranty or future estimate of how long the system will continue to meet the ol~erational requirements of the ADEC er MOA DSD. The content of this repo~ is for the sole benefit of the o~,~or listed above. Any reliance upon or use of this report by any other person oc parly is not authorized, nor will lt confer any legal rlght wha[soever. 5. DSD SIGNATURE /,,'"" Approved for L~- bedrooms. Disapproved. Conditional approval for __ bedrooms, with the fllowing slJpulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitsnance Agreements Supplemental Engineer's Reort Other Original Certificate Date: Municipality of Anchorage Development Services Department OmSlle Water & Waslmter Program Pi0. aox ~m,~o Anc~a;~. AK .gS19-~,~O wv~A~mc~orage~ua (~o'h ~4~7~04 WELL DATA Weld type PRIVATE Date completed 7/1/98 Total depth 192.5 fL Date of test Static water level Well preductlon WATER SAMPLE RESULTS: HEALTH AUTHORITY APPROVAL CHECKLIST GLENN VIEW ESTATES SUBDMSIONo LOT 20~ Parcel ID:. IfA, B, otC provide PWSID# Case(liD 192.5 fL FROM W~I I LOG 7/1/98 '155 lt. 12 g.p.m. Date of sample: 2/12/01 Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Tank alze 1250 gal. Number of Compartments 2 Depression overtenk (Y/N) NO Pumper Foundation cleanout (Y/N) YES Date of pumping 2/9/01 C. ABSORPTION REM) DATA Gate Installed 5/1~/~8 Soil rating (~or tt'/'edrm) 1.2 Length 51.5 fL Width 5 051-521-57 Well Log (Y/N) wre~ pmpedy protected (Y/N) Casing height (above ground) AT INSPECTION 2/9/01 157 6.5 Other bacteria . AWWC, INC. YES YES 18+ in. g.p.m. ~ colonle./lO0 mi. Date ~ste~ed 5/15/98 (~eanout, fi/N)YES High water elam1 (Y/N) N/A dR'S PUMPING Total depth a.o+/- fL Eft. absorption aran 500+ It' MonliDdng tube YES Date of adeduacy test 2/9/01 Result~ (Pass/Fall) PASS Water added 868 gal. Fluid depth In absorption field before test 0 In. Elapsed Time: 110 min. Final fiuid depth 0 Any rejuvenation tmalment (past 12 mo.) (Y/N & t~3e) In. Absorption rate NONE KNOWN TRENCH Gravel below pipe ¢ lt. Oepmsalon over field NO For 4. bedrooms Newdepth 5 In. 600+ g.p.d. If yes, give date - D. UFT ~rATION Date installed. Size In gallona ~__ _ · Pump on' level at In. 'Pump o n. High water alarm level at In. ~ Cycle~ tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCE8 FROM WELL ON LOT TO:. SepUo tenk/iltt stetlon on lot 100'+ Absorpt~oA field on Int. 100'+ Publl~ sewer main N,/A Sewer Ise~c service line 25% On adjacent lots 100'+ On adjacent lots 100'+ Publio sewer manhote/cleanout Hl:ddl~ teRk N/A SEPARATION DISTANCES FROMSEPT1C/HOLDING TANK ON LOT TO: Building foundation 5'+ Properly line 5'+ Water main lO'+ Water sauce ane. 10'+ WelI~ on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line 10'+ Building foundat]o~ 10'+ Wate~ service line Curtain drain F. COMMEHT~ Absorpt/on field. 5'+ Surface watsr. 100'+ Water main lO'+ Driveway, parkJng/vehlcte storage 50'+ 10'+ . Sun~acewater lOO'+ NONE KNOWN . Wel~ on adJacent lots 100'+ t G. ENGINEER'8 CERTIFICATION I cer6t~ that I have determined through field Inspecfona and review of Munlc~al records that the above sys~'ns am In conformance with MOA HAA guidelines In effect on this date. Engineers Pdnt/~d N/~me JEFFREY A. GARNESS HAA Fee $ Date of Payment Recelpt Number Waiver Fee $ Date of Payment Receipt Number. 02-15-01 15:$0 F~OI/,-CTE ENVII~iI,[NTAL ~tK CT&E Environmental Se~lcel Inc. 5515301 T-898 P.02/02 F-34~ CT&£ RtL# Client Name Project Name/# Client Simple ID Matrix Ordered By PWSID Sample Remarks: 10106S3001 AK Watcr& Wastewatcr Consultants lflc. Glenn View Est ~D Lot 20 Glenn View Est S/D Lot 20 Drinking Watcr Nit[ate-lg ResuLts PQL Units Method 3.49 0.500 mg/1. EPA 300.O Client POI~ Prlntcd Da,e/Time 02/15/2001 16:19 Collected Date/Time 02/12/2001 8:30 Received I~.tte/Time 02/12/2001 16:10 Technicnl I~irector Stephen C. Ede Released l~f ~~ Atto~abte Prep Analysis Limits Data Date Init 10 max 02/13101 SCL Total Coliform 0 col/lOOmL SMIS 92228 O2/12/01 KAP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I,D. # . O~'~/-.~/-- ,.~'7 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailin. g address Agent Address Al< Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 o 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 KND Engineering zu44~ Ptarmigan Blvd. Address Eagle River, AK 99577-87~ EngineeFs signature ~~-~~~,~ Phone ~ ~ -~,///// DHH$ SIGNATURE Y Approved for /c"~C/~ Disapproved. Conditional approval for bedrooms. bedrooms, with th-e 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 engineeCs work. 72~2~ (Re*,'. 1/91 ) Beck MOA ~21 i i tVI!D Municipality of Anchorage SIP Z ~ DEPARTMENT OF HEALTH & HUMAN SERVIC~Scr~i~¢/~u~ o~ Environmental Services Division f.N¥1RQN/Y~N'i-AL SERVICES 825 L Street, Room 502 · Anchorage, AlaSka 99501 · (907) 343-4744 Health Authority Approval Checklist LegalDescription: /-.o/ ¢O ~___~/~ ~///~.~ ~ ~l _Parcell,D.: A. WELL DATA Well type /~l k;¢-~-¢~ Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~/1 Cased to Casing height (above ground) Wires properly protected (Y/N) _. ? Date of test Static water level Well production PROM WELL LOG AT INSPECTION · 1~¢- g.p.m. ~ WATER SAMPLE RESULTS; Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Foundation cleanout (Y/N) Date of Pumping' C. ABSORPTION FIELD DATA Date installed / Length .5-',/, Width Nitrate ~' '~ ~J Other bacteria Collected by: Tank size / ~.C20 Number of Compartments ~/ Depression (Y/N) /[// High water alarm (Y/N). /./,4 _ Pumper Soil rating (g.p.d./fF or fF/bdrm) ~ / Gravel thickness below pipe Effective absorption area Monitoring Tube present (Y/N) ~' Date of adequacy test / Results (Pass/Fail) // For ,// rp~r ~ a~ Fluid depth in abso e test (in.); ely after g (in.): Fluid depth ~" (ins) Minutes later: ,/" Absorption rate = g.p.d, g.p.m. /' ~ System type. ~¢t ¢¢'~%~' L../ ' Total depth ~, ~ ~ · _ Depression over field (Y/N) ._Z~____ bedrooms 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested "Pump on" lev7~lOns E. SEPARATION DISTANCES Septic/holding tank on lot Absorption field on lot Public sewer main SEPARATION DISTANCES FROM WELL ON LOT TO: /DO (+ Sewer/septic ~e~ioe line ~/~ ~PARATION DISTANOE~ FROM 8EPTIO/HOLDING TANK ON LOT TO: Foundation /~ /~ Prope~ line /~ ~ Water malmsey/ce line ~ ~+ W Sudace water/drainage /~ ~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Surface water Curtain drain /~(~ ¢~' Building foundation On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station //DO t + ,lDO Y- Absorp,ti0n field /O Wells on adjacent lots Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots //_.00 ,4- F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recor_de,~_tf~e a~/~ ~ems are in conformance with ~OA HAA guidelines in effect on this date. Signature ~/y~~. ~__~~~~///2, Date · HAA Fee $ Receipt Number ZI ?~ ,~ 72-026 (Rev. Waiver Fee $ Date of Payment Receipt Number SEP 21 '98 01:01PM HTL ~NCHOR~GE NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA -q.9701 (907) 456.3116 · FAX 456.3125 8005 SCHOON STREET ANCHORAGE, ALASKA 99~1~ {907} 349-1000 · FAX 349-1016 POUCH 340043 PRUDHOE BAY. ALASKA 99734 (90'2) 659-214~ · FAX 659-2146 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA KND Engineering 20441 Ptarmigan Blvd. Eagle River, AK 99577-3736 Date Received: 9/14/98 Time Received; 14:55 Date Analyzed: 9/14/98 Time Analyzed: 15:30 Date Reported: 9/16/98 Time Reported: 11:49 Next Sample Due: Comments Phone Number: ( )696-6111 S = Fax Number: ( )696-8111 U = POS : Collected by: DEA ND = Sample Type: Special Purpose TNTO = CG = Methoct of Analysis; Membrane Filtration (SM 9222 HSM = B) SA = Comments: Old = R = NT = No Test * ¢ Colonies/100 mi Sample Sample Total* Fecal Other* HPC** Date Time Coliform Coliform Bacteria Result Lal;~ Satisfactory Unsatisfactory Positive Test Result None Detected Too Numerous To Count (>200 Colonies) Confluent Growth Heavy Sediment Masking, Results May Not Be Reliable Sample Age >30 Hours But <48 Hours, Results May Not Be Reliable Sample Age >48 Hours, Too Old For Analysis Resample Required *'~Co on es/mi Location Comments 9/12/98 17:00 0 ND 3 NT AC10230 GLENNVIEWL20 · Satisfactory SA 8herri L. Tmsk Environmental Analyst Northern Testing Laboratories, Inc Anchorage, AK 8/16/9 B SEP 24 '98 04~1P~ NTL ~NCHOR~E P.1×1 NORTHERN 33~0 INngSTRIAL AVENUE 8005 SCHOON STREET POUCH 3400a3 KND Engineeadng 20441 Ptarmigan Blvd. F.~gle River, AK 99577.3736 Attn: Client ID: Cilenn View Lot 20 Client l~oject #: Source: NTL LelY: A158160 Sample Matrix: Water Comments: lvlethod Parameter TESTING LABORATORIES, INC. ~AIR~ANKS, ALASKA 8~791 (907) 4~6-3116·FAX 456-3125 ANCHORAGE, ALASKA 99~18 {807) 349-1000 , FAX 3494016 PRUDHOE BAY, ALASKA 99734 (007) 059-2145 , FAX 6~9-214B Report Date; 9/24198 Date Arrived: 9114/98 Sample Date: 8112/98 Sample Time: 17:00 Collected By: ** .Legend ** MRL = M,tM4 Ikgo~ Lov~l MCL = Max, C~mmln~ l~vel B = ~ 111M~thod ~ Al~ MCL = r.,~. To Dil~ Units Result Date Date ] MRL Prepared Anal)7~d SM 4500 NO3 E Nitrate.N 2,$3 0,50 9/15/98 9/15/98 By: Jorma K, Kuusisto Chembtry Supeavlsor