HomeMy WebLinkAboutTUSTAMENA TERRACE LT 7AT
Lot 7A
#017-381-5
DEPAKI~,OF ENVIRONI~AL CoNsERvATiON'
CONSTRUCTION ~ OPERATION CERTIFICATE
' '- ' ... :.. · FOK . ·
DOMESTIC W~.STE'WATER DISPOSAL SYSTEMS '.:?"
domestic wastewa~r disposal system
'.'"'. have been reviewed and are
I-I ""' d(' ""
¢ondiUon~llZ approv see n_~¢hed condMo~ ,
n,
If constmctlon bas not started [thin two years of the approYal date, this certificate is v~id ~d new plans and specifications must
be submitted for review and approval before construction. .~,, '
B. APPROVED CHANGE ORDERS
Change (conlz~ order number or descriptiv? reference)
C. APPROVAL TO OPERATE .:
.The 'APPROYAL TO OPERATE" s~lon must be co'~plcted and signed by the Department before this system is made available
Theco~,uctionofthc ~,--'~O~ FO~.~5~/~ ,,~ ~,~ domesficwastewaterdisposalsystemwa~complcted
The ~ is hereby granted interim approval to operate for 90 days following the complctlon date.
A.~uih/record... dn~wln~s,., submitted to...the. Deparlment, or an Inspection by thc D~pariment, ha~ conf~med that the domestic
~ ~ sys .t~m was ~ in ~ conformance ~th the approved plans. The system Is hereby granted
A. APPROVAL TO CONSTRUCT
Plans for [he conm'~ctino or modification of C,,/,,~ .~
STATE OF ALASKA
DEPARTMENt, OF ENVIRONMENTAL CONSERVATION
CONSTRUCTION AND OPERATION CERTIFICATE
£OR
PUBLIC WATER SYSTEMS
F-] approved..
[] conditonally approved (see attached'conditinns)i
BY
public water system located in
Alaska, submitted in accordance with 18 AAC 80.300
have been reviewed and are .
If constt'uct|on has not s~ncd within two year~ of thc approval date, ~.is certificate is void and new plans and specifications must
be submitted for rcvlcw and approval before construction. '
B. APPROVED CHANGE ORDERS
Change (contract order number or descriptive reference):
Approved by: · Date:
C. APPROVAL TO OPERATE
.Tae "APPROVAL TO, OPERATE' section must be completed and signed by the DeparU~ent before this system is made available
public water system was completed
on~ (date). The ~stem is hereby granted Interim oppr~val to operate for 90
days
following
completion
date.
aY · DATI?-
As-buih/rccord drawings, submitted to thc Dcp~ent, or au inspection by thc Deparonent, have cool'u'meal that the system was
constructed according to the approved plans, The system is hereby granted final approval to operate.
, Dislrlbutlon: !. Rctaln original for project file
2. Make copies for distribution
L GENERAL
· STATE OFALASKA' , il'
DEPARTMENT OF ENVIRONbl ENTAL"CONSERVATIbN
APPLICATION FOR ON-SrTE WATER AND SEWER
SYSTEM APPROVAL ' '
OR
DOCUMENTATION OF SYSTEbI INSTALLATION '
IlL V,'ATER SUPPLY gYSTEM
Sou~ of W~.r m~l C _o,~*. _ ~.~ {~ ill ~ ~ly)
Ilol~g T~ ~ ~
Well ~ h ~ ~i~ of ~ well ~g ~ ~ 12' ~ ~
~ a ~ ~I ~ well ~ ~It~ ~ ~ well
h ~ d~ away ~ ~ ~ ~ ~g wi~ a ~di~ of 10 f~ of~ well c~ing?
b well wire ergl~l in coaduh?
Oaz*Ddllod, , I De~ of Well (F,.0 '
~i~ ~ ~ ~ Well ~in~ ~ e~ of~ Fotl~ S~ of C~i~ti~:
~i~lotd~lX~ ~ ~ //9/ ~ SO0 '
C~S~loldmg~j~//~/ C~Sew~j~t~lOC
S & S ENGINEERING .' ..'.'::
of Wit.' SuFply Sy,~c.m J rrfl~t of War. (~ elf ~t ~ly)
I Yield ~foMtlable) ~Ra~ (ffa~ilabh
Wain. S~mpk T~m by:. (N.me)
Wt~r S~ml~k R~ul~t:
17034 Eagle River Loop Road No.204
Eagle KIver, Alaska
Sampler
J J~J B.u~et E] Oovemf~ Of~dd
~ota: *~tu~t ~ Itlgn~d k~v a Cer~fi~d Inttotltr. Prof~,ior.~l Engtne~r. D_r~ tta~. or
~°¥0 /
L4.4C,.~4 K~ 4.4, 0
j°", /~ , / e s;
ISe¢ic T~ T)TeAl~nu facturer
Box 1..~69, ST,XR I~OIJ'TE flk A.~'CHORAGE~. ALASI~A 99~02
SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF.
DRILLED AT THE RATE OF' 5'77. OO
PER FOOT,
PROPERTY OWNER £~. ,~/c¢ Bond
LOCATION OF WELL SITF '~' '7 /~" Su~.
DRILLER
400
Ciau~ o~ 2~,o~ .Dr'"'
WELL LOG:
0 .... 3~'
35---£4'
158-2.35 '
2-35--293'
9/'3--400'
1/2 ~"'£t cotrv~q
· t;v:e ,tod: [.,zoa 360 to 400 t'ee,t-. 200 (ee,(
150 7c,.4~ l;e,z h. ou~ co.c,.O~.q
MUNICIPALITY OF ANCHOEAGE
DEPT. OF H-~ALT, I & '~1~1
ENVIRONMENTAl. P^oTcCI'ICqq ' ' ~'
;).vLt, ted ~ 1976 CoL 26~, 1976 --. OEO 2 9 1981
(
COST INCLUDES ALL ~BOR~ND-MAT~AL FOR COMPL~ION OF ~AID.D~I~
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FORTHE S~M OF,
THANK YOU VERY .UCH. ~
1~7~~'~ ',~ "
BERNIE C~US OF ~MPA~
~ERVICE CHARGEOF l~a% PER MOtH Wl~ BE ~S~S~ O~ P~
M~y~r
~700 Br~w
,Anchor~, AK 99~ !9-~6~0
Pump Installation Log
We]_]. DriVing Permit
D~t~ of
parcel Identification Number:__
JJ Property Owner Name & Addrass:
.Pump lPIodel: ~.~-
Pump Size I hp
Pidess .kdap~er Bm4M Deg%h: / D ~t
~ethod ,:( wxsmaec~o a:
IV. DIAGRAM OFSYSTEbt(S)
INSTRUCTIONS FOR DIAGRAM .... ·
I. In a Flaa ~'w. _L~!e ~d Id~llfy ~:h ofl~e follov&~ .... :? ..
a) Well
~ ~ / ~[us , UNDeVelOPeD
~ LOTSA ~ .
~ ~ ~. ~_~ - NEW TRENCHES
SEPTIC TANE~
825 "L" STREET
ANCIIORAGE, ALASKA 9950'1
(907) '264 4111
January 4, 1982
Alaska USA Federal Credit Union
2600 DeBarr Rd.
Anchorage, AK 99504
Permit ~ 811172
Subject: L7 Tustamena Terrace Subdivision
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for
files.
our
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Sewer and }later Program
Enclosure: Copy of Permit
825 "L' STREET, 8?4CHORAGE, RI(. 9958±
2~-,4-4720
Or'l--5 T TE sElqER PERt.11 T
PERMIT ~0. ( Bill?2 > qqS. o~~l~
8F'PLICA~'~T AK US8 FED. CREDIT U~IO 2_~00 DEBARR RD ~_///~mZ.
LEGFIL L? TUSTFIMENFI ¢~'L,h_~(~¢,, J~D LOT _ E
T~'F'E OF SOIL RBSORPTIOf-~ SYSTEM IS: TREe, CH
~IR',dIMIJM t.~UMBER OF BEDROOr'I$ = .~ SOIL RATIHG (SD FT?BR>=
264-2Bi2
14400 SOLIR~ I
THE REQUIRE[) SIZE OF THE SOIL RBSORPTIO~ SYSTEM IS:
DEPTH= 9 LENGTH= -~'¢] f~ GRR%-'EL DEPTH= 5
THE LB~GTH DIMB~SIOf. I IS THE LBIGT~H (~'~.FEET> OF IH~ ~R ~R~I~.IFIEL~.
THE DEPTH OF R TRBICH OR PIT~ T~E DISTR/-~CE BETI4EBI T~SU~'RC~OF THE
GROUr.~D Rr.lD THE BOTTOf,I O~TOE~EXCRVRTIOt. I (IH FEET>. ~ ~ }
THERE IS HO ~ET I,~IDTH FO~REf-ICHES. '~f
THE 6RRVEL DEPTH I~ THE MIf. IIMUM DEPTH OF 6RRVEL BETI,~EEf~ THE OUTFRLL PIPE
Rf.~D THE BOTTOM OF THE EXCRVRTIOH (I~ PEET>.
RE~LI~REB SEPTZ6 TR[-IK S~ZE= ~ 6RLLO[4S
PERMIT RPPLICRr. IT HR$ THE RESPONSIBILITY TO ?~FORM THIS DEF'ART~IE~T DURI~IG THE
if. ISTALLATIOf-I IHSPECTIOf.6 OF A~I'¢ [.ELLS RDJRCEHT TO THIS PROPERTY RND THE
f. IUMBER OF RESIDEHCES THAT THE ~IELL ~IlLL SERVE.
TI-IQ ( 2 ) I 1'4SPE[::T I Of, iS RRE REQU I RED
BRC,(FILLIf',G OF R,"'¢ SYSTEM I.!ITHOLIT FIf,~AL INSPECTI~tff~"'~AHD APPROVAL BY THIS
[,EPRRTblEIIT ~IILL BE SUBJECT TO PROSECUTIOt~ ~ \,)
UPO~'I THE TYPE OF PUBLIC I,IELL.
MIf'IIMUM DISTRt'tCE FROM R PRIVRTE ;.IELL TO R PRIVRTE ~E~ER LI~IE IS 25 FEET R~lO
TO R COMr'~U~'IITY SEI,ER LI~E IS 75 FEET.
OTHER REQUIREMENTS MRY RPPLM. SPECIFICRTIONS Rf'lD CO~GTRUCTIOf4 DIRGRRMS RRE
RVRILRBLE TO I~ISURE PROPER INSTRLLRTIO~.
F'ERr'I I T EXF' I RES DECE. I~I~R 2:--'1.. :298'1
I CERTIFY THRT
l: I RM FRMILIAR' I,~ITH THE I;'.EQL;~[~.'~I S FOR OH-SITE SEI,!ERS R~4D 14ELLS RS SET
FORTH BY THE MUHICIPRLITY OF RH~ORRGE.
' I 14ILL IHSTRLL THE SYSTEM I~'4 RCCORDRF~CE P)ITH THE CODES.
~: I U)'JDERSTRt'4B THRT THE Of'4-SITE SEI,ER SYSTEM ~IRY REQUIRE E~4LRRGE~IEt'4T IF THE
RESIDB'~CE IS REMODELED TO It.~CLUDE t'IORE THRN 4 BEDROOM_~~
RPF -IT R~., CREDIT U~'~ I ON
.............
/'.,
..~-.. GREA .R ANCHORAGE AREA BORt
ii Department Quality
of
Environmental
' 3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCAT,ON--)~ C~.~__ LEGAL DESC.IPT,ON : ~ --~~-- ~/~
SEPTIC TANK:
DISTANCE ~
FROM WE LL~/~,
INSIDE LENGTH
INSIDE WIDTH LIQUID DEPTH LIQUID CAPAClTY().-~O GALLONS·
TILE DRAIN FIELD~ ~ ~
DISTANCE FROM WELL~)~ FOUNDATION ~ ¢
NUMBER OF LINES J DISTANCE BETWEEN LINES
ABSORPTION AREA (oO(~ SQ, FT. LENGTH OF~I LINE
DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE ~ MATERIAL BENEATH TILE.~
NEAREST LOT LINE
TOTAL LENGTH
OF LINES
TRENCH WIDTH ~'IN.
TOTAL EFFECTIVE
ABOVE TILE IN.
WELL:[-~
TYPE ._~-I:u~_~} CONSTRUCTION
BUILDING NEAREST NEAREST
FOUNDATION__ LOT LINE , SEWER LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED ' REMARKS
DEPTH
SEPTIC SEEPAGE
TANK , SYSTEM
DISTANCE FROM:
DISTANCES:
INSTALLED BY: I~/[k'k~ (~'
SEWER LINE DEPTH: ~ ¢
PIPEMATERiALt~'~ J!~%
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
DATE PPROVEO
G.A.A.B.
Form EQ-032
..,~.~; [:'EPRRTHENT , HERLTH tint:' EN'¢IF:ONHENTF~L :FITECTION
. - - 25i6 E. ru£:,OR: FiD., RN3HOR'RGE, RK. 99507
" 276-2221
~.?IlI'N-,. [4ELI_< 76674 >RND' ,IN--SITE SE[4EF:
RF F'L I L-:RNT
LOL':Ff¥ I ON
LEGRL
IZII KE E:ON[:,
NHKF-4~- ~.. LHr'E
r l
L7 TUSTRMENFt _-.LB
7229 LEI.)IS F'LRCE
LOT SIZE
¢4 ~-r --¢..
14400 SFJ_IRF~E FEET
TYF'E OF SOIL ABSORBTION SYSTEH IS: TRENCH
HR;?;I£'IUt'I NUHE:ER OF BEDROOMS = /¢~ SOIL RATIri~3
1HE F:E6!UIF:EB, SIZE OF THE SOIL ABSOF~PTION S'~'STEI'I
[:.E F'T FI = 9 LE[-,,3 TH = ~~ R'...'E L C.E~TH = 5
GROUHD R[.4~¢ THE BOTTOH OF THE B'(CRVRT~ON (ZN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE ORR'eEL DEPTH IS THE r. IINIHUH DEPTH OF GRR',.,'EL E:ET~*EEN THE OUTFRLL PIPE
RND THE BOTTOH OF THE B::CRVRTION (IN FEET).
F-': EI;! I_l I F-: E B, SEF'T I C 1- R r-4 f--. SIZE=
[',FICKFILLING OF RNY S'¢STEH WITHOLIT FINFtL INSPECTION ~NC, RF'PRO',,.'RL E:Y THIS
[:,EF'RR:THENT WILL E:E SLIE:JECT TO F'ROSECUTION.
l.lllllf, lIJf.1 DISTRNCE BETWEEN A WELL Arid RN',' ON-SITE SEWAGE [:,ISPOSRL SYSTEI'I IS
100 FEET FOR A PRIVRTE WELL OR 200 FEET FOP-. R PUE~LIC I.IELL
I.ELL LOGS FIRE REE~UIRE[:, RN[:, HUST E:E RETUF.:NED TO THE DEPF~RTr. IENT I.IITHIN
OF THE I.IELL COHF'LETION
SF'ECIFICATIONS RNE:, CONSTRUCTION DIAGRRMS RRE RVRILRBLE TO INSU~:E PROPER
I NSI'RLLRT I
F'E~-:r.1 I T ~..'RL I D FEIF-: Or-lE ~r'ERF.: FF-:I3hl I SSI_IE
I
1:
FORTH B'¢ T~tE f. IUNICIF'RLIT¥ OF RNCHORRGE.
2: I WILL. INSTRLL THE S'¢STBi IN RCCORDRNCE I, IITH THE CO[ES.
2:: I UN[>E¢:STRND THRT THE ON-SITE SEWER'. SN'STEr,I MRY REOUIRE ENLRRGEMENT
kESIE:,ENCE I~' TO ~;:E THAN 6 BE[:,ROOHS.
- ' RFF'LICR.IT f.iT[~-~ · -
E:'~ ' ~~ DFtTE ~- ~ ~-' ¢~
ISSUED ~ ..........................
CERT I F'~ THRT
I r4f.1 FRHILIRF.' WITH THE REQUIF;EHENTS FOR ON-SITE SB.ERS RN[) WELLS RS SET
IF THE
GARY PLA¥1M_R
VI=NTUR S
CONSULTING GEOLOGIST
IBOX 476-M, STAR ROUTE A * ANCHORAGE, ALASKA 99507 ·
PHONE 344-7071
SOILS TEST
This form reports on visual classification of soils in a backhoe
excavated test pit.
Test performed for
Legal description L~ ~ "['u~e~= T~V~(¢ S~.
Depth (feet)
0-3
3-4
~.~-~
Soil Description
Was groundwater encountered? ~S %~nat depth? ] ~ ~
Depth to I'ue'~'1'v~h ~,,~T~ ,,, '"
~ b~roqk ~0' . How determined?
Respectfully submitted,
Gary F; Player
Consulting Geologist
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.
1. GEN. ERAL-INFORMAT[ON
..Competelegald,escnptic~. Lot 7A & 8Al
Location (site address or flireetions)
C..urrent Property ow~.e.~l~
Mailing address .' 8720 geverly ~t11~ ~,~.
Lending agency
Mailing address
Expiration Date:
Tustamena Terrace Subdivision
5601Naknek Ln, Anchorage. AK qq~5'l~
Dayphone 5ns-828-~gn~
AZbuquerque, NH 87122
Day phone
Real Estate Agent
Phyllis Kruger / Pacific RimDayphone 727-8439
Mailing Address 405 W. 27th Ave. Anchorage, AK 99503
Unless otherwise requested, HAA will be held by DSD for pickup. '
2. NUMBER OF BEDROOMS: 6
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class --, Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site 3~[] ..
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 HeaIth 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 wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.'
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
NameofFirm S & S Engineering Phone 694-2979
Address 17034 N. Eagle River Loop Ste. 204 Eagle River, AK 99577
Engineer's Printed Name ]~obert C. Co.an ..Date ~'/A9 /e ~/
5. DSD SIGNATURE
~ Approved for
Disapproved.
Conditional approval for
bedrooms. I ( .-., .... ,,.o ~
bedrooms, with the [ollowing stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: ~;~ - 3 -' 0 Z./
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewatsr Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6850
www.ci.anchorage.ak, us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: /.-' '-~"~/~'/*~
WELL DATA
Well type cPc**¢~
Date completed
Total depth ~'~o' ft.
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
IfA, B, or C provide PWSID #
Sanitary seal (~N) ~, ~,
Cased to ~ ~ ~ ft.
FROM WELL LOG
/o/z~/~
~e~o~ ft.
g.p.m.
Parcel ID: O I'~' Sg/-~.~
Well Log (~N) Y¢-.-~
Wires properly protected
Casing height (above ground) / ~ ''~' in.
AT INSPECTION
~0~~ .ft.
/' / g.p,m.
Coliform [2 colonies/100 mi.
Arsenic: ~ mg./L
Nitrate 0 · / mg.fl. Other bacteria O colonies/100 mi.
Date of colie <
Date:.sta,,ed
Cleanouts (:~) Y~.-~
High water alarm (Y/~) ~,3e
erave~ baker pipe I0, 5 / ft.
Depression over field [,~
For ~ bedrooms
New depth '~-lq ~n.
~/~(T.) g.p.d.
If yes, give data -------
B. SEPTIC/HOLDING TANK DATA
Tank Type/Me, te~l' ~:~e~/
Tank size :~ ~O gal.. ' / N~;~r of Compartments
Foundation C~eanoUt~TN) ~ .i'Del~sion over tank (Y/~
Date of .~mping '7/Z~ $/0 ~' '.'"Pumper
C. ABSORPT!ON FIELD DATA . . ,"
Total depth l~:;Ift. Eft. absorption area l"/c~b ft2 Monitoring
Date of adequacy test '~/I ~ / ~ 'l Results (~'Fail) .<~,.c~
Fluid depth in ebsorption field before test ~ l~ in. Water added ~J~l gal.
Elapsed Time: '/J }min. Final fluid depth ~ ~ in. ,Absorption rate >=
Any rojuvenatJon troatment (past 12 mo.) (Y/N & type) ~ v~...
D. LIFT STATION
"Pump on" level at -~$ ~'in.
Datum
E. SEPARATION DISTANCES
Size in gallons.
'Pump off' level at 7,~" in.
Cycles tested
Manhole/Access (~/N) ~'~ ~,
High water alarm level at ~gl~ in.
Meets alarm & circuit requirements? ~/,~ %
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot /O "7 /
Absorption field on lot /c~o / ~-
Public sewer main ~J /~'
Sewer/septic service line ~.~ r /
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation /'~' "/' Property line /o /
Water main ( o ~ nu Water service line [
Wells on adjacent lots /~--'O
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line / (~ ~ (- Building foundation /O
Water Service line [O I Jr Surface water ./C~
Curtain drain L.]o-~C, ¥~v,~ Wells on adjacent lots /~<D //-
Absorption field
Surface water
Water main (0 ~ (-
Driveway, pa~tdng/vehirJe storage
F. COMMENTS
G, ENGINEER'S CERTIFICATION
I certify that I have determined through field ir~pectiens 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//LJ~,~ 4.,,~7- C'. (~o ~,~'
Data
HAA Fee $
Date of Payment
Receipt Number
(Rev. 12/O1)
Waiver Fee $.
Date of Payment
Receipt Number
SG$ Ref~
Client I~ame
Project N3mc/#
Client $3mple ID
M~trix
~r~ple Remarks:
1044466001
S & S Engineering
L?AJ~A Tustamena Terrace
LTA/SA Tustamerm Terrace
Drinldng Water
All Date-~rimes are Alaska Stendnrd TiNe
i'rinted Date/rime 07/28/2004 14:26
Collected Date/Time 07/23/2004 9:30
Received Date/Time 07/23/2004 10:00
Technical Director SteplLeh C. Ede
Released ~n~v~/~
PQL
Units M~t~od
~l~lc ~ AneJysis
Container ID I~imi~s T~te D~te Init
Waters Depar ~ent
NJu'atc-N
0.100U 0.100 mg/L EPA 300.0 B (<=10) 07/23/04 JJI3
Microbioloc~, Laboratory
Total Coliform 0 col/100mL S~,L?.0 9222B A (<=1) 07/23/04 DKC
Z
\
\
\
\
\
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN
EXISTING STRUCTURES AND F~ATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL
STRUCTURES OR FENCEUNES.
EASEMENTS OF RECORD. OIldER THAN THOSE SHOWN ON THE RECORDED PLAT, ADE NOT SHOWN HEREON.
NOTE' ANY FENCELINES SHOWN ARE LOC.~TEO APPROXIMATELY AND A~E NOT TO BE USED TO DETERMINE PROPERTY LINES
OR LOCATE STRUCTURES.
AS-SUILT SURVEY
NO CORNERS SET THIS DATE SCALE:I' = 40'
I HEREBY CERTIFY THAT I HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOTS 7A AND SA, TUSTAMENA TERRACE SUB.
ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT
THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE
PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST
OTHER THAN NOTED.
DATED AT ANCHORAGE, ALASKA THIS _19TH
DAY OF JULY 2004 .
ROBERT C. COWAN, RE.
flOBEflT~ SHAFEI~ RE.
July 30, 2004
CML ENGINEERS
(9o7) 694-2979
FAX (9o7) 694-1211
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Reference: Lots 7A & gA; Tustamena Terrace Subdivision
Dear Sirs,
A septic adequacy test was performed on the referenced property on July 17, 2004.
As can be seen on the attached check list, we added 519 gallons to the system. Since this
is a 6 bedroom system, we would normally add 900 gallons of water, which is the daily
requirement for this septic system. We were not able to add the required 900 gallons to
the system in a reasonable amount of time due to the water production rate from the well.
We thereby request exemption from the requirement to add 900 gallons of water to the
system because it is clear that this septic system is capable of absorbing well over the
daily requirement. Only one trench was tested and the absorption rate is well over the
required 900 gallons per day, while the other trench has no water in it, and appears to be
in near new condition. Additionally, the trench that we tested operates in the lower one
quarter of the effective depth.
We believe that the added expense to haul water to this location and pump it up to the
septic system (since it is elevated or uphill septic), system is not justified in this instance.
Please approve the attached tleahh Authority Approval.
Sincerely,
RCC/glc
17034 NORTH EAGLE R1'V~ R LOOP * SUITE ~M ~' EA~LE F~%'~ R. ALA.~KA 99577
TIMOTHY and DIANE KREITINGER, hereinafter referred to as Grantors, whose a.d. dress Is 8720 Beverly
llills NE, Albuquerque, New Mexico 87122 owners of the land described as:
. Lot gA: Tustamena Terrace, as per plat thereof recorded in the Anch(~rage Recording District .und~er pllt file
number 73-23S.
' ' "~'o~wledged, hereby grants and
For good and valuable consideration, Ihe receipt of which is hereby ack
conveys to TIMOTtIY and DIANE KREITINGER, whose address is 8'/20 Beverly llills NE, Albuquerque,
New Mexico 87122 the following easement to be used for Ingress, egress and utilities.
The easement granted is described as:
An easement for septic utilization over a portion of Lot 8A for use by owner ~ind tenants of Lot
· Tustamena Terrace, as per plat thereof recorded in the Anchorage Recording District under plat file number
81-153, and further described as follows: ,
Begin at the most southeasterly corner of said lot gA. Thence, following an bearing NI0°SI'I7'E a distance
of 154.25 feet; N70°$7'35"E a distance of 61.25'; S27° 06'47'E a distance of 75.67 feet to the northern most
corner of Lot ?A; S49~23'S"W a distance of !~0 feet to the point of beginn.[n.gI :: '.:
This easement Is for the benefit of and pertinent to Ihat land and any portion thereof described as:
Lot ?A, Tustamena Terrace
Grantors, their heirs, successors and assigns, agree to said ingress, egress, and utility easements and their use
by TIMOTII¥ and DIANE I~REITINGER, they heirs, successors and assigns. ·
TI,MOTII¥ and DIANE KREITINGER and his successors in interest, s~all use the r ghts granted above.with
due regard to the rights of others In their use thereof. Grantors, and tfi~lr'~bc~essors in interes~ shall not
obstruct the easement in any way.
Grantees and their successors in Interest acknowledge that TIMOTII¥ and DIANE KREITINGER and their
successors or assigns, shall be responsible for development and/or maintenance of the easement. They will
further hold the Grantor harmless from liabilities or damages resulting from their use of this easement.
IN WITNESS %VllEREOF, we have hereto set our hands this ,~ day of~,
2004.
Lot gA: Tustamena Terrace Lot ?A; Tustamena Terrace
· '~ M ~II~(/KI~E~TIN GIH~, Grantor
/~D~FA~I £ KI~ ,TI N/Gi< ~L~ Grantol~
Sub½c~'ibe~n'~l sworn]o b~ore me Subscribed and s~xorn to before me
thls.~_~ day,of ,////LbV' , 2004 this ~day of//~ ,2004
..>; .
~l~ommh~n6 ~xplre~ ~'~ f ~J~. ]
''",'~H. ''~' /-/~-- '~ ~ ~'/
'~'.hJ,n,~~ V~ ~ . ;
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Divislon of Environmental Services
On-Site Services Section
P.O. Box196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # ~\'"~- ~c/-\--~'~t .. HAA#
1. GENERAL INFORMATION ..~ .
Complete legal description
Location (site address or directions),,~.~- /~V/,'~,u~~-~ -.-~/-- ~
e
Property owner
Mailing address
Lending agency
Mailing address
Agent '/-'~-'~' /'~'~'/~"Y'
Address
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBE. OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest- .
lng to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, p~o~'ide written confirmation from State ADEC
attesting to the legality and status of system.
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
David R. DaytO~Z
Name of Firm 20~tOl::~.al~S~. Phone
Address Chugla~,. AI~ ~S67
Engineer's signature ./~.~/)'4~' //~''' [~/~ ~ Date ~'/~,~x/~
/
DHHS SIGNATURE
Approved for ~-l~-/'~/./) bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
The Municipality of Anchorage Department of Health and Human Sen4ces (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.
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDescription: ~,r"~ ~TA,,,~vA 5,,,~o ParcelI.D. 0/'7-.
A. Well Data
Well lype p~ ! U ~"~ If A, B, or C, attach ADEC letter. ADEC water system number.
Log present (Y/N) Y Date completed ~'13! ~//~ '"~, Driller ~',~r~-~-
Total depth ~4~4) Cased to ,~ Casing height ~;~ !
Sanitary seal (Y/N) ~ Wires properly protected (Y/N) Y
Date oftest
Static water level
Well flow
Pump level1
FROM WELL LOG
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer service line '~-~'"/'"
AT INSPECTION
g.p.m. ~.o ~-- g.p.m.
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate
Collected by:
.Other bacteria
~-~,,,,.~
B. SEPTIC/HOLDING TANK DATA
Date Installed tcllU
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping
Tank size
Foundation cleanout (Y/N)
~1~- Ala~ te~:t~d:~)''
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot
To property line
Surface water/drainage
On adjacent lots I ~'o *-.Foundation
Absorption field /~ .Water main/service line
~-ms (3~3). Fm-,t CONTINUED ON BACK PAGE
C. UFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on' level at
Manufacturer
Manhole/Access (Y/N)
'Pump off' Level at
.Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIF~ STATION TO:
Length ~.O
Total absorption area
Date of ad~aqacy., test
Well on lot
D. ABSORPTION FIELD DATA
Date installed '""~,7~'~//~,~
Width
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
On adjacent lots
Soil rating (GPD/Ft=)
Gravel thickness
Cleanout present (Y/N) y
Results (pass/fail)
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
.Surface water
Well on lot I Z ~
To building foundation
On adjacent lots
Surface water
Curtain drain
,/-~'~ 2"~,~'~- System type
Total depth ~ /
Depression over field (Y/N) ~
for ~' Bedrooms
After test O, O /
If yes. give date
On adjacent lots /4> o V--- Property line -~
~, 5" .To existing or abandoned system on lot ,'~,.~
~7 C>' Cutbank n///~+. Water main/service line 2- 5"-r
! ~o-~- Driveway. parking'vehicle storage area ~'"
E. ENGINEER'S CERTIFICATION
I cerb'~/that I have checked, ye#fled, or confom~d to all MOA and HAA guidelines in effect on/~e of this inspection.
Chugl&k, Alaska ~95~7,
Signature ~ . ~. *~,., Y..;J-,;;~',,,..~,~,'.,4~.,~.. ~..
~-ngineers Name
Date
, ,¢ .....
HAAFee$ /~O, ~ WaiverFee$
Date of Payment ~'/-/-- ~'.,~ Date of Payment
Receipt Number ~-/.~Z',~ ~ ~" '~7 b"~'"",~ Receipt Number,
72-028 (3/93)' Back
D. R. DAYTON, P.E., R.L.S.
~]8~]8~ Chugiak, Alaska 99567
20210 Donalar
(907) ~[t~ ~Lg~ ~
696-2417
June 18, 1993
1~,,~a.-~a.~ TEST
Legal Description: Lot 7A, Tustamena Terrace Subdivision
Date of Test: June 15, 1993
Septic Tank: 1750 gallons - 2 tanks
Absorption System: 60' x 4' x 5' effective depth trench
Soils Rating: 150 sq. ft. per bedroom
Requirements: 6 bedroom - 900 gallons per day
Test:
Water was run into the absorption trench while monitoring volume
time, and level rise in the trench.
Results:
The trench accepted 940 gallons with no rise in the liquid level
Conclusion:
The septic system absorption trench is currently functioning
adequately for a 6 bedroom home.
D. R. DAYTON, P.E., R.L.S.
h'6~B~B'd'x~l~ Chugiak. Alaska 99587
20210 Donal ar
(907)
696-2417
June 18, 1993
WELL FLOW TEST
Legal Description: Lot 7A, Tustamena Terrace Subdivision
Date of Test: June 15, 1993
Well Depth: 400 ft.
Static Water Level: 206 ft.
Driller: Rampart Drilling
Requirements: 6 Bedroom - 900 gallons per day
Test:
The well was pumped with the existing pump through an outside
hose bib. The well was pumped until the flow rate evened out at a
steady rate. It was not possible to measure the drawdown beyond
the 260 ft level as the probe hung up in the wires or pipe to the pump.
Results:
The well produced a total of 939 gallons in 6 hours. The average
yield was 2.61 gallons per minute. The yield at the steady flow rate,
during the last 3 hrs., was 2.35 gallons per minute.
Conclusion:
The well iS currently producing adequately for a 6 bedroom home..
COMMERCIAL TESTING & ENGINEERING CO.
ENVIRONMENTAL LABORATORY SERVICES
Chemlab Ref.~ :93.278i-1
Client Sample ID :L7 773STAME~A SU~.
Matrix :WATER
REPORT of ANALYSIS
5633 S STREET
ANCHORAGE, AK 995t8
TEL: (907) 562-2343
FAX: (907) 561-5301
Client Name :DAVID DAY.N, P.E.
Ordered By :
Project Name :
ProJect~ :
PWSID :UA
WORK Order :67192
Report Completed :06/17/93
Collected :06/15/93 @ i0:30 hrs.
Received :06/i5/93 @ 15:00 hrs.
Tect~ical Director:$'t~.~HEN C~ EDE
/'
Sample Re~rks: ~L~rlNE SAMP~.w COt'-rY:u-.i.'L.u BY: D.R.D.
QC Allowable Ext. Anal
Parameter Results Qual Units method Limits Date Date Init
Nitrate-N 0.10 U mg/L EPA 353.2/300.0 i0 06/16 LLH
* See Special Instructions Above UA = Unavailable
** See Sample Remarks ;%bove NA = Not Analyzed
U = Undetected, Reported value is the practical quantification limit. LT = Less T~n
D = Secondary dilution. GT = Greater Than
~SGS Member of the SOS Group {Soci616 G~n61'ale de Surveillance)
ENVIRONMENTAL SERVICES IN ALASKA, COLORADO. UTAH. ILLINOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA
unicipMity of Anchorage
Department of Health and Human Services
Tom Fink. 825 "L" Street
Mayor P.O. BOX 196650 Anchorage, Alaska 99519-6650
August 17, 1993
Cheryl A. Brooking
Hartig, Rhodes, Norman, Mahoney & Edwards
717 K Street
Anchorage, AK 99501-3397
Re: Lot 7 Tustamena Subdivision
Health Authority Approval
Dear Ms. Brooking:
In response to your August 4, 1993 letter requesting information relevant to the subject
Health Authority Approval request, the following documents are attached for your review:
· AMC 15.65 Wastewater Disposal Regulations, effective today.
· AMC 15.65 Wastewater Disposal Regulations, effective in 1982.
· AMC 15.05 General Provisions otTitle 15 Environmental Protection. Please
reference section 15.05.160 pertaining to Health Authority Approvals.
· Health Authority Approval Guidelines dated August 1992.
Please contact me at 343-4360 ifyou have any questions.
Sincerely ,. /
,~Sh~ Smith, P.£., Progra~ Manager, O~-site Services
HARTIG, RHODES, NORMAN, MAHONEY & EDWARDS
August 4, 1993
Anchorage
~AND DELIVER
Ms. Susan Oswalt
Environmental Services Division
Department of Health and Human Services
Municipality of Anchorage
825 L Street
Anchorage, AK 99501
· · t Anchorage
i~un~c~p~l~ °u:,,~n Services
Dept. Health ~ ""'"
Re: Lot 7, Tustamena Subdivision
our File No. 4322-6
Dear Susan:
As we discussed over the phone, I am sending this letter to
clarify my understanding of the department's refusal to issue a
health authority certificate for the sale of Lot 7 in the Tustamena
Subdivision.
This property was purchased in early 1982, following an
agreement to purchase reached in 1981.
In a letter to the Alaska USA Federal Credit Union, dated
December 20, 1981, Robert A. Schafer, P.E. verified that the septic
tanks had a combined capacity of 1750 gallons. The absorption
trench was tested by a continuous flow of 1049 gallons of water
over a period of 24 hours. The engineer verified that the system
serving the existing six bedroom residence was currently
functioning adequately. In addition, the Department of Health and
Environmental Protection of the Municipality of Anchorage issued a
certificate of inspection approving the water and sewage systems
for a six bedroom residence. This certificate is dated January 26,
1982.
Ms. Susan Oswalt
August 5, 1993
Page 2
From these documents, there is no indication that the
municipality approved or the engineer inspected based on a four
bedroom residence. A certificate of Occupancy was issued by the
Municipality of Anchorage, Department of Public Works, Building
Division, dated August 10, 1982, stating that the structure "was in
compliance with the various ordinances of the municipality
regulating building construction or use."
During our telephone conversation this afternoon, you stated
that you were lacking an inspection report on the tank upgrade and
a trench upgrade, apparently done in 1981 and 1982. You stated
there was no permit or inspection done. Please explain why the
certificate of inspection and other documentation are insufficient
for your requirements.
You stated that your office will require a soil test. Please
explain what type of soil test and what results you are expecting.
You asked for a construction diagram and stated that sometimes
it is necessary to dig up the septic system in order to prepare a
construction diagram if one is not existing already. Please cite
any regulations requiring this construction diagram or the
previously mentioned soil test.
Please explain why you
addition to the certificate of
the municipality.
require an inspection report in
inspection indicating approval by
Last month, Mr. D.R. Dayton, P.E., examined both the well and
septic system. He found both to be functioning fine.
Please explain,
of your department
addressed.
as specifically as you can, the requirements
that you feel .have not been sufficiently
Very truly yours,
HARTIG, RHODES, NORMAN
MAHONEY & EDWARDS
Cheryl ~. Brooking~_~
CABIsly
cc: John Noraan
/:~xchg\beaw~4322-66.]tr
Date Date Date
Comments Conditional Approval
Date Sewer Instell~ Permit No. ~ptic Tank Size
Holding Tank Size
~lls Rating Well TO Absorption Area Well L~ Receiv~
Well to Tank
APPLICANT FILLS OUT LOWER HALF ONLY
Mailing Address ///~(.//~ ~ ~ ~-~ ~
Buyer ~~ ~, ~J/~/~ ~.
Address ~ ~ ~ ~ 7 /}//}~Y~ /
Lending Institution~/~7/~)~ ~///~ ~ ~,/~// ~one
Address
Reatty ~. & Agent ~. ~ / 7~ ~/W O Phone
Legal~scrlption Z T ~ ~ 7'1/ 5 ~W /// r ~
Street L~atlon /~ F/F
Type of Residence
~ Single Family
B Multiple Family No. of Bedr~ms
~ Other
Water Supply
~ Individual A~ACH WELL LOG. A ~ell log Is requlr~ for atl wells drlll~ elnce June
B ~mmunlty 1975. For ~lls Crllled prior to t~at date, give ~11 depth (attach log If
B Public Utillt~ available.}
Sewage D~sposal
~ Individual. Year Individual Installed: /~ ~
~ Public Utility When ~nnected to Public Utility:
~ Holdtng Tank
NOT~ THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCE~ING CAN BE INITIATED.
EXCAVATION
ROBERT A. SHAFER
WORK
CIVIL ENGINEER
694-2979
Alaska USA F~der~l Credit Union
ATTENTION: Fred Smith
Pouch 6613
Anchorage, Alaska 99502
Dear Mr. Smith,
Reference: Lot 7:
December 20,
Tustame~a Subdivision
1981
MUNIcIPAlitY OF ANCHORAGE
.,~ DEPT.~C~I~ALT,~ &
A sewer system adequacy test was performed on the system located on
the referenced property as you requested. The septic tanks were
pumped and verified to have a combined capacity of 1750 gallons.
The absorption trench was tested by a continuous flow of 1049
gallons of water over a period of 24 hours. The sump at the end of
the trench was dry both at the beginning of the test and at the
conclusion of the test.
It can be concluded from this test that the waste water disposal
system serving the six bedroom residence located on this property
is currently functioning adequately. However, the system cannot
be guaranteed against subsequent failure.
If we may be of further assistance, please do not hesitate to call.
SincgNely,
//RqBERT a. SHA~R, P.E.
v/~s/ss' /.
cc: Municipality of Anchorage
Department of Health and Environmental Protection