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HomeMy WebLinkAboutDELUCIA LT 5r.)eluci
a
Lot 5
#051-141-47
Jun 13 22 07:04p Anchorage Well & Pump Ser
9072430742 p.1
MUNICIPALITY OF ANCHORAGE
Development Services Department- , Phone: 907-343-7904
On -Site Water & Wastewater Section :v ,3
�/ Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: Date of Issue:
Parcel Identification Number: 051 141 47
Legal Description Block Lot Property Owner Name & Address:
BYRNE JENNIFER ELLEN & JAMES GERARD JR
DELUCIA 5 13 LAKESHORE DRIVE
SHALIMAR, FL 32579
Pump Installation Date: 05 - 13 - 2022
Pump Intake Depth Below Top of Well Casing: 122 feet
Pump Manufacturer's Name: A.Y. MCDONALD
Pump Model: 2307SU3LB/6622-075
Pump Size: '75 hp
Pitless Adapter Burial Depth: 10 feet
Pitless Adapter Manufacturer's Name: MARTS NSON
Pitless Adapter Installer:
Well Disinfected Upon Completion? Yes ❑ No
Method of Disinfection: PELLETS
I Comments:
Pump Installer Name: _
Company:
Mailing Address:
ANCHORAGE WELL & PUMP SERVICE
7640 KING STREET
ANCHORAGE, AK 99518
907-243-0740
State:
Attention: The pump 'installer shall provide a pump installation log to On-site within 30 days of pump installation.
• Municipality of Anchorage Page 1 of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: Sl�l 92-d 16 �L PID Number: 4D"5 114- IQ's'"
Name: ' I
Wastewater System: '❑ New Upgrade
Address:
.��
ABSORPTION FIELD
U
Phone: No.O Brooms:
❑Deep Trench 11 Shallow Trench' ed ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating: /,
Total Depth from original gra de:
• I GPD/S Ft.
Lot.Block: ✓' Subdivision:
ISP
Depth to pipe bottom from original orale,
2•CJ
Gravel depth beneath pipe i
�'�
Ft.
Fl.
Township: 7
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
/
SG
0r- �. Ft.
Ft.
WELL: ❑ New El Upgrade
Gravel width: I�r
Number of lines:
Distance b 1ween lin F:
Fl
Classification (Private. A.B.C):
Total Depth:
Cased To:
Total absorption area:
Pipe material: 'relO -F4
'D Ply
-i)Lf,
FL
Ft.
SO Ft.
T`4TT1
Driller:
Date Drilled:
Static Water Level:
Installer: p (4,!Z
Date Installed:_
Ft.
Yield:Pump
Set at:
Casing Height Above Ground:
TANK
GPM
FL
Ft.
SEPARATION
DISTANCES
❑ Septic ❑ Holding T.E.P.
To
Septic
Absorption
Lin
Holding
ubliUPrivate
Manufacturer: // �� /
apacityy In gallons:
From
Tank
Field
Station
Tank
Sewer Lines
G L� I�r'R�►
!J'L/
Well
IOGf
120,
1OGr/.t�
.�
a
Material:
Number of.Compartments:
Surfac
16vT-�
16L`I'
I�1-I'
–
LIFT STATION
Water
—
Lot
I f7 +
I p=l-
IDI-}-
size in gallons:
size
Man f� actur�� PA
�"jPumPo
Foundation
I Cj /
I ��
I CJ r
�---
"Pump on**level at:
f" 11 at:
High water alarm at:
Curtain
�. _ I
I/ _ 1
�._
Pum Make 6 Mod¢I�4
EI c rical Inspections performed by:
Drain
Remarks:
BENCH MARK
4oca io nd.Dgscri tion:
' t kl V
Assumed Elevation:
r Ft
,. •_.mull c t;tic.^;1.1.;,L;
ENGINE`Epp S SEAL
�.1�1
. OF 4 it
'WeS
••
& S ENGINEERING
f•
0
Inspections performed by: 1"34 Eagle Ritter LOOP Road, N133M: 1s g l3 y
�•••' •••••• •• » »i. •
n Eagle River, Alaska 99577
2nd -0j
t� QQc-r t,�,�.� ^ L �.t,e� �,�_�
/
1 • '••"»•' ••• ••••
ROG J. HAFER
/ /
Department of Health and Human Services approval
�I��ti66041109 N0' 's
Reviewed and approved by: Date:�0 �0 9�-
t1ati, FESS A- 4110
�•'C��
T2-013 (Rev. 9/91) MOA 25
Permit No.
Page -Z- of 'Z
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Descriptions 45 VUG I
i X/ l' lAct A . L.01- G PID No.: 015 11 6_143
-�' wii3 rtt�T
Gol Co
ID -Z
3
r'Sn�.►� �F►v�rF�? X186
3�Fb WP-T=Troµ,,sp
RECEIVED
OCT 19 1992
Municipality of Anchorage
Dept. Health & Human Services
Nf� 'F�t't�u tz1 �,D -� as �- r►.N .
'p�lr�►But10�.1 -P�-fl� co( �� 12SpLIFkC�
• 'P
72.019 A (Rev. 9M) MOA 25
C-'01
�L
M.�4.
r'Ff 1
t1 i Z
Nf
Y�tfq
43'
Iq =
2l!s;
lee
e
22£
V 1
15 ''
1'42
72.019 A (Rev. 9M) MOA 25
J.
ini
L*04 %
J.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
PAGE 1 OF 1
ANCHORAGE, ALASKA 99519-6650 a l9ni
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT 9-JLq'=q
PERMIT NUMBER:SW920198
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:WAGNER JOHN W JR
OWNER ADDRESS:2440 East Tudor Rd. No. 956
Anchorage Ak. 99507
PARCEL ID:05114147
LEGAL DESCRIPTION: DELUCIA LT 5
LOT SIZE: 70132 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 7/27/92
EXPIRATION DATE: 7/27/93
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
SYSTEM IS DESIGNED AS A PRESSURIZED BED. ENGINEER MUST
NOTIFY DHHS AT LEAST TWO HOURS PRIOR TO EACH INSPECTION.
RECEIVED BY: C� DATE • �/ O
ISSUED BY: �'Jotftq SMiTT+ DATE:_ '7/7,7/7Z.
July 3, 1992
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694.2979
FAX 694.1211
HEALTHAUTHORITY Municipality of Anchorage
APPROVALS DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, Alaska 99501
SEWER & WATER
MAIN EXTENSIONS REFERENCE: Delucia Subdivision, Lot 5
Request you issue a permit to upgrade the septic system
SEWER&WATER serving the referenced property.
INSPECTION
An adequacy test was performed on the existing system and the
absorption capacity of the existing trench was found to be
inadequate.
ENGINEERING STUDIES
ANDREPORTS A test hole was excavated and a percolation test was performed
in the area of the proposed upgrade. During excavation of the
test hole water was encountered at 71, and after seven day
ground water monitoring water was at 71. Attached is an
WELL INSPECTION upgrade design which shows the location of the proposed
&FLOW TEST distribution system.
We do not anticipate any adverse effects on neighboring
properties by the installation of the proposed septic upgrade.
SITE PLANS
If you have any questions or require additional information
for your review, please contact us.
ROADDESIGN Sincerely,
1
SOILTEST ROGER J. S.Aj R, P.E.
RJS/lsu
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
0
O
a
u
=111 j LEGAL DELUCIA SUBDIVISION, LOT 5 4! OF q1
�. tJ�,A� DRAWNL. S. ULSHER cKo. R.✓.S DATE 7/2/92 s►+T. ��Q•(�.•..•.... y.Qs
-
t,.. Sly f.. ....«.«... ...
A A,I ; ROGE J. AFER ty/
f J,rti•• No. 82 5dill
•�; ��4'�
ei �f'ROFESStON:.+
L 48 �Z����+
GRE
DESIGN CRITERIA:
m WELL 3 BOW= 450 GPD
SO/LS = 0.7 VD/� (SAND FILTER)
�w„ /� 100' WELL RADIUS 450 • 0.7 = 643 sq. ft. REOD
12'X 54' OR E0.
Y EXIST. HOUSE TO DISTRIBUTION SYSTEM
BE REMOVED
PUMP = 30 OS105HH - 3 STAGE (-35 GF
PROPOSED o \J ) �/ 2 LATERALS =11,50PWLAT
I3BDRM EXIST. SEPTIC 12 HOLES/LAT =1•60vu/MOLE
HOUSE `�\� TO BE ONE IqFT! HEAD NoLG�
PROPOSED 1250 GAL p �1
w T.EP. SYSTEM E ROA ►moi �
LAG
�
Mr rx Mr1' t �•
PROPOSED '
PRESSURIZED JASMINE Ft” "RADE ORIGINAL c TOP500-
ABSORPTION BED 1
u+suLA 31
S.'
! S SR • • T.
0 —MT 12 MLWdt.T DN CENTER MT Q r •C'6Np FILTER' ' • _•• r 2' ORGANIC
IV: �i i
i A c V: NaES CAPS
1 1r assuMED waTER vOLE
Ll KTO 3' MTA
t'
SCALE I" =10' SCALE I"= 10•
A/E SUPPLIES Isom
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR:r�'if t ` `/�' ��i DATE PI
LEGAL DESCRIPTION�U G1 LIOTTz5ship, Range, Section:
DC EPr7 SLOPE SITE PLAN
1 2 -Fie i
3 ''
•o
�� .�
4- -6)
Ott,belITi1 �c Ld1�7��5
5-
7-. 7 '
8-
9-
to -
11
9
1011
12-
13-
14-
15-
16-
17-
18-
191
213141516171819
20
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Water After I
Monitoring? Date:
®Mmm
�[ MU iai19O�,�I
W-M��Sur. IN .at1'wur'-w �—
PERCOLATION RATE -4 J (minutes/inch) PERC HOLE DIAMETER w "
TEST RUN BETWEEN 2- FT AND ;�22 FT
PERFORMED BY: S & S ENGINEERING I CERTIFY THAT THIS TEST WAS PERFORMED IN
17034 Eagle River Loop Road No, 204
ACCORDANCE WITH fE j jWtanjia"Co""UIDELINES IN EFFECT ON THIS DATE. DATE:
72-0081Rev. 4/85)
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NET DISCHARGE, GPM
2826 Colonial Road Roseburg ,OR 97470 5031673-0165
va
Compliance Inspection Report U.S. Department of Housing
Note: Reports of Final end Repair Compliance Inspections left and Urban Development
at site always require reviewer's signature to be Official. Office of Housing
Consult mortgagee for official reports. Federal Housing Commissioner OMB No. 2502.0189
Builder's Name and Address FHA Case Number
a. ❑ Report not left at site.
b. F-7 Report not official without Date of Inspection
J (•b �/ reviewer's signature.�/-13 3
Mortgagee's Name and Address Property Address
G oT $ mel' -y9
" da
I. Inspection of On -Site Improvements Reveals:
1. Construction❑ was, ❑ was not begun prior to the date of mortgage
insurance approval shown on the commitment, statement of appraised value
or "Early Start" letter. (Applies to the Initial report on new construction)
2.0 Builder other than named in application. -
3.0 Unable to make inspection. (Explain below)
41:1 Accepted construction exhibits not available at site.
5.0 Individual Sewage disposal system; ❑ Individual Water supply system
❑ No noncompliance. ❑ Correction essential as explained below.
❑ Submit Health Department letter or form HUD -92573
6.0 Correction req'd. by rprt. dated not acceptably completed.
7.❑ Repairs required by form HUD -92800.58 not acceptably completed.
8.❑ Correction essential as explained below:
❑ a. Will examine at next inspection.
❑ b. Do not conceal until reinspected.
9.® No noncomnliance observed.
10. ❑ Acceptable variations as described below (Request for Change,
form HUD -92577, may be submitted).
11. ❑ Extensive noncompliance as explained below (see IV.A below).
12. ❑ On-site improvements acceptably completed subject to receipt of
certification that mortgagee's inspection reveals satisfactory
completion of all items listed below.
13. ❑ On-site improvements acceptably completed except items listed
below, completion of which is delayed by conditions beyond control
of the builder (see IV.B below).
14. ❑ On-site improvements acceptably completed.
15.0 Off-site improvements:
❑ a. Correction/Completion essential as explained below.
❑ b. Completion assured by escrow agreement
or governing authority.
❑ c. Accentablv completed.
II. Explanation of statements checked in Parts I and III
❑ Initial Inspection ❑ Framing Inspection ❑ Final Inspection Other (explain) ❑ Repair Inspection
Inspection Number
No.
No.
n � p
CZ e4e
Lki r1 n
->?�C E '
Certification: I certify that 1 have carefully inspected this property on this date. I have no personal interest, present or prospective, in the property, applicant,
or proceeds of the mortgage. To the best of my knowledge I have reported all noncompliance, work requiring correction, and unacceptable work.
SignalData ID Number
a
/1 -� 3�3 tdNi Fee Inspector ❑—t Appraiser g
X f di // /7, 7 I I DE Staff Insnnelar I I HUD Insner-tnr .7J On
t lfeme or resubmit incomplete 17. ❑ Acceptable Compliance with all specific 18.0 Submit Termite Soil ❑ None
as noted above. conditions not requiring field inspection. Treatment Guarantee.
❑ as modified ❑ Direct Endorsement Underwriter
by me. X ElChiefArchitect ❑ Deputy
IV. To Mortgagee: When signed below, refer to the statement on the back corresponding to the designation checked.
❑ A. Noncompriance ❑ B. Compliance — Incomplete Items. "Mortgagee's ❑ C. Final Acceptance. Closing papers
❑ (a) Variations from exhibits. Assurance of Completion", HUD -92300, may be submitted. may be submitted provided mortgage
credit analysis is acceptable.
El (b) Unacceptable construction. for completion
❑ (c) Premature construction. $ not later than:
Signature Date ID Number
❑ Direct Endorsement Underwriter
X❑ Director of Housing Development ❑ Deputy
For HUD Use Only for concurrence of Direct Endorsement Processing Signature of HUD Authorized Agent Date
of this Compliance Inspection Report. It signed, this final report is considered
processed by HUD and, thereby, convertible to the Veterans Administration.
X
Previous editions are obsolete form HUD -92051 (7/87)
(M..-413 leans VMP MORTGAGE FORMS • (313)293-8100 • (8001521-7291 ref. HB 4145.1, 4190.1
Seo the statement below that corresponds to the designation
checked on the front of.the form under section "IV. To
Mortgagee
A. Noncompliance. Construction.is not acceptable or all specific
conditions have not been fulfilled in accordance with the terms
of the related commitment because of:
(a) Variations from Exhibits. Inspection reveals extensive non-
compliance, involving variations from accepted construction ex-
hibits.'The property will bo consideredineligible for mortgage in-
surance (11 unless the work has been corrected so as to effect
compliance, or (2) unless reprocessing is requested on the basis
of the mortgage security as it is now being constructed, and this
is found to be acceptable. Requests for reprocessing must be ac-.
companied by a letter, in duplicate, fully describing the work as
now being constructed, signed by the mortgagor and approved
by the mortgagoe. Where the plan arrangement, or either the ex-
terior or interior apperarynGe is affected, the mortgagor's letter
i must be accompanied by drawings, in duplicate, fully indicating
the variations_ and signed by both the mortgagor and the
mortgagee.
(b) Unacceptable Construction. Construction reveals extensive
noncompliance with applicable FHA requirements or good con-
struction practice. The property will be considered ineligible for
mortgage insurance until construction has been corrected so as
to effect compliance.
1 (c) Premature Construction. Inspection reveals that construction
was begun prior, to the, date of approval for mortgage insurance
(in noncompliance with the commitment or statement of
appraised valSte):-.
B. Compliance: (with incomplete items) _
Construction of on-site improvements has been acceptably com-
pleted except for any items listed on the front of this form.
Completion of those items is delayed by conditions beyond the .
parties' control. The property will be considered acceptable for
mortgage insurance and closing papers may be submitted
provided:
(a) All required off-site improvements have been acceptably com-
pleted and so reported, or their completion has been assured by
an acceptable "Mortgagee's Assurance of Completion" form,
and;
(b) All specific conditions not requiring field inspection as in-
dicated on the front of this form have been acceptably fulfilled or
evidence of compliance is submitted with the closing papers,
and;
(c) The closing papers are accompanied by form HUD -92300,
"Mortgagee's Assurance of Completion," properly executed and
providing for withholding the sum indicated, or by indicating the
sum is available on a commercial letter of credit, and for comple-
tion of construction not later than the date stated on the front of
this form.
C. Final Acceptancer ,
Construction has been completed and all specific conditions have
been acceptably fulfilled. Closing papers -may be-submi:�oq( iro;
vided the mortgagee's credit analysis of the borrower is -accept-
ably completed. Evidence of compliance. with specific conditions
r t not requiring field inspection as indicated on the front of this _
form may be submitted with the closingapers.
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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 SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930064
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:WAGNER JOHN W JR
OWNER ADDRESS:19722 JASMINE RD
CHUGIAK, AK 99567
PARCEL ID:05114147
LEGAL DESCRIPTION:'DELUCIA"LT 5
LOT SIZE: 85000 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
DATE ISSUED: 4/22/93
EXPIRATION DATE: 4/22/94
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 DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM 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 AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAI
RECEIVE
ISSUED
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RECLrIVED GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
L J ty/ AM 3330 "C" Street
ANCHORAGE ALASKA 99503
Case #
B;EATEA NCMORAGF AREA 60ROUCFI '
tfT. O!' ENVIR")NOIATAL QUALITY
Performed For Dated Performed Aup, 12, 1972
Legal Descriptio 'Lot 935 Block Subdivision Delucia ub.
This Form Reports Soils Log y Percolation Test
- Soil Test Must Be Logged To 4' Below Proposed Seepage System -
Depth
Feet Soil Characteristics
1 —
2-
3-
4- 07U. well ..sorted gravels .... 85 ...
5-
6—
—6— water
7-
8-
9-
10-
11-
12-
13-
14—
Was Ground Water Encountered? yes
If Yes, At What Depth? 5'
Reading Date Gross Time Net Time Depth to H2O Net Drop
rcl i.Ula1.jull RaoC 19IflULe
Proposed Installation: Seepage Pit Drain Field
Depth of Inlet Depth to Bottom o Pit or Trenc►F
COMMENTS: c5 f -t. 2
Test Performed BY Date Certified BY:
Date:
1
N
h
• '-� Municipality of Anchorage °
On -Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-141-47
1. GENERAL INFORMATION
Complete legal description Delucia_Lot 5
Location (site address) 19722 Lace Rd.
Expiration Date: q-6. -�C_
Current Property owner(s) Neal Darrell _ Day phone
Mailing address
Real- LE -state -Agent
PO Box 671073 Chugiak, AK 99567
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class _ Well
❑
Public Water System
❑
WaiverNariance request for:
3
Jay phone
TYPE OF WASTEWATER DISPOSAL:
Individual
Holding Tank
❑
Community
❑
Public Sewer
❑
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5-50 Waiver Fee $ _
Date of Payment
Receipt Number
COSA# QST -22 100't
Date of Payment
Receipt Number
Waiver #
stance:
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.
Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111
Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date /Z0-
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 due to subsurface
conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. 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 well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerrauarantee that no unseen `
encroachments, deficiencies or discrepancies exist.. _..... _. �a�S> OL -.4i�11\
1 g ;rel
6. DSD SIGNATURE
System #1 Approved for 3
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms. ` KENNETH M. ui_OZ
bedrooms. 1 `'ref, y�xz �" "W
vr�ofr•.ss; 1(0),
bedrooms, with the following stipulations:
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ICES-0��\C�
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BY: _ _ _ 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.
7. ATTACHMENTS:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
COSA blue sheet_10-10-12,doc
Nitrate Advisory
Arsenic Advisory
Other S ( ���Scurx
Legal Description:
Delucia Lot 5
If more than 4 septic system on lot: COSA Checklist # of
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 9/24/92
Total depth 125 ft
Cased to 125 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 33 in.
Date of flow test for COSA 11/25/21
Static water level at beginning of test 112 ft.
Comments
B. TANK DATA
Age of tank(s) 29 years
Tank type/material STEP/Steel
Measured operating fluid level in septic tank 42"
Standpipes/foundation cleanout per record drawing
Date of pumping 6/7/21
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/17/92
ALL standpipes present per record drawing
Total measured depth from grade 3.5 ft (max)
Measured depth to pipe invert from grade ft (min)
N/A — pressurized field
in Monitor tubes go to bottom of effective. If not, state
depth into effective
Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
Parcel 1D: 051-141-47
Structure served by this system
Well production at time of test 4.9 gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes No
Coliform bacteria is Negative
Nitrate 3.75 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L in Arsenic less than MRL (ND)
Collected by Arcterra Consulting
Date of Sample 11/16/21
C. LIFT STATION
Required maintenance completed
Age of lift station 29 years
Lift station material Steel
Comments:
Adequacy test date 12/30/21
Results ®Pass For 3 bedrooms
Fluid depth prior to test * in
Water added 450 gal
New depth ** in
Elapsed time 1320 min
Final fluid depth *** in
Absorption rate 450+ gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
Mtl: 0" Mt2: 5" Mt3: 0" Mt4: 0"
** Mt1: 0" Mt2: 2" Mt3: 17" MM 17"
* * * Mtl : 0" Mt2: 1" Mt3: 0" Mt4: 0"
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'
If absorption field is under driveway comment below
® Yes
if No****
ft
® Yes
if No ft
Neighboring Tank > 100'
® Yes
if No
ft
Private Sewer/Septic Line > 25'2] Yes
if No ft
Absorption Field on Lot > 100'
® Yes
if No
ft
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields
> 100'
Animal Containment > 50' ® Yes
if No ft
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75'
®Yes
if No
ft
® Yes
if No ft
From Septic/Holding Tank on Lot to: (Please
enter distances if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100' ® Yes
if No **** ft
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100' ® Yes
if No ft
Water Main > 10'
Yes
if No
ft
Community Wells > 200' ® Yes
if No ft
Water Service Line > 10'
® Yes
if No
ft
If septic tank is under driveway comment
below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
Yes
if No
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 ft
Surface Water > 100'
® Yes
if No **X*
ft
F. ENGINEER'S COMMENTS
**** Per 10/20/1992 Inspection report & MOA records.
G. ENGINEER'S CERTIFICATION
I certify that t 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.
COSA Checklist yellow sheet
MUNICIPALITY
Development Services Department Phone_ 907-343-7904
On -Site Water & Wastewater Section
Fax: 907-343-7997
Lift Station/Pump Vault
j /
Maintenance Lag
Owner . 61 � yell C [,V M I Street Address—1 � "z
Septic Tank:
-Sludgelevel 0 inches -Pumping: required
Yes� -Pumping completed yes no
Lift station:
-Pump basket cleaned e' no -Effluent filter cleaned
-Control floats cleaned e no -Proper float settings confirmed es no
-Operation satisfactoryes no
Alarm System:
-Dedicated electrical alarm circuit e no -Audible and visual alarm inside dwelling es` no
-Alarm system operation `tisfacto not satisfacto
ry
Manhole Riser
-Ground water intrusion at riser to tank connectiones n
-Ground water intrusion around pipe penetrations es -Weep hole functional 0 no
.*Manhole lid: Functional e§ no Insulated es no Properly Secured es no j
Other I
f
-All manufacturer required inspections and maintenance completed yes no
Comments:
Qualified Maintenance Provider:
Technician __ ��( Date of maintenance
Company _�IN , 2p-hCi �'".....
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval #OSC 221004
Subdivision: Delucia lot 5
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this property is 29 years old. Typical replacement costs range from $9,000 to $12,000
This advisory must be attached to all copies of the subject Certificate of On -Site Systems
Approval.
This is an example of what the metal of a 20 -year-old steel tank MAY look like.
6 ? 8. 9 o.
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Munici alit of Anchora e_ p y g 1OnSiteWaterandWastewaterProgram A, 0,:i�!'
(907) 343-7904 6 Ste° E T. ti
C hC4
Certificate of On-Site Systems Approval ii �� s a L 9
051-141-47 —1 ?
Parcel I.D. Expiration Date: L f./ --r
1. GENERAL INFORMATION
Complete legal description Delucia Lot 5
Location (site address) 19722 Lace Rd.
Current Property owner(s) Zulene & Willis Simmons Day phone
Mailing address 19722 Lace Rd Chugiak, AK 99567
Real Estate Agent Day phone
2. TYPE OF DWELLING:
r] Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well 0 Individual El
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
I
l
Received by: Otct _______cDate: q5f I /1 2>
COSA to be released to the engineer,unless otherwise request d by the engineer.
COSA Fee $ 521, Waiver Fee $
Date of Payment -4-111112 Date of Payment
Receipt Number dct36b6 Receipt Number
COSA# 0 3C121&5Z) 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.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe 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 soil
condition,ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 07/17/2018
j*49 T I\ -17.*fir
6. DSD SIGNATURE •" - /�
System #1 Approved for 3 bedrooms .Seven R. •onnone:
System #2 Approved for bedrooms oo} �• CE-8149
•
Disapproved > `� OF•ESSIONis-
Conditional approval for bedrooms, with the following stipulations:
ep+1 c * civt IC i S Z, I� ea c/'S C9L b
�ac-wIC t •01-1)
Sty '..i / ���� OF tilvc
I w
ON-SITE .
WATER AND
coWASTEWATER o
T PROGRAM
"Jr qi-cAl
Original Certificate Date: Z! H
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other `tea t, { Vt%ic
COSA blue sheet_f ,. J
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Delucia Lot 5 Parcel ID: 051-141-47
A. WELL DATA
Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y
Date completed 9/24/1992 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 125 ft. Cased to 125 ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 09/24/1992 06/29/18
Static water level U N K ft112.3 ft.
Well production 7 g.p.m. 7.0 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEC' colonies/100 mL Nitrate 6.24 mg/L
Arsenic ND ug/L Date of sample: 6/29/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material S.T.E.P./STEEL Date installed 08/17/92
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank .IN) N High water alarm (Y/N) Y
Date of pumping q i I v I Pumper .s a 1
C. ABSORPTION FIELD DATA
Date installed 8/17/92 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.7 GPD/SF System type BED
Length 55 ft. Width 12 ft. Gravel below pipe 0'5 ft.
Total depth 3 ft. Eff. absorption area 660 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 06/29/1 8 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0/0/0/0 in. Water added 450 gal. New depth 0/0/0/4.5 in.
Elapsed Time: 80 min. Final fluid depth 0/0/0/1 in. Absorption rate >= 450+ g.p.d.
N
Any rejuvenation treatment (past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed 8/17/1992 Size in gallons 1250 Manhole/Access (Y/N) Y
"Pump on" level at 42 in. "Pump off' level at 24 in. High water alarm level at 44 in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10+ Property line 10+ Absorption field 5+
Water main 10+ Water service line 1 O+ Surface water 100+
Wells on adjacent lots 100+
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 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
Survey on file.
G. ENGINEER'S CERTIFICATION '`I'' OF A ,'kk�
I certify that I have determined through field inspections and r�p'�P•• `4,•.ti,10
review of Municipal records that the above systems are in 0*; 4.• •i\% •*°
conformance with MOA COSA guidelines in effect on this date. ••• .1741 • f•• 0
Engineer's Printed Name Steven Pannone , ... }even '.•150ririorie:••oi
Date 07/17/2018 Oi t.. CE-8149 5
Ill \Z` ` r
.
COSA canary sheet_2-6-15.doc
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT • / t 907-343-7904
On Site Water and Wastewater Section `/1 Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC181350
Subdivision: Delucia, Lot: 5
A water sample revealed a nitrate concentration of 6.24 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.0. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org
<o > 7 95 -ia61
MUNICIPALITY OF ANCHORAGE
;11
_
Development Services Daperkment t d
On-Site Water& Wastewater Section e
" ' Phone; 907-343-7904
Fax; 907.343.7997
Lift Station/Pump Vault
Maintenance Log
Owner �. Street Address_7_2_2,2L_ _ ____*
5aPtiP Tank:
°Sludge level Q inches Pumping: required yes 49 Pumping completed ano
•Pump Gasket cleaned _o •C-ffiuent filter cleaned y
•Control floats cleaned �e no -Proper � � 4/7/9per float settings confirmed
°Operation satisfactory v np
',Dedicated electrical alarm circuit yds no •Audible and visual alarm inside dwelling jj
-Alarm system operation ..-: .efF.. ou no :: I. : •3[•A
f anbote Ricin
`Ground water intrusion at riser to tank connection
•Ground water intrusion around pipe penetrations
' 'Manhole lid: Functional Q �`�' Weep hole functional 4 no
insulated no , Properly Secured ze no
Other
•AIT manufacturer required inspections and maintenance completed
rants: 0_02
lii
u 1ti rs non P vi w
Date of maintenance 7/,
f Company '
c_
Sigriatu / ba � o
tt
r:':Jiiiti l Addir:;b: P.Q. n.»: 1nu(6r
:,t;c1)�r;iyL. rxU.F;a ieJ519 GiSU v:ti'r,,;
JTtUl1l.o{'‘i
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT ( • 4I r,71 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Septic Tank Advisory
Certificate of On-Site Systems Approval # OSC181350
Subdivision: Delucia, Lot: 5
The septic tank for this property is 26 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $6,000 to $9,000.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
This is an example of what the metal of a 20 year old steel tank MAY look like.
.. .;r ` .. ' $y aCa r'e'f "'s,P zt -
-
•
s Z F
0
1.41
�'i''�z _ •� 'fit i n �..'.:.
g03:' 10' 2
Mailing Address: P. 0. Box 196650 " Anchorage,Alaska 99519-6650 x www.muni.org
C' Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water& Wastewater Program
4700 South Bragaw St.
P.O. Boz 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-141-47 HAA#
1. GENERAL INFORMATION --- - - _.__._ Expiration Date: R - 0 4
Complete legal description DELUCIA SUBDIVISION: LOT 5
Location (site address or directions) 19722 LACE ROAD * CHUGIAK AK 99567
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
_CRAIG LIGHTLE W/ L & N PROPERTIES Day phone 441-4114
P.O. BOX 244922 * ANCHORAG AK. 99524
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
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 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.
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. 1 further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone
* GE AK 99507
337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 ANCHORA ,
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date7 d
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.
5. DSD SIGNATURE
✓ Approved for _ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the filowing stipulations:
v
Zi : ON-SITE
WASTEWATER
• PR
Attachments:
HAA Checklist
ManitenanceAgreements
Septic System Advisory Supplemental Engineer's Reort
Well Flow Advisory Other
By: �� /�{� P Original Certificate Date: o r 0
(Rev. 12101)
unicrpa i y o n
Developrnertt Services
Building gaietytvS,
Parcel 1D � 051 141=47 ""
Win• Lasea io; ffu-r tt. Casing height (above ground)12+ in
� � ATI S `w • a��r
ft
ft 111
fi}
colonies/100 ml. Nitrate 3.53 mg./L. 8�&�0'�Other bac(eria colonies/100 ml.
a /L• Date of sample. Collected by: G.E.G. Ltd
a
(Y/N) ' YES
cnmrmu uttti•_r
� •-�sa� "" "3' "'wrama`Wks',�»#rL�:&..ak�L�;assavd3:-x-3ac.swri':�a +w F e;r:
r"y�oil rating :p d / r ftZ/bdrm) 0�7 System type BED
.�.~��sawcagT��w:,� xi:z.ca,.s'��r�.;t�su��-•�.�a���.��n.. x�: M.�:e=,"
Width 12 ft. Gravel below pipe 0.5 ft
a sorp ion ar'e'a SO ft' Mondormg tube YESDepression over field NO
�,r
Results (Pass)Fall)PASS For 4 bedrooms
�'.t"� s:
afore test ___ in Water added 81 f gal.New depth 8 in,
�� a aYm.�"s ..trQ ��t�:.�fi+-�'w.a'�`S'-�;`-�a.'e.at�s..a:✓^uu.�-. ,s.tv wn r:w
"�Ft-inal fluid depth DRY m .SA; bsorpGon rate > 600+ 9;p d
�� ,+" f":.k.,�'r'-.G'v�ti'a4s�."!.��'.''.J+c�..r ^.e.: e;aa�xu``a"ba "�M�G�;,u^K,.tiN`h. a• "sx>. r ...s :,
�s�,J:� ate_, - , YP If yes, give date 31 2004
..
Department
�
Program
Sp kTY'
995-6650
as
_
Parcel 1D � 051 141=47 ""
Win• Lasea io; ffu-r tt. Casing height (above ground)12+ in
� � ATI S `w • a��r
ft
ft 111
fi}
colonies/100 ml. Nitrate 3.53 mg./L. 8�&�0'�Other bac(eria colonies/100 ml.
a /L• Date of sample. Collected by: G.E.G. Ltd
a
(Y/N) ' YES
cnmrmu uttti•_r
� •-�sa� "" "3' "'wrama`Wks',�»#rL�:&..ak�L�;assavd3:-x-3ac.swri':�a +w F e;r:
r"y�oil rating :p d / r ftZ/bdrm) 0�7 System type BED
.�.~��sawcagT��w:,� xi:z.ca,.s'��r�.;t�su��-•�.�a���.��n.. x�: M.�:e=,"
Width 12 ft. Gravel below pipe 0.5 ft
a sorp ion ar'e'a SO ft' Mondormg tube YESDepression over field NO
�,r
Results (Pass)Fall)PASS For 4 bedrooms
�'.t"� s:
afore test ___ in Water added 81 f gal.New depth 8 in,
�� a aYm.�"s ..trQ ��t�:.�fi+-�'w.a'�`S'-�;`-�a.'e.at�s..a:✓^uu.�-. ,s.tv wn r:w
"�Ft-inal fluid depth DRY m .SA; bsorpGon rate > 600+ 9;p d
�� ,+" f":.k.,�'r'-.G'v�ti'a4s�."!.��'.''.J+c�..r ^.e.: e;aa�xu``a"ba "�M�G�;,u^K,.tiN`h. a• "sx>. r ...s :,
�s�,J:� ate_, - , YP If yes, give date 31 2004
zx ..t.as 44 Min k
Pump b' evet at 42 in High water alarm I`evel a`t' t ,
Cycles tested 3 Meets alarm & circuit requirements? YES
.,u ..., .. ....v ., r .. .�r...K.-�,`..,IL
n ? Frt . �. io—hs s e.
n,nined ough held inspectiohs and
a :
�. . .
• . , , , , . • .... ,
;• he above systems are'in
ape � records that t
a..... ... ..
ith MOA HAA guidelines in effect on this date.
a • . •
.................
'
Je
Gar ss.
ted Nape JEFFREY`A GARNESS
_. _ a /%
11 1
a
Waiver Fee $
�t54
Date of Payment �.
Municipality of Anchorage
• Development Services Department :: * ►`:
Building Safety Division
On -Site Water Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING 2 l (�
Parcell.D. 051-141-47 HAA#_ J� ZA1
1. GENERAL INFORMATION Expiration Date: _ — I (_03
Complete legal description DELUCIA SUBDIVISION; LOT 5
Location (site address or directions) 19722 LACE ROAD + CHUGIAK. AK 99567
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
JOHN WAGNER Day phone
688-4639
2440 EAST TUDOR ROAD SUITE #956 * ANCHORAGE, AK 99507
Day phone
TINA COLE W/ PRUDENTIAL J.W. Day phone 250-2280
3201 C STREET + ANCHORAGE, AK 99503
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 Well
Public Water System
4
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.
TYPE OF WASTEWATER DISPOSAL:
0
Individual On-site
0
❑
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 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 closing for the engineering services provided.
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 further verify that based on the
information obtained from the Municipality of Anchorage fries and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm ALASKA WATER do WASTEWATER CONSULTANTS, INC. Phone
Address 6901 DEBARR ROAD, SUITE 26 ° ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
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, 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. AKWWC, Inc. 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.
5. DSD SIGNATURE
Approved for ! bedrooms.
Date
337-6179
B 3
Disapproved.
Conditional approval for bedrooms, with the filowing stipulations:
t(nC tlltttfl/fA . 0,
Jam: ON-SITE
WASTEWATER
TOGRAM
Attachments: %�cn'•. ••.••
HAA Checklist Manitenance Agreements J��/'�J���O • •1����\,
Septic System Advisory Supplemental Engineer's Reort ���JO )111)1111
Well Flow Advisory Other
By: Original Certificate Date: G — � �- © 3
(Rw.12101)
�I
.. .. .. ... ..............
Je r y
Go ess.:
e
.o
��co
pr tessWON
'
Disapproved.
Conditional approval for bedrooms, with the filowing stipulations:
t(nC tlltttfl/fA . 0,
Jam: ON-SITE
WASTEWATER
TOGRAM
Attachments: %�cn'•. ••.••
HAA Checklist Manitenance Agreements J��/'�J���O • •1����\,
Septic System Advisory Supplemental Engineer's Reort ���JO )111)1111
Well Flow Advisory Other
By: Original Certificate Date: G — � �- © 3
(Rw.12101)
... ... ..... .. _...... ......... ..........
...r....�..........
Municipality of Anchorage
Development Services Department
Building Safety Division < IIA t . r n
Onsite Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196.650 Anchorage. AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description. OELUCIA SUBDIVISION; LOT 5
Parcel ID. 051-141-47
A. WELL'DATA
Wen typeR, � Nom.. If A. S. or C provide PWSID# N/A
Well Log (YM) YES
Date completed 9/24/1992 Sanitary seal (YIN) YES
Wires properly protected (Y/N) YES
Total depot 125 ft. Cased to 40+ ft.
Casing height (above ground) 24+ in.
FROM WELL LOG
AT INSPECTION
Date of test 9/24/1992
5/2/2003
Static water level 48 fL
111 ft.
Well production 7 g.p.m.
5.5 g,p,m,
WATI*R'SAMPLE RESULTS:
'� �
Coliform _� colonies/100 ml. Nitrate U* 1�11 mgJL.
Other bacteria colonies/100 ml.
Arsenio N/A mgJL. Date of sample: 512/2003 Collected by: AKWWC, INC.
B. SEPTICIHOLDING TANK DATA
TankType/Material STEEL/S•T•EP.�
Date installed 8/17/1992
Tank stz9 1250 gal. Number of Compartments3
Cleanouts (YIN) YES
Foundation cleanout (YIN) YMFS Depression over tank (YIN) NO
High water alarm (YIN) YES
Data of pumping 5/2/2003 Pumper
CHUGACH PUMPING
C. ABSORPTION FIELD DATA
Date Installed 6/1^/1992 Soil rating fe> ftlbdrm) 0.77
System type BED
Lenp 55' ft, Width 12 ft. Gravel below pipe 0.5 ft.
Total depth !21=141 Eff. absorption area 660 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 2/2003 Results (Pass/Fall)
PASS For 4bedrooms
Fluid depth in absorption field before test DRY In. Water added 830 gal. New depth 3 in.
Elapsed Time: 23 min. Final fluid depth RY in.
Absorption rate >= 600+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE
KNOWN If yes, give date —
0. LIFT STATION
Date installed 8/17/1992 Size in gallons 1250 Manhole/Access (Y/N) YES
"Pump on" level at 42 in. "Pump off' level at 42 in. High water alarm level at 44 in.
Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
h
Public sewer main N/A Public sewer manhole/cleanout NIA
Sewer /septic service line 25'+ Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 100+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 1008+ Driveway, parking/vehide storage 100+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that / have determined through field inspections and,� �• y*
review of Municipal records that the above systems are in .. • • • .... '
conformance with MOA HAA guidelines in effect on this date.
of omes '•••
Engineer's Printed Na a JEFFREY A GARNESS e —795
Date
�Nd pro t..elOn��
HAA Fee $ .37!5.&v Waiver Fee $
Date of Payment - 03 Date of Payment
Receipt Number Receipt Number
(Rev. 1201) UO
Jun 05 03 02:07p Jack White RCent Services 907-762-7544
p.I
MUNICIPALITY OF ANCHORAGE
• '• DEPARTMENT OF HEALTH & HUMAN SERVICES w
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # 051 — I ¢N " +_7
1. GENERAL INFORMATION
HAA# 7Jvfs�Z
Complete legal description LoT .a �GGLlIc�/� <'e16
Location (site address or directions) 'o / c& den (-'— �RsH„w.s
7G• -//GG suti
Property owner �+ U%1 tn:cT�. Day phone
Mailing address :?V 99 6 7aP,4XAV S:«L 'jS•Z &cl,4- Ale, %Ela OJ
Lending agency
Mailing address •
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well _Al
Community well
Public water
Day phone
Day phone
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: 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 F21
S. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
David R. Dayton P -E. c
Name of Firm 90,310 Dona or S . Phone �C' .'7;Z-
Chugiak, Alaska 99567,
Address
Engineer's signature
6. DHHS SIGNATURE
V Approved -for bedrooms.
Disapproved.
Conditional approval for
Additional Comments
C'
By:
Date
bedrooms, with the following stipulations:
Date ZL
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 indepenuant
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in orderto 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-M (Rev. 1/91) Seek MOA e21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: L.ar S OB'uscuA S`'gParcel I.D.
A. WELL DATA
Well type 20112414L If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) y Date completed �So�' 2`?, i99Z Driller INN TMrZ21 D'Lu„Y+
Total depth ) IiC Cased to 1Z5' Casing heic
Sanitary seal (Y/N) X Wires properly protected (Y/N)
Date of test
Static water level
Well flow
Pump level
FROM WELL LOG
, cA& IcinZ-
NL
1olP"1 g.p.m.
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot los
AT INSPECTION
893
I e> 3 t
S:9 g.p.m.
On adjacent lots 1 oott-
Absorption field on lot8� ; On adjacent lots t tet'
Public sewer main ^�f/I Public sewer manhole/cleanout N/if
Sewer service line L Petroleum tank J
WATER SAMPLE RESULTS:
Coliform o Nitrate �• 8 Other bacteria
Date of sample: ¢/� Collected by:
B. SEPTIC/HOLDING TANK DATA
70
T
rn
rn
Date installed �Ly19 -- Tank size I 7- S-0 Compartments �-
Cleanouts (Y/N) y Foundation cleanout (Y/N) y Depression (Y/N) Al
High water alarm (Y/N) Alarm tested (Y/N) y
Date of pumpingN� sYS� Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 10 57' On adjacent lots Foundation I s - I
To property linelo'+' Absorption field tai Water main/service line LSA
Surface water/drainage I0(p
72-026 (Rev. 7191) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed �L4r Manufacturer
Size in gallons I2 roManhole/Access (Y/N) Y
Vent (Y/N)� "Pump on" level at 2.�0� "Pump off' level at
High water alarm level 3• ZS ' Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
.Well on lot JOS' On adjacent lots 1 oo f' Surface water
D. ABSORPTION FIELD DATA
Date installed 5epf 19`/2- Soil rating 0 11 eed,e System type 1 IUM2144f AnD
Length SS'' Width /Z I Gravel thickness Total depth Z 5.r
Total absorption area Cleanouts present (Y/N) Al
Depression over field (Y/N) /(Iy Date of adequacy test
Results (pass/fail) for bedrooms
f13 Peroxide treatment (past 12 months) (Y/N) A/ If yes, give date
t SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot J ' On adjacent lots I ©e' 'f" Property line 10
To building foundation j `r To existing or abandoned system on lot % 9�
On adjacent lots ( 00 4- Cutbank IJo.uti- Water main/service line
Surface water Z, Driveway, parking/vehicle storage area // ±
-Curtain drain
E. ENGINEER'S CERTIFICATION
1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
David R. Dayton P.E.
20210 Donalar St.
Ch ak, Alaska 99567 ;+ �• ''vvE
Signature Kr:; . ::r -.3 •��tr r
Engineer's Name i; ^ � -• •,.t� .. zs
Date�/3�93 ., ,; ✓h•,
14 a
a ` pRO; ESS�aF
HAA Fee $ Z 7 D D� Waiver Fee: $
Date of Payment '- `!! Date of Payment
Receipt Number '��� �� C72 X Receipt Number
72-026 (Rev. 2/91) Back MOA 21
D. R. DAYTON, P.E., R.L.S.
R�°'xx' 'AR'KI Chugiak, Alaska 99567 (9p7)9VA394 �
20210 Donalar St. 696-2417
April 13, 1993
WELL FLOW TEST
Legal Description: Lot 5, Delucia Subdivision
Date of Test: April 8, 1993
Well Depth: 125'
Static Water Level: 108.3'
Driller: Penn Jersey Drilling
Requirements: 3 bedroom - 450 gallons per.day
Test:
The well was pumped with the existing pump through an outside
hose bib. Volume, time and drawdown were monitored during the pumping.
The well produced 720 gallons in 2 hrs. 5 min. for an average pumping
rate of 5.8 gallons per minute. The maximum drawdown was 4.2:. The
drawdown completely recovered in 2 min. 45 sec.
Results:
The well is currently producing adequately for a 3 bedroom home.
A4
i David Q. Citlom
w ham. 220sC
y �pROFESSl9K;�
Time
APPLIta^NT FILLS OUT UPPER HAI' )ONLY
Property Orwner
Phone
Mailing Address Q , \
l i,„ n too . \ Zip Code ! — 6 - ) J 7
Buyer
Address
. Zip Code
Lending Institution
Inspector
Phone
Address
Zip Code
Field Notes: r' q)A r /„ x,` C-, p n
v
Realty Co. S Agent
� ly^.-
-
Phone
Address
Zip Code
Legal Description .: `� o -t '.
--
j - 1r 1 u l` t C\ Via'Street
Street Location ' (-
2 Cu
Type of Residence
( ) DISAPPROVED
F. Single Family
-•
❑ Multiple Family
No. of Bedrooms_
❑ Other
BY:
Water Supply
Soils Rating
Date Sewer Installed
- '0 Individual
Absorption Area
ATTACH WELL LOG. A well log is required for all wells drilled Since June 1975.
❑ Community ...._ ._ .,
For wells drilled prior to that date, give well depth (attach log If available).
O Public Utility
Sewer Disposal
Q Individual
Year Individual Installed:
❑ Public Utility
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
Da
Date
Date
Date
Inspector
Inspector
-
Inspector
Inspector
Field Notes: r' q)A r /„ x,` C-, p n
v
/,, b �C w ,
ok
� ly^.-
-
/Tv
(_3) APPROVED BEDROOMS
'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL'
ce 2
DATE—
C
BY:
Soils Rating
Date Sewer Installed
Well To
Absorption Area
Well Log Received
Septic Tank Size
Well to Tank
72023 pB1
!"I
rROBERT A. SHAFER
EXCAVATION
,���� WORK CIVIL ENGINEER
A ,� .�!'S 694.2979
August 15, 1982
MUNICIPALITY OF ANCHORAGE
CF^.T C' I'L^1.T'i f%
ENVIR iil".:t,.A.::0 E.-.i:A
Cheryl Langworthy
SR 1 Box 1227
Chugiak, Alaska 99567
Dear Mrs. Langworthy
Reference: Lot 5; DeLucia Subdivision
AUG 17 1982
RECEIVED
A sewer system adequacy test was performed on the system
located on the referenced property as you requested. The
septic tank was pumped and verified to have a capacity of
1000 gallons. The drain field was tested by a continuous
flow of water over a period of 24 hours without any adverse
effect on the system.
It can be concluded from this test that the waste water disposal
system serving the three bedroom residence located on this
property is currently functioning adequately.
However, the system cannot be guaranteed against subsequent
failure.
As requested by the Municipality the system was excavated to
determine the type of system and its proximity to Peter's
Creek. The attached sketch shows the approximate location
of the system with respect to the creek, the residential
well and dwelling located on this property. It has been
determined that the system was installed in accordance with
ordinance No. 28-68, Section 9-71, Paragraph 7 of table 5
and is considered to be adequate -at this time.
If we may be of further assistance, please do not hesitate
to call.
Si
cc: Municipality of Anchorage
Department of Health and Environmental Protection
SRS 196X EAGLE RIVER, ALASKA