HomeMy WebLinkAboutHIGHLAND HILLS #1 BLK 1 LT 6Highland Hills Block Lot 6 #050-382-25  Municipality of Anchorage Development Services Department Building Safety Dlvislon ..~'"~ On-Site Water & Wast°water Program. 4700 South 8ragaw SL . P.O. Box 196650 Anchorage. AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 Page I of On-Site Wast°water Disposal System and/or Well Inspection Report Permit Number. SW010105 PID Number. 050-582-25 N°m":DAVID McDOWE:LL WastewaterSystem: r-I New · Upgrade Address: 5650 HIGHLAND ROAD * EAGLE RIVER. AK 99577 ABSORPTION FIELD phone: No, of Bedrooma: 479-54.36 5 I'1 Deep Trench · ~lellow Trench ri Bed mMound r'lOfl~er LEGAL DESCRIPTION ~' "'": 0.8 ~o/s~ ,~ 5 TO 7 6 I HIGHLAND HILLS #1 0.8-2.8 n 4.2 - - - SEE DWG rL 60 WELLI [] New [] Upgrade .5 ~. 1 / r~ r~ 600 s~ ~ D 5034/F-810/$CH 40 PVC r~ $OUTNFOEK OONST. 5/~0/2001-S/4/2001 ~ ~ ~ TANK SEPARATION DISTANCES =s.p~c =Holding · $.T.E.P. ~o s, pu¢ A~'~r~d~°n StouonUftHold;,gTonk ~.~'/~+~ ANCHORAGE TANK 1250 We, 100'+ 100'+ 100'+ - 25% STEEL 2 s.,o=, wot., ~oo'* lOO'* lOO'. - - LIFT STATION s=. ~ ~ ANCHORAGE Lot Un° 5'+ 10'+ 5'+ - - 1250 TANK/ORENCO SYSTEMS Foundofion 5'+ 10'+ 5'+ - - 41" 41" ~ u~. * ~ ~ ~ ~,~-~ ~. dAMES SADOWSKI Curt°in Dr=In N(~NE KNOW~ t20 OS~ 05 HHF (LICE:NSE ~200451 19754) ,e~ar,.: ~,~ ~X~S~ S[~C ~ W~S CO.P~ZT~,~ BENCH MARK ~DONED. BoTroM OF SIDING AT POINT "A" I*--'"~ ~'"~'~" 100.00 Inspections performed by: AWWC, INC. Dates:lst 5/30/2001 ~ ........... ~,~..t~,~-; .......... 2nd 5/31/2001 ~ ! ~ I...~. ........... 3rd 6/4/2001 Department of Health and Human Services approval Oi~:'***.. ~ ,-79~ .... ~.~, ' ........ R~viewed and approved b ate:~ '/~' ~f ~"~ ~"*": AS- BUILT DRAWING SW010105 050-382-25 ,-- I FCO 9.9 15.2 ~ I ST1 13.0 17.4 ST2 17.9 21.1 ~ I MH 19.3 22.4 -- MT1 36.5 47.6 tit m S.T.E.P. T~K ~~~ d.L.M. ~A~" i /. [-" '~'~ CONSULTANTS, INC. DAVID McDOWELL 47g-54~6 2 OF HIGH.ND HIL~ SUBDIVISION ~1= LOT 6, BLOCK 1, ~.."...~ ....... .'~ ~ o~ .o.~ AS-BUILT OF SEPTIC SYSTEM UPGRADE ~ ~: AS- BUILT D RAWIN G ~ ~ ~'~ SW010105 050-,~B2-25 /'--F1NAL G~E ' ~TOP OF ~HO~ / 101'1' ~ -101.54 / = / ~ ~ ~TOP OF T~K N~W 12~0 ~LON BOSOM OF BUN(:; ~ ~ 106~OR101~ O~E fiLTER F~RIC ~ ~ ~.68 __ = 99.68 (A~E) ~o.~..~..~,,.~. [.~ ................. ~,~ ,o.: ~o.~ ....~.: "~ """"~~..~ 4~.~...., ...:.., DAVID McDOWELL 479-54~6 5 OF 5 ~ ~ f~ ~. c~s~: ~ ~.~.,~: ~::j2.~.:~ ....... ..'~ HIGH.ND HIL~ SUBDIVISION ~1~ LOT 6, BLOCK 1 PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE ~%~ Sent By: South Fork Construction; 694 1122; SOUTH roItK CONSTRUCTION P.O. Box 770567 EAGLE RIVER, ALASKA 99577 (~)07) 6~J4435! FAX (907) {94.1122 Alaska Water & Wastewater Consulting Engr~. 6901DeBarr Rd. *2B Anchorage, Alaska 99504 Jun.14-01 11:3§AU; Page 111 6/14/01 SUSJ£CT ElectriCal inspection Lot 6 Block 1 Highland Hills Subd. > On June 12, 2001, BZectrtca! journeyman, James Ssdowsk! (license ~200451 19754 - contact,~622-1953 or 441-3732} inspected the electrical portion of the septic system lift station on the abov~' property. No code violations were .... ~are~~ and all workmanship was satisfactory. 0 PLF. A~ REP/. Y [] 3un 15 Ol 10:34a p.l ASBUILT - I HEREBY CERTIFY .THAT I HAVE SURVEYED THE SC~E~ FOLLOWING DESCRIBED PROPERTY~ ~-~ ~~~//~/' DATE, AND ~AT NO ENriCHMENTS ~IST ~CE~ AS ~ ~ D~ERMINE T~ ~ISTENCE OF ANY GRID: E~ENTS, COVENANTS~ OR RESTRI~IONS ~.~ ~ NOT ~EA. ~ THE .E~D~ ~- V/S/ON P~T. UND~ NO CIRCUMSTANCES ~DATA H~N BE US~ FOR CONS~U~ION ~ FEtE LIN~ OR ~R E~LISHING ~D- DRAWN~ ARY LINES. Sent By: South Fork Construction; 694 1122; Jun-13-01 10=4tAM; Page 1/1 TO SOUTH FORK CONSTRUCTION P.0. Box 770567 rr. AOLtr RIVER. ALASKA 99577 Alaska Water & Wastewater Consulting Engrst ..... 69010e~arr R6. ~2B ... Anchorage, Alaska 99504 Attn= Jody i OAF 6/12/01 SUBJECT, Lot 6 Block 1 Highland ~ills Subd.. Water weli abandonment South Fork Construction abandoned the well on the above referenced in Ju~e, 2001. The w~11 shaft was filled with benonite and the well casing was completely pulled from the ground. MUNICIPALITY OF ANCHORAGE Development Sen, ices Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 10, 2001 Expiration Date: May 10, 2002 Permit Number: $W010105 Legal Description: iHIGHLAND HILLS #1 BLK I LT 6 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: DAVID MCDOWELL Owner Address: 5630 HIGHLAND ROAD Total Bedrooms: 3 EAGLE RIVER. AK 99577- Parcel ID: 050-382-25 Site Address: Lot Size: 70262 SQ. FT. Permit Bedrooms: 3 This permit is for the construction of: [] DisposalField [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Sou~h Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak.us (907) 343-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number Property owner(s) DAVID MCDOWF'LL Day phone 479-5436 Mailing address (1) 1832 VALLL~' HI DRIVE * FAIRBANKS. AK H4,~ Zip Code ~4,~ address (2} Legal description (Lot, Block& Sub'd.) HIGHLAND HILLS SUBDMSION ~1-" LOT 6. BLOCK 1. Legal description (Section, Township & Range) Lot Size 706~,6- THIS APPUCATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Acres/Sq. FL Number of Bedrooms Well Only ~]~ Water Storage THIS PROPERTY CONTAINS: Hot Tub D[~ Jacuzzi swimming pool water Softening Unit Therapy Pool [] I certify that the above Information Is correct. I further certify that this application Is being made for a Single Family Dwelling and Is in accordance with applicable Municipal codes. ALASKA WATER &: WASTE'WATER CONSULTANTS~ INC. Permit Fees: ~ '..~C:~O · ~ Data of Payment: 5 - ~ ~ I Receipt Number:, ..~ ~7~'~--~ Waiver Fees; Date of Payment: Receipt Number;.. ALASI WATER & WASTEWATER "" CONSULTANTS, INC, April 24, 2001 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Septic System Upgrade for Lot 6, Block 1, Highland Hills Subdivision #1 To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The existing septic system is in a state of failure and needs to be upgraded. A Test hole was excavated on the property. The proposed septic system upgrade will be designed around the 30 foot radii of test hole #1. We are proposing that a 1250 gallon S.T.E.P. tank and a five foot wide drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 0.8 gallons/day/ft2 should be used. 2. TRENCI! DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/ft2 c. NumberofBedmoms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 563 ft2 f. Total Depth: 7 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet i. Reduction Factor: 0.5 i. Minimum Length: 60 feet long j Effective absorption area = 600 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography of this property is a 20 to 25 percent running from approximately west to east; in short, there are no slope concerns. The trench is to be installed parallel to slope contours. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179, or 244-9612. Thank you for your assistance. Sincere~ NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, I soils logs, and a 7page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com I ,, , , I~l ~ I ~!~ ', I I I mT 5. ~K I c.~.~. ~" / ~ ~': ~. AI.AS~ WATER & ~TEWATER CONSO~IANT$, INC. DAVID MCD0WELL 479-54~6 1 0F 5 ...... HI~H~ND HIL~ SUBDIVISION Jlj LOT 8, BLOgK 1, SITE P~NFOR SEPTIC SYSTEM UPORADE J J ~DE ~ ~0 ~ ~NO. I ~H ~ ~ W~ 1/4 INCH HO~ ~ ~ 2 ~ ON ~ STEP T~K  4/25/2001 CONSULTA~S, INC. DAVID ~CDOWE~ 479-5456 HIGH.ND HIL~ SUBDIVISION ~1; LOT 6, BLOCK 1, DESIGN OF SEPTIC SYSTEM UPGRADE ~ · BO' LON~ · [~ 59' IATD~L io I} I I . ,~D£ TI£ ~ BE 1.25 INCH ~H~ ~ 1/4 ~CH D~ HO~ ~OM ~T.[P. ~ ~ 2 ~ ON T~K C~. ~ ~ 0 0 0 0 0 0 0 0 0 0," SPACED EV~ 2 F'EET ON o o o o o~ o o o o o= I' *' '1 ~S~ WATER & WASTEWATER HIGH.ND HI~ SUBDIVISION ~; LOT ~, DLOOK ~t o~ ~o.~ %-:~,~.,,~o~~_ _~ PROFILE DRAWING OF SEPTIC SYSTEM UPGRADE 00000 ALASKA WATER & WASTEWATER ~..-' :f~i ~ ~ ['".'.?.~ ...... ISOIL LOG - PERCO~TION TESTJ ~ DESCRI~ON: HIGH~D HI~ S/D fl;LOT6. BL~K 1, PERFORMED FOR: ~ & ROBIN ~cDOWE~ DA~: 4~17/2~1 ~,,~ CE; ~[~ ~ o~cs ITEST HOLE ~1 ~ GP ~ ML = lO0' m SW MH l SP CH s~ OH ' DEPTH TO DATE // GROUNDWATER ~ t I D~ 4/24/2001 11~J~JJJJJJ DATE RE. lNG CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINGES) RE. lNG (INCHES) 12 4/18/2001 J 13 34 BEDROCK ~ 16 ~7 lg ~RCO~TION ~TE <1 (HIN./INCH) PERC. H~ DIA. 6" (INCHES) TEST R~ BET~EN 3.0 ~. ~D 3.5 2 ' COHHENTS: PERFORMED BY A~ WA~R ~ W~ATER I, JEF~ A. ~NESS, CER~ T~T THIS ~ ~ERFOEMED AND MUNIClP~ CUIDEUNES IN E~ ON ~IS DA~: IN ACCORD~CE W~ ~L ~A~ DEPTH TO DATE GROUNDWATER DRY 4/17/2001 DRY 4/18/2001 DRY 4/24/2001  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ~UNG ~ESS '-- -- LEGAL DESCRIPTION ~OCATION ~0. OF BEDROOMS /Well , Absor~on)na ; / Dwelling PER,[T NO. ~ ~ Manufacturer ~ ~ ~ ~_~ Material No, of compartments Liq, capacity in gallons Inside length Width Liquid depth -- ~ ~C~ IF HOMEMADE: . ~ ~ DISTANCE TO: Well ~ i /DweNing PERMIT NO. O ~ ~ Manufacturer ~: -- ~ Material Liquid capacity in gallons ~ Well ~ ~ No, of lines/ Length of each ,in. Total len~li~s Treech wi~ Distance between.~/4 inches ~a Length Widtl~ Depth PERMIT NO. ~ _ Type of crib Crib diameter Crib depth Total effective absorption area (~la DISTANCE TO: Well Building foundation Nearest lot line ~ Class Depth Drifter Distance to lot line PERMIT NO, ~ DISTANCE TO: ~ ~uil~u~ion Sewer line Septic tank Absomtion area(~) OTHER PIPE MATERIA L~ ~/C' SOIL TEST RATING ~ INSTALLER REMARKS ~~....~4.&~, - ~,~: ~,~' n~ ' ~ ....... ..... .'~"'-"" ~ ~ ..... E NVI RO NM E N TA~ ~ ~. t~ %~ 72-013 (Rev. 3/'~8) DIF.:PAF~TMEI',,. OF HEAl_TH AND ENVIF,,OI'qlIEN I .. l"ld]]* ...... E.C*"f ION 825 L ~3T'Fd-Z:'E'I", AI',IE,14OF~Abb..~ Al',:: 9950;t. 264-47,~,B} F'ERM l' T NO ." DATE I ,c.;SLJED: APPI_ Lr CAN]' ." ADDRESS: CONT(-~[;'T PHONE C]! Ih,Il ...... ~E~ :~: 'T' lEE: S:~ lEE: ~,Jl lC.:!: IF~,". ~4()63:.3 07/27 DE gl',l CON~"I" 5 S&S 'ENG II',IEEI'~I NG EAi3L. E R].'~ER, Al< 99~'77 694-R979 IF" lEE: Fi,', It'dl ]t:: '"'IF: L..[::.bAL DE,.>CF~ 1F: L.CIT SI Zl.::: M/-~X BEDROOMB: SUBDIVISION: HIL. AND HILLS SECTION: 28 TOWNSHIP: 14N 694:!'.',2 (SQ. I:rT. OR ACRES) LOT: 6 ELOCI':..:~ ' ""' :1. F~ANGE. :LW Listed belcw~ ar'e the options available to yc]u in de.siL:H~ing youP septic system. (]hoose 'Lhe option tha{ best fits y[)L[P ~i'~.e,, DEPTH 'TO PIPE BOTTOM (F'T,,) 4.0 4,,0 4.0 BIRAVEL DEPTH (F:'T.) 4,, 0 0,, 5 3,, 5 TOTAL DEI::'TH (FT.) 8.0 4.5 7,, 5 GRAVEL WIDTH (FT.) 2.5 19.0 5,.0 GRAVE',L L. IEIxI(3TH (FT.) [~7.0 :56,, 0 49,, 0 GI:~AVEI_ VOLUME (CL.J. YDS. ) 23.7 25.3 36,,2 ]"ANK . 81ZE (GAL. S) 1,000.0 ,~..~ 1,0C)0,, ~) -~.,~ :1. ~ 000.0 SOIL RATING (SQ.FT. /BR) 150 :[50 :[50 ~,l' "rANI< MLIST IqAVE: Al' L,.InA,.~t TWO ,OMf'AIxTMENIS I cePti£¥ that: 1.I .am t'amiliaP wit. h the pecluipem~mts i'oP on-site sewePs and wells as For't.h by the Municipality oF AnchoPage (MOA) and the 8taCe c)F Alaska. 2. I will insta].l the system in accoPdance with all MOA codes and Pegulat. ions, and in compliance with the design c.r'itePia oF this pePmit. 3. I will adhePe to all MOA and State oF Alasl<a r'equiPements FoP the set back distances FPom any existing well, wastewateP disposal sys'Lem of public sewePage system on th:i.s om" any adjacent oP near'by ],or. 4. I understand that '~.l-lJ,~ per'mit :is valid fop a maximum of' 3 bedrooms and aFly enlar'gement wi1:1, peqLIJ. Pe an additional per'mi'L. ]:F:' A LIF"'I" STATION I8 INSTALL. ED IN AN AREA COVERED BY MOA BUlL, DING C[]DI!~S!, THEN (1) AN EI...ECTRICAL.. F'EF~MIT AND INSPECTION MI.IST BE OBTA]:IqED; (2) AS-BUIL. TS NZI...L NOT BE ~F'F:'ROVED NITHOUT ~N EI,.,ECTRZCAL INSF'IEC]"ZDN REPORT; ~ND (3) THE ELECTRICal.,., NEIRK MUST BE DONE BY ~ LICENSED ELEC]'RICI~Ixl. .:~ ] (3NFD ' ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: ]"'.) ~.~IN,J ("~8 ,',~,S.i~' LEGAL DESCRIPTION: 9 10 11 12 13 /Z.//L SLOPE WAS GROUND WATER ~ / S L ENCOUNTERED? '~ O P IF YES, ATWHAT i E DEPTH? /~.~ DATE PERFORMED: /-/,,.,. SITE PLAN 14 15 16 17 18 19 2O COMMENTS Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE_ _/~¢- //~ (minutes/inch) / TEST RUN BETWEEN FT AND FT PERFORMED BY: CERTIFIED BY: DATE: 72-008 AS-BUILT herebv certify lhat I bare surveyed the following described property: j=~t ~('_23~, Ancbon]~e Recordin~ owh'lap or encronch no mlpmwm~m~s on propeIK, lyin~ ~dj~ce ~t ~ ~c '~o ~ croad on lh~ premises ~ans mqs on lines or otbor visible edsoments on said property excepl ,,. indicated hereon. I.)aled a~ Eagle River, Alaska ROBERT C, JOl [NSON %(;AI.I- Registered Land burveyor No. 880-1 I - l~ Box 77-0456, Eagle River. Alaska 99577 'imm. (qU7) 69&2543 ( er ifie rilling by DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 272, CHUGIAK ALASKA 99567 ~. TELEPHONE688-2759 OWNER OF LAND ADDRESS LEGAL DESCRIPTION DATE - Started Ended PERMIT NUMBER DEPTH OF WELL STATIC LEVEL OF WATER FT, DRAW DOWN FT. GALS. PER HR : KIND OF CASING ~ KIND OF FORMATION: From Ft. to From Ft. to From Ft. to From ____ Ft. to___ From Ft. to From Ft. to From Ft. to From .Ft. to_ From__.Ft. to From____.Ft. to__ From Ft. to From Ft. to__ From Ft. to__ From Ft. to__ Frmn Ft. to From____Ft. to From Ft. to__ Ft. Ft Ft Ft Ft. ,Ft, Ft. Ft. Ft. Ft. Ft Ft Ft Ft. Ft. Ft From Frmn Fronl Frmn From__ From From__ From From Frmn Ft. to__ Ft. Ft. to __Ft. __Ft. to_____Ft. Ft. to____Ft Ft. to_____Ft Ft. to_____Ft _Ft. to____Ft Ft. to .... Ft .__Ft. to Ft ..... .__Ft. to Ft. Ft. to __Ft MISCL. INFORMATION: DRILLER'S NAME ,Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program · 4700 South Bragaw SL · . P.O. Box 196650 Anchorage, AK 995196650 www.cl.anchorage.ak, us (9O7) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING' Parcel I.D: ' 050~382-25 t. GENERAL INFORMATION 'F Com~)lete'legal degc~ipfion - Expiration Date: HIGHLAND HILLS SUBDMSION ~1; LOT'6~- Location (site address or directions) 5630 HILAND ROAD * EAGLE RIVER, · Current Property owner(s) Mailing address ,Lendiqgegency ~ . Mailing address Rial Estate Agent Mailing address DAVED ~cDOWELL EVA LOKEN w,/ PRUDENTIAL VISTA Day phone 689-6476 D~yphone EVA LOKEN w/ PRUDENTIAL VISTA Dayphona 689-6476 16635 CENTERnELD DRIVE * EAGLE RNER~ AK 99577 Un/ess othen44se requested, HAA will be held by DSD forp/ckup. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ~E] Indivldual Holding tank Cc;mmunlty On-site ~ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil engineer registered in the State of AJaska. Certificates of HeaIth Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a pedod of up to one year with valid water samples.) Certificates are valid for one year for properlJes 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: ~. aska Water and Wastewater Consultants, Inc. shall be pald $2545.00 at, or pdor to closing for the engineering sen/ices pro~fded. STATEMENT OF INSPECTION BY ENGINEER As cerb'fied by my seal affixed hereto and as of the validafion date shown below, I vedfy that my Invesfl'gab'on, based on procedures outlined In the Health AuthodO/ Approval Guidelines for this application, shows that the on-site water supp~' and/or wastewater disposal system is(am) safe; functional and adequate for the number of bedrooms and Jype of structure indicated herein. I further ye#fy that based on the Information obtained from the Munldpali~y of Anchorage files and from my Investiga§on and Inspect/on, the on-site water supp~' and/or wastewater disposal system Is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in eff~-'t at the Emu of Installation. Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone Address . 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Pflntad Name JD-H<EY A. (;AENESS, P.E. Date 337-6179 Englneer's Comments: In conducting this evaluation, AtgWC, Inc. attempted to provide a thorough, conscientious engineering ana~Jls of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered et the tZme of the tes~ and separation distances measured to readi~/ Idant~flable features. Tho opera~fenal life of all we/Is end septic systems depend on the Iocal softs condition, grounchvatar leyel$ that may . fluctuate during the year, and the water usage of the family being sorwd by the system. These conditions are outside the control of the evaluator of the s~tam. Satisfactory test results do not guarantee future performance of the system, nor de they guarantee that there are no hidden defects or enc~achmen~s. AWWC, Inc. can therefore not provide any warran¥ or future estimate of how long the system will continue to meet the Operational r~qufrementa of the ADEC or MOA DSD. Tho content of this report Is for tho sole benefit of the owner tisted above. Any reliance upon or use of this report by any uther person or party ls not authorized, nor will It confer any legal dght whatsoever. DSD SIGNATURE Approved for ~> Disapproved. Conditional approval for __ bedrooms. -. · ON-SITE . bedrooms, = WASTEWATER : 7, ;, PROGRAM .: ..... Attachments: HAA Chec~Jist Septic System Advisory Well Flow Advisory Manitenanca Agreements Supplemental Engineers Reort Other Original Certificate Date: Municipality of Anchorage Development Services Department Bulidlng Sa;=~ OMMon On.S~e W~te~ & W~tewater Program 4700 6outh Bragaw St. p.o. BOX 196650 A~, AK ~9519'6650 yAW,: _d:-qchom~.ak.us HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescflptlon: HIGHLAND HILLS SUBDMSION ~1; LOT 6~ BLOCK 1~ ParcellD: WELL DATA * INTO BEDROCK Welltype pRIVAI[ IfA, B, orCpmvldePWSID~ N/A Date coatpleted 1 gs4 ~ardtely leal (Y/N) YES 050-382-25 we, Log (Y/N) YES Wlres pmpedy protected (Y/N) YES TotaldepU1 140 ft. CAsedto .15 It. FROM WELL LOG Date of test 1 g84 Stel~ water level Weft production WATER SAMPLE RESULTS: 4.0 g.p.m. Coliform 0 colordes/100 nd. Date of eample: 5/31/2001 8EPTICdHOLDING TANK DATA Camghe~(atx~egrou~) ATINSPECTION 5/30/2001 36 ~ 4.54 g.p.m. 12+ .in. Nitrate 1.16 mgJL. Other bacteria D colonies/100 nd. AWWC~ INC. Tank Type/Material Tank size 1250 gal. FouedaUon deanout (Y~) YES Date of pumping NEW A~SORPTION FIELD DATA STEEL Numbar of Compadmante 2 Depression over tank fi/N) NO Pumper Oateinstafled 6/~/2001 Qeanoute(Y/N). YES H~hwateralaml(Y/N) YES Date Installed ¥3o/o~-~/,/m SoU mfing ~r~A3drm) 0.8 Lang~ 6o ~ Wlcml 5 Total depth ,e-~ ft. Eft. abaorpflon area 600 fl= Monltedng tuba YES Date of adequacy test. NEW Results (Pass/Fall) - Water added - gal. Ruld depth in absorption field bafom test - in. Etei~ed Time: - min. Final fluid depth - Any rejuvenation treatment (past 12 mo.) (Y/N & type) in. Ab~on rate >= 6,~tem type ~mz~o mgNCH Grovel below pipe 4.2 ft. Depression over field NO For 3 bedrooms New depth - in. - g.p.d. ff yes, give date - D. UFT STATION Date Instelied 6/4/2001 'Pump on' level at 41 In. Datum BO'FrOM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM VVELL ON LOT TO: Size In gallons 1250 'Pump off" level at 41 In, Septlo tank/lilt station on lot. 100'+ Absorption field on lot. 100'+ Publio sewer main N/A Sewer IsepOc service llne 25'+ Manhols/Accese (Y/N) YES High water alarm level at 45 Mseta alarm & dmult requlmmenta? On adjacent lots. 100'+ On adjacent Iota. lOO'+ Public sewer manhole/ctaanout Holding lank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Bulidlng foundafion 5'+ Property line 5'+ Water main N//A Water sewlce line, 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION REID ON LOT TO.' Abso~fion field 5'+ Surface water. 10o'+ Property line 10'+ Water se~ce line 10'+ Cmlaln drain NONE KNOWN F. COMMENTS Bulidlng foundation 10'+ Surface water 100'+ Wells on adjacent lots 100'+ Water main N/A Driveway, parldng/vehlcie storage 10'+ O. ENGINEER'8 CERTIFICATION I certify that I have determined through field inspections and review of Municipal mcerds that the above systems em in conformance with MOA HAA guldeflnes in effect on this date. Englnse~'s PUnted. Date ~ JEFFREY A. GARNESS HAA Fee $ Date of Payment Re(elm Number O~v. Waiver Fee $ Date of Payment Receipt Number. .tU~-0G-01 11:47 FI~U- · ~K CTIE Environmental Services Inc. To445 P.01/02 F-067 Sample Rcm~ks: 1013009001 AK Water & Wastewater Consultants ln¢, Highland Hills S/D #1 L6; BI Highlands HilTs #1 S/D L~; BI Drinking Water 0 PQL UniTs Mc&od Client PO~ printed DateFTime 06/06/2001 11:29 Collected Date/Time 05/30,~001 14:30 Received DsfeFl'lme 05,~1/2001 I0:~0 Technical Bircher Stephen C. ~e ~lowable ~ Analysis LimiTs Date Date ~it Nitrale-N 1.16 0.500 mtn- F. PA 300.0 (<10) 05/31/01 SCL Total Coliform 0 eol/lOOmL SMI8 9222B 05/31/01 KAP MUNICIPALIrY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTIt DEPARTMENT OF [-H']ALTH AND ENVIRON}IENTAL PROTECTION APPLICATION FOR N~EALTH AUTHORITY APPROVAL CERTIFICATE 1. General Infotnnation Application Date ~-.--~2].,~q~ ..... (a) Legal Description (include lot, block, subdivision, section, town,,~hip, range) Location (address or directions) KEN i{iland Nd. EagPe Niver~ AK 99577 Robert, Dean dba (b) Applicants Name~p~L~_ejl~t.~_2{~,]~ap_p_e].~_a~hone _ Home694 9 ] t~siness Applicants ~dress SN Box 9352 l~ag]e Niver~ AK 99577 Buyer ~ill ; Other ~i'l (explain); (d) Lending Institution ~ome oa zings & Loan Telephone Address 001 Benso., /lnchoraFle (e) Real Estate Co. & Agent i',I o n (? Address Telephone Mail the I-L~t to the following address: ]{c, berh !)can 2. T_!l}e__of Residence Single-Famil y [~l]l Number of Bedrooms Other (describe) 3, Water Individual Well t~J Community I~-'[ Public [Al Note: If community well system, must have written confirmation from the State Department of Environmental Consetwation attesting to the legality and status, 4. Sewage Dis~posal Onsite i~-iI Public iili Community ~ilii[ Holding Tank Note: If community we].l system~ must have vr£itten confirmation from the Stato, Department of Environmental (,onoervation attesting to the legality and status. [Page i of 2] _Ej~eerin~ Firm Providin__8 I~n_s.?e~c. ti~on~T_e.~st_:!~_ File Seay_cj}_, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and typo 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 regula- tions in effect on the date of this inspection° Date (ENGINEER SEAl,) Approved for-~}~'cz~?_a:~ . ~ bedrooms Approved .;~ DisaPproved Terms of Conditional Approval. CAL~£ION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAl, PROTECTION (D~[EP) ISSUES HEALTtt AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT,~ ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY /tN INDEPENDENT PROFESSIONAL ENGINEER RE. GISTERED IN THE STATE OF ALASKA. TIiE DIIEP DOES ~[IS AS A COURTESY TO PURCHASERS OF BOMES AND TItEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRF.- MENTS. F~PLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY' OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DitEP SEAL) [Page 2 of 2] 7-19-84 WELL DATA MIJNICIPALITY OF ANCHORAGE DEPT, OF HI~ALI'H & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: RECEIVED /~ f- g A:JA I We].l Classification /9~p We].l Log Present (Y/N) Total Depth_ /~/~ Cased to Static Water Level ~5- / Casing Height Above Ground Electrical Wiring in Conduit (Y/N) separation Distano~s f~om Well: To Septic/Holding Tank on Lot /~m To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line If A, B, or C, D.E.C. Appuoved(Y/N) Date Completed ~/~z/ Yield /&- ,~ ~.~-~pth of Grouting Pu~ ~t At Sanitary Seal on Casing (_Y/N)/~ Depression A~ound Wel]J~ead (Y/N) ~/ ; On Adjoining Lots /~'Y- /~ h ; On Adjoining Lots /~ ~ To Nearest Public Sewer ~.~-+ Cleancut/Manhole /~/, ~ To Nearest Sewer Service Lir~ on Lot Wate~ Sample Collected By /-~ ,~.- ; Date.. Water Sample Test Results :~-,~'/~.= Con~nts SEt~fIC/HOLDING TANK DATA DaL-.e Installed ~/~c~t~ Size /~ <~"~( No. of Compartmsnts C~ , ',,~ Standpi~s (Y/N) ~ Air-tight Caps (Y~ .~_ Foundation Cleanout (Y/N)"~ ~puession ove~ Ta~ (Y~) ~ Date ~st Pu~d ~ P~ing/Maintenan~ Con~act on File (Y~) ~ ; for ~ Ho].ding Tank High-Wate~ Ala~ (Y~) ~ ~m~rary Holding Tank Permit (Y~) Separation Distan~s fr~ ~ptic~Jolding Tank: To Water-Supply Well /~m~ To Property Line /~"~ To Water Main/Servic~ Line cour To Building Foundation To Disposal Field /o To Stream, Pond, Lake, o~ Major Drainage Coi~rmnts [Page i of 2] Receipt ~ Date Paid: Amount: ~-t.~', 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~/~' Width of Field ~ ~[~d ~' Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Type of System Design Length of Field ~-~ / Depth of Field ~ / Gravel Bed Thickness .. ~z / Standpipes P~esent (Y/N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ; dO '~ To P~operty Line /0 ! TO Building Foundation ~ ~ ~- To Existing or Abandoned System on Lot /P ~ ; On Adjoining Lots ~ ~- To Water Main/Service Line ~5-~ ~ To Cutbank( if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area /~ ~ Con~nts d°'~'f~· ~ ~-.~s/,~/-~. DJ LIFT STATION ~ Date Installed Size in Gallons "Pump On" L~vel at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dir~nsions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Pequest I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspec~on. ~ Signed Date / $/ ,~%.o, ~.~{~ ~. company 7DZ, ZOA [Pa~ 2 of 2] ~o~,~. ~ ~.,,, 2-15-84