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HomeMy WebLinkAboutASPEN HIGHLANDS #3 BLK 3 LT 3A pen Highlands Block 3 Lot 3 #017-013-83 'r Municipality of Anchorage Page 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 Permit Number: ~/,U' ~ ~ O ~'7 ~' PID Number: OI 7 - 0 t 3 - Name: Wastewater System: D New ~ Upgrade Address: /z~v/ ~;~o~[ ~.~ A~ ~/4 ABSORPTION FIELD No. of Bedrooms: Phone: ~ -717~ ~ ~ DeepTrench ~ Shallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION ~oi, Rating: Total Depth from original grade: Lot: Block: Subdivbion: ~-~ Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: ~ Range: ~ Section: Fill added above original grade: Gravel length: I WELL: No~ ~ ~ ~e~,~ o~ ~= /~ Gr.v~ width: Number of lines: I Distance betweenlines: Classification (Private, A,B,C): Total Depth: Cased To: ITotal absorption area: Pipe material: Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: GPM IPump Set at: Ft. leasing Height Above Ground:Ft. TANK SEPARATION DISTANCES ~ s..~ic ~ Ho~in. ~ SX.~... To Septic Absorption Lift Holding =ub[ic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~0~ ~ ~ / ~0 Material: ~ ~E ~/ Number of Com~a~ments: Wel~ s.~ace LIFT STATION ~.~. Lot , Size in gallons: ~ Manufacturer: Line ~5- ~0 .... "Pump on" level at: I ,,.am> Off" level at: I High water alarm at: Foundation I 3 7 I Cu~ain Pump Make & Model ~ Electrical Inspections pedormed by: Drain .... Remarks: ~e~ ~x~/. /~/W~ ~ BENCH MARK Location and Description:  Assumed Elevation: ENGINEER'S SEAL Inspections pedormed by: F(uA~F Tv~ ;~ex Dates: 1st 7/zT/gg .'. Health and Human Satires approval Depadment of 72-013 (Rev. 9/91) MOA 25 ,; :~.; '. '~ PERMIT NO: SW980172 ", //[/ PAGE 2 OF 3 PID NO: 017-013-83 ''-. ; 1000 GALLON . ~ "A"  SITE FOR ' ' ' - "- ~ ¢2 ' REP~CEMENT LOT 3, BLOCK 3 T.H. ASPEN HIGHLANDS #3 TRENCHES SWING TIES: FROM: COR. "A" COR. "B" TO: S.T.C.O. "C" 16' 48' S.T.C.O. "D" 22' $3' DBL. C.O. "E" 25' 55' TR. C.O. "F" 41' 62' TR. M.T. "G" 42' 65' TR. C.O. "H" 47' 87.5' C.O. & M.T. 'T'54' 76' TR. C.O. "J" 54' 86' LOT 3, BLOCK 3, ASPEN HIGHLANDS SEPTIC SYSTEM INSTALLATION AS-BUILT INSPECTION REPORT - PLAN FLATTOP TECHNICAL SERVICES SCALE: 1" = 30' 14530 ECHO STREET DRAWN BY YFM ANCHORAGE, ALASKA 99516 SEPTEMBER, 1998 PERMIT NO: SW980172 PAGE 3 OF 3 PID NO: 017-013-83 2" RIGID INV. 98.8' INV. 100.7' INV. 104.0' 2'+ SOIL COVER IOOO GALLON SEPTIC TANK INV. 104.2' BOTTOM TRENCH ELEVATION 93.8' BOTTOM TRENCH ELEVATION 95.7' LOT 3, BLOCK 3, ASPEN HIGHLANDS SEPTIC SYSTEM INSTALLATION AS-BUILT INSPECTION REPORT - X-SECT FLATTOP TECHNICAL SERVICES NOT TO SCALE 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 SEPTEMBER, 1998 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980172 DESIGN ENGINEER: OWNER NAME:FRISON WAYNE & EILEEN OWNER ADDRESS:12841 MIDORI DR ANCHORAGE AK. 99516 DATE ISSUED: 6/02/98 EXPIRATION DATE: 6/02/99 PARCEL ID:01701383 LEGAL DESCRIPTION: ASPEN HIGHLANDS ~3 BLK 3 LT 3 LOT SIZE: 73739 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL 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 ~ THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AATD DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FRO~ OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AATD HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 June 1, 1998 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to construct wastewater disposal facilities on Lot 3, Block 3, Aspen Highlands S/D. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole #2. As can be seen from the soil log, the native material between 1.5' and 7+ feet is a silty sandy gravel with a measured perc rate of 5 minutes per inch. Using a slightly conservative soil application rate of 0.8 gpd/sq, tr., this proposed 3- bedroom residence requires a total absorption area of(3 x 150)/0.8 = 562.5 square feet. The proposed design consisting of 2 parallel 29-foot long soil absorption trenches with 5 feet of sewer gravel has a total absorption area of 580 square feet. The test holes were dug during breakup and a water seep was noted in test hole #2 at the lowest part of the GP/GM stratum where snowmelt percolating down through this relatively porous stratum had become temporarily perched on the underlying less permeable stratum. A deeper SP stratum was dry, indicating the absence of a local shallow groundwater table. I discussed this finding with Dan Roth at DHHS on 5/11/98, and he concurred in the interpretation that seeps of this nature did not constitute groundwater requiring 4 feet of separation from the bottom of a soil absorption system. The topography of the lot in the area of the proposed construction slopes down towards the SSW at approximately 20%. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space-surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. WELL ,' 3-BDRM PROP. / HOUSE SITE ,' T.H. ," #1 © T.H. SEPTIC , .-'TRENCHES ,' '~-. SYSTEM -'~-~ .... ..T.H.O LOT 2 LOT 3, BLOCK 3 ASPEN HIGHLANDS 49TM LOT 4 THEODORE F. MOORE ".. CE-3589 .." ~o fe ss~O' INSTALL GAL. SEPTIC TANK CONSTRUCT 29' LONG SOIL ABS. TRENCHES WITH 5.0- SEWER GRAVEL SEPTIC SYSTEM i~ L3, B3, ASPEN HIGHLANDS SID PROPOSED WELL AND SEPTIC SYSTEM SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH = 60 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 MAY, 1998 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. 1000 GALLON~.~~ SEPTIC TANK DBL. C.O. 29' LONG SOIL ABS. TRENCHES WITH 5.0' GVL. BELOW DIST. PIPE =_ANOUT ONITOR TUBE IN8 DIA. D-3034 BUMP 4" DIA F-810 PERF. DIST. PIPE 1/2" - 2 1/2" SEWER GRAVEL BOTTOM EXCAVATION SECTION "A - A" SCALE: 1" = 5' - 0" GRADE 3 ORIGINAL GROUND FILTER FABRIC LOT 3, BLK. 3, ASPEN HIGHLANDS S/D PROPOSED SEPTIC SYSTEM PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, AK, 99516 SCALE: AS SHOWN DRAWN BY: TFM JUNE, 1998 Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345-1355 Lot 3, Block 3, Aspen Highlands S/D 12841 Midori Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installation of a 1000 gallon septic tank followed by two parallel 29 foot long soil absorption trenches containing a total of 5.5 feet of sewer gravel. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 1.6 Prior to the start of construction the owner shall arrange for a surveyor to place stakes at 50 foot intervals along the property lines in the vicinity of the proposed septic system and well sites. 2.0 Septic Tank: 2.1 The new 1000-gallon, 2-compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.2 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 4 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating 2 parallel 29 foot long trenches spaced 10 feet apart to a depth of 7 feet below ground level. The axes of the trenches shall be along the natural contour of the land, and the 7-foot depth of each trench shall be relative to the ground level at the location of that trench. 3.2 The bottom of the excavations shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. Sand for leveling or serving as filter material shall comply with Municipal specifications. 3.3 A total of 5.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 5.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 The 4" diameter ASTM D-3034 non-perforated pipe connecting the horizontal distribution pipes in the two trenches shall be constructed with a 6 .... bump" located at the edge of the upper trench to ensure that the upper trench is completely filled before effluent flows into the lower trench 3.5 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.6 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric and piping. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filter fabric. 3.7 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.8 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. TEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 3, Block 3, Aspen Hi.qhlands S/D May 7, 1998 Wayne Frison DEPTH -- (feet) 1 Pt. SM/GM Reddish gravelly loam GM Gray silty gravel Damp, many cobbles and boulders GP/GM Gray silty sandy gravel Damp, many cobbles and boulders Lenses of ML/GM, Lenses of GP Water seeps @ 9' SLOPE SITE PLAN 11 ML/GM Gravelly silt Dense, Hard Depth to Groundwater Date Seeps @ 9' 5/7/98 9' - 3" B.G.L. 5/15/98 o, B.H. Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) 5/7 12" Presoak 27 1/2 Add water & start 1:54 23 5/8 #1 1:56 2 21 15116 1 11/16 Add water 1:56:15 23 7/16 ~r2 1:58:15 2 21 3/4 1 11/16 Add water 1: 58:30 23 5/8 #3 2:00:30 2 21 15/16 1 11/16 COMMENTS: PERCOLATION RATE 2 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 4.5 FT AND 5.0 FT Material in perc zone was cleaner than typical of stratum - more similar to underlying stratum. PERFORMED BY FLA']-I'OPTECHNICAL SERVICES. I .~"..~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~0"~ / / ~/~;~:~ TEST HOLE # 2 LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feet) 1 11 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 3, Block 3, Aspen Highlands S/D May 7, 1998 Wayne Frison Pt. SM Reddish sandy loam GP/GM Dark gray somewhat silty sandy gravel Few cobbles or boulders Water seeping into test hole at N. end --Seep @ N end of T.H. only SLOPE Depth to Groundwater Date Seeps ~. 8' (N end) 5/7/98 16' - 9" B.G.L. 5/15/98 SITE PLAN GM/ML Gravelly silt 0% SP Coarse, black sand Dry ML Silt BH Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) 5/7 12" Presoak 27 1/2 Add water & start 3:23:30 23 3/8 #1 3:28:30 5 22 1/4 1 1/8 Add water 3:29 23 5/8 #2 3:34 5 22 3/8 1 3/4 Add water 3:34:15 23 3/8 #3 3:39:15 5 22 1/4 1 1/8 PERCOLATION RATE 5 (minutes/inch) PERC HOLE DIAMETER 7" TEST RUN BETWEEN 4.5 FT AND 5.0 FT COMMENTS: The seep encountered at 8 feet at the time when the test hole was dug appeared to be snowmelt temporarily perched on tighter underlying soils, rather than groundwater. This interpretation was supported by monitoring and agreed to by Dan Roth. PERFORMED BY FLA'I-fOP TECHNICAL SERVICES. I ~'"'..~__'~"~"'~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: O'~/ ! / 9~ TEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH -- (feet) 11 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 3, Block 3, Aspen Highlands S/D May 8, 1998 Wayne Frison Pt. GP Clean black sandy gravel Less silt than material perc'ed in T.H. #2 --Water seeps at southeast end of T.H. ML Gray sandy silt GP/GM Silty sandy gravel Gray B.H. SLOPE SITE PLAN Depth to Groundwater Date Seeps ~ 6' {SE end) 5~8~98 Monitor tube dry 5/15/98 o, Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS: Shallow GP stratum is similar to stratum perc'ed in T.H. ~2, but should perc faster because less silt. PERFORMED BY FLA'I-rOP TECHNICAL SERVICES. I ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~"J ! / ~__¢:7 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL RECORD LOCATION OF WELL BOROUGH SUSDIVI810N LOT BLOCK SECTION QTRS SECTION TOWNSHIP RANGE MERIDIAN S E]w LOCATION/SKETCH: WELL OWNER: DEPTHS MEASURED FROM:i--~casing top i--lground surface WELL DEPTH: DATE OF COMPLETION Depth of hole: /':.'K," ft BOREHOLE DATA: Dep.th Depth of casing: Material Type and Color From To ,-'- .: ' DEPTH TO STATIC WATER LEVEL: - ) ~--/"/,~'-'?!~ ('~ ~ ~'? / ft below "C] top of casing [] ground surface METHOD OF DRILLING: ~",,IT:I air rotary [] cable tool USE OF WELL: i~I domestic [] irrigation [] monitor ,~, ~- ~-'- ,--~ ..... CASING STICK-UP: , ft. Diam: in. to,':,x ft WELL INTAKE OPENING TYPE: [] open end [] screened [] perforated fF-I open hole Depths of openings: to ft SCREEN TYPE: Diam: in. Slot/Mesh Size: Length: ft GRAVEL PACK TYPE': OCl' ~J '~ ~j~ Volume used: Depth to top: , GROUT TYPE: ~',::~-:~: <~'.~-.:r.~..V~Jume: ,:,, ,~M~N~ ~,-,', ....... '~' Depth: from ft to ft D~ELOPMENT M~HOD: PUMPING L~EL AND YIELD: PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPL~ION? ~ YES ~ NO CONTRACTOR INFORMATION: ,,....~. ,/ ~ // ~i ,'". ,." /, ,. ~ ..:..-....../',,,....,...,,..; .,, .~, ,t. ( .~ .'"',,...:?.)~.z", ~ / '. ... Registered Business, Name .,,. / ::"' '~ ' / ,~,-' ': Signature of Authorized Respre~en~ative Date REMARKS: PLEASE MAIL WHITE COPY OF LOG TO.' DNRIDIVlSlON OF MINING & WATER MGMT 3601 C St, Suite 800 ANCHORAGE AK 99503-5935 Phone (9071269-8639, Fax 19071562-1384 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ~l'7-O/~J -g3 1. GENERAL INFORMATION Complete legal description LoS $. Location (site add.ross or directions) I~.&YI Expiration Date: /O - /~ -(~:) 2.._ Current Property owner(s) Mailing address Lending agency Mailing address I'~r,~ ,,~ltxv /,~. ~',~,,J' Day phone t~etl~ F, ct.,-~o ~ ?~v. xA~ ~.,,tl,~,,.,¢ } Dayphone ~,~'~-3~'1"~ RealEstateAgent id,~t '~o,,,,~'./ ~_~,~o Etl F~,,,A.e,- Dayphone. MailingAddress ~'~5' ~'c~-Ct..~ ~u,l~ /o,~v Anct, e,",~e,, ,,4~ 9~-~/ Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Public Water System Well [] [] [] [] 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 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer o~ 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 sample results less than 30 days old. (Cerlificates 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 Munic!pality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I redly that my investigation, based on p.rocedures outJined 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 structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage flies and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. NameofFirm ~(.~ /-Io.~ '?'~c4 ~,'~..I ~,-,,, ,~.,.- Phone Address /¥<;'3~ E~4o ..el) ,4-,,~4o,-,~,/_~, ~: ¢e~-t~ Engineer's Printed Name -'-r'~.~.~,'~ /~. ,'/~,~,--~ Date 5. DSD SIGNATURE ~ Approved for ,-~ Disapproved. Conditional approval for .C',:~'~.. ,& . ~',.- sENGINEER S ~ G-1 *' ."1 ~1'.'~.'~'~' ~'"~.,_ ~ STAMP bedrooms, bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: '7 - /o~.-~ M,nicipality of Anchorage Development Services Department BulldOg Safety Division On-Site warm' & Wastawater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.ancflorage.ak.us (907) :~,3-7904 HEALTH AUTHORITY APPROVAL CHECKLIST WI~LL DATA Well type ~uk IfA, B, or C prov~ PWSID # Date completed ,~/~'/~' Sanitary semi (Y/N) ToY depth t,~';;- ft. Cased t~ ~*1 ft. FROM WELL LOG Date of test ,~//5' / 98 Static water level '~ '7 ft. Well production 1.5' g.p.m. WATER SAMPLE RESULTS: Coliform Q colonies/10OmL Nitrate ~,/c~ mg./I. Date of sample: ~'/~f/o ~. Collec~d by: B, SEPTIC/HOLDING TANK DATA Tank Type/Material ~'e,/~hc //$/',e / We?.Log (Y/N) Y W~res properly prated, ed (Y/N) Casing height (above g~ound) AT INSPECTION ff / Z~'/zoo Z '/I lt. 3', '7 ? + g.p.m. Other bacteria Date installed ~ colonies/100 mi. Co Tank size I ~00 gal. Number of Campartments · Foundation ctaanout (Y/N) ~' Depression over tank (Y/N) Date of pumping '7 / Z / O 7., Pumper ~ ABSORPTION FIELD DATA Date installed 7 / ~'? /~' Soil rating (g.p.d./ff~ or ~/bdrm) .~ Length ~' / f. W'~th "~. ~ ft. Total depth -7, ~ ft. Eft. absorption area ~ I(.~ ~ Monitoring tube Date of adequacy test ~'/~&'/O& Results (Pass/Fall) /~.~' Fluid depth in absorption field before test30', s' in. Wate~ added?Y7 gal. O Elapsed Time: ~'~) min. Final fluid depth ~',~' in. Absorption rate >= Any rejuvenation treatment (pest 12 mo.) (Y/N & type) ,~/o,~¢ J~.~o ~, o Cleanouts (Y/N) Y High water almm (Y/N) System type b.~O~ Gravel below pipe .5'. ~ ft. __ Depression over field For .3' bedrooms New depth ff~.~in. ~/5'~ g.p.d. If yes, give date /V. 4 D. UFT STATION /v*. ~.. Date installed "Pump on" level at in. Datum SEPARATION DISTANCES Size in gallons 'Pump off' level at Cydes t~sted Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lilt station on let · ! O0 ; ' Absorption field on lot I I ? Public sewer main f/./~. Sewer/septic service line On adjacent lots '2 I oo ' On adjacent lots Public sewer rnanhole/oleanout Holding tank ~'. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 1 2' ' Property line _~L=~' Absorption field I~~' Watermain '> cc, ' Water sewice line ~ ,'0' Suffacewater '~ ic, o ' Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '~ o' Building foundation '3 '7 ' Water main '2 ~o · Fe Water Service line ~ t~' Curtain drain /~/0.¢ COMMENTS G. ENGINEER'S CERTIFICATION Suffacewatar ~. ~'oo' Drivev~ay, parktng/v~iclestorage .~ ' Wells on adjacent lets. ~. ~ · I certify that I have determined through field inspections end review of Municipal recon~ that the above systems ere in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date HAA Fee $ Data of Payment Receipt Number (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number FORT[~ PROP· ¢ 1~002 ASPEN HIGHLANDS SUBDIVISION, UNIT NO. 3 LOT 3, BLOCK 3 LOT 3 . IL'I' ' ...... ,,, ................. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.a nchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017.013-83 1. HAA# Expiration Date: GENERAL INFORMATION Complete legal description Lot 3 Block 3 Aspen Hi,qhlands S/D Location (site address or directions) 12841 Midori Drive~ Anchora,qe, AK 99516 Current Property owner(s). Rob Gamel Mailing addres~ Lending agency Mailing address Day phone.344-1571 12841Midofi DHve, Anchorafle~ AK 99516 Day phone Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: .3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public. Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual H?Iding tank [] Comm'tJnity On-site [] Public Sewer [] The Municipality of Anchorage Development Sen/i~es Department (DSD) Issues C~rtificates of Health Authority Approval (HAA) based only upon the representations given in.paragraph 5 by an independent professional civil engineer registered in the State of Aiaska. Certificates of Health Authority Approval are reqt~'ired for the transfer of title (except between spouses) on properties sewed by a single family on-site wastewater, disposal and/or water supply system. DSD also issues HAAs upon request to home ownem. Certificates of Health'Authority Approval are valid for 90 days from the date of issue for properties sen/ed by a pdvate or Class C well and may be reissued with ' new water sample results less than 30 days old. 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. 5. STATEMENT OFINSPECTION 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 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone En.q. Svc. Phone 272-8218 Address P.O. Box t02954~ Anch, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 511412001 Engineers Comments' In conducting an adcquany test, I attempt to pm~idc a thorough, conse~c~t ous ' reported rosults describe thc. . I~ormance of the s~stem andcr the conditions encoenterod at the time of ......~..%r.~,,,,'~..,, thc test, and scpanat~on d,stanccs mcasurod to readily ,dcntifiable features. Thc operational life of all v,.clls and septic systems depend on thc local sell condition, ground v. atcr levels that may fluctuate dunng the )'ear, and the s'aler usage of the family being served by the system. These cond~uons are ~,.,,,,: .................................. outside the control of thc evaluator of this system. All sTstems eventually fail and satisfactory lest hidden defects or encroaclunen~, p .ES can there fore not provide any sm'rarity for furore performance p. (-tx^ ~.5teve n nor give any estimate ofhow long the system will continue to meet the operational ..n?q.irements of the ADE¢ or MOA DSD. The content of this report is for the sole benefit or the o~=er hsted a~ve. ~y reliance upon or use ofllfis r~?port by any other person or pan'y is not anthorizcd nor will it confer any 6. DSD SIGNATURE ~ Approved for ~ bedrooms. Disapproved. Conditional approva! for bedrooms, with the following stipulations: ~ WATER AND Additional Comments ~ : WA~TF"WATFR Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Expiration Date: Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: Reissue Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bregaw Street P.O. Box 196650 Anchorage, AK 99519'6650 www.ci.anchorege.ak.us (907) 343-79O4 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 3 Block 3 AsDen Hiahlaqds A. WELL DATA Well lypa Privat~ Date compiated 8/15/1998 Total depth 19~ ft FROM WELL LOG Parcel I.D.: 017-013-83 IfA, B, otC provide PWSID # Sanitary seal Yes Cased to 6t fl WellLng yea Wims ~opedy ~oteQed Y~ CasingheigM ~bevegmund) 42 ATINSPECTION Date of test 5/1~/1998 5/1 tl2001 Static water level ]7 ft 40 ft Well produclion 1.9 WATER SAMPLE RESULTS: Coliform ~ colonies/100 mi Dat~ of sample: ,6/1t1~001 SEPTIC/HOLDING TANK DATA Tank Type/Material g.p.m . ,:* 3,13 g,p.m ' Nitrate L~I2~ mgm1 Other bacteria'~C~ colooies/100 mi Collected by: Laura Pannone Steel SeptiC: Tpl~k Ce Date installed 712711998 Tank size 1000 gal Number of Compartments_2 Cleanouts Yes Foundation cleaoout Yes Depression over tank N__o High water alarm No Date of pumping 5/ttl2001 Pumper A+ Home Seryi;es ABSORPTION FIELD DATA Date Installed 712711998 Soil rating (g.p.d./ft= or ft=/bdrm) 0.8 ~System type Deed Trench (2t , Length 61' Tgtat fl W,:lth 2,5' each ft Grovel below pipe $ It To*al depth 9.71~ ff Effective absorption area 610 fl= Monitoring tube Yea D~ession over field N9 Date of adequacy test 5/1tl2001 Results (Pass/Fail) Pass * For.3. bedrooms Fluid depth in absorption field before test ~q in Water added450 gal. Now depth~ in. Elapsed Time: ~l~min Final fluid depth ~ in Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date (Rev. D. UFT STATION Date installed 'Pump on' level at Size in gallons in'Pump off' le~vel at Manhole/Access ~ in , High water alarm level at Jn Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lilt s*ation on lot 100+ Al~orption field on lot 100+ · On adjacent lots 100+ On adjacent lots 100+ Public sewer main N/A' Public sewer manhole/cleanout ' NIA Sewer/septic service line Holding tank t00+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 6'+ Properly line 16'+ Absorption field 6'+ Water main 10'+ Water service line 10'+ Surface water, 100'+ Drainage 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT.TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ ' Surface water 100'+ Driveway, Parking/vehicle storage 26'+ Curtain drain NIA Wells on adjacent lots 11~0'+ F. COMMENTS /&,. Bottom Trench Staved Drv. UDDer Trench Ratumed to ~" In 90 MIn. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in confommnce with MOA HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone. P.E. Oate .;I.4ot Date of Payment-' ' Receipt Number (Rev. 11,~) ;...~.-..~,~-~. ........ ~....~ Ponnone.~,~ ~ -.4 ;~ ~..' No. CE o~ '~i~ ~ .............. ,-,x~ ' Waiver Fee $ Dae of Payme~ R~i~ Numar 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. # CERTIFICATE'OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 017-013-83 '" HAA# ~ ~C~ ~ A~ GENERAL INFORMATION Complete legal description Lot 3; Block 3~ Aspen Hiqhlands Subdivision Location (site address or directions) Property owner Mailing address Wayne Frison 12841 Midori 12841Midori Drive Anchorage, AK Day phone Drive Anchorage, AK 345-7032 Lending agency Mailing address Day phone Agent c. avy ~ont~]]./ Dynamic Address Properties Day phone 244-1717 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ..~ TYPE OF WATER SUPPLY: Individual well vv Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- . lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev. 1/91) Front MOA#21 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 effecJ~.~~lllf~, '~ inspection. Name of Firm II~~JCl~__ Phone Address ~ Alaska Water & -~,.,:.~ .~_.. o~ ~ ' Wastewater Consultant, s, ~ ~or to~ closing for the .. 6. ~HHS SIGNATURE ' ~ Approved for Disapprove. Conditional approval for bedrooms, with th~ following stipulations: Additiona~ Comments By: ~.,--~'~ / ~¢J. '7~~ Date //r :?' - ' 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. 72-4)25 (Rev. 1/91) BaCk MOA ~ of Anchorage dUE 08 1999 Municipality DEPARTMENT OF HEALTH & HUMAN SERVICE~N~ClP^U~ oF ^NC,,.~=~lm,~ Environmental Services Division ENVIRONIVIENrALSERVICE$ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: Health Authority Approval Checklist ,/~fj~l J'Jr",_~AI~.~'J:f]' J'c'~L~/~'JX'J2ParcelI.D.: i~ I A, WELL DATA Well type /"l V'~ ~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) y(~'~"~ Date completed Total depth I~'-~ Cased to ~' I Sanitary seal (Y/N) Casing height (above ground) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test ~2/l' ~/cie '~' Static water level ..,2) ~ L//~' Well production I. ~ g.p.m. '~' /''j J g.p.m. WATER SAMPLE RESULTS: Coliform "~ Date of sample: Nitrate /-/, q /'Yl ~//~ Other bacteria / Collected by: B. SEPTIC/HOLDING TANK D~TA Date installed '~"/2~'/¢~ Tanksize I (~(:::) O Number of Compartments'~ Cleanouts(Y/N) '7'~'.~ Foundation cleanout (Y/N) 7~ Depression (Y/N) i/1 ~2 High water alarm (Y/N) Date of Pumping /V'/,~ Pumper / C. ABSORPTION FIELD DATA ~'{'~--'~' ~ [ ~P~ Date installed ~/27 /~ Soilrating ~orff~/bdrm)--'0' ~ Length ~ ~5 = ~ I Width 2. 5 (J Gravel thickness below pipe Effective absorption area ~/~ ~ ~ Monitoring Tube present (Y/N) ~ Depression over field (Y/N)  Results (Pass/Fail) For ~~ooms Peroxide trea~ If yes, give date 72-026 (Rev. 3/96)* System type ~¢ Total depth Date installed ~ Size in gallons ,, ___.------~ Manhole/Access (Y/N) E. SEPARATION DISTANCES . SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On-adjacent lots ! ~O ' ' ~.. on adjacent lots [OO ' ~ Public sewer manhole/cleanout //V~',~- Lift station A/'/~/~j SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation §t J",, Property line I ~)~ -/r-- Absorption field ~ Water main/service line I 0 / 4- Surface water/drainage ! oO ~ ~ Wells on adjacent lots ,+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line J' Building foundation J 0 ' ~ Water main/service line Surface water / OO' J~ Driveway, parking/vehicle storage area J ~ Curtain drain ,,1~¢ /~'~ O ~, ~ Wells on adjacent lots ! ~?(~ / ~ ,, -fl I cedify that I ha~~i~r~ field inspections and review of Municipal recitalS. in conforman~i~~~~esineffect on this date. Signatur~ ~__~~~ ?. aro HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2-B ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers July 1, 1999 Wayne and Eileen Frison c/o Dynamic Properties 3111 C Street, Suite 100 Anchorage, AK 99503 RECEIVED JUL 8 1999 Municipality ot Anchora .ge-~_ Oept. Health & Human Servi~n - attn.: Gary E. Kontul Subject: Aspen Highlands, Lot 3, Block 3, Well Flow Test Dear Mr. Kontul: Per your request, we performed a flow test on the subject well. Prior to the start of the test the water level was 49 feet below the top of the casing (BTC). For the first 2 hours and 25 minutes the well produced over 5 gallons per minute. The static water level did not stabilize until it reached a level of 184 feet BTC, approximately 1 foot above the pump. When the well did stabilize, it produced 3.41 gallons per minute for 2 hours and 20 minutes. Over a period of 4 hours and 45 minutes, 1243 gallons were pumped out of the well, causing the water level in the casing to stabilize at 184 feet BTC. Based upon this data it is clear that the well meets municipal standards for a 3 bedroom house, which is .32 gallons per minute. The production of this well may vary seasonally and future performance is not guaranteed. you have any questi~/I~s, please contact me at 337-6179. /I Pr~ident[] . If