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Home My WebLink AboutFAIRMOUNT LT 15Foirmount Lot 15 #017-111-07 .~-~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONN1ENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT __ J~GRADE L EC~AL~D ESCRI PTION Well Absorption atto Dwelling~ ~ NO. DISTANCE TO: t ~ , PERMIT fo0 , CqO/7 MatCk~ - No. of com~men~s ~ ~ DISTANCE T~ Well Dwelling ~ ~ ~ ~~ PERMIT NO. ~ ~ ~ Man~ ~ ~ Material Liquid capacity in gallons Well Foundation Nearest Io~e PERMIT NO. No. of lines --Z~ - ~f ~ ~ Total Trenchwidt~ ~ Distancebetw~en Total effective absorp~ - /CpO tietofinishgrade ~ Materialbeneathtile ~ inches Length Width Depth PERMIT NO. ~ Typeofc~ " ' diameter Crib depth Total effective absorption area ~NCE TO:-- ~ ~ndation ~ Class~~ Depth ~,. Driller r Distance to ~-I°t line PERMIT NO. ~m DISTANCE~ TO: Building foundation Sewer line · OTHER ,NSTA.. E~ REMARKS ~ On ~:::I~ ]: E:I;:~I',Ff' [:,OiJ(:~?:; E;:,:.:',~;:FI',,,'f::I]~' ;!' I',l(:i I:::'0 I~}::',:.:', :!.(~:.l.....,:~::';:' I;::INE:tl , ..... ~ . . .,., ... ...RZ ,. , ,,,..,-, TI'Il: L.. E:NG'I"H I::' ;1: HE:N::; :1; I:]t~.] ]] ?; THE: L..IEI"it('i'T'H ,:: ]; ~'] F:'[?J~:I" ), I:ZlJ:-:' 'I"I'"IE~Z 'T'I::;:IENE:H 'IT'll::; I::,EF::"T'I'I I:ll:: I:::l 'T'F;;:ENE:H I:)F;;: ~;';[ [ ;JZ::~; THE; D];~;'f'f:II"~E:E E:E:3"HE;I:~:N 'THE: I:~l:;;:Ot...iN[:, I::iN[) TI'"t[~; I:~:(;f'J"T[:llvJ [;)F:: 'f'HE E:*::E:I:::I',,,'I:::fFZiON ,:;];~',J "IT.II:;~:I-;~;E: :[ ::; NO %E: T I.,~ ]: I::,TH F:: OR TI'lIE Gl:;;:l':/'v'13.. I::,l:l:::"r'fl ];% 'TT.IE 1','13N];t,tt..IPI DEF:"f'H Ell:::' I}iF;;'.i::~',,,'J::l.. E:E3"I.,.IIEI~:N FIN[':, 'T'HE E:r;)I"T'OH ('IF:' 1'HE E::.::CFfv'FI I' ]; OP.,i ,:Z ;[ N F::'EI:;"F' ). ;[ E:I:i:f;;:T ]; I:::'*'r' T'l..-h:::f'r :1..: ;[ i:::iH Fi:::$'I);I...);i::iI::;: I,.I]Z"fTJ "I"HE; I:;i'.Ii:!X;:!I.I;[I:;;:EI'"IE]'.,II":!!; F:'OI:;]: Ed'.,I.....:!:!;];'J"l:.; :!!;l:]!],.JJ:ii;l:;i::i!!; i:::ll'.,J[Z:, I,.l!!:l..I.:ii!; Fr.!i; I:::'OI:;;:TH E:"r' "f'HE; I'qLIJ"4:[C'[PI:':It..;['T'"¢ OF' ;;;i': :[ I,.i :[ L.L :[ f',l:i!!;Tf::ll.. I.. THE: :!:i;"r'%TE;l'"l ]; i",l FIE:E:OI:;;:[)I'::Ii",IE:E; l'l ;[ T'H 'T'HE CODE:iii;. ;:i:: ;!; I..INI;;'E]:;;::!i;f'F:IN[) 'T'Hf:'I'T THE; ON'"":i!;]['I'E :!:;E].'.IEI:;;: :ii];"r':!!:'f'Ef'l i"ll:::l"r' I:;;'EiX;;]l .I ;[ l:;:! : bl;HLFII:;;'GI::!;HF;I',I'J' ]!:::' !'l"l!i! f;i:E!;:;i;];[)I!:NC':E; );:!i!; f;;'.E:PIO[:'EL.I!i:[)I'0 ];f'.l(::l I. II)E; I"lOf;;:E!; 'T'I"'IF:II",t :!:.: t:::tt:::'I:::'l. ;[ (:;FIt',FI' f::,OI...tG::!; E::':'X::l:::l'v'l::ff);[ I",IG ARCTIC - SUBARCTIC · Geotechnical Engineering · Petroleum Geology · Engineering Geology · Drilling Management MICHAEL B. BERGMANN GEOCONSULTANT BOX 191, STAR ROUTEA, ANCHORAGE, ALASKA 99502 (907) 344-9150 Mr. Doug Turner May 10, 1979 P.O. Box 10-437 Anchorage, Alaska 99511 Subject: Percolation test for sanitary sewer system on Lot 15, Fairmont Subdivision, Anchorage, Alaska. At the request of the Department of Health and Environmental Protection a percolation test was performed on a drilled test hole located adjacent to the test pit, where a visual soils examination was performed on May 8, 1979. Three test holes were drilled. The depths varied from 6.0 to 7.5 feet. All caved in to a degree, the second test hole was selected for the percolation test as it caved the least. A greater depth than 7.5 feet could not be reached because of the large boulders that occur at approximately that depth. Test Hole No. 2 was drilled to a total depth of 6.5'. Refusal was encountered at that depth on top of a large boulder. Before the percolation test could be performed the hole had caved to a depth of 5.5 feet. The test hole was then filled with water and a perc- olation test performed by measuring the water level drop periodically for one hour. The location of the test hole is 11 feet west and 5 feet south of the backhoe dug test pit. TABULATION OF PERCOLATION TEST RESULTS TIME LEVEL(inches) DROP(iches) ET(min) RATE(min per inch) 1622 13.0" start start start 1632 20.5" 7.5" 10 1.3 1642 23.0" 2.5" 10 4.0 1652 24.0" 1.0" 10 10.0 1702 25.25" 1.25" 10 8.0 1712 27.0" 1.75" 10 5.7 1722 29.25" 2.25 10 4.4 Average percolation rate for entire hour = 3.7 minutes per inch c~j ~~;~'~°'~ ~ Average percolation rate for last one half hour = 5.7 minutes per in ~%~ During the percolation test the side walls of the hole in the upper portion containing the silt layer beneath the organics caved and raised the bottom of the test hole to a depth of 45 inches. This may have resulted in th~ condition that caused the increasing percolation rate for the last one half hour. ARCTIC - SUBARCTIC · Geotechnical Engineering · Petroleum Geology · Engineering Geology · Drilling Management MICHAEL B. BERGMANN GEOCONSULTANT BOX 191, STAR ROUTEA, ANCHORAGE, ALASKA 99502 (907) 344-gl 50 I appreciate the opportunity to be of service to you. Please contact me if you have any questions regarding this percolation test. Very truly yours, Consulti~eologist xc: Department of Health and Environmental Protection 50' ~ ~' --- / Gree~nhouse /--- approx. / 10' high ,~mm~,.,..~w~ Test Pit #1 N 125' Lot 15, Fairmont Subdivision, Anchorage, Alaska Distances are approximate and have not been measured by surveying methods as to location of test pit. Michael B. Bergmann Consulting Geologist Box 191, Star Route A Anchorage, Alaska 99502 (907)344-9150 Test Pit No. 1 5-8-79 0.0' ganics & some Peat, moist, loose, green - dk brn. O.5' Silt: w/trc Gravel~ ~[oist, med dense, bm. (GW - SW - ML) --l~ ' . Interbedded Sandy Gravels, Sands and Silts: sl moist to wet, med dense, brn, abund cobbles & boulders. ~r .f~o~ing into test ~t ~avel on top of Silt. ~tal Silt percentage for strata .5' - 9.0' is approx. 15%.9.0, Silt: w/trc Clay & Sand, occ Cobbles, moist, dense, dk gray. (ML) NO WATER TABLE ENCOUNTERED , 16.0'TD Test Pit Log represents soils encountered on Lot 15, Fairmont Subdivision, Anchorage, Alaska. Mr. Doug Turner ~ (J~ t~ i '{ ). ((~ /1 ~ May 9 P.O. Box 10-437 Anchorage, Alaska 99511 Subject: Soils investigation for sanitary sewer system o Anchorage, alaska. [)ear mr. Turner: '1" A N T 197~ I,ot ].5, Fairmont Subdivision, At your request of May 8, 1979, I conducted a soils ~nvestigation at the proposed location of asanitary sewer system on the subject lot. This investigation, which was accomplished on May 8, 1979, consisted of the inspection of soils removed during the digging of a 16.0 foot deep test pit, using a track mounted Bantam 450 backhoe. The soils encountered are graphically shown on the accompanying test pit log. The soils consisited of a thin surficial layer Organics and Peat 0.5 feet thick, overlying a Silt 1.0 feet thick, underlain by a strata consisting of interbedded Sandy Gravels, Sands, and Silts 7.5 feet thick (Total percentage of Silt layers in this strata is approximately 15 per cent), in turn underlain by a Silt with traces of Sand, Gravel and Cobbles. Water was encountered at the base of the interbedded strata at the top of the silt. This water flowed into the test pit from the bottom 2 inches of the lowest gravel at a slow rate. It is considered to be water resulting from breakup that has seeped through the overlying strata and is prevented from seeping further by the relative impermeability of the lower silt. It is expected that this small trickle will dry up in the very near future.i ~The topography of the subject lot consists of a low knoll on the northern half of the lot, which drops off abruptly and steeply (approximately a 10 foot elevation change) to the southerly lower half of the lot. The lower half slopes in a southwesterly direction at a grade of approximately 2 to 4 per cent. Vegetation presnt on the lot consists of dense spruce with an occasional birch to 35 feet tall, with a ground cover of low bushes and mosses. An accompanying sketch shows the subject lot with the approximate location of the test pit in relation to the property lines. I appreciate the opportunity to be of service to you. Please contact me if you have any questions regarding this soils investigation. Very truly yours, Attachments: Drawing of test pit log with location sketch. xc: Department of Health and Environmental Protection LoT ' , Block .z.- ~." ~ "' t - Anchorage ,Recordbg Precinct, Alaska - ,~.....~,~,~,~t~;.~' .... ~....-. ~....~ LOT SURVEY CERTIFICATION !hereby rerhfy that r hove surveted the property shown and d~st;r~bad ~ Bra~s co. p~.d mor~irnetlt m' ~reon,~]nd t~ the ~mprovements s~tu~ed thereon ore w~hin the prop ') ' , c Iron pipe and/or re~, e~ty hnes aed do r~t overlap or encroach ~'r adjace~ property and that no (~ :x~ hub ~ t~ recovere,, In quttsfk¥~ ,]nd th~ there {~re n{, f~,ndways, ufSt7 lines ~ ,~ther vl~bm Scale Ref, Date F: B N,:) Prepared by Property of Municipality of Anchorage Development Services D6paHment Building Safe~y Division On-Silo Waier and Wastewaler Prog~'am 4700 Sou~h Bragaw St. P.O. Box '196650 Anchorage. AK gg51g-6650 www.cl.anchorage.ak. Us (907) 3,1:~-7g04 CERTIFICATE Of HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING · Parcel I.D. 017-111-07 1. GENERAL INFORMATION Complete legal description Expiration Date: "7-' LOT IS, FAIRMOUNT SUBDIVISION Localion (slte address or directions) 5530 rabbit creek Road. Current Properly owner(s) Mailing address ' Lending-fi~ncy Mailing address Stewart & Dana Hills Dayphone 7231 Meadow Street - Anchorage, Alaska 99507 Day phone Real Estate Agen[ Paul Moore - Distinctive Prnp. Dayphone 727-5494 Mailing Address NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: private Individual Well [] Individual Water Storage [-] Community Class Well Public Water System I--] TYPE OF WASTEWATER DISPOSAL: prtvat e Individual On-site ~ Individual Holding tank Community On-site ~ Public Sewer The Munlcipetity of Anchorage Developmenl Services Department (DSD) Issues Certificales of Health Authorily App,roval (HAA) based only upon the representations given In paragraph 5 by an independent professional civil engineer registered In the State cf Alaska. Certificates of Heallh Authority Approval are required for Ihe transfer of lille (except between spouses} for propedies served by a single family on-site wastewater disposal and/'or water supply system. DSD also Issues HAAs upon request to homeowners. Cedifica{es o~ Health Authorily Approval ere valid for 90 days [rom Ihe date of issue for proper'lies served by a privale or Class C well and may be reissued with new water sample results less than 30 days old. (Cedificates may be reissued for a period of up to one year with valid water snmples.) Cedific~tes are valid for one year for propedies served by Class A or B wells or a public water system. The MunicipalRy or Anchorage ts not responsible for errors or omissions In the proresslonal engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of Ihe validation da~e shown below, I verify that my Invesflga{ion. based on procedures outlined In Ihe Health Authority Approval Guidelines for this applicalion, shows that the on-site water supply and/or wastewater disposal Sy~te~ Is(are) safe. functional and adequate for the number of bedrooms and type of structure Indicated herein. I [urther Verify tha~ based on Ihe Informatlon obtained from the Municipality of Anchorage files and from my Invesiigallon and Inspection. the on-site water supply and/or wastewater disposal system Is(are) In compliance ~vith all applicable Municipal and State codes, ordinances. and regulations tn eft'act at the time of Installation. S & S ENGINEERING 1703~ E;;!.; R~'.':." [-'~-~- ~-"-~ Eagle River, Alaska 99577 Phone Name o/Firm Address Engineer's Printed Name ~';~ o/3 ,"~.;'- ~'. ~"o~-v,~/ bedrooms. 5. DSD SIGNATURE V/ Approved for Disapproved. Conditional approval for ,.. .- ...... bedrooms, with lhe following stipulations: Additional Comments Attachments: HAA Checklist SepIic Sys{em Advisory Well Flow Advisory X Maintenance Agreements SUpplemental Engineer's Report Olher Original Cediricate Date: ~ -/,.~'"' ~ ,.2... Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bregaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchomge,ak.us (~07) 343-7g04 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type ~,~nr~ Date completed 9 /y l q 7 Total depth 30 7 ft. Date of test Static water level Well production WATER SAMPLE RESULTS: ParcallO O I 7 -ltl-D7 If A, B, or C provide PWSID # '- Sanitary sea~ ~m) FROM WELL LOG ,yI -/q7 ~Y7 ft. ]. 5-- g.p.m. WeU Leg (~N) ye J Wlms properly protected ~/N) Y~ -f Cas~g height (above ground) s 9- In. fL ~'-' *~ g.p.m. AT INSPECTION I/,//o ?- 35- Coliform O colonies/100 mi. Nitrate 0,;~ · ~,, mg./I. Date of sample: '5/t ~/o ~ Collected by: D. SEPTIC/HOLDING TANK DATA TankType/Material $~-,~7',c / ~./~e..~r~t.4 sJ Tank Size' ) d° O gal. Number of Compartments Foundation deanout (Y~IJ/,,o/~ Depression over tank {'/~[~J) ~. o Date of pumping ~./I et/'~ 2. Pumper C. ABSORPTION FIELD DATA Date installed 5--/7c/ Soilrafing (g.p.dJft~) ~'O Length &" O fl. Wk~th 5'- , fl. Other bacteria 43 colonies/100 mi. ENGII~'EING ~/u~4 Eagle Rlv~r Loop Roed No. 2D4 River, Al.sim 9957? Hig~ water alarm ('Y~ .~' 0 Totaldepth Io ft. Eff, absorpfionarea /~6,~ f~ Monito~inglube ),~,/ Date of adequacy test "~/' 9'/0 2_ Resultsi~.9~/Fall) ~J-~ Fluid depth in absorption field before tast O in. Water added ~8,4-gal. Elapsed Time: A'//A rain. Final fluid depth/'?'/f in. Absorption rata >= Any rejuvenation treatment (past 12 mo.) (Y/N & 13qoe) /v ~/,,~. ~,~'~ ~v,./ If yes, give date System type Gravel below pipe ~ - ~-- ft. Depression over field For ''~ bedrooms New depth O in. /1/ 3- O g.p.d. D. UFT STATION Date installed 'Pump on" level at Datum E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N) /. in. ~ Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT T~c ' Septic tanldlifl station on lot /~ ~ ~- o C/o On adjacent lots Absorption field on lot Public sewer main Sewer/septic sen'ice line On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation. ,C' ~-/-- Property line 5" '/'- Water main ~J//A Water service line /0 ~ Wells on adjacent lots / 00 -,'- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / O ~" Building foundation /O f- Water Service line / O -F Surface water / O ~ Curtain drain .H,~ ," ~- ~,~c~ Wells on adjacent lots /o0 ~ Absorpfionfleld Surface water )0 o '-/- Water main Ddveway, parldng/vehicie storage F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspec~fons and review of Municipal records that the above systems are in conformance wfth MOA HAA guidelines in effect on this date. Engineer's Printed Name ~OI~/~A T- C. Co~JA/*/ HAA Fee $ "~ Date of Payment Receipt Number (Rev. 1~) Waiver Fee $ Date of Payment Receipt Number Parcel I.D. # ____ 1, 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 -/Il -o GENERAL IHFORMATION Complete 16:.~al description . .'~RTIFICA', _ 9F HEAL. ,t Al.. :Ph *RiTY Ai::,,,OVAL FO¢ ,:, SINGLE i'AMI[. ~ L'.,',,,--LLING Location (si;.., address- or directions) Proper:y ow; ~,r __ Mailin9 addross Day phone Lending agency ~( (' ./~, C_ [.~¢oc< ¢;~. Day phone Mailin,r.: address Agent .... ~'~':~ C~ ~ ~.I~,,~: ' ~ c_ Day phone Address Unless o,fherwise requested, HAA w,,tl be held for pickup. 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 ,ank Commur dty on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front hDA #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 compliance with all Municipal and State codes, °rdinances! and. re~ i,n e, ff.e~,°/~ ihe d~t~e °f this inspecti°n. Name of Firm '~' - ~ Phone Address ~ ~ ~-/! 3-~'~. ~ ~ ~ EngineeFs signature ~ ~ ~ ~ DHHS SIGNATURE ~ Approved for ~-~/~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the 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 p?ofessional engineer's work. 72-025(Rev. 1/91) Back MOA~21 Municipality of Anchorage I VE D DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 343-4744 RECE Health Authority Approval Checklist LegaJ,Dcseri~ti0n.'.' At ~ I~'- FO.,or ~t4~¢~t' Parcel I.D.: A. WELL DATA Well type % , Y Log present iY/N) Total depth '~) 7 Sanitary seal (Y/N) ~'/ MAY 0 2 1997 _ Municipality of Anchorage If A, B, or C, attach ADEC letter. ADEC water system number ~///"J-- Date completed /~/' 5.~ 7 ( b,P-Ef ~ J) Cased to ~Tfa ~ Casing height (above ground) ('~ ! Date of test Static water level q7 / Well production /. ~ FROM WELL LOG g.p.m. Wires properly protected (Y/N) AT INSPECTION g.p.m. WATER SAMPLE RESULTS: Coliform /~/~. / q ...~ Date of sample: B. SEPTIC/HOLDING TANK DATA Ce Nitrate N ~ Other bacteria Collected by: '~--?~ Date installed lq7? Tanksize /t~lS) Number of Compartments ~- Cleanouts(Y/N) Foundation cleanout fi/N) ~ Depression (Y/N) ['"/ High water alarm fi/N) Date of Pumping I 0 }o~/q {,~, Pumper l ~L.a~-LI 5 ABSORPTION FIELD DATA Date installed._[ ~'7 ~ Soil rating (g.p.d./fl2 or fl2Podrm) /,_.~0 System type Length ~0 I --; Width ~D Gravel thickness below pipe ~.~ ~ Total depth Effective absorption area "-'~, ¥onitoring Tube present(Y/N)._j_~ Depression over fie~d fi/N) Fluid depth in absorption field before test (in.); Fluiddepth I~7 (ins.) Minutes later:o~7/r'9 Peroxide treatment (past 12 months) (Y/N) Immediately after/~'Ogal, water added (in.): Absorption rate = > qd'-~) g.p.d. If yes, give date LIFF STATION Date installed Size ill gallons Manhole/Access "Pump on" level at* "Pump off" level at* High water alarm level at* Cycles tested *Datum RECEIVED SEPARATION DISTANCES MAY 0 2 199}' Munlclpallty of Anchora SEPARATION DISTANCES FROM WELL'ON LOT TO: ~ Dept. Health & Human Ser%g~ceea Septic/holding tank on lot /Off'( ~o (', 0 ) : On adjacent lots Absorption field on lot IQ ~::~! '~ : On adjacent lots ~ l O--~ / Public sewer main ~///--~- Public sewer manhole/cleanout Sewer/septic service lille ~ ~'X~ t Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5,~ t ~ Property line ~ [ 0 I Absorption field Water main/service line ~o~ Surface water/drainage II Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~- L// Water main/service line Surface water ~ 1.9 ~/) Curtain drain ~ o v/-~- Driveway, parking/vehicle storage area ~O ( Wells on adjacent lots '~ [0-~ Property line "~ /O I I cert!fy that I have determined thrufield inspections and review of Municipal recqr~9,~e able in conJbrmance with MOA H~ guidelines in effect on this date ................................................................................................. · ....... HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc 203 WEST 15TH. AVENUE SUITE 203 ANCHORAGE, ALASKA 99502-3904 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: Lot 15 Fairmont S/D 5530 Rabbit Creek Road Single Family, Three Bedrooms On Site Single Family FROM MUNICIPAL RECORDS: 3 Bedroom System TANK: Sunset Plastic 1000 Gal. 2 Compart. ABSORPTION SYSTEM: 5 Wide Trench ABSORPTION AREA: 463 Sq. Ft. SOIL RATING: 150 INSTALLATION DATE: May 1979 WAIVERS GRANTED: None Required DATE OF LAST PUMPING: Isaacs, Oct. 8, 1996 DATE OF TEST: Oct. 24, 1996 TEST PROCEDURE: System was inspected and measured. Tank was found with 6.5 feet of cover and with a liquid level of 38 inches. Trench clean out was not :Found. Trench monitor was 11.5 feet deep with 24 inches of liquid. 1250 gallons of water was added to the trench on October 8, 1996. This caused the water level in the monitor to rise to 29 inches. On October 24 an additional 1000 gallons was added to the trench. Prior to adding the water the water depth was 26 inches, after adding the water the depth was 29 inches. The next day the water depth was 27 inches, indicating that the system was working properly. TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE Fill has been added over the system., The monitor to the trench must be replaced with a stronger pipe. It is possible that the Health Department will insist that the trench cleanout be recovered. If so, this should be done after breakup. NOTE The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long this system will function satisfactorily for current or future occupants. All septic systems ultimately fail. Some systems last 15-20 years, others fail after less than five years. PETE FARRIS ~ 1907-261-7608 ~t31/7/97 G 10'19AM ?}2/2 · .. , WATERWELL . TEST PUMP: REPORT . . .' · .:'% .· Well Inlormellon: TII, Depth ~Oeplh el Casing - Screen From '"' To Casing Size ~:~ '~/Screen Diem ~ Screen Slot Remarks Pump Information: Inlake Depth ~ Pump Size .,-r"--"- ' Air Line Deplh , Static Wale, Level /"7 / ' Ay. Ol$charge~OPM, Max. Otewdown,~//_ ~- ~..~¢.~_~ ' WATER PIEZO. FLOW WATER PIEZO- FLOW TIME LEVEL 'I'UBE GPM REMARKS TIME LEVEL TUBE GPM REMARKS ... ~.,~,-,.,=~ ~,,.-~,.~.,~.~_ ~ ,.,"-~ ~.,_..,~ -'- ~.~.'~ '~ / ~.... '... MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON.-SITE SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (a) (b) (c) Application Date Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant blame ~ ' Telephone: Home '~¥~- I'~.~ Business Applicant A d d r e s~~_C~_ _~ ~.. Applicant is (check one): Lending Institution B; Owner/builder~; Buyer ~; Other ~ (explain); (d) Lending Institution Address "~"~__ ~ (e) Real Estate Company and Agent Address Telephone Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family~ Multi-Family Number of Bedrooms Other WATER SUPPLY Individual Wellj~' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL X Onsite I Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025 {11t84) ENGINEERING FIRM PROVIDIN~ INSPECTIONS, TESTS, FILE SEARCH, DA iA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on Name of Firm ..... ~ Telephone Address / ~O ~ ~ 1~ Approved for cvv/--.v--.c.-/ bedrooms b ~'~ ~"~¢-Date Approved ~.~ _ Disapproved _ Conditional Terms of Conditional Approval ' ' CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes an,d their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72~025 (11/84) A. WELL DATA MUNIClPAU~ Of ^NCHOR^GE DEFlr. Of H~,t.TH & sEP 1 t MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Well Classification Well Log Present (Y/N) Total Depth ~'~_~) ~' Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: If A, B, C, D.E.C. Approved (Y/N) &/ Cased to ~) ~ Date Completed ~.~e~e~ · Yield Depth of Grouting J'~ ~N t-- Pump Set At ~,~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Septic/Holding Tank on Lot I ~ To Nearest Edge of Absorption Field on Lot 1 ~ To Nearest Public Sewer Line ~ To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments 4t, ~'~,~ ~,~l NO N. ~ To Nearest Sewer Service Line on Lot :°ate B. SEPTIC/HOLDING TANK DATA Date Installed J'~o.~ Standpipes (Y/N) Ol~ Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line _~ To Water Main/Service Line Course Air-tight Caps (Y/N) Size ! ~ No. of Compartments ~ ~/ Foundation Cleanout (Y/N,~) - t~l,O Date Last Pumped ~ ;for WA Temporary Holding Tank Permit (Y/N} ~ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed J~O.4~ ~ q Width of Field --,.~1 Square Feet of Absorption Area I~ ~_.~ Depression over Field (Y/N) J~ Resu,ts of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well } ~ To Building Foundation 7~ Lot ~O N ~ TO Water Main/Service Line ~ ! O To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field .~.~ Depth of Field ~' Gravel Bed Thickness .;,~, Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) ~.. Comments D. MFTSTATION NO H~.~. Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments Page 2 of 2 72-026 (11/84) ** Check Permitted Bedroom Rating Against HAA Request ** I certify thaLLl.ha~v~hecked, verified,p'~onformed to.all MO~, and HAA guidelines in effect on the date of this inspection. Signed -'~'-~ ~ Date Company / ' MOA No. Receipt No. ~[. -- ~OG~ Dateof Payment q- ~-~ Amount: $ I~ ~ ~ ]49TH ~ Engineer's Seal 203 W. 15th AVE "C' SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: TYPE OF WELL: WELL LOG AVAILABLE: LOT 15, FAIRMONT 5530 RABBIT CREEK ROAD BRUCE RIZER SINGLE FAMILY NO INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM TEST. .45 GALLOMS PER HOUR PUMP YIELD: 5.3 GALLONS PER MINUTE DATE OF INSPECTION: MAY 29, 1986 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 5.3 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL UNTILL THE AUTOMATIC SHUT OFF. STATIC WATER LEVEL WAS FOUND AT 40 FEET BELOW TOP OF CASING. PUMP IS INSTALLED AT 64 FEET. STORAGE IN WELL CASING IS 100 GALLONS. A TEN MINUTE RECOVERY PERIOD CAUSED THE WATER LEVEL TO RISE 3 FEET. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON MAY 30 AND SEPTEMBER 9, 1986. TESTS WERE NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. 203W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 CONSULTING ENGINEER SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOT 15, FAIRMONT LOCATION: 5530 RABBIT CREEK ROAD OWNER: BRUZE RIZER RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WATER SYSTEM: ON SITE WELL SEPTIC SYSTEM.. FROM MUNICIPAL RECORDS: TANK: SUNSET PLASTIC, TWO COMP. 1000 GAL. ABSORPTION SYSTEM: SHALLOW DRAINFIELD ABSORPTION AREA: 463 SQ. FT. SOIL RATING: 150 INSTALLATION DATE: MAY 1979 DATE OF PUMPING: SEPTEMBER 9, 1986. A1 SERVICES DATE OF TEST: MAY 29, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH 12 INCHES OF COVER. WATER DEPTH WAS 49 INCHES. MONITORING TUBE WAS 5 FEET DEEP WITH 3 INCHES OF LIQUID. 300 GALLONS OF WATER WAS ADDED TO THE MONITORING TUBE. THIS CAUSED THE WATER LEVEL TO RISE 28 INCHES. WITHIN 10 MINUTES AFTER ADDING THE WATER THE WATER LEVEL WAS 9 INCHES. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. ' ' THIS SIDE FOR OFFICIAL USE ONLY CEIVED : INSPECTION APPOINTMENTS DATE R TIldE : · · ' TIME ' ' " TIMi~ DATE ' DATE " DATE .... INSPECTOR ; ' ' INSPECTOR INSPECTOR DIRECTIONS~' 1~ TYPE OFRF~IDENCE NUMBER OF BEDROOMB [] SiN~LEFAMtLY [] ONE [] 'THREE [] FIVE [] MULTIPLE-FAMILY [] TWO [] FOUR .' [] .. SIX 2. WATER ~IPPLY ,PERMIT NUMBER [] COMMUNITY CATE DRILLED · [] PUBLIC UTI LITY COrfnectlon. Verjfied~. . ,, LOG RECEIVED 3. 8EWAGE~DISPOSAL SYSTEM PERMIT NUMBER [] INDIVI,DUAL/ON -SITE bATE INSTALLED [] PUBLIC u'TILITY Connect]oh Verified . . INSTALLER [] Septic Te~k or [] Holding Tank Size: . _ If Tank is homemade SOILSRATING ' give dimen~Sns: 'TYPE OF TAI~K ' ".' MANUFACTURER · N TOTAL ABSORPTIO AREA MATERIAL WELL TO: Absorption Area to nearest L~t Line 5. COMMENTS~1~ ~e~.~L~,,~, j~,,.~3~.,~l~ ~._~~' .. · I ' - . ~;~PPROVED FOR ~ BEDROOMS ~ [~'~NDITIONAL APPROVAL (letter must acco/p/certificate) [] DISAPPROVED ~"~ . /~ ~ · 'LEO~.LCESCRIPTION ' - ' ' .... 72-010 IRev, 3178) October 25, 1978 Jack Cutler % Everett ~ionegger 1042 East 6~ Avenue Anchorage, Alaska 99501 Subjects Lot 15 Fairmont S~bdivision This department ]~s reviewed tho am-built survey and did ~un inspection of the above subject property. It has been determined that it is ~ossible to put a sewer system on the subject proparty and still meet the min/~n.'um protective radius requirument between well and Little Rabbit Creek. It should be noted that if the soils are not suitable for a leaching area that a ho!din~ tank would be a second alter- native, If there are any further questions, please oontact this office at 264-4720. Sincerely, l~bert C. Pratt, R.S. Associate Specialist c /ijw Ocs United B~nk Alaska 645 G Street 99501