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Home My WebLink AboutLAKE RIDGE TERRACE BLK 1A LT 1ALake Ridge Terrace Block 1 A Lot 1 A #051-315-51 NAME LOCATION SEPTIC TANK: ,1 GREA I n ANCHORAGE AREA BORu utA Department of Environmental Quality 1ILu 3330 C Street 3 I (f Anchorage, Alaska 99503 �V INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS- 14FL0 S �� Adf H0NE LEGALDESCRIPT10N6e /c '4 ^�'� r �'A��l' 40- P_ dip e:-<� DISTANCE /�, / NUMBER OF e FROM WELL MANUFACTURER 5�- - MATERIAL COMPARTMENTS / INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY_?VQ-GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER OR WIDTH, LENGTHieu, DEPTH LINING MATERIAL/ CRIB SIZE: DIAMETER __CDEPTH 19 DISTANCE FROM: WELL /00 ( I TOTAL EFFECTIVE y BUILDING FOUNDATIONf NEAREST LOT LINEAO �. ABSORPTION AREA (WALL AREA) .76, SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHERSOURCES NEAREST SEWER LINE APPROVED DISAPPROVED REMA DISTANCES: INSTALLED BY: PIPE MATERIAL: r r LOT SLOPE: 4.�:/� •:� M REMARKS: jo -- �hk� DATE DEPTH SEPTIC TANK_ DIAGRAM OF SYSTEM N1 DISTANCE FROM: SEEPAGE SYSTEM _ ?it 1 3 Spgol ,c p, 15 - APPROVED CU NAME OF APPLICANT GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT INSTALLATION LOCATION LEGAL DESCRIPTION A o 7 MAILING ADDRESS 7ffS RL'<II'�i/5 'l �l�f Pe0NE 7� INSTALLATION OF: SEPTIC TANK �� SEEPAGE PIT �'` DRAIN FIELD , OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS DSS - NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE ��f,U ��f%�"�' SEEPAGE AREA SIZE /a1 //,2 G�/I TYPE !�, �ll' MINIMUM DISTANCES, REQUIREMENTS / DIAL M O S STEM FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL ks SEPTIC TANK 5 . SEEPAGE PIT AD , DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK w� / SEEPAGE PIT /04) DRAIN FIELD 42 ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK 49 r SEEPAGE PIT /G , DRAIN FIELD /01 SEPTIC TANK, 14)01 SEEPAGE PIT DRAIN FIELD D TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGN - -�-�-- 10- - - --- IL - I Fj Fut �vfe S- IF I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER CHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. -.__ 7-2 3- 17S' _ (Pol, v Coniftuation gait Za.b "One test is worth a thousand opinions" 6828 TUDOR ROAD. ANCHORAGE, ALASKA 88607 S T[L[►NON[ 333.8472 Performed For lArr !f V /R,y DatePerformed 7 % Legal Description: L t Block/,4 Subdivision This Form Renorts Soils Loq Percolation Test_ Denth Feet Soil Characteristics 1 T'o pso, L 2 — B A01 weap- t�,� " 3 — P V r�.a aQ, u -,o ! 4— `e 19'S t v} W N l 14 5— 6+4G JC h o e //tJ AV A F - evArce ORr-uc-4 7 -. 6G P) q — ao v^` 04� 4'� 10 — Was Ground Water Encountered?—AL If Yes, At what Depth? I Readinq Date Gross Time Net Time Depth to H2O Net Dron' i-- r— Percolation Rate Minute Proposed Installation: Seeoaoe Pit Deoth of Inlet Den rnmMENTS: 3;:,J" A. Drain Field o Bottom Of Pit C renc Test Performed By .T.W MAeZ Data Certified By: w Public Safety/Building Department File. 4-1 Department of Environmental Quality June 6, 1976 Lot 1A. :81. 1A Lakeridge Terrace Subdivision. The subject Int has a sewer permit for an on-site sewage disposal system. sr Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 L it,(1ANe'rrAP,&z e 4 • f s• ir• v CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-315.51 HAA# lcl-r)ntz , Expiration Date: I I�t,1lor., 1. GENERAL INFORMATION Complete legal description _ Lot to Block 1A. Lake Ridae Terrace Subdivision Location (site address or directions) '15032 East Lake Ridge Drive Current Property owner(s) Jay Skaggs Day phone 622.1777 Mailing address 15032 East Lake Ridge Drive Eagle River AK 99577 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Two 2 TYPE OF WASTEWATER DISPOSAL: ® Individual On-site El ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Enalneedna Phone 522.7773 Address P.O. Box 240773 Anchoraae. AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 101512005 5. DSD SIGNATURE __jZ Approved for 0 bedrooms. Disapproved. l 49th mcmm r Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: inu ma 12M) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water S Wastewater Program ' 4700 South Bragaw SL P.O. Box 198850 Anchorage, AK 9951943850 www.d.an homge.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: -Lot 1A Block 1A. Lake Rdae Tertacs Subdivision Parcel ID: _ 051-315411 A. WELL DATA wen type avjj4 If A, B, or C provide PWSID #. Date completed 7nn975 Sanitary seal (YIN) X Total depth _NLR Cased to _U_R. FROM WELL LOG Date of test 7nn975 Static water level 10 R Well production .77 g.p.m, WATER SAMPLE RESULTS: Coliform -L-coloniesl100 ml. Nitrate 0.14 mg.A. Date of sample: IQK=5 Collected by: LH B. SEPTICIHOLDING TANK DATA Wen Log (YIN) Y Wires properly protected (YIN) Y Casing height (above ground) >16 in. AT INSPECTION 76.0 R At g.p.m. Other bacteria LL cotonies/100 ml. Tank Type/Material SeptidStsel Date installed 7R9n975 Tank size 1.000 gal. Number of Compartments j Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) 14 High water alarm (YIN) N Date of pumping 9n5R005 Pumper ,IRs Pumping C. ABSORPTION FIELD DATA Date installed TI26/ M Soil rating (g.p.d.Ae or f Ax1nn)150 SFBDRM System type Ssspaae Ph Length 14 fl. Width 14 R Gravel below pipe 6 ft. Total depth 12 R Eff. absorption area V fe Monitoring tube X Depression over field IN Date of adequacy test 7131fY005 Results (Pass/Fall) Pass For j bedrooms Fluid depth in absorption field before test.% in. Elapsed Time: jo min. Final fluid depth 14 in. Any rejuvenation treatment (past 12 mo.) (YIN & type) Water addedEN gal. New depths In. Absorption rate >- 300 g.p.d. If yes, give date D. LIFT STATION Date installed 'Pump on' level at _ in. Datum Size in gallons ManholelAccess (y/N) "Pump off level at _ in. High water alarm level at in. Cycles tested Meets alarm d circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/1111 station on lot >1W Absorption field on lot AW Public sewer main _NIA On adjacent lots MW On adjacent lots AW Public sewer manhole/deanout NIA Sewer /septic service line >2S Holding tank _NIA SEPARATION DISTANCES FROM SEPTICIHOLDINO TANK ON LOT TO: Building foundation >5' Property Una >, Water main NIA Water service line Mir Surface water >111T Wells on adjacent lots MW SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water XW Driveway, pauking"hide age >2T Curtain drain _None Noted Wells on adjacent lots MW F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review, of Munktipal records that the above systems are in 49th confrmance with MOA HAA guidellnes fn effect on this date. _ Engineers Printed Name Michael E. Anderson. PgaMo. c MMM No, a-aea Date 101212005♦ee�Aaiiitt9� HAA Fee S 4430°o 075 A4JI Date of Payment /0-13-05 Receipt Number 07530 (Rev. lamoi PA Waiver Fee $ Date of Payment Receipt Number OCT.13.2005 9:03AM ALASKA USA MORTGAGE p rfl, bji:Z S�e�,a ��H.� aa:.Ja. 1Soi Z F, tRI d f4 pr. ert%, I.hn.na J • Pio. rbu5 _ I un 9r,1 c 9 r AS -B=T I hereby certify that i have the following described property.-I-oT 1-A I$ i K I- A. � �-iu.� Z3'�Tle-'w1tR 2.w 5H Anchotage Recording precinct,' Alas", and that the Improve - merits situated thereon are within the property Lima and do not overlap or enaoath on the pro rty lytn6 Adjacent thereto, that no Improvements on proingg adjacent thereto encroach on the premises in question And that dmre are no roadways, transmiWon Imes or other viaibk easements on said property except as indicated hereon. Dated at Eagte River. Aheks 'M this d.y of 3 2005 ROB C. JOHNSON - r C W SCALE: , RegisteredtandSurvevorNo.886L5 1" • Sox 774X%..Eagk River, Alaska 99577 Phone (907) 6W2519 t0-06-05;16:33 ; SCS Rcf.M 1056383001 C11entName AndcrsonEngineering ProjectNomde LIA B IA Lake Ridge Terrace Client Sample ID L I A B IA LAke Ridge Terrace Matrix Drinking Water PWSID 0 Samplc Remarks: ;907 561 5301 # 2/ All Datedrimes are Alaska Standard lime Printed Date/rlmo 10/06/2005 16:06 Collected Date/time 0927/2005 15:15 Received DrlcITIme 0927/2005 16:17 Technical Director Stephen C. Ede PuomcterPQL Uafu Method Allowable prep Analria Results Container ID Limits Dote Date 1.4, Nitrate -N MICrobiology Laboratory 0.184 0.100 mg/l, EPA 353.2 B (<-10) 09/27/05 AL Total Coliform 13OU, NoCall CaV100mL SM209222B A (o-1) 09127/05 TLF 10-13-05;10:31 ; SOS/CT&E EN R NM NR ECES %510 1 IDU�s W Drinking Water Analysis'Report for Total Coliform Bacteria READ INSTRUCTIONS ON REVERIE NDS BEFORE COLLSCTNO SAMPLE I MUST BE COMPLETED BY WATER SUPPLIER PUSLIG WATER SYSTEM 100 SAMPLE COLLECTION: •..e._ a" T. ;907 561 5301 # 2/ 2 200 W. POTTER DRIVE ANCHORAGE. ALASKA 99518 Tel:907-582-2343 Fax 907.561-5301 Send Results [113andlnvoles wWr a New M... IYe�.I Y sw. Of SAMPLE TYPE: Transpuned to Lab Dr. j�. Same as collector Other. TO BE COMPLETED BY LABORATORY Sample Recetvino: Routine O Repeat Sample 13 Treated Water O Untreated Water (refer to lab no. 1 0 Special Purpose Date: 10/ 11 10-5 13ssmplge+er301tounold'. ❑ RUSH SAMPLE Time: S'2 t9 R.emq may be untenable Temp: 4 • DaeHovWWer Phone#: Delivery Method: �-1 • A __&f Remote Londonh a%#: Received By. K ✓!/ A dlsn� F (A Comments: V v .................... ......................................................................................................... BaeterioloDleal Water Analysts Record: Analysis Sollon: /O/ Analyst: Analyual Method: embrane Filter MMO-MUG (P/A) MMO-MUG (►IA) RESULTS: Total Conform: G CoA MEMBRANE FILTER RESULTSt Dlr.Ct CWnt CobNos0100ml. V.dllcadow 0.68 Sem 10 ADEC: IWC FBK JUN D.lorTlms• Sent to Client Phoned ❑ Faxed Oatamme. MXZALc Spoke wtth: m...� LTB PG EC: Unsatisfactory ry { EC: ❑ Unsatisfactory TRC •TM NI.reM. M e.W Reported By: ✓ Date/Time:/0/0�0� /G ; O•/G : O•y as o rune Form S FW -0053 17/17103 \Weeslna30l%ANK GmvpDataWublc\DOCUMENTFORM51eppr eMOotl form 11217031111 a Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 f asjCERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-315-51 1. GENERAL INFORMATION HAA " pyc- Expiration Date: _ S`� 7- IG.? Complete legal description Lot 1A; Block IA: Lakeridge Terrace Subdivision Location (site address or directions) 15032 East Lakeridge Dr. Eagle River Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Larry Yahnian same Dayphone 696-7535 Day phone Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. ?W2 Z1 2. NUMBER OF BEDROOMS: _2 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System :L/7/0 3 TYPE OF WASTEWATER DISPOSAL: I Individual On-site ❑ Individual Hcldina tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development °e.wices 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 prcperties served by a sincie-family cn-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 cf 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 per'od of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B we!ls or a public water system. The Municipality of Anchorage is net responsible fcr errors or omissions in the professional engineers 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 dispcsal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. a & S ENGINEERING Name of Firm 17034 Eagle River Loop Road No. 2G Phone �'`I �i— _X `1 - Address =agle River, Alaska Enoineer's Printed Name 483 _,L 7 C — Co wh.� Date -,;i- /C, 3 . .. ?. 5. DSD /SIGNATURE ��i;;.� cs-a3o1 '� v JrF •• ...• :.'� w Approved for Z bedrooms. 1�1 vrL'Z,Ld� Disapproved. \"'^��=—''' Conditional approval for bedrooms, with the following stipulations: ,::(!ll(til Additional Comments = WATER AND �- �11A (+Tr, n n---. PROGRAM .= J�'%illlli)li)1)�' Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other 6y: J. , Original Certificate .J )Rev. 01102) Date: Z I T Ic? Municipality of Anchorage *A9 ' Development Services Department Building Safety DivisionOn-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 DescriptionLer I &-,or-K (Al o(rgc,— parcel ID: �%fJ'/ "3/ S = :5/ A. WELL DATA 2� sly Well type If A, B, or C provide PWSID # Well Log (YIN) Date compieted Sanitary seal (Y/N) Wires property protected (Y/N)_ Total depth ft. Cased too Casing height (above ground) /46min. FROM �WELL LLLOG AT INSPECTION Date of test Static water level I O ft /3 b ft. Well production Qt ?!3 g.p.m. 0-4.3/ g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate ja?� mg./I. Other bacteria ,,_ colonies/100 ml. S R S ENGINEERING Arsenic: &612,g, mg./I. Date of sample: I 03 Epi* Rtw�, Alaska 99577 Collected bA70�4 Emnla Rive. I.,.,^ OMA No. 204 B. SEPTICIHOLDING TANK DATA Tank Type/Material 45* % & &'11 Date installed 9L 2jS Tank size gal. Number of Compartments L Cleanouts (Y/N) '77 Foundation cleanout (YM).� Depression over tank (Y/N) N High water alarm (Y/N) ^1 tN5 r 0� Date of pumping O Z Pumper 'STN 11 -!Ly C. ABSORPTION FIELD DATA Date installedi/ Soil rating (g.p.d./ft, o M T System type CiQRC / I i Length ft. Width 14 ft. Gravel below pipe (_ ft. Total depth 10 ft. Eff. absorption area 2&e_fe Monitoring tube _ Depression over field AJ Date of adequacy test I D O Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test LJ- in. Water added1twhal. New depth n. Elapsed Time: lw_ min. Final fluid depth in. Absorption rate >= 34 � g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN &type) ***J If yes, give date D. LIFT STATION Date installed `Pump on" level at in. Datum E. SEPARATION DISTANCES Size in gallons "Pump ofr level at _ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/liif ,station on lot IVO 14 - Absorption 4"Absorption field on lot l 14 - Public sewer main Symgr�lseptic service line Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots 1 040 I' - Public sewer manhole/cleanout Holding tank N Z'44 - SEPARATION DISTANCES FROM SEPTICAJOLBIlIG TANK ON LOT TO: 1 r Building foundation *5 +_ Property line 5 4- Absorption field S Water main Water service line F- Surface'water l �% Wells on adjacent lots in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: i r / Property line t40 4- Building foundation / D � Water main Water Service line l 1+ Surface water (00 r I` Driveway, parking/vehicle storage r� Curtain drain ty4w&kQ Wells on adjacent lots �f F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are ir. +'. �,. ....y .....,.,;.....� conformance with MOA NAA guidelines in effect on this date. � *� -, AN �y Engineers Printed Name eo tg"LT �. Co -Y jA�'� % Date t HAA Fee $ 3 73% 1 Jf 0 . � � (-14 tt Waiver Fee $ Date of Payment G / o -3 _ Date of Payment Receipt Number o 3 I o C 3 Receipt Number (Rev. 12101) IIFAEn Uuonlol EtY rrmOVAI s stwrnlwAltn 1.UYIE>t1E1G101t9 SEwEn t wAl EII SEI'ECrloll tllcnu[nnlas0mrts Nmntronls WEII RISVECIRAI •rtowrtst SII Ell NIS Innntzsrcul Solt IES1 1111C.EM SulNl I(St SIIS)CIIHIU 1 MEC1 w SCALL 35rEcltrllls 011SUE WAStEWAItn tnro5A1 SYSItt/ Ittsocul 1101111111 C. C0wn1I, PE. 110111-:111 A. s11ArEll.1!E. E:IvIL El1(311ICEIl WELL nLCOVERY TLST DATA rnx(90 )69,l 1211 CLIENT: WELL LOCA11OH (lelpall: /—'/ /7- - 13J xt' Z,4 v c:.�. Qrt-r_ 'T-�rar�_-e-� TEST DATE:: 3, f7� 05 -- TESTEb BY: WELL bEpTll: S?OC7' WELL MULLER: /1-L CASING DEPTll: MATE bhlLLED:-7-/ — IES- t Phoa0JL1 j 11 Draw water down to pump. 2) Shut ptlnlp oil 15.60 hlln. -tecord little -record Itleler readmit 2) 'turn pump on. browdown. Al Shut pump all. -tccorcl lime -record meter readlllo 51 Calctllale pal./tltht. iccovery. Mlsc bA]A, cashltj ltehihl: Saldlary Seat? Wires In Concltlll? EAndillp 0.1(.? pump beplh: Samples lakes? bale: /B "-1- Y M -TJ AI& STAhi11ME: 140 ?2 STAiICWAIERLEVEL: J 3D.__,._,_ TRIAL ��UMP TIME METER r�� GAUMIN. i Orr- -�, ON —orr-_ U0 3 0 / �� / _ &A- r � — _orr_ Flo S I _� Q. 9130 /k 2 ON OFF �� at 3 orr 9 ON —orF- 4 Oi ori-- - !i of orr (tESULIs: WEI-I_ cUrztsLNiLY httouUcrs: O. 'g l _ &1-,Iq rLOW itAIE Not GllnttniJtLkb-sUbsGalJr_Nt VAf21A11ONS CAtJ c1CCllIt. 17(1:)4 tlolil l l EA(111: Illvr.lil EXIT' • 61111C204 • EAGI E lOVEII. AI ASKA (M1577 02-05-03 16:15 FROM-CTBE ENVIRONMENTAL SRV A&L CUE Environmental Services Inc. 9075615301 T-641 P.02/03 F-743 Cr&E Refit 1030567001 All Dates/rimes are Alaska Standard Time Client Name S & S Engineering Printed Date/time 02/05/2003 9:52 Project Name/// LIA. DIA, Lake Ridge Terrace Collected Date/rime 01/31/2003 13:30 Client Sample ID LIA, )31A, Lake Ridge Terrace Received Date/time 01/31/2003 14:43 Matrix Drinking Water Technical Qirector C79 Released Dy Sample Remarks: Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date Init Metals Department Arsenic 0.00200 U 0.00200 mg/L FPA 200.9 (<=0.05) 02/04/03 02/04/03 IMP Waters Department Nitrate -N 0.200 U 0.200 mg/L EPA 300.0 (<=10) 01/31/03 IS Microbiology Laboratory Total Coliform 0 col/100ml- SM189222D (<—I) 01/31/03 SKW UAKt KIUUt I tKKAUt JUbUIVIJIUP LOT 1 A, BLOCK 1 A 349291 S.F. z GAST'ALDI LAND SURVEYING JEFF A. GASI'ALDIt R.L.S. 4726 WEST SM AVENUE ANCHORAGE. ALASKA 99502 PHONE 248-5454 GRID NW553 TE 003 I HEREBY CERTIFY THAT I HAVE SURVEYED THE: PROPERTY DEPICTED ABOVE AND THAT NO ENCRMIiME NTS EXIST EXCEPT AS INDICATED. R M THE RESPONSIBA.TTY OF THE OWNER TO DETERIAINE THE EXISTENCE OF ANY EASEMENTS, COVF2WM OR RE5TR MONS WHICH DO NOT APPEAR ON THE RMOROED SUBDIVISION PLAT. UNDER NO CIRCU14STANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE UNFS. ANCHORAGE RECORDING DISTRICT, ALASKA 1 F.S. I JOB NO. i . I - ,o jvlLl& < PSE ••OF.. * • 4914 100600*04*00** j.j rkNen a 0 '� �•. is—eon -♦ A)-ofersi01M 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 051-315-51 1. GENERAL INFORMATION HAA# lAnCQ,L\Q� Complete legal description Lot IA; Block 1A; Lakeridge Terrace Location (site address or directions) 15032 E. Lakeridge Drive Eagle River AK Property owner Larry Yahnian Day phone 696-7535 Mailing address 15032E Lakeridge Drive Fagla Rivar, AK QAF77 Lending agency Bobbie Rawcliffe/Seattle Mortgage Day phone 762-3224 Mailing add Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 \' 3. TYPE OF WATER SUPPLY: Individual well xxx 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 XXX 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. 7MP.5 IRav 1/Q11 Frnnt MnA II91 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 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 regulations in effect on the date of this inspection. Name of Firm 5 & S ENGINEERING ---Yr�g�-E�r�{e-F�ive�Loop I�aad No 204 Phone C 2 �/ - Vic/ 7 6/ Address Eagle River, Alaska 99577 -- � 14 Engineer's signature 6. DHHS SIGNATURE / Approved for I bedrooms. Disapproved. Conditional approval for Additional Comments W,4 Date bedrooms, with the following stipulations: ow AA\Jly-- Date i/ Lf f 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Aw. 1/91) Back MOA #21 Legal Description A. WELL DATA Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES R E C EI V Ej Environmental Services Division �� (�I�j"t� 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 34��4Y7 Municipality of Anchorage Health Authority Approval Checklist Dept. Health & Human Services t-AKE flrpv,i: r'-ac4L I I-1 Parcel I.D.: 0 -3, 5__ � Well type j?V_,t\J0Mi - If A, B, or C, attach ADEC letter. ADEC water system number Log present ( N) Date completed / 7: Total depthCased to 15 52. Casing height (above ground) i2' Sanitary seal(�XN) Date of test Static water level FROM WELL LOG Well production '06 LOA g.p.rn. WATER SAMPLE RESULTS: Coliform ❑s Nitrate Wires properly protected (Y?V) Lj r --f' O.igZ AT INSPECTION U Other bacteriay Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Tank size Number of Compartments Z, Cleanouts y)N) S Foundation cleanout (Y r� 0 Depression (Y I,�` �'f'(� High water alarm (YO f\10 (1 Date of Pumping I I ° Pumper C. ABSORPTION FIELD DATA Date installed l `G Soil rating (g.p.d./ft2 o ft2/bdrin3 System type Y-3 Length ° � Width 14, Gravel thickness below pipe_ Total depth i Effective absorption area 3 36 Monitoring Tube present (FY I) Depression over field (Y torib Date of adequacy test Result (Pass Fail) PAe- �:,-S For :E"o bedrooms / h (? Fluid depth in absorption field before test (in.); J5 ti Immediately after ' gal. water added (in.): �Z r/ Fluid depth 5 (ins) Minutes later: 1:59 nn in Absorption rate = g.p.d. Peroxide treatment (past .12 months) (Y/N) t erir- ff" c_NJ If yes, give date 72-026 (Rev. 3/96)" D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at' _ Cycles tested E. SEPARATION DISTANCES Size in gallons "Pumf'p-4an" level at" `Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot loci /'k. Absorption field on lot lbj> 7 Public sewer main N lo Sewer /septic service line 2 14 On adjacent lots On adjacent lots "Pump off" level at" Public sewer manhole/cleanout Lift station �f /00 ,4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: rfi1.�. f ] Foundation 5 Property line bJ Absorption field Water main/service line Iv Surface water/drainage 100 Wells on adjacent lots I oL) SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101k Building foundation Ib' � Water main/service line ID } Surface water 100 1J �Driveway, parking/vehicle storage area i I) Curtain drain 1007; koo,l Wells on adjacent lots lbo r F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recor�,trrd!Zt�3 s are in conformance with MA guidelines in effect on this date. .Vv Jr Signature'•" . Engineer's Name ��i_. COciyJ M,. ..•�..�; ROBERT C COWAN "CE 8801 p �� Date HAA Fee $ '2) C L 0'�7 Waiver Fee $ Date of Payment S Q OAS Date of Payment Receipt Number 0,;19 I Receipt Number 72-026 (Rev. 3/96)' MUNICIPALITY OF ANCHORAGE M E M O R A N D U M WATER WELL ADVISORY HEALTH AUTHOR?TY APPROVAL NO .Rk1 w lZ 1 Durina a recent Health Authority Approval on-site inspection and test of rile potable water supply well on Lot i Block i A of �._{�� ;�(�� E2P GE subdivision, the well's productivity was determined to be(�'._ gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a �_ bedroom residence is 0.21 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the product -"on capacit-v of the well may fluctuate. Restriction Of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory mus-- be attached to all copies of the subject Health <u�.-hor_icy �pproval. MAY -21-1998 11:22 CT&E ESI ANCHORAGE CT&E Environmental Services Me. CT&E Ref.# Client Name Project Name/0 Client Sample ID Matrix Ordered By PWSID 982276001 S & S Engineering NIA Lt IA Bk IA Lakeridge Terrace Drinking Water 9075615301 P.02i05 Client PO# ;'Anted Date/Time 05/21/98 11:08 Collected Date/Time 05/14/98 15:50 € wolved Date/Time 05/15/98 11:30 Technical Director. Stephen C. Ede =Meased BY /0 ,9 w _/ Allowable Prep Analysis Parameter Results POL Units ;Method Limits Date Date Init Total Goliform 0 col/700ML W18 9222® 05/15/98 TMW Nitrate -N 0.192 0.100 m9/L ePA 300.0 10 max 05/17/98 05/17/98 RMV 13 HEAITHALTTHORITY APPROVALS SEWER& WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELLINSPECTION & FLOW TEST SITE PIANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL. INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN LS&S i ROBERTO. COWAN, PI a1f1L�f21f1G ROBERTA. SHAPER, P. (qTqAANN[j CIVIL ENGINEERS % ALWA (907) 694-2979 p WELL FLOW TEST DATA FAX(g07)694-1211 CLIENT: �Mll L jA {1A11.4 DATE: _5_1191m LEGAL DESCRIPTION: G.Tr I A ewcx I A LAKe IZTiI L;, ixl. 'g2 4r WELL DEPTH: 306, CASING DEPTH: -15 1 �rj\jlv P_ DATE DRILLING COMPLETED: DRILLER:ASL. CO: MISC. DATA: CASING HEIGHT: iz"-1 SANITARY SEAL: WIRES IN CONDUIT: * it) GRADING O.K.: BACTERIA AND NITRATE SAMPLES COLLECTED (date): TEST DATA: CLOCK TIME METER READING (GAL) PUMPING RATE (GPM) DEPTH TO WATER (FT) REMARKS 4z,004 - 7 r swl F o --J Fv�< ty 961- 3.7- ran` 43o 12 l 5 1-3 111 I?-'. 3iT ,-314 5 214.7 So�S 11,,'56 43tO5 Z.o o 11ZG 43232�,� 3E5, 1.35 r` 4 .J! 3fJ l/5r••+Z� A �i vG kl=, -^ J�I.B7;' T OiF �� I RESULTS: WELL CURRENTLY PRODUCES 4 GPM WITH A 33 DRAWDOWN TESTED BY: Z FLOW RATE NOT GUARANTEED --SUBSEQUENT VARIATIONS CAN OCCUR.