HomeMy WebLinkAboutCLEARY LT 2Cleary
Lot 2
#051-102-77
�\ Municipality of Anchorage
• Development Services Department
Building Safety Division
On-Site Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Pogo 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SWO30066 PID Number. 051-102-77
Name:
DON GLENN
Wastewater System: ■ New ❑ Upgrade
Address:
PO BOX 671308 CHUGIAK 99567
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 688-2098 4
■ Deep Trench D Shallow Trench O Bed D Mound 00ther
LEGAL DESCRIPTION
SoI IoUnq. 0.8
Total Depth hon agiml ° 8
GPD/Sq FL
FL
Block: Lot: Subdivision:
— 2 CLEARY
Depth to pipe bottom from orfglml grads:
Crawl depth beneath pip*:
SEE DWG
R 4.09 R
Township: — Range: Section:
ni added above ongtml grade:
Growl kupth:
_ —
SEE DWG
n 80 n
WELL. ■ New ❑ Upgrade
Crawl Width:
5.0
Number of Ines:
1
Distance, between Ines:
Ft
Ft
Classification(Private, A.B.a :
Total Depth:
Cooed To:
Total absorption area:
" material:
PRIVATE
221 Ft
221 m
800 so.
R D 3034/ F-810
Drlber.
SULLIVAN WATER WELLS
poo Drftlea:
6 17 2003
Stolle Water level:
183
butotler.
REX'S EXCAVATION
Dote Installed:
10/15-16/2003
Yield:
Pump Set At•Casing
Height Above Ground:
12 cPM
UNKNOWN n
24+ in.
TANK
SEPARATION
DISTANCES
■Septic 0Holding 0S.T.E.P. bather
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
utill fvate
sewer unee
Manufacturer
ANCHORAGE TANK
Capacity In gallon:
1250
Well
100 +
100 +
—
—
25 +
Material:
STEEL
Number of compartmerlta:
2
Surface water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
*5'
—
—
—
Size In gallons:
Manufoehrrer:
Foundation
5'+
10+
—
—
_
Pump on level atumD ole at:
High water alarm at
Curtain Drain
NONE KNOW
Pump Mats I:
ElectricalMpecDone perfomud by
Remarks: * 5 FOOT LOT LINE WAIVER GRANTED
BENCH MARK
locuaort and Deecriptlon:
BOTTOM OF SIDING ® NORTHWEST CORNER
OF HOUSE
Assumed EMwBon:
100.00
R,
ENGINEERS
AKWWC, INC.
Inspections performed by: Dates: 1st 10/15/2003
�.. .*�0
0
2nd 10/15/2003
.......... .... ...... ..
3rd 10/16/2003
am ss. 0
�0�
Development ices Department Approval
., c -7s5 : \foo
Reviewed and approved by: Date: �z
4Q�4°4ap o�do
ro f essio�
�OO0000�
M
PiRmrr NUMBER: AS DRAWING PARCEL INUMBER:
SWO
SW030066 051-11 02-77
/
FA
BARN
WELL
ALASKA WATER & AVASTEWATI3R
"" """'^ ^••^•,w -^^-o CONSULTANTS INC.---•^^-- ,....-
69C1 OERARR ROAD SUITE 2R • ANCHORALF. AK 99504 • PHONF (907)337-6179 • FAX (907)338.321.6
PREPARED FOR: PHONE NUMBER:
DON GLENN 762-1627
LEGAL DESCRIPTION:
CLEARY SUBDIVISION; LOT 2
TYPE OF WORK:
AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
rTryt; i
II
10/22/2003 049
ZAWN BY: p
N.C.H. p�A
ALE:
1" = 40'
JOE NUMBER:
2 OF 3
SITE
pyo f e s slono4o`
11
41
t
ROOM
._ ..:
" • M
Bl
�. :~
-
.. :.:�i:°•.,
.
BARN
WELL
ALASKA WATER & AVASTEWATI3R
"" """'^ ^••^•,w -^^-o CONSULTANTS INC.---•^^-- ,....-
69C1 OERARR ROAD SUITE 2R • ANCHORALF. AK 99504 • PHONF (907)337-6179 • FAX (907)338.321.6
PREPARED FOR: PHONE NUMBER:
DON GLENN 762-1627
LEGAL DESCRIPTION:
CLEARY SUBDIVISION; LOT 2
TYPE OF WORK:
AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
rTryt; i
II
10/22/2003 049
ZAWN BY: p
N.C.H. p�A
ALE:
1" = 40'
JOE NUMBER:
2 OF 3
SITE
pyo f e s slono4o`
PERMIT NUMBER: AS -BUILT DRAWING PARCEL 1 NUMBER:
SWO30066 051-102-77
TOP OF TANK
INLET - 97.
INVERT OF BUNG
AT INLET - 97.21
ORIGINAL GRADE -
100.4B O HIGHEST
POINT n
GRADE - 101.30+
NEW 1250 GALLON
SEPTIC TANK
1NAL GRADE -
100.40+
INSULATION
rFILTER FABRIC
of
ALASKA NVATER & WASTE `N'ATER
..a..-.--.-----�--- CONSULTANTS, INC. ----"-'�-
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337.8179' FA%(907),539-32LE
7REPARED FOR: PHONE NUMBER:
DON GLENN (907) 762-1627
.EGAL DESCRIPTION:
CLEARY SUBDIVISION; LOT 2
rYPE OF WORK:
PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM
TOP OF TANK AT
OUTLET - 97.77
-uwvv.uv
INVERT OF BUNG AT
OUTLET - 96.99
ERT OF PIPE -
96.57 (AVG)
BOTTOM OF
TRENCH -
92.48 (AVG)
10/22/2003
1WN BY:
N.C.H.
1LE:
;E'D,
NUMBER:
3OF3
......
Gar ess:
-7 53 .��cAool
f e s 510!°_
01/01/1999 00:01 6882259 SULLIVAN
f■ PAGE 01/01
%E
by
g �
DOC CO. dba
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 89567 • TELEPHONE 688-2750
OWNER OF LAND: J014 SLZ' JtJL: �{L $ kO� "QRE HOLE DATA
ADDRESS: FDEPTH
TO
LEGAL DESCRIPTION:
DATE:-
PERMIT NUMBER:&o s faro
Date oftssue�-�- G3 $�f'� ✓J� � Y S.�/ r
TAX IDENTIFICATION NUMSER:Q5/ - f "Cr�_ - �d 0R�`Jxe
Is well located at approved permit location? rtes��� No
e..
Method of Drilling: U air rotary lJ cable tool ad •�14 -j 0 6 "14-
Depth of well:
Casing Type ,Jrf gL Wall Thickness aS-a - Inchesdz�- al
Diameter
G _inches, depth feet I I :t / &+.0 wf 6A
Liner Type: /J e ht r
Casing Stickup Above Ground: - _ _ feet
Static Water Level: /S3 feet
Recover Rate: _La gpm
Method of Testing:—Al /L
Well Intake Opening Type: - open end G open hole
�j Screened; Start feet Stopped feet
Ll Perforations Start_ feet Stopped feet
Grout Type: Cvolume
__ f 2 a L 4
Depth: from n feet, to '{ feet
Well Disinfected Upon Completion? lao1g; D No
Method of Disinfection: 4CY4La,.V6 5�Olojoen
Comments:
Driller's Name �•�—~'�
ATTENTION: It is the responsibility of the property owner to submit a Copy of the well log to the proper authority. Municipality
Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough:
Department of Environmental Conservation.
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 / WATER SUPPLY PERMIT
Initial
Permit Number: SW030066
:Legal Description: Cleary Lot 2
Design Engineer: 0041 AK Water & Wastewater Consultan-
Owner Name: Don Glenn
Owner Address: PO Box 671308
Chugiak , A 99567 -
Date Issued: Apr 07, 2003
Expiration Date: Apr 06, 2004
Parcel ID: 051-102-77
Site Address: NHN Dallon Court
Lot Size: 44975 SO. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
0 Disposal Field Q✓ 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.
5_12/103 SFF ENS, A,uENQ,t�,7p nFs�G,� !'�vviu� sYsrE.t
SI 7-r,,-
7-0 j7-erz Rr=R1- ,CeACAT 5 /TF p/3 reI9 A)IS GOj titTlfiCflEQ
Received By:
Issued By:
ALASKA WATER F& WASTEWATER
CONSULTANTS, INC.
May 15, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
REVISED DESIGN: SW030066
Ref: Proposed Well and Septic System for Lot 2; Cleary Subdivision
To whom it may concern:
A permit (Sw030066) was granted on 4/7/2003 for the subject property. We are requesting to use
the existing permit and revise the design around test hole #3. Comments regarding the design are
summarized as follows:
1. TRENCII DESIGN:
a. Percolation Rate: 10.9 minutes/inch
b. Proposed Application Rate: 0.8 gallons/day/ftz
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 750112
f. Total Depth: 8 feet (max.)
g. Effective Depth: 4
h. Width: 5 feet
i. Reduction Factor: 0.5
j. Minimum Length: 75 feet
k Effective absorption area = 750 fie
2. LOT LINE WAIVER REQUEST: We request a 1 foot lot line waiver from the north lot
line to the proposed drainfield. We are unaware of any adverse effects on the neighboring
properties with the granting of this waiver.
3. GROUNDWATER WAIVER: We request that you waive the groundwater monitoring
done on 3/13/2003. The groundwater monitoring was done after a couple of days of warm
weather. We believe this reading to be from water runoff into the test hole. The test hole was
checked 3/19/2003 by the homeowner and was dry. The test hole was also checked on 5/14/2003
by AKWWC and was found to be dry. Several soils logs have been pulled from adjacent
properties and have been found to be dry. Given the above information we are unaware of any
6901 Debarr Road, Suite 213' Anchorage, AK 99504
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: akwwc.com
adverse impacts this would create on the proposed septic system with the granting of this waiver.
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
Acc;ctn"^P
I
NOTE.• A site plan drawing, a design drawing, which are all part of the design package for this
septic system.
6901 Debarr Road, Suite 2B' Anchorage, AK 99504
Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: akwwc.com
ASEPTIC
ARaD
CLEARY S/D;
TRACT A.
SERVED BY PUBLIC WATER
PROPOSED 4
BEDROOM HOU:
PROPOSED SEPTIC SYSTEM
(SEE DESIGN PAGE 2 OF 2).�
� I \
/ I
/ \I
CLEARY S/D;
LOT 1. 1
9� I
�T I
THJ'
C;imc I TH/
SARA I
/ \ PROPOSED WELL
At
1 �
1 /
I /
I /
BEAM S/D; /
LOT 2. / (-�-
� ASEPTIC
ARS
PROPOSED BARN \\
�PPRO�
1 100 WELL RADIUS
e'd[F`J"' BEAM 5 D
�\ LOT 1.
\ //
i
---QAL SON COUPT _�---------------------------------
L
W
\ ALTERNATE SITE
/ \
U / \
EL ELL R� I
W 1 IRMA S/D;I IRMA S/D;
1 TRACT A. I TRACT B.
w \\ / NO CONCERNS SEPTIC SYSTEM ON SOUTH
\ HALF OF LOT. SERVED BY PUBLIC WATER A
5/14/2003
DRAWN BY:
ALASKA WATER & WASTEWATER C.J.G.
CONSULTANTS, INC. SCALE:
:901 DFRARR ROAD. SUITF JR • ANCHORAGF, AK 99504 • PHONF (907)337-6179 • FAX (907)33R-3146 I"
- loo,
PREPARED FOR PHONE NUMBER: PAGE NUMBER:
DON GLENN 762-1627 1 OF 2
LEGAL DESCRIPTION:
CLEARY SUBDIVISION; LOT 2
TYPE OF WORK:
SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM
.J. ...
... G ne s.
r
IM1." E 95
+14�f \cp.:
REQUEST A 1 FOOT LOT LINE WAIVER-,
PROPOSED DRAINFIELD.
EXCAVATE A TRENCH THAT IS
8 FEET DEEP MAXIMUM BY 5
FEET WIDE BY 75 FEET LONG.
ADD 4 FEET OF CLEAN,
WASHED SEWER DRAINROCKwJ
\
0
i
,,-POSSIBLE GRINDER
PUMP (SEE NOTE)
PROPOSED WELL
' (SEE NOTE)
PROPOSED %'• rn '
4 BEDROOM
HOUSE {= •r" •.V
INSTALL FOUNDATION ? '
CLEANOUT r!• \
PROPOSED 1250 GALLON
SEPTIC TANK i
INSTALL DOUBLE \ �:• /
CLEANOUTS
L... i
a.6
❑ ❑ ❑
I w •'
DATE:
5/14/2003
DRAWN BY:
NOTE: THE NORTH AN
WEST LOT LINE AND
PROPOSED WELL
SHALL BE FLAGGED
AND STAKED BY A
REGISTERED LAND
SURVEYOR PRIOR TO
NOTE: DEPENDING ON
THE ELEVATION OF
THE FOUNDATION, A
GRINDER PUMP MAY
BE REQUIRED INSIDE
THE FOUNDATION.
(::7
p,R
n
II
II
I I ALTERNATE SITE
II
II
II
II
II
II
II
u if
m;m
ALASKA WATER & WASTEWATER SCALE: c.J.G. - :"
46 -HANTS, INC. 1" = 40' *" ....
901 DFRARR ROAD, SUITF IR • ANCHORAGF. AK 99504 • PHONF (907)337-6179 • FAX (907)33R -374M1 0 ..
-PARED FOR: PHONE NUMBER: PAGE NUMBER:
DON GLENN 762-1627 2 OF 2•
:AL DESCRIPTION: OO o .Jef rC
CLEARY SUBDIVISION; LOT 2
'E OF WORK: Q4
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM P ��0pi
DATE
15—
.
READING
CLOCK
TIME
NET TIME
(MINUTES)
ALASKA.
`WATER
I♦3
1
& WASTE`�V
AT] ✓R
-
6•
CONSULTANTS, INC.
�••—
>� 4 * oO
6901 E&AR ROAD, SURE 28 •ANCHORAGE, AK 99504 • PHONE: (907)337-6179 Fa— 907 336-3246 • YICrZL-• aka° m
"""' ' • ' • • • • • • • • •' •D
3"
SOIL LOG — PERCOLATION TEST
3
LEGAL DESCRIPTION:
CLEARY SUBDIVISION; LOT 2
6•
On et a A. ar ess.
PERFORMED
FOR: DON GLENN DATE•_ 3/6/2003
p
vdo9� C -7953 ` 4�
DEPTH
=��_"
3 1 4"
2 3 4'
r o
(feet)
ORGANICS TEST HOLE#31��
-
p7 °ate
°teselo
1O�O000��
Z
6
3:52
TH11
SOIL CLASSIFICATIONS
4"
2 3/4-
I
2
'a o; GW ORG
I
�
SITE PIAN
3
�!:%�WiGP ML
1"=100'
mllwl GM CL
4
GC OL
°•°• a SW MH
5
'::'• : SP CH
SM , i OH
6
SC
7
GM/SM
(DENSER DEPTH TO DATE
GROUNDWATER
w/ DEPTH)
8
DRY 3/6/2003
10' 3/*13/2003
9
10
11
12
13
q.
14
B.
15
r a
iG
.':�'• 196
➢S
17
RED P
18-
19
PERCOLATION RATE 10.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 5.5
FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO
SOILS LOGGED
BY: JODY MAUS PERCOLATION TEST
PERFORMED BY:
ZACHARIAH GALL
COMMENTS:
PERFORMED
BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W PERFORMED
IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Lo 0
DATE
15—
.
READING
CLOCK
TIME
NET TIME
(MINUTES)
\
I♦3
1
DATE
15—
.
READING
CLOCK
TIME
NET TIME
(MINUTES)
\
NET DROP
(INCHES)
I♦3
1
2:22
-
6•
_
1
�
2:52
30
3"
3"
3
2:52
II
6•
II
4
3:22
30
3 1 4"
2 3 4'
:d
5
3:22
-
6•
Z
6
3:52
TH11
3 1 4"
4"
2 3/4-
I
I
�
SITE PIAN
I TM1z
1"=100'
DATE
15—
.
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
3/7/2003
1
2:22
-
6•
_
2
2:52
30
3"
3"
3
2:52
-
6•
4
3:22
30
3 1 4"
2 3 4'
:d
5
3:22
-
6•
Z
6
3:52
30
3 1 4"
4"
2 3/4-
9$
/ 'k
r
,,/ow , ••(ENGI
�� 49 @4600 MN«
Municipality of Anchorage �
DEPARTMENT OF HEALTH S HUMAN SERVICES - %G*.••
825 "L" Street, Anchorage, Alaska 99502-0650 � Laine A-Buterl
SOILS LOG — PERCOLATION TEST '•<`+'+y. CB 6736
PERFORMED FOR: L_ eA!'�v DATE PERFORMED: 1 y7 -
(� T.QAerA
LEGAL DESCRIPTION: Pro 90SQd CIPa ry 5.14v. Township, Range, Section: 7 -15 -Al )?I w See 9
Fn— SLOPE SITE PLAN
• 1
Net
Time
Depth to
Water
Net
ores)
L"
2
3-1
t
. 0
4
% [_
I' 6
I
65, 1h4
`
I
6-
7-
7
8.
8
4/`..
9-
10-
10
11
11
�—
t
12
13
14
O '
100e
15
16
17
18
19
Ti
(GM) I..;74 5aq�
r!1
A
WAS GROUND WATER , /�
ENCOUNTERED? X//
S
IF YES, AT WHAT ��� L
DEPTH? p
E
Depth to Water Alter
Monitoring? dry Date: Io -18-9}
T1
a•e
Reading Date Grose
Time
Net
Time
Depth to
Water
Net
ores)
L"
6 7/
65, 1h4
2 '/i"
H O: Zy
C If IVIA,
4/`..
S- /01 is
C3 s/i6
100e
20 -j
IL,_—JI PERCOLATION RATE 3' � (mmu1e31mch7 PERC MOLE DIAMETER til�
TEST RUN BETWEEN FT AND 6 FT
COMMENTS /G (JOy fF
PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE.
72.008 (Rev. 4,11.51
i
Munlclpalily of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street. Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
'AwQ
r
gas
I
i� o
T• .�NMN..Nb..p N. {. N
1 LaWs A. are
�0 1�, CE4Ti6 r'r, .As
PERFORMED FOR:C_ eek ry DATE PERFORMED":i G -TI - "17
Lor a
LEGAL DESCRIPTION: Prb_/gl4ecf Upary 5..Jd v. Township, Range. Section: T 1r RI ►✓ S« `1
• ' irEP=1 SLOPE SITE PLAN
TS
4
6 (0
/�Y/ Sanotx
9/ava/1 Hi h San
7Con�en �
aLn-
12
13
14
• 15
16
17
18
19
W4
A
H
WAS GROUND WATER
ENCOUNTERED?
S
IF YES. AT WHATL
DEPTH? �/A p L S �✓ D tr /o
E
Depth to Wmer After
Monitartnp7 dr -y 'M
-�
20 -{ j 'L - PERCOLATION RATE � (minutesnnch) PERC HOLE DIAMETER
TEST RUN BETWEEN S FT ANO 6 FT
COMMENTS - ""•iiiGu�iyi.%ir.✓-fs.6r. ,21' A "Ce9tiSi
s—�alys
PERFORMED BY: C l t` _ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: -7-
72-008
72.008 (Rev. 4,851
Munlcipallty of Anchorage jit
DEPARTMENT OF HEALTH & HUMAN SERVICES �-
825 "V Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST =
PERFORMED FOR:j�f/QA C)e DATE PER
D 7
LEGAL OESCRIF
1
H
.0 -y
2
..�_...- __-.._ ...
tie- — SD
3
4
Q
5
-
'f/r
Z
6
71
8-
9-
13 9 13 U'
14
T5
T6
17
18
19
TS
Gil
g<<y/ s�ltrI.54s'
9/ave( A se7 y;yh
8 v• Township, Range, Section:
SLOPE
'•of 48 *'
Loins A. Sabta
C&6138
+� •�=
• N
+moi
`1
FORMEd:�I g
IsN Rf
SITE PLAN
immmmmazommo
MUM
WAS GROUND WATER — AIC,ENCOUNTERED?
S
IF YES, AT WHAT L
DEPTH? NA p
E
Geplh to Water AAtr
Monitaring7 Gate e - - 4p
Reading Date
20
Gross
Time
Net
Time
Depth to Net
Water Drop
..�_...- __-.._ ...
tie- — SD
ems/
c-
"wv
'f/r
Z
'w
t<114 to//'(4
17,11/9
S 7— as
�y
/
F •
'
r2
2 "ie
r
r -
fi n/1 Wit -
20 - PERCOLATION RATE (minutesiinch)PERC HOLE DIAMETER
TEST SUN BETWEEN FT AND _S2l_ FT
COMMENTS >Fr SN6�I.iiii.•� Srd..,�l1n/ /`«/M/re'/ /sire- - /POVO S -f
PERFORMED BY. - 'C/KCS- I rte ''�!_ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: % - /y—S�
72-008 (Rev. 4/65)
GREATER ANCHORAGE AREA BOROUGH
DEPA' 'MENT OF ENVIRONMENTAL QUA' 'Y CASE #
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
Performed For Ramond Beam Date Performed 7/10/72
Legal Description: Lot 1 ock Su v sion Beam
This Form Reports Soils—Cog z erco at on est
Sec. 9, T 15N, R 1W
Depth
Feet _Soil Characteristi
Brown Silty Sand (SM)
Gray Sand (SW) with Silty Sand Seams
(SM) with few fine gravel
1z_
Was Ground Water Encountered? No
If Yes, At What Depth?
Mmm��
ReadingI Date I Gross Time I Net Time (Depth to H2OF4�etDro
.r .
Percolation ate mute
Proposed Insta at on: Seepage Pit X Drain Field
Depth Inlet
COMMENTS:18585 Depth To Bottom Of Pit r Trenc —
square eet o rainaBe area is required per hedroom "'—
Test Per ..,Uw Uy Carlisle
d d er 1 e y: National Testing
Date:
- - --
Municipality of Anchorage
' Development Services Department1,,,.ia
Building Safety Division °
On -Site Water & Wastewater Program r
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-102-77 Permit Number St030066
Property owner(s) DON GLENN Day phone 688-2098
Mailing address (1) P.O. BOX 671308 * CHUGIAK. AK
Mailing address (2)
Legal description (Lot, Block & Sub'd.) _ LOT 2: CLEARY SUBDIVISION
Zip Code 99567
Legal description (Section, Township & Range) ____ NIA
Lot Size `74lg76' Acres/Sq.Ft. Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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.
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
Permit Fees: � 150 i X100 ' 550. --
Date of Payment: 31212 03
Receipt Number:- 33 CM 1
Waiver Fees:
Date of Payment:
Receipt Number:
ALASKA WATER F& WASTEWATER
CONSULTANTS, INC.
March 14, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Proposed Septic System for Lot 2, Cleary Subdivision
To whom it may concern:
The proposed 4 bedroom house will be served by a private well and septic system. Three test
holes were excavated in the area of the proposed septic system. The septic system will be
designed around the 30 foot radii of test holes #1 & #2. We are proposing that a 1250 gallon
septic tank and a deep trench type drainfield be installed. Comments regarding the design are
summarized as follows:
1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring,
and the percolation test results. Due to the overall appearance of the soils, we are proposing to
use a 0.8 application rate.
2. TRENCH DESIGN:
a.
Percolation Rate: 3.3 minutes/inch
b.
Proposed Application Rate: 0.8 gallons/day/ft2
c.
Number of Bedrooms: 4
d.
Design Flow: 600 gallons per day
e.
Minimum Absorption Area: 750 ft2
f.
Total Depth: 9 feet (max.)
g.
Effective Depth: 6 feet
h.
Width: 2.5 feet
i.
Reduction Factor: N/A
j.
Minimum Length: 63 feet total length
k.
Effective absorption area = 756 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
4. TOPOGRAPHY: The area around the proposed drainfield is relatively flat. In short, there
are no slope concerns.
6901 Debar• Road, Suite 2B' Anchorage, AK 99504
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: akwwc.com
+. 5. LOT LINE WAIVER REQUEST: We request a 5 foot lot line waiver from the east
' ! property line to the proposed drainfield. We are unaware of any impacts this waiver would have
on adjacent properties.
I am 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.
P.E., M.S.
NOTE: Attached is a site plan drawing, a design drawing, three soil logs, and a 7 page
co sinnction specification letter which are all part of the design package for this septic system.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
ALTERNATE SITE WILL
REQUIRE THE USE
OF AN ADVANTEX
TREATMENT SYSTEM.
FA
DOTE: THE SOUTH ANC
EAST LOT LINE SHALL
BE FLAGGED AND
STAKED BY A
REGISTERED LAND
SURVEYOR PRIOR TO
ANY CONSTRUCTION.
,r n I
/3
II I PROPOSED
II 1 4 BEDROOM
I I
HOUSE
LJ
INSTALL FOUNDATION
CLEANOUT
�VI
1
� I\
w
�i
I
F�
o I I
'1
I
\1
.:�_:�: �;_.`; .' •;I
PROPOSED WELL
25,+/•Y`
K
C
l s:
;•
.-••:••
INSTALL DOUBLE
'=
CLEANOUTS
1.
•
-:i
I
Go
~
1250 GALLON
PROPOSED ;.•—PROPOSED
SEPTIC TANK
BARN .r�•
PROPOSED DRAINFIELD.
EXCAVATE A TRENCH THAT
IS 9 FEET DEEP MAXIMUM
BY 2.5 FEET WIDE 63
FEET LONG. ADD 6 FEET
OF CLEAN. WASHED
SEWER DRAINROCK. —
ALASKA WATER & WASTE`N'ATER
NSl3L�ANTS, INC.
6901 DFRARR ROAD. SUITF ?R • ANOHORAGF. AK 99506 • PHONF (907)337-6179 • FAX (907)338-374.
PREPARED FOR: PHONE NUMBER:
4/4/2003 4/4/2003
Z.T.G.
1" = 40'
DON GLENN 762-1627 2 OF 2
LEGAL DESCRIPTION:
CLEARY SUBDIVISION; LOT 2
TYPE OF WORK:
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM
e e A. G Hess:
s
t -
25,+/•Y`
K
C
l s:
;•
.-••:••
INSTALL DOUBLE
'=
CLEANOUTS
1.
•
-:i
I
CID
0
Trig 1
Its
..•.
4/4/2003 4/4/2003
Z.T.G.
1" = 40'
DON GLENN 762-1627 2 OF 2
LEGAL DESCRIPTION:
CLEARY SUBDIVISION; LOT 2
TYPE OF WORK:
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM
e e A. G Hess:
s
OPTIC
EEo
CLEARY S/D;
TRACT A
SERVED BY PUBLIC WATER
PROPOSED 4 PROPOSED WELL
BEDROOM HOUSE /
/ I \ 1
( \ 1
ALTERNATE SITE --\,
1 I
\ I I
1 I /
BEAM
0 S/D /
G �C
PROPOSED BARN-,-,,4,-
CLEARY
ARN CLEARY S/D; PROPOSED SEPTIC SYSTEM \ \
LOT 1, i (SEE DESIGN PAGE 2 OF 2). \\
APPROI�nn
C 1 100 WELL RADIUS
TH/1 �`'gfl'1 BEAM S/D;
/ 1 \ LOT 1,
I THR2 \ /
ASEPTIC
AREEAA 1 \
-- -
--QAL SON COURT '� — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — --
`\
/ \
g r \
\ LLJ
IRMA S/D;
1 TRACT B.
d !<Q0 W ADu) 1 NO CONCERNS SEPTIC SYSTEM ON SOUTH
I I
W IRMA S/D; HALF OF LOT. SERVED BY PUBLIC WATER
1 �
Cn \ TRACT A. /
W \
ALASKA WATER & WASTEVN'ATER
CONSULTANTS, INC.
6901 DFRARR ROAD. SUITF PR • ANCHORAGE. AK 99501. • PHONF (907)337-h179 • FAX (907)338.370
DRAWN BY:
Z.T.G.
1" = 100'
PREPARED FOR PHONE NUMBER: PALL NUMULR:
DON GLENN 762-1627 1 OF 2
LEGAL DESCRIPTION:
CLEARY SUBDIVISION; LOT 2
TYPE OF WORK:
SITE PLAN FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM
T'l / /1R,
Tel A. a ess•�
—79 •.• fie:
fesslo
OF � 0p
4
.ALASKA NNTA ER S �ASITEWATER
:...
6901 DMAM ROAD, SUfTE 2B • MOCRAGF. AK. 19504 • E• (907)337-6179 • FAX. (907)3W-3246 6 Y/EHSfiE; ak..o.wm
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: CLEARY SUBDMSION; LOT 2 Op .J fir ar ess:
PERFORMED FOR: DON GLENN DATE: 1/3/2003 OQ °'s 79 N-0�
DEPT O��Osa/'ro f essio�°a��
(feet =—=— ORGANICS ITEST HOLE ��D0000�a
1 =---
SOIL CLASSIFICATIONS
2
�3
GW ORG
3 i• t.`�c GP ML
jll� GM CL
4 GC OL•°• o SW MH
5 �'• :1 t.2 SP CH
SM OH
6 Sc
7 DEPTH TO DATE
8
GM/SM THo1
9
10
11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP
12
13
14
15-1
16
B.O.H.
17
18 12 5:52 10 3" 3"
19 PERCOLATION RATE 3.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.0 FT. AND 6.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN
COMMENTS: *FIRST THREE READINGS MAY HAVE BEEN INFLUENCED BY PARTIAL FREEZING OF THE BENCH.
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA P RFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 13 03
GROUNDWATER
DRY
1/3/2003
DRY
1/10/2003
1/7/2003
1
4:52
—
TIME
(MINUTES)
�
(INCHES)
1/7/2003
1
4:52
—
6"
—
'2
5:02
10
4"
2'
3
5:02
It
6"
—
�I
'4
5:12
II
II
/
2"
5
5:12
—
I
—
�
�
5:22
10
3 1/2"
2 1 2"
h+iz,�
SITE PLAN
5:22
—
6"
TIME
(MINUTES)
READING
(INCHES)
1/7/2003
1
4:52
—
6"
—
'2
5:02
10
4"
2'
3
5:02
—
6"
—
'4
5:12
10
4"
2"
5
5:12
—
6"
—
'6
5:22
10
3 1/2"
2 1 2"
7
5:22
—
6"
—
8
5:32
10
3"
3"
9
5:32
—
6"
—
10
5:42
10
3"
3"
11
5:42
—
6"
—
ALASKA «'ATI✓R & NVASTER'ATER
p — CONSULTANTS, INC.
6901 DEBARR ROAD. SWE 28 • ANCHORAGE. AX. 99504 • PWNE. (907)337-6179 • FAX. 907 46 • WMM ok--o.
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: CLEARY SUBNASION; LOT 2
PERFORMED FOR: DON GLENN DATE: 1/3/2003
DE _
(feet ORGANICS ITEST HOLE 2
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
GM/SM
DEPTH TO
GROUNDWATER
DATE
DRY
1/3/2003
DRY
1/10/2003
I
�
6-
—
M
19111
-
RUNS
vzzzi11si
3-
�
;
1
�'/�iB. •
01
—
4
�I
DEPTH TO
GROUNDWATER
DATE
DRY
1/3/2003
DRY
1/10/2003
I
�
6-
—
............... ......
J ffr y G ss.�
i • E 953
�4n° pyo f essto��a"
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
ice'
1/7/2003 1
I
�
6-
—
2
4:49
10
3-
�
;
1
—
�I
—
4
�I
I
I
3 1/2"
2 1/2-
5
4:59
THI1+
6-
—
I
5:09
10
i
SITE PLAN
7
I THI2
1-=100'
6-
—
8
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
1/7/2003 1
4:39
—
6-
—
2
4:49
10
3-
3-
3
4:49
—
6-
—
4
4:59
10
3 1/2"
2 1/2-
5
4:59
—
6-
—
6
5:09
10
3-
3-
7
5:09
—
6-
—
8
5:19
10
2 1/2-
3 1/2-
9
5:19
—
60
—
10
5:29
10
3-
3-
11
5.29
—
6-
—
12
5:39
10
30
3 -
PERCOLATION RATE 3.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.0 FT. AND 6.5 FT.
20 ' ' A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN
r'r1MMFNTC-
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: _
IN ACCORDANCE
---- ... _._. -..
ALASKA. N'E'ATER & WASTEWATER
�--- ------•-----�---CONSULTANTS, INC.--------�
6901 DEWAR ROAD, SUITE 28 • ANCHORAO AK. 99504 • PWNU (907)M7-6179 • FA%: (907)3M--3246 • WEBSITE ckwwawm
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: CLEARY SUBDIVISION; LOT 2
PERFORMED FOR: DON CLENN DATE: 3/6/2003
DEPT
(feet =:G;; ORGANICS TEST HOLE 3
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
1B
GM/SM
(DENSER
w/ DEPTH)rl
DEPTH TO
GROUNDWATER
DATE
DRY
3/6/2003
10'
3/13/2003
•'
-
6-
-
�
2:52
I
\
3'
I
\
Ia
6-
-
4
3:22
30
3 1/4-
2 3/4
'1111'I'I
3:22
.I
6-
-
VZ/Zi
/
30
fl
r
V'"'
/I
I
DEPTH TO
GROUNDWATER
DATE
DRY
3/6/2003
10'
3/13/2003
I
I
-
6-
-
DATE READING
19—
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
3
3/7/2003 1
I
I
-
6-
-
�
2:52
I
\
3'
I
\
-
6-
-
4
3:22
30
3 1/4-
2 3/4
5
3:22
.I
6-
-
I
I 1
/
30
fl
r
/I
I
c
THI
I
SITE PLAN
THg2
1'=100'
DATE READING
19—
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
3/7/2003 1
2:22
-
6-
-
2
2:52
30
3-
3'
3
2:52
-
6-
-
4
3:22
30
3 1/4-
2 3/4
5
3:22
-
6-
-
6
3:52
30
3 1/4-
2 3/4-
4'
19 PERCOLATION RATE 10.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 5.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: ZACHARIAH GALL
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS W IS P RFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Lo 0
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THIS DOCUMENT DOES NOT CONSTITUTE BOUNDARY SURVEYAND
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UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE
USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR
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THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY
PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION
SURVEY STANDARDS.
THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY
TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR
ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR ISA
VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED,
THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES
COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT.
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THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
WITHIN THE PROPERTY LINES AND NO VISIBLE
ENCROACHMENTS EXIST EXCEPTAS INDICATED.
DATED THIS 28th DAY OF AUGUST, 2024, ATANCHORAGE,
ALASKA.
FIXED HEIGHT, LLC C.O.A.122554
Land Surveying Services WWW.FIXEDHEIGHT.COM
600 W 41 st. Ave, Ste. C, Anchorage, AK 99503 907.290.8949
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DALLON
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EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE
RECORDED SUBDIVISION PLAT (98-82) ARE NOT SHOWN HEREON.
THIS DOCUMENT DOES NOT CONSTITUTE BOUNDARY SURVEYAND
IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT
BOUNDARY SURVEY MAY DISCLOSE.
UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE
USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR
ESTABLISHING PROPERTY BOUNDARIES.
THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY
PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION
SURVEY STANDARDS.
THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY
TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR
ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR ISA
VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED,
THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES
COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT.
JOB # 24175 1 NO CORNERS SET THIS DATE I SCALE 1" = 40'
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THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
WITHIN THE PROPERTY LINES AND NO VISIBLE
ENCROACHMENTS EXIST EXCEPTAS INDICATED.
DATED THIS 28th DAY OF AUGUST, 2024, ATANCHORAGE,
ALASKA.
FIXED HEIGHT, LLC C.O.A.122554
Land Surveying Services WWW.FIXEDHEIGHT.COM
600 W 41 st. Ave, Ste. C, Anchorage, AK 99503 907.290.8949
y
Municipality of Anchorage
Development Services Department
• ++� Building Safety Division �°
On -Site Water and Wastewater Program
4700 South Bragaw St. $ „ " E T
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: ALASKA WATER & WASTEWATER CONSULTANTS. INC.
Legal description: CLEARY SUBDIVISION LOT 2
The attached paperwork has been reviewed and is being returned for the following reasons:
❑ Original signature or stamp missing on
❑ Calculation error in design.
❑ Additional soils information needed.
❑ Waterlmonitoring results inadequate.
❑ Discrepancy in information submitted.
❑ Topographic information missing or inadequate.
® Incomplete; missing IF THE UPGRADE SITE NEED TO BE DESIGNED WITH THE if
❑ Incomplete; missing
❑ Additional adequacy test information needed:
❑ Water sample unacceptable:
❑ Measured/proposed distances/dimensions missing.
❑ Locations of all soils, percolation and water monitoring tests not shown.
❑ Proposed system too deep for soils information submitted.
❑ Well log required.
❑ Omission in narrative.
❑ Insufficient fill over tank or field.
❑ Other.'
Name of reviewer: DAN Date: 4/3/03
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
Municipality of Anchorage
-� Development Services Department 4_5._
Building Safety Division On -Site Water and Wastewater Program„ °
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING ,t
Parcel I.D.' 0517107-1-4 COSA # Ph OR Q345
Expiration Date: % — % — /0
1. GENERAL INFORMATION
Complete legal description
Location (site address) -Y-27 S51 DALLon Cour
Current Property. owner(s) Vol Qan 1322[ea- Day phone Z40— 9013
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
22251 DoMon Col.}, ('_4;,tk . AK
Unless otherwise requested, COSA will be held by DSD for pickup.
Day phone
Day phone
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
ID
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm SP%AA1and Flul.Ae r,
Address 203 W. 1541' A✓c, 50 202.An �'oq!;9AV, 915DI
Engineer's Printed Name L of5 44CV1411A
S. DSD SIGNATURE
__jZ Approved for _�L bedrooms.
Disapproved.
Phone Z }y -39/b
Date 9jZy/0
.0 y a9s
.I_gnS'SPUnK /
NIL �t=oo
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: P6c�(7 Original Certificate Date: d " _ O-
(Rw 11105)
Municipality of Anchorage
• Development Services Department
Building Safety Division
/ On -Site Water & Wastewater Program
4700 Elmore 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: C(eory 51p �o� 2 Parcel ID: 051 - 102
A. WELL DATA
Well type If A, B, or C provide PWSID #
Date completed ±-7-03 Sanitary seal (YIN) Y
Total depth L21 ft. Cased to 2_IL_ft.
FROM WELL LOG
Date of test 41-4.103
Static water level 1%3' ft.
Well production ) Z g.p.m.
WATER SAMPLE RESULTS:
Coliform $' colonies/100 mL Nitrate 3.5L mg/L
Arsenic: N O ug/L date of sample: 9 oy
B. SEPTICIHOLDING TANK DATA
Well Log (Y/N) Y
Wires properly protected (Y/N) 2
Casing height (above ground) ale in.
AT INSPECTION
4 i5 koll
lei ft.
3.3 g.p.m.
Other bacteria _colonies/100 mL
Collected by: S
TankType/Material fLN& rape TA,%kZ571,J Date installed to t5 o3
Tank size 1150 gal. Number of Compartments 2 Cleanouts (Y/N) i
Foundation cleanout (YIN) Depression over tank (Y/N) /� High water alarm (YIN) N
Date of pumping 20 Pumper A k"ke Stw"
C. ABSORPTION FIELD DATA
Date Installed to r5L03 Soil rating (g.p.d./fe or fe/bdrm) 0.9 System type P Ger? TOlie�.
Length `3b ft. Width 5 fl. Gravel below pipe
Total depth S-3 it. Eff. absorption area _80D fe Monitoring tube Depression over field �✓
Date of adequacy test 9115log Results (Pass/Fail) fisc For,bedrooms
Fluid depth in absorption field before test 2D in. Water added gal. New depth ZG in.
Elapsed Time: 140 min. Final fluid depth 25 in. Absorption rate >= GOO g.p.d.
Any rejuvenation treatment (past 12 moa (Y/N & type) None kylowrn If yes, give date —
D. LIFT STATION
Date installed
'Pump on' Ievei at in.
Datum
E. SEPARATION DISTANCES
Size in gallons
'Pump oft' Ievei at in.
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on tot 1001
Absorption field on tot d loo
Public sewer main Vl fk
Sewer /septic service line +25 1
Animal containment areas 4 501
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit
On adjacent lots
On adjacent lots
+100 1
+loo,
Public sewer manhole/cleanout NIA
Holding tank NIA
'
Manurelanimal excrete storage areas 41001
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 51 Property line +tor Absorption field G 1
1
Water main N k _ Water service line + �5 Surface water +1001
1
Wells on adjacent lots 00 i
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
r r
Property line 5 Building foundation t to Water main I/
Water Service line +ZS1 Surface water + I1)0� Driveway, parking/vehicle storage 't lO 1
Curtain drain 'f t so Wells on adjacent lots + loo 1
F. COMMENTS
G. ENGINEER'S CERTIFICATION Q��'�F A� QS SII
1 certify that I have determined through field inspections and
review of Municipal records that the above systems are in �9—
conformance with MOA COSA guidelines in effect on this date. ... ,,
�+ � )1 p...�
Engineer's Printed Name LABS JOw�RJ(a, d //� �• RSc.b"r
Dale
COSA Fee $ L11 0
Date of Payment 2,-2-9 - 0 C
Receipt Number 0 -7
(Rov. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
in.
8x
C
.I
N
N
r
ASBUILT p.�CLON cG�fT
SEWARD 6 AS9nCTATF
i HEREBY CERTIFY THAT I HAVE SU
VEYED THE
SCALE% yo ,
FOLLOWING DESCRIBED PROPERTY:
GtfA.ny fr/B, ea— z '
AND THAT NO F.I OACHMENTS EXIST EXCEPT AS
DATE=
z10T
INDICATED. IT IS THE RESPONSIBILITY OF THE
ie
OWNER TO DETERMINE THE EXISTENCE OF ANY
GRID:
EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
FB: o/ o
l
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
DRAWN:
pelf
Q
8
w4rFol
OF AteZVI
�.. ........... I.
�'1& •Dvsn. Mark Swerd
III.
tt� LS -5918 ••'
t�;�� gskx�alT�� ±•
"SIi:6r
SCS R[LN
Client Name
Project Name/#
Client Sample ID
Matrix
Sample Remarks:
1094790001
Spurkland Engineering
Cleary S/D Lot 2
Cleary S/D Lot 2
Drinking Water
Printed Date/time
Collected Date/Time
Received Date/time
Technical Director
09/22/2009 15:32
09/092009 14:35
09/092009 16:50
Stephen C. Ede
Allowable Prep Analysis
Parameter Results PQL Units Method Container ID Limits Date Date Ina
Metals by ICP/MS
Arsenic ND 5.00 ug/l. EP200.8 C (<10) 09/15/09 09/21/09 NRB
Waters Department
Total Nitmte/Nitrite-N
Microbiology Laboratory
Colony Count
Total Coliform
Fecal Coliform
3.52
0.100 mg/L
511204500NO3-t
D
(<10)
09/17/09
LCI.
0
col/100mL
SN120922211
A
(<200)
09/09/09
DIX
0
col/100mI..
SM20922213
A
(<I)
09/09'09
DLC
0
col/100ml.
SM20922213
A
(<I)
09/02'09
DIX
L-,5.
Municipality of Anchorage
Development Services Department •'_
1 Yl.'ii et
/ Building Safety Division
On -Site Water and Wastewater Program s A<<�
,�++ 4700 South Bragaw St.
04 t .O. Box 196650 Anchorage, AK 99519-6650
-'� www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING '
Parcel I.D. 01 I - (02 —77 HAA# 05o5-1-7
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Uesr4 SIP Lo{ 2
Location (site address or directions) 22851 DAte , Cour�
Current Property owner(s) Don Glenn Day phone GW -2-01123
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Day phone
Fro^k T(vAr, Day phone 2y4- 8051
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well Is
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank ❑
Community On-site ❑
Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm Spur0a^1 Svwin ri++a_ Phone 1'41-311(p
Address 203 W 15 �T9SoI
Engineer's Printed Name ToI66N Date to S oS
5. DSD SIGNATURE
✓ Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By; Original Certificate Date: /o
(Re, o1NI)
Municipality of Anchorage �
Development Services Department +:
Building Safety Division
On -Site Water & Wastewater Program ' • `
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904 -
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: CI—mla-AIo Lot 2 Parcel ID:
A. WELL DATA
Well type —ioAt If A, B, or C provide PWSID #
Date completed q-1-03 Sanitary seal (Y/N) Y
Total depth Cased to ZZl fl.
FROM WELL LOG
Date of test
Static water level 103' ft.
Well production IZ 9 P.m•
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate 2,31 mg./I.
Arsenic: 0. mg./I. Date of sample: 9 0S
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material AvAe.+aa -64 / sitoi
Tank size 1250 gal. Number of Compartments Z
Well Log (Y/N)
Wires properly protected (Y/N) i
Casing height (above ground) f W in.
AT INSPECTION
gtoos
Ie5 ft.
3.1 g.p.m.
Other bacteria I_ colonies/100 `ml.
Collected by: �5 'L'wy' ad
Date installed 10 r5 20C 3
Cleanouts (Y/N) v
Foundation cleanout (Y/N} Y Depression over tank (Y/N) A _ High water alarm (Y/N)
._ ,.. L'J.'o,F.
Date of pumping o rLo0 c, Pumper Alaska Sevin. Dr ir%
C. ABSORPTION FIELD DATA
Date installed 10JI310C Soil rating (g.p.d.W orfilfh& 0.8 System type Qeep T�tnck
Length 80 ft. Width 5 ft. Gravel below pipe 1.1 ft.
Total depth 8 _3 ft. Eff. absorption area 800 ftp Monitoring tube _1_ Depression over field l±/
Date of adequacy test tt W Results (Pass/Fail) -- For = bedrooms
Fluid depth in absorption field before test = in. Water added= gal. New depth= in.
Elapsed Time: =min. Final fluid depth = in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) -Vof� No If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level _ in. "Pump off" level at in. High water alarm level at in.
Datum Cycles tested Meets alarm & circuit re Irements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot (OD I
Absorption field on lot + IOD I
Public sewer main N A.
Sewer /septic service line
+ 2S'
On adjacent lots + jW I
On adjacent lots +100 (
Public sewer manhole/cleanout AIA.
Holding tank Al A.
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation .51 Property line +tot Absorption field SI
Water main N. A. Water service line i 25 1 Surface water A/. 0.
Wells on adjacent lots +'01)1
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line so * Building foundation +101 Water main N. A.
Water Service line +2S Surface water /V 0. Driveway, parking/vehicle storage +10'
Curtain drain /✓• D. Wells on adjacent lots +100
F. COMMENTS
am
44 e L
G. ENGINEER'S CERTIFICATION ! 4FY_ _ NVI
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name T066cn �✓41 And
Date 16 j51 OS �01ia r
HAA Fee S '/L -+ /75-- Waiver Fee $ _
Date of Payment 1Q11 -74 r Date of Payment
Receipt Number '1 Sola Receipt Number
(Rev. 12101)
SCS ReLN
1056249001
Client Name
Tobbcn Spurkland P.E.
Project Name/N
Cleary SID Lot 2
Client Sample ID
Cleary SID Lot 2
hlatrlx
Drinking Water
Sample Remarks:
All Dates?Imes are Alaska Standard Time
Printed Date/Time
10/04/2005 15:54
Collected Daterrime
09/21/2005 13:00
Received Date/rime
09/22/2005 8:54
Technical Director
Stephen C. Ede
Parameter
Results
PQL Units
Mcthod
Contain" ID
Allowable
Limits
Prep Analysis
Date Date
Init
Nitrate -N
2.97
0.100 m8/L
EPA 353.2
B
(<-10)
0922/05
AZS
Metals by ICP/MS
Arsenic
5.00 U
5.00 u8/L
EP200.8
C
0927/05 09/29/05
SCL
Microbiology Laboratory
Total Coliform
0
coVI00mL
SM209222B
A
(<-I)
0922/05
TLF
logo ?1� e.~" ero
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d , $
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NQ I , r 11
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is 'Tx�E tr.++w: • -
_ _. _ i✓By •S7%f"iti . /fes!—r.T
ASBUILT
SEWARD &ASSOCIATES LAND SURVEYING 694
I HEREBY CERTIFY THAT I HAVE SUF VEYED THE SCALE, Jar
FOLLOWING DESCRIBED PROPERTY
/BL t OF At"%N
t�, Gor DATEt
Q�
AND THAT NO PKCCROACHMENTS EXIST EXCEPT AS
INDICATED. IT IS THE RESPONSIBILITY OF THE fns
OWNER TO DETERMINE THE EXISTENCE OF ANY GRID-�• .....
EASEMENTS, COVENANTS OR RESTRICTIONS ,vw /?X P y.. i
WHICH DO NOT APPEAR ON THE RECORDED SUBDI- %"
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB! D'sns Mark 36w8'd r L
ANY DATA HEREON BE USED FOR CONSTRUCTION /off 0 4 �� �•. 1S-6918 •. s
OF FENCE LINES, OR FOR ESTABLISHING BOUND-��
ARY LINES. DRAWNs \ ikxUtvfe,
29