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DAWN VILLAGE BLK 1 LT 6
Dawn V1*11age Block 1 Lot 6 #014-061-51 , p Ir V t N ON i ~ co sy rt j {[C7 > iN < b ti } Oma to t LO� TI r ti rj Z M M M M M M M R! M M M M M Lyy7 'A 'A '�Ajj '�yy S��ti// 'Syy�7yy7 '.ti LO M e ft< ;G � r V M Z s r c .'.yy9 yy�yy /Z/� Yl O • iNJ i it ;LD lJl O iN ^l It••� jO H H H H H H H H H H H H O O O O O O O O O O C O ? '• j j i I i i i i i i PI ' 1:7 isv � i G i >J r• i� i r• to :� P i ri 0 ft c' < v p N 7J Sb '.9 ?�.o 'A L9 � 70 '.ti 7x� •��t E i i iii irrk� i ° iL� i�j h� H � � � R•�� H H k� N y H � H ;•3 , p Ir V t N ON i ~ co sy rt j {[C7 > iN < IR r• N co 13 b ti } Oma to IR r• N co 13 ti } Oma t LO� TI r ti rj Z . Z 'a � o e ft< ;G � r V M Z s r c /Z/� Yl O • • _ f' r-1 a VJ I 1-- z .: Fl IL_ a -r'-e F- f:i t -A 1_= F . ` e F: 1=f 1,j E=— DEPARTMENT DEPARTMENT OF HEALTH AND EtVIROIJMENTAL PROTECTION 25.16 E. TUDOR, RD. , ANCHORAGE, AK. E49507 276-2221 WELL_ F=P EF_r-1 I T PERMIT 1.40. C 77011 ) APPLICANT PFTFPSnt-4 CONgTPIirTTON SRA BOX 1718X 344-638 LOCATION TESHCAR ST LEGAL L6 81 DAWN VILLAGE LOT SIZE 100+0 SQUAT?E FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQIIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 3:0 DAY OF THE WELL COMPLETION. SPECIFICATIOI'-JS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F•Ef=:r•y I T' 'tisHL_ I r> F C -:, F_ 0r4E YEFaF,� F"F:0rl I :E;1 1E I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM it•J ACCORDANCE WITH THE CODES. SIGNED: 1) L-r ---------------- APPL CANT PETERSOJ CONSTRUCTION ISSUED EY--- —------- :� ----DATE--) -[J�27--- (meas) 1319.52 r 7 i o z d tc 20"E 32986 \ QO 120 9188 1 a = / N.__ 12 R °. 9 0SOF4^ ,-1t 105:f T1C' {W 15,698 60" 0 l Icp70 So FT "o nn/ s,0 --t-68 00-- -436a_56%4 ®��D O $ oO 8 .O EAST ^' ?` 10,228 S0. F7 i797q-- -- -- ��— m T ^' 07 Q •�n e o NT90 IO'UTILITY 13481 3u9� I EASEMENT Y 7 t0 705 50 NF TCS 0 w, 25^ 25 j 6,994 SO FT. j DV N N 89045 36•'E Na " nl i258p PC N 152.13 4, �N SEE NOTE C NO 4 6 5 7.730 So FT S-3203 3 10.290 57 FT w o1 6 t 416FND 3" EiLEANING S W'PK NAIL AT0 POSITION, 6 I �I I 10' UTILITY EASEt.1ENT I S-3203 OV PT j!!il.i S-3203 I Co 0) ti 0 M E 1 ` 25 p� �I PC 1 _C 3203 I d GROUND E RI '' I 1 1 1'54 69 � ALUM. CAP MON I 0 ♦.Z" 1 :; I SET03'ABOVE USK rr 8,753 SV F T Q I = 2 111ccc��� GROUN_ (n I DArN EAST £ J I o $ 9,282 SO FT USK SEE NAIL = : , EAST ACE LOT' VILLAGE 12505 (n __ _ DAAN INS�T I W iso rz 7 W h O VILLAGE A m i EYf COR 8 ) g �I� v I SUB MUSKEG MAN')R O I SE ODR SUB S-3234 111 8,416 SOFT. 25 '025 i 9,972 Sa FT '� LOT 18 Of t07q l— 3L42 z 1142 S-]23. '-"IMDo-�—IL © ® —19478-90° 325 �25 M r NEST 32976 rn . o--- - — ♦ _ _ 15000 —�. 1n ' rn (Basis of Beannp) BlM K'EST* 17976 �._6y - rn M I31908(meas.) RASPBERRY ROAD 125 125 LEGEND _ - >i n I10'UTILITY EASE. N 89 39'OJ �E- in N _ � ,Y 141.65_____ o N 10 UTIL ITr EASE ,w'':Liw Zvi 8,250 SOFT O g �I?v 1 N 89052'24 "E P 1 9,491 $O FT �, _ w— n N 1r -- ----- 42 73 2 N e9017'17"E O z o ^ oiDo �N 4W. 8,783 SO FTT :S- ~ S89032'14'E NR ti , 8,994 SO FT ,. N m I '1110 1516.03 EAST f�� P _�--------, 9,267 SO FT ALUM C{W MON SET 02 ABOY i 125 10 :'`� : I l t 416FND 3" EiLEANING S W'PK NAIL AT0 POSITION, 6 I �I I 10' UTILITY EASEt.1ENT I S-3203 OV PT j!!il.i S-3203 I Co 0) ti 0 M E 1 ` 25 p� �I PC 1 _C 3203 I d GROUND E RI '' I 1 1 1'54 69 � ALUM. CAP MON I 0 ♦.Z" 1 :; I SET03'ABOVE USK rr 8,753 SV F T Q I = 2 111ccc��� GROUN_ (n I DArN EAST £ J I o $ 9,282 SO FT USK SEE NAIL = : , EAST ACE LOT' VILLAGE 12505 (n __ _ DAAN INS�T I W iso rz 7 W h O VILLAGE A m i EYf COR 8 ) g �I� v I SUB MUSKEG MAN')R O I SE ODR SUB S-3234 111 8,416 SOFT. 25 '025 i 9,972 Sa FT '� LOT 18 Of t07q l— 3L42 z 1142 S-]23. '-"IMDo-�—IL © ® —19478-90° 325 �25 M r NEST 32976 rn . o--- - — ♦ _ _ 15000 —�. 1n ' rn (Basis of Beannp) BlM K'EST* 17976 �._6y - rn M I31908(meas.) RASPBERRY ROAD 125 125 LEGEND MUNICIPALITY OF ANCHORAGE. DEPARTME. `OF HEALTH AND ENVIRONMEN, _ PROTECTION 825--'L Street, Anchorage, Alaska 99501 279-2511, ext. 224 or 225 #1: Time 10:30 a.m. #2: Time Date 5-27-77 Friday Date Date Received: May 26, 1977 #3: Time Date Insp Buchholz Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska Mutual Savings Bank Mailing Address: Post Office Box 1120 99510 Phone: 274-3561 2. Property Owner: Pederson Construction Mailing Address: Star Route A Box 1718X 99507 Phone: 344-8638 3. Legal Description: Lot 6 Block 1 Dawn Village Subdivision 4: Single Family Residence: (I Number of Bedrooms: 3 Multiple Family Residence: ( ) Number of Bedrooms: 5. Well System: Individual Well (yt Community/Public System ( ) Permit # ! iJ C Depth Well85 1 9 s Well Logon File ftx) 1,1 Construction / Bacterial Analysis d r4r 6. Sewage Disposal System: On-site System.( ) Permit # Septic Tank Size Absorption Area Installed Public Utility 4cy6 Installer Manufacturer Soils Rate 7. Distances: Well to Septic Tank to Sewer Line to Nearest Lot Line Nearest Lot line Material to Absorption Area Absorption Area MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECT4I,EI�Aur( 2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 Cs ,,.:rvo,!^, T1r`Oj'r.11, REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES { v 1. Type of Inspection 2. Property Owner. x CMRO VA 2 6 1977 FHA - (3rL2 XA s� Mailing Address: Day S 3. Name of Buyer: Mailing Address: Day Phone: 4. Name of Lending Institution:t!.CXl✓ Mailing Address: d- %E"_O' O Phone: 5. Name of Realtor or Agent: Mailing Address: '/� Phone: ' n 6. Legal Description: �j � /, LAA) Z ZO U Location• /�zF. 2aelcl C�Q�� 07 9 ring (0 7. Type of Facility to be Inspected:—No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well / 9. Sewage Disposal System Type of System: Public Utility X individual (on-site) If Individual, date of installation 72.003(3/76) i Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 6 Block 1 Dawn Village Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Approved:A � Date: 46L ;7 Disapproved: Date: Department Worksheet: Municipality of Anchorage On -Site Water & Wastewater Program Sil1t l�'1a (907)343-7904 �i✓ rn IquSHi , yrs CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 014-061-51 Expiration Date: 1. GENERAL INFORMATION Complete legal description DAWN VILLAGE S/D; BLOCK 1, LOT 6 Location (site address) 6610 TESHLAR DRIVE, ANCHORAGE, AK, 99507 Current Property owner(s) JEREMY HINSHAW Day phone Mailing address Real Estate Agent 6610 TESHLAR DRIVE, ANCHORAGE AK 99507 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Day phone 351-1368 TYPE OF WASTEWATER DISPOSAL: Individual Well N Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer 0 Received y: -----7 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 7N1011 Date of Payment t�113/ Receipt Number da2/a6 COSA # lascislat5n Date Waiver Fee $ _ Date of Payment Receipt Number. Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, t verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the onsite water supply and/or wastewater disposal system is (are) safe, functional and adequate_ for the number of bedrooms and type of structure indicated herein. ! 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 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers 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 6 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 orparty is not authorized, nor will it confer any legal right whatsoever. 6. DSDr SIGNATURE V System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for 0 bedrooms. 337-6179 Date LIZ I ? bedrooms, with the following stipulations: ON-SITE WATER AND t�rnSTEWATER Original Certificate Date: The M n cipa(hy oiAAnceor-age Develop, emt 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. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory (Rev. 1110 CI' Nitrate Advisory Arsenic Advisory Other D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at we er alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots N/A Absorption field on lot N/A On adjacent lots N/A Public sewer main *33' Sewer /septic service line aIE k*25'+ Pb Animal containment area 50'+ Public sewer manhole/cleanout **50'+ Holding tank Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main Wells on adjacent lots Property Absorption Water service line Surface water SEPARATION DISTANCE FROM ABSORPTION Property line TO: Water main PUBLIC SEWER Water service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS *PER WAIVER #WR050057. **PER CODE AT TIME OF INSTALLATION. ***PER TED MOORE DRAWING DATED JULY 2005 (IN MOA RECORDS). G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 01Z (Rev. 11/05) If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: DAWN VILLAGE S/D; BLOCK 1, LOT 6 Parcel ID: 014-061-51 A. WELL DATA *ASSUMED BASED UPON SURROUNDING WELL LOGS. SEE ATTACHED. Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 4/25/1977 Sanitary seal (YIN) YES Wires properly protected (YIN) YES Total depth 95 ft. Cased to *40'+ ft. Casing height (above ground) 12+ in. FROM WELL LOG Date of test 4/25/1977 Static water level Za ft. Well production 20 g.p.m. WATER SAMPLE RESULTS: Coliform U colonies/100 ml. Arsenic ` )-ug./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size gal. Number of Compartments Foundation cleanout (YIN)— Depression over tank (YIN) _ AT INSPECTION 6/5/2013 17 ft. 7.03+ g,p,m, Nitrate Q•)t°� mg.IL. Collected by: Date of sample: 6/5/2013 PUBLIC SEWER Date installed Date of pumping C. ABSORPTION FIELD DATA Date installed Length ft. Total depth ft. Eff. Date of adequacy test Pumper Soil rating (g.p.d./ft2or ft2/bdr Width ft. Cleanouts(YIN) High water alarm ft Monitoring tube Results (Pass/Fail) Fluid depth in absor n field before test _ in. Elapsed T' . —min. Final fluid depth y rejuvenation treatment (past 12 mo.) (YIN & type) RUN System type Gravel below pipe ft. Depression over field Water added _gal. in. Absorption rate >_ For bedrooms New depth _in. If yes, give date ..• T�syiiyz� ��, ASBUILT �- S.MJARD & I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE.,, FOLLOWING DESCRIBED PROPERTY: GoT6f: / DATE: AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE.- THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS zoo/ WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER 140 CIRCUMSTANCES SHOULD FS` ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN: yy// %14 OF A Ar Deane Melk �. LS -5y 'fie+}KF il' NP -082 -r- eYtacWjJ J. CA,y�., i Municipality of Anchorage • --) Development Services Department �•''� Building Safety Division ; On -Site Water and 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 Parcel I.D. Ory — 06f - Sr HAA # rj �7j3� Expiration Date: 1. GENERAL INFORMATION Complete legal description L.uf d' Black I Octwr, L4// ye S/6 Location (site address or directions) 4�re'/U _�rMlar` l)rr� Current Property owner(s)�r Gs ka/ lcoJ�/ Day phone SZ9 -Bs-Y7 Mailing address <610 TerAlar- 0 rt�e . /4r clion5 P A-tc 9gSa7 Lending agency flvf4er1&1-c "cp -t. 1rryA^oya/ Day phone 7,<Z.—.SB9c, Mailing address 3 201 : „ S1 �,)cAo��r A-�c 79S,0_? H Real Estate Agent p tom, 70e Cunn; Sell `l Frrr�tDay ph no a 7Zr- Y99S-cell Mailing Address Ra.r3ox 2l -Zssh A�+c�gk 9asZy Unless otherwise requested, HAA will be held by DSD for pickup. Pl tstre call /?rexI16. "4f y.7& Cunw,,9 727-999,r ts�hin &fA r�uuJ :o -rock -'p 2. NUMBER OF BEDROOMS: 3 iQ 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer 12 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 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 sample results less than 30 days old. (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. 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. NameofFirm F/affon T«hn�ia/ SvcJ Phone 35S-�Sss Address 1NS.3o Cctia SSf !t^cho�Q�c !w 94s16 Engineer's Printed Name %ham G, -e F Date J 'L8 Z'=s - 5. DSD SIGNATURE Vf. Approved for -'23_ bedrooms. Disapproved. Conditional approval for bedrooms, with the following •,v � of r ID : •. (- *�' 49TH •.. ••H•ur•N•NNr� •r THEODCRE F. MOORE � aP -•. CF - 3549 �� h?; r' Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: j L rj- �(�� Q.. Original Certificate Date: (Rb. Iwo) i Municipality of Anchorage ' Development Services Department Building Safety Division on -She Water & Wastewater Program 470D South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak. us (907) 343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Ae f 6 R /Gt le 1. D ewn (/, lla4[ s/a Parcel ID: O! b - 06/ A. WELL DATA Well type fir` If A, B, or C provide PWSID # u• A. Well Log (YM) Y Data completed yLT,ty77 Sanitary seat (Y/N) Y Wires properly protected (Y/N) Y Total depth f R Cased to _PSR Casing height (above ground) 12 B n FROM WELL LOG AT INSPECTION Date of test V / =S / 17 7 7 /5- /os Static water level 2 B R 17 R Well production 20 g.p.m. S. P r 9— p.m-WATER SAMPLE RESULTS: Coliform O oolontes/100 ml. Nitrate <a, f mg./l. Other bacteria _ 0 colonies/100 ml. Arsenic: mg.A. Date of sample: /os Collected by: Fttom Teti Svc B. SEPTICIHOLDING TANK DATA N. 4. ( A P�cl. be f ecs.e-) Tank Type/Material Date installed Tank size gal. Number of Compartments _ Cieanouts (Y/N) Foundation cleanout (YIN) _ Depression over tank (Y/N) _ High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA N. A. Date installed Soil rating (g.p.d.W or felbdrm) _ System_type Length ft Width ft. Gravel below pipe ft. Total depth R Eff. absorption area fe Monitoring tube _ Depression over field Date of adequacy best , , - Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. UFT STATION /J • .+- Date installed Size in gallons 'Pump on" level at _ In. "Pump off" level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot )J - A: Absorption field on lot N• A• *Public sewer main ^ 31 Manhole/Access (Y/N) High water alarm level at Meets alarm 6 circuit requirements? On adjacent lots N. k Own adjacent lots #J- A. Public sewer manhole/cleanout x 8S in. Sewer /septic service line 7 ZS' ' Holding tank P. *, ' ' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: AJ - 4. ( Aw wk P. Ill c Sewe -) Building foundation Water main Property line Adsorption Water service line Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: M. A. ( A wc" tq P a /cc Sew a -) Property line Building foundation Water main Water Service line Surface water Curtain drain Wells on adjacent lots F. COMMENTS o6c4,•o( ix )rt !n's G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineers Printed Name *17 '&"y F. H4;V'r Date Tu 1 r8� ZCios' HAA Fee $ H3U �0 Date of Payment 7 / l b/ 01- Receipt SReceipt Number / D'4 Kq (Rev. 12101) Driveway, parldngrvehide storage QTS+ d {/ TH.CDCR: F. ACORg; JP CE -3589 .•sA� r' • , Thar , r .tr Waiver Fee $ 114'0 Date of Payment Receipt Number 7705ZI SCS Ref.# 1053976002 Client Name Flattop Technical Srv. Project Name/# Various Client Sample ID Lot 6, Block 1, Dawn Village Matrix Drinking Water PWSID 0 Sample Remarks: All Dates/Times are Alaska Standard Time Printed Date/rlme 07/122005 1229 Collected Date/time 07/052005 12:55 Received Date/rime 07/052005 13:12 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Waters Department Nitrate -N 0.100 U 0.100 mg/L EPA 300.0 Microbiology Laboratory Total Coliform 0 coVIOOmL SN1209222B B (<-10) A (<-I) 07/07/05 JEM 07/05/05 TLF ml y SAN 9 S 0002'253E 70.24' 1A3.36.3 A .I.I. pI 4 E r L= 36.1 9 S O°04'31.E 1 "E 1:. _ - _ 3AIHO HV-1HS31 I� m N Ir I� Irl M I11 r I I I 1 1 1 1 I o : •' m ; � • ;9T DO P �� ,k oD A` Z 0 O 0 Z0 Ea W -D° -9 Ln1J > lT I < i N p 0 Z M 0 w M m R Z o C < I 4 E r L= 36.1 9 S O°04'31.E 1 "E 1:. _ - _ 3AIHO HV-1HS31 I� m N Ir I� Irl M I11 r I I I 1 1 1 1 I FLATTOP TECHNICAL SERVICES- CRTL 6 ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION i ANALYSIS THEODORE F. MOORE,P.E. 14530 ECHO ST. Pit: (907) 345.1355 July 18, 2005 ANCHORAGE, ALASKA 99516 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99516 Dear Sirs: By means of this letter we arc requesting issuance of a waiver allowing the private well serving the residence on Lot 6, Block 1, Dawn Village SID, located at 6610 Teshlar Drive to be approved in its present location approximately 33 feet from the public sewer main serving this subdivision. A site plan, well driller's log(s), public sewer line as -built, water sample test results, property as -built survey, and HAA application are enclosed in addition to this justification in support of granting.the requested waiver. The public sewer line serving this lot was installed in October of 1976, prior to construction of homes in this subdivision, and according to information on the as -built drawing the portion of the line fronting the east boundary of Lot 6 is 8 -inch diameter Class 2400 AC Pipe. According to the driller's log the well serving this lot was drilled in April of 1977 and has a total depth of 95 -feet. While the aquifer serving this well wa3 encountered at a depth of 92 feet the static water level was reported as being 28 feet, indicating that it is a confined aquifer. Although the specific required distance was not called out on the permit, at the time the well was drilled the required separation distance between a private well and a public sewer or manhole was 50 feet. The 85 -foot separation between the well and the closest sewer manhole was legal at the time of installation. On July 3, 2005 1 conducted an adequacy test of the well serving this lot. At the start of my test the static water level stood at 37 feet below the top of the 2 -foot casing, or 35 -feet below ground level. Steady pumping of 465 gallon of water from the well at the maximum pump output of 5.9 gpm caused the water level in the casing to be drawn down to a depth of 54 feet, but no further. Based on this test data I determined that the total yield of the well is in excess of 5.9 gpm, which is more than adequate for a single family residence. Water samples collected from the well on July 3, 2005 were satisfactory showing 0 coliform or other bacteria per 100 ml., and less than 0.1 mg/1 of nitrate -N. - The following is a breakdown of how waiver analysis points could be assigned in accordance with DEC's 1985 "Separation Distance Waiver Guidelines for SCRO". Category Points Distance to Water Table (92' to aquifer —10' sewer depth = 82') 5.9 Soil sorption (primarily sand with small amounts of clay) 2.5 Permeability (primarily fine sand) 1.5 Water table gradient (level) 2.9 Horizontal senaration (33') 0.8 Total 13.6 Despite the relatively low point total calculated above, several other factors should be considered which help justify the granting of the requested waiver. First, if the same well had been drilled at the minimum required distance of 50 feet the point total would be only 0.2 points higher, yet there would be no issue at all about the well separation being approved. Secondly, the requested waiver is to a sewer line, not to a manhole, so the potential for leakage is significantly less. Even today a well can be located as close as 25 feet from a private sewer service line without any concern as to contamination requiring a waiver. Third, the well has now been in service for over 28 years at this proximity to the sewer line, yet the water test results show 0 coliform or other bacteria and non-detectable nitrates. Because no pollution from the sewer line has yet occurred it is relatively safe to conclude that contamination in the future is also unlikely. Finally, it should be noted that virtually all of the private wells in this block were drilled too close to the sewer and waivers have already been issued for most of them, including at least one well located a comparable distance from an actual sewer manhole. Please feel free to give me a call if you have any questions on this analysis. Sincerely, Ted Moore, P.E. cc: Judy Oskolkoff, 6610 Teshlar Drive _ TESHLAR DRIVE — — — — — — — — — — — — — — — — — — — — — — — — — — — AWWU SEWER (8" DIAMETER A.C. & OuS LOT 6, BLOCK 1 R 50' 3 DAWN VILLAGE SID ^ WELL I LL I I LOT 5,BLOCK 1 I Lu ' O OUS -------- 1 2 I' W WELL R 50' I ; ~ I , I , 1. •I --------- I I •�" F q *' 49m� *1 ......................... 1�Q % THEODORE F. MOORE CE -3589 _ TESHLAR DRIVE —---------------- --- ------- AWWU SEWER (8" DIAMETER A.C. & ' C,Q 1 1 1 LOT 6,BLOCK 1 t 1• DAWN VILLAGE SID LOT 5, BLOCK 1 1 WELL R 50' , i ��G �::4L,q i��' ........................ �..�.. E-.7ka.-zi. • THEODOREF.MOORE i �� �:• CE -3589 �'°� •.,T/off;.•' �i der_ •••• .�•� LOT 6, BLOCK 1, DAWN VILLAGE SID WELL -SEWER WAIVER SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH SWEET 13530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 1 JULY, 2005 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. , I --------- U� 1 LOT 6, BLOCK 1, DAWN VILLAGE SID WELL -SEWER WAIVER SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH SWEET 13530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 1 JULY, 2005 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. i 1 1 I 1 I � V v i �nn 1 c � 1� w I^ k per• i 0 H O Y � W 1� f� a n A n Q ' t A O C Z Z iY A. - V ~ Q •: , LL q f t ca PI l � F' f'1 r) C. v > �nn 1 c � 1� w I^ k per• i H O Y GGtl yC 1� f� a n A n v Q En A O r) C. v > �nn 1 c � 1� w I^ k per• i � O Y GGtl yC 1� f� a n p� n n A A C {n (1 �nn 1 �yC � 1� I^ k per• i � O (1 n i. W W fr fr {O LIS eRO ►C N �k �nn �yC � k per• ply yC y�• p�� p� p� F' R r'1 I•� N P'1 > Nv r r aS > N n i. W W fr fr {O LIS eRO ►C N �k of Anchorage P.O. Ik)x IMN) - Anchomge, Alaska W519.615M - Telephone 0117) 313-K'N)l " Fm (W7) 33. -W(N) ` 4700 nmgaw S(rcct - Anchomgc, Alaska !M07 uim.munl.org Mayor Nark Begich IJuilding Safety Dii3sion 7/28/2005 Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Dawn Village Subdivision, Block 1, Lot 6 Waiver Request #WR050057 Parccl ID 4014-061-51 IIAA# IIA050335 Dear Mr. Moore: Your request for a waiver of the required 50 feet horizontal separation from the public sewer trunk line to the private well has been approved. The approved separation distance is 33.0 feet. This waiver approval applies to the existing public sewer trunk line to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Julie Makela, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department • rr Building Salley Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci. anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR050057 PID#: 014-061.51 HAM HA050335 Date Received: 7118105 Legal Description: Dawn Village Subdivision. Block 1. Lot 6 Engineer. Flattop Technical Services fiL5�i�1�T>E , Waiver Requested: 33 feet from private well to public sewer truck line Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Permit#: Points: .5- Total: 5 Total• L 3. LP ............. ............................ message .... gameness.... noses@@ ... ones@ Waiver is Granted: _11,10, Waiver is not Granted. List Conditions or Reasons for above: Date: .....0sesse Rec#: 71054 t..gName of Reviewer ............................. ....... ......wes...... massages....... Amount: $1.150 Date Paid:_jd" Dawn Village Subdivision, Block 1, Lot 6 Parcel ID: 014-061-51 Waiver for 33 feet from water well on subject property to existing public sewer truck line Issued July 28, 2005 General 1. The public sewer truck line was installed in October of 1976, prior to construction of homes in this subdivision. The portion of the line fronting the east boundary is constructed of 8 -inch diameter Class 2400 AC pipe. 2. The private well was installed on April 25, 1977. Total coliform, other bacteria and nitrates were not detected In the July 5, 2005 well sample. 3. The well is located 85 feet from the public sewer manhole, which met the seperation distance requirement at that time. ADEC Criteria Points Water Table 5.9 Well casing depth 92 feet Assumed depth of sewer main -10 feet 82 feet x=42/45+5.0 x=5.9 Soil Sorotion 2,5 Soil descriptions from well log for subject property Sand & gravel w/ clay 10 - 92 feet Permeability 1.5 Soil descriptions from well log for subject property Sand & gravel w/ clay 10 - 92 feet Water Table Gradient 2,9 Assume 0% slope Horizontal Separation 0,8 65 feet between well on subject property and sewer main x/0.3=8/25 x=0.096+0.7=0.796 Total Points 13.6 Total points do not meet the minimum point requirements, however, waiver granted based upon non-detectable water sample results. V 47!26!2uu5.,IU:36 FAX Buz 313 7997 uS SITE ... _. .. .iQoul ., Municipality of Anchorage Development Services Department v Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. ° P.O. Box 196650 Anchorage. AK 9951M650 • • `" www.muni.orglonstte To Tu (1 e, ; (907) 943.7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET r--fVM mss: plottop Technical Services Legal description: Down Village Subdivision. Block 1. Lot 6 The attached paperwork has been reviewed and Is being returned for the following reasons: ❑ Original signature or stamp missing on _ ❑ calculation error in design. ❑ Additional soils Information needed. ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. _ ❑ Incomplete; missing _ ❑ Incomplete; missing _ ❑ Additional adequacy test information needed. _ ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. _ ❑ Locations of all soils, percolation and water monitoring tests not shown. _ ❑ Proposed system too deep for soils information submitted. ❑ Well log required. _ ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ® Other. Please provide additional information for waiver request. Name of reviewer: julie Makela P.E. Date: 7/22/2005 3 Y3.7906' Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK J.. 1e- k f o oc i++t jG 7 ola Aro<r c.c< ctncl 7'ht or 1"41` Au.rcoh Se4.e< Se.cr�� Ione i -o lAe draw:ny ry ycwr rv+?aorl, 7-1, t ai no m.n�n u, hr cC V .+n rlY Ss/rar-oeAten �iefw.<n Ir'h< wt// anp/ 1t+C 1/r✓, f -h4 4-,;.,r ,,F ;.v/z.l/afti, Ji tr ii- %r �� rn.... /�.<oI r� rise L...«rt.'er Municipality of Anchorage Development Services Department • �.e Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Flattop Technical Services Legal description: Down Village Subdivision, Block 1. Lot 6 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on _ ❑ calculation error in design. _ ❑ Additional soils information needed. ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. _ ❑ Topographic information missing or inadequate. _ ® Incomplete; missing location of private sewer service line ❑ Incomplete; missing _ ❑ Additional adequacy test information needed. _ ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ❑ Other. _ Name of reviewer: Julie Makela, P. E. Date: 7/27/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK