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Home My WebLink AboutFIRE LAKE #2 BLK 1 LT 3AFireloke Block Lot 3A #051-351-29 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.~ ~ ~ Neff Bedrooms LEGAl DESCRIPTION I Block Subdivision Township, Range, Section Tl$','v ell.V .~...,., / TANKS SEPTIC ~,~$,~,~.~. [] HOLDING Capacity in gallons No, of Compartrff~nts I Manulacturer Material TYPE OF SYSTEM [~,TRENCH [] BED [] W. DRAIN [] OTHER Depth to pipe bottom from Totat depth from originai grade originalgrade ~'-'~ FI /-,~-- FT Gravel depth beneath pipe Gravel width Total absorption area Dislance between lines Pipe material SQ FT .~., ?~t3~/., Date Installed WELLS [~ PRIVATE [] OTHER {Identify) Classification {A,B,C) Total Depth ] Cased to I FT )ate Installed: Fill added above original grade Gravel length / FT ~; FT Number of Ii)es ~' FT DISTANCES WELL LOT LINE FOUNDATION SEPTIC TANK ABSORPTION FIELD WELL /_/o / ~'// AS-BUILT DIAGRAM (Show location el well, septic system, property lines, Ioundation, driveway, water bodies, etc.) ~,~, ~'~.] . REMARKS: . Scale: : ENGIblE, J~.~I~AL p.//" / W.,C~f,,.",,r& /~"'r~,.-,.,~X. I Insppcctign,~.Perl(2rrn.ed bt/: _ . I /' /'E.,,. I eQ~5195 ...~-., -~,~,,.,,,.~, . ..,,.. 7-0 - I /~"/~'"'~' **~-'~_ ~' ~' corlify Ihat Ihls inepectlon was performed according Io all Louis A. f'~utercI Municipal and State guidelines in effect on this date: ~'~w'/" %w'/'~''d~' Health Department Approval: ~ ~,'¢-4.Z,"-~L,~'-- Date: ~) '- ~ -oC'? 72-013 (3/85) 3 4. 3- 4 '7 ~.';~ () ] T Day F'hor~eJ: 694'-5 195 Sect :L I,_cr['. ;""l ,,(", ',=;4 '" Max Bed r. c:)l::)m'.-:;~ ',~ "1 i'~ :L s I::.'~,,)r' m i L :: 3 ToT. a 1 Capac i t¥: 3 !iI.:.!iNEI:';'. !iiiY'Si'f!!,M~iil ~: L,..i. ...... , .... .-:.c-:.xm~,:.m sys' em,, C;l'~oose the opt :i. or'~ that best ~' :i, ts 'your' T R E N C H 4.0 8 ,, () :L 3 8 k.I- .I.C [Pd'qJ<.: J'/J:ii'~:~mt,.~u'~ '[-u"t',,aJ sep'k','Jc:: 'k.&'d']}.:: (:: &'d::h':i~,C: :[ '[L "¢" C ]. you in des:i, gn:Lng your : (.~ r. a ]. a P f'rf iii U E;'k'. b e '~ a 1. :1, or"~s. E. ach sept :i. (:: I. sept:i.c tank (s) < 4. ') GRAVEL .;.',! /:',! 1/88 [ CE:F:,' I' :f F:'Y THAT :1,,. ]: am {-am:LLJ.~'~':',~' w:i'k,l'~ k, he r,(,y,)qu:~r'erru,:,:,!r]'t.s for' or'~-,s:i.'Le fC:)F"~.~'t ~':)":/ 'k}'"d.'.' ~'lLkfi:J.c::ij::)&'J.:J.t',/ c:,f af'i[:l'lc)f'agE~ (MI:iA) arid i:'M]c'J :[1"1 E::E)ffij::) :J J&'q']E:~::')~ V.J:J.'[.h thE.) ::5. :f w~]] ad!',v,:,~',,:..:, ~'(::) a:J]. MOA CJ :i.~J~.'t.4~¢d'iC:,'::'~; ~ P(::)~Yi ::',.f~y /:.:~,::-: :j.%~. 'J.~']g} · E;F,)k,~J(::~)F~:;k(.'j¢..-' '~;'S,'~;'L.~":'.']"~] 015 ILJ'l]% (::)~" 4. :l: L~.r',ch,:~:'~"~;L;:~r"~c~ [:. h ,-,,.'t:, Lh :~ % p(,.',pm~'t',. :L?, ',/a.:l, J,(::J ~(::~r' ,':':',, m,':':~::.: i:'~I]'!/ E'.q'l]¢~;Lf'c!~')ffu:::'F;I ~'"~;~ ] ] p~.::~(]u,:i.i"x:¢ and wells as sat ate c,f' Alaska. ::)fflE,)l"lt~ J'(DF the ~}~,. bac:k sys'Lem or' pLtbl i,c: 3 bedr'ooms. [ SAVAGE ]DR, NO CONFLICTING WELLS ' UPGRADE O \~. \ \ \ ~ LEACH i:' ~ ~ \ ) AREA ~ ~'x ~ L gEEPA~~ ~ / SEPTIC SYS, UTIL, ESMT, RIGHT OF WAY EXISTING LEACH FIELD :::::::'. NEW LEACH FIELD :::::::: CLEANOUT SCALE~ 1' = 50' L WELl AND SEPTIC SITE PLAN LEGAL, LOT 3A, BLOCK 1, FIRE LAKE SUB, g2 O~NER, JANET HcGURGAN CONTRACTOR~ CHUCK BARR EAGLE RIVER ENGINEERING SERVICES ' DB BX 773294 E~GLE RIVER, AK, 99577 ~4-~1~ SPEUIF.~ATIONS FOR ON-SITE SEP,z'C dYSTEM LEGAL: LOT 3, BLOCK 1, Fire Lake No. 2 GENERAL 1. The well and septic plan are for a single fam±ly residence only. 2. The drawing and or site plan shall be a part of this specification. 3. Ail materials and workmanship shall meet the Anchorage Department of Health and State Department Of Environmental Conservation require- ments. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified or modlfied in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adiaoent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 'FRENCH 1. The 2. 5. 4. trench is to follow the natural ].and contour to maintain uniform total depth of the trench bottom. The bottom of the trench shall be level, plus OF minus 1.5". The total depth of the trench excavation is not t.o exceed 12' at any point.. The sewer line is to be connected into the existing leach line to allow effluent switching to the upgraded leachfield. The trench grave] is to be covered with typar fabric material. Soil or combination of soil and extruded board insulation to a depth of 4' o¢ equivalent is to be placed over the leachfield. The area OVer the trench is to be finish graded to prevent ponding of surface water runoff. The septic tank and leachfield must not be closer than 100' to any existinq private well. 150' to any Clams: "C" well, cc 200 feet to any community well. RECOMMENDED LEAOHFIELD DIMENSIONS 1OTAL DEPTH = 12' GRAVEL DEPTH : 1RENCH LENGIH" = 25' TRENCH NIDTH : 50" Soil Rating = 133 Bedroom Uapaoity = 3, Septic lank Size = 1250 Existing install valve that allows switching from one system (pit) to trench at later date. See Engineer for details. / ,~ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264~,720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: '~"~ ~ 3) ~:~ t~c ~'~ /, /~'~ 14 DATE PERFORMED: SLOPE SITE PLAN WAS GROUND WATER S ENCOUNTERED? t/~/O L O E IF Y ES, AT W H AT ? ~/~.~ ~- )EPTH? Gross Net Depth to Net Reading Date Time Time Water Drop D ~, /~ ,, ~/ /~ ~,~ ~ - ~ ~ /./~" ~ /~.'~ ~ : ~ / '~," COMMENTS ~z ~,-~,-v-~ PERCOLATION RATE b''~ '~ (minutes/inch) TEST RUN BETWEEN ~ , FT AND ~ , FT PERFORMED BY: 72-008 (6/79) Eagle River Engineering Services Eagle River, Al( 99577 694-5195 CERTIFIED BY: ~::~~--' DATE: GREI ANCHORAGE AREA B0F .... H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE /~,)~_ I FROM WELL INSIDE LENGTH MANUFACTURER INSIDE WIDTH NUMBER OF MATERIAL COMPARTMENTS / LIQUID DEPTH LIQUID CAPACITY,'d~/~ GALLONS. /'z~ ,.., SEEPAGE PIT: NUMBER OF P,TS [ . D,AMETER hO'OR W,OTH /O' 'ENGTH~, DEPTH LINING MATERIAL g~ CRIB SIZE: DIAMETER/./~tDEPTH ~:>/ DISTANCE FROM: Gof-7o, TOTAL EFFECTIVE BUILDING FOUNDATION NEAREST LOT LINE ~..t ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: TyPE BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED ~'~A4. ~_~ ~ DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK_ SYSTEM REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL' LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM DATE ~ ~4'j Iq-/' .~ APPROVED GReATEr ANCHORagE Area BOrOUgh DEPARTMENT OP ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 ! SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT 'NSTALLATIO. LOCAT.L' PERMIT NO. INSTALLATION OF: SEPTIC TANK FINANCED THROUGH ~ DRAIN FIELD , SEEPAGE Pit , OTHER s, ..,,' SOIL TEST RESULTS NOTEz THIS PERMIT I~ NOT VALID WITHOUT BOIL T~BT COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKPILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE:B, REQUIREMENT~ FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT ., DRAIN FIELD . I SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT ~0 , DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK DRAIN FIELD_ · SEEPAGE PIT SEPTIC TANK, -, SEEPAGE PIT . TO RIVER, LAKE, STREAM. DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC T~,/ql~ ANII~ INTt~ ~RIB CROSSING GAP OF EXCAVATioN 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROU~ULATIONS REGARDING INSTALLATION. DIAGRAM OF' SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2S-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH ~AID CODE. G� 0� • '-� Municipality of Anchorage �? . °- On -Site Water and Wastewater Program Q (907).343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-351-29 Expiration Date: , _N a V o, 12 02 1 1 GENERAL INFORMATION Complete legal description FIRE LAKE #2 Blk 1 Lot 3A ._ Location (site address) 13836 Savage Dr, Eagle River Current Property owner(s) Don and Debrah Momblow Mailing address 10211 Baffin St, Eagle River Day phone Real Estate Agent _ Day phone________ 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 . TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: _ Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ S5D Date of Payment7 1Z Z _ ____ Receipt Number COSA# 05GZl i3 73 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm _ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 _ Engineer's Printed Name KENNETH M. DUFFUS Date 6/3012021 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested, The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen r oir s i tL encroachments, deficiencies or discrepancies exist, 6. DSD SIGNATURE SIGNATURE �/ System #1 Approved for 3 System #2 Approved for Disapproved. Conditional approval for t 7 TF1 bedrooms. bedrooms. bedrooms, with the following stipulations: �tl<<<�i ((n�((((((i,- WPB? `\�;A-ER o J')))1)))i)))11111��`l�. By _ Jt... -- — Original Certificate Date:___ 2 z .z.•1..._. The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc Legal Description: COSA Checklist Fire Lake #2 Block 1 Lot 3A If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1973* Total depth 93+* ft Cased to 40* ft ❑■ Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12 in. Date of flow test for COSA 6/9/21 Static water level at beginning of test 90 ft. Comments * information from previous COSA B. TANK DATA Age of tank(s) 48 years Tank type/material Scptic/Concrete Measured operating fluid level in septic tank 55" 11 Standpipes/foundation cleanout per record drawing Date of pumping 6/1/21 D. ABSORPTION FIELD DATA Which system tested (date installed) 616/88 ® ALL standpipes present per record drawing Total measured depth from grade 13 ft (max) Measured depth to pipe invert from grade 5 ft (min) ❑ N/A — pressurized field L Monitor tubes go to bottom of effective. If not, state depth into effective ® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: 21044 COSA Checklist yellow sheet Parcel ID: 051-351-29 of Structure served by this system Well production at time of test 5.1 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ® No N Coliform bacteria is Negative Nitrate 5.29 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Arcterra Consulting Date of Sample 6/4/21 C. LIFT STATION uired maintenance completed Age of lift st years Lift station material Comments Adequacy test date 6/9/21 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 22 in Water added 450 gal New depth 39 in Elapsed time 1200 min Final fluid depth 15 in Absorption rate 450+ gpd Any rejuvenation treatment (past 12 months) NA If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft 0 Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ft ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with g m MOA COSA guidelines in effect on this date. i"d 21044 COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Nitrate Advisory Certificate of On‐Site Systems Approval # OSC211373 Subdivision: Fire Lake #2, Block: 1, Lot: 3A A water sample revealed a nitrate concentration of 5.29 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached “Nitrate Fact Sheet” for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as “blue baby” disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a medi a with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several “wet chemical” methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive “screening test”, and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. J- 0 r� SAVAGE DRIVE 0 "7 BASIS OF BEARING r N 00'09'54"W 180.14' 7- 10' UTfLITY ESMT N00'08'17"W 180.03' (NOO'08'32"W 180.03' R) ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: FIRE LAKE SUBD Not LOT 3A BLOCK] PLAT 96-100 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES. It is the owners responsibility to detenttine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DA7E: ICJLLE E-YAL: JULY 30. 2021 1'=40' echullereak.net 21 —1 09 MAW Bra 8r, GRO wuOM Boat ACE: JLS NW0454 210247 40- = FND ALUMINUM MONUMENT (@) = FND 518" REBAR OF * .:.45� Zi ...............� .;4 I M BHN L. SCHULLER.: / LS -10408 a �� ``CIA dp N �fession& 8- a. 1831 rUia � n 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax a 0 'A 1 .. 20A' o C7 }� •SEPTIC VENT x 'v (tYp).—+ x GRAVEL J 3q0. N { 0/N CD cr) '` l - Q r-- 6 O� 6 07 Di N 0) , -� O Cn r7 O7 s 43.7' LOT 1 A LOT 4A LOT 3A 0L °00 B LK 1 0 r- ». 7• 20.9' to t 7 Lo b)P b) ;3 ;rn 00 O'i `° QED 00 d7 Z 00 Z 00 Z Z 10' UTfLITY ESMT N00'08'17"W 180.03' (NOO'08'32"W 180.03' R) ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: FIRE LAKE SUBD Not LOT 3A BLOCK] PLAT 96-100 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES. It is the owners responsibility to detenttine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DA7E: ICJLLE E-YAL: JULY 30. 2021 1'=40' echullereak.net 21 —1 09 MAW Bra 8r, GRO wuOM Boat ACE: JLS NW0454 210247 40- = FND ALUMINUM MONUMENT (@) = FND 518" REBAR OF * .:.45� Zi ...............� .;4 I M BHN L. SCHULLER.: / LS -10408 a �� ``CIA dp N �fession& 8- a. 1831 rUia � n 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax �u� SGS Ref.# 1210519001 Client Name MOA Development Services Department, 0 Printed Date/Time 02/15/2021 8:38 Project Name/# 13836 Savage Dr Collected Date/Time 02/02/2021 15:00 Client Sample ID 13836 Savage Drive Received Date/Time 02/02/2021 16:00 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Waters Department Total Nitrate/Nitrite-N 4.63 0.200 mg/L SM214500NO3-P B (<10) 02/03/21 EWW Microbiology Laboratory G. Coli Negative 1 100mL SM21 9223B A 02/03/21 A.L Total Coliform Negative I I OOmL SM21 9223B A 02/03/21 A.L 2 of 5 Municipality of Anchorage Development Services Department Building Safe[7 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 Parcel I.D. 0 ~'1 - 3 ~-I - ;~ q CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: 1. GENERAL INFORMATION Complete legal descfiption'7.,o t Location (site address or directions) 1 3 8 3 6 '3 - ..2. o:2_ 3A; Block 1; Firelake Subdivision #2 SavaRe Dr. EaRle River, AK 99577 Current Property owner(s) Franei s HeGur~an Mailing address PO Box 7705/~1 Lending agency Day phone 696-5061 River. AK 99577 Day phone Mailing address Real Estate Agent Maitin~ Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3 T,R,,r~ W..mtlrnn/P',".,'tor, t'~,l Dayphone 68q-§~06 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 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 Hearth Authority Approval are valid for 90 days from the date of issue for properties served by a pdvate 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 Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER Se As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation. based on procedures outfined 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 an-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. $ & s ENGINEERING Name of Firm 17234 Eaffle River I~qq~ Road N,~- ~gft4 Phone ~[= River, Alaska 99577 Address Engineer's Printed Name )~0/~,~'T' C. Co~.,.4,~, Date .... ~.. WATER AflD ...... ,~ ~ '~' ',:,/:'/~'".~" , ~. . ~, ~ ..... ,O"'-,, ,~ c,..,._ C.-8~01 ,.._.-¥,~. · .: Approved for: "' bedrooms. ...... ' ........ ~9, ( O,q,,,~. ,. c¢4AOr-. ~',,~'* · Disapproved. ..' ~'~.Oj.~ 'l 1'~'~9 9 ' ' ' ':, ;..; .~ ~. - '.~.~.-.,.~'"'" conditional approval for bedrooms, with the following stipulations: Additional Comments Note: The ~vell for this property meets existing State and Municipal Codes. There are nitrates presellt. It is su~oe~terl that ~pr~ntl;t- toet;-~, I~,, per.%rmcd t~, [.~u~c ~,|~ ~,~I|~ cu.,ii.ucd ~ui~.abiiii.~. Current nitrate concentration is 5.05 mg/L EPA maximum concentration is 10.0 m~/1. More infori.al, lu. u. a~.raie~ ]~ u,,aiiabie/rom tl~e un-bite Services Program, at 343-7904. Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: / ~ ' :;~ ~' - O / Municipality of Anchorage Development Services Department Butldlng Safety DMsion On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 ~ge, AK 99519-6650 www.ci.anchomge.ak.us (907) HEALTH AUTHORITY APPROVAL CHECKLIST LegalDesoriptlen:LOr 3,t3 t~t.ecg. I FIR/c. J,.A~ 5,/o ~,,~ ParcellD: A. WELL DATA Well type PR~v AT Date completed Total depth q ] If A, B, or C provide PWSID # -' Sanitary seal ~tN) YE J Casedto ~/O ft. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform O colonias/100 mi. Date of sample: I ~. ] I :~ / el Wall Log (Y~ ~' 0 Wires properly protected(~;fl~l) Casing height (above ground) FROM WELL LOG · ft. _/ g.p.m. AT INSPECTION l,. l ot Nitrate .~'.e$' mo./1. Other bacteria O colonies/100 mi. Caltected by: B. SEPTIC/HOLDING TANK DATA TankType/Material Si~/a~-, ~ / Co,- Tank size } ~' ~O gal. Number of Compa,'lments ) Foundation cleanout (~I/N) ¥~' Depression over lank (Y~ ~ o Date of pumping IO//o/OI Pumper C. ABSORPTION FIELD DATA Data installed ~/(i, / ~'~ Soil rating (g.p.d./ft~ or'~ Length ~,. (~ fl. W~dlh ~ fl. Totaldepth J ~ fl. Eff. absorptionaraa ~//{~ ft2 Monitoring tube Data of adequacy tast I~. Jl¥/d! Rasults[~Fail) /~'15 Fluid depth in absmptlen field before test ~t¥ i~. Water added Elapsed Time: ~"/ min. Final fluid depth 3.~_1 in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) p~,v ( ~, ,, u ,~ cdeanoute~) Y'~ ~ High water alarm (Y~ '~' ~ System type 7'~,,,, c Gravel below pipe ~;~ ft. __ Depression over field ~' o For ~ bedrooms New depth-~ 7[ in. ~5"0 g.p.d. If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) __ 'Pump on' level at in. 'Pump ~ level at _.....~--Cycies tested Datum Meets alarm & circuit requirements? E. SEPARATION DISTANCES in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic sewice line On adjacent lots On adjacent lots Public sewer manhole/cleonout Holding tank /v/,4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Property line ~"o Water sen~ice line /o Building foundation ..t" O +- Water main N lA Wells on adjacent lots ) 00/-/- .SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I O + Building foundation 4-0 Water Service line ,/0 '~' Sudacewater /eO /'~ Curtain drain /~0/~4. ~'e~,~ Wells on adjacent lots )OO / Absorption field '~' Surface water ! oO/'+' Water main Driveway, parking/vehicle storage F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer'sPrintedName RO~'~T C. CO~XR~.v HAA Fee $ Date of Payment Receipt Number (Rev. ~2/oo) Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 3�z6E 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3, Block 2, Firelake Subdivision #2 T15N R1W Sec -31 Location (address or directions) Savave Road (b) Applicant NameCharles R. Taylor Telephone: Home 376-0621 Business 2f13_5111 Applicant Address P • O . B 220305 Anchorage, AK 99522 (c) Applicant is (check one): Lending Institution[]; Owner/buildert7 ;Buyer ❑ ; Other ❑ (explain); -- Lending Institution Address Real Estate Company and Agent Address Telephone Telephone 2. TYPE OF RESIDENCE Single -Family Cf Multi -Family ❑ Other Number of Bedrooms 2 3. WATER SUPPLY Individual Well ® Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. C, SEWAGE DISPOSAL Onsite ® 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. Page 1 of 2 72-025(11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, 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 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. EAGLE RIVLRieuli,i :RIPIG �_iiVICE� * vertical separation to GWT dependant Name of Firm EAGLE RIVER, AK 99577 upon Municipal determinaton . Telephone Address P. 0.BOX 94-5195 4-I A 95294 3APIv6 9Y J J Date 1 Engineer's Seal I L E 6. DHEP APPROVAL C-2)()� Approved for L bedrooms by 1�f - —� G�� Date Approved Disapprove ` Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasgrs of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees 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. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) 1VWNICIPALITY OF ANCHORAGE HEALTH AUTHORITY APPROVAL (HAA) DEPT. OF HEALTH & CHECKLIST - FEBRUARY 1984 ENVIRONMENTAL PROTECTION 264-4720 MAR 2 U RW Legal Description: u t -3 ��r /—. n 'lre GGkE .Sar/�c/,� l�c��✓n� -f� •Z AJ'-l..(✓�f4 ASL. �c , � / A. WELL DATA Well Classification eK / t/AT/.= If A, B, C, D.E.C. Approved (Y/N) Vi 1A Well Log Present (Y/N) IV Date Completed /1*73 Yield T�ste� BCrPm Total Depth %% Cased to Depth of Grouting o_A % Static Water Level 93 / Pump Set At /x /"'.— Casing Height Above Ground 42 Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) N grr�wwd rro wdeo( Separation Distances from Well: To Septic/Holding Tank on Lot On Adjoining Lots t/cJt1 / To Nearest Edge of Absorption Field on Lot '/ 2 ; On Adjoining Lots f/oo To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by F4,& 'e'G'-4 E^3" ""'^'S-- ;Date Water Sample Test Results -S'4 t%r4 fa r Comments B. SEPTIC/HOLDING TANK DATA t Date Installed Z273 Size /-;?,-S D No. of Compartments Standpipes (Y/N) / Air -tight Caps (Y/N) Z Foundation Cleanout (Y/N) Depression over Tank (Y/N) N Date Last Pumped 3J,2 Pumping/Maintenance Contract on File (Y/N) ; for IV14 Holding Tank High -Water Alarm (Y/N) y14 Temporary Holding Tank Permit (Y/N) I1 Separation Distances from Septic/Holding Tank: To Water -Supply Well *la2 To Building Foundation To Property Line /lam / To Water Main/Service Line Course Comments Page 1 of 2 72-026(11/e4) -`el6 / To Disposal Field 3. i' l .fie fl eel C.q � f/b To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �'�}" ` @ 9d ��R Type of System Design Sec�o�i� Date Installed 1573 Length of Field -20 Width of Field Depth of Field /O i Gravel Bed ThicknessL;ef"7' Square Feet of Absorption Area 3Co f `?�;-`t Standpipes Present (Y/N) _— i Depression over Field (Y/N1 /U Date of Last Ade uac Test 3�ay,/&c Results of Last Adequacy Test /q y Sc �1t 74 c /- fir 1�2tY 4.9 sr 8 kc1 3ela L%°O Separation Distance from Absorption Field: To Water -Supply Well { J-3? To Property Line To Building Foundation 3 S Lot /14�7'"' e ; On Adjoining Lots To Existing or Abandoned System on 7'-? e, To Water Main/Service Line To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed /v Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) _ "Pump Off' Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent (Y/N) mJt-,tif Pumping Cycles during Adequacy Test. Meets MOA I certify thc/� at I hav c ked,verified.orconformed to all MOA and HAA guidelines in effect on the date of this inspection.,0- / Sega �� mer 3/1s/�c Signed Date Company 11ft—E S , MOA No. Receipt No. -7% Date of Payment Q2 n o� o o a �� *rrgineer's Seal Amount: $ �� Erna a mp ooeo. ea .na erz,:..;. - �r Louis A. 5utera CC -6736 Page 2 of 2 s' , 72-026 (11184)