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Home My WebLink AboutRABBIT CREEK VIEW & HEIGHTS BLK 8H LT 17A MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 4AME VIAl LING ADDRESS ~o~. ON-SITE SEWAGF DISPOSAL SYSTEM AND/OR WELL INSPECTIg,,I~ A ~ ~'~ 'l°l DISTRICT OFFICE LEGAL DESCRIPTION LOCATION DISTANCE TO: I I ~' IAbsorption area IO capacity in gallons / I inside length {0¢ O IF HOMEMADE: DISTANCE TO: Well ]Dwelling DISTANCE TO: ]Well I 2-~ No~es ~ / L~ngtl} of each lin,e/ L_c/ o ¥_6 ~ ~o finish grade Foundation ~,~ Total lengtl~ of lines Wiclth Crib diameter Length Type of crib Material beneath tile Depth l-Crib depth Building foundation __ j DFilier - JSewer line Well DISTANCE TO: i ~t~ Depth Building foundation DISTANCE TO: OTHER Dwelling Material Width Material Nearest lot line~., ~_ Trench w)~y inches ~' inches NO. OF BEDROOMS PERMIT.NO, No, of compartments Liquid depth PERMIT NO. Liquid capacity in gallons Distance between lines Total effective absorption ar~ea 1_7 __ _ PERMIT NO, Nearest lot line Distance to lot line area IPERMITNO. Absorption area(s) MATERIALS p ,~ c't ~'~ ~t ,b3o ~'~ SOIL TEST RATING NSTALLER REMARKS 2' ,sc,...-- ~'~'t~'''~ 6c4'~ '¢a..~t~ I,~ ~,~ ~PPROVED "7 DATE LEGAL I 'r II Itl P-.3 b J-- U:)lq"? (.:: f' ! ..[ii(:(.~d .. December 3, 1984 Mr. Larry Settje P. O. Box 5182 Ketchican, Alaska 99901 Dear Mr. Settje, MUNICIPALITY OF ANC~IORA~I~ DEPT. OF HEALTH & ENVIRONMENTAt PROTECTION RECEIVED The following information is your copy of the well log for the property located at Lot 17, Block 8, Rabbit Creek Heights Subdivision. This should be retained as your permanent record of improvements to your property. 0 17 22 27 62 To WELL LOG 17 Sandy silt, gravel (surface water) 22 Sand, gravel 27 Silt, gravel trace of water 62 Sandy silt, gravel 89 Sand, gravel WATER 5 GALLONS PER MINUTE THIS WELL IS A SLOW ARTESIAN STATEMENT 89 Feet drilled and cased @ $20.00 per foot = $1,780.00 Thank your for specifying BIG DIPPER DRILLING for your water well needs. Please call when you are ready for a pump. Sincere ly, C. R. Kron Owner PO U,...,I-I 6-650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES. MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Permit 9: 840820 January 31, 1985 TO: Permit Applicant SUBJECT: Lot 17 Block 8 Rabbit Creek Heights Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If yo~ have drilled the well, & well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as-built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. Zf there are any further questions, please call this office at 264-4720. Sincerely, Keith E o Bandt, Supervisor Environmental Engineering Program KEB/ljw enc: Copy of Permit SWP/057 - f t....t C, At Il ,, 3 D R IE S S: ]NTAC. T F'H[~NIE: Ih"tl IL,..[I lh,,.~ ]E tel: % F" ¢:::% IL,... % '"~'" '"~¢" !Ell IF:=" ~¢'::~,~ ~',,ll ILl]: II."-'11 Cji IF:k: ~¢::'.~'4 II]Si IEEE DIEF:'AFt:TIdlENT OF::' HIEAI_.,TI'I AND ENVIiI::~[:INMIENTAL 1,[.. r,,:[, .I. 0 I :.,~:, ~ 1... S'I"I:~I[~E:"I", -~1 I{..,l'l ..ll~..hL~l... ~ g~::: 99'.50 ;I. 0 9 / 2 6 ! 8 4 S II~'D:I:V]: SIC ", FIABB]:T '..]lqEl!]-:: I.,'IE]:(3H'f'S LO"f:: SE:CT :1: ON: 1 I (.)WI ISI'.'I I I:::': :1. ;I.N FRANE)I':'.!::3W 3:1.',.2C:,() (S(]),, F:T, (]R ACREES) F;d]BEF~T DI ~ ,I, VIii: 3 El T S :1: Z IE OT LOCAT A X BtEDI::;~C)OMS ',: is'Led v~:~'t:.c~m,, I::;h.cx:;:~e 'l:.he i::~pt:i, or't tha'L best fits ',/C~LU" s:i, t6.:~,, II,,,,,,11 ~, ][7;t, II:::%". ~-':..% % II'"41 4. 6 ,, 0 5 ,, 0 :t. ~, ()C'(),, O .'.4.-~. 22() EF:'TH 'I'C) F:'II::'Ii'~ BC)T'T'OM (FT,,) I:~AVEL., DEF:'TH (FT.) OTAI.... DIEF:'TH (1="1",, > ,RAVEl.. MID'TH (F:'T,,) iI::;:AVIEI.. L,.E:I'q())"FH (t::T.) iRAVEL, VC)LLIME (C;U,, YDS,, ) '(11',11< 'SIZE (GAI,,..S) lC) :t; L. I:::~'1" ]: IxlG (.q(]) ,, I="T' ,, /BR ) .x..~. GRAVI!::L,. LENGTH > 75 FT ,, RE:(]!LI ]: RE'".S MUI...'f' ]: I:::'LE RUNS (NCKf' E XC.',ISED ]: lxl(:':~ '75 F'T ,, I~i:AC:H ) · ~,~-.?,' TANI< MUS]" HAVI?.] AT LEAST 'I'WO COMI='AFUf'Mt!'"-NTS · cer't:i.'~'y that: ~'or"Ll"~ 3v 't'.["16(~ Mun:i. cil)a~:i, ty (::)~' ~l"ld'~c)r'ag~ (MO~) arid 't:.he:~ State o{' ") :t: v-~:i,:l.-:l. :ins'tall 'l'.h6)} system :i,n acc:oPdaric:e wi't.I] all MOA c:clEtos arid :i.n comp 1 :i. anc(~) with the desi(:ln (:;r' :i.'Ler' :i.a of' this pePm:i.t. 3. I w:i.:l.], adh(,;)~'e t.o a].t MDA ar'id State (::~(' Alaska r, eqL~:i,P(~ffl~:(.)r'Kl.t,s {c)r' 't'.h(~) ~(.:;¢t back El :j.s'[',,¢~I]C::(~?% f' r'om any ex i~i~t:i.i](:j ,/~(:(~]. ]. :, ~.¢astewa'tt.e~P d :i. sposa]..system of puli ]. :i.c:: =,(....w(=;i ~.t~.?j(.. t~y~F(.e:.h'~l (:~n this (:~r' any a( ja::ent [~1" n~.~.~ar'by lot '4. ]: t.U'iEJ(:,}r':EF[',.i:~I"~d t'.h~3, t 'LI-t:i.~ [;)6~,r'mit :i.s valid for' a ma>¢;J, mL.(m c~f' 3 I:)E~f:Jr'(:)C)IIHti~ 6':tl]d IF: A I...IFrT STATIQIx ]:S .t4~:~IAI..J...[ .... IN AN ARE:A COVIE:RED BY MOA BU]:LD];NG THEN (J.) AN k. Lb.C, ,1*.1.(..,(.I... F:'EFtMIT ~I*,tD TIxISF'F]CT]ON MUS'f' BE OB"K~INED~ (2) AS'"'BU:I:LTS W;[LI.... NOT BE AF'I:::'ROVED N):THOUT Alxl t:::.I...I:::.L,I,-k.I.r;AI ..... I,l,:.l., ........ I.,..)N RIEF'OR'T': AND C];) TI.IlS EI...,IEC;TF( ]: CAI..1,4CIRK MUST E E DOhlIE BY A I... :1: CIENSED I~SL. IECTF< :1: C :1: AI",I ,, .... . ........... .............. t.,~d::.,:~:: AF'F'L. ]~ DAixIT ~ J AN ", -' ""r', "' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: /"'""~ Iq P_ lC: SLOPE 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS ~O~.t. "t~.~ ~..A?~ P,2 HTg 'r'l+ SITE PLAN S WAS GROUND WATER V 1.1~ ~ ENCOUNTERED? L 0 P E IF YES, AT WHAT Gross Net Depth to Net Reading Date Time Time Water Drop ~ ~o /o o,lq O,~I PERCOLATION RATE TEST RUN BETWEEN I_~ ~" FT AND __2, Q FT PERFORMED BY: ~:~)/~ I~ ("kC /'~0,~ 51 8 ¥ 'O~,~'~/ CERTIFIED BY: ~'/72-008 {6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82!5 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCQLATION TEST SOl LS/-Iz-O G PERCOLATION TEST PERFORMED FOR: \.-,~L L,, ~,. LEGAL DESCRIPTION' 1 2 3 4 DATE PERFORMED: SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER S ENCOUNTERED? ~',,J o L 0 P E Gross Net Depth to Net Reading Date Time 'Fime (¢~ h~,'~ Water Drop Z ~ 5L ~0 ,55 ,i~ ~ z:, ~- ~O ,65 · o9 PERCOLATION RATE TEST RUN BETWEEN PERFORMED BY: EO'\C,,OF /'L%e"-t~'J~'~ / ,~CVC,'/$ CERTIFIED BY: \ q (minutes/inch) FT AND ,~' ~2.- FT 72-008 (6/79) ALASKA 8FIUIROFIITI FITAL COFITROL ~nqineerinq $ I~nuironmcnlol Sludies SPECIFICATIONS FOR ELEVATED BED ALTERNATIVE WASTEWATER TREATMENT SYSTEM - LOT 17, BLOCK 8, RABBIT CREEK HEIGHTS SUBDIVISION 1.0 GENERAL 1.1 1o2 InC. MUNICIPALITy OF ANCHORAC~B DEPT. OF HEALTH & ENVIRONMENTAL PRO1 ECTIoN, Ff:'_t3 i 9 1985 1.3 1.4 2.0 2.1 ~{E DRAWINGS SHEETS 1 THRU 4, ~tALL BE PART OF THIS SPECIFICATION. ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP). ALL EXCAVATIONS AND DEPTHS ARE ADVISORY AND ARE TO BE VERIFIED IN THE FIELD BY THE CONTRACTOR/ENGINEER. IT IS r[~E RESPONSIBILITY OF THE OWNER OR CONTRACTOR TO ADHERE TO APPROVED DESIGNS FOR INSTALLATION, MAINTAIN ~{E SPECIFIED SEPARATION DISTANCES, AND TO HAVE APPROPRIATE INSPECTIONS BY ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. (AECS). AECS WILL NOT BE RESPONSIBLE FOR ANY DESIGN IF THE INSTALLION IS NOT INSPECTED BY AN ENGINEER FROM AECS. SUCH ENGINEER SHOULD BE CONSULTED PRIOR TO CONSTRUCTION TO DETERMINE THE NUMBER OF INSPECTIONS THAT WILL BE REQUIRED. SEPTIC SYSTEM THE SEPTIC TANK SHALL BE A UPS APPROVED TWO COMPARTMENT TANK, SET LEVEL, AND INSULATED WITH AN OVERLYING LAYER OF 2 INCH BURIAL TYPE POLYSTYRENE. THE SEPTIC TANK SHALL REST ON UNDISTURBED SOIL. 2.2 INLET AND OUTLET PIPING SHALL BE FITTED WITH WATER- TIGHT CAULDER OR FERNCO COUPLINGS. PIPING SHALL BE 4 INCH SOLID PVC ASTM 3034, SLOPED A MINIMUM OF 1/4 INCH PER FOOT, WITH A MINIMUM OF 4 FEET OF COVER. IF LESS THAN 4 FEET, USE 1 INCH OF DOW EXTRUDED BLUE POLYSTYRENE FOR EACH FOOT OF COVER LESS THAN 4 FEET. HOWEVER, THERE MUST BE AT LEAST 18" OF SOIL COVER OVER THE INSULATION. 2.3 CLEANOUTS SHALL BE INSTALLED WITH CAULDER COUPLINGS, CAPPED WITH AIR-TIGHT JIM-CAPS (OR EQUIVALENT), AND EXTEND A MINIMUM OF 0.5 FEET ABOVE GROUND LEVEL. 2.4 THE SEPTIC TANK SHALL BE A MINIMUM OF 5 FEET FROM THE BUILDING FOUNDATION, AND A MINIMUM OF 5 FEET FROM THE DRAINFIELD. 3.0 SEEPAGE BED 3.1 THE GRAVEL FOR THE BED SHALL BE SCREENED TO THE SIZES 1200 []]est 33rd Auenu¢, Suile B o Anchoraqe. Alosko 99503 ~,(907) 561-50/40 INDICATED: 0.50 TO 2.5 INCHES. 3.2 ~tE BOTTOM OF THE EXCAVATION SHALL BE RAKED WITH THE BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. 3.3 TWO OBSERVATION PIPES SHALL BE PLACED AS SHOWN IN DRAWINGS. THEY SHALL BE RIGID PVC, ASTM 30303 D-3034. ~{E SECTION SHOWN WITH HOLES MAY BE EITHER DRILLED 0.5" HOLES @ 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE OR A SECTION OF REGULAR PERFORATED SEWER PIPE MAY BE CI~AMPED TO THE SOLID SECTION WITH A NO HUB COUPLING OR SOLVENT JOINT. A RUBBER RAIN-CAP (JIMCAP OR EQUAL) SHALL BE PLACED ON THE TOP OF THE PIPE. 3.4 INSULATION SHALL BE DOW EXTRUDED BLUE STYROFOAM BOARD OR EQUIVALENT (1" PER FOOT OF SOIL LESS THAN 4 FEET OVERLYING THE BED.) 3.5 THE TOP AND SIDES OF THE BED SHALL BE PLANTED WITH A ~{ITE CLOVER AND RED FESCUE MIX OR BLUE GRASS. 3.6 THE SEPTIC TANK OR BED MUST NOT BE CLOSER THAN 100 FT. TO ANY EXISTING PRIVATE WELL OR BODY OF WATER AND SHALL BE NOT CLOSER THAN 150 FEET FROM EXISTING CLASS C WELLS OR 200 FEET FROM CLASS A OR B WELLS UNLESS OTHERWISE SPECIFIED. 3.7 ~{E DISTRIBUTION PIPE SHALL BE 4 INCH RIGID PVC ASTM D 2729 OR EQUAL OR POLYETHYLENE. THE PIPES SHALL BE LAID LEVEL. 4.0 THE LIFT STATION 4.1 ~{E STOCK MATERIAL FOR THE LIFT STATION SHALL BE EITHER GALVANIZED STEEL (ASTM A.-4444-76), OR ALUMINUM CULVERT, CAPABLE OF BURIAL TO 10 FT. 4.2 ~{E 36" DIAMETER PIPE FOR THE LIFT STATION SHALL HAVE A WELDED WATER TIGHT BOTTOM OF THE SAME THICKNESS AND COMPOSITION AS THE CULVERT. 4.3 ALL PENETRATIONS OF THE LIFT STATION SHALL BE WELDED AND WATER TIGHT. ALL WELDS SHALL BE CLEANED OF SLAG. WELDS ON GALVANIZED STEEL WILL BE SPRAYED WITH ZINC RICH PAINT OR COATED WITH BITUMASTIC. 4.4 THE TOP CAP SHALL BE RAIN TIGHT AND SECURELY FASTENED WITH SCREWS. A TWO INCH LAYER OF POLYURETHANE FOAM SHALL BE BOLTED TO THE INSIDE OF THE TOP CAP. 4.5 ALL ELECTRICAL FITTINGS AND CONNECTIONS IN THE LIFT STATION SHALl, MEET THE REQUIREMENTS FOR A WATER TIGHT SERVICE. 4.6 THERE SHALL BE A HIGH LEVEL ALARM, PEABODY BARNES 6147 OR EQUAL SET AT THE LEVEL OF THE SOIL PIPE FROM THE SEPTIC TANK. THE BUZZER SHALL BE LOCATED NEAR ELECTRICAL CONTROL PANEL OR IN A LOCATION DESIGNATED BY THE HOMEOWNER. 4.8 4.9 4.10 4.11 ~ SUMP PUMP SHALL BE CAPABLE OF DELIVERING 10 GPM AT A HEAD OF 20 FEET. PROVIDE A CALDER COUPLING AT THE CONNECTION OF R~E 4" SOLID PVC INFLUENT PIPE AND 4" STEEL NIPPLE. THE PUMP SHALL BE CONTROLLED BY A DIFFERENTIAL MERCURY FLOAT SWITCH, ADJUSTED TO ALLOW A TWO FOOT SPAN BETWEEN ~ON~ AND 'OFF', AS SHOWN IN THE DRAWING. ALL RELAYS AND ELECTRICAL CONTACTS SHOULD BE LOCATED OUTSIDE ~{E CHAMBER TO PROTECT THEM FROM CORROSION, PREFERRABLY IN A DRY LOCATION WITHIN THE HOME. COAT THE INTERIOR OF THE CHAMBER WITH BITUMASIC PAINT OR TAR TO APROXIMATELY 3.5 FEET ABOVE THE BOTTOM. ~{EN LIFT STATIONS ARE INSTALLED WITHIN THE MUNICIPALITY OF ANCHORAGE, AN ELECTRICAL PERMIT AND INSPECTION ARE REQUIRED BY THE MUNICIPALITY. CONTROL SERVIC, , INC. 1200 West 33rd Avenue Suite B ANCHORAGE, ALASKA 99503 Phone 56].-5040 / SHEET NO. CALCULATED BY CHECKED BY SCALE oF DATE_ 2 - / ~' ~$" DATE /.6 ~ z? '/ & × 2_ ALASKA EI~VII'(UI~'-"~ I AL CONTROL SERVICE . iNC. 1200 West 33rd Avenue Suite B ANCHORAGE, ALASKA 99503 Phone 561..5040 SHEET NO. CALCULATED BY CHECKEO BY SCALE OF DATE DATE Ii~ o o.5 Ju~L~;~./-t I;l~IVIl~Ul~lV~"'~i I/-iL CONTROL SERVICE iNC. 1200 West 33rd Avenue Suite B ANCHORAGE, ALASKA 99503 Phone 56t.5040 SHEET NO 3 OF ~1 CALCULATED BY 'T~r'~ DATE ~- /B- ~-' CHECKED BY CATE SCALE p,'? ~ ~ H2Q,~ CONTROL SERvIC ,' ]200 West 33rd Avenue Suite B ANCHORAGE, ALASKA 99503 Phone 561-5040 SHEET NO , OF ~L R£VISED er., $~ COI~D$ DATE_ E/SO/E4 CHECKED BY. DATE. LIFT STAT/ON DETAIL NEMA 4 ENCLOSURE GALVANIZED OR PAINTED METAl COVER POkVER AND PUMP CONTROL LINES 1~4" DIA PULL-PIPE CONNECT£D TO ~" URETHAN£ FOAM GLUED TO PITLESS ADAPTER FOR PUMP REMOVAL GROUND L.EVEL I '~ DIA STEEL PIPE _2_" CONDUIT FIL.LET WELD AROUND PIPE PUMP PUMP PO~IER 4' MIN ADAPTER I:~"-~" COUP/lNG / a" SO~/D PE OR~ J TO ABSORPTION ~HE,4 T T,4 P E ,¢" DIA SOLID PVC PIPE FROM SEPTIC TANK AL ARM CORD GA L. VA N/ZED STEEL A-44,¢*¢-7~) OR AL.UMINUM CULVERT · CAL DER COUPL. lNG DIFFERENTIAL MERcUt~y FL. OAT SWl TCH INSIDE OF PIT SHALL. I BE COATED WITH l BITUMINOUS PAINT OR TAR PUMP AMP PUMP 'ON" LEVEL PUMP "OFF"/_ EVEL 'GALVANIZED OR PAINTED STE~C-£ PLAT~ /7 • T GE BL F t Municipality of Anchorio o ` On-Site Water and Wastewater Pry 1 (907) 343-7904 v ; 7.161 % Certificate of On-Site Syst: - s Nittaltoval P- 4 Parcel I.D. 020-571-42 . • -tion Dat:..`' i -1 - { / 1Il OL oS � 1. GENERAL INFORMATION: Complete legal description Rabbit Creek View&Heights; Block 8H, Lot 17A Location (site address) 8201 Roberts Drive*Anchorage,AK 99516 Current Property owner(s) Deon Mouton Day phone 320-4711 Mailing address 8201 Roberts Drive*Anchorage,AK 99516 Real Estate Agent Mary Cox Day phone 440-9820 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Vis;7� 1' r "2'`4".'~ wn '�'�Distance: Received by: ��1/ Date: I, / 1 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ o .(c Waiver Fee $ i69- Date of Payment J57it' Date of Payment 7/-251/3' Receipt Number 07-0/V) Receipt Number c TO(q G COSA# 04)(1"71 J'SY Waiver# (15 vl W O q(f 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 6/2-1 /67-- 4000444 In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system o OF 4%Q in accordance with the guidelines and regulations established by the Municipality of Anchorage and .�C�•.•••... •. '1 c .ri industry practices. The reported results describe the condition of the system/s on the date/s of the •• un evaluation. Separation distances were measured to readily identifiable features. Hidden defects or V encroachments may exist that were not identified during the evaluation. The operational life of all wells /a'. 4 TA/ ,57*OD and septic systems depend upon a variety of variables, including but not limited to, soil conditions, ! // groundwater levels (that may fluctuate during the year), quality of construction (materials and 1(0"3 1 4 workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and Q� �i ri. are outside the control of GEG. Satisfactory test results do not guarantee future performance of the / '.0 ffre j . Gorness,' LI system/s:therefore, GEG makes no warranty(express or implied) regarding the future performance of vpp U E f the well or septic system. GEG makes no representation whether an alternative well or septic system V4 s •Y / ��0� can be installed on the property in the event either of the current systems fail to perform adequately in � e, ."—• ..1 .`' r°5 O the future. The content of this report is for the sole benefit of the person/party that retained GEG to D�eap,ofeSs;o�a� o perform the evaluation. Reliance upon the information provided in this report by any other person or \4444044 party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE � r� System #1 Approved for 3 bedrooms .... ,-,,,L.„, 4 System #2 Approved for bedrooms ,: L ��,c Disapproved o1-:' KiAD .. Conditional approval for bedrooms, with=the`oIlp `�bstlp lations: --- / / -------- -----r: By: \ -�( Original Certificate Date: ' S 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: 71 COSA Checklist /1. -- Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10.10.12.doc If more than 1 septic system is on the lot: • COSA Checklist # of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Rabbit Creek View Sc Heights; Block 8H, Lot 17A Parcel ID: 020-571-42 A. WELL DATA Well type Private If A, B, or C provide PWSID# N/A Well Log (YIN) Yes Date completed 12/3/1984 Sanitary seal (Y/N) Yes Wires properly protected (YIN) Yes Total depth 89 ft. Cased to 89 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 12/3/1984 8/1/2017 Static water level Artesian ft. Artesian ft. Well production 5 g.p.m. 4.3+ g,p,m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 1.70 mg./L. Collected by: GEG. Ltd. Arsenic: <5 ug./L. Date of sample: 8/1/2017 B. SEPTIC/HOLDING TANK DATA *32 year steel septic tank is approaching the end of its useful life Tank Type/Material *Septic/Steel Date installed *3/5/1985 Tank size *1000 gal. Number of Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (YIN) Yes Depression over tank (YIN) No High water alarm (Y/N) N/A Date of pumping f 1 T Pumper kern e_ C. ABSORPTION FIELD DATA ...Below Existing Grade Date installed 3/5/1985 Soil rating (g_p.d./ft`o ft/bdr ) 138 System type Bed Length 42 ft. Width 12 ft. Gravel below pipe 0.5 ft. Total depth *2.7+ ft. Eff. absorption a ea 504 ft Monitoring tube Yes Depression over field No Date of adequacy test 8/1/2017 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test **0 in. Water added 475 gal. New depth **8.5 in. Elapsed Time: 1440 min. Final fluid depth **0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date — **North MT in bed extends approximatley 0.73 feet below the post tank cleanout, and the south MT extends approximatley 0.38 feet below the post tank clenaout. At the start of the test the south MT had approximatley 1 inch of water and the north (deeper) MT was dry. Liquid level readings were taken from the north (deeper) MT over the initial 50 minutes of the adequacy test (355 gallons of water) before any rise was observed in the south MT. ***Slightly (19%) undersized per MOA sizing criteria but has been approved for 3 bedrooms via COSAs in 2001, 2002, 2003, and 2009. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at '. wa er alarm level at in. - Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75 + Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water *50'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water *50'+ Driveway. parking/vehicle storage 10'+ Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS *See attached waiver request. E. �� SF��.►--'1;a 1 N File: —1 9134 J coni upd 5v �� G. ENGINEER'S CERTIFICATION OF ' 4 �Q ov/P 1 5�-00 r certify that t have determined through field inspections and i ��;' 4 T 0DOreview of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this 0 r -/ date. •• •i i•.' Jbff A. Gar,ess. Engineer's Printed Name JEFFREY A. GARNESS 0071:;.SSP., QE— .. .��OGI Date Si 2.///�- t��4Pa • S ... f ,<A,7'- ' �ofess'o�o0 ��0000��o #AECC884 (Rev. 11/05) 1G` . uanics n -n••. e. Waror 6olrlion• GARNESS ENGINEERING GROUP, Ltd CIVIL&ENVIRONMENTAL ENGINEERS August 9, 2017 Municipality of Anchorage Development Service Department On-Site Water& Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Rabbit Creek View & Heights; Block 8H, Lot 17A To whom it may concern: The subject property is served by a private well and septic system. The existing septic tank and bed serving the property(installed in 1985)are located approximately 50 feet from what is possibly unidentified surface water (see attached image). We request that your department issue a 50 foot waiver from the existing drainfield on the subject property to this possible surface water. Justification for the variance are as follow: -The"surface water" is not mapped in the MOA stream/wetlands database. -The surface water was not identified during either septic system installation/upgrade on this lot or the adjoining property to the east; therefore it is likely that its presence is seasonal. -If the drainfield were to fail, the daylight basement would flood before any effluent could overflow from the septic tank or drainfield and travel to the surrounding area(see attached photo). In short, it is highly unlikely that a failed/surcharged septic system would go unnoticed. Given these facts,there appears to be minimal risk in granting this waiver. We are unaware of any adverse impacts associated with this waiver. Please call or email if you have any questions. cerely, ilk 1 4 Jeff, Ga ••ss, '.E, M.S. Pre.•f I nt 3701 East Tudor Road, Suite 101 'Anchorage, Alaska 99507-1259 Phone: (907)337-6179 'Fax: (907)338-3246'Website: www.garnessengineering,corn Municipality of Anchoragetermir P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http:l/www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV171094 COSA#: OCS171388 Permit#: PID#: 020-571-42 Legal Description: Rabbit Creek View and Heights Block 8H Lot 17A Engineer: Garness Engineering Group Applicant: Deon Mouton Your request for a waiver of the required 100 feet horizontal separation from the septic tank and drainfield to surface water has been approved. The approved separation distance is 50.0 feet. See engineer's letter for justifications This waiver approval applies to the existing septic tank and drainfield only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: ?/31/2Of7 Approved by: 6.4...VrArg/ Name of Reviewer **** VARIANCE/WAIVER REVIEW **** MUNIiAAl17'1�flfi,owrrva3Ao� y TRAFFIC ENGINtEcsRING • ��Q� �~.�`•• [}APPROVED AS S "....y f✓U77EQ C1 APPROVED'AS AMENDED 4: 49th t'} ® APPROVEQ A5 NOTED lb ,.d At07 APPRp D, A. MR =s pondd R Mitdhll ��arr I cx., ._C LS-41ZS •�1s r,rt a,. •.o/I Z/y r �W�fvtra �\1 i*S ` ��r $) *u c‘ $uq. A+ O'r L4 LUT th ' Aki ---". \ on , r" •' 1 "VII 1 . v, • fie' .f1�'a `11?;)C • ' \ 1 \ \ °.1' .' sea �. ` The location of the structure(s)as `, I. shown ori Ihls record drawing :,,,, (as-twin) wilhcomplies � iitlle 21,AMC. \ `\ L) 11,7 dte. I//t'/.;zoi7 ;. �. �.- • fes' ,' EXC SIGN NOTE& It is Ow Mum ns'sintl ty te datumtno the sentence of my lose nshbr• . COWNOrda, or nsbiationa .Isiah do not amour on the r.oprd.d subdholifon plot. NOTE tinder no oir urnet nMS should any data hereon be used for eorod ucti n or kr estdMiehtrso property Ibi.a SURIEY CERTIFICATION: I have oonduotsd a phyetod survey of Nle property oe dsores on This drwho a+d d.tsnnbsed toot {he inept sssd � thereon ars el*in VI. IU .`sd no +naroarhm.nts ardat I Tlps o.Voted PHYSICAL ADDRESS LE6EN0: 2010SBRIGADIER ST EPICats our ( ) t A1ER is Ii NOTE ANCHORAGE. AK. ustm DISTANCES Pf1EVM.otul ICAO* ILNIII roetga WELL . ,..L1, et.... IIkY CAL DISTORSON Rio tyle "b7. :.. • r. . ".B T 2/49 WWI ,MA NO CLS SET THIS SURVEY Ma 1: MOLE . SolonY DATE 17016 I 1""—50' l0A 7/13/2017 7/12/2017 10E0N 1 24-9t 0101301E0 Mt MAY TIMM I�SW 3340 timmic C ANCHORAGE AS—BUILT SURVEY RONALD R. MITCHELL FOR ` P. 0. BOX 141884 LOT 17A, BLOCK 8H Anchorage, AK. 99514-1884 RABBIT CREEK VIEW I& HEIGHTS swim'. (907) 272-3778 \Ribbi4 Creek Wad k Ream-s/-8hcie_84-i 1_04 I7A i �, 8,201 Reber} DO , 615' I 209 6/15 -- 51" ' ,.. .., AlF4 1 0 - i 1'01'. . ,, , 0, 4 ..... )1••• 1MAT 6 LOOT► • • r 4,eliP i� \ D pc R aJ rrarness CF-7,953...'4.. �pbss b2 Ajrcarje ,31>Ae() mo : . , Pkai-C ia"'' . p- cc_8 5 9- 33033, 729 ss jc 0 4 1 '' 3' ,� — • Va... . - . .r' or_ p c,(.p.0 ufA--.-C"..--12-' . F ♦ 11116111 a spa SEPTIC' sa;) ------- if N . �1 1 5 rGyN '�pv C°S • Fr YY. 1 1 '• 1 £0T °r t... • EX/STiNQ ,~' Cfel4i.• v. ,� .+STRJC7L/RE S r ' d4 ' +c!•. �i . o i, WEL1 \ O (Ctio N • (LV- .(2. n q \°P- ' lir • t. 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 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~'-'/~ ~"'~S Telephone: Home ,-~¢--g""~"'~'?~'"'~ Business Applicant Address d~f',~ / ~6~/~-- 2~. /;~'~/;~'~ ~e~. 1¢'~'/~, ~'"/~ ~ (c) Applicant is (check one): Lending Institution [-]; Owner/builder"~; Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family~[~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well~r' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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 (1 b84) 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. Name of Firm /¢/-~-'~/--~.~ Telephone .~O / ~-~ "/~d Address /;~..-¢'~ '~ ,,~.~--'~' /~t/Z/-. ~;i/'2'~ Z¢ ,//¢/~'~,/~.? //¢/~. ~¢~ Date ¢' ,"c-Z-' - '~,~ DHEP APPROVAL Approved for ~'-'-~'~ ('~.~bedrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional 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 purchasers 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 (ll/84) DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION NtUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) MAP, 2, ,) CHECKLIST - FEBRUARY 1984 .6,.4,2o REr' .i V WELL DATA Well Classification --~-~u~'¢~ tf A, B, C, D.E.C. Approved (Y/N) ~' leted /,~..~M ~ ~ Yield Well Log Present CN,) __-- Date Corn? TotalDepth_ ,¢~c~-r , -C,as~edt° ¢~',, ,./~,~3;?.thofGrOutlng Static Water Level __¢/(.*,¢5'~:'~¢' ~ ¢),%'~u0>-~*.'"~-'¢ ~' - Pump Set At Casing Height Above G'round / ~ ' __ __ Sanitary Seal on'Casing~/,~4) Electrical Wiring in Conduit (Y('~> -- Separation Distances from Well: / To Septic/Holding Tank on Lot _ To Nearest Edge of Absorption Field on Lot /~-~ Depression Around Wellhead (Y . ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample 'rest Results; Comments To Nearest Public Sewer / To Nearest Sewer Service Line on Lot _ ,~'" ¢ _; Date ¢~ ¢.',' ~ B. SEPTIC/HOLDING TANK DATA Date InstaLled ¢ Standpipes~N) Depression over Tank (Y~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) -- ,(~ Separation Distances from Septic/Holding Tank: Size Air-tight Caps (~N) _ /¢C) d'? _ No. of Compartments Foundation Cleanou~N) Date Last Pumped '.~5-:~2C) ~ ~------------------~ /¢,.//~d~ :for /¢~'//¢ Temporary Holding Tank Permit (Y/N) / To Water-Supply Well To Property Line ~- / To Water Main/Service Line Course ~/c:~ (Jr' To Building Foundation _ To Disposal Field /O / To Stream, Pond, Lake, or Major Drain.age Comments 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 Depth of Field _ Square Feet of Absorption Area Depression over Field (Y/~ Results of Last Adequacy Test ,'~/~ Separation Distance from Absorption Field: To Water-Supply Well ¢c~' / To Building Foundation ~ ~ Gravel Bed Thickness "Standpipes Present CN) Date of Last Adequacy Test To Property Line ; On Adjoining Lots To Water Main/Service Line ~ /O '''~ To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Existing or Abandoned System on D, LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at M~ole/Access (Y/N) "Pump Off" Level at Tested for Electrical Codes (Y/N)~,'~ C°mmen~.,.~/' Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~".~..~. ~/-~' (~) Date Company Receipt No. Date of Payment Amount: $ Page 2 of 2 MOA No. ~¢>%~-O.,'~y 72-026 (11184) Well Classification j~%~'~'c . ~te ~le~d -~ e~ 3 ;~[~ Yield Well ~ ~esent.. )" ~t F ~Pth of G~outing ~A(~)~_ Total ~p~ ~ ~d to Static Wate~ ]~1 &o,~.t ~-~ ~ ~t At ~.~/ ~ Casing ~ight ~ Ground 3 Sanit~ ~al on Casing Elec~ical Wirib~ in ~nduit (~) ~ession ~nd ~l~ead ~p~ation Distan~s ~n To ~ptie~olding Ta~k ~ ~t // ~ f ; ~ ~joining Lots ~t [ ~ ; ~ Adjoining ~ts ~ To ~a~st ~ge of ~s~Dtion Field on A ' To Ne~es't ~blic" ~ Line ~A To ~est Public , -. -. Clean~t~a~o].e ¢~ To ~est ~= ~=vi~ uz~ on Wate=. S~le Colle~ed By --~¢~,~/ ; ~te Wate=xS~le Test ~sults B. SEPTIC/HOLDING TANK DATA Date Installed _=315'/g'.5 .. Size /ooo No. of Ccmpa~,tments ?- Standpims ~) Aid-tight Caps ~3~) . Foun~tion Cleanout ~p~ession o~ Ta~ (Y~ ._ ~te Imst P~d Pt~ing~intenan~ ~n~a~ ~ File (Y~) Holding Ta~ High-Wate~ ~a~ (y~) ~& ~ra~ HOldi~ Tank Pe~t (Y~) ~J.. Sep~ation Distance ~ ~ptic~olding Ta~: TO Water-Supply ~11 // ~ , To ~ilding F~ndation /i~ To ~o~rty Li~ 2~D ' TO Dis~sal Field / O' To ~ter ~i]~Se~vi~ Li~ /O'~ To S~e~, ~nd, ~e, ~ ~jor ~aina~ Course Receipt ~ Date Paid: Amount: []?age 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date .Installed 5/$-//5 ~'- Width of Field /~ / Square Feet of Absorption Amea Depression over Field (Y~ Results of Last Adequacy Test /3B~'/~ Type of System Design Length of Field., ~ z_/ Depth of Field / Gravel Bed Thickness /' Standpipes lhtesent F~/N) Date of Last Adequacy Test AJA Separation Distance f~om Absorption Field: To Water-Supply Well /z27 ' To P~o~erty Line To BuildinG Foundation Lot /v~/% To Water Main/Service Line To Stream/Pond/Lake/c= Major D=ainage Course To D~iveway, Parking Area, c~ Vehicle Storage Area To Existing or' Abandoned System cn ; On Adjoining Lots zv/( C"3o~z ~,,~ ~,~ /o r+ To Cutbank(if present) D. LIFT STATION Date Installed Size in Gallons "PLu~-~ On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Comments Din~ ns ions /v~ Manhole/Access (Y/N) ~+ "Pump Off" Level at //,~ Vent (Y/N) ~ Pumping Cycles during Adequacy Test. Meets MOA Check Permitted Bedrccxn Rating Ac3ainst HAA Request ** oertify that I have checked, verified, or confo~msd to all MOA HAA Guidelines in effect on the date of this insDection. Company ~ /~ ~c s' ; '~ ~ KB1/dS/s Date MOA No. [Page 2 of 2] 2-15-84 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AN[) ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SFrE SEWER AND WATER FACILITY 264-4720 Application Date_ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~F' ~ Telephone: Home (c) Applicant is (check one): Lending Institution ~; Owner/builder~ Buyer D; Other D (explain); Business Address (e) Real Estate Company and Agent _ 1) Cj Address Telephone (f) Mail the HAA to the~followir'~g address: TYPE OF RESIDENCE Single-Family...~ Multi-Family Number of Bedrooms _ ¢;:Z_ Other WATER SUPPLY Individual Well..~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to Ihe legality and status. 4. 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. 72-025 (11/84) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DA~A 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. Name of Firm ~"'(~"':- ~ .;Z-~ (_'. Telephone Address 6. DHEP APPROVAL A~ed for ) bedrooms by Approved Disapproved Terms of Conditional Approval CAUTION ']-he 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 purchasers 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 7o (l?~ I11/R41 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARi~,iENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR I'IEALTH AUTHORITY APPROVAl, CERTIFICATE 1o General Infom~ation Application Date ,5/73 / ~ (a) Legal Description (include lot~ block, subdivision, section, to~zship, range) Location (address or directions) (b) Applicants Name ~J,:"].'~ ~[re..s'x Tele hone - Home Business Applicants Address ~? ;~ o, /3.o 6 °-; '/' ~>~','~,.c ~_~ ~ ..~ I~ I~.~ (C) Applicant is (check one) Lending Institution ~ ; ~ner/butlder ~ Buyer ~ ; Other [~ (explain); (d) Lending Institution ~,~~~____ (e) Real Estate Co. & Agent .... [~_~ ~- Address felephone (f) Mail the HAA to the following address: 2..3~Mp_e. of Residence Single-Family Number of Bedrooms 3. Water Su__~. Individual Well Multi-Family Other (describe) Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Note: If community well system, must have v~itten confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] E__n~ineerin_g Firm Providi_n_~_~nsp_~ectio~ Tests File SearcJ!z_~ata and Information As certified by my seal affixed hereto and as of the validation date shown below~ I w;rify 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 ~ith all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection° Name of Firm-- Address 1'~-OO Approved for Approved bedrooms Disapproved Conditional Terms o~ Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES ItEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGIL~PH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN TIlE STATE OF ALASKA~ TKE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN laEDERAL AND STATE REQUIRE- MENTS. 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° (DItEP SEAL) RR4/ej/D18 [Page 2 of 2] 7 -19-84 ACHEMICAL & :,GEOLOGICAL LABORATORIES OF ALASKA, INC. Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER [] PUBLIC WATER SYSTEM I.D.# ~RIVATE WATER SYSTEM Name Phone No. Mailin9 Address City State Zip Code SAMPLE DATE: ~ ~ ~ Mo. Day Year SA/M~LE TYPE: O' Routine .×E~ Check Sample (for routine .,;ample with lab ref. no. [] Special Purpose _) [] Treated Water .~Untreated Water SAMPLE NO. , LOCATIOf~ f 31 Time Collected Collected / By~,~ TO BE COMPLETED BY LABORATORY 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 via special delivery mail. Date Received Time Received Analytical Method: Membrane Filter * No. of colonies/lO0 mi. Lab Ref, No. Result* Analys~t' BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter: Direct Count Verification: LTB Final Membrane Filter Results BGB Date Time: _ Coilformll00ml Colllorm/100ml TNTC = Too Numberous To Count OB -'= Other Bacteria C~EMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ~]'E~-HONE (907) 562.23~3 ANCHORAGE INDUSTRIAL CENTER "'¢\~'~1 /'~-~-,', 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: ,, (*) See h on back I.D. NO. Mailing Address Phone No. CiW State MO. Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab reft no. j [3 Special Purpose Zip Code [] Treated Water [] Untreated Water SAMPLE NO, , l LOCATION r~c H Time Collected Collected By // ~¢ TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ,J~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 via special delivery mail. Date Received ,'"~"///- ~,-,J"~' Time Received /~--~,,,,~ ~ Analytical Method: [] Fermentation Tube ~"Mem brane Filter Lab Re~; No. Result' Analyet I ~ F-FI 0~-1220 (b) Re¥.1983 SACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE Membrane Filter. Direct Count Verification: LTB Final Membrane Filter Results Reported By__ -~' __ / BGB CoIH'orm/100ml / /Collform/100ml Time: / /)~C-~)~ ¢ a.m. COLLECTING SAMPLE I'NTC = Too Numerous To Count A4'Home Services 15900 Francesca Drive Anchorage, Alaska 99516 345,1890 * DATE DESCRIPTION CHARGES CREDITS BALANCE PREVIOUS BALANCE I If this statement does no t agree with your records p/ease notify us at once. S TA TEMEN T (~ Municipality of Anchorage 'cvo t$v.-q-13 Development Services Department g ~-.A~ % Building Safety Division On-Site Water and Wastewater Program ~ 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.a,.k, us (907) 343-79o4 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.. 020-113-t0 1. GENERAL INFORMATION Expiration Date: Day phone 345-9945 Day phone Complete legal description ~ Lot t7~ Block 8 Rabbit Creek Heights ' Location (site address or. directions) 8201 Robert Drive Current Propertyowner(s) Francien Burqess Mailing address 8201 Robert Drive, 99516 Lending agency Mailing address R6.al Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 2,-3.___~PE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class Well Public Water System [] Day phone, TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Certificates of Health Authority Approval (HAA) ba~ed 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 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 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. 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 Health Authority Approval Guidelines for this Heatth Authority Approval application 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 flies and from my investigation and inspection, the on- site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm .Pannone Enq. Svc. Phone _272-8218 Address P.O. Box 102954, Anch~ AK 99510 Engineer's Pdnted Name .Steven R. Pannone, P.E. Date 12/2612001 Engineers Comments; In conducting an adcquacv lcst, I attcmpt to providc a thorou.~ conscicntious ,- . n'~ ~cs ,~.. ~t.o..rca~z~yiecaufiablcfcaturcs. ThcoPcrauo~hf¢ofdlwcllsandscpfic~.stcmsdcpc~d "' a -,.,.~' o memca~souconamon, ground watcrlcvclsthatmavflucluatcduringthc).ear, andthcwalerusa~¢ofthc ~' ~.$' 49r. "~ % ~'~ ,- ~`~-~-~--~t~m~tm~re~r~?~Md~d~n.d~fcc~s~re~cr~chmms~PEScanth~r~e~t~mvid~anvwamm~ ~'~%$[even R. Ponnone/~:;~ [~r[uturcpcr]~rmanc~n~r~w¢am.~samat~fh~w~ngth~svs~mw~ntinu~tnm~"~t~h~n~.~"~`"~! ' · ?f~*.. No. CE 8149 A.n.Y re!la,cc UP°n or USC of thru rcport by any od]m' person or party is not authofi~,,cd nor ~511 it ~n£~ ~ le§a .......... '~' ngnt WnaLnocvcr. - "% ~ ,"~O'.~'~ 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for 3 bedrooms, with the following stipulations: $1500 to be placed in escro~ I:operform the work required to confor~ to Municipal code. Money in escrow shall not be released until this office gives ,k~.~;~ ~,'''; .... Additional Comments ,,~ c.,' .-' '-. X Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Expiration Date: .~. -. WASTEWATER ; . ~<'),. ,. ,' ~.. ~atnTenance Agreements Supplemental Enginee¢s RepoA Other Original Certificate Date: / ,~ - ~ "~- 6) / Reissue Date: Mu nicipality of Anchorage Development Services Depacb,,ent Building Safety Division On-Site Water and Westawatar Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage, ak. us (907) 343-79O4 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L 17, B8 RABBIT CREEK HI~ Parcel I.D.: ' 020-113.10 A. WELL DATA Well type PRIVATI~ Date complafed 12/3/1984 Total depth 89 ft Ifa, B, or C provide PWSID # __ Sanitary seal Yl~S casedto, 89 ff FROM WELL LOG Well LOg Y Wires properly protected ,YES Casing height (above ground), 36 in. AT INSPECTION Date of test 12/3/1984 12/4/2001 +2 Static water level +3 · ff ft Well produ~ion 5 WATER SAMPLE RESULTS: g.p.m 4,8 gp.m Coliform 0 colonies/100 mi Nitrate 1~01 mg/I Date of sample: 12/4/2001 Collected by: LRP SEPT~ClHOLDING TANK DATA Other bacteria ~ colonies/100 mi Tank Type/Material E ' Date installed ~ Tank size 1000 Cleanouts Y Foundation cleanout Y Date of I~umping 1Z/112001 Pumper A+ HOME ~;vc ABSORPTION RELD DATA Date installed ~ Boil rating (g.p.d./ft2 or ft2/bdrm) 188 Length 42 fl Width 12 fl Total depth 2.~ fl Effective absorption area ~04 ft;~ Date of adequacy test 12/4/2001 gal Number of ~omp~dments _2 Depression over' tank _N High wafer alaml NIA System type BED Gravel below pipe 0.5 ft Monitoring tube Y Depression over field N~ Results (PassJFail) PA,~ For3 bedrooms Fluid depth in absorption field before test DRY in Water added45.~.q0 gal. New depthDR'Y' in. Elapsed Time: 100 min Final fluid depth DRY in Absorption rate >= 450 gp.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO If yes, give date (Rev. 11/g~) D. LIFT STATION Date installed 'Pump on' level al Datum Size in gallons NIA ' in'Pump off' level at Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: in Septic tan~ift station on lot 108 Absorption field on lot 120 Public sewer main NIA Sewer Iseplic service line 103 Manhole/Access. High water alarm level at ~ in Meets alarm & circuit requirements? Building foundation 10 . Water main N/A Drainage 11)O+ Property line 1,~ Water service line 30 Wells on adjacent lots Absorption field 10 Surface water 100+ 1001- Property line, 10+ Water Service line 60 Curtain drain 100+ F. COMMENTS SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 30 Surface water 100+ Wells on adjacent lots 100+ Request Conditional Approval due to inability to Ret qravel to cover tank and Water main. NIA Driveway, parking/veh~e storage 60 G. ENGINEER'S CERTIFICATION I certify that I have determined through ~ld inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect or~ this date. Engineer's Printed Name Steven R, Pannone. P.E. Date 12-26-01 HAA Fee $. Date of Payment Receipt Number (Rev. 11/99) Waiver Fee $ Date of Payment Receipt Number SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: On adjacent lots 100+ On adjacent lots 100+ Public sewe~ manhole/cleanout NIA Holding tank 100+ · ~C-O?-Ol Oa:lIPV FI~V-CT~ ENVIR~eI~ENTAL SRV ~0~615~01 T-884 P.03/O] F-BZO ~ CT&E En~mn~nml Sewices Inc, _ .... .---- 2~ W. Po~ef Drive ~ohm~e. AK ~618-1805 D~ing Water ~atysis Repo~ for To~l Colifo~ Bacteria ?,,: ~7~ ~ I.~T~FCTIONS ON ~VE~E ~IDE ~EFO~ CO~'6 ~MYL~ Far ~ ~Y BEC in PUBLIC WATER sYSTI M I.D. ~10 PRIVATE: WATER S¥S'I EM s^MPL£ TYP£: j~ I!outlne 0 Repea~Sample(for~Utine sim~e ~lth lib eec no.~ - , ) C ~cclal Pu~ose EtlIIIJ Day Yam' [] Treated Water ~l~ tJntrented Water Ana viis shows thls Wa~cr SAMPLE to be; Sat~st'~:tory C~ ~plc ov~ 30 houm oI~ ~suhs 0 no~ be ov~ms old ~ to ~di~ ~hable ~sel~. rleaSC new s~ple vis ~Ki~ ~elive~ mail. Date ~elved I · ~ IZSO Time Received ~ ~alysls ~gan ~ ~ Ana1)~IcM MathS: ~M~bvane Fil:er ~0 MM~MUG · N~b~ ofco~ome~]~ Lib RtL N~ Rflult* Sent tO ~D.E.C. Ancb ~ Time Collected Colin;ted BA~OLOGIC~ WAT~ ~NALYSIS ~CO~ MMO-MtJG Rr, alt; TeIAI Cal~farm _ Membrane ~'ll~ert Dlre~ CoanI Vertflcatlnn: LIB __ Fecal Coliform Coaflrmetion flnel Membmn~ F1~er Client notified of unsatisfactory resulm: ,D f?nrd -- Spoke E. Ca~ . IIGB . COLIrI1L~! Coliform/1 O0 ml ~VII~Ot~M£NTAL FAL"IL/TIE$ Ih ALA$IUL ~ALffOt~A. FLORIDA. · OEC-OT-01 04:10P~ FR~I~CT&E £NVlI~f~ENTkL SlW 907E6153OT T-88~ P.OZ/O~I F-83~ CT&K Rer.~t 101S255001 Cll~t Name Pannone Er.[ Sty. Protect f~erm~ Lot 17 Bk 8 I~bbit ~k Ht~ Otent Simple ID ~'m~ S~3~ Mat~ D~ ~a,~ ~ed By PWSID 0 Sam?lc Rc'mnrks: Ni.'t~te.N CHeat PrinTed Daft/time 12/07/2001 10:04 Collected Dale/Time ] 2/0.~00 l R~v~ D~t~e IZ~3~O01 13:30 Tec~leal DIe,eel ~tep~ C ~de 1.01 0.500 log'1. EPA 300.0 (<10] 12,~3/01 SCL ii:Lc z~obA o"f og7 L-'~ o:'e t ot"y' Total Ct~ifo4'ra 0 col/I OOn-.L SMI$ 9222B (<1) 17.703/01 KAP Rabbit C k H ight Block 8 Lot 17 #020-113-, 10 Municipality of Anchorage Development Services Department Building Safet~ Division On-Site Water and Wastewater Program 4700 South Bragaw Street 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. 020-113-10 1. GENERAL INFORMATION Expiration Date: Complete legal description Lot 17, Block 8 Rabbit Creek HeLqhts Location (site address or directions) 8201 Robert Drive Current Property owner(s) Francine Burgess Mailing address 8201 Robert Drive, 99516 Lending agency · Mailing' address Real Estate Agent Mailing Address Day phone 360-O155 Day phone Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 ;~ :~ TYPE OF WASTEWATER DISPOSAL: [] IndMdual On-site []' r~ Individual Holding tank [] ~ Community On-site [] [-1 Public Sewer [] ~._._~TYPE OF WATER sUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well The MuniciPality of Anchorage Department of Health and Human ServiCes (DHHS) 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 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 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. (Rev, 11/S9) STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I redly that my investigation based on procedures outlined in the Health Authority Approval Guidelines for this 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 bedreoms and. type of structure indicated herein. I further vedfy 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 applicable Municipal and State cedes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone En.o. Svc. Phone 272-8218 Address P.O. Box 102954, Anch, AK 995'10 Engineer's Pdnted Name Steven R. Pannone, P.E. Date 12/~g/20~_- describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soii condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA. The content o£this r~port is £or the sole benefit o£ the o~vner tisted above. Any reliance UlXm or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. DHHS SIGNATURE ,-/' Approved for Disapproved. bedrooms. Conditional approval for Additional Comments bedrooms, with the following stipulations: ,., ([fllr~ ON-SiTE ~ . WATER AND ~ ' WASTEWATER PROG M ~j~)))))~ Attachments: HAA Checklist, Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Expira (Rev. 11/99) Odginal Certificate Date: Reissue Date: On-Site Water and Wastewater Program 470a South Bragaw Street P;O.' Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Legal Description: L 17, B8 RABB~'CREEK I~TS A. WELL DATA Well type PRIVATE Tota!depth,. 89 fl Date Of, test Static water level Well production WATER SAMPLE RESULTS: Sanitary seat YES Cased to 89 :ff FROM WELL LOG 12/311984 +3 ff 5 g;p.m . Nitrate f: LRP: ;KLIST · Parcel LD.: 020-113-10 Well Log -Y_ Wires prqperly protected '(ES +2: ff 4.8 g.p.m Other bacteria 0 colonies/10Oml Tank TYPe/Material -STEEL cleanouts Y, , ,: Dateof pumping C. ABSORPTION FIELD DATA Date installed 3/1511985 Soil rating (g,p.d~/ff2 or ft2/bd~r~r);188 Numbe~:.of Compartments 2 N High water a arm NIA System type BED Gravel below pipe 0.5 -fi Total depth 2.O ft Monito~'ing tube Y Depression over field N DateOf adequacytest 1ttt7/2002 Re~UE~'(Pass/Fail) .PASS For~_3 bedrooms Absorption rate >=460 g.p.d. If yes give date (Rev. 11 ~[ LIFT STATION Date installed "Pump on" level at Size in gallons NIA in'Pump off' level at Datum Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WEI~L ON LOT TO: Septictank/lift station on lot 108 Absorption field on lot 120 Public sewer main N/A Sewer/septic serviceflne-103 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK* ON LOT TO: Building foundation 10 Water main NIA Drainage 100+ Manhole/Access in High water alarm level at Meets alarm & cimuit requirernehts? On adjacen(:i4Ots. 100+ ?!~ On adjacent lots 100+ Public ~ewer manhole/cleanout N/A Holding tank 100+ Property line t0+ Water service line 30 Wells on adjacent tots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Absorption field:' 10 Surfacewater 100+ Water main N1A Property line 10+ WaterService line 60 Curtain drain .100+ COMMENTS Building foundation 30 Surface water 100+ Wells on adjacent lots ~00+ ENGINEER'S CERTIFICATION I Certify that ~[~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's Printed Name Steven R. Pannone, P.E. Date HAA Fee $ Date of Payment Receipt Number (Rev. 11 in Driveway, parking/Vehicle storage '60 Date,, of Payment Receipt Number CT&E Environmental ,',',',',',',',','~ rvices Inc. CT&E Ref,# Client Name Project Name/# £1ient Sample Matrix 1027925001 Paanone Eng. Sty. Rabbit creek Hei~lats L17:B8 Rabbit Creek Heights Drinking Water PWSlD 0 Sample Remarks: Parameter Results Nitrate-N Microbiolo~p/ Labora=orr Total Colifom~ 0.994 Alt Dates/Times are Alaska Standard Time Printed Date/Time 11/22/2002 9:36 Collected Date/Time 11/I 8/2002 10:00 Received Date/Time 11/19/2002 13:10 Allowable Units MethOd Limits Date Date Init 0.200 mg/L EPA 300.0 I 1/20/02 JS eol/lOOmL SM18 9222B (<=1) 11/19/02 KAP CT&E Environmental Sewices inc. Laboratory DivisiOn ~,~- --r, ~-,~4r~,,~,~r4r. - 200 W. Potter Drive Drinking Water Analysis Report for Total Col{form Bacteria ^.~hor..,,. ^K *~,.~ 6os Tel: (907) 562-2343 READ INSTRUCTIONS ON REP'ER~E SIDE B~FORE COLL£CTING S,4MPLE Fax: (907) 561-530t MUST BE COMPLETED BY WATER SUPPLIER PmVATE WATER SYS~M . , C;~ ~. 4 . Day Year SAMPLE TYPE: CI Routine ~I Treated Water Repeat Sample (for routine sample ~ Untreated Water with lnb tel un, ) BA~E~OLOGICAL WATER ~YSIS ~CO~ MMO-MUG Result: Total Coliform Membrane Fli~er: Direct Count Verification: LTB Fecal Coliform Confirmation Analysis Began TO BE C(~MPLETED BY LABORATORY Analysis shows this. Water SAMPLE to be: Satisfiwtory ~ Un~ti~actory fl ~pl~o~ 30 hom old, resul~ ~y , ve, unre~ame S~plomo t~g ~ U~sit; s~ple should not ~ ~ou~ old. at ~inafion to indicate reliable r~ults. Please new sample ~a ~cifl deliv~ Analytical Method: ~embrane Fitter 'o MMO-MUG lO ml. 1027 1P_.5 Res... .al st Sent ~ A.D.~C. ~nch Fb~ Jun ~ Faxed Time: Client notified of unsatisfactory results: Pbone~ Spoke wRh Faxed Date: T~me: /~ __ Coloni'e~100 mi BGB _. COLIFIRM Collforra/100 mi Time Final Membrane Filter Results (~ ~ Member of the $Q8 Groul~ (Soci6t~ G6n&rale de Survalltanml 3A 18A 19A LEGEND ~( Recovered ~/8" rebar monumem 518~ zebar mormmeaat with oramg¢ plastic cap marked "Municipality of Anchorage 2002' (Re~:t) per proposed Replat Found 5/8' Rebar (Not Orginal~ Not Us~ ~orated) 17A o 33,729 o 8f o 16A 15A ! 1Z o 25A 26A N 0 TES 1. This propofly is wi~in tho MunioipalRy of A~ohorago's Spocial Smvoy Assmsm~nt Distri~ IV96, whi0h was formed to mot plat and survey orrors within Rabbit Cr~k View mad Rabbit Cr~k H~ights Subdivisions. A Complaint and proposed Replat w~-e filod wi~ thc Superior CouR in D~unber, 1998 (C'etil A~on No. 3AN-gg-l1718)~ 2. Monumant locations shown a~ aooording to tho reh-aoem~mt survey poffotmod by Ke, au and Associates for the Replat in 199%98. 3. Property linc locations shown am pcr fl~c proposed Rcplat and wcrc determined using found monumant locations and lho intent of the original plat. ~he monumcats have bccn set. Lots (A) and Blocks (V): The identifier 0 represents tho "Rcplaf' n~ming convention. 4. Signifwantplaterrorswerefoundonthcoriginalplat(P70-3gl). Th~soerw~swercanalyzed and the d/mens/ons ~djusted to obtain ~ho intended rep~en~fion of the lot, shown herocn es (R~C). Lot 17 Block 8 Rabbit Creek Heights Subdivision to be re-designated pending Final Judgment, Civil Action No. 3AN-98-11718 Lot 17A Block 8H Rabbit Creek View and Rabbit Crk Heights Subdivision Replat KEAN & ASSOCIATES 1" = 80' 6927 Old Seward Hwy, #101 yam I~^ ~. Anchorage AK99516 12-18-02[ 3340 5/8" rebar monumem with orange plastic cap (R) Record Information, P713381 (R-C) Computed from Record - See Note 4 (R~loO per proposed Replat 1. This property is within the Municipality of Anchorage's Special Survey Assessment District 1V96, which was formed to correct plat and survey errors within Rabbit Creek View and Rabbit Recovered 5/8" rel0ar monument Creek Heights Subdivisions. A Complaint and proposed Re'plat were fried with the Superior R, rr'~.0~o%J~a.;;~[ · ..l,,~3.~dlv.,lflami~pCourtinDecember, 1998 (CivilAcfionNo, 3AN-98-11718). 2. Monument locations shown are accortYmg to the retracement survey performed by Kean end Associates for the Replat in 1997-98. 3. Property line locations shown are per the proposed Replat and were determined using found monument locations and the intent of the original plat. The monuments have been set. Lots (A) and Blocks (V): The identifier 0 represents the "Replat" naming convention. 4. Significant plat errors were found on the original plat (P70433). These errors were analyzed and the dimensions adjusted to obtain the intended representation of the lot, shown hereon as (R-C). I hereby certify that I have surveyed the property and facilities described hereon and that the improvements situated thereon do not encroach on adjacent property, that improvements on adjacent property do not encroach on the surveyed premises, and that there are no other visible easements or rights-of-way, EXCEPT AS SHOWN OR NOTED lql~ON. RobeRT. Kean, I~L.S. 3943-S No data hereon should be used for positioning additional stntctures, for building fences, or for locating the boundary lines. It is the responsibility of the owner to determine the existence of any easement or restriction that does not appear on the recorded subdivision plat and to verify that all improvements meet all subdivision covenants and zoning ordinances. ~-~"As- ilt" Rabbit Creek View Subdivsion to be m-designated pending Final Judgment, Civil Action No. 3AN-98-11718 Lot 2A Block 5V Rabbit Creek View and Rabbit Crk Heights Subdivision Replat KLEAN & ASSOCIATES 1" = 6927 Old Seward Hwy, #101 nam I~ Anchorage AK 99516 11-06-02[ 3340 ~UqAN !Cir. 25 24 ~ 2.3 22 U ~'lity E=mt. Bk 200 3 Ut, ILy ~n~ Bk 200 Pg UUIIty Esmt. Bk 20~ Pg 396 4 t6 Bk491 F L Scale: 1"=150' prepored by Kean · Associates 14-510 Ahtene Circle Anchoroge AK T~;~, 545-2098 F'~x ~k5--6~,7 INTERIM 99516 'Y,, FINAL I Date: ~,~/_~_/98 under conl:roct with Municipality of Anohor~e P.O. Box 196650 Anchorage AK 99519 c/o Tom Knox 343--81!6