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HomeMy WebLinkAboutFIRE LAKE BLK 1 LT 1AFire Lake Block 1 Lot 1 A #051-361-04 Municipality of Anchorage y Development Services Department `y Building Safety Division Onsite Water and Wastewater Program, 4700 S. Bragaw Sl. P.O. Box 196650 Anchorage, AK 995196650 Page of www.d.andxxageek.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. 0 PID Number. 05136104-000 Nww Sudsbury & Sons Wastewater System: 0 New ❑ Upgrade Ana...: 10928 Eagle River Rd., #122, Eagle River, AK 99577 ABSORPTION FIELD It�: 696-1610 µ Awof 13600//4 El Ow Tn C3 swbw T—ch[3 Bw ❑w ❑om,r LEGAL DESCRIPTION sa Fts": 0.6 Tar DOW r pm onpnr praM. cpotN 9.7 Ft. Bbl Loi: auE6wcn: 1 1A Fire Lake Dpnbp baba are oopnr Ven: 43e Mpm�mPipe: 3.75 Fr 6 FL Towanp: ftwr: Secaon. Fewaa.ew. anpW praaa: Cn Lenpt.. 0.0 Ft. 84 Ft. Well: • El New ❑ Upgrade Grwl ram: 3 Nunbr,xNw. DNlrbe t,* Yin Ft. 1 NA FL cw.«Lntbn (Pmwo. A B. c): Tar Owat. Gaw b: Ta eb,apwn rea. Pq wi«tr Private 120 Fl, 120 FL 1.006 Fe PVC Dtitor. . Zac's Well Drilling 0.w DM . stove wr«Lowe 211/05 71 YLWYr. A & F Contracting Dow V,w . 1/5105 a Y. . 24 Pmp swat 115 Cwp N«pa Aea.e Cwwr. TANK DP. FL 2 FL SEPARATION DISTANCES El Septic ❑Holding ❑S.T.E.P. ❑Other. To Septic Absorption Lift Holding ublic/Pnvate M"'., P«+h From Tank Field Station Tank Sewer uns Greer 1250 Dr w,L 108' 127' NA NA 75' Steel N2acaro.wp,nY. aubuwr« NA NA NA NA LIFT STATION Lot Lm 70' 26' NA NA ar FaM.oan 36' 53' NA NA 'Pv^p on rw.�. 'P.ro ar Yw r. Hpn wr«.wm r. H F H. crur Drab NA NA NA NA a EY kop a p«ap.o Er BENCH MARK Lenwn ana 0..aapnt. Garage Slab YnYan. 100.00 FL **'**- Inspections performed by: Kent Sheets Dates: 1r 1/4105 = 49TM / ' 2nd 1!5105 0 - _ .�..._. Development Se Ices Department Approval L. 6hreves t Q c; �, V CE 9351 b� Reviewed and approved by: Date:F�pROFESS.ONP 67 1 .vA9 a_rs ASBUILT y0.. c✓ ,..-�9�9a I HEREBY CERTIFY -THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: �. fi�E�QCE-��gfvBCeri�/ DATE:..: AND THAT NO E.NCROACHMENTSrEXiST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN: (o 5- hlx l$ added k. cpFH of Of4ttili- 65 .74 Duan• Mork Sward / 1S-6918 �, Jr FIXED FINAL GRADE 99.50ft- ORIG. & FINAL GRADE 100.0ft. - DATUM / / 99.25 ft. 1.250 -GAL SEPTIC TANK DATUM - GARAGE SLAB - 100.0' SEPTIC SYSTEM PROnLE 1�1•fi �I��II ���1"• TRENCH DETAIL w.• �rwr.ww r wrrrr r�.rr..uw ter. rr�rr. r�r rrrr. mudoiv. "w i rir TRENCH SECTION MONITOR TUBE DETAIL r In SECTION X -X 400DDDppd AS BUILT AS P.O. BOX 2749 %% DETAILS jum PALMER, ALASKA 99645 o P ..19,p, pD ENC EE INC. PHONE: (907)745-0222 PS�' �9 Dd FAX: (907)746-0222 49TH ""•••• W.O. 0401225 DATE: 6/16/05 SCALE: nts FILE: 0401225_wN ���•••.•••l7:.t•..........d ALASKA SUBD. A Ida L Shreves. ,�O LOT 1A, BILK 1, FIRE LAKE ,�(� PLAT No. 67-3, ANCHORAGE RECORDING DISTRICT, ANCH., ALASKA CE 9351 EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE QQQ� PRO..... pdd" RECORDED PLAT ARE NOT SHOWN HEREON. DATED AT PALMER, d0��.. o ALASKA, THIS 18th DAY OF NOVEMBER, 2004. Jun 16 05 04:39p H Hocker:RE/MRX 9073529353 p.2 i Zac's Well Drilling "j —And Pump Service P.O. Box 119 Palmer. AK. 99645 (907)745-4877 ROTARY DRILLING WELL LOG OWNER JASQUr7.F Sc]'>S DEPTH OF WCLL I ZO\ �. ADDRESSrT 1"c STATIC LEVEL �\ .11-- ��.�, �•Lr V,c Citi.,J-0 �,'I�IJ 7� GALS. PER MIN. WELLSITE _WTI &2c 2c K 1 SIZC OP CAS(NG !? �;ve Lr�►C� AYce� , k S' Vb t� e•'y ED TOTAL CASING I Z o, DATE 05 PERFORATED/SCREENED KIND OF FORMATION: -" L ] pµp STICKS, FROM: O FT. TO: FT. 4 1");wT FROM: 33 FT. TO: j� l FT. -1 LK�C� FROM. FT. TO: I Z FT. HPAtAN �� FROM: FT. TO: FT. 'AQAwL FROM: 1 Z FT. TO: ZO FT. J�yeL FROM: 91 FT. TO: pg $2 FT. Defy qN opty FROM: 2� FT. TO: ? FT. p�,4 RN �Ni-'"'+ROM: $z FT.•To: 89 FT. —t Z`I 4 9YAvec FROM: .g9 Fr. To: FT. 4 •+ fB•ts*' FROM: 3 t} Fr. TO: u o FT. •'�!'"' 1V""� FROM: 9 0 FT. To: 103 FT. AwI' FROM: q 0 FT. To: S v mom! L 103 FT. TO: (OS W!C PMK1O FT. FRO161: _ FT. TO: _ FT. — FROM: I O S 104 ray pc� lw 5 F r HWIP .w (&Qwf''�ROM: FT. TO: FT• FROM: S 3 FT. TO: b R pAr-kFo9vwtLV FROM: 109 �, TO: I �`t FT. Q FROM: 69 FT. To:. -t -13: FT. d eowDPr �cKY `+ FROM: II� Fr. To: izo X FT. Sw�o ►1:✓' # h -M1 FROM: Z FT. TO: FT. TO: �! FT. FT. SmIlL AMA 9/041- FROM: �� FT. TO: LoR.,c L FT. wHh'C bror+►/ ato., FROM: - _ LJSCO 1�� ���lC $PrvSegC" R+AxO FjPM1tP Foh CaSnv7 SIAL COMMENTS: -100 Lb DRILLER MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 r NNAO ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Dec 15, 2004 Expiration Date: Dec 15, 2005 Permit Number: SW040495 Parcel ID: 051-361-04 Legal Description: FIRE LAKE BLOCK 1 LOT 1A Design Engineer: 0032 Alaska Rim Engineering Site Address: 18310 MULDROW ST Owner Name: SUDSBURY AND SONS Lot Size: 53163 SO. FT. Owner Address: 10928 EAGLE RIVER RD #122 Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER. A 99577 - This permit Is for the construction of: ❑✓ Disposal Field ❑Q Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage All construction must be in accordance with: 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 catling (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 Issued By. Date: Date: 12 its J' Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.sk.us (907) 343-7904 ! e, e..1 Ie �F � ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O 57 131P 10 4 =0 Permit Number SW Propertyowner(s) �7G1 zi17UV` 50615 Day phone oqb—/moo Mailing address EL?xIc JZ, --,w JZ44�)IL`F'?Zip Code qg5-77 Site address Ig3/o ynMI,lrow Sf� �= Zip Code 99s�7 Legal description (Lot, Block & Sub'd.) I'*% /A ;� /OL� / ► P Lct ke Legal description (Section, Township & Range) Lot Size 6_5ji0 3 Acres/Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well 5�r Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above info r tion is correct. I further certify that this application is being made for a Singie F m we ng n ' in accordance with applicable Municipal Codes. (Signature property owner or rized agent) Permit/Rush Fees: %0-t I Date of Payment: 14IQ Receipt Number. (PIl7� (Rev. 09104) Waiver Fees: Date of Payment: Receipt Number. (AVagh ni111 et1(gi116ehi11(g, '911C. Phone (907) 745-0222 Fax (907) 746.0222 akrim®rogershsa.com December 14, 2004 Ms. Julie Makela, P.E. Municipality of Anchorage Development Service Department Building Safety Division On -Site Water and Wastewater Program PO Box 196650 Anchorage, AK 99519-6650 RE: Lot 1A, Lot 1, Fire Lake Subdivision On -Site Sewer and Well Permit Application AK. Rim Engineering Ref. No. 04-01225 Dear Ms. Makela: P.O. Box 2749 Palmer, Alaska 99645 The owner of the above referenced lot is proposing to construct a 4 -bedroom single family dwelling (see attached Site Plan). The proposed dwelling is to be served by an onsite private well and a private septic system. With this letter we are requesting plan review and a permit to drill a private well and install an onsite septic system to serve the proposed development. DESIGN SUMMARY SEPTIC SYSTEM Soils Two test holes (AKTH#1 and AKTH#2) were excavated on December 7, 2004, and groundwater monitor tubes (GWMT) were set in both test holes. A percolation test was conducted in AKTH#1. At that time a temporary datum was set in a tree adjacent to the proposed septic system, with an elevation of 100.00 feet. The elevation of the bottom of the test hole and the GWMT is 82.78 feet. Groundwater was not detected in either test hole. The monitor tubes were probed on December 14, 2004, and no groundwater was detected. The attached Site Plan shows the location of the test holes. The soils in both test holes were classified in the field as SP, consisting predominantly of sand with gravel. The percolation test, conducted at 6 feet below grade, yielded a soil percolation rate of 30 minute per inch (see attached Soil Log — Percolation Test). The proposed drainfield will be designed around the 30 -feet radius of the test hole. A separation distance of 6 feet from the groundwater level will be applied. Engineers • Planners • Surveyors Ms. Julie Makela, MOA Page 2 December 14, 2004 Trench Design The following is a summary of the proposed design of the trench SAS: Percolation rate: Soil application rate (trench): Number of bedrooms: Daily wastewater flow: Drainfield: Septic tank: Minimum absorption area: Total depth (bottom of drain rock): Bed dimensions: Effective absorption area: Topography 30 minute/inch 0.6 gpd/sgft 4 600 gpd Deep Trench 1,250 -gallons 1,000 sgft Elevation 88.78 feet (based on temporary datum of 100'; nail in tree adjacent to proposed drainfield) 6ftED x 84ft 1,008 sgft The topography is such that it is level throughout the lot. There are no slopes greater than 25% within 50 feet of the proposed location of the septic system. Surface Water There are no surface waters within 100 feet of the proposed septic system. PRIVATE WATER WELL well The location of the proposed well is shown on the attached site plan. The onsite septic system and all other potential sources of contamination are outside of the 100 -feet well protection radius. The well will be sited, drilled, and completed in accordance with standards and provisions in chapters 15.55 and 15.65 of the MOA code for water wells, and 18 AAC 80 and 72. Surrounding Properties This property and surrounding properties are served by onsite septic systems and private wells. According to MOA Code 15.55.050 (13)(1)(e), (g), and (h), all wells within 50 feet of the proposed well, and, all sources of contamination (septics, etc), and all animal enclosures within 200 feet of the proposed well are noted on the site plan. There is a water well approximately 50 feet east of the proposed well location, on Lot 17A. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. Development on this lot will not preclude development of wells and septic systems on neighboring lots in the future. If you have any questions regarding this report or its recommendations, please feel free to contact me. Ms. Julie Makela, MOA Page 3 December 14, 2004 Sincerely, ALASKA RIM ENGINEERING, INC. Mary L. Shreves Professional Engineer CC: Sudsbury & Sons AK Rim Engineering File No. 04-01225 Attachments: MOA On -Site Sewer / Well Permit Application Form • MOA Soils Log — Percolation Test Form (2) • Area Site Plan • Site Plan Septic Plan • Septic Details Dec 15 C4 12:27p nLRSKn RIM Alaska (907)746-0222 p•1 Rim Engineering, Inc. Engineers - Planners- Surveyors DATE: �� S TIME: FROM: Alaska Rim Engineering, Inc. PHONE (907) 745-0222 P.O. Box 2749 FAX: (907) 746-0222 Palmer, AK 99,,6/45 E-MAIL: Arim0alaskirim.com TO: Tv e �GGLG� PHONE: 141 PA FAX: 2 ,f9 - 7F4i7 Total number of pages, including cover sheet 3 COMMENTS: THANK YOU ) AAY 11 �lj rew5 !.— i �: 49TH ..iN.Qu. ..w.. I I i�40�'37'A'lPa I I T I ¢ I I I � I I AC. m IAT 4A I AREA SITE PLAN IRS. .00 FEETNOF THE PROPOSED SOURCES OF CONTJAkWATION YELL LOCATION. P.O. BOX 2749 Si PALMER, ALASKA 99645 tut PHONE: (907)745-0222 EE FAX: (907)746-0222 15 04 SCALE--" " - 0 FL 1 D 10 TO VERIFY PROPOSED EXISTENCEAT. OF ANy PL F••� ••••:•••D9R cE�KA SUED LOT 1A . , BLK RECORDING DISTRICT, ANCH., ALASKA - Shreves :d PLAT No. 67-D OTHER THAN THOSE SHOWN ON THE 9351• EASEMENTS AY OT SHOWN HEREON. DATED AT PALMER, OF FESSION o RECORDED / NOVEMBER, 2004. do " ALASKA, T 0 I II -t INA j 1"=60' 1 491H*•• Shreves ��i •. CE 9351 II I II II II 2.5' 2.5' 6'EDX84' DEEP TRENCH SAS v4CEMENT FIELD ^04 0 mi+m 24 AC. �I o• / I CRQ'�,R'1 7"\AI 1 Q7 RA'(hA ISI OF THE OWNER OR BUILDER, S PRIOR TO CONSTRUCTION TO VERIFY PROPOSED ED GRADE AND UTILITIES CONNECTIONAND TO DETERMINE THS EXISTENCE OF ANY TIONS WHICH DO NOT APPEAR ON THt RECORDED SUBDIVISION PLAT. SITE PLAN s P.O. BOX 2749 REVISED 9645 ENC EE Y INC. PHONE-: (90745 0222 FAX: (907)746-0222 W. 0. 0400581 DATE: 12 15 04 SCALE: 1" = 60' I FILE: 0401225—W\ ILI LOT 1A, BLK 1, FIRE LAKE, ALASKA SUBD. PLAT No. 67-3, ANCHORAGE RECORDING DISTRICT, ANCH., ALASKA EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE ALASKA,ETHIS �18t ARE NOT SHOWN HEREON. DATED AT PALMER, DAY OF NOVEMBER. 200 ..s.6 mw tw w. "a« r no Y.1.6 aY....t at .»..Yt ...e �W 11..1 4 8' e/� Ole teak 0 [*p 0 00 0 A \ 00 3' oo t �0 < o \ X 0 0 0 .\ 0 0 \J /i r r ri ..m rue r.o M to0 84' n v TRENCH DRAINFIELD W/ CENTER HEADER bji°„,C PLAN VIEW (0s1"°'"� SECTION X -X uay.97.65' werw.OY bewwIM.aHb.4 1 Y w6 «re.0.r '« welt 95 rvc w L I t�. rey.ef w.rMoek m 6rtlo .11 e•In �o.. i : s i iii �111•.wrlYa si n/a• eo r its i wwe o a s s s i s �° °� r 0 0 clay. 68.79'o 0 o 0 TRENCH DETAIL0 im► at �«t.e 7wr.« C (w �4) en Q �...,n.1_� N0 G1I 0 0 M wMMui.O b r hal l rets w� ��,^d"'b q Y� rrievm w Yw lo.l.. N YwJdla �p0 0 Nab k 11.luam mw9.e 60.6 M r M. 11 f.•i. Y LI.M 62.79 p *Ao 4 BOTI04 TH TRENCH SECTION MONITOR TUBE DETAIL 44pppDDOp� DETAILS s P.O. BOX 2749 lum PALMER, ALASKA 99645 ENC EE INC. PHONE: (907)745-0222 FAX: (907)746-0222 49TH•.•'; 00 W.O. 0401225 DATE' 12 14 04 SCAL I FILE: 0401225_WW '•F�`•4••�•••••••• O FIRE LAKE ALASKA SUBD. 0• j LOT tA, BLK 1, OQ �:,• Mar L Shreves : � PLAT No. 67-3, ANCHORAGE RECORDING DISTRICT, ANCH., ALASKA CE 9351 vo EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE �QQ %j1OO000d`�� ALASKA, THIS HSL PLAT RD YOOFSHOWN NOVEMBEREDATED AT PALMER, 2004 .fE2-1- Municipality of Anchorage Development Services Department Building Safety Division .�..t on-site Water and Wastewater Program 4700 South Sragaw Sl. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 Soils Log - Percolation Test I "8111-1 via ���`' 1 PeAom>ad For. Sudsbury and Sons Date Performed: 1277104 Legal Description:Lot tA. Block 1, Fire Lake y Township, Range, Section: (GWN1T�> Depth 1_Illl Sil+• 2- 3- p 4 :p �aKA w)6St'R��1 r)1 wi-tvbblf5, OCC - 5 6 .O: �1t,Yttit , st syr,+lei 7- o v)tvi�+ hate 911 e WASGROUNDWATER 1a ,,� ENCOUNTERED? NO 1.J: 0. 11- ' 12- 13- r, 14- ... ..0 1 1 S IF YES, AT YR1AT DEPTH? to Depth to Walar Aller P Monitoring? None E PERCOLATION RATE (MMA olnrA) FERC HOLE DIAMETER 6K TEST RUN BETWEEN 60 FT AND 7.0 FT COMMENTS preeoakahan. PERFORMED BY: Kent Sneers I Mary L Shreves. P.E. CERTIFY THAT THIS TEST WAS ICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 12/14104 PERFORMED IN ACCORDANCE WITH ALL STATE AND MUN pate: 12/14/04 1 1 1 1 1 f 1 ' Reading Date Gross Time Net Droprr 12/7104 1523 MDepthtoater .OD� 1' ON- 2 121`/104 1554 .3 12 77104 1625 n. 1 in. PERCOLATION RATE (MMA olnrA) FERC HOLE DIAMETER 6K TEST RUN BETWEEN 60 FT AND 7.0 FT COMMENTS preeoakahan. PERFORMED BY: Kent Sneers I Mary L Shreves. P.E. CERTIFY THAT THIS TEST WAS ICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 12/14104 PERFORMED IN ACCORDANCE WITH ALL STATE AND MUN Municipality of Anchorage Development Services Department Building Safety DMslon On-site Water and Wastewater Program • 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsitO (907) 343-7904 Soils Log - Percolation Test 8Bhreves W� CE 9351 •: a �PROFESSO;N %% Perrormed For Sudsbury and Sons Date Performed: 1217104 Lot 1, Fire Lake Ct^^� Township, Range, Section: Legal Description: 1A. Block Depth :D. 8- a ' 9- '. . 10. .0 11- 12- 13- 14- 1-12-13-14- . 0 15- 1 1 (CW)41 r) 5i lli- !�Cl iA wl gyp L-0 , v,Idtri, to lobif'i, YwOA-Aew?e DCC bovkA h y '0A1PA1Lj V110 it, k 1-40f P yi 14- WAS k COMMENTS WAS GROUND WATER NO ENCOUNTERED? $ IF YES, AT WHAT DEPTH? L0 Depth to Water After P Monitodng7 None E Data: 12114/04 Reading Date Gmss Tima I Net Time I Depth to Water INet Drop RC HOLE DIAMETER PERCOLATION RATE (nvw✓+Ce) FE� TEST RUN BETWEEN FT AND PERFORMED BY: Kent Sheets I Mary L. Shreves. P.E. CERTIFY THAT THIS TEST WAS ICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 12/14 104 PERFORMED IN ACCORDANCE WITH ALL STATE AND MUN Municipality of Anchorage C Development Services Department ri Building Safety Division On -Site Water & Wastewater Program --- 4700 Bragaw Street yy/ P.O. Box 196650 r L/ ✓ �' Anchorage, AK 99519-6650 www.muni.orglonsile ^ (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. COSHtf V 0 n3 1. GENERAL INFORMATION Expiration Date: ! — f' 0.— Wl5 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address FIRELAKE. LOT IA. BLOCK 1 13950 KNOB HILL DRIVE ' EAGLE RIVER, AK 99577 SPENCER MOORE Day phone 622-2021 13950 KNOB HILL DRIVE • EAGLE RIVER, AK 99577 Day phone LANCE DAMS W/ LES BAILEY do ASSOC. Day phone 689-6487 16635 CENTERFIELD DRIVE, SUITE 103 • EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site tiff Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water 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 5. As certified by my seal axed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Corti kale 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 riles 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 S Og 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, groundwaterlevels 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 lost 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 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. Conditional approval for Attachments: COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Reort Nitrate Advisory Other 7 By:Z&^ l �/ Original Certificate Date: 6_/0-00 (Rev IINS) Municipality of Anchorage -� Development Services Department ' Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: FIRELAKE, LOT1A, BLOCK 1 Parcel ID: os 1-3ro�—O A. WELL DATA Well type PRNATE If A. B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 2/1/2005 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 120 ft. Cased to 120 ft. Casing height (above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test 2/1/2005 5/21/2008 Static water level 71 ft. 75 ft. Well production 24 g.p.m. 3.82 g.p.m. WATER SAMPLE RESULTS: Coliform �_ colonies/100 ml. Nitrate_JL�amg./L. Other bacteriacolonies/100 ml. Arsenic:J2ug./L. Date of sample: 5/28/2008 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 1/5/2005 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (YIN) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 5/21/2008 pumper JR'S PUMPING *BELOW THE EXISTING GRADE C. ABSORPTION FIELD DATA SYSTEM WAS INSTALLED AGAINST GRADE Date Installed 1/5/2005 Soil rating KiErft%clrm) 0_6 System type DEEP TRENCH Length 84 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth a 15.58 ft. Elf. absorption area 1008 ft' Monitoring tube YES Depression over field NO Date of adequacy test 5/21/2008 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 12 in. Water added 860 gal. New depth 23 in. Elapsed Time: 3� 55 min. Final fluid depth 112 in. Absorption rate >= 600+ g,p,d, Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN , If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. 'Pump oft" level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 100+ Surface water 100'+ Wells on adjacent lots • 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 1001+ Driveway, parking/vehicle storage 5' Curtain drain NONE KNOWN Wells on adjacent lots '100'+ F. COMMENTS •150'+ FROM CLASS "C" WELL ON LOT 17A G. ENGINEER'S CERTIFICATION v ( f • A q��p, I certify that 1 have determined through field inspections and .7e review of Municipal records that the above systems are in •' •' • • •' • . •' •... conformance with MOA COSA guidelines in effect on this dale. op O f e Go essr, Engineer's Printed Name JEFFREY A. GARNESS CE -79 3 : ' 6�</o a 00 byso'c�o Date 40�°p,ors��to�°`a COSA Fee I L :30 Date of Payment te 5 Receipt Number �IDO$S (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage ,�•r • "` Development Services Department Building Safety Division < s• arr On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval X80173 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot IA of Fire Lake subdivision. This inspection revealed a nitrate concentration of 7.63 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. SGS Ret# 1082286001 Client Name Gamcss Engineering Group, Ltd. Project Name/# Fire Lake DI LIA Client Sample ID Fire Lake 131 LIA Slairix Drinking Water PW'SID 0 Sample Remarks: All Dates/limes are Alaska Standard Time Printed Date/time 06/042008 13:37 Collected Date/time 05282008 8:00 Recehed Date/time 05282008 14:15 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Mcdwd Container ID Limits Date Date Init Metals by SCP/MS Arsenic Waters Department Total Nitratc/Nitritc-N Microbiology Laboratory Colony Count Total Coliform Fecal Coliform ND 5.00 ug(L EP200.8 C (<I0) 06/02/08 06/03/08 NRB 7.63 0.100 mg/L SM204500NO3-F R (<10) 0529/08 LCP 0 coV100mL SM209222B A (<200) 0528/08 DLC 0 coVI00mL SM209222B A (<I) 0528/08 DLC 0 col/l00mL SW209222B A (<1) 0528/08 DLC W �i a 6. 0 all 05/22/2008 11:13 9073449821 i� JRs Pumping PO Box 773415 Cagle River, AK 99577 (907)694-6454 [Billing Information__ Gamess Engineering Group 3701 E Tudor Road Suite 101 Anchorage, AK 99507 (907) 337-6179 lJob Site Information Kyle 13950 Knob Hill Drive Eagle River, AK 99577 Additional Location Comments NEED DESCRIPTION ----- Service Type Septic Service 15K JRS SEPTIC Job Description: 12508 P.O. Number, Order Date: Terms: Net 30 Salesrep: Kadia Map Book: cross streets: Muldrow Street Job Comments: PAGE 01 Service Agreement Number. 025962 Order Date: 20 -May -2008 Service Date: 21 -May -2008 12:0 Technician: Mike Tax 16: 0 Job Type: Repeat Map Grid: 75 ----PUMP TANK ONLY ---- SERV 6 BILL of solids, BF 5 x's *NEED DRANVINGe Oty Price Each Tax? 1 $0.00 No Gallons Planned: 1250 Gal. Actual: Hose Length: Double Tank: ❑ Pump System: ©_� Battles Inlet: ❑ Baffles Outlet: ❑ Extension Actual $0.00 NonTaxable Total Taxable Total Tax Total Grand Total Estimated Charges: Actual Charges: Customer agrees to the terms and eonftons shown. THIS Is A BINDING AGREEMENT. Signature and Title of Customer Representative Date Accepted by JRs Pumping Date Accepted For your added Convenience we accept; American Express, Dicover. Visa and Mosier Card payments over the phone. After 30 Days account WIN be turned over to COLLECTIONS. 330.00 For NSF Checks Returned. • y8�'�gJD�w /tIf•9a .I //09 :J"9 .7a -w /fl7-gam BUILT SEWARD 6 :REBY CERTIFY -THAT I HAVE SURVEYED THE SCh' ,r LOWING DESCRIBED PROPERTY: z COT/.OJ�/ DATES. THAT NO ENCROACHMENTeEXIST EX,CEP7 AS :CATER. IT IS THE RESPONSI9ILITY OF THE IER TO DETERMINE THE EXISTENCE OF ANY GRID: EMENTS, COVENANTS, OR RESTRICTIONS >i DO NOT APPEAR ON THE RECORDED.SUBDI- ON PLAT. UNDER NO CIRCUMSTANCES SHOULDFDRAWN:-... � DATA HEREON BE USED FOR CONSTRUCTION .-ENCE LINES, OR FOR ESTABLISHING BOUND - LINES. sd' OF At C I • cume Mark 3.w.rd // 1� •. LS -6918 Ar \ Municipality of Anchorage ,!�'e • Y • Development Services Department � Building Safely Division On -Site Water and Wastewater Program� �' � ,• `' 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 1 www.muni.org/onsite . (907) 343-7904 lam; CERTIFICATE OF HEALTH AUTHORITY APPROVAL k.— i FOR A SINGLE FAMILY DWELLING Parcel I.D. 05136104-000 1. GENERAL INFORMATION NAA # Expiration Date: 10 Complete legal description Lot 1A, Block 1, Fire Lake Subdivision Location (site address or directions) 18310 Muldrow Street, Eagle River, AK Current Property owner(s) Sudsbury & Sons Day phone 696-1610 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 10928 Eagle River Rd., #122, Eagle River, AK 99577 Residential Mortgage, Jeanne Mee Day phone 694-8818 11432 Business Blvd., #16, Eagle River, AK 99577 Barbara Hooker, ReMax of Wasilla Day phone 352-9312 3161 E. Palmer-Wasilla Hwy, #1, Wasilla, AK 99654 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well (] Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Q Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my 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 AK Rim Engineering, Inc. Phone 745-0222 Address PO Box 2749, Palmer, AK 99645 Engineer's Printed Name Mary L. Shreves Date 6/15105 5. DSD SIGNATURE JL Approved for __L�_ bedrooms. S•��P� OF A4,1' 7, J1'•. CE 9351 _A: Disapproved. X111811; 0FESSIO Conditional approval for bedrooms, with the following stipulail .• J2: ON- ATERAND ; m= Additional Comments • �YA�TEW�rT _ PROGRAM Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: tAs 6:?.5b t 1-4S•OD p D «` ra«.u,�n _ lP I'VOO'S TLe-f-Lo -p X9810 Original Certificate Date: % —1'V OS illliL.G.PO4i •s"T. 0 1 f� ASBUILT SEWARD b I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE, FOLLOWING DESCRIBED PROPERTY: Fi�EL4CE.��y �f!/B---4 • DATE, AND THAT NO ENCROACHMENTS<EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. o� .owI �.va*%w%% OF At4%s,� Duan. Mark S.watd f 15-6918or ;• �1��wwwr • i taat_Su Test Lab of AlaskaU)Ip 0) Mile 1.2 Palmer-Wasilla Hwy. Midtown Community Business Park P.O. Box 2749 Palmer, Alaska 99645 Phone: 745-1005 Fax: 746-3010 Drinking Water Analysis Report Total Coliform Bacteria Client: Alaska Rim Engineering, Inc. Address: P.O. Box 2749 PWSID#(if applicable): Palmer, Ak. 99645 Phone #: (907) 745-0222 Fax #: 746-0222 Work Order#: Owner/Agent: $ „i, y N This SLction to be completed by Sampler Legal Description of Property: Sample'b`ite Location: 77 Delivered to Lab By: CSL (I.E.: kitchen sink, bathroom sink, outside hose bib) Time Sampled:�Date Sampled: L / Sampled by: Sample Type: Routine:® Treated:❑ Untreated:❑ Repeat Sample #: This Section to Be Completed by Lab Analysis Results: [Satisfactory ❑Unsatisfactory E]Sample too long in transit (greater than 30 hrs.) 'Request resample. Copy Sent to State: Yes : No Chromoaenic/Fluorogenic Method Results: Total Coliform Present (P)/Absent (A) Lab I.D. #: r� E. Coli Present (P)/Absent (A) // 17A Date Received: b Time Received: �`� Received by: Date Test Begun: �#JD Time Test Begun: Analyst: Date Completed: 7// Time Completed: 163G Analyst: 17Vi "a r Refer to Back Side for Instructions Matsu Test Lab of Alaska r z Water Quality Testing Mile 3.2 Palmer-Wasilta Hwy. P.O. Box 2749 Midtown Community Business Park Palmer. Ak. 99645 Phone: (907) 745-3005 Email: mat-sutestlabdiliroaershsa.Com Fax: (907) 7453010 Client: Alaska Rim Engineering, Inc. Date Arrived: 6/30/05 P.O. Box 2749 Report Date: 7/6/05 Palmer. Ak. 99645 Sample Date: 6/30/05 Attn.: Sample Time: 1240 Client ID: Lot 1A Block 1 Fire Lake 04 1225 Collected By: CA PWSID #: Source: M.S.T.L.#: 53302 Sample Matrix: Comments: Method Parameter Units Results MDL Date Prepared Date Analyzed MCL SM 4500-NO3-E Nitrate -N mg/L 4.21 0.50 7/6/05 7/6/05 10.0 SM 4500-NO3-E Nitrite -N mg/L 0.65 0.05 7/6/05 7/6/05 1.0 Lead Pb mg/L <0.002 0.002 7/6/05 7/6/05 0.015 Total Nitrate/Nitrite mg/L 4.21 0.50 7/6/05 7/6/05 10.0 Legend: MRL - Method Report Level MCL - Max. Contaminate Level 8 - Present In Method Blank E - Estimated Value H -Above MCL O - Loat to Dilution R ed By Jon Paul Campbell Lab Manager Municipality of Anchorage Development Services Department j Building Safety Division _ On -Site Water and 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 SUBMITTAL COMMENT SHEET To: Mary Shreves Legal description: Fire Lake Block 1 Lot 1A ZD The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on _ ❑ Calculation error in design. ❑ Additional soils information needed. _ ❑ Water monitoring results Inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ® Incomplete; missing Water samples ® Incomplete; missing Test hole Not located on Inspection eport ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. _ ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ ® Other. NA for surface water separation distances Name of reviewer: Jeff Date: 6/30/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK