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HomeMy WebLinkAboutDENALY BLK 1 LT 2Denaly Block ! Lot 2 #050-731-49 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 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW010397 PID Number: 050--731--49 Nome: CARL KAPPEN & ASSOCIATES Wastewater System: · New I-] Upgrade 17054 EAGLE RIVER LOOP ROAD * EAGLE RIVER 99577 ABSORPTION FIELD (907) 622-5585 4 ti Deep Trench · Shallow Trench rlBed 13Uound r'lOther 2 1 DENALY SEE DWG. r~ 4.0 / 5.7 - - - SEE DWG. r~ 60 (2 © .30') I WELL:· New ri Upgrade 5 , 2 15'+ PRIVATE 143 n. 140.63 n. 588 so., D 3034/ F-810 SEPARATION DISTANCES ,s.,,~ a,o,~.~ as.T.~.,. F~om ~enk Field Stetion Tank ~,,~ U~ ANCHORAGE TANK 1250 Well 100'+ 100'+ -- -- 25'+ STEEL 2 Su,oo, water 100'+ 100'+ - - -- LIFT STATION Cu~oln Drain NON[ KNOWN ~~: D~ ~t~, ~ ~ ~o~ks: BENCH MARK TOP OF FOUNDATION ~ NORTH/NORTHWEST CORNER 100.00 Inspections peffo~ed by: AKWWC, INC. Dates: 1st 10/15/2001 ' ~ )~ ~ ~ '"~ Depa~ment of Health and Human Se~ices approval ~J"., ~ - ..' .~ SW010597 050-751-49 CONSULTA~S, INC. . CARL KAPPEN · ASSOCIATES (:907) 622-5585 2 OF ~ ~"~ AS-BUILT DRAWING OF N~ WELL AND SEPTIC SYSTEM LOCATION ~ 32.00 lg.07 DBL1 38.gg 21.80 DBL2 40.80 22.94 C01 51.~1 43.75 C02 ~0.51 36.06 DRAWING pEeUIT NUUBER: AS-- BUILT 0.50-751-49 SWO 10597 FFlU~. ca~oP - 98.78 / FINsu~ON TOP OF T~K AT~ ~ I / = ~TOP OF ~K AT ,NL. - 96.60 ~ -- / ~O~. 96.62 AT INL~ -- 96.04 OU~" 95.8~ I ~o'+ I CARL KAPPEN & ASSOCIATES (g07) 622-5585 3 OF 3 /~ I I~d-~gs~" DENALY SUBDIVISION; LOT 2, BLOCK 1, ~[ OF WORK: ~rofessIO~ PROFILE AS-BUILT DRAWING OF NEW SEPTIC SYSTEM June 26, 2002 RE: Lot 2 Blk 1 Dcnaly To Whom It May Concern: Wc did install on Lot 2 Blk I Deafdy a flo splitter as to $c~s drawing. Il'you have any questions regarding this mailer, plea.sc do not hesitate to contact me. Thc number lh~t I can bc reached at is 253-691-$905. Sincerely, Dick Meyers B;124/2002 13:54 FRX NO. :997-622-~ ,.Tun. 24 ~ ~9:19~/'1 P3 N ~ ~q:ZLLxMs, 'rNC PAGE: 83 M-W Drilling, eP.O. lime 11037~ e Ahem, age, AK egO7-34~F..4000,907-345-3~87 Fm~e Block eHde~: _!43' e~,~l:m . 6" eC4~dr,... H0.63' · ~ ~'m,p/m~: o7 J,~y 2002 ·/,m,p IJu~L. Well Lo i ~?_ b feet from , lop efe~inI. Detnfl~ of hrn..fl,'~ imlt,~lttd~ ~ ~ ma~ ~; end ~.~ 0 TO 2 C~c~., 2 TO .14 8ill.vel: ~bb]ey ]4 TO 34 34 TO ~ S~vel: ~ TO S1 S~ sil~: ~e~y 10~ ~ 120 ~ve~y 120 TO 124 ~vel: 124 TO 143 ~vel: cle~, TO TO .,:. TO ~..,, 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 I WATER SUPPLY PERMIT Initial Date Issued: Sep 26, 2001 Expiration Date: Sep 26, 2002 Permit Number: SW0t0397 Legal Description: DENALY BLK 1 LT 2 Design Engineer. 0041 AK Water & Wastewater Consultan' Owner Name: Carl Kappen & Associates Owner Address: 17034 Eagle River Loop Rd Total Bedrooms: 4 Eagle River, AK 99577- Parcel ID: 050-731-49 Site Address: Lot Size: 54723 SQ. FT. Permit Bedrooms: 4 This permit is for the construction of;. [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail 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 cf Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ~ Issued By:, Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 995196850 www.cLanchon~e.ak, us (907) 343-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number Property owner(s) CARL KAPPEN & ASSOCIATES Day phone Malling address (1) 17034 EAGLE RIVER LOOP ROAD * EAGLE RIVER. AK Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) DFNALY SUBDMSION: LOT 2. BLOCK 1, Legal description (SecUon, Township & Range) Lot Size ~'/4'7.~L~ Acms/~ Number of Bedrooms 99~77 4 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Well Only ~]~ Water Storage THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Ja~rr~l 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 &: WASTE'WATER CONSULTANTS~ INC. Permit Fees: Date of Payment: Receipt Number, Watver Fees: Date of Payment: Receipt Number:. ALASKA WATER & WASTEWATER CO NSU LTANTS o INC. September 18, 2001 Municipality of Anehorage- Development Services Department On-Site Water & Wastewater Program P.O. Box 196650, Anchorage, Alaska 99519-6650 Reft Well Location and Septic Design for Lot 2, 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. TRENCII DESIGN: a. Percolation Rate: 3.07 & 1.75 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600+ gallons per day e. Minimum Absorption Area: 500 ft2 f. Total Depth: 7.5 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 ft2 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 25 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. xJ~/~'l ~ess, P.E., M.S. Presi~Ienfl ~ 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: al6vwc.com -'~',.~-----"~A*~... / ~,'/,'..~- ._ -"-.. ,~-,,.---.~_--.,~.. , _,~4,,,~ ---.. --.../ 9118~200 ALASIr~ WATER & WASTEWATER CONSULTANTS, ~AR[. KAPP£N & ASS0¢IATES ~22-55851440-1'174 DENALY SUSDWISION; LOT 2, [5LOCK 1 SITE PLAN F'OR PROPOSED WELL LOCATION AND SEPTIC SYSTEId INSTA~.L DOUBI F CLEANOUTS-- INSTALL FI~ / / / / / / / / SOUTHERN AND WESTERN aRE TO BE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. ,ROPOSED 1250 GALLON SE. F11C TANK FOUNDAllON CLEArOn' / / / \ \ ALASICk WATER & WASTEWATER CONSULTANTS. INC. CARL KAPPEN &: ASSOCIATES 622-5585/440-1174 DENALY SUBDIVISION; LOT 2, BLOCK 1, DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM DAT~ 9/1812001 C.J.G. SC.N.E: 1" = 40' PAGE NUMBER: 20F2 ALASKA WATER & WASTEWATER CONSULTANTS. INC. ~ ISOIL LO(; - PERCOLATION TESTJ PERFORMED FOR:, ~L ~P~ A ~S~ DA~: g/11/03 ." 0R ,CS ITEST HOLE ~/~ TO ~ GW :====~ ORG GC OL ' / / / ~ ~ ~PROPOSED SE ' SW NH SP CH ,~ / ~~ D~IGN PAGE~ SM ,-/../,/ OH ~/~5-_ DEPTH TO ~'~ ~ GRO~DWATER DATE 10 11 DATE RE'lNG CLOCK NET TINE WATER LEVEL NET DROP TINE (HINGES) RE'lNG (INCHES) 12 9/12/2001 1 2:08 - 6- - 2 2:~8 ~o 2 ~/4' 3 3/4' 13 3 2:18 - 6" - 4 2:28 10 2 1/2" 3 1/2' 14 5 2:28 - 6' - 6 2:38 10 2 1/2" 3 1/2" 15 7 2:38 8 2:48 10 2 1/2" 3 1/2' 16 9 2:48 - 6' - 17 10 2:58 10 2 1/2' 3 1/2' 11 2:58 - 6' - 18 12 3:08 10 2 1/2" 3 1/2' 19 PERCO~TION ~TE 2.85 .(HIN./INCH) PERC. HO~ DIA. 6" (INCHES) TEST R~ BET~EN 4.5 FT. ~D 5.0 2 COHHENTS: PERC. ~ P~FORMED ~ ~B ~LL PERFORMED ~ ~ WATER A W~A~R I, JEF~ A. ~NESS, CE~ T~T ~IS W~ PERFORMED IN ACCORD~CE W~ ~ ~A~ ~D MUNIClP~ CUIDEUNES IN CONSULTANTS, INC. ., ~..~ ,~ ~ .,..o~,~ .~. ,~ ,.,~,-,,,, · ,.~ ,.,~-~. · .~,~ -.~ ;'""l'llir~i ........... PERFORMED FOR:. ~L ~PEN · ~s~S DA~: g/~I/01 .,,'" ~.~ o.~,~ ITEST HOLE ~2I I ~/SW TO Ca/SM ~ 6W ====: ORG  GM CL GC OL SP CH ~ / //~ D~IGN PACE GROUNDWATER ~/. ~ / 11 DATE RE'lNG CLOCK NET TIHE WATER LEVEL NET DROP TIHE (HINGES) RE'lNG (INCHES) ~ . O~~ 19 PERC~TION ~TE ~1 (MIN./INCH) PERC. HOLE DIA. 6' .(INCHES) TEST R~ BET~EN 4.5 ~, ~D 5.0 20 COHHENTS: PERC ~ W~ PERFORMED ~ ~B ~ PERFORMED ~ A~ WATER ~ W~A~R I, JEFFR~ ~ ~NESS, CE~ T~T THIS W~PE~FORMED mN ACCORD~CE W~ ~ ~A~ ~D MUNICIP~ GUIDEUNES IN EF~CT ON ~lS DA~: DEPTH TO DATE GROUNDWATER D~Y ~/~/o~ ! / I ! ! I I I ! ! ! I / I'1 BI Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 E!more Road P.O. Box 196650 Anchorage, AK 99519-6650 vcww.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEHS APPROVAL FOR A SINGLE FAHILY DWELLING Parcel I.D. 050-751-49 1. GENERAL INFORMATION Expiration Date: (::~-..-~:> -/// Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent ,~ Mailir)g address DENALY S/D; BLOCK 1, LOT 2 25651 BENDILENT CIRCLE * EAGLE RIVER~ AK * 99577 LINWOOD & SYLVIA SMITH Day phone 560-8644 25651 BENDILENT CIRCLE * EAGLE RIVER, AK * 99577 Day phone BARBARA CRI'F]'ENDEN W/ PRUDENTIAL VISTA Day phone 242-2227 16655 CENTERFIELD DRIVE * EAGLE RIVER, AK * 99577 Unless. otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 4- 3.' TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · Individual On-site · Individual Water Storage [] Individual Holding tank [] Community Class__Well [] Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4.. STATEB~,ENT OF INSPECT!ON BY ENG!NEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based ~n procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that t,ffe 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 furt,~er verify that based on t,Se ' ,, ~m my investigation ~nd,,,~.,~,,,~ ..... ,;~, .the. ubt=,,~u from ~ZU~C~H~y of Anchorage files and ~'~ on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation~ Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 5701 Eo TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY Ac GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. 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 ~ Approved for bedrooms. Disapproved. ~ : WASTEWATER ~+i~-~=q~ns' ~ Conditional approval for bedrooms, with the following ¢,,~ ...... Attachments: ~,~,o,~, C~ ~eck.s~ Septic System Advisory Well Flow Advisory I~U.I ~l~ ,'~Vl~J~)'~ (Rev 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Se ices Department Building Safety Division On-Site Water & VVastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Legal Description: DENALY S/D; BLOCK 1, LOT 2 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 1/7/2002 Sanitary seal (Y/N) YES Total depth 14,3 ft. Cased to 140.6,3 ft. FROM WELL LOG Date of test 1/7/2002 Static water level ,3 ,ft. Well production 10 g.p.m. WATER SAMPLE RESULTS: Col!~orm' ig~?!' colonies/100 mi. Nitrate~"4~.- mC.IL. Arsenic: ~'J~ dg./L. Date of sample: 5/20/2011 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tanksize 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 5/19/2011 Pumper. C. ABSORPTION FIELD DATA ~*BELOW EXISTING GRADEI Date installed 10/15-18/01 Soil rating ~or ft2/bdrm) 1.2 (2 o 30) Length 60 TOTAL ft. Width 5/5 ft. Total depth '8.8/9.,3ft. Eft. absorption area 588 ft2 Monitoring tube YES Date of adequacy test *'5/20/2011 Results (Pass/Fail) PASS Fluid depth in absorption field before test 0 in. Elapsed Time: - min. Final fluid depth 0 Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN **TESTED EAST TRENCH ONLY. WEST TRENCH HAD 7" CHECKLIST Parcel ID: 050-7,31-49 Well Log (Y/N) YES Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 5/20/2011 4.6+ g.p.m. Collected by: GEG, Ltd. Date installed 10/15-18/2001 Cleanouts (Y/N) YES YES 24+ in. High water alarm (Y/N) SANITARY PUMPERS N/A System type DUAL TRENCH Gravel below pipe 4/3.7 Depression over field NO For 4 bedrooms Water added 620 gal. New depth 0 in. in. Absorption rate >= 600+ g,p.d. If yes, give date - OF STANDING WATER IN IT AT INSPECTION. D. LIFT STATION Date installed "Pump on" level at__ Datum ~ E. Size in gallons Manhole/Access in. "Pump off" leve].~. High water alarm level at Cycles tested, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas. 50'+ ¸in. 100'+ Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A N/A Manure/animal excrete storage areas 100'+ Building foundation Water main Wells on adjacent lots SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property line, 5'+ N/A Water service line 10'+ 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ Absorption field 5'+ Surface water. 100'+ Building foundation. 10'+ Water main N/A Driveway, parking/vehicle storage 10'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A, GARNESS Date COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SGS Reft# 1112004001 Client Name Gamess Engineering Group, Ltd Printed Date/Time 05/27/2011 8:08 Project Name/# Denaly B1 L2 Collected Date/Time 05/20/2011 1 1:00 Client Sample ID Denaly B1 L2 Received Date/Time 05/20/2011 14:00 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container tD Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 05/24/11 05/26/11 NRB Waters Department Total Nitrate/Nitrite-N 2.64 0.100 mg/L SM20 4500NO3-F B (<10) 05/25/11 AYC Microbiology Laboratory E. Coli Ne~.ative 1 100mL SM20 9223B A 05/20/11 SDP Total Colilbrm Ne~.ative 1 100mL SM20 9223B A 05/20/11 SDP // ASBU~LT I NEREBY CERTIFY .THAT ~ HAVE SI.J~VI~YED THE FOLLOWIN6 DESCR. IB~;D PROPERTY: AND ~AT NO EN~O~HMENTS EXIST ~CB~ AS ~N~ ~ D~ER~INE TttE E:(ISTENCE OF ANY E~ENT~ COVEHANT~ O~ EE[;TEI~ION~ SCALE, DATE, / 694~0829 VISION P~T. UNDER ~ FENCE L~NDJ~ OR Munic!pality 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 ,A, UTHOEITY ,PPROVAI FOR ,b, SINGLE FAHILY DWELLING Parcel I.D. 050-731-49 1. GENERAL INFORMATION Expiration Date: / 0 - ~' - ~) .~_ Complete legal description DENALY SUBDIVISION; LOT 2, BLOCK 1 ~ Location (site address or directions) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address CARL KAPPEN Dayphone 622-5585 17034 EAGLE RIVER LOOP ROAD $ EAGLE RIVER, AK 99577 Day phone Day phone Unlessothe~isemqueste~ HAAwillbehe~byDSD~rp~k~. 2. NUMBER OFBEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Indi,~i~ual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site E~ Individual Holding tank Community On-site B 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 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 prior to dosing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As cerJfl~ed by my seal affixed hereto and as of the validation date shown below, I vedfy that my inveS~a~on based on procedures outiined in the Health Authodty Appreval Guidelines forthis application, ' sho'~vs that the on-site water supply and/or wastewater disposal system is(are) safe, functio'~l a'nd adequate for~e number of bedrooms and type of structure indicated herein. I further vedfy that baseci on ~e ~: ·. ~ information obtained from the Municipality of Anchorage files and from my investigation and mspection,: tl~e' on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Munidpal' and State codes, ordinances, and regulations in effect at the time of installation. 'Name of Firm ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. Phone 337-6179 Address 6901 DEBARR ROAD. SUITE 2B * ANCHORAGE, AK 99504 Engineer's Pdnted Name JEFI-REY A. GARNESS, 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 described the performance of the system under the conditions encountered at the time of the test, end separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfacto~ test results do. not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. con 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 autho#zed, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ~ Approved for ['~ bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms, with the fllowing stipulations: ,~¥-~','... · .. "/,-~?,. ON-SffE . : '.. ...'" Manitenanca Agreements Supplemental Engineer's Reort Other (Rev. Original Certificate Date: "~" ,~_ ~ ~ ~ Legal Descdption: A. WELL DATA Well type Municipality of Anchorage Development Services Department Building Safety Olvlsidn On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AX 99519-665O www.ci.enctmmge.ak.us (gOO ~,3-7S04 HEALTH AUTHORITY APPROVAL CHECKLIST DENNY S/D; LOT 2, BLOCK 1, Parcel ID: 050-7,31-4.9 If A. B, or C provide PWSID~ N/A Date completed 1/7/2002 Sanitary seal (Y/N) YES Total depth 14.,3 It. Cased to 140.6,3 lt. FROM WELL LOG Date of test 1/7/2002 Static water level ,3 .ff. Well production 10 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 rnl. Arsenic: N/A mg.lL. B. SEPTIC/HOLDING TANK OATA Nitrate 0.686 rog.IL Date of sample: 6/24./2002 Well Log (Y/N) YES Wires pmpady protected (Y/N) YES Casing height (above ground) 2~- in. AT INSPECTION bacteda ~ ~O~OI~S/IO0 mi, Other Collected by: AKWWC. INC. Tank Typa/Matedal Tank size 1250 gal. Foundation cleanout (Y/N) YES Data of pumping NEW C. ABSORPTION FIELD DATA STEEL Data installed 1 O/15-18/2001 Number of Compartments 2 Cleanouts (Y/N). YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Pumper. - BL NAL Date installed 10/15-18/200! Soil rating (~Jor ff*/bdrm) 1.2 Length 60 (2 O 50)lt. Width 5 lt. Total depth ?.27-8.gSlt. Eft. absorption area 588 It* Monitoring tube YES Data of adequacy test NEW Results (Pass/Fail) - Fluid depth in absorption field before test - in. Water added - gal. Elapsed Time: - min. Final fluid depth - in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) - System type TRENCH Gravel below pipe 4.0/3.7 ft. Depression over field NO For 4. bedrooms New depth - in. Absorption rate >= - gp.d. If yes, give date - D. LIFT STATION Date in,tailed Si~ in gallons ~ "Pump on" level at in. "Pump o~.~n. High water alarm level at ' Datum Cycles tested, Meets alarm & circuit requirements? E.SEPAR~'FION DIST.I~ICES Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic service line Property line 10'+ Water service line 10'+ Curtain drain NONE KNOWN F. COMMENTS SEPARATION DISTANCES FROM WELL ON LOT TO: 100'+ 100'+ 25'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N/A Water service line 10'+ Welts on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation. 10'+ Surface water 100'+ Wells on adjacent lots 100'+ G. ENGINEER'S CERTIFICATION On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manholelcieanout Holding tank N/A N~/A JEFFREY A. GARNESS Engineer's Pdnted Narne __ Date I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. .** F. $ 150 Date of Payment Receipt Number (Rev. 12/01) Waiver Fee $ Data of Payment Receipt Number 10'+ Water main N/A Driveway, parking/vehicle storage Absorption field 5'+ Surface water 100'+ .t~ ,ronment~e~"~J--~ ~ J~mmmlr--~mm~ Laboratory Divialon s~lw~r~~.~~lfm'Jt'd~g~r'~'~~ 200 W. PoRnr Drive A~.horogn, AK 99518-1505 Drinking Water Analysis Report for Total C01ifo~fa Bacteria T,~: eSOT) s6z.2.a YEJ~E SIDE BEFORE cOLLECTING ~MPLE Fa~ (907 561-$301 ~£ SlV~ ~t~r o~ ~u~ ...... ~BO~TORY . MUST BE COMPL~ED BY wA~R SUPPLIER ' · Analysis shows ~is W~ter SAMPLE to ~: n StndRe~ult~ SAMPLE DATE: · SAM?LE TY?E: O Routine t3 Repeat sample (for routlnesample with lab ref. no. ) rt Special Purpose SAMPLE LOCATION Month Day Year Treated Water Untreated Water Time Collected Collected . By ~ Satlsfacto~ 0 U~safisfsctory 0 s~ple over 30 hours olc~ ttsults may be unreliable 0 Sample too long in txansit; sample should not b~ ove~l~hours old at examinatio? , to indicate reliable results. Please sen~ 'Date Received :~ 2-fO Time Received ~ Analysis Be[an Analytical Method: ~L Membrane Filter /n~MMO-MUO * l%mt~r of onlonie.dlO0 :rtl Lab Reg. No. Result* Analyst '-. S~nI to ~.D.E.C. Anch Fbks Jun Fazed Client notified of unsatisfactory results: Ds~e: ~ Tin~: ~ BACTERIOLOGICAL WATER ANALYSIS RECORD £ Cofi Colonies/t00 mi COLIPIRM MMO-MUG Result: Total Collfnrm bleml~rane Filter:. Dlre~t Count ~(~ Verification: LTB , BGB Fecal Coliform Confirmation Flail M. mbrint J:ll. I.~t ec Resulu ~ , Coliform/lO0 mi Tlma ~ ~ 07=~ bra ~,~.~ ~ M.m~w of tM SOl Geo(m I,~,~hf, t~ G6n~'aI~ d~ $uMi$1~nca) ENVIRONMENTAL FACIUTIES IN ALASKA. CAU.FO~NIA. FLORIO.~ ILUNOI$. MARYLAND. MICHIGAn.. MISSOURI. NEM/JERSEY, OHIO. W;S? VgNGIN~A JUN-26-OZ 05:29P1~ FRO~-CT&E ENVIR'~iI~KTAL SRV ZTr~- CT&E Env, ronmenta, Se ~lces Inc. 9075615101 T-437 P.O2/OZ F-324 Cf&£ Re f./t 1023773001 Client Name AK Water ,e, Wastewater Consultants Inc. l'roJect Name/# Dena]y S/D Client Sample ID Lot 2 Block ] Matrix Drinking Water Ordered By PWSID 0 Sample Remarks: All Dntefffimae are Alaska Standard Time Printed Date/Time 06/26/2002 17:21 Collected Dateffime 06/24/2002 15:55 ibceived Date/Time 06/25/2002 13:40 Teehnlca~.~ S~en C. £de lTelease~ Allowable Prep Analysis Limits Date Date Ni~te-N 0.686 0.200 mg/L EPA (<10) 0025/O2 Tnt, i Cntiform col/100mL SMI8 9222B (<l) K.AP