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HomeMy WebLinkAboutSOUTHFORK BLK 2 LT 2Southfork Block 2 Lot 2 #078-031-03 Municipality of Anchorage Q Permit Number. Development Services Department• - Building Safety Divisioneds- 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 Page 1 On -Site Wastewater Disposal System and/or Well Inspection Report SW01 0030 PID Number 078-031-03 • of 3 Nome: CAROLYN LOUDON c/o DYNAMIC PROPERTIES Wastewater System: 0 New N Upgrade Address: ATTENTION: BRIAN ROIT 3111 C STREET * ANCHORAGE, AK 99503 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 261-7600 3 o Deep Trench ■ Shallow Trench CI Bed [Wound GOther LEGAL DESCRIPTION Som oir "' 0.6 GPO,:,, R Igt Tad t " 2 5 e- 6.0 n. Lot: Block: Subdivision' 2 2 SOUTI YORK owls b ave beam from engird Pak 0.5 — 4.0 n pascepa bac,Pqa 2.0 n. Township:Range: Section: — — — ns Gevd wok 110' (1030', 10481, 1032')p. added above enrol gods 1.5 — 3.5 n. WELL: O New • Upgrade Gavel .Idle: 5 R Number el I., 3 DINaa.. bengal ant 15 R C1a inmaen (Pnv.l.. A&C): Total0. It Caged Ta n Told .b.ovp4Ja•I area 766 seen Pp. nvdalat D 3034/ F-810 Mien NG t5� Dat. Saint Stalls water Lent R rMs Ws e.las.d: 3/23-27/2001 RCP EXCAVATING Meld: CPU Pim" ad w: n Conn; WIN Above Croat R TANK SEPARATION DISTANCES ■Septic 0Holding 0S.T.E.P. GOther To FromSlatenat S.p ka Absorption f Sta bre NTadlkg 3.wr P bl.nul ANCHORAGE TANK In gallanw V 1000 Well 100'+ 100•+ — — 25'+ STEEL Reber d 2 Surface water 100'+ 100'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — In� Naenae.. m. Foundation 5'+ 10'+ — — — 'Pump en fl en- ease dorm Curtain Drain NONE neve Maks : a.v.abre by: a.ebbd performed KNOW�1 Remarks: THE EXISTING SEPTIC TANK WAS COMPLETELY BENCH MARK ABANDONED. I.aoae .red D.agaaa BOTTOM OF PATIO DOOR THRESHOLD THE SOUTH AND WEST PROPERTY LINES WERE FLAGGED BY A REGISTERED LAND SURVEYOR. amid o..lo. 100.00 s< , IDIONEER1 =�OF UAL ��''"p Itt r Fri 02nd Inspections performed by AWWC, INC. Dates: 1st 3/23/01 -6th 3/23-27/01 7th 3/28/01 00 �" �0,e.. ft�poo4 fr -A. • ness.� —7953 ........40 fefstoo Department of Health and Human Services approval Reviewed and approved by•/(i /,Date - 3' 0/ (RatO�oo PERMIT NUMBER: SW010030 • AS -BUILT DRAWING INSTALLED FLOW DNERTER (FD) AW.W.C'� INC. TED MOORS. P.E. TEST HOLE /5 PARCEL ID NUMBER: 078-031-03 A B DBL1 14.38 39.74 DBL2 15.96 39.15 STI 19.17 37.16 1572 25.24 34.49 DBL3 27.13 33.30 DBL4 28.36 32.99 FD 28.81 32.86 SI FS2 45.97 32.12 47.10 33.71 CO1� CCP[ 49,20 36,78 68.60 66.28 MT1 CO3 54.24 58.78 44.18 29.18 C04 81.59 73.27 MT2 6253 35.06 MT3 C05 81.27_ 71,29 74.47 43.50 CO6 86 30 68.54 MT4 87 72 69.00 NEW 1000 GALLON SEPTIC TANK NSTAUED NEW CLEANOUT INSTALLED FLOW SPUTTER (FS1) INSTALLED FURY SPUTTER (FS2) INSTALLED NEW MONITORING TUBE 413”4 --TED MOORE. P.E. TEST HOLE /4 TED MOORE. P.E. TEST HOLE /2 •TED MOORE, P.E. � TEST HOLE /1 NEW DRUNFIELDS EAST TRENCH 00 30' MIDDLE TRENCH - 48' WEST TRENCH no 32' TED MOORE, P.E. TEST HOLE #3 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 275 • ANCHORAGE, A% 99504 • PHONE (907)337-0179 • FAX (907)376-0246 DATE 3/28/2001 DRAWN 81': J.L.M. SCALE: 1=30' PREPARED FOR: CAROLYN LOUDON PHONE NUMBER: c/o BRIAN ROIT w/ DYNAMIC (907) 261-7652 PAGE NUMBER: 2 OF 3 LEGAL DESCRIPTION: SOUTH FORK SUBDIVISION; LOT 2, BLOCK 2 TYPE OF WORK: AS -BUILT OF SEPTIC SYSTEM UPGRADE EXISTING DRAINFIEID TO BE USED AS A RESERVE SITE. PERMIT NUMBER: SW010030 AS—BUILT DRAWING PARCEL ID NUMBER: 078-031-03 INSULATO TOP OF TANK AT INLET - 96.36 INVERT OF BUNG AT INLET - 95.83 ST1 FINAL GRADE 99.65-100.05 ST2 TOP OF TANK AT OUTLET - 96.38 INVERT OF BUNG AT OUTLET - 95.60 FINAL GRADE - 92.43-93.31 MT ORIGINAL GRADE - 89.0-90.5 FINAL GRADE - 93.98-96.04 Mr CO ORIGINAL GRADE - 91.84-93.84 FINAL GRADE - 97.81-98.46 MT —ORIGINAL GRADE — 95.34-98.84 INVERT OF DISTRIBUTION UNE 92.84 (AVGERACE) 1.4 OF TRENCH 90.84 (AVERAGE) INVERT OF DISTRIBUTION UNE - 89.84 (AVGERACE) INVERT OF DISTRIBUTION UNE - 88.51 (AVGERAGE) M OF TRENCH - 87.84 (AVERAGE) —A-5' WIDE TTOM OF TRENCH - 88.50 (AVERAGE) —•5' WIDE 10 •5' WIDE 10' it A At DATE: 3/28/2001 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBAAR ROAD, SUITE 28 • ANCHORAGE, M 99504 • PHONE (907)331-0179 • FM (907)338-3246 DRAWN BY: J.L.M. SCALE: N.T.S. PREPARED FOR: CAROLYN LOUDON PHONE NUMBER: c/o BRIAN ROIT w/ DYNAMIC (907) 261-7652 PAGE NUMBER: 3 OF 3 LEGAL DESCRIPTION: SOUTH FORK SUBDIVISION; LOT 2, BLOCK 2 TYPE OF WORK: PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE 1 Qp f e G• 'ss, QQ • C 7953 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 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW010030 Legal Description5SOUTHFORK Bin LT72 Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: Owner Name: CAROLYN LAUDON Lot Size: 91475 SQ. FT. Owner Address: 9436 HILAND ROAD Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER , AK 99577-9411 Date Issued: Mar 12, 2001 Expiration Date: Mar 12, 2002 Parcel ID: 078-031-03 This permit Is for the construction of: Q Disposal Field Q✓ Septic Tank 0 Holding Tank ❑ Privy 0 Private Well 0 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. Received By: Issued By: Alettatta Date: 3 -13-0/ Date: 3- /2 -al Parcel I.D. 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.cl.anchorage.ak.ua (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 078-031-03 Permit Number Sw0/00 3O Property owner(s) CAROLYN LQUDON Mailing address (1) c/o BRIAN ROiT w/ DYNAMIC PROPERTIES Mailing address (2) 3111 C STREET • ANCHORAGE. AK Day phone 261-7652 Dp Code 92503 Legal description (Lot, Block & Sub'd) LOT 2. BLOCK 2: SOUTH FORK SUBDIVISION Legal description (Section, Township & Range) N/A Lot Size -2-4— 4 cre Sq.FL VI 475 Pa THIS APPLICATION IS FOR: Sewer Only 0 Well Only Sewer and Well 0 Water Storage Sewer Upgrade Ill THIS PROPERTY CONTAINS: Hot Tub 0 Jacuzzi Swimming Pool 0 Water Softening Unit Therapy Pool 0 Number of Bedrooms 3 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: Io�,0 • ac) Waiver Fees: Date of Payment 3/ l9\ Date of Payment 1 Receipt Number. ,6Q' Receipt Number. ALASKA WATER F> WASTEWATER CONSULTANTS, INC. March 2, 2001 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade Design for Lot 2, Block 2, South Fork Subdivision To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The existing septic system consists of a 1000 gallon septic tank and a trench type drainfield. The existing drainfield is in a state of failure and must be upgraded for the sale of the home. We are proposing that a 1000 gallon septic tank and 3 - five foot wide drainfields be installed. The drainfields are to be installed within the 30 foot radius of our test hole and the 30 foot radius of Ted Moore's P.E.- test .E:test hole #3. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. In 1986, Ted Moore P.E. performed several test holes on the referenced property. Attached is a drawing which show the ground water levels that Ted Moore, P.E. found in October of 1986. The percolation test performed by our firm was found to be 5 minutes/inch and the percolation rate performed by Ted Moore P.E. in test hole #3 was found to be at 28 minute/inch. It is our opinion that a 0.6 gallons/day/ftL should be used due to the overall appearance of the soils. 2. TRENCH DESIGN: a. Percolation Rate: 5 & 28 minutes/inch b. Allowable Application Rate: 0.6 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 750 ft2 f. Total Depth: 6 feet (max. on uphill side) for the two upper trench and 4 feet (max. on uphill side) for the lower trench. g. Effective Depth: 2 feet h. Width: 5 feet i. Reduction Factor: 0.70 i. Minimum Length: 110 feet total length (2 @ 30 feet long & 1 @ 50 feet long) j Effective absorption area = 786 ft2 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The proposed trenches are to be installed on a slope that ranges from 1 to 20 percent slope that runs from approximately northeast to southwest. The trenches are to be installed parallel to all slope contours. We do not anticipate any slope concerns. 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. Sincerely Jefframess .E., M.S. Pres' NOTE: Attached is a site plan drawing, a design drawing, a detail drawing, two soils log with a site plan of Ted Moore's test holes, 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 I r 1 1 r / / / 1 / 1 1 1 1 / LOT 1. BLOCK 2. SOUnI FORK S/D LOT 3. BLOCK 2. I SOUTH FORK S/D • • • • 1 GARAGE OVM FORK 5/1D NO ENCROACHMENT CONCERNS I\\ I EXISTING \ 3 BEDROOM \ / HOUSE \ / \ / EXISTING \ j / SEPfiC \\ TED MOORE. P.E. TESTHOLE TED MOORE. P.E. TESTHOLES A.W.W.C., INC. TESTHOLE .1 • MOON HONMESTEAD NO ENCROACHMENT CONCERNS DATE: 3/2/2001 ALASKA WATER & WASTEWATER CONSULTANTS. INC. 69010EBARR ROAD, SLAT! tB • ANCHORAGE, AK 99504 • NIDE (907)337-0179 • IAA (907)333-324! PREPARED FOR CAROLYN LOUDON PHONE NUMBER: c/o BRIAN ROIT w/ DYNAMIC (907) 261-7652 LEGAL DESCRIPTION: SOUTH FORK SUBDIVISION; LOT 2, BLOCK 2 DRAWN BY: J.L.M. SCALE: 1"= 100' PAGE NUMBER: 1 OF 3 TYPE OF WORK: SIT EPLAN FOR SEPTIC UPGRADE rte!! f •e amess. Y Vq C:� 7953 c-' N N 1 NOTE: 1. THE CONTRACTOR SHALL HAVE THE SOUTH AND WEST PROPERTY UNES FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. 2. THE CONTRACTOR MAY HAVE TO RAISE THE PLUMBING IN THE CRAWL SPACE IN ORDER TO ACHIEVE GRAVITY FLOW. 3. THE CONTRACTOR IS RESPONSIBLE FOR LOCATING ALL UTILITIES. PROPOSED 1000 GALLON SEPTIC TANK DUSTING SEPTIC TANK TO BE ABANDONED COMPLETELY INSTALL DOUBLE CLEANOUTS INSTALL FLOW INVERTER INSTALL CO AND LIT IN EXISTING TRENCH TED MOORE. P.E. TEST HOLE /2 -TED MOORE, P.E. TEST HOLE 14 EXISTING DRAINFIELD TO BE USED A5 A RESERVE SITE. 110 MOORE. P.E. TEST HOLE /1 TED MOORE, P.E. TEST HOLE /5 PROPOSED DRUNFTELD UPGRADE EXCAVATE A TOTAL OF 3 TRENCHES. THE UPHILL TWO TRENCHES ARE TO BE B FEET DEEP MAX. AND THE DOWNHILL TRENCH 15 TO BE 4 FEET DEEP MAX. ALL TENCHES ME TO BE 5 FEET WIDE THE UPHILL TRENCH IS TO BE 30 FEET LONG, THE MIDDLE TRENCH IS TO BE 50 FEET LONG, AND THE DOWNHILL TRENCH IS TO BE 30 FEET LONG. ADD 2 FEET OF CLEAN, WASHED SEWER DRNNROCK TO ALL TRENCHES. THE TRENCHES ARE TO BE INSTALLED PARALLEL TO THE CONTOURS. (SEE DETAIL, PAGE 3 OF 3) INSTALL FLOW SPLITTERS TED MOORE. P.E. TEST HOLE /3 ALASKA WATER & WASTEWATER CONSULTANTS. INC. 6901 GERARR ROAD, SUITE 29 • ANCHORAGE, AX 9950. • PHONE (907)3374179 • FAX (9071,,1313-3266 PREPARED FOR: Carolyn IOudnn PHONE NUMBER: c/o BRIAN ROIT w/ DYNAMIC (907) 261-7652 LEGAL. DESCRIPTION: SOUTH FORK SUBDIVISION; LOT 2. BLOCK 2 DATE: 3/2/2001 DRAWN BY: J.L.M. SCALE: 1"=30' PAGE NUMBER: 2 OF 3 TYPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE c ppdO O oOQ. Dk °mess/ t2: 4pX4Pia e9s10^od� 0000° 30' LONG DATE: 3/2/2001 ALASKA WATER & WASTEWATER CONSULTANTS. INC. 6901 DEBARR ROAD. SUITE 2B • ANCHORAGE. AK 9950. • PHONE (907)3374179 • FAX (907)331-3246 PREPARED FOR: CAROLYN LOUDON c/o BRIAN ROIT w/ DYNAMIC PHONE NUMBER: (907) 261-7652 DRAWN BY: J.L.M. SCALE: 1"-20' PAGE NUMBER 3 OF 3 LEGAL DESCRIPTION: SOUTH FORK SUBDIVISION: LOT 2. BLOCK 2 TYPE OF WORK DETAIL DRAWINGS OF SEPTIC SYSTEM UPGRADE o4oaoopp oOF t 4 7953 e• `a0 •;Fo4o DOO000�� ALASKA WATER & WASTEWATER CONSULTANTS, INC. S901 DEEMS aaO, SUITE 23 • AMCHOIUOG M. 111504 • PHO t (•0)337-0179 • FM (007)338-3244 • WEBSITE: .b.•.aem [SOIL LOG - PERCOLATION TESTI LEGAL DESCRIPTION: SOUTH FORK SUBDMSION; LOT 2, BLOCK 2. PERFORMED FOR: CAROLYN LOUDON DATE: 2/28/01 (feet ORGANICS 1- 2 5- 7- 8- 9- 10 11- 12- 2- 13- 13- IT 1 ■ Y M Y . F 1 ✓ M GM WITH SOME BOULDERS (DENSER W/ DEPTH) B.O.H. 15- 5- 16- 16- 17- 17- 18- 18- 19 19 — TEST HOLE #1 SOIL CLASSIFICATIONS •:d5:o °e e RANO 7 ;111111111 aKftai GW GP GM GC SW SP SM SC ORG ML CL OL MH CH OH DEPTH TO GROUNDWATER DATE DRY 2/28/01 DRY 3/1/01 SITE PLAN = 100' E19STING THREE BEDROOM HOUSE TED MOORE. P.E. TEST HOLES DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 3/1/01 1 2:31 6" — — 2 2:41 10 3-1/2" 2-1/2" 3 2:41 6" — — 4 2:51 10 3-3/4" 2-1/4" 5 2:51 6" — — 6 3:01 10 4' 2" 7 3:01 6" — — 8 3:11 10 4" 2" 9 3:11 6" — — 10 3:21 10 4" 2' 11 3:21 6" — — 12 3:21 10 4" 2" PERCOLATION RATE 5 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN 20 COMMENTS: PERC—HOLE WAS PRE—SOAKED FOR 4+ HOURS 4.0 FT. AND 5.0 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: �(� 0/ Par P.ar��#�f�AF��SE CIYU. a ENVIRONMENTAL ENGINEERING THEODORE F.MOORE, P.E. PH: (907) 345-1355 • • ENERGY CONSERVATION & ANALYSIS .October 17, 1986 14530 ECHO ST. ANCHORAGE, ALASKA 99516 :-,a i Mr..Robbie Robinson. M.O.A.;Dep't. of Health & Human Services P.Di $e:;6-650 AnthOli va, At 99502 -• RE: Health Authority Approval I, L2, B2, So. Fork S/D Dedi'Mr.'Robinson: On September 22, 1986 I conducted adequacy tests of the well and septic systems serving the subject property located at mile 7.4 of Hiland Road in Eagle River, and submitted information to your office on September 24 indicating that the the systems functioned adequately for a three bedroom home. On October 1, you informed me that the Health Department was concerned about the possibility of shallow groundwater in that vicinity, and that you would require groundwater monitoring prior to issuing Health Authority Approval. What follows is my report on the requested monitoring, including a site plan showing the relative locations of the test holes end the water and wastewater systems. On October 9, the owner arranged to have test holes 1 and 2 dug to 8 feet and 9 feet in depth, respectively. The backhoe operator was unable to attain greater depths due to "bedrock". Based on this information it was apparent that the system could not be in compliance with Municipal and State requirements. so I arranged to conduct additional soil testing on October 15 and 16 for en upgrade system. The soil loge and pert test data for test holes 3, 4 & 5 are enclosed Research of the well driller's loge for Lots 1, 2 and 3, Block 2, So. Fork S/D indicated bedrock to be in excess of 100 feet below grounkilevel. In each ofthe three new test holes we were able to attain approximately 12 feet despite extremely rocky and hard digging particularly below about 8 feet. Thus. I con— cluded that bedrock is not a factor of concern, after all. Groundwater monitoring took place during a•period of intense rainfall and flooding in Southcentral Alaska. Test hole 11 located .approximately 7 or 8 feet east of the soil absorption system does have a stabilized water level 45 inches below ground level. Test hole 12 shows no water to 9 ft. One day after being dug. teat hole 13 had a water level at 10.5 ft. below ground level which is itself 3 feet lower than in 'the vicinity of the septic system. Test hole f 4 had no standing water to 12 feet, and st hole #5 r 5 ft. below d rface hich is e10 feet lowerdthanethe�ground surfaceratntheusepticw aboutsystem. Based on the above, it appears that shallow groundwater is not the cause of the high fluid level observed in the absorption trench. The relatively high level observed in test hole 11 can be attributed to it's proximity to the system, coupled with slow local percolation. Minor seeps observed in the six to nine foot range while digging several of the other test holes are perhaps significant the enoughrecent tointense causeraanfall, and free watern surfacecase are not inthe monitoring tubes at that level. Perhaps the best explanation for the behavior of the waste— watdispsam that he lower of duethe eitherench to surface clogging or tighter soils, causing the fluid level to rise to a point of equilibrium. In both test holes 4 and 5 downhill from the system, Iwhnotnoted donmomore eeapermeable o ablenrmaterial ial occuring in the top few feet, system to behave as it does. The family using the system consists of five people including two children in diapers, necessitating large amounts of washing, quite possibly in excess of design amounts, yet there is no evidence of effluent ever daylighting from the system. Based on the above report, it is my opinion that there is not a groundwater problem affecting the performance of this system, nor is there a threat of contamination of groundwater downthathill from you issuethe theerequestedAHealthngly, it Authorityismy ApprovalIDmendation Sincerely, Ted Moore, P.B. cc. Dave Jones 9436 Hiland Rd., Eagle River, AI 99577 MUNICIPALITY OF ANCNORAOR DEPT. OF HEALTH ENVIRONMENTAL PROTECTION rOCT •171986 RECEIVED t -or f-itp10 ROAD L -0r a' l • f C.o. :UNDEvEWp p •(hl`tESreA,! I�dP.cE�1:.:...4,0 1 „f • S.tre Pi -AN • *�; 49TH•:, . L.07 2, a(_oCbc 2, SourN Pogic Sib _dec4„,4 er7jrs,L f:I'}� i 1f C f THEODO E F. MOORE : . i So Flattop Technical Services ems..\ CEP. e MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH ANO ENVIRONMENTAL PROTECTION 525 L Stmt. Anchorage, Alaska 99501 2644720 SOILS LOG — PERCOLATION TEST B SOILS LOO g PERCOLATION TEST PERFORMED FOR: no ve TOA Il DATE PERFORMED: 10 / IS' / B( LEGAL DESCRIPTION: AO f 2, 2- 3 DEPTH _Jseems 4- 5- e- 8- Pt 3loek 2, _coati) Fork S /1) Gn Stl5 Sandy G -ravel &el San a7 Stlbj. (ravel Maly cobSly i bx adew Soft MID Seer al• eats ental • of fed- hole CP -M (mo;it Sttly grove° 0.14. • 17- e4. ..A�qS�� 18- sr *yl49TH••.9* t., •••••• 19- clatogren iipooOpc p. mom: CE•3589 �••••,,,,,,.••• PERCOLATION RATE �7 X28 T. H.41.3 14i �'/♦ ....♦/• TEST RUN BETWEEN Ji12—. FT AND COMMENTS 6,21rOoL Car,Ac. 'tore( .31 loader '140 of SLOPE t _tot fir WAS GROUND WATER S ENCOUNTERED) Y t- o o P IF YES, ATWHAT Kele IO' -d" E DEPTH? to/1!r T Ni 53. Ota Reading Den Gross „Time Ne Time Cpl /n) Moth to MothWeser Net Drop UV rrw-s°014 to/IS Ia:'cs-m — — — #1 l0/16 ? 16 A~ 30 ea 74( It/k #2 F p:17 II :N7 30 27"/!LI�l toot . 6 *3 II 11:046 r2: L8 3s E:7 34 2s'//s I//` l a . SC— Imim,tasflneh) _-L 6_ FT IrCAC4 PERFORMED BY: nay? Services CERTIFIED BY: r- t0 Moat DATE: LOn/7 Me 7240E 16/79) • .-.J.:: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION • 825 L. Street, Anchorite, AMeek. 99501 2644720 SOILS LOG — PERCOLATION TEST PERPORMEDPOR:.- nlRw 1Tonf1 SOILS LOG 0 PERCOLATION TEST DATE PERFORMED: I O /15" / 8( LEGALDP.scRln+oN; L.of 2, l3foe k 2, soap, Fork S /1) y i A SLOPE SITE PLAN \6� •P f %re\ Sf(17• Crave �r N (,„°4f) I 0 e t+r�,Nek w' N=om 10 Seep TN 5. �: TI i Id' Say �/ Kit --4 Many {.e.co'fl an/ Cobh v Ily vtYyr>, WAS /gr GROUND WATER ENCOUNTERED? 10 11 12 13 14 15 18 17 s OF A..gs�4 .V;t • 49_TH *3 .. a 4.... ... 00o4t r. moon CE -3589. •'motesso........• . 5 L 0 Ho N,<o in E IF YES. AT WHAT rwn dor fele DEPTH? (u/ (6 /8( TN 04 s3. 1 Reading Date Gross Time N. Time Depth to Water Net Droo PERCOLATION RATE (minutes/Inch) /I • TEST RUN BETWEEN FT AND COMMENTS Ground sur4te 3' A.ytieP% *en of •frwc4 FT PERPORMED BYt FUN? y'echmeee( Qrsheo' 72-00* IS/79) CERTIFIED BY: ricape44.. (e•r•c. DATE: (P//7(8C PERFORMED FOR: LEGAL DESORPTION: it • -I:. 1.) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Stmt, Anchorage, Alaska 99501 2644720 SOILS LOG — PERCOLATION TEST flavt 7-0 et 8 a 10 11 12 13 14 B SOILS LOG M PERCOLATION TEST • DATE PERFORMED: 10 / IC/ oe 1 -of 2, Stock 2, foaN1 Fork S /0 Cr fly Grovel Cleaner 4df ol'( Sandy 0r..ay/ f reindr Sig/ Creme/ poc te& awl and, non non. 5^ OtO step tit e. N. • 15I'' swami iii 49altT 18••.•. •••F. MOO.. t. CE • 3589 PrOfeniCat ````.•• PERCOLATION RATE (6.0 (minute./Inchl , .TEST RUN BETWEEN ...i1,.5 FT AND N11:7 FT COMMENTS 4t#a4iZ lent to? lower ,Man a{ 14en44 SITE PLAN SLOPE WAS GROUND WAT ENCOUNTERED? IF YES. AT WHAT DEPTH? ER • r f. 0 P W>fl 6' 84 E 10/!� T HN5 se J 1 i DA Reading Data Gross Time Ne Time et,e4 Depth to Water Not Drop (is) fry Conk lo/r 1= Is Pn #/ fa //6 j f t 3 • 3 o 27 v t7 'it n/ice. 41-2 rt a:er :5Y 30 t7Vy 27 #3 3/4,l? N:sM iter 3o 1r 1t7 se 3/kr fit #f=.T PERFORMED BY: nag HT leo rn[4/ fety' .t.r CERTIFIED BY: Ter' )ne-.c_ 72-006 (6/79) DATE: 10/17/65 • MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 1.),(41.1,- be 46A.O2Q/�4 U:G (APS PHONE ` 69 �3v.zt! c NEW • UPGRADE MAILING ADDRESS 0). 6 ° -77 LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS ‘.3 SEPTIC TANK DISTANCE TO: Well /0t0/ Absorption area R7 Dwelling „4,.Ai"-/ PERMIT NO. 8an6-35( Manufacturer,-,Material ,e�6� S F L No. of compartments 2.. Liq. capacity in gallons /4C,c) IF HOMEMADE: Inside length _ Width _ Liquid depth -- 0 Y _IQZ 2 z F DISTANCE TO: Well Dwelling PERMIT NO. Manufacturer Material Liquid capacity in gallons TILE DRAINFIELD TRENCH DISTANCE TO: Well /cE/ FoundationNearest "`13` / to line '/ PERMIT NO. 8.205-.3c/ No. of fins Length of each line /./ 1 ,j (0' Total length oflines Trench width� nches Distance between lines Top of tile to finish grade '� w a //z / Material beneath tile L/ f Y ine4es Total effectivefabsorption area f (VII SEEPAGE PIT Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line w Clams �� n� q p Depth — Driller ��- Distance to lot line PER NO. P5.2US3S DISTANCE TO: Building foundation Sewer line /GU Septic tank ( /(J Absorption areals) OTHER PIPE MATERIALS b3o3(-1 N SOIL TEST RATING 46 INSTALLER EV`— ()CCd[_ ,=A 1:4646C42.5 R EMAR KS *A-;pua,C_ iS/4 0E4/ .42€.:P•-- iF.>ac% r'e id , 4►� (u.4 '5(&f c-I, /0UPLY n S` �f , ( -17/ - 44-La-Q. Le f?.& 0 .. �yvv \ > /� ��``/ b f� ,“ - ere2,6,- WrAS crc;;,` 42 ,4 39t-c2 d.�teA. _ 4 Ic(t \ J �AP�PR(yO DATE LEGAL //VVED /097R 72-013 (Rev. 3/78) Pi 93 NI fC,' I FP 11,J �E- o1 - DEPARTMENT' HEALTH AND ENVIRONMENTAL t" TECTION ~10 ^ � 825 '�' STREET, ANCHORAGE/ HK. 99501 264-4728 FHPEA__11._ ��1E7). fE; r1=_. ���LE. fR MI I I- :D PERMIT NO. ( 8205I4 ) ."^�- ^o �'��(3�* PO BOX 224 E. R.: 99577 694-3424,411A LOT SIZE 999999 SQUARE FEE| APPLICANT DEHN-DELOCIH BUILDERS LOCATION LEGAL L2B2 SOUTH FORK TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 190 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �E.EFR1-1-1= R___AFEr4G-rk-l= �����,_ RI> —FF"T111-1= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCF BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM. DEPTH OF GRAVEL BETWEEN !HE OUTTHA. PIPE AND THF BOTTOM MF THE EXCAVATION (IN FEET). FR EE COJ I FR1EIFDI FEAEF'"1F 3; in' 'Jr :11 nEfil IP:it Eli Fg INA� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBcR OF RESIDENCES THAT THE WEl/ WILL SERVE 1- 11" 4FEm K. :CP: ":ft I NI ::E; L81F" g-'::nr iC:n1".4B FE,!F• G.11 F.J1 I FR FE EN BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND HPPRO\A8. BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTANCE BETWEEN H WELL AND ANY ON SITE SEWAGE DISPOSAL SYSTEM. IS 100 FEET FQR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING •UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE 5FQER LINE IS 25 FEET AND. TO H COMMUNITY SEWER LINE IS 75 FEET. . WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 20 DAYS OF THE WELI CQMPLFTION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TQ INSURE PROPER INSTALLATION. I CERTIFY THAT t: I HM FAMILIAR WITH THE REQUIREMENT5 FOR ON SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF HNCHORHGE. I k[|| INSTHLL THE SYSTp-M IN ACCORDANCE WITH THE CODES. ]: I UNDERS!HND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE/ REMODELED TO I��CLUDE MORE THAN ] BEDROOTS. n SIGNED APPLICANT DEAN-DELUCIH BUILDES ISSUED BY._� ..[N9 -IT Russell Oyster 694-2774 Performed for: 0 & E ENLNEERING & DEVELO MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Name• -SNI - c.uc.s4 Tel. No 694•-34/e4 Mailing Address' Z 7" , 6-44.4. AUk.rei ,eh , 9 1577 Earl Ellis 688-2280 Legal Description: Depth (feet) Soil Characteristics 0 1 2 3 4 5 6 7 8 9 10 11 12 fr- r L 7 . A,u/_iV c4406= /2 t 4.k- ea <10 / k- (j(f� � Z- r-ANAf.6 FAM. 14. \ 13 14 15 16 j pi`ro.v! e': Rr— PLOT PLAN PERC.TEST !2 Ground Water Encountered: Yes No If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments. Ai C2 .8. 116.17ta i* /49 LH t�. ;* d !• {O L91..tiJatJuno.•••••••.60.. • If V •..•.ft•••••J... �..• •••••, • e� BO f. f f„•„• No. 42E6•E .:<;.. Performed by: '' Date• _J -LJ A)417 (4, /9 4aitte__ ftibH17.010... by DOC Co. dba SULLIVAN WATER WELLS P. O. BOX 272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND /3 /it J � A 3 1 ` ' DEPTH OF WELL 1 # ADDRESS r'a /l0 K T / STATIC LEVEL OF WATER FT. + 0 LEGAL DESCRIPTION DRAW DOWN FT DATE -Started lam!. Ended 66 GALS: PER HR Q PERMIT NUMBER KIND OF CASING; KIND OF FORMATION: From Ft. to Ft 0 i i)4 0 From Ft to Ft From Ft. toFt. h,1•��/ From Ft to Ft From Ft to Ft /L)'< 4 From Ft to Ft From%. Ft to ` j Ft `SRir r� f From Ft. to Ft From Ft. to Ft. u ` / From < Ft to Ft From d Ft. to / l' . Ft. (c / '= G From Ft. to Ft. From Ft. to Ft. Z. 0<-` -g From Ft. to Ft. From / /f 11 Ft. to / / L Ft a w-' = From Ft. to Ft. From Ft. to Ft i From Ft to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft to Ft. From Ft. to Ft. From Ft. to Ft From Ft. to Ft. From Ft. to Ft From Ft. to Ft. From Ft to Ft From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft.' From Ft. to Ft. From Ft. to Ft MISCL. INFORMATION: DRILLER'S NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: Lc•S�) E e S.) 4 1 t LEGAL DESCRIPTION: Le, r j 13 ioc-l.� z, 5.DA.J-,x4 2- 3 4- 5- 6- - TT7= 7>so,I �y, T GM7 5i1/ A 10- 11 In 111 12- 13- 14- 15- 16- 17- 18- 19- 20 - GMS) vel s (ty raVf ae C) -oc�k s,/7/ cx.S SOILS LOG PERCOLATION TEST 7*,/ Z DATE PERFORMED: SLOPE o , WAS GROUND WATER ,. / S ENCOUNTERED? / V O L O P AT WHAT cc„ S DEPTH?IFYES, ri 4147P • • 6.07 et - / S °.° ,G hold, Jr. w� No • .�St$� m 806Epa• V ®� 13® pitOFESSION�•v ®Oo®�S424. COMMENTS / 0 E SITE PLAN Reading Date Gross Time Net Time Depth to Water c-(- Net Drop 1 3--/(—a) 2:3I - 1,63 -6- - 1p z (iI '0 1594ti 3 Z., z.5-1 Io 1.37 p2. y " 3:0i IO 1.SS ©Z .5- 3 : I 1 10 /.S'3 ,o z 6 0 3; -i 10 /.SO .03 PERCOLATION RATE C/ -Z (minutes/inch) TEST RUN BETWEEN 3— FT AND :25~' - . FT - �/7 /7nr e/z -3$Sl j Y 56, 36 = 7 O FI' 2-4c%rnk PERFORMED BY: / %%)l"T-C',,,i(4,.0„, 72-008 (6/79) CERTIFIED BY: L. 2e+cl DATE: r-17-8 a i .. 1 r N ..J 11 ar�1 { V I LIL 1.i '3'22"1"./ 350.04' See De/a// '43 30.0/' 30.0/' N 89°58'3&'W, 989:,73' 24.70' A/89'5941"E 329.99' 3G.0/' 7 140,721 3.23 fro../ A 41,47/S.F. 1./4 Ac. N.77 51.5' s • ;r r. Creek /'lea,Tders Tract B 1,733,275 S.F. 39.79 Ac. 91,4753 . 2.10 .4c 82.74' 2( n189 5 �% 3 ' .92 )J 59•27'02'14 1/5.14' A/OC.'37'/8'E 57.38' 75G'W 329.75' •N59°57'23"W 321.0,3' 1 N 20°38'55"W 149.78' 18,8.32" s.P. 34.11' 227 Ac. . 29.78' /9.80' 0 es -0,5'39"W % NAL NB See De>4a11 "C" N 89'54'22'E 20.00' A.o.w.I 35145 1,38‘ Set 2k't"A/un..Pvs 1,/t/r Zk2'A/urn. A. A/. G.. wi rA Wi /a. Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.munLorg/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING �� 073-031-03 1. GENERAL INFORMATION cosA# DI.cn2yq Expiration Date: 9 `.2 / -O6 Complete legal description SOUTHFORK SUBDIVISION; LOT 2, BLOCK 2, Location (site address) 1536 HILAND ROAD • EAGLE RIVER, AK 99577 Current Property owner(s) FREDRIK WULVIK Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing address c/o EVA LOKEN w/ PRUDENTIAL VISTA c/o AGENT Day phone EVA LOKEN w/ PRUDENTIAL VISTA Day phone 689-6476 16635 CENTERFIELD DRIVE * EAGLE RIVER, AK 99577 Unless otherwise requested, COSA 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 On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 clays 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 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 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. 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 Address GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507 . Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's 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 B Regulations. The reported results described the performance of the system undor tho conditions encountered at the time of the test, and separation distances measured to readily identifiable features. Tho operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may EEuctuate during the year, and the water usage of the family being served by tho system. Those 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 solo 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. 49106 5. DSDSIGNATURE V Approved for 2 bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: 1/41/4kkt�4�1t0FfAA/0 mac': • ON SITE ••'•r, Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory By: Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other WATER AND m" WASTCWATER PROGRAM v' i/O r ENTSSE�.\" Original Certificate Date: -21--06 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muntorg/onslte (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description. SOUTHFORK SUBDIVISION; LOT 2. BLOCK 2, Parcel ID: A. WELL DATA Well type PRWA If A, B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 6/1982 Sanitary seal (WN) YES Total depth 116 ft, Cased to 116 ft. Wires properly protected (Y/N) Casing height (above ground) YES 12 in FROM WELL LOG AT INSPECTION Date of test 6/1982 6/6/2006 Static water level 70 ft, 64 ft. Well production 15 g p.m 6.8 g p m WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate Sat mg./L. Other bacteria n colonies/100 ml. Arsenic:r_ILug./L. Date of sample: 6/6/2006 Collected by GEG. Ltd. B. SEPTICIHOLDING TANK DATA Tank Type/Matertal STEEL Date installed 3/23-27/2001 Tank size 1000 gal Number of Compartments 2 Cteanouts (Y/N) YES Foundation deanout (WN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 9/13/2005 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA e/3t/tas2 190 Date installed 3 3- 7/2oot Soil rating e.p.d. 1•r t bdrn O. System type TRENCH 76/ Length 110 TOTAL ft, Width 36/5 ft. Gravel below pipe 4/2 ft. • •9.Y[ 608/_ Total depth si- -s ft. Eff. absorption area 78 ftMonitoring tube YES Depression over field NO Date of adequacy test 6/6/2006 Results (Pass/Fal) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in Water added9133 gal New depth 6 in Elapsed Time' 313 min. Final fluid depth DRY In. Absorption rate >= 450+ g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date TESTED 2001 TRENCH. WATER ADDED TO MIDDLE TRENCH ONLY. UPPER TRENCH HAD 4" OF WATER IN IT. THE LOWER TRENCH WAS DRY. D. UFT STATION Date installed "Pump on" level at in "Pump off" Size in gallons Datu Manhole/ High water alarm level at in. Cydes tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 100'+ 100'+ Septic tank/lift station on lot Absorption field on lot Public sewer main N/A Sewer /septic service line Animal containment areas 25'+ 50'+ On adjacent lots On adjacent lots 100'+ Public sewer manhole/deanout Holding tank N/A Manure/animal excrete storage areas 100'+ 100'+ N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line Water main N/A Water service line 51+ Absorption field 101+ Surface water Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation Water service line 5'+ 100'+ 10'+ Water main N/A 101+ Surface water 100'+ Driveway, parkinglvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent Tots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 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 Name „job Date JEFFREY A. GARNESS COSA Fee $ 41-706'— Date of Payment &/114/04. Receipt Number .16177c (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 06-07-06 14:2T FROM-Pudentlal Jack White Eagle River r • 1 • 1. .sty 36% 9076896499 T-814 P.002/003 F-976 r� t_Fr ASBUILT NO CORNERS SET THIS DATE ua te a' e 1 hereby cattily that I have performed a Mo gagers action T���� �� ,C• • _ :;'• ojthe lollowin�deso property* Lore, Ink 4, JO!--cTcre L'•r •.Ff7/'•w� e' '•s7''30"E•••' �I'o6.•22. —... ,MB9 S7• p W, 82.7 � 00, 44 Is. ••Anlhoraga..Recording Precinct; Alaska, and that the 1 •I mplvvemerifs'situated thereon are within the property Anes and do .not overlap or encroach. on the •. property tying adjacent •* Cwretort at no hnprovemente on property tying adjacent thereto ancroach'on Cid premises In question and that there are no �) /' ��a roadways, transmission Anes or other visible easements on said psi Lysi. properly except as indicated hereon. t,.,nu. . f Dated at Anchorage. Alaska �t ,✓� this ZO da • la EASEMENTS OF RECORD. OTHER THAN •,` ve THOSE SHOWN ON THE RECORDED • R,Uo O1. AT AGC SIf1T CYf11lf,1:YCOCMI •� sere t"r y of M 14)/ sem°+ • ,.c it/ (907) 248.1666 20.12k— FRED 0jL o -_FRED WA TKA & ASSOCIATES Engineers and Surveyors J tat SGS/CT&E ENVIRONMENTAL SERVICES Drinking Water Analysis Report for Total Coliform Bacteria READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE MUST BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM IDs gRNATE WATER SYSTEM Saul Results ❑. Send invoke Weis' Spies w.&Cat,a,N von. Coated nu.. Phan. Nun:ole Milling Addis. v=� •h‘...erana ( 4 .F» ✓ ps hunter r.. •••rw....rrrr.w 0 Send Results 200 W. POTTER DRIVE ANCHORAGE, ALASKA 99518 Tel: 907-562-2343 Fax 907.561.5301 Lao Ref Na ioszesaip- R a Send Invoke wale SAS, MwCongry Nora Capp Mae lr•PMsuss rum / 2-1,F0 rk Vo; f_ .4.2/ gk-� cobector: d (a.b G •`I ragas Name Transported to Lab By: ❑ Same as collector Other. EC Is— Fe. Motif ap Cade .s .fp,ri.i.rN Routine 0 Treated Water Repeat Sample (refer to lab no. o Special Purpose ❑ Untreated Water ) TO BE COMPLETED BY LABORATORY SamDto ReceMnq. Date: 4,6.06 / 3rf(. Time: Temp: Delivery Method: Received By. Comments: ❑ Sampk over 30 hours old: 0 RUSH SAMPLE Results may be unreliable Bacteriological Water Analysis Record: Analysis Began: 6/�%p»j /57S— Analyst: s7 f Analyst• Analytical Method: Reported By ® Membrane Filter 0 MMO-MUG (P/A) MMO{IUG (P/A) RESULTS: Total Coliform: E. Col: MEMBRANE FILTER RES TS: Meat Count Verification: vases..ITB: {BGESa isfactory ,va..r. ( Ea / g - Unsatisfactory ColoniesnbbmL SeM b ADEC: ANC FBI( JUN Date/Time- Sent to Client Phoned C Faxed ID Dateable: Spoke with: .---10 Zed. Data/Time: rt1.vC, e -o 1Weeslnas01 ANK_Groupbata\Pub/dDOCUMEMIFORMSiapprovedlCol Form 1217034s THTC • Too Mscrismas Is Cosa OS • Odoe. ..awls Foran # FW -0053 12/17/03 SGS Refit Client Name Project Name/# Client Sample ID Matrix 1062860001 Garness Engineering Group, Ltd. South Fork SD Lot 2 Bk2 South Fork SD Lot 213k2 Drinking Water All Dates/Times are Alaska Standard Time Printed Date/Time 06/15/2006 13:30 Collected Date/Tine 06/06/2006 11:00 Received Date/Time 06/06/2006 13:43 Technical Director Stephen C. Ede Sample Remarks: Parameter Results POI. Allowable Prep Analysis Units Method Container ID Limits Date Date lint Nitratc-N Nitritc-N Metals Department hardness as CaCO3 Private Individual Analysis Aluminum Antimony Arscnic Barium Cadmium Calcium Chromium Copper Iron Lead Magnesium Manganese Phosphorus Chloride Fluoride Potassium Selenium Sodium Silicon Silver Thallium Sulfate 0.235 0.100 mg/L EPA 353.2 B 06/06/06 ALR ND 0.100 mg/L EPA 353.2 B 06/06/06 ALR 151 5.00 mg/L SM20 2340D C 06/07/06 06/09/06 SCL 22.0 20.0 ug/L EP200.8 C 06/07/06 06/09/06 SCL ND 1.00 ug/L EP200.8 C (<6) 06/07/06 06/09/06 SCL ND 5.00 ug/L EP200.8 C (<10) 06/07/06 06/09/06 SCL 5.57 3.00 ug/L EP200.8 C (<2000) 06/07/06 06/09/06 SCL ND 0.500 ug/L EP200.8 C (<5) 06/07/06 06/09/06 SCL 37100 500 ug/L EP200.8 C 06/07/06 06/09/06 SCL ND 1.00 ug/L EP200.8 C (<100) 06/07/06 06/09/06 SCL 5.22 1.00 ug/L EP200.8 C (<1300) 06/07/06 06/09/06 SCL 362 • 250 ug/L EP200.8 C (<300) 06/07/06 06/09/06 SCL 1.39 0.200 ug/L EP200.8 C (<15) 06/07/06 06/09/06 SCL 14200 50.0 ug/L EP200.8 C 06/07/06 06/09/06 SCL 62.9 • 1.00 ug/L EP200.8 C (<50) 06/07/06 06/09/06 SCL ND 200 ug/L EP200.8 C 06/07/06 06/09/06 SCL 1.37 0.100 mg/L EPA 300.0 13 (<250) 06/07/06 06/08/06 DSII ND 0.100 mgtEPA 300.0 13 (<2) 06/07/06 06/08/06 DSII 601 500 ug/L EP200.8 C 06/07/06 06/09/06 SCL ND 5.00 ug/L EP200.8 C (<50) 06/07/06 06/09/06 SCL 3530 500 ug/L EP200.8 C (<250000) 06/07/06 06/09/06 SCL 4270 200 ug/L EP200.8 C 06/07/06 06/09/06 SCL ND 1.00 ug/L EP200.8 C (<100) 06/07/06 06/09/06 SCL ND 1.00 ug/L EP200.8 C (<2) 06/07/06 06/09/06 SCL 24.4 0.100 mg/L EPA 300.0 13 (<250) 06/07/06 06/08/06 DSI1 SCS Ref.# Client Name Project Name/# Client Sample 11) Matrix 1062860001 Gamess Engineering Group, Ltd. South Fork SD Lot 2 0k2 South Fork SD Lot 2 Bk2 Drinking Water All Dates/Times are Alaska Standard Time Printed Date/time Collected Date/Time Received Date/time Technical Director 06/15/2006 13:30 06/06/2006 11:00 06/062006 13:43 Stephen C. Ede Parameter Results PQL Private Individual Analysis Total Dissolved Solids Zinc Nickel 11CO3 Alkalinity CO3 Alkalinity 011 Alkalinity Conductivity pl l Alkalinity Total Coliform Allowable Prep Analysis Units Method Container ID Limits Dam Date Init 170 10.0 mg/L SM20 2540C D (<500) 91.1 5.00 ug/L EP200.8 C (<5000) ND 2.00 ug/L EP200.8 C (<100) 128 40.0 mg/L SM20 232013 D ND 40.0 mg/L SM20 23200 D ND 40.0 mg/L SM2023200 D 275 1.00 umhos/cm SM20 25100 D 8.10 0.100 p11 units EPA 150.1 D (6.5-8.5) 128 40.0 mg/L SM20 23200 D 0 col/I00mL 5612092220 A (<1) 06/08/06 KP 06/07/06 06/09/06 SCL 06/07/06 06/09/06 SCL 06/06/06 XZ 06/06/06 XZ 06/06/06 XZ 06/06/06 CRY 06/06/06 CRY 06/06/06 XZ 06/06/06 TLF I 06/05/2006 15:46 9073449821 JRs Pumping PO Box 773415 Eagle River, AK 99577 (907) 6944454 Billing Information Fred & Becky Wulvlk 1538 Hiland Road Eagle River, AK 99577 (907)822.4587 Job Site Information Becky 1536 Hiland Road Eagle River. AK 99577 (907) 622-4567 JRS SEPTIC Job Desenpcon: 1250g P.O. Numbs: Tarns Net 30 Sarno: Nikote moose cross streets: Mile 7.3 Hiland Road Job Comments: PAGE 01 Service Agreement Number. 018407 Order Date: 11 -Oct -2005 Service Date: 13 -Oct -2005 12:00 Technician: Tony Tax %: 0 Jab Type: Repeat Map Grid: 166- - Last service 05/16/03 1000g Checked and pumped tank Additional Location Comments Dlagrem: $ Diamamskt0407.bmo Red two story chalet. 1st drive way on right after you cross South Creek. Pipes in back and visible. Service Type Septic Service 15K DV decee Ink s c• x/0 c do. • Qty Price Each Tax? 1 $0.00 No Gallons Planned: 1000 Gal. Actual: Hose Length: 4.5 Double Tank: 0 Pump System: ® . Baffles Inlet: 0 Baffles Outlet' 0 Extension Actual $0.00 NenTanable Total Estimated Charges: 50.00 Actua Charges: Taxable Total 30.00 Tax Total 50.00 Grand Total 30.00 Customer aryl es to the tams and conditions shown. THIS ISA BINDING AGREEMENT. Signature and Title of Customer Repreeenlethe Date Accepted by JR. Pumping Dae Accepted For your added convenience we accept: American Express, Dkwver, Asa and Mesta Csd payments over the phone. Atter 30 Days accounts will be turned twee to collections. 125.00 For NSF Chocks Returned. Municipality of Anchorage Development Services Department Building Safety DMsion OnSito Water b Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, A/09519-6650 www.d.anchorage.alcus (907)34-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 078-031-03 1. GENERAL INFORMATION Complete legal description HAM I-44 010122 Expiration Date. 7- 3- 0 1 SOUTH FORK SUBDMSION; LOT 2. BLOCK 2 Location (situ address or directions) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address 9436 HiLAND RorP• EAGLE RIVER. AK CAROLYN LOUDON Day phone c/o BRIAN ROT w/ DYNAMIC PROPERTIES 261-7600 Day phone BRIAN ROT w/ DYNAMIC PROPERTIES Day phone 3111 C STREET • ANCHORAGE, AK 99503 261-7600 Unless otherwise requested, HAA will to held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Weil Individual Water Storage Community Class Weil Pubile Wator System TYPE OF WASTEWATER DISPOSAL: Individual On-slto Individual Holding tank Community On-site Public Sewer The Municipality ofMchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Heatth Authority Approval are required for the transfer of Elie (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 private or Class C welt and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued fora period of up to ono year with valid water samples.) Certificates ere 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 rho professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall bo paid $3,080.00 at, or prior to dosing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified bymyseal affixed hereto and as of the valldadon date shown below, l verity that my Inesbgadon, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supptyand/or wastewatordisposal system Is(are) safe, functional and adequate for the number of bedrooms and typo of structure Indicated herein. I further verily that based on the Information obtained from the Municipality of Anchorage Nes and from mykwesdgation and Inspection, the on-slto water sup* and/orwastewater disposal system Is(are) In compliance with al applicable Municipal and State codos, ordinances, and regulations In effect at the rime of ins:e a:Ion. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS. INC. phone 337-6179 Address 6901 DEBARR ROAD. SUITE 28 • ANCHORAGE. AK 99504 Engineer's Printed Name JEFFREY A. CARNESS. P.E. Engineer's Comments: In conducting this evatuatiorz, AWWC, Inc. attempted to provide a thorough, consdendoos engineering anaysis of the system b accordance with ADECand MCA DSD Gukfelnes 3 Regulations. The reported mutts described the performance of the system under the conditions encountered at the limo of the test, and separation distances measured to madly Identifiable features. The oporalonal life of ad wolfs and septic systems depend on the tical soils cond77Aon, groundwater fevers that may fluctuate during the year, and the water usage of the famiybetng sorbed by the system. These o nd ions are outside the control of the evaluator of tho system. Satisfactory:est results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects orencroachments. AWWC, Inc. an therefore not provide arty warrantycoiffure estimate of how brig the system will continua to moot the operational requirements of the ADEC or MCA DSD. The content of this reportIs for tho solo bonorrt of the owner listed above. Aryre5anco upon or use of tis report by any other parson crparty b not authorized, nor will d confer any foga; right whatsoever. 5. DSD"SIGNATURE -_1L Approved for bedrooms. Disapproved. Conditional approval for Date 3_ f zs/ol Ocotirgerogicir ON-SITE ••;'G?— bedrooms, with the fllowln9 P !: WASTEWATER : sti utatio� S WATER AND ;^ ^ : PROGRAM eirszkrecto • Attachments: HAA Checklist Septic System Advisory Weil Flow Advisory c/ Manitenance Agrecment Supplemental Engineer's Reort Other Original Certificate Date. tc ' 3 - O / • Municipality of Anchorage Development Services Department Barr4y Mann On Sts Wain & Waiswtlsr Program 4700 Garth Bnpaw SL P.O. Box 196850 Anchorage. AK 9951946850 t ww.elanchorapesi ue (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Deaaeptica SOUTH FORK SUBDIVISION: LOT 2, BLOCK 2 Paroet ID: 078-031-03 A. WELL DATA Wen type SEM_ IIA, 0. or C provide PWSID# N A Web Log (YIN) YES Date eompietad 6/1982 sanMzy flat (Y/N) Wires property Protected (YIN) Total depth 116 1L Cased to 115 it. Casino height (above groun) 12* b. FROM WELL LOG AT INSPECTION Date of teat 6/1982 2/6/2001 Stab water level 70 1t. 76' lt. Won production 15 g,p,m, 2.0+ g,p,m, WATER SAMPLE RESULTS: Coliform S colonles/100 mL Nitrate • S mgJL Other bacteria 0 colonles/100 mi. Date of sample: 3/27/2001 Collected by: AWWC, INC. B. SEPTIC/HOLDING TANK DMA Tank TypelMateltal STEEL Dale totalled 3/23-27/2001 Tank site 1000 pal. Number of Compaffinents 2 Cleanouts (Y/N) YES Founded= cleanout (YM)YES Depression over tank (Y/N)NO High water slams (YM) N/A Date of pumping NEW C. ABSORPTION FIELD DATA Pumper ::afl?a a1:': t?9!,: Date installed 3/23-27-o1 Son rating ear ft ) 0.6 System typo 5—woc DRADOEIDS Langth 110' TOTAL ft, Width 5 ft. Gravel bekyw pipe Stt. Total depth '6-8 ,1L Eft absorption arca 78a ft' Monttodng tube YES Depression over fletd No Otte of adequacy teatNEW Results pass/Fall) For 3 -bedrooms FAdd depth In absorption Geld before test= In. Water added =gal. New depth=kr. Elapsed Time: =min. Final fluid depth= h Absorption rate a. - 0.124. My rejuvenation treatment (peat 12 mo.) (YM & type) tf yes, gtio date D. LIFT STATION Date installed Site h gallons Manhole/ Pump on' level ath. High water alarm level at Da E. SEPARATION DISTANCES Cycles tested Meets alarm & Bradt reqtdremeC SEPARATION DISTANCES FROM WELL ON LOT T0: Septic tanklvf station en bt 100'+ Absorptcn field on lot 100'+ PutUc sewer main N/A Sewer /septic seMce Ino 25'+ On adjacent bts 100'+ On adjacent bb 100'+ Public sewer manhole/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDINO TANK ON LOT TO: Building foundation S.Properly Ina g'+ Absorption field S'+ Water main N/A Water service line 10'+ Surface water 100'+ Wena on adjacent lob 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line 10'+ Betiding foundation 10'+ Water main Water service line 101+ Surface water 100'+ Curtain drain NONE KNOWN F. COMMENTS 0. ENGINEER'S CERTIFICATION Walls on adjacent lots 100'+ 1 certify that 1 have determined through fid I nspedbr:s end review ofMuNclpe! records that the above systems are 1m conformance with AMOA HM guidelines h effect on this dela. Eng Date 3 >ro vl JEFFREY A. GARNESS NIA Driveway, petfdngrvetlela storage._�0'+ HAA Fee $ 9i'D•DO Data of Payment y' a-t7t Receipt Number 241q Waiver Fee S Date of Payment Receipt Number 03-29-01 16:01 11011{3E ENV110N1EN1A1 4s DTQ<E Reis Client Nene Prelim rumor C1knt Sample ID Matrix Ordered By 'nibs • CUE EMironmantal Straka Inc• • eelafa••NIMssMaae•. • 1011507001 AK Water at Wastewater Consultant Inc. ' South Fork SAD; Lot 2• Mk 2 South Fork SAD; Lot 2• Dlk 2 Drinking Water • • • 5615301 7-924 P.04/04 F-001 pkat PON Printed Date/Tlme Calketed Dete?Ime R•eelred Dalefflme Technical Director Kekiaid Bj •'• • • 03/292001 ' 1536 0327/2001 14:45 03/282001 12:00 Stephen C_ • •r •• Sample Remarks • Ptrent er aeeutte ' POI. Unita Method At tenable prep Analysis Lintte . Date • Date •' loin Katere Department Nittne•N • ytlrrnbin7aay r•ahararory Total Coliform 0.500U 0.500 m0/L EPA300.0 0 • 10 max • 0328001 SCL eaV100mL SM3192223, ' •' 03/28/01 SKW • • • • •1 • Mar -29-01 15:38 CTSE Anchorage/Micro LTE 907 561-5301 P.02 CT&E Environmental Services Inc. [1 1 Afr Laboratory DivWon Iwllltis rances r ar rrarrrr/ll arnarner nrrr) 200 W. Potter Drive Drinking Water Analysis Report for Total Coliform Bacteria e i seiiu311.1605 READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE Fa; 1907)561.5301 MUST BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY 0 PUBLIC WATER SYSTEMI.D.R PRIVATE WATER SYSTEM O Stat Rada 0 Seat brr.lt. to Sw.+NasC Carmen .. ! A WATER tit WASTEWATT:t, e...nw., CVhsUL%W IJ. INC. t.an..wr 6901 DEBARK RD..8101E , Lara... Mao n NC,?UMAUE. Mi MIHYV. en a.. roll i. o SmtRa.hs 0 Safln.ln ALASKA WATER a WAsr,... a.+.rHam cOrebUL ANTg INC 1 DEB�ARR RR. SUM: ... L�.sala.o �,a RMOF Av •P;-,4 to i. ap Gi SAMPLE DATE: u14 Meath O7 Day 0 till Year SAMPLE TYPE: o Rouslas 0 Treated Water O Repot Sample (for Trine sample /( Untreated Water with lab ref. no. o Special Purpose Time Collated SAMPLE LOCATION Collected By S, alt V.sk #4: L0Ft Eik'2t 'Zl►eS eats. Pima/via Analysis shows this Watet SAMPLE to be: Satisfactory O Unsatisfactory O Sample over 30 hours old. results may be unreliable O Sample too long in transit; sample should not beover3Chows old at examination to indicate reliable results. Please send new sample via special 3�� deliyery nail. Date Received Time Received % ark Analysis Began `ter! < Analytical Method: MembraneFiltj a MMO•MU0 • Numbesof coloniea/[M ent. suit' Analyst 101150? v3? DEC: Time Client bet (fled of PM.N spoke *Ma Fared Date: Time: Pbk. Jen mmeelds, i -y r kIis: Faced BACTERIOLOGICAL WATER ANALYSIS RECORD MMO•MVC Rash: Teat Coliform tall Montanus Fitter: Direct Count C� Coboln/ISO mi Verification: LTD BCB COLIFIRM fecal Coliform Confirmstin �•a� Fust Membrane TU Stevan2 )t3 CC..II(termrt00 3 ml Reported By t. ill In` TIaw 1 St 0 brs Comments: MTCor..Mmr..aLd..r os .wars..... itB13E3 Mambar .1 tM SOD Orwn Modena Weal a. 5 urvw1l.nc.) \ ENVIRONMENTAL FACRITIES 1N ALASKA. CALIFORNIA. FLORIDA. ILLINOIS. MARYLAND. MICHIGAN. MISSOURI. NEW JERSEY. ON10. WEST VIRGINIA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES p2_toa l3 DIVISION OF ENVIRONMENTAL SERVICES Ai LS CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date Dunt 7� /98& 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) („of 2i Bloc k 2, Sa«.16 T-ar•k Subettuueon Location (address or directions) 9y3i flrgh/4nd Rc k J Eagle (b) Property Owner Pt 'c Ton 41 Telephone: Home 69 Y - 7770 Business Mailing Address 9�''i36 /t</ai s( Roc le Rtc>d" j n 9'9J� 7 /+ (c) Lending Institution USA rePe CTed f I"' Telephone 76'6' 2600 Mailing Address L/0i0 0 C.'redi" unroo Pr'. i Alch 'erre 9FS�3 (d) Real Estate Company and Agent tG l3 A Rea l b7 C enfer' — bar barb► 3ae.uoC¢ Address ByUO /-Iarize1( Rd, Aotc.4oraq; ,4-k 99507 Telephone 3 yy- ©Sol ✓ (e) Mail the HAA to the following address: or: Check here R, if hold for pick up. List contact person and day phone number below. Ted Atoo'e 3 4S- (34-5 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms 3 3. WATER SUPPLY Individual Well ® Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public 0 Community 0 Holding Tank 0 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 /Rev 8/861 Front 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm F(et l<lop T chnicut Seft; cc-er Telephone 3 c/S- S ICS" Address 1`1.5 3 O techs $f fMc4or-71, ,4 -it 99,5-hs- Date 95/( Date Tune 7 /988 Alte48, OF it � 0Q40, . ...... 4 ®® �' 84 1 ./4gTH ••�."y 0 Engineer's Seal tii . THEODORE F. MOORE CE - 3589 n'` O 4, .4, +4 L ® ro%ssiar�a, v.. 6. DHHS APPROVAL � Approved for L__k,iZ bedrooms by ` /�/��' r— Date �/u��L /� �! Approved Disapproved Conditional / Terms of Conditional Approval A\ Mins CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska, The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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 (Rev 8/861 Back 14INICIPALIV O ER NCE O� GS ON RAE ENVIRONMENTAL I, ;N 71988 A. WELL DATI°C-1\1 t1C) Well Classification Prt vaI•e MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 678 oat 45 Legal Description. d -of 3/ocic 2, Sa cc fh fvr 11* Sed.1, ani i u 11100 If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) r Date Completed 6'/8 Z Yield >6497Y21" P1iCQ1. 9/30/87 Total Depth /1r Cased to I16' Depth of Grouting N.* 1o.S' Static Water Level 72' (MC on 9/30 /87 Pump Set At Casing Height Above Ground 1' Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Y 117' Sanitary Seal on Casing (Y/N) 1" Depression Around Wellhead (Y/N) a' N To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Com ments ; On Adjoining Lots 132', ; On Adjoining Lots N, A. To Nearest Public Sewer >100' > 1001 N. A> To Nearest Sewer Service Line on Lot T• F. Mao re N,4 ; Date 6-43 /88 5aht.facla" " C% Co ft rnn /tea m 1 G 0.1 7/•G Ntf ale -N B. SEPTIC/HOLDING TANK DATA Date Installed g/31 /82 Standpipes (Y/N) Y Size 1 000 74 No. of Compartments Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) N IV Date Last Pumped 10/e/ 87 IV. JR's NIA-. ; for N, /i Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) N. 4. Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line 7 -O' To Water Main/Service Line 1V'�• Course Comments > 100' Temporary Holding Tank Permit (Y/N) N,'9 To Building Foundation To Disposal Field S To Stream, Pond, Lake, or Major Drainage 17' Page 1 of 2 72-026 (Rev. 8/861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 190 a'/Qdr'n Type of System Design T- renub Date Installed 8/31 /62 Length of Field 70- Width 6Width of Field 36'1' Depth of Field 4-1 Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test (06 Gravel Bed Thickness '1' Standpipes Present (Y/N) Y N Date of Last Adequacy Test 9 X30 /6 7 Adermate S 6 &droomj Separation Distance from Absorption, Field: To Water -Supply Well 13 21 To Property Line 7 ` per cid6u•' /! ' To Building Foundation 3 2 To Existing or Abandoned System on Lot t'R• • On Adjoining Lots 7 30 To Water Main/Service Line To Cutbank (if present) N' To Stream/Pond/Lake/or Major Drainage Course > IGD To Driveway, Parking Area, or Vehicle Storage Area /00' Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** 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 T/6` Date Tune 7 1988 Company F70 Her tech $oc1 MOA No 88' -as e Receipt No 1 to 1 a_c 2 q1 Date of Payment 1.c---\ Amount: $ 4;.1i..OF gtlw4 s �P� / �. 15�+�TFf . *,0 Page 2 of 2 °.THEODORE F. MOORE -44, ••••• CE - 3569 w� 72-026 (Rev 8/861 Back Engineer's Seal MUNICIPALITY OF ANCHORAGE/l/1 DEPARTMENT OF HEALTH & HUMAN SERVICES L/ 1 DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ;•., g-, - (CU OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) 4,0 2 Bfack 2, So•.46 Location (address or directions) oc,1,06er 196 7 9 y36 /bland_ Ro( 1=u7le Rt,;cr (b) Property Owner Dave.%o/ra/ Telephone: Home 691f -7770 Business 3 Y9 - 86-/ 6 - Mailing Mailing Address 9`136 th 1a.d RoQJ Edgle R cr /ik 99577 (c) Lending Institution (rer/ Ret Relaccd-ron Kqm} V Telephone (3/ `/) 2 y/ - S9oa' Mailing Address 90/ rvvocrl+r^9f'n /h e. � SA Lo u i fl 6316, (d) Real Estate Company and Agent i_/K A Real /-7 Cerr f'r✓" — 6a.r-barn Louden Address 8Y00 41r 71-7-4? a Rd> Anc4oPere 4-/T 99Sn7 Telephone 3 `!Y - Oso/ / (e) Mail the HAA to the following address: or: Check here ®, if hold for pick up. List contact person and day phone number below. -ret,e rracyre 3Ys-r3S5 2. TYPE OF RESIDENCE Single -Family IN Number of Bedrooms 3 3. WATER SUPPLY Individual Well ® Community ❑ Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public 0 Community 0 Holding Tank 0 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 (Rev 8/861 Front 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Fla ;--Ary. Tech Aica/ Sew«o Telephone 3 yS- 13Sr Address /'1530 C—clAv SfJ ftn choter, 4 -Pt 995 /6" Date Ocfo1967 Engineer 414, lwgE.9.....0 • fr..•4:';*310A 4TH ,� J1:1* •'THEODORE F. MOORE /4' 4' e„:-: ''`*�.•�,. 6. DHHS APPROVAL '• '�D Approved for bedrooms by Gam""'-"/ ��y' `� Date 10-7 — 7 Approved X Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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 (Rev 6/861 Back MUNICIPALITY OF ANriligMI ALITY OF ANCHORAGE (MOA) DEPT. OF HEAL TjjLTHlo�,( AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PR�CjSTTECf unECKLIST - FEBRUARY 1984 A. WELL DATA Well Classification OCT 51987 RECEIVED Prtvoc�2 Well Log Present (Y/N) Total Depth 1 16.' Static Water Level 7e' 264-4744 Legal Description. L04 B (oc k 2, Sou.f P r k• $ /L If A, B, C, D.E.C. Approved (Y/N) Y Date Completed 678 2 Cased to f (6 Depth of Grouting N. ., of 3/3o/et7 Pump Set At Nr A. „>.6:B6-i'H i f 9/3o/s7 Yield t5/rP11 ref Icy Ie•S' Casing Height Above Ground t Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot ((1 ' ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line µA= Cleanout/Manhole N. R. Water Sample Collected by Water Sample Test Results Comments j FM 1J2i ; On Adjoining Lots To Nearest Public Sewer N > tool (CZ*' To Nearest Sewer Service Line on Lot .ia - tiaCC ler On 9/zZ/9 z -e Qrut/er Cs) it suhJ.ecf 8 yes, on 9/30 /67 B. SEPTIC/HOLDING TANK DATA N, A. ;Date 9130 /87 O co/do.+ / too rrt.L -, . O. / „q/e /V'kw /L' -Al ri+eat- ure�! foe we (1 ye O.3." pon+J vno(ts«f�a� �o st�r't �.cwr l c_.,4 of rn &Wa[u c/w.. 51-02ray " 'y Cc f furl k 6e ,Craw') oeuce, 7+/ 4 no fwhitr Date Installed 9 / 3 / /8 Z Size Cvoa y'cI No. of Compartments Standpipes (Y/N) i Air -tight Caps (Y/N) Depression over Tank (Y/N) N '1 Foundation Cleanout (Y/N) N Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) N. A. Date Last Pumped 10/ a/87 47 v.",-/IFL'nt-'Ky ; for N• A. Separation Distances from Septic/Holding Tank: To Water -Supply Well 111 To Property Line > SOS To Water Main/Service Line N' A• Course Comments > (00' N• K. Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage /7I N./J. 39" oav%h in septic iun(^ - Same !e✓Gr of /n Page 1 of 2 72-026 (Rev. 8/86) Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 190 cl./80gro Type of System Design ! ru'ch Date Installed 8/31 /82 Length of Field 7 ti 1 Width of Field 36" Depth of Field 7• S' Gravel Bed Thickness H' Square Feet of Absorption Area 606' Standpipes Present (Y/N) r Depression over Field (Y/N) N Date of Last Adequacy Test 9 / 30/57 Results of Last Adequacy Test Ao(eruofe r 3 6 ed roo n•r Separation Distance from Absorption Field: To Water -Supply Well 13 2' To Property Line 7' per o,r- 6.4,1f To Building Foundation 3 e ' To Existing or Abandoned System on Lot N. A. ; On Adjoining Lots > 30' To Water Main/Service Line N. R. To Cutbank (if present) N. A. To Stream/Pond/Lake/or Major Drainage Course 7P too' To Driveway, Parking Area, or Vehicle Storage Area 1Go ' Comments (-tondo( -kb es do no/ ex /-&) /o L' c /fom o 1 rowel. 1' ' - i' " of Ft,..Q;( Sion dni ,o'e efts at bof/oa of C.a.'s -same 1e,ef a.r in see flc leen k. Itirfe more man «dBrufe �e� 3 b�olrooaJ Ato fro till of wuIer in me rnf/a/f.,' D. LIFT STATION 'n 19 86 clown h� 1/ ,creM r ys #E1^• M. A-. Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** 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 `l ei Date (' /S/87 Company F(af/or Tech Svu MOA No 87 oS 2 Receipt No /0 a / 06 2_2- Date ZDate of Payment / U/c/ 07 Amount $ U e.)0 Page 2 of 2 72-026 (Rev 8/861 Rack � �* �.l�YH� *•�it 4 Engineer's Seal THEODORE F. MOORE ; 1 O' �:• CE - 3589 . �.•�,1`L�41 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 0:�.c�lc- td! Application Date 9/2 it / 86" 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) La , Bac(. 2 SoetOT+ Fork ' 5/_0 Location (address or directions) 91i 36" tit Jan dRocs-ed Fr.yle I$Iviv' (b) Applicant Name Dave Ton es Telephone: Home 6'2 777452Business 3 - 86-1( Applicant Address 9 if 3 6 el(lgrr Ac� Fele %i J .*tc 99577 (c) Applicant is (check one): Lending Institution 0 ; Owner/builder ®; Buyer 0 ; Other 0 (explain); (d) Lending Institution ben Ref (ielaccefroo M7>n f Telephone m4. 9p1 LL/as�rrrc 10 a five S f: 1.c.utt� MO (3 io/ v 6 -an Rel lacc -ron /`tccnaferAen/ G -e -04p Address (e) Real Estate Company and Agent (f) Address '9 f UAW h /on Ave sit Telephone N+A. Pref tf310/ Mail the HAA to the following address: Id ,r iacclr-499.0) 2. TYPE OF RESIDENCE Single -Family ® Multi -Family 0 Other Number of Bedrooms 3 Diss ?, 1,,. 3. WATER SUPPLY Individual Vfell Cornmunity 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the'legality and status. (;11111' 4. SEWAGE DISPOSAL Onsite ® Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm i(a(4t eek," ice,f S-erdte4:4 Telephone 3 — Address I `f5 3 G E•ef�o S� s ch ©� cxxco�� A- k 995 / f Date / 241 / Br 4,.4.'1,' F'1Ao� O Pi49al .�.? . 772/,-+_ d '%THEODORE F. MOORE ; 0 CE - 3589tr e• o Engineer's Seal 6. DHEP APPROVAL /) Approved for 71 -11"e -e- bedrooms by f'717 4' -‘."1---c24 Date /0 - 2--a6., Approved Disapproved Conditional Terms of Conditional Approval /J ira .2-1,1. ny. ia-t P_-� _/- % G•-�I �'c2[t-%n.Gsw C �.�' /-e_.^� (, =7Q- t -n . " CAUTION • The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issfues!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 (11/84) MUNICIPAUTY OF ANCHORAGE DEPT. OF HEALTH & `✓ ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) SEP 2 4 to CHECKLIST - FEBRUARY 1984 264-4720 RECEIVED Legal Description. L-ol 2l I3luc k 2, Souk 111)rk S/Q A. WELL DATA Well Classification Pre&czf4 If A, B, C, D.E.C. Approved (Y/N) N4. 0.3( 9P°" Inea ecre. Well Log Present (Y/N) r Date Completed eme Yield t8 e n rev. (o)Total Depth 116'' Cased to '^` 116 I Depth of Grouting NA.V Static Water Level 79 ' Pump Set At 1061 Casing Height Above Ground 1 S " Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot 11.7' To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by N, A. Depression Around Wellhead (Y/N) N ; On Adjoining Lots 132; On Adjoining Lots To Nearest Public Sewer 100' -> 100` N.A. To Nearest Sewer Service Line on Lot N.4 ?'FM Water Sample Test Results SGckt Adory 4o , Date o14 er heccivrra� Comments 1.4e m e'er./ unzet cuell Po w wolf dust es ver rega r rern en f ,{p r ex 3 e rte mrn ho m e B. SEPTIC/HOLDING TANK DATA t" e Prfrn..sw. Date Installed g/31 /a 2 Size 1000 9f1 No. of Compartments 2 Standpipes (Y/N) r Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) N Depression over Tank (Y/N) N Date Last Pumped 9 /a y / 8( Pumping/Maintenance Contract on File (Y/N) All A. ; for 14'9. Holding Tank High -Water Alarm (Y/N) N, A. Temporary Holding Tank Permit (Y/N) N.6. Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line Si) To Water Main/Service Line ISA Course .> 100' Comments To Building Foundation /7' To Disposal Field To Stream, Pond, Lake, or Major Drainage I Page 1 of 2 72-026(11/84) n , 6 et 4 taw 1 J/27-9 1 0.4/174 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata (90 °' / Liotrr, Type of System Design Date Installed 8/ 3/ / 8 a Width of Field 36'" Length of Field Depth of Field "rrc'c4 76 , Gravel Bed Thickness y Square Feet of Absorption Area 606 Standpipes Present (Y/N) Y. Depression over Field (Y/N) N Date of Last Adequacy Test 9/22/8e Results of Last Adequacy Test Adefuafe Abe 3 bo(roon r Separation Distance from Absorption Field: To Water -Supply Well l 3 2 . To Property Line 7' ter ad- I. «i / f To Building Foundation 3 2 ' To Existing or Abandoned System on Lot pial. ; On Adjoining Lots > 30' To Water Main/Service Line N.4. To Cutbank (if present) N. A. To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area too /00' Comments MO 414641 oda+ not ex keno( /e /ro/71om o1 4'rave(, '7 =10" -of �(ufb J fan dirty aove efts al- i of4,n7 o/ C.o'.c -VsoMe (-eve/ err In Su ieente. D. LIFT STATION N, f}, Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** 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 T °. •21Date 912y/49Ci Company 1 (c4Wc'' 1eS S'Lla MOA No SCS ctSZ Receipt No. Date of Payment Amount $ Page 2 of 2 72-026 (11/84) 4vdt- 000. 9 - as-scb C431--• o Q'� �.'! ,4' 44 s �/49TH ..�* • V,..�1,.�` T 7,10-.4_ •ITHEODORE F. MOORE.• O '$ CE - 3589 44k Air Engineer's Seal CIVR. & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 October 18, 1986 14530 ECHO ST. ANCHORAGE, ALASKA 99516 M.O.A. Dep't. of Health and Human Services P.O. Box 6-650 Anchorage, AK 99502 Attn: Steve Morris RE: Health Authority Approval L2, B2, So. Fork S/D Dear Mr. Morris: On September 22, 1986 I conducted adequacy tests of the on- site water and wastewater systems serving the subject property located at mile 7.4 of Hiland Road in Eagle River. This letter is to supplement the information contained in the Health Authority Approval checklist. Although the well driller's log prepared in 1982 reports a yield 15 gpm, I measured an actual yield of 0.35 gpm in 1986, which is only slightly greater than the minimum acceptable yield for a 3 bedroom residence. It is impossible to predict whether this yield will change in the future. The wastewater disposal system was designed as an absorption trench containing 4 feet of gravel beneath the distribution pipe to allow sufficient sidewall area based on the reported soil absorption rate of 190 sq. ft. per bedroom. Typically, a system this new will have an operating fluid level near the bottom of the trench, however the static fluid level in this trench is the same as in the septic tank. During the adequacy test, the system did absorb additional water at a rate slightly greater than the minimum required for a three bedroom residence. Thus I concluded that the system is functionally adequate at this time, although it is not functioning as originally designed. It is probable that the system will have a shorter than normal life span, however there is no reason to predict imminent failure, nor is there any health hazard as it presently operates. I trust that this will answer your questions. Sincerely, Ted Moore, P.E. cc: Dave Jones NOR1`HERN TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 907-479-3115 8957 OLD SEWARD HIGHWAY, SUITE 101 ANCHORAGE, ALASKA 99518 907-349-8623 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY CLIENT ❑ PUBLIC WATER SYSTEM I.D. # PRIVATE WATER SYSTEM FlHvar %_t'C4IUr ea.l �e�vve c ✓ NAME , 4/53o 6-cAo s-74. Mailing Addres 'qe A-- I-- City / State 995-14-: Zip Code SAMPLE DATE: 9 eZ 96-- Phone 3 17/.5— Mo. uMo. Day Year Purchase Order No. SAMPLE TYPE: Routine ❑ Special Purpose ❑ Check Sample (for original contaminated sample with lab reference no. ❑ Treated Water ®' Untreated Water Sample Time No. Location Collected Collected by ( l� t 04 i3(oc.Pt Z Saute &,.'k S'OJFPO (3.57 3 4 5 6 7 8 .aboratory Ref. No. 9 10 Signature of Representative TjLat,06'C 711et-'-'<_� CASH CHARGE PREPAID TRANSMITTAL SPECIAL INSTRUCTIONS MAIL HOLD FOR PICKUP TO BE COMPLEBY LABORATORY Received at: nch.e� ❑ Fbks. Date Received !/`�/ .V1L Time Received Next Sample Due COMMENTS: SATISFACTORY UNSATISFACTORY U RESAMPLE R OTHER BACTERIA 08 T00 NUMEROUS TNTC TO COUNT Direct Verification Final • Count LSB BGB - Regylt• Comments *No. of yetal Coliform Colonies per 100 mis. Sbv Date Time CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 October 17, 1986 Mr. Robbie Robinson M.O.A. Dep't. of Health & Human Services P.O. Box 6-650 Anchorage, AK 99502 14530 ECHO ST. ANCHORAGE, ALASKA 99516 RE: Health Authority Approval - L2, B2, So. Fork S/D Dear Mr. Robinson: On September 22, 1986 I conducted adequacy tests of the well and septic systems serving the subject property located at mile 7.4 of Hiland Road in Eagle River, and submitted information to your office on September 24 indicating that the the systems functioned adequately for a three bedroom home. On October 1, you informed me that the Health Department was concerned about the possibility of shallow groundwater in that vicinity, and that you would require groundwater monitoring prior to issuing Health Authority Approval. What follows is my report on the requested monitoring, including a site plan showing the relative locations of the test holes and the water and wastewater systems. On October 9, the owner arranged to have test holes 1 and 2 dug to 8 feet and 9 feet in depth, respectively. The backhoe operator was unable to attain greater depths due to "bedrock". Based on this information it was apparent that the system could not be in compliance with Municipal and State requirements, so I arranged to conduct additional soil testing on October 15 and 16 for an upgrade system. The soil logs and perc test data for test holes 3, 4 & 5 are enclosed . Research of the well driller's logs for Lots 1, 2 and 3, Block 2, So. Fork S/D indicated bedrock to be in excess of 100 feet below ground':; level. In each of the three new test holes we were able to attain approximately 12 feet despite extremely rocky and hard digging particularly below about 8 feet. Thus, I con- cluded that bedrock is not a factor of concern, after all. Groundwater monitoring took place during a period of intense rainfall and flooding in Southcentral Alaska. Test hole #1 located approximately 7 or 8 feet east of the soil absorption system does have a stabilized water level 45 inches below ground level. Test hole #2 shows no water to 9 ft. One day after being dug, test hole #3 had a water level at 10.5 ft. below ground level which is itself 3 feet lower than in the vicinity of the septic system. Test hole # 4 had no standing water to 12 feet, and test hole #5 had water 8.5 ft. below ground surface which is about 10 feet lower than the ground surface at the septic system. Based on the above, it appears that shallow groundwater is not the cause of the high fluid level observed in the absorption trench. The relatively high level observed in test hole #1 can be attributed to it's proximity to the system, coupled with slow local percolation. Minor seeps observed in the six to nine foot range while digging several of the other test holes are perhaps related to the recent intense rainfall, and in any case are not significant enough to cause a free water surface in the monitoring tubes at that level. Perhaps the best explanation for the behavior of the waste- water disposal system is that the lower portions of the trench are unable to accept the entire wastewater flow, due either to surface clogging or tighter soils, causing the fluid level to rise to a point of equilibrium. In both test holes 4 and 5 downhill from the system, I noted more permeable material occuring in the top few feet, which would tend to encourage the system to behave as it does. The family using the system consists of five people including two children in diapers, necessitating large amounts of washing, quite possibly in excess of design amounts, yet there is no evidence of effluent ever daylighting from the system. Based on the above report, it is my opinion that there is not a groundwater problem affecting the performance of this system, nor is there a threat of contamination of groundwater downhill from the system. Accordingly, it is my recommendation that you issue the requested Health Authority Approval. Sincerely, Ted Moore, P.E. cc. Dave Jones 9436 Hiland Rd., Eagle River, AR 99577 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION OCT 171986 RECEIVED ooa�r►�\ 40.46:„ ti QF ��� /�......4............. ...... ao 6. THEODORE F. MOORE . •.• � CE-35£39��,�•/ kiklkcof +O �O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Dave To n ej LEGAL DESCRIPTION: if 0 # 27 1.3 lot it 2, DEPTH (FFFT) 2- 3- 4- 5- 6- 7 -- 8- 9- 10- 11 - 12 13- 14- (r SOILS LOG 1 PERCOLATION TEST DATE PERFORMED: 1 0 / is / t96 S-o..c%i Furl.. S 6-11 Sill?, Sundt' c-retvel S'undy, 51117 reeve! Puny cobble d- bad dee,' Smolt lf�v Seer al- ease' end • rv./ 1Yd% hole lrM ( maid' silly grave() 13.14. oF At Ilk w s,�sa�w\ Iff `'� *,: 49TH . THEODORE F. MOORE ; 20 - 541:"... CE - 3589 Vic', , °Q�, ,��yy ' j �`°....... .•`: ,.0 p PERCOLATION RATE 228 (minutes/inch) i-4. 7 ��$kk17 �Y���q�y�+/�� TEST RUN BETWEEN 'u FT AND �'6® FT COMMENTS 6- oano4. s'ar'J c,e le.,e/ 3' lower "doll alb' i-ree,C4 SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? rho le' - e l' la/l6'/g6' S L 0 P E i■■m1�.alis Date Gross Time Net Time C1Tlnj Depth to Water ■■■■■ Pre -Soak 1O/is" i2: 4..5- Pi/ — -- au to/l6 Zo ; M6 Ai/ It • !6 30 27 -lig 2s 7/r( t Igo Is ii is■■■■■■■It■ SO 27 3//6 2g'/�!' I/.t j 6 fii 0 #'3 It : Jig l2 ''-6 30 27 3/6. 2s '/76 1 i/r0 11■■O■■■11111 NINE KM■ 11 111 BO ME .'■■■11111riu■ lira, S■ III ■. I MI NM MI WI 115111 IIIII■I1■■■■■ -14 Reading Date Gross Time Net Time C1Tlnj Depth to Water Net Drop (jn Pre -Soak 1O/is" i2: 4..5- Pi/ — -- #t to/l6 Zo ; M6 Ai/ It • !6 30 27 -lig 2s 7/r( t Igo #2 ii fi .! 17 It •'�t7 SO 27 3//6 2g'/�!' I/.t j 6 fii 0 #'3 It : Jig l2 ''-6 30 27 3/6. 2s '/76 1 i/r0 R r PERFORMED BY: F(aMir •Tec6aifal Ser ' c.'s- 72.008 (6/79) CERTIFIED BY: T:214V430.! /1toege DATE: Lu//7/9t- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Da ve 1ToneJ LEGAL DESCRIPTION: 1-o 1 2� 15 ��rglla� 16 ,r:•4.' C9s''� 17 49TH 18 ,-,. r2-1.1(1-d4 y,_ _' l3 lac it- 2, Si l Ky 6rove (meitf) 5lIfy G-rofre Marty looulolirl and coyblrJ very •) 6^ plc✓r eH1 WAS dROUND WATER S L 0 tit SOILS LOG LI PERCOLATION TEST DATE PERFORMED: l0 / is- / 8( Forl^. S /1) SLOPE Al THEODORE F. MOORE ;�0 19 C - 3589 • 20 "PrenPrOlOSSi01�'�t► PERCOLATION RATE (minutes/inch) ENCOUNTERED? IF YES, AT WHAT DEPTH? No l47_0f n E E mtnrlor j,.tbe ro/r6 /6( SITE PLAN i Date cr Net Time \ Net Drop C)`-‘tM C.0 O 1 [-wtfrity.tilh.° cys r-rr+r T *TO 44— i4 iC T4f#i t ,' 16ir Ml r �I #g 53 Reading Date Gross Time Net Time Depth to Water Net Drop COMMENTS around sUr uee TEST RUN BETWEEN FT AND 3' h Act'? a /-fneAc4 FT PERFORMED BY: rtaktr Thchrcca! Servrcoo' 72-008 (6/79) CERTIFIED BY: (....4-‘,64_ 1°Te^e- DATE: le/ r% /&(s MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: DLf ve Ton LEGAL DESCRIPTION: 10 11 12 13 14 15 4"*„. aFq 'o 17 49121 % •,S t°0 t.o 2/ t3 /oar ce fly Grave / Cleaner 617 Sandy 1roveI bit SOILS LOG NI PERCOLATION TEST DATE PERFORMED: 1 0 / 16" / dd' S oz c% FcrIv S /1) 64`1 Sandy St Or Grave/ pocfre& ©o` Sandy ma/7 moist Sm EIzO S,te( 4Z,® t3. N, 18 THEODORE I-. MOORE •• / ri•" '• CE -3589 •'4* 19 . . 20 k (�professic0 �`♦ s J. f7• COMMENTS 6r0u410( feoe t SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Y L 0 19.4-+ E 10/t6/66 1 Reading Date ti f1Z \ Net Drop (14) Pre Sok ta/ tu/' 1 ! tc Pr/ #f 1® /!e, to i43 it .''z. 3 o 27 ly e7 'V/4 Z !i It .° 2Y ti:SY 34 27 +<y c'7'O®6 3//e - 'i !i :4-1 t2:2y 30 2 7 V4- s7 S6 37d/ 5 °9‘4.,Ls.V'e\ 0 e.iis fill S%s —.Wet Fr+`____), . ° T '714 1t3 / 1. 1 7k1o3 C L !di N� ` —41 1 Reading Date Gross Time Nett Time 6114 Depth to Water Net Drop (14) Pre Sok ta/ tu/' 1 ! tc Pr/ #f 1® /!e, to i43 it .''z. 3 o 27 ly e7 'V/4 Z !i It .° 2Y ti:SY 34 27 +<y c'7'O®6 3//e - 'i !i :4-1 t2:2y 30 2 7 V4- s7 S6 37d/ „PERCOLATION RATE (60 TEST RUN BETWEEN 3'6.- FT AND (minutes/inch) la' let -G, 7100 :S ,4enc4 FT PERFORMED BY: ftCkeitip �lGnn4CCZf Sedvre-tf' CERTIFIED BY: arc,' Met -k,(,_ 72-008 (6/79) DATE: 1a//71d5 i_rr .1 UN DEVElc)PEp yvrr.E.57",EA_! ,S'rrE P1—AN /..G T 2, (3 1-a C k 2, Sou rH FO/ S/fj • Se -44, / " = FIatto'p Technical Services 14530 Echo Street I)Are ; 10/17/ 6( Anchorage, Alaska 995111 *;. 49TH liy �o o- THEODORE F. MOORE CE- 3589 . `r O, MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date 2-2-6-13 T (a) Legal Description (include lot, block, subdivision, section, township, range) C._2. t3 Z So. Fes(- W0 Loo�fi�.�tion (a dress or directions) (b) Applicants Nana Ca ,^ 7 ,E'J S®7 (/ Telephone 1l f—..S77 7 Applicants Address SIL- g e Fis-7) (c) Applicant is (check ore) Lending Institution ; 47.4ister4builder Buyer ' ; Otherf t (explain); (d) Lending Institution iee )J Address C - r 4 Telephone (e) Real Estate Co. & Agent Address Telephone 2. Type of Residence Single -Family Number of Bedrooms 3. Water Supply Individual Well Multi -Family Community Other (describe) Public 11 Note: If ctxurunity wall system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this HAA 4. Sewage Disposal Onsite Public' Corranunity Holding Tank' i Is the wastewater disposal system adequate far the number cf bedrooms [Page 1 cf 2] 2-15-84 5. Engineering Firm Providing Inspections, Tests, Data and Information I certify that have checked, verified, or conformed to all NIDA HAA Guidelines effect on •._ e of thi nspection. Signed -A1/ Name ' Firm Address Signed by Date . t t1MIESRIN s taCK GE 1VER, AL*V 6.DHEP Approval Approved for ApprovedJ< Disapproved' (ENGINEER SEAL) edrooms Date Telephone Z-2 7--6- in By t c a c .,(2! .--e _ Date a < Conditional pi Terms of Conditional Approval The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedrooms and type of structure indicated. (DEEP SEAL). 7. Mail th � tp� the llawing addr$ss:,,,,,id,9 V( i KB2/d5/s [Page 2 of 2] MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION!! MAR 2 1oRa RECEIVED WELL DATA Well Classificatio Well Log Present Total Dept / If A, B, or C, D.E.C. Approved(Y/N) 6692 Depth MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST`- FEBRUARY 1984 Lot 2 Block 2 Southfork Subdivision Date Completed /& Cased to 14' Depth of Grouting Static Water,Level 20 Pump Set At At, Casing Height Above Ground " Sanitary Seal on Casing Electrical Wiring in Conduit Depression Around Wellhead Separation Distances frau Well: r To Septic/Holding Tank on Lot ./n.,/; On Adjoining Lots 4/7/4 To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots / 1 To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/Manhole 0/1//19.�^a To/ Nearest Sewer Service Line on Lot 44/44Water Sample Collected By .5 ..4,57 rlob /lk Date Z 6 Water Sample Test Results //124- 42c: D`y ry Comments /-,4_' 7 _w fr € Gv r %.S B. SEPTIC/HOLDING TANK DATA Date Installe• 8 f/3/ / size / e7O0 No. of Compartments 2 !/I lull Foundation Cleanout Standpipes Depression over Tank Air -tight Caps (� Date Last Pumping/Maintenance Contract on File ( /N) Holding Tank High -Water Alarm (Y ) Separation Distances from Septic , To Water -Supply Well /00 f To Property Line l 4- To Water Main/Service Line Course // Comments � ./ for w mporary Holding T nk Permit (Y/N)f°` - Tank: 1 To Building Foundation To Disposal Field 6 tf To Stream, Pond, Lake, cr Major Drainage r�yv j y. &7, "(2-ecor d J' C. ABSORPTION FIELD DATA Soils Rating in Absor Date Installed Width of Field tion Strata // // 97 Type of System l sign a Length of Field Square Feet of Absorption Area Depression over Field (o9!.% Results of Last Adequacy Test Depth of Field Gravel Bed Thickness Standpipes Present ite of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well /220 To Building Foundation ,/ 3/ /� Lot /(/ //4- ; On Ac} j ining To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course }e ac/ To Property Line / To Existing or Abandoneddystem Lots ///fJcC/C' -re . To Cutbank(if p esent) /1/ %..///4-4 G� /l /e'-ec.e7.7.r To Driveway, Parking Comments Area, or Vehicle Storage Area f-l�r3/v' D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dimensions i/ Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Electrical Codes(Y/N) 1 Continents Pumping Cycles during Adequacy Test. Meets MSA ** Check Permitte. Bedroom Rating Against HAA Request ** I certify th I h.,e ecked. on the da •f th11 All44010Gr t" Signed Compa KB1/d5/s [Page 2 of 2] rified, or confer:red to all MOA HAA Guidelines Date ;,7-2.-.7-/Y MOA No. in effect 2-15-84 ADEQUACY TEST WATER AND SEWER INSPECTION WELL INSPECTIONS AND FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN EXCAVATION WORK ROBERT A. SHAFER March MUNICIPALITY OF ANC`1SI�I°�NGINEER DEPT. OF HEALTH & 694-2979 1, 19�RONMENTAL PROTECTION Municipality of Anchorage Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 fvA\f 2 ennA RECE VED REFERENCE: Lot 2; Block 2; Southfork Subdivision Request the Health Authority be granted for the residence located on the referenced property. The following information is submitted for your review: A. Application for Health Authority Approval B. A checklist dated February 1984 for Health Authority Approval C. Well log 9o09,4 D. A water analysis report for total coliform bacteria. In addition to the information provided above an inspection of the well casing was performed. It is found that the well was equipped with an adequate sanitary seal and that the well wires are in conduit. The ground around the well casing adequately slopes away from the well. A well yield production was performed on this well and it was determined that the welt will produce as a minimum 0.104 gallons per minute per bedroom. However, the well cannot be guaranteed against subsequent reduction in flow or complete failure. The septic system was installed on this property in August of 1982. :The system was never, placed into operation until the current residence wasconsructe A visual inspection of t e "system indicates that 1 the clean -outs are exposed and are equipped with adequate air tight seals. If we ma be of further service, please do not hesitate to contact use Sino E A. F2, P.E. R'S/ss SRB 196X EAGLE RIVER, ALASKA 99577 CHEMICAL & GEO`OGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water Same Mailing A.dress 1 (•) See h on back I.q NO. 6 711 �9 77 / Phone No. 9 -YS -7 2 city /j� SAMPLE DATE. I �!' 1 Z I 0. 2-1' . State Zip Code Day Year SAMPLE TYPE: D Routine D Check Sample (for routine sample 0 Treated Water with lab ref. no ) treated Water !Special Purpose SAMPLE NO. 1 2 1 3 1 4 1 51 Z B Z Time LOCATION Collected e -J lane- (A. `Z_ Collected TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfactory ❑ Unsatisfactory ❑ Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. z - a=t Date Received Time Received / O Analytical Method: ❑ Fermentation Tube ❑ Membrane Filter Lab Ref. No. I I Result' ((Analyst to 111 1 1 1 •No. of colonies/100 ml. or No. of Positive portions. READ INSTRUCTIONS BEFORE 06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1976 Date Collected Source Time Received p.m Lab No y.{e ra.M1o1.w Presumptive 10m1 10m1 10m1 l0m1 10m1 1.Om1 0.1mI 24 Hours 48 Hours Confirmatory 24 Hours 48 Hours EMB Broth 24 hours. Broth 48 hours: COLLECTING SAMPLE Multiple Tube Report' 10m1 Tubas PosltIve/Totat 10m1 Portions Membrane Filter: Direct Count Collform/100m1 Verification: LTB BOB Final Membrane Filter Results Reported BY Date /'�-'8��f� Time. / S Coliform/100m1 a m.