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HIGHLAND TERRACE ADDN #6 TR 9
Onsite File Terrace Ad C3 Highland Terrace #4 Tract 6A-1 #050-311-30 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page/ of 3 www.ci.enchorage.ek.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: _S Vff6 L/ U 6�' PID Number: Na" Z ( Wastewaters stem: New y � [3 Upgrade Aac.a. -$74EPL,f ABSORPTION FIELD Phone 3— loo Ru1MeI of Badrooms aep Trent^ O ShaAow Trento O Bac Q MwM Cl OUror LEGAL DESCRIPTION SW Rating ng /.2 Total Depth from ongne grad GPD*? 810f#. lot SuDdixMon: /� div C Q/"/ Depth to Ppe witom hom onaino trade'. S Gnh4 depth beneath pp, / 1ti� 3. Ft. Ft Tovmamp. Range Seton: FA added above ongmY trace: �� Grerel Length: FI. � it. Well: i�New ❑ Upgrade Cra,el vndm: Ft Humber of ones' Dislance oete,en blas — Ft Classbuuon(Pnvate. A. B, Cy ARI Vere TOM Depth QO FI. Cased ro' p ZO FL TOWabsorpeonaru /+, v Fe P."Malenal. /�C. �:7� Onibr.c Date on d'. Suuc Wafer Level. so Ft tnamnw. ouT a caul Date NaWlad 9 .2 7 G cl Y,Nd S Pump Set at CaPng Height Above GrpuM Z TANK GPM _?M Ft. Ft SEPARATION DISTANCES %Septic [:]Holding ❑ S.T.E.P. ❑ Other. To Septic TankStation Litt Holding Tank umiWrivateFrom Sewer Line /gWt-ORAL: 7_1,W ,Wad/tat'��t�����Number FAbsorption T of Co_,yanmsnls. /.d�s f. �. _ LFT STATIONd�`7VV L01 GM r oO �. ao w.auto, �I FwMabon 56 it $O �^p on. level at Pump O M N al. Hrgn wear e*7rt In m M. Cudsn Dram — — Pump Mead8 Elects a alspecuons pad Jbr'. Rem.rkL BENCH MARK Loudon aho Desmpeon. F ri tWrMdIereLen. ,Ft /QQ �`�(E r�yyyy77\ 4 1 Ate.•' ei9 1Iia� Inspections performedby:,A/6r7�Kijw hn Dates: 1`t / p e.... •• �"J 2n 9a7 y: SldYen W. E W Development Services Department Approval a✓ 1c'' r� •,e PE azsa : Reviewed and approved by: Date: /rE C� i�eFROFESSt`��a —LIN 0 Y c O F- CL 0 V) c O O C7 0 U .d: LO co 00 � LO (D C'LO �n00 nC-4 N N O O p O p d C5 C5 ccov��n a� H H 3 W LLJ U U W Cl o W N I- W A J Z LD ' Q Q ,J W � a 2 I L7 W > N H UCA QZW ,%D u) W Q A W n W F- F- Q ., N ' I F- N GOI F- A t U Q I 0 Q1co a � Q t ° °c vi Z W o 3 �0 Q N p 9 11 P.9 Z o °�¢� O J V) N pJ 11 N .c ° U D_ c •E y p c a, .1.. � tl U :3+, y� C a) �a tl £to i .J UlCL £ c i :��: a�••. `0C .D vii0Oc N t d N VI VI O W0 O CIL Oca Z U p Cj L U V)NA E J. p .� c U) :3° - ° I W a° 05 w F°- F- J F` W S �2 c n Zw a S U c QI i Y L d CL a N c v v d PO N •N 3 O c d U O) C: N O a 0- 0 L Oi O U d `O W L R O S L F- O •N c 0 CL I S O .. 0 lulL +� d CL o, A N � W > u II O 4 Z; W W U x v E U O O U (h U c 0 ar a a 0 u 0 >� d N i+ S •aN U L E O o O If7 a£� y++4. Ind ° N �W E u N 'a V �a _ O L Q �N NL u -'000 ca3 W°a t. WL) dU VI U }a V1 F' 0 O i -cc - H y W 0 dN N �UE N 6) Oi F- Y ZS US L LN CL 0 3 d zn CL4J 3 d 0i a y gNNVli(//Q� a ': cu ri v ui %6 Li W U n n Q 3 Q' z ti W H L,.. r A Q 0 Z 4,0 Q Q J U 2 0 Q o I-4 Q� � Z N 3 -i z ti H L,.. r 0 �-- Q A i Z W WZ J W Q U ~ H W u '-4 Q:D F— Pel a. W N 0 Q certifieb 3arirting log by we m e•• SULLIVAN WATER WELLS P.M sox e7sara, CH=AK Auwero "M, • • . . • •• • ♦. Ao0f*M- mr-AL +4 DOM I- ley TAX IOQ WCAT04 NW1©Eit BXQ IS rd kafad at ars■o•.e f , I be bmg 4-rm D W Metod of fling 4fir muy u caw foot DepmdWdt- c&*oIV%* i c6�- why nkmam - o? s- —kid= Dbwoorr uwlypic_ swmw A6we omxxt a heat SakYJA rLwet so feet p4 wFW 1#1'_9pts mdhw of Tile —4-im l' wen hake opoft'Mm D open eW &cCg holo JSoaerecl;, Start foal Sloppa0 fast u pbbatK m Start feet Deptic iom float b feed Well OWWated Upas C=pWW d•%eas O W usmoddoeiioaiomC'kAaa.A--+s Sb0%rt C4S-,-A6 STic.G✓� _ S off,40 m,4.f&- 4. AA -1 B rdoRJCr 1;09gg Y -a j�Sa�%iJCrC �iLA-1 J�- UTOMON: it Is sa napwosibafy of ft property owner 10 abmt a Copy of the wal by fo the proper auaody. frkrrdl X Aadtrapa Depwftw t of ttesen i HmM 8ervioee WWbr DWwtn" of rn&Wkarwnatat Comerwtian MahSu B= ,ph )epwbnwt of Erwiorenar C4nw v lm MUNICIPALITY OF ANCHORAGE Development Services Department I 2 /� On -Site Water & Wastewater Program �J 4700 South Bragaw Street a ^ P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Jun 03, 2004 Expiration Date: Jun 03, 2005 Permit Number: SW040168 Parcel ID: 050-311-30 Legal Description1Highland Terrace #4 Tract 6A-1 "r Design Engineer: 0838 North Rim Engineering Site Address: 11501 Steeple Drive Owner Name: M2C1, Inc. Lot Size: 345219 SO. FT. Owner Address: 11501 Steeple Drive Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99508 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage 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 ( 1BAAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: b l O _1Inn�� Issued By: I h� fr'� Date: G ?.I 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D.n� _3 I I — 3 0 Permit Number SW Property owner(s) M? C1f , r„fe . (Wjer-) Day phone Mailing address (1 Mailing address Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size 0-397: Zlq Acres sq.Ft. THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Y�:Ib3•� f;T»ita'L ••Z I��I/i�i�F� Hot Tub Swimming Pool Therapy Pool Fj Number of Bedrooms Well Only Water Storage Jacuzzi ZD Water Softening Unit s certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property order or authorized agent) Permit Fees:g 6 D 4- 17 ,5� Date of Payment: Receipt Number: (Rev. 12100) Waiver Fees: Date of Payment: Receipt Number: NorthRim Engineering 17237 Bear Paw Circle Eagle River, AK 99577 907.694.7028 907.830.4186 May 27, 2004 Joe Goodall MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Highland Terrace #4, Tract 6A-1, Eagle River Dear Joe, Please review the submittal for the water & sewer design for the proposed single family home. The tract is under development and will be served by a private water well. This is a very large tract of land, with excellent soil; no adverse impacts are expected. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Sincerely, NorthRim Engineering Steven W. Eng , PH Design Enclosures Y . SIM 1 �ZINEERING Higtdand Terrace #4, Tract 6A-1 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Siang: This is a single family home projected at 2 bedrooms and an office; it will be sized for 3 bedrooms. This requires a 1000 gallon septic tank. This tract is very large; over 7 acres. No adverse impacts are expected from development. The neighboring subdivision tracts are also very large as shown in drawing. The nearest water wells is located on the drawing. The area remains undeveloped to the north and west. No conflicts to any neighbor lots is anticipated. Excellent soil for a septic system was found; a sandy gravel with low silt content. The system utilized a 5' wide trench with allowable reduction factor. An application rate of 1.2 GPD/FT2 with 0.5 reduction factor for utilizing a 5' wide trench. Monitoring revealed groundwater at 13' depth. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment septic tank • Watertight couplings on inlet & outlet • 5 foot minimum between the tank and bed. 10 foot to property lines. • 3 feet of cover or insulation is required for trench; an equivalent of I" insulation for each foot soil cover. • Tank & solid pipe must be set on well compacted, stable soil • 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10 feet from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron • Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain -rock • Drain rock to be 1/2 inch to 2'/2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down • Silt barrier (filter fabric) to be installed above the drain rock • Smeared trench sides must be raked or scarified before drain rock placement • Backfill over drain rock must not be less than 36" • The finish grade must be mounded to promote drainage over the bed • Insulation must be placed over any pipe installed under driveways or parking areas • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required 0 Insulation board to be extruded direct burial polystyrene (Dow Styrofoam III or equal) o •' • 2 .. uJ0•C090'1' )BUa •• sA IA V 2 Oyx'Ct197"��69.a7 ))-id) C)a .9t+ w Q T 1 +.1 v • ,p I -o r r 0 D � Z -D < .-a D m z m 0 r m T /I C/) m M tj o m�-� r o � MZD A y � d : T 7V ti < � H ,1 li • . o 2 M I— D D M Z r d m ;v M 70 < 70 MD ;a n m T /I C/) t '0 `F a n� `n a C+ �o ti ------_ —tet ---------- O ~ N rt, av ZZ �a 2� en Z� V 0 Ul o 0d� ridcD� CD m�� W r o Q, MZD 3 t) �• h M ~ � 2 M o M r D D M Z F- m N M �--i ;u 0 < 70 M D p m R i CD 0 rt CD 4� W N o m p -moi W O N iCD c Z trtn 7 C S 0p Cb Z 0 V -3(a CDDrri < m Za 0QO (D O O ):M3 m � 3 C rW1 3 <0 0 —'3 lD NCD SQOM 3 `1 o o con (D 3 3 0Ui .0 r R i CD 0 rt CD w O S z i M •9 P 3 s. v m z 0 0 P ; h Q WI V ~ b m cn -4 w.0 3 3 3 A Z 3n L C 3 3 • S * O--1 3 4+3 3 m 0 QM < S h N O SMCS �p h Q f N N \ Z Vl A V 0.0 -N N MO Z hQ3 N N N 3 Z O C+ V1 N M h Q n ty oQ 900 n N .. n IU s_ h O fU tz fU Ul r z d Q° m m ~ Z r n 3 m = 3 3 h O N N. = tz Q o ~ _ O n rrl D C m c :{7 a D o T w O S z i M •9 P 3 s. v m z 0 0 P ; h Q WI V ~ b m cn -4 w.0 3 3 3 A Z 3n L C 3 3 • S * O--1 3 4+3 3 m 0 QM < S h N O SMCS �p h Q f N N \ Z Vl A V 0.0 -N N MO Z hQ3 N N N 3 Z O C+ V1 N M h Q n ty oQ 900 n N .. n IU s_ h O fU tz fU 0 O to 7 (O f1 P 3 O C h N m h f m m 3 N m v h n p P 3 7C' Ip 1 Z m 3 n S m 0 C 3 Q P h O 3 A m P 3 O c C+ My �. CD a(A 2� 0% naw (or m 3 p 0 o O o m` n 1 Z >E Z-3 V m 0 00 O x. Mn �T VA �m wp 1 3 3°n+3+�0;7 N C+ rp t Sly Q°3 ° O r -m V) 3- � 0 N M yf Q, VI m m in �w n O h �� P 3 R • C O N 3 = 3 Q O_ (n 1n fU m m Q Ln 'O P `< o n n m 0 m 0- I (7 f 3 D 2 n W 0 N 0 ° 0 3 71Zm Z P < P I ,n.* 3 0 < n D Q >Z 3 I -I m r � ° m m h O -b r. 3 m n UI h h N "h z o 70 D M v = m S y d n i S o� 1 m .p O ^� T P A Ln O N O .D m 0 O to 7 (O f1 P 3 O C h N m h f m m 3 N m v h n p P 3 7C' Ip 1 Z m 3 n S m 0 C 3 Q P h O 3 A m P 3 O c C+ �. CD O 41 = 3 p 0 o O h PO (03 3 rp N � h P � m m N O_ Q 'O m 0 0 I 3 >Z I 0 ° h O 3 O h "h z � 3 S 0 O to 7 (O f1 P 3 O C h N m h f m m 3 N m v h n p P 3 7C' Ip 1 Z m 3 n S m 0 C 3 Q P h O 3 A m P 3 O c C+ A Municipality of Anchorage f,�:4!<NGINE Development Services Department, Building Safety 49 Division 1o. ..ey'..}... � yr On -Site Water and Wastewater Program - 4700 South Bragaw SL e.... w. ! !•o- 4I P.O. Box 756650 Ancho2ge, AK 99519•6650 ell Steven W. Eng � W � (907)343-7of ck.us i fPE 6236 i�►F�pROFESStOtit�.. Soils Log - Percolation Test Per'ortn^n For: 2 CIT'/1_/JC� - _—Date Fer!rm,..+ S �LGY __._ Legal Description:7T/1eJ— CA -1. //%V4 ta(O 7jW4CC411 Township, Range. Section: Slope Site Plan 1 %q . 2- G P 3- p . SAAM 0444-L 4- • W/SIL 5- a 0 6- 10 /V s WAS GROUND WATER 9- ° ENCOUNTERED? 0 _yt�f 5 10- IF YES. AT WHAT DEPTH? 1 O -Depth to Water After ( p 11- e O klonitoring7 1,3 E 12-10- - Date: S 2s Orf 15- 16- 17- 5- 16- 17- 19- 20- 1s- 20- COMMENTS COMMENTS Reading Date Gross Time Net Time Depth to Water Net Drop 6 /o to S U - o a S F - !a y0 �o r S PERCOJAT:ON RATE .Z FERC HOLE DIA.JETER TEST RUN 6ET.VEEN_! FT AND FT PERFORMED BY: 40 rT°rV;,L 674CIn `r, -41 CERTIFY THAT THIS TEST WAS PERFOR%IED IN ACCORDANCE WITH ALL STATE A.\D n1UN:CiPAL GUIDELINES IN _CT ON THIS DATE. DATE: .S a� Gu Municipality of Anchorage ,. Development Services Department �F� Building Safety Division �J' "A i Onsite Water and 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 FOR A SINGLE FAMILY DWELLING Parcel I.D. 0-m- 311-30 1. GENERAL INFORMATION Complete legal description COSA# 0g0�3) Expiration Date:T,10% Location (site address)' /(!Of S jq! pe , Pr�c Current Property owner(s) o� jl Day phone e �U-3 yc) 3 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone i♦�.. i .�iwt Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3 TYPE OF WASTEWATER DISPOSAL: 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. Individual On-site ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ 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 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 Address Firms J�r`IK� G.�q= PhoneZ"l-74� 4 Bac 7'70 Xa Engineer's Printed Name ��� �e Date//G 7 i OF AZ 11 �q.•fW.ff..•a.. ........... S. DSD SIGNATURE r� �� ; seven W. Eno PE 6256 Approved for bedrooms. ......... ..`O,�' Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: 4Z Original Certificate Date: 6 Q (Mv. HA5) Municipality of Anchorage • Development Services Department Building Safety Division ' On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.66W www.muni.orglonsite (907) 343-79D4 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description:�yJ� Molt 4P1C412dCr4– !!%T_%r.a./ 40-1 Parcel ID:OSO–?N–Yr3 A. WELL DATA Wen type _F_ If A, B, or C provide PWSID # Well Log (YIN) T Date completed 'Y �" cxl Sanitary seal (YM) Wires properly protected (YIN) Total depth –410,0—ft. Cased to Casing height (above ground) n. FROM WELL LOG AT INSPECTION Date of testCI7T/6J '?h�a -7 Static water level sQ ft. 5 ft. Well production �. S g.p.m. 2. o g.p.m. WATER SAMPLE RESULTS: Coliform __0__ootonkW100 mL Nitrate G, �UsmgfL Other bacteria colonies/100 mL Arsenic:i gfgA Date of sample: U 0 ? Collected by: B.. SEPTICIHOLDING TANK DATA Tank Type/Material Date installed 9/a :740 a 1 Tank size /DOo gal. 'Number of Compartments Z Ciearouts (YM) Foundation cleanout (YIN) Depression over tank (YIN) High water alarm (YIN) Al Date of pumping C1 1�4 :7 . Pumper C. ABSORPTION FIELD DATA / Date installed 9/n17 f Soil rating (g.p.d /ftZ or = )_ System typed Length 4W ft. Width 5 ft. Gravel below pipe_ ft. Total depth 2,5:ft.T Eft. absorption area V*O ftp Monitoring tube �Depression over field Date of adequacy test V O/0 7 Results (Pass/Fad) _ i�f For 3 bedrooms Fluid depth in absorption field before test //�,�in. Water added,LOQ h gal. New deptin. Elapsed Time: (V U min. Final fluid depth /2 in. Absorption rate >= SO d g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) AZQ If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Acoess (YM) 'Pump on' level at in. 'Pump off level _ in. High water za el at In. Datum Cycles test Meets alarmrequirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot _/0 O r'f' Absorption field on lot /O a r•'' Public sewer main N If i Sewer /septlo service line 2S T Animal containment areas /O L r'r' On adjacent lotsrs- On adjacent lots /a' a 4`4, Public sewer manhole%leariout W14 Holding tank 610-14 Manure/animal excrete storage areas /ad SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 1611- Properly line 1oG ,* Absorption field /0 !*— r Water main 6(f Water service line 50 t Surface water / O O t Wells on adjacent lots O fl- SEPARATION t SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r � Property line /Q6 Building foundation -5-6 if - Water mainA 1if Water Service line Surface water J!% Q �?' Driveway, parlcing/veNcle storage 50 Curtain drain N1,4 Wells on adjacent lots 11" t F. COMMENTS V.,••M••., Wit G. ENGINEER'S CERTIFICATION e!y'�Q ••;r'i9 I certify that I have determined through field inspections and rt:•49TN••...i• review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. /, y i ••r•; •� tiro s Steven W. nor EngineerT� s Printed Name 5 /e ��(J t� sr . PE `62% •. Date 1��3 dO7 ��t,�p�OfeSstU�'".tea= MENNEN COSA Fee $ y 3 r) Waiver Fee $* Date of Payment _ ��/Z/l)% Date of Payment Receipt Number qS;553 Receipt Number (Rev. 11/05) Analytica International, Inc. 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 ANALYTICA GROUP Northrim Eng Report Date: 10/2/2007 Attn: Steve Eng Receipt Date: 9/10/2007 17237 Bear Paw Circle Sample Date: 9/10/2007 Eagle River, AK 99577 Sample Time: 1:00:OOPM 907-694-7028 Collected By: SE Fax: 907-694-7026 Client Sample ID: Sampling Location: Highland Terrace 4 Client Project: Northrim Eng Sample Matrix: Aqueous COC #: PWS#: Residual Chlorine: Comments: Lab#: A0709105 -03A Flag Dcrinitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B = Present also in Method Blank 11= Exceeds Regulatory Limit M = Matrix Interference J = Estimated Value D = Lost to Dilution •• = RL higher than MCL; target not detected TNC = Too Numerous to Count - result rejected CF = Confluent Growth - result rejected TCNG = Turbid Culture No Growth - rejected Analysis Method Pre s MRL MCL Method Prep Analysis Parameter Result Units Flags Date Date Analyst 4500-NO3E (Aqueous) - Nitrate Test was conducted by. Analytica - Anchorage Nitrate as N 0.845 mg/L 0.50 /0 9/14/2007 9/14/2007 AJ Lab#: A0709105 -03B Analysis Method Pre s MRL MCL Method Prep Analysis Parameter Result Units Flags Date Date Analyst Bacteria, Other <MRL CFU/IOOmL 1.0 Total Coliform <MRL CFU/IOOmL 1.0 Lab#: A0709105 -03C Test war conducted by. 9/11/2007 9/11/2007 PL 9/11/2007 9/112007 PL Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 200.8/200.8 (Aqueous) - Family Well Water 1 Test was conducted by. Analytica - Thornton Arsenic 1.45 ug/L 0.15 JO 200.8 9/20/2007 9/21/2007 KS Reported by: Krissy Plen, Laboratory Project Manager Page 4 of 4 Y� T6HS IM F�zINEERING MEMO Steve Eng, PE, PH (907) 694-7028 tel NorthRimEng@aol.com Date: 11/15/07 To: NIOA On -Site Services Subject: Highland Terrace #4, Tract 6A-1 Number of Pages: 1 The private well on the subject property is enclosed in an insulated arctic pipe. This application is recommended for use in the State of Alaska and is consistent with state regulation. The well casing extends the required height and the arctic pipe is equipped with a drain. Photos below. The septic tank was pumped 6/14/07 by JR's pumping. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196850 Anchorage, AK 99519-8850 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Stem Ena Legal description: Highland Terrace #4 Tract 6A-1 ❑Permit ®C.O.S.A. ❑Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. Pumper and date of pumping. 2. Well In culvert does not meet code - See 15.55.060 C. 2. 8 15.55.060 D. 4. Name of reviewer: M Date: November 8, 2007 le0-leA leq1Stever 0t' /0-$-o7 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK 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 99519650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. HAA# �d7i�t Expiration Date: 1. G.gf! A. WFORMATION d;r iplete 1eg81 description : ///6'HZ.X1145 7T2 ,64c f 7 C T 44- / Location (site 'address-or.directions) 1156/ STEEPI6 D)efV€ 22ygL Current Property owners) '/k2 C I , 7n/C. Day phone oZa3— LP o. , ns. P. 8c�x 6 70 0 �{ s � c �s�ak Ma . ili address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site A Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year'with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER 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 _A%&f%zMA, 5;k//' Address / 7-Z 37 ,R rAe P.&Aj efRCGF_ Engineers Printed NameSTEcrF S 5. DSD SIGNATURE Approved for -'2)_ bedrooms. Disapproved. Phone4�9'41— 700?e Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By:Original Certificate Date: C7� (Re, 01102) Municipality of Anchorage , Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �I`'fiLanlD 7f7�Q�1'f T2.4CT'6�- If Parcel ID:0W -IM - eIN A. WELL DATA Well type L If A. B, or C provide PWSID # _ Well Log (YIN) Date completed (&Ioq Sanitary seal (YIN) V Wires properly protected (YIN) V Total depth ko-0 ft. Cased to 28 ft. �i Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Z4L1 40 /�i�l.J 6✓ECL Static water level .S 0 ft. ft. Well production �. S g p•m• 9 -P.M. WATER SAMPLE RESULTS: Coliform _colonies/100 ml. Nitrate Q.140mg.A. Other bacteria (_colonies/100 ml. Arsenic: mg./l. Date of sample: _405" Collected by: rAFdj B. SEPTIC/HOLDING TANK DATA Tank TypelMaterial 4AIC NLWAGf_ % STES L Date installed__! Tank size /6,40 gal. Number of Compartments Z Cleanouts (YIN)y Foundation cleanout (YIN) _y__ Depression over tank (YIN) High water alarm (YIN) Date of pumping �A(6v Pumper N/<� C. ABSORPTION FIELD DATA Date installed _q4wDc( Soil rating (g.p.d./ft' oro 4eIrrn) System type MUCH' Length 44 ft. Width .S ft. Gravel below pipe _ 4 ft. Total depth/. J ft. It" Eff. absorption areaLiAOft' Monitoring tube Depression over field _( Date of adequacy test /UEI.t/ Results (Pass/Fail) For..? -bedrooms Fluid depth in absorption field before test _ in. Water added= gal. New depth in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) 14 If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YI7quirements? 'Pump on' level at in. °Pump off" level at in. High water alarm lein. Datum Cycles tested Meets alarm & circuit E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1D/J rV. Absorption field on lot I r ' a rt Public sewer main ' AJ /d r Sewer /septic service line 25 t' On adjacent lots On adjacent lots Public sewer manhole/cleanout V-4 Holding tank A04 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 50 r'� Property line jjJQ 11" Absorption field /011A Water main N`A Water service line SQ rr Surface water /00 If Wells on adjacent lots 0 r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /000 rf Building foundation 50 I'f' Water main 4114 Water Service line 601?4* Surface water /00 r* Driveway, parking/vehicle storage � r /* Curtain drain N-� Wells on adjacent lots 106 F. COMMENTS - y s'fi G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and e T : = . , • fjr review of Municipal records that the above systems are in `F conformance with MOA HAA guidelines in effect on this date. a •.•^••• STE-1rE 6fy6 aa.v Engineer's Printed Name � `-s'•.• rr •'.�.,! Date IZ2611axV►2' ��:�:-;,.,',(.'.. HAA Fee 5 5 -9,50 Date of Payment A h6.5 Receipt Number 63 IN .404_ (Rev. 12101) Waiver Fee 5 Date of Payment Receipt Number J CSi11:ZCAMi CS Ref.# 1050224001 liens Name NOnhRim Engineering 'rojcct Natrdtl HiWdAnd Terrace N4 Tract 6A•1 Rent Sample ID Highland Terrace p4 Tract 6A.1 lama DibiUigWater WSID 0 ampk Rcmara: i ^n:- SC 15:C1 All Datl'LTImes are Alasia Standard Time Printed Date.Ttme 02/03/2005 10:20 Collected DAWTIme 01/11/2005 12:00 Received Dale/Time 01/12/7005 10:50 TecMical Director Step n C. Ede p,ntcta Raulu PQL knits IlelnaA fvitainrr 1r)I(mis AI'ow,tk P1N Analpis !ni S( L Sarum 65.2 3.V'J u,!L EP200.8 Dmc Dme (<-20001 Nide) 2 CO ll 2.00 uP'L EP200.8 C 01,141D5 01.".5105 S( L Selenium SO 1' 5.00 u3'L EP200.8 C 01:24105 01.45/05 S( L Antirreny 328 1.00 u3'L EP200.8 C 01/24105 01!25A)5 S( L Thallium 1 CO U 1.00 u3'L E?200.8 C 01.7405 01 25.105 S( L •Lala Dopartment Fardnecc ac CAC.01 Ila 5.00 mg'L S.V,2023400 C 0144.05 01126105 S( L atala by ILPIMS Arsenic 5.CC L 5.00 u3rL E?20:).6 A 01:24/05 01 5105 E( L ■tara Departtaant Ninate-N OAC8 0.100 mg'L EPA 300.0 A (<=10) 01:12105 x4 ierobiology laboratory Totalfnlif.t 0 colARIml. S.V.2092220 A (<-1) 01.'12105 DIC civata Individual analyaia Aluminum 38.1 20.0 ug'L E13200.6 C 01,74,'05 013505 S( L Sarum 65.2 3.V'J u,!L EP200.8 C (<-20001 CI .4,'05 OV25005 S( L Cadma:m 0.5CC L 0.500 ug.'L EP200.8 C (o-5) OIT4.'05 01 .505 S( L Calcium 28700 500 ug.'I. EP200.8 C 01 :4105 0172505 S( L Chromium LCC L 1.00 ug'L E1,200.8 C (<-100) 01 .405 01!25/05 S( L Cofper 98.9 1.00 uVL EP200.9 C (<-1300) 01.7405 01.2305 S( L !roc. 250 U 250 ug.'L E?2008 C (o-300) 01'2405 01 :5.05 S( L Lead 0.555 0.200 ug'L E?209.8 C (o-151 01 24105 01 25,45 Sc L Magnesium 7990 50.0 ua L EP200.8 C 01441105 002305 Sf L Manganese 7.76 1.00 u3'L E1`200.8 C (<-50) 01.7403 01 :5105 S( L n 1. ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY. AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OFFENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. 4 n .ow '✓.*lt oe `w _ ioi•By Si -IIA" f)_b ASSOCIATES LAND SURVEYING 64 SCALE- OF At OATEN ......... � Q, .� GRID �... ..... .... iDuan. Merk 3.w.rd FB' 79-JiG I .'.. 15-6918 DRAWN: �»J