HomeMy WebLinkAboutSUMMIT ESTATES BLK 4 LT 2Summil'
states
,I oc.k 4
Lot 2
:015-071-02
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
109
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
MA UNG _. _
ADDRESS ,B'"'~%. ,e~J"/~ ..~ PHoNE-~.~.-~-.-R'
LEGAL DESCRIPTION ./'~/~"'"?-
DISTANCE FROM WELL
LIQUID CAPACITY
GALLONS.
NUMBER OF /
MATERIAL ~_ ~:::)/~/~-7~____.~'~.~:-' COMPARTMENTS
~-"~"~ ,~J~/'~"~'/~ ~"~"~'~ LIQUID
INSIDE LENGTH ~ INSIDE WIDTH ~ DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER
LINING MATERIAl
NEAREST LOT LINE
~ OR WIDTH /"'~'"'/ LENGTH /'-~" ~
, , DEPTH
DISTANCE FROM WELI~~?/'~-,~'~?--~?~')~. /~..'~ /
· _ , BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WAtt AREA)
SQ. FT.
TILE DRAIN FIELD: //J/'/'~ (~/'~-~0''~'-~'''~ ~'~ ~/'~
DISTANCE FROM WELL ~NDATIO~ , NEAREST LOT LINE - ~AL LENGT/ OFfS H ,
WELL: ( ~/'~" gig'?"l'JJ~"l/-") / WATER ///~
TY P E .~'.K2//./--.~ DEPTH Z~// DISTANCE FROM
~ ,BUILDING FOUNDATION, ~ SAMPLE , NEAREST
, , , ~ , CESSPOOL , SOURCES~
DISTANCES:
DIAGRAM OF SYSTEM ..s'~, ,~/-~/~'4~',~' .4.,,o~-
HEA[IH AUIHORIIY --
Certified Well
~or..~ ...... .~...O..~.,'.~..,e~.~ ..... .~.:.a....~..e..~ .....................................................
Location/-. ~- ~ 4' ~'/,{M~fl7' £$~ ,,-,, /=-,~-- ,,~4/,r,~':'~' ,/5:~,,~, .-,
.................................................................... t..~.... L*'....; ................... ;..95......%J...': ~
Date completed ...... "- ./;...".~..--].!.-'~..:~ ."'~:'~ ~L../....':(..'.~..~;:....l ........................................
Depth o[ well ........... ..~...~.~;t., ...... .,.-."~/=g:.,=~.Z--T-~ ..... i ............. L.~. .............. ~.::: .............. ! ·
Size of casi,g..__~.....,.'~'..e.~ ........ '...L,.=.<.;-:.-..;.S:~..,.--..;~ ........ .~iZ.i.;.r~:~i' ~'
Distance to water ....... ~.../'../...Q.:.....,..--_~..~./..-Z.. ..................................................... : ...... ..
Distance to water while pumping .......· ..O~_.,,5:.-_~..--7..~.5'~.2Z. ......................... at rate
of. ........ ..z../.aS.'~X~ ................... gallons per hour.
.'. I'ce;tify the above true and coi'rect. .
..... ~:..c. ......... ~: '(:4..~..~__. ~
\ Driller ................
DOTTEN DRILLING.' CO.
John's Road
SPENARD,.ALASKA
We advise you to attach this certificate to your deed.
GREATE"",, ANCHORAGE AREA("~OROUGH~ ~c~ No.
HEALTH DEPARTMENT ~"', :
. ;p}~27 Eagle St. Anchorage, Alaska 99501 279-25t~~//
SEWAGE DisPOSAL SYSTEM - APPLICATIO'N & PERMIT
NAME OF APPLICANT"~O ~¢~'
LOT ~
,, SEEPAGE PIT,
RESIDENCE ADDRESS
, LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH "~)~
PERCOLATION TEST RESULTS
LOCATION OF INSTALLATION
, DRAIN FIELD , OTHER
TO BE INSTALLED BY
-D
ANTICIPATED~DATE OF COMPLETION
BELOW TO BE FIL'LEDOUT::BYLHEALTH DEPARTMENT
THIS IS TO SERVE AS
AS DESCRIBED BELOW. SIZ
· SEPTIC TANK SIZE
~o
DISTANCES:
,PERMIT TO INSTALL A
OF UNIT TO BE SERVED ,,
:SEEPAGE AREA
DIAGRAM OF SYSTEM
TYPE
EALTH AUTHORITY
OR
DESIGNER
I certify that I am familiar with the requirements of Greater Anchor~_ge Area Bor..ough Ordir, ance No. 28-68 and tha~ the
above described system is in accordance with said code.
DATE /3 7D APPLICANTS SIGNATURE
/~ATER ANCHORAGE ARE~BORdUGH~?.
~ '~ 3~7 EAG~ STREET .... ~ ~;~{" ¢~ ......
' ANC~RAGE, ALA.,KA 99501:t' 7,.. ~ . "'/'.
, - .... DO" ' ""~ D '
Pe~fommed 'FOr Robert Banks z:ou'c~ate"Perf°rmed 9fl~O
~gal ~scription: Lo't 2 Block 4 S~d~ asmon"~:'::j~it Estates ......
This Form Reports a: S~LoK xx ~ 'Percolax~'oB"~esI. ·
~pxh ·
Feet Soil. Chara~:eris~ics Locatibn Sketch
... ; .J J
2'"- brown silty Sand (SM)
.gray. fine sand (SP)
gray gravelly .sand (SW)
8
. gray. pan4y_grayel .}~
i'
' ' ~ I 13. ?,~:'~ T.~m,: '_l :,et T'-'r:,e Depth To H20 :~et :'mop
" i .... ----- ' .....
'vwr..,~'1 u~ ~,',+'~' ' '' ..... ',, ,
~~q~qT-. )~?x-. e
}'rc.r.?~ed ln'~talla..i,:n: Seepaze Pit 11.0' Drain Field
DeptL 7f Inlet Depth To Bottom Of Pft Or Tmench
COMMENTS:
. 105 6auare feet ,of d~ai~a~e area is '~eq~ire~ ~.,bed~oom ' '
Test ~Perfo~d By: R. E. Carlisle. ~ese reco~endations are '~om~ted from
visual observar ion and based on the uni-
fied classification system.
~a Certified By: National Test%ng .Services Inc.
DaTe:
•
• R�GE i �Gi
.A1C- Municipality of Anchorage °
On-Site Water and Wastewater Program 'j >�.
(907) 343-7904 SA CT,'
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 015-071-02 Expiration Date: l- H f
1. GENERAL INFORMATION
Complete legal description SUMMIT ESTATES BLOCK 4, LOT 2
Location (site address) 5420 E 99TH AVENUE,ANCHORAGE, AK 99507
Current Property owner(s) THOMAS J. WAGONER Day phone
Mailing address PO BOX 721 DELTA JUNCTION, AK 99737
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
Duplex
[ I Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual El
Individual Well Z Holding Tank
Individual Water Storage H Community n
Community Class Well ❑ Public Sewer n
Public Water System ❑
WaiverNariance request for: Distance:
Received by: •
Date: ___741/2:5__
COSA to be released-feriFie = • eer,unless otherwise requested by the engineer.
COSA Fee $ 5V, Waiver Fee $
Date of Payment Co 11-1rg Date of Payment
Receipt Number 0000D Receipt Number
COSA# C}` gl dL Waiver#
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 Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ARCTERRA CONSULTING,INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 6/6/2018
THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested.
The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use,
local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the
system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function
satisfactory for current or future occupants or can ArcTerra guarantee that no unseen
encroachments,deficiencies or discrepancies exist. OF A�
ks).
,k49TII* * )
6. DSD SIGNATURE
System #1 Approved for bedrooms. KENNET . • y/r, /
System #2 Approved for bedrooms. <r>, is fv/
Disapproved. \ '� :S1O'0' Ay
Conditional approval for bedrooms, with the following stipulations:
nF ANC,U
\
\NPS -
F P�
PRIG , c
•c 4
/ •/n�)Ar_N IT c'e7
(r /
Original Certificate Date: C) ^ 1
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory r•-• ,
Septic System Advisory , Arsenic Advispry,.;..^1;.
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of_
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: SUMMIT ESTATES BLOCK 4, LOT 2 Parcel ID: 015.071.02
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID#_ Well Log (Y/N) Y
Date completed 6/18/1970 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y
Total depth 60 ft. Cased to 60 ft. Casing height(above ground) 12 in.
FROM WELL LOG AT INSPECTION
Date of test 6/18/1970 5-19.2017
Static water level 46 ft. 48 ft.
Well production 8 g.p.m. 5 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 8.06 mg/L
Arsenic: ND ug/L Date of sample: 5/24/18 Collected by: ARCTERRA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/CONCRETE Date installed 1970
Tank size 1250 gal. Number of Compartments 1 Cleanouts (Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N
Q
Date of pumping "-1 -1 O Pumper N
C. ABSORPTION FIELD DATA
Date installed 1970 Soil rating (g.p.d./ft2 or ft2/bdrm) 105 System type CRIB
Length 15 ft. Width 15 ft. Gravel below pipe 9 ft.
Total depth 12.9 ft. (Measured 5/19/17) Eff. absorption area 540 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 5/19/2017 Results(Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 39 in. Water added 620 gal. New depth 75 in.
Elapsed Time: 1440 min. Final fluid depth 34 in. Absorption rate >= 600 g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons _ Manhole/Access(Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 95'+ On adjacent lots 89'-1998 WAIVER
Absorption field on lot 100'+ On adjacent lots 97'-1998 WAIVER
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+
Animal containment areas 504 Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in conformance 40:`_.111k
with MOA COSA guidelines in effect on this date. OFA
Engineer's Printed Name KENNETH M.DUFFUS 1"
Date 6/612018 1 * q-
-411 LI II Mril
COSA canary sheet_2-6-15.doc KEM.�-
% KENNETH T : S
716 Gw
, `UG e 4,4)AI
Ni,` OPDSS10lAN Air
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT ( a �"2
I', �ti 907-343-7904
On Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite ��
Nitrate Advisory'
Certificate of On-Site Systems Approval # OSC181257
Subdivision: Summit Estates , Block: 4, Lot: 2
A water sample revealed a nitrate concentration of 8.06 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen,which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
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
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
- FOR A SINGLE FAMILY DWELLING
Parcel I.D. O IS- O '7 1 -' O,~
GENERAL'INFORMATION
Complete legal description
HAA# O/-/' 0
Expiration Date~ (:~
Location (site address or directions) ~ ~ 2. (2 ~ ~ ~ ~ ..
Current.Properly owner(s) ~~ ~]~ Day phone
Mailing address ~ ~ ~o ~ ~.~ ~ ~
~ qb-,z~-v I.
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Day phone
I.~ ,-~-, ! c~,.,,; ~,.. V~'~, ~,~. Day phone
Un/ess otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: L~
e
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
'TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site I--i
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 propedies served by a private or Class C well and may"be reissued with
new water sample results. (Cedificates 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.
e
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 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.
NameofFirm '-~"'~/P~-~ ~r~,,,-~/.,~-~ ?./.~. Phone ~7~&~l~
Address ~ ~ I b-~ ~ ~
Engineer's Printed Name."
· DSD SIGNATURE
~ Approved for
Disapproved.
· bedrooms.
Conditional approval for
bedrooms, with the following stipulations:
V-Zo-o y
Additional Comments
Note: The well for this property, meets existing State and Municipal Codes. There arc nitrates
present. It is suggested that periodic testing be performed to insure the wells continued sUitability.
Current nitrate concentration is 5.42 rog/1. EPA maximum concentration is 10.0 mg/l. More
information on nitrates is available from the On-Site Services Program, at 343-7904.
By:
Attachments: ..
HAA Checklist
· Septic System Advisory
Well Fiow Advisory .
X
Maintenance Agreements
· Supplemental Engineer's Report
Other
Original CertifiCate Date:.
(Rev. 01/02)
Legal DesC, rip, tion:
A;I WELL DATA
Well type '~ '
'Date compleied
Total depth ~ft.
Bi
Municipality of Anchorage
Development Serv!¢es,DePartment
! ' . Building ~afety DiviSion:
On-Site water & wastewater Program
4700 South Bragaw St.
P,O. Box '196650 Anchorage, AK. 99519-6650
' wwW.'Ci.anchsrage.ak.'us' !i '
(g07) 343-7904
HEALTH AUTHORITY APPROVAL 'CHECKLIST
If ~, B, or C provide PWSID #
Sanitary Seal (Y/N) ~
Cased to' ~, 0 ft.
FROM WELL LOG
Date of test
Static water level
Well production
WATER sAMPLE RESULTS:
Coliform ~colonieSll00 mi.~
Arsenic: mgr.
SEPTIC/HOLDING TANK DATA
Well Log (Y/N)"- ~ ';'-
Wires properly' protected i(¥/N) : .y
Casing height (abovO ground) ~ i 7_...: i'
· AT INSPECTION
..'
¥¢/
g.p.m. ~
Nitrate ~.q2. mg./l.
Date of' sample: q/~ ¢ V
ft.
g.p.m.
i
Othe~' bacteria
Collected by:
!'~ J.)~ colomes/100 mi.
· i '
Tank Type/Mater. iai. ~,~¢.f/1', !.i ~"[~ ~..¢_../.~--
'Tank size J~..,.5-O gal. Number of Compartments
Foundation cleanout (Y/N) .,..~: Depression over tan, k ~/N)
Date of pumping ~/~. ;//¢, t~! Pumper A ~
C..ABSORPTION FIELD DATA
Date installed * i:i i[¢ 70
Cleanouts (Y/N) .,i ~,.//~!i,, :'
i
High water alarm (Y/N) '.~, '1..~/
Date installed J.~ "/O
Length : ! ~ ft.
Total depth-I I ft. Eft. ab~so~tion area ~ ~l/Ofl~ Monitoring tube. ~
Oate of adequacy test I¢/~'Z~/D:~/ Results(Pass/Fail) -~
Fluid depth in'absorption field before test ~ ~ in. Water added ~'~gal.
Elapsed Time: ~ ~ min. Final fluid depth~i in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (YIN & type) ! ~ ~
Soil rating (g.p.d./ft~ or ft=/bdrm) 1D ~' System type'i ~ i~_.~
Width ! ~ ft. Gravel below pipe
Depression over field
Fc~r. q bed;o~o~s
New dePth'~ b i in.
!~" ~ g,P.d.
If yes, .give 'date ~/' :
LIFT STATION ~ ·
Date install(~d t,/ Sizein gall0ns~ ',. :' .2/.,: ' Manho!e[~ccess /N); ·
"Pumpon"level~t ,,,d'n. ,Pumpoff"!evelat:;,,/~ in. !: , H~ghwa!e,r~a!arm.,,~v~lat~ --. m...
/
Datum . ~ · Cvclesteste ' : ... ~' , Meets alarm &,,Circuit requlrements? ., ,: ~ . '.
SEPARATION DIS,TANCES FROM WELL ON LOT TO: : ' · "~ 'i:
.... ' [ ?' ' · ' ' ' ' t lots
Septic tank/hft stat on on lot. (~;~,~ . · .. ..... On adjacen '/ . .
Absorption field on lot ~) ~ . , On adjacent lots t 1, '1 -,/ ~ v[,,q~,~ u,,,,~., , ·
Public sewer, m~in i~ "'/.z30 ! i : Public sewer manholelcleanou[ ~ i'
Sewer/septic service line ~(~)'.. ~ . . Holding.tank
SEPARATIO, N DISTANCES FRoM SEPTIC/HbLDING T .A~. ~K ON,LOT T0i; .
Building fouSdation 1 ,'1 , 'Absorption
Water main ~'~/~, Water se~ice line
Wells on adjacent lots
SEPA~TION DIST~CE FROM ABSORPTION FIELD,ON ~LOT'To:
~:, Water ma~n
Properly lin ~ ,t O Building foundation ~ i
Water Se~ice line ~ ~ O ~ Sudace water
· · ,,~ I Wells on adjacen116tsi'
Curtain dra~n '
COMMENTS ~ i
ENGINEER'S CERTIFICATION ' '
! certify that I have determined through field inspections and
rewew of Municipal records that the above systems are ~n : I
Engineer's Printed Name ~ IO~H
Date Ap~ ~/
' I '~ I I - ! :
field
Surface water
Drive~ayI parking/vehicle
storage
HAAFee S I ["![
Date of Paymelt I: ' [ I~ 'M I''~ )'~ ~ ~. ~'~
ReceiptNumberl i:: ~l 5:'57
(Rev. '12/0'1) ~,'~
Waiver Fee $
Date of Payment
Receipt Number
05/06/2004 14:52 9078688071 D D/~E PAGE: 01
Lot ,5
t"'" I I t, A I,, A I --I--
".. I I i\/I I\/I I I
"-.,~ %.,/ I I I I I I
I'"-- f" .--I-- A --I-- I'--- t"', , · ,
F-- -. ~ / ~ ~ F-- -. LOT I
', ',-2.,
N ~9°59'00" E ~0.0~' {RI
,~ - -;,; ;~ · ~ ,v,
Ix "Champ. Link Fence
~ ~ a?.o I,, Septic Tank
ro I ~, _
r~ . 4 ~,4 (:;on,-. Pad
Two
~IU STORY II iI!N~, I
t_ '~i~-j~' FRANE li.liF'~ I
~ I , !
I-~i Ii il;_~ .. .
~ II
~WELL I !12 ¢ D~ive
i:30.04' (R) S 89°59'00" W
Lo~ 3
SCALE: I" -- 25'
AS-BUILT
OF LOT 2, BLOCK 4,
SUMMIT_ EST~ATES .. SUBDIVISION
I HEREBY CERTIFY THAT A SURVEY OF
THE ABOVE DESCRIBED PARCEL WAS
MADE ON dULY 24, 1998 ANO THAT THE
PERMANENT IMPROVEMENTS SITUATED
THEREON ARE WITHIN THE PROPERTY LINES
ANO DO NOT OVF.-.RLAP OR ENCROACH ON
ANY ADJOINING PARCELS, NOR DO ANY
PERMANENT IMPROVEMENTS ON ANY
ADJOINING PARCELS ENCROACH oN THE
PARCEL IN OUESTION, AND THAT THERE
ARE NO ROADWAYS OR OTHER VISIBLE
EASEMENTS ON SAID PARCEL. ALL EXCEPT
AS SHOWN HEREON. ANCHORAGE, ALASKA,
3'14[~ eaTH DAY OF AUGU~'r~ 1998. ,
::;, ~'"" i~'"'z' ~'~
· :,: ..;'. ¢..:..'~..
4.'.. ,;~.~; .. ~:.
b
\ ent
Fd. ~§
Rebut
Clicc! .Name
Froj~c;
Clicr. t S~mplc ID
.Xlatxix
] 0~12014001
Tobben Spurtdand P.E.
Lot 2, Bk 4, Surami! Estate
Lot 2, Bk 4, Summit Estate
Drinking Water
;gO7
All Dates/Times are Alaska Standard Time
PHcted Date/Time 04/29[2004 14:28
Collected Datefrjme 04/22/2004 l $:00
Received DatrdTimc 04/22/2004 15:13
Teehnkal Director ~. Stephl~fC. Erie
.
I
Allowable Prc~ Anab'sls
Results PQL Units Methcxl Containc~ ID Ltmtt.~ Date Dar'. ]nit
Watar$ Dupartment
Ni~te-'N
$.42 0.100 mg~ EPA 300.0 B (<=10) 04.r23/On JIB
~L%c=obio!og"~ Laboratoz~
0 col/100m.L SMI89222B A (<=1) 04/22/04 DKC
Municipality of. Anchorage
Deyelopment 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 '
Parcel I.D.
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMIEY DWELL~ING
GENERAL INFORMATION
compie, te leg.al descriptioa
Location (site 'addrbss or directions)
· Expiration Date:
Current Properly owner(s)
Mailing address
Lending agency
Day phone
, :Mailing address
Real Estate Agent
Mailing Address
Un/ess otherwise requested, HAA wi/I be he/d by DSD for pickup.
NUMBER OF BEDROOMS: L/ ,,.
Day phone
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
[~ Individual On-site
[--I Individual Holding tank
I-] Community On-site
F-I Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Ce~'tificates 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) for properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Cedi[icates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private cr Class C well and may be reissued with
new water sample results less than 30 days old. (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 INSPi!iCTION BY : ~'" ~" :
ENGINEER ' '
-,, . ~ . ~ .- t, ;'o ~'..; !~,. ..,,''..i~tJ.~' ~';'-'~"' ' ' ' " ' ' .
iAS ~:e~ified by my seal affixed hereto and as'of the'validation date shown below, I vedfy that my jn,~e~ti~ati0n,
iba~d ~o~'procedures outlined in thO':Health AuthbrityrAPproval Guidelines for'this application,. sh0"wS that tlie
on-site Water supply and/or wastewater dispb'Sal system is(are) saf~,"functional and adequate fOr the' nLimber of
"bedrooms and type of structure indicateid hemki'? I fui:the~:,verify that based, on t. he informatior~ obtained from'the
Municipality of Anchorage files and from' my inve~itigation and inspectiois, the on-site water supply and/or
wastewater disposal system is(are) in complianiiii ivith all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm (o~,,- . ~u' , .........
Address-~ .'
Engineer's Printed Name "~ ~-~'~
DSD SIGNATURE -.
Approved for
Disapproved.
Conditional approval for.
· bedrooms'.
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
· ' Septic System Advisory
' ' Well Flow Advisory'
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
7-/..2.-o
(Re'.,. 12/C0)
DeVelopment serVices* Departmenti
~, ~ , : BUilding safetY DiviSion i
On-Site Water & wastewater Program
,,~ ,. 4700 South Bragaw St. ~
. iP~O.;Box 196650 Anchorage, AK 99519-6650
'. ';! i. , , www.ci.anch0rage.ak.us .
i';~ i HEALTH AUTHORITY APPROVAL CHECKlZlST:
.... t. , l .., .. ~ tCe,'(,-,,,-;'¢,~ I r~ ' ' ~ ~ .... ~ ' Parcel ID'
WELL DATA ........ ' ~: ', ·
wel'~t~p; ~g~ : 'l'f A2 B,:°r C provide PWSID ~- -.,, : ~ ~ ~1 ~ ~ (~/N)
Date;~Co~leted't~lO'; :':,:,,. sa'nita* ~eal ~'(Y/N) ~, '~. :..; ~Wiras'p?l erl~ ~rot~ted (YIN) __
TntRl'de~th ~ fl :' :'~ i ;Cased to '~ O fl. ? ::. ~ ' ~ ~ Casing he ght (above ground) I~ in.
' ]' ~ ; :~. " FROM WELL LOG ., : ,,, ;: . :',, .;. ATINSP~CTIQN -,
Dat~c test'' '"' .... ' " ' :
..'. I~.h !:h :..: : ; ; ',, , X,~'r: ~.:'<-:~,- . -,; ;lO, b',;.: gpm ....
:~'.;:'..:WATERSAMPLERESULTS:"i :.' .,?f'.,'..- :':~:.,:.;...-' ,:, .;~J'i; ~ ;:,'; ,. '
' I ,,,'¢ .:' . ~ , I ' , ~i ; ,' .' ; ; ' , . I~ , i ,..' ;.
SEPTIC/HOLDING TANK DATA ....... .
..... t ' .. ' .... ,I. . ' .... ,: Dat~ instal ed , [
Tank~ype/Matenal' ~ -~ ¢ ~ : '.;.' '.:' .:, ..; .... ' ..... -
Tanksiz~ I~'~D gal.': '.;:~ Number of Compa~ents , 1 .;~, ;.Clean?uts(~/N) , ~ ..
Fbu~dati~n clean°ut (Y/N):;%/': DepresS.on over.tank (WN)~ ~ '.,. H,gb ~at~r ~la(m
Dare'of pumping ~L~i'~ ~ : Pumper' ,~ ~ !."~', ~ I "' ' ' ' - ' ' ·
C. ABSORPTION FIELD DATA : ~: ~ ' .... ' ~' ¢:;;' ~ ,. ~'; e :' ~ ; ~ '
n*teinstale~: [R~O ~' Soilratino food/ff2or.fl%drm),/O~ .. ', ..System~pe
/,nnth [ ' 7 ~' ' , .... ~dth' / ........ ft . Gravel below p pe ~ .
.... i ....... , ......... I , , ,
':. TRt~'d,~iK I I 'ft':' ;' Eff!!ab~orotion'ama .~ofl~ ~':Monitoring tube !'.~ ,~ Depression overfield
Date of adequacy test ,, b/~/¢l .; ;; :.: Resqlts (P~ss/Fa.l).'~'~, I ' i .: For ¢ bedrooms
Fuidde~thin:absorptionfieldbeforetest~ln. · !Wa~eraCded~ga!. ;-.:- Newdepth~l..n.
Elansed.T~me' ~ mn':, ,:" Fmalflmddepth,51~'m.,:., ',: AbsorRhonr~te,>- g.p.d.
Any rejuvenabon treatment (past 12 mo.) ~/N & ~pe) ~ '- ,~ ........ I ,If,yes. g~ve date..
Ee
lons
y...,Pump off,, level at "in;
,// ' Cycles tested
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL'ON LOT TO:
Septic tank/lift station on lot ~ ~ --.,., ~:.c ,:.-iOn adjacent lots __
Absorption field on lot 10o :~ On adjacent lots
LIFT STATION
Date' installed
"Pump on" level at
Datum
High wate.,~d~ lc:el at:.
Meet~m & circuitlr'equirem~nts?
in.
Public ~ewer main : · .. Public sewer, manhole/cleanout
Sewer/septiC serVice line ~ ~, t: Holding tank, 'N/A' ..,
SEPARATION DISTANCES FROM SEPTIC/HOLDING ,TANK ON LOT TO:
Building foundation I ~{ Property line ~' f' Absorption field
Water main ;:t-,l/~ : Water service line ~' ~ Surface water
Wells on .adjacent lots "_'~ ! b'~5:~ . .
· SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line J C)
Water Service lin'e ' ~ 6 O
Curtain drain' ' t'J'~o -
Building foundation
Surface water ' I',1, Io
Wells on adjacent lots. ~' :1 ~::~'
COMMENTS
G. . ENGINEER'S.CERTIFICATION
Water main
I Ce~ify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HA~ gu~de!ines in effect On this date.
Engineer's..Printed Name 'To ~1~ ~ ~1 ~ ~,u ~' ~[~- ~ ~
Date /_.¢,'-~/--~- '-'O I :' ':" , -
Driveway, parkingNehicle storage [ 13
HAA Fee $
Date of Payment
Receipt Number
(Rev, 1~00)
Waiver Fee $
Date of Payment
Receipt Number
J~-~8-l)l {~§:2§ FROM--CT&E ENVIR~tITAL SRV
,~t~ CT&E Envlronmentnl Services Inc.
g6~§61§~01
T-38~ P.02/~6 F-416
CT&£ R~f.# 1013501001
Client Name ToBbcn Spurkhnd P.E.
Project Name/~ N/A
Cllt"n! Snmplc ID Lot 2, ~ Summit ~.st.
Matrix Dt'inldng Wntcz
Ordered By
PWSID 0
Client POSt ?re-Paid Coils/NO3
Printed Date/Time 06/27/2001 15:54
Colk~ted Daterrlme 06/22/2001 11:30
Reeelved Date/Time 06/2212001 16:16
Technical Dlreetor Stephen C. Ede
Sampk Rcn~'ks:
Allowable Prep Analysis
Panm~er Results PQL Units Mc~hod Lim~ Dnt~ Date ]nil
Ni~ate-N
5.42 0.500 ~g/L EPA 300.0 {<10) 0~/22/01
SCL
t~.o =ob~.olocj¥ Lahorat:or~'
Total Coliform
0 0 col/100mL SMISg222B (<1)
06/~2/01 SKW
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
...ivr'u
AUG 2_. 1998
t/,uNICIFALI[Y OF ANCHORAGE
.......... ~ 1~-..:, D!Vl£'"
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
01 5-071 - 02",~ HAA #
GENERAL INFORMATION
Complete legal description
Lot 2; Block 4 Summit Estates
Location (site address or directions)
Property owner
Mailing address
Robert Banks
5420 E. 99th Avenue
Anchorage~ AK
Day phone
5420 East 99th Ave Anchorage, AK
346-1847
99504
Lending agency
Mailin. g address
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
4
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
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:
XX
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA~21
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. 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 compl ance with all Municipal and State codes,
ordinances, and regulations in effect on the date of inspection.
Alask~ Water & W/~_tew-a~s
Name of Firm
Address 7320 Fast C~e~
· ~chorag~
Engine,s signature ~~~/
DHHS SIGNATURE
· ~ Approved for
Phone
Date
bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By:
Date
The Municipality of Anchorage Department of'Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not.
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-O25 {Rev. 1/91) Back MOA
Municipality of Anchorage J~UG 2 C, 1998
DEPARTMENT OF HEALTi:I & HUMAN SERVICES
Environmental Services Division t^UI',II(~IPALI]Y O1: ANCHOP. AGi
;;825 L Street, Room 502 · Anchorage, Alaska 99501 · (907)'343-zt744
.Health AuthOrity Approval Checklist
.'~Wt,~l'T' ~'-/" ~,//~) Parcel I.D.:
Legal Description: L.-~
A, WELL DATA
L
.Log present (Y(N)
Total dePth
SanitarY Real (Y/N)
Date of test
Static water level
,Well production
' WATER SAMPLE RESULTS:
[
IfA,;B,
FROM WELL LOG
,i ~t~t
02.
or C. attach ADEC letter. ADEC water system number
Date completed
Cased to' ~ - ~[" ' Casing height (abo~ve ground)
Wires properly protected (Y/N)
AT INSPECTION
- - '-/8,5'
ilColiform ~
':Date of sample:. "~ ~G
B,: SEPTIC/HOLDING TANK DATA'
Nitrate :Z~. ~1
m/'~ Other bacteria
· : iCollected by: ,4~t~lL~J 0..~~
g.p.m.
i~Dateinsta,edf':O~!lAl~ ~anksize Io~'~O" ~Number of Compartments: J Cleanouts~N).
Foundation cle~anOut (Y/~' [~(~ 'I ' '
Depression ~ ~ High wat~ ~,[rm (Y/~
. Date of Pumping Oi ]1~/~g ~ii, Pumper; ~+. ~E J~
c.~ABsoRPTION. FiELDDATA ~' . :~ .-~ ~ '. ,; · ~
. . ~ ,. . , ', , ' ' " . . 'I
';~Date installed:: ' ~ ' ~ ~ ~ r~1 ()~ 11~rI ~'~r~"'i'~' Soil rating~ (g p'd/fl~O_, " ~ [~; .~.,, . ~~~ . __~.j' y') ]0~ ~, ',.S i S~em t.: gpa
.Length', IS;Width ~1~; ~a~e~,thicknessbe=owpipe ~ '~ !:i Tota~depth
· ' L ' : I : ' ' " ;' ~
:;Eff. oti~e.b~o~ption.~.~, :5~'~]~_ Monitori,g Tube p~.~ent~N) F,, Depr.~s,on o~er fie~d (Y~
, :. ' . . . ~ q · d .,
::~.,o of .~e,u,cy ,os, O~)tS[W9 ReSults'~Fail) ¢~ F~; FO-A bedrooms
Fluid depth in abs°~tion field b'~fore test (in');=[ ~5/~. immediately after ~H~'al ~ater added (in)'
':Fluid deplh (ins) Minutes Ialer:. ~:~ '~ : Abso~tion rate = ~ g,p,d,
iPeroxide treatrhent (past 12 mdnths) (Y,(~.
72-026 (Rev. 3/96), ..
If yes, give date
LIFT STATION ~/~ . ~
Date installed ~
Manhole/Access (WN) _~..-.-~'"~'Pump on" level at' .
High~ ' *Datum.. .
Cyclbs tes;ed ' ' ' '
"Pump off" level at*
E. SEPARATION DISTANCES
Septic/holding tank on lot
Absorption field on lot
Public'sewer main -
SEPARATION DISTANCES FROM WELL ON LOT TO:
~'O -I-- ' On adjacent lots
t OO ~ On adjacent lots
r,)///:) Public sewer manhole/cleanout
Sewer/septic service line ~ ,~' J'- Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation '~ ~4-
Property line ~ '4- Absorption field
Water main/service line l O'-/-' Surface water/drainage (be '-/-
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line t'7_ P_~Co,q_PS. Building foundation / O -J- Water main/service line
Surface water 1(50 '.-F Driveway, parking/vehicle storage area -~'
Curtain drain ~,.~c~,.~E. ~--l~(~u~ Wells on adjacent lots
F. ENGINEER'S CERTIFIC ~,~ oF ,4~.~tt.
I cedi~ that l ~e ~rm~/th~ field inspections and review of Municipal r~~~~~s are
SignatureinC°nf°rmaffce~~~esineffect°nthisdate'~ ~/'Y ~ - ~ Y ~~~ ~.~ j~~ .
Engineer% Name ~ ~ ~ -/ ' ' ~ ~~~ ~
Date ' e 8 ~--.;:~:o,, ~:--
HAA Fee $ ~ ~ ~ ~ Waiver
Date of Payment ~_ ! ~ / c~ o~ Date of
Receipt Number (,,)~l '~ ~rt~{3{o(~. Receipt Number
72-026 (Rev. 3/96)*
AUG-23-1998 21: 52~ CT~E ESI ANCHORAGE.
9075615~0~
CT&E
Ciitnt
~oJect ~TamD/#
Clien~ Sample ZD
~fatrJx
Orcler~d
?WSID
~ample Ren~ks:
984555O01
AK Water &Wast. ewnter Consultanu Inc.
N/A
5420 E 99th L2 B4 Sununit Est
Drin~g Water
0
Client ]~0~
Printed Date/Time 05/23/98 20:23
Collected ]Date/Time 08/18/98 16:30
Received DaCe/Time 08!19/9E 09:35
Technical Director.. Stephen C. Ede
Nltrnte-~
0 COt/IOO~L
~.87 0.IC0 ~/L
M__e~ed ,,. l_~lmtt~ ~,fta Date Init
£q18 9222a OB/19/~B KAP
EPA $00.0 10 ~ax
Rick Mystrom,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
http://www.ci.anchorage.ak.us
343-4744
· September 8, 1998
Jeff Garness, P.E.
Alaska Water & Wastewater Consultants, Inc.
7320 East Chester Heights Circle
Anchorage, Alaska 99504
Re: Waiver Request For Lot 2 Block 4 Summit Estates Subdivision, Waiver
Request Number WR980053, P.I.N. 015-071-02
Dear Mr. Garness:
Your request for waiver of the required 100 feet separation of a wastewater
disposal absorption field and a private well has been approved. The approved
separation is the private well on the subject lot to the following:
The seepage pit on Lot 1 Block 4 Summit Estates of 86 feet;
The seepage pit on Lot 3 Block 4 Summit Estates of 80 feet;
The seepage pit on Lot 5 Block 2 Williamson Subd. of 93 feet.
These waiver approvals apply to the existing subject well to above listed
seepage pits only. Any future upgrade to any item will require all separations be
met or another waiver approval from this office.
Sincerely,
tYhh
Civil Engineer
On-Site Services Program
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
015-071-02 HA# HA980246 Permit
Date Received: Au§ust 26, 1998
Legal Description: Lot 2 Block 4 Summit Estates Subdivision
Engineer: Jeff Garness, P.E., AlaSka Water & Wastewater Consultants~ Inc.
7320 East Chester Heights Circle, Anchorage, Alaska 99504
Applicant: Robert Banks
Waiver Requested: (1) Private well on Lot 2 Block 4 to the septic system on Lot 3
Block 4;ofiS03feet;~ (-2)Itoithe~septiclsystem.~on?Lotc~l Block 4 of 95 feet; (3) to the
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL ·
2. Special Conditions:
3. Other:
Waiver is Granted: ~ Waiver is NOT Gr~nted:
List Conditions or Reasons for above: f~'£ /97~-;~
Date:
By:
Rec #: 04136/4669 Amount: $ 920.00
Name of Reviewer
Date Paid: Au~ 26, 1998
I I'
..: k,, E Z. t.. ;. S E P T' ~ c P'~ r,/9. --
I
I:z.
~(~.2.Y' 2-
poi, t/Y$
/.7
Water & Wastewater Consul[rants,
7320 East Chester Heights Cirde .-- Anchorage ~ Alaska 99504
Phone (907) 33%6179 ~ Fax (907) 338-3246
August 23, 1998
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box ! 96650
Anchorage, Alaska 99519-6650
Subject: Summit Estates, Lot 2, Bk 4. Waiver of Separation Distance from Well to Septic
Systems.
To whom it may concern:
The well on the subject property was drilled on 6/18/70. The septic system on the lot was
installed on 9/18/70. At that time the required separation distance from the well to the septic tank
was 50 feet, and to the absorption field was 100 feet. The well is far enough away from the well
and septic system on the subject lot, but is too close to the septic systems on several of the
adjacent properties. The encroachments are shown on the attached survey prepared by Greg
Frazier, L.S. The closest absorption field appears to be on Lot 3, Bk ~,, Summit Estates. The
separation distance to the crib clean-out lis 89.8 feet. The crib on Lot 3 existed prior to the well
being drilled on Lot 2. The dimensions of the crib are unknown, but it is reasonable to assume the
edge of the system is at least 10 feet clOser than the clean-out. Consequently, we are requesting a
waiver of the separation distance from the well on Lot 2, Bk 4 to the septicI system on Lot 3, Bk
4..The assumed separation distance is 80 feet. Additional waivers are being requested as
follows:
a. To the septic system on Lot 1, Bk 4, Summit Estates: Approximately 95 feet.
b. 'To the septic system on Lot 5, Bk 2, Williamson: Approximately 93.5 feet.
c. To the septic system on Lot 3, Bk 4, Summit Estates: Approximately 80 feet.
Attached is a copy of the well log for Lot 2, Bk 4. The soils above the water table are primarily
gravel and sand. Also attached is a copy of the recent (8/18/98) water sample analysis for nitrates
and bacteria. No bacteria was present, and the nitrate levels were moderately elevated, at 4.87
mg/1. The numerous encroachments on this well have existed for approximately 28 years. It is
anticipated that as the septic systems in this area fail, and are upgraded, the nitrate levels will
decline over time. Many of the septic systems on the adjacent properties are original, and are due
for replacement.
The topography is such if any of the subject septic systems were to overflow, it would not nm
towards the well on Lot 2, Bk 4, Summit Estates. In short, the only path of contamination is
subsurface. Given the fact that the subject encroachmems have existed for 28 years, with no
significant adverse impact on the groundwater quality, we are requesting that the aforementioned
waivers be granted.
If you have any quest~t~ st, please
Jeffrey, ~. Gayness, lEE., M.S.
Presfdedt ~
contact me at 337-6179, or 244-9612.
EAST 98th AVE.
LoT
BL
Grcun<t Elev = 96~9'
Grcurd Elav -, 98.9'
TOp Well Pipe Eiev = I00.0'
Lof 5
\,
SCALg.. r,'= ,4,9' ,,.----.---
'AS,BUILT
OF LOT 2, BLOCK 4,
SUMMIT ESTATES SUBDIVISION
HEREBY CERTIFY THAT A SURVEY OF
THE ABOVE DESCRIBED PARCEL WAS
MADE ON ,JULY 24, 199B :AND THAT THE
PERMANENT IMPROVEMENTS SITUATED
THEREON ARE WITHIN THE PROFERTY LINES
AND DO~ NOT OVERLAP OR ENCROACH ON
ANY ADJOINING PARCELS, NOR DO ANY
PERMANENT IMPROVEMENTS ON ANY
ADJOINtNe PARCELS ENCROACH ON THE
iPARCEI. I,'~ QU~.~TION, AND THAT 'THEt~E
ARE NO !ROADWAYS OR OTHER. VISIBLE
EASEMENTS ON SAID PARCEL, ALL -EXCEPT
AS SHOW~J HEREON. ANCHORAOE, ALASKA,
~ls e~ DAY; or ~,uou?'r, ,1~9~., I, ,,
Septic Tank Vent Lot I
Cesspool Vent
'Ground .Elev ,, 94.0'
N 89°59'00''
Lot 2
BL 4
E 130.08'
Chain, Link
27.0'
TWO
STORY
WOOD
FRAME
HOUgE
-LO'
'Septic Tank
', Cesspo~
\
Paved
Driv~
;Vent
130,04'. IR} S 89'59~00" W
~ ~' Grou'ld Elev = 94.9"
~ e~.e.Lot 3 // I
· o,, . 'N. ;'
,/
..... ~ ~, ~'ound EI,v · ,O,.e'
Or~und"Elev = :04LO'
.!
',,,300
UICDO
0
~ 0
ooo0
0
0
0
~OH
0 h~
r~
5071
28
5O80
5155
/!
/$
553O
5511 5521
E. 98
/0
5451
I 5421
5411
AVE,
15420
4
5501 5521 5541
E. 97 AvE.
5500 5522
5542
5425
/0
5481 5511 5531 5541
E. 98 AVE.
5480 5500 5520 5540
~,,~455 5501 5521 1554~
E. 99 AVE.
548O
55O0
552O
5540
12
'%%
·
·