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Home My WebLink AboutHAMANN LT 3Hamann Lot 050- 6 ! ! -03 , , : Municipality of Anchorage Page'~ of_ 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: '~V~/ d~ (-~ O0 7 '7 PID Number: z~),..~ Name: ~O/~ ~[ Wastewater System: ~New ~ Upgrade Address: PO~o~77/~3~ ~e~P~ ¢~77 ABSORPTION FIELD Phone: 0 Nc. of Bedrooms:~ ~Deep Trench ~ Shaltow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION so, Rating: ~, ~ GPD/Sq. Ft. Total Depth from original gra~: Lot: ~ Block:~~ Subdiv~iop:~, Depth. to pipe bottom from original~ .grade: Ft. Gravel depth beneath pipe ~ Ft. Township: Range: Section: Fill added above original grade: Gravel length: Number of lines: Oist~ncebe~eenlines: WELL: ~ New ~ Upgrade Gravel width: ~ Ft. / ~ Ft. Total Depth: Cased TO: ~ Total absorption area: Pipe material: Driller: ~~~'~ #~ DateD~il[ed: Static Water Level: Installer: Dateinsta[led: Pump Set at: ' Casing Height A~ve Ground: SEPARATION DISTANCES ~s~p~c~ Holding ~ S.T.E.P. TO Septic Absorption Lift Holding =ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~ Material: Number of Compadments: Sudace ~ Lot Sizein gallons: Manufacturer: ~ "Pump on" level at: "Pu~I at: High water alarm at: Foundation /D Cu~ain ~ ~ Pump Make & Mode~ical Inspections pedormed by: Drain Remarks: BENCH MARK Location and Description: Assumed / ~ ~, Elewtion: ENGINEER'S SEAL P P Y.- . ,, Department of Hea~h~nd Humen~ices approval ,- 72K)13 {Rev. 9/91) MOA 25 qS-]}U1LT SYSTEM ]?ETAILS/SITE LOT 3, HAMANN SUI}DIVISIF1N 120.8' WELL° PLAN SCALE: 100' A-C=31' B-C=20' A-D=38.8' B-I)=24' A-E=49,8' B-E=35' A-F=135' B-F=116,9' 6A ~ EXISTII WELLS PRIOR 7A FINISHED GRADE SEWER ROCK 87' ¥ BOH SCALE: NTS PREPARED FOR: HARRY R, ENGEL 9003 W, PARKVIEW TERRACE LDBP EAGLE RIVER, AK 99577 KN9 ENGINEERING 20441 PTARHIGAN BLVB EAGLE RIVER, AK, 99577 (907)696-6111/Fox (907)696-8111 DATE: 10/10/96 DRAWING i~ SCALE: AS NOTED 9GOOl=SI ( er ifle Drill .g by SULLIVAN WATER WELLS P,O. BOX 670272, CHUGIAK, ALASKA I)9567 * TELEPHONE 688,2759 L£GALDESCRIPTION~~'~ '3 d~eq~°/]~t DATE - Started Ended PERMIT NUMBER DEl>TH OF WELL __ STATIC LEVEL OF WAT£R FT. DRAW DOWN FT. ~s.~R.~ . .~O~ KIND OF FORMATION: From O Ft. lo o~ Ft. O__4S/~ ,~'~fe./<~__ Fro,,,. FI, ,o~Ft, From ~ Ft, to ,~ Ft,~O~ From~Ft. to_ . Ft,. Fro~ FI. to g~ FI.~~' ~ From~Ft. to.. Ft From ~ Ft.t~Ft, ~O~ ~ From.. Ft. tn ~Ft.. From. l~O Ft. to/dC,Ft.~Ce ~[d7 From Ft. lo Ft, From Ft. fo.__Ft. Froml~ FromJ.J~Ft. to t~/ Ft.~ From Fromm_ ~ From __ From From_ Ft. to Fi, From ~Ft, to Et, From Ft, to FI, . FI. toe"'){0 Ft. //~d,~0~~~'j From_ FLtO, FI,_ Fi, to '~O{~) Ft.-~fiC-'(( (~ .- From_~.Ft. to Ft ri q ~ _ FI. to--Fi- ~AC~ ~g~Y. 7 rrom~Ft, lo Ft Ft, to Ft- From Ft, to, Ft, to Ft, From Ft, to,~ gECFIVED F,OCT 'J'l ]996 MI$CL. INFORMATION Dept. Health & Human Services s-I-l'qVI ~t=CLrOH Ht~ehI-I-IIqS lqd 6'f,-' c;O ;~FI.L ~ .o~.oc L.c>T ~ PLOTPLAN ~ ASBUILT ~ SCALE l'=t~:~' GRID 5W~,l Project No. 1731 Geo,rge Bell Circle ~.(~[~]~[~]. ~ ~~ ~ Anchorage, Alaska 99~15 (907) 345-6476 I Hereby certify that I have surveyed the following described groperty: ~o~ Recording District. Alaska, and that the improvements situated ~.~ ~ thereon are within thc property lines and do not encroach onto the property ~'~ .." ,'%. ....... · adjacent thoreto, that no improvements on the property lying adjacent thereto ~*:, ~.. ~,," encroach on thc survcycdprcmises andthat therearen°r°adways, transmissi°n ~...~'~' lincs or other visible easements on said property except as indicated hereon. · 19~Q, Alaska Dated this the ~'" DaY of ~~ at ~chorage, ~, ~ , ,, ~ ~ · ~ennefh G. teac · - ,~ ee ~ It is tho responslbilily or lhe ownor ~o detormine the exJslonce of any easements, e~ ~"%. ... covenants, or rcs,rictions which do not appear on thc recordcd subdivision plat. ~2~: ....... PLOT PLAN __ AS BUILT )~ SCALE II1'~ 4~Ot GRID 5',N I¢,,I Project No. ~' ~5 1731 Geor. ge Bell Circle Anchorage, Alaska 99515 (907) 345-6476 I Hereby certify that I have surveyed' the followi~8 described property:' Lot '~ . Block 'g , ~t~,~.~.~ ~U¢-~O~lc~,~ ~b~ ~-~ ~~ Recording District, Alaska, an~ that the improvements situated thcrcon are within thc property lines and do not encroach onto the property adjacent thereto, that no improvements on thc ~ropcrty lying adjacent thereto encroach on ibc surveyed premises and that there arc no roadways, ~ransmission Daled ~is the ~ Day of ~~ ' , 19~, al Anchorage, Alaska It is the'responsibility of the owner to dctcrmine thc existence of any easements, covenants, or restrictions which do not appear on thc recorded subdivision plat. MUNICIPALITY OF ANCHORAGE DEPAiITMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960077 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:ENGEL HAROLD R & MELISSA A OWNER ADDRESS:9003 WEST PARKVIEW TERRACE LOOP EAGLE RIVER, ALASKA 99577 PARCEL ID:05061103 PAGE 1 OF 1 DATE ISSUED: 5/16/96 EXPIRATION DATE: 5/16/97 LEGAL DESCRIPTION: HAMANN LT 3 LOT SIZE: 114600 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2o ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15o65 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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4~ FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED B'~~~~ DATE: ]~ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAl,, SERVICES DIVISION ,'~Y 03 1996 RECEIVED May 1, 1996 Subject: Lot 3, Hamann Subdivision - Sewer and Well Permit Gentlemen: Following a request from the owner regarding the proposed development of the referenced property, we dug two testholes for the proposed system and replacement field. The results of those tests are attached. The system will be placed on the southeast portion of the lot. As indicated on the site plan there is sufficient grade to maintain a gravity system. A 1250 gallon tank will be installed in anticipation of a 4 bedroom house being constructed. There is also sufficient area and grade to maintain a replacement gravity fed field. As indicated by the site plan drainage arrows, natural drainage is away from this site and will be maintained after construction. There is no surface water within 100' of the proposed installation. There are no curtain drains within 50' of the proposed installation. No wells exist within 100' of the proposed installation. If you have any questions about this application, please call me at 696-6111/FAX 696-8111. Respectfully submitted, ~D Engineering Kenneth M. Duffris, P.E. attachments: On-Site Well and Sewer Application Wastewater Absorption System Details Site Plan Soils Log/Percolation Test SIT WASTEWATER LOT 3, HAHANN 117.3j't' PI AN DISPFISAL SYSTEM SUBDIVISION ,PROPOSED TANK o NO W£LL WITHIN E00' DF SYSTEH. 6A ~EXISTIN WELLS 7A LOT SIZE: 114,600 LESS HOUSE/WELL FOOTPRINT: 31,589 LESS EXISTING SYSTEM, 840 TOTAL AREA AVAIL,, 85,851 S,F, PREPARED FBR: HARRY R. ENGEL 9003 W. PARKVIEW TERRACE LOOP EAGLE RIVER, AK 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/FAX (907)696-8111 DATEi 5-1-96 DRAWING # DESIGN DETAILS WASTEWATER glSPOSAL SYSTEM LF1T 3, HANANN SUBDIVISION ~CO~NNECT ~TO PROPOSED HOUSE ~ ~ ~ ~ ~ 'LOWER i d d dd d FINISHED GRADE/ORIGINAL GRADE 0,5 u,.. "quJ ' 12 "~. SE~ER RgCK 84' Permit BOTTOM OF TRENCH 8,0 BOTTOM OF TEST HOLE 14,0' NO WATER OBSERVED oCONNECT TO PROPOSED HOUSE ° 2.0. 84' C,O, M,T, DESIGN CRITERIA 1. ~ BEDRODMS X 150 6AL./DAY/BEDROOH = 600 GPD ~. SOILS RATING: 16 MIN./INCH = 0.6 GPD/SF(TRENCH) 3. GO0 GPD/O,GGPD PER SF = 1000 SF 4. lO00 SF /G'D x 2 = 83.8 L (USE ~ TRENCH 84 L) 5, MINIMUM DESIGN SIZE = 84' L x 3' ~ x 6' D Trench 6, 2' HD INSULATION REQUIRED OVER FIELD <3' OF COVER 7, 2' HD INSULATION REQUIRED OVER TANK <4' OF COVER PREPARED FOR: HARRY R. ENGEL 9003 ~, PARKVIE~ TERRACE LOOP EAGLE RIVER, AK 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/FAX (907)696-8111 DATE: 5-1-96 ~DRAWING # NOT TO SCALE / 9601-$2 PERFORMED FOR: Municipalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS ~/~/ WAS GROUND WATER /~d~ ~C ENCOUNTERED? IF YES, AT WHAT DEPTH? ~t~; Kenneth M. Du~.~ Township, Range, Section: SLOPE SITE PLAN s Reading Date Gross Net Depth to Net Time Time Water Drop I IZ: ~,¢ z ,,,'n ? '/&" ~/~ ~ /~ Z~,~ 7~/~'' .,, Depth to Water Alter Monitoring? / Date: PERCOLATION RATE /'~' (minutes/inch) PERC HOLE DIAMETER ~// 7 FTAND (~ FT CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MU~C'IPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: .~-~/~ 72-008 (Rev, 4/85) / / Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" SI. reel, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 6 7 8 9 10- 11 12 13 14 15 16 17 18 19. 20 WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? P E Monil~rinll? 0ate Township. Range. Section: ~ ~/ SLOPE SITE PLAN Reading Date Time Time Water Drop PERCOLATION ~ATE /~ EST.U .ETWEEN 2' 5 /- -- (m,nul,e~,nch} PERG HOLE DIAMETER FTANO I~'''~ Ff ACCOHI)ANCE WI'Iii ALL Si'AlE ANO M0~CIPAL GUID£t It~{ .% IN El I ECl Ot,I 1HI.% ()All Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCR~PT~O.: ~'~.~ c~ 7~ ~ .' .~ 1~;~ ~ ,,,, '~."~. 0..' ~ DATE PERF Township, Range, Section: SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18 19 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Geplh to Water After Monitoring? Gate: Reading Date Gross Net Depth to Net Time Time Water Drop /~ ~ ~/~ PERCOLATION RATE //~-'~ [minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN '-~'~ FTAND ~'""~ FT COMMENTS J ACCORDANCE WITH ALL STATE AND MUNiCiPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage .~o ~ ~.~T~H DEPARTMENT OF HEALTH & HUMAN SERVICES ,~'" '""~e~'~"'¢~"~.~""~'~,o'°o~ 825 "L" Street, Anchorage, Alaska 99502-0650 ~ .~.~. SOILS LOG -- PERCOLATION TEST ~., SLOPE SITE PLAN 4 5 6 7 8 9 /z, &" 10 WAS G ROUND WATER ENCOUNTERED? 11 s IF YES, AT WHAT <,.~ OL 12 DEPTH? P E 13 , -- Depthlo Waler After ~ ~ ~c..,-~/' .~o ,/"/,~ O Rlonitering? _ Oate: j Reading Date Gross Net Depth to Net / Time Time Water Drop 14 16 17 18- 19 20, PERCOLATION RATE _ /~, (mmutes/mch~ PERG HOLE DIAMETER TEST RUN BETWEEN 7 FT AND (~ FT 72-008 (Rev. 4/85J / Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-611-03 GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: C~_ ///;7/ . / / Hamann Subdivision, Lot 3 24243 Alpenglow Drive Eagle River, AK 99577 Current Property owner(s) Harold and Melissa Engel Mailing address 2424 Sprucewood Street Anchorage, AK 99508 Day phone Lending agency Mailing address Real ,E~t~ii~ A~ent,, "' Mailing Address Unless Oth~rFvise;~reque gt"ed, COSA will be held by DSD for pickup. NUMBER'OF' BEbROOMS: Four (4) Day phone Day phone TYPE OF WA-TER SUPPLY: Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] 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 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 vedfy 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. 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. DSD SIGNATURE ~'"'"Approved for Disapproved. Conditional approval for bedrooms. Phone 522-7773 Date 6/9/2011 bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11105) X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewatar Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type Private Date completed 5/1996 Total depth 300 ft. Lot 3, Hamann Subdivision Date of test Static water level 8o Well production 1.75 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Arsenic: 12.6 ug/I B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Foundation cleanout (Y/N) Y Date of pumping 6/9/2011 C. ABSORPTION FIELD DATA Date installed 7/26/96 Length 87 ft. Total depth 11 ft. Date of adequacy test IfA, B, or C provide PWSID #~ Sanitary seal (Y/N) Y Parcel ID: 050-611-03 Cased to 63.4 FROM WELL LOG 5/1996 g.p.m. Nitrate .232 mg/L Date of sample: 5/9/2Oll Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) __ AT INSPECTION 6/6/2011 106.7 ft. .45 g.p.m. Number of Compartments Two Depression over tank (Y/N) N Pumper Sanitary Pumpers Collected by: A. Harala Fluid depth in absorption field before test 47.5 Elapsed Time: 1,440 min. Final fluid depth 47.5 Any rejuvenation treatment (past 12 mo.) (Y/N & type) Date installed 7/26/96 Cleanouts (Y/N) Y High water alarm (Y/N) >18 Soil rating (g.p.d./ft2 or ft2/bdrm) .6 GPD/SF Width 3 ft. Eft. absorption area 1,044 ft2 Monitoring tube 6/6/2011 Results(Pass/Fail) Pass in. N Y in. System type 5' Wide Trench Gravel below pipe 6 ft. Y Depression over field N For 4 bedrooms Water added 600 gal. New depth 51 in. in. Absorption rate >= 600 g.p.d. If yes, give date D. LIFT STATION Date installed "Pump on" level at ~ in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >1oo' Absorption field on lot >1oo' Public sewer main N/A Size in gallons "Pump off" level at Cycles tested in. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On adjacent lots >1oo' On adjacent lots >1oo' Public sewer manhole/cleanout N/A Sewer/septic service line >25' Holding tank N/^ Animal containment areas None ..~'~ 7~-/)'/.~. Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main N/A Water service line >10' Wells on adjacent lots >lOC' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Water Service line >10' Curtain drain None Noted COMMENTS: Absorption field >5' Surface water '>1oo' None Building foundation >1o' Water main N/^ Surface water >1oo' Driveway, parking/vehicle storage 5'-10' Wells on adjacent lots >1oo' G. ENGINEER'S CERTIFICATION ~j~l::m,~." A ~-.~e~ I ce~i~ that I have dete~ined through field inspections and ~ ~ 4~ ~ ~ ~ ~. ~vi~w of M~.~cip~/ ~ ~h~t th~ ~ov~ ~y~t~ a~ i. ~~~ ~fo~a.ce w~h MOA COCA guid~#.e~ i. ~t o. thi~ dat~. ~~~ Engineers Printed Name Michael E. Ande~n, P.E. ~81 Date ~9/2011~ ~ ~''" ~'1/ ' COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) C~L~5~5~o Waiver Fee $ Date of Payment Receipt Number SGS Ref.# l 1 11778001 Client Name Anderson Engineering ; /LJP~i~k ti ~ ~,,~ Printed Date/Time 05/17/2011 8:12 Project Name/# '" '~ ~Cq~ ~'t Collected Date/Time 05/09/2011 16:42 Client Sample ID Drawn from Utility Sink Received Date/Time 05/10/201 I 8:38 Matrix Drinking Water Technical Director Stephen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic 12.6 * 5.00 ug/L EP200.8 C (<10) 05/11/11 05/16/11 NRB Waters Department Total Nitrate/Nitrite-N 0.232 0.100 mg/L SM20 4500NO3-F B (<10) 05/13/11 AYC Microbiology Laboratory E. Coli Negative I 100mL SM20 9223B A 05/10/11 SDP Total Coliform Negative 1 100mL SM20 9223B A 05/10/11 SDP Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci. anchorage, ak.us (907) 343-7904 Water Well Advisory Certificate of On-Site Systems Approval (COSA) # 111194 During a recent COSA on-site inspection and test of the potable water supply well on Block , Lot 3 of Hamann subdivision, the well's productivity was determined to be 0.45 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4-bedroom residence is 0.42 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On-Site Systems Approval # 111194 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 3 of amann Subdivision. This inspection revealed an arsenic concentration of 12.6 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Ad dress Day phone Day phone Day 3hone Unless otherwise requested, HAA will be held for pickup. ./ NUMBER OF BEDROOMS: Y 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, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ~21 STATEMENT OF INSPECTION BY ENGINEER. AS certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm KND Engineering Phone Address Ea,q!e River. AK g9577-873~ Enginee¢s signature ~-*-~~ · /_~, ~ Date DHHS SIGNATURE ,~_____ '~ Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their Mending 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-OZ5 (Rev. 1/91) Back MOA ~ Municipality of Anchorage ~, _ /.~'_~\ DEPARTMENT OF HEALTH & HUMAN SERVICES~ ~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority ApprOval Checklist Legal Description: //-7/~,~?,~- -'~ ~ '='~ ~" Parcel I.D.: A. WELL DATA Well type //~/ Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) wires properly protected (Y/N) Date of test Static water level Date completed Cased to ~.~ ~-~ FROM WELL LOG Well production WATER SAMPLE RESULTS: Coliform Date of sample: AT INSPECTION Nitrate ~, Y~' ,~q/~ Other bacteria J g.p.m. B. SEPTIC/HOLDING TANK DATA Date installed ~/¢~ Foundation cleanout (Y/N) Y Tank size ,"/~'~-~ Number of Compartments ~ Cleanouts (Y/N) . Depression (Y/N) /V/ High water alarm (Y/N) /f/'.,4z. Date of Pumping Pumper C. ABSORPTION FIELD DATA Date installed ~/~/~/~ Length ~ 7 Width Effective absorption area Soil rating (g.p.d./ft2 or fF/bdrm) O. /~ System type ~¢/~ ~"'r~-n C ~/ .~ / Gravel thickness below pipe ~, / Total depth // / '~ /DC/-// Monitoring Tube present (Y/N) )/ Depression over field (Y/N) /V' Date of adequacy test Results (Pass/Fail) For ~ bedrooms Fluid depth in absorption field before test (in.); _~ Immediately after~Z gal. water added (in.): ~___ Fluid depth / (ins) Minutes later: Absorption~e = ._ Peroxide treatrne~nt (past 12 months)(Y/N) / If yes/,/give date / 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES F. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /~ /+ Absorption field on lot //~O / '/' On adjacent lots On adjacent lots Public sewer main Sewer/septic service line /cA Public sewer manhole/cleanout Lift station ,/VA- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation /D Property line /D / Water main/service line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Surface water Building foundation /~ ''¢ Water main/service line ~-/.5~/+ Driveway, parking/vehicle storage area /~ '''~ Curtain drain WA Wells on adjacent lots /O O '+ I certify that I have determined thru field inspections and, review of Municipal reco~,~h¢tt~e~.~.li~s are in conformance with MOA HAA guidelines in effect on this date. ~?' ~ '~ " HAA Fee $ Date of Payment , ~ O/////~ Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number NORTHERN TESTING LABORATORIES, NC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456 3116 o FAX 456-3125 8005 SCHOON STREET ANCHORAGE, ALASKA 99518 (907) 349 1000 o FAX 349-1016 KND Engineering 20441 Ptarmigan Blvd. Eagle River, AK 99577 Report Date: 10/02/96 Date Arrived: 09/30/96 Date Sampled: 09/30/96 Time Sampled: 0900 Collected By: KND Attn: Our Lab #: A147375 Location/Project: South Side of House Your Sample ID: Hose Bib Sample Matrix: Water Comments: Hamann S/D, Lot 3 Lab Number Method Parameter ** Definitions ** B = Present in Blank H = Above Regulatory Max E = Estimated Value M = Matrix Interference D = Lost to Dilution MDL = Method Detection Limit Units Date Date Result * MDL Prepared Analyzed A147375 SM 4500E Nitrate-N mg/L 0.42 0.10 10/01/96 Reported By: Anthony J. Lange Chemistry Supervisor