Loading...
HomeMy WebLinkAboutHUNDRED HILLS BLK 1 LT 4AHundred Hills Block 1 Lot 4A #078-181-02 Municipality of Anchorage Page ) of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: Sw9S0SI3 PID Number: 078--IS%-°Z Name: TVleM$enl Wastewater System: New 0 Upgrade Y Address)134BSORPTION 17343 �1.ftA 1�tAt1A DO—E.A.Ki AK 'TIM FIELD Phone: 29O - 2.020 No. of Bedrooms: 3 Deep rench Shallow Trench O Bed O Mound O Other LEGAL DESCRIPTION Soil Rating: ' • 2 GPD/Sq Ft Total Depth from original grade: 81 _ 91 ± Lot: �t/^� Block: Subdivision-Deptn —T�"1 I iitlrlCceC HILLS to bottom from originalgroee: 31 - 41 ± Ft Gravel depth beneath pipe S Ft Township: Range: Section: Fill added above original grape: 0.51 -1.S Ft Gravel length: / qo Ft Gravel width: 31Number Ft of lines: 1 Distance between lines. ^ Ft WELL: (® Ne) 0 Upgrade Classification (Private. A.BC): PIi1 petr Total Dept`: 26e Ft Cased TS: 10 Ft Total absorptiontarea 1400 `I' SO Ft Pipe material: 11 P1STM D-3037 Driller. Sfa,l4P0J �A7U .. Weu.S Date Drilled: '1 4/ s Static Water Level: 20 Ft. Installer: Decd Caos'rcucro4 Date In stall ig%zS-26A98 Yield:I Pump Set at: Cuing $eight Above Ground. 20 GPM V• 1L ) 1' Ft 2FI TANK SEPARATION DISTANCES at> OHolding 0S.T.E.P. To From Septic Tank Absorption Field Litt Station Mowing Tank Public/Pnvate Sewer Lines Manufacturer. PiovA4..p.C.e 7-1044 K. Capacity In gallons: le/00 Welt IoSit )2113 --- --• Z51•r Material: Slew._ of Co artmants: Surface Water 10011- )001-i --- r LIFT STATION LotSiz Line 68 4 131'1- — •- . Ions: Manufacturer. Foundation 101= ( Z8 1 �,,,, Pump on" level at: Y R� High water alarm at: �� Curtain Drain NONE y,,. Pump Make I Elec rical Inspections Performed by: Remarks: Se Pte_ -Arm wAs • BENCH MARK / Per. ep PeeateActat I$sUl0.TC Location and Description: "TSM a 'i4 es Nb I.C. of Den ,L (czarSE Te PotaT 11131) Assumed Elevation: /. AtFt EN • a 7 3 • E•Idf� '0 Lf • 4 e..:.. l •. ••• f ..•••••- PI= -'1 1 H ) . (romeu ?t% , `,2 . le , • •,: 7957 s. f. aV 1 ,+� a •••.... •ct,\• _ �....s.:. Inspections performed by: 11 •vt• W• G• 14 c• Dates 1s 1-3 u • r3 t 2nd 4 2 - c Zech 11 •© . Department of Health and Human Services approval Reviewed and approved by: 14114 C frj &Gtr11.19 .c Date- /' 72-013 (Rev. W91) MOA 25 PERMIT NUMBER: SW980313 AS -BUILT DRAWING PARCEL ID NUMBER. 078-181-02 \ NEW DRAINFIELD • f \ ‘XPA, / K^ • TOP OF CUTHANK--' \\ \ (APPROX. LOC.) \\\ / / \ 1 /\ ( I I FINAL GRADE 98.6+ 7yg2 ALTERNATE SITE A FC0 23.6 9.3 ST1 29.4 13.5 ST2 34.6 11.1 /1 DE3L1 38.0 11.7 \ // DBL2 38.9 12.1 CO1 55.6 28.9 NEW 1000 GALLON /' MT1 84.6 64.2 SEPTIC TANK / CO2 87.8 67.5 / ' MODERATE HAZARD - / AVALANCHE ZONE /• • 512 / \•// FW �\/ / WELL T\` ' / / -3/4,-\ / / -` / / / N.moi' / / -HIGH HAZARD / \ AVALANCHE ZONE / / / / ///;::.;5\ /C- \ CO MI an FINAL GRADE ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7320 E. CHLaItH HEIGHTS CIRCLE. ANCHORAGE. AK 99504 PHONE (907) 337-6179/FAX: (907) 338-3246 CO1 - 82.8 CO2 - 92.9 MT1 - 87.8 8077014 OF 1H/1 - 81.8 -LGAL DLSCR1PIION. HUNDRED HILLS SUBDIVISION, LOT 4A, BLOCK 1, IYPL Of WORK: AS -BUILT OF SEPTIC SYSTEM 'HLPARLU FON. PHONE. NUMRLN: JOHN THOMSON 240-2020 _AI L: 11/4/98 irtAWN I 3LALt: J.L.M. 1 = 40' 1PA6L: 2 OF 2 Sop \,,��oleeelo� e .`u\`LDnoo�y II/09/98 MON_13:04 FAX 6396490 VISTA REAL ESTATE ER fm 001 Clerttfitb Tang by tOC Co no • SULLIVAN WATER WELLS P.O. BOX 670272. CHUGIAK, ALASKA 99567 • TELEPHONE 606.2759 OWNER OF LAND • 01-1.-J TFfd.4tJ•ar ADDRESS _11 3 13 _SA 1 et A• ,QQedF LEGAL DESCRIPTION 4.. _Wad Mit S ier 4 4 . PERMIT NUMBERSW 91b3/ bate of issue ? - b TAXINDENTIFICATIONNUMBER D iL=�a Is well located at approved permit location? rPfeC Q Nc 'Method of Drilling: F.r rotary 0 ceb:e tool Depth of welt: �1 Casing Type aL.,.Wall Thickness . T v inches Diameter 4 U Inches, depth 1 O 1 feet Liner Type: rJ n4 Casing Stickup Atove Ground. oZ feet Static Water Level (from ground level). _T) feet Pumping level: feet after hrs. pumping gcm Recover Rate: D a gpm Method cf Tasting: J41 A. Well Intake Opening Type: Q Oper, End Fen Hoic Screened; Start feet Stopped Perforations Start feet Stopped Grout Typell3e-^,TI—1 r t. Volume _25-o LBO Depth: from ,Q feet. to —' feet Pump Intake Depth: feet Pump Size np Brand Name Well Disinfected Upon Completion? C.3 -'c' O No Meti:ot of Disinfe .on: C1/4. •.t,.,la 5Th PP.l ago BORE HOLE DATA DEPTH r 4 ISS 1 4 5- 1 0 qn , /5ci St in c.45 "J,f.rreK.lP S ovt_.A oche der r<T i Cc's.? 1404JA,. (^r 4:` 644.4c c. 14440 /4-4 . Co0r3<ct 1366 te ac it a< .C. b.s,ebpo c C /s -GREE r36-e&c t 4vQJ BF', c G (�eier.],J d46 13EO4act ,440 feet feet ys Asir—) p,c4/Act 6REEr� ��hc"—JI1cQ ^ '4r 1�eel acIC t/4 ,C0 URA•1' Comments: OAra" 9Ii&ct4 9/F/t=P Muni opt ECE,D lov 1 3 ip31 ty orage alth & Human Service Drillers Name ATTENTION: It is the responsibility of the property owner to submit a copy cf the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough Department of Environments! Corsevation. Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Ileights Circle — Anchorage — Alaska 99504 Phone (907) 337-6179 — Fax (907) 338-3246 August 27, 1998 Municipality of Anchorage Department of Health & Human Services P.O. Box 196650 Anchorage, AK 99519-6650 Attn: Laura Montgomery REFERENCE: Lot 4A; Block 1; Hundred Hills Status of septic system documentation RECEIVED AUG 28 1998 Municipality of Anchorage Dept. Health & Human Services A permit (#SW980313) was issued to install the referenced septic system 8/20/98. This property is undeveloped and a new home is being built. The septic system has been installed, however there are no points of reference to swing -tie the new septic system on the property. After the house is completed, final grading is done and an as -built survey is done, I will complete the documentation and as -built of the septic system which will be submitted to your department (DHHS) for review and approval. If you have any questions, please contact me at 337-6179 or 244-9612. Thank you for your assi y ce. JAG/gk MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial dpm Date Issued: Aug 20, 1998 Expiration Date: Aug 20, 1999 Permit Number: SW980313 Parcel ID: 078-181-02 Legal Description: HUNDRED HILLS BLK 1 LT 4A Design Engineer-42CA "n (24.(.A. L, W of it ress: Owner Name: JOHN THOMSON Lot Size: 80172 SQ. FT. Owner Address: 17343 SANTA MARIA DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER , AK 99577 - This permit is for the construction of: ❑� Disposal Field ❑✓ Septic Tank ❑ Holding Tank 0 Privy 0 Private Well ❑ 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 DHHS at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-4744 (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: fat-ciAlinbt< iv( P �7" Date: 25-ao-9$ Date: 8 -2o-98 Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle — Anchorage — Alaska 99504 (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers August 7, 1998 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well and Septic Design for Lots 4A, Block 1, Hundred Hills Subdivision To whom it may concern: The proposed 3 bedroom house will be served by a private septic system and a private well. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil profile, and the percolation test results. The soils below the organic layer are a GW -GM material with some silt and some cobbles to a depth of 15 feet to 16 feet (bottom of the test holes). No groundwater was encountered during the excavation of the test holes. After 7 days, the monitoring tubes in the test holes were checked and found to be dry. The percolation tests were performed between the depth of 7.0 feet to 7.5 feet in both test holes. The percolation rate was <1 minute/inch in both test holes. There is enough silt in the soil so that a cast can be formed by hand with the soil, therefore it is our opinion that a sand filter is not necessary. A sample of the insuti soils can be provided if required. 2. TRENCII DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 375 ft2 f. Total Depth: 9 feet (max.) g. Effective Depth: 5 feet h. Width: 2 feet i. Minimum Length: 40 feet j Effective absorption area = 400 ft2 (375 ft2 OK) 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the design, the average slope in the proposed septic area is approximately between 20-24%. There is a cutbank south to southwest of the proposed trench, but it will be over 50 feet away. All effort will be made at the time of installation to ensure that the proposed trench is at least 50 feet uphill from any slope greater than 25%.. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. 1 / / i LOT 4B, BLOCK 1 HUNDRED HILLS 4 LOT 5, BLOCK 1 HUNDRED HILLS P a K ROIL LOC. LOT 1, BLOCK 3 HUNDRED HILLS o�• • ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7320 E. CHESTER HEICFRS CIRCLE, ANCHORAGE, AK 99504 PHONE (907) 337-8179/FAX: (907) 338-3248 .SCAL C15CRIPIION: HUNDRED HILLS SUBDIVISION, LOT 4A, BLOCK 1, "IPE 01- WORK: SITE PLAN 72LPARL0 10H: JOHN THOMSON 240-2020 PHONL NUU3LR: JAIL: 8/7/98 1NAWN tlT: 1 = 100' 1 OF 2. NOTE: THE CONTRACTOR IS RESPONSIBLE FOR HAVING THE NORTH PROPERTY LINE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. ALTERNATE SITE 1y,Gt INSTALL OBL CO PROPOSED TRENCH 9' DEEP (MAXIMUM) BY 2' WIDE BY 40' LONG \ WITH 5' OF SEWER DRAINROCK \ (INSTALL TRENCH PARALLEL i ` TO SLOPE CONTOURS) • PROPOSED 1000 GALLON SEPTIC TANK TOP OF CUTBANK (APPROX. LOC.) \ MODERATE HAZARD \\ ' AVALANCHE ZONE \ \ 1` • \ \• / • \ \ / PROP/ W ELL / i ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7320 E. CHESTER HEIGHTS CIRCLE. ANCHORAGE. AK 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 ..LGAL OLSCRIPIION: HUNDRED HILLS SUBDIVISION. LOT 4A, BLOCK 1, YPL Of WORK: DESIGN OF SEPTIC SYSTEM 'RLPA.RtO 104: PMONL NUMULR: JOHN THOMSON 240-2020 JAIL: LtAWN at: 4i -dui - 8/7/98 8/7/98 I J.L.M. 1 = 30' 1 PAIaL: 2 OF 2 C:i 7953 ; \dam as•s '•..•.....•' ,F,o4os �° ALASKA WATER & WASTEWATER 7320PHONE (077)) 337-6179 FAX (907) 338-32443 • 99504 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: HUNDRED HILLS SUBDIVISION; PERFORMED FOR: DATE PERFORMED: (feet 1- 2- 3- 4- 5- 6- 7 8- 9- 10 — 11 — 12- 13 — 14- 15 7.7 16- 17- 18 — 19- 20 9- 20 JOHN THOMSON 7/29/98 ORGANICS GW -GM WITH SOME SILT AND SOME COBBLES COMMENTS: B.O.H. LOT 4A. BLOCK 1, TEST HOLE #1 SOL CLASSIFICATIONS •..9.•. 4166i14144 "VW:94 GW GP GM GC SW SP SM SC II111II !I!I! '/%r ORG ML CL OL MH CH OH DEPTH TO GROUNDWATER DATE DRY 7/29/98 _ DRY 7/31/98 DRY 8/5/98 REOURED DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 7/31/98 — NO PRESOAK REOURED --------- -- 2 3:50 MIN. 0' 6" — 3 6' — — — 4 3:50 MIN. 0' 6' 5 6 0' — 6 3:50 MIN. 6' PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN 7.0 FT. AND 7.5 FT. PERFOMED BY ALASKA WATER & WASTEWATER I, THIS WAS PERFORMEp )N ACCORDANCE WITH ALL STAD UNIDEUNES IN EFFECT ON THIS DATE. DATE: CERTIFY THAT ALASKA WATER & WASTEWATER 7320 E. CHESTER HTS. CIRCLE • ANCHORAGE, M. 99504 PHONE (901) 337-6179 • FAX (907) 338-3246 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: PERFORMED FOR: DATE PERFORMED: (feet 1- HUNDRED HILLS SUBDMSION; LOT 4A, BLOCK 1, JOHN THOMSON 7/29/98 GW -GM WITH SOME SILT AND SOME COBBLES COMMENTS: TEST HOLE #2 SOIL CLASSIFICATIONS I°.IIUI /11/44 M _^•jet GW GP GM GC SW SP SM SC 1111111 ////4- :I:I: ORG ML CL OL MH CH OH DEPTH TO GROUNDWATER DATE DRY_ 7/29/98 DRY_ DRY 7/_31/98 8/5/98 — NO PRESOAK A GOmrness,• o 953 :O 1°r egr Q74,!4p 1a�4Ci �o DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 7/31/98 — NO PRESOAK REQURED___ 1 6' 0' — — 2 1:30 MIN. 6' 3 6' 4 2:00 MIN. 0' 6' 5 6' 6 2:40 MIN. 0 6' 7 6' 0' — — 8 2:40 MIN. 6' PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6' (INCHES) TEST RUN BETWEEN 7.0 FT. AND 7.4 FT. PERFOMED BY ALASKA WATER & WASTEWATER I, THIS WAS PERFORM D ACCORDANCE WITH ALL ST DATE. DATE: t4,I Nr, a/ ICIPALi3ra , CERTIFY THAT EUNES IN EFFECT ON THIS Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 078-18 J -OZ COSA# 0Q 006 LI Expiration Date G - f!'1 — C% q 1. GENERAL INFORMATION Complete legal description Lot 4A; Block 1; Hundred Hills Subdivision Location (site address) 1075 Hiland Rd. Eagle River. AK 99577 Current Property owner(s) Richard Cannot a Dena Strait Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone 766-3689 Day phone Eva Loken Day phone 689-6476 Unless otherwise requested, COSA 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 ❑� Individual Water Storage 0 Individual Holding Tank 0 Community Class Well 0 Community On-site ❑ Public Water System 0 Public Sewer 0 The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site 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. 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 s IS Engineering Address 15861 S. Birchwood Loop Rd. Chugiak, AK 99567 Phone 6944979 Engineer's Printed Name Robert A. Shafer Date .3 - 6 -- 0 5. DSD SI94ATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bt .r_ O . , af... akt p',IA ........ ..M•V••r .r. A. t;=f X l iro7 Na..u s74 J; v- ` .9d.: �r • bedrooms, with the following stipulations: tuu�1 U)11,. \`1/40)urgArC .y0 .. : ON SITE •• 0i Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF s�ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot ' TR'3 ; woc l7 � j tnvbe rl iLL,S Parcel ID: 070- /%F02 A. WELL D Well typeE'-LVfh / If A, B, or C provide PWSID # Date completed 1445 Sanitary seal)l) Iles Total depth abo ' ft. Cased to 01 ft. FROM WELL LOG 9/€/9g Date of test Static water level OW i ft. Well production a0 g p.m• WATER SAMPLE RESULTS: Coliform Arsenic: colonies/100 mL ug/L Nitrate 0,09 mg/L date of sample4.R/07 B. SEPTIC/HOLDING TANK DATA NK Tank Type/Material 6 -PTI C /sTF-E C Tank size I ttO gal. il ` / Number of Compartments t Foundation cleanoutei l) /(5 Depression over tank (Ye)) Date of pumping 3/ 5/DCI Pumper -1 ` s Well Log1N) yes Wires properly protecteddiN) VES Casing height (above ground) Olt- in. AT INSPECTION a ft. Other bacteria Collected by: g.p.m. colonies/100 mL 34-5EAtx, botem Date installed • 0/02104S/02104 CleanoutCt9) 7 gi hip High water alarm (Y/19 ii\a serfcc --A44,71 C. ABSORPTION FIELD DATA Date installed 2,S5 Soil rating (g.p.d./ft2 or ft2/bdrm) 1' a Length 14Q r ft. Width 3' ,II/ Total depth' el ft. Eff. absorption area //OOft2 Date of adequacy test 4.St .. /a% Results Fluid depth In absorption field before test f ^ in. ,. rr Elapsed Time: � min. Final fluid depth 0 Any rejuvenation treatment (past 12 mo.) (Yei type) System type b . - Tcrttz f( ft. Gravel below pipe $ ft. Monitor' tube VES Depression over field kit ail) 45S For 3 bedrooms �h rr Water added'! 7 6gal. New depth �� In. t Absorption rate >_ 6D -i' g.p.d. If yes, give date in. 1Jn D. LIFT STATION NA Date installed Size in gallons Manhole/Access (Y/N) 'Pump on level at _ in. 'Pump off' level at i a er alarm level at in. Datum Cycles tested Meets alarm 8 circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot loo .1 On adjacent Tots Absorption field on lot a>0* On adjacent lots t'Q0 Public sewer main N/1i Sewer /septic service line o25 Animal containment areas Co t' Public sewer manhole/cleanout Holding tank N Manure/animal excrete storage areas /00 '/" SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 f Property line, 5 Absorption field r Water main /0/11 Water service line /0 4- Surface water Wells on adjacent Tots /00 '1 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 fa - Water '~Water Service line /0 r Curtain drain NOD( 40010A) Wells on adjacent Tots too 4- F. COMMENTS Building foundation /0 /- Surface water /00 14 - Water main S 4- /0(2f Driveway, parking/vehicle storage /0 Fina rimErcri cart) By pomp t ?""1-11/1 "1.11tier/ Flap iYf 4974vi emt.�T�OD-SUBStcoticr'YfFtt�17)CA73 c4RJ cU/ .cs" t' G. ENGINEER'S CERTIFICATION •t • A rw• Or Ir � C .F _�'•.�.s.a, I certify that I have determine review of Municipal records that conformance with MOA COS Engineer's Printed Name Date 3- G—O9 ugh field inspections and e above tems are in in: s frjeff ct nth . • ate. COSA Fee $ 1110 Date of Payment 311610 Receipt Number Ott We- (Rev. C (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SG$ SCS Refit Client Name Project Name/11 Client Sample 11) Matrix 1090705001 S & S Engineering L3A;131;1Iundred hills S/D L7A;131;I lundrcd I tills S/D Drinking Water Printed Date/Time Collected Date/1'ime Received Dale/Time Technical Director 03/13/2009 9:28 02/24/2009 11:30 02/24/2009 12:25 Stephen C. Ede Sample Remarks: Parameter Results PO1. Allowable Prep Analysis Units Method Container ID Limits Date Date Inil Metals by ICP/MS Arsenic Waters Department Total Nitratc/Nitrite-N Microbiolou Laboratory Colony Count Total eolith= Fecal Coliform ND 5.00 ug/L EP200.8 C (<10) 03/03/09 03/10/09 NRI3 0.129 0.100 mg/L Sh1204500NO3-F 13 (<10) 0 0 0 col/100mL Sh120922213 col/100mL Sht20922211 col/100mL Sh120922213 A A A (<200) (<1) (<1) 03/06/09 107. 02/24/09 DSI1 02/24/09 DSII 02/24/09 DSII ID, s o `, • • • A s NOTE: AVALANCHE ZONES SCALED FROM MOA MAP 16, DATED APRIL 1985. "a er—yFirap, �/'1j7it ASBUILT SEUARD HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: Mvv,,�.O.ra- to drive car ft -of /• ND ATHAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SCALE: \ ^% pp 0;7 h ASSOCIATES LAND SURVEYITvC-694-082q 1 DATE: GRID: rte. izes- o FB: 7s•L7 DRAWN: • y • i Dean. Mork Seward • A1q ms k i4L41;/// Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 07A- /p/- o Z 1. HAA # O a C G 3 O Expiration Date. 3L - GENERAL GENERAL INFORMATION Complete legal description LoT 4A BICt Hu r4tRt" Th 1•-i ILLS Location (site address or directions) 1015 1-1 ILA N O RoATT Current Property owner(s) M A RC_.l A 4-i != e- R Day phone 6 I Mailing address Lending agency Mailing address Real Estate Agent EVA Lo41Nr TN, Day phone Mailing Address 1 W, 35 C Unless otherwise requested, HM will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: • Individual Well Individual Water Storage Community Class Well Public Water System z Day phone /514 b$1.-6 try, Ar�u� e PL 44577 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 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 sample results. (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 welts or a public water system. The Municipality of Anchorage is not responsible for errors or emissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Iohbc).t Stu rlda_kct . Phone ,En -'39 II. Address 02•o3 W 1 ti LA $L 0.03 Engineer's Printed Name Io/keit go.)rk.\&tore ) 5. DSD SIGNATURE 1. - Approved for 3 bedrooms. Disapproved. Conditional approval for Date VHS.. to z bedrooms, with the following stipulations: lttltl.' A'''1r'/ ••Cp: Additional Comments ON-SiIE •'�= tom : WATr io min _ m WASTEWATER : • • Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: (Rt. 01/02) Original Certificate Date: /2 - / 9 - D. 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.clanchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST B9C1 Legal Description: LOT 4 A t-1 u NbtE o u t LLS C 10 Parcel ID:O78 —161- 157— A. t. A. WELL DATA Well type R Date completed CIS A 3 Total depthli./00 fL Date of test Static water level Well production If A, B,orCprovide PWSID# N/A* Well Log (Y/N) Sanitary seal (Y/N) y Wres properly protected (Y/N) '/ Cased to l o l fL FROM WELL LOG q Wigs' Casing height (above ground) 1 g in. AT INSPECTION 12140 2 Y et0 • ft > •'Lq ft. g.p.m.. ./o g.p.m. WATER SAMPLE RESULTS: Coliform J colonies/100 mi. Nitrate Ni)mg./I. Arsenic: mg./I. Date of sample: 144 z- 8. SEPTIC/HOLDING TANK DATA t TankType/Material Scp-Lci Stet( Tank size /000 gal. Number of Compartments S Foundation cleanout (Y/N) y Depression over tank (Y/N) J, Date of pumping t 2- 160 • 1. C. ABSORPTION FIELD DATA Date installed ta,2115 Soil rating (g.p.d./ft2 er-& bdw r) , 1-2. System type i e.K tit Length 14 D ft. Wdth 3 f. Gravel below pipe ft. Total depth 9 fL Eff. absorption area 1/3D ft2 Monitoring tube 'y Depression over field N Date of adequacy test / 2/44 2_ Results (Pass/Fail) W For 3' bedrooms .2Zv Fluid depth in absorption field before test 0 in. Water addedit&"gal. New depth -ro—in. Elapsed Time: min. Final fluid depth "1n. Absorption rate >_ 415v — g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N Y If yes, give date '" Pumper Other bacteria Nt i) colonies/100 ml. Collected by: f Sgurik(.a,wc� Date installed gbh /9 a Cleanouts (Y/N) High water alarm (Y/N) N D. LIFT STATION Date installed §i% in gallons 'Pump on' level at in. 'Pump off" level at_ Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1 0 5 Absorption field on lot 1 AO hole/Access (Y/N) in. ,7 High water alarm level at Meets alarm & circuit requirements? Public sewer main Sewer /septic service line g y t in. On adjacent lots ) 100 On adjacent lots 7 100 Public sewer manhole/cleanout N Holding tank Ty %A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building.foundation 1 2"i Property line 1 0 .r Water main NI hi Water service line :S + Absorption field Surface water Wells on adjacent lots '> IDO SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT, TO: Property line • 7. 10 Building foundation 29 Water main • Water Service line 5o Surface water til j o Curtain drain' N (o - Wells on adjacent lots ) 10-6 F. COMMENTS 21 NA Driveway, parking/vehicle storage G. ENGINEER'S CERTIFICATION ! 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 o 1313 S � u •r -V I & ac( Date 12404I01 - ' "Are. ton is ifv*••t 49L .....»....-t • .M �• 1fl c,� it f• t's'% lit 1. • ,frecttesz er— HAA Fee $ 375 v4g/O 7 - Date of Payment Receipt Number (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number Dec 03 02 04:S3p Eva Laken 907 C89 6476 p. 1 �rG�r yf 0,04j' Ai 1I 1 In "Q2' -2.- NOTE: AVALANCHE ZONES SCALED FROM MOA MAP DATED APR_L 1985. A5BUILT HEREBY CERTIFY THAT I HAVE SURVEYED THE rOLLOWING DESCRIBED PROPERTY: ,✓o/i4ro1O,u/!!S•f77 Ler y,1sy�; / ?fin TNO ENCROACHMENTS EXIST EXCEPT AS INO'CATED. IT 1S THE RESPONSIBILITY OF THE ' CN'NE.S TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WiICH DO NOT APl_AR ON THE RECORDED SUBOI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOILD ANY DATA HEREON BE USED FOR CONSTRUCTION 0° FENCE LINES, OR FOR ESTABLISH1143 BOUND- ARY LINES. SEWARD & ASSOCIATES SCALE: Cr -t r4)1 DATE: y/o/s GRID: •r"w.2s0 FB: DRAWN: •.S \ 1 5I LAND SURV�EYIx.-c—e-WL=OFz� :�P� % • • OF Azs`t 0 .-• •.'G' 4 CI) 4 '' yl ,--'1> 4 Mane M,r �ird 44 t" •. I.5.6918 ~ / P a k 11r ter, 0 ^* tt% .T• Dec 03 02 04:53p Eva Laken 907 689 8470 JLC a ro' Ira fur' /1°'` ,/;f0 •\ \ \--'\�� \ ,/.7 \`'.., '''..-.\ ~'.... 11 .. -' p. 1 \ 30 •\ I NOTE: AVALANCHE ZONES SCALED FROM MOA MAP 16, DATED APRIL 1985. ASBUILT HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: ✓/rG9 �1- 'fjDi d'' td p,.:j MD THAT NO ENCROACHMENTS EX1ST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWN TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- V3SION PLAT. UNDER NO CIRCUMSTANCES SHOULD MN DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SEWARD & SCALE: DATE: GRIDt FB: �S•Z9 DRAWN:' . \ :1 .9 1, ASSOCIATES LAND SURVE9Z 0&2 4owwwwso .•• `G OF AC►a ,r�P . _ ly} ' S.c �� •yam, x i DvMa Merk $award ' ' ,/ LS -69) ..• -P 1 It -112 13:11 cROP-CUE ENVIRUtEN'al SRV 91T5e1i201 T-153 P,02/03 2-139 ACt C'T&b. Rtf.a Client Name Project Names; Clknt Sample ID Mtatrlt 1 "l SID Sctrplc Remarks -C T&E Environmental Services Inc. 1028306001 Tobben S?urkland P.E. Lot 4A Hooded Hills 4 Lot 4A Hooded Hills Drinking Wates 0 All Datestfinec are Alaska Standard Time Printed Date/time 12/11/2002 14:38 Collected Date(flnw 12/09.'2002 12:30 Received Datel lne 12/09/2002 14:27 Tecbnkal Director Stepbey�f+ Ede Released By Parameter Ratan PQL Uniu Method Albv.ebk Prep Analysts Limits Dna Gm Inst Waters Department Nittaie-N Microbiology Laboratory Tani Col:farm 0200 0.200 me/L EPA 300.0 0 (<=101 12/09102 IS cot/1OOmL SMI8922213 (<-11 12/09'02 SKR' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ParcelID # 078-181-024 HAA# " c1CSl'�1�`�1 1. GENERAL INFORMATION Complete legal description Lot 4A; Block 1; Hundred Hills Subdivision Location (site address or directions) Hiland Rd & Lynx Lane Eagle River, AK 'Property owner John Thomson Day phone 240-2020 • Mailing address 17343 Santa Maria Drive Eagle River, AK 99577 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water XX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer XX NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 73-025 (pot 1/91) Front MOA 121 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 ofjhis inspection. Alaska Watt= as Wast �a g37-6/ 719 Name of Firm . •ts, •• •• Phone 7320 :: C.!' . h ircle te 1 Address Engineer's signature ALASKA; WATER & WASTE�[ATER CONSULTANTS, INC IS TO BE PAID IF 85Zi,b AT CLOSING FOR ENGINEERING SERVICES PERFORMED. 6. DH SIGNATURE Approved for 1-INZE6 Disapproved. Conditional approval for bedrooms. ?, ./r!I .:.••1 ...:... r . r i^l7�Jefirt A. Goma 8441 • E•7953 • 3i bedrooms, with the following stipulations: Additional Comments By:4tn'o- C (.P,OUJJ Date fii • i 9.9s CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-0:5 (R••. ust) Back MOA Rl Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 6\0\ 1 Environmental Services Division„ ,.,,�,,, ur ANL -110825 L Street, Room 502 • Anchorage, Alaska 99501 • (9O)43'4744"° Health Authority Approval Checklist Legal Description: ntl4Mpo 1I«t 46 LST 44 ., &Lk. I t Parcel 1.0 078 — 18 1 — 0 7-- A. A. WELL DATA Well type PROorWE If A, B, or C, attach ADEC letter. ADEC water system number h /A 9/`5/9'3 Log present (YIN) %./E s Date completed 1/ Total depth 2.(:, 0 Cased to I 0 I Casing height (above ground) - 18 + Sanitary seal JN) Yes Wires properly protected ON) YES FROM WELL LOG AT INSPECTION Date of test 9/8/'5' 8 Static water level ZO' Well production Z 0 g.p.m. g.p.m. WATER SAMPLE RE LILTS: Coliform Nitrate • 252 ^'`o.I12. Other bacteria 6, Date of sample. I% 13/96 Collected by: A •u1 • uJ • c • 1 i tJc.. B. SEPTICMOLDINGTANK /IDATA Date installed 8126/96 Tank size 000 Number of Compartments Z. Cleanouts &N) Yes Foundation cleanout am VE.) Depression ore 1I° High water alarm (Y/8, No Date of Pumping 1•)E(A1 Pumper C. ABSORPTION FIELD DATA Date installed eizcAin Soil rating (.p.d.70t erste:tem) 1.2 System type Tkar4c(} t • r Length • �0 Width `» Gravel thickness below pipe 5 Total depth 1 i— 10 r Effective absorption area q°0 45 Monitoring Tube present 01) Yes Depression over field' (YJ tia Date of adequacy test IJ E u3 Results (Pass/Fail) For 3 bedrooms Fluid depth in absorption field before test (in.); — Immediately after= gal. water added (in.): — Fluid depth (ins) Minutes later. Absorption rate = g.p d Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)' D. LIFT STATION Date installed Man ss (Y/N) "Pump on" = - 'Pump off" level at' High water alarm level at 'Datum Cyc E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /0614.-•-- On adjacent Tots I oo �t Size in gallons Absorption field on lot 12(1 't On adjacent tots 1001 t Public sewer main /4 by Public sewer manhole/cleanout a A Sewer /septic service line 2511 Lift station As SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation le* Property line 66 f Absorption field ) 7 — Water main/service line 10 1+ Surface water/drainage I 001÷ Wells on adjacent Tots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: loot Property line 131Building foundation 2 grt Water main/service line 10 1 4 - Surface water loo t;- Driveway, parking/vehicle storage area 6.0 ± Curtain drain Wells on adjacent Tots 10014 F. ENGINEER'S CERTIFICATION lcertifythatlh: t- i in conlorman. '����� Signature _dash% Engineer's Name ( (J errw•y ,4 • C., ,,cSS Date /1//o/9p hspections and review of Municipal in effect on this date. OF A4� teMS are t i4 7�1�9 * It 1.0 r 2 e a r A:6omni': W ir e -J''•.• n„, CEJ953'.i .". §' , �C'% 4t4ao•..........•,.,� .• . 0 F,?OFCs'IO n.= HAA Fee $ Sew. Waiver Fee $ Date of Payment Date of Payment Receipt Number 041 6 o 7 (70 0±) Receipt Number 72-026 (Rev. 3/96)' NOV-06-96 16:23 FPCV-CTE ENVIR 'DENTAL CT&E Environmental Services Inc. CT&E Reri Client Name Project Naale/r Client Sample 1D Matrix Ordered By PWSID $ample Remarks: 986527001 AR Water & Wastewater Consultants Inc. 1t aA Bile 1 Htmdr.A Hills S/D Outside Hose Bib Dti'*lag Water 0 6615301 T-450 P.05/06 F-560 Client PC, Printed Daterl'lme 11/06/98 10;47 Collected Date?ime 11/03/98 15.28 Received DatetFbne 11/04/98 11.20 Technical Director: Stephen C. Ede .0� Paraenter Total Colltorm eicrasa•a tssetts 69L units Petnoo AllOWB:e Prep timet Dace *retitle Data Inir 6 001100 nn. NO CJ:1 0.252 C.1X aa/n 1,18 02226 IPA 370.0 11/74/98 [AP 10 Net 11/04/90 11/74/90 CCP RECEIVED NOV 10 1998 Mumcipa6ty Vi ekocnorage Dept. Health & Human Services &SBUiL'J' HAVE SURV~:YED THE ROI~ERTY, ITS EXIST EXCEPT AS ~IK)N$1Bi LITY OF EXISTENCE OF ANY O1~ RESTRICTIONS 'N£ RECO~D suB~i- 1 HEP, EBY CERTIFY .THAT AND THAT NO ENC~IOACHMEI iNDiCATED, IT IS THE RE OWNER 1"0 DETERMINE THE EASEMENTS, COVENAN?~I, WHIOH DO NOT ,N~PEAR ON ' VISION PLAT. IJNDE'R NO C ANY DATA HEREON BE USED FOR CONBTRt.ICTION. OF FENCE LrNES, OR FOR ,ESTA~I..tSN~N~ I~XJND ARY LINES,