HomeMy WebLinkAboutROUSE LT 1Rouse
Lot 1
#050-321-65
Municipality of Anchorage t ?
On -Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number. OSP131178 PID Number: 050-321-65
Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade
Name:
Daniel & Carol Sweeney
ABSORPTION FIELD - EXISTING
❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound
Address
18529 Rouse Cir., Eagle River, AK 99577
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
-- GPD/SF
-- Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
-- Ft.
Gravel depth beneath pipe
__ Ft.
Subdivision Block Lot
Rouse 1
Fill added above original grade
-- Ft.
Gravel length
— Ft.
Township Range Section
Gravel width
-- Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION
DISTANCES
0
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
— Ftp
—
Ft.
Well
100'+
—
_
__
25'.1.
TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
GREER TANK
Capacity
1 1500 Gal.
Surface water
100'-1-
__
__
_
Material
HDPE
Number of compartments
2
Lot Line
5'+
__
__
—
NA
Foundation
5'+
__
__
_
LIFT STATION
Manufacturer
Capacity
Curtain Drain
tNA
--_T
NA
--
--- --------- —
Gal.
Remarks Existing septic tank decommissioned
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
per code & reconnected to existing system.
New tank insulated.
Pump make and model
Electrical Inspections performed by
Installer JRS
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
Drainfield -- CO/MT D3034
Inspector ARCTERRA
BENCHMARK (Assumed elevation) 100 ft
Inspection
dates: 1" 8/27/13 2 d 10/16/13
Location and description
3°' 41'
Garage slab
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
.
Conditional Approval: Date
a
:. .:,...
Approved Date
Inspection Report ST copy 3.doc
AS—BUILT TANK DETAILS/SITE PLAN
ROUSE S/D LI
NEW 1500 -GAL SEPTIC TANK
A -C=32.8'
B -C=69.0'
A -D=38.0'
B -D=65.0'
A -E=26.2'
B -E=52,6'
A -F=42.8'
B—F-77.6'
A -G=44.2'
B -G=78,8'
A -H=36.3'
B -H=69,6'
�a-
0
�W
4 a
QC
J
.J y
O
y fU
c, ,
SEPTIC
E
to F
MT
RECENT ADD.
EXISTING
4BR HOUSE
T SCALEi NTS
AW,`�..aF {' �'{Q PREPARED FOR:
Air• DANIEL SWEENEY
18529 ROUSE CIR.
yj EAGLE RIVER, AK 99577
"�
S FIELD BOOKS WMPUTED:
CD -7 BOUNDARY: BOUNDARY Dmvm- BMW
Af STAFaNGSTAKING C"E KMD
! ' sAIWASBUrLM DMS DAT 6/28/13
h'ESSI DM ALE: craw: NW0254
ADAD Fly: FILE X08 No" 13-178
Permit: OSP131178
PID# 050-321-65
SCALEi I' = 30'
14
Illk�N■,
wolill!"cru �
("LTI NC, - ,6
AIC 99577"
33'
S89'53112"W 266.00'
8.0' 8.0' pEGK
SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a i 0 F
physical survey of this property as shown on this drawing and that the 119 . • ' ' <Q ,,
improvements situated hereon are within the property lines and no
enchroachments exist other than noted. Under no circumstance should% * ; 49TH I
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lines. . . . . . . . . .1 . . . . . . .
EXCLUSION NOTES: It is the owners responsibility to determine F, '.o .: • . • ' • • ' • ' ' ' ' ' ' • ' ' ' • ' •.
the existence of any easements, covenants, or restrictions which •.JQHN L. SCHULLER: ° � aLS_10408 .•• ��'
do not appear on the recorded subdivision plat.40
WORK ORDER NUMBER: Date scat£ E-YNG N Z : I.41•' SJ%
FEB 12, 2019 1'=40-
19-009
'=40' ®°p �
19— 009 MAS+ BY gffgffD BY Oft NUMML Book ACE ®®r°fessionot ®
JLS NW0254 190108 ®��.siono\ '
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LAND
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1831 Talkeetna Street
Anchorage, Alaska 99508
(907) 227-1455 office
(907) 274-4992 fax
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0 300
2.5'x15'
BW CANT
COVERED
ENTRY
GRAVEL
D/W
r
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LOT 1
33'
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\r'p�O2' 45.00'
L=44.1 2,2,
N 89'50'12"
E R=205.00
47•00
6
S 77-'50P
L- 4
00"
ROUSE
CIRCLE
ANCHORAGE RECORDING DISTRICT, ALASKA
AS -BUILT OF:
ROUSE SUBDIVISION
OO = FND 5/8"
REBAR
LOT 1
PLAT 86-202—r—
SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a i 0 F
physical survey of this property as shown on this drawing and that the 119 . • ' ' <Q ,,
improvements situated hereon are within the property lines and no
enchroachments exist other than noted. Under no circumstance should% * ; 49TH I
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lines. . . . . . . . . .1 . . . . . . .
EXCLUSION NOTES: It is the owners responsibility to determine F, '.o .: • . • ' • • ' • ' ' ' ' ' ' • ' ' ' • ' •.
the existence of any easements, covenants, or restrictions which •.JQHN L. SCHULLER: ° � aLS_10408 .•• ��'
do not appear on the recorded subdivision plat.40
WORK ORDER NUMBER: Date scat£ E-YNG N Z : I.41•' SJ%
FEB 12, 2019 1'=40-
19-009
'=40' ®°p �
19— 009 MAS+ BY gffgffD BY Oft NUMML Book ACE ®®r°fessionot ®
JLS NW0254 190108 ®��.siono\ '
O
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LOT 2
LAND
U e r
UZ n
1831 Talkeetna Street
Anchorage, Alaska 99508
(907) 227-1455 office
(907) 274-4992 fax
On -Site Wastewater Disposal System Permit
Permit Number: OSP131178
Tax Code Number: 05032165000
Work Type: Septic
Permit Effective Dates: July 11, 2013
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
to July 11, 2014
Design Engineer: ARC TERRA CONSULTING INC
Subdivision: ROUSE
Site Legal Address: ROUSE LT 1 G:0254
Owner/Address: SWEENEY DANIEL C &
SAMPSON CAROL L 18529 ROUSE CIR EAGLE RIVER AK 995777933
Site Mailing Address: 18529 ROUSE CIR, Eagle River
This permit is for the construction of:
N Disposal Field Y Septic Tank N Holding Tank
Lot Size in Sq Ft: 62582
Total Bedrooms: 4
N Privy N Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received B
Issued By:
By
Date: 7-1
- 1 - 3
ti� Date: / ��
MUNICIPALITY OF
Community Development Department
Development Services Division 6
On -Site Water & Wastewater Program
ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 050-321-65
Property owner(s) DANIEL SWEENEY & CAROL SAMPSON Day phone
18529 ROUSE CID EAGLE RIVER AK
Mailing address ' , 99577
Site address 18529 ROUSE CIR., EAGLE RIVER, AK 99577
Legal description (Sub'd., Block &Lot)
ROUSE LOT I
Legal description (Township, Range & Section)
62582A
Lot Size Sq. Ft. Number of Bedrooms
APPLICATION IS FOR:
(® all that apply)
Absorption Field
❑
Septic Tank
[
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
APPLICATION IS AN:
TYPE OF DWELLING:
Initial ❑
Single Family (SF)
Upgrade
(w/wo ADU)
Duplex (D)
❑
Renewal F-1
Multiple Dwellings
❑
(SF and/or D)
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Sign atuffg.6f property owner or authorized agent)
Permit/Rush Fees: Waiver Fees:
Date of Payment: -11 a I i a) cJ
Receipt Number: 605113
Permit No. Ob -e 13\ 11 �
Permit App_9-1-12.doc
Date of Payment:
Receipt Number:
Waiver No.
e p►RcTeRRq ¢
} ARC 1m
1I,RRA
dna Y
CONSULTING, INC
212 E. 51"Ave, Anchorage, AK. 99503
ye Office 907 868-3791, Fax 907 868-3793
June 28, 2013
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Septic Tank Permit — Rouse Lot 1
It has been determined that the septic tank of the subject property is in failure.
Subsequently, the owner has requested we proceed forward to obtain a septic
permit to upgrade the septic tank.
The property and adjacent lots are served by private water. There are no known
curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system. If you have any questions,
please contact me at 868-3792 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
Kenneth M. D usJP.
Attachments: On -Site Sewer Application
Wastewater Absorption System Details/ Site Plan
20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793
WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN
ROUSE S/D Ll
NP
411�'30
0
vi
N
1
130
E
I!l W
n
N Yj
p$\ ^ cw 2
NO PUBLIC WELLS WITHIN 200' OF
PROPOSED SYSTEM.
NO PRIVATE WELLS WITHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED.
NO SEPTIC SYSTEMS WITHIN200' OF
PROPOSED WELL EXCEPT AS NOTED.
In
2
k
, i�
' 45.
M
-
yy iv
`e. a
L 1 y
4.12 47 :. YELL
OA` �
N
30.75
s&1
W
PAGE 1 OF 2
DESIGN DETAILS
DECOMMISSION EXISTING SEPTIC TANK PER CODE
INSTALL NEW 1500 -GALLON SEPTIC TANK
INSTALL POST TANK COS - CONNECT TO EXISTING SYSTEM
NOTES;
1. INSULATE TANK IF <4' COVER.
2. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK.
3. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
WELLS & SEPTICS.
OF�\ vie✓rsim-Is 7-��-�3
�� 1 PREPARED FOR;
��.
DANIEL SWEENEY
U 7 18529 ROUSE CIR.
/ *
49 Tx * 0/ EAGLE RIVER, AK 99577
KENNETH M. / FIELD BOOKS CCNPuTm:
3 , CE -7118 .a eouNOARr.BOUNDARY
DRAWN` BMW
0 1 L �� %�. •� STAKINQ STAKING CHECKED: KMD
1; / ASBULT: DMS DATE: 6/28/1
OLI \D��
z SSl DWG. FILE- a00: NW0254
ACRD FILE' FILE '10B Na'` 13-178
II`7■■11111
FR• AKrl NG
N577'�
WASTEWATER DISP❑SAL SYSTEM DETAILS
ROUSE S/D L1
m lel
RESERVE H.
444 �1,
/ * 4 TH
/ KE S: /
CE 1�$4�
SSlO�=
:L .
PER CODE, INSTALL
NEW 1500 -GAL SEPTIC TANK
&RECONNECT TO EXISTING
FIELD WITH POST TANK CO'S,
MAINTAIN 5' SEPARATION FROM
FOUNDATION & FIELD
CO
EXISTING
4BR HOUSE
Ex.1250 Gal.
S.T. to Oe
Decommissioned,
FLAG ALL WELL RADII,
EASEMENTS & LOT LINES
PRIOR TO CONSTRUCTION Scale; 1'= 30'
PREPARED FOR:
DANIEL SWEENEY
18529 ROUSE CIR.
EAGLE RIVER, AK 99577
FIELD BOOKS
EWNOARr.. BOUNI
STmNQ STAKII
Assuia. DMS
DW. FILE.
ACM "FILE
Cp pum:
DRAm: BMW
C EcK o: KMD
DAM 6/28/13
mo: NW0254
dos N..: 13-178
PAGE 2 OF 2
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:j1W FloD�2S PID Number: 4956- 32-/-6%5-
Name:
Wastewater System: ¢ New ❑ Upgrade
Address:ABSORPTION
LQ Zlo za e 1< XX
FIELD
Phone:
� .
No. of Bedroo s:
❑Deep Trench g Shallow Trench ❑Bed ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
� / ' /
GPD/Sq. . Ft.
-
Lot: / Block: Subdivision:
/'OUSi?�
Depth to pipe bottom from original grade:
5. /.� - .3. Z/ Ft.
Gravel depth beneath pipe
3 • Ft.
Township:
Range:
Section:
Fill added above original grade,
Gravel length:
Ft.
Ft.
WELL: 1�New ❑ Upgrade
Gravel width:
5
Number of lines:
Distance between lines:
I
Ft.
Ft.
Classification (Private, A,B,C):
Total Depth:
Cased To:
1
Total absorption area:
Pipe material: FB /0
*a - le
'ji 0 Ft.
9-1. -6- Ft.
560+ SO. Ft.
D3D3Y
Driller:
d tr%�Pr�jo�5
Date Dr'lied:
io �G
Static Water Level:
B Ft.
Installer:
GCC s ruc . _
Date installed:
101:51f 7
Yield:�j
Pump Set /at:
Casing Height Above Ground:
TANK
•� GPM
Lv�-�Cn /'l Ft.
Ft.
SEPARATION DISTANCES
XSeptic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer: / �/
A/�G'{f
Capacity in gallons:
/z,O
From
Tank
Field
Station
Tank
Sewer Lines
� h•G..
welN/DD
11
/OD
(
Material:
Number of Compartments:
Z
urf (e
I
-
—
LIFT STATION
WatLot
/vD
/1)40_
i
r
Size in gallons:
Manufacturer:
Line
/0
/O f
_
Foundation
"Pump on" level at:
"Pump eveI at:
High water alarm at:
A)0
/D
_
_
_
Curtain
5o
v
T
Pump Make 6 Mod
Electrical Inspections performed by:
Drain
BENCH MARK
Remarks:
Location and Description:
AIW e✓ auSe
Assumed Elevation: TT
ENGINEER'S SEAL
��qlt
OF X84. %t
®�ti+.��e•••ee• •eee �..3fi�
N /D s
s
Inspections performed by: Dates: 1st
. ..��. .. e...Z•:
2nd
0••••••e•e• ••• ..• ••••fie ..
Department Health Human Services approva�
9 % Kenneth M. t us
®�� s;'.e0 CE 7116 ; ���
of and
•a
Reviewed and approved by: �G %��Yt+( Date: S-z�- 9
®ROFESSO�P�+
72-013 (Rev_ 9/911 MOA 25
AS—BUILT SYSTEM DETAILS/SITE PLAN Permit SW960325
I E— LOT 1, ROUSE S/D PID#050-321-65 -
I
I
�I
�I
�I
�I
�I
�I
A—C=39,7' I
B—C=58.4' I
A—D=47.8' I
B—D=65.5'
A—E=40.7'
B—E=52.8'
A—F=89.6'
B—F=103.6'
�I
EllI
F
Ap[rox. Top of Cut Bank
i �F...AL 1
Jol* TH
I`
'- KENNETH M. D US
CE -7116
1'RDFEssl() 0- �dr'
Approx. location of curtain drain,
Primary Feld � 1250 gal
CO I S.T. �
C D C m $��M
F MT P EC SFR
�7�
�RES�ER�VE H.
d .Q
.add.
a
d
WELL
O /
w
92.81
0
t
0z = z
o
a
J.
u9147 ORIGINAL GRADE
nn z
1
11 11 FILTER FABRIC\
SEPTIC
PREPARED FOR:
MICHAEL QUINN CONSTRUCTION
P.O. BOX 772641
EAGLE RIVER, ALASKA 99577
SEWER ROCK
52•
SCALES NTS
SCALE: 1' = 50'
VARIES
1
T
3.9'
T
BOH 7L54' '
KND ENGINEERING
20441 PTARMIGAN BLVD
EAGLE RIVER, AK, 99577
(907)696-6111/Fax (907)696-8111
aTE: 5/8/97 DRAWING #
'ALE:AS NOTED 96080 -SI
MAY -27-97 TUE 01:00 PM KND.ENGINEERING 907 696 8111 P.02
KN Jam/ ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
/VAX
May 27, 1997
Municipality of Anchorage
Dept. of Health & Human Services
On -Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Lot 1, house S/D - Well site location
Gentlemen:
The well site on the referenced lot was moved by the driller at the time of the work. The new
location does not have any adverse effect on the new septic system on this lot or any of the
adjoining lots to my knowledge. There are no septic systems within 100 feet of the new well
location.
If you have any questions, please contact me at 696-6111/PAX 696-8111.
Respectfully submitted,
II HD Engineering
uffus l'
Kenneth M. D ,
MAY -14-97 WED 08:00 AM SULLIVAN WATER WELLS 688,2759444444444444 P.03
Tvirtifirb Priffing ift.Ejag
by
DOC Ca. dba
SULLIVAN WATER. WELLS
P_0. BOX 670272, CHUGIAK, ALASKA 98567 • TELEPHONE 668.2759
OWNER OF LAND _ %C 1Y/994 ij 4004 s ( DEPTH OF WELL O d
ADDRESS STATIC LEVEL OF WATER FT.
LEGAL DESCRIPTIO .t= DRAW DOWN FT.
DATE • Started Ended /Q GALS. PER HR
PERMIT NUMBER KIND OF CASING
611
KIND OF FORMATION:
From 0 Ft- to -4 -2 -_Ft. CAS'tllp 3%/4ky iA From Ft. to
Ft.
From,C'�_Ft. to—r--Ft. cot= AC .PatrJe From Ft. to
Ft.
From -6y-6 Ft. to -d— Ft. Ciro jft L From Ft. to
Ft.
fE,,ycs
From �yQ : Ft. to�Ft, QL'��t%G� N From FI, to
Ft,
Froml/10 Ft, to,,t„�`_Ft. �K /�L/1tG/w Ft. to
Ft
Front
From r�✓��"� Ft. to -L7 7 Q Ft. �al' ,e Gk it/t'r X K'9�fiFrm� Ft. to
Ft.
Froth_ r r v Ft, to -90 T`Ft. 43&ac, j,G ge 6 C#47 6 Rgot Ft. to
Ft.
From Ft. to Ft. From Ft. to
Ft.
to_304-Ft . /3i�/7iedC-C l�i���E� From Ft. to
From-7���
Ft.
''TFt.
From3LLFt. to_3aX.Ft. IE094 K so R� y From Ft. to
Ft.
From da Ft, to 31� Ft, Aef%�'�C F �` �'�_ t~��iom to
Ft.
�ft,
From��
Ft. to�Ft. 6#<1 om Ft, to
Ft.
From Ft. to Ft. �,nj l L-FClfH4- From Ft. to
Ft.
--���� ....��
From -N, T Ft. to�QFt. BOJ From—Ft. to
Ft.
/�/�LF.d�"&C-C //�t��
Fron&�Ft. to C%3 Ft. 1��Il�tU.e .Uwe- 4 Fn6m Fi, to
Ft.
From Ft. to Ft. From Ft. to
Ft.
From Ft. to Ft. From Ft. to----gt
MISCL, INFORMATION: `" " ' ° L v
c� t 7D7'14a 6 C44/-vG JUN 12 1997
Municipality of Anchorage
Dept. Health & Human SerVICBS
DRILLER'S NAME
TaK�IIHD ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
11/FAX (907)696-8111
November 12, 1996
Municipality of Anchorage
Dept. of Health & Human Services
On -Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Incomplete on-site construction projects
Gentlemen:
�> s Clvcn
NOV 7 4 1996
1V1t" lc1Pa)JiY of Anchorage
Dept, Health & Human SerMices
As of this date we have several on-site septic and well permits which have not been
completed for various reasons. This letter is to update your department on those
projects and the reason for the delays in the submittal of the final inspection reports.
Permit #
Project Name
Status
SW960281
T14N, R1W, Sec 6, NE4SW4
Winter shutdown, Upflow filter system
installed; Well drilled; No foundation, no
electricity
SW960103
Woodridge Sub, Blk 2, Lot 1
Well and Septic installed; Have not received
survey as -built or well to
SW960097
Glacier View Hts, Blk E, Lot 3
Well, Septic, and Foundation installed; Have
not received as -built survey or well to
SW950400
Hamann Sub, Lot 5A
Well, Septic and Foundation installed; Have
not received as -built survey or well to
SW960195
River View Est, Blk 3, Lot 1
Well and Septic installed; Foundation not
done, no as -built survey, no well to
SW960226
100 Hills 1st Add, Blk 4, Lot 8
Well, Septic and Foundation installed; Have
not received as -built survey or well to
SW960264
Knik View Est, Blk 3, Lot 14
Septic and foundation in; Have not received
as -built survey
SW960325
Rouse Sub, Lot 1
Well and Septic installed; No foundation, no
as -built survey
SW960327
Hylen Crest #3, Blk 4, Lot 1
Septic installed; No foundation, no as -built
survey
Respectfully submitted,
1KHD Engineering
Kenneth M. Duffus,
n ✓ M_ C&/ PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE /o�5�P6 yfJow
DEPARTMENT OF HEALTH AND HUMAN SERVICES oA lolsAl
P.O. BOX 196650, 825 "L" STREET, ROOM 502 aft i d P�lot9�`tG
Cy i�:uor h
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW960325
DESIGN ENGINEER:KND ENGINEERING
OWNER NAME:MICHAEL QUINN CONSTRUCTION
OWNER ADDRESS:P.O. BOX 772641
EAGLE RIVER, AK. 99577
PARCEL ID:05032165
LEGAL DESCRIPTION:
ROUSE LT 1
LOT SIZE: 62582 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED:10/01/96
EXPIRATION DATE:10/01/97
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 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:
TRENCH MUST BE CONSTRUCTED NO CLOSER THAN 35 FT.
FROM THE EXISTING CUTBANK LOCATED WEST OF PROPOSED
TRENCH ALC
RECEIVED P
ISSUED BY:
DATE:-
DATE l� OI
ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
AX (907)696-8111
September 13, 1996
Municipality of Anchorage
Dept. of Health & Human Services
On -Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Sewer/well permit - Lot 1, Rouse S/D
Gentlemen:
Attached are soil test and water monitoring results for the above lot. A total of three holes were
excavated during the subdividing process to date. Results from those tests confirm our findings.
Our water monitoring results show no water present; however, the some of the material showed
signs of being damp and we have chosen to keep the system as shallow as possible. Previous soil
tests/water monitoring show the testholes to be dry including our most recent inspection.
Therefore our design assumes a total depth of the trenches will not exceed 7.0' as a precaution. A
single 50' trench will be installed, and additional fill will be added to insure a total of 3' of cover
over the system. Due to several low areas, we are limited in the location we can place the sewer
system, and that location requires a waiver to slope. To mitigate the potential impact of
installation near the slope, we have turned the trenches perpendicular to the slope. Due to the
extremely porous soils, I am confident that there will be no negative impact created by being
within 50 feet of the slope change. As designed, we have met the lot line setback and are within
20 feet of the change in slope. I am requesting that a waiver be granted to this required setback.
There are no surface water sources within 100' of the proposed design. Drainage along Rouse and
Rainwater Circles will be carried west and then north along existing right-of-way ditching. There
are no known curtain drains within 50' of the proposed trenches however a new curtain drain is
anticipated along the east property line. The development of this lot will not negatively impact
lots surrounding Lot 5.
If you have any questions regarding this application, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
KHF Engineering
Kenneth M. Duffus,
MUNICIPALITY Of ANCHORAGE
ENViRUNMENIAL URVICES DIVISION
attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
SEP 16 1996
RECEIVED
WASTEWATER ABS❑RPTI❑N SYSTEM DETAILS & SITE PLAN
LOT 1, ROUSE S/D
VACANT
!wry of C.Ba h
X479, .
r. x rm 9 BpRM
Lzso w�
X39,
PROPOSED
WELL O
kVIA
.rikyl
NO WELL WITHIN 200' OF PROPOSED SEPTIC SYSTEM, EXCEPT AS NOTED.
NO SEWER WITHIN 200' OF PROPOSED WELL, EXCEPT AS SHOWN.
� r
%
DESIGN CRITERIA
600 GPD
1. 4 BEDROOMS X 150 GAL/DAY/BEDROUM =
``\ 2. SOILS RATING: 1 MIN,/INCH = APPL. RATE 1.2 GPD/SF
OFA \ 3, 600 GPD/1.2 GPD/SF = 500 SF
w-.......-4�'� 1 4. 500 SF /5 X 0.5(rf) = 50'L
/11 1 5. MIN. DESIGN SIZE = 1 TRENCHE - 50' LONG x 5' WIDE x 4' DEEP
6. DEPTH OF GRAVEL IS 4'.
7, TOTAL DEPTH OF SYSTEM IS 6.0' FROM ORIGINAL GRADE.
* 9 TH * g 2" HD INSULATION REQUIRED OVER FIELD <3' OF COVER
I 9. 2" HD INSULATION REQUIRED OVER TANK <4' OF COVER
/ 10. CONTRACTOR TO VERIFY AND INSURE MAX 21 GRADE FROM HOUSE.
KENNETH M. D S:
cE_71I m00 1 PREPARED E❑R: KND ENGINEERING
w/
P OFESSIO0—
MICHAEL QUINN CONSTRUCTION
P.D. BOX 772641
EAGLE RIVER, ALASKA 99577
20441 PTARMIGAN BLVD
EAGLE RIVER, AK, 99577
(907)696-6111/Fax (907)696-8111
,Tl l/1Z/9F. DRAWING It
Municipality of Anchorage ® r 49TH a �®
DEPARTMENT OF HEALTH & HUMAN SERVICES o'• a.°°• .�a a.°....e• Q
2 -
825 "L" Street, Anchorage, Alaska 99502-0650 6.1.
g'e'•Kenneth M•D • 5 cc,
SOILS LOG - PERCOLATION TEST �0 s 0 CE 7116
A
At
t{..� (y�� a� PROFESSI��,��' Q /
PERFORMED FOR: f4'l l%�.ae.� QtLtiVlti Con �" Ems/' ' DATE PERFORMED:
.� w Township Range, Section: -f
LEGAL DESCRIPTION:
SLOPE SITE PLAN
(FEET)CL.tC—�
-
1 u
2
3
4
5
6
7
8
9
10
11
12
13
61�pl�lo raC115�7 w/
�vdd>/es �0 8''a
no
o<ecreas�l�" w/d��
rtes
14 6P169- 114 W
5Q,aL,d d s,,'11
15-
16-
17
5 161]
18 —
19
20
v'
COMMENTS
WAS GROUND WATER
ENCOUNTERED? 4
S
L
IF YES, AT WHAT O
DEPTH? P
E
Depth to Water After
Monilorinpl ✓T�'U Date:
PERCOLATION RATE Iminutevinchhl PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
PERFORMED BY. 1J. Ii��.CL r CERI IFY THAI THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE GUIDELINES IN EFFECT ON THIS DATE DATE
Gross Net
Depth to
Net
Reading Date Time Time
Water
Drop
_
-
/
,31
7
Zele
.'20
PERCOLATION RATE Iminutevinchhl PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
PERFORMED BY. 1J. Ii��.CL r CERI IFY THAI THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE GUIDELINES IN EFFECT ON THIS DATE DATE
ti ° °.7
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST D �,
PERFORMED FOR: � L. �t-��1 '' DATE PERFORWI;L'`
LEGAL DESCRIPTION: �1 , 1" JGiL�i Sb Township, Range, Sectionr-�It4i� I 10� ul)�
UyJ-� SLOPE SITE PLAN
DYZ` TT—T-7
1 fa•
2 t
�o /n
3 /� O
4 .0
v.
l00
5
6 < _
7-
8 8
9-
10-
O 10 O
11 p a-
12-
13-
12 13 `
14 t`
15
16
17
18
19
� \� " 6vf",3, ,moi
4'P/ \�
WAS GROUND WAT
ENCOUNTERED?
S
IF YES, AT WHAT L
O
DEPTH? P
E
Depthto Water
Monitoring?
gtt�er,�, 0_,p,� 1
Monitoring? �V� gale:
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
-2g- a1 I Z!
lv
2•"fti
3 -3n
u
tp e
3:4�
lv S
2.5
20 I�
PERCOLATION RATE " r (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN UO FT AND FT
COMMENTS
S & S ENGINEERING
17034 Eagle River Loop Road NO. 204'
PERFORMED BY: PsgieRiyer Alaska 99577 I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON HIS DATE. DATE: L��'
Municipality ®f Anchorage
' Department of Health and Human Services dhh5
825 "L" Street
Tom Fink,
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
September 14, 1992
Disotel Construction
PO Box 770210
Eagle River, Alaska 99577
Subject: Lot 1 Rouse Subdivision
Permit #SW910286, PID #050-321-65
The subject permit, issued September 12, 1991 by this office for a
single family well and/or on-site wastewater system, has
expired as of Sepember 12, 1992.
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as -built inspection report must be sent to this office for
review, approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $200.00 for an
on-site wastewater permit; $75.00 for a well permit and
$275.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
Si @erel
(r
J hn Smi
rogram Manager
On-site Services
enc: Copy of Permit
MUNICIPALITY OF ANCHORAGE
DEPARTMENT 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:SW910286
DESIGN ENGINEER:S & S ENGINEERS
OWNER NAME:DISOTEL CONSTRUCTION
OWNER ADDRESS:P.O.BOX 770210
EAGLE RIVER, AK 99577
PARCEL ID:05032165
LEGAL DESCRIPTION: ROUSE LT 1
LOT SIZE: 62585 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
DATE ISSUED: 9/12/91
EXPIRATION DATE: 9/12/92
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY: W �`^'� �R- DATE:
ISSUED BY:A t DATE: �"
i)k
ROBERT SHAFER, P. E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-297
t 9, 1991 FAX 694.1211
� It* September
HEALTH AUTHORITY
APPROVALS
Muwi.cipa.P.ity as Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Stkee.t
P.O. Box 196650
SEWER&WATER
Anchong� a e AKaska 99519-6650
MAIN EXTENSIONS
REFERENCE: Lot 1; Rouse Subdivizion;
SEWER & WATER
INSPECTION
Request you .issue a pejunit .to dt tt a wet2 and .in3.tatt a septic system
,to senve .the 3 bedroom house proposed son .the nesenenced pnopenty.
The doit6 on .the property wm sound .to be very good with a weft
ENGINEERING STUDIES
AND REPORTS
drained GW Kayer unden,2ayed by a .sandier boil Kayen su(.tabte bon
wa.6tewatek 6 2tAati.on.
Due to .the targe Kat sizes .in .the area we do not 6o4aee any negative
.impacts on - neighbojr i.ng propenes by .the .inata tati.on os the proposed
WELLINSPECTION
&FLOW TEST
wett and septic system.
Is you have any questions on nequike additi.ona2 .insanmati,on son your
nev.i.ew, ptea6e contact us.
SITE PLANS
S.incmety,
ROAD DESIGN
ROGER J. SHAFER P.E.
RJS/gm
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSALSYSTEM
ll. onrro nn. CAnl o onroo AI Acle ooS77
u
�Yo
SCALE
l MT
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1
1 �V-C;2el�
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eco 5��iU•° • ���
m.•
m
p4 F
gym. y�
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=°
> � �'(FSIGJNEEEi'S��AL)
yes ,"
• Municipality of Anchorage --
t t DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650,
SOILS LOG — PERCOLATION TEST',
jz
PERFORMED FOR: 1/� t �iyL� �t•-� DATE PER FOAIF ."'f
LEGAL DESCRIPTION: I ` t`�bJ /�j Township, Range, Section --\4:44 �\ L'
jZE P�
SLOPE SITE PLAN
r rnu" Ti :_t�-
2
�o n
3-
1)
/07
4 Q O
l f7.0
5
f% c%
6
7
- a
8
9
10
11
c
12
13
L � �
14
51617 15-
16-
17
18-
19-
20-
COMMENTS
81920
COMMENTS
G\'Fj -�1�2't,F�--T� ?�"
S & S ENGINEERING
WAS GROUND WATER �—
ENCOUNTERED? �
S
IF YES, AT WHAT L
DEPTH? O
P
E
Depth
Montt to Water I�Ser , �l C)'
Monitoring? �_ Oate:
Reading
Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
2 - A"c-
`ate ✓I 1 r
Q7
it
�7
t0
'j.%
n
lvs Pi
2.5
3••3d
u
b e
Z.S"
3:4�
(o �
2•S
PERCOLATION RATE - 1 (minutes inch) PERC HOLE DIAMETER
TEST RUN BETWEEN Lel
FT ANDFT
PERFORMED BY. E^qlp Yc:vPr. Alaska 99577 I r tJ r CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON � HIS DATE. DATE: `— I' 2 I
72-008 (Rev. 4i85)
Municipality of Anchorage
-tel Development Services Department
Building Safety Division
On -Site Water and Wastewater Program 70
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D.�ar0— 39/-&5 HAA# 65-0,�t7a--
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Lot 1, Rouse Subdivision
Location (site address or directions) 18529 Rouse Circle, Eagle River, Alaska 99577
Current Property owner(s) Dennis and Mary Mattson Day phone 552-1150
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
18529 Rouse Circle, Eagle River, Alaska 99577
Day phone
Audrey Mason Day phone 242-7777
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Q
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site Q
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B 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 verity that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. 1 further verity 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 Finn Douglas T. Kenley Phone (907) 746-1073
Address 9960 E. Puffin Dr., Palmer, Alaska 99645
Engineer's Printed Name Douglas T. Kenley Date 9A=ne
5. DSD SIGNATURE DOUGLAS• •T KME
1j�Zfj;,
Approved for �_ bedrooms. 1- CE61760�
Disapproved. ���. �r���••
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: �i/. � Original Certificate Date:
(Rev 01A2)
Municipality of Anchorage
• "' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519650
www.muni.org/onske
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 1, Rouse Subdivision Parcel ID:_ 03"0 — 3 2 1- 6 9-
A. WELL DATA
We" type P�
Date completed /Yfz
Total depth 400 ft.
Date of teat
Static water level
It A. B. or C provide PWSID # _
Sanitary seal (YIN) Y
Cased to 21.4 fl.
FROM WELL LOG
10/96
5'
n.
Well production 2 g.p.m.
WATER SAMPLE RESULTS:
Coldorm _L—colonies/100 ml. Nitrate 4.05 mg./I.
Arsenic: ng.A. Date of sample: e12w
B. SEPTICIHOLOING TANK DATA
Well Log (YIN) i/
Wires properly protected (YIN) Y
Casing height (above ground) 15 in.
AT INSPECTION
5/12/05
5„ fl.
2.5 9. p. m.
Other bacteria 4 colonies/100 ml.
Collected by: F. Kenley
Tank Type/Material 318011dstsel Date installed 10/05/97
Tank size1250 - gal. Number of Compartments 2 Cleanouts (YIN) Y
Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N/A
Date of pumping 9/13/04 Pumper Sanitary Pumpers
C. ABSORPTION FIELD DATA
Date installed 10/05/97 Soil rating (g.p.d.Ke or IF/bdrm) 1_2 System type Shallow trench
Leery 52 fl. Width 5 fl. Gravel below pipe 3.9 fl.
Total depth7-9 1t. Eff, absorption area 500* It2 Monitoring tube Y Depression over field N
Date of adequacy test 6/12/05 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 5.25 in.
Water added 547 gal. New depth 7.75 in.
Elapsed Time: 23 min. Final fluid depth 6.75 in.
Any rejuvenation treatment (past 12 mo.) (YIN & type) _
N
Absorption rate >= 500 g.p.d.
If yes, give date __
D. UFT STATION
Date installed
Size in gallons
Manhole/Access (Y/N)
'Pump on' level at _ in.
'Pump oft' level atW�ii1gR
i er alarm level at in.
Datum
Cycles tested
Meets alarm 8 circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
180+'
On adjacent lots 100+1
Absorption field on lot
170+'
On adjacent lots 100+'
Public sewer main
N/A
Public sewer manhole/cleanout N/A
Sewer /septic service line
25♦'
Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 351
Property One 70�'
Absorption field 10'
Water main N/A
Water service line
25+' Surface water 100+'
Wells on adjacent lots 100+'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 20+'
Building foundation
35f Water main WA
Water Service line 25•'
Surface water
100+' privsway. parking"hide storage 90+'
Curtain drain 50+'
Wells on adjacent kits
100+' ,
F. COMMENTS
•.7r� �.F•.Au.
O. ENGINEER'S CERTIFICATION
I certify that / have determined through field inspections and'• • +
review of Municipal records that the above systems are in; KBQ.EY
conformance with MOA HAA guielines in effect on We date. I f, i •, . CE ei�
Engineer's Printed Name Douglas T. Kenley • • .
r
Date
HAA Fee $ Ll, -y) . t�
Date of Payment
Receipt Number
(Rev. 12/01)
Waiver Fee $ _
Date of Payment
Receipt Number
06-16-05 04:46PM FROM-CUE ESI, SCS ENV SERVICES
-SG$-
SCS RetO
1053325001
Client Name
Douglas Kenley P.E.
Project Namt/N
Lot 1. Rouse SID
Client Sample ID
Lot I, Rouse SID
Matrix
Drinking Water
PWSID 0
Sample Remarks:
9075615301 T-124 P.02/09 F-614
All Date rimes are Alaska Standard Time
Printed Date/time 06/16/2005 13:14
Collected Daterrime 06/12/2005 20:15
Received Date/Time 06/13/2005 11:02
Technical Director Stephen C. Ede
Allowahlc Prep Analysis
parameter
Results PQL Units Method Container ID limits Date Due Init
Waters Department
Nitrate -N 4.08 0.100 mglL EPA 300.0 D ("10) C6/17/05 JIB
Microbiol0gy Laboratory
Total Colifonst 400. No Coli coU(OomL SM2092220 A (<=1) 06/13/05 TLF
Jun 15 05 10:41p Audrey Mason 907-696-0214 _
A
N
s%rrn
,povs� cifrA'r
.fE�t�TFr�.9iu✓6/�.l
ASBUILT
• SEWARD S ,
I HEREBY CERTIFY -THAT 1 HAVE SURVEYED THE
SCALE{
FOLLOWING DESCRIBED PROPERTY:
ryo
iYvUfE .�'v.�� tor/
DATES
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS
t��>
INDICATED. IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
GRID:
EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH 00 NOT APPEAR ON THE RECORDED SUBDI-
Hw zrsi
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
FB:
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
DRAWN:
-o-rf
I
1
p.l
OF AC�`rfi°e
4CITH
•. DWOI Mirk Shr�.A - Ar
�, . 1S-6918 '`yas
5. STATEMENT OF INSPECTION BY ENGINEER. `
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. l 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 KMD Engine®fin, Phone
Address 20441 Ptarmigan Blvd.
Engineer's signature Date
VV
6. DHHS SIGNATURE
-X Approved for bedrooms.
- Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
AdditionalCpmment$Note: The well for this property meets existing
State and Municipal --Codes. T ere are nitrates present. It is
suggested that a periodic testing be performed to insure the wells
continued suitability. ; Nitrate concentration is 8.76 mg 1. EPA
maximum vonc n a ion is 10.0. mg/l. More information on nitrates is
mailable f�ym t� On— e Services Section at DHHS, 343-4744.
By. , . / ��/ Date S 28—
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificatafei based only upon the representations given in paragraph 5 above by an independent
,
professional engih , r r6gistered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes
and their lending institutions in orderto 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-M (Rev. 1/91) Back MOA #21 - -
MUNICIPALlry OF ANCHORAGE
ENVIRONMENTAL SERVICES D1
ON
�Municipality of Anchorage MAY 74 199
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division F� V E hs
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-47 V
Health Authority Approval Checklist
Legal Description: Lo/ /f 0a5e, 4a Parcel I.D.: 05D ' 32/ — laS
A. WELL DATA
Well type Ind. If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) t Date completed 10IR6
Total depth `/DU Cased to 2 / �✓ Casing height (above ground)
Sanitary seal (Y/N)
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
/047
Wires properly protected (Y/N)
AT INSPECTION
/0/Z/
7•�
g.p.m. /. 9 Z g.p.m.
Coliform C// Nitrate 8. 7, Ln% L Other bacteria
Date of sample: 3// //'Z Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed /O 5 Tank size /z 5D Number of Compartments Cleanouts (Y/N)�
Foundation cleanout (Y/N) �_ Depression (Y/N) A/ High water alarm (Y/N) NA•
Date of Pumping /114 Pumper
C. ABSORPTION FIELD DATA
Date installed 10161
Soil rating (g.p.d./ft2,or4lrrt) System type �Iallaa /✓eilClvl
Length .SZ Width Gravel thickness below pipe 3. 9 Total depth 7 ' 9
Effective absorption area 5007' Monitoring Tube present (Y/N)—Y-- Depression over field (Y/N) /V
Date of adequacy test \� Results (Pass/Fail) �� For bedrooms
Fluid depth in absorption field before `estlr
Fluid depth (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N) _
72-026 (Rev. 3/96)"
Immediately after_ gal -,water added (in.):
Absorption rate =
If yes, give date
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
Size in
"Pump on" level at*
s
"Pump off" level at*
High water alarm level at* *Datum RKECEIV ED�
Cycles tested
E. SEPARATION DISTANCES MAY 1 5 1957
Municipality of Anchorage
SEPARATION DISTANCES FROM WELL ON LOT TO: Dept. Health & Human Services
Septic/holding tank on lot 1DD I -f" On adjacent lots / DO r
Absorption field on lot IDD' +
I
Public sewer main /00 _(_
Sewer /septic service line / 0 D +
_ On adjacent lots ! 0 U -4-
Public sewer manhole/cleanout 1 D D
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
i
Foundation /0 -- Property line /D 4- Absorption field /D _k
Water main/service line /0 F Surface water/drainage /OD F Wells on adjacent lots /00
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line /U 4- Building foundation /0 fi Water main/service line /0 �
Surface water /00 F Driveway, parking/vehicle storage area
Curtain drain SD Wells on adjacent lots /00
F. ENGINEER'S CERTIFICATION
I certify that l have determined thru field inspections and review of Municipal recoAlpt®Z a4Q19mtems are
in conformance with MOA HAA guidelines in effect on this date. �,c,P�,•°°°'�0 Fa°°e,e 6�,� j1„
Signature % .. o 4VJ,14#;%
Engineer's Name K e R yx ff fk S •••.:.�
Q g. Kenne li 1
Date / B �� ee CE 7
HAA Fee $ -5 d � a
Date of Payment 'EZ//% 7
Receipt Number ? xx En
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
NORTHERN TESTING LABORATORIES, INC.
3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 a FAX 456-3125
8005 SCHOON STREET ANCHORAGE, ALASKA 99518 (907) 349-1000 a FAX 349-1016
DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA
KND Engineering Public Water System I.D.#
20441 Ptarmigan
Eagle River, AK 99577 Date Received: 05/01/97 Time Received: 16:50
Date Analyzed: 05/02/97 Time Analyzed: 15:30
Date Reported: 05/06/97 Time Reported: 11:26
Next Sample Due:
Phone No.
Purchase Order No.
Collected by: DEA
Sample Type:
Routine
Method of Analysis:
SM 9222B
Comments:
Comments:
S = Satisfactory
U = Unsatisfactory
POS = Positive Test Result
ND = None Detected
TNTC = Too Numerous To Count (>200 Colonies)
CG = Confluent Growth
HSM = Heavy Sediment Masking, Results May
Not Be Reliable
SA = Sample Age >30 Hours But <48 Hours,
Results May Not Be Reliable
Old = Sample Age >48 Hours, Too Old For
Analysis
R = Resample Required
NT = No Test
* # Colonies/100 ml ** # Colonies/ml
Sample Sample Total* Fecal* Other* HPC**
Date Time Coliform Coliform Bacteria Result Lab# Location Comments
-----------------------------------------------------------------------------------------------
1 05/01/97 15:15 0 ND 0 NT AC2200 Rouse Lot 1 Satisfactory
�a
Sherri Trask
Environmental Analyst
NORTHERN TESTING LABORATORIES, INC.
3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 • FAX 456-3125
8005 SCHOON STREET ANCHORAGE, ALASKA 99518 (907) 349-1000 • FAX 349-1016
K.N.D. Engineering
20441 Ptarmigan
Eagle River, AK 99577
Attn:
Our Lab #:
Location/Project:
Your Sample ID:
Sample Matrix:
Comments:
Lab
Number Method
--------------------
A149623 SM 4500B
A149623 SM 4500E
A149623
Rouse Lot 1
Water
Parameter
--------------------------
Nitrite-N
Nitrate -N
'-w /,-
Re orted By: Daniel J. Bacon
Operations Manager
Report Date: 05/07/97
Date Arrived: 05/01/97
Date Sampled: 04/01/97
Time Sampled: 1515
Collected By: Dea
**
Definitions **
B =
Present in Blank
H =
Above Regulatory Max
E =
Estimated Value
M =
Matrix Interference
D =
Lost to Dilution
MDL =
Method Detection Limit
Units
Result *
MDL
----------------------------
mg/L
0.20
0.020
mg/L
8.76
0.10
Date Date
Prepared Analyzed
-----------------
05/02/97
05/05/97