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
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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