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Home My WebLink AboutTURPIN #1 BLK 6 LT 11Turpin #,I Block �•J Lot I I #006-096-15 °i•° "D1 GRL. :R ANCHORAGE AREA BOROL'� DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 27&8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM Ei31 •.5��/� SEPTIC TANK: DISTANCE FROM WELL MATERIAL NUMBER OF / COMPARTMENTS LIQUID CAPACITY Ar,�YFt L /'NA. CCI. "' (•e-t-t-t•e>t) LIQUID `� GALLONS. INSIDE LENGTH INSIDE WIDTH-DEPTH- SEEPAGE IDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH ��!, , LENGTH, DEPTH .�-�/ LINING MATERIAL ('c)cf�EY'� /S%C KS SX5 X d•�. DISTANCE FROM WELL ��n ' , BUILDING FOUNDATION 150 NEAREST LOT LINE 25 TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SSD SQ. FT. TILE DRAIN FIELD: DISTANCE FROM NUMBER OF ABSORPTION BETWEEN LINES FT. LENGTH OF EACH TOTAL NEAREST LOT LINE , OF LID TRENCH WIDTH EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE 11 1 WELL: ,.Z/_ 1r DISTANCE FROM WATER _ i TYPEnf r� DEPTH ,BUILDING FOUNDATION. SAMPLE/ZrJe'l NEAREST, NEAREST LOT LINE ZC /r` /J EWER LINE , TANK C y / , SYSTEM SEEPAGE ��C ' ,CESSPOOL , STHER OURCES'_ DIAGRAM OF SYSTEM DISTANCES: Kcle; 3 �X-&•ecx P;t HuD N.4et LIkic. S•'I 4ea nllo rD s"4tt_Av%,r• Q'Qr cN Ck;V 13F i,rncoF IwSp.��cw. DATE r,W GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6.650 ANCHORAGE. ALASKA 99502 TELE1M9NE 279.9686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAM! OF A►PLICANT�J/r V// INSTALLATION LOCATION �.(. LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED MAILING ADDRESS 6m cul _ 71 V • 1 / .A,...� / r SEEPAGE PIT DRAIN FIELD TO BE INSTALLED BY PERMIT NO. PHONP-7-14—mi OTHER • 4— OTHER NOTE, THIS PERMIT 13 NOT VALID WITHOUT SOIL TEST FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. r � SEPTIC TANK SIZE TYPE SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS / DIA RAM SYSTEM FOUNDATION TO SEPTIC TANK '`J FOUNDATION TO SEEPAGE PIT :;2O / DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT v GRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT 0 DRAIN FIELD ALSO CONSIDER AREA WELLS. / ol WATER MAIN TO SEPTIC TANK / SEEPAGE PIT DRAIN FIELD , SEPTIC TANK, SEEPAGE PIT DRAIN FIELD TO RIVER. LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. /LIN w DIAMETER CAST UON SIPH PIPES ON SEPTIC TANK AND SEEPAGE PIl FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKPILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION i / ( I HEALTH AUTHORITY OR �• LICENSED DESIGNER 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GRE TCR ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. C�APPLICANT'S SIGNATURE GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL DUALITY PERMIT NO. SS -11 ♦ 3700 TUDOR ROAD POUCH 6.650 ANCHORAGE. ALASKA 69502 TELE.Kow[ 279.666a SEWAGE DISPOSAL SYSTEM — APPLICATION ANDD PERMIT NAME OF APPLICANT ��`4 ""'�u "� MAILING ADDRESS G3 S ""d i PHONE , l -.W INSTALLATION LOCAT LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH FHA SOIL TEST RESULTS COMPLETION DATE ANTICIPATED PIT " DRAIN FIELD OTHER TO BE INSTALLED BY - NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION, 24 HOUR NOTICE REOUIREO. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. Co,.cu �/" SEPTIC TANK SIZE /000 TYPE 4kK4L SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT �( DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL— SEPTIC ALL SEPTIC TANK S SEEPAGE PIT OQ DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK " " r/�1/ / SEEPAGE PIT /00' OO/ DRAIN FIELD WATER MAIN TO SEPTIC TANK ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD / 1 SEPTIC TANK. �i SEEPAGE PIT "_L � 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 BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.60 AND THAT THE ABOVE DES RI SYSTEM IS IN ACCORDANCE WITH SAID CODE. -Lb L( ` .(� h�I ///J/ / DAT APPLICANT'S SIGNATURE v-n!� CREA.TER ANCHOPA^F AP.L'A D�1;}{ MALTH DEPAf:7.''E1:T 327 EAGLE STREET AACHORA.CF, ALASKA 99501 Fcrformed For Legal Description:Lot �� ".LOCOTTDate Fer_forred T"s Fcrr, Reports a: S011ss~Log Depth _Feet Eoil Ct:ar_.te^istics Has Ground :later Encountered?��/L� If Yes, At what fepth CAS: .! e Locaticn S'KPfr{, Frcpored Installat— o .Sfepa-,e Pit Dept), 0: Inlet i �� Drain ..^field } Ceptn i0 BottoT Of pit Trench /^ . COM'•;f:liTS:__ rt,�—��,So,�r�J� r Test ?erforred By:_ ffl Data Certified By: i Dat .�U �c L /OJP/y d a `9 0 . Has Ground :later Encountered?��/L� If Yes, At what fepth CAS: .! e Locaticn S'KPfr{, Frcpored Installat— o .Sfepa-,e Pit Dept), 0: Inlet i �� Drain ..^field } Ceptn i0 BottoT Of pit Trench /^ . COM'•;f:liTS:__ rt,�—��,So,�r�J� r Test ?erforred By:_ ffl Data Certified By: i Dat .�U L.5 Municipality of Anchorage �O�y qb4 -• Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 00(o — 0% -15 COSA # 1 Expiration Date: — 02 1. GENERAL INFORMATION Complete legal description Turpin " � GIV, G Lol 11 Location (site address) 6345 MAviZ5Leon Current Property owner(s) Lezl. kinwret Day phone 36o— 285'9 Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup 2: NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: -- Individual Well Individual On-site ❑ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer W The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Address Phone 279-3916 Engineer's Printed Name _Leirs .Spur 1ACInA V Date tlzs%zolo 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. _ �E0FA�q 1�1 1 4gTN S. .LAns E.5PURKLAND � I �I t F.I ikijz0kq- \\\�#iOFES``C1�► Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other___ BY Original Certificate Date: (Rw, 11Ni) , . ....., 1 1-___- _- _____1_____.__- Municipality m _. _. _. Municipality of Anchorage �,� •., Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Street P.O. Boz 190650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: T��P�� ')_ (31K fo (,,,I 11 Parcel ID: 00(c- 09 - I S A. WELL DATA Well type-QCigAe. If A. B. or C provide PWSID # = Well Log (Y/N) N Date completed =ffl Sanitary seal (Y/N) Y Wires property protected (YIN) Y Total depth > 5Lfl. Cased to >40 ft. Casing height (above ground) O in. FROM WELL LOG AT INSPECTION Date of test 112(.12010 Static water level unh.now" ft. 53 ft. Well production _ur%l6_n0wr g.p.m. i5 g.p.m. WATER SAMPLE RESULTS: Coliform _g_colonies/100 mL Nitrate O,I (30mg& Other bacteria _�coloniesl100 mL Arsenic: L,4L ug/L date of sample: 112D. 10 Collected by: L r1Z )r4 B. SEPTICIHOLDING TANK DATA Public Sewe,., Tank Type/Material Date installed _ Tank size gat. Number of Compartments = Cleanouts (YIN) — Foundation cleanout (YIN) = Depression over tank (YIN) = High water alarm (YIN) Date of pumping — Pumper C. ABSORPTION FIELD DATA P4%I iL Sewer.. Date Installed Soil rating (9.p.d.lft2 or ft21bdrm) System type Length ft. Width _ ft. Gravel below pipe ft. Total depth =ft. Eft. absorption area ft2 Monitoring lube = Depression over field Date of adequacy test "' Results (Pass/Fail) — For "-bedrooms Fluid depth in absorption field before test=in. Water added =gal. New depth =In. Elapsed Time: 'min. Final fluid depth In. Absorption rate >= — g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date -- D. LIFT STATION Date installed 'Pump on' level _in. Datum E. SEPARATION DISTANCES Size in gallons Manhole/Access (YM) 'Pump off" level a _ in. High water alarm lev in. Cycles t ed Meets ala circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /V A Absorption field on lot /V JA I Public sewer main 5 t Sewer /septic service line ZS 't- Animal 1 Animal containment areas 50 t On adjacent lots 100+ 1 . On adjacent lots I� t Public sewer manhole/cleanout 100 Holding tank N/A Manure/animal excrete storage areas 1 Co + SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main Property line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line _ Water Service line Curtain drain _ F. COMMENTS '/` r. r it . r u t Building foundation Surface water lots Surface water Water main parking/vehicle storage G. ENGINEER'S CERTIFICATION • G} QAOM • pc'S PJ'{ IeZA. I certify that I have determined through field inspections and review of Municipal records that the above systems aro in conformance with MOA COStA guidelines in e'ff'ect on this date. Engineer's Printed Name Lars Spun h�J Date l 2g t0 COSA Fee $ 490` Date of Payment Receipt Number O 3 (p(o 5 (Rev. 11/05) I �I c�saa it��i�e+e � w Dr4i� �o�e OF At-'% .......... FAt.9�� 9TFlT�3" /r Waiver Fee $ Date of Payment Receipt Number i S-6 SCS Rer.# 1100220001 Client Name Spurkland Engineering Printed Date/Time 0127/2010 11:43 Project Name/# Turpin #1 B6 Ll l Collected Date rime 01202010 11:45 Client Sample ID Turpin #1 B6 Ll l Received Date rime 01212010 10:00 Matrix Drinking Walcr Technical Director Stephen C. Ede Samplc Remarks: Allowable Prep Analysis Paamaa Results LOO Units Method Container ID Limits Date Date [nit Metals by SCP/MS Arsenic 6.41 5.00 ug/L EP200.8 C (<10) 0121/I0 0125/10 NRB Waters Department Total Nitmtc/Nitritc-N 0.100 U 0.100 mg/L 51120 4500NO3-F D (<10) 0125/10 RIT Microbiology Laboratory Colony Count 0 col/IOOml- SN1209222B A (<200) 0121/10 SDP TotalColifomt 0 col/IOOmL SM209222B A (<I) 0121/10 SDP FccalColifurm 0 col/IOOmL 5:112 0 92 2 2 8 A (<I) 0121/10 SDP Municipality of Anchorage ' Development Services Department y; Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 1 \ www.muni.org/onsite a (907)343-7904 O CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 00(P -Ogtp -16 COSA# NP MACC- 1. GENERAL INFORMATION Expiration Date: 11-14 —0G Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address TURPIN SUBDMSION #1: LOT 11. BLOCK 6 6345 MARKSTROM DRIVE • ANCHORAGE. AK 99504 DAVID BRIGHT do CAPUCINE FICK Day phone 552-1219 6345 MARKSTROM DRIVE • ANCHORAGE. AK 99504 Day phone cHRis •1 DYNAmir PRoPFRTIFqDayphone 727-77S5 Unless otherwise requested. COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer 0 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality ofAnchorage (les and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date t3 l2 -kb Engineers 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 8 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 idontirlable 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 meal the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sofa benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE l/ Approved for z bedrooms. Disapproved. Conditional approval for Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory bedrooms, with the fllowing stipulations: Arsenic Advisory Maintenance Agreements Supplemental Engineers Reort J Other By: lC/. J WATER AND ECdATfR' PROGRAM Original Certificate Date: Q - i - 0 6 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program Y ` • , 4700 Bragaw, Street P.O. Boa 196650 Anchorage, AK 99519-6650 www.muni.oryloraite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: TURPIN SUBDIVISION )E1: LOT 11, BLOCK 6 Parcel ID: Q400-0'1 g-�� *WELL INSTALLED IN WATERTIGHT MONITORING WELL MANHOLE A. WELL DATA ENCASED IN CONCRETE WITH DRAINPIPE AT BOTTOM Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (Y/N) NO Date completed -1971 Sanitary seal (Y/N) YES Total depth 54+ ft. Cased to 40+ ft. FROM WELL LOG Date of test 1-1 Static water level ft. Well production N g.p.m. WATER SAMPLE RESULTS: Wires property protected (YIN) YES Casing height (above ground) '0 in. AT INSPECTION 7/14/2006 53 ft, 6.5 g.p.m. Coliform 0 colonies/100 ml. Nitrate 0.5 mg./L. Other bacteria 0 colonies/100 ml. Arsenic: 6.05 ug./L. Date of sample: 7/14/2006 Collected by: GEG, Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size gal. Number of Compartments Foundation cleanout (YIN) Pumper PUBLIC SEWER Date Installed (Y/N) _ High water alarm (Y/N) C. ABSORPTION FIELD DATA PUBLIC SEWER Date installed Soil rating (g.p.d./ft'or ft%drm)_ System type Length ft. Width ft. Gravel bel ft. Total depth ft. Eft. absorption area— ft' Monitoring W _ Depression over field Date of adequacy test Resub ail) For bedrooms Fluid depth in absorption field bef=malfluid _ in. Water added _gal. New depth _in. Elapsed Time: depth _ in. Absorption rate >= g.p.d. nation treatment (past 12 mo.) (Y/N &type) If yes, give date D. uFT STATION Date Installed Size in gallons "Pump on" level at _in. "Pump ofP le High water alarm level at Datum l Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot N/A On adjacent lots 100'+ Absorption field on lot N/A On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER Building foundation Water main Property line Water Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water Water service line Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal reowds that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date BiZ/kv COSA Fee S u 40 0 Date of Payment 0 it Receipt Number 13 (Rev. 11105) Waiver Fee $ PUBLIC SEWER parking/vehicle storage Date of Payment Receipt Number SCS I2eL8 1063897001 Client Name Ganness Engineering Group, Ltd. Project Name/a Turpin NI Ll I Blk 6 Client Sample ID Turpin #I Ll l BIk6 Matrix Drinking Nater Sample Remarks: All Dates/Times are Alaska Standard Time Printed Date/Time 07282006 9:42 Collected Date/Time 07/142006 12:55 Received Date/Time 07/142006 13:30 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date [nit Metals by ZCP/MS Arsenic 6.05 5.00 ug/L EP200.8 C (<10) 0720/06 0725/06 MI I Waters Department Nitrate -N 0.500 Microbiology Laboratory Total Colifoms 0 0.100 mg/L EPA 353.2 D (<10) col/100mL SN1209222B A (<1) 07/14/06 ALR 07/14/06 TLF Municipality of Anchorage •., • Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 006-096-15 HAA# 0�,OS 1. GENERAL INFORMATION Expiration Date: Complete legal description LOT 11, BLOCK 6: TURPINX SUBOIVISION #I Individual Water Storage ❑ Community Class Weil Location (site address or directions) 6345 MARKSTROM DRIVE • ANCHORAGE. AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address TED NOVOTNEY Day phone 333-2097 6345 MARKSTROM DRIVE • ANCHORAGE, AK 99504 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: ❑ Individual Well ❑ Individual Water Storage ❑ Community Class Weil ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer 0 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 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 typo of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage rites 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 ALASKA WATER & WASTEWATER CONSULTANTS. INC. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 ' Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKW WC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readilyldentiflable 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. AKW WC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Phone 337-6179 Date 10 L d bedrooms, With the fllowing stipulations: J' ON-SITE a : WASTEWATER : s� Manitenance Agreements Supplemental Engineer's Reort Other By: Original Certificate Date: 10-13—o3 (Ra. 77A7) Municipality of Anchorage Development Services Department Building Safety Division ` On.Sse Water b Wastewater Program : • , 4700 South Bragaw St. P.O. Box 198850 Anchorage, AK 995198850 www.ci.anchorage.ak.us (907)343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT 11, BLOCK 6: TURPIN SUBDIVISION #1 Parcel ID: 006-096-15 A WELL DATA 'WELL INSTALLED IN WATERTIGHT MONITORING WELL MANHOLE ENCASED IN CONCRETE WITH DRAINPIPE AT BOTTOM (SEE ATTACHED PHOTOS). Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YM) NO Date completed 1971 Sanitary seal (Y/N) YES Total depth 53'+ ft. Cased to 40'+ ft, FROM WELL LOG Date of test StaGo water level ft. N Well production g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: N/A mg./L. B. SEPTICIHOLDING TANK DATA Tank Type/Material Tank size gal. Foundation cleanout Wires properly protected (Y/N) YES Casing height (above ground) '0 in. AT INSPECTION 9/16/2003 48' ft. 6.1 9 - p.m - Nitrate 0.10 mg./L. Other bacteria 0 oolonies/100 mi. Date of sample: 9/16/2003 Collected by: AKWWC, INC. Number of Compartments PUBLIC SEWER Date Installed _ N01 over tank (Y/N) _ High water alar (Y/N) Pumper C. ABSORPTION FIELD DATA PUBLIC SEWER Date Installed Soil rating (g.p.d./ft'or ft'/bdr) _ System type _ Length IaNNESEENUTCir7 ft. Gravel tpla f ipe fL Total depth ft. Eff. absorption area _ ft' �Monitorin ba' Depression over HeidDate of adequacy test Rasu lFaiq For bedrooms Fluid depth in absorption field bef _ in. Water added _ gal. New depth _in. Elapsed Time: n. Final fluid depth _ in. Absorption rate >= g.p.d. treatment (past 12 mo.) (Y/N 8 type) If yes, give date D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankilitt station on lot N/A Absorption field on lot N/A Public sewer main 100'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manholeldeanout 100'+ Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER Building foundation Water main Property line Absorption Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: PUBLIC SEWER Property line Building foundation Water main Water service line Surfa Driveway, parking/vehide storage Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through Neal inspections and e ; e review of Municipal records that the above systems are in ' . conformance with MOA HAA guidelines in effect on this date. Je r y . am ssr Engineer's Printed me JEFFREY A. GARNESS E- ' Date 10�216� 4 4p^ : rofs.bod'. o HAA Fee $ 375.0Waiver Fee $ Date of Payment 10-1.03 Date of Payment Receipt Number 4zg57� Receipt Number (Rev. 17/01) 9-23-03: 5:30PM: _Sfo .CS Ref.# 1036036001 tient Name AK Water & Wastewater Consultants Inc. 'rolect Name/# Turpin SID #1. Ll 1. B6 :heat Sample W Turpin S/D #1, L11, B6 4atrir Drinking Water ample Remarks: :907 6615301 All Dates/rimes are Alaska Standard Time Printed Date/rime 09/23/2003 14:59 Collected Date rime 09/16/2003 10:27 Received Date rime 09/16/2003 13:50 Technical Director / 51tphuPCAde x E- 2 ammeter Qalifien Results PQL Units MethodContsincrlD Allowable Prep Limit Date Date Init raters Department Nitrate -N 0.100 U 0.100 ticrobiology Laboratory Total Coliform 0 mg/L EPA300.0 B (<-10) col/100ml. SM18922211 A .(<-1) 09/16/03 JJB 09/16/03 DKC 2-13-9e;17:12 ;Asalat 2 Sell fc S'I o q.t. ;8073382480 e 2/ 2 EASEMENTS OF RECORD, OTHER THAN 'THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. "ASBUILT" No corners set THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELINES. Book 87 pg /3/ I hereby certify that I have surveyed the following described property, Lot _._L_, Block G Pkv OF .q�q ��` r4lff/n/ :,UC3C, N•. / Anchorage ncording Cislriq Alaska. ono mat the e!�~•�• *eWImprovements IiWeted thereon are Within the property lines and do not overlap or encroach on i * X49L �' the property lying adjacent thereto, that no Improvements on property lying adjacent thereto �•• ••""• •••••»}••• encroach on the promises In question and that there are no roadways, transmission linea or other •. •. •. �.....•..•.. t visible easements on said property except as Indicated hereon. 1r E u HBdonon No. 1500.5 ; Via`` % fdo Anchorage. Alaska 9 OCT. 2003 � P' 9.0 \� 9. + � o / 2 SF�CTOKY c o- w N ' � NurJSf a 4 4!•0 9. O Z V) o sca L F I "e 30' chwrn Lrn1c c T M ' ML7KKsrRoM DR. EASEMENTS OF RECORD, OTHER THAN 'THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. "ASBUILT" No corners set THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELINES. Book 87 pg /3/ I hereby certify that I have surveyed the following described property, Lot _._L_, Block G Pkv OF .q�q ��` r4lff/n/ :,UC3C, N•. / Anchorage ncording Cislriq Alaska. ono mat the e!�~•�• *eWImprovements IiWeted thereon are Within the property lines and do not overlap or encroach on i * X49L �' the property lying adjacent thereto, that no Improvements on property lying adjacent thereto �•• ••""• •••••»}••• encroach on the promises In question and that there are no roadways, transmission linea or other •. •. •. �.....•..•.. t visible easements on said property except as Indicated hereon. 1r E u HBdonon No. 1500.5 ; Via`` % fdo Anchorage. Alaska 9 OCT. 2003 09/16/03 08:28:13 AM Eire Ed,' Ye« EPg, Zoom Ione 6MOb40o j.+elp sit'le a ed I'I®let 5080% J' J 01':I r: r❑ It, I r 99 :-n jf IN IN a /SDI\` TIDA5 (TID) „IDAI ( _ eu �„ T ' 1 28 00 T -` EAS 1;'tll Avenue 6 r i SAC'o SAC � _ Vj iw C; 1 t R MARKS_TROM Drive SAC', 11t w> r t r 1 a; 1 1 \ 58ag- _. I i M.. NNN Lj w_. or Help. press Fl —. _-----_--- 15080: 55egeI oll 9' tIL^J --.•__._ .......__ _.... ___ .. .._.., _.._ .._, .. _.W ..lie 828 PM ft .� e,4(. op rror 'f tRa..�T MUNICIPALITY OF ANCHORAGE MUNIcIPALMY OF ANCHORAGE DEPARTMENT OF HEALTH ® ENVIRONMENTAL PROTECTIOeI 825 L Street DEPT. OF I I_ALT11 g FNVIROWTNTAL • Andwrage, Alaska 115601 - F.:J; CTfON ENVIRONMENTAL ENGINEERING DIVISION JAN 18 19/9 Telephone 2644720 NUMBER OF BEDROOMS (('' CC REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE�R[[' AC&Vf D DIRECTIONS: Complete NI parts on page 1. Incornpless requests will not M prPlaty allasr ten (101 toys for processing. 1. PROPERTY OWNER ❑ Two ❑ Five PHONE 1 7. WATER SUPPLY MAILING ADDRESS 1 —I)r ' ATTACH WELL LOG. A well log is required for all wells drilled 7oN since June 1975. For wells drilled J.udujo that date, give well PROPERTY RESIDENT (If afferent from above) depth (attach log if available.) PHONE 2. BUYER ❑ INDIVIDUAL/ON-SITE" PHONE MAILING ADDRESS - If system is over two (2) years old an adequacy test is required 2. LENDING INSTITUTION1PHONE by this Department NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. �n�// . ) TC17P MAILING ADDRESS 4. REALTORIAGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION Tle,ck L_e4 11 71-1r ) r-) First Adaf� r, STREET LOCATION C.��fs !�r/rs.frnm Dr S. TYPE OF RESIDENCE NUMBER OF BEDROOMS D.3 SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY E7 INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled J.udujo that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM ❑ INDIVIDUAL/ON-SITE" elf individual/on-site, give installation date If system is over two (2) years old an adequacy test is required Q' PUBLIC UTILITY by this Department NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. naltulslral 5 _ y A THIS SIDE FOR OFFICIAL USE ONLY _ - INSPECTION APPOINTMENTS OATERECEIVED - TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank Absorption Area Sevviir Lina Nearest Lot Line Absorption Area to nearest Lot Line 6. COMMENTS t s APPROVED FOR BEDROOMS ❑ CONDITIONAL APP OVAL (letter must accompany certifi ❑ DISAPPROVED —1--1� DATE ByKt LEGAL MPTION 72-010 (Rev. 3/78)