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HomeMy WebLinkAboutWOODRIDGE BLK 1 LT 5Woodrid Block I Lot 5 #020-093 -04 · ~'-~/ MUNICIPALITY OF ANCHORAGE I ~' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION !~ ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ~N-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT '3 ~-/J~-- O~-~5- [] UPGRADE MAILING ADDRESS ~_~O ] C L,'pF~s~,;~¢ C~ J¢,~Lo~46c= 4~ LEGAL DESCRIPTION LOCATION ~ ~ ~ ]Lcq'b~U~ NO' OF BEDROOMS ]~11 ,d~~ Absorption area Dwelling PERMIT NO, ~ DISTANCETO: ~,~' ' / ~ p~o~oEc=~ '~O~ ~ ~z Manufacturer ~ Materlal~.~ L No. of ~mpartments ~ ~ Liq. capacitv in gallons IF HOMEMADE: Inside length Width Liquid depth ~ ~ . ~ PERMIT NO. ~o~1 ~STA~C~ ~ Manufacturer Mate~ .. ~ ~apacity in gallons ~ ~ ~ Well Foundation 'Nearest lot line PERMIT NO, ~ No. of ,ines ~i~ ' ~g~of lln~ Trench width Distance between lines ~ ~ inches ~ ~ Top of tile to finish grade Material beneath tile ~ ~sorption area ~ inches Length Width Depth ~ PERMIT NO. ~ ~ Type of crib CHh dlamet~r Crib de,th ~,/ Total effective absor tion a~ea ~- ~T~EC I,~' 6x ~z x z ~ ~ ~ Well Building foundation Nearest lot line ~ DISTANCE TO: /0~ ~ 3~~ ~/ ~ Class ~ Depth DrilJer Distance to lot Jine PERMIT NO. ~ DISTANCE TO: BuiJding foundation~ Sewer line / ~ ~ ~ Septic tank ~ ~ ~ Absorption/o ~/I area(s) OTHER PIPE MATERIALS SOIL TEST RATING /0o REMARKS .- ~ - APPROVED DATE LEGAL 72-013 (Rev. 3/781 £: I PRL I T'~ OF ~-JCHOR~3E DEPRRTMENT OF HEBLTH ~ND ENVIRONMENTRL PROTECTION 825 L STREET., RNCHORBGE, 8K 99501 264-472~ Ol'-,J--$ T TE SEI-,-IER & L--IELL PEP. I'"I 'r T PERMIT NO: DPITE ISSUED: 840_?..4:.t 05/14/84 RPPL I CRNT: RD£ RE~_,. CONTRcT PHONE: CLRSSIC BUILDERS 60i CLIPPERSHIP CT RNCHORRGE, PIK 995±5 277-0551 LEGRL DESCRIF': LOT SIZE: LGT LOCPITION: MRX BEDROOMS: SUBDIVISION: WOODRIDGE SECTION: ~ TOWNSHIP: 40i52 (SQ. FT. OR PICRES) BETTY STREET LOT: 5 BLOCK: RPINGE: LISTED BELOW PIRE THE OPTIONS PIVPIILPIBLE TO YOU IN DESIGNING YOLIR SEPTIC SYSTEM. CHOOSE THE OPTION THRT BEST FITS VOUR SITE. T F: E I'-~ L--:H BEE-',, ~,1. [:,RR DEPTH TO PIPE BOTTOM (FT.) 5.0 5.0 5.0 GRPIVEL DEPTH (FT.) ~.0 0.5 2.5 TOTPIL DEPTH (FT,) B. 0~'---- 5. 5 7.5 GRPIVEL WIDTH (FT.) 2.5 17.0 5.0 GROVEL LENGTH (FT.) 6~.0 ~4.0 48.0 GRRVEL VOLUME (CU. YDS. ) 20. 4 2±. 4 26. 6 TPINK SIZE (GRLS) i, 000.0 ** i, 000.0 ** 1,000.0 ** SOIL RPITING'<SQ. FT.?BR) ±25 i25 i25 · *.*. TFINK I'ILIST ,HRVE PIT LERST TWO COMPPIRTMENTS CERTIFY THPIT: 1. I RM FRMZLIPIR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNtCIPPILITY OF PINCHORPIGE (MOR) PIND THE STRTE OF PILPISKPI. 2. I WILL INSTPILL THE SYSTEM IN RCCORDPINCE WITH PILL MOPI CODES PIND REGULPITIONS, PIND IN COMPLIRNCE WITH THE DESIGN CRITERIR OF THIS RERMIT. ~. I WILL PIDHERE TO PILL MOPI PIND STPITE OF PILPISKR REQUIREMENTS FOR THE SET BPICK DISTPINCES FROM RNY EXISTING WELL, WRSTEWPITER DISPOSRL SYSTEM OR PUBLIC SEWERPIGE SYSTEM ON THIS OR RNY RDJRCENT OR NERRBY LOT. 4. I UNDERSTPIND THPIT THIS PERMIT IS VPILID FOR R MPIXIMUM OF ~ BEDROOMS RND' PINY ENLRRGEMENT WILL REQUIRE RN RDDITIONRL PERMIT. F PI LIFT STPITION IS INSTRLLED THEN (i) PIN ELECTRICPIL'PERMIT, PIND INSPECTION MUST BE OBTPIINED~ 4ILL NOT BE RPPROVED WITHOUT PIN ELECTRICRL INSPECTION REPORT~ SLECTRICPIL,WORK MUST BE DONE BY R LICENSED ELECTRICIPIN. ,I~NED ~ .~..~_ DRTE: ~PPLicRNT:.~LRS~DERS --T ......... IN RN RREPI COVERED BY MOR BUILDING CODES, (2) RS-BUILTS AND '~' ~ THE M UN lC ipALI'i~[~-Jk- NC HO RAG E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 264~4720 SOILS LOG - PERCbLATION TEST r~ WAS GROUND WATER ENCOUNTERED? 13 [] . PERCOLATION TEST DATE PERFORMED: 14 15 16 17 18 19 20 IF YES, AT WHAT r ~ DEPTH? " I Z~ S Dross Net Depth to Net Reading Date Time Time Water Drop ~;.'~.. ....76',: l~. · ..': PERCOLATIC N RATE -minutes/inch) TEST RUN 8E~NEEN FT AND FT : - -~. DATE: SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH DRILLED AT THE RATE OF.$~'00 PER FOOT. 277-0551 ~o~ LOCATION OF WELL SlT~ DRILLER B~ ~ WELL LOG: 17---39' fta.~par~. 39--265t Bed~ocJ*. Ito ma, t.~ q.,Le. Ld ,~how, b~ umb~ 215 ,to 219~ wa,.~ p.zo~ aLL ~ ~o4~ ,t.o 265 ~5~.o To.ia2. ~ o~. 120 q.a. bLor~ wat. e~ ,zccmm..'~ bo.d~ .bo m,i,t~ 25 ~ o~. ~u.~f~. 1o6 q. o22.or~ p~. 300 Ca. LLo,'~ o~ ~a,~.~, ~ ,~,t.o,'t~¢o 3/4 Ito.,~e .~,t. a22.cd 15 f...f, o.f~ Co,~ o~ ~,'v~.~.n4: g9-3.0o p.~ ~ X 250 f,t: g5750.00 /vlUNICIPALITY OF ANCHORAQE DFPT, OF HEALTH & I:NVIRONMENTAL PROTECTION NOV 1 5 198a RECEIVED COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS for THE SUM OF g5750o00 THANK YOU VERY MUCH, BERNIE CLAUS OF RAMPART DRILLING WORKS DATE ~ 3,~, 1984 ( ( SERVICE CHARGE OF 1~% PER MONTH WILL bE ASSESSED ON PAST DUE ACCOU~qT~. 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.a k.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-093-04 1. GENERAL INFORMATION Expiration Date: .-2 '-' ......O .~-'_ 'C' ~ Completelegaldescription WOODRIDGE SUBDIVISION; LOT 5, BLOCK 1 Location (site address or directions) 16,541 VIRGO "' ANCHORAGE, AK Current Propertyowner(s) TIM &: DIANNE HAVARD Mailing address Lending agency Mailing address Real Estate Agent Mailing address Day phone 522-6441 Day phone DAVE AQUINO w/ JACK WHITE Dayphone 762-3120 3201 "C" STREET SUITE 200 * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: .3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site Individual Water Storage [] Individual Holding tank Community Class Well B Community On-site Public Water System 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 samples. (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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER at, or pdor J As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authodfy 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 wastewaler disposal sys. tem is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WASTE'WATER CONSULTANTS, INC. Phone ,337-6179 Address 6901 DEBARR ROAD, SUITE 28 · ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNE$S, P.E. Date Engineer's Comments: In conducting this evaluation. AKWWC, Inc. attempted to provide a thorough. conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The repealed results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactoq/ test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therafora not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ~ Approved for ..~ bedrooms. Disapproved. Conditional approval for be;:lrooms, with the fllowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other --~- WATER AND . ~ .. PROG~N~ Original Certificate Date: Legal Description: A. WELL DATA Well type pmvA~ Municipality of Anchorage Development Services Department Bu~lng ~afe~ Division On..Slte Water & Wastewater Program 4700 South Bregaw St. P.O. Box 196650 Anclx~age, AK 99519-6650 www.d.anchorege.alLus (9O7) 343-79O4 HEALTH AUTHORITY APPROVAL CHECKLIST WOODRIDGE S/D; LOT 5, BLOCK I Parcel ID: If A, B, or C provide PWSID~ N/A Date completed 6/3/1984 Total depth 265 ft. Date of test Static water level Well production 2 WATER SAMPLE RESULTS: Coliform .(~ colonies/100 nd. Arsenic: N//A mgJL.' B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size 1250 gal. Sanitary seal(YIN) YES Cased~ 265 ft. FROM WELLLOG 8/3/1984 25 ft. g.p.m. Nitrate ~'~ ~ mg./L. Date of sample: 11/1/2002 $1cEL Number of Compartments 2 Foundation deanout (Y/N) YES Depression over tank (Y/N). NO Date of pumping 10/31/2002 Pumper C. ABSORPTION FIELD DATA Date installed 6/~si~. Length 24 ft. Soil rating (g.p.d~ft~on~ 100 Width 22 ft. O 020-093-04 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 11 / 1/2002 30 ft. 3.2 g.p.m. YES 12+ in. Other bacteria ~ colonies/100 mi. Collected by: N<WWC, INC. Dateinstalled 6/1984 Cleanouta (Y/N) YES Hlghwataraarm(Y/N) N/A CHUGACH PUMPING System type SEEPAGE PIT Grovel below pipe 6 ft. Totaldepth .11.e ft. Eff. absorptlonarea ,55,2 ff~ Monitedngtube YES Deprassionoverfleld NO Date of adequacy tast 11/1/2002 Results(Pass/Fail) PA~S For 3 bedrooms Fluid del)th in absorption field before test. 10 in. Water added*e683 gal. New depth .15.5 in. Elapsed Time: 16 min. Final fluid depth 13.5 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - · %AST 520 GALLONS CAUSED NO RISE IN THE I. JQUID LEVEL D. UFT STATION Date installed 'Pump on" level at .__in. Datum - E. SEPARATION DISTANCES Size in gallons "Pump off' I~,v~l et Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot'98'+/- Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Manhole/Acc~= (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? Holding tank On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manholeJcleanout N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main N/A Wells on adjacent lots 100'+ Property line Water service line 5'+ Absorption field 5'+ 10'+ Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10°+ Water service line 10'+ Curtain drain NONE KNOWN COMMENTS *WAIVER GRANTED G. ENGINEER'S CERTIFICATION Building foundation 10'+ Sudace water 100'+ Wells on adjacent lots 100'+ I certify that I have determined through field inspections and review of Municipal records that the above systems am in conformance with MOA HAA guidelines in effect on this date. Enginser's Printed Name Date Water main N/A Driveway, parking/vehicle storage JEFFREY A. GARNESS HAA Fee S Date of Payment l, ~ - ~.~. -O~. Receipt Number ~4~<~ (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number I0'+ ./ I# "1 I 'I' ~,.,~ '.str~c~to~ which do not appea~ on dfvtstOn pla~. Unde~ no c~cmst~nces should I~ ~ . ' ~/~~..; . . d~t~ he~lon be used for construction or fo~ es~ab- T*S~TS 0~0,0~ r~ '. 11ehJng boundar~.'or fence-lines, The surveyor · t~lmM~b~ll.t,y for the tntttal transaction only.' mT~:~ ' ' ...~OCK ,. /' ANCHO~E RE~RD~G DISTRICT 1S-2Z-OZ 0?:36 FI~I~,-CT&E ENVIi~NI/ENTAL SRV ,~TK CT&E Environmental Se~icen Inc. 9075615]01 T-902 P.OZ/OZ F-441 CT&g Ref. N Client Name PrnJeet Name/ff Client Sample Il} Matrix PWSID 0 Sample Remark: 10:27940001 ~ Water & Wnstcwater Consultants Inc. lot 5, Blk Outside Faucet Drinking Water All Dar t~'Tlmes are Alalka Standard Time Printed Date/Time 11/22/2002 '7:31 Collected Date/rime i 1/20/2002 9:20 Received Date/Time 11/20/2002 9:40 Technical Dlrtet_gr..--~_ Steph ej~Ede Released By ~~ R~e,I. PQL Unin Mc~hod Allowable Prep A~alysis t.imits I~te D~te ln{t WaCmr$ De~ar~men~ Nitmte-N 0300 0.200 mg/L EPA 300.0 {<=10) 11/20/02 .IS Microbiolo~, Total Coliform col/10OmL SMI8 g222B {<-I} I U20/02 BAG Department of Health and Human Services Division of Environmental Sarvices On-Site Services Section 825"L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak, us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-093-04 1. GENERAL INFORMATION Complete legal description HAA # Expiration Date: LOT 5, BLOCK 1 WOODRIDGE S/D Location (site address or directions) 16541 Vir.qo Ave Current Property owner(s) Ms. Donna Leonardo Day phone 345-7178 Mailing address 16541 Virgo Ave, Anchorage, AK 99516 Lending agency Mailing address Day phone Real Estate Agent I~lr. Colin Roth Day phone 727-1191 Mailing Address 2600 Cordova St, Anch. AK 99503 Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 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 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. 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 Health Authority Approval Guidelines for 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 fifes and from my investigation and inspection, the on- site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Eno. Svc.. LLC Address P.O. Box 102954. Anch. AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Phone 272-8218 Date 2/28/2000 6. DHHS SIGNATURE M-'" Approved for ~ Disapproved. Conditional approval for bedrooms. ~ · .,~oc~¢ ~,. .~. ~ bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Expiration Date: X Maintenance Agreements Supplemental Engineer's Report Other X Original Certificate Date: ~" ,,) ~'"'- ¢ e -/..¢-,o o Reissue Date: Municipality of Anchorage Department of Health and Human Servic~[; ~. E I V ~- D Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 ~P~ 09 tSD~l www. oi:anohorage, ak. us (907) 343-4744 ~(~e~,~.t~'t O[" ANCHORAGE. ~ m~,~t~EN-fAL $~p,v~CES OIvy°' HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type PRIVATE Date completed 6/3/1984 Total depth 265' fit LOT 5, BLOCK 1 WOODRIDGE S/D Date of test Static water level Well production 2.0 WATER SAMPLE RESULTS: Coliform -- c3~ colonies/100 mi Date of sample: 212712000 B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Parcel I.D.: 020-093-04 IfA, B, or C provide PWSID #__ Well Log Y Sanitary seal _Y Wires properly protected Y Cased to 265 fit Casing height (above ground) 23 FROM WELL LOG AT INSPECTION 6/3/1984 2/26/2000 25' ft 21' ft g.p.m 6+ g.p.m in. Nitrate C~. ~ mg/I Other bacteria C -- colonies/100 mi Collected by: S.R.PANNONE Date installed 6/1/1984 Tank size 1250 Cleanouts Y Foundation cleanout Y Date of pumping 2~29~2000 Pumper A+ HOME SVC C. ABSORPTION FIELD DATA Date installed 611/1984 Soil rating (g.p.d./ft2 or fit2/bdrm) 100 Length 24 ft Width 22 fit gal Number of Compartments _2 Depression over tank N High water alarm N/A System type CRIB Gravel below pipe 6 ft Total depth 12.25 ft Effective absorption area 552 ft2 Monitoring tube Y Depression over field N Date of adequacy test 2/26/2000 Results (Pass/Fail) PASS For_3 bedrooms Fluid depth in absorption field before test 15 in Water added460 gal. Elapsed Time: 1440 rain Final fluid depth 15 in Any rejuvenation treatment (past 12 mo.) (YIN & type) UNKNOWN (Rev. 11/99) New depth22.5 in. Absorption rate >= 460 g.p.d. If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons N/A in"Pump offl level at Cycles tested in Manhole/Access _ High water alarm level at in Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent Pots 100+ Public sewer manhole/cleanout N/A Holding tank 100+ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 98' Absorption field on lot 100+ Public sewer main N/A Sewer/septic service line 85' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Property line ;107. Water service line 25+ Wells on adjacent Pots 100+ Building foundation 5+ Water main 25+ Drainage 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 10+ Surface water 100+ Wells on adjacent lots 100+ Property line 10+ Water Service line 25+ Curtain drain 100+ F, COMMENTS Well refracted in December of 1999. Note: Bedrock well. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P.E. Date 2-28-00 Absorption field 10+ Surface water 100+ Water main 25+ Driveway, parking/vehicle storage 50+ HAA Fee $. Date of Payment Receipt Number (Rev. 11199) o3 Waiver Fee $ Date of Payment Receipt Number Pannone Engineering Services, LLC Consulting Engineer HEALTH AUTHORITY ADEQUACY INVESTIGATION Legal: Owner: Residence: No. of Bedrooms: Septic System: Date of Pumping: Date of Test: Lot 5, Block 1 Woodridge S/D Ms. Donna Leonard 16541 Virgo Ave, Anch. AK 99516 Three (3) Tank Size: 1250 gallons Absorption System Type: Crib Absorption System Size: 24'x22'x6' Absorption Area: 552 s.f. Installation Date: 11/13/84 2/28/00 By: A+ Home Services 2/26/00 P.O. Box 102954 Anchorage, Alaska 995 l 0 (907) 272-8218 ~.....~ ..................... ~.,.,.~ Soil Rating: 100 sf?or Test Procedure: System was inspected visually and measured. The tank was found to have 6 feet of cover. Liquid depth was measured to be 50 inches. The drain field was found to have 75 inches of cover and a total depth of 181 inches. There was 15 inches of hquid measured in the field's monitor tube. Water was added from the well over a t05-minute period directly into the crib. Liquid depth was measured in the monitor tube. The liquid levels rose 7.5 inches in the monitor tube with the induction of 460 gallons of water into the crib. After the water was turned off, the liquid level returned to the original level within 1440 minutes. This system is able to absorb 460 gallons per day. The septic tank clean-out was measured to be 99.2 feet from the well. A waiver is on f'lle for this encroachment into the 100' well radius. It should be modified to 98.5' from the well to edge of septic The well was tested in conjunction with the septic system. The static water level was measured at 21 feet below the top of the casing (BTC). Casing extends 23 inches above the ground level. The well produced 6+ gpm, causing the static water level to draw down to 73 feet BTC. The records indicate this well is able to produce 0.99 gpm. I was informed that the well was re-fractured in December of 1999 to improve production. This is a bedrock well. Bedrock is known to shift with minor earth movement, causing the water bearing fractures to close unexpectedly, thus reducing the yield of the well. The water was tested for total coliform and other bacteria and nitrates. TEST RESULTS: This system meets the code and operational requirements of Municipality of Anchorage, Department of Health and Social Services for a 3 bedroom house. In conducting an adequacy investigation, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DHHS Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features, and are only valid for the specific day of the test. Furthermore, because of the limited nature of the investigation, it is possible that there are hidden defects or encroachments, which may not have been detected. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, water usage of the family being served by the system, and types of substances deposited into the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DHHS. The content of this report is for the sole benefit of the owner 1/sted above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. ,~ CT&£ Envirm~mentel 8gwJcg$ Inc. T-$~T P.02/05 F-OgO Client Samplc ~ Front Hos~ Ma~ ~nk~g Wa~r Ordered By PWS~ 0 Sam?le Remarks. Client ~v~'lnted Date/Time 03/03/2000 9:3 i Col|no,ed Date/Time 02/27/2~0 10:30 ~W~ Dare. line 02~8~ 12:05 Tec~ical D~ Stephen C. 0.500 mg/L ~PA]OD,0 t<~O) 02/28/00 02/28/00 Rick Mystrom, Mayor Mtmicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage.ak.us March 15, 2000 Letter for File A State of Alaska, Department of Environmental Conservation waiver which is on file approves a 99.2' separation distance from the well on the property to the septic tank on the property. That distance is actually calculated from the tank standpipe. The engineer of HA000090 states that the distance should be modified to 98'. I spoke with Keven Kleweno of ADEC and he suggested that I modify the waiver because it was not clear. Keven also stated since it is a single family home it is MuniciPality jurisdiction. Any questions, please call me. JeffPoet MUNICIPALITY OF ANCHORAo~ MUNICIPALITY OF ANCHORAGE EN~NlvtENTAL SERVICES DIVISION DEPARTMENT OF HEALTH & HUMAN 8EFIVICE$ Division of Environmental Services ~j~UG 05 1997 On-Site Services Section p.o. Box1966 o Anchora,e.A,aska343.4744 RECEIVED ParcelI.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING -- O~"~ '~, ~ O'd¢' '~ HAA# ~ GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency. Mailing address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~:~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-O25(Rev. 1/91) F~Onl 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 Alaska ,.,V~amr ,~, A Phone Wastew,~'~tcr 8ervJ~e~/ \ Address ~..~¢/~ ~i.3d,~ '~ \ Engineer's signature ~/~..?:~/~ ~)~ (..~./~ -- Data '~t/~~' bedrooms. DHHS SIGNATURE /~ Approved for ~ Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 DH HS 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. 72-0'2.5 (Rev. 1,91) Back MOA fi21 B= Legal Description: MUNICIPALITY OF MUnicipality of Anchorage ENVIRONMENTAL SERVICE~ DEPARTMENT OF HEALTH & HUMAN SERVICES AUG 0 $ Environmental Services Division 825 L Street, Room 502. Anchorage, Alaska 99501. (907) 34::~Et~E !V E Health Authority Approval Checklist ~.~0~[- ~'.) J~-..I..) ,(J-)OC)oj~'IO~-'~' Parcel I.D.: ~0 "-~_~ WELL DATA V~ell type ~::~<~" If A, B, or C, attach ADEC letter. ADEC wa/tar system number Log present (Y/N) '~/~------- ~ Date completed d/.~/~ 4'- Total depth ~ (o(~/ Cased to ,~--~"/ Casing height (above ground) Sanitary seal (Y/N) "~"~' Wires properly protected (Y/N) Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform "7/~/~ '~- .~ Date of sample: '7/%, Jo/? FROM WELL LOG AT INSPECTION SEPTIC/HOLDING T~K DATA Date installed /o/~~'' Tanksize l~-"~'-0 Number of Compartments ~ Cleanouts(Y/N) Foundation cleanout (Y/N) Y-~"-~ Depression (y/N) ~ High water alarm (Y/N) Date of Pumping ~/~:::~ ~ Pumper C= ABSORPTION FIELD ~)ATA Date installed ~/~ ~ Soil rating {g~ or fF/bdrm) /~4~) System type Length ~'4~d' Width '~."~--- Gravel thickness below pipe ~:) t Totaldepth /?---,~;~'/'""'~ Fluid depth in absorption field before test (in.); /~" q Effective absorption area t~'"'~_ Monitoring Tube present (Y/N)~"'~ Depression over field (Y/N)/~J~ Date of adequacy test '7/).-~;/'~ :~ Results(Pass/Fail) ~/~' For ~ bedrooms ~I Immediately after gal. water added (in.): Fluid depth J'~ ''~/i (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Absorption rate = g.p.d. If yes, give date D. LIFT~ Date installed ~ Size in gallons Manhole/Access (Y/N) ~f" lev~l~at* Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line ""~ On adjacent lots /OO ~" On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~'/~- Property line ~-/4- Absorption field Water main/service line /O ¢-N Surface wateddrainage /O©/¢- Wells on adjacent lots F, SEPARATION DISTANCE-' FROM ABSORPTION FIELD QN LOT TO: Property line Surface water Curtain drain ENGINEER'S CERTIFICATION ///( I certify that I have d~ete~C/~necY~r~fi'~ inconformance/yv~h~¢idel lesineffectonthisdate. Signature ~/'//~'/¢//(///{'-'/( ~ '-' . 7/ Engineer's Name ('//~~ 4' ~-~ Building foundation /~) f4- Water main/service line /O/'¢'' Driveway, parking/vehicle storage area ~-'-~ ~'/" ~',-vo uJ r'v/ Wells on adjacent lots Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev, 3/96)* MUNICIPALITY OF ANCHORAGE MEMORANDUM WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. ~970~S During a recent Health Authority Approval on-site inspection and test of t~e potable water supply well on Lot .~ Block I of \~OO~lg~[ Subdivision, the well's productivity was determined to be ,9~ gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a ~ bedroom residence is ·~[ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity 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 must be attached to all copies of the subject Health Authority Approval. It, ~s the ~espon$tb41~tY of 'the o~ner to det:erm'~ne.:', .~e existence. Of'. any eas~en~s, covenants, 'o~. ~e~./ strtc~iom ~htch do not appea~ on the recorded dtvts~on plat. Unde~ no ct.~c~stan~es should an~ data he,eon be used for ~onsttuct~on or for estab- lishing boundar~'or fence lines. The surveyo~ takes ~nlib~ll~ ~or the. tnfttal transaction only.' ~T ~ ..~OCK ,. ~,: ' ANCHORAGE RE~ORDING D,IST~ICT . -'. ~ ' · ' W R~ 8471 Brookridge Drive ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers August 1, 1997 Municipality of Anchorage Department of Health & Human Sereices Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: HAA for Private Well & Septic System. Lot 5, Bk 1, Woodridge S/D. To whom it may concern: The subject lot has a 3 bedroom house on it which is served by a private well and septic system. The results of the field investigation and adequacy tests are sununarized as follows: A. WELL: The static water level on 7/26/97 was 52' BTC. Water was irfitially pumped from the well at a rate of 3.61 gpm for a total of 30 minutes (108.5 gallons). This caused the level to drop 69 feet, to 119 feet. We could not obtain accurate reading below this depth because water was weeping over the probes on the well sounder. Pumping was continued for an additional 120 minutes at an average flow rate of 1.72 gallons per minute, at which time the pump began to cavitate, indicating that the water level was at the pump intake. The pump was then shut off. The well is 265 feet deep (per the well log) and the pump is set at 250 feet (recommended pump depth per well log). The level in the casing was measured 3 hours later and the water had rose to 130' BTC, an estimated rise of 120 feet (The seep, or spray, which had previously affected the sounder readings had apparently dissipated). Given the fact that the casing volume is approximately 1.48 gallons per foot, the recharge was approximately 178 gallons ((250'-130') X 1.48) in 180 minutes, or .99 gallons per minute. Based upon this data it was determined that the capacity of the well exceeds the Municipal requirements for a 3 bedroom house (.31 gallons per minute). An M.O.A well advisory shouM accompany the Health Certificate. B. SEPTIC TANK: The septic tank was installed in June of 1984 (13 years old). According to the inspection report, it is 1250 gallons, and made of steel. The useful life for a steel septic tank is typically around 20 years. No warrantee is made regarding the future life of the tank. C. SEPARATION DISTANCE FROM WELL TO SEPTIC TANK: In June of 1984 a waiver was issued approving a reduced separation distance from the well to the septic tank of 99.2 feet. According to our field measurements, it is 99.2 feet from the first septic tank c/o to the well, and the edge of the septic tank is only about 98 feet from the well. We are requesting the existing waiver be modified from 99.2 feet to 98 feet. D. SEPTIC SYSTEM ADEQUACY TEST: The drainfield is a seepage pit type system that has an effective depth of 6 feet, and an absorption area of 552 square feet. Prior to starting the adequacy test, the M.T. had 15 inches ofliquid in it. Seven-hundred & sixty-one gallons (761) was added to the pit, over a period of 140 minutes, and the liquid level rose 6 inches (total depth of 21 inches). Twenty-four hours later the level had dropped back down to t3.5 inches, indicating that more than 761 gallons had been absorbed. Based upon this data, it was determined that the absorption rate of the seepage pit exceeds 450 gallons per day, as required for a 3 bedroom house. E. SEPARATION DISTANCE FROM BOTTOM OF DRAINFIELD TO GROUNDWATER: According to the 1981 soils log, groundwater was encountered at a depth of 12 feet (5/12/81). According to the 1984 inspection report, the septic system was installed at a depth of 8.2 to 11.3 feet. This installation was approved by DHHS in 1984, and again (issuance of HAA) in 1984. The system has been in operation for over 13 years with no adverse impact on the well water quality. In short, there does not a appear to be any imminent health hazard associated with the existing installation. F. STANDPIPES ARE SCHEDULE 40 ABS: Although ABS is not an approved standpipe material for M.O.A installations, it is approved by the State of Alaska, Department of Environmental Conservation for all commercial/residential systems outside the M.O.A. Cdven the fact that the system had been in place for over 13 years, and the ABS pipes are still in good shape, I see no reason why the current configuration should not be approved. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1 Jeffrey/~.r( Princttp~l ifor your assistance. NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not limited to, seasonal surface water infiltration, groundwater variations, septic system maintenance (frequency of septic tank pumping, usage of biological additives), condition of drain pipe and pipe joints (which can be damagdd by seismic activity and deteriorate with age), type of substances deposited in septic system (cigarette butts, sanitary napkins, raise· objects), and the amount of water being introduced on a continual basis. Consequently, the results of this adequacy test are only valid for the specific day of the test. Furthermore, because of the limited nature of this investigation, it is possible that there are hidden defects which may not have been detected No warrantee ia' made regarding the future performance of this well or septic system c.c. Jack White Real Estate, Dave Aquino 1. General Information (a) Legal D~cription (include lot, block, Location (address or directions) ~-'r'r ~' S r MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEP NT OF AND ENVI O NTAL OTEOTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE ~--~pplication Date }1//~,/~ subdivision, section, township, range) (b) Applicants Name ~lJfFh~ O~ Do~AL,~ Telephone - Home 3 9~'~u%-iness Applicants Address~)~ (..~L~/~/~g~ ~,'/~ ~r (c) Applicant is (check o'ne) Lending Institution ~ ; ~; Buyer~ ; Other~ (explain); ~er/builder (d) Lending Institution Telephone Address (e) (f). Real Estate.Co. & Agent Address Telephone Mail the HAA to the following add£ess: 2. Type of Residence Single-Family..~.. Number of Bedrooms 3. Water Supply Individual Well ~ e Multi-Family Other (describe) Community~-~ Public~--~ Note: If community well system, must have written confirmation from the Stage Department of Environmental Conservation attesting to the legalit, f al~ eta~u~. Sewage Disposal Onsite ~ Public ~-~ Commmity ~ Holii~8 Tank ~ Noce~ If community well system, must have writ~en co~ft~aCium fr~a ~ Stm Department of Environmental ConservaZion a~e~zl~8 Zo the ~egali~y [Page 1 of 2] e Ensineering Firm Providin8 Inspections~ Tests~ File Search~ Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for. the number of bedrooms and type of structure indicated herein. I further verify that, based on the informatiom 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 regula- tions in effect on the date of this inspection. Name of Firm Address ; ~ OO Date /,// DHEP Approval Approved for_~__ Approved.__~. Disapproved Terms of Conditional Approval THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ~IEALTH AND ENVIROnmENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 WELL DATA Well Classification ]~/~ ~ %/l~ 't~ Well Log Present ~N) Total Depth ~ ~.%~' Cased to Legal Description: ~6T ~' ~/)(~am W,'D&&~' 'TI2A) If A, B, or C, D.E.C. Approved(Y~) Date ~leted ~/~ ~ ~ ~ ~pth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit ~N) Separation Distances f~om Well: To Septic/Holding Tank on Lot Pump Set At Sanitary Seal on Casing ~) Depression Around Wellhead (Y~ ; On Adjoining Lots > /Oo' 2.) To Nearest Edge of Absorption Field on Lot /O q-! ; On Adjoining Lots >/O ~3 Cz') TO Nearest Public Sewer Line A |/~ To Nearest Public Sewer Cleancut/Manhole AJ/K% To Nearest Sewer Service Line on Lot /f|/1% Water .Sample Collected By ~_~-~ Ct- ; Date //,/~/~((_ __ ~ Wate~ Sample Test Results ~/~ ~l'~F/,t~ B. SEPTIC/HOLDING TANK DATA Date Installed 11///~ ~ Size / ~- %-O No. of Cc~partments Standpipes ~N) ' Air-tight Caps ~/N) Foundation Cleanout ~N) Depression ove~ Tank (Y~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N)~/~,/~; for Holding Tank High-Water Alamu (Y/N) ~)/;~_ Temporary Holding Tank Permit Separation Distances from Septic/Holding Tank: To Water-Supply Well ~, ~' Gf/t/ /0J/To Building Foundation [,) "~ g ' To Property Line ~ 7~ ~°~/ To Disposal Field ~ q ! To Water Main/Service Line ~fj/~ To Stream, Pond, Lake, or Major D~ainage Course Receipt % Date Paid: Amount: [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /7/I/~¢ Width of Field ~_7_ ~ Square Feet of Absorption A~ea Depression over Field (Y~ Results of Last Adequacy Test Date of Last AdsquacyTest T!~lze of System DasignC__~ ~ ~ Length of Field __ ~' __. __ Depth of Field ~ ] j,'~-_~.,L( Gravel Bed Thick.ss ~ ' Stan~i~s ~esent ~) Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot /t;~ To Water Main/Service Line /~SQ-' To Property Li~ ~'? / ,.~ 7 / ~') To Existing or Abandqned System ; On Adjoining Lots >30; ~'~ To Cut.ha(if pressnt) ~/~ To Stream/Pond/Lake/or Major Drainage Course /~/~ To Driveway, Parking Area, or Vehicle Storage Area D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Ccn~ents ] Dimensions ~ ~ ,, Vent (Y/N) /~ Cycl~g Adequacy Test. ~ets MOA ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conform~.d to all MOA Hk~ ¢~aidelines in effect on the date of this insp~ctiono ~.~----~_.~_~-- KB1/d5/s ~ · ~.~.~.~-~ ~/~-.~ ~ [Pa~ 2 of 2] ~%~SV~;:.?' 2-.15-84 DEPT. OFEN¥1RONMENTALCONSERV/kTION SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: 274-2533 Ms. Wendy Donald Classic Builders 601 Clippership Court Anchorage, Alaska 99515 June 14, 1984 MUNICIPALI]¥ OF ANCHOP,~\G~ DEPT. OF HEAl.TH & ENVIRONMENTAL PROTEC[ION Dear Ms. Subject: Donald: Lot 5, Block l, Woodridge Subdivision On June 13, 1984, you submitted a request to us in person to waive the septic tank Separation distance from the well on the subject lot to 99.2 feet. We were told verbally by you that the waste system serves a single family residence, well depth of 265 feet, that there is no gradient from the waste system towards the well and there is a downslope gradient south of the seepage pit in a southerly direction. The request for waiver for separation distan'ce of 99.2 ft between the septic tank and the well is hereby approved. Richard M. Farnell Environmental Engineer RHF/msm cc: Robbie Robinson (HOA)