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Home My WebLink AboutBIRCH TREE ESTATES BLK 1 LT 17Bi ch T Block Lot 17 #017-141-21 Municipality of Anchorage Page / of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~L"J~t~OO-/~ PIDNumber: OI-IIH~ ~1 i Name: -~'r~ H'~:~aw"r Wastewater System: D New D Upgrade Ph°ne:C''~O~ ~-- ~ ~ No. of Bedrooms: ~ ~ Deep Trench D Shallow Trench D Bed ~ Mound ~Other LEGAL DESCRIPTION so, Rating: Total De~th from original grade: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe / ~ Townsh p I Range: I Section: Fill added above original grade: Gravel length: WELL:~/sr/~~ C New ~ Upgrade Gravel width: ~ I Ft. Number~of lines: ]lDistance between~lines:Ft. Classification (Private, A,B,C): Total Depth: ~ Total absorption area: Pipe material: Driller: ~ ~ Drilled: Static Water Level: Installer: Date installed: Y'e'd: ~ I Pum. Set at: I Casing Height Above Ground: ~ GPM Ft. Ft. TANK SEPARATION DISTANCES n s~ptic n ~o~ui~g ~S.T.E.v. TO Septic Absorption Lift Holding 3ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ We,- l~ g~ /~ ~ Iq3 / ~ ~% ~Materia~: ~ Numbe~ofCo~pa~tme.ts: Surface Water /OO~ /OO~ /OO~ ~ ~ LIFT STATION ~x~r~.~ Lot I t t ~ Size in gallons: ~ Manufacturer: I Foundation ~ ~ ~ ~' ~ ~' CurtainDrain - ~O~ ,~ ~~ ~ _ ~lectrical Inspections performed by: Remarks: ~ ~ sy~ ~s ~~ BENCH MARK Location and Description: I Assumed Elevation: E~S SEAL , . ~ & S ~N~INBERING ~gle River, Alaska ~5~ ' 2nd~ ~ ~.~ ROBERTcE - 880]C' CowAN Department of Healt~nd Hu~n Se~ices approval Reviewed and approved b Date: 72-013 (Rev. 9/91) MOA 25 Permit No. SW950075 Page 2 of 2 Municipality of Anchorage 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 LOT 17, BLOCK 1, BIRCH TREE EST. 01714121 Legal Description: PID No.: NEW PRESSURIZED DIST. SYSTEM SCAf.~. t" = 40' ii 72-013 A (1/93)* .FND CO MT3 MT4 g~ 1NSUI~TION ! &87.5' WATER' FOUND FCC) 10' __ STli 28' 41' ST2 32' 42' MH~ 35' 43' .... T"i ....... ...... 'ss' .... MT~ 48' 43' MT,~ 90' 89' MT& 86' 92' FINAL GRADE 9~.0' S.T.E.P. TANK * NOYE: NEW SYSTEM i PLACED EXISTING SYSTEM LO( ATION. ON ROBERT C. COWAN CE - 8801 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950075 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HACKETT PETER OWNER ADDRESS:2219 RIMROCK ROAD GRAND JUNCTION. AO. 81503 DATE ISSUED: 5/16/95 EXPIRATION DATE: 5/16/96 PARCEL ID: 01714121 LEGAL DESCRIPTION: BIRCH TREE ESTATES BLK 1 LT 17 LOT SIZE: 35793 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ISSUED BY: ! ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. May 2, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of H~alth and Human S~rvic~s P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 17; Block I; Birch Tree Estates bed;mom TeAt hol~s were excavated in an effort to ~stablish an alternate site. High ground water and poor permeability soils were encountered and deemed unsuitable for a wast~water disposal system. Th~ coupled with the w~ll location (which was r~located in 1990) has produced a situation where the only suitable septic system site is wh~re the present system is located. Attached is the proposed upgrade d~sign to be placed in the same location as the current system. Also attached is the test hole soil log of 5/15/90 which we have used for the basis of this design. The approximate location of the test hole is located on the attached site plan. At the time of excavation water was encountered at four fe~t and after seven day ground water monitoring water was found at four feet r~spectiv~ly. We do not anticipate any adverse effects on n~ighboring properties by the installation of the proposed septic system. There are no points of contamination within the proposed w~ll radius which can be seen on the attached site plan. If you require additional information please contact us. Sincerely, Robert C. Cowan, P.E. RCC/gk ENCLOSURE 17034 NORTH EAGLE RIVER LOOP · SUITE 204 ° EAGLE RIVER, ALASKA 99577 1,, J - 50' SITE PLAN SCALE ~ _~ ~"r- 0 ,.., :>-~ -o C~ · · o¢,')L~-? .~ -,-., ~ 0 0 0''-'''T'' C)- "J ~bb', L-z'J ~oO-CU ~ r'-' c:: mt/) z > ;:u z ;;o ,..ira _,~ -o cr~ r-., C) ::o m ~r.q c~0 ~zc~ ::o ;:o .._I ~;;o o'r zo o~ z o ~ z 0 N.T.S. PROFILE SCALE ['~---2' MIN. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~ ~ ~ ~'R Township, Range, Section: 1 2 3 4 5 6 7 SLOPE SITE PLAN 8 9 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L DEPTH? .O E Depth to Water After ~t ~J;*~-'~ i MonitorinD? Dale: Reading Date Gross Net Depth to Net Time Time Water Drop "5 tL~' ~ ~ ~'/~ PERCOLATION RATE__ ~g~ 0 (minutes/inch) PERC HOLE DIAMETER COMMENTS TEST RUN BETWEE~ FT AND ~¢"~FT f--~ PERFORMED By~:,~ ~.~le R'~ L~ ad No. 2~ /~~~CERTiFY THAT THIS TEST WAS ACCORDANCE¢~RiVer, Alaska 99 // ~ / PERFORMED IN 72_008 (Rev, 4/85)'H ALL STATE AND MUNICIPAL GUIDE~cT ON THIS DATE' DATE: ~~ ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS sEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN REFERENCE: Lot 17, Block 1, Birch Tree Est. May 2, 1995 GENERAL: me The scope of this project includes the installation of a pressurized absorption bed to serve the three bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Se Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 17034 NORTH EAGLE RIVER LOOP . SUITE 204 " EAGLE RIVER, ALASKA 99577 Page Two Lot 17, Block 1, Birch Tree Est. May 2, 1995 Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. PRESSURIZED MOUND SYSTEM INSTALLATION: 1. Any peat or organic matter must be removed from the elevated mound site. The bottom of the basal bed area as well as the top of the sand filter is to be within two inches of level. The distribution piping is to be of PVC (ASTM D3034 or equal)· All joints are to be solvent cemented· The side slopes of the top layer of the mound system must not be steeper than 33% (3:1). ® The top of the mound shall be covered with a minimum of 6 inches of topsoil and vegetated sufficiently to prevent erosion. The distribution pipes are to be embedded in sewer rock. Care should be taken to backfill in such a way as to prevent damage to the piping system. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Page Three Lot 17, Block 1, Birch Tree Est. May 2, 1995 e Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. e Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Se A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. ® Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the $200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 17, Block 1, Birch Tree Est. May 2, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 0 The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 17, Block 1, Birch Tree Est. May 2, 1995 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950302 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:HACKETT PETER OWNER ADDRESS:5115 METZ CT ANCHORAGE, ALASKA 99516 DATE ISSUED:10/02/95 EXPIRATION DATE:10/02/96 PARCEL ID:01714121 LEGAL DESCRIPTION: BIRCH TREE ESTATES BLK 1 LT 17 LOT SIZE: 35793 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY:~ ISSUED BY: /j ~/~f~ SCALE SEP 28 '95 ll:34AM REMAX PROPERTIES P.3 45TH o 89'4.3'44-" W 109.22' 10' UTILITY EASEMENT LOT 17 EXIS]]NG ~ HOUSE c~. LOT "18 witlm RI=' M X LAND ~ CONSTRUCTION SURVEYOE$-PLANNEI~S-ENGINEER$ ~40 WEST BENSON at. VD, /~ 10.3 ANCHORAGE, ALASKA 99503 (gO7) 562-5291 1"=30' (fax) 561-6626 95-L-574A ~o37 EXCLUSION NOT~; It it the ownere' miDaneibilltv te ~ef, ermine LE:CEND: 5~1 FND the ,.i.t--c. of ~,, ,a,~.nt., c~.n,nt,, o, ~,trl~,lon. I~/,.RBW/~,.,/,,,,BgI which do not appear an the reaoed~d aubdMa~on plat, NO~: ~aS' A~M~, ~MONUM~T Under no o;r~metOnoea ehould any da~a he~ be uaed roe I Hue A TA~ ~ ~UR~Y ~CA~ON~ L~CH hoe eond~¢~ a O~RH~- ~h~eel eu~ of EhJa p~perty aa ahe~ an this ~ tawing a~.d that the Impe=~ent. = ~uated he. CON~- an qre wleqin ,~he Rrop~y.lJqe~ gnd no en~ag~h- mane, exis~ omar men net~, gEA~L- LOT 17, BLOCK 1, BIRCH TREE ESTATES FROM : ANN & T!M R!TTAL 0CT--2~I--95 'TUE ~12"-~2 PH PHONE NO. M-W DRILLZHG ~ : 907 248 2249 P02 M-W DRILLIN~I~ II~. P.O. ~ 1 t01~78 · 103,q00Jd ~WlI~ Highway ANCHOIqAOE. AbI~KA I~1511 OlUml~ me PETER [.lAC KETT We]/Owoer_ -- .- Location (addre~ of: Township, l~ngo) ~, 1~ ~o~n; or dlst~ ma~ ro~ LOT l, BLOCK t7 BIRCH TRE[ ESTATES; 5115 HETZ CIRCLE 83.06 .urfue. I'lutsh of well (cheek one) -U,e o~ Wa'])~DOIdlE ST I C __ ANCHORAGE~ ALASKA SL~e of ea$1AlL..6": ~epth of Hal- feet of draw~ f~m .tat~ ~eP~ ~f~t from gro~d sU~ace ol~enend ( X ); (minute) tot- -~ - hours witk 100% ft. 0 TO Z ~ TO 1~ lZ ,TO Z4 TO, 34 34 _'lC) z16 .- 46.~.___TO._ 52 _ 56 ~ 6~ 6Z .~0 73 73_.10 75 ;,~. -:::-. '-' - .............. v ....... ~,-';' ~,~. ,. ' . ~' ~" ' ': " ' ' i~"L~' ' G~ ' d~. ~k Of formations penetrated, size of m~terzal, ~cr~R~'b~f~.'. __ C.q .~.rv~ces ~' ~'V' ~ ............ :~:h~ S~I'CKUP '".. ' . ' Oept, Hea~m -~;AR~ '. , ..GREY, '~, " ' -' LTV . _ --' ~ ~ , ~'~ I - ~ ' - ' ,r~ ' '~' ' ' ~ M~ '~ '' CO~ ' ~:"__ ..~.~ .,. .? ..~.,.. ~ ~ ~ ~ ~:: ' ,::.~.., ....~ . o~'.. IL "~0 ~ ~,A~, _ ~, ,, .: . ~ -~a~.., :,..~.<~..~1,.~' ....~ ;~<~ ~'~,:1~ ....... · .... ~l'u~a". ' :~"% L~S.: .-~ ' ' CLAY: SI'LTV, COBBLEY CLAY; SILTY, ~ATER GRAVEL MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name Address Phone(s) I Permit No. [No. ol Bedrooms LEGAL DESCRIPTION Township, Range, Section TANKS SEPTIC IManufacturer Mat~ri~'l [] HOLDING Capacity in gallons No, of Compartments TYPE OF SYSTEM [] TRENCH [~ BED [] W. DRAIN [] OTHER originaIDepth tOgradePipe bottom from To.~..~f re m original grade (~ Fill added above original grade Gravel length Gravel depth beneath pipe Gravel width ~ FT ~" FT Total absorption area /~"-~,~' SQ FT Number of lines I Soil rating ~' I ~'~ SO FT Installer ~L..~- r"q j'"'~ Distance between lines Pipe material Date Installed (~ FT WELLS PRIVATE [] OTHER {Identify) Classification (A,B,C) Total Depth I Cased to Installer Date Installed: REMARKS: FT >W--~LL LOT LINE FOUNDATION DISTANCES SEPTIC ABSORPTION TANK FIELD WELL ' AS-BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway, water bodies, etc.) S & S ENGINEERING 17034 Eagle River Loop Road No. 204 I nspectio~'f,f~ by: Date: ~ ..- ~ ,...~::~ i~ I Ea_~le River: Ala,~Ea e~;77 ce)ltly that ~Is inspe~ion was pedormed accordin, Municipal and State guidelin, in effect on this date'. ~//Z/~ / / Health Depadment Approval: / 72-013 (3/85) INSPECTION REPORT MUNICIPALITY OF ANCH(~RAGE, BUILDING SAFETY DIVISION 3500 EAST TUDO'i~ ROAD INSPECTIONS (907) 583-3464 INFORMATION [907) 786-8211 FOOTING [] ELEC. TEMP. ~ ~ # [] PLBG. UNDGR. [] FOUNDATION [] ELEC. SERVICI~,_.~,~ ~ PLBG. ROUGH [] BOND BEAM [] ELEC. ROU~L~ GAS TEMP. [] FRAMING [] ELEC. FINA~-.~ l~ [] GAS [] INSULATION [] OTHER ~ [] MECHANICAL [] SHEETROCK [] MEOH, FINAL [] STRUCT. FINAL [] FIRE FINAL [] PLBG. FINAL [] OTHER [] ZONING [] OTHER [] XNO NONCOMPLIANCE OBSERVED [] CORRECTIONS ESSENTIAL AS EXPLAINED BELOW [] WILL REEXAMINE AT NEXT INSPECTION [] DO NOT CONCEAL UNTIL REINSPECTED COMMENTS .. DATE ~;-IEN CORRF~IONS ARE MADE, PLEASE CALL FOR INSPECTION DO NOT REMOVE THISNOTICE 84-002 (Rev. 11/87) AI',ICH, AK 99508 Sect. :i. c,r~: ;'..':?.3 "J'C)l,-,,iFi~i!.~h :i.p: :t. 2N f:!an,:;;!e: 3W t....crt. S:i. ze 3579:3 (sq,, f'.t:..,, c:~r' a,::::r'es) Hax B6'.,d r' c, oms: "l"h :i. s l:::'e r' m i t ~ :]; l"c,t a 1 Cap ac :i. t y ~ L'!; must ha,./e at. least ;'..';..'. cc.~ml::,ar"t.m~.¢.:,,n't.s,, Depth to t.c,p !",:.:i.?,;::lL.t:J.r'e,:ii~ :J.r"lsLt].a'~:.:j.(:::,r"~ c)vc-:.:,:,r' 't'..ar]k (~.~i~),, TH]iS UF::'(3RADE HUS1" BE INS'T'ALI....E;D AS SHC)WI',I C)N THE REVIESED ENC.""JINtEI!ER,S I'}E:S ;[ (:i';t',l DATED '?/6/90 ,, 'T'HE lEX I ST I I'..IE'~ TAI;IK MUST BIE t:::'ROF::'I!D':~'.LY ABANDON ..... lEI],,, NOT]:F:'Y DHHS BtEFOF:i'.E AL1 .... BE:OI;:,,'001"! S I NGL..E; I:::'f..:M1 ]: LY RES :i; DIEt',lE;liii; OIqL'¢., AND W XI:::' t RES CII",I 12/31/90,, Municipality of Anchorage 825 "L" Street, Anchorage, Alaska 99502~650 SOILS LOG- PERCOLATION TEST LEGAL DESCRIPTION: L.-~,I ~'~ J '~:;~. ~.i~ Township, Range, Section: · ,~~ ~ SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN S IF YES, AT WHAT 12 DEPTH? ~ ~ _ .,.~ ~ Depth to Water Aller 13 ~'~ \ L~@L~u'~- Monitoring? .__~ 14 . ~ ~' ~T-- ~ I Reading/ Date ~ross / Net ~ ~ ~ Time ~ Time Depth to Net ~ _ ~~ ~ Water Drop 19 20. PERCOLATION RATE ~ -~ ~iv~r Alaska ~S~ -- ~ ~ ' ' - C~RT~Y THAT TH~S T[ST WAS P~R~ORUE~ ~N 1 2 3 4 5 6 7 8 9 10 11 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ~:>t ~ '~.~Township, Range, Section: SITE PLAN SLOPE WAS GROUND WATER ENCOUNTERED? S DEPTH?IF YES, ATWHAT ~;;~ ! E Depth to Water Alter ! monitoring? ~ Date: ~::~' ~' '""C:;L'"'~ Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE -- (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN~,~--~FT AND FT COMMENTS f ,/ ~ 17034 Eagle Ri.v~ L~p Road No 2 PERFORMED BY: .... ., . ..... ' ~ THAT THIS ~EST WAS PERFORMED IN eagle Klver, ~laiKa ~13// ~ / CERTIFY 72-008 (Rev. 4/85) ~ SCALE OWNER OF LAND ADDRESS LEGAL DESCRIPTION DATE - Started PERMIT NUMBER ( erlifie rillittg by DOC Co. SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759 DEl'TH OF WELL Ended STATIC LEVEL OF WATER FT. GALS. PER HR )~ ~ KIND OF CASING ('~, ~': ~ ~9 /4/- KIND OF FORMATION: From ¢') Ft. to ?'? Ft. From ? Ft. to ~"' Ft. From ,_'~ Ft. to.__Ft. From Ft. to Ft. from r' Ft. to (~:'~,P Ft. From Ft. to.~.Ft. From_~.:,~ Ft. to '7c~ Ft. From__Ft. to__Ft. From 7~L Ft. to 7 ~ Ft. From ~ Ft. to ~>~ Ft, From__Ft. to.__Ft. From (: J FI. to Ft. From FI. to Ft, From Ft. to Ft. From__FI. to Ft. From Ft. to.__Ft. From FI. to Ft. · , -' v, ~ct-U{~ From.__Ft. to. Ft.. From ' Ft. to Fronf . Ft. to From . Ft. to From Ft. to From Ft. to From Ft. to From MISCL. INFORMATION: Ft. Ft. Ft. tl~LhllCIP~J.J:TtY- J~ ~Hp~ g D t:Nv.i~O~,iMEb.~TA~_ .qF R~ IC-~Sq31V I~lO1q AUG 1 5 1990 RECEIVED ~.,.,,.,,.,,~. onoT[lcwe NAME ': ' ' , .... ' GRE' ,,FR ANCHORAGE AREA BOR-,.JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: FROM WELL ?O MANUFACTURER ATERIAL _ . _ COMPARTMENTS INSIDE LENGTH ~ / INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY/~'~ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL / ! ¢7 FOUNDATION 7 '~ ! NUMBER OF LINES '~ DISTANCE BETWEEN LINES ABSORPTION AREA S(~-F-~LENGTH OF EACH LINE ~ ~'~_~ ~,~¢. ~ ~ DEPTH: TOP OF TILE TO FINISH GRAD~// MATER AL BENEATH T L~ ~TABOVE T LE TYPE , ~ '~ (~"'~-- '~ONSTRUCTION ' / TOTAL LENGTH NEAREST LOT LINE OF LINES TRENCH WID TOTAL EFFECTIVE DEPTH DISTANCE FROM: BUILDING NEAREST FOUNDATION__ LOT LINE__ NEAREST SEPTIC I SEEPAGE SEWER LINE__, TANK SYSTEM '~r'/ CESSPOOL OTHER SOURCES APPROVED __ DISAPPROVED REMARKS DISTANCES: ~~'~ ~~~ ~~GRAM OFSYSTEM SEWER LINE DEPTH: ~ - LOT SLOPE:~: .... ;. ~ -~ REMARKS ~ ¢~ ~ ~ ~' ............... / /¢ G.A.A.B. Form EQ-032 NAME OF APPLICANT .EPARTME.T OF E.V,.O.ME.TAL OUAL'TY 3330 "C" STREET ANCHORAGE, ALASKA 99503 S~W~G~ mS~OS~ S~ST~ -- ~UC~T:O~ ~ INSTALLATION LOCATION /'/7 g / , INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS OTHER COMPLETION DATE ANTICIPATED FINAL INSPECTION: Z4 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK TYP SIZ~ - FOUNDATION TO SEEPAGE PIT- --~ DRAIN ~ -- ' ~ - EEPAGE PiT WALL SEPTIC TANK TO S . ~ SEPTIC TANK ~, SEEPAGE PIT , DRAIN _ ' ~ TO NEAREST LOT LINE. WATER MAIN TO SEPTIC TANK ~~, SEEPAGE PIT ~ DRAIN FIELD ~. / / · CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF L~ EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH ~EGU~TIONS REGARDING INSTALLATION. LICENSED D~SIGN~ DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. . ~/ , DAT ' ~3 '~ APPLICANT'S SIGNATURE ' FO I 6 CONSU LT.%.NTfi., INC. A,'WCtlOR AG E FAIRBANKS JUNE.~U ~249 EAST 51ST AVENUE · P.O. BOX 6087 · ANCHORAGE. ALASI~.A 99503 · TELEPHONE 907-279-048'3 · TELEX 090-354t9 July 22, 1975 R & M No. 562069 Mr. Lance Gavalya SRA Box 325 A .Anchorage, Alaska 99507 RE: Test Hole and Soil Log Report for Sanitary System Lot 17 Block 1, Birch Tree Estates Dear Mr. Gavalya: We are submitting herewith' the test boring results and our comments regarding soil conditions encountered at the subject site. This investigation was per- formed in accOrdance with your request of 7-21-75, and those procedures out- lined in a letter dated, December 19, 1974 by Mr. Rolf Strickland of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 17 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with anauger type drilling rig and the test hole was extended to a total depth of 16.0 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in th~ test hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us.. Very truly yours, R & M CONSULTANTS, INC. Vice President JWR/ja xc: GAAB T .H .-1 7-21-75 ORGANICS ORGANIC SILT 0.0~ 1.0' 2.0' SILTY SANDY SILTY SANDY GRAVEL w/qOBBLES (GM) NO WATER TABLE 16.0' T.D. Log Represents Lot 17 Block 1 Birch Tree Estates R Engineering t& Geological Consultants Inc. ANCHORAGE FAIRBANKS ALASKA JU.EAU IDWN SY W'ED ICHKD BY WED Lance Gavalya Property Log of Test Hole Anchorage, Alaska PRO~.NO. 562069 OWG NO. )1 7-21-75 IS,cAL~: 1."=3' Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.alcus (~07) 34~7~04 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 017-141-21 '1. GENERAL INFORMATION Expiration Date: Completelegaldesc~pflon BIRCH TREE ESTATES S,/D; LOT 17, BLOCK 1 Locafion(siteeddressordiracflons) 5115 I~i:~,' COURT * ANCHORAGE;, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address FRAN MORLEY Day phone 5115 METZ COURT * ANCHORAGEf AK 99516 ,345-4533 DELYNN w,/ CITY MORTGAGE Dayphone 265-0714 121 W. FIRE'WEED LANEf SUITE 120 * ANCHORAGEt AK 99503 Day phone Unless otherwfse requested, HAA will be held by DSD for pickup. 2. NUMBEROF 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 Individual Holding tank Community 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 Naska. Certificates of Health Authority Approval are required for the fl'ansfer 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 cf 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. (CedJficetes may be reissued for a pedod of up to one year with valid water samples.) CertJficetes are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work, Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ ~ ~ ~ a~ or pdor I to dosing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validaEon date shown below, I verffy that my investigation, based on procedures outlined in the Health Au~hority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(ara) safe, functional and adequate for the number of bedrooms and type of s~ructure indicated herein. I further verify that be. ed 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 afl applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. 6A~NESS, P.E. Date 337-6179 Engineer's Comments: In conducSng this evalueUon, A WWC, In~ attempted th provide e thorough, conscienUous engineering analysis of the system In accordance wfth ADEC and MOA DSD Gu/defines & RngulsE~ns. The reported results described the perfermsnce of the system under the conditions encountered et the Ume of the test, end sepamUon d/stances measured to readily identifiable fealums. The operaUonal life of all wefts end sepUc systems depend on the Iocal soils condition, groundwalor levals that may flucfuate dudng the)teaC end the water usage of the femt7y being served by the eysfem. These conditions ere ootslde f~e ¢onkol of the evalualor of the sysfem. Se#sfactory tesf results do not guarantee future perfom;snce of the system, nor do they gusrentee that them are no hidden defects or encroachments. A WWC, Inc. can ~refem not provide any w~lanfy orfutum estimate of how long the system will confnue to meet the operational requimments of ~he ADEC or MOA DSD. The c~ntent of thls repeat is for the sole benefit of the owner #sted above. Any reflance upon or use of this report by any othor pe~on or par~y la not authorized, nor wffi lt confer any legal ~ght whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for __ Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms, wtth the fllowtng stipulations: .d,~ -,,~ c,,..~; ~, ~.-.o -- .. ~..- ON-SI E , · WASTEWATER: - Manitenan~ Ag~men~ ~)J)) ) ))) )~)~ Supplemen~l Engln~fs R~K O~er Original Certificate Date: Municipality of Anchorage Development Services Department On-Site Water & Wastewater I~ 4700 6o~h Bragaw b"t. p.o. Box 196650 Allclmmge, AK 99519-~850 A. WELLDATA HEALTH AUTHORITY APPROVAL CHECKLIST BIRCH TREE ESTATES S/D; LOT 17t BLOCK 1 Parcel ID: 017-141-21 Welltype plaVA~. IfA, B, orCprovldePWSlD~ N/A Oatecompeted lO/18/95 Sanm=y~ea;(Y/N) Total dePl~ 84 It. Cased to 83.06 ft. FROM WELt. LOG Dete of test 10/18/1995 Statlc water level 55 fL Well produclion 7.0 g.p.m. WATER ~AMPLE RESULI~: Date of ~ample: 11/22/2OOl 8EPTICJHOLDING TANK DATA Tank T~Materlal Tank elze 1250 gal. Number of Compartments 2 Fcmnda~cmdeanout(Y/N) YES Oepresslmovertank(Y/N) NO c eofpump .o cPI P per ABSORPTION REID DATA Date Installed Length 45 fL, Wen log fi/N) YES wire~ pmpedy protected (Y~N) Ca~nghe~ght(~a~w%ra~d) 18'+ in. AT INSPECTION 2/26/2001 55 fL 4.4 g.p.m. AWWCm INC, ,,, Date Installed 8/5/1990, High water alam~ fi/N) J System type' PRESSURIZED BL~ C~avel below pipe 0~5 fL Total deplh .~-4 fL Eft. ab~xpUm area 2250 fiI Monitoring tube YES Oate of adequacy test 2/26/2001 Results(Pass/Fall) PASS Rulddeplhinat~fleldbefomtest 0 In. Wateradded 527 gal. Elal:~ed'Tlme: 0 ndn. Flnalfluld depth 0 In. Absorption rate Any mJuvenallon tnmtment (past 12 mo.) (Y/N & type) NONE KNOWN Depresskm over field NO For 3 bedrooms Newdepth 0 In. 45O g.p.d. ff yt~. give da~e - ~ 50 fL Son raUng (~or ~Ax~m) o.3 PBELOW FINAl. ORADIrl D. UFT STATION Date Installed 8/5/1 'Pump on' level at ¢3 In. Datum BoI'rOM OF TANK E SEPARATION DISTANCF.~ SEPARATION DISTANCES FROM WELL ON LOT TO: $lz.e In gallons 1250 , 'Pump off' level et 39 In. Cydee te~b~ 3 ~eplic tenk/l]ff ~tefion on lot, 100'+ AbsorplJon field on lot 100'+ Public sewer maln N/A Sewer/eepfio eewlce ,ne 25'+ High water a~arm level at 46 In. Meets alarm & c~rcult requirements? YES On adjacent ~ 1 oo'+ On adjacent lots 100'+ Public ~ewar manhole/deanout .... N/A Holding tank N/A , SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+., Properly line 5%, Water main lo'+ Water ~en4ce line 10'+ Wells on adjacent Inte 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO.' Bulldtng foutxlatlon 10% Water main Property Ilne 10'+ Water eewlce line 10'+ Curteln drain NONE KNOWN F, COMMEI~'S Ab~on field, .5'+ Surfaco water 100'+, 10'+ Surface water lOO'+ Driveway, retiring/Vehicle storage, 1'+ Welts on adjacent Iote lo0% G. ENGINEER'S CERTIFICATION I cer~ that I have determinnd through field In,~s and mt4ew of Munlclpel mconfs that the above s~sterns em In conformance v/Eh MOA HAA guldel~ee In etTect on this date. Englnee~ PdntedName u~,~EY A. OARNESS Date HAA ee$ Date Of Payment Receipt Number p~v. ~2/oo) Waiver Fee $ Date of Paymont. Receipt Number Municipality of Anchorage De olopment Services Department Building Safety Division Or>Site Water & Wastewater Program ' 4700 South Bragaw SL ?O. Box 196650 A~chorage, AK 99519-6650 wvw.cl.anchorage.ak.us · ; (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-141-21 1. GENERAL INFORMATION Expiration Date: Completelegaldescdption BIRCH TREE ESTATES S/D; LOT 17, BLOCK 1 Locefion (sIte address or directions) 5115 M~.lz COURT * ANCHORAGE, AK Current Propea7 owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address 345-4533 FRAN MORLEY Day phone 5115 I~_lZ COURT * ANCHORAGE, AK 99516 DELYNN w,/ CiTY MORTGAGE Dayphone 265-0714 121 W. FIRE'WEED I.ANE, SUITE 120 * ANCHORAGE~ AK 99503 Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBEROF 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 Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Se~ces 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 Alaska. Certificates of Health Authority Approval are required for the transfer of rifle (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. Certificetes of Health Authority Approval are valid for 90 days from the date of issue for proper'des served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Cer[Jficetes 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. Nota: Afaska Water and Wastewater Consultants, Inc. shall be pald $1,0OO. OO at, or prior to closing for the engineering sarvfces prot4ded. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the velida~on date shown below, I vedA/that my Invesb'gation, based on procedures obi#ned in the Health Authod(y Approval Gu[defines for this application, shows that the on-site water suppA/ and/or wastawatar disposal system is(are) safe, funcb'onal and adequate for the number of bedrooms and ~ of structure Indicated herein. I further vedA/that based on the informab'on obtained from the Municlpali(y of Anchorege files and from my investigation and Inspection, the on-site water suppO/ and/or wastawater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the tYme of Installation. Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. (~ARNESS, P.E. Phone 357-6179 Date ': / Engineer's Comments: In conducting this evalua#on, AWWC, Inc. attempted to pnwlde a thorough, consclen#ous engineering ana~sls 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 at the time of the test, and separation dis:ances measured to readi~, identifiable features. The operational life of all wells and septic systems depend on the Iocal soils condition, groundwater lemls that/nay fluctuate dudng the year, and the water usage of the fami~, belng sen/ed by the s~tern. These conditions are outside the control of tho eva/uator of the system. Sa§sfactoty test results do not guarentoe future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provfde any warren~y er future estimate of how long the system will continue to m~et the oporatYonal requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owaer ~sted above. Any reliance upon or use of this report by any other person or party is not authorized, nor will lt confer any legal dght v~atsoever. 5. DSD SIGNATURE ~ Approved for ,-~ bedrooms. Disapproved. Cond[Uonal approval for __ .. -.. ~: ON-SITE '..'~ ~ . WATER AND . bedrooms, wtth the tllowing stipulation~ t. W~A?..E..W~A,T, ER ..' . Attachments: NAA Checklist SepUc System Advlsory Well Flow Advisory Manltenance Agreements Supplemental Engineer's Reort Other Odginal Cer'dficate Date: ~ - //7/ ° (O / Municipality of Anchorage Development Services Department On. Site Water & Wastewater Program 4700 Soulh 8ragaw SL p.o. Box lg6650 Anchorage. AK 99519-6650 www=i~nchomge~lcus (9O7) 343-79O4 Legal A. WElL DATA HEALTH AUTHORITY APPROVAL CHECKLIST BIRCH TREE ESTATES S/D; LOT 17f BLOCK I PamellD:. 017-141-21 Well type Date completed Total depth 84 Date of test Static water level Well production WATER SAMPLE RESULTS: ifA, B. orC provide PWSID# 10/18/95 Sanltery ~eal (Y/N) YES Cased t~ 85.06 ff. FROM WELL LOG 10/18/1995 55 ft. 7,0 g.p.m. Well Log (Y/N). YES Wires pmparly protected (Y/N) Casing height (above ground) AT INSPECTION 2/26/2001 55 ff. 4.4 g.p.m. YES 18"+ .in. Oate of eample: 2/26/01 Collected by: SEPTIC/HOLDING TANK DATA Tank Tybe/Materlel STEEL Tank size 1250 gal. N~bar of Compartments 2 Depression over tank (Y/N) NO Pumper Ol~er bacteria .__~ colonies/100 mi. Date Installed 8/5/1990 Cleanouts (Y/N) YES High water alarm (Y/N), YES NORTHLAND PUMPING Total depth ,3-4 ff. Eft. absorption area 2250 ft' Monlt~ tube YES Date of adeduany test 2/2o/2OOl Results(Pass/Fall) PASS Sell ra~ng ~c~ ~rndrm) 0.3 Width 50 ff. System typa PRESSURIZED BED Gravel below pipe 0.5 ff. Depresalon over flald NO For 3 bedrooms RuM deplh In absorption flald before test 0 In. Elapsed Time: 0 min. Final auld depth 0 Any rejuvenation tma'm~ant (past ~2 mo.) (Y/N & Water added 527 gal. New depth 0 in. In. Absorption rate >= 450 g.p.d. NONE KNOWN If yes. give date - Foundalton deanout (Y/N) YES. Date of pumpIng 10/2000 ABSORPTION FIELD DATA Date Installed 5/~7/~e95 Length 45 ff. AWWCt INC. D. UFT STATION Date Ins[aBed 8/5/1990 "Pump on" level at 43 In. Datum BOTTOM OF TANK E. SEPARATION DISTANCES Size In gallons 1250 · l~p off" level at 39 in. Cydse tested 3 SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Abserption field on lot 100'+ Publl~ sewer main N/A Sewer/septic sentlce line 25'+ Mafiho~t.a~.~,ss fi/N). YEs High water alarm level at 46 Meets alarm & circuit requlremente? YES On adjacent lois 100'+ On adjacent lots 100'+ Publlo sewer manhole/deanout Holding tank N/A N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main 10'+ Wells on edJacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION fiELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water se~ce line 10'+ Surface water 100'+ Driveway, pa~ng/vehlde storage Cuflalndmln NONE KNOWN Wells on adJacent lots 100'+ F. COMMENTS Pmberty line 5'+ Absorpti°n field. Watersentlcellne. 10'+ * Surface water. ,5'+ 100'+ 1'4- .In. HAA Fees ~> C..~:~ Date of Payment Receipt Number 0~ev. limo) waiver Fee $. Data of Payment Receipt Number, . '" : ~ MUNICIPALITY OF ANCHORAGE !~...?:~.~. ~: DEPARTMENT OF HEALTH & HUMAN SERVICES · ..~,. Division of Environmental Services ~"~:~" ~" "~;' '-':': "' :~' P.O.. Box '196650 Anchorage, Alaska ~.9951~650 . - . CERTIFICATE OF H~LTH AUTHORI~ . ' 'APPROVAL FOR A SINGLE FAMILY DWELLING 1. GINIRAL INFORMATION Lot 17; Block I; ach Tree Complete legal description Locatio,n (slate address Or directions) -.- , -J,; · '~.'"'L. 5115 M~tz Court Anc~o~z~e, AK Day phone Gr~nd Janc~Zon, ¢olor~do Day phone 81503 Add . .~.,..*;~,~ Unle~ o~eMise ~equested,...,~a will be he d for pfc up ..................... ,;,,-:-;~>a:a,¢.,~,; Individual well_~: ................ X~ - '--'; . ........... Public water ,% .... .... ~" ' "~' ....... NOTE: If communi~weil.sysmm, provide wri~en confirmatio~_from State ADEC a~est- ". " ing to the legali~ and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: ._! attesting to the 72~}25(Rev. 1/91) Front MOA~21 STATEMENT OF INSPECTION BY ENGINEER ...... '...' : As certified by my seal affixed hereto and as of the validation date shown.below,' I' ve~:i~' that my investigation of thid 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 and tyPe of structU'~eindicated herein. I further verify that based °n the the Municipality of Anchorage fil~q and from my inves.t~ation and insp~'~tion, the on-site water supply and/or wastewater disposal system is in corn pliance with all Municipal and State codes, ordinances, and rc~:julations in eff~t on the date of this insp~tion. · S.& S ENGINEERING Name of Firm "17034 Ea,ie River Loop. Read No. 204 Eagle River, Aieskl 99577 ;~,nree~r's signature ""~~_ .'~a~" ~(/~~ Phone DHHS SIGNATURE -? .' Approved for bedrooms. ............... ~'3'~ ..... ~' ~'~~'~<~ ..... '~ ......... : .......~"·'~" ........... Human Seryices_'(DHHS) Issues The Municipality Of Anchorage Department'of Health 'and" '~ "~:'~'""~'" ' ........ '~"~"'~"' ......... ~* ~"~' ~' .......... :~: Approval' Certificates based 'only upon the representations given, in paragraph 5 above by an ndependent ~ii??;:; Legal Description:/.-o Y' I 7 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERX~i~E E IV E Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) ~-~7'3J{) 1995 Municipality of Anchorage Dept. Health & Hurnan Servicee Health Authority Approval Checklist /$L~ I Bt4c[~ ~',qS..( £$~.Parceli. D,: Ol7 -Iff/ A. WELL DATA Well type tOt~/vtt T' Log present ~q) Total depth Sanitary seal If A, B, or C. attach ADEC letter. ADEC water system number Date completed ! off I ~ // ':'/ Cased to ~' q / Casing height (above ground) Wires properly protected Date of test Static water level FROM WELL LOG /o / ,C' Well production AT INSPECTION WATER SAMPLE RESULTS: 7o o . g,p.m, g.p.m. Coliform ~) Nitrate Date of smnPle~: / O ~/~ .3//a/.f'- B. SEPTIC~ TANK DATA Date installed ~[~/q 0 Tank size 13. ~"O Fou~ nd~$kea~el0anO~q.t ~)N) ¥~ 5 Depression (Y~ o ?q ~ Pumper ~+ ~o~t C. ABSOR~ION FmLD-DATA Date installed '~'/~" '~ r Len~ ~ ~ ~ 19. / / Other bacteria Collected by: $ & S ENGINEERING iiO~l ~lgia KiVer LOOp ~ Riv~, Aliskl ~577 Number of Compartments ~ Cleanouts ~ o , ~gh water ~a~ (~) Soil rating ~or ft2/bdrm) 0. 3 System type ,.~ 0 Gravel thickness below pipe O. 5' ~ Total depth Effective absorption area ~' ~' g" O Monitoring Tube present(~/N) Y* J Depression over field (Y/~ .v O ' r N/~ -- t~ w Results (Pass/Fail) For Date of adequacy test Fluid depth in absorption field before test (in,);i ~ '): Fluid depth (ins.) Minutes later:~i~ .d Peroxide treatmen~Y/N) If yes, give date LIFt STATION Date installed Manhole/Access (~N) High water alarm level at* Cycles tested 3 ¢ Is-/, o Size in gallons "Pump on" level at* /'/$ *Datum T~I~~ "Pump off" level at* "~ ~' rSo 7 l'on E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/hehtm8 tank on lot ~ ~ <~ ' 4--- ; On adjacent lots ! Absorption field on lot ] Oo ~ ; On adjacent lots Public sewer main 3//~q Public sewer manhole/cleanout r Sewer/septic service line / 0 0 '/'- Lift station SEPARATION DISTANCES FROM SEPTIC~ TANK ON LOT TO: ! Building foundation ¥ t. Property line ~1 3 Absorption field ! Water main/service line ~- ~ 'P' Surface water/drainage /o~ "/'- Wells on adjacent lots loc} /''/- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~ 6 Water main/service line Surface water / 0 0 '~-', ;: ..~: .: ~ Driveway, parking/vehicle storage area I Curtain drain ~'°~ ¢ t~,,,o ~,,/ Wells on adjacent lots ! o 0 4- Property line F. ENGINEER'S CERTIFICATION I certify that I have determined thrufield inspections and review of Municipal records in conformance with MOA HAA_euidelioes in effect on this date. signature Engineer's Name Date HAA Fee $ 3 00~ ~ 0 Waiver Fee $ Date of Payment ~ / / q / * 5'-- Date of Payment Receipt Number ] 3 ~ "& ( 30 °t 6 ) Receipt Number Rev. 8/95 OSS: haa.wk.doc MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Lot 17; Block I; Birch Tr~ Estates Location (address or directions) 5115 M~tz Court (b) Property owner Alaska F~d~ral Credit Ur~,:.OnTelephone. (home) Mailing Address 3400 LaTo~ch~ Anchora~]~ Alash~. 99508 (c) Lending Institution ' "Telephone Business 257-7226 Mailing Address (d) Real Estate Company and Agent AREA/COLDWELL BANKER,INC. ATTN: Bob Address 4105 T~dor C&ntr~ Drive, Anchorage, Alaska 99503 Telephone 561-2488 Martin (e) Mail the HAA to the following address: (or check hereY~, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eagle River Loop Road Ne. 2t4 Eagle River, Alaska 99577 TYPE OF RESIDENCE Single-Family ~ Number of bedrooms WATER SUPPLY Individual WellY~ Community [] Public [] . Note: If community well system, must have writ!en confirmation from the State Department of Environmental Conservation attesting to th legality and Status. SEWAGE DISPOSAL On-site ~x Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 '>IJOM s,Jeeu!Sue leuo!ssetoJd eqj u! suo!ss!uJo Jo sJoJJe JO~ elq!suods~J ~,ou s! e§eJoqou¥ to X~,!led!o!UnlAI eq.L 'penss! s! eleoIl!lJeo e eJoteq elep eZXleUe Jo sUoIloedsu! lonpuoo leu op SHHa to seeXoldUJSI 'slueuJeJ!nbeJ elels pue leJepet u!m, Jeo Xts!les el JepJo u! suo!lnl!lsu! §u!puel J!eql pue seuJoq to sJeseqoJnd ol ~sm, Jnoo e se s!ql seep SHHQ eq.L '~>ISel¥ to eim, S eLI1 u! peJe~,s!§eJ Jeeu!§ue leuo!ssetoJd ~,uepuedepu! ue ~q e^oqe ~ qdeJBeJed u! ue^!§ suop, elueseJdeJ eqi uodn ,~lUO peseq peleo!J!Jeo le^oJdd¥ Xl!Joqln¥ qlleeH s~nss! (SI-IHa) seo!^Jes ue~unH pue q~,leeH Jo lueuJlJedea e§eJoqou¥ to X~,!led!o!unlAl eqj. ~[eJp qlk;L4' eiecI leuo!1!puoo leAoJdd¥ leUO!i!puoo to SLUJe.I. peAoJddes!a .x~ pe^oJddv ~q SLuooJpeq~JoJ. poAoJdd¥ 'lVAOIdddV SHHa 'g ~" -/ZS66 e~lSel¥ ',leAI~l elBe'd I, OI~ 'oN peoB doo'l ,~e,~!a eli!ie3 t:'~0ZL sseJpp¥ ONIB=I~INION:1S ~' $ euoqdele.L wJ!:l t.o eWeN MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) AUG 5 1.990 A. WELL DATA Well Classification Well Log Present~ ~N)'~ d~ Total Depth ,.. Case to Static Water Level (..~'Z..' Casing Height Above Ground Electrical Wiring in Conduit fi~)N) RECEIVED Date Completed "7~ c~ ~O/'~ Depth of Grouting SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ~'~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ~J To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Legal Description: [--~-r ,. If A, B, C, D.E.C. Approved (Y/N) Yield Pump Set At I~hJ V,.,~t ~ w/M Sanitary Seal on Casing (~/N) y Depression Around Wellhead (Y/~ ~/ ; On Adjoining Lots \0~~ +' ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole 7..~~- -~ '~ ~ ~-~~~G ; Date ~-.- Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~"5'-~1(5 Size Standpipes ~/N) (~y Depression overTank ,(~ Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~ [7--~''-~ No. of Compartments '7~ Air-tight CapS (~N) y Foundation Cleanout /'V/ Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well [C¥.-~ ~ To Property Line \L~~ To Water Main/Service Line ~?G' ~ +' To Stream, ~,.~, Lake or Major Drainage Course Comments'7'~ ~_./....~a,~:> 0 ~"' To Building Foundation To Disposal Field 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~'~ Width of Field Type of System Design Length of Field 4 Depth of Field Square Feet of Absortion Area Depression over Field (Y/~ /~/ .// Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well [(.)Ot To Building Foundation Lot ~' To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~ ~-~_~ S'r'~_~- ¢ Gravel Bed Thickness ~ ~¥r~/~,~_..~ Statndpipes Present ~)N) Date of Last Adequacy Test To Property Line ~f) ~ l- To Existing or Abandoned System on ; On Adjoining Lots .~_.~/+ To Cutback (if present) '~//~ /r.,O/+ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for /~//~ /V'~' v~/ / Meets MOA Electrical Codes ~1) Comments Dimensions ~,-/.5-r7 Manhole/Access (~N) y "Pump Off" Level at Vent ~)/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on4.13¢~,[~ of this inspection. S & $ ENGINEERING .~... oF ~, ~. Signed 17034 Eagle River Loop Roaa Nc. 2'; '4 ~ ~~'"~';~' Company Eagle Eiver, Alaska ,,577 ~~T~' ,"~;~ Date ¢¢~ ~~~ Receipt No. ~ I) q% ~~ Receipt No. %~'¢ Date of Payment ~ ~% -~ Waiver Fee: $ Amount: $ ~ ~ O~ Date of Payment z~-o~ (.~, z/~) B.o~ ~ Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street ~~'~'//J// Anchirage, Alaska 99518 Drinking,Water AnalySis Report~for Total Coliform Bacteria,.;~,i:~ "; TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY [] PUBLIC WATER SYSTEM I.D.# xPRIVATE WATER SYSTEM Name $ & S ENGINEERING Phone No. 17034 E~gle RiYm' Leap Road N~ ~ Mailing AddiallleRiver, Alaska ~577 City State Zip Code Mo. Day Year Analysis shows this Water SAMPLE to be: Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send ' new sample ~ia special delivery mail. Date Received ~--[O 'c1~(~ · Time Received SAMPLE TYPE: ~Routine ~' Check Sample (tor routine sample with lab ref, no. ) [] Treated Water [] Special Purpose [] Untreated Water SAMPLE Time Collected NO. ,. LOCATION Collected By 31 I 41 I Analytical Method: Membrane Filter * No. of colonies/100 mh Lab Ref. No. Result* I FT-! I FT-] I I FT~ Analyst READ INSTRUCTIONS BACTERIOLOGICAL WATER ANALYSIS RECORD Membrane Filter:. Direct Count Collform/100ml BEFORE COLLECTING SAMPLE Verification: LTB Final Membrane FiJ~esult.~ . ,/~ BOB Date Time: TNTC = Too Numberous To CoUnt Collform/100ml p.m. OB = Other Bacteria CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order # 26174 Date Report Printed: AUG 9 90 @ 11:53 Client Sample ID:5115 ~TZ CT. PWSID :UA Collected AUG ? 90 e 15:15 hrs. Received AUG 7 90 ~ 15:30 hrs. Preserved with :AS REQUIRED Client Name : S & S ENGINEERING Client Acct: SNSENGP P.O.! NONE RECEIVED Req ~ Ozdered By : R. S~AFER Analysis Completed :AUG 8 90 Send Reports to: £)S & S ENGINEERING 2) Special Instruct; Chemlab Ref #: 902887 Lab Smpl ID: 1 Matrix: WATER Allowable Pazametez Tested Reeult Units Method Limits NITRATE-N 0.16 mE/1 EPA 353.2 10 Sample SAMPLE COLLECTED BY JIM. Remarks: ROUTINE SAMPLE. 1 Tests Performed ' See Special Instructions Above UA-Unavailable ND= None Detected *' See Sample Remarks Above NA- Not Analyzed LT-Lese Than, GT-Greater Than