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HomeMy WebLinkAboutSTOCKHAUSEN LT 3AStockhausen Lot 3A #051-063-85 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING, LAND & WATER Alaska Hydrologic Survey WATER WELL LOG Revised 08/18/2016 Drilling Started: ____/____/______ Completed: ____/____/_______ Pump Install: ____/____/_______ City/Borough Subdivision Block Lot Property Owner Name & Address Well location: Latitude Longitude Meridian ____________ Township ______ Range _______ Section _______ , _____ 1/4 of _____ 1/4 of _____ 1/4 of _____ 1/4 BOREHOLE DATA: (from ground surface) Suggest T.M. Hanna’s hydrogeologic classification system* https://my.ngwa.org/NC__Product?id=a185000000BYub3AAD Depth From To Drilling method:  Air rotary,  Cable tool,  Other Well use:  Public supply,  Domestic,  Reinjection,  Hydrofracking  Commercial,  Observation/Monitoring,  Test/Exploratory,  Cooling,  Irrigation/Agriculture,  Grounding,  Recharge/Aquifer Storage,  Heating,  Geothermal Exploration,  Other Fluids used: Depth of hole: __________ ft Casing stickup: ___________ft Casing type: __________ Casing thickness: _________ inches Casing diameter: _________ inches Casing depth: __________ ft Liner type: _________ Depth: _____ ft Diameter: _____inches Note: Well intake opening type:  Open end,  Open hole, Other Screen type: _________, Screen mesh size: ____________ Screen start: ________ ft, Screen stop:________ ft, Perforated  Yes  No Perforation description: Perf from: ________ ft, Perf to: _______ft, Perf from: ________ ft, Perf to: ________ ft Gravel packed  Yes  No Gravel start: ______ ft , Gravel stop:______ ft Note: Static water (from top of casing): _______ ft on____/____/_____ Artesian well  Pumping level & yield: ______ feet after _____ hours at _____ gpm Method of testing:__________________________________________ Development method:______________ Duration: ____________ Recovery rate: _________ gpm Grout type: _________________ Volume __________________ Depth: From ___________________ft, To ___________________ft Final pump intake depth: __________ ft Model: _______________ Pump size: _____________ hp Brand name: __________________ Include description or sketch of well location (include road names, buildings, etc.): Was well disinfected upon completion?  Yes  No Method of disinfection: Was water quality tested?  Yes  No Water quality parameters tested: Well driller name: .................................................................................. Company name: ................................................................................... Mailing address: .................................................................................... City: __________________________ State: AK Zip: ___________ Phone number: (________) ________- ______ Driller’s signature: Date: ______/______/_________ Anchorage Municipal Code 15.55.060(I) and North Pole Ordinance 13.32.030(D) require that a copy of this well log be submitted to the Development Services Department/City within 30 days of well completion. City Permit Number: _____________________________ Date of Issue: _____/____/_________ Parcel Identification Number: ______-_______-________ *Guide for Using the Hydrogeologic Classification System for Logging Water Well Boreholes by Thomas M. Hanna NGWA Press AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a copy of the well log be submitted to the Department of Natural Resources within 45 days of well completion. Well logs may be submitted using the online well log reporting system available at: https://dnr.alaska.gov/welts/ OR email electronic well logs to dnr.water.reports@alaska.gov North n 3 n 2 SW n 6 78 1563 -149.438461 163 Municipality of Anchorage 133.5 0 001W PO BOX 110378 144.8 L03 198 9 NW015N 198 n SE 2 1 n 125 163 2 perforated n NE BEDROCK - GREEN STONE 3287945 WAYNE WESTBERG STOCKHAUSEN SILTY GRAVEL OCC COBBLES 18 SILTY GRAVEL AND COBBLES 1982 ANCHORAGE S 144 78 99511 907 131 RON JONES , 61.4150696 6 ORGANIC BEDROCK 143.5 M-W DRILLING 144 :Permit #: 820484 $20.00 Permit Fee needs to paid in this office January 31, 1983 TO: Permit Applicant Subject: Lot 3 Stockhousen 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 Robert C. Pratt* R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 ll 5i y I�IJ�L��a �tl �) POUCH 6-650 ANCHORAGE, ALASKA 99502-0650 -- (907) 264-4111 TONT FN O V✓L ES. D EP AR"iM ENT Oi-I... ,, L. ili/� .. NVIRONIMENTAL PROTECTION :Permit #: 820484 $20.00 Permit Fee needs to paid in this office January 31, 1983 TO: Permit Applicant Subject: Lot 3 Stockhousen 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 Robert C. Pratt* R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 PERM ,'I- 'r.Ji.. APPLICANT LOCATION DEPAF MEl ( HEALTH AN ENVIRONMENTAL �I!!,IhiF-k+lTAL OTE l :f!. N 825 xi" STREET. ANCHORAGE, AK W5131 r !. 820484 (YLA.LYW �1 0"� Vl3Jl5 UCL r9_? JONES g=.BOX 376—L 9950.7 i._EGi'!i._ L - =TOCk:FU;:tl_h EN S 'C! nm ^5 277-7054 LOT SIZE 20000 SQUARE FEET TYPE 1.!F SYSTEM ;::_.TEM I_;: SOIL ABSORPTION I!.�!I':I .: TRENCH :rl`:.; Fni It'I !J.._!':._:..L*, OF BEDROOMS SOIL RATING (SQ .''::.- ;-;: THE REQUIRED SIZE OF THE ..T_ FE<OrfTIikSYSTEM ..... THE LENGTH DIMENSION 15 THE LENGTH (isN FEET) OF THE TRENCH OR DRF!INFIELD. THE: DE_r.,•-!H OF F! TRENCH OR PIT IS THE DISTANCE BETWEEN THE, F:URF=111_E OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). ). THERE IS NO SET" WIDTH FOR TREP•?!_HE''_•. THE GRAVEL DEPTH L_? -THE HIN:Et•11_M DEP'T'H OF iaF<:EP•:'F.L BETWEEN THE OUTFALL PIPE: AND THE BOTTOM OF THE:. EXCAVATION (IN FEET) _ C.p 0.y a"'f ` L.- C_..y fi - PERMIT _..._L rl_:ANT HAS THERESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE: INSTALLATION INSPECTIONS OF f?t,iY WEa_i._:=! ADJACENT ..O THIS PROPERTY FIND THE NUMBER OF RE_";'IDEi''?I:_ES THEE!.. THE: WELL WILL '_•EF"„E. _..__ ...-._ _.. 10_°.9 N_ F < :;x :.� n -•p __� A.c_ • E` aW�.....�... F�- t^a r-� °�:10 K F::'_ Br-:t:r-.t-7:E_,,_I'NU' OF F=iP.iY SYSTEM L:1I"('i-!I_tUT FINAL INSPECTION AND APPROVAL BY .. H. DEPARTMENT !'?ILL.,, BE SUBJECT TO F'F=1OSECia..!-ION MINIMUM DI:•`CF=!k.it_E BETWEEN A WELL F!kID ANY ON-SITE SEWAGE DISPO_AL.. SYSTEM IS 100 FEET FCIF'.' A PRIVATE NELL.. OR 150 TO 20 FEET FROM A F'!_!E:LIC WELL DEPENDING UF'CIN THE: TYPE: OF PUBLIC WELL. 'i?1gJ'CI:I1thE FROM H PRIVATE WELL TOH PRIVATE SEWER LINEI_ :5 FEET AND TO A C:Uk'1i''11.!k,ll..!Y SEWER LINE IS -r'i= FEET. OTHER REQUIREMENTS fFTAPPLY. AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. T=" K Fit I., l I -u- EE :' F- 7F Fr • t E -> E=. E� 4'11 E3 IE- Ff _ :L, _ ,9 . 1 CERTIFY THAI' L.,; I f-il''I E=Fit'1IL.;!:F!h: t,ill-!i THE: F::E!::!L!:fREaMEk?'F'=. L=C!E:: Ci'td---•T:TE. '-FF•!EF'-: F=IkiC> WELLS AS SET FORTH :..., THE; MUNICIPALITY OF Hn,E1'r'iO:=a-!G_:. T' p.!ILL., INSTALL THE '_,,'_;TEM IN ACCORDANCE WITH THE CODES. UNDERSTAND THAT THE ON-SITE _.EWE.F. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BE1:i1?=!C MS - APPLICANT RON JONES MUNICIPALITY OF ANCHORAGE lna Department Health and Environmental ?rotection 825 ,y Street, Anchorage; AK. x.501 --_ 264-4720 ## HANDWRITTEN PERMIT # # Permit, # c L( ON-SI"TE SEWER PERMIT Applicant: � C"TY( Mailing Address: 5rf� �� L Location: Phone Number: ;2 72- V Legal Description: 1-3 kx�Lot Size: Type of :Soil Absorption System Is Trench: )—c_ Drain£ield: 'Seepage :Bed: Holding 'Tank: Maximum Number of Bedrooms.: Soil Rating(sq.ft/br)_ c /The Required Size of the Soil Absorption System Is:' .DEPTH- _L—.LEN:GTH._ Z__ 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(HO.LDING) TANK SIZE = GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent :to this property and thenumber of residences that the well will serve. # # TWO(Z) INSPECTIONS ARE .REQUIRED # # # 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 "2"5 feet and to a:community sewer line is 75 feet. Well logs are required and must bereturnedto 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 31, 1 9 u 2 # # # 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 understand that the on-site sewer system may require enlargement if the.residence is remodeled to include morethat3 bedrooms. Signed: Issued by: Applicant ������ Date: SWP/024(1/81) { - MliNUIPAWY OE Aidlin e Department: vC Hoalth and Env0nn. 025 L Street! Anchorage! ��4-4720 w0doomfift 01 -SITE SEWER RAN ental protection & 99503 § f It PERMIT %1 Phone Nuabar: Legal posariptioa. 'mss of SKI Absorption Sysi Is: Trencht < ' tor: infield; Seepage Beds r a Lotti Site! _ _ aolding Tara`.: >n - maximum NuWaer ok Bedrooms: . ---licit Rat:ittg(sc{:ftfbr) Ci � The Required Size of the Soil Absorption System Is: LEFI NGRAVEL WIDTH Pl€L't_ Eie length diSYSansaicn is the lengtvh(I.s f0eh) of the t:rencb nt flrazn i [' depths of a tranch or pit is the distanal batwuen the s:_trtate of the grotnt-,: the bottom of the excavat;ion(in feet). There is no 3Qt width ftl' tren"hts;: The gravel depth is the minimum depth of gravel between the outfall We a the bottom of the excavation(in feet) R Qt7tRt<b acf i"I4 FfCiI31IAtG i NK SIZE Y GAi.l�M g � permit ap,pl,Lwant has the reeponaibilit_y to inform this departmQnt: during thI s installation _aAd_,Maww : � of Cagideacers that t'he =gel`!_ will Ueevs. a f ARe$ 8ack€illing of any system withChut final Inapecabon and approval by this ; aPW Wi_il be subject to proeenutich. Ninimum distance between a well and any to -mite afWa90 d POOat system is 19N OK, private weLl 9e. 15o to Zoo to*t Erom a public well Upending upon tart ! ,public wren .< mi-nitaftuWt: distance from a private well to a private aewar"U! i% 25 Leet; and to a Community sewer line is 7S teats. wall. Lags are re_-4ulck and mist returned to this d partzxs nt Within 30 days of the walL completi Other requirements may apply. SpeCiE?uai i.czrts and Construction 'diagrams aEl available to insure proper i<tlstallatiom. PERMIT EXPIRES DECHUR 1 certify that: (1) S ars ta,Liaz with the tequ revents Nc cn-site sewers and W"lla a set: tooth by the municipality of Anchorage. (2) L wsil tnztwalL LYSa system in accordance with codes. (3) is understand that the on-Oite sewac system may require enlargement. ttSe nce r del.ed to LnClUd. more : that 3 b rums. ignela _ __ Issued by; Date: Ar PE N I P413LI L. A ENGINEERING 2820 'C' Street, Suite 113 Anchorage, Alaska 99503 276-4855 April 10, 1981 Rick Ellis Chugiak, Alaska 99567 Re: Lot 3 Stockhausen Subdivision Section 3, TON, R1W, S.M. Soils Investigation Dear Mr. Ellis: As per your request, a soils investigation was performed on the above legally described lot for the pupose of determining the suitability for on-site sewage disposal. The subject lot 'as is' presently contains approximately 5 acres and is planned to be subdivided into two lots, one of which will be approximately 3 acres and the other 2* acres. The two acre lot will be on the east side surrounding the existing home and the three acres will be on the west side. The existing two acre parcel. has a well and septic system installed, which appears to be functioning adequately. Therefore, only one test hole was felt necessary in the area of the proposed new home location on the west end of the lot. The property slopes gradually from west to east and has been developed for present usage as barn and large horse arena. The top soil has been removed on the majority of the area of the proposed 3 acre lot exposing a continuous gravel underburden throughout the entire area. The test hole verified that the gravel extends to at least 13 feet with no ground water to that depth. The soil from 0 to 13 feet is classified in accordance with the Unified Soil. Classification as being well. graded Sandy Gravel (CW). Therefore, the septic system for this subdivision should be designed using an absorption area of 85 square feet per bedroom. When the system is installed, it would be advisable to provide at least 5 feet of cover over the absorption system or provide some additional insulative cover to deter frost. The system could be installed with the lower part of the drainfiel.d being below 9 feet if at the time of installation the lower level from 13-16 feet deep is explored and no ground water is encountered. In conclusion, it is my opinion that a septic system, if designed and installed correctly and maintained adequately by pumping the septic taxa: reg" Inrl.y, will rI:n r. l'i0it 8'erl ia-tri. For _.u a mnr_.. _.. __... Sincerely, �? PENINSULA ENGINEERING ,r 0 .., —FD � v, P� w � 20 TEST HOLE LOG PROJECT: c', /- z - 0 LOCATION: , 5L4-%' SOIL DESCRIPTION TEST HOLE #: CVEQ-i�-opbr-N 1411,; `3cGA/ -Ke IV? 0VEl) _ (-TrpiCA14 g "- /D" c)F O%G-AN/G 1v1 A— E�prq�� wI-r1-I Co -',BLEs T0 ��( C W) of Ak1-7 e°®, B. REMARKS: -� f f � / �-/ JA / � � c� C (�Ct_ CGC C't ON / ) '-�V.,I .BUJ V'E� � C'���%(/G. �C, �C1i% i.J�F�N iiL (( l dl✓/CPcy L0 0- (5 LiI.Q I 7 4, li-e /✓ f C) V \ -,ki ro�u P�l0nJ. LOGGED 6Y: PENINSULA ENGINEERING PROJECT 81' A-49 TYPICAL LOT DIAGRAM ONSITE WATER AND SEWAGE SYSTEMS KEY WELL SEPTIC TANK ( i nHu ya i li7ii II I i SEEPAGE PIT (F �-I �I FUTURE SEEPAC:E PIT U 100 FOOT MINIMUM WELL TO SEEPAGi PIT AND-100FEET TO SEPTIC TANK HOUSE `I'O ci;PT' AN c) z 3 X SIDE LENGTH OF SEEPAGE PIT GAABHD.I �� �`I GPIATER ANCHORAGE AREA BORO "'H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279.2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME Fl- e !d Sm/ rx/ IN. ABOVE TILE MAILING x2'5 - ADDRESS ' A �T PHONE , NEAREST ATlr Kl fn {ALF / ✓, / c OTHER IFCTAL DESCRIPTION Z-07-3 TANKSEPTIC ,TANKC ° SYS EME rCESSPOOL SEPTIC TANK: NUMBER OF F DISTANCE FROM WELL MATERIAL -� COMPARTMENTS LIQUID f LIQUID CAPACITY /coo GALLONS. INSIDE LENGTH � INSIDE. WIDTH � DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER T OR WIDTH , LENGTH—, DEPTH LINING MATERIAL (204)°GX,CJX . DISTANCE FROM WELL ," BUILDING FOUNDATION , -`- NEAREST LOT. LINE TOTAL EFFECTIVE ABSORPTION. AREA (WALL AREA) SQ, FT. TILE DRAIN FIELD TOTAL LENGTH DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE , OF LINES , NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH. IN. TOTAL EFFECTIVE ABSORPTION AREA FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE. - IN. ABOVE TILE WELL' (��r.�" TYP, DEPTH E , DISTANCE FROM , ` WATER BUILDING FOUNDATION. -50 - SAMPE , NEAREST / ✓, / c OTHER NE LOT LINE , SEWERSUNE—, TANKSEPTIC ,TANKC ° SYS EME rCESSPOOL , SOURCES— DIAGRAM OF SYSTEM - DISTANCES: f A -B So C- 10 DATE g U-6'? – Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 n 4E BG/ y�P TO y 2 5A ETT CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. C)51- 01:3-g5 HAA# du i)`! Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 3A, Stockhausen Location (site address or directions) 23606 Dolly Avenue ftmal{ A1( 13ka 99567 Current Property owner(s) Rodney Hoover Day phone 688-2370 Mailing address'; Lending agency plat-Sn T r i P Co Day phone Mailing address 951 E Bogard—&d - Wasi t l a', Ak _ 9gA54 Real Estate Agent Mailing Address Harvey Prickett, Sr. Dayphone" 244-5212 Unless otherwise requested, HAA will be held by DSD for pickup. y� �, L,^� y/z /p y 2. NUMBER OF BEDROOMS:_ 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 13 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Individual On-site ❑ 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 5. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S Engineering Phone 694-2979 Address 17034 Eagle River Tp Rd Ragle River Ak. 99577 Engineer's Printed Name Robert G Cowan Date a6/oy —r Additional Comments This Health Authority Approval is only for the water well located near the northwest property boundary andservicesthe two bedroom single-family dwelling. This Health Authority Approval IS NOT for the Class C water well located near the eastern property boundary or the community sewer system near the southwestern property boundary. Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By:�LQ �ctQ� Original Certificate Date: (Rev. 01/02) iv Devi .age e i P u xr 3. x m mss , 4 Y . J/4 Parcel ID: 5 s�;�� �• ..:� • ,. •p i�"'14��rKV.i,1k "a'.o-V'au If 0 R nr f` est t$ G tib �i " Zl Ca �F Na er levet "t: ...7 o "uc ion 9 -P.M. • - L r z ^sat 7w? 'MPS $ ?sv �.+k v x u i colonies/100 m! Nitrate 9 mg:/I Other bacteria 0 colonies/100 ml Collectedby- C gk 6s, ,7777;7357"'- C N . S C.L. '�u'ri„ ape a ena .._� a e,insta e fW 'e "gal. Number ofOompaifinents ' _ pouts (Y/N) t on c eano t ( �` ,pression over tank YIN hli "h viater a"1arm """ "` " ""'""� ° mg Pumper... -��.« � e•mrva��' ros's. nv,- Ci a ,§, x .� `�uttt em�a _ Ta e outing (g }sdJ or ft /bdrm) System type GfuAc=w.M, i ow p1pe ` ft p _'i y a sorp ion area ` Mo ' be _ Depression over field _ a equacy tes ufts (Pass/Fail) For— bedrooms p m a s`orp ion i ore test in: Wafer added gal. New depth_ in' im =min. Final `ffutd depth_ _ in. `Absorption rate' >_ g.p.d. venation treatment (past 12 mo.) (Y/N & type) If ves. ive data, �II 'Pump off level _' High water alarm level at in. Cycles tested Meets alarm & circuit requirements? On adjacent lots On adjacent lots /moo tank N//s coy rlvu 'r`/ YCAYlc S s that the abov_e,systems are in 4A guidelines in effect on this date. 'P y ti aoeeRt t''; cowaty �`«� dcdQGR: C. Cdw�9.� Waiver Fee $ �'bL} Date of Payment 5 q,t �) Receipt Number "k: ulltat'vice line Surface water lots TANCE FROM 4 'SOR'PTION, ELD ON LOT TO Building foundation r mam ace water Driveway, parking/vehicle storage Wells on adjacent lots s that the abov_e,systems are in 4A guidelines in effect on this date. 'P y ti aoeeRt t''; cowaty �`«� dcdQGR: C. Cdw�9.� Waiver Fee $ �'bL} Date of Payment 5 q,t �) Receipt Number S. U. A. 01 V. OF WATER FAX NO. 0075621384 P.04 163T., \�'� Vx 1.7 P,1! Certified Well . . . . . . P14NJ4r'+ owkqe'f; Alvin IzNver3 yd Sm 1.1, .................... .......... - �6' 1),*k(C completed .... J.0 me ... I T I 9 ......... hT ............... ............ 1— .................... Depth of WC11_8.7 ... jF.e .................... . . I'll ............. ...... I ...... .......... Size of cafing...6 .. j, n r, h .... . ............ .... .. . .......... _ ..................... ....................... Distance to water... ............. ................... ...................................... Distance to water whilepumping ...... P-e'e.t ........ le ............. ........ at rate of . .47.Q...............................gallons per hour. A M. Description of Formation from to a P'Y r —70 ir I certify the above trUC and correct. . .. . ............................ Driller -� SIYIJ�6(9 ing you to attach IN We advise An W. . tljis. ceartul &a:ttC91903Y00U1r deed. TONYKNOWLES, GOVERNOR ' . ,ta ,DEPT.,OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH r DRINKING WATER and WASTEWATER PROGRAM. 555 CORDOVA STREET Telephone: (907) 269-7519 ANCHORAGE, AK 99501'',,1,54`' ;�� Fax: (907) 269-7650 http://www.state.ak.us/dee/home/htm August 31, 1998 Mr. Robert Cowan, P.E. S & S Engineering 17034 North Eagle River Loop, Suite 204 Eagle River, Alaska 99577 Re: Lot 3A, Stockhausen S/D ADEC # 9821 -WW -353-136 Dear Mr. Cowan: Your letter of request to cancel our Approval to Construct for Lot 3A, Stockhausen S/D In Eagle River due to your clients change of plans has been received. Your Letter reads as Follows: "The modification to both class `C' water system and the wastewater, system is no longer planned and construction of the proposed two bedroom house has been canceled." "''` A file review shows your December 15, 1997 letter requested the approval of the construction that had taken place for the existing lot's wastewater system and requested modifications to allow for the proposed two bedroom house addition. On June 21, 1995 a deep trench system and new septic tank of 2500 gallons had been authorized to be installed (ADEC # 9521 -WW - 157 -334). Your attachments include as-builts which indicate the system approved on June 21, 1995 was installed by July 13, 1995 but as-builts were not turned in timely per terms of this approval within 90 days of completion or October 11, 1995. Attached you will find the wastewater Approval to Operate form authorizing the design installed on July 13, 1998 to be operated per your December 15, 1997 submittal and request without modification. The Drinking Water Class "C" system was approved to operate on May 10, 1995 and a copy of this certification is also attached. Respectfully, WRR/cf William R. Rieth, P.E. Environmental Engineer. J STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL- CONSERVATION! CONSTRUCTION AND OPERATION CERTIFICATE FOR DOMESTIC WASTEWATER DISPOSAL SYSTEMS 41 J - pF— 351 NG APEC # 3821- W W -- 353- l 36 vJ JWE TEI A. APPROVAL TO CONSTRUCT Plans for the construction or modification of located in - A t� c Q okAby S Ch�� ` VALE S T6CKHA USEN S D domestic wastewater disposal system Alaska, submitted in accordance with 18 AAC 72.210 have been reviewed and are approved. [� conditionally approved (see attached conditions). a�,./ BY IITLB DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Date change (contract order number or descriptive reference) Approved by M I ♦ 'moi �.- �. �L. i C. APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before this system is made available for use. The construction of the 2,S� t/ ny `f T�/F ome is wastewater disposal system was completed on 441,1511- (date). The system is hereby granted interim approval to operate for 90 days following the completion date. rm n DATE As-built/record drawings, submitted to the Department, or an inspection by the Department, has confirmed that the domestic wastewater disposal system was constructed in substantial conformance with the approved plans. The system is hereby granted final approval to operate. BY =E DATE (Rev 4/97) Distribution: 1. White -Engineer (Complete Section C) 2. Yellow -System File (Complete Section C) 3. Pink -Engineer Muni/Borough (Complete Section 4. Goldenrod-Muni/Borough (Complete Section C) STATE OF ALASKA g �+ DEPARTMENT OF ENVIRONMENTAL CONSERVATIONh� CONSTRUCTION AND OPERATION CERTIFICATE ALwfMr for PUBLIC WATER SYSTEMS '.r A. APPROVAL TO CONSTRUCT Plans for the construction or modification of L of 3 9 , S -kac./ CVs er C kwel la4Z GhSS C wLvF r%4 V �IE-1 f—A/� S6publlc water system located O O o in r�� Alaska, submitted in accordance with 18 AAC 80.100 been reviewed and are r� approved. ❑ conditionally approved (see attached conditions).. .2 C .¢yG 4PS -° TITLE DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contrwt order no. w dewripti" refotonoy Approved by Date C. APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water Is made available to the public. �n The construction of the -A,40 Ci.us public water system was completed +iif ,d:04JU0, W%A a+jstM. `ne.0/.i!±arr (date). The system is hereby granted Interim approval to operate for 90 days following the completion date. DATE As -built plans submitted during the Interim approval period, or an inspection by the Department, has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. 00 023 By r TITLE DATE DISTRIBUTION: 1. WHITE • ENGINEER (Com Wto SWUM C) Z YELLOW • WATER SYSTEM FILE (Oompbtb saim CI --.--. ._ n. PINK.. ENGINFEnnr, W-BOR000H 10CMD14to SkNi C) �h 'ver '41-51 0 9 X00 v I HEREBY CERTIFY -THAT I HAVE SURVEYED THE SCALE, FOLLOWING DESCRIBED PROPERTY /' yo pF A( srac�.fi9lL�EySUB GoT�.9 DATE- AND ATE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS G INDICATED.....IT IS THE RESPONSIBILITY OF THE * 4, TH "S° OWNER TO DETERMINE THE EXISTENCE OF ANY GRID., '/~ • EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI-Duan • e Mark Seward VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB` `9 . LS -69186 ANY DATA HEREON BE USED FOR CONSTRUCTION ����� ��� 2�''•.,,,,,,. ''��° OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. Owls a.; S EUU: ..', .ELL , -r2 5 7' H OLS O C 4 -T -IO IV -PROTec,%of-&-o u LOG�j.` IN C SE'/;SE3, i i NOTE= -.._� LQ -(- 5 1 THFLO UGN 12 A1`iD l_OT try SHO V'J OtV C'F-iIS P1_Ai CONFORM To ORIC',INraL lv1ETES ri F3 c`UNllS DES CTL IPT IONSply PT ACFLEAC�ES SI-Io��N AR TO EDGE OF GLErvry H EXCEVo-D r OF v�AY 1cvSr E -AI) OF OLDDIC AT ED 1-5-Y Do uT UALCO LIrvE. LOTS I! t}. I`) AHE ADJUSTED BYP,D IV S1Orinkty-F OtivNE- fjS-OTI�LFi i_oTS A11E- 30 NEW SU�. a _OT CCFLNE LS AR' X3 30 �iAF�ES 4 E C O R D 5 8 9 g 7-1 0 W 6 fn 1. O• -7' r. 5 5 -)1 • b 1& a. 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