HomeMy WebLinkAboutROBINDALE #1 BLK 2 LT 3Robl*ndale
Block 2
Lot 3
#051-052-55
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program. 4700 South Bragaw St. -.
P.O. Box 196650 Anchorage. AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 43
On -Site Wastewater Disposal System and/or Well Inspection Report052 55
Permit Number
SW020099 PID Number.
NaTe: Wastewater System: ■ New O Upgrade
TIM dC SHERRYL MCDOWELL
Address:ABSORPTION FIELD
P.O. BOX 113055 a ANCHORAGE, AK 99511
Phone: No. of Bedrooms: 0 Deep Trench a Shallow Trench ■ Bed 0 Mound 0Other
(907) 338-2912 3
SOY RalYp: Total DWth Rom enpkwl wed
LEGAL DESCRIPTION 0.4 apD/aa• In. 4.5-5.0 n
Block: tet Subdivision: Depel b 0" Son" /nm eelyaal eroae• areew depth pw*QM PIP" 1-09 In.
ROBINDALE 3.41-3.91 n
2 3 Ran s la eaa.a 0E sAg" weave anew Wgft
Township: q : _ Section: _ SEE DWG. n 75 n
crae.l slam: N~ Of .e.e IWtona. 5 eewl .ties
Upgrade 15 n 3 n
WELL: t New O U OP � ,^°,e1W:
CknewwaU ^ Prkaw A C: Tww aWm: D°ed T" Te1d o°'"°'I°"'e°`In. D 3034/ F-810
PRIVATE 181 n 181 n 1.125 :°
Drwea Date Dred: s+nua "~ Uw: Ywt~. CALKINS EXC. oe. '8/8-12/2002
WHEATON WATER WELLS 9 17 02 140 n
St At Caw" "ht A TANK
15 tsu UNKNOWN n 2 n
0 Other
SEPARATION DISTANC
■ Septic 0 Molding 0 S.T.E.P. ES aWewe ti
em—
To Septic At.o�tton StatiUfton Holding /Pneet• ed"a ANCHORAGE TANK 1000
From Tank iia d Tank see+ O1e' el eon^;
Well 100'+ 100'+ — — 25'+ STEEL 2
Surface Water 100'+ 100'+ — — — LIFT STATION
AYe ti eObec Ywwlactvr•
Lot Une 50+ 10'+ — — — .t:
M leew al
Foundation 5'+ 10'+ — — — .wveelb p.n"m.a W.
Pw.w Yeb
Curtain Drain NONE KNOW
BENCH MARK
Remarks: tao~ and peearptm:
1,E Q(,13.EvC?TF� 160'-ro ILF�f BOTTOM OF SIDING
Inspections performed by: AKWWC, INC. Dates: 1st 8/8/2002
2nd 8/8/2002
3rd 12/2002
Development Services Department Approval
Reviewed and approved by: Date:
(R«. 12/01)
10 .00
ENGINEEI:S SEAL
O�
Q
�..
. .................
15
y . Come
C 3
fin_..........' aS4v�
PERMrrNUMBER: AS -BUILT DRAWING PARCEL NUMBER:
SW0
SW020099 051-00 52-55
inn' wn l RAnn 1C
I � � � I
\ / NEW DRAINFIELD
N
B
\ j 1 TH/2 i J BNEW
I I 1 1 OUSE
A
i i I
r I
i I I r
I / L 1
" i B I I
IL
I TMII
ALTERNATE SITE WILL
REQUIRE THE USE OF AND
i ADVANTEX TREATMENT UNIT
A B
STI 41.71 60.89 CO3
ST2 47.88 65.90 Mit
I D9L1 49.73 67.32 MT3
i DBL2 51.72 69.05 C04
Mit 64.32 61.58 C05
C01 62.10 58.83 C06
I CO2 66.45 63.06 MT4
i
I
1
`NEW TODO GALLON
SEPTIC TANK
\�E / / / /
Ion' writ RAnlrr,
DATE.
10/4/2002 0l!�GF.
..�._...... . .�.. :�_ +• _— ......... .....�:...... DRAWN BY: ,(1[,, . . . {'.•."7.(140
SKU WATER S WASTENVATER C.J.G. _11� r V�
CONSULTANTS, INC. SCNIEM = 40� *,........ " " ...........
0001 DFRnRR AOGD. SUITE iP • AAfNORAGF. AR 99504 • MOW (00])11]-0I]0 • PAX (907)338.3746
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
TIM do SHERRYL MCDOWELL (907) 338-2912 2 OF 3 el r , A. ..a ss
LEGAL DESCRIPTION: OQ� i
ROBINDALE SUBDIVISION; LOT 3, BLOCK 2, 00 —79 .F A
TYPE OF WORK: Q(1oeQ p••••••••••a�oo
AS—BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM �OtoTesslol,
A
B
70.92
67.55 f
68.28
65.34 1
78.74
103.08 I
81.40
105.451
76.83
101.87 1
72.45
98.95
74.36
99.64 \
Ion' writ RAnlrr,
DATE.
10/4/2002 0l!�GF.
..�._...... . .�.. :�_ +• _— ......... .....�:...... DRAWN BY: ,(1[,, . . . {'.•."7.(140
SKU WATER S WASTENVATER C.J.G. _11� r V�
CONSULTANTS, INC. SCNIEM = 40� *,........ " " ...........
0001 DFRnRR AOGD. SUITE iP • AAfNORAGF. AR 99504 • MOW (00])11]-0I]0 • PAX (907)338.3746
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
TIM do SHERRYL MCDOWELL (907) 338-2912 2 OF 3 el r , A. ..a ss
LEGAL DESCRIPTION: OQ� i
ROBINDALE SUBDIVISION; LOT 3, BLOCK 2, 00 —79 .F A
TYPE OF WORK: Q(1oeQ p••••••••••a�oo
AS—BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM �OtoTesslol,
PERMIT NUMBER:
SW020099 AS -BUILT DRAWING
INSULATION FINAL GRADE r".52-9.96
-
AEnwn950 /
-.8amFT -s
�I r
SUNGNEW 1000 GALLON
WMff J SEPTIC TANK
AT WALT- 99.]5 WANT UOF -UNC AT
RLf . 9s -9 -
ORIGINAL GRADE FINAL GRADE
- 98.19-98.89 - 98.57-99.17
TH#1 Co Mr co Mr co
FILLER FABRIC
j;. :;f?[:;iitl:;i;i.}S,Si::l;f,;�,esjiah,;:;iiai�ii i+i�ii ,'i•��.
715' WAIDE
BOTTOM OF •- a.
���INVERT OF PIPA
RELATIVE ELEVATION OF BOTTOM OF
0 TESTHOLE - 85.89 (TESTHOLE DRY)
%.���A-
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
0001 DFAARO ROAD. SIPTE 7R • ANfNOAAGF. AK 9"" • RNONF (007)337-0170 • FAX (00713M -3M
PREPARED FOR: PHONE NUMBER:
TIM do SHERRYL MCDOWELL 338-2912
LEGAL DESCRIPTION:
ROBINDALE SUBDIVISION; LOT 3• BLOCK 2
TYPE OF WORK:
PROFILE AS—BUILT OF NEW SEPTIC SYSTEM
PARCEL ID NUMBER.-
051-052-55
UMBER:051-052-55
TH#2
RELATIVE ELEVATION OF BOTTOM OF
TESTHOLE - 87.89 (TESTHOLE DRY) --@-
DATE:
10/4/2002
DRAWN BY:
C.J.G.
SCALE:
N.T.S.
PACE NUMBER:
3OF3
RECOV. 5i8•
/ RESAR (TYP)
r
— T
N
N 89.55'24'E 300605'(R)
N 89•56'00'E 2919.81'(M)
0
etJ
O atu
\I• tJ. \1Y YIr.
3 Ir nwa
e av
asseoc
xir
A A '
N 89.55'24'E 300.06' (R)
0
141.3'
MV
C�
10/ ni02
GATE
8221 STRUTt`�TANCIMACE. NASxA 99502 �.
N0K 2u 45e0
A9 BUILT
57-02
FLO. BK.
1
19xlrcl�sii.3ejiiillu�l
LOT 3, BLOCK 2.
30 R(e00ALE ADDITION KI
PUT NO. I SCALE I GRID
75—T4 1 1'e40 1 NW 1561
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NOTES: EoeemanU not appearing on record sl4division
1 i 3
Plot ore not shown bless description of easement is
o
provided by c6anL It is the mponsib9lly of the owner
i
or budder. prior to coMhuction, to verily proposed
u -
O •�
O
Du4&V grade re(otive to finish grade and utihtiss
j
Z
CIXMIeC11DM, and to determiM the wastence of coy
1 z
easements. covenants, or restrictions which da not
i
TM
O
appear an the recorded witrd'ivision plot.
1
Cr
ENwtions based on osn ed datum unless ott r se
i
uxKcWo4 and beanngs and distances we record data.
1
0.4:NT: ALASKA WATER s WASTEWATER
1
19xlrcl�sii.3ejiiillu�l
LOT 3, BLOCK 2.
30 R(e00ALE ADDITION KI
PUT NO. I SCALE I GRID
75—T4 1 1'e40 1 NW 1561
R
kl
3
3
R
R
F3
8
N
a
OCT -31-02 10:40 AM PREFERREDCUSTOMHOMES 907 357 9136 P.02
Cot 31 02 10t49a
WN9 IMJLFXNOW WiLpr3ext VVELLfS,9 x c:.
p0 Box
071215, Ilva mma, AJw 99E tS?
<¢J0'1> 370-2041
�'S�ELL LOC,r
+� Name: Preferred Custom Homes of Alaska
1 Address: P.O. Box 875910 - Msc 172
City: Wasilla State: AK .Gip Code: 99687
` Well Site: Robindale Addition # t Lot: 3 Block: 2
Well Depth:
181ft.
From: 0
To: 2
Formation: topsoil i
2
25
hardpan, gravel
Gal/Min:
15.00
23
32
gravel. sand
32
100
silty gravel, sand
loo
125
gravel, sand
fatiC Level:
140 �•
125
140
silty gravel, rand
140
150
gravel, sand
i
using;:
6" ID
ISO
165
hardpan. boulders
165
175
gravel, sand, water
�iner Pipe:
Done
175
191
Cray clay I
(Greened:
none
Perforated: 163-168 fL
Grouted: Bentonite
Other:
none
ate Drilled_
9-17-02
i
I
Driller: M110 Pitner
W s
2
30
N 89.55'24'E 300.05' (R)
N 89°56'00'E 299.81 (M)
o i
i
rn �
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141.3'0 YELL z
0en wn. w — O
0 u IY
3 c.V«n
v r S Z
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Y 133.5' i O
w� M
r
GARAGE
r
1
N 89.55'24'E 300.06' (R) r
30
rd
G 8221 DEL STREET
ANCHORAGE, ALASKA 99502
PHONE 243-4890
10/17/02 AS BUILT 57-02
DATE♦��t*O tt,,* FLD. BK. AQ
Wilfirt. Flhnlnq : 1
�# + LS -5773 i
AV
4101
♦f ^�Op •�... •.••pnd
NOTES: Easements not appearing on record subdivision
plot are not shown unless description of easement is
provided by client. It is the responsibility of the owner
or builder, prior to construction, to verify proposed
building grade relative to finish grade and utilities
connections. and to determine the existence of any
easements, covenants, or restrictions which do not
appear on the recorded subdivision plot.
Elevations based on assumed datum unless otherwise
indicated, and bearings and distances are record data.
CLIENT: ALASKA WATER 8 WASTEWATER
LEGAL DESCRIPTION
LOT 3, BLOCK 2,
ROBINDALE ADDITION 1:11
PLAT NO. SCALE GRID
75-74 1 1"=40 1 NW 1561
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Date Issued: May 08, 2002
Expiration Date: May 08, 2003
Permit Number: SW020099 Parcel ID: 051-052-55
Legal Description: ROBINDALE #1 BLK 2 LT 3
Design Engineer: 0041 AK Water & Wastewater Consultan, Site Address:
Owner Name: Tim & Sheryl Mcdoweil Lot Size: 48578 SO. FT.
Owner Address: PO Box 113055 Total Bedrooms: 3 Permit Bedrooms: 3
Anchorage , AK 99511 -
This permit is for the construction of:
0 Disposal Field ❑✓ Septic Tank Holding Tank F] Privy 0✓ Private Well E] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
`n r lit_ "
r O r
Date: 5— 1—n q
Date: 5/8/02
0
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water 6 Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage. AK 99519.8650
www.d.anchorege.akus
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. r
0
Permit Number SIA/00 00'79'
Property owners) TiM do SHERRYL MCDOWELL Day phone 338-2912
Matting address (1) P.O. BOX 113055 • ANCHORAGE. AK
Mailing address (2) Zip Code 99511
Legal description (Lot, Block & Sub'd.) ROBINDALE SUBDMSION!' LOT 3. BLOCK 2
Legal description (Section. Township & Range) N/A
Lot size qS,"7? Acres/Sq.FL Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only
❑
Well Only
❑
Sewer and WellWater
Storage
❑
Sewer Upgrade
❑
THIS PROPERTY CONTAINS:
Hot Tub
❑
Jamnal
❑
Swimming Pool
❑
Water Softening Unit
❑
Therapy Pool
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and Is in accordance with applicable Municipal codes.
ALASKA WATER do WASTEWATER CONSULTANTS, INC.
(Signature of p.-apoyj ownor or au#*Kzod ogont)
Permit Fees: Z% 5 r • �
Date of Payment
Receipt Number.
5-(n-00
019,-3f7
Waiver Fees:
Date of Payment
Receipt Number.
Ii4
ALASKA WATER WASTEWATER
CONSULTANTS, INC.
December 28, 2001
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Well and Septic Design for Robindale Subdivision; Lot 3, Block 2
To whom it may concern:
The proposed 3 bedroom house is to be served by a private well and septic system. Test holes
were excavated on the property. The proposed septic system will be designed around the 30 foot
radii of these test holes. We are proposing that a 1000 gallon septic tank and a bed type drainfield
be installed. The proposed well location is shown on the site plan and design drawings.
Comments regarding the septic system design are summarized as follows:
1. SOILS: Attached is a log which shows the soil classifications, groundwater monitoring, and
the percolation test results. It is our opinion that due to the overall appearance of the soils, an
application rate of 0.4 gallons/day/ft2 should be used.
2. TRENCH DESIGN:
a. Percolation Rate: 8 & 24 minutes/inch
b. Allowable Application Rate: 0.4 gallons/day/ft2
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 1125 ft2
f. Total Depth: 5 feet (max.)
g. Effective Depth: 0.5 feet
It. Width: 15 feet
i. Reduction Factor: N/A
j. Minimum Length: 75 feet long
k. Effective absorption area = 1125 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
4. TOPOGRAPHY: The area for the proposed septic system is generally flat; in short, there
are no slope concerns.
6901 Dcbarr Road, Suite 2B + Anchorage, AK 99504
Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
assistance.
V
Cr
re�X. ss P.E., M.S.
Pres do t
NOTE. Attached is a site plan drawing, a design drawing, two soils logs, and a 4 page
construction specification letter which are all part of the design package for this septic system.
6901 Debarr Road, Suite 26 • Anchorage, AK 99504
Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: akwwc.com
ARE!D
•------------ --------------------
I
I
r;&DC ARa
I ROBINDALE SUBDIVISION
SAMPSON ESTATES I LOT 1. BLOCK 2
LOT 1, BLOCK 3 1
I
KEPDC AREA
I
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1
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11
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/ 13PBi
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'ALTERNATE
I\
II
SITE�
r
ISM _ESTATES
ARS
SAMPSON ESTATES
LOT 3, BLOCK 3
SAMPSON ESTATES
LOT 13, BLOCK 3
r
`-SEPTIC ARS
SAMPSON ESTATES
LOT 14. BLOCK 3
ROBINDALE SUBDIVISION
LOT 2. BLOCK 2
1 I
_ 1 I
1��\1
1
/ \
ROPLL \
�1 1
1 1
I !
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PROPOSED
.��GARAGEi
}PROPOSED SEPTIC SYSTEM 1
1(SEE DESIGN, PACE 2 OF 3)
I I
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tF� V
/ 7 ROBINDA-E SUBDIVISION /
LAT 4. BLOCK 2
I �
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1 !
I.
� ' 1
ROBINDALE SUBDMS10X I \\
LAT S. BLACK 2/ I 1
I
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
6901 OFBARR ROAD. SUITE 211 • ANCHDRAGF. AK "SM PHONE (9026376129 • FAS (901)338-3766
PREPARED FOR PHONE NUMBER:
TIM do SHERRYL McDOWELL 338-2912
DATE
12/28/2001
DRAWN BY:
J.L.M.
SCALE:
1" = 100'
PAGE NUMBER:
1 OF 3
LEGAL DESCRIPTION:
ROBINDALE SUBDIVISION; LOT 3, BLOCK 2.
TYPE OF WORK:
SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM
100' WR I RADIUS I
I
/
ROBINDALE SUBDMSION
LOT 1, BLOCK
i
C) ROBINDALE SUBDIVISION
Q LOT 2, BLOCK 1
O
ROBINDALE SUBDIVISION
LOT 4, BLOCK 1
1W WF1I RABBIS ,
ROBINDALE SUBDIVISION
LOT S, BLOCK 1
O
U)
Z
ROBINDALE SUBDIVISION
M
LOT 3, BLOCK 1
Q
CEPTIC ARaD
w
ROBINDALE SUBDIVISION
LOT 4, BLOCK 1
1W WF1I RABBIS ,
ROBINDALE SUBDIVISION
LOT S, BLOCK 1
I � �
II Inn' WFII RA(311m
PROPOSED IWO GALLONSEPTIC TANK
/
�i
I\\ ALTERNATE 1 \ \ 3 PROPOSED
�S/ PROPOSED WELL
81
co
1100
.. . ,. •DRNE3ArAY.i.�,t�...,.
I 1
'Al ; ^
8 88
IJ
p % \
U 1 I j j �� @ PROPOSEDGARAGE
/ \\
L
j I \ INSTALL DOUBLE CLEi NOUTS
I
I �A BESDWTHAT"'IS s FEET EXCAVATE
EEP
MAXIMUM BY 15 FEET WIDE BY 75
FEET LONG. ADD 0.5 FEET OF CLEAN.
WASHED SEWER DRAINROCK. I 1On' WFII RAWK 0
I I
1 THE TANK IS TO BE 5'+ FROM FOUNDATION
THE TANK IS TO BE 5'+ FROM DRAINFIELD
THE TANK IS TO BE 5'+ FROM LOT LINE
THE DRAJNFIELD IS TO BE 10'+ FROM
\ THE DRAINFIELD IS TO BE 10'+ FROM LOT LINEON
I
CUTE:
12/28/2001 40000000
- DRAWN BY:
ALASKA WATER & WASTEWATER SCALE Z.T.G.Op�
M CONSULTANTS INC _ % .. ...............
6901 OFRARR ROAD, SUITE • ANCNORAGF. A9 99504 • AMONF 1907)3574179 • FAX (0017)39-StG6 1 — 40' 0 • • ••
PREPARED FOR: PHONE NUMBER: PACE NUMBER: / 1 J
TIM do SHERRYL MCDOWELL 338-2912 2 OF 3 e Ganess.•
LEGAL DESCRIPTION: 0 a -7 .: •��O
ROBINDALE SUBDIVISION; LOT 3, BLOCK 2
OtJOeypro. sasloOot��
TYPEDESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM 000 o0 0
2.5' fir ---------------
5,- OMf
5' I
-FROM Sem T"
------------------------- — mf o --
CC l
`cA _
------------------------- Mr o OA �-
VIA MOW02W M Af EACH
CORER, MITORATEV 6ETWEEN BOffOM
OF VRA W EL17 KV P15TROUfiON PIPE IM/ERf,
CO Mf
ORIQ/NAI. CY.PDE —
FLTER FAN
OYER VRw
411 VWd✓:TER LATERAI5 (M-15)
CO Mf CO
/1 --lm aza
'si'• •ti:�:�:_:=:•:�i :"�:�•i•=::::•:=iii •'�'' '
Eii;.;:;:;::s:• : :;:?::i:i.::sfi:ii:�:� :i:ii �s �.•s
DATE
8/16/2001
DRAWN BY:
ALASKA WATER & WASTEWATER SCALE: '
CONSULTANTS, INC. N.T.S.
6901 DEBARR ROAD, WTE 29 • ANCHORAGE, AK 99304 • NI@R (9OM37-6179 • FAX (907)5w3246
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:-
TIM
UMBER:TIM do SHERRYL MCDOWELL 338-2912 3 OF 3
LEGAL DESCRIPDON:
ROBINDALE SUBDIVISION; LOTS, BLOCK 2
TYPE OF WORK:
PROFILE DESIGN OF SEPTIC SYSTEM
— 6 FEET VEEP
MAXIMUM
f'
ALASKA WATER &: WASTEWATER
CONSULTANTS, INC.
6001 DQ9MM MOw, W" 26 • M MMAGC Mt 0064 • M ONE: (007)357-6170 • FM (007)]]6-3246 • WUMM• ebea.emn
SOIL LOG - PERCOLATION TESTI
LEGAL DESCRIPTION: ROBINDALE SUBDMSION; LOT 3, BLOCK 2
PERFORMED FOR: TIM & SHERRYL McDOWELL
15-
16-
17
=ORGANICS
SOIL CLASSIFICATIONS
(feat
11
1
X.
=::=:=:q ORG
2-
-4-5-6-7—
"+ GPML
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CL
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4-
Q.?, eSW
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CH
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j�}{1-; jTjT} SM '' ..' OH
TH#2 •��_ ��•
5-
ROBINMLE SUBDMSION
LYoL�
LAT 3. BLOCK 2_
6-
TMI1
DEPTH TO
DATE
• '
7-
r �'�•
MIX OF
i
r :•��
DENSER/ML w/
DRY
;�.'
DEPTH
DRY
8/8/2001
9—
DRY
8/10/2001
I ARE APPROXIMATE
r ,•
10—
` �•
1.100' ;
11—
DATE READING CLOCK
NET TIME WATER LEVEL
NET DROP
r ,
1•
TIME
12—
r ;
,
8/6/2001
1 2:55
— 6•
—
3
13-
2 3:25
30 4 3/4'
/4'3
1 1/4-
3 3:25
14 —
14-
—
15-
16-
17 —
18-
19 —
20 —
DATE: 8/6/2001
"OF
A ;,� ......:
D�..le-f-e,w A. ness•:
G -r-7953 : ' ��O
ITEST HOLE #11
SOIL CLASSIFICATIONS
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CL
1
/
GC
OL
Q.?, eSW
'•'•'
MH
CH
. SP
j�}{1-; jTjT} SM '' ..' OH
TH#2 •��_ ��•
SC
ROBINMLE SUBDMSION
LYoL�
LAT 3. BLOCK 2_
TMI1
DEPTH TO
DATE
• '
��
GROUNDWATER
i
DRY
8/3/2001
j
DRY
8/8/2001
NEST HOLZ LOCATIONS
I
DRY
8/10/2001
I ARE APPROXIMATE
SREPLAN
1
1.100' ;
DATE READING CLOCK
NET TIME WATER LEVEL
NET DROP
TIME
(MINUTES) READING
(INCHES)
8/6/2001
1 2:55
— 6•
—
2 3:25
30 4 3/4'
/4'3
1 1/4-
3 3:25
— 6'
—
4 3:55
30 4 3/4'
1 1/4-
5 3:55
_ 6•
—
6 4:25
30 4 3/4•
1 1/4'
PERCOLATION RATE 24 (MIN./INCH) PERC. HOLE DIA. 6' (INCHES)
TEST RUN BETWEEN 3.5 FT. AND 4.0 FT.
COMMENTS: PERK HOLES PRESOAKED FOR 4+ HOURS PRIOR TO TEST.
PERCOLATION TEST PERFORMED BY CALFS GALI
PERFORMED BY ALASKA WATER do WASTEWATER I. JEFFREY A. GARNESS. CERTIFY THAT THIS WPE FORMED
IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: I Z ZB/OI
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
8901 DMM ROAD. W n 28 • MOOW& AK 89sM • K&C (907W7-8179 • FAX: (907)&M-3246 + WEesrM atwoAOT
SOIL LOG — PERCOLATION TESTI
LEGAL DESCRIPTION: ROBINDALE SUBDIVISION; LOT 3, BLOCK 2
PERFORMED FOR: TIM k SHERRYL McDOWELL
DE
y—
(feet
ny»z ORGANICS
/ � ,rx1• wFI1 RAnurc
�
GP
ML
GM
CL
2-
-3-4-5-6-7GM/SM/ML
GC
OL
ODD o, SW
3-
���' SP
CH
OH
71112
SM
!
4-
SC
ROBINDALE SUBDMSION
LOT 3, BLOCK 2
5-
ATER
6-
THj1
•
SII
GROUNDWPH
7—
GM/SM/ML
8/3/2001
DENSER w/
8 —
' ��
DEPTH
DRY
8/10/2001
I ARE APPROXIMATE I SITE PLAN
9
1'=100'
DATE READING CLOCK
NET TIME WATER LEVEL
NET DROP
10—
'
(MINUTES) READING
(INCHES)
8/6/2001
1 2:55
- 6•
-
11
'
5-
B.O.H.
- 6.
12 —
4 3:55
13 —
14-
15 —
16 —
17 —
18 —
19 —
20 —
TEST HOLE #21
DATE: 8/6/2001
SOIL CLASSIFICATIONS
, . ,
77,-77,
o, GW
�—.
-� ORG
/ � ,rx1• wFI1 RAnurc
�
GP
ML
GM
CL
GC
OL
ODD o, SW
MH
���' SP
CH
OH
71112
SM
!
SC
ROBINDALE SUBDMSION
LOT 3, BLOCK 2
ATER
DATE
THj1
•
SII
GROUNDWPH
DRY
8/3/2001
DRY
8/8/2001
NEST HOLE LOCATIONS
DRY
8/10/2001
I ARE APPROXIMATE I SITE PLAN
1
1'=100'
DATE READING CLOCK
NET TIME WATER LEVEL
NET DROP
TIME
(MINUTES) READING
(INCHES)
8/6/2001
1 2:55
- 6•
-
2 3:25
30 1'
5-
3 3:25
- 6.
-
4 3:55
30 1 •
5-
5 3:55-
6 4:25
30 1
5"
PERCOLATION RATE 6 (MIN./INCH) PERC. HOLE DIA. 6' (INCHES)
TEST RUN BETWEEN 3.0 FT. AND 3.5 FT.
COMMENTS: PERK HOLES PRESOAKED FOR 4+ HOURS PRIOR TO TEST.
PERCOLATION TEST PERFORMED BY CALEB CALL
PERFORMED BY ALASKA WATER & WASTEWATER I, JEFFREY A. GARNESS, CERTIFY THAT THIS Wks PERFORMED
IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: S/Z-flo/
-Pool
E
�s T
'mma-vift, ,i j.
M iii _ tIRAl c
. Wit
t ['iuR;�sCi WY3
COMM
— t MUNICIPALITY OF ANCHORAGE
SER O DEPT. Or HEAITI I u
ENVIRONMENTAL Pr.OTECTION
TOM 8ff7x4;--
FOR upopAof only ADD 10 URGIN ANDIOR A00 GALLOP TANK.
7-s 131.2 pml -
Wt' -''AG ;mll os
ENCCK)Hl ERFUZ
1 } y E l'i l A"? W 'r-1 A
DEPIM?
E
Q $ FlAL 1 T Y 0 F i C-) H, A (3 ft
K A N10 i N V I R ON W.- t N", A L 1P RiUl' E'll7f I ON'
I- f F R 0'-� A 7 1 ON
ICS1
0651 v=?n
S 1. 0(3 K RVATATION I its!
;,f fi i opmf p Or�.:
t F'Am"
ry:
Vic
PC04
---- -----------
, Jj
Wt' -''AG ;mll os
ENCCK)Hl ERFUZ
1 } y E l'i l A"? W 'r-1 A
DEPIM?
E
IVIN, p I I VVE N F" AH,o
r' I'M i M ( N
- ------- --
PERFORMED BY:
AJ
---- -----------
IVIN, p I I VVE N F" AH,o
r' I'M i M ( N
- ------- --
PERFORMED BY:
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 Certificate of Onsite Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm _Pinard Engineering Phone (907) 357-3647
Address PO Boz 871347 Wasilla Alaska 99687
Engineer's Printed Name Paul E. Pinard Date -- 9/16%" i
9
e.
'rev• zb°di'°• ,00
.1•• � 4..°.Ol.J.° oau°ol
5. DSD SIGNATURE ECQ � �C►AcS °,6o°r?r
Approved for �y,
PP _� bedrooms. �.5i ' •�cJF�/"i+.ri .. y
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
ttl(lnlrr�rrr.
Nq"'Z
ON -RITC
..J,)cKAND : `
Additional Comments WASTim-
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: I Original Certificate Date:
(Rev. HA5)
Municipality of Anchorage
Development Services Department
Building Safety Division
�:7" On Site Water 8 WastePlaterProgram -
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.orglonsite j
(907) 343-7904
*
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Block 2 Robindale Subd, Add#1 Parcel ID. 051-052-55
Legal Description: Lot 3+ +
A. WELL DATA
Well type,p=tvate If A. B, or C provide PWSID # _
Date completed 9117/02 Sanitary seal (Y/N) JB
Total depth 181 ft. Cased to 181 ft.
FROM WELL LOG
Date of test 9/17/02
Static water level 140 ft.
Well production 16 9.p -m.
WATER SAMPLE RESULTS:
Coliform �–colonies/100 mL
Arsenic: ND mgA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Steel
Well Log (YIN) Yea
Wires properly protected (YIN) Yes
Casing height (above ground) 18+ in.
AT INSPECTION
8/26/08'
135.6 tt.
3.7: g.p.m.
Nitrate 3i18 mglL er, -Other bacteria p colonies/100 mL
Date of sample:8/08 Collected by Pinard Engineering
S
Date installed 8/8 – 8/12/02
w .
Tank size 1000 gal Number of Compartments 2 Cleanouts (Y/N) Yes
Foundation cleanout (Y/N)Yea Depression over tank (YIN)No High water`atarm (YIN) NA
Date of pumping /12/08 Pumper JRr s Pumping
C. ABSORPTION FIELD DATA
Date installed 8/8 – 12/H81 rating (g.p.
d.lfe orStRl%aT4 0.4 System type Seepage Bed
Length 75 ft. Width 15 ft. Gravel below pipe 1 .1 ft.
Total depth yj ft. Eff. absorption area 125 fe Monitoring tube YP s liDepression over field RD—
Date of adequacy test _8L28 & 29/08 Results (Pass/Fail) Pass a For _3 bedrooms
Fluid depth in absorption field before test 3 . 5_ in. Water adderYQ_8 gal. New depth! 0 • an.
Elapsed Time: 503 min. Final fluid depth 7_2 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN 8 type) None KnOvn If yes, give date
y
i
D. LIFT STATION NA
-Date installed - = -Size in gallons - - --- Manhole/Access (Y/N)
'Pump on' level at —in.
Datum
E. SEPARATION DISTANCES
'Pump oft" level at _ in.
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanknift station on lot - 00 r +
Absorption field on lot 1001+
High water alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots 1001+
On adjacent lots _- 1001+
Public sewer main NA Public sewer manhole/cleanout NA
Sewer /septic service line ---25L+— Holding tank NA
Animal containment areas NA Manure/animal excrete storage areas NA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5 r + Property line _ 51+ Absorption field 51+
Water main NA Water service line 101+ Surface water 100 r +
Wells on adjacent lots 100 r +
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line10 I_+ Building foundation 101+ Water main NA
Water Service tine 101+ Surface water 1_.DoDriveway, parking/vehicle storage 10 r +
Curtain drain None Knnvn Wells on adjacent lots 100 r+
F. COMMENTS
SAS was filled saturated with:va ^� a rior
to the testing 550 Rallons was added at that time. .... `,�
G. ENGINEER'S CERTIFICATION
ef
I certify that I have determined through Geld inspections and ✓�5• �Y .'"' °•�8'• ra
review of Municipal records that the above systems are ini•••� �°Ly�--✓ .; a
conformance with MOA COSA guidelines in effect on this date. 4 , • a
Engineer's Printed Name Paul E. Pinard
Date_ 9/16/08 Cdr .:
goes
COSA Fee $
Date of Payment
Receipt Number_
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
3onfe5'
�tI �
wail
K i( x. J y • -O CA 1 rte.. _
yts-e4f � �-7�+_•��I
J i
Igo
Ir
` I
> Jl.
l
1 C
p 10�.
Yr '
JA
P,w
00,
AS -BUILT
I hereby certify that I hace surveyed the following described
property: I -OT 3 '_L Z_
Anchorage Recording Precinct. Alaska, and that the improve-
ments situated thereon are within the property lines and do not
overlap or encroach on the property lying adjacent thereto, that
no improvements on property Ivmg adjacent thereto encroach
on the premises in question and that there are no roadways,
transmission lines or other visible easements on said property
except as indicated hereon.
Dated at Eagle River, Alaska
this 3 rd day of =o>t�_
ROBERT C. JOHNSON -A r, :-
SCALE; Registered Land Surveyor W. RAO -LS
Box 77-0456. Eagle River. Alaska 99577
Phone (907) 694-2543
PINARD ENGINEERING
t Paul E. Pinard
Registered Engineer/AK & ID
C, P.O. Box 871347, Wasilla, AK 99687
(907) 357-ENGR(3647)
ONSITE DRINKING WATER AND SEWER SYSTEM
ENGINEER'S EVALUATION
PROPERTY DESCRIPTION: LOT 3, BLOCK 2, ROBINDALE SUBDMSION, ADDITION 91
This property is developed to serve a single—family residence with a total of 3 bedrooms.
Owner's Name(s): Sean Brown & Kevin Kristof
Owners Address: PO Box 1941
Bethel, Alaska 99559.1941
Buyer's Name(s): Unknown
Buyer's Address:
ON-SITE DRINKING WATER SYSTEM:
This property is served by a Public Water System approved by ADEC.
XX Recent drinking water samples were collected and were tested at an ADEC certified laboratory and found to be
1 satisfactory, meeting ADEC standards for coliform bacteria, nitrate and arsenic.
NOTES: A 4 hour flow test was conducted during which the welt produced an average of 3.6 ppm
ON-SITE WASTEWATER DISPOSAL SYSTEM: ars this system
_A new wastewater disposal system has been installed. Based on periodic visual observations, it apps Ys
was constructed in general conformance with current 18 AAC 72 regulations and ADEC policies.
This wastewater disposal system was Installed by an ADEC Certified Installer and approved by ADEC.
XX The e>asting wastewater disposal system was tested in accordance with current MOA/ADEC policy and found to be
pereling satisfactorily. The readily identifiable features of this system were observed and documented.
X It appears that this system meets 18 AAC 72 regulations and MOA requirements, based on record information at
the MOA.
This system does not meet the horizontal separation distance requirements of 18 AAC 72 regulations and
conformance with the vertical separation requirements of these regulations, to seasonal high groundwater and
impermeable layers, is unknown. Components are unknown and it is undocumented with ADEC.
NOTES: The septic tank was Pum *d1cleaned on9112108-
This
ied as 10 the
re performance of this
wastewater disposal s not system. It does accuratelystitute a guarantee of ny kind, portray theconditions
explicit tlonsl found on Me d� they were tested and/ docun enfi dr
DAT 1
PAUL E PLNARD
CEA793
PINARD ENGINEERING
P.O. Box 871347
Wasilla, AK 99687
(907) 357-ENGR (3647)
ADEQUACY TEST
LOCATION: Lot 3, Block 2, Robindale Subdivision, Addition 01
APPLICANT: Kevin Krlstef 6 Sean Brown
PO Box 1941
Bethel, Alaska 99559-1941
SEPTIC TANK TYPESIZE: Steel/1000 Gallons, per MOA Records
ABSORPTION SYSTEM: Seepage Bed, per MOA Records
DAILY FLOW:
3 BEDROOMS x 150 GALJBR - 450 Gallons
TEST DATA
JOB NUMBER: 08.182
DATE OF TEST. 8128 E 8129108
FIELD STAFF: A. Wien
NUMBER OF BEDROOMS: 3
SCUM: 0.3' SLUDGE: 0.3'
NEEDS TO BE PUMPED: Yes XX No
CURRENTLY IN USE: Yes No XX
*ALL MEASUREMENTS IN FT.
TEST: PASSED XXX FAILED
on
COMMENTS: were Liquid
then taken to evalthe SAS to rail it to the invert of the uate the absorption rate. The absorption was ideteirminpiping.
d to exceed 450 Recovery
measurements
Reviewed by: Paul Pinard 1 4
Date: 913!08
Flow
Rate
(GPM)
3.8
3.9
4.0
4.1
4.0
4.0
4.0
4.0
Volume
(GALS)
-
115
239
241
246
243
244
245
465
Cumulative
Volume
(GALS)
715
354
595
841
1084
1328
1573
2038
Septic Tank
L i A Level
•
4.1
4.2
4.2
4.2
4.2
4.2
4.2
4.2
42+
Septic
Tank
A Level
-
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Soil Absorption System
Monitor A SAS Monitor A SAS
Tube V Level Tube 2' Level
0.3
0.4 0.1
0.5 0.1
0.5 0.0
0.6 0.1
0.7 0.1
0.7 0.0
0.8 0.1
0.9 0.1
Comments
Start Flow -Meter 159953
160068
160307
160548
160794
161037
161281
161526
Stop Flow 161991
Time
PM
9:39
10:09
11:09
12:09
1:09
2:09
3:09
4:09
6:02
*ALL MEASUREMENTS IN FT.
TEST: PASSED XXX FAILED
on
COMMENTS: were Liquid
then taken to evalthe SAS to rail it to the invert of the uate the absorption rate. The absorption was ideteirminpiping.
d to exceed 450 Recovery
measurements
Reviewed by: Paul Pinard 1 4
Date: 913!08
U t'3
PINARD ENGINEERING
P.O. Box 871347
Wasilla, AK 99687
(907) 357-ENGR (3647)
WELL FLOW TEST
LOCATION: Lot 3, Block 2, Robindate Subdivision, Addition #1
DRILLER: Wheaton Water Wells
DATE WELL COMPLETED: 9117102
WELL DEPTH: 181'
—11a .A,Ar D t cvcn non of Casino): 135.8'
JOB NUMBER: 08-182
DATE OF TEST: 8128108
FIELD STAFF: A. Wien
RECOVERY
11:16 1 1135.6'
to starting static water
Average Flow Rate: 3.7 Qpm D no
Comments: DURING THIS TEST. THIS WATER SUPPLY WELL WAS CAPABLE OF Reviewed by: Paul Pinard (�(
PRODUCING 3.9 GPM. THIS TEST DOES NOT CONSTITUTE A
WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM Date: 9r1/08
WILL CONTINUE TO FUNCTION AND PRODUCE AT THIS RATE.
Municipality of Anchorage .,
y Development Services Department
Building Safety Division
On -Site Water 3 Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519.6650
www.d.anchorage.ek.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING !/
Parcel I.D. 051-052-55 HAA# _ _ D4 W9
1. GENERAL INFORMATION Expiration Date: 2 — / 8' 0
Complete legal description ROBINDALE SUBDIVISION #1: LOT 3. BLOCK 2
Location (site address or directions) 22686 ROBINSON ROAD * CHUGIAK. AK. 99567
Current Property owner(s) SHERRYL McDOWELL Day phone 338-2912
Mailing address c/o BROOKE STILTNER w/ REMAX E.R.
Lending agency Day phone
Mailing address
Real Estate Agent BROOKE STILTNER w/ REMAX E. R. Day phone 694-4200
Mailing address , 16600 CENTERRELD DRIVE * EAGLE RIVER, AK 99577
Unless otherwise requested, HAA Wit be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual Onsite
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Weil
❑
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.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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
onsite water supply and/or wastewater disposal system is(em) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of Installation.
Name of Firm
GARNESS
ENGINEERING
GROUP, Ltd.
Address 3701
E. TUDOR
ROAD, SUITE
101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily Identfable 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. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore 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 3 bedrooms.
Disapproved.
Phone 337-6179
Date tt/IZ/oIf
Conditional approval for bedrooms, with the fllowing stipulations:
Attachments: NNO•'• • • • S�
HAA Checklist c/ Manitenance Agreements
Septic System Advisory Supplemental Engineer's Reort /lilll ij1
Well Flow Advisory Other
By, O ,J _ tu. /42&'Lt Original Certificate Date: g d
(RW.1Z101)
Municipality of Anchorage
( ' Development Services Department
Building Safety Division
On.SiteWater &Wastewater Program
a 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
i
Legal Description: ROBINDALE S/D• LOT 3 BLOCK 2 / Parcel ID: 051-052-55
A. WELL. DATA
Well type PRIVATEIf A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 9/17/2002 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 181 ft, Cased to 181 ft. Casing height (above ground) 24 in.
e FROM WELL LOG AT INSPECTION
Date of test 9/17/2002 11/1/2004
E Static water level 140 ft, 143 ft.
Well production 15 g.p.m. 5.04'
! 9.p-m.
WATER SAMPLE RESULTS:
Coliform _ colonies/100 mi, Nitrate 19LmgJL. Other bacteria _colonies/100 ml.
Arsenic: N/A mg./L. Date of sample: 11/1/2004 Collected by: G.E.G. Ltd.
I B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL Date installed 8/8-12/2002
Tank size '1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
9 Foundation cleanout (YIN) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
s Date of pumping 11/4/2004 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA ELow ANAL cRnDE
Date installed 9/8-12/2002 Soil rating .p:d./ r ftlbdrm) 0_4 System type BED
r Length 75 ft. Width 15 ft. Gravel below pipe 1.09 ft.
Total depth *4.88-5.4s
1 p ft. Eff. absorption .area 1,125 ft Monitoring tube YES Depressionover field NO
Date of adequacy test 11/1/2004 Results (Pass/Fail) PASSED For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 540 gal. New depth Oin.
Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 450+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N/A If yes, give date
(;
r
Date installed Size in gallons
"Pump on" level at _in.
E. SEPARATION DISTANCES
High water alarm level at in.
Cycles tested Meets alarm &circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption Feld on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100'+
On adjacent lots 100'+
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'+
Absorption field
5'+
Water main N/A
Water main N/A
Water service line 10'+
Surface water
100'+
100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
10'+
Building foundation
10'+
Water main N/A
Water service line
10'+
Surface water
100'+
Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION o �• �F q� 4
1 certify that 1 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. , • .. ......
J Garn ssr
Engineer's Printed Name JEFFREY A. GARNESS 0004 s `�a
4 e,ea �iLF,00
Date 9/ j?Lw Prof Selo'
HAA Fee $ Li2C)`6�'
Date of Payment L
Receipt Number DGU� 1
(Rev. 12!01)
Waiver Fee $
Date of Payment
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Municipality of Anchorage OA
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
V
CERTIFICATE OF HEALTH AUTHORITY
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.APPROVAL IV)
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-052-55 HAA# 11G D.? SIC
1. GENERAL INFORMATION Expiration Date: 2/yIeT
Complete legal description ROBINDALE SUBDIVISION; LOT 3, BLOCK 2
Location (site address or directions) ROBINSON ROAD . CHUGIAK, AK
Current Property owner(s) TIM & SHERRYL McDOWELL Day phone 338-2912
Mailing address P.O. BOX 113055 ' ANCHORAGE, AK 99511
Lending agency Day phone
Mailing address
Real Estate Agent BROOKE STILTNER w/ REMAX E. R. Day phone 694-4200
Mailing address 16600 CENTERFIELD DRIVE ' EAGLE RIVER, AK 99577
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
0
Individual On-site
Im
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
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 S at, or prior
to closing for the engineering services provided.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below,'I venly 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. 1 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 ALASKA WATER & WASTEWATER CONSULTANTS. INC.
Address 6901 DEBARR ROAD, SUITE 2B . ANCHORAGE, AK 99504
Engineers Printed Name JEFFREY A. GARNESS. P.E.
Engineers Comments:
In conducting this evaluation, AKW WC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines 8 Regulations. The reported 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. Satisfactory 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 therefore 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 SIGjJATURE
Approved for bedrooms
Disapproved.
Conditional approval for
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
By:
(Rev. 1=0
Phone 337-6179
Date "/,X" /"
OF
bedrooms, with the fllowing stipulatl�. ON-SITE O"
z : WATER AND • m
VVNJ I t i�� rT _P.
PROGRAM :•�
Manitenance Agreements
Supplemental Engineers Reort
Other
Original Certificate Date: jr//L
1
1
ES.
Legal Description:
A. WELL DATA
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water 6 Wastewater Program
4700 South Bregaw, SL
P.O. Box 196650 Anchorage, AK 99519 -NN
www.ci.enchorage.ak.us
(fes 343.7904
HEALTH AUTHORITY APPROVAL CHECKLIST
•`0
ROBINDALE S/D; LOT 3, BLOCK 2 Parcel ID: 051-052-55
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
l
Date completed 9/17/2002 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES
Total depth 181 ft. Cased to 181 ft. Casing height (above ground) 24 in.
FROM WELL LOG AT INSPECTION
Date of test 9/17/2002
Static water level 140 ft. ft.
Well production 15 g,p,m. g.p.m.
WATER SAMPLE RESULTS:
Coliform oolonies/100 ml. Nitrate L-2-mg1L. Other bacteria 0 colonies/100 ml.
Arsenic: N/A mg./L. Date of sample: 11 /4/2002 Collected by: AKWWC, INC.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material STEEL Date installed 8/8-12/2002
j Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N)'NS Depression over tank (Y/N) NO High water alar (Y/N) N/A
Date of pumping NEW Pumper
I C. ABSORPTION FIELD DATA reELOw FINAL DHADEI
N
j Date Installed e/e-12/2002 Son rating fk.p.d r Mbdr) 0_4 System jype BED
Length 75 ft. Width 15 ft. Gravel below pipe 1.09 ft.
�I
aTotal depth •4.es-5.48 ft. Eff. absorption area 1.125 fe Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) — For 3 bedrooms
tl
Fluid depth In absorption field before test = in. Water added =gal. New depth =in.
Elapsed Time: = min. Final fluid depth = in. Absorption rate >= - g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) - If yes, give date -
D. LIFT STATION
Date installed Size in gallons Manhole/Accp— (Y/IJ)
"Pump on" level at _in. "Pump ofP IPvgl at in. High water alar level at in.
Datum Cycles tested Meets alar & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer /septic service line 25'+ Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 100+ Surface water 100'+ Driveway, parking/vehide storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS I
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.
Engineers Printd lvu
me JEFFREY A. GARNESS
Date �lI �
HAA Fee $ 375 552405'—!w ! alver Fee $
Date of Payment t -%—O i. Date of Payment
Receipt Number 214" �1/� Receipt Number
(Rev. 12101) \ t
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