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NORTH SLOPE #2 BLK 5 LT 8
North Slope #2 Block 5 Lot 8 #050-581-11 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.ei.anchorage.ak.us (907) 343-7904 Page 1 of 4 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO30466 PID Number: 050-581-11 Nome: JEFF PATTERSON Wastewater System: ■ New ❑ upgrade Address: 31001 SAGWON AVENUE ' EAGLE RIVER. AK 99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 441-1115 4 O Deep Trench O Shallow Trench E Bed D Mound 0 ether LEGAL DESCRIPTION sa w'�° 0.5 Total °'° th f ° °""'"' wo/se. n 4/4 rL Block: 'Lot: Subdivision: 5 8 NORTH SLOPE #2 a.qh to Pi- eouan hpn 0" pee.: SEE DWG. u C aptn b. U ypr. 0.5/0.5 r< rL Township: — Range: Section: 11 aea.a avow oftwa poae: CovOl wvh: _ — SEE DWG. r< 62/62 R WELL: ■New ❑Upgrade o� 11 11 / rL NU a "TDelo":. 2/2 7..m w., 5.5+/— r< Clowukotion (Prm. *. Ae.Q: TOO DAft" To: TOW ale tion awa: Fp. met.na: PRIVATE 181 rt 175 rL 1342 so. n D 3034/ F-810 wear: M—W DRILLING Dab Ddlw; 22 2004 stone wets tot: 113 Mtpner: BILL COURTNEY Dole eud~ 9/2003 n rw: wep so'u: Co" height Aeoe. Wound: 10+ CPN UNKNOWN n 2 rL TANK SEPARATION DISTANCES ■septic OHolding DS.T.E.P. 00lher To From septic Tank Absorption Field Lift station Holding Tank /Pn.ate s.... unn ww%o . ANCHORAGE TANK CopoNry n a 1250 Well 100'+ 100'+ — — 25'+ 1a.'w. STEEL a conpwt w 2 Surface water 100'+ too'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — s,. In wNotwa I Foundation 5'+ 10'+ — — — on, level acal at hyh water a+am au Curtain Drain e25+ e25+ _ _ _ A.ro taw. ` Deau`eo, tn.p.el,arr polomwd er Remarks: BENCH MARK *CURTAIN DRAIN IS UPHILL FROM DRAINFIELD Ux Out Doocdpu DOOR THRESHOLD 102.90 rL ENGMEENB a OF Inspections performed by: GEG, Ltd. Dates: 1st — °�94000 — ...... ............ 2nd �... .. .... ....:....� 3rdf — Q � f y A. ness: O� y o00p.e^• Development Services Department Approval 0 z(3o�go�� Reviewed and approved by Date: 1 2v S •E— �4po,Prafess;a0000 DO0000�o V" Jan 19 05 02:25p Jeff Patterson 907 -CSG -3467 p.2 PLOT PLAN _ AS BUILT X SCALE 1 : 40* GRID SE 703 Project No. 04-220 Lang & Associates, inc. 1/500 Daryl Avenue, Anchorage. Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax o�o�o www.langsurveyors.eom / IntoOlangsurveyon.eom o�!_ •„A� 1 hereby certify that I haw surveyed the following described properly: 04`Q :4' lrO LOT 8. BLOCK 5. NORTH SLOPE SUBDIVISION, No. 2 (PLAT No. 73-17)off; 491H !V y Anchorage Recording District. Alaska, and that the Improvements situated thereon are O • within the property Ones and do not encroach onto the property adjacent thereto, that Q"'....""""' "t no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission Ones or other visible easementa �• ••• •• on sold property except as Indicated hereon. � KENNET LAN LAN: Dated this the 94' D of _ �'�n Zcs� LS -5202 i Day 4- . at Anchorage. Alaska _ G It Is the responsibility of the owner to determine the existence of any easements, covenants. or restrteHons which do not appear on the recorded subdivision plat. PERMIT NUMBER: SWO30466 r ATB I STI 22.05 22.73 STI 22.05 22.73 ST2 29.34 27.27 DBL1 31.36 28.79 DSL2 33.70 30.53 FO 38.90 33.93 C01 40.87 39.04 MTI 41.11 39.82 CO2 42.34 35.65 MT2 43.38 35.68 CO3 98.53 88.68 MTS 98.81 89.84 C04 100.11 87.90 Mrs 100.17 57.44 COS 48.55 19.81 MTS 48.35 20.76 COB 150.98 20.71 63 21 M4.2 .517598 AS -BUILT DRAWING \ \ ALTERNATE SITE WILL REQUIRE THE \ \ USE OF AN AOJANTEX SYSTEM \ \ --CETM+Ztd. \ \ i -NEW DRAINFlELDS \ S�wvo ` \� V�UF RECENTLY INSTALLED M.O.A. FRENCH DRAIN \ \ / rINSTALLED FL011\ a7' \ DBL2 SPLITTER (FS) '7G \ r 4 / "000 NEW WELL PARCEL ID NUMBE 050-581-11 NEW 1250 CALLON SEPTIC TANK Y �/ >L _ \ LLTKAL. � C�r7iidf \ b C 044 \ GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS& GENERAL CONTRACTORS 701 F TIMOR ROOD $NRF 101 • ANfHORAGF. AK 00507 • FNONF (007)H 170 • FAX (001)110-174f 1 A.J.G. 1" = 50' EPA ........ i... IIILZ. f...I......... tEPARED FOR: PHONE NUMBER: PAGE: JEFF PATTERSON (907) 441-1115 2 OF 4 J ff y A. ess: GAL DESCRIPTION: QO y� C 7953 LOT 8, BLOCK 5; NORTH SLOPE SUBDIVISION 2 . D .p PE OF WORK: �40.rtlp/o/...... a��o AS -BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM ��DOO0000�� LED. THII PIERRE M. STI7ACIEL, P.E. TH/2 RE M. STIIACIEL, P.E. TH/1 S�wvo ` \� V�UF RECENTLY INSTALLED M.O.A. FRENCH DRAIN \ \ / rINSTALLED FL011\ a7' \ DBL2 SPLITTER (FS) '7G \ r 4 / "000 NEW WELL PARCEL ID NUMBE 050-581-11 NEW 1250 CALLON SEPTIC TANK Y �/ >L _ \ LLTKAL. � C�r7iidf \ b C 044 \ GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS& GENERAL CONTRACTORS 701 F TIMOR ROOD $NRF 101 • ANfHORAGF. AK 00507 • FNONF (007)H 170 • FAX (001)110-174f 1 A.J.G. 1" = 50' EPA ........ i... IIILZ. f...I......... tEPARED FOR: PHONE NUMBER: PAGE: JEFF PATTERSON (907) 441-1115 2 OF 4 J ff y A. ess: GAL DESCRIPTION: QO y� C 7953 LOT 8, BLOCK 5; NORTH SLOPE SUBDIVISION 2 . D .p PE OF WORK: �40.rtlp/o/...... a��o AS -BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM ��DOO0000�� PERMITNUMBER: AS -BUILT DRAWING PARCELID NUMBER: SWO SW030466 050-581-1-111 NORTH BED I BOTTOM OF BED / RELATIVE ELEVATION OF BOTTOM - 92.67 (AVG.) -J OF TESTHOLE - 85.17 (TESTHOLE DRY) SOUTH BED FINAL GRADE 92.00-93.00 GEC TH/1 BOTTOM OF BED RELATIVE ELEVATION OF BOTTOM - 88.13 (AVG.) OF TESTHOLE 80.63 (TESTHOLE DRY) GARNESS ENGINEERING GROUP, Ltd CONSULTANTS i GENERAL CONTRACTORS 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 90507 • FHONF (007)3374170 • FAX (0071339-5746 PREPARED FOR: PHONE NUMBER: JEFF PATTERSON (907) 441-1115 LEGAL DESCRIPTION: NORTH SLOPE SUBDIVISION #2; LOT 8. BLOCK 5 TYPE OF WORK: PROFILE AS -BUILT DRAWING OF NEW DRAINFIELDS INSULATION -FILTER FABRIC FABRIC 10/11/2004 1WN BY: A.J.G. LLE: 1"=40' ;E NUMBER: 3OF4 'ORIGINAL GRADE - 96.67 O HIGHEST POINT VERT OF DISTRIBUTION UNE - 93.18 (AVG.) ORIGINAL GRADE 92.13 O HIGHEST POINT VERT OF DISTRIBUTION LINE - 88.68 (AVC) MY11,01W41/1 I SW030466 AS -BUILT DRAWING PARCEL ID NUMBER: 'TOP OF TANK AT INLET . 94.32 ST2 n u NEW 1250 GALLON -INVERT OF BUNG SEPTIC TANK AT INLET - 93.74 *BOTTOM OF - 89.4! TOP OF TANK AT OUTLET - 94.34 'INVERT OF BUNG AT OUTLET - 93.59 10/12/2004 �OF DRAWN BY: GARNESS ENGINEERING GROUP Ltd. 3 A.J.G. 4 CONSULTANTS i GENERAL CONTRACTORS 3101 E. TUDOR ROAD, SUITE 101 • ANGHORAGF. AK 90507 • RNONF (901)337.6179 • FAX (007)33R.376E SCALE. 1n 401 QAJ' �..... Q .... . . ...... A O� PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JEFF PATTERSON (907) 441-1115 4 OF 4 t e O . oa a • •,• _ • " Gor ess:. p LEGAL DESCRIPTION: NORTH SLOPE SUBDIVISION #2: LOT 8, BLOCK `vO� 4�a�P�o . (e3lTOaslolO �DOO�o TYPE OF WORK: AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE yT 4 M -W Drilling, Inc. *P.O. Box 110378#Anchor'age, AK 99511• •907-3454000 • 907-345-3287 Fax* Job No.: 04146 Parcel No.: 050-581-11 Permit No. ♦ Well Owner: ♦ Legal Descrlptto_n Groundwater Well As -Built & Loe Jeff Construction ♦ Use of Well: W11111ZM Domestic * Hale Depth: 181' •Casing Size: 6" ♦Cased To. 151 AY *Material: A 53 Steel •Drltl Method: Air Rotary 4 X^ 145'-175' PVC Perf.. ♦ it ell Completion- Open end X Screen Perforated Method: •Liner description: Skil saw slotted: lt4^ x 3^, 1 slot per foot: 152'— 175' • Grout Notes: ♦ Notes: Sacks- No. 8 ♦ Well Development: Method. Air surge Notes: *Static water level (SWL) 113.25' (above) (below) top of casing (TOC). ♦ I fell yield test at' 10+ gallons per minute (CPM)/gallonsperh"#-(GPN) for 1 hours Wilk 100% of drawdown (DD) from static level (SWL). ♦Afethod: Airlift ♦ Date of completion: 22 June 2004 • Pump Install: WPII i.on Depth in feet from . top of casing. Details of formations penetrated, size of material, color and hardness. 0 TO 2 Casing stickup 2 TO 10 Organics 10 TO 40 Silty gravel: cobble 40 TO 42 Silty sand: gravelly, dam 42 TO 51 Silty ravel: dry 51 TO 101 Silty gravel: sand 101 TO 104 Boulder 104 TO 122 Graven silt: cobble 122 TO 126 Silty ravel: damp WAYNE E. WESTBERr- 126 TO 130 Boulder President, M - W Drilling, Inc. 130 147 TO TO 147 151 Silty ravel Bouldei Bedrock: fractured, 3-4 gpm NQWACertified Contractor Celt' Ice e os. ji I LO&O tractors-License-NoNo t 151 TO 170 170 TO 181 As above: 10-15 gpm TO TO TO Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 47DO South Bragaw SL P.O. Box 196650 Anchorage, AK 99579.8650 w .mumorgtanwte (907)343-7904 _ Solis Log - Percolation Test Pedonned For: _ _ �-Tl aer-S:J Date Legal Description: —Lgy-, e7 R,c. FCY.iIt �a�- -x,-v- TowroWv, Pww. Seaton: Tir.•t!. Depot nQ(.rpJILS (G4 dj F C, C Cr" ►t�ST �• 1- 91IRe', �� 'i•�,-t rN 1 WAS GROUND WATER �t•/' i ENCOUNTERED? 1 IF YEA AT WHAT DEFTNTO,j S(�E.I Depth b W WrA1W Ilorleorlrp? It21 � Date: Readkp Date Gross Time Net Tirne Depth b Water I Net Drop 1 1 V92 45 gt' 0 &1 114• 1 ,, . _.__.............. .Iv ._,..-.imr Y "OLE DU AE,ER V •• TEST RUN BETWEEN 4 FT AND f-7 FT I PERFORMED BY: 12A, g Oc.N'4 1 ic,L+i •• • .s, I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ' I I I ILa, Municipality of Anchorage Development Services Department Bunding Safety Dlvbion • +.r Onsite Wale." Wastewater Program P.O. Bax 196650 47DSo a �Qa' SL AnUarepe. AK 99SIMSO www.mum org"s4e (907) 3417904 Solis Log - Percolation Test Performed For. .�. 14atx Date Lspa1 DesonPrbn: Lp< S v,S. �.-r` `-x�vi. .�."l L TmTw*. Rwov, secwn: "opt" CR1 O�' eet 1 -)�zto3 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DFFTH? Dap1h b Warr After morworkq? Date: Rea&V Date Grose Time Net Time Dem to Waw Net Drop I "12 oe� ?jam (,p' t. u Z qo �o• w..� LA5% � 1 �.,, 4 II C� Qn .. . -I-Iii I '711 e_• I 'lift _. t7�.�N PERCOLATION RATE A", seY.aiarAU PERI NOLE DIAVAIE-TER TESTRUNBETWEEN - AND jy FT COMMENTS F'�a- Soyr PERFORMED BY: �A1S17r.M DSSK r GS Cr,I Y I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: -111-11O'� Municipality of Anchorage Development Selvkes Department BuUngSafety Dlvlsion • - •` 7 . aI-Sile walef and Wastewalef Ploglam '0— vo0 Sou" Bragaw SL v CE G 04 P.O. Box 146650 Andwrage. AX 995146650 CE ->? %01 wwwd.anchg ak.usIMI) 3.13-7904 r i l� +ti'• ... l�. Soils Loi - Percolatiop Test Perrrnmed ror. .CCJy' cX50V ,1 Dale Pedamed: Legal Descdpliorr L I-. �jS A/,SC !•/�F �'/�nN ��' J ,___ —T I cl—. Dep?l O1WI1vICSIUI-- 5. (I. 6 n'• 6m 7 ` O;I103 6 f�. . 10 0 11 • 12. 13- 14- 15- 16- t 7- 20-1 - 20- VI:S GPOUt) VIAIER E:KCtAlfcpP97 -1� S L IPYES.AIVIIIAIDEP11" D V.PWeVIA"Alt.,( P LIo IlwingT 7E D,Iet 03 I ReaJing Date Gross Time Ncl Time Deptl, to Waler NO Orel, - T- �I V/.� ,•. �fP 1 _ 10 1 /1L� / & I 4 ----- _ - 3�`C11 _ -- FE3--oLAvcaIPat= rM7 Tciatr�Fc�) f'..:c l;cl.e ur::.lc ler: ISStmAIGET?IC-tI FI ACID 5_FI — —• �7fK� _CE.i1TIF'/ 11!:I 11115 I'Ei'.rUt!),IE(11:'i: P 7 �'V_(7 �IEl ��L,��'= 1' _ -. P.RPOR:.Icn IN A.CCOR!.I:.(IC'c Y1I111 ALL STATE AfiD (.ItllnCl TL 0.1)1 LlttES Itl EFFErt Ott T111S WIC. I)AIE: T- �I V/.� ,•. 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 I WATER SUPPLY PERMIT Initial Permit Number. SW030466 Legal Description: (North Slope #2 Block 5 Lot 81 Design Engineer: 0041 AK Water & Wastewater Consultaru Owner Name: JEFF PATTERSON Owner Address: 31001 SAGWON AVENUE Eagle River . AK 99577 - Date Issued: Nov 04, 2003 Expiration Date: Nov 03, 2004 Parcel ID: 050-581-11 Site Address: Unknown Lot Size: 51863 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit Is for the construction of: Q Disposal Field ❑d Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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. Received By. Issued By. B. Covered, sealed, and heated to prevent freezing. 0110 WMI'll Date: 11 I► -7 /03 Municipality of Anchorage Development Services Department j 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 05'0 `581 —11 Permit Number 514.'6304AW Property owners) JFFF PATI RSON Day phone 441-1115 Mailing address (1) 19532 HIGHLAND ROAD • EAGLE RNR AK 16&4i4gaddress (2) '310015)96 WON A VEN14 E zip Code 99577 Legal description (Lot, Block & Sub'd.) LOT B. BLOCK 5• NORTH SLOPE SUBDIVISION #2 Legal description (Section, Township & Range) N/A Lot Size 51863 Acre(ED 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 ❑ 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:. ;7-5- 0 Date of Payment: / / 0 7 Receipt Number. !V !V 0 q 2_ Waiver Fees* Date of Payment: Receipt Number. ALASKA WATER & WASTEWATER CONSULTANTS, INC. October 22, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well and Septic Permit for Lot 8, Block 5; North Slope Subdivision #2. To whom it may concern: In the month of September of 2003, a septic system was installed on the referenced property by Bill Courtney, an excavator from the Valley. Two test holes and a design were performed by Pierre M. Stragier, P.E. Mr. Stagier's test hole #2 appears to be identical to a soil log performed by S & S Engineering (see attached). The septic system was installed without a permit and without inspections by an engineer. It appears that the septic system was installed similar to the design done by Mr. Stagier (see attached). The owner of the property has hired AKWWC, Inc. to obtain a well and septic permit. It is our understanding that your department has performed a site visit to the referenced property and deemed the septic system acceptable if new test holes were excavated and an engineer documented the installation. On October 14, 2003, new test holes were excavated and percolation tests performed. The test hole (TH#1) excavated between the two beds had a percolation rate of 10.9 minutes/inch which equates to a 0.5 gpd/sq.ft. application rate. The test hole excavated approximately 20 feet uphill from the beds had a percolation rate of 40 minutes/inch which equates to a 0.3 gpd/sq.ft. application rate. On October 18, 2003, the ends of each bed were exposed in order to install cleanouts and also to document the beds. Elevation shots and field dimensions were taken and found that the uphill bed is 1 I feet wide by 62 feet long and the downhill bed is 11 feet wide by 60 feet long. Both beds have an effective depth 0.5 feet. The maximum depth of the fields appeared to be 4 feet on the uphill sides of the beds. All separation distances were checked and there appears to be no conflicts. Attached are photographs taken by the excavator during the installation. As can be seen on the attached photograph the septic tank is a 1250 gallon steel tank. The beds are within in the 30 feet radius of our test hole #1, which as stated before, had an application rate of 0.5 gpd/sq.ft. The combined square footage of the beds is 1342 sq.ft. and for 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: akwwc.com a 4 bedroom residence, this equate to a 0.45 gpd/sq.ft. application rate. It is our opinion that the beds are adequately sized for a 4 bedroom residence. Attached is a site plan drawing and a partial as-built/design drawing for the septic system and the proposed well location. We request that a well and septic permit be issued for the reference property. Once the house and well are installed a full as -built package will be submitted to your department. please contact us at 337-6179. Thank you for your assistance. A.S. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179 0 Fax: (907) 338-3246 • Website: akwwe.com ` \\ LOT S. BLOCK 5; \\\ \\\ NORTH SLOPE S/D 12 \ \ AKWWC, INC. \ \ TEST HOLE 01 \ \ PIERRE M. ST12AGIEL. P.E. \ \ TEST HOLE /1 c• / LOT 9, BLOCK 5; \•f, NORTH SLOPE S/D /2 PIERRE M. Si12AGIEL, P.E. TEST HOLE /2 NORTH SLOPE BLOCK 5: SITE 64 04"? \ PROPOSED `\ 00 HOUSE �_,,,'.�._ / LOT 7. BLOCK 5; / / I NORTH SLOPE S/0 /2 \`O -'4`\� �r % PRO LLSEO Nie / , \, LOT BLK NORTH 1SLOPE 5/D4 /2 LOT 14. BLOCK 4: NORTH SLOPE S/0 J2 ALASKA NATER & WASTKNVATKR SULE. J.L.M. -- -LILTANT&ANC. 1 ^ 100 70 F TIMR MU0 SUIT- 10. a AWWRA" AX 00507 a P. N- (007)357.6170 a FAX (007133e-3716 oroeocn rno PHMF NUMBER_ PAGE NUMBER: JEFF PATTERSON 441-1115 (LL. DESCRIPTION: LOT 8, BLOCK 5; NORTH SLOPE SUBDIVISION TYPE OF WORK: SITE PLAN FRO PROPOSED WELL AND SEPTIC SYSTEM LOT OCK NORTH 15. SLOP S/D4 J2 r CDrness:' e(ji o E 7953 :. V9,e .oA AKWWC, INC. TEST HOLE 01 PIERRE M. SITZACIEL. P.E. TEST HOLE PIERRE M. STIZAGIEL, P.E. TEST HOLE 12---,. .TERN,XTE SITE WILL REQUIRE THE USE OF AN INNOVATICE SYSTEM NEW IV WIDE BY 60 LONG BCD WITH 0.5 FEET OF EFFECTIVE INSTALLED FLOW SPUTTER NEW lI* WIDE BY 62' LONG BED WITH 0.5 FEET OF EFFECTIVE INSTALLED DOUBLE CLEANOUTS -,,�NEW 1250 GALLON STEEL SEPIC TANK o/v 10/22/2003 DRAWN BY: J.L.M. ALASKA "'ATTR& WASTE WATER Ll F, CONSULTANTS. INC I" -- 50' .... . ..... ..... 00ACl AK Ql ' P~ 10071W.W0 - FAX l0l711XR-X?46 11', F Tll��P 0, Al 9,,,Tc IPI I AN'"W PREPARED FOR: PHONE NUMBER: 2 OF 2 JEFF PATTERSON (907) 441-1115 2 OF 2 e A Garn ss..: 53 f4 LEGAL DESCRIP71ON:C LOT 8, BLOCK 5. NORTH SLOPE SUBDIVISION #2 . .... .. P , slc,,o TYPE OF WORK: PARTIAL AS-BUILT/DESIGN OF SEPTIC SYSTEM AND PROPOSED WELL ALASKA. NATER & NNASTENTVATER CONSULTANTS, INC. w.c: (007)338-3246..cca. SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: NORTH SLOPE SUBDIVISION /2; BLOCK 5, LOT 6 PERFORMED FOR: JEFF PATTERSON DATE: 10/14/2003 DEPTH (feet) z ORGANICS TEST HOLE 1 1 2 3 5 7] lijill WDENSER / DEPTH 8 9 10 11 12 13 14 15 16 17 18 SOIL CLASSIFICATIONS DRY 10/14/03 GW 10/21/03 ---= ORG 6' GP 2 I ML ii U GM 3 4:31 CL ``i GC i AKWWC, INC. OL TEST HOLE 01 SW 5 5:01 MH 6' SP I • •��.:3_a'vy", HOUSE CH 3 1/4 SM OH \\ i PRYO�PLLED SC DEPTH TO GROUNDWATER DATE DRY 10/14/03 DRY 10/21/03 4:01 EWLY INSTALLED 6' SEPTIC SYSTEM t.s.........:._ A. cr ess ....53'' Eco":V 'of esslodoo" SITE PLAN AKwwC. INC. NET TIME (MINUTES) TEST HOLE /2 1'-100' 10/14/2003 1 4:01 EWLY INSTALLED 6' SEPTIC SYSTEM 2 4:31 30 3" 3" 3 4:31 — ``i — i AKWWC, INC. / a.-• TEST HOLE 01 ••.`;." i 5 5:01 PROPoSED 6' 4 BEDROOM I • •��.:3_a'vy", HOUSE I i 3 1/4 / `S4Ck,0 \\ i PRYO�PLLED \NAH�f DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 10/14/2003 1 4:01 — 6' — 2 4:31 30 3" 3" 3 4:31 — 6' — 4 5:01 30 3 1/4 2 3/4 5 5:01 — 6' — 6 5:31 30 3 1/4 2 3/4 19 PERCOLATION RATE 10.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.5 FT. AND 5.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN COMMENTS: PERFORMED BY AKWWC, INC. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS W PE ORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:10 Z3 O ALASKA. NATER CONSUL ►ASTENVATER INC. SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: NORTH SLOPE SUBDIVISION /2; BLOCK 5, LOT 8 PERFORMED FOR: JEFF PATTERSON DATE: 10/14/2003 DEPTH____ (feet) ORGANICS TEST HOLE21 2 3 4 5 70]§11111 fIIS##IWDENSER /MDEPTH 8 9 10 11 12 13 14 15 16 17 18 SOIL CLASSIFICATIONS CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING GW 10/14/2003 1 4:00 ORG "- ^ GP 2 I I ML I I I GM 3 4:30 CL 6' GC 4 5:00 OL o>°• o SW 5 5:00 - MH ': �'• SP 5:30 30 CH 41 1 SM OH Sc DEPTH TO DATE GROUNDWATER DRY 10/14/03 DRY 10/21/03 AKWWC. INC. % C TEST HOLE #11- PROPOSED 1 PROPOSED 4 BEDROOM 1 HOUSE I l -S4CK•0 �N TEST INC. E 02 NEWLY INSTALLED SEPTIC SYSTEM DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 10/14/2003 1 4:00 - 6' - 2 4:30 30 5• 1' 3 4:30 - 6' - 4 5:00 30 5 1/4- 3/4' 5 5:00 - 6" - 6 5:30 30 5 1/4- 3/4" 19 PERCOLATION RATE 40 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.5 FT. AND 5.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN COMMENTS: PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAP P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 7,3 ��! �ad�� •s niJ• tM . 1, AA,±tI"y��♦ ��t : e r � r. Via, `/a � a -, Mfr„;�,''�.., :rt JKV- 1 1` { Tai IT bit it ~ '• 1 '%;'-.1�• ;.�Cn' � � •_, it `-��f - TP gir --yrn't —ra Ar- gir --yrn't —ra ♦.r+ r rt t • 1. . l 'Rr ( ♦r • • 1 { ` l'' �� j u ''' r ,.i i • ' ' a III (f �; `!-'ate♦ � � { � ' 1 moo. ,. -v��.'a�r•�•`� % ` s s tf1 %�-, � �iJ,V�''�-I. •.�`� ' ir.• J'. i �•C•t3�r� -f a !•f � 4_ �"} --r,� '�`\ t ^'waw+�! `II. ��- / ✓ � �[. r r � � • Y f • i �•� �.w•`Y"• �Yr!G.. 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'moo-= + ! ��.Si. � •.,�' .. .f `� `ry'fT.: �_ � Y ate.. a.: .. .`. .Y�'•y.t�Y +'+syr x �► `��. ,.� `'iaa„� ' �'.,• - r t " •-�) - •�. •.4 .. � r� r� � ,yam A*' 1 - J V K Cwt I 1W. •. LYa y.. •. .s o i , C 44 ;r' � �'_M f {.'^� .'•-. PYA I�: ..M+'L+•: i • - _moi • ,il; .. .. J �iI�f'.(r�s' �i • \i `,, f`4"" ._ . ') a L _YyY a f 41 ��. i n w♦ T stn`Y tits t' -.t. ► �+ �;, ' ,_t1 .,�r-.. r{i �j� r��'� 1�f\ I���« A7', Ya'�t• w V^�tt•,wF� r.{ T� ��''� '� �1 1 r'` zfl r. ' �?,i,•'1 /1 , � 1\i '4: e : it } :r.t ® Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 050-581-11 1. GENERAL INFORMATION: Expiration Date: 1 Q ? zZ Complete legal description NORTH SLOPE #2; BLOCK 5 LOT 8 Location (site address) 31001 SAGWON AVE., EAGLE RIVER, AK 99577 Current Property owner(s) DAVID & MANDY BEAULIEU Day phone 907-360-5527 Mailing address 31001 SAGWON AVE., EAGLE RIVER AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well . ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ T 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: C �2q 27— 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 system/s on the date/s 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,I 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 C1 bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms OF 114 - . . / I of i ay Gorne- o� C 7953 \c k I� t' 0 0 Iro f e s slono 0 GPLITY pFi$$/ °TF'S��,� do Z5 rn p�ST 41 rn; RSG FR with the following tions: '5'9M O=� By: Vti� �` Original Certificate Date:_/ — Z Q2Z7 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% _ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10.10.12.doc AIS Legal Description: NORTH SLOPE #2; BLOCK 5, LOT 8 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 6122104 Total depth 181 ft Cased to 151.4 ft On Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/9/22 Static water level at beginning of test 98.9 ft. Comments B. TANK DATA Age of tank(s) 119 years Tank type/material STEEL Measured operating fluid level in septic tank 50.75" ❑ Standpipes/foundation cleanout per record drawing \\ Date of pumping �1 t u.n e- 'DC), ).--C> ) - �. D. ABSORPTION FIELD DATA DUAL BED DRAINFIELDS Which system tested (date installed) 9/2003 ❑ ALL standpipes present per record drawing Total measured depth from grade '4.515.2 ft (max) Measured depth to pipe invert from grade `2'$13.2 ft (min) ❑ NIA — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Parcel ID: 050-581-11 Structure served by this system 1 Well production at time of test 6.3+ gpm Water storage tank volume gallons Well disinfected for coliform test? E] Yes ❑ No ©'Coliform bacteria is Negative Nitratey. 4 l3 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 2 -Arsenic less than MRL (ND) Collected by GEG,LTD. Date of Sample 6/9/22 STATION ❑ Requir ai Age of lift station Lift station mater Comment Adequacy test date 6/9/22 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test "0/0 in Water added *4991485 gal New depth '5.75/3 in Elapsed time 294/240 min Final fluid depth 310 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) NO If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes if No Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft Q Yes if No ft Neighboring Tank > 100' [-] Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' Z Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' [] Yes if No ft 0 Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' El Yes if No ft [E] Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' [✓�) Yes if No ft Property Line > 5' Rl Yes if No ft Wells on Adjacent Lots: Cj Yes Absorption Field > 5' n Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' E] Yes if No ft Community Wells > 200'rQ Yes if No ft Water Service Line > 10'11✓, 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) Building Foundation > 10' Q Yes if No ft if absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' Cj Yes if No ft Private Wells > 100' Yes if No * ft Water Service Line > 10' Q Yes if No ft Community Wells > 200' S Yes if No ft Surface Water > 100'✓Q Yes if No ft F. ENGINEER'S COMMENTS *NO MOA RECORDS FOR WELUSEPTIC ON NORTH SLOPE #2; BLOCK 5, LOT 5. NO WELL -WITHIN 100 -FEET OF LOT 8 SEPTIC. G. ENGINEER'S CERTIFICATION J 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 #AECC884 PERM NUMBER: AS -BUILT AWI G• SWfl30466 NORTH BED FINAL GRADE RtC TNSUtA110N �(,Li7TS i " F1tTER FAB 7 C.,1 X1.22 `� f' 0 Cot= g3 -P CoZ.-= CJZ.Z(o co3 =- c13.Io �o�f— X3.13 RELATIVE ELEVATION OF I OF TESTHOLE - 85.17 SOUTH BED m BOTTOM OF BED - 92.67 (AVG,) —FINAL GRADE - 92.00-93.00 ::7 INSULATION —FILTER FABRIC t SOSlia = _ r WID£ Cod C CA& OTrOu OF BED B" -r (' �• RE LA OF BOTTOM 88.13 (AVG.) OF TESTHOLE - 80.83 (TESTHOLE DRI" 1'C Q tldgi .• li TE 10 11 004 .s x� 0 BY. GARNTESS ENGINEERING GROUP, Ltd. SCALE: A.J.G. CONSULTANTS 6 GENERAL CONTRACTORS „ 3701 E. TUDOR ROAD. SUITE 101 . ANCHORAGE. AK 00507 • PMONF (007)337.6170 " FAX (007)336.3746 1 — 40 PREPARED FOR: FHONE NUMBER:PAGE NUMBER: JEFF PATTERSON (907) 441-1115 3 OF 4 LEGAL DESCRIPTION: NORTH SLOPE SUBDIVISION #2; LOT 8, BLOCK 5 TYPE OF WORK: PROFILE AS—BUILT DRAWING OF NEW DRAINFIELDS PARCEL k7 NUMBER: 050-581-11 °ORIGINAL GRADE - 96.67 0 HIGHEST POINT VERT OF DISTRIBUTION UNE - 93.18 (AVG.) *ORIGINAL GRADE - 92.130 HIGHEST POINT OF DISTRIBUTION - 88.68 (AVG) AJ�� 4�P.Zl *A. Municipality of AnchorageOn-Site Water and Wastewater Program(907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel 1. D. O tTo — �3 z� —I I 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent Expiration Date: / - __12' - I v � k S(roae- 5 0 47- [35-_Lv 3 i 0 n l S_qa w eh . Avl—' 2. TYPE OF DWELLING: ( Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone Day phone 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [ Individual (� incli aa—1 ;Ar.tor c+ornoo I I Hnldinn Tank ❑ Community Class JY Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ q0 Date of Payment 2 7 3 Receipt Number �g 213 COSA# 315b3 Waiver Fee $ Date of Payment Receipt Number inFmca�:3 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 10( -e t r 4Ln(_n k a,' S o VI Address �l/i fo / A1.1 4-ru n oy k cG Engineer's Printed Name MIs a -e / ., L-er 4 u I 6. DSD SIGNATURE �� System #1 Approved for — bedrooms. System #2 Approved for bedrooms. Disapproved. Phone Z 2 7 - ear �4, `( Date 't y��gry.OF agCq���d,' *"49TH po 0 MICHAEL i6,=ltt @'E 2SON • CE -9469 \: Conditional approval for bedrooms, with the following By: Original Certificate Date: / 0 - �2 -/ The lie' f o ge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-1-12.doc If more than I septic system is on the lot: COSA Checklist # of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: f&#''I-� 5491eG s62-4�2 Parcel ID: OSSo –SSM A. WELL DATA Well type PttvAtVIf A, B, or C provide PWSID # Well Log (Y/N) Y Date completed Sanitary seal (Y/N) Wires properly protected (Y/N)_ Total depth t3ft.Cased to f 2f . Casing height (above ground) �_in. FROM WELL LOG AT INSPECT ON Date of test `L O v%2 3�i '3 Static water level I 1 3 ft. // ft. Well production /D g.p.m. 9-1), m* WATER SAMPLE RESULTS: Coliform _4colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material g * r Date installed 1/0-3 Tank size f 7.�� 0 gal. Number of Compartments 'L— Cleanouts (YIN) - Foundation cleannnit (YIN)--,.,(— Depression over tank (YIN) High water alarm (YIN) Date of pumping 2 2 Pumper Q ruu k d. 44,,., C. ABSORPTION FIELD DATA j Date installed Soil rating (g.p.d./ft' or ft /bdrm) 0, 4;_ System type R e o+ Length - 12 ft. Width / IF ft. Gravel below pipe 0"5—ft. Total depth `� Sft. Eff. absorption area Ljkfe Monitoring tube Y Depression over field Date of adequacy test `� j�3/er 3 Results (Pass/Fail) P c, 6 5 For _�L bedrooms Fluid depth in absorption field before test Q in. Water added r7 d +gal. . New depth in. Elapsed Time: ?-q0 min. Final fluid depth 4— in. Absorption rate >= D D F g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) .4 vl If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump ofr Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot / Ot ' - - Absorption field on lot / U o' 4 - Public sewer main N Sewer /septic service line z �� Animal containment areas /U 8` SEPTIC/HOLDING TANK ON LOT TO: r Building foundation r Property line `S / � Absorption field 5 - water Water main Water service line I D d-. Surface water Wells on adjacent lots ( 0 0 t E— in. High water alarm level at Meets alarm & circuit requirements? in. r On adjacent lots 10 0 On adjacent lots to d r t! - Public sewer manholetcleanout n/ _ Holding tank W . Manure/animal excrete storage areas V 0 ` ABSORPTION FIELD ON LOT TO: Property line L9' 4 Building foundation 10 f c Water Service line (C) 4- Surface water /,) D >L Curtain drain `Z gT 4— Wells on adjacent lots 10 mil QV-- 'T, (�t, F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelinespin effect on this date. Engineer's Printed Name Ik/1 r- la V WLAA Cter0F Date — ?7 COSA brown sheet_10-10-12.doc /do Water main /V r Driveway, parking/vehida storage ! l7 �.OF Ajgs,! MICHAEL N. ANDERSON - . CE -9469. .•a`�. Jan 19 05 02:25p Jeff Patterson 907-696-3467 p.2 PLOT PLAN -,.- AS BUILT X SCALE --1L = 40' GRID SE 703 Project No. 04-220 Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) $22-4625 Fax 400000 www.langsurvw"rs.corn / infoOlongsurveyors.aom herebycern that I have su • •_.......... '• h rveyed the following described properly: SjryQ LOT 8. BLOCK 5, NORTH SLOPE SUBDIVISION, No. 2 (PLAT No. 73-17) d(�. Anchorage Recording DlsMct. Alaska, and that the Improvements situated thereon arm D * . 49-113 wffhin t•'•��thep................. ......:..... no Improvements on the property lying adjacent lhersto encroach on the surveyed property plies and do not encroach onto the Properly adjacent thereto. that A �D7 0•• promises and that there are no roadways, tmnsmieston lines or other visible easements on said Property except as indicated hereon. Q KENNETH C.••LAN ...0 n Dafed this the 6 Day of mil. Zcf> a! Anchorage, Alaska 15-5202 G _�.. o It Is the responstblifty of the owner to delermins IM existence of arry easements. MAILcovenants. or, restrictions which do not appear on the recorded subdMilon plat. pMo rr)�Municipality of Anchorage . bevelopmejit,Seniice"s Department - `. Building Safety Division ' On -Site Water 3 Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519650 www.cl.anchorage.ak us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. Dez 5_ HAA# 6 1. GENERAL INFORMATION Expiration Date: —,q 12L, Io S Complete legal description Location (site address or directions) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address 31001 SAGWON AVENUE • EAGLE cnE AK 99577 JEFF PATfERSON Day phone 441-1115 31001 SAGWON AVENUE * EAGLE RIVER AK 99577 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Water Storage • a ❑ Individual On-site 0 Community Class Well ❑ Individual Holding tank ❑ Water System El Community On-site El Public Sewer11 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 samples. (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, 1 verify that my Investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the onsite 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 onsite 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. SURE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines d Regulations. The reported results described 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 soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for Me sole benefit of the owner listed above. Any reliance upon or use of this report by any other person orparty Is not outhorizad, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Phone 337-6179 Date Approved for bedrooms.\\`lktP���Y OF'���rr Disapproved.`\�G '�.• •.� �y Conditional approval for bedrooms, with the following stipulaj lg-: ON-SITE • • "G) WATER AND ; �^ PROGRAM : Attachments: HAA Checklist Septic System Advisory Well Flow Advisory By: (R«. 1201) Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: � Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519650 www.ckanchorage.ak.us (907) 343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: NORTH SLOPE SUBDIVISION i2• LOT B. BLOCKS 1 Parcel ID: A. WELL DATA Well type PMTE K A, B, or C provide PWSID# NIA Data completed 6/22/2004 Sanitary seal (YM) YES Total depth 181 ft. Cased to 175 ft. FROM WELL LOG Data of test 6/22/2004 Static water level 113 ft. Well production 10+ g.p.m. WATER SAMPLE RESULTS: Coliform ._0 colonies/100 ml. Nitrate 0150 mgJL. Well Log (YM) YES Wires property protected (YM) YES Casing height (above ground) 24 in. AT INSPECTION Other bacterla 0 colonies/100 ml. Arsenic: N/A mg./L. Date of sample: 10/25/04 Collectedby: GEG. Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date Installed 9/2003 Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (YM) YES Depression over tank (YM) NO Date of pumping NEW Pumper Cleanouts (Y/N) YES High water alarm (YM) N/A C. ABSORPTION FIELD DATA Date installed 9/2003 Soil rallng.pA fttbdnn) 0_5 System type DUAL BED 124' TOTAL Length 62/62 ft. Width 11/11 ft. Gravel below pipe 0.5/0.5 ft. Total depth 04-5 ft. Eff. absorption area 1364 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fall) — Fluid depth In absorption field before test _ in. Water added _gal. Elapsed Time: _ min. Fhal For 4 bedrooms rate >= g.p.d. (past 12 mo.) (YM & type) If yes, give date D. UFT STATION Date installed Size in gallons 'Pump on' level at _in. E. SEPARATION DISTANCES High water alar level at in. Cycles tested Meets alarm 3 circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/ ift station on lot 1001+ On adjacent kits 100'+ Absorption field on lot 1000+ On adjacent lots 1001+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Budding foundation 5'+ Property line 51+ Absorption field 5'+ Water main N/A Water service line 101+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 101+ Surface water 100'+ Driveway. parkinglvehide storage 10'+ Curtain drain •25'+ Wells on adjacent lots 100'+ F. COMMENTS O. ENGINEER'S CERTIFICATION I certify that I have determined through field inspedlons and *'. „ .;�• ,;. review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effed on this date. , .. ............. Engineer's Printed Name JEFFREY GARNfSS HAA Fee E !i% 5_ Date of Payment 9{Lly Receipt Number♦r�.— MW. 12MI) Waiver Fee $ Date of Payment Receipt Number