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Home My WebLink AboutELDON BLK 3 LT 3Eldon Block 3 Lot 3 #016-202-12 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion?;;<HV No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. 016 202 12 ELDON 3 3 MCQUALITY STEFANIE R 620 JACK STREET ANCHORAGE, AK 99515 3599 04 20 2023 70 BERKELEY B7P4JP05221-02 .50 10 MARTINSON PELLETS ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET ANCHORAGE AK 99518 ,ten Geon((, 1. 11'uerch, Mayor Anchorage Municipality of Anchorage d - A& I All -America City Btuildind Safety Divdsioti ' I I I 2002 November 13, 2002 David Grenier, PE Triad Engineering 440 West Benson Blvd., Suite 101 Anchorage, Alaska 99811-1349 Subject:: Waiver Request For Eldon Subdivision Block 3 Lot 3 Waiver Request Number WR020080 Parcel Identification Number 016-202-12 Dear Mr. Grenier: Your request for a waiver of the required 100 feet horizontal separation from the public sewer trunk to private well has been approved. The approved separation distance is 69.0 feet. This waiver approval applies to the existing public sewer trunk to private well separation only. Any future upgrade to the sewer trunk 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, Daniel J. Roth Civil Engineer On -Site Water & Wastewater Program P.O. IA)s 196650 • Anchorage, Alaska 99,519-6650 • Telephone. (907) 343-&301 • Fwx: (907) 343-8200 4700 South Bragaw Street • Anchorage. Alaskn (1`).507 h l t p://��c.ci.a ncl r oragc.nlca s r Municipality of Anchorage Development Services Department 'r Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995196650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR020080 PID#:016-20242 HA#: Date Received:10121102 Legal Description: Eldon Block 3 Lot 3 Engineer. Triad Enaineerina David Grenier. PE Applicant: Tom Seaward Waiver Requested: 69 feet from sanitery sewer main to well Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation 0 Total: Permit#: Points: Waiver is Granted: Waiver is not Granted: List Conditions or Reasons for above: SE E A Y.4CA-WAP Date: 10/28/02 By: PAA I Name of Reviewer Rec#: 027192 Amount: $1.000.00 Date Paid: 1012112002 Ar 0.01 r^ w6ivER RFQuEsT FOR fLDOly EURO/✓/S/OA/ Bz.aCH 3 Lar 3 Pv#I%IER REQUEST P14MVER WRO20080 tolAWER REQuESr FOR Pt?OPOibp $EWER L.I.vB TO WATER #vELL (fY!lTlA6>i� ('p 1 fEET. .. wr-" S£w6R LIaF Po,aTt — �N A,N� THE loROPosE-P sEw6R 1WE ^WILL Of CIAST p/pE. TNf TO/NTS 1A, rwtf SEw£R IIA/E 041tL SE TYTor✓ J01A47 WRAIPEp wiry 8 jw,L FoLYErarLr if fu(afE/ rA�r M/ITExe4L iNvjrMtep TO PROPER TN'E frL`-PA LINE !S POw" 64OW"erf at TUE w E u !!v Q L< F. S T/o�'. rNE wATF-ti IuFLL /S /01 FfiF_r pc, -c)° M KLrIP�6 op SILT f &jrovELLY S'X-r Ex1sr DETwcE41 6,ROu,uP SURFACE IWO WgfjeE TKg AiVVIFER 15 AWe*Puw7rReP i►r 9B fear. ME mar/c wArE,Q LEUFL IS or 37Frrr FRcA1 6KOuv0 SuRFACF. rK/t 1✓!�LL ,410PE/4RS rV 9E SUPPLIFP OY AV #QU.rfelQ r"Ar IS COWF/NfO. REUENr w*mv, ShAcpL6t /Np/C/4rF_ T"nr No BACM-re/a Atr ` pRESENT E NO /VIrRAT&.T 1�-ME vE7-ECM04.E. TK/S /J /A/ AY.#,Vr rm4r Is JFrnv60 BE ONS I7'E a-WsTE6,►¢-TE/Z 7WPtr w/LL GRAna tLY C,ONVEoCT" 7-0 r'L401,/c- SEwE1e. I S. of A. A. E. C. 5. A W. G, for 5. C. R. O: Po /,vrS � 6v1476R Tl49cF 90 SOIL So�BTiaN �J .mango Y --/-//)I`)'�. Jr7�/ �O.f./ •.J .6 N li 1` 1 NMA NNN C90 1.7Si00 / 3 t (42, w►�r�R rpBce (tK/40i6ar ASSWtt� CowSERuriT/✓f - S°/a .'. 2.0 NOR��oNrp2. SEp�4le/�t/ON I� ' ►4 Gl�nam �amL /6.9 comcl uS/ow 6-IP14Nr "WE IT m 440 W. Benson Blvd, Suite 101 P.O. Box 111349 Anchorage, AK 99511-1349 September 30, 2002 State of Alaska Department of Environmental Conservation Drinking Water and Wastewater Program Division of Environmental Health 555 Cordova Street Anchorage, AK 99501 TRIAD ENGINEERING Telephone 907-561.6537 FAX 907-561-6869 e-mail: davegrenier@triad-quest.com SUBJECT: Eldon Subdivision; Lots 9-13 Sanitary Sewer Extension Request for Well Separation Waiver Gentlemen, On behalf of the owner, Firstmark Homes, we request an ADEC approval for waiver of separation distances between the proposed sanitary sewer line to serve Lots 9 though 13 and the existing well located on Lot 3, Block 3 of Eldon Subdivision. The well, which serves a single- family residence, is 69 ft from the proposed sanitary sewer line, 6 ft short of the required 75 ft. The following comments address the items on the "Waiver Requests Checklists, For a Reduction in Separation Distance". 1. This letter and the attached plans have been sealed by a registered engineer. 2. The public health & drinking water is protected and the waiver request is justified for the following reasons: The line will be located down slope from the existing well. The sanitary sewer line will be constructed using ductile iron pipe with tyton joints. All materials & installation techniques will be approved by AWWU. AWWU along with an engineer from Quest Engineering will be inspecting the installation. AWWU will be providing maintenance after the line is installed, inspected and accepted. 3. The existing soils in the area consist of sandy silts to silty sands/gravel. No ground water data is available at this time; however, the proposed line is relatively shallow due to the existing line inverts (See attached plan/profile sheet). 4. The attached plans show the location of the proposed sanitary sewer line, existing utilities, existing wells plus the existing ground contours. The location of the existing well on Lot 3 with the 75 ft radius is also shown. The well was field located using survey methods & procedures. 5. Details of the system design are shown on the attached plaas�The plan s•reference— Municipality of Anchorage Standard Specifications (MASS), whichl!0 C d by he Anchorage Water & Wastewater Utility (AWWU) for cons=tion of improvements tha' the) will eventually accept & maintain. SEP 3 02002 L RECEIVED Your prompt response would be appreciated since the client is wanting to install the line yet this fall. If you have any questions, of if we can provide any additional information for your review and approval, please call. Sincerely, Ltier.,P.E. NG David A. UOt U4 U2 12:45p Triad Fraa- 9075616869 p-3 T-535 P.002/003 F-913 NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99707 19071456 -3116 -FAX 4663125 5761 SILVERA00 WAY: UNIT N ANCHORAGE, ALASKA 99518 (9013a-1130 - FAX 349 1018 POUCH 340043 PRUDHOE BAY, ALASKA 99734 10071 SS9.21A - FAX 659.2148 Marry Westbrook 3615 W. 84th Ave. Anchorage, AK 99502 Alen: P11011e: (907) 749-4495 Fax: NTL Lab#: A304301 Client Sample ID: Lot 3Blk 3 Location: Eldon Subdivision Client Ptojecr. COC#: 30177 Sample Matrix: Water Comments: Report Due: 10/3/02 Date Arrived: 10/2142 Sample Date: 1Or2/02 Sample Timc: 13:49 Collected By: MW Flne Definitions MRL = Method Report Level MCL = Max. Contaminant Lcvcl D — Present in Method Blank N = Above Reaulamry Maximum M = MnWx Tatafi=mc 1 = Estimated ValueBelow MRL D—Lesrta 011udan E v FArim l d Value Analysis Method Result Flag MRL - MCL Units Prep prep Analysis Parameter Method Date Date 1 SM 4500 NO3E Nivate-N *IRL 0.10 10 mg/L 1013/02 R;P&6dd By: Wendy Mitchell Anchorage lAboratory Manager Uct 04 02 12:44p Oct -03-2002 05:51w FrDm- Malty Westbrook 3615 W. 84th Ave. Triad 9075616869 T-53$ P.903/003 F-913 NORTHERN TESTING LABORATORIES, INC. 1330 INDUSTRIAL AVCNVE PAIRBANKS, ALASKA 09701 (90714.56-311G • I AX 456.372S 5761 SILVERADO WAY: UNIT N ANCHORAGC, ALASKA 99510 19091 340-1000 • r -AX 349-1016 POUCH 340(143 PRUDHOE DAV, ALASKA 9973A 1007) 959-2145 • FAX 659.2146 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA Anchorage AK 99502 Phone Number. (907)748-4495 Fax Number: Collected by: MW Sample Type: Routine Method of Analysis: MMO-MUG (SM 9223 S) Comments: Date Received: 10/2102 Date Analyzed: 10/2!02 Date Reported: 10/3102 Next Sample Due: Time Received: 14:18 Time Analyzed: 17:40 Time Reported: 17:25 Comments S = Satisfactory U - Unsatisfactory POS = Positive Test Result NO = None Detected TNTC = Too Numerous To Count (>200 Colonies) CG = Confluent Growth HSM = Heavy Sediment Masking, Results May Not Be Reliable TLIT = Sample Age >30 }lours. Too Long In Transit R = Resample Required NT = No Test . # Colonies1100 ml ^-0 Colonies/ml Sample Sample Total` E. Coli- Othere HPC" Date Time Coliform Bacteria Result Lab# Location Comments 10/2102 13:49 ND ND NT NT AX1922 Lw 3 Elk 3 Eldon Sm, sati3t4otory Kerry A. Lynch Enyironmenlal Anaryet 1013102 Northern Tesena Laboratories- Inc Mahora9e. AK p.2 r. a =Myo -mw =1044+-' 14f4)4-1 IL 5i 1 z halo 0 0 Ipp- jI y mm m� SP 32LD La' 8 ATA Hx? R8 ;�W24 ys �m N yZN$Z < err : ....... 1 IN: AL'fi0R0ANCE: j s �s Nyyj ,.�W/ACC; ::'.:7::::. MUNI:: RMS: :rT' �z 6p 1.6 . g y- � N ¢m T y mm m� SP 32LD L �m pl p2 n E? F N yZN$Z < err : ....... 1 IN: AL'fi0R0ANCE: j 4� �s p ,.�W/ACC; ::'.:7::::. MUNI:: RMS: :rT' �z 6p 1.6 . g y- � ...... .....: ...... .:......... �D F� U O T O STA.' 21+08:07 .:. E7(.: ..:........ ......:ar...... .:.... ...:...�/. .:.... ......... w : 8" "q.G:::::: STUB STUB ; W{PW f_ iYL GROSSING � � " ............... ....:.........: TO l0E! REMOVED u�l. ....:....... ..: . 'IN: AND:DISPOSED: of err : ....... 1 IN: AL'fi0R0ANCE: j N STATE,"FED. : bho;...�"....::::'di:'. ,.�W/ACC; ::'.:7::::. MUNI:: RMS: :rT' : ::: FDR: HAZ.: MAT':i ♦N♦ 1.6 . STA 24+43.22 g L F AI y >A ie' 9 W29 A9 Hui it PR (!) D Z D U) M M M R STA.' 21+08:07 ..:........ ......:ar...... .:.... ...:...�/. .:.... ......... ...:.. ...........,.:............. .:. ... .... . STA.' "ZI+28:00. . s zm a iYL GROSSING � � " ;.d�,.;:.....I .............:..:.::.:.:.:.:.:..:.:.:.:.:.:.:.: N N ::[".::: :'::::::::: i:::::::.. yNy ♦N♦ QN g y- IpVWJJO ...... .....: ...... .:......... �D ..... ..:.. A.:.:.:...:..........:.:..4..................;.................. A All 2 ................. .:.......:........ ..:.......:........ ..:...............:.................. ........ t STA 24+43.22 g L F AI y >A ie' 9 W29 A9 Hui it PR (!) D Z D U) M M M R Y SCALE : "-50' TRUE IaM II I \ ,1I 1 1IQ ® voa®�lb°�II� j 0 ®NI 11011 �I I PRAM ISN ;5q> g�ggig' ELDON SUBDIVISION OWNS ' 1z rn Z 0 s H m s zm a Nii N N yNy ♦N♦ QN g y- IpVWJJO �D 2 owa+ g � yA oA ;s y � m ao,o `iT is 4m r 9 _ y � sos W p W gp O < y� 0 A g 4 oN V I I I IO O 0 �W W M �2 a is c m N N � A Y SCALE : "-50' TRUE IaM II I \ ,1I 1 1IQ ® voa®�lb°�II� j 0 ®NI 11011 �I I PRAM ISN ;5q> g�ggig' ELDON SUBDIVISION OWNS ' 1z rn Z 0 s H PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW950369 DATE ISSUED:10/31/95 DESIGN ENGINEER:DUMMY COMPANY EXPIRATION DATE:10/31/96 OWNER NAME:NICOLAYSEN DARLENE OWNER ADDRESS:P.O. BOX 772013 EAGLE RIVER, AK. 99577 PARCEL ID:01620212 LEGAL DESCRIPTION: ELDON BLK 3 LT 3 LOT SIZE: 10800 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 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 BY DATE: DATE: ///%rJl- ,,r �� nom: Igo m sw ys t � •� iia �.�,�� - o b STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL,•RECORD LOCATION OF WELL BOROUGH SUBDIVISION LOT BLOCK SECTION OTRS SECTION TOWNSHIP RANGE MERIDIAN v Signature of Authorized Respreseptative Date ON 0 ❑S ❑W LOCATIOWSKETCH: WELL OWNER: l -yi V,07 <Ue( DEPTHS MEASURED FROM:[Icasing top ❑ground surface WELL DEPTH: DATE OF COMPLETION Depth of hole: / (! / ft BOREHOLE- DATA: Depth Depth of casing: 4,,-,l t /.2- Material Type and Color From To / %- DEPTH TO STATIC WATER LEVEL: '7 ft below ❑ top of casing ❑ ground surface Date: METHOD OF DRILLING: El air rotary ❑ cable tool .4�1 / ❑ other USE OF WELL: '❑ domestic ❑ irrigation ❑ monitor 5 ❑ public supply ❑ other f ,,l CASING STICK-UPS ft. Diam: /9 in. to/Of ft (7, Casing type: f,in. to i`_ft f" WELL INTAKE OPENING TYPE: El open end ❑ screened 1-- ❑ perforated ❑ open hole - Depths the of o ft openings: to r �E rt',�zc-,.-�...l.."-t., d!• I"�.,. / SCREEN TYPE: Diam: in. ' .��,. ,r ..-—X•/-rj�r. Slot/Mesh Size: "-,,Length: ft GRAVEL PACK TYk' Volume used: Depth to top: GROUT TYPE: Volume: JAN 2 G Depth: from ft to ft Municipality of nchorag DEVELOPMENT METHOD: r , #, u an Seryl es Duration: /_'6 , PUMPING LEVEL AND YIELD: A'1`0 ft after f hrs pumping /Ci gpm PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPLETION? 2.YES ❑ NO CONTRACTOR INFORMATION: REMARKS: I PLEASE MAIL WHITE COPY OF LOG TO: DNR/DIVISION OF MINING & WATER MGMT 3601 C St, Suite 800 Anchorage, Ak 99503-5935 Ph(907)762-2538,Fax(907)562-1384 Reglsterep Business'Name v Signature of Authorized Respreseptative Date REMARKS: I PLEASE MAIL WHITE COPY OF LOG TO: DNR/DIVISION OF MINING & WATER MGMT 3601 C St, Suite 800 Anchorage, Ak 99503-5935 Ph(907)762-2538,Fax(907)562-1384 t" UN I C XORL- T'T`Y OF= ANiC RFi1IE: DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ' 825 'L' STREET, ANCHORAGE, AK. 99801 264-472@ WEEL.L- P'F= F ZM I T PERMIT NO. C 790556 a APPLICANT JUDIE ROWLAND 3647 E. 65TH AVE 344 1642 LOCATION JACK ST. LEGAL L3 83 ELDON SeD LOT SIZE 10938 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL FIND ANY ON-SITE SEWRGE DISPOSAL SYSTEM IS EET FOR A PRIVATE WELL) OR 150 T 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. LOOS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION: BATHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION: F eRM T T EYjP i RM:r*E>FE0MM0r=Ft 3�!L, 1.SO750 I CERTIFY THAT 1: I AM FAMILIAR WITH TME RE UIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALLY OF CHORALE. 2: I;WILL INSTALL THE SYSTEM `ACCORDRNCE WITH THE CODES. SIGNED:---------- ._ _ _ �RPPLICANT UDI'E ROWLAND f` ISSUED B _ _ -- _ V3. 2 J M -W DRILLING, Inc. UPALi 'r P O. Box 4-1224 • 1310C International Airport Roan` pr T. (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG REt \ ' L�eJtl� Well Owner Tudie Rowland __Use of Well Location (address of: Township, Range, Section, if known; or distance main road - Lot 3 Block 3 Eldon Subdivision,_Anchorage Size of casing—.6 Depth of Hole— _440 _feet Cased to -42 2 —.2 5 feet Static water level -n/ -A—. -ft. (above) (below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or Well pumping test atm—gallons per (hour) (minute) for _hours with of drawdown from static level. Nate: kietl was not completed, Owner Date of completion 10/16/79 electe to ahandon the hole. WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 12 12 To 35 -35—To 41 ___41 _To 94 _94 TOS—. 101 150 165 —Silty sand—.-- I and. I acl—silt�_sand �t _ i 1 ' r mean U� 150 Wet sand: TO 165 TO 440 TO Sticky sand & c Gra s 1 —CUSTOMER r ;<:.ri1 17, 1973 I '.r. Ronald i ov:l and Alaska 99;30 ct: ';1-'ublic 'fell on Lot 3, ;:luck 3, Lldo!a ;i(! _ir. I_:owI and. T - I-] Well on Lot 3, a1oc1 3, Eldon Sub«ivisiun, til--"•.., t:y yu,: "Ias a'jai S co!;;e to our attention. Tac ire noc ffi !_; Servet; fay putable cater, 3s in.Iicateu by St 'T! e, ;a','C" Fv�-I1 is still iiprune rly cunstracL,-,- i r crvi0J3 so l was glut used to f l l i n the Wel l Ipi t r :zing L rf.+,;r A1ask;!i is<'.: ;. Tc tenants are entitlecS to Huta})Ie wstcr. A well Mai is conta:.Ina ted cannot be 'I UVJC.,r' to continue. . Aanuuaiu',; file existing Bell requir,,c' ti�3 1+t.:�Ii F' filled in with arproveJ tlaterials. +. grt-sift sewaa_;e disposal SVStews i.�a% trot public serer iS available to d lot. l le ri:ceipt of t;;is letter wilt serve as notice tlac: 1. Tit, existing well must be properly upgradeu and dis- infected within five (5) days, or new well construc:ii;lr started within fifteen (15) days. 2. The cesspool serving the residence of Gary tKedisin be abandoned and a connection made to public sewer. e.,. nVuulu AVYf Pv-1 E1 Pine Two April 17, 1973 r If you have further questions, please contact ire at 274-4661. Sincerely, i Les N. 3uchnolz, R.S. 4nvirun.;iental Control Officer II is r April 2, 1973 hr. Ronald Rowland Lax O-SI64 Anchorage, Alaska 99506 Account Subject: Well Upgrade - N, 63, Lloon S/U Dear Mr. Rowland: The well upgrading I oenLioneu in my letter of Varch 0, Inii, was zo be compleced within fifteen says of rQ,wipz. To K;z; notniny has been done except for a well house LUnStrWLQiU0. With spring breakup coming, 1 feel the upgrading should be clone very soon to protect against reconLa"inatiun. I will expect this upgrading to be Sone within five joys after receipt of this as you leave already had fifteon days by Ify previous letter. Sincerely, Los A. 6ULnholz, P.O. Environmental Control Officer 11 i s r March 9, 1573 Ronald Rowland Account.f: 016-202-12 box 8-9164 Anciiorage, Alaska 99508 Subject: Well located on Eldon Subdivision, Block 3, Lot 3 Dear Sir: A pit well on your property in Eldon Subdivision has been brought to our attention, due to an outbreak of intestinal disturbances in a familyserved by this well. Closer examination of the well showed evidence of standing water around the well casing allowing for ground water con- tainina%ion. We would like to call your attention to this fact and suggest well disinfection until up=grading the well is complete. Alaska law forbids this type of pit well arrangement and we are asking that the well be up -graded within fifteen (15) days from re- ceipt of this letter. Up -grading consists of extending the well casing eighteen (18) inches above ground and filling in the well pit with impervious soil. The area around the well should slope away to prevent standing water. Your cooperation would be appreciated and will prevent legal action. Thank you. Sincerely, Les Buchholz Environmental Control Officer mld MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Al ah Division of Environmental Services an On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0169 2O Z. 1 Z HAA #' 1. GENERAL INFORMATION Complete legal description 3 Lei Lc fC 3 F_ folo-v_ `St ..i Location (site address or directions) 62c) Jo -p -1L _'�Yee4 Property owner Mailing address Lending agency Mailing address. Agent Address Day phone �(✓e-r'i A K q'5 Day phone Day phone 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 Puhlic sewer NOTE: dcommunity wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm KND Engineering Phone ��o-loll 2(3441 armigan Blvd. Address r, ile River. AK 99577-8736 Engineer's signature Date a` C.OFe`�<.A @h k:.ons:n k.. C ii 711 6. DF�HS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments El IV: auric 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(R.v.V91) Beck MOAN21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 MUNICIPALITY O Health Authority Approval Checklist ENVIRONMENTAL SERVICES DIVISION I „`'N 2 ; 1996 Legal Description: LOT 3 Q/ock 3 Ed o Flu A{. Parcel I.D.: Dl G Z O Z /Z iR !^ r r - d v E D A. WELL DATA Well type /ND If A, B. or C, attach ADEC letter. ADEC water system number Log present (Y/N) / Date completed 1'�2 /,:z;, /%i Total depth /D / Cased to /0/ Casing height (above ground) ,;2 Sanitary seal (Y/N) Date of test Static water level FROM WELL LOG laLa 9S 37` Well production g.p.m. WATER SAMPLE RESULTS: Wires lI es properly protected'' (Y/N/) � 9 / AT INSPECTION Fi:t eF ..-, We%f lr� e Coliform Nitrate D. D3 mq IL Other bacteria/�- Date of sample: 1 II % I i!o Collected bv: kAID �A fmCGYvr B. SEPTIC/HOLDING TANK DATA Date installed Tank size umber of Compartments Cleanouts (YIN) Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y Date of Pumping Pumper \ \ C. ABSORPTION FIELD DATA Date installed Length Effective absorption area Date of adequacy test _ Soil rating (g.p.d./ft` or ft`/bdrm) Fluid depth in absorption field before Gravel thickness below pipe Monitoring Tube present(Y/N) Results (Pass/Fail) Fluid depth (ins.) Minutes later: Immediately after System type Total depth )epsion over field (Y/1) For t Absorption rate = Peroxide treatment (past 12 months) (Y/N) \ If yes, give date gal. water aN fied (in.): D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" le I at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 11,1A ; On adjacent lots Absorption field on lot NIk On adjacent lots "Pump off' i Public sewer main la -t- Public sewer manhole/cleanout /� f Sewer /septic service line 4-11-6 Jam" Lift station &A SEPARATION DISTANCES FROM TANK ON LOT TO: Building foundation Property line Absorption field Water main service line Surface water/drainage Wells on adjacent lots SEPARATION DISTANCE FROM BSORPTION FIELD ON LOT O: Building foundation Surface water Curtain drain F. ENGINEER'S CERTIFICATION Water main/service line Driveway, park i vehicle storage area on adjacent lots Property line I certify that I have determined thru field inspections and review of Municipal in conformance with MDA NAA guidelines in effect on this date. Signature Engineer's Name //emir /� !�!•��S Date HAA Fee $ J Date of Pavment Receipt Number Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number n are JACK STREET CD CD M M N89�55'45"E 60,00' i LOT 3 Go 0 0 CD 00 00 LOT 2 w 1D.zl zs.o LOT 4 Cin In � � o C 0 CD C`" U z M Y o----�16.67nI 10' UTILITY ESMT N89°55'45"E 60.00' P I herbycertify the following described property;LOT 3 , BLK 3 , ELDON SUBDIVISION BLS Anchorage Recording Precinct, Alaska, has been p. �F' AL�` surveyed by me, or at my direction, and that the CX. _ ` improvements situated thereon are within the 4s�t1 property lines and do not overlap or encroach on the ASSOC.. property lying adjacent thereto. That no improvements * 4- on the property lying adjacent thereto encroach on the P.O. BOX 0084 premises in question and that there are no roadways, ANCHORAGE, AK 99523 transmission lines, or other visible easements on said Tele. (907) 526-6050 a property, except as indicated hereon. - - ASN BB R BURNE � The information hereon is for the use of. lending ins- Fax (907) 562-6040 1 ,� vs -5464 A01 titutions specifically to show any conflicts between DATE: existing structures and platted lot lines or easements 9-11-95 and is notto be used for positioning additional SCALE: I" = 30' structures or fencelines. Easements of Record, Other \�\� than those shown on the recorded plat, are not GRTTI �,n�,