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HomeMy WebLinkAboutDENALY BLK 1 LT 25benaly Block 1 Lot 25 #067 - 062 - 05 Anchorage Municipality of Development Services Department Building Safety Division• On -Site Water & Wastewater Program, 4700 South Bragaw St. . QP.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 On -Site Wastewater Disposal System and!or Well Inspection Report SW010298 PID Number. 067-062-05 __ =e of 3 Permit Number. Nome: CARL KAPPEN & ASSOCIATES Wastewater System: III New 0 Upgrade Address: 17034 EAGLE RIVER LOOP ROAD • EAGLE RIVER. AK 99577 ABSORPTION FIELD Phone: No. of Bedrooms (907) 622-5585 3 0 asp Trench ■ Shallow Trench 0 Bed Otbund OOUIer LEGAL DESCRIPTION Soil Ronny 1.0 cvvne. n. Told Depth *meate . al peeve 5.0-7.0 rt. Lot: Block: Subdivision: 25 1 DENALY Dopa b pie bottom wan original t►.dw 0.81-2.81 n. Grovel ..pat be.oe. pipe 4.19 n• Township:_Range: — Section: ended arm— Fi ended ergine) draft b SEE DWG. n. Gm., length: 60 rc WELL: ■ New O Upgrade Good'WU' 5 n. Number of row 1 Debra bete.., rrw — rt `a'dnooton &nNmb. AB.D); PRIVATE tidal Depth: 181 n. const To: 180 n. Told ae.a`Won stew 600 so. n t3034/ F-81 D Dry.; M—W DRILLING Dab Dried 8/24101 statist Motor fwk 8 n. le JONES EXCAVATING Dat. Halla: 8/8/2001 Tod: 50 CPU Pura Sot At (c.sng rrlpht Mev. GraYIQ UNKNOWN n 2 n. TANK SEPARATION DISTANCES ■septic CI Holding 0S.T.EP. OOther To From Septic Tank Absorption Field Litt Station Holding Tank Pubic/Pre/tato�"'rOCu1e'' Sower Linn ANCHORAGE TANK Capac� b � 1250 Well 100'+ 100'+ — — 25'+ lfat«,ot STEEL Number d 2 Surface water 100+ 100'+ — — — LIFT STATION b tA..dacbpr: Lot Une 5'+ 10'+ — — — s . Soewrw Foundation 5•+ 10'+ — — — 7..° on in on —Puny air ab MSwetr Nam et: Pump Make D.ctrlstd Inspections performed ,. by. Curtain Drain NONE KNOWN Remarks: —SEPTIC SYSTEM SIZED FOR 4 BEDROOMS BENCH MARK Location end D..onptbw BOTTOM OF SIDING 0 POINT "A" Ae.mw F'.n tom 106.24 ,. ENGINEERS SEAL .00604 •: 0 o P OF op ii Il Inspections performed by AWWC, INC. Dates: 1st 8/8/2001 , 2nd 8/8/2001 1 3rd 8/8/2001 DO ' f y A. • • ess. Department of Healtp end H an S i approval �p'�, ' °o • E-7953 ,.• •4 oc/ A /- 014/02 Reviewed approved by: Date �o �0 p�oreee10 0 € • and (e«. ,Lac) 'k0000ooa PERMIT NUMBER: SW010298 AS -BUILT DRAWING PARCEL ID NUMBER: 067-062-05 APROXIMATE LOCATION OF KENNETH HOM. LE / 99E 29. E. ALTERNATE SITE ST1 45.80 14.80 ST2 48.12 20.36 DBL1 50.50 24.05 OBL2 50.87 25.61 CO1 74.08 71.60 MT1 74.43 72.60 CO2 21.72 47.13 MT2 22.46 49.48 1 • 1 1 i T NEW WELL / 1 / 1 \ / 1 \ / / i \ / / 1 \ 7 1 N / / i / 1 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6001 DFRARR ROAD. SUITF 2R • ANCHOPAGF. AK 90S01. • PHDNF (007)331.6170 • FAX (001)336.31176 DATE: 12/14/2001 DRAWN BY: C.J.G. SCALE: 1-40' 'REPARED FOR: PHONE NUMBER: CARL KAPPEN & ASSOCIATES (907) 622-5585 .EGAL DESCRIPTION: DENALY SUBDIVISION; LOT 25, BLOCK 1, • PAGE NUMBER: 2 OF 3 TYPE OF WORK: AS—BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM LOCATION Co e 1. PERMIT NUMBER: SW010298 AS -BUILT DRAWING PARCEL ID NUMBER: 067-062-05 TOP OF TANK A INLET • 99.81 INSULATION ir FINAL GRADE • 103.56-104.04 INVERT OF BUNG AT INLET • 99.25 TOP OF TANK AT OUTLET in 99.86 94ERT OF BUNG AT OUTLET - 99.09 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 690 OFRAPR ROAD. SURF 7P • ANCWORAGF. AK 9050L • PHONF (907)1374179 • FAX (007)358.3766 PREPARED FOR: PHONE NUMBER: CARL KAPPAN & ASSOCIATES (907) 622-5585 DATE 12/14/2001 DRAWN 8Y: C.J.G. SCALE: N.T.S. PAGE NUMBER: 3 OF 3 LEGAL DESCRIPTION: DENALY SUBDIVISION; LOT 25, BLOCK 1, TYPE OF WORK: PROFILE AS—BUILT DRAWING OF NEW SEPTIC SYSTEM ess. -7953 °gid • 6 �40000 ejr'o fessiol± Extended Page 1.1 M -W Drilling, Inc. .P.O. Box 110378 *Anchorage, AK 99511• •907-345-4000 • 907-345-3287 Fax• Groundwater Well As -Built & Log *Well Owner: Kappen, Carl (Kappen Homes) • Legal Description: lot 25, Block 1 Dena!), Subdivision Eagle River, Alaska Job No.: 01-187 Permit No.: 5W010298 Project No.: N/A •Use of Well: Domestic Construction • hole Depth: 181' • Casing Size: _ • Cased To: 180.34' *Drill Method: Air Rotary • Material: A 53 Steel Peri • Well Completion- Open end X Screen Perforated _ Method: • Screen/ Perforation description: None *Groat Notes: (61/i) Sacks- No. 8 bentonite granules • Well Development: Method: Air surge Notes: • Static water level (SWL) 8± (above) (below) top of easing (TOC). • Wei lyield test at 50 gallons per minute(GPM)/ for 1 hours with 100% of drawdown (DD) from static level (SWL). •Method: Air lift: well flowing at 20 gallons per minute over the TOC. • Date of completion: 24 August 2001 •Pump Install: Depth In feet from top casing. Details of formations penetrated, size of material, color and hardness. of 0 TO 2 Casing stickup Gravelly silt with top soil: brown Silty sand Sitly, damp 2 TO 6 6 TO 33 33 TO 42 sandy,gravel: silt: dry and 42 TO 68 Gravelly gray 68 TO 158 Clay: dry and gray 158 TO 170 Gravelly clay Water bearing 170 TO 181 gravel TO TO `• TO _.-- — TO - TO ---- - --WAWA-Certified -Contractor • 7/g) gitrwt MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM 1 WATER SUPPLY PERMIT Initial Permit Number: SW010298 Legal Description: DENALY BLK 1 LT 25 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: Carl Kappen Owner Address: 17034 Eagle River Loop Rd Eagle River , AK 99577 - Date Issued: Aug 03, 2001 Expiration Date: Aug 03, 2002 Parcel ID: 067-062-05 Site Address: Lot Size: 40658 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: j Disposal Field Q✓ Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. PRIOR TO CONSTRUCTING THE WATER WELL, THE WELL DRILLER SHALL SUBMIT A DRILLING PLAN TO THIS OFFICE. THIS PLAN SHALL SHOW HOW THE WELL CONSTRUCTION WILL PREVENT ALL LEAKING AROUND THE CASING ANNULUS FROM THE CONFINED AQUIFER. Received By: Issued By: Date: Date: 5/ (o/D! S/3/0/ Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cianchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Q Parcel I.D. o -7 -6a -0 (O Co 5 Permit Number O Z� V Property owners) CARL KAPPFN Day phone 672-2719 Mailing address (1) 17034 EAGLE RIVER LOOP ROAD • EAGLE RIVER. AK Mailing address (2) Zip Code 99577 Legal description (Lot, Block & Sub'd.) LOT 25. BLOCK 1: DFNALY SUBDIVISION Legal description (Section, Township & Range) N/A Lot Size 4/0 5 g Acres/Sq.FL Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only 0 Well Only 0 Sewer and Well 1 Water Storage 0 Sewer Upgrade 0 THIS PROPERTY CONTAINS: Hot Tub 0 Jami 0 Swimming Pool 0 Water Softening Unit 0 Therapy Pool 0 I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS, INC. Permit Fees•.` Li 4 0 • 00 Waiver Fees* Date of Payment S j a 10 1 Date of Payment Receipt Number. 81 aq Receipt Number. ALASKA WATER Fr WASTEWATER August 1, 2001 ��- CONSULTANTS, INC. Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 South Bragraw St. P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well and Septic Design for Lot 25, Block 1, Denaly Subdivision To whom it may concern: The proposed 3 bedroom house will be served by a private well and septic system. A test hole was excavated on the property. The proposed septic system will be designed around the 30 foot radius of test hole. We are proposing that a 1000 gallon septic tank and a five foot wide drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that the insitu sandy soils should act as a sand filter and that an application rate of 1.0 gallons/day/ft2 should be used. 2. TRENCII DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 1.0 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 450 ft2 f. Total Depth: 7 feet (max.) g. Effective Depth: 4.0 feet h. Width: 5 feet i. Reduction Factor: 0.50 i. Minimum Length: 45 feet long j Effective absorption area = 450 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 Fax: (907) 338-3246 Website: akwwc.com 4. TOPOGRPHY: As can be seen on the attached topography site plan, the average topography in the area for the proposed drainfields ranges from is a 5 to 20 slope running from approximately east/northeast to west/southwest. There are some small slopes that range from 25 to 33 percent adjacent to the proposed drainfields; but we due not anticpate any slope concerns. The trench is to be installed parallel to slope contours. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincere e fr; t amess, Presi .E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soils log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B • Anchorage, AK 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com PROPOSED 3 BEDROOM HOUSE (APPROXIMATE LOCATION) PROPOSED SEPTIC SYSTEM (SEE DESIGN, PAGE 2 OF 2) PROPOSED NI KENNETH DUFFUS, P.E. TEST HOLE ALTERNATE SITE • \ i % % / / DENALY SUBDMSION LOT 24, BLOCK 1 100. 1 PJ,�,xrtC VOS DENALY SUBDMSION LOT 6. BLOCK 1 DENALY SUBDMSION LOT 7. BLOCK 1 �- -tea EAGLE RIVER GREENBELT v DENALY SUBDIVISION LOT 22, BLOCK 1 ALASKA WATER & WASTEWATER CONSULTANTS. INC. 6001 0ERARP ROAD. SUITE ER • ANCHORAGE. M 99501. • PHONE (907)337-6179 • FAX (907)336-3?46 DATE: 8/1/2001 DRAWN BY: SCALE: 1" = 100' PREPARED FOR PHONE NUMBER: CARL KAPPAN & ASSOCIATES (907) 622-5585 PAGE NUMBER: 1 OF 2 LEGAL DESCRIPTION: DENALY SUBDIVISION; LOT 25, BLOCK 1 TYPE OF WORK: SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM ere .��•U.•gS`'jI NOTE: THE TANK IS TO BE 5+ FEET FROM FOUNDATION AND THE DRAINFIELD IS TO BE 10+ FEET FROM FOUNDATION. PROPOSED WEU- PROPOSED ELL APROXIIMTE LOCATION OF KENNETHTEST HOLE / 9.E 9529 PROPOSED ORAINFIELD. EXCAVATE A TRENCH THAT IS 5 FEET DEEP (MAXIMUM). BY 5 FEET WIDE. BY 45 FEET LONG. ADD 3 FEET OF CLEAN. WASHED. SEWER DRAINROCK. ALTERNATE SITE INSTALL FOUNDATION CLEANOUT PROPOSED 1000 GALLON SEPTIC TANK INSTALL DOUBLE CLEANOUTS DATE: 8/1/2001 DRAWN BY: J.L.M. ALASKA WATER & WASTEWATER - C NSULTANTS. INC. 6901 DE8ARR ROAD. SUTE SO • ANCHORAGE. AX 9950. • PHONE (907)557-6179 • FAX (907)3584246 1 " = 40' PREPARED FOR: PHONE NUMBER: CARL KAPPEN & ASSOCIATES (907) 622-5585 LEGAL DESCRIPTION: DENALY SUBDIVISION; LOT 25, BLOCK 1 PAGE NUMBER: 2 OF 2 TYPE OF WORK: DESIGN FOR PROPOSED WELL AND SEPTIC SYSTEM lb ALASKA WATER & WASTEWATER CONSULTANTS.• ---- 6901 DUMP ROAD. SURE 79 • 114C1100AiCE. M. 99504 • PHONE. (9071137-6179 • FAX. (907)136-3246 • NE95RE: •k••c••.. ISOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: DENALY SUBDIVISION; LOT 25. BLOCK 1 PERFORMED FOR: CARL CAPPEN & ASSOCIATES (i et ESE ORGANICS • 1 •^..•t•, II •GP/SP 2 ••'.r. '••` ••..•••1 •.• .•,. 3 �••:.••••• •••••••• • ••• :••••• 4 .10:••• 5 J.▪ •. • .•. ..:.1 ••:es* 6 ▪ •.••000. .•:gee . 1••••••• 7 —••.• •• • •:.•.•:•• 8--••.:.. • •:•• • 9 _•'• •': •••••••• lo -17.1. .; .• ••.•.•1 •.:.o .0 11—•••:.•• •; .•. •. •. •• 12—••.•. ••4 ••• •l 13�• ▪ ...•. ••••••• •....•. 14 ••, •'••1 B.O.H. 15- 16 — 17 — 18- 19 — 20 COMMENTS: THE INSRU SANDY SOILS SHOULD ACT AS A SAND FILTER. PERCOLATION TEST PERFORMED BY CALEB GALL SP TEST HOLE #1 SOIL CLASSIFICATIONS 7 GW GP GM GC SW SP SM SC DATE: 7/23/01 ORG ML CL OL MH CH OH DEPTH TO GROUNDWATER DATE DRY 7/23/01 DRY 8/1/01 DATE READING CLOCK NET TIME TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) NS G OP LEPRo:M o' PCE 1 PERCOLATION RATE <1 (MIN /INCH) PERC. HOLE DIA. 6' (INCHES) TEST RUN BETWEEN 5.5 FT. AND 6.0 FT. PERFORMED BY ALASKA WATER & WASTEWATER I, JEFFREY A. GARNESS, CERTIFY THAT THIS pERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE: 8///of Sent By: .F ROBERT BELL AND ASSOCIATES; 007 272 7531; 'L��.1�Y _ D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 G.. _..__:`............:. _,.�..—_—"F—_.�._.._..... orb ail Apr -7-00 8:59; Page 39/39 + • ttiy i 491.4 tit e m. us IRS 116 bti r 4 SD `_:Or Date Performed• 4/23/99 SOILS PERCOLATION TEST Performed for. F. Robert Bell df Associates Project: 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - Depth (Peet) bol McIntxre TEST HOLE N Lar 257 So.aCL I1 Qc,'W ,l ORG — soft, black, moist SM—stiff w/cobbles moist SP- Med dense gravelly silty sand gray, moist (3'-6') slightly gravelly B.O.N. HOLE PRESOAKED PRIOR TO PERCOLATION TEST S/p 99-29 SEE ATTACHED SITE PLAN FOR HOLE LOCATION WaaCroundwater encounters& Yea Depth to wean after monitoring? 9.8' t 13' Date? 5/15/99 Reading Date Gross Time Net Time Depth to Water Net Drop 1 4/23/99 3:00 - 8" - 2 3:10 10 min 514/16" 2 2/16 3 • 3:11 - 8' - 4 3:21 10 min 6" 2" 5 322 - 8" - 6 3:32 IO min 6 1/16" 115/16" 7 • 333 - 8" - 8 3:43 10 min 6 1/16" 115/16" 9 3:44 - 8" - 10 354 10 sun 6" 2" 11 3:55 - 8" - 12 4:05 10 min 6" 2" • • Water Added Percolation Rate 4.9 (min/in) Pere Hole Dtamete 6" Test Run Between 3.5 feet and 4.5 feet 1, Kenneth M. Duffus, certify that this test was performed In atwrdance with all State and Municipal guidelines in effect on this date. -�- S - -- {- f -e ct 1 S tog 4- S c..n • 11/40 e s'- s" 8• G- ot.• o2 Ql2-O ,iJD '7/Io/0l. (' Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# Parcel I.D. 067-062-05 1. GENERAL INFORMATION Expiration Date: / / " .S' 0 3 Complete legal description DENALY SUBDIVISION; LOT 25, BLOCK 1, Location (site address or directions) 25524 DENAINA DRIVE * EAGLE RIVER, AK 99577 Current Property owner(s) JANA CHATHUM Day phone 694-1184 Mailing address 25524 DENAINA DRIVE * EAGLE RIVER, AK 99577 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 1111 Individual On-site 211 Individual Water Storage 0 Individual Holding tank 0 Community Class Well 0 Community On-site 0 Public Water System D Public Sewer 0 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 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 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 samples. (Certificates may 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. Note: Alaska Water and Wastewater Consultants, inc. shall be paid $ at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by. my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. Phone 337-6179 Date 7/ 31103 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Ur �`�� .• x'•50 • ON-SITE •;56- bedrooms, with the fllowing stipulations WATER AND m WASTEWATER PROGRAM a •• �. J 1 Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Man itenance Agreements Supplemental Engineer's Reort Other (Rev. 12/01) Original Certificate Date: 8 - .5-- n 3 i l':unici aii y o nch r g' v kopmen Se tc s ,R a t e t Building Safety Division On -Sits; Water &Wastewater Program 4700 South Bragaw St P.O.Box 1.96650 Anchorage, AK 99519-6650 • www ci.anchorage ak us (900`349 79©4 HEALTH;: AUT# ORITY APPROVAL" CHECKLIST DENARY SUBDLVISION, LOT 25r BLOCK•" i. Parcel 10 067-062-05 )'=sDATA *WELL LESS :THAN 2 YEARS OLD {ape PATE If A B or C� provide,PWSID# �A Well Logy: {YIN) YES •remptete f 8/24/2001 :Sa Jtaryseal (Y/N) YDS Vltiresproper# prt�tected (Y/N) YES Depth 1`131 ft Cased.to 180 . ft Casing l etght (above grouted) 24+ In. Coliform colonies/100.i 1 litraf rng':....1!.;',7..,.,/L Other bacteria ��ibcolonies/i00 ml.: Arsenic N A mg./L.Date of sample 7/22/2003 Collected by < AKWWC, INC SEPIt /HOLDING TANK DATA ank size• {1250 gat " Number of Compartments_.2 oundation cleanout. (Y/N) YES,; Depress on over tank(Y/NN bate iinstalled: Cleanouts (Y/N) High: water alarm (Y%! JR: '>5..;PUMP.ING ::::. I>tBS '0' DASA l"BELOW DOSINGGRADEI Aate trtstalled8/8/2001 Sotl ratfn9 s p d4 •r ftz/bdrm) 1 0 System type TRENCH t 4ngl "60 . Width 5 ff Gravel•belo.W pipe 4.19 ft . Total depth '!:6-5':f!...•*,. Eff absorption area 600 ft2 Monitoring tube YES 131epression over field NO Qate osf adequacy test **.NEW Results (Par. ss/l=ail) 'PASSFor ***4 bedrooms. Fluid depth in absorption field re befotest in " Water added gel clew depth ;. i Elapsed -Time —min Finatfluid depth Any re}uuenation tre•atment (past 12 mo { (YIN & type) t**4SYEPTIC SYSTEM ESS ThLAN 2 YEARS OLD SRT?. 4v SEPTiC:'SYSTEM ;;SIZED :FOR 4 : BEDROOMS Absorptionrate NONE -KNOWN • If yes give date D: LIFT STATION. Date:installed:. Size in;gallons... - Mannofe%Ac .. "Pump: on" level at in 'Pumploff' in..; High water alarmlevel at Datu Cycles tested Meets alarm & circuit requirements? E. SEPARATION'. DISTANCE$'.. SEPARATION DISTANCES FROM WELL ON LOT TO Septictank/Iift station on lot 1 00'+ On adjacent Tots: 100'+ Absorption field on lot 1 00'+ On adjacent Lots 100'+ Public sewer main . • ..N/A ' 'P:ublic•sewer manhole/cleanout N: Sewer'/septic, service line 25'+ :• Holding:tank `' N/A' SEPARATION" DISTANCES FROM SEPTIC/HOLD:ING TANK ON LOTTO :. Building foundation 5'+ Property line' N Absorption field 10'+ Water main N/A Water.service line Surface water 100'.+: Wells' on adjacent lots 100'+• SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO Property line: 10`+ Building foundation 1' 0'+ -Water main-. N/A Waterservice line 10'+ Surface water 100`+ Driveway;" parkinr9/vehicle'storage ': '10'+: Curtain`drain' NONE KNOWN Wells on adjacent lots '1'00'+ F. COMMENTS G::ENG.IN EER'S"CERTIFICATION. ,Icertify that! have determined through field inspections and review of Municipal records that the above systems are /m. conformance with. MOA HAA guidelines in effect on this date Engineer's Printed Name : JEFFREY A'.;LARNESSh Date 7� 'I f Q • • ,7 . i • ••. ••= 1. ff 40 y: C. F°A y....... ss HAA Fee $ . 375 • Date of Payment 2 • 51. o-3 Receipt Number 39 9 2 l (Rev. 12/00) Waiver Fee $ Date of'Payment' • 'Receipt -,.Number` ` PROM : Fleming Surveying Servlce5 E$X 111. : 90? -243 4090 Jan. U. £tit 11:4141 PI Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw SL 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 HAA#I o2On/h Expiration Date: 4//4/0 2 Parcel I.D. 067-062-05 1. GENERAL INFORMATION Complete legal description CDENALY SUBDIVISION; LOT 25, BLOCK 1 Location (site address or directions) DENAINA DRIVE • EAGLE RIVER, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address CARL KAPPEN & ASSOCIATES Day phone 622-5585 622-5585 Day phone AUDREY MASON w/ REMAX PROPERTIES Day phone 694-4200 16600 CENTERFIELD DRIVE • EAGEL RIVER. AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 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 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. (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. 975.•" Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $.Z1z2S:BO at, or prior to closing for the engineering services provided. 4. 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 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD. SURE 2B * ANCHORAGE, AX 99504 Engineer's Printed Name JEFFREY A. CARNESS, P.E. Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory (Rov.12V1) rde72?4 Date IIB/02 bedrooms, with the thawing stipulations: 1/40P \SYIOF4A, ••. t•, •• ON-SITE •• dr - V.= WATER AND ' me : WASTEWATER: re 11- PROGRAM • Manitenance Agreements Supplemental Engineer's Reort Other WASTEWATER/wATERIvEtt 2Air/Pre/Mu REPORT Original Certificate Date' 1//4/O2 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.d.enchorage.ak.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description* DENALY SUBDIVSION; LOT 25, BLOCK 1 Parcel ID: 067-062-05 A. WELL DATA Wen type FATE If A. B, or C provide PWSID# N/A Well Log (WN) YES Date completed 8/24/01 Sanitary seal (Y/N) YES Wires properly protected (YIN) Cased to 180 ft. Casing height (above ground) 24+ in FROM WELL LOG AT INSPECTION Date of test 8/24/01 Static water level 8 ft. ft• Wen production 50 g p.m g p m WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.493 mgJL. Other bacteria 1 colonies/100 mi. Arsenic: 0.001 mgJL Date of sample: 1/3/02 Collected by: AWWC. INC. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date installed 8/8/01 Tank size 1250 gal Number of Compartments 2 Cleanouts (Y/N) YES Total depth 181 ft. YES Foundation cleanout (WN) YES Depression over tank (WN) NO Date of pumping NEW Pumper C. ABSORPTION FIELD DATA aTit•:.sr [eliWA »0Nt.Y 3 BEDROOM HOUSE Date installed 5/8/01 Son rating e.p.d '►•rfttbdrm) 1_0 System type SHALLOW TRENCH Length 60 ft. Width 5 ft. Gravel below pipe 4.19 ft. Total depth s.0-7.0 ft Eff. absorption area 600 it Monitoring tube YES Depression over fletd $10 Date of adequacy test NEW Results (Pass/Fail) — For•=4 bedrooms Fluid depth in absorption field before test — in Water added=gal. New depth =in Elapsed Time: = min. Final fluid depth = in. Absorption rate >_ — g p.d. High water alarm (YIN) N/A Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/ "Pump on° level at in. *Pump off' r . _ n High water alarm level at in. Datu • Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lif station on lot 1 0O'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service Zine 25'+ Holding tank On adjacent lots 100'+ On adjacent Tots 100'+ Public sewer manhole/deanout N/A N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 5'+ Absorption field 51+ Water main N/A Water service line 101+ Surface water 1001+ Welts on adjacent Tots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 101+ Water main N/A Water service line 101+ Curtain drain NONE KNOWN F. COMMENTS G. ENGINEER'S CERTIFICATION Surface water 100'+ Wells on adjacent lots 1001+ 1 certify that 1 have detemdned 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 P ' iame Date44b7— JEFFREY A. GARNESS Driveway, parking/vehide storage 10'+ HAA Fee $ 375 . Go Date of Payment / 7 -0 a Receipt Number a/ Val) 9 (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number