HomeMy WebLinkAboutDENALY BLK 1 LT 21Densly
Block 1
Lot 21
#067 - 041 - 27
�_'`''
' Municipality of Anchorage ;'^'
.4 b' Development Services Department ria
l:
– j Building Safety Division
''
- - - On -Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.cl.anchorage.ak.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW010200 PID Number: 067-041-27
Name:
Masterpiece Homes. Inc.
Wastewater System:
0
New
•
Upgrade
Address:
PO Box 773471, Each River. AK 99577
ABSORPTION FIELD
Phone: Nunn` of Bedrooms:
0 Bee 0 Mona 0 Otter694
7390 5
O DeepTrenchTr«rth ®Shallow Trench
LEGAL DESCRIPTION
Sol Rang:
1.2 GPD/F12
total Depth Wan original wade:
7 Fl.
Block: Lot Subdrvnnn:
1 21 Denary
Dept to pipe bottom Warn original grade:
2.98 Ft.
Gravel depth beneath pp*:
4.01 FL
Towmahp: flange: Becton:
Fa added above original grade:
2.22 FI.
Gravel Length:
63 FI.
Number Ines:
Distance between ansa:
NA FL
Well: 0
New • Upgrade
Grevel rvpth:
5 Ft.
or
1
Caas.twon (Private. AB, CC
Private
Total Depth:
201 Ft.
Cased to:
201 FL
Tate) sbsaWon ena:
630 Fr
Pigs Matenat:
D3034 & F810
Neer
M -W Drilling, Inc.
Date paled:
913/2001
Static Water Level
4+/- FL
Installer.
Eagle Mountain Excay.
Date installed:
10/25/2001
Void:
35 GPM
Pump Set at:
unknown FL
Casa/ Haight Move Grand.
2 FL
TANK
SEPARATION DISTANCES
•_ Septic • Holding • S.T.E.P. El Other.
kr
To
From
Septic
Tank
Absorption
Field
Lin
Station
Holding
Tank
Public/Private
Sewer Line
Manuraqu«:
Anchorage Tank
Capacity: 1500 Gat.
Wed
1001+
100'+
NA
NA
25'+
Weenie:
Steel
U
N anbe wrAnpOM d.:
2
1001+
100'+
NA
NA
LIFT STATION
Lot Line
Lot
51+
5'+
10'+
NA
NA
Sete:
Gal.
Gal.
Manufacturer:
FaaMatan
5'+
10'+
NA
NA
'PumpSize. °" 'PSI at:
In.
'Pump °� le
In.
HO WSW SUM at
lo.
Curtain igen
NA
*501+
NA
NA
""'° Make a Model
Inspections pMamed by:
'none known
'none
BENCH MARK
Location and Dssc pbon.
bottom of patio door sil
Assumed tevabon.
100 FL
Engineers Stamp
rte* ...Fs44 4!
Inspections performed by: KND Engineering. Inc. Dates: 1' 10/25/2001
.e CO: ' ,a� 'If
i * ��49L "'� .'k �I
a .... ..:... •
2"d 1012512001
i
a..........
Development Srces Department Approval 3rd ozlfz o
/�
Reviewed and approved by:/�., / zc' 0— Date: a– 14{' CI�
I onne:h M. ' u T L��
�j t....�cls n1
�����
(Rev.12.03)
1,\ .
t�,; pROFESS\O ..tom
AS -BUILT SYSTEM DETAILS/SITE PLAN PERMIT Sw010200
DENALY S/D, LOT 21, BLOCK 1 PID11067-041-27
S22
40.189 SF
0.92 ACRES
KND
VACA T
21
40,542 SF
0.93 ACRES
EXISTING 1500
GAL SEPTIC TANK
E
MT
CO
A -C= 33.6'
B -C= 26.5'
A -D= 42.9'
B -D= 21.3'
A-E= 76.6'
B-E= 39.8'
A -F= 29.3'
B -F= 46.3'
VACANT
20
55,032 SF
1.26 ACRES
SCALE: 1' = 50'
fi
r- -'ru i\
CE -7116
\P4ig3Sio06
67
PREPARED FOR:
MIKE LESTER
MASTERPIECE HOMES, INC.
(907) 694-7320
SCALE' NTS
1
nCLO BOOKS
sa.0 "r GAS TAI DI
OA"nc VBG
1T" C: GASTALDI
"MI MAD
"MT' GASTALDI
Oa tilt
WE' 2/13/02
a1O SW362
"END ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
*0.0 Fac: 01061.DWG
a "64 01061
(907)696-6111/FAX (907)696-8111
7�,
rarer rurh:�
van71NOPTIACI-
1A
TANK
93.51 93.5
4.
1
SEWER ROCK
89.50 C89.1/1>s,
9z93i 94.7
r- -'ru i\
CE -7116
\P4ig3Sio06
67
PREPARED FOR:
MIKE LESTER
MASTERPIECE HOMES, INC.
(907) 694-7320
SCALE' NTS
1
nCLO BOOKS
sa.0 "r GAS TAI DI
OA"nc VBG
1T" C: GASTALDI
"MI MAD
"MT' GASTALDI
Oa tilt
WE' 2/13/02
a1O SW362
"END ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
*0.0 Fac: 01061.DWG
a "64 01061
(907)696-6111/FAX (907)696-8111
02/11/2002 15:03 3453287
RECEIVED
FFR 1 1 2002
• Well Owner:
M W DRILLING, INC
M -W Drilling, Inc.
*P.O. Box 110378* Anchorage, AK 99511•
•907-345-4000 • 907-345-3287 Fox*
Groundwater Well As -Built & Lor
Masterpiece Homes
• Legal Description:
I.ot 21, Block 1 Denary Subdivision
Eagle River, Alaska
PAGE 01
Job No.: 01-182
PermitNo.: SW010200
Project No.: N/A
j 0: KND
lax : et,a• 3183
• Use of Well: Domestic
Construction
• Hole Depth: 201' • Casing Site: 6" • Cased To: 200.68'
• Drill Method: Air Rotary __
*Material: A 53 Steel
Per!
• Well Completion- Open end X Screen Perforated r_ Method:
♦Screen/Perforatlon description: None
•Groat Notes: (9) Sacks -No. 8 bentonite granules
• Well Development: Method: Air surge Notes: Well flowing at 15 gpm over the TOC
*Stark water level (SWL) 4'± (above) (Maw) top of casing (TOC).
• Well 'kid tat at 30-35 gallons per minute (GPM)/galkn/erhewr`(GPM) for 1 horn
with 100% of drawdown (DD) from static level (SWL).
•Method: Airlift
• Dau of completion: 03 September 2001
• Pump Install:
.. i.. MOOR
Depth In feet from
Details of formations penetrated, size of material, color and hardness.
top of easing.
0 TO 2
Casing stickup
2 TO
4
Fill
4 TO
5.5
Trp soil
5.5 110
43
Sandy gravel, silty
Sandy cobble gravel
43 TO
51
51 TO
81
Gravelly silt
81 TO
175
Silt: dry
175 TO
182
Silt with gravel interbeds
182 TO
199
Sandy_gravel
Gravelly silt
, . _-:
199 TO
201
TO
TO
1
TO
t
TO
sWWA—Certifrea contf3dtobr
Ce•rtd+c-'a 2'•;' £1+ do 973
TO
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
/o/Z5fr Z : S bfa")
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SW010200
Legal Description: Denaly Subdivision Block 1 Lot 21
Design Engineer: 0070 KND Engineering
Owner Name: Masterpiece Homes (Mike Lester)
Owner Address: No Address Given
Eagle River , AK 99577 -
Date Issued: Jun 20, 2001
Expiration Date: Jun 20, 2002
Parcel ID: 067-041-27
Site Address: NHN Denaina Dr
Lot Size: 40542 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
Disposal Field E Septic Tank fl Holding Tank El Privy 111 Private Well n 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
THROUGH THE CASING ANNULUS FROM THE CONFINED AQUIFER.
Received By: F:�! Date: —2( — 0
Issued By: C/Y4 t Date: 6.-20 — so/
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. o1,7- oil -.27
Property owner(s) Masterpiece Homes (Mike Lester) /f.S/1Jh14 Ir/C• Day phone 694-7320
Permit Number SW 0 /0200
Mailing address (1) Eaale River. AK
Zip Code 99577
�nilsagaddress (2) di
Legal description (Lot, Block & Sub'd.) Denaly SID. B1.121
Legal description (Section, Township & Range) N thl ix /4 A•t7Jy4 oil -
Lot Size 40.542 Acres/Sq.Ft. Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well ® Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub 0 Jacuzzi 0
Swimming Pool 0 Water Softening Unit ❑
Therapy Pool 0
I certify that the above information is correct. 1 further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(gnature of property owner or authorized agent)
Permit Fees: IWO
Date of Payment: lP/.7'O /
Receipt Number:
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
ID ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
June 4, 2001
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: New sewer & well permit — Denaly S/D, Block 1, Lot 21
Gentlemen:
The owner has requested we proceed forward to obtain a well and septic permit on the
subject lot. On April 23,1999 we dug one testhole for the proposed system. The results
of this test are attached. The general slope of this lot is from northeast to southwest at a
grade of approximately 4 - 10%. Art individual well will serve the lot. We propose to
install a 5' wide shallow trench for the proposed 4 -bedroom house. Water was not
encountered during the excavation or monitoring.
There are no public or private wells within 200' of our proposed system location except
as noted. There is no surface water within 100' of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
ICND Engineering
Kenneth M. Duffus, P.E.
Attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN
23K�11D
.7351
ACR
DENALY S/D, LOT 21, BLOCK 1
U.V.) AL:KtS
VACANT
8
41,172 SF
0.95 ACRES
VACANT
40,224 ;
0.92 ACR
BLOCK 1
9
40,784 SF
0.94 ACRES
VACANT
r-fs4
VACANT
NO PORK WILLS VITMIN 200' Or
P00SCD STUCK
IC PRIVATE WILLS WITHIN 200' Or
PROPOSED SYSTEM ESCEPT AS NOTED.
,a SEPTIC SYSTEMS VITNIN 200' Or
PROPOSED VEL- [PLEAT AS NOTED.
KENNETH
CE -7116
• .. ••,avo'moi
FYSSIONt'=
20
55,032 SF
1.26 ACRES
BLOCK7
-44
19
40.449 SF
DESIGN DETAILS
5 BDRM X 150 GPD = 750 GPD
750 GPD/1.2 GPD PER SO. FT. (2.2 MIN/IN.)= 625.0 S0. FT
<625/5'CW)) X .5<RF) (4.0' GRAVEL) = 62.5 FT. TRENCH
USE 1 TRENCH - 63.0 (L) X 5' (V) X 4.0'(D)
Total depth of system is 7.0' from original grade.
Total depth of gravel below distribution pipe Is 4.0' .
NOTES:
1. USE 1500 GAL. SEPTIC TANK AND INSULATE IF <4' OF COVER.
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM.
3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK.
4. ADDITIONAL FILL VILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED.
5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
YELLS 6 SEPTICS.
PREPARED FOR:
MIKE LESTER
MASTERPIECE HOMES, INC.
(907) 694-7320
Scale: 1'= 100'
PAGE 1 OF 2
FIELD BOOKS
CaMVTEO
'01iDAR° GASTAI DI
0RA.c VBG
STA'' CASTALDI
acmEIA KM0
"B114 CASTALDI
DAR' 6/6/01
END ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
DMF MAC:
ac SW362
ACM ra: 01061.DWG
Na: 01061
(907)696-6111/FAX (907)696-6111
WASTEWATER DISP❑SAL SYSTEM DETAILS
DENALY S/D, LOT 21, BLOCK 1
MIN
10' MIN
N
PRO'❑SED 1500
GAL SEPTIC TANK
CO
TH#99-24B
OF Az‘
Ar +
CE -7116
.NkP•••'�
'ES510NA'
10' MIN
PREPARED FOR:
MIKE LESTER
MASTERPIECE HOMES. INC.
(907) 694-7320
10' MIN
Scale: 1'= 20'
PAGE 2 OF 2
nap BOOKS
CPNlttR
Ki"an GASTAI DI
VBG
STAKING
GASTALDI
*[ON Kin
ASBU LT:.
OsC. YU:
GASTALDI
OATC:
6/6/01
END ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
G°G SW362
Ac"° nc: 01061.DWG
'0B N' 01061
(907)696-6111/FAX (907)896-8111
JI ,N D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
1
Performed for.
Project:
Depth
(Feet)
2-
3 �Y4
5- :;':?r44i,
6 t1' „
0.:
y01; £t,
8-
9- S SP — Med dense, gray, slightly
10- ,y;. silty, gravelly sand
A i .t�; w/ cobbles
11- 4jr
12- . i1
13-V:.s"£
1.i..>,.h,
14 `i_-; B.O.H.
SOILS PERCOLATION TEST
Masterpiece Homes
Denaly Block 1, Lot 21
Org — soft, black to orange, moist
ML —Stiff, brown slightly sandy,
silt, moist
15-
16-
17-
18-
19-
20-
IIOLE PRESOAKED
PRIOR TO TEST
,� 1
Pkt.
1. ... .................•
•
T • Kenneth M. Wive
,44 f•. CE7116 /4
• Ilkin;:iO�" O."
Date Performed: 4/23/99
TEST HOLE # 99-24B
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO
Depth to water after monitoring? DRY
What depth? NA
Date? 5/15/99
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
4/27/99
2:00
-
7"
-
2
2:10
10 min
26/16"
410/16"
3
•
2:11
-
7"
-
4
2:21
10 min
2 6/16"
4 10/16"
5
•
2:22
-
7"
-
6
2:32
10 min
214/16"
4 2/16"
7
•
2:33
-
7"
-
8
2:43
10 min
2 8/16"
4 8/16"
9•
2:44
-
7"
-
10
2:54
10 min
2 8/16"
4 8/16"
11
•
2:55
-
7"
-
12
3:05
10 min
2 8/16"
4 8/16"
•
Water
Added
Percolation Rate 2.2 (min/in) Pere Hole Diameter 6"
Test Run Between 3.5 feet and 4.5 feet
1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
Municipality of Anchorage
On -Site Water & Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 067-041-27
1. GENERAL INFORMATION
Complete legal description DENALY; BLOCK 1, LOT 21
Expiration Date: S -2 0 - 1 3
Location (site address) 25636 DENAINA DRIVE *EAGLE RIVER, AK 99577
Current Property owner(s) ANTHONY & TRACY DAVIS
Day phone 242-1442
Mailing address 25636 DENAINA DRIVE *EAGLE RIVER, AK 99577
Real Estate Agent
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
•
n
5
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
•
n
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSAFee$ Ll`IQ-W
Date of Payment 5/ig%!3
Receipt Number Olgri-73%
QSC131/Rq
COSA #
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address
3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineers Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results deschbed 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. GEG, LTD. 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.
6. DSD SIGNATURE
System #1 Approved for bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
Phone 337-6179
Date
bedrooms, with the following stipulations:
7723
ness.•
CE— .Zr f es siot`Ccrk
m"p0
chi?. F 0
fr
\S\\» (OFi(46ifir
J ON-SITE
WATER AND "'"~
WASTEWATER g
PROGRAM sel
•
J/rSFR v��::v •
Original Certificate Date:
Thor/Anchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represe ations 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. ATTCWMENTS'
COSA Checklist l/
Septic System Advisory
Well Flow Advisory
(Rev. 11/05)
Nitrate Advisory
Arsenic Advisory
Other
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: DENALY; BLOCK 1, LOT 21 Parcel ID: 067-041-27
A. WELL DATA at 1-4°.3 PLu 4- — C104LS) N.rs (��T 5'1-a.1', c LPSL_
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 9/3/01 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 201 ft. Cased to 201 ft Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 9/3/01 4/22/13
Static water level 4+/— ft * ARTESIAN ft,
Well production 35 g.p.m.
WATER SAMPLE RESULTS:
Coliform 4 colonies/100 ml. Nitrate pJfl mg./L. Collected by: GEG. Ltd.
Arsenic: 1\)0 ug./L. Date of sample. 4/22/13
B. SEPTIC/HOLDING TANK DATA
4.19 + g.p.m.
Pu+•PE° Ig 30 6au,o,..sO S A
stun of 364- t1
Tank Type/Material
Tank size 1500 gal.
SEPTIC/STEEL
Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
Date of pumping 91 i g ! 13 Pumper n i GArd
C. ABSORPTION FIELD DATA
*BELOW EXISTING GRADE
Date installed 10/25/01
Cleanouts (Y/N) YES
High water alarm (Y/N)
taute.rv,--CS
N/A
Date installed 10/25/01 Soil rating (g.p.d./ft2or(/bdrin) 1_2 System type SHALLOW TRENCH
Length 63 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth x8.66 ft. Eff. absorption area 630 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 4/22/13 Results (Pass/Fail) PASS For 5 bedrooms
Fluid depth in absorption field before test E in. Water added 1830ga1. New depth 3 in
Elapsed Time: 120 min. Final fluid depth E in. Absorption rate >= 750+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date —
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YM
"Pump on" level at in "Pump off" level - High water alarm level at in.
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
100'+
100'+
N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Sewer/septic service line 25'+ Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 51+ Property line 51+ Absorption field 51+
Water main N/A Water service line 101+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Properly line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
Driveway, parking/vehicle storage 10'+
G. ENGINEER'S CERTIFICATION
t certify that I have determined through field inspections and
review of Municipal records that the above systems am in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed ame JEFFREY A. GARNESS
Date 161 r3
(Rev. 11/05)
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PLAT N0. 2000-12
DENALY SUBDIVISION
LOT 21, BLOCK 1
40,542 S.F.
AS -BU I LT
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.L.S.
2000 E. DOWLING RD., SUITE 8
ANCHORAGE, ALASKA 99507
PHONE 248-5454
GRID
SW0362
DATE
5/16/2013
ER.
01-13
JOB NO.
05211
I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
TT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT. ALASKA
NOTE: NO CORNERS SET THIS DATE.
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Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 067.041.27
HAA# /-//7626 o50
Expiration Date: S' /' - O 2
1. GENERAL INFORMATION
Complete legal description 'r DENALY LOT 21. BLOCK 1
Location (site address or directions) NHN Denaina Drive. Eagle River, AK 99577
Current Property owner(s) Masterolece Homes, Inc. Day phone 6944320
Mailing address PO Box 773471. Eagle River. AK 99577
Lending agency
Mailing address
Real Estate Agent
Day phone
Becky Minton • Dynamic Properties Day phone 529-1495
Mailing Address 3001 C Street, Suite 100. Anchorage AK 99503
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
5
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
O Individual Holding tank ❑
❑ Community On-site 0
O 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 results. (Certificates may be reissued for a period of up to one
year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or
a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
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 KND ENGINEERING, Inc.
Address 20441 Ptarmigan Blvd., Eagle River. AK 99577
Engineer's Printed Name Kenneth M. Duffus
5. DSD SIGNATURE
Approved for .0 bedrooms.
Disapproved.
Conditional approval for
Phone (907) 696-6111
Date 02/14/2002
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Additional Comments WASTEWATER :
PROGRAM •
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Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
By:
(Rev. 01/02)
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: a - / I - C,2
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.enchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Deny Lot 21. Block 1
A. WELL DATA
Weil type private If A, B, or C provide PWSID #_ Well Log (Y/N) Y
Date completed 91312001 Sanitary seal (Y/N) lL Wires properly protected (Y/N) Y
Total depth 201 ft. Cased to 201 ft. Casing height (above ground) 2
FROM WELL LOG AT INSPECTION
Date of test 913101
Static water level 4H• ft. ft.
Well production 35 g.p.m 9•p•rn•
WATER SAMPLE RESULTS:
Coliform Scolonies/100 ml. Nitrate la mg./1. Other bacteria colonies/100 mi.
Arsenic: 16 mgJI. Date of sample: 2112102 Collected by: KID Enalneering. Inc.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Anchorage Tank 1 Steel Date installed 10125101
Tank size 1500 gal. Number of Compartments 2_ Cleanouts (YIN) y
Foundation cleanout (YM) i_Depression over tank (YIN) ILHigh water alarm (YIN) NB
Date of pumping NA - new tanklsystem Pumper
C. ABSORPTION FIELD DATA
Date installed 10125101 Soil rating (g.p.d./ft2 or ft'/bdrm) ],2 System type Shallow Trench
Length j),_ ft. Width 5 ft. Gravel below pipe j_ ft.
Total depth L ft. Eff. absorption area 630 ft2 Monitoring tube L. Depression over Held y
Date of adequacy test NA • new system Results (Pass/Fail) pass For j bedrooms
Fluid depth in absorption field before test _ in. Water added_ gal. ' New depth_ in.
Parcel ID: 067.041.27
Elapsed Time: _ min. Final fluid depth _ in.
Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (WN & type) If yes, give date
D. LIFT STATION
Date installed NA Size in gallons
'Pump on- level at _ in.
Manhole/Access (Y/N)
"Pump off' level at _ in.High water alarm level at in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankllft station on lot 100'. On adjacent Tots
Absorption field on lot 100'+ On adjacent Tots
Public sewer main 15'+
Meets alarm & circuit requirements?
Sewer /septic service line 25'+
100'.
100'+
Public sewer manhole/deanout 100'+
Holding tank 100'.
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'. Property line'J'+
Water main 10'. Water service line 10'.
Wells on adjacent Tots 100'.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'. Building foundation 10'+
Water Service line 10'. Surface water 100'.
Curtain drain 50'.
F. COMMENTS
Wells on adjacent lots 100'.
G. ENGINEER'S CERTIFICATION
I certify that 1 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 Kenneth M. Duffus
Date 0211412002
Absorption field 5'+
Surface water 100'.
Water main 10'.
Driveway, parldnglvehicle storage 25'+
Aft_ Kcnne:n on. t...uf
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I
1 SOP oFESSIv~:�e
HAA Fee $375.00 + $150.00 (RUSH)
Date of Payment 02/14/2002
Receipt Number 0 3f{
(Rev. 12,01)
011oovg
Waiver Fee $
Date of Payment
Receipt Number
FEB -14-02 09:34AM FROM -CUE ENVIRONMENTAL SRV 9075615301 T-333 P.O1/02 F-818
CT&E Refit
Client Name
Project Name1M
Client Sample ID
Matrix
Ordered By
PWSID
CT&E Environmental Services Inc.
1020819001
KND Engineering
Denaly 131, L21
Denaly 131, L21
Drinking Water
0
Client POM
Printed Date fame 02/14/2002 7:51
Collected Date/Time 02/12/2002 14:00
Received Date/Tlme 02/12/2002 14:37
Technical Director Stephen C. Ede
Released By
Sample Remarks:
Parameter
Ylatara DaeartMent
Nitrate -N
Results
0.200 U
IE IDILt ggY *-boratory
Total Coliform 0
P01. Units Method
0.200 mg/1- EPA 300.0
coVl00mL SMI8 92228
Allowable Prep
Limits Date
(<10)
(<1)
AnalysisDate Init
02/12/02 1DT
02/12/02 KAP