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Home My WebLink AboutGREENLAND BLK 2 LT 3Greenland Block Lot 3 #015-172-16 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241200 PID Number: 015-172-16 Dwelling: X Single Family (SF) ❑ with ADU El Duplex (D) El Two Single Family Project: El New X Upgrade Name MICAH & HOLLY BOYER ABSORPTION FIELD Fj Deep Trench RN Wide Trench M Bed M Mound Site Address 4900 E 11 3TH AVE., ANCHORAGE, AK 0 Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-240-16r,i53 1 4 0.8 GPD/SF 1 SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe **2.06 2.01 FL Subdivision Block Lot GREENLAND 2 3 Fill added above original grade SEE DWG. Ft. Gravel length **56.5 55 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 796 Ft2 2 6+ Ft. Well 100,+ 100'+ 100'+ - 25+ TANK [I Septic [9 S.T.E.P, [__1 Holding [I Other Manufacturer GREET TANK Capacity 1500 Gal, Surface Water 1001+ 1001+ 1001+ - Material Number of compartments Lot Line 51+ *11+ 51+ - NA PLASTIC 2 Foundation 10'+ 10'+ 10'+ LIFT STATION Capacity IManufacturer Remarks *LOT LINE WAIVER GRANTED (OSV241030) GREER TANK/ ANCH. TANK —500 (2ND COMP.) Gal. NORTH TRENCH / SOUTH TRENCH Alarm location INDOOR/6GE Electrical installed by 7 Installer PIPE MATERIAL House to tank D3034 Tankto drainfield D 1785 JR'S EXCAVATION Drainfield D3034 CO/MT D3034 Inspector GEG BENCHMARK (Assumed elevation) 100.00 ft Inspdatesn ectio1 st 8/7/2024 11/25/2024 Location and description : 2nd 31d 11/25/2024 41h 11/2612024 BACK DOOR THRESHOLD ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date 4=7 s0 0 . o 9 T ......... ....... .......... Ai Septic System Approved Date arn ss CE-7 3 7#' Note: this approval does not include well permit requirements. (Y10rof e' 57101, #AECC8U �61 I (Rev 05102/18) PERMIT OSP241200 RECORD DRAWING 015-172-16 NUMBER: PARCEL ID NUMBER: I / i� 1 I I I 1 1 1 1 1 / I . \ I 1 R.O.W. EASEMENT—/` b EXISTING 4-BEDROOM / HOUSE / A i OLD DRAINFIELD. PER CONTRACTOR, DECOMMISSIONED IN PLACE. NEW OWNER TO REMOVE CO'S AND MTS IN THE SPRING/SUMMER OF 2025--\ NEIGHBORING DRAINFIELD N 1" = 40' LGENERAL LOCATION OF MICHAEL ANDERSON, P.E. 2005 TEST HOLE #1 GENERAL LOCATION OF VEGETATED DRAINAGE WAY./)? NO VISIBLE WATER ON 7/11/2024 & 10/8/2024 EAST 113TH AVENUE A B FCO 14.5 37.9 C01 35.6 48.5 MH1 37.6 49.4 MH2 41.6 51.4 DBL1 43.6 52.6 DBL2 44.6 53.1 MT1 104.7 111.6 MT2 130.3 113.1 f MT3 119.0 120.0 / MT4 144.2 125.E / NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910LASER DISTANCE METER, SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. i NEW 1500-GALLON GREER PLASTIC STEP TANK WITH ORENCO COMPONENTS PER THE CONTRACTOR, THE LINE AFTER DOUBLE CLEANOUTS ON OUTLET OF TANK WAS CAPPED AND IS NOT CONNECTED TO OLD DRAINFIELD 1-1/2" SCH 40 PVC PIPE GENERAL LOCATION OF MICHAELANDERSON, P.E. 2005 TEST HOLE #2 a ' 1' LOT LINE WAIVER —Z GRANTED (WR241030) Mra 1 I NEW ORAINFIELDS. EAST 114TH AVENUE (UNDEVELOPED) GARNESS ENGINEERING GROUP, L -• ... ENGINEERING � SALES,, CONSULTING 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, ALASKA • PHONE (907) 337-6179' VVESSITE www.aamassonaineet(no.com PREPARED FOR: MICAH AND HOLLY BOYER PHONE NUMBER: 907-240-1653 PAGE NUMBER: 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: GREENLAND; BLOCK 2, LOT 3 J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 12/6/2024 >f U CE-79 3 Z'n �� F,p'••.,, t Z�b Z t•.••''� 40 SfLICENSE t,� ESS, .W #AECC884 raaal� PERMIT NUMBER: PARCEL ID NUMBER: OSP241 00REC"ORD015-172-16 FINAL GRADE TOP OF MANHOLE 98.47-98.52 TOP OF MANHOLE = 98.84 = 98.80 W DBL1 DBL2 L�1 MH1 MH2 - TOP OF TANK Li INLET = 94.89 tip 7 0 ul Q TOP OF TANK NOTE: PER CONTRACTOR TANK U. - 2 qq m �` .. CV OUTLET = 9�4.89 HAS 2" OF INSULATION OVER IT w �' z cy � �- m TOP ET TANK (NOTE SHOWN FOR CLARITY) w Q z 0 INLET = 94.89 w p� H� d d ,,,,---PER CONTRACTOR, LINE : • AFTER DOUBLE CLEANOUTS WAS CAPPED INVERT OF PIPE INLET = 94.22 PUMP FILTER, PUMP, y FLOAT CONTROLS, ETC. SUPPLIED BY 1", ANCHORAGE TANK-411 x NEW 1500-GALLON GREER PLASTIC E STEP TANK 3 i AVOW Lj a. W SOUTH G MT#1 ! G MT#2 NORTH i NOTE: CONTRACTOR PULLED . TRENCH �� r .. IL MOTE. BENCHMARK FOR PROJECT IS MT3 BOTH GWM TUBES DURING TRENCH MT1 MT4FINAL GRADE TRENCH CONSTRUCTION FINAL GRADEco MT2 BACK PATIO [BOOR THRESHOLD = 100.00 �� = 1 C}ti.ilf�-1 Qfl.55 = 1 Qfl.33-1 flfl.54 �� .J GRADE @ GWM-MT 1 = 99.00 W GRADE @ GWM-MT#2 = 98.11 .h CL UL e uju wo OF w M 2°' OF INSULATION, 2" OF INSULATION, NOTE: PRESSURE DISTRIBUTION LINES ARE PER CONTRACTOR PER CONTRACTOR 1.25" SCH. 40 PVC WITH 3116" HOLES (FACED FILTER FABRIC DOWN) SPACED 3-FEET ON CENTER. 18-HOLES FILfiER FABRIC c, PER LATERAL - 39-HOLES IN ENTIRE SYSTEM © L • w V 0 w • ,; ? asp•—. • w m • • INVERT OF DISTRIBUTION • i INVERT OF DISTRIBUTION' - • • LINE - 96.51 w • LINE - 96.56 i • • i e2. ,^: tip �, Li. ww 5-FEET WIDE , :M $ ' _ w , �ti f ' r _ :- `• .p./p (/�} BOTTOM OF DRAINROCK 94.50 61_ ' ' .` ` `` -'$ �` Y .� ' `'� `� TOP OF MOA FILTER SAND / w BOTTOM OF DRAINROCK 94.50 CF tilt, :+� ' ry 1-p r sa : ;,•' 4.5* FEET OF IMPORTED ♦4► , i i ' ++ 4_ Air + s4 .T 8 . "1 Jb«•'. m°'..•' �.'• MOA SAND* Air AIF ` r,• Alt-7 Z- ♦ 1 . �• " � ii.iiisiiiiiii die eiiiaiiiiiieeaiAll feaaa� _ ',,. •ter y y-._ _ .. .... a:•'. t•• . r '• iiiiiiii i GROUND WATER MONITORING GV1(I TUBES INSTALLED N 10181SAND) asset seas'.. es' i■i O 2024 PRIOR TO PLACING MOA FILTER ". _• ' 7-DAY GROUNDWATER MONITORING I G -GWNI TH1 - 90.32 ON 10/15/2©241 G-TH#2 = 90.23 ON 10/1512024 i//)//►.i`j-niy/+ 5-FEET WIDE Now APPROXIMATE LIMITS OF EXCAVATION OF TRENCH = `'` +�a cos �,,�,Ar PROFILE 1 ! 3t3.00# GROUNDWATER ENCOUNTERED. ► ' a�a�.ee.evaa**s ► VIEW OF DRAINFIELD UPGRADE ♦ p. ♦� EIS tc�' ,+ LICENSE ��'''"�'"'► #AECC884• LAJ LILJ 40 IAJ z �. a ui' , ui a 0 ui LU tl $: 3 40 2, 3` F 4At .: e :. a alt ; d> s �F Alt s xg aka' � fir: 1f MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241200 Work Type: Septic Upgrade Tax Code Number: 01517216000 Site Legal Address: GREENLAND BLK 2 LT 3 G:2636 Site Mailing Address: 4900 E 113TH AVE, Anchorage Owner: BOYER MICAH JOHN & HOLLY RENEE Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date: S': J fi L)cpartmtrIIt Lot Size in Sq Ft: Total Bedrooms: 7/24/2024 7/24/2025 27000 Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 11 bV*1 1 �25i yo` 4 4,,ctcc /4710 J Reee*ved-By: Issued By: Date: Date: 71z_Y1 �( 4 Mun*dpaflty of Anchorage Ihp;n ttnt nt .. P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development I Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV241030 COSA#: Permit#:OSP241200 PID#: 015-172-16 Legal Description: GREENLAND BILK 2 LT 3 Engineer: Garness Engineering Group Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 1 foot to the east and west property lines. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: Approved Z Approved by: -- — Name of Reviewer **** VARIAN C E/WAIVER REVIEW **** ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-172-16 Property owner(s) MICAH & HOLLY BOYER Mailing address 4900 E 113TH AVE., ANCHORAGE, AK Site address 4900 E 113TH AVE., ANCHORAGE, AK Day phone 907-240-1653 Legal description (Sub'd., Block & Lot) GREENLAND; BLOCK 2, LOT 3 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑ Upgrade ❑X Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: DRAINFIELD TO EAST AND WEST LOT LINES Distance: 1 certify that the above information is correct. 1 further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: S� Waiver Fees: Z Date of Payment: l Z f"%y° Date of Payment: Receipt Number: Receipt Number: Permit No. t�? 'Z L/2_0 Waiver No. {' Z Y 1 0 .' GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc d -N A UARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING October 16, 2024 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Attention Deb Wockenfuss Ref: Revisions to Design of Septic System Upgrade for Greenland; Block 2, Lot 3 Ms. Wockenfuss: A permit was issued for this septic system upgrade on 7/24/2024. A new 1500 -gallon Greer plastic septic tank was installed on 8/7/2024. The tank was larger than required and 24" manhole risers were installed on both compartments of the tank. On 10/8/2024 GEG was called out for a bottom of trench inspection. Upon arrival, a significant portion of the 88 -foot -long trench had ponded or seeping water in it near the bottom of the excavation. I disused the situation with GEG consultant Jody Maus and asked him to contact you. After discussion, it was agreed that 7 -day groundwater monitoring would be performed and the design revised. Two groundwater monitoring tubes were placed in the excavated trench and then approximately 60 -feet of the east end of the trench was filled with 4.5 feet of MOA filter sand. The west 28 -feet of the trench was backfilled with native soil. Attached is the revised design. We are proposing the septic tank be converted to a STEP tank and that dual pressurized 5 -wide trenches (with 2 -foot effective) be installed. We request this change -order be approved expeditiously so the contractor can proceed with the installation. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Jeffry 136rnes, P.E., M.S. Presliit 1--i 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com • July 11, 2024 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System Upgrade for Greenland; Block 2, Lot 3 To whom it may concern: The existing house is served by a private well and septic. The septic system was installed in 2005 for a 4 -bedroom house and consists of a 1,250 -gallon steel septic tank and a 5 -wide trench type drainfield. The drainfield was 97% full on 7/3/2024 and did not pass an adequacy test. We are proposing that the alternate (reserve) 5 -wide drainfield be installed. See the attached design drawings, and specifications. 1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the percolation test results for Michael Anderson, P.E. test holes. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: Attached is the MOA Watershed Wetland map for your review. There is a vegetated drainageway south of the proposed drainfield. No water was found in this drainageway on 7/11/2024. In short, there does not appear to be any surface waters within 100'+ of the septic system. 4. TOPOGRAPHY: The design drawing shows the general topographical information. There are no slopes greater than 25% within 50 -feet of the proposed drainfield. In short, the proposed drainfields meet the slope requirement set forth in the MOA Wastewater Ordinance. 5. LOT LINE WAIVER: The existing drainfield was issued a 1 -foot lot line waiver to the west lot line (see waiver WR#050068). We request the waiver be amended for the alternate drainfield site and to include both the east and west lot lines. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. A Jeffreyl (I3arnes`.E., M.S. Presicl 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241200, Deb Wockenfuss, 07/24/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241200, Deb Wockenfuss, 07/24/24 DESIGN CRITERIA: NUMBER OF BEDROOMS: 4 GALLONS PER DAY (GPD): 600 PERCOLATION RATES: 13.0 & 14.2 MINUTES/INCH PROPOSED APP. RATE: 0.8 GPD SQ.FT, \ / ,/'-- c� •'; , .. •: / / / MINIMUM DRAINFIELD SQ.FT.: 750 1 DRAINFIELD DESIGN: MAX. DEPTH: SEE PROFILE DRAWING, PAGE 3 OF 3 WIDTH: 5 -FEET I i'�•. r LENGTH: 110 -FEET (2 @ 55' LONG EACH) EFFECTIVE: 2 -FEET MOA FILTER SAND: 4.5'+/- (IN EXCAVATED TRENCH ONLY) REDUCTION FACTOR: 0.70 ACTUAL SQ.FT,: 786 '' " O!`'r ." EAST 113TH AVENUE �\ GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. � m / \ \\ EXISTING \� 4 -BEDROOM o HOUSE / c " N ' \ FCA��/ .- ' �SCALE: 1" = 40' NEW 1500 -GALLON SEPTIC TANK INSTALLED ON Bl7/2024. TO BE CONVERTED TO STEP TANK USING DRAINFIELD. µx RISERS TANK STEP TANK PACKAGE. EXISTING S HAVE ALREADY BEEN INSTALLED APPEARS BE ENCROACHING ON rnx ON BOTH COMPARTMENTS GROUNDWATER. TO BE NOTE: CONTRACTOR SHALL HAVE DECOMMISSIONED IN PLACE THE EAST, WEST, & SOUTH LOT LINES FLAGGED/STAKED BY A REGISTERED LAND SURVEYOR PRIOR TO ANY CONSTRUCTION. i h NEIGHBORING �\ ;� w ; GENERAL LOCATION OF DRAINFIELD L: - �- y MICHAEL ANDERSON, P.E. 2005 TEST HOLE #2 88' LONG TRENCH EXCAVATED TO -9' DEEP. ` _r GROUNDWATER FOUND. SEE DETAIL ; �•...r,,! AREA FOR TRENCHES IS GENERALLY FLAT DRAWING FOR DESIGN REVISION _ t f V LOT LINE WAIVER GRANTED (WR050068). i G REQUEST NEW DRAINFIELD BE INCLUDED— ------ GWM 1' LOT LINE WAIVER GRANTED (WR050068). REQUEST NEW " - ---`� DRAINFIELD BE INCLUDED NOTE: NO SLOPES GREATER THAN 25% WITHIN 50+ FEET OF THE DRAINFIELD UPGRADE PROPOSED DRAINFIELD GENERAL LOCATION OF UPGRADE. SEE DESIGN -�-- MICHAEL ANDERSON, CRITERIA AND DETAIL ---..__ P.E. 2005 TEST HOLE #1 DRAWING, PAGE 3 OF 3 GENERAL LOCATION OF VEGETATED DRAINAGEWAY. EAST 114TH AVENUE (UNDEVELOPED) NO VISIBLE WATER ON 7/11/2024 & 10/8/2024 --w— k OF Al :x ENGINEERING SALES CONSULTING y 3701 E, TUDOR ROAD, SUITE 101 ' ANCHORAGE, ALASKA' PHONE (907) 3376179' WEBSITE: VN.w.gamessengineadng.com Z •••S•!9 ••• • t••�••••••r•••••••••••••s! PREPARED FOR: MICAH AND HOLLY BOYER_ PROJECT/LEGAL DESCRIPTION: GREENLAND; BLOCK 2, LOT 3 TYPE OF WORK: DESIGN OF DRAINFIELD UPGRADE PHONE NUMBER: PAGE NUMBER. 907-240-1653 2 OF 3 DRAWN BY: J.L.M. DATE: REVISEI 10/16/2024 '+; V CE -7953 �`�;;Fo•pp..........1•?�•�P�, #AECC884 LU 88' EXCAVATED TRENCH -GROUNDWATER ENCOUNTERED Om -28' OF TRENCH BACKFILLED WITH NATIVE SOIL -COMPACTED IN -60- FEET OF MOA FILTER SAND ADDED TO EXCAVATED TRENCH ON 10184/2024 J LIFTS PER THE CONTRACTOR .I 1.5"SCH. 40 PVC FEED LINE - SLOPE TO DRAIN (NO BELLIES) AFTER EACH PUMP CYCLE O ^�1 = M - O O O m w cnN i �r M7+ Q LL Ln m IL Z0) Wcr)O s� w� 1.25" SCH. 40 PVC PRESSURE DISTRIBUTION LINES WITH a a o NOTE: CONTRACTOR TO REMOVE GWM-MT#2 » - 3/16" HOLES (FACED DOWN) SPACED 3 -FEET ON CENTER. GROUNDWATER MONITORING TUBES 18 HOLES PER LATERAL -36 HOLES IN ENTIRE SYSTEM PRIOR TO PLACING DRAINROCK MTO i f OMT � 52 FOOT LONG LATERALS ENDS CAPPED (TYPICAL) 55 FOOT LONG TRENCHES IE PLAN VIEW OF DRAINFIELD UPGRADE ra z€ tit W 0 NOTE: BENCHMARK FOR PROJECT ISZ; 01, BACK PATIO DOOR THRESHOLD = 100.00 GWM-MT#1 2+ FEET OF GWM-MT#2 2+ FEET OF COVER MT COVER MT t%3� w - J x GRADE @ GWM-MT#1 = 999.00:t,�, LU az:GRADE @ GWM-MT#2 = 98.11 V) Z w W? W Zs co W 2" OF INSULATION 2" OF INSULATION d Z. O FILTER FABRIC FILTER FABRIC �� of o N CL Y LL w O C9 INVERT OF DISTRIBUTION INVERT OF DISTRIBUTION p Z LINE = 96.50 LINE = 96.50 a0 It w J •• v -. wLu 0 W�i 5 -FEET WIDE - ow LLW ui TOP OF MOA FILTER SAND i `•.. n BOTTOM OF DRAINROCK = 94.50 8+ i.` �' - ''-rJ; :` '•`". `+-' ` TOP OF MOA FILTER SAND / - BOTTOM OF DRAINROCK = 94.50Ok 4.5t FEET OF ®O!^C� OF ° i,t :�.• .=- MOA FILTER .®��\............ ,�•�� SAND ADDED/ 4 .•'` ••. ,�' TO BE ADDED �•'� �',� AV t �....:.... .......1 ..........::.....0 GROUND WATER MONITORING GWM TUBES INSTALLED ON 101812024 PRIOR TO PLACING MOA FILTER SAND 7 -DAY GROUNDWATER MONITORING - GWM-TH#1 = 90.32 ON 10/15/2024 / GWM-TH#2 = 90.23 ON 10/15/2024 - p' .'..t:: r: ;' ? �- : ••effrey ar ess a Lv.. ♦ �J,l. CE -7953 .�Ar a APPROXIMATE LIMITS OF EXCAVATION OF TRENCH = •�♦ (•• i o t -i ! �+ 1.�d/•� �� 4 5 -FEET WIDE 90.00* - GROUNDWATER ENCOUNTERED. CALLED MOA + (��`'•+....... ..n••� +4 PROFILE VIEW OF DRAINFIELD UPGRADE ONSITE DEPARTMENT ONTO/8/2024AND DISCUSSED °+i pROFESS��Pi�� DESIGN REVISIONS AND INSTALLATION OF LICENSE M,IATA A GROUNDWATER MONITORING TUBES. #AECC884 iL.i >- c) s Q, Z �J s� g G g a� AR x, a s: r r b 3. ; : i Municipality ot'Anchorage Page I of 3 Development Services Department On-S~te Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519~650 www.ci, anchorage, ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW050071 PID Number. _ 015-172-16 Name Merit Homes WastewaterSystem: New P.O. Box 111982 Anchorage, AK 99511 ABSORPTION FIELD 334.9233 Four (4) 5' Wide Trench LEGAL DESC RIPTIO N s~ ~ T,,~ o.~ ~,,,~ ~,.~ .8 ~o~e' 6 r,. 2 3 Greenland 3 1-3 E,. 88 F,. Well: New c,,.,~ I 5 Private 223 E,. 223 E, 758 ~eASTM 3034 PVC Alpine Drilling 7102/05 152 ~t Red Dog 5/11/2005 40 c~ F,. >2E, TANK SEPARATION DISTANCES Ig Septic I-1 Holding I-1 S.T.E.P. [] Other: Tank Field Station Tank Se~rU~ Anchorage Tank 1,250 w~ >100' >100' NIA N/A >25' Steel Two (2) s~w.~,, >100' >100' N/A N/A ~/ LIFT STATION - NONE ON LOT ¥ t,,t~. >5' 1' N/A N/A c~..~ o,.~ None Noted P~.,~ BENCH MARK Carage Slab Inspections performed by: AH Dates: ,,, -~.-.~,--.*./ .... ~.........~f.~,.._~ 511110 5 e...Z~...~.~ Department of Health and Human Services approval ~, ~.\ .o ¢, ~,~,, ~.~'-' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Ancl'~_r-a.~ AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal ~-y~er~ or Well Inspection Report Permit Number. SW050071 Page 2 of 3 PID No. 015-172-16 EAST 113TH AVENUE S 8~'~'20'[ 100.00' 48.7 52.9 112.1 111.9 95.5 96,7 GREENLAND SUBDIVISION LOT 5, BLOCK 2 27,000 S.F. · ,~.~..~.. ~...~ PLAN AS-BUILT · ,.......- ~C-"~ ¢ _~ ~-; Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number. SW050071 Page 3 of 3 PID No. 015-172-16 1,P50 G~tton % Septic Tank 5.65 9 13rolnFletd Rock ~ ~5.5 88' (Trench Length) ~ 80.0 PROFILE AS-BUILT Scale: 1' - 10' Sap 01 05 11:28a ALPINE DRILLING & ENTERPRISES Permit Number: #SW050071 Date oflssue: ,4-07-05 Date Started: 7-2-05 Date Completed: 7-3-05 Legal Descriptiou: Property Owner Name & Address: Borehole Data: SoN T)~, 'l'Mekness & Water Steam stick-up organics & silt gravelly silt silt silty gravel wet silt gravelly silt silty sandy grave/ H20 I gpm gravelly silt silty gravel wet water sand & gravel Parcel Identification Number: 015-172-16 Is well located at approved permit location? [] Yes [] No Green/and Sub BIk 2. ~.ot 3 Merit Homes 4901 E ~ 14'~ Ave, Anchored/e, Alaska 99516 Depth (ft) Method of Drilling [] air rotaxy [] cable tool From To Casing type: .steel 0 2 Wall T~ckncss: .250 inches 2 5 Diamctcr: _6 inches Depth: 223 feet 5 21 LinerType: 21 62 Diameter: inches Depth: fcct Casing stickup above ground: 2 feet 62 63 63 77 static ~vater level (~rom Found level): f52 feet Pumping level: 223 feet after 77 103 _2 hours pumping 40 gpm 103 105 Recovery Rate: 40 gpm 105 113 Method of Testing: ~/rlift 113 198 Well Intake Opening Type: 198 219 [] Open End r-I Open IIole 219 223 [] Screened Start ~ feet Stopped feet [] Perforations Start feet Stopped feet Grout Type: Oentonite granules Volume: 1 Bg Depth: Start_0 feet Stopped? feet Pump: Intake Depth feet Pump s/ze hp Brand Name ~,Vell Disinfected Upon Completion? [] Yes [--I No Method of Disinfection: chlorine tablets Comments: well was perforated at 104 Ia ! 0~ when depth of 185 was reached The water diminished in production so was not usable. The caving was continued deeper $o the perforation$ are at a finished depth of 144- 145 Well Driller:. Alpine Drilling & Enterprises PO Box 1'10496 Ancorage AK 99511 Attention: The '~ell driller shall provide a well log to thc property owner within 30 days of completion and the property MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Apr 07, 2005 Expiration Date: Apr 07, 2006 Permit Number: SW050071 Parcel ID: 015-172-16 Legal Description: ~GREENI.~ND SUBDIVISION BLOCK 2 LOT.3 / Design Engineer: 0014 Anderson Engineering Site Address: 4901 EAST 114TH AVENUE Owner Name: MERIT HOMES Lot Size: 27000 SQ. FT. Owner Address: 4901 E 114TH AVENUE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516- This permit is for the construction of: [] DisposalField [] SepticTank [] Holdingmank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail 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. Issued By~ Date: Date: 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.ak.us (907) 343-7904 ON-SITE SEWEPJVVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW Property owner(s) Merit Homes Mailing address (1) P.O. Box 111982 Anchorage, AK 99511 ~..~e..q address (2) 4901 East t14", Avenue Zip Code Legal description (Lot, Block & Sub'd.) Lot 3, Block 2, Greenland Subdivision Legal description (Section, Township & Range) Lot Size 27,000 SF Acre qs~.Ft. Number of Bedrooms Four (4) DayphoneT/0A999 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool [] Well Only [] [] Water Storage [] [] Jac, ,~i [] [] Water Softening Unit [] 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. (Signature of property owner or authorized agent) 1' '~ I?$"' /~aiver Fees: Date of Payment Receipt Number:. ANDERSON EN ';.2..,:- ........... 522:7.773 ................ 522~779 {FAX}., .................... MEMO DATE: 511112005 TO: Joe Goodall MoA/On-Site Water and Wastewater FROM: Mike Anderson SUBJECT: Lot 3, Block 2, Greenland Subdivision Septic System Permit No. SW050071 Lot 4, Block 2, Greenland Subdivision Septic System Permit No. SW050072 The topography of the subject lots makes it difficult to have gravity flow from the houses to the septic system areas. We have themfora redesigned the absorption trenches to have a 3' effective depth rather than the originally permitted 4'. The bottom of the trenches will be a minimum 'of 4' above groundwater and 6' above bedrock as measured today and In the next week. The length of each trench will now be 87' and encroach into the lot line setback of 10'. Lot llne waivers will be submitted In the next week to allow the absorption trenches to encroach Into the setback area. Please review the aforementioned Information in conjunction with the previously approved deslgn and advise If you have furl, her questions. I/I 'd 8SIO'ON 6LLgZ~§L06 ~dOO:Z gOOZ 'll'XelN ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) Apd17,2005 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 3, Block 2, Greenland Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer:. The owner of Lot 3, Block 2, Greenland Subdivision intends to construct a new four- bedroom home on the property. We are therefore requesting a permit be issued for the construction of a new well and septic system to serve the home. No conflicts exist between the proposed well and septic system and those on adjacent properties. The Site Plan and backup documentation identify the location and configuration of the proposed well and septic system. Existing drainage arrows and the current drainage pattern are also identified on the Site Plan. The drainage pattern will be maintained after development of the new system is complete. Test holes placed near the location of the new absorption trench and alternate site revealed silty sand and gravel to depths of 16' to 17'. The accepting soils were tested and found to have a percolation rate of between 6 and 15 minutes per inch. No groundwater was found during excavation and none was noted during the monitoring period. Our design includes the placement of a new 1,250-gallon septic tank along with a new 75' long by 5' wide absorption trench with a 4' effective depth to collect and treat the sewage generated in the house. The bottom of the trench will be 7' below the ground surface. The distribution pipe will be 3' below the surface. A minimum of 3' of cover will be placed atop the bed and a minimum of 4' of cover will be placed atop the new septic tank. The ground surface on the lot slopes from the middle of the lot both east and west at grades approximating 2% to 5%. The new absorption trench will be constructed parallel with the slope of the ground surface as much as possible in conformance with Municipal requirements. The new septic system will be constructed 100' from all wells and 100' from any surface water. It will also be constructed a minimum of 10' from any · Lo't 3, Block 2, Greenland Subdivision April 7, 2005 Page Two water service in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments E 112~ lt4~h ~XAvenue AREA HAP s~ ' ~ , ' .;REENLAND SUBDIVISION LOT 3, BLOCK 2 27,000 S.F. EAST 113TH AVENUE 8g'5,,,3'20"lr 100.00' A.C. DRrVE ~) Pr~Pe~sed PROPOSED BUI~ING x 1,250 Gallon Septic Tank 20' ~l Depth ~sorption Trench S 89'53'20"E 100.00' EAST 114TH AVENUE ~..ZC.<L r. ^Nncr~a./ SITE PLAN SCALE: 1' = 40' LOT 3, BLOCK 2, GREENLAND SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom House 5' Wide Trench System Parc. Rate: 6-15 Min./inch 1,250 Gallon Septic Tank Application Rate: ·8 GPD/SF 4' Drainfield Rock 4 Bedrooms X 150 GPDI.8 GPD/SF (Application Rate) = 750 SF Absorption Area 750 SF/5 SF ' .5 (Red. Factor) = 75 LF Trench Length THEREFORE: Construct a 75' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trenches to be 3' Below Odginal Ground Surface. Total Depth to be 7' Below Existing Ground. Provide 4' Cover Over Septic Tank and :3' Cover Over Trench. 2'6" 4'0" 3' Cover ,,,,,,/'~atural-~ Over Trench Backfill Geotextile -- Fabdc 4" Perforated PVC (Holes Down) -- Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION ~.o SCA,E) .._'~;~ .......... NOTE: Grade Area Over Trench to D~in Away. ~ .~. Minimum 6 Separation From Bed~k. ..~.,~.....~.......~.....~ Minimum 4' Separation From Groundwater. ~ Minimum 100' Separation From Wells in the Area. ~'~[ Minimum 10' Separation From Water Se~ices. ~% No Minimum 100' Separation From Sudace Water or Streams. '~,~..~.'"~ Pedormed For: Legal Description: ~ "'r- ..~ 7- 8- 9- 10- 11~ 13- 18- 19- 20- Mh nicipa'lity of Anchorage Development Services Department Building Safety Division On-Site Water and Waslewater Program ' 4700 South Bragaw St. P.O. Box 195650 Anchorage, AK 99519-6550 www ci ah~horeoe ak.u~ (90?) 343.7904 Soils Log - Percolation Test Date Performed: ,~' ~ L,jl~:~wnship. Range. Seotion: Slope · . I'1-t I · WAS GP, OUNO WATER ENCOUNTERED? · Read!ng Site Plan Net Time ~ · Water Net D~op I~,.~ .' I ~.~,~. PERC HOLE DIAMETER FT .I I ' PERFORMED ~Y: ,/~ I !RTIFY THAT THIS TEST WAS PERFORMED II'J ACCORDANCE WiTH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THtS DATE.· DATE: 2- 3- 4- 5- 9- 10- 11, 13- 14- 15- 18- 19- 20- M~nicipa'lity of Anchorage Development Services Department Building Safety Division On. Site Water and Wastewaler Program 4700 South Braga~v St. P.O. Box 195650 Anchorage, AK 99519-$~50 (907) 343-7904 Soils Log - Percolation Test Perc. <15 Min.'/I.n, Slope I 't III Date Pefformed:~ Township, Range, Section: ' :. Site Plan · WAS GROUNDWATER '1 . ENCOUNTERED? ~ '* · Dmz-.:4/7/05 Read!rig Net 'rime J Depth tb Water Net D~op -'~.' I ~".' ~ .~..IZ" I · Date Gr6ss'iqme I" ~ :,,~ -' I I ~ .: ~' I I FT 'AND '1', PERC HOLE Dt.~ME?ER FT PERFORMED BY: ,~ J lk"Y THAT THIS TEST WAS PERF~RMED it``~ AC~c~RDANcE ~ITH A~L ~TATE AND MUN~C~PAL GU~DEL~NES ~N EFFECT ~N TH~S D~TE~ DATE: MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 015-172-16 Certificate of On -Site Systems Approval OSC241267 Expiration Date: Legal description GREENLAND BLK 2 LT 3 Site address 4900 E 113TH AVE Current property owner(s) BOYER MICAH JOHN & HOLLY RENEE X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other RMOOM Development Services Department On -Site Water & Wastewater Section Ve L'9':Mfop rJ 0"-'— ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-172-16 Complete legal description GREENLAND; BLOCK 2, LOT 3 Location (site address) 4900 E 113TH AVE., ANCHORAGE, AK Current property owner(s) MICAH & HOLLY BOYER Day phone 907-240-1653 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: 1101] Private Well R Private Well serving 2 dwelling units El Private Well serving 3+ dwelling units F-1 Community Well or Public F Water Storage 4. TYPE OF WASTEWATER DISPOSAL: FE-1 Private Septic F-1 Private Septic serving 2 dwelling units R Holding Tank R Community Septic or Public Sewer 5. SEPTIC TANK: F-1 Steel 0 Plastic ❑ Concrete F-1 Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: R AWWTS R Bed F] Deep Trench RE Wide Trench [I Seepage Pit Waiver request for: Expedited review requested: F-1 Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ Date of Payment Z `/ Date of Payment COSA # 4 -) C_ Waiver e" _) COSA Application —June 2022 COSA Checklist Legal Description: GREENLAND; BLOCK 2, LOT 3 Parcel ID: 015-172-16 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA R Well log is filed with Onsite (or attached) Date drilled 7/02/2005 Total depth 223 ft Cased to 223 ft ❑ Sanitary seal is functioning correctly R Wires are properly protected Casing height (above ground) 1 g+ in. Date of flow test for COSA 7/3/2024 Static water level at beginning of test 147 ft. Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 817-11/26/24 ❑ ALL standpipes present per record drawing Total measured depth from grade 6.05 ft (max) Measured depth to pipe invert from grade ft (min) 0 N/A — pressurized field. Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective V i � Isy ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced _gallons date Any rejuvenation treatment (past 12 months) NIA If yes, enter date Comments/Deficiencies: Well production at time of test 3.5+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes R No ❑ Coliform bacteria is Negative Nitrate 0.412 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L AN Arsenic less than MRL (ND) Collected by GEG, LTD. Date 6/25/24 C. LIFT STATION ❑ Required maintenance completed Age of lift station NEW years Lift station material PLASTIC Comments: Adequacy test date NEW Results Q Pass Fluid depth prior to test 0 in Water added 0 gal New fluid depth 0 in Elapsed time 0 min Final fluid depth 0 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 24 in Effective depth used 0 in Effective depth remaining 24 in COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' © Yes if No ft © Yes if No ft Neighboring Tank > 100' ❑i Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' n Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' 0 Yes if No ft ❑i Yes if No ft Community Sewer Main > 75' Yes if No ft Manure/Animal Excreta Storage > 100' 0 Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' on Yes if No ft Surface Water > 100' 0 Yes if No ft Tank to Property Line > 5' © Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ Yes if No * 1 ft Private Wells > 100' (Q Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' ❑ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *LOT LINE WAIVER GRANTED (WR#OSV241030) G. CERTIFICATION & 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, indicates that the on -site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gamess Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances oa600�� were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic depend systems upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test *; L) T y Q results do not future .:. ..... .... .......... 0 3uarantee performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well G or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The this is for ey rness:- G content of report the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information in this by �' O OQ ' CE— 79 3 provided report any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6Ps • c�Qp jr?-. l'f�•2' �f�� Ao e COSA Checklist June 2022 - LICENSE©O �ofess-,oa1=> MEccaea OO0000 Cya+45 MUNICIPALITY F ANCHORAGE . t� I Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel 1. D. 015-172-16 1. GENERAL INFORMATION Complete legal description Greenland B2 L3 Location (site address) 4900 E 113th Ave Expiration Date: 3-30-20210 Current property owner(s) Brian & Julie Buck Day phone Mailing address 4900 E 113th Ave Anchorage, AK 99516 Real estate agent Day phone 2. TYPE OF DWELLING: I] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: ,),50 TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic I -XI Water Storage ❑ Holding Tanki ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer' ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ ,),50 Date of Payment �alal�9 Receipt Number COSA # 05C_ 1'%oS Waiver Fee $ i Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date OF A�, 6. DSD SIGNATURE TH • . .... — . .. ...: System #1 Approved for bedrooms Steven Ponnore System #2 Approved for bedrooms ��¢� 3 - CE 8749 r� Disapproved Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the i representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Greenland B2 L3 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA FE -1 Well log is filed with Onsite (or attached) Date drilled 713/05 Total depth 223 ft Cased to 223 ft ❑ Sanitary seal is functioning correctly © Wires are properly protected Casing height (above ground) 18°+ in. Date of flow test for COSA 7217'19 Static water level at beginning of test 155.6 ft Comments B. TANK DATA Age of tank(S) 5111105 years Tank type/material s"Wst °' Measured operating fluid level in septic tank 50" FW Standpipes/foundation cleanout per record drawing Date of pumping 12/20/19 D. ABSORPTION FIELD DATA Wide Trench Which system tested (date installed) 5/11/05 Al ALL standpipes present per record drawing Total measured depth from grade 9.5'68 ft (max) Measured depth to pipe invert from grade 6.3-3.5 ft (min) ❑ N/A — pressurized field F0 Monitor tubes go to bottom of effective_ If not, state depth into effective FO -1 Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet f Parcel ID: 015-172-16 Structure served by this system 1 Well production at time of test 2.45 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes 0 No X Coliform bacteria is Negative Nitrate •5 mg/L E]Nitrate less than MRL (ND) Arsenic ug/L X Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 1217/79 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 1217119 Results [DPass For 4 bedrooms Fluid depth prior to test 19/19 in Water added 600 gal New depth 23/25 in Elapsed time 1440 min Final fluid depth 19/19 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) If yes, enter date MAS E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes Community Sewer Manhole/Cleanout > 100' Q✓ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' M✓ Yes if No ft Private Sewer/Septic Line > 25' E] Yes if No ft Absorption Field on Lot > 100' Q✓ Yes if No ft Holding Tank > 100' R1 Yes if No ft Neighboring Absorption Fields > 100' F-1 Yes if No ft Water Main > 10'✓Q Animal Containment > 50' Q Yes if No ft 0 Yes if No ft Q Yes if No ft Water Service Line > 10' ✓0 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' MV Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' F71 Yes if No ft Wells on Adjacent Lots: this system is operating at 67% used. Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' F-1 Yes if No ft Water Main > 10'✓Q Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' ✓0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 1.0* ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' []✓ Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100'✓CJ Yes if No ft F. ENGINEER'S COMMENTS * Waiver on file. Based on adequacy test, this system is operating at 67% used. Reverse or flat grade from septic tank to drain field (2.5" of standing water in double clean out). G. ENGINEER'S CERTIFICATION OF 1 certify that t have determined through field inspections and review eco - of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. % {� 1Z2 • • • • Steven 10onnone CL 8,149 ��- COSA Checklist yellow sheet Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-172-16 GENERAL INFORMATION Complete legal description Location (site address) COSA # Expiration Date: Lot 3, Block 2, Greenland Subdivision 4900 East 113th Avenue Anchorage, AK 99516 Current Property owner(s) Fillipe and Jody Clark Mailing address 4900 East 113th Avenue Anchorage, AK 99516 Day phone 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. NUMBEROF BEDROOMS: Four (4) 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 [] 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 vedfy 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. DSD SIGNATURE ~ Approved for Disapproved. bedrooms. Date 4/5/2o Conditional approval for bedrooms, with the following stipulations: By: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other _~_~~Original Certificate Date: (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmora Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 3, Block 2, Greenland Subdivision A. WELL DATA Well type Private Date completed 7/2/0.5 Total depth 223 ff. Cased to 223 FROM WELL LOG Date of test 7/2/2005 Static water level 152 Well production 40 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Arsenic: N/D ug/I B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Foundation cleanout (Y/N) Y Date of pumping 4/6/2011 C. ABSORPTION FIELD DATA Date installed 5/11/2005 Length 88 ft. Total depth 6-8 ft. IfA, B, or C provide PWSID # ~ Sanitary seal (Y/N) Y g,p.m. Nitrate .10 mg/L Date of sample: 3/25/2011 Number of Compartments Two Depression over tank (Y/N) N Pumper Denali Sewer and.Drain Soil rating (g.p.d./~ or ~/bdrm) .s GPD/SF Width 5 f. Eft. absorption area 758 ft2 Monitoring tube . Date of adequacy test 3/26/2011 Results (Pass/Fail) Pass Fluid depth in absorption field before test ~ 17.5 in. Elapsed Time: 1,308 min. Final fluid depth' 17.5 Any rejuvenation treatment (past 12 mo.) (Y/N & type) N Parcel ID: 015-172-16 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 3/26/11 145 ff. 8.2 g.p.m Y >18 in. For Four bedrooms Water added 667 gal. New depth 23 in. in. Absorption rate >= 600 g.p.d. If yes, give date System type. Wide Trench Gravel below pipe 3 ft. ,Y Depression over field N Date installed 5/11/2005 Cleanouts (Y/N) High water alarm (Y/N) Other bacteria o colonies/100 mL Collected by: A. Harala LIFT STATION Date installed "Pump on" level at Datum in. E. SEPARATION DISTANCES Size in gallons "Pump off" level at Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: in. Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas N/A > 100' >100' >25' None ~ ~) ~'' Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots >1oo' On adjacent lots >1oo' Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas in, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main N/A Water service line >10' Wells on adjacent lots >lOO' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: N/A None / O 83 ' Property line 1' Water Service line >1o' Curtain drain None Noted Absorption field >5' Surface water >100' Building foundation >10' Water main >10' Surface water >100' Driveway, parking/vehicle storage >25' Wells on adjacent lots >100' F. COMMENTS: Lot line Waiver Issued. G. ENGINEER S CERTIFICATION* ~w~w of MuniCipal m~s that the above sy~ems am in confo~an~ w~h MOA COSA guidelines in e~ on this date. EngJn~r's Printed Name Michael E. ~demon, P.E. Date 41512011 COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SGS Reft# 1111098001 ClientName Anderson Engineering Printed Date/Time 03/31/2011 8:17 Project Name/# Greenland Subd L3 B2 Collected Date/Time 03/25/2011 9:12 Client Sample ID Greenland Subd L3 B2 Received Date/Time 03/25/2011 13:00 Matrix Drinking Water Technical Director Stephen C. Ede PWSID 0 SampLe Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 03/25/11 03/29/11 NRB Waters Department Total Nitrate/Nitrite-N 0.328 0.100 mg/L SM20 4500NO3-F B (<10) 03/30/11 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 03/25/11 DLC Total Coliform Negative I 100mL SM20 9223B A 03/25/ll DLC Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700, Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni. org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROMAL FOR A SINGLE FAMILY DWELLING Parcel I.D._ 015- I~,~L- I~ 1. GENERAL INFORMATION Complete legal description Lot 3. BIoc~ 2, Greenland Subdivision *Location (site address) . 4900 Eas~ 113th Avenue Anchorage, AK 99516 cos^# g O I q Expiration Date: R Current Property owner(s), Jennifer R. Toomet- Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) 4900 East 113th Avenue Anchorage. AK 99516 Day phone Day phone Day phone. 3. TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class Well [] Public Water System [] TYPE OF WAS'I e:WATER DISPOSAl': Individual On-site [] Individual Holding Tank IJ~ Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site S terns Approval (COSA) based only upon the renresentations ,-iv~- , .......... '. ys u ~- f- paragraph n oy an Inaepenaent professionat civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approvat are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposat 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 varify 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 (am) safe. functional and adequate for the number of bedrooms an(ttype of structure indicated herein. I further varify that based on the information obtained, from the Municipality of Ancho=ge flies and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(am) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect al:the time of installation. Name of Firm Andemon Engineering Address P.O. Box 240773 Anchorage, AK 9~524 Engineer's. Printed Ns. me Michael E. An(lemon, P.E. 5. DSD SIGNATURE ~ / Approved for J~ Disapproved. Conditional approval for Phone ,,d{((ff((((O'~ . WATER AND : m= ~ : WASTEWATER: .,,-4 ..... - ~5~ ~ , HIII))H~ Attachments: COSA Checklist X ' Septic System Advi-~ory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Pregram 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni, org/onsite (907) 343-7904: CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: _L~t 3, Block 2, Greenland Subdivision A. WELL DATA Well tYPe .Private IfA, B, or C provide PWSID Date completed .7/2/05 Sanitary seal (Y/N) Total depth _223 ft. Cased to .223 fl. FROM WELL LOG : 7/2/2005 g.p.m. Nitrate .254 rng/L Date of sample: _5/'//08 'Number of Compartments ..Two Depression ove~ tank (Y/N) N ,Pumper Denarl Sewer and Drain Parcel ID 015-172-16 Date of test Static water level t52 Well production 40 WATER SAMPLE RESULTS: Coliform 0 colonles/100 mL Amenic: N,13 ug/l B. SEPTIC/HOLDING TANK DATA Tank Type/Material. S~ttc/St~el Tank size _1,250 gal. ' Foundation cleanout (Y/N) Y Date of pumping _5/5/'2008 C. ABSORPTION FIELD DATA Date instatled ? 1/2005 Length: 88 , ff. Total depth. 6-8 ft. Well Log ('Y/N) V Wires propedy protected (Y/N) y Casing height (above ground) >18 AT INSPECTION 5/10/'2oo8 5 2 g.p.m. in. Other bacteria .o colonies/100 mL Collected by: _J. Davis Date installed s/11/2o05 Cleanouts (Y/N) y High water alarm (y/N) .... N Date of adequacy test 5/10/o8 Results (Pass/Fail). Pass For .Four bedrooms Fluid depth in absorption field before test__ 8 ' in. Water added 650 gal. New depth, 'Elapsed Time: 1,440 min. Final fluid depth , ~ 8 in. Absorption rate >= 600 Any rejuvenation tmab'nent (past 12 mo.) (Y/N & type) N If yes, give date Soil rating (g.p.d./ft~ or ft=/bdrm) .8 GPD/SF System type W~de Trench Width., 5 ft. Gravel below pipe 3 Eft. absorption area .758 'ft~ Monitoring tube. Y Depression over field in. g.p.d. Do UFT STATION Date installed 'Pump on' level at in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off' level at Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank~iff station on lot >1oo' Absorption field on lot >1oo' Public sewer main NIA Sewer Iseptic service line >25' Animal containment areas None in. Manhole/Access (Y/N) High water alarm level at. Meets alarm & circuit requirements?. tn. On adjacent lots >10o' On adjacent lots >1o0' Public sewer manholelcleanout Holding tank N/^ Manure/animal excrete storage areas NIA; None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main N/A Water service line >10' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1' Water Service line >10' Cuff,.3in drain None Noted Absorption field >S' Surface water >100' , Building foundation >10' Surface water. >100' Wells on adjacent lots >100' Water main >10' Driveway, parking/vehicle storage >25' F. COMMENTS: Lot line Waiver Issued. G. ENGINEER'S CERTIFICATION I ce~'fy 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.F_ Date 5116/2008 COSA Fee $ Date of Payment Receipt Number (Rev, 11/o5) Waiver Fee $ Date of Payment · Receipt Number P-268 GREENLAND SUBDIVISION LOT 3, BLOCK 2 27,000 S.F. EAST 1.15TH AVENUE S 8g'53'20'£ 100.00' 28.8' L EXISTING BUILDING 27.0' i o I , ! · S 89'53'20'E 100.00' EAST 114TH AVENUE AS-B U I LT I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. i SURVEYING,' LLC IT IS THE RESPONSIBILITY OF THE OWNER TO; JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, 4726 WEST 88TH AVENUE COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99502 APPEAR ON THE RECORDED SUBDIVISION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DAT~ HEREON BE USED FOR CONSTRUCTION OR FOR 2636 8/30/2005 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA r.8. JOB NO. 05-12 ~ CS32 NOTE: NO CORNERS SET THIS DATE. Municipality of Anchorage Development Services DBpartment Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-172.16 1. GENERAL INFORMATION Complete legal description* Lot 3. Block 2, Greenland Subdivlslon Location (site address or directions) . 4841 East lt4~' Avenue HAA # DSD~tq ~ Expiration Date: _/o~-. -~,..- 0 ,.~ Current Property owner(s). Merit Homes Mailing address Lending agency Mailing address . P.O. Box 111982 Anchorage, AK 99511 · Day phone .334-9233 Day phone, Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: _Four r4) Day phone 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class. Public Water System Well [] [] [] [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil engineer registered In the State of Naska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties sewed 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 sewed by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a pofiod of up to one year with valid water samples.) Certificates are valid for one year for properties sawed 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 4. STATEMENT OF INSPECTION BY ENGINEER As certitied by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the 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 vedfy that based on the information obtained from the Munidpality of Anchorage files and from my investigation and Inspection, the an-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 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 Date 911/2005 5. DSD SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: c/..~.. _ O..~ (Rev. t2,'00) Municipality of Anchorage Development Services Department Bmldlng ~af~ty Oiv~lon Or~lte Water & Wastmrater Program 4700 Sou~ Bragaw 6L P.O. Box 196650 Ancl~orage, AK 99519-6650 www.cl.anchorage.ak, us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Das~¥~on: A,, ~ DATA Well type Prlwta Date completed ;rff~0~ Total deplh Date of test SteUc water level Well produc~on WATER SAMPLE RESULTS: · Coliform, ~ colonieS100 mi. Date of .ample: B. SEPTIC~IOLDING TANK DATA Tank Type/Material b~c/Steel Tank size ~ gal. F~daUon deanout (Y/N) Date of pumping C. ABSORPTION FIELD DATA Date iflstelted ~/tl/2009 Total dep~ 6-~ ft. Date of adaquacy test Lot 3. Block 2. Greenland 8ubdlvl~t911 Parcel ID: 0t~-"172.11~ If A, B, or C pmvtde PVV~ID #. Sanlte~y seal (Y/N) Y Casadm 223 IL FROM WELL LOG t52 ft ,~1 g.p.m. We, Log (Y/N) y Wlra pmpe~ protected (Y/N) y Casing height (above ground) Z4 AT INSPECTION g.p.m. Nitrate .10 mg./I. Number of Compartments Z Depression over tank (Y/N) N Pumper New Conltmctlon ,0 colonies/100 mi. Date installed 5/tt/2005 Cmanoum (y/N) y. High water alarm (Y/N) 8ollm0ng (g.p.d./~or~/tx:lrm) JGPD~F System (ype WldeTmnch ff VVldlh ,0 ff. Gravel below pipe ]1 Eft. absaq:~On ama ~i8 ~ Monitoring tube Y Dapre~ion ove~: field'N Results (Pass/Fall) Fluid depth in absofplton field before test in. Water added gal. Elapsed T~me: min. Final fluid depth in. Atmori~on fate >- Any rejuverm~on Imatmant (past 12 mo.) (Y/N & type) H If yea, give date New depth in. g.p.d. D, UFT 6TATION Date installed 'Pump on' level et in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off' level at in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lilt station on lot >1~ Absorpfien fiekl on lot Pubftc ~ewer main FUA Sewer les~c esrvtce line >25' Manhole/Access (Y/N) High water alarm level at Meats alarm & ,J,~.tt mqulmmer~? On adjacent lots >IQQ' On adjacent lots >IQQ' Publlo ~ewer manhole/cleanout FUA Holding tank FUA in* HAAFee S./~'7 ~ ~. ,~r# WaNerFee$ '-/I?~' ~-- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >[r Property line ~ Absorption field >~' Water main N/A Water service line >1~' Surface water >t00' Wefts on adjacent lots >100' SEPARATION OISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line t'* Building foundaUon >1l}' Water main Water Service line >IQ' Surface water >t00' Driveway. paddng/vehicle ~Orage Cudain drain None Noted Wells on edJacent lots >100' F. COMMENTS "See Lot Line W~wf, o. ....... Enginesr'e Pdntml Name Mlch.el E. Anderson. P.E. ~'~ ' ~'"~/'~~"'~... 09-01-05;12:01 ;907 561 5301 # 2/ 4 SGS Ref.~ Client Name l~roJeet Name/# C~ent Snmi~]e ID 105~439001 Dr[~J~ g Water All DatcJ/Tlmes are Alaska $tnndard Time l'rtnted D~te/Tlme 08/29/2005 11:06 Collected Datefl'lme 08/23/2005 10:45 Received D~t.e/Time 0~/23/200.5 1~:00 Technical Dlrector Ste~hen C. Ede Sam~le Remarks: 'Hit~te-N 0.100 U 0.100 m,~r., EPA 353.2 B (<-I0) 08~3/05 AZS l,f. ie~'ob'l ol o c~y Labo=a~o=¥ ~ Total Col/form ~"~C.w/ coVl00:nL SM20 g222B ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) September 1, 2005 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Su~e~: Lot 3, Block 2, Greenland Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: The absorption trench on the subject lot was constructed within 1' of the west lot line to accommodate the construction of the new house and to take advantage of the favorable topography of the lot's surface. In addition, soil conditions on the lot made it necessary to lengthen the trench and shallow the effective depth. A memo to the City was forwarded on May 11, 2005 advising of the field conditions and explaining the necessity of the lot line waiver. The placement of the absorption trench within 1' of the west property line will have no impact on the surrounding lots and will not encroach into areas reserved for septic systems or wells. We therefore request a waiver be issued allowing the trench to be 1' from the west property line. Sincerely, Michael E. Anderson, P.E. Municipality of Anchorage Development Services Department Building Safety Division On-Site Watcr and Wastcwatcr Program 4700 Bragaw Strc~ P.O. Box 196650 Anchorage. AK 99519-6650 www. cl.anchorage, ak.us (907) 343-7904 Waiver Review Worksheet WRY: 050068 PID~:015-172-16 HA#: 05044~ Permilg: Date Received: 9-1-05 Legal Description: Greenland Block 2 Lot 3 Eng{neen Anderson Enaineerina P,O. Box 240773 Anchoraae Ak. 99524 Applicant: Merit Homes Waiver Requested: 1 foot separation distance absorption field to DrODeftv line, Criteria: C-:-:-:-:-:-:-:-:-:~ ~ o g y Points: A. Water Table B. Soil SorptJon C. Permeability D. Water Table Gradient E. Horizontal SeparaUon Total: Waiver is Granted: (.,.,,'/ Waiver Is not Granted: Ust Condi§ons or Reasons for above: Rec#: ~.1~5 Amount: $175 Date Paid: 9/2/2005