Loading...
HomeMy WebLinkAboutSKY HARBOR ESTATES #2 LT 1 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 NAME MAILING AD DI~ ESS PHONE ~IEW LOCATION. ~:~/~) ~ DO ~ NO. OF BE..~ROOMS I Well . Absorption area Dwelling .. PERM T NO ~"' DISTANCETO: I 1~5'~'1 _~ ~ ~' g~o I~1 P~ ~Manufacturer ~. Material ~ No of compartments --- Liq capacty riga ~ns ,, Inside length Width Liquid depth ~ I ~ IF .OME~DE: ,~ ~ .... --~ , I ~I~TANCETO lWell ~ lDwelling ~--~ Manufacturer / ~~ ~ia] Liquid capacity in gallons ~ I I Well Foundation , Nearest lot line . PERMIT N~ ~ I P~STANCETO: [ I~' ~'~ '70 ' '7~-~ ~ ~ Z ~ No. of lines , ] Length of each li~e Total length of lines Trench width Distance between lines ~ ~ I Topoftile to finish grade ' Material beneath tile ~ , l- Total effective absorption area ~ Length Width Depth PERMIT NO. ~ ~ I Type of crib C~ib dlam~ ~ Total effective absorption area ~ I We~ Bui ding foundation Nearest lot line -- L DISTANCE TO: ~ ] - Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO / OTHER PIPE MATERIALS · '- ,-6c>.~, SOIL TEST RATING INSTALLER REMARKS t,~ ~ ~,,,.~ ~,.~ 0~.~.~ DEPT. OF JUL DA' Department Permit Applicant: ~.~ O~ Location: I~EI ~ Phone Number: Legal Description: ~'~ .... /~-/--~/~3-O~,j Type of Soil Absorption System Is: Trench: ~' Drainfield: Seepage Bed: Maximum Number of Bedrooms: ~UNICIPALITY OF ANCHORAGE Health and Environmental rotection 825 L Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND/OR ON-SITE SEWER PERMIT ~--~k~<~ Mailing Address: Lot Size: Holding Tank: Soil Rating(sq.ft/br) ~ DEPTH /1 The Required Size of the Soil Absorption System Is: LENGTH / I~'~ GRAVEL DEPTH //'' WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~]0 GALLONS * * Permit applicant has the responsibility to inform this department during-the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this departmeni will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee~ for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 1 9 $ S * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understa~d~hat the on-site sewer system may require enlargement if the r~i~ce~xremodeled to include more that 3 bedrooms. Signe~: ./~,~-W~, Issued by: Appllic ant ~ - ~/ /~ Date: ~_)//' ~/~ SWP/024(1/81) PERFORMED FOR: LEGAL DESCRIPTION: 2 3J,~x 5 6 7 8 9 10 . .11 12 13 14 15 16 17 18 19 2O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SLOPE /.L~, SOILS LOG [] PERCOLATION TEST WAS GROUND WATER ENCOUNTERED? IF YES, ATWHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Drop PERCOLATION RATE (minutes/inch) COMMENTS TEST RUN BETWEEN FT AN[) FT C~DN-~RACZ[ NG_EbLG I N E E P~5 & PERFORMEO BY: 212 E~st Irdernafional Airport Rd~ %Site ~04 CERTIFIED BY:_ '. , Anchorage, Alaska 99502 f~te Drliledl. Static Water Level Draw Down N/A 9-27-83 105 feet feet Gallons Per Minute 7 Total Feet of Uastng~ 220 ~y~erial~Drille~, 0 feet to 11 Sand 11 feet to 40 Sand Gravel 40 feet to 60 Sand ~ feet to 100 Clay ~00 feet to 105 Water (1-2 GPM) ]05 feet to ~60 Sandy Clay & Gravel 160 feet to ]80 G~ave] 180 feet 200 feet te 200 Clay Gravel to 220 Gravel w/water Hefty Drilling S.R.A. Box 1553 H Anchorage,Alaska 99507 Casing perforated at 100o110 feet AriA.. nicipa i� PO�rt 6-650 ANCHOf?AGF. At ASKA 9°,`.=0:? -0650 o{' 1 (907)26.:.;t!, MAYOR DEPARTMENTor HEALTH AND ENVutONV.ENTAL PHOTEC110N cPermit #: 820558 •January 31, 1983 TO: Permit Applicant Subject: T12N R3W Section 21 NE; SW'-; (Lot 2A Boyle Subdivision) A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. 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 needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerely ��d�- Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 I F• Fi L_ I T Y r -ti F 1=1 CA F_ Fi G E DEPARTMENT HEALTH AND ENVIRONMENTAL 0"OTECTION 225 STREET, ANCHORAGE, AK.i1 4C 264-472+ FJEL_L_ FAP4E> CDr4—= I -ra --ELJEF_ PERMIT NO. { 520552 PERtl I T APPLICANT THOM FISCHER 2520 W.77TH CT 49502 LOCATION 243-7995 LEGAL T12NR3W 521 NE4 SW4 r O 1O S� 9ayy SQUARE FEET wns TYPE OF SOIL ABSORPTION SYSTEM IS:G'TF:ENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING CSO FT/6R)= 25 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: L'�EF•TF-l= 11 LEt-49TH= GFRF!'ti•'EL C EF - THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). FRECfU I F:FEE E> EEF}T I C_- Tl--ft•JK —"-, 12: E: = 1 �L [3 13RLL_0tJ1 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TIJCA C j> it I t4coF•EiCT I C7t•JIn FA FRE F'ECALJ I FEZE> --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER. LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER. INSTALLATION. F•EFRtfI I T E:4F0I F E= L�ECEtyEEF2 1 s 1n40^� I CERTIFY THAT 1: I AM FAMILIAR, WITH THE REQUIREMENTS FOR ON-SITE SEWER, AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER.. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE f EMODELED TO (jNGLUDE MORE THAN 4 BEDROOMS. 4 SIGFJED:--- -- - -- --=-------------- �O r L �/ APCANT ICITHM FISCHER �j( / /t- ISSUED BY__1! -- � L/ V4. O Scotch' 7664 "Post.lt- Flouting Request Pads ROUTING - REQUEST Please T' / READ To— HANDLE o HANDLE ❑ APPROVEt�r�n ! ✓17 and n l�� • C r•l (off t ✓1[� ❑ FORWARD ((ll r �. .Y. ['• O i—r �� f ❑ RETURN ❑ KEEP OR DISCARD ❑ REVIEW WITH ME YY�hDQQ Date From !Y-�- 4 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and wastewater Program 4700 South Bragaw Street 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. 015-282-37 GENERAL INFORMATION Complete legal description Lot 1 Sky Harbor Estates #2 Location (site address or directions) Expiration Date: q- 7- O /'~ 600 CanRe Street, AnchoraRe, AK 99516 Current Property owner(s) , Mailing address Lend!ng agency Scott Henderson Day phone 276-4441 11600 Can.qe Street, Anchoraqe, AK 99516 Day phone e Mailing address Mailing Address US Inspect Attn: Stella Michel Day phone 800-872-3660 3650 Concorde Pkwy, Ste 100, Chantill¥, VA 20151-1129 Unless otherwise requested, HAA will be held bj~ DHHS fo~'pickup.'HAA picked up by: NUMBER OF BEDROOMS: 4 J TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class, Public Water System TYPE OF WASTEWATER DISPOSAL: [~ Individual On-site I--I Individual Holding tank [--I ['-i Community On-site D Public Sewer I-'] The Municipality of Anchorage Development Services Department (DSD) Issues Cedificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request'to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for propedies served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Cedificates are valid for one year for propedies 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. (Rev. 11~99) 5. STATEMENT OF INSPECTION BY ENGINEER , . As certified by my seal affixed hereto and as "of the validation date'shown below, I verify that my investigation based .on procedures outlined in the Health Authority Approval Guidelines for 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Enq. Svc. Address P.O. Box 102954, Anch, AK 995'i 0 Phone 272-8218 Engineer's Printed Name _Steven R.,Pannone, P.E. Date Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of~ the test, and separation distances measured to readily identifiable features. The operational life ofall wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the systen~ These conditions are outside the control ofthe evaluator of this system. All systems eventually fail and satisfactory test results J do not guarantee future performance of the system, nor do they guarantee that there are no hidden def~ or encroachments. PES can therefore not provide any warranty for future performance nor give any ~ ('t~Steven · estimate of how long the system will continue to meet the operational requirements ofthe ADEC or' ~'~".. , _~, MOA DSD. The content ofthis report is for the sole benefit ofthe owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right 6. DSD SIGNATURE : . L'"/" Approved for ~"'* bedrooms. Disapproved. Conditional approval for Additional Comments '. bedrooms, with the.following stiP"U'lations: " .,~,~,;,~x ... '-..",~, _.. WATI:RAND · · ITl- % ; PROGRAM :' _~ ~'.. .. :,~.-.~' Attachments: "HAA Checidist Septic System Advisory Well Flow Advisory · (Rev. 11/99) - Maintenance Agreements Supplemental Engineer's Report Other' , original'Certificate Date:. Reissue Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wast~wate~"Program 4700 South Bragaw Street 'P.O:Box 196650 Anchorage, AK 99519-6650 www.ci ,anchorage .ak.us '(907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Lot I Sky Harbor Estates #2 Legal Description: WELL DATA Well type P Date completed 912711983 Total depth 220 fl Date of test Static water level Well production WATER SAMPLE RESULTS: Parcel I.D.: 015-282-37 Well Log Y If A, B, or C provide PWSID # Sanitary seal _Y Wires properly protected Y Cased to 220 ft Casing height (above ground) t28 105 ft 7 g.p.m Nitrate Collected by: FROM WELL LOG 9/2711983 Coliform ~ colonies/100ml Date of sample: 5/1212004 B. ;SEPTIC/HOLDING TANK DATA in, AT INSPECTION 511212004 124 mg/I 2.59 ' g.p.m · Other bacteria ~ colonies/100 mi Laura Pannone , Tank Type/Material '. Greer Steel Date installed 511411983 Tank size Cleanouts Y_. ...... Foundation cleanout _Y Date of pumping 511212004 Pumper A+ Home Services ABSORPTION FIELD DATA " : Date installed 5/1411'98'~ Soil rating (g.p.d./ft2 or ft2/bdrm) 8._~5 Length 31 ft Width ;2 ,. ft- 1250 gal Number of Compartments 2_ ' - Depression over tank N High water alarm NIA System type Deep Trench Gravel belowpipe 5.9 ft .'· Total depth t 0.6 ft Effective absorption area 366 ft2 Monitoring tube _Y Depression o~,er field N Date of adequacy test 511212004 Result~ (Pass/Fail) ~ Pass For 4 bedrooms i, Fluid depth in absorption field before test ~. in Water added606 gal. Elapsed Time: 1440 min Final fluid depth _6 in Any rejuvenation treatment (past 12 mo.) (Y/N & type) No New d~pth8.5 in. Absorption rate :~= 600+, g.p.d. If yes. give date (Rev, 11/99) LIFT STATION · , ~; , ~,. ,. .. :. Date installed . Size i 11 s "Pump on" level at, in Pump off" Datum Cyc~ tested ' , SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ' ' Septic tank/lift station On lot ' 100+ Absorption field on lot 100+ Public sewer main N/A ' Sewer/septic service line 25'+ Manhole/Access ~ in High water alarm level at in Meets alarm & circuit requirements? On. adjacen! 10ts 100+' ' . ' -' On adjacent lots 100+ Public Sewer manhole/cleanout N/A Holding tank 100+ .' ' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Properly line 70'+ Absorpti(~n field 6' Water service line 50'+ '-. Surface water 100+ .Wells on adjacent lots 100+. .. ~ 55' Building foundation Water main 50'+ Drainage, 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 75' Building foundation 70' Water main :' 75'+ Water Service Ii'ne '75'+ ' · '' .' 'Surface water "100+ Driveway,' parking/vehicle storage 35'+ F. .Curtain drain None Observed Wells on adjacentlots 100+ .COMMENTS , ,~'Y?'Z//'/ G. ENGINEER S CERTIFICATION : ' . ~, * . ~;~: .......... '.~. ,'1 ce~ify that I have determined through field inspections and ~ ~ / 4 9 ~ review of Municipal records that the above systems are in ~ ..... ~~ ............... conformance with MOA HAA guidelines in effect On this 'date. ' ~~.~.~ ........... . Engineers Printed Name Steven R. Pannone, P.E. ~*%_ No,-CE 8149 / . Date ' ~ [Z[~ . . ' . ' HAA Fee. $ . ,~.-"~ (Rev.Date of Payment 1/99) Receipt Number ~~7~ Waiver Fee $, Date.of, payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENTOF 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 /--~//,6~.~¢~-~ ~ HAA # 1. GENERAL INFORMATION Complete legal description Lot I; Skyharbor Estates tt2 Location (site address or directions) Property owner Mailing address Lending agency Mailing address Scott Henderson 11600 Canqe Rd. 11600 Cange Stree~ Anchorage, AK Day phone Anchorage, AK Day phone 345-8562 Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well X×X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing 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. XXX 72-025 (Rev. 1/91) Front MOAtf21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water sup'ply 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 tIle 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. 4 Name of Firm Address S & S ENGINEERING Engineer's signature 17034 Eagle River Loop Road No. 204 Eaqle Riveh Alaska 99577 DHHS SIGNATURE ~.' Approved for Disapproved. Conditional approval for Phone 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 Stat~. 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 p,'ofessional engineer's work. 72-025 (Rev. 1191) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type Log present Y~N) Total depth Sanitary seal ((~N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~/-,='~ '~' ~ ~ Driller //~--~ iL----'7,~' Cased to ¢-~-.;~0 ' Casing height Wires properly protected (~)'N) Date of test Static water level Well flow Pump level FROM WELL LOG AT INSPECTION 'D/_ g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/I.~i~g tank on lot Absorption field on lot (¢,q, 5 r,~_ Public sewer main /'d/~ Sewer service line c~5 ~'~' ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout ~J//¢ Petroleum tank g.p.m. ~ o IOO '¢ oz WATER SAMPLE RESULTS: Coliform 0 Nitrate Date of sample: Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed ~-~- lq- 8 Tank size Cleanouts (~N) ¢ Two Foundation cleanout (~N) c/'¢' (--'%, High water alarm (Y/~) Date of pumping F-(~ ' ~'~ Compartments Depression (Y/~___) Alarm tested (Y/~} Pumper A'f' /'/O/HE' .~'~-;~ V,,¢ ~ g SEPARATION DISTANCES FROM SEPTIC~TANK TO: f Well(s) on lot 1(3~ -t On adjacent lots To property line "~ (--) ~ff- Absorption field Surface water/drainage /00 ~L Foundation .~ 4- ~'~ Water main/service line .~0 '-/- 72-026 (Rev. 7191) Front '7~ CONTINUED ON BACK PAGE C. LIFT~N / Date installe~' ¢'~//~/- Manufacturer .~ Size in gallons ~ Manhole/Access (Y/N) ~~ Vent (Y/N)_ "Pump on"~ ~....~..-.-"~um~ off" level at High water alarm level ~~ycles tested _~ Meets MOA electrical codes (Y/N) _,..,~ ~ Well on I.~ On adjacent lots Surface water ~.~.~ D, ABSORPTION FIELD DATA Date installed ~-lo/'-~ Soil rating (~ S~,'//~,~ System type ~)E~_/'~ "7-~/~c/.¢ Length ¢ '~1' Width Total absorption area Depression over field (Y/(~ Results (l~s/fail) Peroxide treatment (past 12 months) (Y/(~) Gravel thickness ~ ._~/u' Cleanouts present ~N) Date of adequacy test for '~ Total depth- /.~ O/~E,, ~-~ ~7/+~p If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Onadjacentlots ,/OO'./- Propertyline ~ '~'~ * --~-O ' To existing or abandoned system on lot AJ//~ Cutbank ~(~ ~'f- Water main/service line ~z~ ~¢- Driveway, parking/vehicle storage area ~3 ~-/-- Curtain drain ~ OP46~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on ipection, $ & $ ENGINEERING Sig ~ ....................... nature .~ ~m~,~ ~:.~; ...... Eagle Rivm', AJasl(a 99~77 Engineer's Name Date ~ ~ ~ ~ HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. July 6, 1993 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOl'TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Scott Henderson 11600 Cange Rd. Anchorage, Ak. 99516 Reference: Lot 1, Skyharbor Estates #2 Dear Mr. Henderson, Per your request we have completed a water and sewer assessment on the referenced property in accordance with the Municipality of Anchorage (M.O.A.) guidelines for obtaining a Health Authority Approval. A flow test was performed on the well serving the referenced property on April 5, 1993. The static water level was measured in the well at 114 ft. below top of well casing. A meter was connected to the water system and the flow turned on full. The water level was drawn down to the pump at 209 ft. The flow was allowed to continue for a duration of 4 hours where the flow rate stabilized at 6.5 gallons per minute (GPM). This flow rate is not guaranteed to remain constant, subsequent variations can occur. Water samples where taken by our firm on April 5, 1993 and tested for coliform bacteria and nitrates by Alaska Chemical and Geological Laboratory, The results were satisfactory (See attached water analysis). Also an adequacy test was performed on the septic system serving the referenced property on April 6, 1993. Water was added to the leachfield t_~~_cleanout at the beginning of the trench (Installe~4/~/93)~-w~l~liquid levels were monitored in the septic tank and leachfield (Leachfield monitor tube installed 4/5/93). From the data collected we have determined the existing septic system meets municipal absorption requirements for a four bedroom house. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RI'VER, ALASKA 99577 From the inspection report dated May 14, 1983 , the septic system consists of a 1250 gallon septic tank followed by a 31 ft. long, ten foot deep trench with a 71 inch effective depth (gravel depth). The sketch on the inspection report shows a cleanout five feet after the septic tank (indicating the beginning of the trench), and a monitor tube 31 ft. from the first cleanout (indicating the end of the trench). The standpipes are shown to be in line (approx. due east) with the septic tank cleanouts (See Attached inspection report). Upon our initial visit to the property we found the septic tank cleanouts to be apprq~imately 4 inches below grade with metal plates over the 31m caps. The cleanout at the beginning of the trench and the monitor tube at the end of the trench was also reportedly buried with metal plates over the jim caps as was the septic tank cleanouts. After several visits to the property with a metal detector and digging by hand with a.shovel and again probing the area indicated by the inspection report we still were unable to locate the cleanout at the beginning of the trench or the monitor tube at the end of the trench. On April 5, 1993 we returned to the property with a rubber tire mounted backhoe and began to excavate at the end of the trench (per inspection report '5/14/83) in search for the monitor tube. We began excavating approximately 40 ft. East from the second septic tank clean out. At the end of the excavation we had dug a hole approximately 15 feet wide, 22 ft. long, and 10 to 12 ft. deep. We found no monitor tube and preceded to fill the hole back in. We then began excavating immediately after the septic tank in search for the cleanout at the beginning of the trench. After excavating down to the line leaving the septic tank we continued uncovering the line until we encountered the perforated leachpipe, we found no cleanout. Before backfilling the excavation we installed a cleanout and monitor tube at the beginning of the trench (see photos xY HARBOR ESTATES SECOND I~DITION LOT I s e,~° 5~' o~"w ': 50' AS ~JILT ttlTAL~I. II.L.I. BAY LOOP CH(CKCO FI(LD lOOK: I "ER£BY CERTIFY THAT I NAVE SURVEYED THE FOLLOWING I:~$C"':ED PROPERTY: ~ot Ha~bo~ Estates Second Addition ~." S~ THAT "O ENCRO~NTS EXIST T~ ~. ~o ~T~.~ T~ ~X,.T..~ VISION ~T UNDER NO CIRCUMSTANCE8 v~-,,..~-~ .~ : - :~LD ~Y DATA ~ON ~ USED F~ CON- ~ S~CTION OR FOR E~TABLI$HIN" 8~N~RY ~ FENCE LINES. ANCHORAGE RECORDING D~STRICT, AK. Installation of cleanout and monitor tube at the beginning of the trench. ( Note: second cleanout to septic tank - upper right hand corner) Leachfield, looking East Leachfield, looking West Cleanout and monitor tube installed 4/5/93 Excavation immediately after the tank, in search for the cleanout at the beginning of the trench. (note: septic tank cleanouts below grade) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1, GENERAL INFORMATION (a) Application Date (b) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name '-.-.~-O-['"'T' , .~t~_~,.r"'x-"~S_C~..,elephone: Home Business Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyep~; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family,~¢' Multi-Family Number of Bedrooms Other WATER SUPPLY Individual WellJ~2 Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite,[~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 {11/84) 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 flies 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 ~ .M-. ! .-F,c't,,4, ."~"r~ (~"M'~, Address ~,, Telephone Engineer's Seal Approved for ~ bedrooms by Approved (~___ Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84} MUNICIPAL TY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) I:NVIRONMENTAL.SERVICES DIVi$10~EALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 R[6EIVED WELL DATA Well Classification ~\1~.~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ~4,~'"'~ Date Completed _c:~ [~.7/~ Yield Total Depth ~ '~O Cased to 'Z~O/ Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Pump Set At ~¢~-I O" Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot [ / ~ / To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line __ Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ; On Adjoining Lots [ (2)Cb ! ~ I '7_._(;:? ; On Adjoining Lots LI;~::I~ I--~-- ~/~. To Nearest Public Sewer t,.5 / ¢'t TO Nearest Sewer Service Line on Lot /~"~ f I~ "'% ;Da,e_ B, SEPTIC/HOLDING TANK DATA Date Installed %/,~,,/_~_.-'~_ Size _! '~¢~-0 No. of Compartments Standpipes (Y/N) "'~"~-'~ Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well _ To Property Line "7-~ / To Water Main/Service Line . Course f'"'~ A C\ '¢'~ ~' r''~-'' Foundation Cleanout (Y/N) Date Last Pumped ~;:;z/~:~--~ ~'~/¢~ ;for ~..~ /~.~ / ~'~/r~F- Temporary Holdin9 Tank Permit (Y/N) ~ ~'J/¢~- __ To Building Foundation To Disposal Field _ ----%-/ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~., ~._./ Width of Field Square Feet of Absorption Area '~(;~? / Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well \ To Building Foundation '7 Lot To Water Main/Service Line _ ~&/'(:~' / ~.~- ¢/tr'%¢4'~ Type of System Design Length of Field Depth Of Field I~)/ Gravel Bed Thickness Standpipes Present (Y/N) Date of Last AdeqUacy Test To Property Line '~,~-/ To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if pres~.nt) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicie Storage Area Comments D. LIFT STATION · . // Date Installed D~mens~OJ:z~_ : Size in Gallons ,..Manhole/Access (~'/N) ~ "Pump On" Level at j "Pump Off" LJvel at J - ;~gsthedW;; ,u yoles during st. Meets MOA CommentsElectrical Codes~(Y/N) / L.~ _~.~,--J ** Check Permitted Bedroo~.~at~.~ainst HAA Request ** I certify that I haye checked,~erified,,.,or c~bnfor mad to all MO~ and .HAA guidelines in effect on the date Signed ,,-'~"L,~.~...... ~-~"~,..~__ Date __~/'~-7~~ ~ Company ~~~~OA No. Page 2 of 2 ~ ~ ~,~ CE- 6793 Zr~¢ %%::. .......... of this inspection, Engineer's Seal CHEMICAL~ & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ~¢'PRIVATE WATER SYSTEM Name Phone No. Mailing Address ¢' City State Zip Code Mo. Day Year SAMPLE TYPE: ~q Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose ) [] Treated Water ~¢. Untreated Water SAMPLE NO, 1 2 3 4 LOCATION Time Collected Collected _. By TO BE COMPLETED BY LABORATORY Date Received Time Received Analytical Method: Analysis shows this Water SAMPLE to be: E~Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Membrane Filter * N'o. of colonies/100 mi. Lab Ref. No. Result* I J Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE RECORD BACTERIOLOGICAL WATER ANALYSIS Coilform/100ml BGB Time: Membrane Filter: Direct Count Verification: LTB Final Membrane Fi~er~Re/ts ~ Reported By ¢~/.¢~4-d ,.ZC-~Z PART 1 OF 2 REMAINDER TO FOLLOW TNTC = Too Numberous To Coun OB = Other Bacteria Coilform/100ml LAB INSTRUCTIONS £or W6zk Ozdez % 6910 Date Report.,,~. Printed: MAY 31 88 ~ 08:47 Client Semple ID:L1, SKY ]{ARBOR EST.-2ND ADDITION PWSID :UA Collected MAY 27 88 ~ 15:00 Received MAY 27 8~ % 16:00 hrs. Preserved with :'NONE Client Name : WHITEWATER ENGR Client Acct : WHITEWT P.O.$ NONE REC'D Req ~ Ordered By: : ChemLab Ref. ~ :1197 Analysis Completed : ~-- - ~ Send Reports to: Laboratory Supervisor :STEPHEN C. EDE . 1)WHITEWATZR ENGR Released By : .~ 2) Special Instruct: Result Chemlab Client Parameter Sample ~ Sample Description Matrix To Test Method Units WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 Legal Description: ~..o.*T' Well Classification '"-~-',"-/~.F/.:-- If A, B, C, D..E.C. Approved (Y/N)~ ~'~ I ~ Well Log Present (Y/N) "'(~ _ Date Completed ¢-i / 7_. 7/~:g'~.-~ Yi(el~.~.~'J ~ ~'~"¥°-¢Pt' - Cased to. Total Depth Static Water Level Depth of Grouting I,.5 [¢~ Pump Set At '~.| ~ / Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: / To Septic/Holding Tank on Lot I ~ ~(~ IZ~' ), ; On Adjoining Lots To Nearest Edge of Absorption Field on Lo~" I C~t.-:: ~ ; On Adjoining Lots To Nearest Public Sewer Line ~ / ~ To Nearest Public Sewer Cleanout/Manhole ~ ) ~ To Nearest Sewer Service Line on,or Water Sample Collected by "~'~ ~;'~L.t,~ ~- ; Date Water Sample Test Results ~2~ Comments SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) "~:~ Air-tight Caps (Y/N) Depression over Tank (Y/N) ~"~'~----~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well_ To Property Line To Water Main/Service Line Course No. of Compartments "~'~-:~"~ Foundation Cleanout f.Y/N) Date Last Pumped '~'--~/I c~ / t-3 / ~- ;for ~'"~ / ~ ~ I Ct- Temporary Holding Tank Permit (Y/N) / To Building Foundation~'-- To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72 026 (Rev 8/86~ Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed %/'~:~ /~ ~ Width of Field 'Z / Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~ '~-~ To Building Foundation "~ Lot ~'~ /IOI- / To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ,~P~ Type of System Design Length of Field . ~l / Depth of Field I (,~ / cGravel Bed Thickness '-? i I/ Standpipes Present (Y/N) Date of Last Adequacy Test TO Property Line '-'~'- / TO Existing or Abandoned System on ; On Adjoining Lots _ ~ ~ I.~L- To Cutbank (if present) D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at j~'-~ "Pump Off" Level at High Water Alarm Level at Tested for J Electrical Codes (Y~/ / eck Permitted Bedroom Rating Against HAA Request ** I certify that I ha~ checked~ conformed to all MOA and HAA guidelines in Signed '~ ~-, ~~ Date _~/~/~ Company ~'~, rt~-'~r'rT~t~ Receipt No, / Date of Payment Amount: $ Page 2 of 2 72-026 IRev 81861Bac~ Vent (Y/N) J Pumping ~rin"~ Adequacy Test. Meets MOA effect on the date of this inspection. Engineer's Seal MUNICIPALITY OF ~CHORAGE DIVISION OF ENVIRONMENT.~J~ HEAl,TH DE~PARTMEW£ OF [~]ALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEAL%]~ N. rfHORITY A3PPROVAL CERTIFIC3tTE (a) legal Description (include lot, block, subdivision, se, ction, tovmship, range) Location (add~ess o~' directions) (b) Applicants Nar[e ........ ["[i~.~&~__~-'~.'%c--/-~ Te lephoEe '~ ~/~ (j~_-~f~ (c) (d) Applicant is (check 0~) ~nding Institution ~ ~ Buyer l:-q ; Other [~ (explain); ~ndir:g Institution .... ~.~l~,q ~.~ (] Telephone '7 ...~2~' (e) l%ea]. Estate Co. & Agent Address Yin!ti-Family ~ Other (c%scrib~) 3, i~_a_t e r Note: If ~nity veil system, must have ~it~n confirmation f-r~ ~e State ~pa~nt of ~viro~ntaJ. Conservaticn attesting to t}m legality and status. Is ~%e ~mll adequate for the n~r of ~ s~cified in this ~ (Y~) Is t~ wastewater ais~sal s~stem adequate f~ the tamer of l~dr~s (Y/N) [Page i of 2] 2-15284 5. _En~gi]__~.e_~_in~t Firm Prov].dinq_!in__s.~.__ctions, Tests, Data and Information I certify that I have oheckg~, verified3 or confor~d to all MOA HAA Guidelines in effect on ~he date of/this Signed by ~'~"YEL~,.?-_Y2~---- '~. ( ENGINEER SEA/.,) 6. pH__~, A_j2p~rova 1 Ap.F~oved for Disapproved E~jt Conditional ~er~.~ of Conditional App~.,oval 'Fne Municipality of Anchorage Department of Health and Environmental Protection dces not guaran{ee the ccntinued satisfactory ~rfo~:n~nce of the water supply and/or the wastewater disposal system~ %nis approval indicates that, as of the, validation date shc3~D, abow,, based on the data and information ftrcnished by an ep~gi~er registered in the state of klaska, the water supply and wastewater disposal system is safe and func~ tional' fo~z the number of bedrooms and type of structure indicated. ( LTdEP · SEAL ) 7. Mail the HAA to the following address: KB2/dS/s [Page 2 of 2] 2-15-84 MUNICIPALITY OF ANCHORA(31[j DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION H .,TH ALrmO "n' PROVAL CHECKLIST - FEBRUARY 1984 APR P, ECEIVED A. WELL DATA Well Classification ~D~l\ Well Log P~esent (Y/N) Total Depth ~?_G) Cased to Static Water Level . Casing Height Above Ground Electrical wiring in Conduit (Y/N) ~--~ Separation Distances from Well:. To Septic/H~l~%i~ on Lot To ~arest Edge of Absorption Field on To Nearest Public Sewer Line .... ~ If A, B, c~ C, D.E.C. Approved(Y/N) Date Completed ~ /~7/.~ Yield 'iT:Z.© Depth of G~outing. ~ ~t At Sanit~y ~al on Casing (Y~)~ ~ession ~ound ~l~ead (Y~) ; On Adjoining Lots~ J c~c) ~- ; On Adjoining Lots j oo.-W . To Nearest Public Sewer Cleancut/Manhole ~- ~.~/% .... To Nem~est Sewer Service Wate~ Sample Collected By '~D---~ ~Cl+~ ; Date Water Sample Test Results C~ments B. SEPTIC/HOLDING TANK DATA Date Installed ~-/a65/~_i~ Size I~f~C3 No. of C~,~a~tn~nts Standpipes (Y/N) ~o---% Air-tight Caps (Y/N) ¥~ Foundation Cleanout (Y~) ~pression ove~ Ta~ (Y~) ~ Date ~st P~d .... ~ P~ing~aintenan~ Con~a~ ~ File (Y~) ~/6 ; for Holding Ta~ High-Wate~ Ala~ (Y~) ~/~ .~ra~y Holdi~ Tank ~r~t (Y~) D/~ Sep~ation Distan~s ~ ~ptic~olding Tank: To Water-Supply ~11 ~ jjj / To ~ilding Foundation To ~o~rty Li~ 7~/ To Dis~sal Field To ~ter Main/~vi~ Li~ ~- ~ ...... To S~e~, Pond, ~e, ~ Major ~aina~ Con~ents 2-15-84 ABSORPTION FIELD DATA Soils t~ating in ~Josorption Strata Date Installed _ Width of Field Square Feet of Absorption Area ¢~._ Type. of System Design Length of Field Depth of Field .... J_~ Gravel Bed Thickness ~ ~ Standpipes Pr-esent Depression over Field (__y/N) ~O Date of Last Adequacy Test - ~ '--- Results of Last Adequacy Test .~ Separation Distance from Absorption Field: To Water-Supply Well ~~ / To Property Line To Building Foundation ~ / To Existing or Abandoned System cn Lot ~--- ~/~ ; On Adjoining Lots ;O~ To Water Main/Service Line .--. ~//+ ~ To O]tbark(i___f_pre_s~nt__~_) TO Stream/Pond/Lake/o~ Major Drainage Course__-f ~//~¥ To Driveway, Pa~kir~ Area, o~ Vehicle Storage A~,ea _ ~-0... Co~[~f~nts D. LIFT STATION Date Installed Dimensions Ma e/~ole/Ac ce ~{?Y~ ) __ _ size in Gallons LeVelyat ) "Pump On" Level at -' "~P~P~f~"~ ...... High Water Alarm Level at ~/ Vent Tested fo~ '~ing Cycles during Adecuacy Test. Electrical Codes(Y/N) Conments Mee ts MOA ** Check Permitted Bedroom Rating ~gainst HAA Request I certify that I have chec, ked, ~erified, or conformed to all MOA HAA on the da~of this ~f~p~tion,~. Signed ~/_~'~/~/~[~~////~f~' ~-~ ~ Date company K l/dL/s [Page 2 of 2] 2-15-84