HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 3 LT 8River View
Estates
Block 3
Lot 8
#050-72! -26
Municipality of Anchorage
Development Services Department -<',
Building Sa~ely Division
On-Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-6650 Page
www.cLanchorage.ak.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: ~ ~l.)O{~ ~)L~LZ~ PID Number. 0.~'0 ---7~/-- ~ 04`
"'"~ B/'aJ ~&~r WastewaterSystem: ~..ew E]Upgrade
'5'~5"~1/ S fan~C~ ~J.,qv¢ /~/,~A,,/'a~e /~' qq~'O~ ABSORPTION FIELD
LEGAL DESCRIPTION
Well: ~ New D Upgrade ~--~
'~ 5 ~.~ ~n~ ~,. ~ ~, TANK
SEPARATION DISTANCES ~sept~c DHol~ing ~S.T.E.P. ~Othec
Tank F~ldStation Tank S~, Lee ~
,~=--- I~ I~ X / ' UFTSTA~O.
V
"~'~ ~.0,4, ~cv~ 3~ BENCHMARK
Inspections pedormed by: ..~,~ ~.;;;~ 5~= ~5~ uams:
DevelOpme~e~]~s~ Depa~ment~Approval _
Reviewed and approved by: ~
PER,~IT NO. SW000246
PAGE 2 OF 3
Municip. Gilt oF
DEPARTHENT OF HEA~_THAND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P,D, Box 196650 eAnchorage, Alask~ 99519-6650eTele~hone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 8, BLOCK 3, RIVERVIEW ESTATES
P.I.D. NO. 050--721--26
-PALLING
tO' MIN.
NE~W 1250
$~PTIC TANK
LOT 9
I
I
I
SCALE: 1'
ENGI
.,%.
Kennelh M
CE 7116
PER,lIT NO. SW000246 PACE 3 OF 3
Municip. cd, i-t oF' .~. r)._c h.o r- c~ g.e,
DFPARTHF:NT OF HI=A THANL) HUMAN SERVICES
F:NVIRONMF:NTAL SFRVICES DIVISION
P.D. Box 196650 ®Anchorage, Aloska 99519-6650eTelephone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LECAL LOT 8, BLOCK $, RIVERVIEW ESTATES
P.I.D. NO. 050-721-26
ST1 ST2 /98.7'
FINAL O~ ~NSULATION,__
_. _,/I NEW 1250 I~_. ~---
CO1 C03
MT1 C02 CO1 = 97.7' MT3 C04 C03 = 95.8'
C02 = 96.6' C04 = 96.0'
CO1 = 93.0' C03 = 92.9'
= 93.0'
= 92.9'
MT1 =
A B C
FCO 15.5' - 18.0'
ST1 12.5' - $2.0'
ST2 12.5' - 39.5'
DBL1 15.0' 39.0' -
DBL2 16.5' 39.0' -
FS 28.5' 44.0' -
C01 21.5' 22.5' -
MT1 20.5' 22.5' -
C02 39.0' 63,0' -
MT2 38.5' 62.0' -
905 38,5' 58.0' -
~T3 37.5' 37.5' -
~04 47.5' 68.5' -
vlT4 47.5' 68.0' -
= 92.4'
MT3 = 91.9 = 92.2'
(EXTENDS 0.3'
INTO SAND)
2' M.O.A.
APPROVED
SAND N. 'r. s.
·
WATER FOUND ®
83.2' B.O.I-[.
87.7'
~RCOLAT~:)N
TEST
ROBERT C. COWAN. P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 6944211
November S, 2001
KND Engineering
20441 Ptarmigan Blvd.
Eagle River, Ak. 99577
REFERENCE: Lot 8, Block 3, Rivervicw Estates S/E
Attention: Ken Duffus, P. E.
Regarding the above referenced property, since we were not a party to the changing well
location, we are providing an attached inspection report for your review, stamp &
signature.
For your information, an additional soils test was performed. The original soils log is
attached for test hole #2, which also needs to be submitted to the Municipality of
Anchorage for this property.
If you require additional information, please contact us.
Sincerely,
Robert C. Co,van, P.E.
RCC/jhm
Enclosures
17034 NORTH EAGLE RIVER LOOP · SUffE 204 * EAGLE RIVER. ALASKA 99577
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
y,,ww.~t.~ncho~a~e.ak.us
(907] 343-7904
Soils Log - Percolation Test
Performed For:. ~ Date.Performed:
~ / Sk~e
2-
3-
4-
6-
7-
8-
9-
10-
11-
12.
13-
14-
15-
16-
17-
18-
19-
20-
ENCOUNTERED? ~
Depth to Water After / pO
~onltodng? ~ E
COMMENTS
c//,dm
/ /
Site Plan
Reading Date Gross Time Net Time Depth to Water Net Drop
~ ,~,~r-I 7'-4 o ';~__,~_~._
PERCO[.ATION RATE ~ I (n~ule~l~ch) PERC HOLE DIAMETER
TEST RUN BETWEE. ~ FT AND
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPALli~u~OE'~.INES IN EFFECT ON THIS DATE. DATE:
M-W I r!lling, Thc.
eP.O. Box l10378eAnchorage, Ag: 9951te
+907-34~4000 · 907-345-3287 Fax·
"~Job No.:
Permit No.:
Project No.:
Groundwater Well ~4s-Bullt & Log
· Well Owner: Krue~er, Brad · Use of Well:
· I. egal Description: Lot 8~ Block 3 River View Estates- Eagle River
01-130
N/A
N/A
Domestic
Construction
· iloleDepth: 140' ·CaslngSlze: 6" ·Cas·alTo: 113.91' ·Material:
· Drill Method: Air Rota~ .....
Perf.
· WelICompletlon- Open end X Screen Perforated Method:
· Screen/Perforation description: None
A 53 Steel
· Grout Notes: (I) Sack- No. 8 bentonite granules
· WelIDevelopment: Method: Air surge Notes:
+ Statlc watee level (SWL) 92' (above) (Sc:c::') top of caslng fTOC).
· Wellyleld test at $ ' gallons per minute (GPM)/g~~) for
with '100% of drawdown (DD) from statlc levet (SWL).
· Method: Air lift
I hours
· Date of completion: 23 May 2001 · Pump Install: N/A
; ' Well Log
Depth in feet from
top of easing. Details of formations penetrated? slze of materlalv color and hardness.
0 TO 2 Casing stickup
2 TO 4 Silty clay
4 TO 37 Sandy gxaveh boulders: damp, dark ~;ray
37 TO 65 Sandy ~;raveh boulders: brown, silty sand
65 TO 103 Sandy gravel: boulders: damp
103 TO 140 Bedrock
TO
TO
TO
TO
TO
TO
TO
TO Cea-tiLi~a~e ~i'o'a,
~D ENGINEERING
20441 PTARM/GAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
May 17, 2001
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: New well permit - Riverview S/D, Lot 8, Block 3
Gentlemen:
The owner has requested we proceed forward to obtain a well permit on the subject lot.
His current septic system was permitted by S&S Engineers, but the owner wants to
change the location of the proposed well due to the distance from the house.
The neighboring lot has a well and septic but we do not anticipate this location change
will adversely effect the lot due to the steep topography behind the lot.
There are no public or private wells within 2,~0~.' of our proposed system location except
as noted. There is no surface water within 100 of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
~i~l~ Engineering
Kenneth M. Dufffis, P.E.~
Attachments:
On-Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
V/ELL LBCATIBN DESIGN DETAILS
RIVERVIE~¢ S/l), LBT 8, BLBCK 3
D
3 2
KMD
5/17/01
$W357
01055
Sc~te, 1'= 100'
PAGE 1 OF 2
I~) ENGINEERING
9.0441 PTARMIGAN BLVD.
EAGLE RIVER, AX 99§77-§736
~/ELL LDCATIDN DESIGN DETAILS
RIVFRVIEV/ S/IL LnT 8, BLrlCK 3
;£PTIC
SEPTIC
SEPTIC
~%.<q.~.:.... - ............. ~%,.'~ l PREPARED FaR,
~.'"' i '"-~ ~_ ~RA~ KRU~R
~"' ~ '~ A 3541 STANFORD ~R.
~' ' ~ ~EMIN~
~ ~EMING
~ ~ 01055.D~
~ KMD
5/17/01
SW357
01055
Scc~te~ 1': EO'
PAGE E OF E
]]~H]]~) ENGINEERING
E0441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
I HEREBy CERTIFY.THAT I HAVE S~V~ED THE S~E~
FOLLOWIN~ DES~IB~D PROP,RTY,
Nu JNAT NO EN~HMENT~ ~ST ~CZ~ ~
~l~ DO NOT ~PE~ ~ THE RE~ ~BDI-
ISlON P~T. UND~ NO CIRCUMSTANCES 8~ F8~.~ t~... ~-eel~ ..~
~ DATA H~[O~ ~[US~ F~ CONS~ION
JRY LINES.
ROBERT C. COWAN, RE.
ROBERTA. SIIAFER, RE.
CML ENGINEERS
(gO?) 694-2979
FAX (907) 694-12
Municipality of Anchorage
DEPARTMENT OF HEALTH AND NUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
The septic iqspegtigns for ~he. referenced property were
performed on ~-E~)-6F3 and IO-O;°OO · Prior to submitting
the On-site Wastewater Disposal Syste~ and~or Well Inspection
Report we are waiting for the ~9-~,'/~6V~y . to be
completed.
If we may be of further service please contact us.
Sincerely,
Rob~r~d. Cowan, P. ·
S04t. I'ESt
17034 NORTH EAGLE RIVER LOOP ~ Sbt'rE 204 * EAGLE rdVE R. ALAS,,KA 99577
~epsrtment o~
Public Works
6/8/2001
Brad Krueger
3541 Stanford Dr.
Anchorage AK 99508
Subject:
On-Site Water and/or Wastewater Permit.
Permit Number: SW000246
Parcel ID: #050-721-26
Dear Brad:
An On-Site Water/Wastewater Permit, number SW000246, issued by this office for a single-family
system, will expire on July 18, 2001. This permit was valid for 365 calendar days.
If this was a well permit and the well has been drilled, a well log must be sent to this office for
documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as-built inspection report must be sent to
this office for review, approval and documentation. This as-built inspection report must be signed by
the licensed Professional Engineer who inspected the installation of the system. As-built inspection
reports are required to be submitted within 30 days of the completion of the system.
If no system was installed under this permit, and you are still planning to install a well or wastewater
disposal system, a new permit must be obtained from this office. A new permit may be issued free of
charge for a second year if the application for the renewal is received on or before the date of expiration
of the original permit.
When applying for a new permit, the fees are: $320.00 for a wastewater permit and $120.00 for a well
permit.
If you have any questions, please call this office at 343-7904.
Manager
On-Site Water and Wastewater Program
eno: Copy of permit
MUNICIPALITY OF ANCHORA GE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 190650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Jul 18, 2000
Expiration Date: Jul 18, 2001
Permit Number: SW000246
Legal Description: RIVER ViEW ESTATES BLK 3 LT 8
Design Engineer: 0003 S & S Engineering
Owner Name: Brad Krueger
Owner Address: 3541 Stanford Dr.
Anchorage, AK 99508-
ParcellD: 050-721-26
Site Address:
Lot Size: 50544 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
construction must be in accordance with:
1. The attached approved design.
2. mi requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
mnq
June 28, 2000
ROBERT C. COWAN, P.E.
CML ENGINEEP,*..q
(907) 694-2979
FAX (907) 694-121 !
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 8, Block 3, Riverview Estates S/D
It is requested that you issue a permit to install a septic system and well to serve the
proposed 3 bedroom house on the refereuced property.
A test hole was excavated. The approximate location of the test hole is located on the
attached site plan. At the time of excavation on 5/23/00 water was found at 8 feet. After 7
days of ground water monitoring water was found at 7.5 feet.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
comtmction of th/s system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/jhm
Enclosure
o~ NAOrtOtC~,Ot
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 99577
~ LOT 8, BLOCK 3, RIVI~VIEW SUBDIVISION
DESIGN CRITERIA:
3 BD~ - 450 GPD SHOWN ON ~lS
SOI~ = 1.0 GPD/SQ-~.
WILLIAM D. F~MING
450/1.0 = 450 S~.~. ~Q'D.
TRENCH CRITERIA: ~o v~ ~.
D~C~, ~D PROP~
~' DEEP (~D 2' M.O.A. ~PR0~D
0.5' EFFE~E
5' WIDE
90' ~NG (a ~CH~ ~ 45' ~.)
/
~ LOT 8, BLOCK 3, RIVERVIEW SUBDIVISION
-" r-°'' I" I- ".~':' ~-'""':'~'"~' '
DESIGN CRITERIA: ~u~. r~su~, o~ ~C~OA~
SOl~ = 1.0 GPD/S~.~. ~ ~-B~LT S~v~ D~WN BY:
WI~M D. F~MING A ~,~ R~ERI C COWAN
TRENCH CRITERIA: *o ~m~ ~sz~z~, ~qUmZD SiPA~nON CE-8801
DI~ANC~. ~D PROP~ ~ P~OR TO '~ ~'~'.,
· ' DEEP (ADD ~' M.O.A. ~PRO~D ~D) CON~U~ON.
0.5' EFFE~
90' ~NG (a ~NCH~ · 45' ~.)
~ ~ ' ~ ~ ~ ~ wo~
I ,:: ::a
~LT. ~1~
~T~-
DOUBLE p ,
. CL~NOUTS OSED
- - -- ~ ~ / / HOUS[ ~t~*v
~ooo ~AL? ~ ~/~ tO~
S~m,C *~x ~ / - *~0~ ~
(~,~,~u~) / 'SLo~ .
FCO ~ ~
s~s,~ ~ / ~ -
~ LOT 8, BLOCK 3, RIVERVIEW SUBDIVISION
J.H.M. R.C.C. 6-28-00 3 OF
~ng DESIGN CRITERIA:
3 BDRM = 450 GPD
SOl~ = 1.0 GPD/S~.~.
~so/Lo - ~o s~.~. ~'~. CROSS
TRENCH CRITERIA:
~; (~o;)~l-~l~ 90'
~ T~NCH~ ~ 45' ~.
NOTE:
i~ POTIONS OF SYSTEM
WITH ~SS ~AN 3.5' OF
COVER REQU~E INSU~TION.
Municipalily ol Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 'L" Street. Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: DATE PERFORMEI I (~'-~ /~'"
LEGALDESCm.T~O.: ~ ~4~ ~owns~'p.R~ ang ,Section:e
~LOPE ~ITE PLAN
1
2
3
4
5
6
7
8
9-
10-
11
13-
14-
15-
16
17
.18
19
2O
WAS GROUND WATER
ENCOUNTERED?
Cross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~ (rnmutes/,nch) PERC HOLE DIAMETER
TESTRUN BETWEEN ,~ FTAND ~"'** FT
PERFORMED BY: 170~4 Fa'" ~t'x-' te.~ P..~ ,,..~04~~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE
72-008 (Rev. 4/85)
~CX%TEST
ROBERT C. COWAN, P.E.
CML ENGINEERS
FAX(~07) S94-121 I
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Lot 8, Block 3, Riverview Estates Subdivision
May 31, 2000
GENERAL:
The scope of this project includes the installation of a 1000 gallon septic
tank and an absorption bed to serve the proposed three bedroom residence
located on the referenced property.
Construction shall be in accordance with the approved site plan and design
drawings, Municipal pc,mit or ADEC Authority to Construct 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.
Contractors installing wastewater disposal systems must be certified by the
Municipal Health Department or ADEC if required, 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 * SUffE 204 ,, EAGLE RIVER, ALA.~ KA 99577
Page 2
Lot 8, Block 3, Rivervlew Estates
May 31, 2000
3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade.
4. Septic tanks installed with less than 4 ft. of cover shall be insulated.
A foundation cleanout shall be installed one to four feet bom the building foundation. In
the line between the tank and the leachfield there shall be two adjacent cleanouts. 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.
LEACHFIELD BED INSTALLATION:
Excavate the proposed Bed Area to the depth shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the bottom of the excavation becomes
smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement.
Ifa sand layer is required, place sand over entire excavation to the required depth shown on
the design. The top of the sand layer must be within 2 inches of level.
Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution
pipe must be installed level with perforations down. Gravel depth below the perforated pipe
shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a
minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a
minimum of twelve (12) inches.
The perforated distribution pipes must be no more than six feet apart. The distance between
the outermost perforated distribution pipes and the sidewall of the absorption bed must be
no more than three feet.
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.
Monitor tubes shall be of four (4) inch diameter, installed at the locations shown on the
design, and extend a minimum of 12 inches above final grade. The portion of the
monitoring tube extending through the gravel depth shall be perforated six (6) inches below
the bottom of the horizontal distribution lines. The monitoring tube should not extend
below the bottom of the gravel surface.
Page 3
Lot 8, Block 3, Rlvervlew Estates S~D
May 31, 2000
7. 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. The finished grade
over the bed must be mounded to prevent the formation ora depression after settling.
8. A mound system is to have the upper six inches of top soil and be seeded for vegetation.
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 Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use ora type ofpipe other than listed above must be approved by the inspecting engineer.
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, Femco, or
equal).
A permeable nontoxic silt barrier (Typar 3401, Mirafl 140N, or equal) must be installed
between the final leachfield gravel layer and the native soil backfill.
All 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 MOA or ADEC requirements.
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:
Page 4
Lot 8, Block 3, Rlvervlew Estates
May 31, 2000
I. 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.
3. The fmal inspection is to occur upon final grading ofthe 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. I f necessary, a pre-conslruction
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 MOA permit or ADEC Authority to Construct.
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 ofthe contractors work rests
with the owner.
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
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O50-721-26
1. GENERAL INFORMATION
Complete legal description
HAA #
Expiration Date:
Rlvervlew Estates, Block 3: Lot 8
Location (site address or directions) NHN Falling Water Circle: Eagle Rlver~ AK
Current Property owner(s) Brad Krueger Dayphone
Mailing address 3541 ~;tnnford Or.~ Anch. AK 99508
Lending agency
Day phone
Mailing address
Real Estate Agent
Dayphone
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Well
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 Alaska. Certificates of Health Authority Approval are required for the
transfer of title (except between spouses) for propedies 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
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 Municlpality of Anchorage is not responsible for errors or
omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the vaIidation date shown below, I verify that my
investigation, based on procedures outlined in the Health Authority Approval Guidelines for this
application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional
and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the Information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all
applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm KND Englneerlng
Phone 696-6111
Address 20441 Ptarmigan Blvd. Eagle River; AK. 99577
Engineer's Printed Name Kenneth M. Duffus
Date 1112 9IO'~
DSD SIGNATURE
X
Approved for ,~
Disapproved.
Conditional approval for
~.~'_..' ~ ... ~'J , ·
bedrooms. , .,. ,., ~
bedrooms, with the following stipulations:
Additional Comments
Attachments: HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:,/~////~)/
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Soutl~ Bragaw St,
P.O. Box 196650 Anchorage, AK 99519-6650
www,cLanchorage.ek.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description;
A. WEII DATA
Well type.J~.LV. JtUt
Date completed 5/23/01 Sanitary seal (Y/N) y
Total depth 140 ft. Cased to 114 ft.
Rivervlew Estates. Block 3. Lot 8
If A, B, or C provide PWSID #
FROM WELL LOG
Date of test
StaUc water level ~ 2 fl.
Well production § g.p.m
Parcel ID:~
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi. Nltrate_i?,,.~Z~ng./I.
Date of sample: 11119101 Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Typ~Vlaterlal Greer I Steel
Date Inatalle~L~Z.~ Tank size 1250 gal.
well Log (Y/N) y
Wires propedy protected (Y/N) y
Casing height (above ground) 2'
AT INSPECTION
g.p.m.
Other bacteda 0 colonies/100ml
KND En_olneerlno
Number of Compartments 2
Cteanouts y Foundation cleanout..Y._Depresslen over tank H High water alarm NA
Date of pumping NA - new tank Pumper
C. ABSORPTION FIELD DATA
Date installed 10/1101
Length 2 O 46 ft. Wldth 5
Total depth 3 ft. Eft. absorption area 450 fi= Monitoring tube Y
Soil rating (g.p.d./ft~ or fi=rodrm) 1.0 System type
ff.
Date of adequacy test NA - new system
Fluid depth in absorption field before test __
Elapsed Time: __ min. Final fluid depth __
Any rejuvenation treatment (pest 12 mo.) (Y/N & type)
Results (Pass/Fall) Pass For ~. bedrooms
in. Water added__ gal. New depth in.
in. Absorption rate >= g.p.d.
ff yes. give date.
ft. Gravel below pipe 0.5
Depression over field N
D. UFT STATION
Date installed NA
'Pump on' level al in.
Datum
E. SEPARATION DISTANCES
Size in gallons
'Pump off' level at
Cycles tested
Manhole/Access (YIN)
in.High water alarm level at.
Meets alarm & circuit requirements?.
¸in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 1
Public sewer main 75'+
Sewer/septic service line 25'+
On adjacent lots 1 0 0' +
On adjacent lots 1 0 0' 1.
Public sewer manhole/cleanout 1 0 0 ' +
Holding tank I O 0 ' +
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Absorption field ~ ' 1.
Surface water I 0 0 ' t.
Building foundation ~'+ Property line § ' 1.
Water main 10'+ Watercewicellne I 0'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation I 0 ' +
Surface water 1 0 0 ' +
Wells on adjacent lots 1 0 0 ' +
Property line 10'+
Water Service line 10'+
Curtain drain 50'+
F. COMMENTS
Water main I 0 ' +
Driveway, parking/vehicle storage
I c~.rtify that I have determined through field inspecfiona end
rewew of Municipal records that the above systems ere in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Pdnted Name Kenneth M. Duffu~
Date 11/2g/01
HAA Fee $300
Date of Payment 11130/01
Receipt Number
(Rev. 12/00)
Waiver Fee $
Date of Payment
Receipt Number
#0V-29-01 09:55Akt FRO~I-CT&E ENVIRONI, ENTAL
.~tr~ CT&E Environmental Services Inc.
907561530t
T-559 P.02/03 F-4OZ
CT&E Ref.~t 1017978001
Client Name KND Engineer,ag
ProJet't Name/~' R~ver Vw B3,1
~ent Sample ID ~ver Vw B3, ]
Matrix DriVing Waxes
Order~ By
PWSID 0
Client pC)r/
PrintedDate/Time 11/28/2001 8:20
Collected Date/Time I 1/19/200! 15:00
Received DaXeITIme 11/19/2001 16:40
Tt~hnical Director Stephen C. £de
Released ~ ~
San~Jle Re.tLs:
PQL UniL~ M~hnd
Allowable Prep Analysis
Lknia Date Date Init
Wa~ers Departmenc
Ni~x~-N
2.07
0.500 mg/L EPA 300.0 (<10} 11119101
SCL
M::Lcrob'l ology' Laboratory
Total Coliform
col/lOOmL SM18 9222B
(<D
11/19/01 KAP