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HomeMy WebLinkAboutCARIBOU LT 3Caribou Lot 3 #050==321-78 Municipality of Anchorage Page 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW000142 PID Number. 050-321-78 Name: wastewater System: ■ New ❑ Upgrade STEVE WAKELAND Address: P.O. BOX 771822 EAGLE RIVER, AK 99577 ABSORPTION FIELD Phone: (907) 696-5534 No. of Bedn»ms: 3 ■Deep Trench OShallow Trench OBed ONound OOlher LEGAL DESCRIPTION S.4R 0.8 ,M/:,, n Tad D.�, `�'9.06-9.66 FL Lot: Block: Subdivision: OWth to ppse eaeam Nom argad Pao« Qr" depth ewwau PIW 6.5 3 _ CARIBOU 2.56-3.16 R n Township: Range: Section: — Fal added des^ edpnal pm` cr "d kn9ti 45 — — 0.5— 1.0 n n rrra.d eau,: 1lwneer of s"ee: aYlawe eeteeen lh o WELL: ■ New ❑ Upgrade 2.5 Ft 1 — In. Ca.madw" P"wb. Ae.a : Taal D"ft Coed Ta: Tod aeewpUm area: 585 "p. M.Wrae ASTM D -3034/F-810 PRIVATE 142 n 141 n sa. Fe. ° 0r SULLIVAN WATER WELLS Date Draaa 6/5/2000 Istow wdw era. 115 R 6.tGREEN GENERAL Date �� 6/7/2000 TINd: " see m Cawre Nelpet "sat" Orwrd: TAN K 15 cpN UNKNOWN n 3 n SEPARATION DISTANCES ■septic 0Holding 0S.T.E.P. To Septic Absorption HTonkg ib c ANCHORAGE �« CHORALE TANK -' ~ 1000 From eld Station Lines — — STEEL ~ 2 Well 100'+ too'+ — Surface 100'+ 100'+ - - - LIFT STATION Water Lot— 5'+ 10'+ — — site In toured Ywwlaourw: P Una e" b"N m: wrw en wyr .ow aarm eL Foundation 5'+ 10'+ — — — Curtain pump saw De`aam swpectb perrarmd W Drain NONE KNOWN BENCH MARK Remarks: terauwr and DesAplb": BOTTOM OF GARAGE DOOR THRESHOLD IN BACK b.r"rw D."aaea. 100.00 rt [No0111"S AL 000�00004� O LP S fV�� Inspections performed by AWWC, INC. Dates: lst 6/�/2000 ...... ... ....... P, 2nd 6/7/2000 p 3rd 9/13/2000 0o4p fry Gar est,Department of and Human Services aDpap E .7 �o�oov Reviewed and approved byth eo /d .13 - 000p4�40o ro/saslo� o o \O�oo n-ou . 91"not 25 PERMrrNUMBER: AS -BUILT DRAWING - PARCEL ID NUMBER: 050-321-78 SWO SW000142 W I I I A B ST1 17.8 18.6 p ST2 14.5 20.9 DBL1 13.7 22.3 9L/ D131_2 13.7 22.9 / C01 13.8 23.9 MT1 12.3 27.4 CO2 46.0 62.5 MT2 45.8 61.4 / NEW DRAINFIELD I J�o�S00M THR1 o N o O U F e NEW 1000 GALLON C_ SEPTIC TANK DBL1- DBL2 �TM#2 L _ J ALTERNATE SITE ... DATE: 10/6/2000 ,vo6�4 �. ._..'_�._..Y./ P \ •••• S 0 DRAWN BY: C.J.G. ALASKA WATER & «'ASTEMME'R' ° � Sj- CONSULTANTS, INC. _ 30� Q ie • ANCHORAGE. AK "SOL • WONE 07)337-6170 • FAX 90MSe-324e 6901 DERARR ROAD. sure NC — „ QQ A f y mess; 0°may E 53 •• `FOD �4�'s�� cod Osolp eealD�°\o PREPARED FOR: PHONE NUMBER: STEVE WAKELAND (907) 242-4270 PAGE NUMBER: 2 OF 3 LEGAL DESCRIPDON: CARIBOU SUBDIVISION. LOT 3, TYPE OF WORK: AS -BUILT DRAWING OF NEW WELL LOCATION AND SEPTIC SYSTEM 420,11 oa PERMITNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SWO SW000142 050-321-78 FN4. GRPDE- 96.981 cr or 511 5i2 A1fUlf 92.96 Af=-92.98 I I NSW 1000 CAUON mRror5ePTIC TANK AT Ulf - 92.41 85.15 (AVG) 1 ALASKA)NIATER S NVAST : VATI:R CONSULTANTS. INC. 600 DEBARK ROAD SUITE 28 • AWHORAGE. AR 99304 • PRONE (907)3374179 • FA% (907)338-326 REPARED FOR: PHONE NUMBER: STEVE WAKELAND (907) 242-4270 :CAL DESCRIPTION: CARIBOU SUBDIVISION; LOT 3. rPE OF WORK: PROFILE AS—BUILT OF NEW SEPTIC SYSTEM ,i= GF Iftm Af CUVtf - 9224 96.45 94.799539 C.J.G. Ur4 M�Gall 09/29/2000 07:24 9076965534 EAGLE UENTU2ES PAGE 02 �3 (IS�exttft�e Prilling tag by DDC Co. tlW SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99667 • TELEPHONE 688-2759 OWNER OF LAND �7-,Inji5 (/J r:LAn/V BORE HOLE DATA . n�ru ADDRESS LEGAL DESCRIPTION PERMIT NUMBER Date of Issue-6-- TAX ssue TAX INDENTIFICATION NUMBER Z2 -W iQ �/7� Is Weil located at approved permit location? � Q No Method of Drilling: V,&-fotary ❑ cable toot Depth of well: .1141 Casing Type _STE.6j. Wail Thickness Inches Diameter 1 Inches,.depth—/A feet LlnerType: r0l3otgE Casing Stickup Above Ground: 3 feet Static Water Level (from ground level): J/ *3 feet Pumping level _feet after hrs. pumping _gpm Recover Rate:�m �P Method of Testing: 41 Q 'Well Intake Opening Type: popan End ❑ Open Hole ❑ Screened; Startfeet Stopped feet ❑ Perforations Start ../ffpel Stopped feet Grout Type: g" o" �/'Votume Depth: from n feet; to. —�� feet Pump Intake Depth: feet Pump Size hp Brand Name Well Disinfected Upon Completion? fires ❑ No Method of Disinfection: CAILa lode i'010-Aell- Com;1.20 (, 0a 1 Human Drillees Name �� 1 f • ATTENTION: It Is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health 8 Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. 09/29/2000 07:24 9076965534 EAGLE LENT RES PAGE 03 LOT 50, EAOLE'S 1KST SM- _ KIRK AVENUE _ 11 IT TELECOM. S ELECT. EASMENT—+ — — S MOO' I I � I I I z I $ a I Lot 2 1; Lot I 1 m w I 150.33, I I 1 IS' TELECOM, a ELECT. I I� 20' 7ELECOM.-LJ e ELECT. Lot 3 EASEMENT 2.501 Acro Qs Y v n svav m -e xnw 10' CANYON VIEW DRIVE— � ---F ——— — — I— — — Lot I" I Lot too I Lot II SHEET I Of 2 PLOT PLAN _ ASBUILT i SCALE 0 . 1W GRID NW rm Project No. 00-071 Lang do Associates. Inc. 11500 Daryl Avenue. Anchorage. Alaska 99515 Registered Land Surveyors 907 9073 522-6470 Phone 522-4e2s rax OF q 1 Ranby wrNry thof I how surveyed IM fes" dewrmd plomir: Let S. SV0o1MM Ile. 94-126 '� ....•........... qs ' • CAMM (PW Anahorwpe Reewdlny Oloblat. Abeka, and Mot IM bnprewrnMM SWAA d �P %• : lhueon ore aNhM lir prapry Mna Md do nal onoroseh oMe IM prowlyfo Moro ....'.. 49� •• •• •••••• adlowM 1MrNo. 9taf no ImprowmoMo M the prepory lylne edteoMf encrooah M Iho ourwyN prwMop and Mai Iher ar no roodr. ya e� MonomlootM anM N e1hN vloMle eaeernonle M aaW preporty eaoopf h InNaaf Mren.• .• �..���� D.Mthe ..LZ— Del' of - '1KPrM_ M&. - . ot Ano wep. Aleoba M. :NNNETN l L E •. LS -5202 D N the rwponoibinly of the owner to defentdm the aalaton" of any ".+lmpnK.. eaeemeMe, oownonto, N rehlatlano which do not op"or M the roerded 09/29/2000 07:24 9076965534 EAGLE LOITLRES PAGE 04 I I I I I. I I I I I I I I I I I I I I I I I °�a I I I I L_I . t KPW aco,-ani SHEET 2 OF 2 FILE: K0007195.crd/K0007186.p11 SCALE: 1" - 30' 10-09-00 10:45 FROM -CTE ENVIRONIENTAL 5615301 T-184 P.01/02 F-993 CT&E Environmental Services Inc. Laboratory Division CUE Ref. #: 1006195001 Client Name: AK Water & Wastewater Cons. Project Name: n/a Client Sample ID: Caribou; Lot 3 Matrix: Drinking Water PWSID n/a 200 W Potter Drive Anchorage, AK 99518 Tet: (907) 562-2343 Fax: (907) 561-5301 Client PO#: rVa Printed Date/Time: 10/09/00 09:55 Collected Date/Time: 10/04/00 18:30 Received Date/Time: 10/05/00 13:12 Technical Director. Stephen Ede Released By: 1 A f ndJ- - - mculoc Total Coliform (MF) p coV100 ml SM92220 Nitrate 3.21 0.5 mg/L EPA 300 Allowable Prep Analysis 10/05/00 KAP 10.0 10/05/00 SCL MUNICIPALITY OF ANCHORAGE Department of Health and Human Services Onsite Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW000142 Date Issued: Jun 01, 2000 Expiration Date: Jun 01, 2001 Parcel ID: 050-321-78 Legal Description: CARIBOU LT 3 Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: Owner Name: Steve Wakeland Lot Size: 104130 SQ. FT. Owner Address: PO Box 771822 Total Bedrooms: 3 Permit Bedrooms: 3 Eagle River , AK 99577 - This permit is for the construction of: 0 Disposal Field 0 Septic Tank E] Holding Tank I] Privy Q✓ Private Well ❑ Water Storage 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 (907) 343-4744 ( 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: 6— / �Ge) Date: ( — / — 0 ) ALASKA WATER & WASTEWATER CONSULTANTS, INC. May 31, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well and Septic Design for Caribou Subdivision; Lot 3 To whom it may concern: The proposed 3 bedroom house will be served by a private well and septic system. Two test holes were excavated on the property. The proposed septic system will be designed within the 30 foot radius of test hole #1. We are proposing that a 1000 gallon septic tank and a deep trench type drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil classifications, groundwater monitoring, and the percolation test results. In TF1#l, the soils below the organic layers are a SP to GP/SP material to a depth of 2 feet and then transitions to a GM/SM material to a depth of 16 feet (bottom of test hole). In T11#2, the soils below the organic layers are a SM material to a depth of 2 feet and then transitions to a GM/SM material to a depth of 16 feet (bottom of test hole). No groundwater was encountered during the excavation of the test holes. A percolation test for TIN 1 was performed between the depth of 6.5 feet to 7.0 feet which had a percolation rate of 2.9 minute/inch. A percolation test for TH92 was performed between the depth of 6.0 feet to 6.5 feet which had a percolation rate of 13.3 minute/inch. It is our opinion that due to the overall appearance of the soils, a application rate of 0.8 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 2.9 R. 13.3 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/82 e. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 563 fi2 f. Total Depth: 9.5 feet (max.) g. Effective Depth: 6.5 feet h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 45 feet long k. Effective absorption area = 585 ft2 6901 Debarr Road, Suite 213 — Anchorage, AK 99504 — Ph: (907)337-6179 — Far: (907)338-3246 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The area of the proposed septic system of this property is a 3 to 5 percent running from approximately north to south; in short, there are no slope concerns. The trench is to be installed parallel to these slope contours. I am 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. A P.E., M.S. NOTE: Attached is a site plan drmving, a design drmving, 2 soils logs, 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 PROPOSED THREES BEDROOM HOUSE 1 I 1 1 I I I I 1 �J THJ2 ALTERNATE SITE ---------------------------- ---------- -------------------------------------_` `- CSOf4Ll_VJE"LD31YE----------------- SERVED BY PRIVATE WELL AND SEPTIC SYSTEM NO ENCROACHMENT CONCERNS LOT 109 LOT 11 LOT 1a-1 TIMBER RIDGE S/D TIMBER RIDGE S/D TIMBER RIDGE S/D �ACANT WELL LOCATED 100'+ SOUTH 5/30/2000 ./ ♦ , DRAWN BY: \�• f' •.\ ALASKA NVATKR & WASTEWATER SCALE K.D.W. ` 4 CONSULTANTS, 6901 DESARR ROAD. SUITE is • ANOHORA E, AX99500A PHONE (907)117.6179 • rax 9073338-1m6 1 w = 100 g ...... • • • • • 'REPAIRED FOR PHONE NUMBER: PACE NUMBER: v EAGLE VENTURES/STEVE WAKELAND (907) 696-5534 1 OF 2 �y+M1 ere A. GarneS EGAL DESCRIPTION: 441 p '•. • —79$3 CARIBOU SUBDIVSION; LOT 3 �V� s�6 '' •......••'' E YPE OF WORK: SITE PLAN FOR DESIGN OF SEPTIC SYSTEM LOT 2 Qa / CARIBOU S/D .+ \ • ?,i4 LOT 1 1 CARIBOU S/D I fai l I �EP71C CORDON W MCCRATY HOMESTEAD 1 CORDON W CRAIY HOMESTEAD '7ACAWD 1 \\\ % PROPOSED SEPTIC• PROPOSED THREES BEDROOM HOUSE 1 I 1 1 I I I I 1 �J THJ2 ALTERNATE SITE ---------------------------- ---------- -------------------------------------_` `- CSOf4Ll_VJE"LD31YE----------------- SERVED BY PRIVATE WELL AND SEPTIC SYSTEM NO ENCROACHMENT CONCERNS LOT 109 LOT 11 LOT 1a-1 TIMBER RIDGE S/D TIMBER RIDGE S/D TIMBER RIDGE S/D �ACANT WELL LOCATED 100'+ SOUTH 5/30/2000 ./ ♦ , DRAWN BY: \�• f' •.\ ALASKA NVATKR & WASTEWATER SCALE K.D.W. ` 4 CONSULTANTS, 6901 DESARR ROAD. SUITE is • ANOHORA E, AX99500A PHONE (907)117.6179 • rax 9073338-1m6 1 w = 100 g ...... • • • • • 'REPAIRED FOR PHONE NUMBER: PACE NUMBER: v EAGLE VENTURES/STEVE WAKELAND (907) 696-5534 1 OF 2 �y+M1 ere A. GarneS EGAL DESCRIPTION: 441 p '•. • —79$3 CARIBOU SUBDIVSION; LOT 3 �V� s�6 '' •......••'' E YPE OF WORK: SITE PLAN FOR DESIGN OF SEPTIC SYSTEM •s' I T I I I I I I I I I I I I Sia i � I I I I I I i PROPOSED 1000 � CALLON SEPTIC TANK I � I THAT PROPOSED 9. DFEET DEEP. EXCAVATE 2A5 FEET WIDE, N BY 45 FEET LONG. ADD 6.5 FEET OF CLEAN, WASHED SEWER DRAINROCK. INSTALL TRENCH PARALLEL TO SLOPE CONTOURS. I I I I I I I L_J I #H#2ALTERNATE SITE 17 ALASKA WATER & WASTEWATER CONSULTANTS, INC. oni noeeoo engin tivT M • AWwMlf.F 8N 001n • eWlac romllv.Ano • sex (901"38-3]L PREPARED FOR: PHONE NUMBER: EAGLE VENTURES/STEVE WAKELAND (907) 696-5534 LEGAL DESCRIPTION: CARIBOU SUBDIVISION; LOT 3 TYPE OF WORK: DESIGN FOR SEPTIC SYSTEM (NEW CONSTRUCTION) K.D.W. p�' O A ;T i= 30• .............................. 2 OF 2 ................... .Q�..nr:;w.e�:••G.. ..:�. Jeffrey A. arness, CE -7953 .............. ..... GA4G ALASKA WATER & WASTEWATER CONSULTANTS, INC. SOIL LOG — PERCOLATION TEST I LEGAL DESCRIPTION: CARIBOU SUBDIVISION: LOT 3. PERFORMED FOR: EAGLE VENTURES DATE PERFORMED: 5/5/00 (feet _ ORGANICS TEST HOLE #71] 1 •.t . GM/SM TIGHTER W/ DEPTH DATE DRY DRY I I 1 I I I I I I I I I I I I TH#1+ I I i I • CARIBOU 9/D I 1 I I I I TH12+ LJ GENERAL LOCATION OF TEST HOLE ----------------------- DATE READING • SOIL NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/8/00 1 •. — 6" 11GPIllllllp 2 4:48 10 rJll'GM 4- CL 4:48 — H/NHS • 4 4:58 111111111 2 1/2' 3 1/2- +�%//%CH 4:58 — 6' '1!111111 D.6� •Sc 10 2 5/8' 3 3/8- 7 GM/SM TIGHTER W/ DEPTH DATE DRY DRY I I 1 I I I I I I I I I I I I TH#1+ I I i I • CARIBOU 9/D I 1 I I I I TH12+ LJ GENERAL LOCATION OF TEST HOLE ----------------------- DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/8/00 1 4:38 — 6" — 2 4:48 10 2- 4- 3 4:48 — 6' — 4 4:58 10 2 1/2' 3 1/2- 5 4:58 — 6' — 6 5:08 10 2 5/8' 3 3/8- 7 5:08 — 6' — 8 5:18 10 2 5/8' 3 3/8' 9 5:18 — 6' — 10 5:28 10 2 5/8' 3 3/8* 11 5:28 —6. — 12 5:38 1 10 1 2 5/8' PERCOLATION RATE 2.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RLN BETWEEN 6.5 FT. AND 7.0 FT. PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING PERFORMED BY WAS PERFO M DATE: U LASKA WATER do WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901PHONE 907) 33758 9 0 FAX (90 )ANCHORAGE.38 2489504 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: CARIBOU SUBDIVISION: LOT 3, PERFORMED FOR: EAGLE VENTURES DATE PERFORMED: 5/5/00 ee R1T11= ORGANICS TEST HOLE #2 1 SM 2 3 s CLOCK TIME GM/SM I WATER LEVEL READING ` TIGHTER W/ DEPTH 10 1 4:30 — 11 I 2 12 3' mum 13 Q IIS 14 111111111 5:30 30 t I f %//% 15 ; I D.�� RI 3 3/4- 16 B.O.H. 17- 18 19 20 PERCOLATION RATE TEST RUN BETWEEN 13.3 (MIN./INCH) PERC. HOLE DIA. 6.0 FT. AND 6.5 FT. COMMENTS: • CLOCK TIME I• I WATER LEVEL READING NET DROP (INCHES) 5/8/00 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING - Illlllln 1 4:30 — 6- — 2 Ma 3' mum 3 • IIS — 111111111 5:30 30 t 2 3/8- %//% 5:30 — lilllll — D.�� • 3 3/4- 2 1/4 - DEPTH TO DATE GROUNDWATER DRY 5/5/00 DRY 5/15/00 I I I I 1 I I I 1 I I I I I TH#1+ I I I I DoT 3 I I CARIBOU S/D I i I I L -J THJ2♦ GENERAL LOCATION OF TEST HOLE ------------------------- DATE READING CLOCK TIME I NET TIME (MINUTES) I WATER LEVEL READING NET DROP (INCHES) 5/8/00 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 1 4:30 — 6- — 2 5:00 30 3' 3' 3 5:00 — 6. — 4 5:30 30 3 5/8" 2 3/8- 5 5:30 — 6. — 6 6:00 30 3 3/4- 2 1/4 - PERCOLATION RATE TEST RUN BETWEEN 13.3 (MIN./INCH) PERC. HOLE DIA. 6.0 FT. AND 6.5 FT. 6 (INCHES) PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON MUNICIPALITY OF ANCHORAGE Department of Health & Human Services on -Site Sewer/Well Permit Application Q__ N��76 NOTE: Applicabw must be aced out wmdeteiy SINGLE FAMILY DWELLING Parcel Iden0caftn Property Owner Name y[ LJA14rU O EAGLC \leaTvZEJ Day Phone 6%—S.Ty Po 60( '7718-.7. �e iP 4CC . AK zip Code 9iS7-T Mailing Address /' .3 4f �i , ISM Li Legal Description > sea rm LM Saconn To�m•v RVW Lot Size ' 2.S re / y Number of Bedrooms 3 Inspections will be Eon cf y: Approved Engineering Firm ❑ Municipality (permit fee included) Does your house contain any of the following: ❑ Hot Tub ❑ Swimming Pool ❑ Therapy Pool ❑ Jacuzzi ❑ Water Softener Unit This application is for: ❑ Sewer Only ❑ Sewer and Well ❑ Sewer UpgradeEXKoeelll Onnlyr ❑ Water Storage I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and N . WW,G lei In accordance with applicable Municipal Codes. Fees: 112-d f 6V Receipt M / Waiver Fees: Receipt N 72-012 (Rev. 4198)' Permit M Waiver R ALASKA WATER & WASTEWATER CONSULTANTS, INC. May 10, 2000 Municipality of Anchorage Department of Health & Iiuman Services Division of Environmental Services On -Site Service Section P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Exploratory Well permit for Caribou Subdivision; Lot 3 To whom it may concern: Attached is a site plan for a proposed well location and a septic system area for the referenced property. Recent test holes have been excavated on the property and found suitable soils for a conventional type septic system, both for a primary and alternate site. Per the request of our client, we are requesting a exploratory well permit be issued. The well will be drilled 100 feet from all septic systems (proposed and existing). We are unawrae of any adverse effects on the neighboring properties with the drilling of this well. If you have any questions, please contact us at 337-6179. 6901 Debarr Road, Suite 2-13 • Anchorage, Alaska 99504 Ph: (907) 337.6179 0 Fax: (907) 338-3246 • email: awws@alaska.net % CARIBOU ZS/D I � 1 1 i AREEA1 I 1 I CORDON W n ADRA HOMESTEAD 1 I I \♦ I 1 I I I I i I LOT 3 I CARIBOU S/D I 1 I I �J 1S/D j AREA 1 I GORDONRAn HOMESTEAD / `-VACANT ` \ l I \. I \` I GAn�9L�VJEY�_DQQ�E---------- SERVED BY PRIVATE WELL h SEPTIC SYSTEM NO ENCROACHMENT CONCERNS LOT 10A-1 TIMBER RIDGE S/D LOT 10B TIMBER RIDGE S/D �ACANf� r/ w/ cvvv -.41;- tY .. DRAWN BY: ALASKA NIMER S «'ASTL'��MER K.D.W. CONSULTANTS, INC. 1. = 100 6001 DEBARK ROAD. WTE tB • ANCHORAGE. M 00504 ' PHONE (007)3374170 • FAX (007)53""46 PREPARED FOR PHONE NUMBER: PACE NUMBER: EAGLE VENTURES/STEVE WAKELAND (907) 696-5534 1 OF 1 LEGAL DESCRIPTION: CARIBOU SUBDIVSION; LOT 3 TYPE OF WORK: SITE PLAN LOT 11 TIMBER RIDGE S/D WELL LOCATED 100-+ SOUTH ALASKA WATER & WASTEWATER CONSULTANTS, INC. SOIL LOG — PERCOLATION TEST I LEGAL DESCRIPTION: CARIBOU SUBDMSION; LOT 3. PERFORMED FOR: EAGLE VENTURES DATE PERFORMED: 5/5/00 DE et ==99 ORGANICS TEST HOLE #2 1 SM 2 6 � I 7 I WATER LEVEL READING NET DROP (INCHES) 8 y' GM/SM ¢ TIGHTER 9 4:30 W/ DEPTH 10-1 r 2 11 • 3" 3- 111111111 5:00 12- 2 6. %//% 13 � i 30 14 14-1 1 I AI:�� 15- 516B.O.H. — 6' 16— 6 6:00 30 B.O.H. 2 1/47— /4'PERCOLATION 17 18 19 20 COMMENTS: DEPTH TO DATE GROUNDWATER DRY 5/5/00 I I 1 1 I I I I i I I I 1 THjl+ I 1 1 I CARIBaT 0U35/D I I I I 1 I TH#2 + LJ GENERAL LOCATION OF TEST HOLE DATE READING CLOCK TIME I NET TIME (MINUTES) I WATER LEVEL READING NET DROP (INCHES) 5/8/00 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 111111111 11M. 11!11 4:30 ����i 6. %/E 2 RHIN • 3" 3- 111111111 5:00 � 6. %//% 4 1�1�1�1111 30 1'Ji • AI:�� 5:30 — DEPTH TO DATE GROUNDWATER DRY 5/5/00 I I 1 1 I I I I i I I I 1 THjl+ I 1 1 I CARIBaT 0U35/D I I I I 1 I TH#2 + LJ GENERAL LOCATION OF TEST HOLE DATE READING CLOCK TIME I NET TIME (MINUTES) I WATER LEVEL READING NET DROP (INCHES) 5/8/00 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 1 4:30 — 6. — 2 5:00 30 3" 3- 3 5:00 — 6. — 4 5:30 30 3 5/8' 2 3/8' 5 5:30 — 6' — 6 6:00 30 3 3/4' 2 1/47— /4'PERCOLATION PERCOLATION RATE TEST RUN BETWEEN 13.3 (MIN./INCH) PERC. HOLE DIA. 6.0 FT. AND 6.5 FT. 6 (INCHES) PERFORMED BY ALASKA WATER do WASTEWATER. 1. JEFFREY A. GARNESS. CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON 0 ALASKA WATER & WASTEWATER CONSULTANTS, INC. SOIL LOG - PERCOLATION TESTI LEGAL DESCRIPTION: CARIBOU SUBDIVISION: LOT 3. PERFORMED FOR: EAGLE VENTURES DATE PERFORMED: 5/5/00 ((r e1 ORGANICS TEST HOLE #1 t 2 MML SP TO CP/Sp CLOCK TIME SOIL CLASSI—CATIONS WATER LEVEL READING t 5/8/00 1 I11GW•' — 6- — 2 4:48 • IIIIIIIQ DEPTH' 3 u�ln�llGMilii.CL — 6' � f 4 4:58 GCHHN 2 1/2- 3 1/2- /2"5 • 4:58 — , IllllllllMH 6 f 10 !fitSp%//%CH 3 3/8- 7 5:08 — Rl111111SM�'.6� — 8 • 10 2 5/8' SC 9 DATE DRY I I I I I I I I I I I THgt+ I I I I Lar 3 I I CARIBOU S/D I I I I I I TH#2+ LJ GENERAL LOCATION OF TEST HOLE ----------------------- DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING t 5/8/00 1 4:38 — 6- — 2 4:48 10 2- DEPTH' 3 4:48 — 6' � f 4 4:58 ! ! 2 1/2- 3 1/2- /2"5 lit � 4:58 — , — 6 f 10 2 5/8" 3 3/8- 7 5:08 — 6" — 8 5:18 DATE DRY I I I I I I I I I I I THgt+ I I I I Lar 3 I I CARIBOU S/D I I I I I I TH#2+ LJ GENERAL LOCATION OF TEST HOLE ----------------------- DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/8/00 1 4:38 — 6- — 2 4:48 10 2- 4' 3 4:48 — 6' — 4 4:58 10 2 1/2- 3 1/2- /2"5 5 4:58 — 6" — 6 5:08 10 2 5/8" 3 3/8- 7 5:08 — 6" — 8 5:18 10 2 5/8' 3 3/8- 9 5:18 — 6' — 10 5:28 1 10 2 5/8' 3 3/8' 11 5:28 — 6 — 12 5:38 10 2 5/8' 3 3/8' 19� PERCOLATION RATE 2.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 6.5 FT. AND 7.0 FT. COMMENTS: PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING PERFORMED BY ALASKA WATER do WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON UMCW UTY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 050-321-78 Expiration Date: - 2-q ^ 2-/ 1. GENERAL INFORMATION Complete legal description CARIBOU LOT 3 Location (site address) 19820 KIRK AVENUE, EAGLE RIVER, AK 99577 Current property owner(s) JOHN & RANEY HARDMAN Mailing address Real estate agent PO BOX 773521, EAGLE RIVER, AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 560 Waiver Fee $ Date of Payment _!�__-2-1( r2 Date of Payment Receipt Number 6-1 '/Z 33 Receipt Number COSA # 0S C x 1 1 0-'75 Waiver # Distance: 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 system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTIN Phone 907.350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 5/22/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to �! OF Ad these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory /S�g�Q:'' • • • �;9 ��� for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWCS ' * • 11-I ....•.* JJ 6. DSD IGNATURE Curtis Huffman / System #1 Approved for bedrooms F��s•, CE 128991 �F�' • .5/22/Z9 • •F� r System #2 Approved for bedrooms >>FoPROFESSIo Disapproved Conditional approval for bedrooms, with the following stipulatl1' ,�illlllt���(ffr✓��,, �r<VII�G�..��� BOriginal Certificate Date: 5 2 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Scc l i'AA P t/iSic7v`�/j Legal Description: CARIBOU LOT 3 Parcel ID: 050-321-78 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 6/5/2000 Total depth 142 ft Cased to 141 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/17/2021 Static water level at beginning of test 114 ft. Well production at time of test 6.1 gpm Comments B. TANK DATA Age of tank(s) 21 years Tank type/material SEPTIC/STEEL Measured operating fluid level in septic tank 51" ® Standpipes/foundation cleanout per record drawing Date of pumping 5/17/2021 D. ABSORPTION FIELD DATA Which system tested (date installed) 6/7/2000 ® ALL standpipes present per record drawing Total measured depth from grade 10.2 ft (max) Measured depth to pipe invert from grade 3.7 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: Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 6.59 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by F. Date of Sample C. LIFT STATION 5/17/2021 - ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 5/20/2021 Results M Pass For 3 bedrooms Fluid depth prior to test 46 in Water added 500 gal New depth 59 in Elapsed time 1100 min Final fluid depth 46 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date M 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' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below _ Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No _ Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® 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' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® 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. �0 ''• • Z �. ..�: : Curtis Huffman �$ 9•., CE 128991 •4�+®o' �`rl�c • 5/24/21.. AW >�O PROFESSIO�.� ft ft ft ft ft ft ft ft Nitrate Advisory Certificate of On -Site Systems Approval # OSC 211275 Subdivision: Caribou Lot 3 A water sample revealed a nitrate concentration of 6.59 milligrams per liter (mg/Q. 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. 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 hnum org 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 media 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. Mailing Address P O� Box 196650 *Anchorage, Alaska 99519 6650 *www muni org � � f c� „ �; � r .�:,,. ���aa ;k.�. ,-.aL, .:,. .,mid � ,:..5.�z-;�.r �2.r 3� s '�a.�h �. �: 0.. .� _"''S :� ..✓ ? '�.a-�. r'I Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 211275 Subdivision: Caribou lot 3 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 21 years old. Typical replacement costs range from $8,000 to $11,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 -year-old steel tank MAY look like. 4 Ma�Ung Address P O ZB0XII96650 Anchorage, puska 99519 6650 *www mum org s T t � 1 I 0- I C5 a / I I > I I N < ( N 00° 15 50 W 312.50 S 00015'50'E' 333.60' N 11 I� I ( — — — — — — — — — — I I r N 00° 15'50"W 306.54' S 00015'50'E 285.50' _O i 1 50' V a W 4 AY N lF.:* M tNsLO 0. F kOQ�Y w 00 W co CO fl � L) O U J J w to !n _O i 1 50' V I AY N lF.:* tNsLO 0. F W J W z VO qfi m 3p 0 0)p© . VIS ° 04AVoo��' ci O m >= y rn° o u' N ti Q L -0 a Z�a° a v c�pnOCgqcL a .n it C U a on® C O Com? 6= a oL .. nLCL 8 0 CO LO° v v v a'Nt( -0 E�` co COl ANN ao.�oCL n X a Lo LO -0a-n® O a�opO00 o uj < p^�1_C� w -O o> '�-7 c O.. oC o V �4b CD 0)o. O ."- 0 OO.. T f -a • ° :F L. cn0 v a$ U Lw z vr;�c" S o^ °� I Q v v--a'"o n a a E; c 0 o Lo M o� m 'Z¢p-O C V) a in li n. I- a O o O-� m o GTS Q o _.. '- 5- °c � a v = mA o 0 0 0 0 m w 0 v LO> CY'�' �4a�0aa VC Q1 UC00 0. OU _J IM a m C O E 0-0000 O L -a j O �ya> O -9 V G ap a C b C C Q h m 1 p- .� tS. .G zit C/41C Municipality of Anchorage % Development Services Department j Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING c Parcell.D._ r��`�-3a�- to COSA# DOO;L,� Expiration Date: " 17 ' O R 1." GENERAL INFORMATION Complete legal description caribou SID, Lot 3 Location (site address) 19820 Kirk Avenue, Eagle River, Alaska 99577 Current Property owner(S) Cynthia Johnson Day phone (907) 317-2997 Mailing address 4226 Hampton Dr., Anchorage, AK 99577 Lending agency wens Fargo Home Mortgage Day phone Mailing address Eagle River, AK Real Estate Agent Audrey Mason, RE/MAX of Eagle River Day phone (907) 622-3344 Mailing Address 16690 Centerfield Dr., Ste. 201, Eagle River, Alaska 99577.7702 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site ❑Q Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-$ile Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the 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 system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Douglas T. Kenley, P.E. Phone Address 9806 E. North Star Circle, Palmer, Alaska 99645 Engineer's Printed Name Douglas T. Kenley 5. DSD SIGNATURE V� Approved for 3 bedrooms. Disapproved. (907) 7461077 Date"? • 1 `/ • °e Conditional approval for bedrooms, with the following Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory %Other p By: l/, Original Certificate Date: — P7 — p (Ra H105) MuniCipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Caribou SID. Lot 3 Parcel ID: 050-321-78 A. WELL DATA Well type Pri=ate If A. B, or C provide PWSID #— Date completed 615100 Sanitary seal (Y/N) v Total depth 142 ft. Cased to 141 ft. FROM WELL LOG Dale of test 615100 Static water level 115 ft, Well production 15 9 -P.M. WATER SAMPLE RESULTS: Coliform'--2—colonies/100 mL Nitrate 484 mg/L Arsenic: ND mg/I Date of sample: 711/08 B. SEPTIC/HOLDING TANK DATA Tank Type/Material septldsteel Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (YIN) Y Depression over tank (YIN) N Date of pumping 5118108 C. ABSORPTION FIELD DATA Well Log (Y/N) Y Wires properly protected (Y/N) v Casing height (above ground) 37 in. AT INSPECTION 715108 155 8 ft. 384 g.p.m. Other bacteria 0 colonies/100 mL Collected by: F. Kenley Date installed 8/7/00 Cleanouts (Y/N) Y High water alarm (Y/N) NIA Pumper JRs Pumpers Date installed 6f7/00 Soil rating (g.p.d./ft= or fetbdrm) O.9 System type Deep french Length 456 ft. Width 2.5• ft. Gravel below pipe 6.5• ft, Total depth 10.6 ft. Eff. absorption area 585• fl? Monitoring tube Y Depression over field N Date of adequacy test 715/08 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 47.1/2 in. Water added 660 gal. New depth 63.114 in. Elapsed Time: 100 min. Final fluid depth 61 in. Absorption rate >= 450 g.p,d, Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date N/A D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on' level at _in. `Pump off level g water alarm level at in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Meets alarm & circuit requirements? Septic tankAift station on lot 120+ rt. On adjacent lots Absorption field on lot 130+ ft. On adjacent lots. Public sewer main NIA Public sewer manhole/cleanout NIA Sewer /septic service line W ft- Holding tank NIA Animal containment areas None -moo ' Manure/animal excrete storage areas None ice ' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 100+ ft. 100+ ft. Building foundation s+fto Property line 50+ Water main NIA Water service line 10+ft. Wells on adjacent lots too+ rt. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field 5+ ft. Surface water 100+ ft. Property line so+ft. Building foundation 13+ ft- Water main NIA Water Service line 10+ ft. Surface water 100+ ft. Driveway, parkingtvehicle storage 17+ ft. Curtain drain a°^° Inpw "I Wells on adjacent lots 100+ ft. F. COMMENTS: • From MOA records. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and r%>k � 97" review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Douglas T. Kenley �+� CE 5176 Date+'tAF9Ni'.71 COSA Fee $ !j -� 0 Date of Payment �7 — 114 r O A Receipt Number 1/0 V O, (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SCS ReEN 1083175001 Client Name Douglas Kenley P.E. Project Name/N Caribou S/D Lot 3 Client Sample 11) Caribou S/D Lot 3 Matrix Drinking Water PWSID 0 All Dales/Times are Alaska Standard Time Printed Date/time 07/10/2008 13:44 Collected Date/rime 07/01/2008 18:30 Received Dale/rime 07/02/2008 13:30 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results POL Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (q0) 07/07/08 07/09/08 NRB Waters Department Total NitrahJNitritc-N 4.84 0.100 mgfL SM204500NO3-F B (<10) 07/03/08 JDZ Microbiology Laboratory Colony Count 0 col/100mL SM209222B A (<200) 07/02/08 DLC Total Coliform 0 coVI00mL SN1209222B A (<I) 07/02/08 DLC Fecal Coliform 0 coVl00mL SM209222B A (<I) 07/02/08 DLC t' 05 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES a Division of Environmental Services _ On -Site Services Section P.O. Box 196650 Anchorage. Alaska 99519-6650 (907)343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.O. # 050-321-78 HAA # 1. GENERAL INFORMATION Complete legal description CARIRnu SuaDIASION, LOT 3 Location (site address or directions) KIRK AVENUE EAGLE RIVER. AK 99577 Property owner STEVE WAKELAND Day phone (907) 242-4270 Mailing address P.O- BOX 771829 EAGLE RIVER AK 99577 Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 XXX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC ing to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 1121 Computer Version S. 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 inspe(�;UIon, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal �id State codes, ordinances, and regulations In effect on the date of this Inspection. /t Name of Firm (907)337-6179 Engineer's Signature '-' I f Date /a ry 1 OD In conducting this evaluation, AWWC, Inc. att; mpt I ' top e a thorough, conscientious engineering a alysis of the system in accordance with ADEC and MCA HH uidelines & Regulations. The reported results described 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 soils condition, groundwater levels that may fluctuate during the year, and the water o�4p usage of the family being served by the system. These conditions are outside the control of o0 the evaluator of the system. Satisfactory test results do not guarantee future performance o // of fho system, nor do theyguarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty for future estimate of how long the p G,j. • 4 system will continue to meet the operational requirements of the ADEC or MOA DHHS. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, ............. nor will it confer any legal right whatsoever. f A, ess, E-7953 , 6. DHHS SIGNATURE Approvedfor—bedrooms Disapproved Conditional approval for Additional Comments 2 Pro bedrooms, with the following stipulations: Date 0-13-00 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 1121 Computer Version Municipality of Anchorage RECEIVE DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division OCT 1 0 200 825 "L' Street. Rm 602 Anchorage, Alaska 09501 (907) 343-4744 MUNICIPALITY OF ANCHORAGE Health Authority Approval Checklist EmAL SERVICES DIVISION Legal Description: CARIBOU SUBDIVISION; LOT 3 Parcel I.D.: 050-321-78 A. WELL DATA Well Type PRrVATE It A. B. or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N) Y Date completed 6/5/2000 Total depth 142' Cased to 141' Casing height (above ground) 36' Sanitary seal (Y" YES Wires properly p (YM) YES FROM WELL LOG Date of test 6/5/00 Static water level 115 Well production 15 g.p.m WATER SAMPLE AT INSPECTION . 21 th ^ V Other bacteria Date of sample: 10/5/00 Collected by: A.W.W.C.. INC. B. SEPTIC/HOLDING TANK DATA Date installed 6/7/00 Tank size 1000 Number of Compartments 2 Cleanouts (Y/N) YES Foundation deenout (Y/N) YES Depresslon (Y/N) NO Hgh water alarm (Y/N) N/A Date of Pumping NEW Pumper C. ABSORPTION FIELD DATA + tfo .l F,,+4 -t, &Z&OES Data installed 6/7/00 Soll rating .p.d Wbdnn) 0.8 System type TRENCH Length 45' Width 2.5' Gravel thickness below pipe 6.5' Total depth's 10.62' Effective absorption area 563 S0. Fr. Monitoring Tube present (Y/N)YES Depression over Heid (YM) NO Date of adequacy test NEW Results (Pass/Fall) – For – Bedrooms Fluid depth In absorption geld before test (In.); Fluid depth – (Ins) Minutes later. Perwdde treatment (past 12 months) (Y/N) 72-M Mw. soar comvuwv nwn Immediately alter – gal. water added pn.): — Absorption rate R yes. give date – D. LIFT STATION Data installed Size Manhole/Access High water alarm level aY 'Pump oft' level aY *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SeptldlWding tank on lot 100'+ On adjaoent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main Public sewer manhole/deanout N/A Sewerlseptic service One 25'+ Lift station N/A SEPARATION DISTANCES FROM SEPTIC(HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field 5'+ Water main/service line 10'+ Surface wateddrainage 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Properly line 10'+ Building foundation 10'+ Water main/service line 10'+ Surface water 100'+ Driveway. parldngfvehide storage area 50'+ Ch�P F. ENGINEER'S I car* that I of Munidpal n with MOA HA, Engineer's field InspeWons and review systems are /n conformance on dds date. Date of Payment I /n —/© .Qb RecelptNumber0�757 3g35) 72-M tR«. reel' oarouar VVWW Wells on adjacent lots 100'+ Waiver Fee Date of Payment Receipt Number