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HomeMy WebLinkAboutWHALEY #1 TR 6Whal T act 6 #051-111-10 oG REA~.,iR ANCHORAGE AREA BOR(.,GH Depsrtment of I:nvironmentsI C).uslity 3330 C Street Anchorage, AIssk8 ggs03 NAME LOCATION INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE / FROM WELL /~ INSIDE LENGTH MANUFACTURER _ INSIDE WIDTH  NUMBER OF MATERIAL COMPARTMENTS / LIQUID DEPTH LIQUID CAPACITY //d~'~GALLONB. TILE DRAIN FIELD: DISTANCE FROM WELL /~g~)/ . FOUNDATION NEAREST LOT LINE NUMBER OF LINES / DISTA]2CE BETWEEN LINES TRENCH WIDTH ABSORPTION AREA. 4;'~3'~0¢~//~J SQ. FT. LENGTH OF EACH LINE ? DEPTH: TOP OF TILE TO FINISH GRADE_ TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE DEPTH OF FILTER ~ ?/' MATERIAL BENEATH TILE_ . ABOVE TILE__ -~' IN. TYPE__ CONSTRUCTION DEPTH BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE__ SEWER LINE TANK , SYSTEM 7 DISTANCE FROM: CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: SEWER LINE DEPTH: d'~ / '/ LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM Form EQ-032 INVOICE · INVOICE NO. DEPTH ~(' DEPTH DEPTH IN FT. CASIN FORMATION 1NFT. CASIN FORMATION IN FT. CASIN~ li' __2 ( 'l ( ~x 102 __4 i t F- 104 5 ! I ~'a ~o~ ~-~6 i ~ ., lO6 --lO I / 1~o --11 I ~ ~.~ 111 115 _18 ! I '~ 118 i ~ ~ 218 21 ~ I~/~ 121 -- ' 122 I ~. 222 __22 J 1 -- ' 124 --25 I t " 125 Z27 I ) 28 ~ !-~- 128 "-29 ; /f~ 129 t 229 ---30 ! { · ~' 130 I 230 _~31 . I ~ 131 ] 231 __35 i ~ ~.~. 135 I 235 39 f I ("-. ~40 I 240 --45 ~ I i- 145 [ 245 ! { 142 --53 I I c~. 154-- I 254 --ss I ~ 15s 159 I 259 --63 I /Ii 163 --70 t ~- ~ '::' ~7o I 2~o --80 ~ ~83 --82 ~1 ~"~ 183 I 283 84 t )'ih 184 284 --86 { I '" 186 { 286 --87 I I/g 187 [ 287 --88 I I~'~ 189 I 289 ~91 I 191 I 291 92 I ~ 192 I 292 -- 193 ~ 293 93 / / 194 , 294 195 I 296 --95 ~ I 196 --9~ ~ ~, 197 ! 298 --98 v/ /fl ~¥ 198 PLEASE PAY FROM THIS INVOICE per foot AMOUNT MOON W LL DRILLING 7043 Terry Place y'::: ~:~ Z~/bt2l,/,z~',l~' ,~'~('~::{ [ YOURP 0 NUMBE~ Phone: 344-6139 or 337-2406 ~//, /~,, /r//z.~ ..,/2~ , ~-f'Z..~ :'( .~, g.,. ) T~R~S ,~,,.,~ ,~.)[~ /~ ,' ~ELL LOG ~ ' PERMIT NI.".). ( ) MICHREL O '" CI.']N NO~.: LOCRT ION HHRI..E"r' RV LE-'~RL ' '"' ' ' -" '=" : _, I ~E ~.,_0 ':-:,Q F T Lilt '-~ '~ ,T't'PE OF 'SCIIL. RBSORPTION $'T"STEH... TRENCH DEF'F~F,.':Tf'IENT OF HERLTH RND EN',,,'IRONf'IENTRL PRL-FI'EF:TION _ '.~ .... RNCHOF-:RGE-, RLRSF'.'.R 99503: ~]::'~E'; C ,.. 1 REEF ..... ,,~7'4-4. o N--- s :e -r E ~ F_" L41E F~_" F" E R [~-1 ~E T ......">~'--0t C:IiIMhlEF,:CIRL DR NI..IMBEF.: OF BEDRCIIiIh'I% ~ .=,. 1L RH7 INU., -.-,L4FL" BR. o= ,-..'~- c-' - "-- ''" -. R 'q ' ' IS:[:~: LENGTH=~ THE REQIJIR'.E[:, =,.t.,cE. OF THE _,~II HB=,I..IRF1 I_N ...'T_TEM THE 'MINZf'ILIH [:,EF'TFI OF GRRVEL. BETNEEN THE OUTFRLL PIPE ~ THE EXCRVR'~BOTTON THERE Ic NO SET' P.IIE:,TH FOR ]~.E. NI.,HE..,. FOF< [::,RRINFIEI_D$~ THE NIDTH Ib.q 2: FT. THE /DEPTH 'OF I~EN_.H IR PIT 1_ THE DI:TRNL, E BETNEEN THE 13ROUND ,.,I_IRFRI~E RND THE BOTTI3H OF THE E,...,~ RTIL N, THE I_E, NJlH' ~ ' DIf,IENSION 1'c. THE I.,..ENGTH OF ERCH 5I[:,E FO~' R '-aEEFHaE'-I-' PIT OR THE LENGTH OF I'HE 7REN,H O~ DRRINFIEL[:,. THE' ~.E(,LIIRE. D :EFIIu TRNK =,I~E .[... IE~80 ~RLLI3N_ BRCKFILLING OF' RN'¢ S'¢5TEN NII'HEIU~RL INSF'E2:TION B'¢ THI~; DEF'RRTHENT NILL E:EclJE JEL.:' '"1 TO P~'~SEE_ .... JTIKN , MINI.,-~IIM,. E.,I:,FHN..,E' '- ..... FROM NELL TO RN't' :,EPTIU' ..... TFINK,,"PFtCKRGE F'LRNT OR :,OIL HB_,ORFTION- 'c -' ~.,,~- c; ':tOO ,, ,, ' __,, -' -' :,m...,FEH I_ FT F'OR R FRI RTE NELL RND 200' FT :FFIE' R FLIE:I_Iu NELL NELL LOGS MI.J:,F E,E RE"FURNED TO 'THE [:'E~'RRTMEN? NITHIN ~:0 [:'R'¢~ OF, THE NELL CCIHPLET I ON. 5PECIFICRTION:5 RN[> CENSTR_ICTION [:,IRGRRNS RRE RVRILRBLE TO INSIjRE PROPER l N~TRLL. RTI ON. I CERTIF"," TFIRT R- , .... T" ..... F-' ..... b 5ET FORTH B'¢ THE MIJNI..]PRL...TT OF HNL. HJRRuE RND ~4ILL INSTRLL NITH THE COI~:,E. .... .............. I Rhl F'RMIi_IRF.: HITH THE KE.F..!IJ1F..Ef4ENT_ FLR uN-_I IE _,ENER..., RND NELL:, IN RCCORDRNCE GRE/ . R ANCHORAGE AREA BOR Department of Environment Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /,'~'~("/'~'"~CV~'r" MAILING ADDRESS LOCATION /22.,Zt(' "/~. U~//////~ e~/f_EGA~/~ESCRIPTION PHONE SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH / MANUFACTURER I~ INSIDE WIDTh ~ ,~7~,~/ NUMBER OF ( MATE RIAL ' COMPA RTM ENTS LIQUID DEPTH LIQUID CAPACITY ]~'~E~-PGALLONS, TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE_ FOUNDATION NEAREST LOT LINE DISTANCE BETWEEN LINES TRENCH WIDTH SQ. FT, LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE IN. WELL: TYPE BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED NEAREST SEWER LINE I REMARKS DEPTH SEPTIC SEEPAGE TANK__ SYSTEM DISTANCE FROM: DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE:_ REMARKS: DATE APPROVED G.A.A.B. Form PW*027 GEOIL CHNICAL DEVELC JMENT Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 Soils 8 Foundations Perfomed for: Legal Descrlptton:~.-T,'t~' CO. Earl Ellis 688-2280 S0[L LOG Land Development Hatltng Address: '~<~ ('~~c.,~ ~ .~s:~ ~'~.~<~ Sol1 ~haractertstlcs ]2 / Ground ~ater Encountered: Yes No v/ If yes, what depth P~oposed Installation: Seepage Pit v~.Drain Fte~d~ P~fo~ed by: ~ ~ - Municipality ol' Anchorage Development Services Department Building Safety Division On-Site Water and Was[ewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.ancherage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-111-10 1. GENERAL INFORMATION Complete legal description Expiration Date: Tract 6, Whalev Subdivision. Addition No. 1 o,:z r) .2-;o-/- Location (site address or directions) 2~17 Whale,,, Avenue Chuqiak, AK Current Property owner(s) Casey Campbell Day phone 688-4456 Mailing address 24417 Whale¥ Avenue Chuqiak, AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless ctherwise requested, HAA will be held by DSD for pickup. 2. HUMBER OF BEDROOMS: Three 3. TYPE OF WATER SUPPLY: Individ?al 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 Development Se,vices Department (DSD) Issues Certificates of Health Authority Approval (HA,a,) 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 bob. yeah 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. Cedificates of Health Authority Approval are vclid for 90 days from the date of issue for properties se.wed by a private or Class C well and may be reissued with new water sample results less than 30 days o'.d. (Ce.'"ti,'icates may be reissued for a period of up to one year with va!id water samples.) Certificates ere valid fcr one year for propedies served by Class A or B wells or a public water system. The Municipality of Anchorage is net respcnsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As cedified 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 Aulhority Approval Guidelines for this applicalion, shows that the on-site water supply and/or wastewater disposal system ks(are) safe, functional and adequate for tt~e number of bedrooms and type of structure indicated herein. I fudher verify that based on the infcrmatJon oblained 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 cedes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson En.qineerinq Address P.O. Box 240773 Ancheraqe, AK 99524 Engineer's Printed Name I',tichael E. Andersen. P.E. 5. DSD SIGNATURE X Approved for 3 Disapproved. Conditional approval for Phone 522-7773 bedrooms. bedrooms, with the following stipulations: Note: The well for this property meets existin~ state and municipal codes.There are nitrates present. It is suggested that periodic testing be performed to insure the wells continued suitability. Current nitrate concentration is 5.55 mg/1. EPA maximum Attachments: HAA Checklist Septic System Advisory Well Flow Advisory concentration is t0.0 mg/1. }tore information on nitrates is available from the On-site Services Program, at 343-7904 Additional Comments ; WASTEWATER: : .- .. ...... ~)/,, "~h 5=~. .,~ Supplemental E~ginccr's RepoN ~ Other Original Cedificate Date: [ .,' - ~ i - (C ~'2.. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Westewater Program 4700 South Bragaw St. ' P.O. Box 196650 Anchorage, AK 995196650 www.ci.anc~:~aga.ak.us (9O7) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Tract 6, Whaler Subdivislan WELL DATA Well type I=~va~e Date completed 2~9/1971} Total depth 277 ff. If A, B, or C provide PWSID # Sanitary seal (Y/N) Y_ Cased to. >40 ft. FROM WELL LOG Date of test 2/9/1976 Static water level Unknown ft. Well production I g.p.m. WATER SAMPLE RESULTS: . Caliform 0 colonies/10Oml. Nitrate 5.55 regal. Date of sample: 11/11/2002 Collected by: MEA SEPTIC/HOLDING TANK DATA Tank TypedMaterial SeptidSteel Tank size t,000 gal. Numbe~' of Compartments ~_ Foundation cteanout (Y/N) Y_ Depression over tank (Y/N) Id Date of pumping 1.lllr20~2 Pumper Chu~lachPumping ABSORPTION FIELD DATA Parcel ID: 051.111-t0 Well Log (Y/N) Y W~res properly protected (Y/N) Y Casing height (above ground) >24 AT INSPECTION 11/11/2002 101 ft. 1.5 g.p.m. iN. Other bacteria 3.colonladlO0 mi. Date installed 5/1/1976 Cleanouts (Y/N) Y High water alarm (Y/N) Date installed 5/1/1976 Soil rating (g.p.d./ft2 or ~/bdrm) I15 SFJ~ORM System type Dee~ Trench Length 43 fl. W~dth 3 ft. Gravel below pipe 4 Total depth 8_ ft. Eft. absorption area 258 ~ Monib:xing tube Y_ Depression over field N_ Date of adequacy test 11/1t/2002 Results (Pass/Fail) .P'dss Fluid depth in absorption field before test 24.8 in. Elapsed Time: ~5 min. Final fluid depth 24J in. Any rejuvenation b'eatment (past 12 mo.) (Y/N & type) N Water added515 gal. New depth31 in. Absorption rate >= 450 g.p.d. If yes, give date D. LIFT STATION Date installed "Pump on' levol at __ in. Datum E. SEPARATION DISTANCES Size in gallons 'Pump ofF' level at Cyoles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot >100. Public sewer main N/A Sewer/septic service line >25' Property line >t0. Water Service line >t0. Curtain drain None Noted F. COMMENTS in. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit i'(Nluimmerd~?. On adjacent lots >100' On adjacent lots >tlX~ Public sewer manhole/cleanout Holding tank NIA N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5* Property line. >5' Water main N/A Water service line >t0. Wells on adjacent lots >t00. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation >t0' Surface water Wells on adjacent lots >100' Absomtion fiold >5' Surface water >t00' Water main >t0' Driveway. parking/vehicle storage 1' Monila' Tube is Adiacent lo Dmewa~ and Bel0w Grade to Prevent Damage Duri~ Snow I:qowin~, 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 Michael E. Anderson. P.E. Date 11118/2002 HAA Fee $ Date of Payment // Receipt Number ~._~,,~ (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number in. ANDERSON'ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 , 522-7773 522-6779 (FAX) November 18, 2002 Casey Campbell 24417 Whaley Avenue Chugiak, AK 99567 Subject: Tract 6, Whaley Subdivision, Addition No. 1 Well and Septic System Inspection, Testing and Certification Dear Casey: At your request we inspected the well and septic system on the subject lot to determine if they met the requirements for certification by the City. Prior to the inspection we inspected the Municipal records and found the septic system was originally constructed in May of 1976 and no Improvements have been made since that time. The accepting soil material in the absorption trench according to existing documentation is a clean well graded gravel with an absorption rate estimated at 85 square feet per bedroom. The absorption trench is approximately 43' long and crosses the driveway with the monitor tube/sump approximately 1' from the edge, The monitor tube was buried approximately 3' below the surface to prevent damage during snow plowing of the driveway. The well was also constructed in*February of 1976 and is 277' in depth with 6" steel casing to at least 40' below the surface. The septic system was tested approximat~iy 2 years ago and no water was found in the absorption trench. On November 11, 2002, we probed the monitor tube at the end of the trench and found nearly 24.5" of water indicating the absorption characteristics have deteriorated over the past two years. We then injected 515 gallons of water into the monitor tube and the water was distributed to the trench. The water level in the tabe rose to 31". The water level was checked approximately 50 minutes later and was found to have receded to the elevation recorded prior to the test. We conclude from this test the trench is capable of absorbing the required 450 gallons of water per day and meets Muni.cipal requirements for certification. It must be noted, however, that the lifespan of a septic system ,s affected by many variables and no guarantees or warrantees as to the future'life of the system are made or implied as a result of our test. The static water level in the well was measured at 101' below the ground surface prior to our test. Water was allowed to run freely from the well through a hose bib and through a 5~8" hose and measured with a volumeter. Flow was slightly restricted as we noted from previous tests the well produces less than 2 gallons per minute. Flow was measured at an average rate of slightly more than 1.5 gallons per minute with the static water level in the well dropping to 206.4'. Once flow from the well was stopped t.he static water level returned to its original level in an hour. The well is therefore capable of producing in excess of the required 450 gallons per day. A sample from the water system was taken to the laboratory for analysis and found to be free of coliform and other bacteria with only a trace of nitrate content. The well and water are therefore eligible for Municipal certification. Sincerely, Michael E. Anderson, P.E. Attachments , ,.? ..-%., ,.i ' ' '" "~ '~'5 · ' ' ;: '- ' "'"" ' :' ~,' ~:~;. '.-~.' "' .,'-".,' i'.. · "':'.'"', ' · ' ' " ~ · ~ " / .... · ' "~e.- :" '-*~ } ~ '- "...':: - . /. , . . ~ -- -." '-'"~'t49~ '"'- ~' ' · ' ' " P~CENT, ALASKA, AND THAT THE IMPROVEMENTS $ TU TED ~A~ ..... ~.~...' :' '"- .... . '..'-LA~ ~'[~ROACH ON 3HE ~TY LYIN~ ADJ&C[NT THERETO, THAT '.t-.' ROAD~AY,,TRANSM SS ON LIN[I OR OTH[R'VISIBL[ EASEMENTS ONt. ... :...' I1-15-0Z 10:11 FROk~-CT,IE ENVlROHtENTAL SRV .~T~__' CT&E Environmental Send,es Inc. 907501S301 T-756 P.02/03 F-243 CT&£ Re£~t Client Nam~ Project Hame/~ Client Sample 102776S001 An~rson £ng~necring Various Tract 6, ~hale¥ DTinking Water PWSID 0 Sample R~mntks: All Dates/Times ire Alaska Standard Time Printed l)atefl'ime 11/1';/2002 10:23 Collected Date/Time !1111/2002 14:15 Eeceived Date/Time 11/11/2002 Technical Director SJ~en C. Ede Resul~ PQL Allow&hie ~ Analysis I.imit~ I:~tc Date Init Nitra~-N 0.600 mg/L EPA 300.0 (<-101 I t112/02 IS I~.crob~olog~' Z. abo~rato~ Total Coliform 3 OB. No coin col/100mL SM18 9222B 11111/02 Received Time Nov.lS. 10:ITAM Parcel I.D. 051 -1 1 1 -1 0 1. Municipality of Anchorage Department of Health and Human Services Division of Environmental Services 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 Expiration Date: GENERAL INFORMATION Complete legal description Location (site address or directions) Tract 6, Whaley Subdivision, 1st Addition 24417 Whaley Avenue Current Property owner(s) Michael T. O ' Conner Day phone Mailing address P.o. Box 670736 Chugiak, AK 00567 688-3051 Lending agency Mailing address Day phone Real Estate Agent Mailing Address Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: Three TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class Well [] Public Water System [] (3) 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. 72 025 (Re'/ 011rO0)' 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 the Health Authority Approval application show 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 ail applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchoraqe, AK Engineer's Printed Name Michael E. Anderson, P.E. DHHS SIGNATURE ~ Approved for . Disapproved. bedrooms. Phone 522-7773 99524 Date 7/12/00 ~? · .',:-~ - . ,~ ~'-," .......EN~Ii~EER'S ' Conditional approval for bedrooms, with the following stipulations. Note: The well for this property meets existing State and Municipal Codes. There are nitrates present. It is suggested that periodic testing be performed to insure the wells continued suitability. Current nitrate concentration is 6.28 mg/1. EPA maximum concentration is 10.0 mg/1. More information on nitrates is available trom the On-site~erv~ces ~rogram, DHHS, 343-4744. Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: Original Certificate Date: '~ ~ / ~/-' O O Reissue Date: 75 025 <Rev 01 00)' L'- Municipality of Anchorage Department of Health and Human Services Division of Environmental Services 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 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Tract 6, Whaley Subdivision, Addn. No. 1 ParcelI.D.: 051-111-10 Well type Private If A, B, or C provide PWSID # __ Date completed 2 / 9/7 6 Sanitary seal Y Total depth 277' ft Cased to >40' FROM WELL LOG Date of test 2 / 9 / 76 Static water level Unknown ff Well production 1 g.p.m WATER SAMPLE RESULTS: ft Well Log Y Wires properly protected Y Casing height (above ground) > 2 ' in. AT INSPECTION 7/2/00 110 ff 1.4 g.p.m Coliform 0 colonies/100 mi Nitrate 6.20 mg/I Other bacteria 0 colonies/100 mi Date of sample: 7 / 2 / 00 Collected by: [~EA B. SEPTIC/HOLDING TANK DATA Tank Type/Material steel Date installed 5 / 7 6 Tank size Cleanouts ¥ Foundation cleanout Date of pumping 6/30/00 C. ABSORPTION FIELD DATA 1,000 gal Number of Compartments 1 Y Depression over tank N High water alarm N Pumper CuFcr Duper ~ ~ Sanitary Pumpers Date installed 5/76 Soil rating (g.p.d./ft2 or ft2/bdrm) ~5r; Length 43' ft Width 3' ff Gravel below pipe Totaldepth 8 ff EffectiveabsorptJonarea258 fF MonJtorJngtube Date of adequacy test. 7/2/00 Results (Pass/Fail) Pass Fluid depth Jn absorption field before test 0 in Water added__ Elapsed Time: 24 Hrs min Final fluid depth 0 in Any rejuvenation treatment (past 12 mo.) (Y/N & type) N s~System type Deep Trench 4' ft Y Depression over field N For 3 bedrooms 450 gal. Newdepth 18 Absorption rate >>=4 5 0 If yes, give date in. __ g.p.d. 72-026 (Rev. 01/00)* LIFT STATION - N/A Date installed "Pump on" level at in Datum E. SEPARATION DISTANCES Size in gallons __ "Pump off" level at __ Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot> 100 ' Absorption field on lot > 100 ' Public sewer main N/A Sewer/septic service line > 2 5 ' in Manhole/Access High water alarm level at __ in Meets alarm & circuit requirements On adjacent lots > 1 0 0 ' On adjacent lots > 1 0 0 ' Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation > 5 ' Property line > 5 ' Water main N/A Water service line > 1 0 ' Drainage > 1 0 0 ' Wells On adjacent lots > 1 0 0 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 0 Property line > 10 ' Water Service line > 10 ' Curtain drain None Noted COMMENTS Absorption field > 5 ' Surface water > 100 ' Building foundation > 1 0 ' Surface water > 100 ' Wells on adjacent lots > 100 ' Water main. N/A Driveway, parking/vehicle storage (See Letter) Effective Absorption Area Size Taken From As-Built 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 MichaP_] R_ A~qr']c,'c~On ~ P. E · 5/18/76 Date 7/13/00 HAA Fee $ ,.~ Date of Payment'~ Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-~26 (Rev. 01/00)* July 13, 2000 Municipality of Anchorage Department of Health and Human Services 825 "L" Street Anchorage, AK 99502-0260 Attention: Onsite Services Engineer Su~e~: Tract C, Whaley Subdivision Certificate of Health Authority Approval Dear Onsite Services Engineer: Our initial inspection of the absorption trench on Tract C, Whaley Subdivision indicated a portion was located under the driveway. The septic system was originally constructed in May of 1976. The absorption trench was 43' in length with a total depth of 8'. The effective depth of the system is between 3' and 4' as indicated on the inspection report completed by Robert Neale and dated 5/18/76. The cover over the trench is therefore between 4, and 5'. The current owner of the property has lived in the house since the septic system was constructed more than 24 years ago. He has no recollection of any damage to the trench due to the proximity of the driveway. The system has functioned well since its initial construction and continues to absorb water at a rate greater than 450 gallons per day. The trench has never frozen nor has any damage occurred to the distribution pipe due to traffic over the top. It is apparent therefore that placement of the driveway over the trench has had no adverse impact to the septic system. We recommend the portion of the trench currently under the driveway be allowed to remain in place. The monitor tube at the end of the trench must be protected to prevent damage from traffic. Sincerely, Michael E. Anderson,P.E. 07.-05'00 20:5T FROM'¢TE ENVIRONMENTAL 5615301 T-O?? P.02/03 F-407 CT&E Ret:# Ctient Name Projeei Name/# Client Sample ID Matrix Ordered By PWSID ]003563001 Anderson Engineerin,=' Tract 6, Whaley Sub. Tract 6, Whaley Sub. Dnnkmg Wa:er 0 Client PO~ Printed Date/Time 07/05/2000 13;43 Collected Date/Time 07102/2-000 13'00 Received Date/Time 07103/2000 11:20 Technical Director Stephen C. ~de Released~~~_~ Sample Remaxks: N~ra~e-N 6.28 0.500 ff~/L ~PA $00.0 10 max 07/05/o0 SCL Hicrob[olo9y La~Ora:org To:at cotiform col/lOOlaL Siqq8 9222B 07/03/00 JOT Received Time Jul, 5. 7:58PM · q:,-- AppLi~NT FILLS OUT UPPER .HAt ~ ONLY PropertyOwner /~/~i ¢.~:' /){'t ~"'( /. ~ 2} ~/-~_Z 7 /~ ,~t. ()'C}o//~ld~~ Phone Address .~'~ P)3 ~ Zip Code / Phone Really Co. & A~nt Address Zip Code Type of Resi~nce ' Single Family ~ Multiple Family No. of Bedroo~ ~ Other Water Supply  - A~ACH WELL LOG. A w~l Icg is required for all wells drilled since June 1975. ~ Individual ~.~ . ~ Community For wells drilled prior to that date, give well deplh (attach Io~ if available). ~ Public Utility 8ewer Disposal ~' ~'/~ ~ ~/~/ /~-~7.~ ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility; ~ Holding Tank NOTE: THE INSPECTION FEE MU8T ACCOMPANY EACH HE. EST BEFOHE ~OOESSING GAN BE INITIATED. Date~) D~ Date Dat.~.,~, Inspector Inspector ~ r [nsp~tor ~_~ ~ ~~ JULO6~983 A~P.OVED ~O~M~- 'CO~DmONS OF A.P.OVAL ( ) DISAPPROVED ( ) CONDIT[ NAL P ROVAL* Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ~/7C Well to TanA Septic T~k Size 72.023 (3182) P.O. BOX 754 EAGLE RIVER, ALASKA 99577 (907) 694-2131 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Upon your application for Health Authority Certificate approval for the individual sewer and water facilities cannot be granted until the following circled items have been completed: 1. A well log submitted to this Office for otur files andreview. o The top of the well casing should be sealed so that it is water tight. The depression or pit around the well casing needs to be filled with impervious ty~e soil so that it slopes away from the well casing. The well casing needs to be extended twelve (12) inches above ground level. Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit. The water facilities were not turned on at the time of the scheduled inspection. Please call this office for another appointment. The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. Expose the well for our inspection to determine proper construction, also to insure minimum distance requirements are met between the well and sewer system. The septic tank pumped with a receipt submitted to this department. The septic tank pt~nped with a receipt submitted to this department. The total number of gallons pumped needs to be on the receipt and verified by a registered engineer as to the actual number of gallons pt~ped. This is to verify the size of the septic tank. 11. Expose the septic tank manhole to verifty its existence. 12. Locate and expose the cleanout to the seepage pit and/or leaching area for ottr inspection. ~his is to insure the ~inimum distance requirements are met between the well and sewer system. 13. A four (4) inch cleanout needs to be installed to the septic tar~. 13a. A four (4) inch cleanout needs to be installed to the leaching area. 14. An adequacy test needs to be performed on the existing leaching area. This tes. t ~ill deterrmine if the system is adequate according to National Standards. A listing of private fi~ms performing the test is enclosed. ~nis report needs to be submitted to this office for our review. 15. A maintenance contract for the Jet unit serving the sewer system needs to be obtained from Consteel Company, 376-5919, and a copy subn~itted to this office for our review and our files. 16. The permit for the installation of the on-site sewer system will expire December 31,198 · We have not received the as-builts of the installation in this office. If a private engineer inspected the system, please send us the report for our files and review. 17. The application shows the number of bedrooms exceeds the number the on-site sewer system was originally designed for. An upgrade will be required. Prior to any upgrade, a per, nit needs to be issued from this department. 18. An outside water tap was not available. Please call this office to make arrangements to have an inspector to meet ~u at the site ......... 19. ~he depression over the sewer systems will need to be filled so that surface water drains away from the sewer system. 20. The standpipe to the sewer system need caps on them. 21. The water sample could not be taken due to silt content (turbidity). ~he well shot~ld be flushed clear by turning on a garden hose until clear water is evident over an extended period of time. Please contact this department for a resampling appointment.