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THOMAS L BOYLE BLK 1 LT 6A
Thomas L 0 Boyle Block 1 Lot 6A #015-282-03 " Municipality of Anchorage Development Services Department J. Building Safety Division ,... On -Site Water and Wastewater Program, 4700 S. Bmgaw SL P.O. Boz 196650 Anchorage, AK 99519-6650 Page I Of 3 www.ci.anchorage.ak.us (907)343.7904 ON-SITE WASTEWATERDISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number: -/ PIDNumber. 0I5- Pgv?-03 Nan,*:Naa. Por, n oG Wastewater System: []New Upgrade Adtra e. Lan f 7Q/1G�0� g`J7� n✓1`�a� / ABSORPTION FIELD plwnr 3 }� O ^ �p� Kwa NBedn=a' •Jl_ XUU O D pTnndt �sNao. Tnan 1 0 Bad O Maaq D Dear LEGAL DESCRIPTION sol Rating: • P ,F Ta Dept, from ori grace: I•� I� Ft B,ocle La subngNabn[ Tho."., 5 Dopm b ppe bodge Yam atpW grad - GnN depN bYradt pp.: L 0 Ft. Ft TdwnYdD: Range: Sacan r FA added aan W.VW pada \ O t. Ei, M Lange[ O 570Ft. Well: ❑ New ❑ Upgrade Dra.al aeddc Nc Qfkwv I D.atancailt* eenlnea: I -/ Ft. FL Ctasificaticn (Pnitate, A B t, TqY Dpac Cafad Taal aUfapnai vaa: //�) 0V D Mma(n* S 093 Q G / / Q�e Fl Fe 1M DMar. Oe StaticWYY LaM r t Dais astaoant 7 Ft r»'d: Pump so acHalla Qma G and YANK CPM FL n SEPARATION DISTANCES KSeptic ❑ Hokling ❑ S.T.E.P. ❑ Other. To From Septic Tank Absorption Lift Station Holding Tank Pubnc?dvat Seav Line ' `t'a'V a 1 e mIC//F.'�^ - / ,s eaDa�'i I OD Cal. VIVA 1 7L fFiiiee�ldd 981 ..�� � ��-F" Mafanat O /�L.— Y Num[arN ComFamcenla: 1ll�at O'C] Safacewa:ar ( t- LIFT STATION LN Lu,a 6aL V 5.x�K ia1 Faxkatien 1 1 / �wM'Im1c •Y .. N6n water Yarm at, V (J �J „ h Perp Mated Eldw" L+apacacna PHfamad by. Curtain Drain OnG n Ramar'ax BENCH MARK L=awn aro Daar;trn gac Q%of T resho%I Aga✓ed E a.Ccn IOD FL Ui All 'Alt E Road, No. 17034 Eagle River Looe M Inspections Dates: 1 0�" -63 performed by:Eagle River, Alask&49577— 1 2 A D -7-o3 I, e i ROBERT G COWAN j Development Services Department ApprovalcE-Blot J f Reviewed and approved b Date: 3 - 3 - 03 +� r (t J "' "• PERMIT NO. SW020489 PACE 2 OF 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAL LOT 6A, BLOCK 1, BOYLE S/D P.I.D. NO. 015-282-03 LOT 4B I I I I I LOT 5 100WELL RADIUS i I B I 1 CCK i LOT 5A wl TZ w1T1 C01 100' WELL RADIUS �� m v1Q� Tem iscla"= '• \T1 ST2 v DV (DIVERTER VALVE) . �T DBL, . _ . NEW 1 300 GALLON '�� _ •� E °•_�•�•�.�/•� 4 HDPE SEPTIC TANK " / i PAVED DRIVEWAY N I I Q 100' WELL RADIUS I IZ W IIJ 100' WELL RADIUS (APPROX. LOCATION) LOT 5B IW o'Q LOT 6B BLALF. ' ` D°' I SAR / I EA f } ROBERT C. COWAN *,27 ?. g•:� CE -8801 � V ��1(r`•'T I 1 ;� r PERMIT NO. SW020489 PAGE 3 OF 3 Municipalit of Anchoraqe DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 6A, BLOCK 1, BOYLE S/D P.I.O. NO. 015-282-03 S ST2 98.2' FINAL GRADE -/2" INSULATION NEW 94.0' 1300 GALLON POLYETHYLENE 93.7' SEPTIC TANK A B CO1 FCO 11.0 81.0 --T8 �O STI 29.O' CO2 MTl COI = 94.7' ST2 32.0 78.0 CO2 = 97.2' TMT 29.5 81.5 DBL1 3 4.5 78.5 FINAL GRADE DBL2 35.5 78.5 DV 1 39.5 79.0 2" INSULATION C01 1 99.0 104.0 MT1 109.0 97.0 Col= 88.5' CO2 1 130.5 94.5 - R 0.CO2 = E 88.7' MTI = 84.7' N. T. S. n A r.'+, NO WATER FOUND 77.7' B.O.H. rl 4 ? 4 ROBERT C. COWAN �Q 1. c3 y CE -8801 r�i• fi tlti, `�/., .... MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW020489 Uegai Description: THOMAS L BOYLE BLK 1 LT .6A r Design Engineer. 0003 S & S Engineering Owner Name: Ron Mock Owner Address: 11800 CANGE STREET ANCHORAGE, AK 99516-2029 Date Issued: Dec 19, 2002 Expiration Date: Dec 19, 2003 Parcel ID: 015-282-03 Site Address: 011800 CANGE ST Lot Size: 46200 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. 0 Disposal Field Z Septic Tank Holding Tank El Privy F] Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Z Date: /3-/7-o /0 'Z Date: OQ Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Sl. P.O. Box 196650 Anchorage, AK 99519-6650 www.cf.anchorage.ak.us (907) 343-7904 Parcel I.D. ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 01S-av-).-03 Permit Number SWO204B Property owner(s) Ro f✓ iy o 6' K Day phone 3'15- -6 S o 3 Mailing address (1) 11 4 0 0 c -L1 ot-4- 57 -- Mailing i Mailing address (2) Atj r�d e M(-# PC f /q S l Ln Zip Code Legal description (Lot, Block & Sub'd.) L C+ a, 8b 6� Legal description (Section, Township & Range) Lot Size `7 Qon cre 6D THIS APPLICATION IS FOR: Number of Bedrooms `7' Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade R 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. Z. (Signature of property owner or authorized agent) v• Permit Fees: wo, Waiver Fees: S & S ENGINEERING 17034 Eagle River Loop Read No. 204 Date of Payment: I Xj 7( /0;. Date of Payment: Receipt Number: 02 Cl 1 9 o - Rect:ipt Number: (Rev. 12100) ROBERT C. COWAN, P.E. ROBERTA. SHAFER PE. CML ENGINEERS (907) 694-2979 FAX(907)694.1211 December 12, 2002 WEXTHRHMN AULS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWER &WATER MHN EXTENSIONS REFERENCE: Lot 6A, Block 1, Boyle Subdivision SEWER& WATER MPECRON It is requested that you issue a permit to upgrade the septic system serving the existing 4 bedroom dwelling on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of ENGINEERMSTUMS AWREPM3 the test hole is located on the attached site plan. At the time of excavation 12/9/02 no water was found. After monitoring, ground water was not found. I WELLOrPECWe do not anticipate any adverse effects on neighboring wells, septic systems, reserve &FLOWTEST areas or drainage patterns by the installation of the proposed septic systema The construction of this system will not prevent any future development on any of the adjacent properties. STE PLANS If you require additional information, please contact us. Sincerely, ROAOOESIGN V2' Zt.,7,- WILIEST Robert C. Cowan, P.E. RCC/bjj Enclosure PERCOLATION TEST STRLCTURAL& 1 MECHAWAL , HSPECTIONS CN SITE WASTEWATER DMPOS&SISTEM OESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 1" = 40' n�> 1^ - s O zfz �o Cyt ¢xu OFew yun Ul w 10' CEA __ EASEMENT L-1 C) DESIGN I SITE—PLAN m C l -J neo b m a 9;4 "OA> ��2$2 •O �JJ tl-n 0) N A d O O O — r s � � O % on n O C)v'nvm m m m c" ins \..V/ F-3 � '-7 ; ^> — � D.y =ung m C l -J neo b m a 0 4 8f/OT\` "__�DUSEDM d !sj n -Ai �a SJ• �JJ 0) N A d O O O — cZ �3 n \�v� c" r, \..V/ 9 — O X Ln N� O O __0-0.0 r0 s� O�CO or fir^ m <•-i-v- or >� 00 p \„ .., r� DZ mr�A +�.\4 (1 0 0 o�n MO � A .- iI . n m_y �O D < �7N3j Zv m m mwOy O � D-• Dr y !•1 � 0 4 8f/OT\` "__�DUSEDM d !sj n -Ai �a SJ• 0) N A d O O O — s �3 \�v� r, Ln __0-0.0 00 p \„ .., +7 Q v . n m m r O � D-• '-3 o V a L N I � N O � v !sj n -Ai �a SJ• Municipality of Anchorage C `(F,IYGINEER' ,L7 ft Development Services Department NO Building Safety Division �•• •••••• 4 ail On -Site Water and Wastewater Program ••---•- 47CO South Bragaw SL .a4y R BERT G COWAN ! Q P.O. Box 196650 Anchorage. AK 99519-6650+// �C�•ti CE - 8801 / vnvw d 7) 343.7ce.ak.us /t+f ••••- - -• / O' (907)333.7904 + �„ Soils Log - Percolation Test Performed For. A r 4 k4 0 e K Date Performed: LegalDescription:%a7 (,R BLOeK 1 QOyLL Township, Range,Secticn: Sime Site Plan 1 COMMENTS /2- ESCCUN RED? - Depth to Water S 3- 3- .._ L 0 $ 4- 4- 5- 5- 10bnmorinR7 aL% E 6-L 6-��/ LL7 S 7-0 8 r7/1 •, .7-0 0 3 ..' 10- f I 337 11. ',• i s„ 12- �•IJA/L S MJsr 13- r SRu() 14- riy„ S-" 15-�",' 16- _ 17- ' 18H 1s20 - WASCROLNOVIAMR 1'0 ESCCUN RED? +7� Depth to Water S IF YES, AT WHAT DEPTIV .._ L 0 Depth to Water Ager p 10bnmorinR7 aL% E Date: AlLL1-L Reading Date Gross Time Net Time Depth to Water Not Drop 1 nl r7/1 •, .7-0 I AO,• o ,• r Y>. I 337 I yO 3/y., s„ I y3 .. ly 0 I /D y „ Jr of riy„ S-" o F-cRCCLATICN RATE ck p+'nan5x+) F= -RC F:CL E DIA:.!ETE:Z TEST PVN 6ETh'EEti 10 FT AND /a- FT S 3 S ENGINEERING PERFORMED 817034 Ewb Rivor Loop Rad No. 404 I CERTIFY THAT THIS TEST WAS PERFORMED lW(i'RWW,:Alakk"5777AT= ASD h!Uf7ICIPAL GUIDELINES CI EFFcCT ON Tr.:S DATE. DATE: / I / 1 e t ROBERT C. COWAN. P.E. ROBERTA. SHAFER, P.E. CMLENGINEERS (907)694-2979 FAX(907)694-1211 AWHORITY FICY&S ON-SITE WASTEWATER DISPOSAL SVSTEDI CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWERBWATER IAM EXTENSIONS REFERENCE: Lot 6A, Block 1, Boyle Subdivision December 12, 2002 SEWERS WATER INSPECTION GENERAL: p�MP1�✓�-7 CAvJliirG 'L ABRwDUNMt«r 1. The scope of this project includes the A.• _ of the existing 1000 gallon °ro°REEPCRTS 0�g septic tank, installation of a new 1300 gallon IIDPE septic tank, and installation of a trench to serve the existing four bedroom residence located on the referenced property. a LOWTTEST 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. SITE PIANS 3. The contractor shall be responsible for obtaining any necessary underground utility locates. ROADDESICN 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. SOIL TEST 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal °ERCCLAT10N Health Department. P TEST SEPTIC TANK INSTALLATION: STRLCnJR&A MECNANIOAL INSPECTIONS 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. CNSITE WASTEWATER OISPo6ALSYSTEM DESIGN 17034 NORTH EAGLE RNEn LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 Page 2 Lot 6A, Block 1, Boyle Subdivision December 12, 2002 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 R. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCIIIDIZAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page 3 Lot GA, Block 1, Boyle Subdivision December 12, 2002 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (IIDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam III or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leach6eld gravel layer and the native soil backfill. 6. All leach6eld gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the 4200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. Page 4 Lot 6A, Block 1, Boyle Subdivision December 12, 2002 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted ager the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER �..� MUNICIPALITY OF ANCHORAGE DE ITMENT OF HEALTH AND HUMAN SER FS 0 / r :)L$ A 03 „ Environmental Health Division 825 ••L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name RoN MOCK DISTANCES TO FROM SEPTIC TANK ABSORPTION FIELD WELL Address // gOO �NGE WELL 10/, If /215 Phones) 345- 0803 permit No 870/7/ No of Bedrooms THREE, LOT LINE �O 45' 10, LEGAL DESCRIPTION Lot (oA Mots I SuDdwlslon BDY� FOUNDATION 5 a 2.51 %0 township, Range. Section 5 21 T12-N R 3W AS-BUILT DIAGRAM (Snow location of wen, septic system, property lines, foundation. duveway. wale Doges.s. etc I TANKS ❑ SEPTIC ❑ HOLDING Manulaclorer capacity In ga ions Material No, of compartments TYPE OF SYSTEM ❑ TRENCH X BED ❑ W. DRAIN ❑ OTHER (+Y ) Depth to' DiDe bOIIUm bom --/ ongmal grade 7 5- FT total Depth from onginal grade FT eic L 500D - Uri/ 3 1 D I • B qct nmr Fal adoed acove original fl'adv •5 FT Glavetlepin Deeam pipe -5 FT Gravel leng:n 36 FT Gravel Pi 193 FT Total absorption area X84 SOFT Distance between lines to FT ° el 4 Pne TAN ', _ ' NUMW of hors 3 Sal rating 125 SO FT Pipe material PN/C InFtaller SA N D LA ND pN ST: CONS Date lnstaued 7 _2 1 87 WELLS ❑ PRIVATE ❑ OTHER (Identify) ' (.IessA�calwn tA.b.LI lotai D¢plh FT cases to FT Q ' IL- A B C D Inataurl Date Installed . I — (X 13' 3q' REMARKS: n5 B B91tel t EXIST L0 CRIB REMOVED. G 73 'a — 141l D 39 55 42' - !� ./� DVtJV W [TO ItJ RaH7✓ �5 GPmoo Scale: J s O Inspe/c�D/onPe lormeD^b/y__�a Date. '714/07.s : _: v`u� ` '•c"�-+d� w •'a' , 1 ''; ,g-Fla v zc. �+ '% 'DDIe R. M rot/ • •• , d s '•, No. 2055•E •' !� 0 . � Fo •......•;,ate _ . i` No E\11DEr1GE OF WINTM A fE -�m 0 rrSTrwon0 'role w 15F I Wily that this inspection was performed according to all - M1 clpal and State guidelines in ell Lt on this date: Health Department Approval: Date. 72.013 (3,85) PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: LEGAL DESCRIP: LOT SIZE: (�k, I_1U1\1 I c I FPaL I 1-Y o1= DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION S25 L STREET, ANCHORAGE, A„ 99501 264-4720 ON— I -I-EE FEWI_f::Z F='LF_-CM I -1- 070171 UPGRADE 07/14/07 PON MOCK 11500 CANGE ANCHORAGE, AK 99507 345-0003 SUBDIVISION: BOYLE LOT: 6A SECTION: 21 TOWNSHIP: 12N RANGE: 3W 46200 (SG.FT. OR ACRES) BLOCK: 1 I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. Z. I will adhere to all MOA and State of Alaska requirements for the set back: distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT: AND (3) THE ELECTRICAL WORh:: LUST DE DONE BY A LICENSED ELECTRICIAN. SIGNED�� 'Jt DATE: 7/�!,- �SI T: -��---- �'T/------------- --------------- APPLICANRON MOCK ISSUED BY Q_0 - -• DATE: ------ P'----- P'- vW" a /YSr-�%TS pT c�,.,o.....,.Qi..Ja-�l� i�a.Ow:U��..�. .tet �•....� of ;.,st.:r(�f„�.... r`, r BESSE, EPPS & POTfS ENGINEERING, PLANNING, SURVEYING SOILS LOG PERFORMED FOR: RON MOCK DATE PoyLE OUSPIVIVIoN LEGAL DESCRIPTION:_ LOT &A -, OL DM I Township, Range. Section: O T SLOPE SITE PLAN 1 2 3 a 6 6 7 6 g 10 11 12 13 14 16 16 17 18 19 20 COMMENTS PERFORMED BY: F/U Pwr MAT SILTY 5AND , 5M 5kND WITRAC54MVEL, 5P 1fLRC:TEST SAND W jQZAVEL , 5W cow, 6!W5LWrSA9D 3amrl of HOLE NO CZRDUNO WA"tt='!ZE1 -WoTmep LINE■■■fie!■■■ Ui�-G- /25 rw"10 IMIIIIIIIIIW107m IW m = ms VAWpN ffwl.WW� IIIrel WIIIIIIIIII1"W Ms�ri Ui�-G- /25 INyfACL NEW C.O. i Ibo 70 r'1 TH C• i — / I b IIY1l1IL RON.Yl�EB � I L l NW KE ca►INEcfia✓ rE>riSY: ITPe � I AND INSrALLt4Er1 G.O. / I)$" W,T TW Z 1000 GOAL :. TELL (YRIIATE) i F- 35 IuiTAU, CO 4F O D 3OJJI6 L — SCAX /",:70, I MCrrES : ALL COIJSRUCTIOIQ SHALL BE Irl ACCORDAIJCE WITH DHEP rmmIT cn►.I- DCTIONS AND REGuMTION5. NO WM WfiUlhl 150'OF ftft05CO vittoEXl05. 7,`- Or 44"M�41 co : •..9 d0 dcjTu �v u. ea]. •i.. •...•µ�Mw.wi..• CareMey��• W �•.. f 53 i ala��pROFESS��NAe"'� 3 �ED�oDMrj SDl[, r1A-nNG= �Z� SF�BDwm Lc5qELr Lo -i. !'1 Pr9c, < 5 miN1iNc<I 3 ewv-pornS)4 t7-5 SFl SOrzr» = 375 SF ARP 3"l5 5F X. /.5' = 562.55r (r'EQtz'O AREA S(o2.5 5F j/s, Wr�N = 3l • 25 CE�.1CyTu �Slly� 32�� TQr.3L DEPTH 5PAU, Be 5 FEET s0774Ar i14E 6y4-5 T- 5A+J0 iniwe Ar -7 oiFLow cAN fiE UTIU2EV As THEtZeQvig6V sl -17vCN SNP LAyer,.. 5E A'i77?u1t-0 STEVO ANALy5/5. Mo 3� CW -.4r AND FROPo5EO FINiSyEt� GRA96 --rim 4r Ftp nPg ,�- 151 -;�rwvoyca-t� i 1 80. 20 10 0 100 GRAIN SIZE It: MILLIME-ERS 100 i � I 90 1 11 I } 80 } + 70 160 50 40 30 } 20 10 10 1 .1 .01 IE -03 DIAMETER 6 10% .095 DIAMETER B 30% .191 DIAMETER O BOX .343 CU- S. 573 CZaa 1. 108 I ISIEVE XPASSINC 3.0 100 2.0 100 1.5 100 1.0 100 3/4 100 1/2 99.4 3/8 98.5 W 4 97.3 w 10 95.7 I M 20 91.2 N 40 71.8 N 60 42.6 k 100 18.9 W 200 5 SAMPLE SOURCE CLASSIFICATION BOYLE SUBDIVISION SIEVE ANALYSIS SAND SP—SM AS RECEIVED 7-9-87 J M L LABORATORIES, INC. PLATE Soils and Material Laboratory BESSE. EPPS AND POTTS No.: •ppf.: Dab: 87-310.20 �m 7-10-87 0 V O S Z A Z J U W 0 D Lu z Z W 0 NiN: ..; r4:I co '+ (73n t oy.oy. 0p; 0 0a 0 `oy. oa� oa 0 { ro m b a Lu i 4) e, > ; o -al E (. w1 a : ci o vi w. La: A; L ; vH , m;ro; 0E o: royr{ : to w m m ro; I tj 6 '.j , .+c vet y: .ti ai b a W. a M:E u D i s w N rot ro Ni to a ..t, .-L—N %0 r._.:- ,.4 vi .T; m W; rt .4 V-41 i i i i l i E E F N: W t0 t f 'T. 00: Ni t4 •-t; N; .0-0 i M; N t- to O S LN . U M � z to U q vFi Q C7 NiN: ..; r4:I co '+ (73n t oy.oy. 0p; 0 0a 0 `oy. oa� oa 0 { ro m b a Lu i 4) e, > ; o -al E (. w1 a : ci o vi w. La: A; L ; vH , m;ro; 0E o: royr{ : to w m m ro; I tj 6 '.j , .+c vet y: .ti ai b a W. a M:E u D i s w N rot ro Ni to a ..t, .-L—N %0 r._.:- ,.4 vi .T; m W; rt .4 V-41 i i i i l i E E F N: W t0 t f 'T. 00: Ni t4 •-t; N; .0-0 i M; N t- to O S LN . U M ,I TO I R On'siTs SiiU/'�oS L M 82S L • �� iI SUBJECT /r> ��Y %��� /�.. _ S �/% DATE MESSAGE/,,•� 100, a 1 1;. SIGNED i�� C u(n f� p j REPLY I a i r; i p p, SIGNED DATE r _ _.. ._ _. ._...__._ ._...., r a i i• 4S 472 SEND ARTS 1 AND J INTACT REPLY. carbaniess POLY PAK (50 SETSI AP472 PART � WILL RE RETURNED WITHRFWITX DETACH AND FILE FOR FOLLOW-UP GRE' cR ANCHORAGE AREA B01 "IGH y NDN' il�C a Department of Environmental Quality ; b pr9a tl 3330 C Street rlb UFy Anchorage, Alaska 99503 16, n r INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEMAl, A4 d NAME eu.eTCS AYOC/C- MAILING ADDRESS Sn22, ��% PHONE 6t O 42'e- LOCATIONP/Cfr AnClT</P 65- 0/M'0u EL. LEGAL DESCRIPTION SEPTIC TANK: CA/ Lo7- (5 A DISTANCE go/ f- FA,s CA L W /S,�---L NUMBER OF / FROM WELL MANUFACTURER STt-sz MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH 1 IQUID CAPACITY GALLONS. SEEPAGE PIT: / NUMBER OF PITS DIAMETER OR WIDTH LZ LENGTHZy DEPTH LINING MATERIAL 4f Zoo S CRIB SIZE: DIAMETER —DEPTH 6 /DISTANCE FROM: WELL C./TOTAL EFFECTIVE BUILDING FOUNDATION � / /, NEAREST LOT LINE ZO . ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION AS4 C Sdc TUT Wl i_ 0A1 LOT 649 SEW t)CS— / �°) - /�o w/ /J L O %/O Com. WELL: ti.rr� L i ✓ . TYPE 5FA4/ /u 6C /Q. CONSTRUCTIONC'A'<-O ��A DEPTH DISTANCE FROM: Qt°ser T G3[oscdT BUILDING C-- NEAREST /f- NEARESTC� SEPTIC SEEPAGE FOUNDATION LOT LINE Z0 SEWER LINE //O TANK 41 S/, SYSTEM /?n r 49A CESSPOOL OTHER SOURCES APPROVED 241-, DISAPPROVED REMARKS Ste- Z6T7E/L DISTANCES: 4-G /20Ar DIAGRAM OF SYSTEM B -C bg� rr0 / INSTALLED BY: SEcG PIPE MATERIAL: C4sr Z-od , TRAnIS/>E Bc7u/Pr's✓ LOT SLOPE: Tn 20C17- , REMARKS: Form No. E0,031 G.A.A.B. %A GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 •'C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMIT NO. SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT C, F 1."S 110C MAILING ADDRESS PHONE INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK T4E AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOILREST RESULTS COMPLETION DATE ANTICIPATEC TO BE INSTALLED BY FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE E AREA SIZE /?ALK W/%j) tp'CTV E MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT �y DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL /!5' / / r SEPTIC TANK 5 SEEPAGE PIT DRAIN FIELD TO NEAREST L T LINE. WELL TO S 6E fCIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA ^WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT / C r DRAIN FIELD f,=�n � F SEPTIC TANK. SEEPAGE PIT OD DRAIN FIELD TO RIVER,/LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO B;z;G.A:A.;B NSTALLATION. OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.66 AND THAT THE ABOVE DESCRII/B/6D SYSTEM ISIN ACN ACCORDANCE WITH SAID CODE. /" " 3 APPLICANT'S SIGNATURE FORM NO. EG -016 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Case # 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For Cur hs' moc'L Dated Performed 121 -?l �3 Legal Description: Lot__L_Block�( -#Q Subdivision _x3e,iJe This Form Reports Soils Log X Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics 2- -t.� =d.� 3— q—�s- 5— 6— 7— 10— 11— 12— 13— 14— Was Ground Water Encountered? yy If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H2O Net Drop rercuidilon Kate minuLe Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom o Pit or TrenclF COMMENTS: / 9't-- ---r— Test Performed BY ctA.a. S_ Date Certified BY: Date: r. /rJ� �]�j.e�—� r v�l� '' l / � / r'�l� yl � 7� �1�" �✓��.L-t,.rt� . 41, 11 ti January 14, 1974 IV Leo Eddington S.R.A. Box 15495 Anchorage, Alaska 99507 Re: lot 6A. Block 1. Boyle Subdivtsio Dear Nr. Eddington: Ms office has inspected the on-site sewage system and well at the subject property and found them satisfactory for temporary approval until June 30, 1974. At that time, per previous in- structions stated in the encloded letter dated June 30, 19739 upgrading will be required. If you have any questions regarding this please contact me at 274-4561. extension 142. Sincerely, William Bouwens. Environmental Control officer WD/ko Enclosure G JL� • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Parcel I.D. 015-282-03 Certificate of On -Site Systems Approval Expiration Date: ✓� 1 J 1. GENERAL INFORMATION Complete legal description Thomas L. Boyle, Block 1, Lot 6A Location (site address) 11800 Cange Street Anchorage, AK 99516 Current Property owner(s) Mickey Sleeper Day phone Mailing address 800 E. Dimond Blvd. #3-131 Anchorage, AK 99515 Real Estate Agent 2. TYPE OF DWELLING: Rx Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four Day phone _ 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Q Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by:� Date` fv �3 COSA to be released to thf enginger, unless otherWise requested by the engineer. COSA Fee $ 5240 Date of Payment Receipt Number 0951% COSA# 05C1,1180. Waiver Fee $ _ Date of Payment Receipt Number _ Waiver # WWI NT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 6/24/2015 „ agar _ 6. DSD SIGNATURE ,[�0NrtARCr,C.MOM / �,;MICHAEL E. ANDERSON V System #1 Approved for bedrooms No. CE -4361 ; System #2 Approved for bedrooms �I Fido •..e .23„5 Disapproved Conditional approval for bedrooms, with the following stipulations: By: GL/ G Original Certificate Date: �P ' � 3 Z � The ni li ofc age 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAblussheetr'- 1, c If more than 1 septic system is on the lot: COSA Checklist # of " Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Thomas L. Boyle, Block 1, Lot 6A A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 4/22/79 Sanitary seal (YIN) Y Total depth 182 ft. Cased to 182 ft. FROM WELL LOG Date of test 4/22/79 Static water level 110 Well production WATER SAMPLE RESULTS: 10 Coliform 0 colonies/100 mL Nitrate Arsenic ND ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/HDPE Tanksize 1,300 gal. Foundation cleanout (Y/N) Y Date of pumping 6/24/15 C. ABSORPTION FIELD DATA Parcel ID: 015-282-03 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 6/20/15 ft. 103 ft. 9.p -m. 6.0 g.p.m. .158 mg/L 6/1/15 Collected by: Anderson Engrg. Date installed 2/7/03 Number of Compartments 2 Cleanouts (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Pumper Around the Clock Pumping Date installed 2/7/03 Soil rating (g.p.d./ftz or ft2/bdrm) 1.2 GPD/SF System type 5' ode Length 50 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 12 ft. Eff. absorption area 500 ftZ Monitoring tube Y Depression over field N Date of adequacy test 6/20/15 Results Pass/Fail Pass 4. ( ) For _ bedrooms Fluid depth in absorption field before test 6 in. Water added 953 gal. New depth 19 in. Elapsed Time: 1,440 min. Final fluid depth 6 in. Absorption rate , 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N if yes, give date D. LIFT STATION No Add On Manhole - Gravity Flow to Absorption Trench. Date installed Size in gallons _ "Pump on" level at in. "Pump off' level at Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot > 100' Public sewer main >75' Sewer /septic service line >25' Animal containment areas >50' SEPTIC/HOLDING TANK ON LOT TO: >5' Building foundation Property line >5l Water main >10' Water service line >10 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10, Building foundation >10' Water Service line >10' Surface water >100, Manhole/Access (Y/N) in. High water alarm level at in. _ Meets alarm & circuit requirements? On adjacent lots >100' On adjacent lots >100' Public sewer manhole/cleanout _ Holding tank >75' >100' Manure/animal excrete storage areas >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 6/24/2015 COSA brown sheet 1D-10.12.doc Absorption field >51 Surface water >100' Water main >10' Driveway, parking/vehicle storage 0' e Municipality of Anchorage O • Development Services Department Building Safety Division =:•• _' ;'= On -Site Water and Wastewater Program 4700 South Eragaw St. P.O. Eox 196650 Anchorage, AK 59579-6650 www.ci.anchoraoe.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 01 — 3 5 3- C 3r�,� HAA # _ %1 H"h CJD 71 Expiration Date: 1. GENERAL INFORMATION Complete legal description Lc T 6,4 8 LC GK f 13 p y L f- 1 �� Location (site address or directions) 11500 C.A.+ C— f- S:. Current Property owner(s) 0 C nl MO CK Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address _))TCL C-,4-vC=#- sj'. . , 19Nci,444Ct.ffa CrS'/G Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 3 A/,P y 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 9 Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well Q Community On-site ❑ Public Water System ❑ 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 d 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 betNeen 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 C:ass C Weil 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.) Cenincates are valid for one year for properties served by Class A or S wells or a public 'Nater system. The Municipality of Anchorage is net responsible for errors or omissions in, the prcfessicnai engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm 5& 5 ENGINEERING Phone 6 c H 3 9 7 Address Eagle River, Alaska 99577 Engineer's Printed Name Fi 4o ,f r C- C o w4,./ Date a 1a 6 /c 3 RC25RT C. COWAN S. DSD SIGNATURE �`�c,;.� CE -3201 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments WATER AND • in: WASTEWATER : Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Ey: % / `. Oricinal Certificate Date: (Rev. 01N2) Municipality of Anchorage Development Services Department Building Safety Division OnSlts Water & Wastewater Program . 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT 64 &K I & yt. t. S/D Parcel ID: QI S - a 8 -03 A. WELL DATA Well type pR"V*iC If A, B, or C provide PWSID # = Well Log(j9N) -YC J Date completed H t 1471 Sanitary seal &N) -Y—f- J Wires properly protected&N) YL I Total depth -L%2:3. Cased to y0+ ft Casing height (above ground) I a 3 in. Date of test Static water level Weil production FROM WELL LOG q/1 I. /-7c) WATER SAMPLE RESULTS: 11 O ft. 104- 9— p.m- Coliform colonies1100 ml. Nitrate 0-0101 mg./I. Arsenic: Date of sample: J1017/03 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPT' 4 / YD PE Tank size 1300 gal. Number of Compartments AT INSPECTION 10 a ft S g.p.m. Other bacteria I coloniesl100 ml. Collected by: S & S ENGINEERING 17034 Eplo River Leep Road No. 204 Eapio Rlwr, Alaska 99377 Date installed a- / 7/ C 3 CleanoutsON) yE J Foundation cleanout &N) Y6J Depression over tank (YO N o High water alarm (Ya N t7 Date of pumping N /a - N C W Pumper C. ABSORPTION FIELD DATA Date installed :070 3 .SFl4 �� �✓ Soil rating (g..d.lftz or flz/bdrm) f!_a System type 744N c r/ Length 5'0 ft. Width S R Gravel below pipe ft. Total depth IDL ft. Eff. absorption area SO 0 f Monitoring tube *5 Depression Depression over field u O Date of adequacy test JVJ,4 N4 W Results (Pass/Fail) For --t bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Fina depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatmen st 12 mo.) (Y!N & type) If yes, give date D. UFT STATION Date Installed 'Pump on' level at _ in. Size in gallons 'Pump off level at _ in. Manhole/Access (YIN) at in. Datum es Meets alarm & circuit requirements? E. S ION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanWilft station on lot 11-7 On adjacent lots ) O C 4 - r. Absorption field on lot ) S Public sewer main N A# Sewer /septic service line a S -A- On adjacent lots / O O �4 Public sewer manhole%leanout _ Holding tank A)1A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ) $ Property line G a Absorption fiel Water main A/ 1A Water service line )o4 Surface water Wells on adjacent lots / 00 '4 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line l x Building foundation 'if'� Water main A//A /00 4 W /A Water Service line JO f Surface water /DID f Driveway, parkirVNehicle storage i Curtain drain N'—'t KN4'#-/ Wells on adjacent lots /00 { F. COMMENTS 0r /it G. ENGINEER'S CERTIFICATION t �,�` cjL–✓ .�. 1 certNy that 1 have determined through field inspections and review of Municipal records that the above systems are in M f' conformance with MOA HAA guidelines in effect on this date. as Q ROB c, 1 Engineer's Printed Name Q1-4 J– C. Gw'4^/ Date HAA Fee $3 i S • Waiver Fee $ Date of Payment xz 3.7 0 7 Data of Payment Receipt Number 3 g 3 J, Receipt Number (Rev. 12101) 12- 5-02; 2:53PM; CTAE Environmental Services Inc. AL W�...... w WOR.. - CP&E Ret.0 1028101001 Cllent Name S & S Engineering Project Name/q Lot 6A Blk 1 Boyle SID Client Sample ID Lot 6A Blk 1 Boyle S/D Matrix Drinking Water PWSID 0 Sample Rcmarks: :907 5615301 0 2/ 3 All Dates rimes are Alaska Standard Time Printed Daterrimic 12/05/2002 14:16 Collected Date/Time 11/272002 12:00 Received Date/Time 11272002 13:50 Tethned Stephe 7..Ede Released y Allowable Prep Analysis Parameter Rnalo PQL Units Method Limits Date Date Init Waters Department Nitrate•N Microbiology Laboratory 'total Coliform 0.201 0.200 mg/L EPA 300.0 (<-10) 1127/02 JS I OB, No Coli col/100m], SM18 9222B («1) 11/27102 IUP cn ' D N 00006'00'W 165.00' (R) e—d dd o PW R. UNE i a -Ni A O I y 'V m N Nm .KyyK.. T O �r D O O v 0 a O TR B— I Nco 4 g A M / vC SI • O CO ®mi g� R 0,00* X `rte �• o � � b P. 67.6 29.1"' Ek/STING r� — 40.8' zto• $ r HOUSE •nC N k • PokM b hx!' 1. m O m x rar v4* -4 -4:0'' 0D 0 V) 2 y A iri 2 n A0 s t\ pN31�x— x N 00-06-00•W 165.00' (R) a O TR B— I CANGE STREET 00 r mO� m N D p n� o�onm omm ^' 0 A -I NW N J u J v+ p p C r m OOn 3N ON mOOm f7n SO AV L i �^ O m 0 l• M O v • rr 5 W r O C M '• N V I N • N �� : .00 B v s ,3 .23 O N .. n Nm«5 V :.no C/I s J O i •' O_ y N G •••V N V ro L1 V0 ry m C A A o O N A m r U 0 o m J N G O � J m OD V g g� R CANGE STREET 00 r mO� m N D p n� o�onm omm ^' 0 A -I NW N J u J v+ p p C r m OOn 3N ON mOOm f7n SO AV L i �^ O m 0 l• M O v • rr 5 W r O C M '• N V I N • N �� : .00 B v s ,3 .23 O N .. n Nm«5 V :.no C/I s J O i •' O_ y N G •••V N V ro L1 V0 ry m C A A o O N A m r U 0 o m J N G O � J m OD Po O MUNICIPALITYRACE HEAL • DEPARTMENT OF HEALTHH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # /%/�-9 ' rJ HAA # "IpleC7l - 1. GENERAL INFORMATION Complete legal description Location (site address or directions) g address :I►• 4F_',I. rig - r_ 5-0 Agent 1%OH C/ Mil PT/SLI /Rs"�7 /r ©FF/ ) Day phone'_ 3 namh Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: .3 v 3. TYPE OF WATER SUPPLY: Individual well �— Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(R.r.1/91) F„m Mo.n1 S. 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm %_ 4ZAI CL2aSU/ 7-,9rV7:S Phone t?95-&947 Address ZDD, zz3nX // / Xrirr gAezAot yy s// Engineer's signature �� 7 DaDate /22/79/ 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments M CC •a, 7604 __ - _ _-- 7777 - _ _ i'� �9 ,� -- -._ .,✓��� q.: --- -- _ bedrooms, with the following stipulations: Date 7 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given In paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. non (F1w +A,) 8+ MOAR21 r r, Municipality of Anchorage ARL Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST MOO Legal Description: LOT 6A 910Ck Z Parcel I.D. (114--, W F A. WELL DATA Well type P,?ZY_ITC If A, B. or C, attach ADEC letter. ADEC water system number N/j Log present (Y/N) Date completed 12-11PH/L /,9 760DrillerZO- V .T P Fig Total depth 18ZF7-O Cased toZ1A1"owAr-11 r1wm Casingheight ?WVCMZ-S C .'-&44 L4W677f Sanitary seat (Y/N) Wires properly protected (Y/N) WATER SAMPLE RESULTS: 47MCHCD Coliform 1 Nitrate AID Other bacteria '— Date of sample: 12DEC 9/ Collected by: .SS /-1ENSL x - B. SEPTIC/HOLDING TANK DATA 5N Date Installed 7 /zlZ-f?7 Tank size aYiti Compartments 1kA-,VQ&JA1 Cleanouts (Y/N) T Foundation cleanout (Y/N) Al Depression (Y/N) d High water alarm (Y/N) A/,d Alarm tested (Y/N) lull Date of pumping SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO' Za r Wells) on lot © On adjacent lots G Z ' Foundation AIA z r To property line �O�' Absorptionfield 4:5 -Fr Q Water main/service line AIA - Surface water/drainage McAiF �oUwD rxme(Aw. volt Fart MOA 21 CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION X 70 Date of test /? A59 2 // DEC..9/ 0 ! fi IrTI Static water level ll //� 97 Z ro P77 Well flow g.p.m. .9, 4 Z? g.p.r� q - G Pump level ��T /PEl/1u�En i/oI m 7 N r a0 !t! Citi %:v o �i SEPARATION DISTANCES FROM WELL TO: 4P Septic/holding tank on lot -- ADS PT ;On adjacent lots NONE AZYiAI0 u,/nYar /Srl r Absorption field on lot 461) rr ® ; On adjacent lots AAloeic Azymlo w,TYiv /Sor Public sewer main AIA Public sewer manhole/cleanout /t% i26, Public sewer service line _ Alla Petroleum tank AAAJF' FOuv1) WATER SAMPLE RESULTS: 47MCHCD Coliform 1 Nitrate AID Other bacteria '— Date of sample: 12DEC 9/ Collected by: .SS /-1ENSL x - B. SEPTIC/HOLDING TANK DATA 5N Date Installed 7 /zlZ-f?7 Tank size aYiti Compartments 1kA-,VQ&JA1 Cleanouts (Y/N) T Foundation cleanout (Y/N) Al Depression (Y/N) d High water alarm (Y/N) A/,d Alarm tested (Y/N) lull Date of pumping SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO' Za r Wells) on lot © On adjacent lots G Z ' Foundation AIA z r To property line �O�' Absorptionfield 4:5 -Fr Q Water main/service line AIA - Surface water/drainage McAiF �oUwD rxme(Aw. volt Fart MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Installed Size in gallons Vent (Y/N) "Pump High water alarm level Meets MOA electrical codes (Y/N)- _ Manufacturer Manhole/Access (Y/N) "Pump off" level at �ycles tested SEPARATIONJIBnNCE FROM LIFT STATION TO: On adjacent lots Surface water D. ABSORPTION FIELD DATA (D Date)nstalled .`•'-7-20 -f37 moil rating 125,5 F�60PM Stem type l�CD Le gth 3Rfr Width /8 rr Gravel thickness /tira/-ti Total depth 'Fr i Total absorption area �h'�fsA' Cleanouts present (Y/N) Y Depression over field (Y/N) // 0 Date of adequacy test Results(pass/fail) for bedrooms Peroxide treatment (Past 12 months) (Y/N) /V If yes, give date A //1 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: z /,SaGT Well on lot /IoOFT On adjacent lots �AAc-1'OUAJZ1 � 1 � Propertyline 45F7 To building foundation 400 Mo existing or abandoned system on lot lra o %cC_P_/li.P[mpu6p Mav/TDR Tup£ Onadjacentlots NOAJr Cutbank u^ Water main/service line—A/C >L' Surface water /VO.UC FOUn/6 Driveway, parking/vehicle storage area 90 F7- Curtain T Curtain drain AIA E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on Signature zzzl� 49th l�V t 01% Engineer's Name sTCt/i.'A%il/SLlrC ". ' L"t " • rr c H. T" Date /. T/SKz;U FROM MOA ONf/S F/L6'S4 ,i°p PRO Z, 741cCu F120M SZIRVC,0. Y S-(/V/Gr Mrrli TrD 3-/4-89, _NX hcN40 �.,�`\+st� 3, TU'O FCe T OG SNOW C Ov<R OVCA' T</C CRO&A40 SUR/Acc HAA Fee $ OG Waiver Fee: $ Date of Payment / /-1LX�/ % / Date of Payment Receipt Number Z9�/R Receipt Number 72-M (RM. fit) axk MOA 21 CHEMICAL & GEOLOGICAL LABORATORY t A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. y TELEPHONE (907) 562.2343 5633 B Street .. Anchorage. Alaska 99516 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM I.D. B 170 X PRIVATE WATER SYSTEM _ - Zo 6A P O AOSIC //OZ& / Mvna Acewa - .. Zy cua. SAMPLE DATE: = = .9 Mo. Day Year SAMPLE TYPE: M Routine ❑ Check Sample (for routine sample with tab ref. no: 1 ❑ Treated Water " ❑ Special Purpose ❑ Untreated Water SAMPLE Time Collected No. LOCATION Collected By 1 r4 �� 21 1 TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: �J Satisfactory /❑-' Unsatisfactory ❑ Samplo too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received S R/ Analytical Method: Membrane Filter No. of colonies1100 mf. Lab Ret. No. Result* Anal st 91-6629* m II II m l� m U m A.D.E.C. 41 )C ff BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter: Direct Count 0 colllorm/100ml BEFORE COLLECTING SAMPLE Verification: LSB BGB Fecal Coliform Confirmation Final Membrane Fitter suits coliform/100 ml Reported By Date TNTC = Too Numerous To Count 746 a.m. PART ONE OF TWO: p.m. OB = Other Bacteria REMAINDER TO -FOLLOW CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE. ALASKA 89518 TELEPHONE (907) 562.2343 FAX: (907) 561-5301 INILTSIS RESULTS for INVOICE t 41303 Chealab Ref.t 91.6629 Sample t 1 Matrix: NATER Client Sample ID : LOT 61 BLOCK 1 EOILE PNSID : OA Collected DEC 12 91 4 15:55 hrs. Received DEC 13 91 4 15:30 hre. Preserved with : 13 REQUIRED Analysis Completed DEC 16 91 Laboratory Sup PREN C. EDE Released Ey u Sso EL 'FL" Client Name :S R 1 N CONSULTANTS Client Acct :SELNCON IPOt : Regt : Ordered By :3. RENSLIE Send Reports to: 1)S I L R CONSULTINTS 2) POt :NONE RECEIVED .................................................................................................................................... Parameter Results Units Method Allowable Limits NITRITE -M ND(0.10) mg/l EPI 353.2 10 Sample ROUTINE SIMPLE COLLECTED II: S.N. Remarks: .................................................................................................................................... 1 Tuts Performed See Special Inutructions Above UA-Unatallable ND- None Detected " See Sample Remarks Above NA- Not Analyzed LT -Less Than. CT -Creator Ihan fZ%SGS Member of the SGS Group (SociM6 GAnArale de Surveillance) =1 Time . � y. Time a Data Date Date A Inspector Inspector Inspector Comments Conditional Approval �( r • •,� ^ ; Bedrooms oved Approval nn Q-�1' Date Sewer Installed Permit No. Septic Tank Size /pm0 4 X73 Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner �/r p Phone Melling Address Buyer /1-f ,ne.-%cl Address Lending Institution Phone Address Realty Co. 6 Agent Phone Address Legal Description /f / aTC, r Street Location l G 4 Type of sidence'15— Single Family 3 ❑ Multiple Family No. of Bedrooms O Other Water S ly Individual ATTACH WELL LOG. A well log Is required for all wells drilled since June ❑ Community 1975. For wells tfr IJed or to that date, give well depth (attach log if � ❑ Public Utilityavailable. �� !pr Sewage Disposal Individual Year Individual Installed ❑ Public Utility When Connected to Public Utility ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. April 27, 1982 Ronald S. Mack SRA Box 1745-11 Anchorage, All 99507 Subject: Lot G A Block. 1 Boyle Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: • The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. • The septic tank, pumped with a receipt submitted to this department. Please notify this department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 2G4-4720. Sincerely, Robert C. Pratt Associate Environmental Specialist RP89/p/En l�GREATER ANCHORAGE AREA BOROUGH �5000Department of Environmental Quality udor Road, Anchorage, Alaska 99507 279-8686 crk Date Received z/%3 1 Time of Inspects �+ Date of Inspection /Z Z REQUEST FOR APPROVAL OF giA INDIVIDUAL SEWER S WATER FACILITIES 7.S!7 w.. FOR 1. Aoproval Requested By: Address: 2. Prooertv Owner: 3. Legal Descripti 4. Location: 0 Phone:�S 7 5. Type of Facility to be Inspected: Number of Bedrooms: 6. Well Data: A. Type C. Construction 7. Sewage Disposal System: e?v�. B. Depth 4e S / D. Bacterial Analysis���t/3 A. Installed B. Installer / 41 C. Septic Tank: 1. Size 14&40 2. Manufacturer �PPflye5//��[1 Z D. Seepage Pit: 1. Size X/ 2. Material 4yr . t 10&1.6z- E. Disposal Field: Total.Lergth of Lines B. Distances: A. Well To: Septic Tank [!�S/ Absorption Area/049,., Server Lines Nearest Lot Lire D/- Other Contamination B. Foundation to Septic Tank j, Absorption Area�l� C. Absorption Area to Nearest Lot Line Z /f AW • MWE /2:i, 4 "acgjett for Approval of Ino,vidual Sewer S Water Facilities Pale Two Te,�P 9: Comments: �e,,���!f�e.�tiw—� ,Gc.�tcL�.30. /974,� /1"T Approval Valid for One Year From Date Signed r,. Greater Anchorage Area Borough, DeF.artment of Environmental Quality DIAGRAM OF SYSTEM. certify tnat the information contained in this request for approval to be a true ani accurate representation of the subject sewer and water facilities located at: Signed Date r-� 1 V/j{l/1 V - / aAlA, V4* SIR -(,f 7 June 25, 1974 Mr, Curtis Mock S.i;,A. Dox 414 AnchoraQe, Alaska 99,02 SUBJECT: Lots 6q and E6 Dear f,r, block 1. Coyle Subdivision mock.. " Following my insaccLio Puhlie Well servin n todauhlecttlots, cin nov a to any additional 9 th' otflcr. dviellings, This Weil nl Cnot" Thank you for y not 1 Your ccoperation, Sincerely, y Susan EDickerson, Sanitarian SED/ko 11 June 13, 1973 Mr. Curtis Mock SRA Box 414 Anchorage, Alaska 99502 Dear Mr. flock: Following our discussion of the use of a well on lot 60, you are hereby granted a waiver for use of the well. This waiver is granted until June 30, 1974; at that time you must provide either an individual well on lot fiA-, or correct the distance deficit from the septic tank on toter to the well. Please contact me if you have any questions on this utter. Sincerely, Susan E. Dickerson Sanitarian I lb enc. FORK Nw 91-AFFIDAVIT-CR.NERA410 STATE OF 8$pWCM, • es. County sof._---------- ----- ------------------------ .d. 1 Ml being first duly sworn, depose and say ........f"��t.T......t_.....!£-.c✓cj.e.. _. _5YsT.r. r�n......... L2:�Tll%: .....�s'v......-_ c.� .......a7........ xrx, rl ...../....... L .a7......-.L.B.:....e.��c........stf.��.._...................... _.............................. _.......... Subscribed and sworn to before me this........................day of 19 ... _...... Notary Public for Oregon. My commission expires................................._....................... i BOREALIS SUBDIVISION Soil Actual Req. Inst. Req. Classi- Tank Tank Absorption Absorption fication Size Size Capacity Max. poss. bdrr Lot 11 250 sq.ft./bdrm. T250 gal. 2 bdrms. anYool Lot 12 250 sq.ft./bdri. 1250 gal. 2 bdrms. no reply Lot 13 vacant lot Lot 14 225 sq.ft./bdrm. 1000 gal. 1000 gal. 2 bdrms. o.k. Lot 15 vacant lot ' Lot 16 225 sq.ft./bdrm. 1250 gal. 1250 gal. 2 bdrms. 4 bdrms. Lot 17 225 sq.ft./bdrm. 1250 gal. 1250 gal. 2 bdrms. 4 bdrms. Lot 18 225 sq.ft./bdrm. 1250 gal. 2 bdrms. Lot 19 250 sq.ft./bdrm. 1000 gal. 2 bdrms. Lot 20 250 sq.ft./bdrm. 1250 gal. 1250 gal. 2 bdrms. 4 bdrms.