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HomeMy WebLinkAboutGLENN VIEW ESTATES LT 14s o es 14 051-521 -51 Municipality of Anchorage Page [ _.. 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: .~<'V~/c/'7 ~ ~ 7 7 PI D Number: ~ -~'~ / -~ / ~:~ ~~ Wastewater System: ~ New ~ Upgrade Address~x ~¢ /~~ ~¢~ ABSORPTION FIELD Phone: 7¢~~ ,o. of Bedrooms~ ~ Deep Trench U Shallow Trench OBed ~Mo,~d UOthe, L E G A L D E S C R I PTI O N Soil Rating: O. &/~ GPD/Sq Ft Tolal Deplh from original/¢,grade:z / .o,: /¢ d p,h Township: Range Section: Fill added above original grade Gravel length: GCvel width: Number of lines: D~stance betwee~ lines WELL: ~ New ~ Upgrade ~'~¢¢¢ ~¢~¢ ~ 2 Ft. / ~ FI Classilicabo~ (~rivate, A.B.C): Total Depth: Cased To: Total absorption area: Pipe materiel:  Casing Height Above Ground: Yield: ~ O"~ ..m. :~ ,~. ~ ,,. TANK SEPARATION DISTANCES ¢ Septic ~ Holding ~ S.T.E.P. · o Septic Absorplion Lift Holding ~ubHc/Pdvat( Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~~ ~ I Malarial: i ~ / Number of Compadments: Sudace Water /0~ /p¢~ .... LIFT STATION Lot / I Size in gallons: ] Manufacturer: T Line /D ~ /0 ~ .... I ~ou.~tio. /¢ % /O % .... ",.mp o." ~.~ ~: ~~ ~t: High w~t.r ~ar~ ~: Curtal,Drain ~U~D ~ ~-D +' .... ,~¢ ' I ~ctri~l ,~peotions perlorme8 by: Remarks: ~t~g ~4~/~ BENCH MARK ~1 ~~ ~~~ Assumed ENGINEER'S SEAL H m ~ s/~~ ~ ~enneth M. Du¢¢~ ~ ~ Department of Health___and H~ an¢__S~rvices approv. I ~'., c~ ~ Reviewed and approved by' ~~ ~~ Date: ~- ~-~ ~ i?ROFEsS¢X 72-013 (Rev 9/91) MOA 25 K r. of Z_ D AS-BUTLT SYSTEM GLENN VIE~/ ESTATES S/D ]]ETATLS/SITE PLAN Permi-t SW970a77 PIS~O51-5al-5i VACANT LBT 14, -/U. Zo. o 'WELL I_I]T 15 TH ERES PROPOSED RESERVE A-C=38,5' B-C=62,3' A-]]=47,3' B-D=67,7' A-E=43,6' B-E=75,3' A-F=113,~' B-F=l~7,4' CO~ 30 ~PRIMARY SYS L_BT 14 *BM ~ ;,T, SCALE, 1' = 50' FINISHED GRADE ROCK PREPARED FOR: REX TURNER ARCTIC ]]EX/CB, INC, P.U, BOX 3489 PALHER, ALASKA 99645 FIELD BOOKS CO~PUT~D: 80UNOARY: DRAY,N: KMD ASBUILT: LANG L*A~re 3/24/98~ ' ~ NW1560 AC~D ~mE: 97074.DWG ~o. No.: 97074 ENGINELRING 20441 PTARMIGAN BLVD. LA(,LL RIVI.,I;~, AK 99577-8736 /907)696-611i/FAX /907)696-8111 . SULLIVAN WATER P.O. BOX 810272, CHUGIAA, ALA. J~KA ~iiJ~? (; TJ~LEPHONE OWNER OF LAND "7-U/{~I=',~ LEGALDE$CRIPTION 4o~ t~ ~4E~ PERMIT NUMBER q O27 Date m Is well located at approved pe~lt location? ~e8 ~ No Method of Drilling: ~[r rota~ ~ cable tool Depth of well: CasingType ~T~ ~allThickness ,~O inches Diameter ~~lnchea, depth ~..l feet Liner Type: Ca~ing Stickup Above Ground: ~ feet Statio Water Level (from ground level): ~ O feet Pumping level: feet a~er hrs. pumping ~gpm Recover Rate: _ ~ gpm Method of Testing: ~ I ~ Well Intake Opening ~pe: ~n End ~ Open Hole ~ Screened: Start feet Sloped feet ~ Per, rations Sta~ feet Stopped . feet GmutType' ~m~,~b VOlume Depth: from O feet, to ~ feet Pump Intake Depth', feet PumpSlze ; .hp Brand Name Well Disinfected Upon Completion? ~ ~ No Methodof Disinfection: ~(~A,~[ ~ 8ORE HoLIA DATA APR 2 1998 I' Commenta: .... ~,l / ~ / ?~ OeM~?.'c[palJty of Anchora.~e ATTENTION: It is the responslblll~ of the prope~ owner to submit a oopy of the well log to the proper authod~. Munlolpall~ of Anchorage: DepaAment of Health & Human Se~l~8 and/er Oepa~ment of Envimnmon{al Conae~atlon. MatSu Borough: Department of Environmental Conse~atlon. MAR ~6 '98 02:48PM HTL AHCHORAGE P. 1/~ NORTHERN TESTING LABORATORIES, INC. ,"~,3:~,0 INDUS'rRIAI. AVENU~ FAIH~ANKS, ALASKA 99701 (907) 456.31'i6 · FAX 456-.q'[25 R006 SC:,IOON STREET ANC;HORAGE, ALASKA 99518 (907) 349. 1000 * FAX 340-1016 KND Engineering 20441 Ptarmigan Blvd. Eagle River, AK 9957%3736 Attn: Client ID: Glenn View Lot 14 Client Project #: Source; lxYiL Lab#: 3.154635 $~unple Matrix: Water Comments: [Method Parameter R~port Date: 3/26/98 Date Amveil: 3/24/98 Sample Date: 3/24/98 Sample Time: 13:00 Collected By: KND ** Legend ** MRL = Ivieth~ReportL~vel MCL =Max. Con~anlill~lltLev¢l B = Pr~t In M~lhod BI~ M = Ma~x I~ = ~ MCL D - ~st To Dilu~ Date Date Units Result ~ Prep~ ~fly~ SM 4500 E Nitrat~-N mg/L 0.62 0.10 3/25/98 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH BJqD 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:SW970277 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:REX TURNER OWNER ADDRESS:P.O. BOX 3489 PALMER, ALASKA 99645 PARCEL ID:(~-!~ Ogl- ~21~ ~/ DATE ISSUED: 8/26/97 EXPIRATION DATE: 8/26/98 LEGAL DESCRI PT ION: ~fs Fad ~'~ _S T_t~54q--R ]zW--S EC--~i=0--S W--C© R_N W 4- I.o¥ I-4 ~-&k.~,~ LOT SIZE: 45630 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PEI~MIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 (18A_AC72) 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 SANE DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PROPOSED TRENCH SHALL HAVE A MINIMUM OF 3 FEET OF COVER, OR, 2 FEET OF COVER AND INSULATION. SEE AMC 15.65.060, SUBSECTIONS E-7 AND E-8. RECEIVED BY: ISSUED BY: ~? ~ // DATE ' J//../Xf DATE: ~D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 August 9, 1997 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer/well permit - Glenn View S/D, Lot 14 Gentlemen: The owner has requested we proceed forward to obtain a welt and septic permit on the subject lot. There is one previous testhole which was dug during the preliminary plat process. We have designed our system utilizing this testhole, however, we anticipate verifying soils and may possibly modify the system, with your concurrence, if we encounter better soils for the four bedroom house which is proposed for this lot. The results of the existing test and water monitoring are attached. We propose to install a 2' wide deep trench. The original testhole indicated no water, and we did not find any water during our monitoring. Additional fill will be placed over the system to provide a minimum of 3' of cover when complete. There are no public or private wells within 200' of our proposed system location except as noted. There is neither surface water within 100' nor any curtain drain 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 696-6111/FAX 696-8111. Respectfully submitted, .~l(~lxJ D Engineering Kenneth M. Duffus~ .E~. attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test LOT 16 SEPTIC YASTE ./ATER SYSTEM DETAILS/SITE LOT 14, GLENN VIE~/ ESTATES S/D LOT 4 · PROPOSE~ ~ELL VAOANT · wEu L ~ 1 VACANT LOT 15 LIlT i4 VACANT LOT ]3 PLAN SEPTIC LOT 6 ~ ~ O?~SS1 DESIGN DETAILS 4 BDRM X 150 GPD 600 GP]) 600 GPD/0,45 GPD PER SQ, FT, - 1334 SQ, FF 1334/(9'X8') (9,0' GRAVEL) - 74,1 FT. FRENCH 'rotc[ dep~sh oF sys'tem is H,O' From or'i9in0,[ spade, lot(iF depth oF gr'ove~ be[ow dlstrdbullon plpe is 9,0' NI FI-ES', L USE i~50 GALLUN SEPTIC lANK, INSULATE TANK IF <4' COVER, ~. INSULATE TRENCHES WITH ~' lid BURIAL FOAM.. 3, CONTRACTOR WILL ENSURE MAXIMUM ~Y. SLOPE INTO SEPTIC FANI<, 4. ADDITIONAL FILL ~ILL BE ADDED OVER SYSTEM TO ACHIEVE MIN, 3' COVER IF REQUIRED, PREPARED FEIR: REX TURNER ARCIIC DEVCI], INC. P,B, ]]l]X 3489 PALMER, ALASKA 99645 I<ND ENGINEERING 80441 PFARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696 611]/Fox (907)696 8111 I- SEAL. E: 1~ = 100' 97074 SI ..~VMunlcipallly of Anchorage DFPARTMENT OF HEALTH & HUMAN SERVICES 825 '%" Street, Anchorage, Alaska SOILS LOG -- PERCO~TION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 ~7 18 19- 20- SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Oepli~ Io Wiler Aller moniloting? d.~r~ Gross Net Depth to Net Reading Date Time Time Water Drop ~ ~ ,~ :~ 30~ IO//~" /z//O" PERCOLATION RATE 1~0 [rnlnuleS/mchJ PERC HOLE DIAMETER ~,~/1 TEST RUN BETWEEN _ 7 FT AND ~ FT COMMENTS CERTIFY THAT THIS TEST WAS pERFqRMED IN ...... 001>¢/¢5 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 Parcel I.D. 051-521-51 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING E)~piration Date: / O - ;.-~. ~.-// 1. GENERAL INFORMATION Complete legal description GLENN VIEW ESTATES LOT 14 Location (site address) 23322 GLENN HILL CIRCLE, CHUGIAK, AK 99567 Current Property owner(s) TIMOTHY & SHANNON DEHAAS Day phone Mailing address 23322 GLENN HILL CIRCLE, CHUGIAK, AK 99567 Lending agency Mailing address Day phone Real Estate Agent Mailing Address Day phone Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER,OF BEDROOMS: TYPE OF WATE.R SUPPLY: Individual Well c IndividUal~Wate~'Storage iDommunity Class __ Well Public Water System 4 TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] Individual Holding Tank F-~ [] Community On-site [-"1 [] Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems 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 verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that theon-site Water supply and/or wastewater disposal system is (are) s.a¥ functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify t~a!~ ba~ed on the information obtained from.the Municipality of Anchorage files and from my investigation and in'S~eCt[bri, 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 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 07/15/2011 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. DSD SIGNATURE .[/'"' Approved for J7L Disapproved. bedrooms. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water& Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GLENN VIEW ESTATES LOT 14 A. WELL DATA Well type ~ATE IfA, B, or C provide PWSID #__ Date completed 2./9/~998 Sanitary seal (Y/N) ~ Total depth 221 ff. Cased to 221 ft. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform ~J~__colonies/lOOmL FROM WELL LOG 2/9/1998 150 ft. 5 g.p.m. Nitrate 0~ ~ mg/L Arsenic: A/D mg/I Date of sample: 7/7/2Oll SEPTIC/HOLDING TANK DATA Tank Type/Material Septic[Steel Parcel ID: 051-521-51 Well Log (Y/N)__Y ~res properly-protected (Y/N) Y_' Gasing height (above ground) _ 24+ in. AT INSPECTION 71812011 152 ft. -=, g.p.m. Collected by: ArcTerra Date installed 2/4/~998 Tank size 1250 gal. Number of Compartments '2 Cleanouts (Y/N) _Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) __N' High water alarm (Y/N) N Date of pumping 7/8/11 Pumper IRs C. ABSORPTION FIELD DATA Date installed 2/~998 Soil rating (g.p.d./~ or ~/bdrm) 0.~ Length 75.8 ff.' ~Width2~t, ' Gravel below pipe 9.2 ff. Eft. absorption area 1395 ~ Monitoring tube Y Date of adequacy test 718/2011 Fluid depth in absorption field before test 31.2 Elapsed Time: 120 min. Final fluid depth 31.2 System type Total depth 1__[1 ft. Depression over field N Deep Trench Results (Pass/Fail) Pass For 4 in. Water added 630 gal. New depth __ in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N__lf yes, give date--~- bedrooms 38.4 in. LIFT STATION Date installed "Pump on" level at __ Datum .in. E. SEPARATION DISTANCES Size in gallons "Pump off=' level at ~ Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 75'+ Sewer/septic service line 25'+ Animal containment areas 50'+ in. Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requ rements~ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 200'+ Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots laY+ lO0'+ Property line 10'+ Building foundation lO'+ Water Service line 10'+ Surface water 100'+ Curtain drain 50'+ (None Known) COMMENTS SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Water main 10'+ Driveway, parking/vehicle storage 10'+ Wells on adjacent lots 100'+ G. ENGINEER'S CERTIFICATION certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineers Printed Name KENNETH M DUFFUS '"' ....... '~"~ Date 7/15/2011 COSA Fee $490.00 _~- g~C~- Date of Payment "7 I ~-~ I ~ \ Receipt Number --~ ! L{q ~ 3 ~.. (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number ......... SGS Ref.# 1113013001 Client Name ArcTerra Engineering and Surveying Printed Date/Time 07/13/2011 15:22 Project Name/# Glenn View Est. Lot 14 Collected Date/Time 07/08/2011 9:00 Client Sample ID Glenn View Est. Lot 14 Received Date/Time 07/08/2011 12:15 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init bletals b~r ICP/blS Arsenic ND 5.00 ug/L EP200.8 C (<10) 07/11/11 07/12/11 NRB Waters Delmar tment Total Nitrate/Nitrite-N 0.803 0.100 mg/L SM204500NO3-F B (<10) 07/08/11 AYC l~icr obiolo~r}r Laborator~r E. Coli Total Coliform Negative 1 100mL SM20 9223B A 07/08/11 CR Negative 1 100mL SM20 9223B A 07/08/11 CR 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. ~L,~l- .~',g! -,.~! HAA # O~"O.~";J,,'~ Expiration Date: 1. GENE~L INFORMATION Complete legal description I Location (site address or directions) 2~ ~~ ~/~ Current Prope~ o~er(s) ~C~f~ ~ ~ ~ Day phone Mailing address ~~ ~ ~1~ Lending agency Day phone. Mailing address Real Estate Agent Mailing Address P/~r/~r~J' t~ ~'~- Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well [] [] TYPE OF WASTEWATER DISPOSAL: 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 (HM) 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 sen/ed by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HMs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties sen/ed 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 ope year with valid water samples.) Certificates are valid for one year for properties sen/ed 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 verify that my investigation, based on procedures ouUined 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 Address ~ Engineer's Printed Name 5. DSD SIGNATURE Approved for L.~ bedrooms. Disapproved. Conditional approval for , Phone 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: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewatar Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK g9519-6650 www.ci.anchorege.ak.us (907) 343-79O4. Legal Description: HF_.ALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type p Date corn pletad ~_.~/~:~ Total depth ,Z :~ (. ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (Y/N) ._~ Cased to .2,g.I ft. FROM WELL LOG !~',,3 ft. /4/7 ft. S g.p.m. /,~ ' gp.m. WATER SAMPLE RESULTS: Well Log (Y/N) y Wires properly prbtected (Y/N) ~ Casing height (above ground) ~ in.'*' AT INSPECTION Coliform Arsenic: B. SEPTIC/HOLDING TANK DATA oolonies/lO0 mi. Nitrate ~ mg./l. Other bacteria (3 colonies/lO0 mi. mg./I. Data of sample: ~7/~_,~//0,5' Collected by: ~, Tank S'~ Z,~sO' gal.' ." ..; .Number of Compartments Fo;da"°ncl;";; De.rassio. over tan, (V,.) Date of pumping ~ Pum~r ~ ~ ABSORPTION FI~D DATA. ~ D,~ ins="~~.',* :~il rating (g.p.d.~ o~)~. ~ .. Cleanouts (Y/N) ~ High water alarm (Y/N) /~'/,~ System type Gravel below pipe ~.~. ft. Total depth .. Data of adequacy test ._7_~0 ~" Results (Pass/Fail) ~ Fluid depth in absorption field before test C~.. in. Water added~__..~ gal. ~ Elapsed Time: ~ min. Final fluid depth ._~ in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (YIN & type) Ud~'PC // ft. Eft. absorption areat~C~ ~ Monitoring tube._~ Depression over field ~ For /-~ bedrooms New depth ~ in. ~'O F,..,] . g.p.d.W If yes, give date D. LIFT STATION Date installed / 'Pump on" level at._7/_, in. / Datum ,/' E. SEPARATION DISTANCES Size in gallons 'Pump off' level at/n. Cycles tasted SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot /¢~O'~P Public sewer main 7~ Sewer/septic service line .~,,~' Manhole/Access (Y/N) / High water alarm level at / Meets alarm & circuit requi~rmenls? On adjacent lots /Od/ On adjacent lots /0(3/~' Public sewer manhole/cleanout Holding tank /~ '/*f" SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Property line ,~0 Water service line Building foundation Water main /g~ Wells on adjacent lots /¢~g~ ~'' Property line Water Service line Curtain drain Absorption field //(~) /~' Surface water //00/'F'' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Sudace water ,/¢;;)0 "~' Wells on adjacent lots /(10 ~' F, COMMENTS Water main ~,/'¢~) ~" in, Driveway, pad<lng/vehicle storage G. ENGINEER'S CERTIFICATION /certify that/have determined t. roug. field in~ct~ns and rev~w of Mun~i~l r~ds mat the a~ve systems a~ in c~ance w~h MOA H~ guidelines in eff~t on this date Date ~ ~ HAA Fee $ /-4 ~ .Ct) Data of P. m.nt Receipt Number "1 t,_~ ~ ~ (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number Mat-Su Test Lab of Alaska Water Quality Testing Mile 3.2 Palmer-Wasilla Hwy. Midtown C~mmunit~ Business Park Phone: (907) 745-3005 Emaih [~at-sutest ab{~roqershsa.com P.O. Box 2749 Palmer, Ak. 99645 Fax: (907) 745-3010 Client: North Rim Engineering 17237 Bear Paw Circle Eagle River, Ak. 99577 Attn.: Client ID: PWSID #: Source: M.S.T.L.#: Sample Matrix: Comments: Lot 14 Glenn View Est. 51523 Date Arrived: 7/13/05 Report Date: 7/15/O5 Sample Date: 7113/05 Sample Time: 1530 Collected By: N.R.E. Method Parameter Units Results MDL Date Prepared Date Analyzed MCL SM 4500-NO3-E Nitrate-N SM 4500-NO3-E Nitrite-N Total Nitrate/Nitrite mglL 0.96 0.50 7115/05 7115/05 10.0 mg/L O. 13 0.05 7115/05 7115/05 1.0 mg/L 0.96 0.50 7/15/05 7115/05 10.0 Legend: MRL = Method Report Level MCL = Max. Contaminate Level B = Present In Method Blank E - Estimated Value H =Above MCL D · Lost to Dilution Re~e~l By Jori Paul Campbell Lab Manager tM' lB, I0' I /- Legal Description: Municipality of Anchorage Development Services Department .Building Safe~y DM~IOO On-Site Water & Wastawater P~gmm 47~0 Go,~th 8ragaw Gl. P.O. BOX lg6~5C) Anchorage: AK 99519-6650 www.ci.anchorage.ak.us . . (go7) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST View Estates Lot 14 * ff A,*B, or C provide PWSID # Sanltmy seal (Y/N) y Cased to .222_ft. FROM WELL LOG 5 g.p.m Date of sample:~__/.~o'Z* WELL DATA Well type erlvate Date completed 2/9/98 Total depth 221fl. Date of teat Static water level Well production WATER SAMPLE RESULTS: Coflform (~ colonies/100 mi. Arsenic: rog J1. SEPTIC/HOLDING TANK DATA Tank Type/Material ~EEL Date installed 2]4/199ll Tank size 1250 gaL Number of Compartments 2 Parcel ID: 051-52i-51 Well Log (Y/N) Y Wlrea property protected (Y/N) y Casing height (above ground) 2+ AT INSpEcTION 7/1~)2 150 ft. 1.32 g.p.m. Other bacteria 0 ~olonies/lO0 mi. Collected by: KNO Enalneefina Water add'ed 450 gal. New depth g.5 in. Absorption rate >= 450+ g.p.d. N If yes, give date System type DEEPTRENCH Fluid depth in absorption field before test 5,5 in. Elapsed Time: 45 min. Final fluid depth 5.5 in. Any rejuvenation traal~nsnt (past 12 mo.) (Y/N & type) Foundation cleanout (Y/N) LOepmsaion over tank (Y/N) I~._High water alarm (Y/N) Date of p~u. mplng 7/t5/2002 Pumper J.R.'S ABSORPTION FIELD DATA Date installed [/4/1998 Soil rating (g.p.dJfi2 or ~/bdrm) 0.45 Length 75.8 ff. Widlh ~ fi, Gravel below pipe 9.2 ft. Total depth '10.7 fl, Eft. absorption area '1395 fi2 Monltortng tube Y Depression over field N Date of adequacy teat 7/15/'2002 Results (Pess/1=ail). PASS For 4 bedrooms : Cleanouts (Y/N) ~ 4. 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. Name of Firm KND ENGINEERING Address 20441 Ptarmioan Blvd., Eaale River, AK 99577 Engineer s Printed Name Kenneth M. Duffus 5. DSD SIGNATURE /.~ Approved for J'3L' Disapproved. Conditional approval for Phone 1907) 695.6111 Date 7/15/2002 bedrooms. bedrooms, with the following stipulations: Additional Comments By: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer s Report Other Odginal Certificate Date: ~_,,~. c~ _ ~)~,. (Rev. 01.<)2) D. LIFT STATION Date installed Pump on level st __in. Datum E. SEPARATION DISTANCES Size in gallons _ .~ Manhole/Access (Y/N) . Pump off level at; __ irt, High water alarm level at Cycles tested ' Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot t00'+ Absorption field on lot Public sewer main 75'+ Sewer/septic sen, ice line 25'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation fi'+ Property line ~'+ Water main t0'+ Water service line 10'+ Walls on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Surface water I00'+ Wells on adjacent lots t00'+ On adjacent lots 100'* On adjacent lots Public sewer manhole/cleanout Holding tank 100'* Property line t0'* Water Sewice line Curtain drain 50'+ COMMENTS Absorption field fi'+ Surface water t00'* Water main t0'+ O~veway, paddnghmhicJe storage 25'~ G. ENGINEER S CERTIFICATION I certify that I have determined through field inspections end revfew of Municipal records that the above systems ere/n conformance with MOA HAA guidelines in effect on this date. Engineer s Pdnted Name Kenneth M, Duffus Date 7115/2002 HAA Fee S Date of Paymem Receipt Number (Rev. 12/m) Waiver Fee $ Date of Payment Receipt Number 90755153~1 T-104 P.02/03 F-252 CT&£ Ref.~ 1024460001 Client I~ame KND Enginecring Project Name/# Glenn View Est Lot 14 Client Sample ID Glenn View r'st Lot 14 Matriz D~inking Water Ordered By PWSID 0 Samp{e Rerr~tks: All Dates/Times are Alaska Standard Time PUnted Date/Time 07/23/2002 14:48 Collected Date/Time 07/18/2002 12:30 Received Date/Time 07/18/2002 13:30 Technical Director Stephe~de Released By Patame~r Ib~ul~ PQL Umts Allowable prep Analysis lin*dm Dme D~e Ini! Nitra~e-N 1.4] 0.200 mg/L EPA 300.0 (<lO) 07/10/02 JD~. ~ic:ob:Lology' Labo~-atory' Total Coliform col/I OOmL SM{8 9222B (<1) 07/I 8/02 KAl