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Home My WebLink AboutDENALY BLK 1 LT 1naly Block Lot ! #050-731-48 Municipality of Anchorage Development Servlces Department Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 wvw.ci.anchorage.ak.us (907) 343-7904 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW010410 PlO Number:. 050-751-48 NOm':CA~L KAPPEN Wastewater System: r'l New I-I Upgrade 17034 EAGLE RIVER ROAD * EAGLE RIVER, AK 99577 ABSORPTION FIELD No. of Bedmomw: Ph°~e:(907~ 622-5585 4 I'lDewp Trench .~hallow Trench r'lBed rlMound LEGAL DESCRIPTION 1.2 ~/~ ~ 7 MAX 1 1 DENALY 3.03 MAX r~_ 4.16 - - - SEE DWO. ~ 60+ (2 O 30+)~t WELL: · New [] Upgrade 5 ~ 2 PRIVATE 122 ~ 120.35 r~ 600 ~ D 3054./ F-810 ,JONES EXCAVATING 10/13-18/2001 M-W DRILMNG 1//14/02 8+ 10+ a,~ UNKNOWN ,. 2 ,, TANK SEPARATION DISTANCES ,s.p~ =Nov.; =s.~.~.. ~o SopU¢~Uon St~onU~Ho~wZa.k ~=~/~'~ ANCHORAGE TANK 1250 we~[ 100'+100'+ - - 25'+ STEEL 2 S~a~* Wat.r I00'* 100'+ - - - LIFT STATION tot Une 5'+ 10'+ -- FoundaUon 5'+ '8'+ -- -- -- 3'~e" ' ' ~-~-'~'~ ' I' -- -- ee-'-- ' ~ernark$: *SEE ATTACHED LETTER BENCH MARK TOP OF FOUNDATION O SOUTHEAST CORNER {*""'~ :'-"=-" 100.00 inspections performed by: AKWWC. INC. Dates: 1st 10/13/2001 .... 3rd 10/17/2001 4th 10/18/2001 Department of Hoaltl~nd ,Hu~n~n $~rvlce.~ approval . ~0~';~.ii ¢15 i9~...'~,~ by:/,~.~tr ~. ~t~. - - D~ta: ~/~]~?~ Uff~;. ,~,~o}Jo"".. ~1 ......, ,,a~":""~°~:~ R~viewed and approved ALASI WATER & WASTEWATER ~ , ,, CONSULTANTS, INC. July 3, 2002 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Waiver for Lot 1, Block 1, Denaly Subdivision To whom it may concern: We request that your department issue a 8 foot waiver from the foundation to the new drainfield. The foundation was installed after the drainfield and is a crawlspace with no living area. Also the elevation of the drainfield is lower than the foundation. Giving the porosity of the soil there should be minimal lateral migration. I am unaware of any adverse impacts this waiver would have on the existin:l drainfield or foundation. If you have any questions, please contact us at 337-6179. Thank ~j ~u for your assistance. 6901 Dcbarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com AS BUILT DRAWING pERUIf NUMBER: SW010410 0S0-751-48 ~ ~ ~ ~ ~S.72 16,69 ~ ~ OO~ 31.B 23.57 I ~ ~ ~n. ~ ~2 ~0,1~ 25.~ ~ ~ ~ ~ 49.65 24.~1 ~ ~ N ~ H.72 42,04 ~ , ~ ~ ~.61 4~24 ~ '~ ~ ~'~,~ /' ~ '.~./ / ./ ~S~ WATER & ~STEWATER ~ ~o~u~A~T~, In~. , .... : .. ~ ,...=~) ~.. ¥. ~ ~ ..... :....j CARL KAPP[N · ASSOCIATES (907) 622-5585 2 OF ~ ~ D~Ri~ON: .~.~ su.o~v~s~o.= ~o~ ~. ~ocx ~ '"~:,:-[.. ....... ..'b~ AS-BUILT DRAWING OF NEW WELl. AND SEPTIC SYSTEM LOCATION AS BUILT DRAWING SW010410 050-731-48 fflrlN~L GRAD£ - 99.7 ~P OFT~K AN = J J : ff~P 0r T~K AT I~ OF BUN~ S[~C ~1~ ~ BUNG AT [LOWER TRENCHl DPPER TRENCHI ~7 j ,,.~ (A~.) 10' ' J , CONSULTANTS, INC. ' .... :... CARL KAPPEN · ASSOCIATES (907) 6t2-5585 2 Or ~ ~ ~.~.: ~<..,.. .... ...~ DENALY SUBDIVISION; LOT 1, BLOCK 1, PROFILE AS-BmLT ORAWlNO OF NEW SEPTIC SYSTEM g4Sg~g7 FP.X NO. :997-622-b--~-~ 3un. 24 2f3~2 ~9:l?~tq P2 H I,/ I~ILEIN~, INC PAGE: 82 M-W Dr. Jllfng, Znc. ~P.O. ~x Z10378,dflchof*ege. AK 99a11, t~7-34~.4~00 · ~C)7.345.3287 ~fu~o · (;~dNeef~.. (7) hr.b. No. I bcm~;~ iTmubs Well Lo ~epth In feet from ..... n ~ Id'tldaL Dee' Ill of.lo .nnlUolf ISdmeb'tbd. ~ of atlterbl, eolor iud hrdv*~et 0 TO 2 Casingstidcup :2 TO 32 Gtavelly silt: brown :32 TO 38 Gravelly silt: gray 38 TO 50 Silt: gray 50 TO 103 Clay: gray 103 TO, 116 Grnv¢lly¢Iny 116 TO 122 Waterj~vei TO TO TO " ?o , , .~/.;.~....~.e~//.~-.~.... TO ~=& .- ..... ¢, ...... ,. , MUNICIPALITY OF ANCHORAGE Development Sen/ices Department On-Site Water& Wastewater Progrem 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7g04 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Oct 01, 2001 Expiration Date: Oct 01, 2002 Permit Number: SW010410 Legal Description: DENALY BLK 1 LT 1 Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: Carl Kappen & Associates Owner Address: 17034 Eagle River Loop Rd Eagle River, AK 99577- ParcellD: 050-731-48 Site Address: Lot S~e: 62886 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. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 043-7904 ( 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. Date: Municipality of Anchorage Development Sentices Depadment Building Safety Division On-Site Water & Wastewater Program 4700 South Bmgaw SL P.O. Box 196650 Anchorage, AK 99519-8850 v, ww.d.anchomge.ak.us (9O7) 343-?e04 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number Property owner(s) Mailing address (1) Mailing address (2) Legal description (Lot, Block & Sub'd.) DENALY SUBDIVISION: LOT 1. BLOCK 1. Legal description (Section, Township & Range) N/^ Lot Size ~',~ ~'/-,P Acms/Sq. FL Number of Bedrooms CARL KAPPEN & ASSOCIATES Day phone 17034 EAGLE RIVER LOOP ROAD * EAGLE RIVER. AK Zip Code §22-5585 99577 THIS APPUCATION IS FOR: Sewer Only E]~ Sewer and Wall Sewer Upgrade [] Well Only [~ Water Storage THIS PROPERTY CONTAINS: Hot Tub Swimming Pool 'Therapy Pool Jac~-"~! Water Softening Unit I certify that the above Information Is correct. I further certify that this application Is bolng made for a Single Family Dwelling and Is In accordance with applicable Municipal codes. ALASI~.A WATER & WASTEWATER CONSULTANTSr INC. Permit Fees: ,~/-~ L~(") . Date of Payment Receipt Number:. Waiver Fees; Date of Payment: Receipt Number:.. ALASKA WATER & WASTEWATER CONSULTANTS, INC. September 18, 2001 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program P.O. Box 196650, Anchorage, Alaska 99519-6650 Ref: Well Location and Septic Design for Lot 1, Block 1, Denaly Subdivision To whom it may concern: The proposed 4 bedroom house will be 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 radius of this test hole and a subdivision test hole. We are proposing that a 1250 gallon septic tank and a dual 5-foot wide trench type drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and .the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 1.2 gallons/day/ft2 should be used. 2. TRENCIt DESIGN: a. Percolation Rate: 3.07 & 1.75 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/ft2 e. Number of Bedrooms: 4 d. Des!gn Flow: 600+ gallons per day e. Minimum Absorption Area: 500 tt2 f. Total Depth: 7.8 feet (max.) g. Effective Depth: 4.0 h. Width: 5.0 feet i. Reduction Factor: 0.5 j. Minimum Length: 30 feet long each (60 feet long total) k. Effective absorption area = 600 112 3. SURFACE WATERS: There is no surface water within 100 feet of the proposed septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography of this property is a 5 to 15 Percent running from approximately northeast to southwest; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179, or 244-9612. Thank you for your assistance. ~, Mo$o President~ ~ NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, 2 soils logs, and a 7page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwe.com , '-..... ,,, X ,'--. '-. "- ..... --' tt '--.."-... ------... / ---.....:::..... ~I, ~ ~ ~"~ ~% .... / "- '~~. ~~. ~ '~/ ~1~. ,~~~x,. ~/ ,, J.~M. CONSULTANTS, INC. CARL KAPPEN · ASSOCIATES 622-5585/440-1174 1 OF 2 DENALY SUBDIVISION; LOT 1, BLOCK 1 SITE P~N FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM ~.. ~ ~. NOTE: THE CO~CTOR S~ ~VE ~ ~ ~E ~RN ~D SOLON LOT MNE ~ ~ ~GG~ ~ A REGI~R~ ~D ~ ~ ~ ~ ~ SU~OR PRIOR TO CON~U~ON. ~~ WATER a ~STEWATER ~ , 4 CO~8~L~ANT$. INC. ~ LZ.:(.I., '1 .... ~ ............ CARL KAPPEN · ASSOCIATES 622-5585/440-1174 2 OF 2 D~,~L~ SUmWS~O,= ~OT ~. SLOC~ ~, "~,.. '....~ .... .~ DESIGN OF PROPOSED WE~ AND SEPTIC SYSTEM LOCATION ALASKA WATER & WASTEWATER CONSULTANTS, INC. ISOIL LOG - PERCOLATION TESTI LEGAL DESCRIPTION: DENALY SUBDMSION; LOT 1, BLOCK 1~ I~.;.~ OROANICS JTEST HOLE #~1 II ~. '--., Gc OLx ,, s SW 'd \ DEPTH TO DATE GROUNDWATER ~ON II~ltl~II ca/sa ~ 9/~8/ol ' 11 DATE RE. lNG CLOCK NET TINE WATER LEVEL NET DROP TINE (HINGES) RE. lNG (INCHES) 12 9/13/2001 1 2:07 - 6. - 2 2:17 10 2 1/2" 3 1/2' 13 3 2:17 - 6- _ 4 2:27 10 2 1/2" 3 1/2" 14 5 2:27 _ 6- 6 2:37 10 2 1/2' 3 1/2" 15 7 2:37 - 6- - 8 2:47 10 2 3/4" 3 1/4' 16 9 2:47 - 6- _ 17 10 2:57 10 2 3/4' 3 1/4' 11 2:57 _ 6' - 18 12 3:07 10 2 ~/4' ~ 1/4' 19 PERCO~TION ~TE ~.07 (HIN./INCH) PERC. HO~ DIA. 6' (INCHES) TEST R~ BET~EN 4.5 ~. ~D 5.0 20 COHHENTS: PEEC ~ PERFOR~ ~ ~O ~ PERFORMED BY ~ WA~R & W~ATER I, JE~ ~ ~NESS, CER~ ~T ~IS W~ PERFORMED IN ACCORD~CE W~ ~L ~A~ ~D MUNIClP~ GUIDEUNES IN E~CT ON ~IS DA~: 20441 PTARMIGAN BLVD. ~'",'~'"~".:',~..-.--:--- ~- EAGLE RIVER, AK 99577-$736 ~, %~:..~: ~ ........ . ..... ...... .... ~-.,>,.~,,,~.~ ~- ~.;-~ .- ;,~:'-:;" ~'~ "' · ' :',,~..~-4~';..~ ~.:~' t~."--' r~i..~'-~.;.. '.~':.~ . -. 7 ., .... soI P gCOLATIO 'TEST q Per~o~ed loc F. Robert B ell & A ss o cla t es .Date Performed:~~ ~pth ff~t) SEE A~ACHED SI~ P~N · FOR HOLE LOCA~ON 1- ORG - bro~ ~at, wet 2- [ Was Ground water en~unt~? ~ ~at dep~? 2~ ~ [ ~pth towateragtermo~to~g? 11~' ~te? 4- Reading Date Gross Net Depth to Net Time' Time Water Drop I 4/23/99 3:00 7" 2 3:10 lO rain 1" 6" 3 ' 3:11 4 3'.21 10min 1 2/16" 514/16' 5 '* 3..22 7 6 3'~2 ' lOmLn I 4/16' 512/16" ? '* 3'.33 7"' 8 3:43 lOmin I 2/16' 514/16"' 9 3:44 - 7- o. 10 3:45 lOmln I 4/16' 512/16" 11 3'.55 - 12' 4.'05 10rain I 4/16' 512/16' " ' Water Added 5- CP - Meal dense, brown 6-. w/cobbles moiSt 7- 8- 9- 10- 11- 12- SP~ Med dense gravelly silty 13- sand brown, moist MI,- Brown, wet 14 B.O.H. 16- 17- HOLE PRESOAKED PRIOR 18- TO PERCOLATION TEST 19- I percolat~onRate ~1.75(rnin/in)PercHoleDiameter 6",. 20- Test Run Between 4 feet and ~ feet I, Kenneth M. Du flus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date· ! ! ! ! ! ! / ! ! / / / · BI MUNICIPALITY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section �,J/ Fax: 907-343-7997 i a; Certificate of On -Site Systems Approval Parcel I.D. 050-731-48 Expiration Date: l6 -3 " 20 1. GENERAL INFORMATION Complete legal description DENALY BLOCK 1, LOT 1 Location (site address) 25629 BENDILENT CIRCLE, EAGLE RIVER, AK 99577 Current property owner(s) JERRY & JULIE ONEY Day phone Mailing address 25629 BENDILENT CIRCLE, EAGLE RIVER, AK 99577 Real estate agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: Private Well Private Septi Water Storage ❑ Community Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Private Septi Holding Tank ❑ Community ❑ Public Sewer, ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 b Waiver Fee $ Date of Payment a1 a51 aoav Date of Payment Receipt Number Receipt Number COSA # 65C O I N060 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 2/25/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change �'�► i, due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of '�V • • • • • [t1 construction (workmanship & materials), the water usage of the family being served by the ��• • • •� ()� system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the k ' TM •.* well and septic system. Therefore, any estimate of how long a system will function satisfactory- • • • • • • • • • • • • - for current or future occupants or guarantee that no unseen encroachments, deficiencies or l discrepancies exist can be given by First Water Consulting & fWGS ' • • • • • • • • • • • • • • • • • j� Curtis Huffman 6. DSD SIGNATURE��1��'�`�l • • •CE 128991• • �� /� 2/25/2020 System #1 Approved for bedrooms �I�iFQP�p�ESS10NP,�-�"' System #2 Approved for bedrooms ��►\Zt�- Disapproved %S POTY OF Conditional Conditional approval for bedrooms, with `h`, wing stipudot& ®jv- S E If ftcE� V is Original Certificate; Date: 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. NEWINirT44:1614kq Ill 13a COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: DENALY BLOCK 1 LOT 1 Parcel ID: 050-731-48 If more than 1 septic system on lot: COSA Checklist # _of — Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 1/14/2002 Total depth 122 ft Cased to 120 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 2/17/2020 Static water level at beginning of test *NA ft. Well production at time of test 5 gpm Comments *ARTESIAN PLUG B. TANK DATA Age of tank(s) 19 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 48.5" ® Standpipes/foundation cleanout per record drawing Date of pumping 2/10/2020 D. ABSORPTION FIELD DATA Which system tested (date installed) 10/18/2001 ® ALL standpipes present per record drawing Total measured depth from grade 8.8 ft (max) Measured depth to pipe invert from grade 4_8 ft (min) ❑ N/A – pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 1.65 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) NES Collected by �- Date of Sample 2/17/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: 30" deck with supports approx. 24" from edge of tank. Adequacy test date 1/20/2020 Results R Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 700 gal New depth 11 in Elapsed time 1440 min ® Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 700 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: Lower trench tested results shown. 14" of fluid in upper trench. F> 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' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5'+ ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Private Wells > 100' ® Yes if No —ft Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ 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' ❑ Yes if No *8 ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No —ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *Per IR / Waiver. G. ENGINEER'S CERTIFICATION l certify that l 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. w :. Zt'. ...... •...... ' Curtis Huffman �� 'FG, •. CE 128991 .• i�`�i ,P*. .2/25/20��C�� '°RQFESSIONP ft ft ft ft ft ft ft ft Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program ,~7oo so,~ ,ragaw St. P,O, Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.a k.us (907) 343-7904 ~ ' ' '~' -CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAHILY DWELLING piration Date:/0/ /0 Complete legal description DENALY SUBDIVISION; LOT 1~ BLOCK 1 Location (site address or directions) 17034. EAGLE RIVER LOOP ROAD * EAGLE RNER~ AK 99577 ParcelI.D. 050-731-48 1. GENERAL INFORMATION Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address CARL KAPPEN Day phone 622-5585 17034- EAGLE RIVER LOOP ROAD * EAGLE RIVER, AK 99577 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 er 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 $ at, or prfor I to closing for the engineering services provided. I 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furfher verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspecb'on, 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 ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone Address 6901 D!=BARR ROAD, SUITE 2B * ANCHORAGE. AK 99504 Engineer's Print'ed Name JEFFREY A. GARNESS, P.E. 337-6179 Date '7/~'/~' 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 desctfbed 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 durfng the year, and the water usage of the family being served by the system. These conditions ara 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. AKWWC, Inc. can therefore not provfde 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 authorfzed, nor will it confer any legal tfght whatsoever. 5. DSD SIGNATURE X Attachments: Approved for ~ Disapproved. Conditional approval for HAA Checklist Septic System Advisory Well Flow Advisory bedrooms. ·. bedrooms, with the fllowing stipumdons:,~'_,.\',~ .. %-__ ~ ~ '. pRnT, L,,~ER : '".- '~ Manitenance Agreements Supplemental Engineer's Reort Other ~$-~ut~7 /x,~_¢~'/oN ffE~/~- F~I~ Odginal Celibate Date: 7/C/°z Municipality of Anchorage Development Services Department Bdldlng ~afety Division On-Site Water & Westewater Program 4700 ~outh Bragaw St. P.O. BO~ 196650 A~=tlorage, AK g9511~0 (9O7) ~43-?g04 Legal Description: A. WELL DATA Well type m~VA~ HEALTH AUTHORITY APPROVAL CHECKLIST DENNY SUBDMSlON; LOT 1t BLOCK 1 Parcel ID: 050-731-48 If A, B, or C provide PWSID~ Well Log (Y/N) YES Data completed 1/14/2002 Sanitary seal (Y/N) ~ Totaldepth 122 ft. Casedto 120,35ft. FROM WELL LOG Data of test 1/14/2002 Static water level 8+ fl. Well production 10+ g.p.m, WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nsenic: N/A mg~. B. SEPTIC/HOLDING TANK DATA Tank Type/Mataltal bYE.U. Tank size 1250 gal, Number of Compartments Foundation deanout (Y/N) YES Data of pumping NEW C. ABSORPTION FIELD DATA Wlra$ propedy protectad (Y/N) YES Casing height (above ground) 24+ AT INSPECTION g.p.m. Nlttata 0.319 mg./L. Otherbactarla Date of sample: 6/24/2002 Collected by:. iff. 2 Deprass~n over tank (Y/N) NO Pumper colonies/lO0 mi. INC. Date ~'tstalled 10/13-18/2001 Cleanouts (Y/N) YES High water alarm (Y/N) N/A System ~pe SHALLOW TRENCH Gravel below pipe 3.97/4.16 ft. Depression over field NO For 4. beclmoms New depth - in. Absorption rata >= - g.p.d. N/A If yes, gtve data - Data installed 'r0/13-18/2001 Soil rating ~ ft~'odrm) 1.2 Len0th 6O+ ft. VVIdU'J 8 fL Totaldepth 1.47-tO.2~ft. Eff. apsorptioflaraa600+ ftI Monltedngtube 'YES Date of adequacy tast NEW Results (Pass/Fall) - Fluid depth in abso~tion field before tast -~ in. Watar added - gal. Elapsed Time: - min. Final fluid depth - in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) D. UFT STATION Date installed Size in gallons , ~ -Pump on. lo~gh water alarm ~ ~t .~_~. _ .in. Cycles tested Meets alarm & clmult requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot. 100°+ Absorption field on lot, 100'+ Public sewer main N/A Sewer/septic sewlce line 25'+ On adjacent lots 100°+ On ed]acem lots 100'+ Public sewer manhole/cleanout Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field Water main N,/A Water sewice line 10'+ Surface water Wells on adjacent lots. 100'+ N/A 5'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation .8'+ Water main N,/A Water service line 10'+ Surface water 100'+ Driveway, parldng/vehlcle storage Curtain drain NONE KNOWN Wells on adjacent lots 100'+ COMMENTS 10'+ *SEE ATFACHED Ll:llt~ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspec~ona and revfew of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Prin~fKI I~ama Data dP..PPI~EY ~ GARNESS HAA Fee $ Date of Payment Receipt Numar ~-.~-~ _77 (Rev. 1aol) Waiver Fee $ Date of Payment Receipt Number TRACT B = S ~3~ 331~ ~ ... ~ ..~,~, -. / ' '~' ......... -...... ~-- -..