HomeMy WebLinkAboutPREUSS #2 BLK 2 LT 16 · ** MUNICIPALITY OFANCHORAGE .
DEPARTMENT OF HEALTH & HUMAN SERWCES..
On-Site Services TrensmitMI Sheet
The attached paperwork has been reviewed and is being returned
for the following reason(s):
Discrepancy in legal description and/or owner name.
Discrepancy in number of bedrooms.
Signature and/or stamp missing on ·
Show measured distances to sewers/wells, curtain drains
and streams within 200 feet of proposed system.
Replacement disposal site not shown and/or tested.
Calculation error in design.
Show locations of all soils, percolation or water table
tests.
Proposed system too deep for soil'test submitted.
Topographic information missing or inadequate.
__Narrative missing or inadequate.
Additional soil/perc test needed.
Sand filter requirements not satisfied.
Water monitoring results missing or inadequate because
Incomplete; missing
__Well log required.
__ Water sample unacceptable because
Other
Please supply the necessary information and re-submit your
request. Your cooperation is appreci, ated ....
.'.': .Revie~{er~ .' i'Date--~~~
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. .. MUN~ClPAL,T¥ OF ANCHORAGE
, DEPARTMENT OF HEALTH & ENVIRONMENTAL PRoTEcTION
~ '* ENVIRONMENTAL ENGINEERING DIVISION
N;i 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
O - TE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
MAI LING/C~DDRESS
LEGAL DE~IP~ON
~ Manufactu~ ~,{ DISTANCE TO: IWetllBO/~{e%~ ~'r Absorption .rea/~ ~ Mate~l./Dwelling8 t~ b~ CS~ PERMIT NOT~ O No. of com~en~
Liq. c~n gallons IF HOME,DE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Nell Dwelling PERMIT NO.
O Z ~ Manufacturer Material Liquid capacity in gallons
Q Well --I Foundation / Nearest lot line / PERMIT
~ ~ ~ No. of lines Length of ~ach line Total length of lines Trench~i~t' ~ Distance ~t~en lines
~ ~ ~ Top of tile to~inish grade~ / Material ath tile , Total effective absorption area
O ~ inches
Length Width Depth PERMIT NO.
~ Type of crib Crib diameter Crib depth Total effective absorption area
m Nell Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
/ !
PIPE ~ATERIALS
SOl L ~EST'RATING g~ I ~__ Jl
INST~LLER
72-0 ~ev. 3178)
, DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 'L' STREET, ANCHORAGE, AK. 99501
264-4?20
DON ZlMMERMAN JR
WREN ST
L~6 B2 PRUESS S?D
PERMIT NO. ( 79032~ )
?PLICRNT
LOCRTION
'LEGAL
ON--S · TE SE~ER PFR~I ! T
BOX 596 EAOLE RIVER 6941~~
LOT SIZE 21780 SQt]~RE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS:
MAXIMUM NUMBER OF BEDROOMS = ~
TRENCH
SOIL RATING (SQ FT?BR)= ~
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ~
DEPTH~ --~ LFNGTI~:= -~ GRAVEL DEPTH= A
THE LENGTH DIMENSION I~ THE LENGTH (IN FEET) OF THE TRENCH OR DR~INFIELD.
THE DEPTH OF 8 TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
8ND THE BOTTOM OF THE EXCAVATION (IN FEET).
RFCIU I RFD SFPT I C TA~'4K S I ZE= ::1.000 ISRLLON$
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTRLLRTION INSPECTIONS OF ANY WELLS RDJRCENT TO THIS PROPERT~ AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TWO
BACKFILLING OF RNV SVSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSRL SYSTEM IS
100 FEET FOR R PRIVATE WELL; OR
150 TO ~00 FEET FROM R PUBLIC WELL DEPENDING UPON THE T~PE OF PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURRED TO THE DEPRRTMENT WITHIN ~0 DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS RND CONSTRUCTION DIRGRRMS ARE
RYRILRBLE TO INSURE PROPER INSTALLATION.
PERM I T E;4P I RES D~:-¢FMBER 3~ . "~ 9?9
I CERTIFY THAT
l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
~: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
SIGNED: ~- ~~
RPPLICRNT D~ ZIMMERMAN JR
V3. ~
June ]8, 1979 R&M No. 951201
Don Zimmerman, Jr.
P.O. Box 396
Eagle River, Alaska 99557
Subject: Soil Investigation for Sanitary Sewer System, Lot
Prness Subdivision, Eagle River, Alaska.
Dear Mr. Zimmerman :
16, Block 2,
At your request of June 15, 1979, we conducted a subsurface soils investi-
gation at the proposed location of the sanitary sewer system on the subject
lot. The investigation complied with those procedures required by the
Municipality of Anchorage Department of Health and Environmental Protection.
This investigation, which was accomplished on June 18, 1979, consisted of a
test hole excavated to a depth of l&.5 feet below the existing ground sur-
face. The test hole was sited according to your instructions and its loca-
tion is shown in attached Drawing A-01. Excavation was accomplished with a
backhoe and all material excavated .was continuously monitored by an
experienced engineering geologist.
The topography at the excavation site is generally horizontal. At the time of
the investigation the site had been stripped of original Ve~_~on. The top
of the test hole was located at original ground surface.
The soils encountered in the excavation are shown in the test hole log in
Drawing A-01. This log displays specific conditions encountered at the test
location. However, subsurface conditions may vary in other parts of the lot
without any apparent surficial evidence of the change. Groundwater was not
encountered and bedrock was not encountered. At the time the hole was
excavated seasonal frost was not present and permafrost was not encountered.
Based on the visual classification of the soil and the requirements set forth
by the Huncipality of Anchorage, a percolation test was not necessary within
the test hole on the subject lot.
We appreciated this opportunity to be of service to you. Please contact us
if you have any questions concerning this letter or if we can be of addi-
tional service.
Very truly yours,
R&MCONSULTANTS, INC.
Ernest R. Rahaim
Staff Geologist
ERR:GS/rm/ATSI-N
ANCHORAGE
BORING NUMBERTP-1 Date Completed: 6-18-79
SOIL DESCRIPTION
SANDY GRAVEL W/TRACE SILT, GP
0' - 14' Numerous Cobbles
14t,
LOCATION SKETCH
No Scole
8o,T
10'
NOTE: DISTANCES SHOWN ARE APPROXIMATE AND HAVE
NOT BEEN MEASURED BY SURVEYING METHODS.
EXPLANATION
~' ~ ORGANIC MATERIAL
Little Visible Ice OqO' Vx
5,.."~ ~Ss 7Z 5Z1% 85.9~cf
~ SAMPL~
BEDROCK
~ f~OZ£N GROUNO W~..-WH/LF ORIUJN~
TYPICAL SOILS LOG ~
A.a-AFTF;~ BORING
SI 14~SPUT SPOON With 140A~ HAMMFR
SZ 1.4~ SPAIT SPOON WITH $4D /.~. NAMMFB
Sh ~$~ SPLIT St:~ON WITH $40 ~D. NAMM~B
Sp S. 5" SPLIT SPOON, PUSN£O
A AUGEIq SAMPLF
SAMPLER TYPE SYMBOLS ~
-~ ORSANIC ~ GRAVF~
MATFB/AL
~ SAND
SOIL SYMBOLS
IDWN. ERR
CKD.
DA'rE.6-18-79
SCALE:. N/A
"_~~ · Lot 16, Block 2 £S. '
CONSULTANTS. INC. Pruess Subdivision GRID. NW 56
Eagle River, Alaska PR0aNa 951201
SOILS LOG DWG. Na A-01
July 6, 1979 R&M No. 951201
Don Zimmerman, Jr.
P.O. Box 396
Eagle River, Alaska
99557
Re: Soil Investigation for Sanitary Sewer System, Lot 16, Block 2, Pruess
Subdivision, Eagle River, Alaska.
Dear Mr. Zimmerman:
This letter is submitted as a supplement to our report on the subject
property dated June 27, 1979.
On the basis of a site investigation this date, the following additional
information is provided per the request of the Municipality of Anchorage,
Department of Sanitation.
1. No groundwater was noted in the trench excavation to a total
depth of 15 feet.
2. A percolation test was performed earlier in the material shown on
the soils log from a depth of 4 feet to 9.5 feet. This material was
noted to extend to a depth of 15 feet at the point investigated and
appears to be fairly uniform throughout the length of the trench.
We appreciate this opportunity to be of service to you. Please contact us if
you have any questions concerning this letter or if we can be of additional
service to you.
Very truly yours,
R&M .~ONSULTAN~S, INC.
Gary ~J Smith
Senio(;/Geologist
GAS/rm/12-V
BORING NUMBERTP-1 Date Completed: 6-26-79
~i SOIL DESCRIPTION
~'o" SANDY GRAVEL W/TRACE SILT,
~.~ OCCASIONAL COBBLE, GW
m '0_'~'~' 4'
· ;g
s. ~)~,~ SAND W/TRACE SILT, TRACE
· o TO SOME GRAVEL, OCCASIONAL
· ' · COBBLE, SW
_
-- i.e..'~ 9.5~T.D.
[o, No Water Table
DWN. MCH
· 6-28-79
£. N/A
LOCATION SKETCH
No ScoPe
NOTE: DISTANCES SHOWN ARE APPROXIMATE AND HAVE
NOT BEEN MEASURED BY SURVEYING METHODS.
EXPLANATION
~-'UNFI?OZ£N GROUND
ORGANIC MATERIAL
Little Visible Ice O;IC)' Vx
'"~--A.B. ~"ICF DE$CRIP?ION
~,1) S$,72,5Z I°/o 85.9 pcf
..~$AMPLE
~ $~MPLE~ TYP~
BEDROCK
~.--F,'~OZFlY 6ROUND W.O,-WNILI~ ~IUJNG
TYPICAL SOILS LOG
SI X4"EP~I~ SP~N
Sz 1.4" $PL~ $~ON WIT~ 340 ~. HAMMEN
A ~ ~MPL~
T~ SHF~Y TU3F
Tm MOO/F/FO SMFL~Y
B~ BULK S~MPLF
SAMPLE~ TYPE SYM~S
~ ORG4NIC ~ ~RAVFL
MAT~NML
~OULfl~$
~ SILr ~ ~FD~OCK
~ SAND I IC~
CONSULTANTS, INC. Pruess Subdivision GmE NW 56
..o~.o,... .~A.~... .u....... Eagle River, Alaska PR0~NQ 951201
SOILS LOG ~owG. na a-O1
June 27, 1979 R&H No. 951201
Don Zimmerman, Jr.
P.O. Box 396
Eagle River, Alaska 99557
Re: Soil Investigation for Sanitar~ Sewer System, Lot 16, Block 2, Pruess
Subdivision, Eagle River, Alaska!
Dear Mr. Zimmerman:
On June 26, 1979 we conducted an inspection and percolation test at the above
referenced project site. Our observations and test results are contained
herein.
At the time of this investigation a hole had been excavated for p~acement of
septic tank and leach field. The leach field was approximately q~4~ in
depth.
The soils encountered in the investigation at the location of the percolation
test (adjacent to the septic tank) consisted of a sandy gravel with trace,'
silt and occasional cobble from the surface to four feet in depth. Beneath
this layer a well-graded sand with trace silt and trace to some gravel and
occasional cobble was encountered to the total depth of excavaton at 9~5 feet
(see Drawing A-01). ......
A percolation test was performed within a secondary hole at the base of the
excavation and extended from 9.5 feet to 11.5 feet in depth. The data in
Table 1 contains the average infiltration from the depths indicated to the
bottom of the hole. The measured percolation rate was 19 minutes per inch.
We appreciate this opportunity to be of service to you. Please contact us if
you have any questions concerning this letter or if we can be of additional
service to you.
Very truly yours,
R&M CONSULTANTS, INC.
Michael C. Hartley
Geotechnical Engineer
Jim McCaslin Brown
Senior Geologist
MCH: JHB/dj/L4-H
Table 1
PERCOLATION TEST
Lot 16, Block 2
R&M No. 951201
TIME
9:20
9:21
9:23
9:25
9:30
ELAPSED
TIME
(MINUTES)
LJ
9..50 I 30
lo:oo I 40
10:10
10:20
I SO
WATER
LEVEL
(INCHES)
INCREMENTAL DROP
(INCHES)
2.1
2.6 0.5
3.2 0.6
3.8 0.6
4.3 0.5
5.0 0.7
5.6 0.6
6.1 0.5
6.7 0.6
7.2
1.6
19
0.5
I inches
January 25, 1980
TO: %~om It May Concern
Subject: Lot 16 Block 2 Preuss Subdivision
The above subject property does not have public water
or public sewer to it, therefore, the only method
feasible for developing is on-site sewer and water.
If there are any further questions, please contact
~issoffice at 264-4720.
Sincerely,
Les N. Buchholz, R.S.
Senior Environmental Specialist
OEt E GED _:CHNICAL E~ DEVEL', PMENT CO.
Box 90, Davis St,, Eagle River, Alaska 99577
694.2774 or 688-2280
Russell Oyster
694,2774
Soils Et Foundations
Perfomed for:
SOIL LOG
Natltng Address:._.~ AJ.
£ad Ellis
688-2280
Land Development
,Depth,(feet)
5otl Cherecterlstlcs
li
12
13
15,., ,
16,.
Ground Nater Encountered: Yes ,.
No ~
If yes, wh&t depth ....
Proposed Installation: Seepage Pit,,
Comments: ~ ~-~~
mm m Drmtn Field
Perfomed by:
Z. VELL LOG
GRVL
Till
0 88
88 13o
U.S.G.S. Local t~.
A.0,L. Ho,
3. ow,[~ 0r WELL: Don Zimmerman
P.O. BOX 596
Eagle River, Ak,
99577
WELL DEPTH: (co,,~l*ted} I Surface [tevatlon Date of
I
Completion
1~O 't. -- $-18-79
[-]Test Vail r~other:
I~s/fC.
9. STATIC WATER LEVEL: 84 ft.
[~Above ~6elo~ land surfac4
lO. PUMPING LEVEL below lind %urface
ft. after -- hfs, pumping 5 g.p.m.
GROUTING: Veil Grouted:
.aterlal: r-~aeat Cement r-]other:
13. PU~P: (If available) HP 1/~
'Leqgth of Drop Pt~e 122 ft. ca~aclt¥
IS. 1dATER WELL COqTnACTOR'5 ¢£RTIFICATICa:
Cotten-Magnuson Drilling 76-77-5385
~ ..... P~O, Box 504 Eagle River, Ak. 99577
Perforations at 85-88 f't.
•
• Municipality of Anchorage
u •
On-Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-572-09 Expiration Date: (0-1 3 r ig
1. GENERAL INFORMATION
Complete legal description _PREUSS #2 BLK 2 LT 16
Location (site address) _10049 WREN LN, EAGLE RIVER AK
Current Property owner(s) _STEPHAN TAYLOR Day phone
Mailing address _SAME
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver/Variance request for: Distance:
Received by: 'ALA-- Date: —V/VV
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 52t-0-00 Waiver Fee $
Date of Payment 31 j ,o1s7 Date of Payment
Receipt Number gea l0.3 Receipt Number
COSA# OSC IS? Dr) 0 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.
Name of Firm MIKE N ANDERSON,P.E. Phone 727-8864
Address 4661 NATRONA AVE.
Engineer's Printed Name MIKE N ANDERSON,PE Date 2/28/18
•
6. DSD SIGNATURE _.`•'
System #1 Approved for 3bedrooms.
System #2 Approved for bedrooms. '`:v;�\ 3WV'.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
OF AN.r,
gON-SITE
WATER AND
WASTEWATER
PROGRAM
'11FNT SERV\
By:"="_47Original Certificate Date: 3 —
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
COSA blue sheet 10.10.12.doc
• 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: PREUSS #2 BLK 2 LT 16 Parcel ID:_050-572-09
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (YIN) Y
Date completed 5-18.79 Sanitary seal (Y/N)Y Wires properly protected (YIN) Y
Total depth 130 ft. Cased to 130 ft. Casing height(above ground) 24"+
FROM WELL LOG AT INSPECTION
Date of test 5-18-79 2-19-2018
Static water level 84 ft. 87 ft.
Well production 5.0 g.p.m. 4.5+ g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 5.84 mg/L
Arsenic: ND ug/L Date of sample: 2.19-18 Collected by: Mike Anderson
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL STEP Date installed 9-3-15
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N)Y
Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y
Date of pumping new Pumper
C. ABSORPTION FIELD DATA—1985 SYSTEM TESTED
Date installed 9-3-15 Soil rating (GPD/SF) 0.8 System type DEEP TRENCH
Length 40 ft. Width 2.5 ft. Gravel below pipe 8.0 ft.
Total depth 12 ft. Eff. absorption area 640 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 2.19-2018 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 44 in. Water added 500+gal. new depth 66 in.
Elapsed Time: 1350 min. Final fluid depth 43 in. Absorption rate >=_450_g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date
D. LIFT STATION
Date installed 9-3-15 Size in gallons 1250 Manhole/Access (Y/N) Y
"Pump on" level at 43 in. "Pump off' level at 39 in. High water alarm level at 45 in.
Datum TANK BOTTOM Cycles tested 3 Meets alarm&circuit requirements? Y
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 5'+ Property line 5'+ Absorption field 5'
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10 Water main 100'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(None Known) Wells on adjacent lots 100'+
F. COMMENTS
WATER LAB RESULTS REQUIRE NITRATE ADVISORY. �:•' °° ;'.
•
49T"_ �'�
G. ENGINEER'S CERTIFICATION d•••• '•••...... .- .. .
I certify that I have determined through field inspections and /`;:.:MICHAEL N. ANDLiisi:
review of Municipal records that the above systems are in Pr`s. . C 4G
conformance with MOA COSA guidelines in effect on this date. 111•'•it
.t:
Engineer's Printed Name MIKE N. ANDERSON,PE ��ildeo -= ',
Date 2/2812018
COSA canary sheet_2-6-15.doc
Municipality of Anchorage
• `� Development Services Department
t Building Safety Division
'Y
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage,AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC 181070
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 2, Lot 16 of
Press #2 subdivision. This inspection revealed a nitrate concentration of 5.84
milligrams per liter (mg/L) was reported for the property's well water
sample. 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.
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.
s ,
DAVID AVE
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W --. • _ _
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Al
i\
Satellite ® ® Sewer Clean Out
Dishes Wire
a
0 0 Fence --\
re.....•�.e...•-----•--a...• �_..S ..11--f, -a_p 3-_9 �.4.. 2_ _ - _ -
����������� 10' Utilitya
OF p 11��� • Easemen
�E .... �,q .' • l
=.c-,.• 5,�9'1// Fd Rbr S 89°59' E 150,00' Fd Rbr
*:• 49 TT-1
\ * ; I hereby certify that I have surveyed the following described
?. iaproperty:Lot 16,Block 2,Preuss Subdivision Unit No.2,Plat
' ' No.70-42,Anchorage Recording District,and that no encroachments
'. An ony P. Bonetc:
/ • exist except as indicated hereon. This As-built will only show the
','I'`� LS-10393 - easements that appear on the recorded subdivision Plat No.70-42,
�rr��b 4/... r!�yo Anchorage Recording District;under no circumstances should this data
11 ' EssIcom hereon be used for the construction or establishing of boundary or fence lines.
t'Ittxx‘‘‘•••`'
,s 3i0 Preuss Subd. Unit No.2 ASBUILT SURVEY APB Land Surveying
SCALE a, Lot 16 Block 2 Taylor Stephan W & Y g
As Depicted on:Plat No.70-42 Snowden-Taylor Elizabeth M 12204 East Prince of Peace Drive
1"=30' 10049 Wren Ln Eagle River,Alaska 99577
Anchorage Recording District Eagle River,Alaska 99577
Surveyed:April 20,2017 GRID: NW0056 (907)227-1361
MUNICIPALITY OF ANCHORAGE
i-
•
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section �' Fax: 907-343-7997
Lift Station/Pump Vault
Maintenance Log
Owner Tut., (0✓ Street Address CA)wr✓!
Septic Tank: �G c( a tt�r
-Sludge level 0 inches •Pumping: required yes no •Pumping completed yes no
Lift station: \n 2. 0
,
-Pump basket cleaned a no -Effluent filter cleaned no
-Control floats cleaned no •Proper float settings confirmed no
•Operation satisfactory no
Alarm System:
•Dedicated electrical alarm circuit ye- no -Audible and visual alarm inside dwelling no
-Alarm system operation satisfacto not satisfacto
Manhole Riser
•Ground water intrusion at riser to tank connection es no
-Ground water intrusion around pipe penetrations es no •Weep hole functional St no
-Manhole lid: Functional Ono Insulated Cff no Properly Secured CP no
Other
-All manufacturer required inspections and maintenance completed yes no
Comments:
w eAs lut) in 2 (ii g--
Qualified Maintenance Provider:
Technician
Date of maintenance //ik
Company Nil / 1
Signature Date /7/1-7/
Mailing Address: P.0. Box 196650*Anchorage,Alaska 99519-6650*www.muni.org
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot. block, subdivision..s, ection, township, range)
Location (address or directions)
10209 O]~t~t I_gnp_
(b) Property Owner M,~. ! F~n,~d
Mailing Add~ess
(c) *'Lending Institutipn Po,~x,~ Up~
Mailing Address
(d) Real Estate Company and Agent EFU~V/U~,,oo, P~5/~n,
Address !A~ P~~ ~'~. ~'~ ~!, ~_ ~. '~.~
Telephone , ~a~O0
1f~-91-R7
Telephone: Home /,q4-q?~/7 Business
Telephone
~$77
(e) Mail the HAA to the followina address: or: Check here [~. if hold for pick up.
List contact person and day phone number below.
,~ & S ENGINEERIN~
17034 Eagle River L~p .~,~ .......
TYPE OF RESIDENCE
Single-Family I~
Number of Bedrooms
WATER SUPPLY
Individual Well [] Community [-I Public I-i .'
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite I~ Public r'l
Community I'1
Holding Tank []
Note: If cor~ munity well system, must have written confirmation from the State Department of Environmental Conservation
attesting tO the legality and status. : :.' ' ":/i:': '... :.;"
Page 1 of 2 ~ ~ 72.025 fRev 8/861 Front
ENGINEERING FII~M PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
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 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 !drther 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
Address
Date
the date of this inspection.
Name of Firm S & S ENGINEERING
17034 Eagle River L~3p Road No. 204
Telephone
Approved for ~bedrooms by ._
Approved ~/,,. Disapproved Conditional
Terms of Conditional Approval
Date
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
certificates based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is issued. The Municipality of Anchorage is not'responsible for errors or omissions in the professional
engineer's work.
WELL DATA
Well Classification
Well Log Present ~1)
Total Depth /..~
,~:~ MUNICIPALITY O~ ANd~0RAGE (MOA)
CHECKLIST - FEBRUARY 1984 '
~ ~X :.'. LegalDoscription: -- ~ ~/~ ~
~' F If A, B, C, D.E.C. Approved (Y/N) M/~
' Date Completed: ' : ~--/~- ~ Yield
Cased to i ~ ~ t Depth of Grouting
Static Water Level " *' ~
Casing Height Above Ground
Electrical Wiring in Conduit~q)
Separation Distances from Well:
To Septic/Ho~ on Lot
Pump Set At L,I,, I~
Sanitary Seal on Casing(~/N)
Depression Around Wellhead (Y/~
To Nearest Edge of Absorption Field on Lot ! ,.~c) / -~
/ ~_~c, / -: ' ' ; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Line
Cleanout/Manhole
/'-//A To Nearest Public Sewer
M/p,. To Nearest Sewer Service Line on Lot ~--~ !
· ,--~'f---% ~-----ML~'/F~IhJ~'~' ;Date I~-~-~-~'
Water Sample Collected by
Water Sample Test Results
Comments .
S E PTI C/H O~=~=~RI~A"O ATA
Date Installed .:~- f/-- ~"~ Size ,/¢:>¢>o No. of Compartments
Standpipes ~N) Air-tight Caps ~q) Foundation Cleanout
Depression over Tank (Y,~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well / ~
To Property Line /0 I.~
To Water Ma,~/Service Line ~/c:, I-~
Course
Comments -~'' '-~---'~
Date Last Pumped ~ /C:~ -
;,or
Temporary Holding Tank Permit (Y/N)
'To Building Foundation /'~ '"; *. ' .... ~ '"
TO Disposal Fi I; *: :" .. ~..: r~; ~ .~
To Stream, Pond, Lake, or Major Drainage
Page.lof2 .
72-026 CRev 8/86t F~o.I
Co ABSORPTION FIELD DATA
Soils Rating in Absorption Strata / ~---~
Date Installed ~ --/! - ~F ~
Width of Field .'~
Square Feet of Absorption Area ~ ~ ~,_ z~
'L'
Z~'//~/~ Type of Syster6 D~sign "':'~-~/
' ,~/:~ , ~_.. .'-
Length
of
Field
Depth of Field }~ t"/,,%
Grovel Bed Thickness
Standpipes Present
Depression over Field (Y,~. Date of Last Adequacy Test
Results of Last Adequacy Test ,...~,-r-/~/'=~7'z::~_.,/ ~"'~-- ~_~ ~.-.
Separation Distance from Absorption Field:
To Water-Supply Well : / ~ I.~, To Property'Line /~,r
To Building Foundation / ~ !
To Existing or Abandoned System on
Lot /~/'/J:~ ; On Adjoining Lots ,-..~/'/'
To Water Mahq/Service Line ,/~ L-~ To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course /"///'~l
To Driveway, Parking Area, or Vehicle Storage Area /-',/E;~ / ~ '
Comments ' '
Do
LIFT STATION ,
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (WN)
Comments '-'
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy 'Test. Meets MOA
** Che~:k Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all M OAxand I~AA guidelines in effect on the date of this inspection.
Si ne~ & S ENGINEERING - ate ,,o/2
Receipt No. /'o o / 0 o ~.,~
· Date of Payment /~'/'~ "~/~J-
Amount: $ /~) O°/fJ~' ' ' '
Page 2 of 2
72-026~Rev 8/861 Back
L & GEOLOGICAL L~ORAIORIES OFALASKA, INC. "
5633 a STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2~43
FEDERAL TAX ID # 92-0040440
Client PO~ : V~BAL
Client ~pl ID: ti6, ~2 PCJL*'o
OCT 2i 87
Re~¢rts ~a:
S & S
17034 £[~rj] ~lVL~ LOCP ~D.,
EAGLE ~IV~, AK. 99577
Vark OrOer I;o. : 3521
Client Account :
Date ~epcrt ?rinte~:
~eleased B7 : 2 ¢: ~'
Repcrts Addreas t2
$~eciaI
Im~true::
Cheulau Eel #; 8t08 Lab .~-pl ID: t )latrlx; ~ter
AIIowaule
Parameter ~ested ~e~ult/Unlts Method Limits
~I~T~-I~ 1.2 mCtl lO
O~JkO
Detected *~ See .S~."ple P, cm.'ks Above
A.'.aly:cd ' LT=Les~ Than, GT=~reater Th~n ' O~G~ ~''
~ , MU, NICIPALITY OF ANCHORAGE
DEPARTMENT 13F'~EALTH~'~ AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
'264-4720
GENERAL INFORMATION
(a)
(b)
(c)
Application Date
Legal Description (include lot. block, subdivision, section, towns.hip, range)
Location (address or directions)
Applicant' Name ~J~t,,~,lh.,~,, ~. [.-.-/~,~.'~'~ Telephone: Home I-~dr'- ~-'Z,"'7
APplicant Address
t
Applicant is (check one): Lending Institution-FI; Owner/buildeC~Buyer Fl; Other [] (explain);
Business '
(d) Lendir;~'!n. sti(.ution ~"~-. }L'~L~t)~'t.,- '~t/.-- Telephone
(e) Real Estate Company, and Agent
Address
Telephone
(t)
Mail the HAA to the following address:
$-&$-ENGINEEEING
SI~B.,_1 g6X.
TYPE OF RESIDENCE
Single-Family'~ Multi-Family []
Number of Bedrooms "~ '
Other
WATER SUPPLY
Individual Well~ Community Fl Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsitel~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 ill/84)
5., ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
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 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 Ihe 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.
Name of Firm ~.S-&-S-ENGINEERING Telephone
Address ¢;~ _17, !96X
Date EAGJ.F.J'RLV_ER,J~_K 99577
DHEP APPROVAL
Approved for ~"'~' (~) bedrooms by
~' Disapproved
Terms of Conditional Approval
Conditional
' CAUTION
The Muncipality of Anchorage Department {)f Health and Ehvironr~ental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy Io purchasers of homes and their lending
institutions in order to satisfy certain lederal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Mun~mpahty of Anchorag~ ,s not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
MUNICIPALITY OF ANCHORAGE
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
MUNICIPALITY OF ANCHo2AG2
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
JUN :1. 9
Legal Description:
WELL DATA
Well Classification
Well Log Present. N)
Total Depth
Static Water Level
Casing Height Above Ground '~
Electrical Wiring in Conduit(~N)
Separation Distances from Well:
To Septic/Held~Tank on Lot
Cased to
If A, B, C, D.E.C. Approved (Y/N)
Date Completed "~ ~t ~ '"7~ Yield
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (~)N)
Depression Around Wellhead (Y,,~)
; On Adjoining Lots
To Nearest Edge of Absorption Field on ~.ot ~"~---- ~ ; On Adjoining Lots
To Nearest Public Sewer Line ~//~ To Nearest Public Sewer
Cleanout/Manhole ~/~' To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Comments
B. SEPTIC/-~,~~ANK DATA
Date Installed Size I ~
Standpipes ~)/N) __ Air-tight Caps~N)
Depression over Tank (
Pumping/Maintenance Contract on File (Y/N)F'
Holding Tank. High-Water Alarm (Y/N) ~'
Separation Distances from Septic/Held~Tank:
"5,.../
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
No. of Compartments ~
Foundation Cleanout (Y/I~ (-D (/~''
,,3/i~Date Last Pumped
; for ,.--'-'
Temporary Holding Tank Permit (Y/N)
To Building Foundation '
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-o26(11/84j '
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Water Main/Service Line I, ~=, I Jr'"
To Stream/Pond/Lake/or Major Drainage Course
To Driveway. Parking Area. or Vehicle Storage Area
Comments
Type of System Design '"'~'~
Length of Field t'J¢1 /
Depth of Field ] ~
/
Gravel Bed Thickness L~,
Standpipes Present (~N)
Date of Last Adequacy Test I,o -- 1 ~ --(~:)to
I
To Property Line I ~
To Existing or Abandoned System on
; On Adjoining Lots ~ ~
To Cu~ank lif present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
S & S ENGINEt:~ING
Signed Date
SRB 196X
Compan~..y._ - -~,57'~' MOA No. ~'.5'"~,~'O_
,':AL~LE RIVER, AK
Receipt No. ~"'~ c'[
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
~.-". ' - DATE RECEIVED
..... INSPECTION APPOINTMENTS ~~ )
TIME ~ TIME TIME
DATE DATE DATE
INSPECTOR . INSPECTOR INSI~I~CTOR
MJNICIPALITYr~w. ^ _ OF ANCHO~A~
MUNICIPALITY OF ANCHORAGE E~IRo~ENTAL P~OT~CTIoN
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
~E~UEST FO~ APPROVAL OF INDIVIDUAL WATER AND SE~ER FACILITIES
DIrECTIOnS: Complete all pa~s on page 1. I~omplet~ ~u~ will not ~ pr~. Please 811ow ten {10] days for pro~essing.
PROPERTY RESIDENT (If different from above~
2. BUYER / PHONE
MAILING ADDRESS
3. LENDING INSTITUTION ~ PHONE
MAILING ADDRESS
4. REALTOR/AGENT ~
6. TYPE OF RESIDENCE NOMBER OF~BEDROOMS
D One [] Four
[~NGLE FAMILY [] Two ' [] Five
[] MULTIPLE FAMILY . ~ -Three [] Six
Other
7. WATER SUPPLY
I~tNOIVIDUAL*
[] COMMUNITY
[] PUBLIC UTI LITY
* ATTACH WELL LOG, A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISFOSAL SYSTEM
[] PUBLIC UTI LITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/?e) ~. ~ T . ......... --~ ~
__ THIS SIDE FOR OFFICIAL USE ONLY ·
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] I NDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY '"J
Connection Verified INSTALLER
[]Septic Tank.or [] Holding Tank ,
Size: ! O ~'~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK. MANUFACTURER
,/
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/H°lding Tank IAbs°rpti°n Area Isewer L'ne INearer L°t Line
Absorption Area to nearest Lot Line
5. COMMENTS
[] CON DITIONAL APPROVAL (letter(~uj/~'~cco~p/,~ny.~ificate)
~ISAPPRQ~ED ~ ~yy
72-010 (Rev. 6/79)