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HomeMy WebLinkAboutSEA TURN BLK 2 LT 14Sea Turn Lot 14 Block 2 #017-121-38 Municipality of Anchorage Page -!-of -Z- DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW 466 03 PID Number: 3_a_ Name: 1IL (j> & --c— Wastewater System: tld New ❑ Upgrade AddreIss: � � � 61 WLt�'�/��.�./ar AN O IQ11—� �•.��� ABSORPTION FIELD Phone: z {c No. of Bedrooms: ❑ Deep Trench ❑Vhallow Trench ❑ Bed ❑ Mound O Other LEGAL DESCRIPTION Soil Rating: O Total Depth from original grade: FW1aC — ^ I I t '2•_ ! • GPD/Sq. Ft. R Lot: Block: Subdivision: Depth to pipe bottom frorraorigip`al grade: Gravel depth beneath pipe S�t�—F ja�4 l l©•C� Ft. ' .S Ft. Township: Range: Section: Fill added above original grade: Gravel len the _Z Ft. _� Z1S Ft. WELL: ❑ Upgrade Gravel width: r Number of lines: Distance between lines: -New .S Ft. 2 /0 Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:/ 2tUA-r� Ft. Ft. &2.S- SQ. FL � ` 1 d 303 if Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. Lk -2 44—rTtU)S LX C Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES Kseptic 0 Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines G i2 Z: Gm- /r2 S- C� Well tl-3 (' /07, Material: S`re.&_L Number of Compartments: �L_ Surface Water X48 ��Zf LIFT STATION Lot ( 32 r l3 Size in gallons: Manufacturer: Line Foundation — �St "Pump on" level at: _ "Punt evel at: High water alarm at: Curtain �,� Pump Ma odel Electrical Inspections performed by: Drain Remarks:,, o o `�. BENCH MARK Location and Description: r2N��C��OCJiL iLr2SNOtI� 00TJ4 Sa>& Assumed Elevation, ENGINEER'S SEAL 1 a50a"N',1 *A performed by: Dates: "-13-4(v_ el� •�•^^• ••r .�,.»�M�r,,.� 4'Inspections 2nd u- f 3 - 4 6 f ..;�.. .,.�, •,.,..•,....,. ,.: Steven `Fi,vA t_4e)ADr% %or„ R. Pannone !` Department of Heal and u an ervices approval �'s,SS�.. CE' 8149`M cjF�.,S�eas2.��.�z,,�,, Reviewed and approved by: Dater°nofes�oaa`" 72-013 (Rev. 9/91) MOA 25 AS—BL LT WAST,ZWATER ABS❑RRTI❑N SYSTEM L❑)",4�4, BLOCK 2� EATURN ew Well 12 159.5' TO LOT 14 NEIGHBORS WELL NEW M X39 I EEK NOTES ELEVATIONS ON SITE PLAN ARE FOR GRADING PURPOSES ONLY, THEY DO NOT CORRELATE TO SEPTIC SYSTEM ELEVATIONS, U U U U 99,1' -, NEW 12 95,3' / SEPTICnT50 GANK \ 95.0' TANK ELEVATION OIL, - 'vM p'• 4 9T •••• No. CE 8149 a C,\Work\14-2SEA,DWG UNDEVELOPED SWING TIES B SEE SECTION FOR EVEVATIONS b parf Plpo - — ----- rr , -� rn -rnr r. ,+moi-.• n � s.�'�: , r�u�tt irfva fir, 4�tyy4 +' 1 tie % 1 21-1 �Y rxf rs�T `�tYi"t x 5' Wide Trench 1 8 62' Long, 1 P 63' Long TRENCH PROFILE S. TRENCH N. TRENCH MT1 CO3 MT2 C04 91.7' - 95' n n n n 95 TO 98' 90' PREPARED F❑Ri BILL BOUSQUET P.O. Box 111432 Anchorage, AK 99511-1432 (907) 244-5951 90.B' SP t 89,4' Filter Fabric 4' dia Drain Pipe SM Draln Rock TRENCH SECTION 80.0' Bottom of Test Pit NO WATER FOUND PANN❑NEE ENG, SVC P. ❑, BOX 142025 ANCHORAGE, ALASKA 99514 272-8218 Phone & F(.x DATD 5525-97 AS -BUILT SCALE -1 1 04/09/96 TUE 12:30 FAX 907 786 8200 MOA BLDG SAFETY 121001 4q`r , N � � 0 PROPOSED HOUSE S i pal 159.2. HOUSE DETAIL SCALE 1"=30' 12 Munidp&ty of Anchotagoy- 15 PROPOSED MOUSE 26.0 BUII,DuZ SAFETY DIVISION i SEE 9UILAiNU APR 01 1996>01 iieocl.>�g BLUFF LINE��','R�" Y ' 100STREAM SETBACK LINE a L, 0 T 14 CO , , Y & GRA �� -- --------•---•----- 10 UTILITY UTUTILITY EASEMENT S 89'56'33"W 2.00.85' -- iaost-P brand fax transmittal memo 7671 M or pages r To n 7 7 IlFrOM i,.-) Ory 61) ?• 4 V9 THGG� � 'meth?0, reyer, IpN� LS -820a '• ar'G` Post -It's brand Fax transmittal memo 7671 Fal pages* To J Froin Dept. Phone Department of Health and Human Services 825 U' Street Rick Mystrom. P.O. Box 196650 Anchorage, Alaska 99519-661,50 Mayor 343-4744 March 28, 1997 William E. Bousquet PO Box 111432 Anchorage, Alaska 99511 1432 Subject: Lot 14 Block 2 Sea Turn Subdivision Permit #SW960036, PID #017-121-38 The subject permit, issued March 28, 1996 by this office for a single family well and/or on-site wastewater system, has expired as of March 28, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sinc rely, I� 1 �J cll J mes Cross, P.E. rogram Manager On-site Services enc: Copy of Permit cc: Steven R. Pannone, P.E. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960036 DESIGN ENGINEER:STEVEN R. PANNONE OWNER NAME:G T CONSTRUCTION INC OWNER ADDRESS:6100 AZALEA DR ANCHORAGE, ALASKA 99519 PARCEL ID:01712138 LEGAL DESCRIPTION: SEA TURN BLK 2 LT 14 LOT SIZE: 55566 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 3/28/96 EXPIRATION DATE: 3/28/97 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: DATE: -9 ISSUED BY DATE : 3 -26 - �& Department of Health and Human. Services 825 " L" Street Rick Mystrom. P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor 343-4744 December 4, 1995 G T Construction, Inc. PO Box 190329 Anchorage, Alaska 99519 0329 Subject: Lot 14 Block 2 Sea Turn Subdivision Permit #SW940444, PID #017-121-38 The subject permit, issued December 2, 1994 by this office for a single family well and/or on-site wastewater system, has expired as of December 2, 1995. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Si erely, am'es hdss, Program Manager On-site Services enc: Copy of Permit cc: Polarconsult Alaska 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 PERMIT PERMIT NUMBER:SW940444 DESIGN ENGINEER:POLARCONSULT ALASKA, INC. OWNER NAME:G T CONSTRUCTION INC OWNER ADDRESS:P.O. BOX 92710 ANCHORAGE, AK 99509 PARCEL ID:01712138 LEGAL DESCRIPTION: SEA TURN BLK 2 LT 14 LOT SIZE: 55566 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: /6 I PAGE 1 OF 1 DATE ISSUED:12/02/94 EXPIRATION DATE:12/02/95 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST.' 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 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: THIS PERMIT REPLACED PERMIT NO.SW930414 WHICH EXPIRED ON 10/06/94. , / / RECEIVED BY: ISSUED BY: DATE: DATE : '�� o z 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 PERMIT PERMIT NUMBER:SW930414 DESIGN ENGINEER:POLARCONSULT OWNER NAME:PICKERING CHAS H & OWNER ADDRESS:2880 ENCHANTED CIRCLE WEST COLORADO SPRINGS, CO. 80917 PARCEL ID:01712138 LEGAL DESCRIPTION: SEA TURN BLK 2 LT 14 LOT SIZE: 55566 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED:10/06/93 EXPIRATION DATE:10/06/94 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: 1. PERMIT IS REQUIRED PRIOR TO DRILLING WELL 2. WELL WILL B ; SITED ON NORTH SIDE OF LOT. RECEIVED BY: C tib` ,— c i FOR THIS LOT. DATE: ISSUED BY: Wa+<N _ DATE: r l .� polarconsult alaska, inc. ENGINEERS • SURVEYORS • ENERGY CONSULTANTS October 4, 1993 DHHS, Environmental Services, On-site Services P.O. Box 196650 Anchorage, Alaska 99519 Attn: Susan Oswalt Re: Design and Construction Approval for On-site Sewer System at Lot 14, Block 2, Sea Turn S/D. Dear Ms. Oswalt: To repeat, as per our conversation, the current test holes were previously dug,�Y__C,----A another excavator. The third hole is not a part of our design, and the 35 fee"t in �y question was confirmed to be the distance between the top two holes. The middle hole's original monitoring well was checked upon our arrival and found to be dry. Because of the unusual circumstance that we were asked to retest the same locations, I did not think monitoring wells were mandatory. I thank you for clarifying this matter and will make it a future policy to install monitoring wells in all cases. Also, our monitoring tubes are slotted, and were monitored a minimum of seven days after the test. There are no wells on adjacent properties within 100 feet of the proposed system site. Thank you for your help on this project. If you have any other questions or concerns please give me a call. Sincerely, Matthew Korshin POLARCONSULT 1503 WEST 33RD AVENUE • SUITE 310 • ANCHORAGE, ALASKA 99503 PHONE (907) 258.2420 • TELEFAX (907) 258-2419 polarconsult alaska, Inc. JOB L l�' 6 2 1 1503 West 33rd Avenue • Suite 310 SHEET NO. OF ANCHORAGE, ALASKA 99503 CALCULATEDBY G_ DATE (907) 258.2420 Fax (907) 258.2419 CHECKED BY DATE SCALE & ('l L ,o �q :sc.. 1 „ - ALL � , �•,,• €3'p 000 9p0®9000 00600 99• A � _ � cf�®©o o©vua9�gog000� ••• %� J , CE189 , a %&,4 000090°° f€A411�+�' •} %•� , �t .�i ; .. q. /loon ,".i ! , / , ' ryr � • / , ap a rl..v ,� �` , ,. �, 'Ave ' uu •'� ! �c c. •,e CID :� 1 'A. w. �+': 9 •- co ♦; ! A r Gale kQA ,D fff BLUP7 ONF4=1 �•,Itll �nPPfoK•� :i• f%Gb K , P = ' � ! r 1 , r�7 ' % r �,� :,Th,;:A`A aF?hACr, l.11lE ,. 1 r CO Ir /�-, /�'• Psi �...� %• � �� ,�..' ... op. a PGM f �" r• C 1.AN �'' r e. PRODIJOT204I (5!)ghShee!s) 2051 (Padded) ®e!M.. Gr0!00. Nass. 011/1. to Order PHONE TOLL FREE 18*2254W polarconsult alaska, inc. 1503 West 33rd Avenue • Suite 310 ANCHORAGE, ALASKA 99503 (907) 258.2420 Fax (907) 258.2419 JOB L 1 S/, $ Z,a rn S%D SHEET NO. Z OF Z CALCULATED BY DATE U/3 VA3 CHECKED BY PRODUCT 20411Sin] Ws)M 1(P&,,d) � ln<.. Gialon. Wm 01471 To Met PHONE TOLL FREE 1200.225M o� Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR:r"+S \k-� / DATE PERFORMED: LEGAL DESCRIPTION: G/Z/' i SA�%rn s1D Township, Range, Section: SLOPE SITE PLAN (FEET) I O 2 3- 4 5 - 6/. 6 �` 0 7 8 ni 9 0. 10 12 13 14- 15 16 17 1s 19 20 COMMENTS GS 13ec�rcck WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? tlQ �OOOo�FOO��cee !ti✓ !701-t - 6p09[YOo ° o9eo°. N61 W V. AUSMAN CE ¢ 1393 efl0 Gflu ICY. ?ham Bflnn..ne Ofre� S L _ /n O � Depth to Water Atter �1 {9t/" Monitoring? Date: /^ / h Reading Date Gross Time Net Time Depth to Water Net Drop �ESoftK $ ZV 41:00 C) min. 2 0 ZH41-lI vnrn s s 3 8/2--/ : 12 / w n A mom B Zd ly I,.■�W 5 at y;iN �� 71 /'x 'Z/b , 7 1 r 8 Q 2y 17 S L _ /n O � Depth to Water Atter �1 {9t/" Monitoring? Date: /^ / h Reading Date Gross Time Net Time Depth to Water Net Drop �ESoftK $ ZV 41:00 C) min. 2 0 ZH41-lI vnrn s s 3 8/2--/ : 12 / w n A B Zd ly 5 at y;iN �� 71 /'x 'Z/b , 7 1 r 8 Q 2y 17 PERCOLATION RATE (minutesnnch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 6_ FT PERFORMED BY: PD/Rrccm S(/ZT _ W - '/21! -CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. _ 8/27A3 72-008 (Rev. 4185) 35 ? 5-VV'4-v 'ntcrrer{ _see s�Je U PERFORMED FOR: `— Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST LEGAL DESCRIPTION: 171 62, -S?A /U DEPTH (FEET) O 1 6' d" 2 p. 3 WAS GROUND WATER Net Time Depth to Water ENCOUNTERED? b 4 S 5 L 0 lj 2 p, NIA P 6 0 E p, b. AJZA- 7 Monitoring? la' r, $ 7,W �. 9 -C 3'rG 2�?L - 02 2A 10 11 12 13 14 15 16- 17 18 19 20 COMMENTS T/j Z L Yi 'Ire (Y�//a(,+ onion o 0,000 €IARW- V. AUSMA y DATE PERFORMED: Township, Range, Section: SLOPE SITE PLAN k I? 0 Reading WAS GROUND WATER Net Time Depth to Water ENCOUNTERED? b S L IF YES, AT WHAT O 2 DEPTH? NIA P < � N E Depth to Water AlterIL 1A Date: AJZA- Monitoring? la' 0 Reading Gross Date Time Net Time Depth to Water Net Drop - 7i 2 �{` 57 rntn• $ 7,W 3? v S:OI I min. 3'rG 2�?L 7S 02 2A PERCOLATION RATE _fit? (minutes/inch) PERC HOLE DIAMETER `o TEST RUN BETWEEN FT AND 5 FT PERFORMED BY: Po /ArcCR'S U# I � l CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. p/27(/93 72-008 (Rev. 4/85) polarconsult alaska, inc. ENGINEERS • SURVEYORS • ENERGY CONSULTANTS August 31, 1993 DHHS, Environmental Services, On-site Services P.O. Box 196650 Anchorage, Alaska 99519 Attn: Permit Review Officer Re: Design and Construction Approval for On-site Sewer System at Lot 14, Block 2, Sea Turn S/D. Dear Sir or Madam: Please accept the following design for review and permitting. The proposed system does not affect the current use of the adjacent properties and will have minimum future impact. If you have any questions, please give me a call. Since y, David Aus n, CE POLARCONSULT Attachments: On-site Sewer/Well Permit Application Site Plan, Sheet 1 of 4 System Design Calculations, Section, Sheet 2 of 4 Percolation Test, Sheet 3 of 4 Percolation Test, Sheet 4 of 4 $320 Check for Permit Fee 1503 WEST 33RD AVENUE • SUITE 310 • ANCHORAGE, ALASKA 99503 PHONE (907) 258.2420 • TELEFAX (907) 258-2419 polarconsult alaska, inc. ENGINEERS • SURVEYORS • ENERGY CONSULTANTS August 31, 1993 CURTIs KUTIL Jack White Company 3201 C Street, Suite 100 Anchorage, Alaska 99503-3994 Re: Septic Design for Lot 14, Block 2, Sea Turn S/D Dear Mr. Kutil, In accordance with our proposal, Polarconsult has completed the percolation tests and system design at the subject property. Attached are the soils percolation logs, design drawings, and a letter of transmittal to the MOA. Based on the site investigation, the property appears suitable for the installation of the on-site waste water disposal system provided the subsurface conditions encountered are representative of the general area. The attached septic system design has been developed based on soil tests performed in locations selected during our discussions at the site. To fall within the 30' radius of these test holes the proposed bed system must measure 20' x60' . Special approval from the municipality is required to construct a bed larger than 15' wide and the feasibility of this design is based upon that approval. We don't anticipate the approval to be a problem. The total cost for this work is $1,530; $480 for performing the tests, the system design $600, and $450 in excavation fees. Thank you for giving us the opportunity to be of service and if you have any questions, please give me a call. Sin e ely, David Ausman, CE POLARCONSULT 1503 WEST 33RD AVENUE • SUITE 310 • ANCHORAGE, ALASKA 99503 PHONE (907) 258-2420 9 TELEFAX (907) 258-2419 PRODUCT2Ot-1(SiDgb"IS)205.1{PaMj®oIn. Gio'.W.Mau 01471. ToOIN,IPMTOLL FREE 1-80D?25 i0 JOB /— //1 62, - em -Torn 5/D polarconsuilt alaska, Inc. 1503 Wast 33rd Avenue • Suite 310 SHEET NO. OF ANCHORAGE, ALASKA 99503 CALCULATED BY DATE y��0�y (907) 258.2420 Fax (907) 258.2419 CHECKED BY _ DATE PRO NO1204-I W qlf Sneels) 2051 IPaMedI �oTnc. GmtonJ&ss 01471 To Olde, PHONE TOLLFPEE I 225W Municipality of Anchorage .r DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST Q 9rsITE v, AUSMAN E PERFORMED FOR: L / Ku -h DATE PERFO1*%; � i?` l!„41��' ZM LEGAL DESCRIPTION: J �F'A';!tt)� JIt� Township, Range, Section: �121\/) 1�,3\J, !Spc, 35 _ DEPTH SLOPE SITE PLAN (FEET) I C) 77—F--- I � t—r —F— --� 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Sr S/ ( W/5 rye t}. COMMENTS Dief I -n a ih �a i Yl 7N 3 WAS GROUND WATER ENCOUNTERED? / VD S IF YES, AT WHAT L DEPTH? _ 0 P E Depth to Water After PKY N/l9/9 y Monitoring? Date: 3 T1 n, Reading Date Gross Time Net Time Depth to Water Net Drop 3 m;, 2 Min. ,nit. 3 S mrn % r•„irt / min• i3 /6 ywhr '-///6 sB„ yarn l min, y /0 mill I� ih. "�6 z” V / / tn,-h I / mlq• /� �l. PERCOLATION RATE _ Z _ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 5 FT AND 6 FT //� a /W s Aye _-t- , e la., iy. le wxs YP�'IIPd bei/�rn / 47 �i� i PERFORMED BY: olorecm Se,,?# I /i ti` fi5 %moi%^ CEF ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: 72-008 (Rev. 4,85) 'THAT THIS TEST WAS PERFORMED IN 1//3A9 �E $ V • Municipality of Anchorage IN; _ On -Site Water and Wastewater Program (907) 343-7904 S E TYY Certificate of On -Site Systems Approval �l Parcel I.D. 017-121-38 Expiration Date: 1. GENERAL INFORMATION: Complete legal description SEA TURN: BLOCK 2, LOT 14 Location (site address) 6100 Azalea Drive *Anchorage 99516 Current Property owner(s) Mike McCauley Day phone 306-.5041 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well z Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 4 10,5c) W\1 i p-19 Date of Payment ?-2.9_—?_0-Z0 Receipt Number (191e�1 (�, S COSA# 05C20H 50 Waiver Fee $ _ Date of Payment Receipt Number Waiver # 111 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: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: Zn Zis In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality, of Anchorage and industry practices. The reported results describe the condition of the systemis on the datels of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systemis; therefore, GEG makes no warranty (express or implied) regarding. the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 1— bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the foll .._. . . ......... e fey o ess. CE 79 3 �4�nProfess10n o #AECC884 QP�\1Y OF�(���/i \ ON-SITE WATER AND R` Jct PROGRAM �n J� .- `— Original Certificate at The 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 7�7— Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other OA-vfe— A-3 e 1 COSA Checklist Legal Description: SEA TURN; BLOCK 2, LOT 14 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 5/3/96 Total depth 230 ft Cased to 230 ft FMJ Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 8/3/20 Static water level at beginning of test 133.3 ft Comments B. TANK DATA Age of tank(s) 24 years Tank type/material SEF%C.Si EE Measured operating fluid level in septic tank 49" ® Standpipes/foundation cleanout per record drawing Date of pumping 6/24/20 D. ABSORPTION FIELD DATA DUAL TRENCH Parcel ID: 017-121-38 Structure served by this system 1 Well production at time of test 4.2+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ® No Coliform bacteria is Negative Nitrate mg/L ® Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 8/3/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Which system tested (date installed) 4/13/96 Adequacy test date 8/3/20 ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 9.41 ft (max) Fluid depth prior to test 7 in Measured depth to pipe invert from grade 3.91 ft (min) Water added 602 gal ❑ N/A — pressurized field 10 New depth in ❑ Monitor tubes go to bottom of effective. If not, state 120 depth into effective Elapsed time min ® Code -required soil cover over field Final fluid depth 8 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced N/A gallons If yes, enter date N/A Comments/Deficiencies: 'NORTH MT EXTENDS 15" BELOW INVERT/ SOUTH MT EXTENDS 13" BELOW INVERT- TESTED NORTH TRENCH ONLY COSA Checklist yellow sheet ��I S% , 0 -, J T E. SEPARATION DISTANCES F. ENGINEER'S COMMENTS 'MET CODE AT TIME OF INSTALL SOUTH TRENCH WAS FULL UPON ARRIVAL G. ENGINEER'S CERTIFICATION I 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. COSA Checklist yellow sheet Or o° C"'�.' 4 T �..... .l ...................� ess, dQ 9, /•, / CE 7953 �V2, DRe�pro f essiono #AECC884 From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' �1 U1 M Yes if No ft [ 7✓` Yes if No ft Neighboring Tank > 100' P1 Yes if No ft Private Sewer/Septic Line > 25' F,-/� Yes if No ft ,n Absorption Field on Lot > 100' Fv Yes if No ft Holding Tank > 100' F/� Yes if No ft A Neighboring Absorption Fields > 100' Animal Containment > 50' � Yes if No ft '' F/� Yes if No ft Manure/Animal Excreta Storage > 100' —✓Q Community Sewer Main > 75' [� Yes if No ft Yes if No ft �l From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water> 100' Yes if No ft e Property Line > 5' P/ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' [✓ Yes if No It Private Wells > 100'✓0 Yes if No ft Water Main > 10' P/ Yes if No ft Community Wells > 200' 0✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) c� Building Foundation > 10' Yes if No ' ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓(1 Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS 'MET CODE AT TIME OF INSTALL SOUTH TRENCH WAS FULL UPON ARRIVAL G. ENGINEER'S CERTIFICATION I 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. COSA Checklist yellow sheet Or o° C"'�.' 4 T �..... .l ...................� ess, dQ 9, /•, / CE 7953 �V2, DRe�pro f essiono #AECC884 HOUSE DETAIL Scale: 1 " = 30' Tract A 10, LMUTY RFMN!NC WALLS PLOT PLAN AS BUILT X SCALE 1" = 50' GRID SW 3136 — Protect No 20-459/R1 q 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang G. 99'' C. A S S O C l a f e S9 inc. (907) 522-6476 Phone (907) 522-4625 Fax o�a4��Oq�e Professional Land Surveyors ken®langsurvey.com �� OF A4�`1t%% jonothan*langsury:5,ay.com ` ;7S1Qo I hereby certify that I have surveyed the following described property: LOT 14, BLOCK 2, SEA TURN SUBDIVISION (Plat No. 79-197) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on sold property except as indicated hereon. Dated this the 1• Day of at Anchorage, Alaska It is the responsibility of the owner to determine the existence of onv easements ' 49THI 7•� KENN 13. G .. f F '•.�S-520... �J44 °o'!��SSIONW- o. Q Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 201450 Subdivision: Sea Turn Block 2 Lot 14 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 24 years old. Typical replacement costs range from $8,000 to $11,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. n x # MaiUng Address P 0 Box 196650 *Anchorage, Alaska 51 0 � 99 9 665 www murn org 3 Municipality of Anchorage j 44 • 43 t,�Ej�zl' On -Site Water &Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-121-38 Expiration Date: f �� 1. GENERAL INFORMATION Complete legal description SEA TURN S/D; BLOCK 2, LOT 14 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 6100 AZALEA DRIVE, ANCHORAGE AK 99516 JOSEPH & BRENDA RIORDAN Day phone C/O AGENT 6100 AZALEA DRIVE, ANCHORAGE AK, 99516 KATHLEEN POULIN W/ KELLER WILLIAMS Day phone N Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: 865-6561 TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ A6, 0) Date of Payment 6/97"!! Receipt Number Q`1 � 5&6 COSA # ascAlws— Date: 7A/' Waiver Fee $ _ Date of Paymen Receipt Number 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. 1 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under he conditions encountered at the time of the test, 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 guctuate 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. SahBfactory test results do not guarantee future performance of the system, nor do they guarantee that them 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 sole 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. 6. DSD SIGNATURE VSISystem #1 Approved for 4 bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date 6(261(g bedrooms, with the following stipulations: OF f yop9% �V ON-SITE WATER AND eco WASTEWATER o^ Original Certificate Date: Z - a- 13 The N� cip ty Anc a Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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 missions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11/051 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: SEA TURN S/D; BLOCK2, LOT 14 Parcel ID: 017-121-38 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 5/3/1996 Sanitary seal (Y/N) YES Total depth 230 ft. Date of test Static water level Cased to 230 ft. FROM WELL LOG 5/3/1996 Well production 20 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate ©• 10 mg./L. Arsenic: / V rJ ugdl_. B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) YES Wires properly protected (Y/N) YES Date of sample: 6/7/2013 Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments E Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 02 Pumper C. ABSORPTION FIELD DATA #BELOW EXISTING GRAD Casing height (above ground) 12+ in. AT INSPECTION 6/7/2013 144 ft. 6.23+ g,p,m, Collected by: GEG, Ltd. Date installed 4/13/1996 Cleanouts (Y/N) YES High water alarm (YIN) N/A Date installed 4/13/1996 Soil rating .p.d./ rftlbdrm) 0_8 System type DUAL TRENCH Length 125 TOTAL ft. Width 5/5 ft. Gravel below pipe 1.5/1.5 ft. *9.0/ Total depth *9.6 ft. Eff. absorption area 625 ft � Monitoring tube YES Depression over field NO Date of adequacy test **6/7/2013 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 8.5 in. Water added*101 %al. New depth 9 in. Elapsed Time: 90 min. Final fluid depth **4 in. Absorption rate >= 600+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date **HOUSE WAS VACANT AT TIME OF TEST. PER CONVERSATION W/ DEB WOCKENFUSS P.E., NORTH DRAINFIELD WAS PRE—SOAKED AND TESTED ONLY. NORTH DRAINFIELD HAD AN INITIAL LIQUID LEVEL OF 4" AND WAS PRE—SOAKED W/ 1045 GALLONS IMMEDIATELY PRIOR TO TEST. TOTAL OF 2055 GALLONS WAS INTRODUCED INTO NORTH TRENCH. SOUTH TRENCH HAD 1" OF LIQUID AT TIME OF INSPECTION. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump ofr' level at wa er 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'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A 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 Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 100'+ Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION / certify that i have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date bh(,Lfg (Rev. 11/05) Driveway, parking/vehicle storage 10'+ BiLL- ANG IORACE. ALASKA J 49inneth L. '7 LS -8202 131, a � r �Fq 12 meAVLt. QN. : ,;,E XISTING A? � HOUSE 4 100' S'REAM SETBACK LINE LOT 14 CREEK MSIR A — 10r UTILITYI.Ascu1 NT S 89 5fi'3,3 w 200.85` TRACT A 0 15 QLe� 1 E T ERCLu510n NpWES: ll it lhr owners' rttppntibuity t0 tlelpmtnk Ue tWieltnCt OE ony eastmMter L C N : SET FNI rhtch docp enonto. w rWe 'L nt not appt0l On Iht reowdetl subdldion 1 pot. NOTE; tinder no ereumatanGes Mould On S/8*49 w/Ckr® pis• t5• �y W5 C d Conetruotlan O' fes establishing y etP htreon M Ywd Ie' o Mopwty 1%nee. ,y ,Lys tuomUKhT LId1T . SUIOXY CERT61CATi0N: LANTECII hps t:Gnduetsd O phytit:nl turwy of Mle p'pper,y scticE— FENO%tCE- - �wr` M oe shpt+t on this end Ihel the (n(pro=m to situoled there oft M " Within the property linw WOOD VMS - and no encroach- mtntt salt, other th,, notes, . TC YOORS—PLANNERS—ENGINEERS AS -81-11L.7, pts; LrcAL *Esmpppp, CRAvcL_ xpne ITAhpPMte- wtTER Watt_ I (967) 562-5291 LOT 14, BLOCK 2, . .b: 0' _ p1O3178�SB�/63 iTdx) 581-8828 SEA TURN SUBDIVISION MUNICIPALITY OF ANCHORAGE DEF ARTMENT OF HSEALTH & HUMAN SEHVICE1t- � c 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 Parcel 1. D. # HAA # 1. GENERAL INFORMATION Complete legal description �o (- y���r CcSeIL -A`r� 2A) Location (site address or directions) Property owner ' utLCrr�, ,cis uy - ;- Day phone 4' Mailing address Lending agency Day phone Mailing add Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. hjfUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well --- Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER , Individual on-site 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 (Rev. 1/91) Front MOAF21 5. STATFIVIEWT 9F INSPECTION BY FNG3l iFrPR As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verifythat based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name ofFiPhone z -'7--X 21S Address Q 0 •V3o(- Engineer's signature-�� Date ?I fy ;w 51149 6. Di-HS,Sf'GNATURfe Approved for 2 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments (Jif aVXj Date ® s 'W010 - "•t�{ �-�i .c`k' k ATF;'_ _ 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 (Rev. 1/91) Back MOA 821 Municipality of Anchorage ��jjrr nn 0* DEPARTMENT OF HEALTH & HUMAN SERRIME I V C Uki Environmental Services Division �pp�� 825 L Street, Room 502 • Anchorage, Alaska 99501 • ( . A%-4Nl�F+'+ Municipality of Anchorage Health Authority Approval ChedIdjatHealth & Human Services Legal Description: L iii -a-. Parcel 1.D.:_0I7— A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed 7 C Total depth . iJ t Cased to 2 J Casing height (above ground) 7 `/ t� Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test 3 _61�1 I � Static water level Well production _� �� g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform " d Nitrate Other bacteria Date of sample: ?I -z4 19 Collected by: Q B. SEPTIC/HOLDING TANK DATA Date installed '03114 Tank size /? SO Number of Compartments _'- Cleanouts (Y/N) *C Foundation cleanout (Y/N) 'C Depression (Y/N) ✓� High water alarm (Y/N) Date .ofPumping'j?_4�4 Pumper fa{ �M� 't.,40TC3: �J YS'rCiM�l��70T[aO T`t/'CC) SLYL�IfCU V�T(L C. ABSORPTION' -FIELD. DATA Date installed_ a jl Soil rating (g.p.d./ftz or ftz/bdrm) �� _ System type IT Length Width,' S� Gravel thickness below pipe Total depth `t-111 Effective absorption area b ?T Monitoring Tube present (Y/N) Depression over field (Y/N) _ e7stqr Date of adequacy test /ULAW :,%c07U lesults Pass/Fail) '�SS For 4( bedrooms IYu ck be & i A Fluid depth in absorption field before test (in.); ' Immediately after=gal. water added (in.): Fluid depth , (ins) Minutes later: 120Absorption rate = � �� g.p.d. Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)' If yes, give date D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm E. SEPARATION -DISTANCES SEPARATION DISTANCES FRO,M,WELL ON LOT TO: Size in gallons at' "Pump off" level at" t Septic/holding tank on lot 113On adjacent lots /no Absorption field on lot C29 `7 On adjacent lots lore � Public sewer main /V AA Public sewer manhole/cleanout IuI A Sewer /septic service line • Lift station , : • _ ! vv. T SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation C? !2 Property line 32 Absorption field Water main/service line Surface water/drainage 1C'0 + Wells on adjacent lots «F •S + SEPARATION DISTANCE FROM ABSORPTION FIELD -ON LOTTO: Property line 1:31 'Building foundation is - Surface s Surface water !d01 - Curtain drain C ads F. ENGINEER'S CERTIFICATION f Water main/service line 6O Driveway, parking/vehicle storage area (oO Wells on adjacent lots l 157T -Is-( 1 certify that t have determined thru field inspections and review of Municipal records in conformance with MOA HAA guidelines in effect on this date. { c'; Signature._ Engineer's Name --S-rW fW 1�d, JW DN 9 is Datef24j�s HAA Fee $'�f'), c'�t� Waiver Fee $ Date of Payment - "z Receipt Number���C� ✓ 72-026 (Rev. 3/96)" Date of Payment Receipt Number 70a"19"aq!'�, are aev�n ";7Z=00"' CE-8149 Steven R. Pannone, P.E. P.O. Box 142025 Consulting Engineer Anchorage, Alaska 99514 ^(907) 272-8218 SEPTIC SYSTEM ADEQUACY TEST Legal: Lot 14, Block 2 Sea Turn S.D, Owner: Mr. Bill Bousquet Residence: 11600 Azalea Drive, Anchorage, AIC 99516 Septic System: Tank Size: 1250 gallons. Absorption System Type: 5 -Wide (from Municipal records) Absorption System Size: 125x5x].5 Absorption Area: 625 s. f. installation Date: 4-13-96 Soil Rating: 188 sf/br Date of Pumping: 7-29-98 By: A+ Home Services Date of Test: 8/5/98 Test Procedure: System was inspected visually and measured. Tank was found with 3 feet of cover. Liquid depth was measured to be 4 Inches. The drain field was found to have 8'-5" of cover and a total depth of 9'-11". There was 1 "A" of liquid measured in the field's monitor tubes. Water was added from the well at a rate of 5.85 gallons per minute (GPM) The water levels in the tank and drain -field monitor tubes were monitored. A total of 600 gallons of water was added. During the test, the liquid level rose 4 inches in both of the fields. No rise was noted in the tank. The infiltration rate was monitored for 2 hours. During this period, a total of 600 gallons were absorbed. By the observations made, this system has an absorption rate 600 gallons per day at the time of the test. An adequacy test to determine the wells production was conducted at the same time as the septic system adequacy test. The initial static level of the water was found to be 128 feet below the top of the casing, with a total depth reported to be 230 feet from MOA records. Water was pumped from the well at a constant rate of 5.8 GPM for 103 minutes. A total of 600 gallons were pumped from the well with the static water level drawing down to 156 feet below the top of the well casing. The water quality was tested for bacteria and nitrates, there were no nitrates noted and no bacteria present. TESTS RESULTS: This system meets the code and operational requirements of the Municipality of Anchorage. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. 49 T'' •. z even R. Ponnonr•'t,-jii 81, .9 ^ �1 From : ALPINE DRILL 907 345 0202 LOCATION OF WELL Jul.28,1998 10:22 PM P©1 STATE OF ALASKA DEPARTMENT OF NATURAL REBOUR060 DIVISION OF MINING S, WATER MGMT WATER WELL RECORD 111001.10Hc BUYdIVIVION C.ci, TJ LOT c� BLOW L SEOTION ON 410TION TOwsls#gr ON MANOL 131 M1lt110{AN ``�� MS OW LOCATIONISKETCH; WELL OWNER; .'DAPTHS MEASURED FROM:6cesln8 top Oground surface WELL DEPTH: DATE OF COMPLETION Depth of hata:_ y�t „1 Depth of oaslnp: �It �! / f10REHOLE DATA: Depth MEWIll Type and Color From To 1 DEPTH TO STATIC WATER LEVEL: It below M top of casing M ground surface Date: . r..". { METHOD OF DRILLING: .11 sir Fotery 0 cable tool C�' USE OF WELL: V_domeatle 0 irrigation 0 monitor Cl public supply Cl other YCASING $TIC ft. clam: In, 10Lot Casing type{ WELL INTAKE OPENING TYPE: Z open end 0 screened Y C�,Ur- -L' , ��{ (' ! �.�� I 0 perforated 0 open hole Depths of openings; — to It $ORION TYPE: Dlam: in, Slot/Mash Slee: Length: ft GRAVEL PACK TYPE: _ r`• .; . , . , , ., ' (. �; ! ' 1 / used:__ Volume used: Depth to top: c 71, `' � . �� S� � 7� � GROUT TYPEt rt-t•_r.r : -; ; .,.,. , rf, :.,r.- •��";; j i` ri Depth: from it t0 ft DEVELOPMENT METHOD, Cly 11 I,VIC f%tVf , ! L �c PUMPIN LEVEL AND YIELD, " r i. 1' It of ter hra pumping OEM PUMP INTAKE DEPTH: ,__•„_,e it Horsepower: WELL DISINFECTED UPON COMPLMONF•'41,,,YES 0 NO COfkTRACTOR INFORMATION: REMARKS: Plegia er us ness ams na urs o u or r e presen ve atii'"e '"' " PLEASE MAIL WHITE COPY OF 11,00 TtQ: ONR(DIVIIIDN OF MINING & WATER MGM 3601 0 St, Suit* 800 Rnohoragat Ak 99503-5935 Ph(907)742-2638,Fax(907)562-1389 T = Fes— i; z Sid GIOLULN VIE,% DRI',- N$30 (� m.� am 3-9;m �o 4 9 4 1to Zm C1 O j 6 g r Y`2 iA' 3 2 N Nil p. u" ov �Y rt4 1^ 10 J V vE O a n a= V b Nr V Wp i \ T X s 2 -"ski re q' T = Fes— i; z Sid GIOLULN VIE,% DRI',- N$30 (� m.� am 3-9;m �o 4 9 4 1to Zm C1 O j 6 g r Y`2 iA' 3 2 p. u" ov INS r q 1^ 10 J V vE T = Fes— i; z Sid GIOLULN VIE,% DRI',- N$30 (� m.� am 3-9;m �o 4 9 4 1to Zm C1 O j 6 g r Y`2 iA' 3 2 p. u" INS r q T = Fes— i; z Sid GIOLULN VIE,% DRI',- N$30 (� m.� am 3-9;m �o 4 9 4 1to Zm C1 O j 6 g i � o vE O a n a= V b Nr V Wp Ui a <A Em jlS c,^ U\ 3 4i law Q R p��(Try 5 An too eMov� a aY sm ` o i_ m iVo 8 mx 3 T c r noil VpT b r s� a rx p R c X I` IJJ d 2 �.jm � HOW x F 011 Ria, rt F- .\ Zm C1 O j 6 vE O a n a= V b Nr V Wp i Ui a <A Em jlS c,^ U\ 3 4i law Q R p��(Try 5 An too eMov� a aY sm ` o i_ m iVo 8 mx 3 T c r noil VpT b r s� a rx p R c X I` IJJ d 2 �.jm � HOW x F 011 Ria, rt