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Home My WebLink AboutCLEARVIEW LT 13 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LOCATIOJ:~--.. NO. OF BEDROOMS ] W~i$ ~ I AbsorPtion area - I Dwelling ___ o PERI~'I_.T NO. DISTANCE TO: I ~ )00 I~ ;~ l~'l ~ ' ~ ~ 1 Manufacturer ~ / ~ - ~ Ma~ . No. of ~mpartm~nt~ ~ I. . .W~- , .~/~ ~' ns I FH O ME ~DE'. Ins ,de len gth WI dth Llqu Id depth DISTANCE TO [Well Dwelling PERMIT NO. : I i Manufacturer ] Material Liquid capacity in gallons IWel~ ~ ~ .~i Foundatio~ INearestlotli~e PERMI~O~ D,STANCETO: ~ I0~ ~ I ~ ~/~/ No of lines ~ Length pf ~ach line _ TotalJenqth of/ines ~ ~n~iGth -/~[ Dista~ebetween lines ' ~ I ~1 ~ 9~ 114,~ I I,~.~& ~h~ ~/~ ' Top of tile t~ ~i~ish grade/ Material beneath tile ~ .~ ~ Total e~v~b~orption ~ ~ inches ~ Length ~ Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: lClass Depth Driller Distance to lot line PERMIT NO, ........... Building foundation Sewer line Septic tank Absorption area(s) OTHER SOI"L TEST R~TING .__ , INSTALLER REMARKS APP~ ~ DATE LEGAL Box 1369, ...~TAR ROU'TE A ANCHORAGE, ALASKA 99502 ~,~14-?714 SlX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 9~ ~:~.~. DRILLED AT THE RATE OF PER FOOT. PROPERTY OWNER £~.. ~.t'~¢,~.¢ ~nh~.,4rm. ~f 9-77'3'6' LOCATION OF WELL SITE WELL LOG: ¢ CO~F-TI~CLUDES ALL LABOR AND MATERIAL FOR COMPL~ION ~~ OF SAID DRILLING. / WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF ,~225~. O0 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE SERVICE CHARGE 0 F 1~% PER MONTH WILL BE ~SSESSED ON ~ PAST DUE ACCOUNTS. F'ERMI T NO. l~LIt-~ I~;: I c;~'RLZT'~" C,F Rt-~E:F DEPRRTMENT HERLTH RN~ ENVIRONMENTRL HROTECTION 825 'L' STREET, RNCHORRGE, RK. 9950i 264-4720 L4ELL RFIC' I]It-&--SITE SEP]ER ( 8~0~47 ) SRA E:OX 2192 99507 AF'PLICANT ROBERT H JOHNSON LOC:AT I ON LEGAL Li-~ CLEARVIEW LJ]T SIZE T'¢PE OF SOIL ABSORPTION SYSTEM IS' DRRINFIELD MAXIMUM NUMBER OF BEL':,ROOMS = 4 SOIL RATING (SO FT,--"BR)= ,=, ,,_ t' '~ THE REQUIRED SIZE OF THE SOIL ABSORPTION _~=,TEM IS' ~'-" [)EF'TH= 7 LEI"'"IGTH=E~N~ GRR%,-"EL C, EF'TH= Z~ ..J L THE LENGTH DIMENSIOI'.,I IS THE L FEET) OF THE TRENCH OR [:,RAINFIELE:,. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THE TREI'-.IC:H P..I I [:,TH I S 5. E1ElO FEET. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFFILL PIPE AND THE BOTTOM OF THE EXCAVATION ,.':IN FEET). ~:EC_-!LI I D'E[-', SEF'T I C: TRI'~k-'.' S I ZE= -1 25~-_--~ ,3RLLCI[-IS PERMIT APPLICANT HRS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT [:,IJRING THE INSTRLLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUM8ER OF RESIDENCES THRT THE WELL WILL SERVE. TL-IO ,:: '=' ::, I I"-.i_~-F'EC:T I I_-II%iS RRE RE ~_---! U IRE[:, '-'~"-'nf-I~,'~"' BY BRCKF ILL I NG 'IF RNY SYSTEM W I THOUT F I NRL INSPECT I ON RND n~'~' r~:_ ~ n- TH I S DEPARTMENT WILL E:E SUBJECT TO F'ROSECUTION. MINIMUM DISTANCE BETWEEN A WELL RND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS t00 FEET FOR A PRIVATE WELL OR ±50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. . MINIMUM DISTRNCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET RND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICBTIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'ERr'I I T E:-(P I RES [)ECEr-IBER %-I , iLr4-SZ-: I C:ERTIFY THAT ±' I AM FRMILIF~R WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS AS SET FORTH 8Y THE MUNIC:IPALITY OF ANCHORBAE. '2: I WILL INSTALL THE SYSTEM IN FtCCORDANC:E WITH THE CODES. Z~' I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MA'¢ REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELE[:, T~ INCLUDE MORE THAN 4 8EDROCIMS. .~ ,. SOl LS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: 5 8 --9 10 11 12 13 14 15 16 17 18 19 2O II i ! -I I II , III 1 I iIII l~ll]llllI COMMENTS PERFORMED BY: SLOPE SITE PLAN WAS GROUND WATER ~O S ENCOUNTERED? L O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ti."= ~ o ~ i~:~ Io ,~1 .O~ PERCOLATION RATE ! ~:~ (minutes/inch) TEST RUN BETWEEN +I/3''~. FT AND ~ , ET CERTIFIED BY: ~~ ~-'~/~ 72-008 (6/79) 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 Parcel I.D. # 01 ~ -;;;)- ~'~ -'~"~, HAA# ~ ~/.~ O~'-(.~,~ GENERAL INFORMATION Complete legal description Lo-i- Location (site address or directions) Property owner Mailing address Lending agency Mailing address -~OO ~-7~ "~ L2(L~ P~-L Day phone [~t¢ Il $1,4 o 90~_1N ~__ C_~. i2.C LI~_ '~-,u~ .~-.~-v~A L ~2~-F_..L.OC~,T*k o % Day phone Agent "T'o"~-~: H, ""~0 ~ "~ ~/~-- Day phOne aare' -ss " ' Unless Otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: W TYPE OF WATER SUPPLY: Individual well Community well Public water ..-,.. . NOTE: if community Well system, provide written confirmation from State AOEC atte§t- ...... lng to the legality and status of system. · TYPE OF WASTEWATER DISPOSAL: Individual on-site ',~ :''~ :'~--'' ,-'~;i' ':~?:'~ ~" - ' ~' --~:-~ **.~ :.'w-.'?~: ;~:-:, ~ Holding tank Community On-site ."~': ...... ~-. ......... '.~'.. Public sewer ~:.' : .-,, NOTE: :; If communi~ wastewater system, prowde wri~en confirmation from State ADEC a~esting to the legali~ and status of s~tem. 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 vedfy 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. NameofFirm-1~-~ ~u~-~._w_e~ --~-~' Phone~'7c]-~O/~ Address ~_o~ tJ~ / ~-'~,~ ~ 61''0 '~ 6. DHHS SIGNATURE '.~,, Approved for ;;' *~"/ .... bedr°~3ms- Disapproved, Conditional approval for 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 esa courtesyto purchasers of homes. and their lending institutions in 0rder to satisfy certain federal and state requirements. Employees of DHHS do not C~'nduct inspections or analyze idata before a certificate is .issued. The Munici of 'is n~ _responsible for err'ors or omissions in the professional Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. Well Data Well type '~ Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level1 / FROM WELL LOG Parcel I.D. r'm .~. If A, B, or C, attach ADEC letter. ADEC water system number ::5~ z-/8 ~ Driller Date completed Cased to g.p.m. ~ Casing height .~ ,t Wires properly protected (Y/N) ~ / AT INSPECTION ~. ~ g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot J Public sewer main l"-////..~ Sewer service line ; On adjacent lots ; On adjacent lots "2'"~ Public sewer manhole/cleanout Petroleum tank ~ l ~;~ WATER SAMPLE RESULTS: Coliform ~,~L/ Date of sample: ? Y Nitrate J. 0~--~ Other bacteria '[/' /~ ~'( Collected by: -{~ ~"~-~ B. SEPTIC/HOLDING TANK DATA Date installed ~//~O/~'-~ Tank size /~.. C7 ~ Compartments Cleanouts (Y/N) ~'// Foundation cleanout (Y/N) ~ Depression (Y/N) High water alarm (Y/N) ~'///A- Alarm tested (Y/N) Date of pumping ! 0/~7 l ~' ~ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot [ O 2-- ~ /~ To property line ~ ~ ~ Surface water/drainage IO (~_-~) On adjacent lots Absorption field Foundation Water main/service line CONTINUED ON BACK PAGE 72-026 (3/93)* Front C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~/~ o/~ _~ Length J I ~,. ~ Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (y/N) System type Soil rating (GPD/FF) Width _ ~ Gravel thickness ~/~:~ ~ Cleanout present (Y/N) ~/ I l ltl o,,.[ Results (pass/fail) ~' After test Total depth ~ -- Depression over field (Y/N) for ~/ Bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ) I ~ '~ On adjacent lots To building foundation L~_,.,~ + On adjacent lots ~> l ~ Cutbank Surface water (~..'~ Curtain drain Property line To existing or abandoned system on lot ,2-~ ~- -~ ,~ c~ / o/~ ~_ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect?n~® date of this inspection. HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back zTL CT&E Ref.# Client Sample ID Matrix ClientName Ordered By Project Name Project~ PWSID Commercial Testing & Engineering Co. Environmental Laboratory Services ~jj~r~,~,~jjj~j~j~,~,~,~,~,l LABORATORY ANALYSIS REPORT 94.4980-] LOT 13 CLEAR VIEW WATER TOBBEN SPURKLAND, P.E. TOBBEN UA WORK Order 82590 Printed Date 09/30/94 ~ 21:12 hrs. CollectedDate 09/28/94 ~ 15:45 hrs. Received Date 09/28/94 ~ 17:00 hrs. Tebhnical Director STEPHEN C. EDE Released ~....~~ ~~ Sample Remarks: SAMPLE COLLECTED BY: T.S. Parameter Qc Allowable Ext. Anal Results Qual Units Method Limits Date Date Init Nitrate-N 1.08 mg/L EPA 353.2/300.0 l0 09/30/94 CMR t * See Special Instructions Above ** See Sample Remarks Above U = Undetected, Reportedvalue is the practical quantification limit. D = Secondary dilulion. UA = Unavailable NA = Not Analyzed LT = Less Than GT = Greater'l'han 5633 B Street, Anchorage, AK 99518-1600 -- Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA Drinking Water Anal}sis Report for Total Coliform Bacteria ]LEAD .{NSTRUCTI01¥S ON REVERSE SIDE.BEFORE COLLECTING umc WATER SYSTE / .D. I Ill mVATE WASa SYSTZ,.M [] Send Resudxs [] 'Send Invoice W, ter Sy~ra Sarne~Co~y Name Phone ~% umber Commercial Testing & Engineering Co. ;,. Environmen~tal Laboratory Services 5633 B Street { ~' Anchorage, AK 9951 8-1 600 Tel: (907) 562-2343 Fax: (907) 561-5301 ~' az :Number Send Results U1 Send Invoice Clt'y Smte Zip C,o~e Month Day Year ELE TYPE: outine ./rn Treated Water epcot Sample (for routine sample ~ Untreated Water with lab ref. no. ) / - El Special Purpose Time Collected SA.IVEPLE LOCATION Collected By PI,~ Priat TO BE COMPLETED BY LABORATORY siS shows this Water SAMPLE to be: atisfactory Urmadsfactory Sample over 30 hours old, results may be unreliable Sam¢le too long in transit; sample should not ~e over 48 hours old at examination to indicate reliable results. Please send n~w s?_mp!e -da soecial delivery' mail. SiP 2 ? I%',, Date Received Time Received Analysis Began Anaiyticz! Methnd: _~a~_.v.C&--_.bra.ne Filter ~ ~O-MUO * N'amber of colonies/100 mi. Lab Ref. No. Result* ~nalyst Sent to A.D.I~.~.-. Fbks Jun Client notified of unsatisfactotD' results: Phoned Spoke wfth Faxed Fa. xed Date: TL,~c: Cornlilents; BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-.~G Result: Total Coliform Membrane Filter: Direct Count E Coli ~,t~ {~6 Colonies/100 mi COLIFIRM Verification: LTB BGB Fecal Coliform ConFlrmatioln Final Membrane FUter ReSUlts (~ :: 815'P 2 ~ lvv,t Reported By'J', O3. b~2J~_ate Colifon'nYlO0 nd T~e I to OC_) I~AD"r f~kll: fll: B ~'~1% I vm ,nm~ -tWO TO ''~ ~~ Member of ,~e SGS Grou, (Soei~,~ G~n~ral, de Surveillance} ENVIRONME~AL FACILITIES IN A~S~. COLORADO. FLORIDA. ILLINOIS. MARY~ND. NEW JERSEY, OHIO. UTAH. WEST VIRGINIA TF= Drink/rig Water Analysis Report for Total Coliform Bacteria READ INSTRUCTIONS ON REVERSE SLDE BEFORE COLLECTING SAMPLE Commercial Testing & Engineering Co. Environmenta! Laboratory Services 5633 B Street Anchorage, AK 99518-1600 Tel: (907) 562-2343 Fax: (907) 561-5301 MUST BE COM:PLETED BY WATER SUPPLT'FR BLICWA=R SYSTEM LD. {llllll RIVATE WATER SYSTEM iD gend ResuP. s [] Send ~rnvoice iD Send ResuPs [] Send In~oice SAMPLE DATE: Month R L E TYPE: outi~ e Repeat Sample (for routine sample ~Sth lab ret'. no. ) [] Special Purpose SA.VfPLE LOCATION Day. Year iD Treated Water Untreated Water Time Collected CoUected Bv.~.. PI~ Print TO BE COMPLETED BY LABORATORY Analysis shows this Water S~5_M2PLE to be: fl~' Satisfactory --._ ~ [] Unsatisfactory El Sample over 30 hours old, results may be unreliable [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Zl[~ / Time Received Analysis Began Analytical Method: .~ Membrane Filter * Number of coton/es/100 wA. Lab Ref. No- Result* 411012 ~ ~--] Sent to A.D.E.C. ~ Fbks Jun Client notified of unsatisfacto~' results: Phoned Spoke with Analyst Date: Time: Faxed Faxed Com.mei1ts: BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-M'UG Result: Total Coliform Membrane Filter: Direct Count ~_ Verification: LTB BGB Fecal Coliform Cont-u'mation Final Membrane Filter Results ~ F_ Col; Colonies/100 mi COLIFIRM Coliform/lo0 nd OB - O~h~r B.t~trla I~ ~-~1~ Member of the SaS Group (Soci~t~ G~n~rale de Surveillance) ENVIRONMENTAL FACILITIES IN ALASKA. COLORADO. FLORIDA. ILLINOIS, MARYLAND. NEW JERSEY, OHIO, UTAH. WEST VIRGINIA Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 December 9, 1994 Mr. Tobben Spurkland 6751 W. Dimond Blvd. Anchorage, AK 99502-3904 Subject: Waiver Request for: Lot 13, Clearview Subdivision Waiver Approval: # WR940066 Dear Mr. Cowan: Your request for waiver(s) of the required 100 foot horizontal separation of an absorption field to surface water drainage has been approved. The approved separation distance(s) are: Absorption Field to Surface Water Drainage 93 feet This waiver approval applies to the existing absorption field to surface water drainage only. Any future upgrades will require all separation distances be met or another approval be obtained from this department. Robert W. Robinson Civil Engineer On-Site Services kb WR~ W~940066 PID# Date Received: Legal Description: Engineer: MUNICIPALITY OF ANCHORAG~ Department of Health and Human Services On-site Services Section Waiver Review Worksheet 015-242-52 HA# HA940648 Permit 11-23-94 Lot 13 Clearview Subdivision Tobben Spurkland 6751 W. Dimond Blvd. Anchorage, AK 99502-3904 Applicant: Waiver Requested: Absorption Field to Surface Water Drainaqe - 93 ft. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: X Waiver is NOT Granted: List Conditions or Reasons for above: Overflow from the standpipe in the absorption field would be interrupted by Klatt Road before it could reach the creek. Date: Rec #: 00516 (7925) By: Name of Reviewer Amount: $ 920.00 Date Paid: 11-23-94 T.SPURKLAND P.E. 6751 W. DIMOND BLVD. ANCHORAGE, ALASKA 99502-3904 (907) 248-5095 RECEIVED Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 L Street Anchorage, Alaska 99501 November 14, 1994 Subject: Gentlemen; REQUEST FOR WAIVER OF SEPARATION DISTANCES FOR SURFACE WATER TO DRAINFIELD LOT 13 CLEARVIEW S/D We are submitting a request for waivers fi.om the separation distances stated in Title 18, Alaska Administrative Code, Chapter 80.020. During a HAA inspection of this property we measured 93 feet fi.om the end of the drainfield to the nearest point on ~ small creek flowing on Lot 1 of Arant S/D This septic system was installed in 1983 and the field notes prepared by a Municipal Inspector makes note of a ditch 90+ feet fi'om the end of the drainfield. No mention is made of flowing water, but the fact that the ditch was noted may indicate that there was water observed. The enclosed siteplan was prepared with a surveyed As Built of the property and a rag tape and a slope indicator. Yours The direct line between the trench and the creek is 93 feet. Subsurface flow of septic effluent to the creek is prevented by the presence of Klatt Road. Even if subsurface flow was possible the travel distance and the soil material will effectively filter the effluent and trap any contaminant. Any surface flow of effluent towards the creek can only happen if the drainfield completely fails, and causes effluent to surface through the standpipe. The shortest line of travel to the creek is 120 feet, more or less. In order to reach the creek the effluent must travel across 60 feet of maintained lawn, then 60 feet more or less in a road ditch that was dry at the time of inspection. It is unlikely that a drainage pattem along the lawn can be established. The owner of the property will notice the effluent when cutting the grass and most likely react to the overflow. Also, field observations indicates that overflowing septic effluent will be absorbed by the ground in a relatively short distance. There are instances where septic effluent have created a permanent drainage pattern, but in the majority of those cases, groundwater and surface drainage has aggravated the situation. In this case neither groundwater or surface drainage will aid in promoting surface drainage of septic effluent. ?'-~ .:. :'.: .:' ,, /':~ , -. T.SPURKLAND P.E. 203 WEST 15TH. AVL~NUE SUITE 203 ANCHORAGE, ALASKA 99502-3904 (907) 279-3916 Fax (907)-276-6013 LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: SEPTIC SYSTEM ADEQUACY TEST Lot 13, Clearview 11611 Snowline Circle Doug Ruckel Single Family, 4 Bedrooms Private, On Site 6-? ~'./ · , · :j , · .-,.?'~' FROM ~ICIP~ RECORDS: 4 Bedroom System T~: ~chorage Tank 1250 Gal. Two Comparts. ABSORPTION SYSTEM: ABSORPTION AREA: SOIL RATING: INSTALLATION DATE: WAIVERS GRANTED: 5- Wide Trench 1004 Sq. Ft. 220 8/30/83 None. Ditch/Creek 93 feet from trench. DATE OF LAST PUMPING: Anch. Cess Pool 10-07-94 DATE OF TEST: Sept. 29 and Nov. 1, 1994 TEST PROCEDURE: System was inspected and measured. Tank was found with 3.5 feet of cover and with a liquid level of 56 inches.~' trench clean outs ~ Trench cleanouts were six and ei ht feet~___d~eP wit~ 13 and 15 inches of water. ~600 gallons of clean water was added to the trench without backup. On October 7, the outlet pipe of the tank was replaced and cleanouts installed. A week later the system was water jetted. On November 1, 800 gallons was added to the system. A 2-inch steel monitor was driven to 2 feet below the trench distribution pipe. There was no water observed in the cleanouts, and no water in the monitor. After adding 300 gallons of clean water 11 inches of water was observed in the monitor. The addition of another 500 gallons caused the water level to rise to 25 inches. The water level dropped rapidly after the water flow was stopped. After 90 minutes the monitor was dry, indicating that the system was operating satisfactory.. TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE: The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long this system will function satisfactory for current or future occupants. All septic systems ultimately fail. Some systems last 15-20 years, others fail after less than 5 years. I i 2' WIDE CREEK I I I L ROAD DITCH J ~ BOAD DITCH NO FLOW KLA TT S = TOBBEN SPURKLAND P.E. LOT 13 CLEARVIE~ S/D SEPTIC SYSTEU LAYOUT 20~ W 15TH. AVENUE DATE: NOK 6, 1994 ANCH. AK. 99501 11~11 SNO~LINE CIR. (907/ 279-~916 DOUG RUCKEL SHEET: 1/I GRID: 2640/2740 WEST 15TH. AVENUE SUITE 203 ANCHORAGE, ALASKA 99502-3904 (907) 279-3916 Fax (907)-276-6013 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: Lot 13, Clearview S/D 11611 Snowline Circle Doug Ruckel TYPE OF WELL: Private, Single Family WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET: Yes WAIVERS GRANTED: None Required WELL YIELD FROM WELL LOG: 20 Gallons per Minute PUMP YIELD FROM TEST: 6.6 Gallons per Minute DATE OF INSPECTION: Nov. 1, 1994 TEST PROCEDURE: Well was pumped at a constant rote for two hours. A total of 800 gallons were pumped without loss of pressure. This well is artesian and access to the well casing is prevented by a mechanical plug.. TEST FOR E.COLI AND TOTAL NITROGEN: Water was tested for E.Coli and total nitrogen on Sept. 28, 1994 E.Coli 0. Other Bacteria 2 Total Nitrogen 1.8 mg/l. Max. allowable Total Nitrogen 10 mg/l. No Bacteria Allowed Well was retested on Nov. 1, 1994. E. Coli 0 Other Bacteria 0 TEST RESULTS: This well meets the requirements of the Municipality of Anchorage. THIS WELL WILL PRODUCE MORE THAN 3 GALLONS PER MINUTE FOR MORE THAN FOUR HOURS The Municipal requirement for well flow is 150 gallons of water per bedroom per day. This well exceed this requirement. The assessment of the condition of the well applies only to the conditions as of the day tested. The flow rate may change due to subsurface conditions that may not be observed from the surface, and changes in the land use and other factors that may impact the aquifer feeding the well. MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Location (address or directions) (b) Property owner ~,~,<,~- ~, ~,~ ~e ~ ~ Telephone' (home) Mailing Address It~ '~~[;~ (c) Lending Institution ~ ~( ~G~ ~%~ Telephone Business Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here [], if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family,' Number of bedrooms 3. WATER SUPPLY Individual Well ¢ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to'th legality and status'. 4. SEWAGE DISPOSAL On-site ~, Public [] Community [] Holding Tank [] Note:~'f community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72*025 (Rew 7/88) Page I of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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. Nameof Firm "~o/',~,~,~''~--, ~/~'~r~"J/'---/~2'~-J-~elephone ~--~7'/'~~ ~ ~ Address ~ Z~--/ ~' ~'~~ ~ '/2 .~. ' .C/-J-~~' Engineer s Seal 6. DHHS APPROVAL Approved for ¢ bedrooms by Approved ~ __ Disapproved ~,.. Terms of Conditional Approval ~._~/~ _~_~ _~~Date Conditional The Municipality of Anchorage Department of H~alth and Human Services (DHHS) issues Health Authority Approval cerificated 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. 72-025 (Rev. 7/88) Back Page 2 of 2 A. WELL DATA Well Classification Well Log Present (Y/N) Total Depth MUNICIPALITY OF ANCHORAGE (MOA) ~ Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: L c)-i' 1'5 ~ ~ If A, B, C, D.E.C. Approved (Y/N) "/ Date Completed Y~£/~-~ Yield Cased to ?~ Depth of Grouting IX////~. Pump Set At ~o o~ Sanitary Seal on Casing (Y/N) ~' Depression Around Wellhead (Y/N) ~J ; On Adjoining Lots ; On Adjoining Lots Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments t)(/ ~J/ ,'.s B. SEPTIC/HOLDING TANK DATA Date Installed ~/~.~ Size Standpipes (Y/N) Depression over Tank (Y/N) · Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) /,2 G~> No. of Compartments Air-tight Caps (Y/N) ~/' Foundation Cle, anout (Y/N) IX/ Date Last Pumped ~///~ ;for Temporary Holding Tank Permit (Y/N) N'//,~.~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well /0 ~- To Property Line .~,~ ~' To Water Main/Service Line ? ~"C~ To Stream, Pond, Lake or Major Drainage Course To Building Foundation To Disposal Field Comments 72-026 (Rev, 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption St~.~ta Date Installed ~//¢'¢' Width of Field Type of System Design' Length of Field /1~,. Depth of Field '7 ~ Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot /7//~ TO Water Main/Service Line Gravel Bed Thickness "5' Statndpipes Present (Y/N) Date of Last Adequacy Test To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line ~ 1 D To Existing or Abandoned System on ; On Adjoining Lots "2 /~ _'> ,~r~ To Cutback (if present) !'///,~ Comments ,No D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA,gui.del~.es in effect on the date of this inspection. Signed Company Date l ov' z-E5 lq tO MOA No. Receipt No. Amount: (: ,~? L? ?' . ,., -, ' : . - Receipt N~. ~ ~~ ' waiver Fee: $ Date of Payment Engineer's Seal 72-026 (Rev. 7/88) Back Page 2 of 2 b?Sl W. DIHOND ANCHORASE, ALASKA ~gS02-~g04 LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM ADEQUACY TEST Lot 13, Clearview 11611 Snowline C:i. rcle R (:) b e.~r t J o fi n s o n Single Fami Pr'ivate~ On Site 4 Bedrooms SEPTIC SYSTEM: F'F;,'OM MLINiCIPAL F;:ECORDS: 4 Bedr'oom S'ystem "['ANK: (~nc:horage 'T'ank 1250 Gal. Two Comparts. ABSORPTION SYSTEM: Shallow Trench ABSORPTION AREA: 1004 Sq. F't. SOIL RATING: 22() INS-r'ALLATION DATE: AUgust 198:3 DATE OF LAST PUMPING: Anc:l"~. []ess Pool Nov. 29, 199() DATE OF TEST: November ~.8, 199(i) TEST PROCEDURE: System was inspec:ted and measured. Tmank was ~ound with 5.5 ~eet o~ cover and with a liquid depth o~ 47 inches. A monitor tube and a__~.ean out wer"e ~ound ~or the trench. M(:)nitor was :8 ~eet deep and dr"~, ,cleanout was 6 ~ee"E""~ 600 gallons o~ c:lean water was added to the bed while the water levels in the tank and the monitor tube were monitored. T'he water level in the tank did not chanc~e~ no water was observed ir"m the m o n i t (:)r. TEST RESULT: This system meets the code r'equiremer~ts c::,.6 t. he Health and Social Services Department o~ the Municipa~:[ty o-~: Ar'mc::hor age. NOTE The opera'L: i oF)a], t i ~:e o~ al 1 sept. i c: systems depends on the ].oc:al soil. c:ondit, ions, groundwater leve].s thai: may ~luctuat. e during the year~ and the water usage o~ the ~amily being served by 'l:he system. 'l'hese cor'lcJitior~s ar"e outside the control o.f the evalua'Lor c:)f tl"'~:[s septic: system. We can ther'e~:c)re not (aive an'v estimate of how long this system ~l[ fLtnct:Lon satis~:actory for c: Ltf' F' e n 'k. o r- ~: t.t'[', t..t r e o c: c LIp a ntz s. 675! W, DIM§ND BLVD. ANgHORABE, ALASKA 99502-3904 (907) 24B-5095 LEGAL: RES I DENT I AL WELL INSPECT I ON [...or 15: Clear'view LOCATION: OWNER: TYPE OF WELL: 11611 Snowline Circle Robert. J ohr"~son F'rivate~ Single Family WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET:Yes WELL YIELD FROM WELL LOG: 2(]) Gal 1 ohs per Mi nute PUMP YIELD FROM TEST: ..;- Gal 1 OhS per" Mi F)LI'Le DATE OF INSPECTION: November' 28, 1990 TEST PROCEDURE: This is an artesian weii,.U~ When the well cap was removed, a mec~-a'ill)i'C'~'~i i~-l~g wis +c)und. The above portion o~ the casing was ~rlozen solid. No water level readin(js were ob- tained. The well was pumped ~or 2 hours at a constant rate o¥ 5 gallons per minute. A total, o~ 600 r~a]l, lons were removed. TEST FOR E.COLI AND TOTAL NITROGEN: War. er was res'ted ~or E.C,;:)i i and total nitrogen on 11t2'Zt90 E.Coli 0. Total Nitrogen 1. lmg/1. Max. allowable Total Nitrogen 10 rog/1. TEST RESULTS: 'mira ~ ~. S wel il meets the requi r'ements Municipality c)~ Anchorage.. THIS WELL WILL PRODUCE MORE THAN 5 GALLONS PER MINUTE FOR THAN FOUR HOURS MORE I"he Municipal requirement ~or well ~low is ].5(.') gallons c)~ water per bedraom per- day. "l"l'~is well exceed this requirement. The assessmer",'t o¥ the condition o¥ the well applies only to the c:c~nditions as o.F the day tested. ]'tie ~:l(:)w rate may change due to subsur-~ace condi~:ions that may not be observed ~rom the sur'~ace, and changes in the land use and other ~actors that may impac:t the aqui~:er Yeeding the well. 1. CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 56.33 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT EY PARANETER Client PO! : NONE RECEIVED Req $: Sample Rec'd : NOV 26 90 Ordered Ey : REPORTS ADDRESS $1 TOBBEN SPUR~LAND, P.E. Work Order Ho. : 303?3 Client Account : TOBBENS Date Report Printed: NOV 29.90~ 10:08 Released By : REPORTS ADDRESS 6751 W DIMOND ANCHORAGE, AK. 99502 Special Instruct: Chemlab Ref $: 904987 Analysis Completed: NOV 28 90 Matrix : Parameter : Lab Sample Client's Sample Limits : ID Identification Method : 1 LI3 CLEARVIEW POTABLE 2 L13 CLEARVIEW POTABLE WATER NITRATE-N 10 EPA 353.2 1.1 n~/1 TOTAL SAMPLE COLIFORM COLLECTED DATE & TIM SEE ATTACHED NOV 26 90 { 11:45 HR NOV 26 90 @ 11:45 HI{ Report Remarks: · See Special Instructions Above ND= None Detected "See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT=Greater Than MUNICIPALITY OF ANCHORAGE DMSION OF ENVIRONMENTAL HEALTH DEPARTME~ OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE I. General Information Application Date ~ (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) \ (c) Applicant is (che~ o~) ~nding Institution ~ ; ~r~il~r ~; 8u~r ~; ~her ~ (e~lain); (d) ~i~ Institution .5~~ I~Y. ~% ~ ~{~ ~lepho~"%c?~:, 5':L.~ -~ (e) Real Estate Co. & Agent Address Telephone 2. Type of R~sidence Single-Family ~ Number of Bedrooms 3. Water Supply Individual Well Multi-Family ~--~ Other (describe) Ccll~unity ~-~ Public Note: If cu~,,.~nity ~11 system, must have written confirmation fTcr~ the State Department of Enviro~Ja~ntal Conservation attesting to the legality and status. Is the ~11 adequate for the number of bedrooms specified in this HAA (Y/N) 4. Sewage Disposal Onsite ~ff~ Public ~--~ C~,~,~nity ~-~ Holding Tank ~--~ Is the wastewater disposal system adequate f~r the number of bedrcx2ms (Y/N) [Page 1 of 2] 2-15-84 5. Engineering Firm Providing Inspections, Tests, Data and Information I certify ~ checked, ~rified, c~ conforn~d to all MOA HAA Guidelir~s effect on/~~/of th. is inspection. Signed / ,~'W.)~.-~ Date Nam~ of Firm Date f----l.$ ~-/% 4- in ( ENGINEER SEAL) 6. DHEP Approval Ap~o~d for ~ Terms of Conditional Approval The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory perfcrmance of the wate= supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shown above, based on the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedrocms and type of structure indicated. ( DHEP SEAL) 7. Mail t~e HAA to the following address: KB2/d5/s [Page 2 of 2] 2-15-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Log Present (Y/N) Total Depth ~ ~eT' Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Legal Description: ~.o,7" ~33 c.~.~.~, q~ If A, B, C~ C, D.E.C. Approved(Y/N) ~m Date Cca~pleted Pump Set At ~-;~-es~ Yield z~>. Depth of G~outing ~ ~/- ~"~ Sanitary Seal on Casin9 (Y/N)%~-~ Depression Around Wellhead (Y/N) ~o Separation Distances f~cm Well: To Septic/Holding Tank on Lot ioo ~.-~ ~~}~; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~z~3 ~ee~7' ; On Adjoining Lots To Nearest Public Sewer Line ~.//~ To Nearest Public Se~r Cleanout/Manhole ~//l~ To Nearest se~r Service Line on LOt C~m~nts B. SE~IC/HO~I~TANKE~TA Date Installed % - ? - ~ ~ Size Standpipes (Y/N) W~ Air-tight Caps (Y/N) ~ s Foundation Cleanout Deuression over Tank (Y/N) ~o Date Last Pumped 7-{ Pumping~intenance Contract on File (Y/N)Ho ; fo~ ~.~_~ Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances frcm Septic/Holding Tank: To Water-Supply Well IO0 /-~_.7"' TO Building Foundation To Property Line 7~' ~_~7~,//~- ;=~7-To Disposal Field /~' To Water Main/Service Line .~//~ To Stream, Pond, Lake, c~ Major Drainage Comments No. of Compartments --~ (Y/N) ~ ~ [Page 1 of 2] 2-15-84 C.' ABSORPTION FIELD DATA SoilS Rating in Absorption Strata Date Installed ~ -! - ~/~ Width of Field .~ 3~/~-T~ square Feet of Absorption A~ea ~) Depression over Field (Y/N) Results of Last Adequacy Test Type of System Design Length of Field . ! t ~. ~ /~d~'7~ Depth of Field ? ~ /~ Grail Bed Thickness~-~;~ Standpipes P~esent (Y/N) Date of Last Adequacy Test Separation Distanoe f~cm Absc~ption Field: To Water-Supply W~ll ilo ~ To ~o~rty Li~ '7f~~ To ~ildi~ F~n~tion c-~; ~ To Existing Lot ~ ; ~ ~joining ~ts To Wa~ ~i~vi~ Line ~/~ To ~t~(if pre~nt) To St~e~ond~ke/~ ~j~ ~aina~ To ~i~way, P~ki~ ~ea, ~ Vehicle St~a~ ~a D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dime ns ions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Electrical Codes (Y/~) Cc~m~nts '/4, / ~ ** Check Permtitted Bectrocm Rating AGainst HAA ~quest I certify that I have checked, verified, o~ eonfc~m~d to all MOA HAA Guidelines in effect on the dat~ inspection. ~'Wb~ Signed /~/.~-~-~ Date ,.,o,,,,,o.'" Cc~pany KB1/d5/s [Page 2 of 2] 2-15-84