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Home My WebLink AboutTUNDRA JEWEL RANCH LT 18ATundra Jewel Ranch Lot 18A #051-193-27 · Municipality of Anchorage Page ! of '2. DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 9951.9-6650 · Telephone: 343~4744 On-Site W~istewater Disposal System and/or Well Inspection Report Permit Number: ~'3'=1 ~' oo'1o PID Number: o51 - 1'~3-27 Neme: Wastewater System: D New [] Upgrade Address: ~ ,,.~~ ~ D DeepTrench ~ Shallow Trench ~ Bed D Other LEGAL DESCRIPTION so, Raft.g: GPD/Sq. Ft. Total~origl.algrade: Lot: Bl~k: Subdiv~[on: Depffi to pipe ~om from odginal grade: ~el depth beneath pipe Township: I Range: ISect'on: __ Fill added above oHgina~ ~ -- FL WELL: ~,5~/~ New D Upgrade a,.ve~w~ath:~ Num~r of lines: ~ FL I Cla~sili~flon (Frigate, A,B,C): Total Depth: ~: Total ~on ama: Pipe ~rm~ ~ ~ Draining: s~t~c water L~eI:FL ~lec Date InstallS: ~ m Pump set at: ~ ~sing Height Abo. Ground: PM Ft. I FL TAN K SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P. To 8epUc Ab~Uon Lift Holding =ubll~Hvate Manufa~urec Capacl~ In gallons: From Tank F~td S~tlon Tank ~wer Unes ~~ ~ ~ WelY ~[~ Material: Number of Companmenm: SudaCewater ~~ LIFT STATION Line Remarks: BENCH MARK Locetion and D~crlption: I Assumed Eleyation: ENGINEER'~ ~L S & S ENGINEERING Depadment of Heal ~ and ~ma~.~e~ices approval ~'.., CE-~SO~ '~ Reviewed and approved by: X I[~ Date: ~ [~ ~ 72-013 (Rev. 9/91 ) MOA 25 ~. 96-0'/-19 1i:44 RCVD Permit No. SW960090 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box'il96650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site wast~'.w. ,ater Disposal System and/or Well Inspection Repod ,:,. :".-;,...'.. EOT,-18A,'TUNDRA JEWEL RANCH S/D 051-193-27 Legal Des(~ription:. ' ' · PID No.: ~-~' ,~T ~ ./f--NEW 1250 GAL ~ ~SULATED PI ~IDER DRIVE~ AY . SB ~B //.~j LOT 1 gA .[ CO1 53.5 72' ~' - 4o' ST1 61' 78' ' ~ ST2 69' 84' DBL171' 86' _ , .~ ....... ~~.~ ?~ 90 S.T. _ . ~ · Per~itNo. SW960090 Page 2 of 2 Municipality of Anchorage 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 Legal Description: LOT 18A, TUNDRA JEWEL RANCH $/D PIDNo.: 051-193-27 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PERMIT NUMBER:SW960090 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:WELCH, LARRY & JANINE OWNER ADDRESS:8561 BROOKWAY CIR. ANCHORAGE, ALASKA 99504 PARCEL ID:05119327 PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE~ PERMIT DATE ISSUED: 5/28/96 EXPIRATION DATE: 5/28/97 LEGAL DESCRIPTION: TUNDRA JEWEL RANCH LT 18A LOT SIZE: 87120 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: SEPTIC TANK 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 (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ISSUED BY: DATE: ROBERT C. COWAN, P.E. ROBERTA. SHAFER, RE, May 16, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MNN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & R. OW TEST ROAD DESIGN SOILTEST F~RCOLATION TEST STRUCTUR,~. & MECHANICAL INSPECTIONS ON SITE W~TEWATER DISPOSAL SYSTEM E~$1GN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 18A, Tundra Jewel Ranch S/D Request you issue a permit to replace the septic tank serving the four bedroom house on the referenced property. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. The proposed 1250 gallon septic tank is to be placed outside the well protective radius. Attached is a site plan which depicts the location of the proposed tank. If you require additional information, please contact us. Sincerely, · Cowan, P.E. Rcc/gk Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 * EAGLE RIVER. ALASKA 99577 1"'= 60' SITE PLAN r DESIGN 0 P~O ...i-~ ~0 I-' ~o 'Z oO~ ~o ~ z r ~ 0 OF CODY CT ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUtHORItY APPROVALS SEWER&WATER MNN EXTENS~3NS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST ROAD O~SIGN ~OILTEST F~:~.ATIO~ TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAl. SYSTEM E~.SIGN 8EFERENCE: Lot 15A, Tundra Jewel Ranch S/D May 16, 1996 GENERAL: 1. e Se e The scope of this project includes the intallation of a 1250 gallon septic tank outside the 100' well protective radius to serve the four bedroom residence located on the referenced property. The existing 1500 gallon septic tank is to be excavated, pumped, crushed, and abandoned in place. Construction shall be in accordance with the approved site plan and design drawings, Municipal pezmit with any special provisions or conditions, and all applicable State and Municipal Wast.water Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INST~T.~.~TION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to · prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP ° sUrrE204 * EAGLE RIVER, ALASKA 99577 Page Two Lot 1SA, Tundra Jewel Ranch S/D May 16, 1996 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than l0 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfleld. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. MINIMUM MATERIAL SPECIFICATIONS: me Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM.D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4.. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Page Three Lot 1SA, Tundra Jewel Ranch S/D May 16, 1996 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the tank has been set; lines, cleanouts, standpipes, and insulation are in place; and prior to backfilling. ® The final inspection is to occur upon final grading of the property. The inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. pe~,~t. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons perfor,~ng work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER MUNICIPALITY OF ANCHORAGE ~ · D[ RTMENT OF HEALTH AND HUMAN SER..,ES d~C~g Environ'mental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 L~ ¢|[[DON-SITE'- SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name Address Phone[s) Township. Range. ~t~on TANKS i. Kgooo F.o, zioo-, LEGAL DESCRIPTION [] HOLDING Capacny m gaflons No. ol Companments TYPE OF SYSTEM [~i'REN CH [~ BED Deptr~ I0 p~pe bottom lrom ~ S FT [-I W. DRAIN [] OTHER Total depth from Orrgmal graOe lb,, WELLS PRIVATE [] OTHER (Identifv) FTI FT DISTANCES SEPTIC TANK ABSORPTION FIELD WELL iO[}~ LOT LINE ~.~1 FOUNDATION q Ur I WELL AS-BUILT DIAGRAM IShow Iocat,on ol well. sephc System. pIopedy hnes. Ioundat,on, '~,~..A R KS: ~ale: ~ Iz~spect~o. ns P...ed_ormed by: ,"~.~ ~'''- 4 termly lhal this Inspection was pedormed according lo all 72.-013 (3/85) Altnn W. Murfitl, Iqo. 477~.E M U N I C.I P A L I T Y 0 F A N C H 0 R A G Department of Health & Human Services 825 L Street, Anchorage,. Alaska 99501 Permit Number: 880048 Date Issued: 05/16/88 ON-SITE Upgrade SEWER PERMIT Owner Name: W.L. PAINTER Owner Address: SRA BOX 1221 CHUSIAK, AK 99567 Day Phone: 688-2177 Parcel Id: 051-195-27 Lot Legal: Subdivision:~~ ~ RASH Lot:,....~8~. Block:.- Section: 9 ~Township: 15N Range: 1W Lot Size 86856 (sq. ft. or acres) Max Bedrooms: This Permit: 4 Total Capacity: 4 SEWER SYSTEMS: Listed below are the options available to you, ir; TRENCH Depth to Pipe Bottom Gravel Depth (ft>: 6.0 Total Depth (ft): 10.~ Gravel Width (ft): Gravel Length (ft): 42.0 Gravel Volume (cubic yds): Soil Rating Used (sq ft/brm): 125 LIFT STATION: If a lift station is installed~ a 'high water alarm must be connected to the residence. SEPTIC TANK: Minimum total septic tank capacity: 1,250 gallons. Each septic tank must have at least 2 compartments. Depth to top of septic tank(s) < 4.0 feet requires insulation over tank(s). INSTALL PER ENGINEERS DESIGN. TRENCH: 42' X 6'. NOTIFY DHHS PRIOP TO 1ST & 2ND INSPECTIONS. ~HIS PERMIT EXPIRES 1~/~1/88. I CERTIFY THAT: 1. I am familiar with the requirements for on-site sewers and;wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compli~nce with the design criteria of this permit. 5. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well~ wastewater disposal system or public · sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum o£ 4 bedrooms. I also understand that the capacity of the total system is 4 bedrooms and any enlargement will require an additional permit. DATE: DATE: SERVICES DEPARTMENT OF HEALTH & HUMAN 99502~6~ 825 "L" Street, Anchorage, Alaska SOILS LOG ~ PERCO~TION TEST~ No. ',,. . . _ DATE PERFORMED: SITE PLAN IF YES, AT WHAT ~[k' P .-;% 11 s L O DEPTH? 13 I~n~mng? Da Gross Net Depth to Net Reading Date Time Time Water Drop 14 15 16 17 18 19 .'~-T'~'~3'O~t'~<,- "~ e.5;~'~) PERCOLATION RATE ~ (mmute~mc~) PERC HOLE DIAMETER · ~ ~ - ~- " ~ ' i ~'~ PERFORMED BY ! 199. m m mmm m I -. I-' '.".',-~-.::";"i....' i~-'. ' :" '..." . I I ' ' ,..~3 " ' , --' .... ' ..... "' ,',-'-, _----~ I ' ' · · I · -'-, · I" :'~ '."-%' :, I '~':' =~ ,;. · ';' -'; ~- - ~:'~'~" ?"'%':- ' :"-~a:=~ · . ~·/ - ~ ·I · '' 1- ·, : ~~[~;ei-. SUBDIVISION ...... " MONTGOMERY ' ' ' "=Ti ..' · :.'..- - - ' · C.o. nsultlng Engineers & Testing A.W. Murfitt Com_pany.dz 13810 Venus Way · Anchorage, Alaska 99515 Telephone [907} 349-7531 SIEVE CUM. FINE SIEVE ORGANIC CONTENT WT. ~ED,*TARE WT BURNED+ TARE WT. TARE % c~c~mc HYDROMETER A"N A LYSa S CYUNDF...R NE SP. GRA'~'TY O. O2 mm A O.C)O$mm R O002 mm HYDRO MOISTURE CONTENT TARE N~ WET * TARE DRY 4. TAR[ TARE % .o,szu.: GRAJN SaZE % OF DIA. mm P TOTAL O I:~.SSING SPECIFIC GRAVITY- LECHATEUER WT. Or S~MPLE INITIAL BLANK READING [BI F'INAL BLANK READING FLASK READING CORREC'r~ B-C &PR SE' OR. J~fF SPECIFIC GRAVITY COARSE OVEN DRY WT. (Al WT. m APP. FINE FLASX N,~ FI. ASK F/.~ WET SO1. DRY W! FI_~ S(:XL* H2D TEMR SE GRAVITY q CHECK .,M:'P~ lATE SAMPLE PR~ PAN WASH SIEVE I ~OISTU~ ORGANIC SD GR. LECHATEUER HYDRO. O.OZ SP G~ COARS~ HY~O. QOOZ ~. GK FINE HYDRO. WASH ATT. O •za-04;+2: r6» ; SCS ReEM 1043617001 Client Name S do S Engineering Project Ne1te7H LISA, Tundra Jewell Ranch Client Sample 10 LI SA, Tundra Jewell Ranch Matrix Drinking Water Sample Remuks: IGO? 6015301 r A— _ Laboratory Analysis Report All DatuR3mes ere Alaska Standard Time Printed DatcMme 06/252004 631 ColleetedDatemme 06222004 14:30 Recelved DateMme 06004 16:16 Technical Director St ea C. Ede peraneru Results PQL Units Method Contskmrlp Allowable Prep Analyst b Init Natera Department NitrawN 3.47 0.100 Microbiology Laboratory Tout Coliform 2 OB, No Coll MVI EPA 300.0 B (o-10) 0623/04 JJB eol/100mL SM20922211 A (cbl) 06122/04 DKC CTU EmnannrnulSerritnsM�WbmsrOMticn 200 WenPonerOrive.anrnerape.aK99516-ISM • tf907IS512343 1190715515001 www 1 spsanvepenaiul can M -M, I M SOS ewe tse kf sm&e doSwwa.el Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-4744 Parcel I.D. 051-193-27 1. GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: Lot 18A~ Tundra Jewel Ranch S/D Location (site address or directions) 2606 Needles Loop Current Property owner(s) Janine Welch Day phone 762-5818 Mai[ingaddress PO Box 670786, Chugiak, AK 99567 Lending agency Mailing address Day phone Real Estate Agent Day phone Mailing Address _ / // / "7 ~/ Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates 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) on propedies served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 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 less than 30 days old. 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. 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 Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. S & S ENGINEERING 1: '; '?-::!~ ;'V,v.:r Loop Road No. 204 Name of Firm Sadie Address Engineer's Printed Name DHHS SIGNATURE ~ Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations:~%%''~*''~ Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Olher Expiration Date: Original Certificate Date: (¢ - / ¢) -O o Reissue Date: Municipality of Anchorage JUN 09 DEPARTMENT OF HEALTH & HUMAN SERVICEIBUNIOP^uT¥ o~ Environmental Services Division 'nPQNMENTALSERVICES 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: A. WELL DATA Well type ~ / Log present (Y~) Total depth Sanitary sea, N) Date of test Static water level Health Authority Approval Checklist ~-~A/'/~,&~/~ ~--"~"~"C/¢"'~-~- Parcel I.D.: Date completed Cased to / ~ ~ / If A, B, or C, attach ADEC letter. ADEC water system number '/,CC-z/ Casing height (above ground) Wires properly protected~N) /Z FROM WELL LOG Well production ~ WATER SAMPLE RESULTS: Coliform 0 Nitrate Date of sample: ~ / 7~-/~~''~ B. SEPTIC/HOLDING TANK DATA g.p.m. AT INSPECTION 4~' '~- g.p.m. Collected by: Other bacteria O .i ~aCe Rfver Loop Road No. 204 Eagle River, Alasl(a 99577 Cleanouts~N)_ _~ Date installed (¢:~/;2/¥~ Tanksize Number of Compartments Foundation cleano~l)/'--¢'~ Depression (Y~ .,47(~) High water alarm (Y/N) Date of Pumping ~_-~/~/~?'/_)' Pumper C' AD't% iOnRstPa%:eOdN % ~% 'Soil rating (g,p.d./ft2 ~ /4~, ~'/~ System type }l ._ / / / Length 4~ Width. ~ . Gravelthickness below pipe ~ Total depth /~ Effective absorption area ~4 ~MonitoringTubepresent~N)('~'¢'~noverfield(~ Date of adequacy test ~/'~/~/~ Results(Pass/Fail)/~,.~ For ,/~'//~--. bedrooms Fluid depth in absorption field before test (in.); -~'~ Immediately after¢~gal, water added (in.): Fluid depth ~ (ins) Minutes later: (/O Absorption rate = 'TL~7 g.p.d. Peroxide treatment (past 12 months) (Y/N)/~/¢g/V~' i~I//C/C/,/V/ If yes, give date '-'--'- 72-026 (Rev. 3/96)~ D, LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested ~~-~ Size in gallons ~ "Pump on" level at* ../~'~_"Pump off" level at* .-~'~-tu m E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /(~(~/'-/'- Absorption field on lot On adjacent lots On adjacent lots Io0 % Public sewer main .A///~ Public sewer manhole/cleanout Sewer/septic service line '¢- ~--~;~ ~' Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation ~//_ Property line ~' /¢- Absorption field Water main/service line ~/~) ~ Surfacewater/drainage ,/~:~'/) ~/ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / O /.'~ Building foundation / ~) Surface water / O(~ /.7L Driveway, parking/vehicle storage area Curtain drain /,~/g2,A,,'~-. ,,~__/V'ff~(./A./, Wells on adjacent lots I certify that I ha ve determined thru field inspections and review of Municipal re/~t~,,lh'~t the in conformance with MOA/~lAA~uidelinec'in effect on this date. ~ Water main/service line ,/~P /¢- are HAA Fee $ ~ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number FICATE OF HEALTH AUTHORI ,'i'~, ..;,;,! t~'address ~. : , :.:., ..... . .~,* . ~ . ~ ~.~-~ , ~¥;..;-/- ; I'!~- ........ , ......... · ........ .:., ~ ,.. .... .: , .,r ~ ..__ Day I: bono. ' '~ .... ? ,,*~ !'~'m '~ f ~,~, ~; ~ ~l ~.:~..'~ , OF WATER - ';' ,'., ... .' ...... ,.. '...:.'.' , · ':.':.' '.-:'~i ' · ~.X.,'..~ '.i;... ' --',: ~.,'a," · :':,. .: .: qC ~ii'ittbn'~o'n'firma~ion' fr'~. "' l;'" ~ ,,~'. ,-v .--. .,/~'][., , ... .\,., 1 ~,1.~ " '"':"~" ""' ' '" .... · ', .... '. ' ~''\ \ ' OF..WASTEWATER ,~: :..;~ ~'~l. :~\1 · . ' \,' · , ~ .. ~'XX' ' " ;~. :. ', ~ ..... , :,- *'** 5.'?~ STATEMENT OF INSPECTION BY ENG NEER - '*: :-.:: · ' As certified by my seal affixed hereto and as of the valid~ti0n date shown b~low~ I verify that my .}...~: ~ investigation 6f:~hi..s Health Authority Approval application shows that the on-site water supply '. i..~ ...- <a.n'.d~or wastew~t~r disposal System is ~fe, functional and adtu:iuate for the number of I:~drooms ...... and type of structure Indicated heroin. I further verify that ba~,:t on the information obtained from the Mumc~pahty of Ancho~ge files and from my investigafi~3n and inspection, the on-site water~'' supply an, d/or waSte=~'t~'~isl~o~l system'is in compliance With'all Municipal and State codeS~ * ' .......... ordinances;'an.d.r, egulations in effect on the date of this inspection.: $ & $ ENGINEERING ~', .... " Name of Firm .~- ........ ~.-6..~ HHS.SIGNATURE ,.... /: ~ Tt3e Mun~liW of ~chomge ~ent of H~ th and Human ~wic~ (DHHS) i~u~ Hca th A~hofl~. Appro~l ~.~f,~t~ ~ .on~.u~n the repr~n~tions given n paragraph 5 a~ by an inde~ndent ~,. p o ~onal engm~r ~tster~ in ~ S~te of Al~ka. The DHHS d~ this ~ a cou.~ to pumh~m of hom~ ".,::;. and mci[ lending In~t[t~p~ ~.~q.~tis~ ce~ip f~eml and s~te ~ul[emen~: Employ~'°f DHHS do not. condu~ ins~ctions or anal~e '~ ~fore a ce.ificate is I~u~: ~h~ MuniciPali~:of An~hO~ge is not" i I *" ' : ' . : , ~,~.."};3%~;~ ,: ', ',[.; .I,L;)': - . ~ns b e for e~om or oml~,o~.in the prof~onal engm~fs, wo~..: ; . ' · .'-. · ','. Legal D~cripfion: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) JUN 2 ! 1995 Health Authority Approval Checklist A. WELL DATA Well type p=ent Date of test Static water level Well production If A, B. or C. attach ADEC letter. ADEC water ,system number ~ {~, Date completed Cased to t (~ ~ ~ Casing height (above ground) I ~.t t 4- FROM WELL LOG g.p,m. g.p.m WATER SAMPLE RESULTS: Coliform Date of ~nmplc: ,{.¢ ..-'~../N~, CoUected by: Othc~ bacteria B. SEPTIC/ItOLD~G TANK DATA Date installed Foundation cicanout/~N) q D~mssion (Y~iI:P ¢,~ ,ABSORIq'ION I;11~;n~I~ATA 'Date imlalled .5"'-;~;P, '"~ ~..~ Soil ming (~p~m2 or l~redm) ~ O~~ '." '~ ~' G~I ~ ~1~ pi~ ~.r~t,. Tn-k size 1'Z~¢1~> Number of Compartments ~ Cl~tnouts(~N) High water alarm (Y/N) Fluiddcpth in absorptionflcldbcfom t¢~1 (in.); OIb'- latmNia!dy altcrp~POgaL wat=radded (in.): Finiddcpth 0~..-- (ins.) IvUnutcs later: Ott~4~ Absoq~tion rate = b°o ' :: g.p.d. Pcroxidctrcatmcnt(past i2monflts)(M~ ,~,~ g-~'~,) lfycs, givedate ~L[p C/ Total depth tO ,~' I Depression over field (Y~ ~ For q =~' bedrooms Do LII~ STATION Date ins'tailed Size in gallons el al*" " " ' ' ManholedAccess (Y/bO *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line : On adjacent lois ; On adjacent lots ~ c:)o ~ ¥ Public sewer n~mhole/cleanout ~ [~. Lift s~ation ~[~- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~. O ~' ¥' Propcny line ~ o \1'- Absorption field Water main/service line ~ o ~' ~ Surface water/drainage ~.oo ~ ~-Wells on adjacent lots SEPARATION DISTANCE FROM ABSOPdaT[ON FIELD ON LOT TO: Building foundation kC) t~ Wa~r main/service line I o ~' ~' Surface water ~.o~ t-k" Driveway, paridng/vehicle storage area q--~"' ~ Curtain drain ~,,-~¢. 1~-,.~o..~3,.) Wells on adjacent lots lo~l~"..'-- Properly line F. ENGINEER'S CERTH;'ICATION I certi~, that I have determined thrufieM inspections and review of Municipal records' that t~ in conJbrmance with MO,4 ti/ifA guidelinesjn effect on this date. Engine~r'sNmne ~-A ~- ~'- Waiver Fee $ Date of Payment Receipt Number Rev. 8~95 OSS: haa.wk.doc .FI::ZOt'I IJ~CK IKIHITE REi::R. ESTATE TO · __. I I ~ - ' .... '~ · I I ~ I~ · J Eagle River. E 9 nccrmg 5ervJces P~0. Box 775294. Eogle ~lver. Alosko 99577 FAX 694-F^XS Total rtut ~ber of If you h ~ve any WA'rE~ $1$TEM: WA~R &~JPL~: poge8., 3 , including quet~tlon8 or if you $94-5195. Prlvat~ Welt Taken by Enll~er On I~/IgD5 S,e..PTIC $¥ INSTALL~ ;TEIVI: From Municipal this cover sheet. ore mls~in~ ony p~ges I I1'':::' H I I I Tank: 1500 Galloru Ab~o~ton System: Tremh Tyl~ rlON DATE: May 20, 1985 ~p~'ide, field 0n~y INSTAUL~.~ ABSORPTION AR~A: 504 $q~¢ ORIGINAL{SOIL ~NG: I~ From Orl$~l Soil ~$ { T~ PROCEDU~ ~: ~ l~d ~S charged ~ 13~ ~110~ of ~ from ~c on-site well Bt ~n average n~ of 6OPM.. ~. I ~e ~pd¢ ~ a~ I~chfield lic~id Icvch were monl~red referencing a level ~s n~ ~ ~ter wis ad~ and ~n absor~d mto ~e eutl0u~ sod. ~ w~t l~vd fa ~e ~¢ ~ ~d :~t ~i~ afar ~e addition of 1~ I~chfiotd Md a~p~ ~o onfire amount. A to~l ti~ in ii.id level in ~e I~chfield wn ~cor~d as 0'. The mo~ lng l~citc8 ~e septic wmm ~ll a~pt Ore rcq~r~ 150 gailo~ ~dt~nl, u dch ts ~e r~r~ t~Oo~ r~ for MuScle! a~tovd. ~.1 .: ~, ~ was ~ It m randy flow ra~ of 6.0 OPM. To~l drm~own ~om at 1~ f~tl ~Ow ~ t~ of~ ~. ~e fl~ ta~ Of ~e wo}J ~vas ~r~ m,d ~lc~ at ~xlmum ra~ or' 6.0 ~M. ~1 flow tale i, ~ m~xlm~ [a~ ~1 ~ ~ ca,blind by we of ~ ~ll~ pump. / I I ~Iso m~B ~e FHA 4 ho~ appli~O~ ~ MOA ~h ~y ~ if~ ~a~ lo~s l~ ~ m ~ ~a ~r ~ re~mme~d a ~ ~plncem~nt ~ 0~ ~8t opdon, ~t, ~t $3,~.1 I ~ ~f e~ m~m ~[~ by ~ ~ ~cr b ~ ~ i~n ob~i~ from itmbe~ M ~on ~n ~ ~Ct ~tl ~ ~t~ ~n~t. W~ ~ ~ ~ ~ ~ If~ · e ho~ !; ~t m~a~ The eltra0 ,hal Ute and ~e maOe, r of ¢ompilanOe wl~ Su~ m~d Municipal ~cs, for all wa~r and a~ ~ on ~ I~l ~oil ~ifio~, Vou~t~r ~vela ~t ~y ~t ~ o~cd from ~ ,~Mmlve ~, wMch ~d rcnder ~o I~chfield unu~ble. ~s Is ~ of all ~c %ttO ~s~O k~arl~ ~ ~ w?l I~ ~pfiC sy~m ~ ~ll ~e: ~ rcqulr~tn~ for appr~l in ~rt, ~e tc~ $a~ aM Jnve$~gafiofl of e~sOag ~0~ 18 provjd~ tO Our ¢lient ~ ~b~lul to M~H~ ~1~ Dopt~ent for ~ie review tM approval. A~ conc~aq ~ O~h ~t re~t s~ul~ ~is~ ~ ~ ~O ~ng e~r. If it it requited ~c ~li submit ~e xt~rt ~r~dy to ~ CT&E Environmcntat gsrvl~e5 DfinkingiWater A.qalysis Report for Total Coliform Bacteria ,.:o ~,. 't. MUNICIPALITY 0~ ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES . CERT. F,CATE OF ,NSPECT,ON FOR HEALT. AUTHOR,TY ^PP.'OVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property Owner~k},~.o~l~{~ ' Telephone: Home ~ Business Mailing Address~ (c) Lending Institution (..~'r~'~ J~lO~'~. ~)~.,,-~ Telephone .~'~2'~ -O '/'O{;) Mailing Address g~,-O~ f~r~o'~,~01~- ;, .~(.~FF'~~- J OO~ ~O112~-'- ~g] ~_"~ (d) Real Estate Company and Agent Address Telephone ............ (e) .. Mail the HAA to the followina address: or: Check here ~, if hold for pick up ............................. List contact person and day phone number below· . ~-' TYPE OF RESIDENCE Single-Family ~ Number of Bedrooms ~ WATER SUPPLY individual Well ~'~"Community I-] Public [] Note: If community well System. must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ~"~ublic 1-I Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 ~Rev 8/86t Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA 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 the date of this.inspection. Name of Firm ~U) IV~U~ [_T? ~ ,']~f~.~ Telephone '"'~Oj -~ ~ Note: 6. DHHS APPROVAL Approved for Approved Terms of Conditional Engineer's Seal The well for this p~~ets existing State and Municipal Codes. There are nitrates present, however, it is suggested that periodic testing be perfo~ed to insure .the wells .continued suitability. Nitrate concentra%ion is 4.0 mg/1. EPA maximum'Concentra~i0n i~* 10.0 mg/1. : .. (~ bedrooms by Date Disapproved Conditional Approval CAUTION 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. Page 2 of 2 ?~-o~s mev e~e6~ eack 886[ 0 g ~iOV'~OHDNV ~O WELL DATA Well Olnssifio~tion ~I~IR ~ ' MUNICIPAM';rY Ol~ ANCHORAGE (MOA) .EALT. AUT.O.' APPROVAL (.A^) CHECKLIST- FEBRUARY 1984 ' 264-4744 If A, B, C, D.E.C. Approved (Y/N) Well Log'~resent (Y/N) ~J o~ ' Date completed' '~ ~'TZ~.' Yield Total Depth 16~'# Cased to I~~'' Depth of Grouting Static Water Level , t '~ ~.# Pump Set At ! ~/' Casing Height Above Ground'4~ ~,lf ~ U~. ¢~anita,',, Seal on Casin~N) e;L,UO~. ' · Depression Around Wellhead Electrical Wiring in Conduit (Y~ Separation Distances from Well: To Septic/Holding Ta. nk on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line i On Adjoining Lots · 4- II I~ ; O'n Adjoining Lots 'ro Nearest Public Sewer Cleanout/Manhole ~J/~ To Nearest Sewer Serv~ Water Sample Collected by k'l~ll)o~l.l~' ;[3~e ~ . Water Sample Test Results Comments WF44, B. SEPTIC/HOLDING TANK DATA Date Installed Standpipe~N) Depression over Tank (Y,~ Pumping/Maintenance Contract on FiI~/_N~) ~ Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line I~ O I , . . To Water Main/Service Line, ' '" Air-tight Cap~) Foundation Cleanou~) Date last Pumped ~~ ; for Tempora~ Holding Tank Permit (Y/N) ~ To Building Foundation ,-~, TO Disposal Field To Stream. Pond, Lake. or Major Drainage Page 1 of 2 . , 72-026 {Rev 8.'86) Front Co Soils Rating in Absorption Strata I Z~ ~ ~/~ Type of System Design Date Installed ~ I ~ ~8~ Length of Field 4 Z ~ Width of Field ~ ~ Depth of Field ' II ' ' Gravel BedThickne~ _~ ~ ~ ~ ~ Standpipes Presen~N) Date of Last Adequacy Test Square Feet of Absorption Area Depression over Field (Y~ Results of Last Adequacy Test 1~j~'1LE.O , Separation Distance from Absorption Field: To Water-Supply Well ~ I OO I To Building Foundation C~ 4~ I Lot ~'e~ ~' TO Water Main/Service Line ~1~ To Stream/Pond/Lake/or Major Drainage Course To Driveway. Parking Area, or Vehicle Storage Area IO Co men, To Property Line ~ To Exis'ting or Abandoned System on ; On Adjoining Lots J OO To Cutbank (if present) UFT STATION ~*'~/A" ' Date Installed Size in Gallons "Pump On" Level at ..' Dimensions ~ Manhole/~ jJ Pumping Cycles during Adequacy Test..Meets MOA High Water Alarm Level at Tested for Electrical Codes (WN) Comments ** Check PerjUred Bedroom Rating Against HAA Request ** I ce~ec~rmed to all MOA .and HAA guidelines in effect on the date of this inspection. Co~pany~~OA No. _ . / o nece,pt No. ~ / Amount: $' }~O~ ' ' ~'~~ngineer's S~al 72-026 (Rev 8'861 I~ack ~ · ' Anchorage, Alas~(a 99518 Drinking Water Analysis RePort for Total Collf~)ilm Bacteria). TO BE COMPLETED BY WATER SUPPLIER n PUBLIC WATER SYSTEM I.D.ff ;~ Name Phons No. Ma,~lng Address · City State Zip Code Mo. Day Year SAMPLE TYPE: COt..O~FOJ~ "'Routine '-PLt4 NtTI .A't [] Check Sample (for routine sample with lab ref. no. ) [] Treated Water r-I Special Purpose [] Untreated Water TO I~E COMPLETED BY LABORATORY s shows this Water SAMPLE to be: Er'Sa't'lsfactory ' [] Un. satisfactory r'l sample too long In transit; sample should not be over 30 hours old at examination to Indicate reliable results. Please send . new sample via special delivery mall. Date Received ,:~ - ~,D --~'~ Time Received Analytical Method: Membrane Filter * N~). of colonlesll00 mi. b~:R SAMPLE Time Collected La ef. No. Result* m m FT'I ~/ATER ANALYSIS RECORD Analyst READ INSTRUCTIONS' BEFORE i COLLECTING SAMPLE Membrane Filter: Direct Count {~ Verification: LTB. __BGB Final Membrane ~Z~l~r Rjl~ults , /'/,~ Time: , TNTC = Too Numberous To Count OB = Other Bacteria Collformll00ml Collformll00ml L & GEOLOGICAL LABORATORIES OFALASKA, INC. FEDERAL TAX ID ~ 92-0040440 ~*~ .- itNALI$I$ I~-P01~! [I SAMPLe- for Mork Order ! 6766 Date Eepo~t P~l~ted: ~ 23 S8 ~ 08:22 Client $~pla ID:L1OA. llP~I~A Jl~L I~NCH P~ID :UA Collected MAI 20 08 t 12:15 bas. ~ecetvod MAI 20 88 ! 13:00 bat. Preserved vith Client Nm : A.W. M~hPIIT COMPANI, INC, Client Acct : AI~II[ETA l~lyele Completed :MAT 20 88 Semi [eports to: Laboratory Supervtso~ :$TEPItEN C. [DE 1)A.M. M~FITT COMPANI, INC. Neleased ly : ~ ~_....'~--~ 2) / Special CALL fOE PICK-UP. I~tzuct: Chealab ~ef !: 1107 Lab Smpl ID: I Matrix: #ater lllovablm PazaMter Tested Eesult/Untts Method Llaits NIT~ATi-N 1.4 m~/1 EPA 353.2 10 SAMPLE COLLECTED IN TOTAL COLIFORM BO'I'TLE. SOD IUMTHI~ULFATE t~U~Y INTERFERE WI'II-INITRATE TESTING. 8ample EOUTI~ SAMPLE. Temtm Perfozmed ' See Special I~truction~ Above UA-Ormvatlable None Detected "See Sample Ee,~rkm Above Not Analyzed AT-Keel Than, ~T-~reater Than CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. _ _~"'~"~, :' , ~Ea^, ~x ~, ~.oo~o~o ANALYSIS ~P0~T ~! SA~L~ fo: g~:k O:8a: ! 5584 Data hegozt Printed: FAR 16 88 ~ 12:02 Client Sample ID:LISA, ZL~ORA J£h~Lt 9/~ ~k~IO :UA Collectea FAR 11 88 { 12:25 F~s. Aecaive~ I~A 11 88 ~ 14:30 hxs. ?zese:te~ ~lth :XOh~ Analyal~ Completed :¥1R 14 88 Lahozato:y ~upe:vt,~ :$TEPHEg C. EDE / Special Irdtruct: Sat:pla EOUTI~E S k~/~ ~ ~. Rema:k~: 1 Tests Polio:mod ' See ~pecial Irmtxuctlotm Above UA-Or~vallable ~O- ~one Detected "See ~ple Eema~k~ Above ~A- ~ot A~aly'ze~ LT-Les~ Than, CT-Create: ~han CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, Ip~rc. .~ TELEPHONE (907) 562-2343 5633 B Street ~8, Anchorage. Alaska 99518 ~.,,~ ~. Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER [:] PUBLIC WATER SYSTEM I.D.# ~Y'P. RIVATE WATER SYSTEM Name Mailing Address City Phone NO. State Zip Code Mo. Day Year SAMPLE TYPE: FI Check Sample (for routine sample with lab ref. no. ) I-I Treated Water FI Special Purpose [] Untreated Water SAMPLE Time Collected NO. LO C.A, TIO N /.~ : Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mall. Date Received { _ Time Received / Y.TC_) Analytical Method: Membrane Filter No. of coloniesll00 mi. Lab' Ref. No. Result* Analyst BACTERIOLOGICAL WATER ANALYSIS RECORD I .; READ INSTRUCTIONS~ Membrane Filter:. Direct Count !' (~ Coll_formll00ml BEFORE I Verlflcatlon: LTB ReportedFInal MembraneDy FI I t'~.~t s'~,~/x~-~/, _ COLLECTING SAMPLE !, ' TNTC = Too Numbero~s To Co nt OB = Other Bacteria I BGB, Collformll00ml Time: ~xdJ a.m. pome PArer ! OF 2 P--EI~,INDER TO FOLLOW MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRO~XfENTAL fIEALTH DEPARTmeNT OF ~ALTH AND ENVIROnmENTAL PROTECTION APPLICATION P0R ~ALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date 17 Sep 84 (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 1SA, Tundra Jewel Subdivision Location (address or directions) Needles Road, Chugiak (b) Applicants Name W. L. Painter, P.E. Telephone - Home688-217~usiness276-7105' Applicants Address SR1 Box 1221, Chugiak, Alaska 99567 (c) Applicant is (check on~) Lending Institution Buyer~; Otber~-~(explain); (d) Lending Institution FedAlaska FCU ~ Address Pouch 7-505 , Anchorage, AK 99510 ~-~ ; Owner/F~f~%X~r ~ ; Telephone 522-1131 (e) Real Estate Co. & Agent N/A Address (f) Telephone Mail the HAA to the following address: Nold for Pickup 2. %ype of Residence Single-Family~ Number of Bedrooms 3. Water Supply Individual Well~ Multi-Family~--~ 4 Other (describe) Community[- Public[-- Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Sewage Disposal Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. En~ineerin~ Firm Providin~ Inspections~ Tests~ File Search; Data and Information e 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 nu:ber 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 w~ter supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm A. W. Murfitt Company Telephone349-7531 Address 8010 KinE Street, Anchorage, AK 99502 Date ... Co~t~on~ DHEP Approval Approved for Approved ~'/ bedrooms Disapproved -- Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPAR~NT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARACRA/~H 5 ABOVE BY ~N INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF [{~S AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. ~MPLOYEES OF DHEP DO NOT CONDUCT INSPECTIO4~ OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR ~{ISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/eJ/D18 [Page 2 of 2] 7-19-84 A® MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUIMORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: Lot 18A Tundra Jewel Subdivision Well Classification Residential If A, B, cr C, D.E.C. Appro%~d(..Y/N) Well Log Present (Y/N) No Date C~,pleted 1974 YieldS.4gpmi Total Depth 164 ft Cased to full depth Depth of Gratify/ Static Water Level 134 Pump Set At 164 Casing Hsight Above Ground 6" above indoor conc slab Sanitary Seal on Casing (y/N)Yes Electrical Wiring in Conduit .(Y/N) No Separation Distances f~cm Wall: To Septic/Holding Tank on Lot 100 TO Nearest EdGe of Absorption Field on Lot To Nearest Public Sewer Line N/A +100 Depression Around Wellhead (Y/N)N° ; On Adjoining Lots +200 ; On Adjoir~rg Lots+200 To Nearest Public Sewer Cleancut/Manhole N/A To Nearest Sewer Service Line on Lot N/A Water Sample Collected By Diane Painter ~ DeteAuKust 27, 1984 Water Sample Test l%~sults Satisfactory. Chem & Geo Laboratory of Alaska C~,,~nts See ~ff~davit On wa~gr sample~ attached. B. S, EPTIC/HOLDING TANK DATA Date Installed 1975 Size 1500 ~al No. of C~,~a=tmsnts 1 Standpipes (Y/N) Yes Air-tight Caps .(Y/N)Yes Foundat. ion-Cleanout (Y~)Yes 1'8, Depressicn over Tank (Y/N) No Date Last Pumped/A~gust Pumping/Maintenanos Contract on File (Y/N) N/A Holding Tank High-Water Alarm (Y/N) N/A Temporary Holding Tank Permit .!y/N)N/A Separation Distances from Septic/Holding Tank: To Water-Supply W~ll 100 To Building Foundation 25 80' to neiEhbor prop line TO Property Line 59' te reod {~'o~.~ To Disposal Field 35 To Water MaimJService Line N/A ' ' To Stream, Pond, Lake, or Major Drainage Course N/A Coram~ts precast concrete tank from Wallace [PaGe 1 of 2] Receipt % Date Paid: Amount: 2-15-84 C. ABSORPTION FIELD DATA wSDOils Rating in Absorptiom Strata ate Ic~talled idth of Field Square Feet of Absorptic~ Area Yes s' Depression over Field (Y/N) Date of Last Adequacy Test 18 August 1984 ults of Last Adequacy Test See comments ~ ~~ [e.~Jey- ~Z *~' paratlon Distanoe frcm Absorptic~ Field: 80 to neighbor p.1. TO Water-Supply Well 100 To Prcperty Line 50 to road (needles) To Building Foundation 55 To Existing or Abandcned System can Lot N/A ; On Adjoining Lots +200 To Water Main/Service Line N/A To Cutbapk(if present) N/A To Stream/Pond/Lake/c~ Majo~ Drainage Course N/A To Driveway, Parking Area, or Vehicle Storage Area +20 Cca~rlts 8x8x8 ~o~ crib. introduced 600 ~al in 1.75 hours, ab~obtion ~mmed~at~. no water ever standing. See AK Testlab letter on adjoining lot(attached.) Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) D. LIFT STATION N/A Date Installed Size in Gallons "P~,%~ ~" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) C~ts Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. ~ets lq)A ** Check Permitted Bedrocm Rating Against HAA Request ** I certify that I have checked, verified, cr confcrm~d to all MOA HAA Guidelines in effect on the date of this ir~pectio~. Comoanv A.W. Murfitt Company MOA No. ST8~-015:",,: ~ .. :,f,-~,, ,,,'~.~..,..~ ., I,,, - [Page Murfitt Company. CONSULTING ENGINEERS 8010 King Street · Anchorage, Alaska 99502 · {907} 349-7531 September 26, 1984 Mr. Wilfred L. P~{nter, P.E. Star ~oute 1, Box 1221 Chugiak, AK 99567 On Site Septic System Lot 18A, Tundra Jewel Subdivision Chugiak, Alaska Dear }~. P~4nter: Pursuant to your request, we again made a visit to the referenced site to respond to the }kn%icipality of Anchorage, Department of Health and Environmental Protect/on conoe_~ns expressed September 21, 1984, regara~ng site soils, 9&oundwater, and bedrock for the application for a Health Authority Approval Cer~ ficate of your on-site septic syste~ In view of the information and test results s,,~nitted with your application, certified by Mr. Allan W. I.~rfitt, P.E. on September 21, 1984, we are surprised that your applicatic~ has still not b~n approved. Furthermore, it is our opinion that soil conditions at your hcm~ are consistent with those described in the letter prepared by Mr. 14el Nichols, P.E. of Alaska Test Tmh, Inc. on the adjoining propert/es. During our recent site visit we photographed your site to document drainage and the position of the system. A copy of this photographic record is attached. Exploratory drilling at the site is not only very expensive but would also note t~%an likely result in the same collapsing hole situation as observed by Mr. Nichols. It %ould then be rather difficult to install a standpipe to measure the static ~uundwater table and/or perform a peroolation test. The photos of the site we trust are self-explanatory. During our photo work, we measured the ground slope away frcm the seepage pit (towards Needles Boad) and inspected the site soils and road ditch for any signs of ~£uundwater seepage. No sccpage wa~ evident. In addition, there is approximately 18.5 feet of elevation change between the top of the seepage pit (stake in photograph) and the road ditd% on Needles Road (distance of approximately 120 feet). This would position the static 9~oundwater ~h]e, as a m~nimun, approximately 6.5 feet below the bottem of the crib. We have asstm~d that the top of the crib is four (4) feet below the existing 9~ound surface and the crib is eight (8) feet high as insta/led. Soil exposures at the site appear to be clean fluvial (water worked) sands and gravels. As we understand it, no bedrock was encountered /n dril]~ng the adjacent water wells which are Mr. Wilfred L. P~nter, P.E. Page 2 well in excess of the oae on this site which is 164 fcct. Adjacent gravel rain/rig pit exposures show sand and gravel fo=maticns to depths in excess of 100 feet. Pit bottc~s are dry. In closing, we agR~n cQnclude that your on site septic systen is satisfactory and adequate for the purpose of which it was intended. Please call if you have any questicrm. At~t W %}~ Allan W' Murfilt~ f~ ~ ~RR;ICIPALITY OF ANCHORAGEf'~ DIVISION OF ENVIKOIC~ENTAL ~£ALTH DEPARTMENT OF HEALTH ~.ND ENVIRO~iENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. C~neral Information Application Date AUqust ?2, ]984 (a) Legal Description (include lot, block, subdivision, section, township, range) Lot !~A. Tundra Jewel Subdivision Location (address or directions) Ueedles Road. Chuqiak, Alaska (b) Applicants Name W, L. Painter. 333-7189Business276-6777 Telephone - Home Applicants A~dress 1507 Kepner Drive, Anchorage, Alaska 99501 (c) Applicant is (check one) Lending Institution ~ ; Owner/b~f~-~ ; uyer[---l; Other[---[ (explain); (d) Lending Institution FedAlaska F.C.U. Telephone Address Pouch 7-505, Anchorage, Alaska 99510 (e) Real Estate Co. & Agent [I/A Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Stngle-Famlly~ Number of Bedrooms 3. Water Supply' Individual Well~-~ Multi-FamilyF--1 Other (describe) Community~ Public~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Sewage D~sposal Onsite ,~ ' Public ~ . Community ltolding Tank~--~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] En~ineerin~ Fim Providin~ Inspections~ Tests~ File Search~ Data and Info~ation 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 M~nlcipality of Anchorage files and from ~y investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm A. W. ~lurfitt Company Telephone 349-75~1 Address 8010 Kin9 Street~ Anchorage? AK 99502 / / - ' ' ...... "' '" . · ~ '.. ,. · ."~ ., ,,?~: .~ ~uar Approval , ~.-,.. ~,, .... ....- ,'~'~ Approved Disapproved ~ Condt~ton~ Terms of Conditional Approval CAUT I 0 N THE MUNICIPALITY OF ANCHORAGE DEPARTMEN~ OF I~ALTII ~;D EI~IROh.'~E}~AL PROTECTION (DHEP) ISSL~S IiEALTH AUTHORITY APPROVAL CERTIFICATES BASF~ SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY A~ INDEPENDENT PROFESSIONAL ENGINEER P~EG£STERED IN THE STATE OF ~SKA. THE DHEP DOES ~tIS AS A COURTESY TO PURCI~SERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAZ ~ID STATE REQUIRE- MENTS. ~MPLOYEES OF ~tEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. ~ MUNICIPALITY OF ANCHOraGE IS [IOT RESPONSIBLE FOR E.LRORS OR OMISSIONS IN ~ PROFESSIONAL ENGII~ER'S WORK. (DtlEP SF. AL ) RR4/e~/D18 [Page 2 of 2~ 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUITK)RITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 ,'~UNICIPALITY OF ANCHOI~kC, E DEPT. OF HEALTH & ENVlI~ONMENTAL PROTECTION AU6 ,"5 0 DATA R E C E IV E D Well Classificati~/~e~identia If A, B, cr C, D.E.C. App~oved(Y/N Well Log P~esent (Y/N~No--~ ' Date' Oa~pleted ~.(~n~k~ yield Total Dep Un/known ) ~--Cased b~'-6~k'gg~-vn~ D~'~h of Grouting N/A' Static Water Level Unknown Pump Set At Unkn0;Iq Casing Height Above Ground 6" (cone slab, indoor) Sanitary Seal on Casing (Y/N)~ Elect~ical Wiring in Conduit (Y/N)~_. Depression Around Wellhead (Y/N) Separation Distances f~cm Well: To Septic/Holdirg TarR ca Lot 100 To Nearest Edge. of Absc~ption Field on Lot +100 To Nearest Public Sewer Line Cle ancut/Manhole N/A I~W,~ts'~'. S~"~P-i~' ~0iiect~d By Water Sample Test Pesults ; On Adjoining Lots +200 ; On Adjoining Lots +Z00 To Nearest Public Sewer To Nearest Sewer Service Line on Lot '"Diane Painter ; Date Auqust 27, 1984 Chemical & Geoloqical Laboratory of Cc~,~ents 5.4gpm~ well installed prior to 1975 B. SEI~fIC/HOLDING TANK DATA Standgipes (Y/~) Yes Depressicn over TarR (Y/N) Size<U.~knm No. cf Ccmparh,ents . U~'~o,,.m No Date Last Pumped 8/18/84 Pumping/~intenance Contract on File .(Y/N) ; for N/A Holdirg Tank High-Water Alarm (Y/N) N/A Temporary Holding Tank Permit (Y/N) N/A Separaticn Distances frc~ Septic/Holding Tank: To WateriSupply Well 100 To Building Foundation 55' 80 to proper, ty I'~ne. To Property Line 50 at road (ll~edle$) To Disposal Field gnkpovln To ~ater Main/Service Line I;/A To Stream, Pond, L~ke, ar Major Drainage Course N/A System buill~ nrior to 1975. [Page 1 of 2] Ce ABSORPTION FIELD DATA Date Installed ('d~novln ~ length of Field ~(~_n? Width of Field Depth of Field Gravel Bed Thickness Squaze Feet of Absorptic~ Area ~(~_ Unkn0wn __ .) Standpipes Present (Y/N) Depression over Field (Y/N) NO ~te of Last Adequacy Test Results of Last Adequacf Test Sepazration Distance frcm Absorpti~~Fi'~id: 50' to Needles R0ad~s Road To Water-Supply Wall +100' To Property Line 80' to property line To Building Foundation 55' To Existirzj or Abandoned System Lot Unknown ; O~ Adjoining Lots Unknown To Water Main/Service Line N/A To Cutbank(if p~esent) I]//~ To Stlream/Pond/Lake/or Major Drainage Cxcxzrse To Driveway, Parking Area, or Vehicle Storage Az'ea +20 Cc~ents introduced 600 ga]]0ns in 1.75 hours, no rise ~n tank. System built prior to 1975, no records at DEC. D. LIFT STATION Date Ir.~talled ' Size in Gallons N/A Dimensions Manhole/Access (Y/N) "Ptm~Oo" level at High Water Alarm Ii, vel at Tested for ElectricalCcdes(Y/N) "P~;~ Off" level at Vent (Y/N) Pumpin~ Cycles du~irzj Adequacy Test. )~ets )DA Cc4~u~ts ** Check Permitted Bedrcxcm Rating Against Hk~ Request I certify that I have checked, verified, or ccnform3d to all MOA HAA Guidelines in effect on the. date of this ir-~pection. Signed Co,pany A. W. l.lurfitt Compooy KB1/d5/s MOA No. -~ [Page 2 of 2] ~'~F.~" ~.~'-'.-..~ -'.:"; ,..-~,.. ~ ~ ...... ~,~.-~,~ -~y~-... ...' 2-15-84 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ~ 5633 B Street . ' i ' Drinking Water Analysis Report for Total Coliform 'Bacteria TO BE COMPLETED BY WATER SUPPLIER ! WATER SYSTEM: /5-o'? ' (°) Sea h on b~ck SAMPLE TYPE: Roullna Check Sample (for routine a~mple with lab mi. no. Special Purpose Treated Water Untreated Water , I I I ~ Collected Coll.'rid By TO BE COMPLETED BY LABORATORY : Suanalysis shows this Water SAMPLE to be: tisfactory satisfactory I-I Sample too long in transit; sample should · not be over 30 hours old at examination to Indicate reliable results. Please send new sample via special delivery mail. Time Received Analytical Method: ID Fermentation Tube ,~ Membrane Filter Lab Ref. No. Result* Analyst ! I-T'I M-IZ2O ~) BACTERIOLOGICAl. WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane FIItec Direct Count . * Collform/100ml : Verification: LTB BGB' Final Membrane Filter Raeultl., ~ Collfon~/100ml R.port.d By ~ D.t..~..;~ · '" Time: /,--%--~:~ ..m. p.m. TNTC = Too Numerous To Count 4040 "B" STREET, ANCHORAGE, ALASKA 99503 PHONE: 907.279.2581 May ~6, ~977 W.O. %~80~9 Mr. Curt Josoitis Box 439 Chugiak, AK 99567 Subject: Subsurface Investigation for Feasibility of On-Site Sewerage Disposal System, Lots 12 and 13 · Tundra Jewel Ranch Subdivision, Chugiak, Alaska Dear Mr. Josoitis: We have completed our subsurface investigation on the above referenced property. The investigation consisted of the placing of 4 test holes as shown on Figure 1 of this report. Three of the test holes were placed to 16' and one was terminated at 8' b%cause of drilling refusal. The logs of these test holes are included in this report as Table A. It may prove helpful in interpreting the data on the test hole logs to review the standard explanatory information contained on Sheets 2-4. Below the top 1' of material, the soils encountered in all four test holes were very uniform. The soil was a non-frost susceptible, well-graded .san_~_~ gravel with a slight trace of silt. Unified classification for this material is GW/GM. A composite gradation was run from samples on this material from samples of all four test holes and appears in this report as Sheet 1. Because of the clean, granular nature of the s6ils, the augered holes would not stay open, and it was not possible to case them with plastic pipe and run an in-place percola- tion test. Water was poured into what was left standing of the holes. The water ran out of the holes as fast as it was being poured in. ..~Jdsoitis / 1977 .~,It ts ~cu%.t to imagine a soil condition that could be ~gCh more.?onducive to the development of the on-site S~ge disposallsystem than the materials encountered on ~9ur_.site. We recommend that the sewerage disposal system ~'design according to the "Manual of Septic Tank Practice" publish~ by the U.S. Depar~ent of Housing and Urban Develo~ent. We further recommend a design value for the percolation rate of the system of 1.0 minutes/inch. This should be a conservative value, and yet allow the system to be relatively small. We will now take the data contained in this report and meet with Mr, Kyle Cherry of the State of Alaska, Department of Environmental Conservation and see what kind of a well system can be approved to determine the number of apartments that can be placed on each lot and the requirements for any well serving such units. If you have any questions about this report and the progress of our discussion with Mr. Cherry, please do not hesitate to contact us. MP~N:rb Enclosures Very sincerely yours, ALASKA TESTLAB R. Nichols, P.E. Laboratory Manager Z-O~ , oZ/4b . i=UP.~JI sH~"~ ISV' cx,owo~, P- ~ ~ EMU. ~a=vAq~ ohts AFFIDAVIT I hereby swear and affirm: That I am a Registered Professional Engineer in the State of Alaska. That the water sample tested and approved by Chemical and Geological Laboratories of Alaska, Inc. was taken from the stated location, i.e. Lot 1SA, Tundra Jewel Subdivision. That the sample was taken in accordance with proper procedures and does, in fact, reflect the well water at that lot.