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SCHROEDER EAST BLK 6 LT 15A
Schroeder East Block 6 Lot 15A #050-062-39 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW080097 PID Number: 050-062-39 Name` MARTIN FLOWERS Wastewater System: ❑ New ■ Upgrade yas Address: 12516 HOPE CIRCLE * EAGLE RIVER, AK 99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 696-0558 3 ❑Deep Trench ❑Shallow Trench ■Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: Total Depth from final grade: GPD/Sq. Ft. Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel pth beneath pipe: 6 15A SCHROEDER EAST \\ Fill added above original grade: \\ Ft. Township: — Range: — Section: — Gravel length: WELL: Ft. Gravel width: �\ Ft. Number of lines: Distance between lines: ❑ New ❑ Upgrade Ft. Ft. Classification (Private, A,B,C): ^ Total Dept (`J Cased To:(BEDRaCK) Total absorption a: Pipe material: Ft. Ft. SQ. Ft. Driller. �\ / \5� Date Drilled: Static Water Level:Install GEG, Ltd. Date installed: 7/3/2008 Ft. Yield:Pump Set At: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ■Septic ❑Holding ❑S.T.E.P. ❑Other* To Septic AbsorptionTSta Holding ublic/Private Manufacturer. GREER Capacity in gallons: 1000 rom Tank Field Tank Sewer Lines Well 100'+ — — 25'+ Material: STEEL Number of compartments: 2 Surface Water 100'+ - - - - LIFT STATION Lot Line 5'+ — — — — Size in gallons: Manufacturer. Pump on level at: Pump off" at: High water alarm at: Foundation 5'+ — — — — Pump Make & el: Electrical Inspections performed by. Curtain Drain NONE KNOWN Remarks: OLD SEPTIC TANK WAS PUMPED, BENCH MARK Location and Description: CRUSHED, AND COMPLETELY ABANDONED TOP OF 2" X 4" TRIM AT BOTTOM OF SIDING Assumed Elevation: 100.00 F{ Inspections performed by: GEG, Ltd. Dates: 1st 7/03/08 ENGINEER'S SEAL 06 0 — 2nd 3rd Development Services Department Approval :: � Conditional approval: Date: .. .... ....................� p of rey A. ar ss: OQ -)3�CE-7P53 e° Q� 044 ere ct �� _ ). _ Reviewed and approved by: L ate: U �ofessfo� po 40D0�0�0� (Rev. 4/06) PERMIT NUMBER: AS _BUILT DRAWING PARCEL ID NUMBER: SW080097 050-062-39 SCHROEDER EAST, \ 1 LOT 16, BLOCK 6 I A B \\ \\ ST1 42.21 20.13 I 1 ST2 47.79 19.11 DBL1 49.18 17.46 \ \\ DBL2 48.83 15.04 ST1 BL ST2 BENCH MARK i EXISTING \ DRAINFIELD 1 00, We44 �OjUS / PQQRO�\Mp'(E / \ NOTE: WELL RADII ON DESIGN \ WERE APPROXIMATE LOCATIONS. ALL WELL RADII SHOWN WERE FLAGGED BY SHANE HOLT, RLS. 760• SCHROEDER EAST, / LOT 19A, BLOCK 6 SCHROEDER EAST, LOT 18, BLOCK 6 c% NEW 1000 GALLON SEPTIC TANK / A /EXISTING i 3 BEDROOM HOUSE i GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3701 E. TUDOR ROAD, SUfTE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-8179 • FAX (907)338-3248 • WEBSITE: www.game ngln s lnq.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: I MARTIN FLOWERS 696-0558 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SCHROEDER EAST, LOT 15A, BLOCK 6 K.D.M. TYPE OF WORK: DATE: AS—BUILT DRAWING 7/7/2008 SEPTIC _ AREA / / SCHROEDER EAST, / LOT 14, BLOCK 6 I I I \ 1 " = 40• / I 1 / 4� OF... Z.,gSpO - 0 .•44q :....1. T ..........*l .ry ........ ....... .f E y Ga ess. CE -79 3� I (� .7 rC, �O�'professlo� o� TOP OF TANK AT INLET = 97.21 INVERT OF BUNG AT INLET = 96.89 4" OF INSULATION FINAL GRADE = 99.27-99.43 ST1 ST2 /TOP OF TANK AT OUTLET = 97.22 NEW 1000 GALLON SEPTIC TANK GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-8179 • FAX (907)338-3248 • WEBSITE—garneeaengl—ing.— PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARTIN FLOWERS 696-0558 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: SCHROEDER EAST, BLOCK 6, LOT 15A K.D.M. TYPE OF WORK: DATE: AS -BUILT PROFILE 7/7/2008 (Rev. 01105) INVERT OF BUNG AT OUTLET = 96.56 Q 9� CE -7953 4��4 rOfesrslon°o MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 24, 2008 Expiration Date: Jun 24, 2009 Permit Number: SWO80097 Parcel ID: 050-062-39 Legal Description: SCHROEDER EAST BLK 6 LT 15A Design Engineer: 0855 GARNESS ENGINEERING GROW Site Address: Owner Name: MARTIN FLOWERS Lot Size: 24063 SQ. FT. Owner Address: 12516 HOPE CIRCLE Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER, AK 99577 - 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 ( 18AAC72 ) 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: 4 Date: v Issued By: i C' Date: ' Municipality of Anchorage A; Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 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. ©JO __�q Property owner(s) MARTIN FLOWERS Day phone 529-9084 Mailing address 12516 HOPE CIRCLE * EAGLE RIVER, AK Site address Zip Code 99577 Legal description (Sub'd, Block & Lot) SCHROEDER EAST, LOT 15A, BLOCK 6 Legal description (Township, Section & Range) Lot Size '�4' 1) b � Sq.Ft. THIS APPLICATION IS FOR (® all that apply) Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I 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. GARNESS ENGINEERING GROUP, Ltd. Permit/Rush Fees: q('0.00 Date of Payment: / `'� f! U iC Receipt Number: 51 (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS June 20, 2008 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Tank Upgrade for Lot 15A, Block 6, Schroeder East To whom it may concern: A documented 1000 -gallon septic tank currently serves the existing 3 -bedroom house. We exposed the tank to verify the integrity, and confirmed it had holes in it. We are proposing that the existing 1000 -gallon septic tank be replaced with a new 1000 -gallon septic tank in accordance with the Municipal standards. There are no surface waters within 100 feet of the proposed upgrade. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. M.S. NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com SCHROE R EAS SCHROEDER EAST, I LOT 10, BLOCK 6 / SCHROEDER EAST, LOT 14, BLOCK 1 LOT 7, BLOCK 6 SCHROEDER EAST, LOT 17 8L6CIf-1-- 00, \ SCHROEDER EAST, LOT 11, BLOCK 6 SCALE: 1" = 100' SCHROEDER EAST, / / SCHROEDER EAST, SCHROEDE� EAST, S LOT 6, BLOCK 6/ A LOT 15, BLOCK 1 LOT 16, B�.00K 1 ' SCHROEDER EAST, LOT 12, BLOCK 6 SA1TA \ I 1p0 WELL RAO/U C) SCHROEDER EASTI SCHROEDER EAST, 1 1 \ S \ LOT 13, BLOCK LOT 5, BLOCK 6 \ \ SCHROEDER EAST, \\ \ \ LOT 16, BLOCK 6 / 3 EXISTING SCHROEDER EAST,\ \ / HOUSE DROOM LOT 17, BLOCK 6 \ ` \ / Ff SEPTIC — I SCHROEDER EAST, ` / \' // \� SCHROEDER EAST, / / LOT 4, BLOCK 6 LOT 18, BLOCK 6 \ 700, \ / SCHROEDER EAST, \ LOT 14, BLOCK 6 I / 1 1 WELL RADIUS 100' WELL RADIUS \ �OjUS I \\ I APPROXIMATE APPROXIMATE CSEP4 -13 SCHROEDER SCHROEDER EAST, \ LOT 19A, BLOCK 6 --lo 0' WELL RADIUS \ SEPTIC \ \ �,w�d I SCHROEDER EAST, \� \\ \ o \\ \\ V LOT 3A, BLOCK 6 / o \ SCHROEDER EAST, LOT r \ \ / \ SCHROEDER EAST, 20A, BLOCK 6 aN \\ \\ / � \\\LOT 2, BLOCKCSE/ Q�\\ TIC- AP� C) GARNESS ENGINEERING GROUP, Ltd. p�* : T*� CONSULTANTS & GENERAL CONTRACTORS �"""""' ' . """' """' 701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)336-3246 • WEBSITE: w .gamossanginwing.00m PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •••• • ••••• ••• MARTIN FLOWERS 696-0558 1 OF 2 J ffr A. G ss: LEGAL DESCRIPTION: DRAWN BY: Q 9; / -7953 SCHROEDER EAST, LOT 15A, BLOCK 6 K.D.M. TYPE OF WORK: DATE: 400dp�ofess%o�oo SITE PLA6/19/2008 N FOR SEPTIC TANK UPGRADE (Rev. 01/05) GEG, Ltd. HAS A 7 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. NOTE: THE CONTRACTOR SHALLO TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD HAVE THE WEST LOT LINE, AND WITH THIS INSTALLATION, THE ENGINEER, ALL WELL RADII FLAGGED BY A WELL DRILLER, CONTRACTOR AND REGISTERED LAND SURVEYOR Cj) PROPERTY OWNER AGREE THAT THEY PRIOR TO CONSTRUCTION. HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. SCHROEDER EAST, / PROPOSED 1000 GALLON LOT 16, BLOCK 6 SEPTIC TANK \ \ EXISTING 1000 GALLON SEPTIC / TANK TO BE PUMPED, \ \ CRUSHED, AND COMPLETELY ABANDONED CSEPTIC /G F A R E \ / EXISTING i \ \ / 3 BEDROOM / / HOUSE SCHROEDER EAST, DEXISTINGRAINFIELD \ / LOT 18, BLOCK 6 / \ SCHROEDER EAST, / 100• LOT 14, BLOCK 6 � CC / PQQRoy,�MP�� II SCHROEDER EAST, LOT 19A, BLOCK 6 I / \ SCALE: 1" 40t 000�o oOp 0 0 GA R N ESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS Q• • • •' • • • • • • ...... • .......... 13701 F TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 • WESSRE: w .gamwwnginwring.com D I. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .. . .................... MARTIN FLOWERS 696-0558 2 OF 2 ff e G Hess:' LEGAL DESCRIPTION: DRAWN BY:049 E-7953 �Q` SCHROEDER EAST, LOT 15A, BLOCK 6 K.D.M. ��� � TYPE OF WORK: DATE:4od prof esslov\ PROPOSED SEPTIC TANK UPGRADE 6/20/2008 ��O000�a Municipality of Anchorage Page / of Z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 a Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: swe�a `37 PID Number: aSoo�z39 Naive: Wastewater System: ❑ New ®. Upgrade �/aLL 1i/Aa aArAC Address. ABSORPTION FIELD /28'/e, _ PhoneT No. of Bedrooms- F Deep Trench ❑Shallow Trench X1 Bed E) Mound F1 Other v Soil Rating. Total Depth from original grade: LEGAL DESCRIPTION a. S' GPD/Sq. Ft Block Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe Lot: In ScN204'DB.4 EAST Z Ft. • 5 Ft. Township: Range: Section: Fill added above original grade: Gravel length 2 E Ft. �Ft Gravel width: Number of lines: Distarce bel veen lines: WELL: ❑ New ❑ Upgrade 5 'r� Z- 2 FI G Ft. Classification tPrivate. A.B.C): Total Depth: Cased To: Total absorption area. 2 / 3& Pipe material: ASTAI F00I(� 19 /vATG Ft- Ft, ! S4. Ft. 14E7*Ll? Driller. Date Drilled: Static Water Level: Installer Date installed: --P —nt.� Ft. lJ[s 6F0 E�X�•QVATIOAJ /! Yield: Pump Set at CHAbove Ground asmy eiyht nd: TANK GPM FL Ft SEPARATION DISTANCES XSeptic El Holding LJS.TEP. Lift Hold,ng aublic Private Manufacturer Capacity in gallons: To Septic Absorption From Tank Field Station Tank Sewer Lmes AA(f,o%a✓4 G^Lr /A,V/t / Material: Number of Compartments: Well /00 r/ /00 z 7� -r Teo-,- 2 SurfaceLIFT STATION �^ Water / 00 rf /00 Size in gallons: Manufacturer. Lot Line /0�f /0 �+ �^ - "Pump on' level at. ump off' level at High water alarm at: Foundation r 71 �--- --- Pum Model Electrical Inspections performed by Curtain: NON Drain l�- BENCH MARK Remarks: 0'/-/ f i /; rl / Location and Description. 4 ti �� _ /Oi' OF FOUN.OAi/ON Assumed Elevation .. iW •u F ENGINEER'S SEAL 17034 Eagle River Loop Road, No. 204 Inspections performed by: E. Rfver, Alaska 99577 Dates: 1st / 2nd Department of Health and Htiman Services approval Date: j "" Reviewed and approved by: _G/f 72-013 (Rev 9/91) MOA 25 --. n"I.M PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930433 DATE ISSUED:10/14/93 DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE:10/14/94 OWNER NAME:WALBERG DALE L OWNER ADDRESS:12516 HOPE CIRCLE EAGLE RIVER, AK 99577 PARCEL ID:05006239 LEGAL DESCRIPTION: SCHROEDER EAST BLK 6 LT 15A LOT SIZE: 24063 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 OR 343-4681 AFTER BUSINESS HOURS 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: RECEIVED BY: ISSUED BY: ou U0 -Eu '_1 1O- 1S -°1Z' DATE: (O (S �j 43 DATE : �O IT B i4. 1N October 9, 1993 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS Municipality of Anchorage MUNICIPAUIY OF AN(-HL)KAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION 825 L Street Anchorage, Alaska 99519-6650 OCT 1 1 1993 SEWER & WATER MAIN EXTENSIONS RECEIVED REFERENCE: Schroeder East Subdivision, Block 6, Lot 15 SEWER & WATER INSPECTION We request you issue a permit to upgrade the septic system serving the ENGINEERING STUDIES three bedroom house on the referenced property. AND REPORTS An adequacy test performed on the existing system for Health Authority Approval purposes found the absorption capacity of the existing system to be inadequate. WELL INSPECTION &FLOW TEST A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked SITE PLANS and found to be dry. Attached it the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by the ROAD DESIGN installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. SOIL TEST Since y, PERCOLATION TEST �--� A. Shafer, P.E. STRUCTURAL& MECHANICAL RAS/LSU/Isu INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 LO O 0 Lu 7i q o vi e� o w V) J uj nJ Z W O z � �o Oz w Z V O O O cr Q D-- Z O 00- w afln O n U a Z w Zw> O=Ow OZ SOO <0 F n. o F- w z � vi 0- >- CO F -O w V)V)w Zed tZ-F-m waQp Ln �O0�w WZ50:� rviF- OfOQI =EC)p UZ� F wz� 3a > <Z O U) O a V) r J J > o:: ch: 0- �HNOZ w 0 J L'Jw Q 0 m < =) O'OJOf a- r - L fF- w v) F- 0 w Q Z 0 z o z0 za<<-U y'! [y 0 1 v 9l H o F �O% 0 o sow b a w o % a a a o< < 0 070 w � LL) V U K OJX w w � o: s w 6 aw sco oD\ 0 Q wE l — U =1 O a � Z Fnr OOV O d � S; LO O 0 Lu 7i q o vi e� o w V) J uj nJ Z W O z � �o Oz w Z V O O O cr Q D-- Z O 00- w afln O n U a Z w Zw> O=Ow OZ SOO <0 F n. o F- w z � vi 0- >- CO F -O w V)V)w Zed tZ-F-m waQp Ln �O0�w WZ50:� rviF- OfOQI =EC)p UZ� F wz� 3a > <Z O U) O a V) r J J > o:: ch: 0- �HNOZ w 0 J L'Jw Q 0 m < =) O'OJOf a- r - L fF- w v) F- 0 w Q Z 0 z o z0 za<<-U y'! [y 0 1 v 9l H o F �O% 0 o sow b a w o % a a a o< < 0 070 w � LL) V U K OJX w w � o: s w 6 aw sco oD\ 0 Q wE l — U =1 O a � Z Fnr OOV O d � a— a w Sj1I Xa Z Ism .00 [ S a E" \ laedadn 1 'os = „t 1 v 9l H o F �O% b a w o % o o �� O m w w Cl) 0 e 0 o: Q w 6 aw sco oD\ laedadn 1 'os = „t 1 v 9l H o F �O% co Z a r z cr 'ter w 6 aw sco oD\ O wE l E- V E- O laedadn 1 'os = „t ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Schroeder East Subdivision, Block 6, Lot 15 GENERAL: 1. The scope of this project includes the installation of an absorption bed to serve the three bedroom residence located on the referenced property. The existing septic tank is to be excavated to verify its integrity and relocated. If of poor integrity, the tank is to be abandoned and a new 1000 gallon septic tank installed. The existing leachfield is to be abandoned in place. 2. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. 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 INSTALLATION: 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. Page Two Schroeder East Subdivision, Block 6, Lot 15 October 9, 1993 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. 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 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed -up) before gravel or sand placement. 2. If a sand layer is required, place sand over entire excavation to the required depth ,shown on the design. The top of the sand layer must be within 2 inches of level. 3. Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a minimum of twelve (12) inches. 4. The perforated distribution pipes must be no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Page Three Schroeder East Subdivision, Block 6, Lot 15 October 9, 1993 5. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 6. Monitor tubes shall be of four (4) inch diameter and installed at the locations shown on the design. The portion of the monitor tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. 7. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. 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 Four Schroeder East Subdivision, Block 6, Lot 15 October 9, 1993 5. A permeable nontoxic silt barrier (rypar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, it's gradation specifications must conform to current M.O.A. or D.E.C. requirements. 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: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, 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. " (E EERS`'SEAL) — „` i Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG s PERCOLATION TEST 1,I '�1k1� 1/�"L�PJ�} r :C1 PERFORMED FOR: DATEP RFORIV ��yr �� Township, Range, Section: LEGAL DESCRIPTION: (/�i✓�-CA SLOPE SITE PLAN 3 c/ 4 5 � n co 6 a 7 8 r G�6' 9 1011 ' a 12-- 13 - 0 213-Uw 4 14 15 il.{k'1� QOri 16 17 18 19- 20 COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Irv. S L O P E Depth to Water At Mnnilnrino? `1� LAale: Reading Date Gross Time Net Depth to Net Time Water Drop Yom- k 5vz0-w. — ' - -� I U 10 t ,) 3 itIt gN n It �(2 ! l u u PERCOLATION RATE -J_.L= rn nutesnnch) PE,RC HOLE DIAMETER TEST RUN BETWEEN �T AND _ FT PERFORMED BY: S & S ENGie R� aYN Loop qa 77934 Eng ACCORDANCE WITU gJLL &1;6 AWk1 7 1- GUIDE CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE- DATE. - MUNICIPALITY OF ANCHORAGE �\ DEPARTMENT 01= HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM ANO/OR WFLL INSPECTION REPORT NAME ^ ❑ UPGRADE /✓/�-� �/S ✓CJ-- !/ - - ( i'- 9�I _ MAILING ADDR ESSS��a x LEGAL. DESCRIPTION LOCATION NO. OF BEDROOMS We ll +- Absorption area DISTANCE TO: //0 Dwelling r, a PERMIT NO . P / U y _ _ _ h Q Manufacturer o,e Mater al No, of compartments v rn �Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth Q y DISTANCE TO: Well Dwelling PERMIT NO. aManufacturer Material Liquid capacity in gallons q w�. DISTANCE TO: Well r Foundation Nearest lot line PERMIT NO. J LL z No. of lines Length of each line Total length of w Trench width Distance between lines H Z cc cc�_ _ I " inches f. Top of tile to finish grade — Material beneath tile ' Total effective ,� �� p absorption area inches Length Width Depth PERMIT NO. - w Q F- as Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: Well Building foundation Nearest lot line w Class D Depth Driller Distance to lot line PERMIT NO. a: DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) OTHER _t b PIPE MATERIALS nn SOIL TEST RATING INSTALLER el ,✓ REMARKS �r r I P LEGAL I APPROVED !' DATE ��s - NICIPALITY OF ANCHORAGE I �S 5 4ALa-s� Department of Health and Environmental __otection ,/� u-(14 825 L Street, Anchorage, AK. 9950 � 264-4720 HANDWRITTEN PERMIT / pJ_ AW/OR ON-SITE SEWER PERMIT;.�5 Applicant: eC> o,ar �_� eQ Mailing Address: `J'� Location : Phone Number: _ (,� 9 q- 9/ % Legal Description: 46-abco- fp=rCLot Size: 30 oP(: Type of Soil Absorption System Is: Trench: Drainfield: I<_ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: -3 Soil Rating(sq.ft/br) /.Z2 The Required Size of the Soil Absorption System Is: DEPTH 3.5 LENGTH GRAVEL DEPTH —f J WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). OO GALLONS # # # REQUIRED SEPTIC(HOLDING) TANK SIZE = iD�— Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(Z) INSPECTIONS ARE REQUIRED # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. # # PERMIT EXPIRES DECEMBER 31, 1 9 u 1 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the re idence remodeled to include more that 3 bedrooms. Issued by: ` Signed: pplicant Date: SWP/024(1/81) EXE i I. yt ,S7� Ives �d 0� A s' of OWNER OF LAND , ADDRESS LEGAL DESCRIPTIO DATE Started Ended PERMIT NUMBER • t� DEPTH OFWELL STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR KIND OF CASING From . _..L� Ftto Ft. /3 From Ft. to Ft. From Ft. toFt. From Ft. to Ft. From ' _iFt. to___L,_'Ft. From Ft. to Ft. From Ft. to Ft.From—Ft. to—Ft- From Ft. to Ft. From Ft. to Ft From Ft. to Ft. From —Ft. to Ft. From F Ft. to Ft. From Ft. to F#. From Ft. to 6� Ft. From —Ft. to Ft. From Ft. to Ft.From Ft. to Ft. From—"' Ft. to__L,_-'-�:JFt°' 16,**_"- From Ft. to Ft. From Ft. to Ft. From—Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From—Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From —Ft. to Ft. From Ft. to Ft MISCL. INFORMATION: DRILLER'S NAME _ M R -,.R PA 1 1 F"' Fil L__ I '"I" O -e C. -O F" F-9 P-4 C"-. 9-1 R _4�� DEPHRTMENT ' HEALTH HND ENVIRONMENTRL OTECTION 825' STREET/ HNCHORHGE/ HK. 264�4720 IL ~L IP E.- Fl;l 11-1 1^� PEP.111I1" NO. ( 810050 ) HPPLICANT ROBERT DEAN SR BOX 93'52 694~9��7 LOCHTION LE11-30L L15 B6 �CHROEClF`:R EAST LOT SI'_-. 41000 FEET MINIMUM DISTANCE BETWEEN H WELL HND nNY ON-SITE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVRTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FI -POM Fl PRIVATE WELL TO H P�IVATE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. WELI. LOGS H�E REGUIRED HND MuST BE RETURNED TO THE DEPARTMENT WITHIN �0 DHYS OF TH� WELL COMPLETICN. OTHER REQUIREMENTS MHY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRHMS RRE HVH��H�LE TO INSURE PROPER INSTALLHTiON. I "T' LE���������� I CERTIFY THAT � 1. I RM FAMILIAR WITH THE REQ.1IREMENTS FOR ON --SITE SEWERS RND WELLS AS SET RTH BY THE MUNIC1PHLITY OF HNF:HORHGE. I IdILL. THE EM IN ACCORDANCE WITH THE CODES nrr�ICHNT ROBERT DEAN ISSUED BY � V4.0 Municipality of Anchorage • F On-Site Water and Wastewater Program .-2.11- (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-062-39 Expiration Date: I - ( -1-- 415 1. GENERAL INFORMATION Complete legal description Schroeder East Block 6 Lot 15A Location (site address) 12516 Hope Circle Current Property owner(s) DEHASS Day phone 726-3796 Mailing address Same Real Estate Agent Temple Day phone 854-8625 (1 c, 5 5 '07I4 2. TYPE OF DWELLING: �� 1. J ® Single Family (w/wo ADU) ❑ Duplex d OCT 0 4 2017 E Multiple Dwellings (Single Family and/or Duplex) �� ti �!` O[ 6 9 G9�h 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: ----- y: c.-,u Date: /(I// 2 J COSA to be released to the engineer, unless of ise requested by the engineer. COSA Fee $ 6-Aie Date: Date of Payment 1015/17 Date of Payment Receipt Number c4(0? 10 Receipt Number COSA# O5Ct7100 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this .application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 10/4/2017 :-L i WW 6. DSD SIGNATURE" • System #1 Approved for bedrooms. - Z ; • << System #2 Approved for bedrooms. `•;µ Disapproved. /a�y�,� `�`r"� Conditional approval for bedrooms, with the following stipulations: t,,kociti(itrt,oF , ON-SITE 0,' WATER POD WASTER o - PROGRAM A FNT SFRv\C) By: \t=7__( S Original Certificate Date: JO r ( 7 The Municipality of Anchorage Devlopment Services Division(DSD) Issues Certificates of On-Site Systems Approval(COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_9-1-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On Site Systems Approval Checklist Legal Description: S 'raedQer 64,is gC 4/54 Parcel ID:05066Z57 A. WELL DATA Well type Ip If A, B, or C provide PWSID## Well Log (YIN) rf Date completed /?8/ Sanitary seal (YIN) Wires properly protected (YIN) Total depth PC) ft. Cased to 35 ft. roC.k Casing height (above ground) /8 in. FROM WELL LOG AT INSPECTION Date of test /e. e2-0.7 Static water level 30 ft. 05. P ft. Well production 20 g.p.m. q. g.p.m. WATER SAMPLE RESULTS: q Coliform _ U colonies/100 mL Nitrate 4./. //mg/L / Arsenic I/ L ug/L Date of sample: /G l 7 /1 7 Collected by: rv7r f=n B. SEPTIC/HOLDING TANK DATA Tank Type/Material S el)i -(& i i( Date installed ]/3,/0cf Tank size fia O gal. Number of Compartments Z Cleanouts (Y/N) Foundation cleanout (Y/N) +`/ Depression over tank (YIN) A) High water alarm (Y/N) A/ Date of pumping 7/ZS//7 Pumper `,.<< r 4if J C. ABSORPTION FIELD DATA Date installed ///r97Q3 Soil rating (g2 or ft2/bdrm) a • 5 System type eed Length 5/f 2-7 ft. Width 21//31" ft. Gravel below pipe C:;P• -s ft. Total depth ft. Eff. absorption area / 36. ft2 Monitoring tube Depression over field A. Date of adequacy test /07J/1 7 Results (Pass/Fail) P For 3 bedrooms Fluid depth in absorption field before test Q in. Water added -5- gal. New depth Z in. Elapsed Time: 6"0 min. Final fluid depth 9 in. Absorption rate >= 1-7/5- 0 g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N & type) /t/ If yes, give date D. LIFT STATION 4.4 Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot /DD "- On adjacent lots /DC(-0- Absorption field on lot /Oo �'�' On adjacent lots / 7e) Public sewer main /d d f Public sewer manhole/cleanout / 7a. {'r Sewer/septic service line z 5 `-f- Holding tank /4 o f Animal containment areas 50 Manure/animal excrete storage areas /00 " SEPTIC/HOLDING TANK ON LOT TO: Building foundation (I- Property line .�7 � Absorption field Water main /Q �f Water service line /0 " Surface water /d'a !4- Wells on adjacent lots /0 O t ABSORPTION FIELD ON LOT TO: �C ��- i Property line /C.) •— Building foundation Water main /d rf" •'� � /01f. Water Service line �G Surface water f 6� Driveway, parking/vehicle storage Curtain drain Li/t.) -- Wells on adjacent lots /d 4 '7- F. COMMENTS A / -' i /4/99 v�o{ G. ENGINEER'S CERTIFICATION • • AZIN I certify that I have determined through field inspections and '.4.4 ,r review of Municipal records that the above systems are in `•.}" conformance with MOA COSA guidelines in effect on this date. F Engineer's Printed Name S(F.1 6 C Y`' Date /1/47/7 -- 1� 14/ i w7 ,ry K COSA yellow sheet_2-6-15.doc • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 050-062-39 Expiration Date: hl__ 1. GENERAL INFORMATION Complete legal description Schroeder East, Block 6, Lot 15A Location (site address) 12516 Hope Circle Eagle River, AK 99577 Current Property owner(s) Toni Dobson Day phone Mailing address 12516 Hope Circle Eagle River, AK 99577 Real Estate Agent 2. TYPE OF DWELLING: E] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Day phone Waiver/Variance request for: Distance: Received by: U-U/UYU f�L COSA to be released to the engineer, unless by the engineer. COSA Fee $ Waiver Fee $ Date of Payment loll &//I- Date of Payment Receipt Number L)351- (1 Receipt Number COSA # 05C4 61 5'15 Waiver # TYPE OF WASTEWATER DISPOSAL: ❑ Individual E ❑ Holding Tank ❑ ❑ Community ❑ El Public Sewer ❑ Waiver/Variance request for: Distance: Received by: U-U/UYU f�L COSA to be released to the engineer, unless by the engineer. COSA Fee $ Waiver Fee $ Date of Payment loll &//I- Date of Payment Receipt Number L)351- (1 Receipt Number COSA # 05C4 61 5'15 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE SI System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Phone 522-7773 Date 10/14/15 OF.44 41�® 49TH. MICHAEL E. ANDERSON ow CE -4381 00*06- e (/1,tii® SS :ir Conditional approval for bedrooms, with.the following B rZ'dT/LE� �G �i/I�✓/ ZOriginal Certificate Date: cSs T e Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory OOSAbluesheet � - . - Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Schroeder East, Block 6, Lot 15A Parcel ID: 050-062-39 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 1981 Sanitary seal (YIN) _ Total depth 80 ft. Cased to 35 ft From 7/7/08 COSA FROM WELL LOG Date of test UKN Static water level 30 ft. Well production WATER SAMPLE RESULTS 20 9 -P.M. Well Log (Y/N) Y Wires properly protected (YIN) Y Casing heigti (above ground) >18 in. AT INSPECTION 10/7/15 46 ft 1.5 g.p.m. Coliform 0 colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 9/30/15 Collected by: And. Engineering B. SEPTIC/H©LDING TANK DATA Tank Type/Material Septic/Steel Date installed _ Tank size 1,000 gal Number of Compartments 2 Cleanouts (Y/N) Y N 7/3/2008 Foundation cleanout (Y/N) _ Depression over tank (Y/N) _ High water alarm (Y/N) Date of pumping 9/23/15 Pumper Sanitary Pumpers Y 7 C. ABSORPTION FIELD DATA Date installed 11/9/93 Soil rating (g.p.d./ft2 or ft /bdrm) .5 GPD/SF System type Bed' Length 51/27 ft. Width 24/34 ft. Gravel below pipe ft. Total depth 6'25 ft. Eff. absorption area 936 fe Monitoring tube Y Depression over field N y' Date of adequacy test 10/7/15 Results (Pass/Fail) Pass For 3.. bedrooms Fluid depth in absorption field before test **6 it . Water added 450 gal. New depth 9.4** in. Elapsed Time: 1,440 min. Final fluid depth 6 in. Absorption rate >= 450 g.p.d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date **MT Extends 10.2" Below Distribution Pipe Invert Per 7/7/08 COSA. I D. LIFT STATION Date installed "Pump on" level at in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons "Pump off" level at in. Cycles tested Septic tank/lift station on lot >100' Absorption field on lot t 1001 Public sewer main >75' Sewer /septic service line >25' Animal containment areas >50' V1 Manhole/Access(Y/N) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots >100' On adjacent lots >100' Public sewer manhole/cleanout >75' >100' Holding tank Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation >51 Property line >51 Water main >10' Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: >150' to Class C 7'** Property line >10' Building foundation Water Service tine >10' Curtain drain None Noted F. COMMENTS G. ENGINEER'S CERTIFICATION Surfacewater >100' Wells on adjacent lots >100' 1 certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 10/14/15 COSA brown sheet 10-10-12.doc Absorption field >51 Surface water >100' >100' Water main 10' Driveway, parking/vehicle storage >10' >150' to Class C 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my sea! fixed hereto and as of the validation date shown below, I verify'that my investigation, based on.Mocedures 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 arid 41?quate for the number alredrooms and type of structure indicated herein. I further verify that based on the . information pblained from the Municipality of Anchorage riles 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 GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS. P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines B Regulations. The reported results doscribed the performance of the system under the conditions encountered at the time of the lost, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the solo benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for _,3— bedrooms. Disapproved. 337-6179 Date _71-1109 004 Off[ j.•� d ''�-Y�� Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Nitrate Advisory Other By: (Rev IVOS( a . r....,L... " -/-.1,104 �pFo/es �oo\\�Y OF,gNcy�� i �J`�=• ••ON-SITE ••:�� WATER AND ; m= WASTEWATER PROGRAM ' Original Certificate Date: - Q= Municipality of Anchorage C Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SCHROEDER EAST, BLOCK 6, LOT15A Parcel ID: o.'a — C 2 —.3 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 1981 Sanitary seal (Y/N) YES Total depth 80 ft. Cased to 35 ft, (BEDROCK) FROM WELL LOG Date of test UKN Static water level 30 ft. Well production 20 g.p.m. WATER SAMPLE RESULTS: Well Log (Y/N) YES Wires property protected (Y/N) YES Casing height (above ground) 18 in. AT INSPECTION 6/6/2008 24 ft, 1.52 g.p.m. Coliform 0 colonies/100 ml. Nitrate 9.15 mg./L. Other bacteria _0 colonies/100 ml. Arsenic: ND_ug./L. Date of sample: 6/6/2008 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date Installed 7/3/2008 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N)NO High water alarm (Y/N) N/A Date of pumping NEW Pumper , C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE Date installed 11/9/1893 Soil rating (g.p.d./ft'o /bdr 0.5 System type BED Length 51/27 ft. Width 24/34 ft. Gravel below pipe 0.50 ft, Total depth *6.25 ft. Eft. absorption area 936 ft' Monitoring tube "YES ,Depression over field NO Date of adequacy test 6/6/2008 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test"5 in. Water added 458 gal. New depth"9 in. Elapsed Time: 180 min. Final fluid depth, "'7 In. Absorption rate >= 600+ g,p.d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — **MT EXTENDS 10.2 INCHES BELOW THE INVERT D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" leve High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ AND 150'+ CLASS "C" SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 2 `j'd Water main N/A Water service line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ AND 150'+ CLASS "C" F. COMMENTS APER 12/3/1993 MOA SEPTIC INSPECTION REPORT G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date -17IWO rnsA FAP.T, t4-;; IJ " I Date of Payment N0 Receipt Number 619q323 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Development Services Department Building Safety Division ' On -Site water and wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 080209 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 6, Lot 15A of Schroeder East subdivision. This inspection revealed a nitrate concentration of 9.15 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS S GENERAL CONTRACTORS July 8th, 2008 Municipality of Anchorage Development Services Department Building Safety Division On -Site water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519-6650 Attn: Jeff Poet Ref: Schroeder East Subdivision, B6, L15A. Proximity of Dminfield to Foundation Dear Mr. Poet: On the 1993 inspection report prepared by S&S Engineering, the separation distance between the drainfield and the foundation was left blank. Based upon our field measurements and judgment, it appears that the drainfield is about 4 feet from the foundation. During the installation of the septic tank we accessed the crawl space of the house. It is approximately 4 feet below grade and there was no water/moisture noted. The existing encroachment has existed for approximately 15 years. Based upon these facts, it is my recommendation that the subject separation distance be approved at 4.0 feet. If you have an� questions, please contact us me 337-6179. P.E., 3701 East Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com o SCF'• ...F' A 9s0� 9 A, 0, eU!' 4 9 ZH a ........................... 5.�. IIA&4- C SHANE A. HOLT.' LS -6914 �MNC 4n9 Y : a •� ..... "��. o S tiCPE 1 � PECK F � D �~tO v«use r>n�l< i . fPLMC nCUSC 14 III C.I RCffLE �1 r� Ln N ( 0 m, N N O N L 1, Ap L'iCN.:.i 2EJN S FOR TIC USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW AN, CONFLICTS BETWEEN >'tiJ 5 ti'e':'URSS AVC +lA'T E3 LOT LINES OR EASEVEMS AND IS NOT TO BE USED FOR PoSITIONING ADDITIONAL ;,.C:INh'•t:R cdal:T_LIII__ >„!+T•�iN"'17,4 THAN THOSESHGWNON THE RECORDED FLAT. ARE NOT SHOWN HEREON(UNLESS INOICATEDI ? A:I'E-NCE- NES SNMx. ME LOCATE'3 P O%IW'ELY AND ARE NOT TO 99 LSED TO DETERMINE PROPERTY LINES S 89'41.'34"E 3S.H7' AS -BUILT SURVEY (NO CORNERS SET THIS DATE I 1' • 30' IHENESYCERIIFr tH TIRAVEPERFORMEDA MORTGAGEES INSPECTION OF THE FOLLOWING DGSC:RIDEO PRJPCRT" LOT 1'J. BLOCK SCROEDER SUB. EAST AWN ANCHORAGE RECORDING DISTRICT. ALASKA AND TIWT THE WS'RLE IMPROVEMENTS SITUATED THEREON ARE WDHIN INS FRf ERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE. ALASKA TNIS _1ST_ DAY OF JULv:fNk HOLT LANG SURcF) ING 10% FG 13:46 TE.. 3N5 6.i 13 E L1-1-2008 09:018 FROM: ONE ARROW PUMP & WEU SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 • Fax (907) 333-8976 Eagle River: (907) 622-9335 CUSTOMER r / I epi i 0-7^ i i -. 11 70:3383246 JOB SITE P.1 DMOSCE NP 08062 PAY THIS AMOUNT Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that 0 above work Is not paid for In 90 days I agree to allow Aarow Pump a Well Service, L.L.C. are right to remove unpaid for equipment and charge for labor already performed a labor to remove unpaid for equipment) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. ' - - v Qp(,dCC Q�TE WELLOEPTH Ilft CMLORNATED PUMP DEPTH E QUANTITY DESCRIPTION PRICE AMOUNT tA w) LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED BY DATE COMP. I TOTAL LABOR PAY THIS AMOUNT Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that 0 above work Is not paid for In 90 days I agree to allow Aarow Pump a Well Service, L.L.C. are right to remove unpaid for equipment and charge for labor already performed a labor to remove unpaid for equipment) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. Parcel I.D. # 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING C s- C- c e z- j `i 1. GENERAL INFORMATION Complete legal description Lot i 5A: Block 6: S k o dex Ea6t Su.bd,iv.i6,ion Location (site address or directions) 12516 Hope, C,ikae. Eagle Riven, AK Property owner Th.2c,ia Vail Day phone 267-6548 Mailing address P.U. Box 90624 Anchorage., AK 99509 Lending agency Day phone Mailing address Agent KatGu U2nr6Lead; Remax a -11 °e. Riven Day phone 694-4200 Address 16600 Ce.nte.466 _`etd Vu..ive. Eag.2e. Riven, AK Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: MUN(CiPAUTy OF ����NMEWALSERvI OXAGE DrvIS1ON Individual well XXXJUN 7 4 Community well 1996�� Public water _ RECEIVED NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. ,2-025(Rev. 1/91) From MOA 021 Municipality of Anchorage r° w �Q o DEPARTMENT OF HEALTH & HUMAN SERVICE `" Environmental Services Division 41996 825°L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-479 Municipality of l"ch�ervic®a [),pt. Health & 0 M an Health Authority Approval Checklist Legal Description: L - o c 15 (�„ - (a pct >6y -6J-- Parcel I.D.: 0 S' 0 - 0 6 A. WELL DATA Well type iQlp,nj� If A. B. or C, attach ADEC letter. ADEC water system number Log presentcYA) Date completed lam( Total depth 4` Cased to 3��> Casing height (above ground) Sanitary seal (9N) Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform C% FROM WELL LOG 01 17� . U, g.p.nt. Nitrate Wires properly protected O1) AT INSPECTION rX Other bacteria 0 Date of sample:(9 ' �j to Collected by: B. SEPTIC/HOLDING TANK DATA Date installed kk-- 3 = ct 2� Tank size l C -> y c-> Number of Compartments 2 Cleanouts CI1)--�--- Foundation cleanout (�YRV) Depression ( Jj3 High water alarm (Y/N) _ ^t+/� Date of Pumping (o -.12 -"i 4 Pumper S@' . & ,v;p i .S(-, ki C. ABSORPTION FIELD DATA Date installed 1 - F� • `j _ Soil rating (g.p.d./W or ft-/bdrnt) 1J„S' _ Svstem type _r5y Length _11� 6 G1_V[: A1midtb 1 �e-yGC UL -A Gravel thickness below pipe U ` Total depth ;S ' Effective absorption area 933, Monitoring Tube presen(Y�N)__*_ Depression over field (Y(&y Date of adequacy test to•-1\°ILo Results&is ail) fA---;) For I_ bedrooms Fluid depth in absorption field before test (in.); e) N Immediately afterSSS` gal. water added (in.): / o •- Fluid depth d _(ins.) Minutes later: /d Absorption rate = _ 7S J /g.p.d. Peroxide treatment (past 12 mouths) (Y(& A)JA,b /4v� A4es, give date ^� { D. LIFT STATION Date installed Manhole/Access (YM) High�wstcd t es E. SEPARATION DISTANCES Size in gallons "Pump�tl=level "Pump off' level al* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot \00 \ : On adjacent lots _ =� %1 �l Absorption field on lot I \c2t- On adjacent lots n Public sewer main 1 _ Public sewer manhole/cleanout Sewer /septic service line _ Z� t Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: f d' t' '71 Property line I'D t'\ Absorption field Bun auilding olou + Water main/service line /5 Surface water/drainage foo Ik Wells on adjacent lots !bb SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: t� Building foundation 10 t plav�"•�f 4a Water ulail /service line Surface water _ 1 OV-> t k Driveway. parking/vellicle storage area Curtain drain '` Ip Wells on adjacent lots \UC, rt _ Property line. ID F. ENGINEER'S CERTIFICATION I certify that l have determined thru field inspections and review ofNlunicipal records t Y �,CIS�tall(Jlte,?z+�+ ty e in confovnance with MOA 1L4A guidelines in effect on this date. C7 Jf , Signature �1 .o.. .. •r .m nr..nn.rn t� ely -i x r co Wali✓ Crl gg C21' em... Engineer's Name� _ yp ROB EFET C. COWAN �,4? �0;fly CE -8301 Date HAA Fee 4 cyv " Date of Payments, Receipt Number Rev. 8/95 OSS: llaa.wk.doc Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES 6' Division of Environmental Services On -Site Services Section an P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. # -�n� - �c1 HAA # _�A Q_'C)11a'A 1. GENERAL INFORMATION Complete legal description Lot 15; Block 6; Schroeder East subdivision Location (site address or directions) 12516 Hope Circle le River, AK 99577 6-43 Property owner Dale Walberg Day phone 694-3978 Mailing address 1251.6 Hope Circle Eagle River, AK 99577 Lending agency City Mortgage Attn: Elaine Day phone 277-0786 Mailing address 121 W. Fireweed Lane Anchorage, AK 99503 Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: .3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community 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 (Roy. 1/91) Front MOA 021 5. STATEMENT OF INSPtL;TION 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 furtherverify that based on the information obtained from the Municipality of Anchorage files}}nd 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 re( ulatio in t on the date of this inspection. Name of F=irm Address Engineer's sig VEERING e River hoop Road No, 204 Alaska 99577 6. DHHS SIGNATURE Approved for —_ 3 bedrooms. Disapproved. Conditional approval for Additional Comments Phone — GK�j� —2�� Date _ _2 `D L R 3, bedrooms, with the following stipulations: Date 12-1— 3 _ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rov_ 1191) Back MOA 421 Municipality of Anchorage O Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: hTLa SCt\zor aG_s Parcel I.D A. Well Data Well type �iL� �I bei If A, B, or C, attach ADEC letter. ADEC water system number �` Ik Date completed iC100 l Driller Log present ON) P Total de th �� P Cased to �� t Q� 3� Casing height Sanitary seal O/N) Wires properly protected CDN) -- Date of test Static water level Well flow Pump levell FROM WELL LOG AT�INSGPE(!:�Ta,ION 1 1 V1 1^� 1 1J ZJO �y�I o g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: x `(k ZStk 0 0 _; On adjacent lots \ _; On adjacent lots ublic sewer manhole/cleanout Petroleum tank 2S�k Coliform d Nitrate \ 1Other bacteria Date of sample: \� — 0 —X13 Collected by: B. SEPTIC/HOLDING TANK DATA \ oD�A- Date installed 1 1 - �GI 3 Tank size l L.;'-� 0 Compartments 2 Cleanouts &N) Foundation cleanout O/N) __Depression (YQ High water alarm (Y& Alarm tested (Y/N) Date of pumping \Dc — Pumper 1' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: i Well(s) on lot _ \7 -"D -On � k- adjacent lots 10 Foundation To property line \ D� Absorption field 15' Water main/service line Surface water/drainage 1 o t::> t� CONTINUED ON BACK PAGE 72-026 (3/93)' Front r, f py -N' C o z Z D r c)C i (n G: Date installed 1 1 - �GI 3 Tank size l L.;'-� 0 Compartments 2 Cleanouts &N) Foundation cleanout O/N) __Depression (YQ High water alarm (Y& Alarm tested (Y/N) Date of pumping \Dc — Pumper 1' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: i Well(s) on lot _ \7 -"D -On � k- adjacent lots 10 Foundation To property line \ D� Absorption field 15' Water main/service line Surface water/drainage 1 o t::> t� CONTINUED ON BACK PAGE 72-026 (3/93)' Front C. LIFT STATION Date installed Manufacturer Size in gallons —Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "P High water alarm level ycles tested Meets MOA electrical codes (Y/N) SEPARATION DtSTANCE FROM LIFT STATION TO: on lot D. ABSORPTION FIELD DATA On adjacent lots at Surface water Date installed \ \ - 9j `3 Soil rating (GPD/Ft') D• S System type (5cz,> Length /2m. Width /QAe. Gravel thickness / Total depth _5715 - Total absorption area 3 Cleanout present 49N) _Depression over field (Yo _ Date of adequacy test ��I t-�F-,J Results (pass/fail) — for — Bedrooms Water level in absorption field before test After test Peroxide treatment (past 12 months) (Y/N) \ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot \ o o ` To building foundation K On adjacent lots e t Surface water \ oo � Curtain drain /11A E. ENGINEER'S CERTIFICATION I On adjacent lots Cutbank \ o Property line \ d To existing or abandoned system on lot \0, k rh Water main/service line t i4 - Driveway, parking/vehicle storage area !�M - I certify that l have checked, verified, orgonformed to all MOA and HAA guidelines in effect on the date of this inspection. Signa Engin Date HAA Fee $ OCO e6Z Date of Payment Receipt Number c215 - 2 72-026 (3/93)` Back 2 0Y Waiver Fee $ Date of Payment Receipt Number APPLI( NT FILLS OUT UPPER HA' ONLY Properly Owner \'j Phone Mailing Address-?--, �?r tv (n `,), Zc7f Zip Code C --�� •7' _ .-� c Buyer 7 r CJLAQ Address Zip Code Lending Institution �" 'A" _ � Phone Address (() L r,. Zip Code % U S�, ,, Realty Co. & Agent (. ,ca„ G Phone `- Inspector Address c� is (. f lt) FJ(�= Zip Code J`T �C� c� t Legal Description ZC.,y.. /- f1 ��� !. r C-r'L�t-C'�' l= �e�r2-+�-•--�J , MUNICIPALITY OF ANCHORAGE Street Location / DEPT. OF F!`.�.LTFI & Type of Residence ENVIRONMENTAL PROTECTION X-Single Family T' ❑Multiple Family No. of Bedrooms- edrooms RECEIVED 0 ❑ Other 'CONDITIONS OF APPROVAL - (� ) DISAPPROVED Water Supply ( ) CONDITIONAL APPROV ' p Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community For wells drilled prior to that dale, give well depth (attach log if available). Public Utility J Sewer Disposal Soils Rating Date Sewer Installed &] Individual Year Individual Installed:C �_• ',; r �� (• j 79 091 ❑ Public Utility ❑ Holding Tank When Connected to Public: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time r CJLAQ Date Date Date Date l v Inspector Inspector Inspector Inspecto11lJ�/11 Field Notes: /t «gyp MUNICIPALITY OF ANCHORAGE W DEPT. OF F!`.�.LTFI & ENVIRONMENTAL PROTECTION RECEIVED (` -) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL - (� ) DISAPPROVED ( ) CONDITIONAL APPROV ' DATE BY:�4-T"-i l �/ J Soils Rating Date Sewer Installed Well To Absorption Area ." <1 Well Log Received �_• ',; r �� (• j 79 091 Well to Tank Septic Tank Size Ga«Gaza If Sade ley 0 CO J -%IY. 51lice 2206 &n6 c 1,930; Gmjuet; tot .1-5, 12,10c2 4j, o v,---1 I d 'I'l scmlol - . and I.- faci i i Lics caullo L 'l -c'- be olted until U 1(2 itc,'111c; have xe u ) I C, em leteu: (I C, .1vice:1 wQll Goad a<e v J.)-1 at. ol: 1 -he em,icipulity of A.11chol aqo oe, conduic, repok:L n000''s, Lu �xL:teen Lo LiJs f. �j I L I G I I ')t633 ouv r view, j� ».ease vlo til j. s I)a r Ui.lcflc j, -)r a "V. « m Em2fon cc n the not c; discs mam«eo nave Please Call thisotticeat 1)1u Rob( 2 0 2Specialist h,�k 4 Marston Realty 2804 West Northern Anchorage, Alaska ATTENTION: Robert EXCAVATION WORK April ;4-�- 1983 It Lights Bo�and 99 50 3 Bloomfield ROBERT A. SHAFER CIVIL ENGINEER 694-2979 MUNICIPALITy OF ANCHORAGE REPT. OF H".�'.'_��-I ENVIRON�+��N1AL PicJieCiION Dear Mr. Bloomfield, " Reference: Lot 15; Block 6; Schroeder Subdivision A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The drainfield was tested by a continuous flow of water over a period of 24 hours without any adverse effect on the system. The flow during this period of time exceeded the basic requirement for a three bedroom residence. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. It should also be noted that the work required to place the well wires in conduit has been performed in a satisfactory manner. If we may be of further service, please do not hesitate to contact E. cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA ,- INSPECTION APPOINTMENTS DATE RECEIVED (0-e t� TfME TIMET IME DATE DATEDATE `' INSPECTOR INSPECTOR INSPECT"OR 6. TYPE OFRESIDENCE MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH &ENVIRONMENTAL PROTE:CTIOffiVIRONMENTAL f'IiOTECTION 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION JLfl4 Telephone 264.4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWEOII�IE DIRECTIONS: Complete all parts on page 1. Incomplete requests will. not be processed. Please allow ten (10) days for processing. 1. PRC!gERTY OWNE PHONE Wo19PIr a�? MAILING DRESS � �-f- PROPERTY RESIDENT (It different from ab&ua4 ONE 2. WJyER 16 PHONE 33 MAILING ADDRESS �2�2 / C/ 5��� ;?-7 � cz_ c c �7 rora C'_ 3. LENDING INSTITUTION /_��-V PHONE ra- / SQ - MAILING ADDRESS INDIVIDUAL/ON-SITE** 4. REALTO AGE/j4T z6? C2 ❑ PUBLIC UTILITY MAI LI DRESS NG AD (- j r t 0 5. LEGAL) o� (f) l 5/EX Ic �� SCIS U� �Z P r/ Sce_� r4 STREET LOO ATION / J S 6. TYPE OFRESIDENCE NUMBER OF,BEDROOMS X SINGLE FAMILY ❑ One ❑ Four ❑ Other ElMULTIPLE FAMILY? ❑ Two 0 F=ive Three ❑ Six 7. WATER SUPPLY �- N' INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX ❑ OTHER 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ED PUBLIC UTILITY Connection Verified PERMIT NUMBER '�— DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER - - DATE INSTALLED INSTALLER ❑Septic Tani< or ❑Holding Tank Size: _l()�U If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL _ 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ILK APPROVED FOR 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79)