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Home My WebLink AboutEAGLE CREST #1 TR A LT 25 Municipality of Anchorage Page / of 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 Inspection Report PermltNumber: ~.Jq~oo¥/ PIDNumber: g)5''OZ°3' Name: WaslewaterSystem: D New ~Upgrade ~ ~s~ ABSORPTION FIELD ~one: ~_ ~ IN°'O~'r~m': O Deep Trench O Shallow Trench OBed OMo~Other Soil Rating: Total ~p~rtglna, grade; LEGAL DESCRIPTION GPD~. Ft. -- ,,. WELL: D New D Upgrad/ m..,depth: /. Ft. Num~rolllnes: I~'-. F~. SEPARATION DISTANCES ~Septic OHolding * DS.T.E.P. Water~/~' LIFT STATION Line ~/0I Foundation ~7' // "Pump on' level .t:~l~l a~ Remarks: T~& : /R&~6~ <~a BENCHMARK ~ ~8 ~ r~ ~ ~/~/~ L~atlon and Description: Inspections pedormed by: ~E g Dates:lst 2~=/s~ ~~~~...... .... 2nd ~/- ..... ~... ......... ~ ~ · tau ~ A. ~u~e(~ · Department of Health and Human Se~ices approval -aa ~ .%~ .... ..."' Reviewed and approved by:, ~ ~~ Date?~/ /O~ PermltNo. ~J~ ~,3,0 ¥/ Page ,='?" of 3-. Municipality of Anchorage 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 Inspection Report Legal Description: /~2..0 PID No.: PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 #L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920041 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:WELIN SVEN G OWNER ADDRESS:19412 THIRD ST EAGLE RIVER, ALASKA 99577 DATE ISSUED: 3/25/92 EXPIRATION DATE: 3/25/93 PARCEL ID:05030326 LEGAL DESCRIPTION: EAGLE CREST TR ALT 25 LOT SIZE: 17820 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: 3-27-- Louis Bulera. P.E. Registered Civil Engineer March 24, 1992 John Smith, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Eagle Crest #1, Lot 25, Tract A Narrative Dear Mr. Smith: On the behalf of our client, Mr. Sven Welin, we are requesting a permit for a possible relocation of the septic tank on the above referenced lot for inclusion in the waiver application submitted to your office February 28, 1992. The purpose of applying for permit at this time is to receive waiver of separation distance on both the existing tank site (50'), and the proposed site (70'). The owner wishes to keep his options open for building a garage on the existing site at sometime in the future. The proposed septic tank relocation would have very limited impact on adjacent properties for the following reasons: 1. The area has large lots allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate. This is a tank upgrade only. 4. Drainage will not be effected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773291 · Eagle Rirer. Alaska 99577 · Telephone ~907) 69.1-5195 · Fax (907) 69.1-3297 ~ . .. 57g '\. .-, I ~ <9,9 ~ .~::0.~ ~Z..., .;'-...,.. ,-,.,,.,,~ .,- · :'':',~ ~,"r~? ~*/ ~, * Septic Tank · ~, .,~.~.~ ~ ~ ~ .. Only ~/~ ~/~'/ ~.; / //~.'~~~ Tom Fink, 825 "L" Street Mayor P.O. BOX 196650 Anchorage, Alaska 99519-6650 343-4744 March 27, 1992 Lou Butera, P. E. Eagle River Engineering Services PO Box 773294 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 25 Tract A Eagle Crest Subdivision Waiver Request #WR920009, PID #050-303-26 Dear Mr. Butera: Your request for waiver of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distances are well to the septic tank 70 feet; well to the seepage pit 83 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services C°nc~'r:/ //~ohn Sm[~, PiE. VProgram Manager On-site Services ljm:#6 *1o % /_._8 II Louis BuYers. P.E. Regislered Civil Engineer February 28, 1992 John Smith, P.E. Municipality of Anchorage On-Site Services 825 L Street Anchorage, AK 99504 RECEIVED FEB 2 8 1992 De~L~Heatlcipallty of Anchoral~ Re: Eagle Crest #1, Lot 25, Tract A Waiver Request Dear Mr. Smith, On behalf of my client, Mr. Sven Welin, we are submitting a request for determination of waiver of horizontal separation distance for the above referenced two bedroom residence. The request is for a waiver of well to leachfield distance of 83'. There is a site plan and topographic map attached. The septic system was installed in 1973 and appears to have a historical waiver for a well to septic tank distance of 50'. The septic tank will remain in the existing position with regards to this present application for Health Authority Approval. However, there is the possibility that our client may desire to build a garage in the area of the septic tank this summer, and therefore is requesting review and approval of a separation distance of 70' for a new 1,000 gallon tank in new location as shown on site plan. We realize that a permit will be required to move the tank, but it would be more economical to have both waivers reviewed at this time. Soil characteristics in the area are well documented and are fairly consistent. The immediate subsurface soil is a sandy gravel (GW) down to the typical test hole depths of 12-18'. Soil logs are attached for lots directly above (Lots 15 & 17, Tract A) and directly adjacent (Lot 24, Tract A) to the subject lot. These lots are at approximately the same elevation as Lot 25, Tract A. The soil in this area was typically visually rated at an average of 85 SF/BR. No ground water levels were shown on these lots which are attached for your review. While there is no well log for our subject lot, well depth is noted on the original inspection report as being 310'. This is consistent with adjacent well logs of 295', 301' and 322' for lots North and East. Our well flow test shows a static water level of 279' with a total drawdown of 7' pumping at 5.3 GPM. This would indicate a large confined aquifer. Well logs in the area show a confined type aquifer. Soil layers from surface to bedrock level for adjacent well logs indicate multiple clay and hardpan layers which would act as a barrier. There are consistent indications of static water levels of 275'-280' in available area well logs. P.O. Box 773291 · Eagle River, Alaska 99577 · Telephone (907) 691-5195 · Fax (907) 691-3297 Page 2, Lot 25, Tract A, Eagle Crest #I Waiver Request The ground surface gradient provides the most positive evidence in support of waiver. Topographic mapping between up-gradient well head locations and down-gradient seepage pits shows an averaged gradient of 30% in a direction downhill from our water source. The surface gradient would ensure that any possible contaminate from the septic components located at less than 100' would definitely travel down gradient to the South, and away from the well. There are other mitigating physical characteristics that should be taken into consideration in the evaluation: The house is located between well and septic components providing a physical barrier. The area has a low population density with 18,000 square foot lots. Water samples of the on-site well show no evidence of coliform, and no background Nitrate levels (<MDL of 0.1 rog/L). The system has been in place for 19 years. There are many waivers on file for this subdivision with approvals based on existence of deep wells. We are also requesting the Municipality consider the approval of the system for three bedroom capacity. There was no bedroom designation on the inspection report, however, it is apparent that there is a 1,000 gallon tank installed, and the pit has an area of 288 SF. If the soil was properly graded as GW, then the system would have a capacity of three bedrooms. The soil log indicates a GW classification with a description of 'sandy gravel, coarse and fairly well graded, small amounts of silt-clay.' A GW classification would seem appropriate which allows for up to 4.5% fines. The soil tester arbitrarily listed 100 SF/BR, but it could just as correctly been called 85 SF/BR. The pit was also indicated on the soil log as being 11' x 15' which could indicate an actual absorption area of 312 SF. If the installer had intended on a two bedroom system, the pit could have been considerably smaller. The system passed adequacy for a three bedroom plus rating. Considering this evidence, it would seem that this system could qualify for a three bedroom capacity. Please review the attached data and if you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. A/ ~. ,C~ CO" W ~GREk."R ~,NCHORAGE AREA BOR. ~. GH~'' "~ ~[1~ Dep.rtment of Environmental Quality ~ 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE NUMBER OF FROM WELL ~"0'~ MANUFACTURER T,~U.~C~'" MATERIAL C ~(.'~'t(c-- COMPARTMENTS I INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH IIQUID CAPACITY. ~OOO .GALLONS. SEEPAGE PIT: NUMBER OF PITS J' DIAMETER L,NING ~ATER,AL t~ ¢,;t, cR,B S,ZE= BUILDING FOUNDATION OR WIDTH r'/'1 ~ LENGTH I'tI DEPTH DIAMETER '~ DEPTH ~*' DISTANCE FROM: WELL O* TOTAL EFFECTIVE NEAREST LOT LINE ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION WELL: BUILDING FOUNDATION CESSPOOL APPROVED. CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED DEPTH NEAREST SEPTIC SEWER LINE TANK __ REMARKS ¢~.~ DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: ~-~l~'J~ REMARKS: Form NO. EQ-0311 DIAGRAM OF SYSTEM DATE II /.A.A.B. Russell Oyster 694-2T/4 Civil Engineering Soils Et Foundations 0 Et E ENGINEERING Et DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 333.5240 SOIL LOG Perfomed for: Legal Description: Depth (feet) 0 1 Earl EY/is 333-5240 Surveying Land Development Name: ~t~%~'~-~f--~ ~K-.i~Ct~r--/ Tel. No. Mailing Address: '~ ~7 ~-.~z~"~'~/xtv4 ~.A,,~L ~.R~G~ Soil Characteristics 3 4 5 6 7 8 9 10 11 12 Ground Water Encountered: Yes Proposed Installation: Seepage Pit torments: '~,~ No tx'x If yes, what depth ~"Oraln Field Perfomed by.' UNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 050-303-26 Expiration Date: � — --G --2 o ZC 1. GENERAL INFORMATION Complete legal description EAGLE CREST #1 TR A LT 25 Location (site address) 19412 THIRD ST EAGLE RIVER AK Current property owner(s) Mailing address Real estate agent KEVIN & JACQUELLE ROY 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WAST Private Well Q Private Septic Water Storage ❑ Holding Tank Community Well ❑ Community Public Water System ❑ Public Sewer Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee a Waiver Fee $ Date of Payment _ I�-(a� L-/ Date of Payment Receipt Number /l�i<��0 Receipt Number COSA # C I Waiver # ,N r TER DISPOSAL: 2� Distance: 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 12-23-19 0 6. DSD SIGNATURE e o 0 0 •. o° e a o 0 0 0 0 0° O o 0 o FA System #1 Approved for 3 bedrooms �° °� 0 0 0 0° 0 0 0 0 0 0 0 0 0 o e a o o MICFI EL N. ANDLRSCiJ ,.vim System #2 Approved for bedrooms ¢�,�,, CE - 94 9 �. r'Ye 74 Disapproved Conditional approval for bedrooms, with the following stipulations s� Original Certificate Date: 12 —2P —1 1� The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other qp 61 COSA Checklist blue sheet COSA Checklist Legal Description: EAGLE CREST #1 TR A LT 25 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UN Total depth 289 ft Cased to 40'+ ft ■❑ Sanitary seal is functioning correctly ❑E Wires are properly protected Casing height (above ground) 12"+ in. Date of flow test for COSA 12118/19 Static water level at beginning of test 281 ft. Comments NO WELL LOG, APPROX 1973? B. TANK DATA Age of tank(s) 27 years Tank type/material STEEL Measured operating fluid level in septic tank 49 ■❑ Standpipes/foundation cleanout per record drawing Date of pumping 12/18/19 D. ABSORPTION FIELD DATA * BOTTOM OF CRIB Which system tested (date installed) ( I - 3 -73 ❑■ ALL standpipes present per record drawing Total measured depth from grade *7.8 ft (max) Measured depth to pipe invert from grade 4.2' ft (min) ❑ N/A — pressurized field Al Monitor tubes go to bottom of effective. If not, state depth into effective ❑■ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Comments/Deficiencies: 'NEW LOGS ADDED TO THE ROOF OF THE CRIB COSA Checklist yellow sheet Parcel ID: 050-303-26 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑W N ■❑ Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/LArsenic less than MRL (ND) Collected by MNA Date of Sample 12/18/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 12/18/16 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 500+ gal New depth 2 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 500+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date UN 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' 21 *70 + Community Sewer Manhole/Cleanout > 100' ft If absorption field is under driveway comment below F1 Yes if No ft Q Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' E] Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *83'+ ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' ft Animal Containment > 50' ❑✓ Yes if No ft ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft ✓❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10'✓❑ 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' 21 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'✓❑ n :4. r r;oresCIN Yes if No ft Private Wells > 100' U Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS * SEE EXISTING WAIVERS G. ENGINEER'S CERTIFICATION`'° ` ` ° `° ° �•`' ``'i I certify that l have determined through field inspections and review e 10 y 1-1 °4 i• aA of Municipal records that the above systems are in conformance with °oe m° a°c� aaooaoea �`�� MOA COSA guidelines in effect on this date.,ry]a r n :4. r r;oresCIN -,,,&AlCliAEL y ` S CE- 45 COSA Checklist yellow sheet Septic Tank Advisory Certificate of On -Site Systems Approval #OSC191608 Subdivision: Eagle Crest #1 Tr A Lt 25 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 27 years old. Typical replacement costs range from $8,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. DEVELOPMENT SERVICES DEPARTMENT i y On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC191608 Subdivision: Eagle Crest #1 Tr A Lt 25 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 27 years old. Typical replacement costs range from $8,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. 'Municipality of Anchorage Development Services Department .~. Building Safety Division . On-Site Wa. ter & Wastewater Program 4700 South Bragaw St. · .'P,O, Box 1966~0 Anchorage, AK 99519-6650 www,ci.anchorage,ak.us (907) 343-7904 (. ERTIF. ICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 056-305-26 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address or directions) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address EAGLE CREST SUBDIVISION #1; LOT 25, TRACT A, 19412 THIRD .STREET * EAGLE SVEN WELIN 19412 THIRD STREET * rlVErf AK. 99577 Day phone 694-7788 EAGLE RIVER~ AK. 99577 Day phone MARYLIN MOORE w/ REMAX PROPERTIESDayphone 244-2844. 16600 CENTERFIELD DRIVE * EAGLE RIVER, AK. 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: ;5 3. · TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site [] Individual Water Storage [--I Individual Holding tank O Community Class Well [~] Community On-site ~ Public Water System ~--~ Public Sewer [~] The Municipality of Anchorage Development ServiCes Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of.Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are v~lid fdi"iSh~-y~-~-for pr0-p-e-rti~,§-s'e~-d by-Cla~s A or B'~vells-or-a-p-dblic-wat~i--~stetn~ The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. STATEMENT OF INSPECTION BY'ENGINEER As certified, by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGI'NEERING GROUP, Ltd. Address ,.5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY-A, GARNESS, P.E. Phone 337-6179 Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance tWth 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 operation, al life of all WeIls and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the System. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 'DSD SIGNATURE ^ rovo ,or 53 Disapproved. Conditional approval for bedrooms. bedrooms, with the fllowing stipulations: WATER AND Attachments: 'HAA Checklist Septic .System Advisory. Well Flow Advisory =_ .: WASmW^ : .-' :, PROGRAM ..". Manitenance Agreements ~'~).);,, .'~'[r. s?,~;~ SupplementaI,Enginee¢s Reo~ ,.. Other : - - ...................... (Rev. 1 ?.~M ) Odginal Certificate Date: Ae Legal' Description:- EAGLE CREST S/D' ~1'; LOT 25, TRACT A, j~ : Municipality 0.fAnchorage DeveloPment services Department Bhilding Safety Division On-Site wat'~r & Wastewater Program - - 4700 South Bragaw St. ! P.O. Box 196650 Anchorage,AK 99519-6650 ' w,,~.ci.anchdrage.ak.us ~ - ;(907) 343-7904 HEALTH :AUTHO:RiTY AppRovAL CHECKLIST If A,-Bi or C provide PWSID# . i973 Sanitary s!~i iYIN) YES , Cased iFROM WELL LOG " 'g'.p~m. ' ~i'l. :' Nitrate _~LJ_ mg./L. ate oT sample: 4-/21/04 WELL DATA Well type: !i PRIVATE Date ~dP~ete~PPROX. Totald~pth 289+ ft. Dart, 6f itest Static Water level Well 'prO~uction WATER SAMPLE RESULTS:i Colif6rm i¥ '(..~ colonies/100 mi. ArseniC: ;'! N/'A mg./L. Be' Parcel ID: 056-303-26 N/'A . Well Log (Y/N). NO . Wires properl~,.protected (Y/N) YES Casing heigh~,~.(above ground) 12+ in. AT INSPECTION 28c~,~ ft. 7.2 .~ g.p.m.. Other bacteria (") colonies/100 mi. Collected ~by: GEG, LtD. Date installed ·7/21/'92 SEP~'IC/~OLDING TANK DATA : Tank' Type/Material ; STEEL Tank~ size" ~1ooo gal. ', Number of Compartments 2 ., ,. ....... t.I,,-, UO ' N/A FoundatiOn cleanout (Y/N) YES . Depress on over tank (Y/N) High water alarm (y/N) ' , .... "~ .... ' '"'"'"' ' ' ' i' ' ' ' 04 J McDONALDS PUMPING Date of ~umping ,4/22/ : ' Pumper . ' ," · I;[;; · ' , , · ' ~ l' ·!: . . ABS'ORPiTION FIELD DATA: ' lj ;~*~I[~-OW'EXISTM GRADI~ . i! : . ' Date~installed ~ 1/o3//73 .Soil rabng (g.p.d./ft o~ 100 . Syst,em type LOG CRIB Length' ~;~, 12 :, fi. :. ii .,., .i, Width! i:"~ - I12 fi. Gravel below.pipe **6 fi. 'total d'~,ih *.3.2 :ft i Eff absorptiona,~e~,~'288 ft' Monitoring tube **YES J ~ Depression overfie~d NO D~teiofh~lequacytest ;4/21/04 ·" Ilj Resultd(Pass/Fail) PASS "!i For 3 bedrooms ,: : ! ~ ~Ii; , -' ~ ' :~ i . ' , . ', ' . , '~' .. Fluid de~th in absorption field before test I:0!'~ !n. ' l Water added 666 gal;!i- . Newdepth 7 ,n. E apsed~ime: ,10 min.~ ' ~ Finalfluid~epth 0 ~n. , Absorpt~oprate>=~ 45~ g.p.d. Any ~e]~nation treatment (past ~2 mo.) ~/N & type) , YES . ~ If yes, give date · ~/lg/O ' :' ~ ~ ~ ~ ' ~ ': : r~;~*SEE.~HED=D~WlNG,~ONLY , ~' ' ~ ~:~ , · ~ 'E~ENDS~: BELOW TOP Of. CRIB '~ ~ D. LIFT STATION Date installed- '.~Pump on"levelat ' in. "Pump off" ' m., , High water alarm level at' :Cycles tested Meet~ alarm & circuit requirements?. SEPARATION DISTANCES ,:. :, SEPARATION DISTANCES FROM WELL ON LOT TO: *70' On adjacent Iot~ On adjacent lots Public Sewer manhole/clean°ut · Holding tank ' '; Septic tank/lift station on lot Absorption field on Io[ ~ *83' ', Public sewer main N/A sewer/septic service line 25'+ .in. 100'+ toO,+ ,,, SEPARATION DISTANCES'FROM SEPTIC/HOLDiNG TANK ON LOT TO:' Building foundatio'n 5'+ "Propertyline,', · Water main N/A Water service line Wells on adjacent lots · ' 'i00'+. 5'-!- i ' Absorption field 10'+: Surface water sEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ...... 10'+ Building foundation 10'+ Water Service line 10'+ Surface water 1'00'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'-!-' COMMENTS. - ' ' -; *EXISTING WAIVER G. ENGINEER'S CERTIFICATION I, cerlify 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. Engineer's Printed Name Date . ~r'/~. ~/O& ' JEFFREY. A. GARNESS '100'+ .Water main '. .N/A Driveway, parking/vehicle Storage lO'~ Waiver Fee $ Date of Payment · Receipt Number May, 6. 20041 3:46PM Garness Ensineerins Group, Ltd, No,5885 P, I ~t~) O~ k~5 ~"/'i~o... "ir-c, LOT . LOT SURVEY CERTIFICATION I hareby cectify lh~t I h~ve surveyed 1~ I~ ~hown end described he, e~n,ortd that the ~provements situated thereon ore wl~hln the prop- erty linee and do r~ ovecbp o¢ encroach on odiocent properly end tho1' no improvemenTS O~ e~ocen~ proper/y o. verlap Or en .?'. O(x:h o~..the p. re,?..ses in question Ond thc~ there ore no ro=oways, uY~lity line9 or all, or vlsi:le eosemenls On sold properly excel~ as indicated he~eon. /O-°/VT//_.. E'2W177. LEGEND 0 rlren pipe and/or rel~r recovered 0 = 2XZ hubP~tock recovered · ; 5/e"~ ~3"rebar at trois 9utvoy 'el--0/, I I '0~l Prepared by: R. L. BUTTON Registered Lond Surveyor (907]279-~00 519 ~ Mght~ Ave. Anc~age, Alas~o 9950i~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D.# 050-303-26 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# Eagle Crest #1, Lot ~, Tract A T14N R1W Section 7 Location (site address or directions) Property owner Mailing address Lending agency Mailing address Sven Welin Day phone 786-4682 19412 Third Street. Eagle River, AK 99577 City Mortgage/Don Presser Day phone 696-0701 11401 Old Glenn Hwy. #ll0A, Ea~le River, AK 99577 Agent N/A Day phone Address · Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. Engineer's signature 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of 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 Eagle PJ.ve~. Eng~eer~ng Services Phone 694-5195 Address P.O. Box 773294, Eagle River, AK 99577 DHHS SIGNATURE, ' / ~ Approved forT'/'~ ~/~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: % Additional Comments 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. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~'A~.~ O.R~ 5'T ~ / A. WELL DATA ~l~'/J .~1/,O 5~ ~ Well ~pe ~IV~ ~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ~ Date completed /~ ~5~ Driller Total depth ~/D / ~ Cased to ~ ~ / Casing height Sanita~ seal (Y/N) ~ ~ Wires properly P[0tected (Y/N) · Parcel I.D. 0~- .-~0 ~ - Z. ~, Date of test Static water level Well flow Pump level FROM WELL L AT INSPECTION ~ g.p.~ ~ ~ ~ SEPARATION DISTANCES FROM WELL TO: Septic/l'~g tank on lot ~) ; On adjacent lots ~/~Z; On adjacent ets Public sewer manhole/cleanout Petroleum tank +lOP / Other bacteria Compartments ~' Depression (Y/N) ,/v/~ Absorption field on lot Public sewer main Public sewer service line ~//,'~ WATER SAMPLE RESULTS: Coliform ~ .~---'--NIt rate--- Date of sample: //'~~~-- ~?) Collected by: B. SEPTIC/HOL:DtNG TANK DATA Date Installed ~ ~/I ?~/~ ~- Tank size Cleanouts (Y/N) Y~ ~ Foundation cleanout (Y/N) High water alarm (Y/N) ,/~/.4 Alarm tested (Y/N) Date of pumping /4V'/,~I -- Foundation Surface water/drainage SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /~' ~0' On adjacent lots '~ / OO · To property line '/"/~ ~ Absorption field .~' / Water ........ service line CONTINUED ON BACK PAGE Datelnstalled. '. . ,~ .--_~~.~..:= *. Size in gallons ....... __.,~[ml~ole/Acc. ess (Y/N) Vent(Y/N) ,,Pump on'y ' .'. ."PumP off" I.~vel at High water alarm level ~ I ~ Cycles t~sted , , ~,~ql~n lot On adjacent lots' ,Surface water , - D. ABSORPTION FIELD DATA D'~e installed';, **' .-_ /]/'~ :~ . L~*~'gth :~ I ~" Wid~ /%~ Total absorptio~ area ~ ~ Depression over fie d (Y/N) .' ~b Results (pass~f~il) /~A ~S Peroxide treatrn,e ~nt (pa~t !2 months) (Y/N) Soil rating /~' '~/"'~ Gravel thickness System type 5E/~P~& ~ Pl.7' Total depth Cleanouts present (Y/N) ~/~'.~ Date of adequacy test HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot ~',~/ On adjacent lots "~'/~/") 1 Property line To building foundation -,~ ~ / To existing or abandoned system on lot On adjacent lots -- ~ / Cutbank ~/~ Water m~Lq/se~ice line Sudace water ~/A DrivewaY, par~ng/vehicle storage area ~ Cu~ain drain ' E. ENGINEER'S CERTIFICATION I cedi~ that I have checked, verified, or conformed to alIMOA and H~ guidelines in effect on the date of this inspection. for ~ ~ bedrooms If yes, give date Louis Butera. RE. Registered Civil Engineer January 27, 1992 John Smith, P.E. Municipality of Anchorage On-Site Services 825 L Street Anchorage, AK 99504 Re: Lot 25, Tract A, Eagle Crest #1 Dear Mr. Smith, At the request of our client, Mr. Sven Welin, we are submitting a request for Health Authority Approval on the above referenced single family dwelling. There are two documents on file with the Municipality which apparently waive horizontal separation distance of well to septic tank distance of 50' and well to absorption field of 90'. The system soil log was accomplished September 29, 1973, and at that time it was the practice to log the seepage pit hole as the test pit indicating the pit was installed this date. The system asbuilt and approved date is November 3, 1973. There is a memo dated June 18, 1986 from Stephen S. Morris, P.E., DHHS, stating that the septic system is approved and suitable for a two bedroom single family dwelling. The system was inspected by our firm with the separation distance verified as the well to tank distance as 50' and well to field as 83'. This is the first property transfer, and therefore, the first time a Health Authority Approval is requested. Water quality samples were satisfactory. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773291 · Eagle £iver. Alaska 99577 · Telephone (907) 69.1-5195 · Fax (907) 69.1-3297 ............ DEPARTME~.OFH~LTH & HUMAN SERV CES .... . . , ...... ~ERTIFIOATE OF H~LTH AUTHORI~ . . APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ~ 050-303-26 HAA~ GENERAL INFORMATION Complete legal description Eagle Crest Lot 25, Tract"A T14N R1W Section 7 Location(siteaddressordirections) 19412 Third Street, Eagle Riger Property owner Mailing address Sven Welin Dayphone 786-4682 19412 Third Street, Eagle River, AK 99577 Lending agency city Mortgage/Don Presser Day phone 696-0701 Mallingaddress 1140! Old Glenn Hwy. ~fll0A, Eacjle River, AK 99577 Agent N/A Day phone Address Unless otherwise requested, HAA will be held for pickup. 2.. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well. Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site x Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. '.1 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of 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. With approval,of_well to septic waiver .distances. Name of Firm i' ,:ag-e ~lver ~ng~n~erlng berv[ces Phone 694-5195 Address P.O. B~x 773294~ Eagle River, AK 99577 Engineer's signature · 6.-- DHHS SIGNATURE ": __ Approved for ..... :~,, ~, ,,n;sa,,,,rove,t . .. -~' C0~diti0nal approval for bedrooms. bedrooms, with the'following stipulations: Additional Comments ,? By:. Date · , The Municipality of Anchorage Department of Health and Human Services (D .HHS) issues Health Authority ;~'"~:: Approval Certificates based only upor~ 'th~ r6p~es~n{atlonS giVe~l' I~ 'p~r:agraph 5 above by an Independent . '. . '~i:~,~..,'>;; pr0feS~lonal engineer registered In the State of Alaska. The DHHS does th s as_a co?~esy..to i~urchaSer~ of homes'' '. ' ~'1. .... .. ~ ~i ::¢~. and their lend. lng Institutions In order to ~atish~ certain f~eral and state requiremen~ ~nplo~o~ of DHHS do not,'~, , -. i: ' -: -- * ,~ - conduct Inspections or analyze data before a certificate Is~ Issued. The Municipality of Anchorage is not,. :L :" ' ~: ...:~ ..,: resp.o~nsmm ~or errors or om~ss~ons ~n me prom~sonm eng~n..e~_ rs .w..9~: ~ ,:,, ' .: i ,;.. ".: :'" :~:. :: "..~-;* :.~- ,: :'. ~ ::.: ~' ,. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Log present (Y/N) Total depth '~/~'/ Sanitary seal (Y/N) Legal Description: ~('~/-*": 0/~,7' // Well type P,~/V~7'r"' If A, B, or C, attach ADEC letter. Date completed ~,--,.-~- Cased to Date of test Static water level Well flow Pump level FROM WELL L~ ./ ADEC water system number ./~' ~ 7' ~'s*. Driller + ~"'~ Casing height Wires properly protected (Y/N) SEPARATION DISTANCES FROM WELL TO: Septic/hetd~3-tank on lot 5(:::) / Absorption field on lot E' :~ · Public sewer main' Sewer service line AT INSPECTION ; On adjacent lots g.p.m. ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate /t~D Z. Other bacteria Collected by: SEPTIC/HOLDING TANK DATA ,, Date installed ///~ 3 Tank size /~) Compartments Cleanouts (Y/N) )'/~-.-~ Foundation cleanout (Y/N). ~/ Depre,~slon (Y/N) Alarm tested (Y/N) '///'"~ ~)'/~/?~- Pumper --.-]"/~ ~ High water alarm (Y/N) Date of pumping SEPARATION DISTANCES FROM 'SEPTIC/N~LD~.~G TANK TO: Well(s) on lot ~D · To propertyline /~ Surface water/drainage On adjacent lots '"'/~'~' Foundation ~/~ / Absorption field' .Z~ ~t water maln/service'line '~ ~- / ' CONTINUED ON BACK PAGE 72-026 (Rev. 7/91) Front C. LIFT STATION ~/.' Date installed. -- . ~ ~ * ' Manufact~j~. -. . ' Vent(Y/N, "Pu~'p on~~~ -'~__ ' ~ "pu~ o,,". leve~ at~ High water alarm level _/ ~ ~P Cyc~ tested.~ Meets MOA ele~) . ~ ~ Io~ On adjacent lots . Sudace water D. ABSORPTION FIELD DATA Date installed II ' ' Boil rating /~"~ Lengt~ /.z _ Width /.z.. Gravelthickness &'" Total absorpt?0r~~ area ~ ;~' ,r~ Cleanouts present (Y/N) Depression over field (Y/N) /'"/ Date of adequacy test Results (pass/fail) P.'~$$ for. ~ ..~ Peroxide treatment (past 12 months) (Y/N) ./~/,/~ System type if yes, give date Totaldepth ~-/:z ' bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot ,~/ :~ ' ' ' On adjacent lots To existing or abandoned system on lot Cutbank '"',~ Water. Tab,service line "/(.z,~) ' Surface water Driveway, parking/vehicle storage area :' ' A Curtain drain E.~ENGINEER'$ cERTIFICATION I certify that I have checked, verified, or conformed to all ,MOA and HAA guidelines in effect ~n the'date of this inspection. To building foundation. Onadjacentlots ~ / Engineer's Name Date //~* ~_/~-~ HAA Fee $ ,17~-/ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number