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Home My WebLink AboutPROSPECT HEIGHTS #1 BLK 3 LT 7AP ospect Heights Block 3 Lot 7A #015-092-09 Municipality of Anchorage Development Services Department ' :-' Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 ~ ~" www.ci.anchorage.ak.us (907) 343-7904 Poge I of On-Site Wastewater Dlsposal System and/or Well Inspection Report Peri. it Number:. SW020080 PID Number:. 015-092-09 Nam~;RON HAS BROUCK WastewaterSystem: I-I New · Upgrade 9301 NORDIC STREET * ANCHORAGE. AK 99507 ABSORPTION FIELD No, of I}edrooml: Ph°nl:(907) 346--2388 4 f'lDeep Trench ISh~llow Trench I'lBed ~3Uound DOther LEGAL DESCRIPTION ~' "'~ 1.2 ~ ,. 7.5-8.5 3 7A PROSPECT HEIGHTS #1 4.28-5.28 ~. 3.22 - - - O r~ 58 ~ ~.,,.,,~ ::..:--,.,,-.: I WFI I '. [] New r'l Upgrade 5 ~ 1 - ..~ r~r~ 5004' ~o. rL D 3034/ F-810 ~ ~ o~. ~ ~ *~" ~r~ D~"~ALI SEWER &: DRAIN ~ ~'4"~"~0-5/6/2002 SEPARATION DISTANCES .s.,~c a.o~,, =s.T.~,. Tank meld ~*-fl-.Tank ANCHORAGE TANK 1250 we, lOO'+ lOO'+ - - 25'+ STEEL 2 s.,o.o Wo~.. ~oo'+ ~oo'+ - - - LIFT STATION ,.. ,o., - - - "'"'-I ~emor~=: BENCH MARK -EXISTING SEPTIC TANK ABANDONED PER UPC. BOTI'OM OF SIDING BY FOUNDATION CLEANOUT · .._,.4 _~ ~ -: 100.00 nfl Inspections performed by:, AKWWC, INC. Dates: 1st 4/30/2002 '..~....~..~ 3rd 5/6/2002 [ '..d, ~ ~, Development SeTic. ,I. _, ,DePa"ment Approva , :. R~'v~i~e°w'? and appr°ved bY:( Date://=/*? ~ "~%~:,~.~-'~" 'r J ..' SW020080 Ol 5-092-09 A I B 53'1 35.88 51.89 L, I ST2 43.22 60.06 1~' C~.Z~,~.2 DBL1 46.67 63.95 ~) ~X~ DBL2 I 47.89 65.29 N~ ~ ~ ~ ,54.99 72.96 V~ (~)~ ~i1,~ ~1 49.14 60.10 ~,~~ ~ ~.,o ,,~.7~ ~ ~~~ ~ / / ~~ / / ,.q ~.'.;',/..%';:r..;:~:~.7-:..:~?~: .~'~: ~.z.~ · ~S~ ~TER & WASTE~VATER R0~ HAS BRODCK (~07) 346-2388 2 0g S "' .......... :'"'t PROSPECT HEIGHTS SUBDIVISION ~1; LOT 7A, BLOCK AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE A B 53'1 35.88 51.89 ST2 43.22 60.06 DBL1 46.67 63.95 DBL2 47.89 65.29 FD 54.99 72.96 C01 48.59 I 59.52 M1'1 49.14 60.10 C02 96.50 114.09 MT2 96.10 113.75 AS BUILT DRAWING PERMIT NUMBER: ~ 01 5--092--09 SW020080 98.~-98.66 = ~P OF T~K AT 0~ ~ 94.42 N~ 1250 ~ON ~ OF BUN~ SE~C T~K I~ or ~c AT ATIN~- g3.87 ~ ~ 0~- g3.66 '~""4 ~ ;~ ~;" ."~ ~S~ ~rATER & WASTEWATER ~ .... ~ .... ~ ...: .... ~ ~o~ ~o~ ~,,~: ~ ~'~: ~5~q ............... ., RON HAS BROUCK (go7) 346-2388 3 OF PROSPECT HEIGHIS SUBDIVISION ~11 LOT 7A, BLOCK ~' PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Apr 29, 2002 Expiration Date: Apr 29, 2003 Permit Number: SW020080 Legal Description: PROSPECT HEIGHTS #1 BLK 3 LT 7A Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: Ron Hasbrouck Owner Address: 9301 Nordic St. Anchorage, AK 99516- Parcel ID: 015-092-09 Site Address: 009301 NORDIC ST Lot Size: 153331 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit Is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be In accordance with: 1. The attached approved design. 2. Ail requirements specified tn Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By,: ~ Date~ Issued By: Date: .~_.~{~ 2 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 015-O92-09 Permit Number Property owner(s) Mailing address (1) Mailing address (2) RON HAS BROUCK 9301 NORDIC STREET ANCHORAGE. AK Day phone 346-2388 Zip Code 99516 Legal description (Lot, Block & Sub'd.) PROSPECT HEIGHTS ~/1. LOT 7A. BLOCK Legal description (Section, Township & Range) Lot Size / "-~'~, ~'~ J Acres~ N/A Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Well Only ~r~ Water Storage THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Jacuzzi [] Water Softening Unit [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS~ INC. Permit Fees: ~/'"'/(-){~ Date of Payment: '~'- Receipt Number:. Waiver Fees; Date of Payment: Receipt Number ALASIG WATER & WASTEWATER ~ CONSULTANTS, INC. April 15, 2002 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water 8: Wastewater Program 4700 South Bragra~v Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Proposed Septic System Upgrade for Lot 7A, Block 3, Prospect Heights Subdivision gl To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. A test hole was excavated in the area of the proposed septic system. The septic system will be designed around the 30 foot radii of this test hole. We are proposing that a 1250 gallon septic tank and a five foot wide drainfield be installed. Comments regarding the design are summarized as follows: I. SOILS: See the attached logs which shows the soil classifications, groundwater monitorings, and the percolation test results. It is our opinion that an applicat'on rate of 1.2 gallons/day/ft' should be used. 2. TRENCII DESIGN: a. Percolation Rate: 4.4 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/ft: e. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 500 fta f. Total Depth: 8.5 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet i. Reduction Factor: 0.50 j. Minimum Length: 50 feet long k Effective absorption area = 500 fl~ 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: ak~vwc.com 4. TOPOGRAPIIY: The area for the proposed septic system is a 10% to 15% slope running approximately northeast to southwest; in short, there are no slope concerns. We are una~vare of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance, d,, Sincere]~ /q/,/~ NOTE: Attached is a site plan drmving, a design drawing, a soil log, and a 7page constrttction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwe.com LOT 6A, BLOCK 3 I ! I ~ PROSPECT HEIGHT~ ~I I / I ,' I .o =.=~.= /// , , /// . LOT 2. BLOCK 1 CO NI~.R HFJGH~ Ill ti /I// , II , , / J,~ NO CONCFr. RNS :--I ' I ~, ,/!~ ' LOT 1. "~OCK 1 , ~ I )':'.~'~ ~ ~ /// , .......... ~ I _ ~/~ / /// I <. , " I I ' / /// "' ' ' I I =,~.= i// / ~ .o~ / / / . / I . __CONI~ H~6~ I O, ~ zj , / I I ' .......... ,/ J J I .~o~..~ -.~../ / / I I I I , , I "~ / / ,~w. c.~.o. F~" "~'& ~SI~ ~q'ER & ~S'rE~TER CONSUtTA~IS, P.~ FOR P.ON[ NUUem: P~[ .UUe~: [~$~ ........... : .... PROSPECT HTS SITE P~N FOR PROPOSED SEPTIC SYSTE~ UPGRADE [ [/ ~PROPOSED DRAJNFIELD. ED(CAVAT~ A 'I~£NCH 4/15/2002 ~ ' ~ ~, RON HAS BROUCK 34e-2388 2 OF PROSPECT HEIGHTS SUBDIVISION ~ LOT 7A, BLOCK 3. ~ .... L .DESlON DRAWINg OF PROPOSED SEPTIC SYSTEM UPSRADE '~%~ AI.J SIiA WATER & WASTEWATER ISOIL LOG - PERCOLATION TESTJ,A ~, ~A.u~~"~'~":,"',:/~':~-- PERFORMED FOR: RON ~BROUCK DA~: 4/3/2002 .'"' ~[ ORGANICS ITEST HOLE ~1 I IF TIN ORO ~ GP ~ NL GH CL GC OL SW NH sP CH /g .----- SH OH /~ SC // DEPTH TO DATE/ l/ GROUNDWATER I ~ ~ '~ 10 11 DATE READING CLOCK NET TINE WATER LEVEL NET DROP TINE (NINOTES) READING (INCHES) 12 4/9/2002 1 12:52 - 6- - 2 1:02 10 3 1/2" 2 1/2" 13 3 1:02 - 6' _ 4 1:12 10 3 3/4' 2 1/4' 14 5 1:12 - 6- s ~:22 ~0 3 3/4' 2 1/4' 15 7 1:22 - 6- 8 1:32 10 3 3/4' 2 16 9 1:32 - 6- - 17 10 1:42 10 3 3/4' 2 1/4' 11 1:42 - 6- - ~8 12 1:52 10 3 3/4' 2 1/4' PERCOLATION RATE 4.4 (HIN./[NCH) PERC. H~E DIA. 6 (INCHES) 19 TEST RUN BETWEEN 5.5 FT. ~D 6.0 FT. 20 A FO~ HOUR PRESO~ WAS PERFORMED: ~ YES ~ NO SOILS LOGGED BY:. JE~ ~RNESS PERCOLATION TEST PERF~HED BY: JODY MAUS COH~ENTS: PERFORMED BY kW.W.C., INC. I, JEFFR~ A. ~NESS, CERTI~ T~T ~IS~ERFORMED IN ACCORD~CE W~ ~ ~ATE ~D MUNICIP~ CUIDEUNES IN E~ECT ON ~HIS DATE: ~[~/0~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME [] UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION ~ ~,~ NO. OF BEDROOMS ~ ~ DISTANCE TO: ~ ~ / ~ ~ '3 PERMIT N ' ~ ~ Manufacturer Liq. capacit~n gallons IF HOME.DE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT O ~ ~ Manufacturer · --~ Material Liquid capacity in gallons No. of lines / Length of each line Total length of lines Trench width . Distance between lines ~ Top of tile to finish grade q'~ ~/ ~'- ~inches ~ ~ Materia~ beneath the Total effective absorption area m Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ DISTANCE TO: Well Building foundation Nearest lot line ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PiPE MATERIALS SOIL TEST RATING ~[ J. APPROVED r DATE LEGAL /~/ Date Drilled: ~-.,, WELL LOG R, Habrouck !.t o 7~-A Blk.3 Prosoect Hei?bts ~J Static Water Level 115 Draw Down ~/A feet feet Gallons Per Minute 5% Total Feet of uasing ~.~3 Type Material Drilled: 0 feet to !40 S~nd¥ city w/?:ravel feet to 153 .,3 :feet to ~89 Pmdrock fractured (3~ to Perforsted cssinq. :,_ =rom 140 ft. to _150. ft. to to S.R.A. Box 1553 H Anchorage, Alaska 99507 MUNICIPALITY OF ANCHORAGB DEPT. OF HEALTH & ENVIRONMENTAL pROTECTIOb[ Iq0V I ' g84 RECEiYED FIF'F'L. ]1CFINT: FI [:, D Fi: E: :iii;ti~; · C,E:F'F:d:RT'HF::?.,FI" OF' H[Et:::IL. TH FINg, ENV.'t;F.:ONHENTFfL F'ROTECT :t: ON ':":.'~:i L.. ' .... , *..to T .::, F:.E,.: .... FIBtr":,~4 - iq'F:l liE' I::11< ;~.' E, ,cl. L. ,cl. ';:-' ;:;..: :3 S!._IE:C, ]: ',,,' !' :':'!; :[ ON: F::'ROSF'E:CT HE i' GI.-I'T'S ' SiECT'ZON: :I.~::: TOi.,.!I'.,i:SFIZP: 2:. 50Fi ,:::E;Q. I::'T. OR: L lilt · '?'FI RF:INGE: ~:[,.t EL "Zl'::: ..'2..': L.Z':~TFZ[, E:ELFI,I FI!:;?.E THE OF:'T:[Cd'.,I:~ -'F ~ FI:" ~- . ' ....... '- F' ..... ,. ].,-.-I..:,L.[:~: 'I'O ?FII i[~'-J t)I:EE";Ir'_:ii'.,t~TN'~i '~.'I]IUF.'..:JEFII_. ::,..:,.Eh1. [:H ..... '::::' THE LqF"I"Y']N TH!::iT E:EL:;..T F):T::; '¢C..I::: LS.!:'l"E. [.:'Ei:::'TH TO F:']:F'E E:O"i"'T'EtH ~::F'T. > {::iRF:?,/E'L. DIEF"TH CF'T: -.I:OTFIL DEI::'T'H CF:']". ::, Gi:;~:Fi',,,'E[... !-,.!]:g, TH '::FT. GF::FI',,,'E:L L.E:NGTH ':: F'T. "i' ~ai",ii-::: ::ii; Z ;F::E: .':.' GI:::~L. 5; ::, i. ~'"~l' F;:F!T Z NG < :E;Q. FT. ,-'"br..'""- ' / m:+: g'EF:'TH TO F:'ZPE: E',OTTOH '::: 4.. 0 FT. R:EQI :[R:E FI L'J:FT F:;TRTZLqI'.,I :+::+: 'TF:Ii'.,II.C !"iI...I:E;"F HFI',/E FIT I...,EF:IST TWO E:OHF'F:IF;i:THENTS I~:EFi:T Z 1::'? THI:::iT': :I.. :[ FIH F'F!H:t:I..L:I:F!F~: H:!:'T'H 'THE F;:EE!L.I:[F:F.{HENTS; FOE: Ot",I-S]:TE SEI4EF.:~; FIND t.,.tEL.'LS las SET F'OF~F!'I-I F3'¥' 'T'HE I"ILJN:['CT.F:'F!L.:[T'¢ [)F' FII",tCFIOI:~'..F~EiE: (HOFI::, FIND THE ?TFI']'E' OF: FILFISI<FL :ii:. :[ !.,.I :[ !... L_ ]:NSTFIL.L. THE L:!;"/F;TE]"'I :[1",! F!CCEd:~:I.':,FII'-,tCE: I.,.IZTPI FILl.. HOFI CODES FINE:, F-'.EGULRTION2;., f::tl'.,ii:::, ]: h,I COHI::'L. :1: FINCE H :[ "FH T!-..IE: [::,ES': :[ GN C:R I TEF: :[ F,.' OF TH I ~; PE'R:I"I ;1: '1". 3:. Z HZL..L F'i[:,Hr.:~:Fi:F:.: TO F:!LL HEq::! l:::l~.,l[:, ~?Ff:iTI:Z O1::: FtLFrE;KFi F.:EE-.!U!'I.:{[i~:HENT% FOF.: THE SE]' E',FtCI<.' · [:'Z:E;T'Fd',!C[~S: F'r~:E)P'I FIN'.? E;:.:;I':STZNG !.4E:L!. .... g!FI:STEHF:!TEF', g,]::E;F'CIS;FtL. '-2'¢:STEFI CiE: PLIE:I..IC Z;E:HE:F:F~GE :!.~TT':STE]·,i Ed,,t 'l"H:[S OF.' FIN'./ FII)JFICE:NT O1-:~: NEFtF:E,"¢ LOT. 4. :[ !..!f'4g, IE?.:iSTF!Ng, THFIT 'TH]:S F'E:Ri',I:[T :[.':5, VFfl.._I[:, FOF: FI HFI',:.::.T. HUH OF 4 E,'EDF.'.OOH$ FIND Fii',!Y E:NL.F:ff;~:GEHE:hFF H Z L.L. Fi:E:QLJ ~ F:E FIN F![:,C, Z T .T. ONFIL PEF. ff"t ]: T. FI LZF'T Z:TFIT:[ON L,"'S :[NS'T'F:ii....L. ED /[i'-,l f:~i'-,! FIR:EFI IZ:OVEI:~:F2£, E,"¢ HOFI BLIiLC, ING COg, ES., 7'.,L!EF,! CZ::, FIN ELE:C:TF::)':CFd_ F'E:g':H:[T FINE:, Zi",!:-2;F'E~CTIO!',I !'"it..t$'1" BE OE~TFIINEE:,.; ':.'2> Fr:T,--BLJIL..T$ F.I:[LL. NOT' DE FIF'F'Fb:]VE[::, H]:'T'HOLFF FiN EL. ECTF'.iCFIL. ZN:E;PEC'!":[ON F:'.EF'OF..'.T.; l::Ih,lE:, <:5:> THE !2L.EC"Fi:R Z::: .:~L~]..; "" 'I i,...~...: ~' :: .... L,E:' ' !...,uN~:: ~ ~. ..................... f'-tL .[ i....EN'::,!:::[., ELEL: FI-,:: I L: 1FIN. F:i "iF:: [, ~~ ' [:'Ft'TE ' :::fF:'F:'L .]: C.:F:i?'gT: F'~:(.)i'-,il::: .", ill!:. Ir ~..,t:. I,. I. ~ .. ..... . ~ ~ [:,FtTE - PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19, 20 COMMENTS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST ~ SOILS LOG [] PERCOLATION TEST DATE PERFORMED: SLOPE SITE PLAN WAS GROUND WATER t \ S ENCOUNTERED? ~'~ ~ P E IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND -- FT 72-008 (6/79) ,/~ SOILS LOG PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST J-~°~S bro,~. }:- DATE PERFORMED: PERCOLATION TEST LEGAL DESCRIPTION:, 2 3 4 5 6, 7 8 9 10 11 12 13 14 16 17 18 19 2O COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? ~] o ~ O P E IF YES, AT WHAT DEPTH? '~"d,-~ t~ ~o1,~ ' Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~O (minutes/inch) TEST RUN BETWEEN ~ FT AND--~ ~/Z- FT PERFORMED BY: CERTIFIED BY: DATE: 72-008 (6/79) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. O15-092-09 1. GENERAL INFORMATION Expiration Date: Complete legal descdption PROSPECT HEIGHTS SUBDIVISION gl; LOT 7A, BLOCK ,3 Location (site addressordirections) 9501 NORDIC STREET * ANCHORAGE, AK 99507 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address RON HAS BROUCK Dayphone 346-2388 9301 NORDIC STREET * ANCHORAGE, AK 99507 Day phone Day phone Unlessothe~iserequeste~ HAAw~beheldbyDSD ~rp~k~. 2. NUMBER OFBEDROOMS: 4 3. TYPE OFWATER SUPPLY: Individual Well ~ Individual Water Storage Community Class Well [--~ Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ to closing for the engineering aery/cea provided. 4. STATEMENT OF INSPECTION BY ENGINEER a& orprior I As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(am) safe, functional and adequate for the number of bedrooms and type of structum indicated herein. I fur~her verify that based on the information obtained from the Municipatity of Anchorage fi/es and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with ali applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. NameofFirm ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD, SUITE 2B "ANCHORAGE, AK 99504 / Engineer's Printed Name dEfl-t<E'f A. GAENESS, P.E. Date Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results descdbed the petfon~ance 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 wens and aeptic systems depend on the local soils condition, groundwater levela that may fluctuate durtng the year, and the water usage of the family being sewed by the system. These conditions are outside the control of the eva/uator of the system. Satisfactory test results do not guarantee futura peffon'nanca of the system, nor do they guarantee that there ara no hidden defects or encroachments. AKWWC, Inc. can therafora not provide any warranty or future estimate of how long the system wi//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 pady la not authorized, nor wi//it confer any legal right whatsoever. .5. DSD. ~N~TURE v Approved for ~/ Disapproved. Conditional approval for __ Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms. Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: ~/~Z/~'~. Municipality of Anchorage o Development Services Department On-Site Water & Wastewater Program ~ 4700 Souttt Bragew SL P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (~;,) Legal De$=tplJon: WELL DATA Ce HEALTH AUTHORITY APPROVAL CHECKLIST PROSPECT HEIGHIS S/D l~1; LOT 7A, BLOCK ,3 Parcel ID: 015-092-09 Well type PmVA-rE If A. B, or C provide PWSIDft N/A Well Log (Y/N) YES Date c~mpletacl 5/21/1984 Sanitary seal (Y/N) YES Wires pmpedy protected (Y/N) YES Totaldepth 189 ff. Cassdto 153 ft. Castnghelght(aboveground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 5/21/1984 7-11-2002 Static water level 115 ft. 125 ff. Well production 5.5 g.p.m. 4.9+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Nitrate 5.41 mg./L. Other bacteria Arsenic: N,/A mg./L. Date of sample: 7/11/2002 Collected by: SEPTIC/HOLDING TANK DATA Tank Type/M.ate;tal STEEL Date installed 5/6/2002 Tank size 1250, gal. Number of Compartments 2 Cleanouta (Y/N) YES Foundation cteanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper - ABSORPTION FIELD DATA PBELOW ~ Gmat1 Date installed s/s/2oo2 Soil mfing (~or ft'/Ixlrm) 1.2 Length 58 ft, * ' Width 5 ft. Total depth s.~ ft. Eft. absorption area 500 ff~ Monitoring tuba YES Date of adequacy test NEW Results (Pass/Fall) - Fluid depth in absorption field before test - in. Water added - gal. New depth Etapsed T~me: - rain. Final fluid depth - in. Absorption rate >,= - Any rejuvenation treatment (past 12 mo.) (Y/N & type) - ti'yes, give date 0 colonies/100 mi. AKWWC, INC. sYStemtype SHALLOW TRENCH Gravel below pipe 3.22 lt. Depression over field NO For 4 bedrooms - in. g.p.d. D. LIFT STATION Date installed "Pump on" level at in. Datum E. SEPARATION DISTANCES Size in gallons "Pump ofr le~l at SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllilt station on lot100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Manhole/Acc~-~ (Y/N) In. High water alann level at in. Meets alarm & circuit requirements?. On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5°+ Property line 5'+ Water main N/A Water service line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorption field 5'+ Surface water 100'+ Water main N/A Driveway, paWJng/vehicle storage Pmberty line 10'+ Water service line 10'+ Curtain drain NONE KNOWN COMMENTS Building foundation 10'+ Surface water 100'+ Wells on adjacent lots 100'+ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections end review of Municipal records that the above systems are/n conformance with MOA HAA guidelines in effect on this data. Engineer's Printed Nan~ Date '-~ /1~/0~, J~rREY A. GARNESS WaNer Fee $ Date of Payment Receipt Number 10'+ ~.,-15-02 05:42~ FI~I/cCT&E ENVIROIII~NTAL SRV ZeE C:T&E Envlro~mental ServIcel Inc. 9075515~01 T-854 P.02/03 F-gll CF&E Ref.~ Client Name Project client Sample Matrix Ordered By PWSID San'~pl¢ Remade: 1024173001 AK Water & Wastewatc~ Consultants Inc. 9301 Nordic St Lt 7A Bk 3 Prospect IRa #I Drinking Wate~ All Date~,~'lmes are Alaska Standard Time Printed Date/Time 07/15/2002 8:46 Collected Datr./'rime 07/I 1/2002 11:00 Re~ehed Dare, rime 07/11/2002 13:00 Technical Director Rcs.la PQL Units Mccad X.imit~ i~te Date Init NitTatc-N 5.41 0.200 mg/t. £PA 300.0 (<10) 07/11/02 N:L ct'ob ~.o3.ogy La~oF&toc~Z Total Coliform 0 col/I OOmL 5M18 9222B 07/I 1/02 SBH N 90°00'00"~ 379.20' L- HONICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF ~LTH AND ENVIRONMENTAL PROTECTION I. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name_~3 )d~ ~&~C6ocA Tel,,ephone - Homei?96~usiness Applicants Address (C) Applicant is (chec~ o~e) Lending ~nstltution ~-~ ; Owner/builder.~; Buyer ~--~ ; Other .~.'.,~explain), - ' (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. T~pe of Residence Single-Family~ Number of Bedrooms 3. water Supply Multi-Family ~--~ Other (describe) Individual Well ~ Community ~--~ Public ~-~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal 0nsite ~ Public ~-~ Community ~ Holding Tank ~-~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] Engineering Firm Providin~ Inspections~ Tests~ File Search, Data and Information, As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Approved for?/ ) bedrooms Approved ~ Disapproved Terms of Conditional APproval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF ItOMES AND THEIR LENDING INSTITUTIONS IN oRDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. RR4/ej/D18 [Page 2 of'2] (DHEP SEAL) 7-19-84 ae ~'%UNICIPALIT( OF /,;,!G!ORAG~ DEPT. OF i~2ALTiI & MUNICIPALITY OF ANCHORAGE (MOA) Well Classification Well Log P~esent C~N) Total Depth I~ ~ Cased to Static Water Level 11~ Casing Height Above Ground ~ ! Electrical Wiring in Conduit ~Y_~N) l, OV I 1984 HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST FEBRUARY 1984 - ,, If A, B, or C, D.E.C. Approved(Y/N) .~/]~ Date Completed j~_~ 3,5 Depth of G~outingoA2/~4~o~ Pump Set At Separation Distances f~om Sanitary Seal on Casing ~/N) Dep:ession A~ound Wellhead (Y~ ; On Adjoining Lots ; On Adjoining Lots To Septic/Holding Tank on Lot J(~7 ~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sev~: Line ~J/~4_ To Nearest Public Sewer Cleancut/Manhole ,4)j.~, ' TO Nearest Sewe~ Service Line on Lot Wate~ Sample Collected By ~ ~ ; Date Wate~ Sample Test Pesults .~t-~1'~'~ B. SEPTIC/HOLDING TANK DATA Date Installed~//~/~ Size /~O¢L NO. of Compa~tr~nts Standpipes~N) Air-tight Caps-,,~) Foundation Cleanout ~p~ession ove~ Ta~ (Y~) Date ~st P~d P~ing~aintenan~ Con~act on File (Y~)~/~ ; fo~ Holding Ta~ High-Wate~ Alam (Y~) ~/~ Te~ra~y Holding Tank Permit (Y~)~/~ Sep~ation Distanms ~m ~ptic~olding Tank: To Water-Supply~ll ](pb' To ~ilding Foundation To ~o~rty Li~ ~ ~;) TO Die. scl Field .. To Water Main/Se~vim Line ~/~ To S~e~, Pond, ~e, ~ Major ~aina~ , [Page 1 of 2] Receipt ~ Date Paid: Amount: 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~ '~j Type of System Design '~ Date Installed ~/) %,/~(~. __ ~ngth of Field ~C' Width of Field ~' ~1 ~p~ of Field ~ ~- ~ vel ~d Thickness .... ~, ~ aquae Feet of ~sorption ~ea ~' Stan~i~s ~esent ~) ~pression over Field (Y~ ~te of ~st A~qua~ Test ~/~ Results of ~st Ade~a~ ~st ~ Separation Distan~ from ~sorption Field: To ~ter-Supply ~11 /~ ~/ To ~o~rty Line I O :~ To Building Foundation ~ ~ 1,) TO Existing or ~ndo~d System Lot ~/~ ; ~ Adjoining ~ts > ~, L) To Water Main/~rvi~ Line ~/~ To Cut,DR( if pre~nt) ~/~ To Stre~ond~ke/~ Majo~ ~aina~ C~se ~/~ To ~iveway, Parkin~ ~ea, om Vehicle Stora~ ~ea ~) ~ ~ De LIFT STATION /~ ./Di~p~ . ions ~ Manhole/Acces/z~Y/N ) ~ I'th~y Le us i. at High Water ~ ~vel at / Vent (Y~) Tested fo~ . ~c!es d~ing Adequacy Test. Electrical Codes (~/ Date Installed Size in Gallons "Pump On" Level at Meets MOA ** Check Permitted Bedrcom Rating Against HAA Request I ~rtifv that I have checked, verified, or conforn~d to all ~A HAZ C~idelines in ef:F_ect on the date of this ins,pection. Signed ~ [~,.~~x 'MoADate Contpa,T~/v/~ ~C ,.~., ~, Z~ C.- KB1/dL/s [Page 2 of 2] 2-15-84