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TONJESS ESTATES BLK 2 LT 7
Onsite File Tonjess Estates Block 2 Lot 7 #051-832-22 - Municipality of Anchorage Page / of a. ' 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: -7,51? a / 0 9 PID Number OS/P3 m-2. Z Name: tSoA.,/ %%ior.t,,,.rcw Wastewater System: 12fNew 0 Upgrade Address: 7 3 .4e3 5a... h ..go,.........,. ECJ 4 iP..,r� ABSORPTION FIELD Phone: rZ I/- -1., a ek No. of Bedrooms: '.3 tg Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: 0. 6 GPD/Sq Ft. Total Depth from original grade: 6 ' Lot:Block: Subdivieion: 7 ..? T ^'5 err EJfr Depth to pipe bottom from original grade: . Ft Gravel depth beneath pipe y Ft. Township: Range: Section: Fill added above original grade: / Ft. Gravel length: /1.! Ft. WELL: AfNew 0 Upgrade Gravel width: 3 Ft. Number of lines: oZ. Distance between lines: /O Ft. Classification (Private, A,B,C): PI-f be4 'le Total Depth: /4/6 Ft. Cased To: 01-0 Ft. Total absorption area: /Dom SO. Ft. Pipe material: .S77,' 3B3 se r e,0 Driller. /9 /p/" C Date Drilled: 5-"' j'42 -98 Static Water Level: eZ 7 Ft. Installer. 5re e.- 6r evr-c 6-."- Date installed: 9 /9:S Yield: D''"". ''". 1.1 GPM Pump Set at: H w.r i.c Ft. Casing Height Above Ground: .2 FL TANK SEPARATION DISTANCES ❑Septic ❑ Holding ti'S.T.E.P. To From S.ot a Tank Absorption F1.ld Lift Station Holding Tank Publ o/Prlvat. Sower Unes Manufacturer 4,4 b1 w<.s.e 7 -.r Capacity in gallons: /aro Welt /'30 iaa' //0 ' r/s /�' Material: Srt / Number Of Compartments: 3 Surfaceer ` o/V/ 411,4)/ 474,." '/Di•/ LIFT STATION Line Sr / / 3S �S' 8 0 t Size in gallons: l,2s�� Manufacturer. A.�f•(. ,.., %-.- K Foundation j -/ rd / /s / D "Pump � level at: `"Pummp off' level at `High'' alarm at n I I Curtain Drain N/A --�� �'- Pump Make & Model DSc -OT-Hs/ I Electrical Inspections performed by: , fie etc-,c /a..+ rq/i.'"• .e/C0in Remarks: BENCH MARK Location and Description: 7755. ,"c (46 CG-5...,s Assumed Elevation: ENG`SSIA t , ,: Permit' No. YB-- 0 / 0 7 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196656 Anchorage, Alaska 99519-665A Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legol Description: TONJESS ESTATES, LOT 7, BLK 2 PID No.: 05183222 NLS sq. 1' SEPTIC 50' DISTANCE WELL +100' FROM PROPERTY LINE LOT 8 SW VG Ties C 0 E A 8 F ac 7.4 43 23 Sal3y ELEVATIONS CNOT TO SCALE) LOT 13 iDP Q VEL.VEL. CASING •V SSIIER C.EV • 10¢DO' 1• AROED FILL 124'1 ORIGINAL EEVEI.R LAT• TRI 141.1 TR2 URe 35PSI INSULATION 24'1 TRi! 1117 I\ R/1 �x7 re, .i ro-sy r t ¢woe . s WELL +100' DISTANCE V c'T 0 1217 LOT 14 - TEST HOLE • - MONITOR TUBE o - SEWER CLEANOUT • - WELL PROPOSED LEACHFIELD EASEMENT • 1'=50' 2-16-99 0401NEER'e BEAL \n". �,Q —D O`02;'49TH: �eODN o D0 .Louis':7�. BUTERA . ;CE -6736 DOFESS� ''4000004 01/21/1996 20:04 9076886919 • TODD & CHRISTI BELL f �e tft Jril ling by Doc Co. dba SULLI VAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99561 • TELEPHONE 688-2759 C3E1. (; % b t C%t ry S`fij A BORE HOLE DATA OWNER OF LAND N.1044,.1 7F I n1 S ('►KJ/ ADDRESS 45I38 Oince, LEGAL DESCRIPTION loT (3c ,t' TO.�I�EST Sr*rES `t)E4 . 0EE/t.Jea 4//.2/ 9 7 PERMIT NUMBER Date of Issu TAX INDENTIFICATION NUMBER Is well located at approved permit location? Q Yes Q No Fair rotary 0 cable tool Method of Drilling: Depth of well: c25 Casing Type SSECz_ Wall Thickness inches Diameter to " inches, depth feet Liner Typo: /,tart Casing Stickup Above Ground: a' Static Water Level (from ground level): Pumping level: feet after hrs. pumping,�_gpm Recover Rate: 190 feet feet qpm Method of Testing: fit} ► Q. Well Intake Opening Type: 0 Open End ❑ Open Hole 0 Screened; Start feet Stopped feet ❑ Perforations Start feet • Stopped feet Grout Type: Volume Depth: from feet, to feet Pump Intake Depth: feet Pump Size hp Brand Name Well Disinfected Upon Completion? es 0 No Method' of Disinfection: (/i..u,q i,.,te_ rQ /erY) Comments: �cFoe.j/a j ctq DEPTH From To PAGE 01 a /46 t3 - X43 24-3 0146 rx4-7-,.J6 tAi6rec. AGr,f! Bei,D cr< 6iter-1 q )a�z SA -.4.-1 /3 Lcait r%,t-44 y3Edctbt_,c t1.J Driller's Name 4.1-0 J -""-"-'- ATTENTION: It Is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. Kok CA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980109 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:JOHN THOMPSONSWQ OWNER ADDRESS:17343 SANTA MARIA DR PARCEL ID:05183222 LEGAL DESCRIPTION: TONJESS ESTATES BLK 2 LT 7 LOT SIZE: 42580 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 'AkCr 3P 'C \ DATE ISSUED: 5/12/98 EXPIRATION DATE: 5/12/99 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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 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. SPECIAL PROVISIONS: RECEIVED BY: ISSUED B DATE: �'/7-9U 5/B' REBAR MARKER INISH GRADE -1/A' PLUG -1/4' CDUPLINI FILTER BRIG•° -1/4. 45• EL • :SEVER ROCK (11013`°.0 80 LATERAL END PRESSURE PIE CLEANOUT NO SEPTIC SYSTEMS Li1T 5 VA ANT S\ Ic +100.7 100' SEPTIC 50' DISTANCE WELL +100' FROM PROPERTY LINE LOT 8 NO SURFACE WATER NO KNOWN CURTAIN DRAINS WELL +100' DISTANCE V LOT 13 DE: •0 LOT 14 - TEST HOLE - MONITOR TUBE - SEWER CLEANOUT - WELL PROPOSED LEACHFIELD EASEMENT WELL/SEPTIC SITE PLAN LEGAL: TONJESS ESTATES LOT 7 BLK 2 OWNER: DOWAH PARTNERSHIP CONTRACTOR: N/A JOB # 96-00 DATE: 5/8/98 1 SCALE 1" = 50' AEAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 June 3, 1997 Dowah Partnership 8001 Upper O'Malley Road Anchorage, Alaska 99516 1122 Subject: Lot 7 Block 2 Tonjess Estates Subdivision Permit OSW960069, PID #051-832-22 The subject permit, issued May 6, 1996 by this office for a single family well and/or on-site wastewater system, has expired as of May 6, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Si y+Q ely, /1()b/ LEP) Jaf's Cross, P.E. P gram Manager On-site Services enc: Copy of Permit cc: Eagle River Engineering Services CDC \ _ 7 _r1 « STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES `�� N��� DIVISION OF MINING & WATER MGMT WATER WELL RECORD LOCATION OF WELL BOROUGH SUILDIVISION pr,.-//alj LOT BLOCK SECTION OTRS SECTION TOWNSHIP ON RANGE ■ E MERIDIAN .e, l 4..-17 7 OS OW LOCATION/SKETCH: WELL OWNER: • DEPTHS MEASURED FROMpcasing top Oground surface WELL DEPTH:DATE OF COMPLETION Depth of hole: ,41/6ft BOREHOLE DATA: Depth Material Type and Color From To Depth of casing:, er ft --,— /.00 / yf7 ..ft -e..:10 � t c.r� 0 DEPTH TOSTATIC WATER LEVEL: 27 ft below atop of casing 0 ground surface Date: S l 0 / 96 • " �/ � , Fit-d://7.4 .L�.t /7.49r1C _ *Lir /4/6. METHOD OF DRILLING: Dair rotary 0 cable tool 0 other , • . ,. , r I USE OF WELL: A domestic 0 irrigation 0 monitor • public supply 0 other CASING STICK:VP ft. Diam: Gin. to___ ft Casing type: .•. t G in. toa /.J ft WELL INTAKE OPENING TYPE: 0 open end 0 screened ❑ perforated ja open hole Depths of openings: to ft SCREEN TYPE: '-------- Diam: in. Slot/Mesh Size: Length"'----_.. ft GRAVEL PACK TYPE--._ Volume used: Depttrto-top:, RECEIVED GROUT TYPE: `---.__ Volume: Depth: from ft to"----.. ft JUN 1 2 1997 DEVELOPMENT M HOD: 4'14 - ..LDuration:%. Duration: ...-i -_-s Municipality of Anchorag Dept. Health & Human Servi .es PUMPING LEVEL AND YIELD: / / a ft after .4/ hrs pumping -2•J gem PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPLETION? c YES 0 NO CONTRACTOR INFORMATION: • �C.REMARKS: • RegisttEd Business Name �l2 Signature o•Authorize. PLEASE MAIL WHITE COPY OF LOG T0: / . 96 DNR/DIVISION OF MINING & WATER MGMT 15-0- 3601 C St, Suite 800 Anchorage, Ak 99503-5935 Alpine r Sling & Enterprises bomestic -- Commercial Pump & Water Systems P. O. Box 110496 Anchorage, Alaska 99511 (907) 345 - 0202 TO: INVOICE N- 3692 r__ ob iv Lo,3t n iak t L-u ..]OC. FoutJ � ( 00 La .r t Yrs I tL PHONE •.Z 3 Lk,....1 U rv f{ OM 0., I�� �. DATE • ) .-1 / _7l/ , QUANTITY DESCRIPTION AMOUNT Itgal 6`l (,t)ofe_r CJc.11 r 3t tuv (Qn,ve-1 ; t& u i \li e.ta.. ; c;' t.5 CSM .\\r‘i 4) S.;) 4 LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED BY DATE COMP TOTAL LABOR PAY THIS AMOUNT 3c)1� Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960069 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:LEBARON KAYLEN D OWNER ADDRESS:8001 UPPER O'MALLEY ROAD ANCHORAGE, ALASKA 99516 PARCEL ID:05183222 LEGAL DESCRIPTION: TONJESS ESTATES BLK 2 LT 7 LOT SIZE: 42580 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 5/06/96 EXPIRATION DATE: 5/06/97 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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 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. SPECIAL PROVISIONS: RECEIVED BY: / " DATE: 05/4V9C./ ISSUED BY: i I/ DATE: r-‘ - / • Eagle River Engineering Services Louis Butcra, P.B. P.O. Box 773294 Eagle River, AK 99577-3294 (907) 694-5195 tel (907) 694-3297 fax April 25, 1996 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Tonjess Estates Lot 7, Block 2 Narrative & Permit Application Dear Mr. Cross: The proposed well and septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. The leachfield is sited on a bench area of the lot. 2. All neighboring septic systems are +30' distant; all adjacent lots are vacant. 3. Reserve space is adequate, due to absorption capacity and large lot size. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \1996\96-004A.NAR Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 Eagle River, AK 99577-3294 (907) 694-5195 tel (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Tonjess Estates Lot 7, Block 2 - 04/25/96 A. GENERAL 1. The well and septic plan is for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled. B. SEPTIC TANK/LIFT STATION 1. Septic tank and lift station shall be 1,250 gallon Orenco/Anchorage Tank model OSI 05-20-HHF. 2. Receipt from certified electrician stating the lift station was wired to applicable codes to be supplied to Engineer. C. TRENCH 1. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. 2. The bottom of the trench shall be level, plus or minus 1.5". 3. The total depth of the trench excavation is not to exceed 6' at any point. 4. The effluent line within the trench shall be laid level within 0.03'. 5. The trench gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 7. The area over the trench is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 6' GRAVEL DEPTH = 4' under pipe, 2" over pipe TRENCH LENGTH = 125' TRENCH WIDTH = 3' SOIL RATING = 0.6 GPD/ft2 BEDROOM CAPACITY = 4 SEPTIC TANK = 1,250 gallons with lift station Twenty-four (24) hours notice required for all inspections. 1996\96 -004A -SPC 5/8'.REBAR MARKER FILTERF ERIC,,° :SEVER ROCK n ° ° LATERAL END PRESSURE PIPE CLEANOUT INISH GRADE 1-1/4' PLUG -1/4' COUPLINI NO SEPTIC SYSTEMS -1/4' 45' EL PROP. WELL 10' LOT 6 VACANT LOT SEPTIC 50' DISTANCE WELL +100' FROM PROPERTY LINE LOT 8 NO SURFACE WATER NO KNOWN CURTAIN DRAINS WELL +100' DISTANCE v LOT 13 0 • 0 LOT 14 - TEST HOLE - MONITOR TUBE - SEWER CLEANOUT - WELL PROPOSED LEACHFIELD EASEMENT WELL/SEPTIC SITE PLAN LEGAL: TONJESS ESTATES LOT 7 BLK 2 OWNER: DOWAH PARTNERSHIP CONTRACTOR: N/A JOB # 96-0041 DATE: 04/25/961 SCALE 1" = 50' AEAGLE RIVER ENGINEERING SERVICE'S P.0. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 q .r/N-.•• •••s �i • (0 • ,i . V '• II /\ .. *• s• • -_ • ,v - •• •• LOUIS A. BUTERA • tea. tVAll> •.• CE -6736 ..• 2A AI 1 je •••••••6. 4 — s*:49TH PERFORMED FOR: Fours Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST LEGAL DESCRIPTION:el.S BEST L % /3 2 77/ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (FEET) � �''�`{ENGI ER'S.S�AFtr'gr i9 e' • 4gTW I' Vt• louts A. Entero ; 14 'of . CE -673 6 . •41,.' F �F��o9,: �'£c 't•r-.. DATE PERFORMED: y ir, Township, Range, Section: T/rt/ R/'✓ Sic SLOPE SITE PLAN • •u P o Dfr/_/telCr.L'e~f( PEP It ea t,( - WAS GROUND WATER , , ENCOUNTERED? / "U IF YES, AT WHAT DEPTH? Depth to Water Alter Q 2 Ma: onitoring? y Dale: y- "96 S L O P E N 1T Reading Date Gross Time Ne Time Depth o Water Net Drop Pic — Seo ,Ec/ 1 y-2.2 •115 7' X8 s2 '/i/ .2. 3% all is -.,- r3 '/16 /M/6 •, 3 1 3: YY rz. i.,r Y ) 3.'5•7 ls.... r 2 "x„ )z/,/" t LI: oo 5-2. '//6 6 if:IS Is..:. - 2 '.4//,4 "Ps ' PERCOLATION RATE / (minutesiinch) PERC HOLE DIAMETER TEST RUN BETWEEN 2-4" 3.5" AND 3 s FT COMMENTS PERFORMED BY. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE' 72-008 (Rev. 4/85) PERFORMED FOR: F4TS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST LEGAL. DESCRIPTION: /cMJets Fir, L. 7 a 2 7Pz 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 OEPJH rTp/en/ (1 * . tciE'GIe EER'S SEA..(fel) )* •Y� F 111.011. .J H• o.•••• •i• .n.....•orf CV+ 1 L^u;- A. Bu7era •• 1.140# ..� CE -6736 : � J. • oy 1111 TOFF.aSIL-a. rC DATE PERFORMED: Y-42 -f 6••• Township, Range, Section: T/1-4/ R/:✓ sic 2 .{/p/ �Y6z SLOPE SITE PLAN • 0.• .0. ,.o .6 It '•D G w/ we rh 5,11— E271 /005C/Oet1+J/o•+o/ SP pock c'T WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? /t/v S t. 0 P E Dept to Water Aller Moretering7Dry--gale: y- z T Reading Date Gross Time Ne Time Depth o Water Net Drop Pre sel.k e../ I '1-22-96 1'z.3 • 7r ', , I 3 : 3B tr... 7r 'f/ c Y)//s " 3 7: 34 7r '/i s / 71 !-•s/ !S'..... 7r is/ii r y /I c .. 5" 1 3:55 7r -//d 6 I y:Io Ir...., 76 4//6 '1/16'• PERCOLATION RATE TEST RUN BETWEEN 1 (minutes/inch) PERC HOLE DIAMETER FT AND 7 FT 6" COMMENTS PERFORMED BY G/2C 1 1 �" CERTIFY THAT THIS TEST WAS PERFORMED IN -,- ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE 72-008 (Rev. 4,85) EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 96-004 Calculated By: LB Date: 4/26/96 Legal: TONJESS EST. LOT 7 BLK 2 Single Family 4 Bedroom Dwelling TEST HOLE 2 fa'i.n.,be, evera Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 600 gallons Percolation rate = 16 minutes per inch Wastewater application rate = 0.6 gallons per day per square foot Required absorption area = 1000 square feet Trench width (W) = 3 ' feet Gravel depth (D) = 4 feet Required length = Required absorption area / 2 / D Required length = 1000 / 2 / 4 Required length = 125 feet Total Excavation Depth = 6.0 feet • SINGLE FAMILY ON-SITE WORKSHEET ERES PROJECT NUMBER: 96-004 CALCULATED BY: LEGAL DESCRIPTION: TONJESS EST. LOT 7 NUMBER OF BEDROOMS: 4 WATER USE PER BEDROOM: 150 PERCOLATION RATE: 16 DEPTH TO GROUNDWATER: 15 DEPTH TO IMPERMEABLE LAYER: 15 ANTICIPATED DEPTH OF COVER: 2 MOUND OR BED SYSTEM WASTEWATER APPLICATION RATE: ABSORPTION AREA REQUIREMENT: MINIMUM BED LENGTH 12 FEET WIDE BED 15 FEET WIDE BED TRENCH SYSTEM WASTEWATER APPLICATION RATE: ABSORPTION AREA REQUIREMENT: SHALLOW TRENCH OPTIONS 5 FEET WIDE TRENCH EFFECTIVE DEPTH (FT) 1 2 2.5 3 3.5 4 BLK 2 GALLONS MINUTES PER INCH FEET LB FEET USABLE SOIL STRATA FEET TOTAL USABLE DEPTH: 9 USABLE SOIL STRATA DEPTH: 7 0.45 GAUSQ.FT 1333 SQ.FT REQUIRED TRENCH ENGTH (FT) 175 140 127 117 108 100 111 FEET 89 FEET 0.6 GAUSQ.FT 1000 SQ.FT DEEP TRENCH OPTIONS 3 FEET WIDE TRENCH EFFECTIVE DEPTH (FT) 4 4.5 5 5.5 6 7 8 9 REQUIRED TRENCH ENGTH (FT) 125 111 100 91 83 71 NA NA DESIGN SPECIFICS FIELD SYSTEM: D (B=BED, S=SHALLOW TRENCH & D=DEEP TRENCH) GRAVEL DEPTH: 4 FEET TRENCH OR BED WIDTH: 3 FEET LENGTH: 125 FEET TOTAL EXCAVATIO N DEPTH: 6.0 FEET EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 96-004 Calculated By: LB Date: 4/24/96 Legal: TONJESS EST. LOT 7 BLK 2 Single Family 4 Bedroom Dwelling TEST HOLE 1 ,Cesrz vF_ .r,cAa Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 600 gallons Percolation rate = 18 minutes per inch Wastewater application rate = 0.6 gallons per day per square foot Required absorption area = 1000 square feet Trench width (W) = 5 feet Gravel depth (D) = 1 feet Required length = Shallow trench factor * Required absorption area / W Shallow trench factor = (W + 2) / (W + 1 +2 D) Shallow trench factor = 0.88 Total Excavation Depth = 2.0 feet Required length = 175 feet ' SINGLE FAMILY ON-SITE WORKSHEET ERES PROJECT NUMBER: 96-004 CALCULATED BY: LB LEGAL DESCRIPTION: TONJESS EST. LOT 7 BLK 2 NUMBER OF BEDROOMS: 4 WATER USE PER BEDROOM: 150 GALLONS PERCOLATION RATE: 18 MINUTES PER INCH DEPTH TO GROUNDWATER: 8.5 FEET DEPTH TO IMPERMEABLE LAYER: 8.5 FEET USABLE SOIL STRATA ANTICIPATED DEPTH OF COVER: 1 FEET TOTAL USABLE DEPTH: 2.5 MOUND OR BED SYSTEM USABLE SOIL STRATA DEPTH: 1.5 WASTEWATER APPLICATION RATE: 0.45 GAUSO.FT ABSORPTION AREA REQUIREMENT: 1333 SQ.FT MINIMUM BED LENGTH 12 FEET WIDE BED 111 FEET 15 FEET WIDE BED 89 FEET TRENCH SYSTEM WASTEWATER APPLICATION RATE: 0.6 GAUSQ.FT ABSORPTION AREA REQUIREMENT: 1000 SQ.FT SHALLOW TRENCH OPTIONS DEEP TRENCH OPTIONS 5 FEET WIDE TRENCH 3 FEET WIDE TRENCH EFFECTIVE REQUIRED TRENCH EFFECTIVE REQUIRED TRENCH DEPTH (FT) ENGTH (FT) DEPTH (FT) ENGTH (FT) 1 175 4 NA 2 NA 4.5 NA 2.5 NA 5 NA 3 NA 5.5 NA 3.5 NA 6 NA 4 NA 7 NA 8 NA 9 NA DESIGN SPECIFICS FIELD SYSTEM: S (B=BED, S=SHALLOW TRENCH & D=DEEP TRENCH) GRAVEL DEPTH: 1 FEET TRENCH OR BED WIDTH: 5 FEET LENGTH: 175 FEET TOTAL EXCAVATION DEPTH: 2.0 FEET Municipality of Anchorage rE� On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 051-832-22 1. GENERAL INFORMATION: Expiration Date: S�� 95 ao�2L", Complete legal description TONJESS ESTATES S/D; BLOCK 2, LOT 7 i V. Location (site address) 25138 PRINCE CIRCLE, CHUGIAK, AK 99567 Current Property owner(s) ERIC SYMMES Day phone 242-1583 Mailing address 25138 PRINCE CIRCLE, CHUGIAK, AK 99567 _ Real Estate Agent BROOKE STILTNER Day phone 244-6742 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 1' ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: Date: I COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6-6b / Lit Waiver Fee $ Date of Payment ('0 ( [;to -;z6 Date.of Payment Receipt Number Receipt Number COSA # O 5 CQ0I d`2c�(o Waiver # COVID-19; 215% DISCOUNT APPLIED 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: _Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for -3 bedrooms bedrooms bedrooms, with the followi #AECC884 0 ON-SITE hulaWtTER AND g711W) WASTEWATER Z. o� r�JiJJ) S ERV By: &ftu &iwff 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 Septic System Advisory Well Flow Advisory COSA blue sheet_10-10-12.doc Nitrate Advisory Arsenic Advisory Other _T"k (-qx- la",5on X Legal Description: COSA Checklist TONJESS ESTATES; BLOCK 2, LOT 7 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA Al Well log is filed with Onsite (or attached) Date drilled *5/27/96 Total depth *250 ft Cased to **20 ft F0 Sanitary seal is functioning correctly 9 Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/22/20 Parcel ID: 051-832-22 Structure served by this system 1 Well production at time of test 3.5+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes No U Coliform bacteria is Negative Nitrate 1.59 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L VArsenic less than MRL (ND) Collected by GEG,LTD. Date of Sample 5/26/20 Static water level at beginning of test *15.7 ft. Comments *WELL DEEPEND ON 4/12/99. **TO BEDROCK B. TANK DATA Age of tank(s) 21.5 years Tank type/material STEEL Measured operating fluid level in septic tank "40.5° X Standpipes/foundation Clea out per record drawing Date of pumping D. ABSORPTION FIELD DATA DUAL PRESSURIZED TRENCHES C. LIFT STATION Of Required maintenance completed Age of lift station 21.5 years Lift station material STEEL Comments: `IN 1ST COMPARTMENT, 36.5' IN 2ND COMPARTMENT SEE ATTACHED LIFT STATION MAINTANENCE LOG Which system tested (date installed) 9/25-26/98 Adequacy test date 5/22/20 Al ALL standpipes present per record drawing Results [DPass For 3 bedrooms Total measured depth from grade 7.8 ft (max) Fluid depth prior to test *3.25 in Measured depth to pipe invert from grade ft (min) Water added 619 gal X N/A — pressurized field *4 New depth in ❑■ Monitor tubes go to bottom of effective. If not, state 163 depth into effective Elapsed time min ANCode-requiredsoil cover over field Final fluid depth *3 in El System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: TEST UPPER TRENCH ONLY. LIQUID LEVELS IN LOWER TRENCH DID NOT CHANGE WHILE ADDING WATER TO UPPER TRENCH. LIQUID LEVEL IN LOWER TRENCH WAS 9.75' IN ONE MT AND 10" IN THE OTHER MT AT START AND END OF ADDING WATER. COSA Checklist yellow sheet 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' 0 Yes if No Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft 0 Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' M Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑✓ Yes if No ft 0 Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' E] 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' El Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' 21 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' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' M Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' E] Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' El Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS "5'+ TO HOUSE FOUNDATION AND PILES FOR DECK - MET SEPARATION DISTANCE AT TIME OF INSTALLATION. NOTE: STEEL STEP TANK IS LIKELY APPROACHING THE END OF ITS USEFUL LIFE. G. ENGINEER'S CERTIFICATION I certify that / 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 o F .. �24 T y a .......�� .....'. {#V',Effr,:wGarness•: �1.1/,CE-179 3 e�� pro f e s sio�°Qc� #AECC884 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Septic Tank Advisory Certificate of On‐Site Systems Approval # OSC201246 Subdivision: Tonjess Estates Block:2, Lot: 7 The septic tank for this property is 21.5 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. 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 30 year old steel tank MAY look like. Lift Station/Pump Vault Owner Street Addres AJ Septic Tank: -Sludge level inches -Pumping: required yesi_-run. completed Lift station:��I�]�/�� -Pump basket cleaned -Effluent filter cleaned -Control floats cleaned -Proper float settings confirmed -Operation satisfactory Alarm System: no -Dedicated electrical alar �ndvi�u8| �|�nD in�idedvveUing -Alarm system operation ot I Zatisfa*cnot satisfactory Manhole Riser -Ground water intrusion atn totank connection -Ground vwaterintnusionaroundp\pepenetnaUo~Weep hole functional Ces� no -Manhole lid: Functional Insulated_ Property Secured Other .All manufacturer required inspections and maintenance completed les__I�� 17* Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, Al< 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I D 051-832-22 HAA# 03OL1QL} Expiration Date: / - —0 1. GENERAL INFORMATION Complete legal description TON.IFSS ESTATES, BE OCK 2, L OT 7 Location (site address or directions). 25138 PRINCE CIR- CHIJGIAK, AK 99567 Current Property owner(s) TODD & KRISTY BELL Mailing address Lending agency ..Mailing address Real Estate Agent Mailing Address Day phone 688-6916 Day phone TRACY CRAIG Day phone 261-7510 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATERSUPPLY: Individual Well Individual Water Storage Community Class Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank Well 0 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 sample results. (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. Name of Firm KND ENGINEERING, Inc. Address 20441 Ptarmigan Blvd., Eagle River, AK 99577 Engineer's Printed Name Kenneth M. Duffus 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 in land 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, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Phone (907) 696-6111 Date 9/26/2003 ........."4:6"407‘1 11411111 N= A• 7k /..i•N• �iC Kerne.. • fu If Is•• CE 7116 00 t41 k.of 4.; •PROFESS\ON%,. r 4,N>..c.<tttY � OFr@ a : . ON-SITE Wim: WATER AND : R': WASTEWATER : • PROGRAM yc4 bedrooms, with the following stipulations: ▪ -4))))1111 Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory By: ,i7X2 /C);)-a— Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date• / 0 - - 0 3 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 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: TONJESS EST.. BLOCK 2, LOT 7 Parcel ID: 051-832-22 A. WELL DATA Well type private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 4/12/99 Sanitary seal (Y/N) Y Wires properly protected (Y/N) ¥ Total depth 250 ft. Cased to 20 ft. Casing height (above ground) FROM WELL LOG AT INSPECTION Date of test 4/12/99 9/22/2003 Static water level 2 0 ft. 2 5 ft. Well production 8 g.p.m 7.7 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 m1.Nitrate 2.54 mgil.Other bacteria 0 colonies/100 ml. Arsenic: j mg./I. Date of sample: 9/22/2003 Collected by: KND Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL pate installed 9/98 Tank size 1250 gal. Number of Compartments. Z, Cleanouts (Y/N)Y Foundation cleanout (Y/N) Y_Depression over tank (Y/N)R_High water alarm (Y/N) Y Date of pumping 9/2212003 Pumper J R s C. ABSORPTION FIELD DATA Date installed //29/98 Soil rating (g.p.d./ t2 or ft2/bdrm) 0.6 System type TRENCH Length 1g6 (t. Width 3 ft. Gravel below pipe 4 ft. Total depth ft. Eff. absorption area 1008 ftp Monitoring tube y Depression over field N Date of adequacy test 9/22/03 Results (Pass/Fail) PASS For bedrooms Fluid depth in absorption field before test 0 (dry) in. Water added 630 gal. New depth15.5 & 6.5 in. Elapsed Time: _L5_ min. Final fluid depth 0 (dry) in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N 1f yes, give date D. LIFT STATION Date installed 9/98 Size in gallons 1250 Anch. Tank Manhole/Access (Y/NjX "Pump on" level at 41 in. "Pump off" level at 39 in.High water alarm level at 45 in. Datum Tank Bottom Cycles tested 3 Meets alarm & circuit requirements?j E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent Tots 1 0 0 + Absorption field on lot 100'+ On adjacent lots 1 00 ' + Public sewer main 75'+ Public sewer manhole/deanout 1 00'+ Sewer /septic service line 25'+ Holding tank 1 0 0' + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5 ' + Absorption field 5 ' + Water main 1 0'+ Water service line 1 0' + Surface water 1 00 1 + Wells on adjacent Tots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 1 0'+ Water main 1 0'+ Water Service line 10'+ Surface water 1 00 ' + Driveway, parking/vehicle storage 1 0' + Curtain drain 50'+ Wells on adjacent Tots 1 00'+ F. COMMENTS Well deepened on 4/12/99 under existing permit at that time—see attached w� Q _ G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HM guidelines in effect on this date. Engineer's Printed Name Kenneth M. Duffus Date 9/26/2003 41.4 O� �aC'4`r'f',1 9/ it a; - • *11. ... *'•i '•'� el. emnth M. •` s• It -W.* Sy. CE 711 •��/ `•Li' Rorasst0 e► HAA Fee $375.01) Waiver Fee $ Date of Payment Receipt Number (Rev. 12/01) 1-).)o103 tiu33 5� Date of Payment Receipt Number 09-26-03 02:41P11 FROM-CT&E ESI, SGS ENV SERVICES 9075615301 T-099 P.02/03 F-311 SGS.. SGS Ref.# Client Name Project Nante/# Client Sample ID Matrix Sample Remarks: 1036150001 KND Engineering Tonjess Est Tonjess Est B2, L7 Drinking Water All Dates/Times are Alaska Standard Time Printed Date/time 09/26/2003 13:17 Collected DatelTlme 09/22/2003 14:15 Received Date/Time 09/22/2003 16:30 Technical Hit ctoa; SteC. Ede Release Parameter Qualifiers Results PQL Allowable Pry Units Method Container10 Limits Date Analysis Date Ind Waters Department Nitrate -N Microbiology Laboratory Total Coliform 2.54 0 0,100 mg/L. EPA 300.0 B (<-10) 09/23/03 JIB co1/100m1. SM189222B A (a'1) 09/22/03 DKC ,1;11 ege ,404,521,00 0 ‘.17.7.14/"." .f--.�"o Z y87> • • ASBUILT 1,4f SEWARD & ASSOCIATES LAND SURVEYING 694-0829 I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: TGit/.>drS Er70,24"f ‘07- -.die: Z . AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS IICH DO NOT APPEAR ON THE RECORDED SUSDI rISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SCALE: i DATE: 99 GRI"Y.P//Sre--r FB: 77- Z7 DRAWN: A(st .�ysrt ♦ •• 0 •. Duane DMork Sewerd k lgzr , •. 1S-6918 a MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 r�ceiJec bu! CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I D # ,05-/g 3' HAA # CNC/P1 r('• 1 1. GENERAL INFORMATION Complete legal description ,Cor 7 /srTd/✓CS-G J f res 72 .r Location (site address or directions) P,R / n'c,= ci ec.z.z_ "?e-775":s- Property .ETA.: s- Property owner Mailing address Lending agency Mailing address Agent f� ,Te/iti' e• ."•." /)3N3 ,ham rrG. Day phone " `/e f=�r5- /Pi kr-) 951-7J rsrrr,er /%%mit_ -ir Day phone Ars. e•r lhr re; Day phone 6,r5'6`>'EHi Address �7'77'74/ rt; Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 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 1.40A '21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein.) furtherverify 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 re ulat'ons in effect on the date of this inspection. kag1e River Engineering Services. Name of Firm P O_ Boa 773294, Rivrx, AK 99577-3294 Phone ‘5-1-/ Address Engineer's signature ��'� Date -2—/ — T s 6. DHHS SIGNATURE Approved for 1 H1ZEC bedrooms. Disapproved. �g• OF • A�k�9 C ..• ail.. any.• ���• • 9� $*/49Z°i . ' 6® r... i.� HON.N.Ni.N.H•.. i.. �i•MMO.M •r N.N.N M.!1 Nto , i ,,i s - Jj plouis A Buten �' `( °Sr' CE -6735 " ." � Wry/rtti- i�j�L� �� (Gr Conditional approval for bedrooms, with the following stipulations: Note: The well for this property meets existing State and Municipal Codes. There are nitrates prenpnr Tr is nit£gesterl that periodic tenting he performed to insure the wells continued suitability. Current nitrate concentration is 6.52 rg/1. EPA maximum concentration is 10.0 mg/1. More information on nitrates is available from the On-site Services Program, DHHS, 343-4744. Additional Comments By 1??�Ci1'fi0�— 11 ,a(i(46 Date 2 . 1O .99 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Ranr, 1/91) Bark MOA 121 Municipality of Anchorage RECEIVE DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division FEB 17 1999 825 L Street, Room 502 • Anchorage, Alaska 99501 • (9041%1:F44Df AncJlorage Dept Health nut Serylces Health Authority Approval Checklist Legal Description: lof 7 B/y.z 7 "SefJ .1=r/o/rf Parcel I.D.: C$ 18 3. A. WELL DATA Well type f%'w-- k If A, B, or C, attach ADEC letter. ADEC water system number i✓ /4 Log present (Y/N) i Date completed 5-- -1-0 � s Total depth /G/ 6 / Cased to a o ' 4I'fr Casing height (above ground) a Sanitary seal (Y/N) i Wires properly protected (Y/N) Y FROM WELL LOG AT INSPECTION Date of test - - 7 8 / Static water level a 7 I Well production d.,5- GPr>. WATER SAMPLE RESULTS: Coliform Nitrate 6. S1 `Ms/4 Other bacteria Date of sample: /97 Collected by: Eos Roti L'NS /CCN B. SEPTIC/HOLDING TANK DATA Date installed 7/9e Tank sizebUO05 Number of Compartments 3 Cleanouts (WN)__7 Foundation cleanout (Y/N) )' Depression (Y/N) N High water alarm (Y/N) Y Date of Pumping Nth✓ 7'a..'( Pumper N/4 C. ABSORPTION FIELD DATA Date installed ��.19. Soil ratin p.d /ft2 r ftz/bdrm) D/ .6. System type Tre-r< `- Length /.?-6 7 Width 3 Gravel thickness below pipe 4/ / Total depth 6 Effective absorption area /Aye 46 Monitoring Tube present (Y/N) Y Depression over field (Y/N) /& Date of adequacy test n/ec✓ Results (Pass/Fail) P For `/ bedrooms Fluid depth in absorption field before test (In.); Al/- Immediately afterN b gal. water added (In.): "' 4 Fluid depth / /A ens) Minutes later. Absorption rate = p14_ g p d. Peroxide treatment (past 12 months) (Y/N) If yes, give date N/4 72-026 (Rev. 3/96)• D. LIFT STATION Date installed 9t Size in gallons /242,41 Ova, Manhote/Access (Y/N) Y "Pump on" level at y/ "Pump oft" level at• 39 High water alarm level at* 4/.3- Cycles tested ti hs G.•✓ 'Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WEU. ON LOT TO: Septic/holding tank on lot / 3o Absorption field on lot /.2 Public sewer main AIM - Sewer M - Sewer /septic service line L is On adjacent Tots -t-lo U On adjacent lots Public sewer manhole/cleanout "'A'F Litt station / 3 v SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ) $ ' Property line SS' ' Absorption field. 3.5" f Water main/service line S0 Surface water/drainage "fel'' Welts on adjacent lots 7`AC/' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line 3o ' Building foundation /cf Water main/service line tie Surface water riv, Driveway, parldng/vehide storage area Q Curtain drain ^1/+ Wells on adjacent lots t�o� F. ENGINEER'S CERTIFICATION 1 certify that 1 have determined thni field inspections and review of Municipal recu t gm* 1pms are in conformance with MOA HAA guidelines in effect on this date. syr%r.r1, 1 Signature . .. ir* '49ilj, `.*� Q1 Engineer's Name �irr.r 4 ,'t - - %SO� �•�•�• •»• .«� Date 2/f6// / Ie, \ 4$14-36 •'• r ..:••., 14`.6.44 HAA Fee $ _34"-Y"- inc) Date of Payment a_ tZ Receipt Number OL -t o (©!A 7 72-026 (Rev. 9/913)• Waiver Fee $ Date of Payment Receipt Number r:. FEB -18-83 10:15 FRON-CTE ENVIBONtiENTAL 5615301 .441tk. ChemLab Ref. it: Client Name: Project Name Client Sample ID Matrix. PWSID CT&E Environmental Services Inc. Laboratory Division 99.0584 Eagle River Engineenng Svc. n/a L7 EiIK 2 Tongass Estates Dunking Water n/a 200 W. Potter Drive Anchorage. AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 Client P0N Prmte4 Date/Time. Cotrectes Datelrune: Receives DatefCne: Technical Director. Roleased Far T-839 P.01/01 F -D00 Na 2/17199 17.30 211B199 1415 2116199 1620 Stephen Ems Sample Remarks: Parameter Total Coliform (MF) Nitrate Results POL units ARow2srie Method Limits Prep Date 0 cot 100 m1 SM92229 6.52 0.1 mg/L EPA 300 10.0 Analysis Date mit 2116199 KAP 2117199 SCL.