HomeMy WebLinkAboutDENALI VIEW BLK 3 LT 6benali Vi w
Block 3
Lot 6
#015-461-07
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP191309 PID Number: 015-461-07
Dwelling: ■❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade
Name
STEPHEN MARSHALL
ABSORPTION FIELD
❑ Deep Trench ❑ Wide Trench ❑■ Bed ❑ Mound
Site Address
12300 SULTANA CT *ANCHORAGE, AK
❑■ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
907-301-8047
5
*2.0 GPD/SF
SEE DWG Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
SEE DWG Ft.
Gravel depth beneath pipe
0.53 Ft.
Subdivision Block Lot
DENALI VIEW; BLOCK 3, LOT 6
Fill added above original grade
SEE DWG Ft.
Gravel length
30 Ft.
Township Range Section
N/A
Gravel width
12 Ft.
Beds: Number of Lines
5
Distance between lines
2.5 Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
360 Ft2
-
- Ft.
Well
*50'+
25'+
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer Capacity
Surface Water
*50'+
Gal.
Material Number o partments
Lot Line
10,+
NA
Foundation
10,+
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks *CAT III - PER OWNER SEPTIC TANK WAS
REPLACED WITHOUT A PERMIT IN 2003
Alarm loc
Electrical installed by
PIPE MATERIAL House to tank UNK Tank to1785
drainfield
Installer
A+ HOME SERVICES
Drainfield 1785 CO/MT3034
Inspector DAVID GARNESS & TIM ECKLUND
BENCH MARK (Assumed elevation) 97.55 ft
Inspectiond1st 7/31/19 7/31/19
Location and description
2nd
dates:
TOP OF MANHOLE
3rd 8/1/19 4th
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
0600 �O
Date
.........¢.. 9s,4p0
oo
............... ....... D
Septic System _
_L
000 A795arne s.
ApprovedDatesel
Note: this approval does not include well permit requirements.
Opo rofess'O°o�
#AECC884 0000 d
(Kev u5N2/18)
PERMIT NUMBER:
OSP191309
A I B F C
FCO 21.3 5.2 36.5
STI
23.1
16.9
44.6
ST2
17.9
22.7
55.3
MH
16.9
24.2
57.1
MT1
28.3
30.2
57.7
MT229.5
36.8
69.9
MT3
60.0
64.2
86.8
MT4
57.6
57.9
75.7
RECORD DRAWING PARCEL ID
015-461-07 NUMBER.
1 00'WELL RADIUS
/ I \
I
DECK •:; •. .
DENALI VIEW; BLOCK 3, LOT 5
MT2
M EXISTING 4
MT S BEDROOM HOUSE \
?i
MT1 =•'''•
S C
T4 •• •'' K
\ NEW IDSF REBUILD •�- ORNE�P +� •..
I THE STEP TANK INSTALLED IN 2000 WAS REPLACED WITHOUT
A PERMIT IN 2003 PER CONVERSATIONS WITH THE OWNER;
ATTACHED IS THE RECEIPT FOR THE SEPTIC TANK
I INSTALLATION FROM A+ HOME SERVICES; SEPTIC TANK WAS
EXPOSED BY A+ HOME SERVICES AND INSPECTED BY MOA I DENALI VIEW; BLOCK 3, LOT 7 ONSITE EMPLOYEE TIM ECKLUND AND DAVID GARNESS PRIOR
TO THE INSTALLATION OF THE IDSF
/ � N
SCALE:
/ 1 1" = 40'
GARNESS ENGINEERING GROUP, Ltd
— ENGINEERING o SALES o CONSULTING — — -
3701 E. TUDOR ROAD. SUITE 101 'ANCHORAGE. AK 99507' PHONE (90713376179' FAX (9 071 3 3 632 4 6' WEBSITE: vnvw.aamessenameema.com
PREPARED FOR:
PHONE NUMBER:
PAGE NUMBER:
SHARON MARSHALL
907-301-8047
2 OF 3
LEGAL DESCRIPTION:
DRAWN BY:
DENALVIEW; BLOCK 3, LOT 6
D.J.G.
TYPE OF WORK:
DATE:
SEPTIC SYSTEM RECORD DRAWINGS
8/7/2019
-q •cp —.4 .... \,
LICENSE 844, �;;;`S`%
#AECC884
PERMIT NUMBER: PARCEL ID NUMBER:
OSP191309 RECORD DRAWING 015-461-07
GEG WAS NOT PRESENT DURING THE SEPTIC TANK 'SLUDGE IN 1ST COMPARTMENT OF TANK DID NOT ALLOW
INSTALLATION; PER OWNER AND RECEIPT PROVIDED BY FOR AN ACCURATE MEASUREMENT TO BOTTOM OF TANK
A+ HOME SERVICES, THE TANK WAS REPLACED IN 2003
WITHOUT A PERMIT; ALL ELEVATIONS WERE
CALCULATED IN 2019 AND HAVE LIMITED ACCURACY TANK SIZE IS ASSUMED BASED UPON PREVIOUS TANK SIZE
FINAL GRADE = 97.16-99.42
TOP OF TANK STS ST2 MH
AT INLET = BUNK TOP OF TANK AT OUTLET = 91.3
/(ASSUMING A T TANK DIAMETER)
EXISTING
VERT OF S.T.E.P. TANK INSTALLED IN 2003
INF BUNG
IN INLET BUNK PER OWNER AND A+ HOME
SERVICES. MAX BURIAL DEPTH AND
VOLUME IS UNKNOWN -ASSUMED
ji 2000 GALLONS
BENCHMARK SHOWN ON 2000 INSPECTION REPORT ORIFICES DRILLED ARE 1/8" DIAMETER AT 2 FEET ON CENTER
COULD NOT ACCURATELY BE DETERMINED;
THEREFORE, ELEVATIONS WHERE SHOT AND FILTER FABRIC
CALCULATED AFTER THE SYSTEM WAS EXPOSED MT (ONE AT EACH
CORNER TYP.)
FINAL GRADE = 95.9-97.5 R
INVERT OF NEW
DISTRIBUTION LINES = 90.93
12'+
ORIGINAL AIR LINE
GARNESS ENGINEERING GROUP, Ltd
---_--- ENGINEERING o SALES o CONSULTING— -
3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507' PHONE (907)337-6179- FAX (907) 3383246' WEBSITE: w gamessengineenng.com
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
SHARON MARSHALL 907-301-8047 3 OF 3
LEGAL DESCRIPTION: DRAWN BY:
DENALVIEW; BLOCK 3, LOT 6 D.J.G.
TYPE OF WORK: DATE:
� SEPTIC TANK AND DRAINFIELD PROFILE 1 8/7/2019
WASHED PEA GRAVEL
-OP OF NEW SAND = 90.40 - BOTTOM
OF "OLD" SAND WAS SHOT AT 90.30
BOTTOM OF SYSTEM = WAS NOT
EXPOSED DURING INSPECTION
F
. ...............,
0
• .. ............• •...........• 0
0♦ :t a A. Gar ss ::
om
♦♦% C -7 �_=
•
LICENSE 1ItIR�FESS1v:����
#AECC884 1������ /
7/
/. 11 )1-1
MUNICIPALITY OF ANCHORAGE 1/3�n�'
On-Site Water&Wastewater Program ,•',ver,t S{,
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http://www.muni.org/onsite
Rh�HORTGE epartmenc
On-Site Wastewater Disposal System Permit
Permit Number: OSP191309 Effective Date: 7/23/2019
Work Type: Septic Upgrade Expiration Date: 7/22/2020
Tax Code Number: 01546107000
Site Legal Address: DENALI VIEW BLK 3 LT 6 G:2741
Site Mailing Address: 12300 SULTANA CT, Anchorage
Owner: MARSHALL STEPHEN & Lot Size in Sq Ft: 42115
Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 5
This permit is for the construction of:
Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: No exception to total absorption field area being 15 sq.ft. less than required, utilizing the 2
gpd/sq.ft. soil rating required of an IDSF system.
7
0Received By: Date
Issued By: feljOlea, 6-AitD- Date: 7
aZ 3 1 9
MUNICIPALITY OF ANCHORAGE
Community Development Department -
Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On-Site Water & Wastewater Program
Mayor Dan Sullivan
On-Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 015-461-07
Property owner(s) Steve& Sharon Marshall Day phone 907-301-8047
Mailing address 12300 Sultana Court 'Anchorage. AK 99507
Site address 12300 Sultana Court *Anchorage. AK 99507
Legal description (Sub'd, Block & Lot) Denali View; Block 3, Lot 6
Legal description (Township, Section & Range)
Lot Size Sq.Ft. Number of Bedrooms 5
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING:
(®all that apply) Initial
Absorption Field ® ❑ Single Family (SF)
Upgrade ® (w/wo ADU)
Septic Tank ❑ Duplex (D) ❑
Renewal ❑
Holding Tank n Multiple Dwellings ❑
Privy ❑ T OS (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR:
N/A
Distance: -
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 15 Waiver Fees:
Date of Payment: -7-lict 9 Date of Payment:
Receipt Number: n01193 L7 Receipt Number:
Permit No. 05P1` 1367 Waiver No.
(Rev.01/11)
. t• __ Quaiiics
GARNESS ENGINEERING GROUP, LtdAdvanced Trevnt 5, C,„'"
ENGINEERING SALES CONSULTING Cr.-M v
Dealer
July 15, 2019
Municipality of Anchorage
Development Service Department
On-Site Water&Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic System Upgrade for Denali View; Block 3, Lot 6
To whom it may concern:
The existing 5-bedroom house is served by a private well and septic system. The bottomless
IDSF is in a state of failure and needs to be upgraded. We are proposing to re-utilize the existing
2,000-gallon STEP tank and re-build the IDSF. We are proposing to excavate out all contaminated
material, import MOA approved sand as needed, and re-build the existing drainfield at a higher
elevation. It should be noted that the existing IDSF was given a 3 gpd/ft2 soil rating, even though
only a soil rating of 2 gpd/ft2 is allowed. Using an application rate of 2, the re-built bed will be
undersized by 15 ft2. We are requesting a variance that your department allow for either the use
of the application rate of 3 which was used previously, or to allow the drainfield to be slightly
undersized when utilizing an application rate of 2. Comments regarding the design are
summarized as follows:
1. SOILS: See the attached 2000 soil log by Mike Anderson. P.E. which shows the soil
classifications, groundwater monitoring, and the percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY: As can be seen on the attached design drawing, the average topography
around the proposed drainfield is less than 10% running southeast to northwest.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If yo have any questions, please contact us at 337-6179. Thank you for your
assistance.
S :rel
41
Jeffr_r ' . arness, '.E., M.S.
Pre d_ t
3701 East Tudor Road, Suite 101 *Anchorage.Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com
I
DENALI VIEW;BLOCK 2, DENALI VIEW;BLOCK 2, DENALI VIEW;BLOCK 2. DENALI VIEW:BLOCK 2,
LOT3 LOT4 LOT5 LOT6
,44
> A 41*•
. /..
44
700.E ( 100'WELL RADIUS
R9p/ps 1 ' I
100'WELL'•DIUS iP.
D IEW.BLOCK 3,
SULT• NA DRI TirMigial L. 10
millir VACAN
100'WEL -�
IIIIIIIIIIIWIIIIIPraIPIr
v
L RAD DENALI VIEW;BLOCK 3.
00• LOT 9
\ • IF 4411111111 111111111" K>
*To, -1000•.
...0-14KN
111.1* 11116
100'WELL RADIJS
' �•0' Y DIUS
lir
/// •
DENALI VIEW;BLOCK 3.
D t LI IEW;BLOCK 3. DENALI VIEW:BLO 3. LOT 7
LOTS
011rV, D. ALI VIEW;BLOCK 3,
LOT 8
110'WELL RADIUS
SCALE:
1"=100'
— ...._�
n
— - L , oma4.
A�
" * : . � 'GARNESS ENGINEERING GROUP, Ltd/:
•
.
ENGINEERING SALES CONSULTING 3-
• • 0
3701 E.TUDOR ROAD,SUITE 101'ANCHORAGE,AK 99507•PHONE(9071 337-6179•FAX(9071 338-3246'NEBSfTE:www.gamessengneenng.com 0 • ••• It.
•
PREPARED FOR: PHONE NUMBER PAGE NUMBER: : Jeffr A. G ness : 1.
STEVE& SHARON MARSHALL 301-8047 1 OF 2 #j0 .� C 53 ���
PROJECT/LEGAL DESCRIPTION: DRAWN BY: ��`P�'' �\,:
DENALI VIEW: BLOCK 3, LOT 6 PNB ���f'F�'•7 �: (• ''••�•�'i•
TYPE OF WORK: DATE: ♦41 pROFESS\c ♦
SITE PLAN 7/15/19 LICENSE ��-Vi„"..10♦
#AECC884
7�,
GEG,Ltd.HAS AN 8 PAGE SPECIFICATION LETTER DESIGN CRITERIA:
THAT PERTAINS TO THIS DESIGN.BY PROCEEDING
NOTE:CONTRACTOR SHALL HAVE ALL WELL RADII FORWARD WITH THIS INSTALLATION,THE NUMBER OF BEDROOMS:5
SHOWN ON DESIGN DRAWING AND THE WEST LOT ENGINEER,WELL DRILLER,CONTRACTOR AND GALLONS PER DAY(GPD):750 GPO
LINE FLAGGED BY A REGISTERED LAND PROPERTY OWNER AGREE THAT THEY HAVE PERCOLATION RATES:*29 MIN/INCH
SURVEYOR. READ THESE SPECIFICATIONS AND AGREE TO PROPOSED APPLICATION RATE:"2.0 GPD/FT'
ACCEPT THE TERMS AND CONDITIONS OUTLINED. - MINIMUM IDSF SQ.FT.:"'375 FEET'
*PER MIKE ANDERSON 2000 SOIL LOG
"PROPOSED IDSF
"REQUEST FOR VARIANCE ON REQUIRED FT'
DRAINFIELD DESIGN:
•
MAXIMUM DEPTH:LIMITED TO REMOVAL
OF CONTAMINATED MATERIAL
WIDTH:12 FEET
LENGTH:30 FEET
SULTANA DRIVE M.O.A.APPROVED SAND FILTER:2 FEET
EFFECTIVE:0.5 FEET(MINIMUM)
4 i
iiiiillirrIDSF FEET':360 FEET'
i//////////////////////////////////ir 11666.,
100'WELL RADIUS .IV NG
72\e,,,,, r"
7
114 t
DENALI VIEW EXISTING AIRLINE TO
BLOCK 3,LOT 5 BE RE-UTILIZED
\.,;,.
INSTALL FCO IF ONE DOESN'T EXIST
��� EXISTING 4 �
• MT BEDROOM HODS 0016* •7. '.
I EXISTING 2,000 ALLON STEP •+•�•"�,•••
TANK TO BE - -UTILIZED•
EXISTING IDSF 12'X30' +: ...... • ` •'' tea••; .•.
BED TO BE RE-BUILT '-•••".••' ''j°• ••••.:•4) ':•••
\?,1 ',•i`, `-Z• DRIVEWAY
\Q �••i••.•..Itr )k
S ALE:
DENALI VIEW;BLOCK 3,LOT 7
1"=40'
GARNESS ENGINEERING GROUP, Ltd •• -
ENGINEERING•SALES•CONSULTING % •
,••3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE,AK 99507•PHONE(907)337-6179•FAX(907)338.3246•WEBSITE:www.gamessengYleming.com •
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ,0 J: ' A. Gar -ss
STEVE&SHARON MARSHALL 301-8047 2 OF 3 ♦j�p•••• C.--•s .•:' =�
PROJECT/LEGAL DESCRIPTION: DRAWN BY: #. �,
DENALI VIEW; BLOCK 3, LOT 6 PNB ♦♦ •�•••''� •(b •�0:0*(e, '4,0
TYPE OF WORK: DATE: 440 FL. *) 444
LICENSESEPTIC DESIGN UPGRADE 7/15/19 #AECC884 1�'��'���
i
3/4"DIA.SCH.40 PVC LATERALS
(HOLES,SHIELDS,AND FLUSHING
VALVES PER ORENCO DESIGN)
12'x 30'BOTTOMLESS IDSF.
EXISTING AIR LINE COIL
/
i I I 1 1 1
• / 4 I 1 1 { I 1 I 10
1 I 1 1 1 1 I 1 I 1 1 1 1 �O
1
{ , , , V I 1 V I J Q cv
\ 1 I 1 1 1 :ORATE:
111IIIAQI1IiIIIIII1I •IqI30 14"DIA.MONITORING TUBE AT EACH FLUSHING VALVESEXISTING DISCHARGE LINE CORNER PERFD BETWEEN TOP (WITH PROTECTIVE COVERS)
FROM STEP TANK AND MANIFOLD OF SAND AND DISTRIBUTION PIPE (EXTEND ABOVE GRADE)
INVERT.(DRILL 1/4 INCH DIA HOLES)
MINIMUM 2'+OF COVER 9"OF WASHED PEA
AN ALARM FOR THE AIR GRAVEL MEETING
PUMP MUST BE INSTALLED MOA IDSF SPECS
MT FILTER FABRIC
MT
fINSULATION
37
S(OQF
•••i•i•'•i i•i••i•i•:•i•i•'•i•i•i•+• 4•i•i•i•.•i•i•i•i•i• •in •ice'•'•
REMOVE CONTAMINATED PEA -- �' ` `�'°�' ��sa'r. r"'''erg •t'u"
GRAVEL AND SAND �?•r+4`'S.. is Y'3;`'F` �+'.3A �3.�+X,... .< '�y,s INVERT OF PIPE=0.50'ABOVE TOP OF SAND
EXISTING AIRLINE '4"•"''y l'='.�'4}r•:•� -c417.1i- '='.� "� •:;',.
N V.4.�'•A-F"Y' TOP OF PROPOSED SAND=0.1'
N4••'A Y.•f.=K•i:;�•,9. . HIGHER THAN EXISTING SAND
12 FEET 1
LIMITED TO REMOVAL OF
CONTAMINATED MATERIAL TOP OF EXISTING SAND
NOT TO SCALE
dk�%% %%al
.4 I 1
� •
1
GARNESS ENGINEERING GROUP, Ltd 9 / �'�'� �:
Fa.........._ ��� ��CIVIL&ENVIRONMENTAL ENGINEERS -a - 0 •��••
3701 E.TUDOR ROAD.SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337.6179•FAX(907)338-3246'WEBSITE:www.gamessengneering corn %.. •
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • J •• A. -•S i z-Li/
STEVE& SHARON MARSHALL 301-8047 3 OF 3 �• - Er/7913 _‹a
PROJECT/LEGAL DESCRIPTION: DRAWN BY: ..v/s, . •*CD'ar
j'
DENALI VIEW; BLOCK 3, LOT 6 PNB �1 .. �r• �'T• _�'.�
TYPE OF WORK. DATE. ♦�� �'ROESS\ P�•
IDSF DETAIL 7/15/19 #A CC 114��'I"
Anchorage Tank&Welding,Inc. Intermittent Sand Filter
SAND FILTER CONFIGURATIONS
30. -
50 MIL PVC LINER
12" ORIFICE 5NIELD
�a`�,p--() - -0_ -�'-_�Owl 0- 0 60
50*
FLU5WN6 VALVE 90x
>0 a 4 0 a 0-- 0 0 0 '-0---0 0 0
FROM 5 T E p. ---,G / C
GAP
S"'5177`. ... D15CNAR6
a \\...0 --TOAILINE
SE LIN
_..)
12'
4'CLASS 125 SLOTTED PVC
PIPE(1/4'?NOE SLOTS 2-1/2'
- .• ... ....•.. .. •. •--. • • O DEEP AT 4'04)
FROM AIR y
COMPRft 3/4'PVC;.ATERAL
0,-._-�__.0_0---- -,•=.---=6-..4' (w/I/5'4,ORIFICES)
I-I/4'PVC MANIFOLD
TOP VIEW
12 x 30 SAND FILTER w/GRAVITY DISCHARGE
Page 37
PLAT NO. 76-211
DENALI VIEW SUBDIVISION
LOT 6, BLOCK 3
42,115 S.F.
---' pR�vE �,
SU�Tp,NA G
LA
C 2`
7
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1.. 211.20' n
WELL J, OG\
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ck
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Igo
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. SEPTIC SYSTEM f • ��`S rn `6°� `1S.4141`�1 6,O
'. 76.3' •
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AS -B U I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE
���' p'• q*♦ GASTALDI LAND PROPERTY DEPICTED ABOVE AND THAT NO
.� ♦ ENCROACHMENTS EXIST EXCEPT AS INDICATED.
G' .•.• qs, ♦. SURVEYING. LLC IT IS THE RESPONSIBILITY OF THE OWNER TO
a JEFF A. GASTALDI, R.L.S.al *: 49TH *\ v*.. 2000 E. DOWLING RD.. SUITE 8 DETERMINE THE EXISTENCE OF ANY EASEMENTS,
• ./ COVENANTS OR RESTRICTIONS WHICH DO NOT
•� �'0a .0 ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBOMSION PLAT.
Jeffery A. Goslola� •: o a PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA
♦ 4, �.• 7/12%2019 e " GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR
•♦♦PdA� ••••••'•'eo�e`'J�.� SW2741 7/12/2019
ESTABLISHING BOUNDARY OR FENCE LINES.
♦♦;fess�ono�;'�� ANCHORAGE RECORDING DISTRICT, ALASKA
1■W1 F.B. JOB NO.
00-13 DVS63 NOTE : NO CORNERS SET THIS DATE
Municipality of Anchorage Pa~e. I o! 3
· DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 ~, Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater'Disposal System and/or Well Inspeclion.Repod, .-.
..: . Pe'rmitNumber: SW000029 ' ' ' · PiONumt~r:. 015-461-07 ' "..
'~""": " ..... '" ...... · ' ' ' .... Wastewater S~,s{em:'.' 0g New'~ ' O upgrade
crown Pointe/:jI~6. ' ' '. · · '
:. PiO.'.Box'.112313 'Ankh.',' 'A]~.':9'~511'. '":'. : ·':ABSORPTION FIELD.. :.:..'..
"~" · ....... '.'." . .... . '.I,o.,"B~,oo-~ .... · '" · ..... ,;'' ~". o~d..o' "' ' ,o~,d'm~,~,.'" '"'
.34526277 .-....v.;.' =' i. '. I Five..(5)' .. ODeepTrenc.h ,OSha!° Tren~.
' .: %?'. LEGAl:DESCRIPTION .':.: . --:..
cot : "" "i "' ~ ' '" ' ."5 ' "J'"? '
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Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 - Anchorage, AK 99519-6650 - 345-4744
On-Site Wastewater Disposal System or Well Inspection Report
Page 2 of 3
Permit Number SW000029 PID No. 015-461-07
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PLAN
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 -Anchorage, AK 99519-6650 -343-4744
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number SW000029 PID No. 015-461-07
Page 3 of 3
"0" ~ 2,000 GAL.
88. STEP Tank
'87.4
85.3
. 96.2' :.
' Flushin~ '/" . -
Valve
'Geotextile Fabric
2' Ftlter'San~
I · 30' ' ' '1 ' '
6" of.3/8'~ Pea...
Airline '- '
",.:[ ' ': - -',,..T.: ................
Municipality of Anchor. age
Department of Health anti Human Services
825 'L' Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
Rick Mystrom htr p://vnvw cl anchor age.ak us
Mayor
Permit Number: #SW ..p00029 Date of Iaaa," .3-8..00 .Parcel J,h'ntifleation .Number: 015-461-07
Date Started: 4-5-00 Dale Completed: 4-6-00 Is well located at approved permit location? [] Yes [] No
Legal Description. Denati View blk 3 It 6
Property OwnerName & Address: Crown Pointe INC.
PO Box112313
Depth (fl) Method of Drilling [] air rotary [] cable tool
From To
Casing type: steel
Borehole Data:
Soil Type. Thickness & Water Strata
stick-up
Gravelly silt
BedroCk
0 2
2 13
13 226
RECEIVED
flOV 29 2000
Mumc~pality ot Anchorage
Oept. Health & Human Services
Wall Thickness: .025 inches
Diameter: _6 inches Depth: 20 feet
Liner Type:
Diameter: inches Depth: .~ feet
Caslng stickup above ground: _2 feet
Static water level (from ground level): 13 feet
Pumping level: 226 feet after
_2 hours pumping _4 gpm
Recovery Rate: _4 gpm
Method of Testing: airl~
Well Intake Openlng Type:
[] Open End [] Open Hole
[] Screened Start feet Stopped feet
[] Perforations Start feet Stopped feet
Grout Type: bentonite # 8 Volume: I bgs
Depth: Start 0 feet Stopped - feet
Pump: Intake Depth feet
Pump size hp Brand Name
Well Disinfected Upon Completion? [] Yes [] No
Method of Dislafection: clorine tablets
Comments:
Well Driller: Alpine Drilling & Enterprises
PO Box 110496
Anchorage, AK 99511
A'ttemim~. 'Th~: weal drillet'shali vtovide a well log to the property owner w{th;,, 30 days of completion and the property
MUNICIPALITY OF ANCHORAGE
Depa~ment of Health and Human Sen/ices
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Mar 08, 2000
Expiration Date: Mar 08, 2001
Permit Number: SW000029
Legal Description: DENALI VIEW BLK 3 LT 6
Design Engineer: 0014 Anderson Engineering
Owner Name: Crown Pointe, Inc.
Owner Address: PO Box 112313
Anchorage, AK 99511-2313
Parcel ID: 015-461-07
Site Address:
Lot Size: 42115 SQ. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well
[] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 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:
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On-Site Sewer/Well Permit Application
Single Family Dwelling
Property Owner Name: Crown Pointe, Inc.
Mailing Address:
Legal Description:
Lot Size: ./~,~//5
Number of Bedrooms:
Day Phone: 345-6277_
P.O. Box 112313 ' Anchorage, AK 99511-2313, _
Lot 6, Block 3, Denah View Subd,v,s,on ~--~/- ~'~ ~'~'~
..Square Feet ' Inspections will be conducted y:
Five (5)' X Approved Engineering Firm
"Municipality (permit fee included)
. . Does your house contain any of the following: Hot Tutti Swimming Pool, 'l'~erapy Pool, Jacuzzi,
Or Water Soflener Unit? No Ifyes, whichone?
This Application is For: Sewer Only Sewer and Well .XXX Sewer Upgrade Well Only
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and in accordance with applicable Municipal Cedes.
Engineer
Fees: ' ~/~x'//'~' ~ O Receipt#
RECEIVED
· ' I AR 0 2 2000
MUNICIPALI[¥ OF ANCHC~RAC~I:
~ 'm*"~IMENTAL ,SER¥1CES DlVle'
ANDERSON ENGINEERING
P;O. BOX 240773 ' '
ANCHORAGE, AK 99524 ·. "'
522-7773 , 522-6779,(FAX):
MEMORANDUM
DATE:
March 8, 2000
TO:
FROM:
Dan Roth
Mike Anderson, P.E. "~/[~1~-~
SUBJECT: Lot 6, Block 3, Denali View Subdivision . . · . .
Septic System Design 'and Construction Permit
I have modified the affected pages of our original permit request to reflect'a piping'
depth of 1:5' to 2' below existing ground. I have also changed the number of monitor
tubes required from 4 to 2. Please replace the sheets previously submitted with those .
attached. Thank you for your assistance with the design of this system. . .
I ANDERSONENGINEERING
. *': ' ~ 'P;O; B0~-240773 ' : , ::.I
.. ".::..: ~NCHOR~G~E'; AK 99524': ','"
Mar~h 1, 2000
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
. Anchorage, AK 99502-0650
· - 'Subject: Lot 6, Block 3, Denali View Subdivision
Septic System Tank Replacement Permit Applicati~)n
Impacts to Adjacent Properties ·
Dear Onsite Services Engineer:
The :owner (~f Lot 6, Block 3, Denali View. Subdivision intends to construct a five
bedroom home on the lot. We are therefore applying for a permit to construct a well
and septic system to serve the house..The Site Plan shows the location of the new
system with the alternate site. It also shows th.e Iocati.o.n of the p. roposed well and the
100' protective.radius. Additional information Is submitted showing the location 'of all
wells and septic systems on the surr0undiqg lots. - '
The testholes placed on the lot revealed silty gravel which percolated at rate ranging
· ' from 20 to 30 minutes per inch. No groundwater was encountered nor was any noted
during the monitoring period.. Bedrock was enco.u, ntered, however, at depths of 12.5'.
We have therefore designed a bottomless intermittent sand filter system to dispose of
: the septic effluent generated in the house. The distribution pipe will be placed at 1.5' to.
2' below the surface and the total depth of the system will be 3.5' from odginal ground.
The system will be a minimum of 8' above the bedrock layer.
The ground surface on the lot slopes from south to north at varying grades, but none
greater than 10%. The new absorption bed will be constructed across the slope in
accordance with Municipal requirements. Surface grading will be accomplished to
assure drainage is away from the finished bed surface.. Efforts will be made to protect
the bed from surface runoff water. .
All wells in the area are more than 100' from all elements of the proposed septic
system. In addition; the well proposed for the lot is also more than 100' from any sep. tic
system in the neighborhood. If the system is constructed in accordance with our design
the following statements apply: - -
1. The system, if constructed as designed, wiil have no adverse Impact on the wells
in the area or those to be constructed in the future.. The subdivision is currently
served bY the Municipal water system.
The system, if constructed as designed; will have no adverse Impact on existing
Lot 6, Block 3, Denali View
March 1, 2000
Page Two ' -
septic systems in the area' or those to be constructed in the future.
4~
The system, if constructed as designed, will have no adverse impact on reserved
space, either surface or subsurface, on any lots located in the area.
The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson P.E,'
-Attachments
.4
'THIS PROJECT
"7 ·
AREA MAP
SCALE 1" = 100'
500
5OO
Proposed Well
2,000 Gall
STEP Tank
~ HDPE Air Lin'e
12' Wide X 30' Long
F~ Bedroom
~ouse
'FF E1~07
au~e Mou e
n ~ara
Bottomless -Intermittent
Sand Filter (See Details)
NOTE:
Air Compressor Shall Be a Thomas
Industries Model 5070 As Supplied
By Anchorage Tank. Compressor Shall/
Be Located in the Garage Along WI
A 0-10 PSI Pressure Gauge ~oun~
For Ease Of'Viewing.
. Air Line To Be ~" HDPE With
~ Foam Pipe Wrap Insi~ chedule 40
PVC. Jacket. 3".
/
510
./
LOT 6, BLOCK 3, DENAL! VIEW
SUBDIVISION
DESIGN. FACTORS:
5 Bedroom Home
Perc. Rate: 29 MinJInch
Application Rate: 3 GPD/SF
SYSTEM REQUIREMENTS:
Bottomless Inter. Sand Filter
2,000 Gallon STEP Tank
2' Coarse Sand (See Spec.)
Air Supply Line (Anch; Tank)
6" of 3/8" Pea Gravel
5 Bedrooms X 150 GPD = 750 Gallons Per Day
750 GPD/3 GPDISF 112 LF (Width of Bed) = 21 LF Length of Bed
Therefore: Construct a Bottomless Intermittent Sand Filter System I 2'
Wide X 30' Long. Distribution Piping to be Placed at 1.5' Below Original
Ground Surface. A Mini~hun~'"o~ 2;'~f"'Cover Re'q'uii'6d Over Bed.
ViEW
NOTE: Grade Area to Drain Away.' ~~E~'~.~
Maintain 6' Separation From Bedrock. ~;~...
Provide 4' of Cover or 2" Insulation and 2' Cover.*~. ..t~
LOT. 6, BLOCK 3, DENALI VIEW
SUBDIVISION
· DESIGN FACTORS:
5 Bedroom Home
Perc. Rate: 29 MinJInch
Application Rate: 3 GPD/SF
SYSTEM REQUIREMENTS:
Bottomless Inter. Sand Filter
2,000 Gallon STEP Tank
2' Coarse Sand (See Spec.)
Air Supply Line (Anch. Tank)
6" of 3/8" Pea Gravel
5 Bedrooms X 150 GPD = 750 Gallons Per Day
750 GPD/3 GPD/SF 112 LF (Width of Bed) = 21 LF Length of Bed
Theref6re: Construct a Bottomless Intermittent Sand Filter System I 2'
Wide X 30' Long. Distribution Piping to be Placed at 1.5' Below Original
Ground Surface. A Minimu~ of 2' of Cover Required Over Bed.
N~WAY N g~ ~
· Direct ' Bury
=;U~ Insulatior
NOTE:
.I
· PROFIEE VIEW
BO~OMLESS SAND FILTER DETAIL~~~/'~
(NO SCALE) ,~~ ·
~ . . .~
Grade Area to Drain Away.
Maintain 6' Separation From Bedrock.
,rov,** 4' o, Co.e, o, =" ,..u,=,io. =.* =' Co,=r.-~;~~C~
Perforr~ed For:
Legal Description:
Municipality of Anchorage
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
Crown Pointe Inc.
Lot 6. Block 3, Denali View Subdivision
~LOPE
3
4
7
1
11
13
14
16
17
18
PTIOL
Testhole Number
GM
Cobbles
1.5"-3"
Was Groundwater
Encountered?
If Yes, What Depth?
Depth to Water
After Monitoring
Date:
Bedrock
See Site Plan
No S
L
O
None P
311/00 E
Reading Date Gross Net Depth To Net
Time Time Water Drop
1 23-Feb 4:30 3"
2 5:30 60 5.88" 2.88"
3 5:31 3"
4 6:01 30 4.06" 1.06"
5 6:31 30 5.12' 1.06"
Perc. Rate: 29 Min./Inch Perc. Hole Diameter: 6'
Test Run Between 4.5 Ft. and 5.5 Ft.
Comments: Testhole Presoaked Prior to Percolation Test.
Performed By: ~ I, [dichael E. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 3/1/00
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 6, BLOCK 3, DENALI VIEW SUBDIVISION
GENERAL:
The scope of this project includes the procurement and
placement of a new 2,000 gallon combination septic tank/lift
station and pressure distribution system, Work also includes the
construction of a new 30' long x 12' wide Bottomless
Intermittent Sand Filter. A minimum of 2' of coarse sand
material meeting the attached specification must be imported
and placed in the filter area. The filter must then be constructed
atop the imported material. Distribution piping must be placed
1.5' to 2' below the existing ground surface.
Construction shall be in accordance with the approved site plan,
design drawings, Municipal Permit with any special provisions or
conditions, and all applicable State and Municipal Wastewater
Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground
utility locates and for the layout of the septic system.
Unless specifically agreed otherwise, the contractor shall be
responsible for final grading areas subsequently depressed from
soil settling. The property owner shall be responsible for
revegetation of affected areas unless specifically agreed
otherwise.
Contractors installing wastewater disposal systems must be
certified by the Municipal Department of Health and Human
Services for system installations, Owners installing their own
systems must receive prior approval from D.H.H.S. before
beginning system installation,
SEPTIC TANK/LIFT STATION INSTALLATION
1. The 2,000 gallon septic tank/lift station is to be constructed by
a certified tank manufacturer. Construction shall include an 18"
manhole for access to the lift station.
The septic tank/lift station shall be sufficiently bedded to
prevent settling or shifting of the tank.
Lot 6, Block 3, Denali View Subdivision
March 1, 2000
Page 2
3. All standpipes shall extend a minimum of 12 inches above final
grade.
4. Septic tank/lift stations installed without 4' of cover shall have
a minimum of 2" of direct burial insulation.
A foundation cleanout shall be installed one to four feet from the
building foundation. No cleanouts are required between the lift
station and the drainfield in a pressure distribution system.
6. Final grading over the septic tank/lift station shall be such that
a positive slope exists away from the septic tank.
ABSORPTION BED CONSTRUCTION:
1. The absorption bed shall be constructed to the dimensions shown
on the design. The bottom of the bed shall be within 2' of level.
Distribution piping must be placed level with perforations down
atop a level bed of drainfield rock. Rock should then be placed
over the pipe to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the
drainfield rock and the natural soil backfill.
Monitor tubes must be 4' in
locations shown on the design.
must be perforated.
diameter and installed at the
The portion in the drainfield rock
Direct bury insulation must be placed over the distribution
system when less than 3' of backfill depth is available.
Finish grade over the bed must be mounded to prevent
settlement or depressions.
MATERIAL SPECIFICATIONS:
1. The lift station must be constructed by a Municipally approved
septic tank manufacturer. An Orenco 20 OSI 05 HHF- 5 is
recommended.
2. The following pipe materials are approved for use in septic
system installations in the Municipality of Anchorage:
Lot 6, Block 3, Denali View Subdivision
March 1, 2000
Page 3
Cast iron (perforated and solid),.ASTM D3034 or PVC (Perforated
and solid), ASTM F810 or HDPE (perforated, but not solid) and
ASTM D2662 or ABS (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial
polystyrene (Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight
couplings (Caulder, Fernco, or equal).
A permeable geotextile fabric (Typar, Mirafi or equal) must be
installed between the final drain rock layer and the native soil
layer.
6. All drain rock shall be .5" to 2.5' in diameter with less than 3%
passing the #200 sieve.
EQUIPMENT SPECIFICATIONS:
Air Supply Line Shall be a Wasteflow Emitterline, 1/2" Inside
Diameter from Anchorage Tank. Line shall be insulated with
1/2" foam pipe wrap inside a 2" Schedule 40 PVC Jacket buried a
minimum of 3' below the surface.
Air Compressor Shall be a Thomas Industries Model 5070 as
supplied .by Anchorage Tank. Compressor shall be located in the
garage or crawl space.
3. Pressure Gauge from 0 to 10 PSI Shall be furnished and installed
in the garage at a location easily accessible for viewing.
INSPECTIONS:
A minimum of two inspections are required by Municipal Ordinance.
These inspections must be conducted under the supervision of a
professional engineer registered in the State of Alaska. The first
inspection must be conducted after the excavation of trenches, beds
or pits and .before the installation
of any gravel. A septic tank may be set in place, but may not be
backfilled.
The second inspection must be conducted after the placement of
the geotextile fabric, gravel, distribution piping, standpipes,
Lot 6, Block 3, Denali View Subdivision
March 1, 2000
Page 4
cleanouts and insulation. No backfill should be in place at the time
of the second inspection.
The contractor
assure that all
area are met.
is responsible during the layout of the system to
separation distances from adjacent wells in the
OPERATIONS AND MAINTENANCE MANUAL
An Operation and Maintenance Manual for the Design, Installation
and Maintenance of Intermittent Sand Filters is available from the
Municipality of Anchorage, Department of Heath and Human
Services, Onsite Services Program at,825 L Street, Room 502.
Additional information is available from the supplier' of the
intermittent sand filter.
It is imperative the system be maintained in' accordance with this
manual to provide trouble free service.
FILTER SAND SPECIFICATION.
Coarse Well Graded Sand
'Maximum 2% Passing No. 100 Seive
Maximum 1% Passing No. 200 Seive
: Municipality of Ancl?rage
DEPARTMENT OF IIEALTII & IIUMAN SERVICES -
825 "L' Street, Andtorage, Alaska 99502-05501 '
· · PROPERTY OXVNER MAINTENANCE AGREEMENT ;... '. .
ON SITE WASTEWATER DISPOSAL; SYSTEM
This agreement, dated .: /~' 5" ,260_~ 'is made between the Municipality . . .
' of~Afichb~ge Department'of IIealth and IImnan Services (DIIIIS) and the property . :'. - : - '
.Owner(s) of: Lot' 6, Block 3~ Denal~ .View Subdtvtst~ · "' "':
Add ....
..... : - 'Ti r' 6purp f intaini g r'dLsp
. ils agreement is made fo tit oseo ma n an on-site xvasiewate os'al .....
Sy s6t;j ct p p~rty - ' .... - - -
-- The property owner(s) a e'tothefoIIo : ' '" ' '' ' ' " ' '
-, . . .The pro. l{erty owfier(s) will have an annnal inspection of the ay!tern performed by :'
.... - a registered professional engineer. 'This in~pectidn shall verify that all effluent'and air ' · , .' i- ..
. . ~ Pump~, Ihners,~'and alarms are funcfio~fin~ as designed. Any deficic~ici~s shall b~" c :, .:' . ..
'~.'"'. ~'ropcrty~fl'}ner Na~ne ,. · · . '.. :.. .' .. ..' - :':Property Owner Na~ne i J" ..:.":,'" '}'. ". "- ".
, .....: .... .:'- .. ...'. : ..'".' . . . . .~ . ,..~ ,.
.... Third .Judicial District '. ...... . .
..' . The fo{ego'ing instrum;,nt .was acknowledged before'me this 5th day of
-. December, 2000, by.Wesley W. Clubb. ' ' ' ' ' '" ' '" '
'- · Notary Public in and for Alaska .
My Co-mmis~ion Expires: "2-4-2003 '.
Parcel I. D.015-461-07
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION:
Complete legal description DENALI VIEW; BLOCK 3, LOT 6
z
Expiration Date:
Location (site address) 12300 SULTANA COURT *ANCHORAGE, AK 99507
Current Property owner(s) SHARON MARSHALL Day phone 907-301-8047
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
5
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual
Individual Water Storage
❑
Holding Tank
❑
Community Class _Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for:
Distance:
Received by:
Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $/��/
Waiver Fee $
Date of Payment
Date of Payment
Receipt Number 4"
Receipt Receipt Number
COSA # 65C I37 -a
Waiver #
CA,
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date:
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system
in accordance with the guidelines and regulations established by the Municipality of Anchorage and
industry practices. The reported results describe the condition of the system/s on the date/s of the
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or
encroachments may exist that were not identified during the evaluation. The operational life of all wells
and septic systems depend upon a variety of variables, including but not limited to, soil conditions,
groundwater levels (that may fluctuate during the year), quality of construction (materials and
workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the
system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of
the well or septic system. GEG makes no representation whether an alternative well or septic system
can be installed on the property in the event either of the current systems fail to perform adequately in
the future. The content of this report is for the sole benefit of the person/party that retained GEG to
perform the evaluation. Reliance upon the information provided in this report by any other person or
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
bedrooms, with the foll
o':z=;OFq�-MA,p
Je re . Gorne s:
3 � G
Op 11e e ., g�1? 147
0
pro f esslo —
art- A see, 0 `f
ON S,
rE o
In St
WA
0 'SNL) rn
,P wASTEWA--ct, _ ZZ
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PROGRAM- • o`
o
00
Original Certificate Date: 'l
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist
Legal Description: DENALI VIEW; BLOCK 3, LOT 6
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑O Well log is filed with Onsite (or attached)
Date drilled 4/6/00
�pt,�lr
Total depth 226 ft b11
Cased to 20 ft Lo
❑■ Sanitary seal is functioning correctly
❑■ Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 7/9/19
Static water level at beginning of test 19.5 ft.
Comments
SEE 2019 RECORD DRAWINGS 
REGARDING 2003 TANK INSTALL
B. TANK DATA
Age of tank(s) 16 years
Tank type/material SEMOSTEE
Measured operating fluid level in septic tank -
■❑ Standpipes/foundation cleanout per record drawing
Date of pumping 8/5/2019
D. ABSORPTION FIELD DATA NEW
Which system tested (date installed) 8/1/19
❑■ ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade * ft (min)
❑ N/A — pressurized field
❑E Monitor tubes go to bottom of effective. If not, state
depth into effective
Parcel ID: 015-461-07
Structure served by this system
Well production at time of test 2.5+ gpm
Water storage tank volume NO gallons
Well disinfected for coliform test? ❑ Yes ■❑ Nc
■❑ Coliform bacteria is Negative
Nitrate 10.1 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑■ Arsenic less than MRL (ND)
Collected by GEG
Date of Sample 7/17/19
LIFT STATION
❑■ Required maintenance completed
Age of lift station 16 years
Lift station material STEEL
Comments:
Adequacy test date -
Results ❑✓ Pass For 5 bedrooms
Fluid depth prior to test in
Water added - gal
New depth in
Elapsed time - min
❑■ Code -required soil cover over field Final fluid depth in
❑ System presoaked Absorption rate gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months)
date of test) _
If yes, enter date
Gallons introduced gallons
Comments/Deficiencies: *SEE ATTACHED RECORD DRAWINGS
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
0✓
Yes
Community Sewer Manhole/Cleanout > 100'
0✓ Yes
if No
ft
M Yes
if No ft
Neighboring Tank > 100' 0✓ Yes
if No
ft
Private Sewer/Septic Line > 25' 0✓ Yes
if No ft
Absorption Field on Lot > 100' 0✓ Yes
if No
ft
Holding Tank > 100' R1 Yes
if No ft
Neighboring Absorption Fields > 100'
Yes if No ft
Water Main > 10'✓0
Animal Containment > 50' El Yes
if No ft
0✓ Yes
if No
ft
Yes if No ft
Water Service Line > 10'
Yes
if No
Manure/Animal Excreta Storage > 100'
If septic tank is under driveway
Community Sewer Main > 75' 0✓ Yes
if No
ft
0 Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
0✓
Yes
if No
ft
Surface Water > 100'
[Z] Yes if No ft
Property Line > 5'
0✓
Yes
if No
ft
Wells on Adjacent Lots:
0✓
Absorption Field > 5'
❑✓
Yes
if No
ft
Private Wells > 100'
Yes if No ft
Water Main > 10'✓0
ft
Yes
if No
ft
Community Wells > 200'✓❑
Yes if No ft
Water Service Line > 10'
Yes
if No
ft
If septic tank is under driveway
comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' 0✓ Yes if No ft If absorption field is under driveway comment below
Property Line > 10'
0✓
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
0
Yes
if No
ft
Private Wells > 100' Q Yes if No
Water Service Line > 10'
0✓
Yes
if No
ft
Community Wells > 200' 0✓ Yes if No
Surface Water > 100'✓0
Yes
if No
ft
F. ENGINEER'S COMMENTS
*CAT III WWTS **SEE ATTACHED PHOTO - TANK APPROXIMATELY 4.5 FEET
FROM DECK POST
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
COSA Checklist yellow sheet
I
J f ey Go ess.-
��4p
C r7 53 � f3li.•'• •.c�G
pro f essic) r000
#AECC884
ft
ft
DEVELOPMENT SERVICES DEPARTMENT
On -Site water and Wastewater Section
www.muni.org/onsite
907-343-7904
r Fax: 343-7997
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC191376
Subdivision: Denali View, Block: 3, Lot: 6
A water sample revealed a nitrate concentration of 10.1 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
ox5Q'AeEAi95�
6 Q *intirtr�i�i�g
:�"S'�' 9�a���E��,.,"��a
IV HOME SERVICES INC.
7501 E. 140th Avenue
Anchorage, Alaska 99516
345-1890
-CUSTOM ER
Poo
WL
..-Block Lot
DATE DESCRIPT16N,
0 66 Tan!.:
W
Gallons Septic Leach Area Holding Tank Standpipes Time
El PROBLEM AREA CALL FOR MORE INFORMATION
El NEEDS 70 BE DONE AGAIN IN 6 MONTHS
El Good Shape ❑ sludge buildup on bottom ❑ Floater on top
Jim cap missing or ET Cut standpipe to 1' above ground El Needs Septictrine
needs replacing
Sonja Blewett
From: Jeff Garness
Sent: Saturday, August 17, 2019 11:52 AM
To: Sonja Blewett
Subject: FW: 12300 Sultana
From: David Harper<dlharper2@gmail.com>
Sent: Saturday, August 17, 2019 8:07 AM
To: Jeff Garness <Jeff@garnessengineering.com>
Subject: 12300 Sultana
Jeff, as in the previous report from checking the well interior with a camera, there was a small amount of water from a
fracture at 41.5 feet below grade. A PVC liner was installed with a shale packer to 52 feet below grade and bentonite
chips were positioned above the packer which when hydrated forms a seal so the incoming water cannot go down the
well. it overlaps the fracture so the water cannot go up the well bore also. As this water has been entering the well for
some time , I assume it will be a continuing lowering of nitrate count as water is used.
David Harper
Aarow Pump & Well Service, LLC
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of thinrs__ 30'A Day of of 20j_q _, by and between
V -S �e l�'� , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as ( _IDSF -- - -- - - -
located at (legal description)
Denali View 133 L6 - - ---
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
(= Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
r l� Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Tk Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
y guidelines for the construction, maintenance and repair of the Owner's AWWTS.
1 r Owner agrees to. maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER: ,
By: (signature) Date: 7137-,qj9
(Print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this -96 day of 30 l ,
20 0L, by -rhm.t, 94W
tAE iW
.,
NZMURY PUBLIC FOR ALASKA
My Commission expires: 0 3
MUNICIPALITY:
_ J
By: (ti� G (signature)
name)
Date: l
Title:
(rev. 05/18/2018) Page 3 of 3
Jeff Garness
From: David Harper <dlharper2@gmail.com>
Sent: Thursday, July 18, 2019 11:39 AM
To: Jeff Garness
Subject: 12300 Sultana Ct
There were no fractures or incoming water encountered during the camera viewing of the well located at the above
address to a depth of 40 feet ground level. However there was incoming water of approximately a 32cnd of a gallon per
minute coming through a fracture 41 to 41.5 feet ground level.
David Harper
Aarow Pump & Well Service, LLC
Sent from my iPhone
PLAT NO. 76-211
DENALI VIEW SUBDIVISION
LOT 6, BLOCK 3
42.115 S.F.
-rnNA ORNE
®��P�.OF1�A�gs�♦
a x'•49 !V k®®
r
...00
• : Jeffery A. Gasm7Ci •�
®? LS -6091 • m m
a '• _ 8/0!2019
�p afp55ianal lana S
sof�sle�e®®
Ex/ll
AS -BU I L T
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
GASTALDI LAND
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING. LLC
1T IS THE RESPONSIBIUIY OF THE OWNER TO
JEFF A GASTALDI. R.L.S.
DETERMINE THE EXISTENCE OF ANY EASEMENTS.
2000 1— DOWLING RD.. SUITE 8
COVENANTS OR RESTRICTIONS WHICH DO NOT
ANCHORAGE. ALASKA 99507
APPS ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
GRID
DATE
HEREON BE USED FOR CONSTRUCTION OR FOR
SW2741
8/8/2019
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT. ALASKA
F.B.
Joe N0.
00-13
0V563
NOTE: NO CORNERS SET THIS DATE
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorag e.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAHILY DWELLING
Parcel I.D. 015-461-07
· 1. GENERAL INFORMATION
Expiration Date: 7 '-~' "2., .~ 0 ~
Complete legal description DENALI V1EW SUBDIVISION; LOT 6, BLOCK 3,'. ';
Location (site address or directions) 12300 SULTANA COURT * ANCHORAGE, AK 99516
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
WESLEY & BARBARA CLUBB Dayphone 346-2329
12300 SULTANA COURT * ANCHORAGE~ AK 99516
Day phone
JEANNE BIERLEiN w/ DYNAMIC PROPERTIES Day phone 244-1921
,3111 "C" STREET SUITE 200 '~ ANCHORAGE, AK 99503
Unless otherwise requested, HAA wi//be he/d by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
3. TYPE OFWATER SUPPLY:
Individual Well ~r~
Individual Water Storage
Community Class Well [~
Public Water System
II
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Cedificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may 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'~
work.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or pdor
to closing for the engineering services provided.
4. STATEMENT OF INSPECTION BY ENGINEER
· As certified by my seal affixed hereto and as of the validation date shown below, I ve6fy that my
investigation, based on procedures outlined in the Health Authorfty Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further vedfy that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations In effect at the time of installation.
NameofFirm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone 337-6179
Address 6901 DEBARR ROAD, SUITE: 2B * ANCHORAGE, AK 99504
Engineer*s Printed Name JEFFREY A. C, ARNESS, P.E.
Engineers Comments:
In conducting this evaluation, AWWC, Inc. attempted to provide a thorough,
conscientious enginee6ng analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfectory test
results do not guarantee future perfo~Tnance of the system, nor do they guarantee that
there are no hidden defects or encroachments. A WWC, Inc. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
olher person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Z Conditional approval for .5 bedrooms, with the fllowing stipulations:
At the time of title transfer the new ow=er shall sign the attached
maintenance agreement which shall be returned to this office before a
unconditional approval is issued.
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Manitenance Agreements
Supplemental Engineer's Reort
Other
X
Original Certificate Date: Z./- '~-~ ~__
Legal Description:
A. WELL DATA
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Wafer & Wasfewatar Program
4700 South Bmgaw St.
P.O. Box 196650 Anchorage, AX 99519-6650
www.ct.ancherage.ak.u~
(~07) ~,.~-~'~04
HEALTH AUTHORITY APPROVAL CHECKLIST
DENAU ViEW SUBDNISION; LOT 6~ BLOCK 3 Parcel ID: 015-461-07
Well type PRNATE If A, B, or C provide PWSID~ N/A
Date completed 4`/6`/2000 Sanitary seal (Y/N) YES
Total depth 226 ft. Cased to 20 ft.
FROM WELL LOG
Date of test 4`//6`/2000
Static water level 13 ff.
Well production 4
WATER SAMPLE RESULTS:
Colifo~n 0 colonies/100 mi.
Arsenic: 1.9 mg./L.
SEPTIC/HOLDING TANK DATA
Tank Type/Matertal
g.p.m.
Well Log (Y/N) YES
Wires properly protected (Y/N)
Casing height (above ground) 24+
AT INSPECTION
Tank size 2000 gal.
Foundation cieanout (Y/N) YES
Date of pumping 3`/25`/2002
ABSORPTION FIELD DATA
Date installed 4/29/2000
Length 30 ft.
g.p.m.
in.
Nitrate 1.97 mg./L. Other bacteria 0 colonies/100 mi.
Date of sample: 2`//8`/2002 Collected by: AWWC~ INC.
STEEL
Number of Compartments 2
Depression over tank (Y/N) NO
Pumper
* LESS THAN 2 YEARS OLD
Soil rating ~r ft~edrm) 3.0
Width 12 .ft.
Date installed 4/28`/2000
Cteanoufe (Y/N). YES
High water alarm (Y/N) YES
A+ HOME SERVICES
Total depth --8,8 ff. Eft, absorption area 360 fi2 Monitoring tuba***YEs
Date of adequacy test *NEW Results (PessJFall). -
Fluid depth in absorption field before test - in. Water added - gal.
Elapsed Time: - min. Final fluid depth - in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N/A If yes. give date
** TO TOP OF SAND PER 11/6/00 INSPECTION REPORT
~** SYSTEM DRY 3/5/02
System type ~ro~e.~ss
Gravel below pipe .5 ft.
Depression over field NO
For ,5 bedrooms
New depth - in.
- g.p,d.
LIFT STATION
Date installed Size in gallons ~
'Pump on" level at. in. 'Pump n. High water alarm level at .in.
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
SEPARATION DISTANCES FROM WELL ON LOT TO:
100'+
100'+
N/^
25'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line
Water main N/A Water service line 10'4-
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+
Water service line 10'+
Curtain drain NONE KNOWN
F. COMMENTS
G. ENGINEER'S CERTIFICATION
Building foundation 10'+
Surface water 100'+
Wells on adjacent lots 100'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cieanout
Holding tank N/A
Absorption field 5'+
Surface water 100'+
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Water main N/A
Driveway, parking/vehicle storage 25'+
Engineer's Printed Hame
Date
dEFFREY A. GARNESS
HAA Fee $.
Date of Payment
Receipt Number
(Rev. 12/01)
Waiver Fee $
Date of Payment
Receipt Number
FEB-18-02 04:40P" FR01~CI'&£ EN¥1"0NgENTAL
''~tK CT&E Environmental Services inc.
9075615301
T-435 P.0Z/03 F-934
CT&E Ref.~
Client Name
Project Namc/~
Client Sample ID
Matrix
Ordered By
PWSlD
Sample Remarks:
1020779001
AK. Water & Wastewater Consultants Inc.
Lot 6, Block 3 Denali View S/D
Lot 6, Block 3 Denali View S/D
Drinking Water
Client PO#
Printed Date4Time 02/18/2002 14:07
Collecled Date/Time 02108/2002 12:50
Received Date/Time 02/08/2002 14:54
Technical Director Stephen C. £de
Released By ~
Private Individual 3Lnalynla
Aluminum
A~scnic
Barium
Cadmium
Calcium
Chromium
Copper
Iron
Lead
Magnesium
Manganese
Phosphorus
Potassium
Sadmm
Silicon
Silver
Zinc
Onlonde
Fluoride
Nitrate-N
Nitrite-N
Sulfate
Total Dissolved Solids
HCO3 Alkalinity
CO3 Alkalinity
OH Alkalinity
Conducfivhy
pR
Alkahnity
Total Coliform
PQL Units
Mc~hod
Allowable Prep Anal/sis
Limits Date Date Init
20.0 U 20.0 ng/L EPA 200.8 (<50) 02/18/02 KGF
1.90 1.50 ug/L EPA 200.8 (<~0) 02/18/02 KOF
55.4 3.00 ug/L EPA 200.8 (<2000) 02/I 8/02 KGF
O.10OU 0.100 ug/L EPA 2008 f<51 02/18/02 KGF
56]00 500 ug/L EPA 200.8 02/18/02 KGF
3.00 U 3.00 og/L £PA 200.8 (<100) 02/18/02 KGF
55.9 0.800 ug/L EPA 200.8 (<1300) 02/18/02 KGF
250 U 250 ug/L EPA 200.8 (<300) 02/18/02 KGF
0.727 0.400 ug/L EPA 200.8 (<l 5 ) 02/18/02 KGF
12200 $00 ug/L EPA 200.8 02/18/02 KGF
3.00 U 3.00 ng/L EPA 200.8 (<501 02/18/02 KOF
500 U 500 ug/L EPA 200.8 02/18/02 KGI;
500 U $00 ug/L EPA 200.8 02/1~02 KGF
4590 500 ug/t. EPA 200.8 02/18/02 KGE
5380 lO00 ug/L EPA 200.8 02/I g/02 KQF
1.00U 1.00 ug/L EPA 200.8 (<100) 02/18/02 KO[
12.7 2.00 ug/L EPA 200.8 (<5000) 02/18/02 KG!
8.76 0.200 mg/L EPA 300.0 (<2501 02/08/02 JD'I
0.200 U 0.200 mg/L EPA 300.0 (<2) 02/08/02
1.97 0.200 mg/L EPA 300.0 (<10} 02/08/02 JD'
0.200 U 0.200 mg/L EPA 300.0 (<1) 02/08/02 JD'
15.6 0.200 mgdL EPA 300.0 (<2501 02/08/O2
274 80.0 mg/L SM20 2540C (<500) 02/08/02 SD]
167 mg/L SM20 2320Pt 02/13/02
0.00 mg/L SM20 2320/3 02/13/02 SBI
0.00 mg/L SM20 2320D 02/13/02 SB~
420 2.00 umho~/cm SM2510rl 02/08/02
7.36 0.100 pi[units EPA 150.1 (6.5-8.$) 02/08/02 SPt
167 ! 0.0 mg/L SM20 232013 02/I 3/02
0 eol/100mL SMI8 922213 (<11 02/08/02 ICa
C
F~ : GASTPi. D I Lf~qD ~
: 9072489~62
Rpr. ~ 21~2 ~4:5-JA~ P1
Municipality of Anchorage
Department of Health and Human Services
Division of Environmental Services
On-Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci.anchorage.ak.us
(907) 343-4744
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 01 5-461-07
1. GENERAL INFORMATION
Complete legal description
Expiration Date:
Lot 6, Block 3, Denali View Subdivision
Location (site address or directions)
Current Property owner(s)
Mailing address
Crown Pointe, Inc. Dayphone 345-6277
P.O. Box 112313 Anchorage, AK 99511
Lending agency
Mailing address
Day phone
Real Estate Agent
Mailing Address
Day phone
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Five (5)
Well
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site []
[] Individual Holding Tank []
[] Community On-site []
[] Public Sewer []
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates cf
Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independem
professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are
required for the transfer of title (except between spouses) on properties served by a single family on-site
wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners.
Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by
a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificate~
are vatid for one year for properties served by Class A or B wells or a public water system. The Municipalir.,
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
72-035 ~Rev O! 00)'
5. ' STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as oi the validation date sh~)wn below, I verify that my investigation
based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval
application show 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 applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
Name of Firm Anders6n Engineering ' ' ' Phone '522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 11/29/00
DHHS SIGNATURE
Approved
for
bedrooms.
Disapproved.
, - .~. .~
Conditional approval for bedrooms, with the following stipu~i~ns.
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Expiration Date: ~ - ~" - 0 ~
Original Certificate Date:
Reissue Date:
12
75-025 (Rev 01,'00i'
Legal Description: Lot 6
A. WELL DATA
Well type
Date completed 4 / 6 / 0 0
Total depth _2Z6__ ft
' Municipality of Anchorage R E C E I V E
Department of Health and Human Services
Division of Environmental Sewices
On-Site Services Section 825 "L' Street Room 502 NOV ~. 9 2000
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage, ak.us MUNICIPALITY OF ANCHORAGE
(907) 343-4744 ENVIRONMENTAL SERVICES OltqSION
HEALTH AUTHORITY APPROVAL CHECKLIST
Block 3~ Denalt View Subdivision
If A, B, or C provide PWSID #
Sanitary seal ¥
Cased to ? N ft
FROM WELL LOG
Date of test 4 / 6 / 00
Static water level 1 3 ft
Well production 4 g.p.m
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi Nitrate 3.1 1 mg/I
Date of sample: 1 1 / 2 7 / 0 0 Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Typs/Material Septic STEP/Steel
Data installed 4/28/00 Tanksize 2,000 gal
Cleanouts ¥ Foundation cleanout Y Depression over tank
Date of pumping [qew Construction Pumper N/A
C. ABSORPTION RELD DATA
Date installed 4/29/00 Soil rating (g.p.d./tt2 or ft2/bdrm) 3
Length 30 fl Width 12 ft Gravel below pipe .5
Totaldepth 11 ff Effective absorption area 360fl
Date of adequacy test New ¢onst .Results (Pass/Fail)
Fluid depth in absorption field before test __ in Water added__
Elapsed Time: min Final fluid depth in
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N
Parcel I.D.:
015-461-07
Well Log ¥
Wires properly protected ¥
Casing height (above ground) 2 4
AT INSPECTION
ft
g.p.m
Other bacteria 0 colonies/100 mi
Number of Compartments 3
High water alarm __
in.
System type Bottomless Sand
Filter
__ Depression over field N
For bedrooms
gal. New depth in.
Absorption rate >= g.p.d.
If yes, give date H/A
72-02~ (l:~v. 01~)·
D. LIFT STATION
Date installed 4/28/00
"Pump on" level at 42 in
Datum R~'l'~m C~:~ m,~nk
Size in gallons 500 Manhole/Access y
"Pump off" level at 42 in High water alarm level at 44 in
Cycles tested New Const. Meets alarm & cimuit requirements Y
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lilt station on lot > 100 '
On adjacent lots > 100'
On adjacent lots > 100 '
Public sewer manhole/cleanout N/A
Holding tank N/A
Absorption field on lot
Public sewer main
Sewer/septic service line
Property line > 10 '
Water Service line > 10 '
Curtain drain None Noted
F. COMMENTS
Building foundation > 10'
Surface water > 100 '
Wells on adjacent lots > 100 '
>100'
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation > 5 ' Property line > 5 ' Absorption field > 5 '
Water main N/A Water service line > 10 ' Surface water > 1 00 '
Drainage > 1 00 ' Wells on adjacent lots > 100 '
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Water main N/A
Driveway, parking/vehicle storage > 20'
_7'. ~ill Place__~.~d Ove__r Tan___~k and Field___._I.
G. ENGINEER'S CERTIFICATION
Ice. rtify that I have determined through field inspections uno
revmw of Muni~pel records that the above systems are in
conformance w,th MOA HAA guidelines in e.ect on this date.
Engineer's Printed Name Michael E. Anderson, P.
Date 11/29/00
Receipt Number
/
Waiver Fee $
Date of Payment
Receipt Number
72-03~ (Re~. 01~o}'