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HomeMy WebLinkAboutNORTH SLOPE #1 BLK 3 LT 4North Slope Block 3 Lot 4 #050-511-15 Municipality of Anchorage Development �ervices Department Building Safety Division On-site water and Wastewater Program, 4700 S. Bragaw St. P.O.BOX196650 Anchorage AK 99519-6650 wvm,,CJ.anchorage.ak.us (;07) 34X7904 Page tof ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT SW040 PID Number —050-S. "u .. 0 Wastewater System: New Upgrade Ave.,Fagle R" B iyer, AK 99S77 ABSORPTION FIELD Nmbw od;rBd�r:: NOP T.�h E tun� 13 Dp T..h 03 Shal. T� 0 Sod mou"(1 LEGAL DESCRIPTION ScOill RaWV: — — tank & field insulated field hydro -seeded Top of BENCH MARK Inspections performed by: K6D--En9ftMCf09----Inr.Dates: "'2L16LZQD-4 Development Services Department Approval 2 nd Balamr- 3' 5/2612005 Reviewed and approved b� �'�Date: P": .9 FBI 13 Other ;=,�y 1000". 100 FL Engineer's Stamp M. In. 2.84-3.19 Well: 0 New Upgrade Ft. N.6w ol k,,,- c4as.katim (Frimita. & a. c): TOW D.O: Cow b: Ft. 2 Ft Ft P"Mw~ S70 Fe D4nQA Owe Dr&.d: Swk Wow L".. hr�. Martin Const. D" ln�, 9/ "SON: 6 CIPM k wn z Ft TANK SEPARATION DISTANCES To Septic rphon Lift 0 Septic E3 Holding 0 S.T.E.P. Frem Tank Field Stabon ding pubirjpmat Tank Se�Lk- Anchorage Tank W04 100'+ 1001+ NA NA 25'+ '"Steel sud,ic,i, WSW 100'+ 1001+ NA NA LIFT STATION W Lkw 5'+ 10'+ NA NA Fouws� 5'+ 10'+ NA NA 'P� Gal C,~O D� NA *50'+ NA NA In in Pury 1,01"Oke & MOXI'O,1 tank & field insulated field hydro -seeded Top of BENCH MARK Inspections performed by: K6D--En9ftMCf09----Inr.Dates: "'2L16LZQD-4 Development Services Department Approval 2 nd Balamr- 3' 5/2612005 Reviewed and approved b� �'�Date: P": .9 FBI 13 Other ;=,�y 1000". 100 FL Engineer's Stamp M. In. AS—BUILT SYSTEM DETAILS/SITE PLAN Permit SW 040273 NORTHSLOPE SUBDIVISION, LOT 4, BLOCK 3 PID# 050-511-15 ............ 00 11 KI/ K D )N //"�LOT 4 X ofli A -C= 58.71 B -C= 14.71 A -D= 61.1' B -D= 22.6' t� A-E= 33.71 I 1000 G B-E= 48.11 TANK A -F= 81.31 B -F= 56.7' 91.08 < A -G= 42.4' E -G= 62.0' A -H=93.2' B-H= 69.01 9 FINAL GRADE SEWER ROCK TRENCH I FINAL GRADE SEWER ROCK TRENCH 2 PREPARED FOR, Jim Bickman 4316 UPPER KOGRU DR. EAGLE RIVER, AK. 99577 (907) 694-9694 0— 100, �wrtt I Qof� �'� txrsr LOT 3 ............... SCALE�-* 50' WK , "� V� I SCALE, NTS FIELD BOOKS C0&ftXD. MAW. HKI41D ENGINEERING STAMM CHECKM KMQ 20441 PTARMIGAN BLVD. ASMAT-. OAT, 6 5 EAGLE RIVER. AK 99577-8736 ow� F&E. — _n�_SE0703 AVSf'_AS13LT.DWG I Joe �: 04031 I (907)696-6111/FAX (907)696-8111 (farfiffeb 3DdIting 109 U0, by DOCCO.dbe SULLIVAN WATER WELLS P.O. UM670272, CHUCAK, ALASKA 92M a '--- ' . * -_ OVMMOFIAMM *'JIM- &�Kow;q*_3 F it's I =�g "Will i IsudbCdodatmov I pwabconon? 616s CAM MedWofDVnW ittirmtwy rjcWbi3W Doohatwowt t0) (�mft,r)w vwmyxictim d2m MwwW 1 -1 1 deggh It" lad climmimpmomemalm —fed Sta&Vglhwlewk 6t fed P=Owpe.,M__L_wn mawaviesew Ae- wel, -pi opwkvmm &Cqrmew mopmhom :15munet. swt—w —bd 0 Pedonftm SW _- 43- im to w waffoli, I Upm ommpbuo& brle;� a No MUMWCIFNI- , -- C 14 4 A --hC Jb JOIM IO/TO 3DVd NVAITM ESZZ889 ZT:11 GGQz/9z/Go 56Z 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 /WATER SUPPLY PERMIT Initial Date Issued: Jul 21, 2004 Expiration Date: Jul 21, 2005 Permit Number: SWO40273 Parcel ID: 050-511-15 Legal Description: !North Slope #1 Block 3, Lot 4 Design Engineer: 0070 KND Engineering Site Address: 31000 Kuparuk Ave Owner Name: Jim Bickman Lot Size: 43260 SQ. FT. Owner Address: 31000 Kuparuk Ave Total Bedrooms: 3 Permit Bedrooms: 3 Eagle River. AK 99577 - This permit Is for the construction of. nv' Disposal Field E Septic Tank Ej Holding Tank [:] Privy Private Well Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907)343-7904 ( 24 hours). (Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same ddy. B. Covered, sealed, and heated to prevent freezing. Received By - Date: , Z&Zo�/ lssuedBy-.- Date: 7 Municipality of Anchorage %*�. lob,, Development Services Department eor Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-511-15 Permit Number SW OY"O 2 Property owner(s) Jim Bickman Day phone 694-9694 Mailing address (1) 4316 Upper Kogru Dr, Eagle River, AK. 99577 Mailing address (2) —Zip Code Legal description (Lot, Block & Sub'd.) North Slope Subd. Addn. #11, Block 3. Lot 4 Legal description (Section, Township & Range) '3k0O0 ku P3 rLLK Ne, Lot Size 43,260 Sg. Ft. Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only Well Only El Sewer and Well Water Storage E] Sewer Upgrade THIS PROPERTY CONTAINS: HotTub Jacuzzi Swimming Pool El Water Softening Unit El Therapy Pool n 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. of property owner or authorized agent) Permit Fees: Y%(/0 'I" kel7U— Waiver Fees: Date of Payment: W-2 V'0 Y, Date of Payment: Receipt Number: Receipt Number: (Rev. 12100) KNDENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER. AK 99577-8736 (907)696-6111 / FAX (907)696-8111 July 19,2004 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99319-6650 Subject: New sewer permit — North Slope S/D Addn :1, Block 3, Lot 4 Gentlemen: The owner has requested we proceed forward to obtain a septic permit to construct a wastewater system on the subject lot. On June 14, 2004 two test holes, TH04-1 and TH04-2, were performed for the proposed system. Then on June 30, 2004 two more test holes were performed, TH04-3 and TH04-4. The middle of the property appears to be the most suitable area for septic system construction. The test hole on the west side of the property (TH04-1) has approximately 1.5-2' of organics with ground water at 4' so with the 1' penalty (for June water monitoring) ground water is approximated to be at 3' in high ground water season, there is only Y of unsaturated accepting soil, so this test hole will not be used. The test hole on the cast side of the property (TH04-3) has approximately I' of organics and ground water measured at 4.89'on 7/7/2004. With the 2'penalty (for July water monitoring) ground water is anticipated to raise as high as 2.89'making this test hole also unusable. The test holes located in the middle of the property (TH04-2 and TH04-4) appear to be the most suitable for septic system construction. As a side note they are also very similar to the two test holes used for the lot to the east (N. Slope Addn. #1, Block 3, Lot 3) in regards to ground water depth. TH04-2 has about 1-5-2' of organics with ground water measured at 5.5' on 6/21/2004 and at 6.89 on 7/7/2004, and at 7.53' on 7/19/2004. Even with all of the penalties for June and July water monitoring this test hole appears to be in an area well suited for a septic system. TH044 was performed above TH04-2 to determine if the ground water conditions were consistent in the area. TH044 has approximately l' of organics with ground water measured at 7.19' on 7/7/2004, ground water was measured again on 7/19/2004 and found to be at 8.00'. It appears that this test hole has even deeper ground water than that of TH04-2. It is our conclusion therefore that this area is adequate for a wastewater system. Since there is no seasonal high ground water level information for this property we looked at the surrounding area for information. The properties in the immediate area have all been successfully developed to date and some have had test holes with water monitoring conducted in the high ground water season. The property to the west (N. Slope Addn. #1, Block 3, Lot 5) had ground water at 5', 4', and 2.5' during high ground water season, the test hole with ground water at 2.5' was not used. The wastewater system that was constructed to serve this property was an IDSF (see attached site plan Subject: North Slope Addn. $1 Block 3, Lot 4 7/19/2004 Page 2 of 2 & test hole documentation). The property to the east (N. Slope Addn. #1, Block 3, Lot 3) had ground water at 7.5', 4.5', and 5.5' during high ground water season. The wastewater system constructed to serve this lot was two shallow at grade trenches (see attached site plan & test hole documentation). The ground water depths found on these two properties is a good indication that the ground water tables in TH04-2 and TH04-4 are not inconsistent with the ground water tables in the immediate area. Typically in North Slope Subdivision there are portions of the lots that are not well suited for wastewater system construction. We have identified the area that will best serve this property in wastewater disposal and intend to keep as far as possible away from TH04- 1 and TH04-3. We believe that two shallow at grade trenches utilizing TH04-2 and TH04-4 will best serve this property for years to come (see design for details). During the construction of the system soil consistency will be monitored to ensure there are no drastic changes. The general slope of this lot is from north to south at a grade of approximately 15-20%. The lot and surrounding lots are served by private water systems. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100'of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111 /FAX 696-8111. Respectfully submitted, END Engineering, Inc. Kenneth M. Duffus, P.E. Attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/ Percolation Test Adjacent property documentation Owner/ Excavator Specs WELL & WASTEWATER I North Slope DISPOSAL SYSTEM Addri. #1, Block 3, Lot DETAILS/SITE PLA 4 NO PUBLIC WELLS WITHIN &W Or P�SED SYSTEM. NO PRIVA TE WEUS WITHIN 2W OF P�Ell SYSTEM EXCEPT AS NOTED. M SEPTIC SYSTEMS WITHIN EW OF PROPOSED WELL EXCfPT AS NOTED. OF A Z4 Ar ............. . .. is Aq A111111' DESIGN DETAILS 3 BDRM X 150 GPD 450 GPD 450 GPD/0.8 GPD PER SO. FT. (13.3 MIN/IN.)z 563 SO. FT (563/5'(W)) X I.O(RF) (0.5' GRAVEL) = 112.6 FT. TRENCH USE 2 TRENCHES - 57 (L) X 5' (W) X 0.5'(D) Totat depth of system Is 2.0' from originat grade. Excavate top 2', remove organics & Instatt _Z�_ OF MOA approved sand. Totat depth of gravet below distribution pipe Is 0.5' NOTES: 1. USE 1000 GALLON SEPTIC TANK, INSULATE IF (4' OF COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED. 5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS, SEPTICS, LOT LINES, FOUNDATIONS AND ALL OTHER SETBACKS. PREPARED FOR, Jim BIckman 4316 UPPER KOGRU DR. EAGLE RIVER, AK. 99577 (907) 694-9694 FIELD BOOKS COMPUTM. BOUNOmr. DRAWN: STAKINCZ CMECI(CO. ASDULt; DAM. DWI FILL CF"D'. I 4C^D"1-'0403I.DWG1 ""' 04031 Scale: 1'= 100' PAGE I OF 3 ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER. AK 99577-8736 11 WASTEWATER DISPOSAL SYSTEM DETAILS North Slope AcIdn. #I, Block 3, Lot 4 PROPOSED 1000 GAL SEPTIC TAN 16' D Co 00 Corl� 4 F 46' -ft'7"%�NX -d. - - -1dw qT..A-Z4 ' AV AL 9TE *T 0 .... ... ... ...... KENNETH M. CE -71 ................ . EN mill PREPARED FOR: J1m Bickman 4316 UPPER KOGRU DR. EAGLE RIVER, AK. 99577 (907) 694-9694 nEU) BOOKS COMPUTM D�Aft. — 0" V13G KMD DAM 7/20 om FLE GFAD. SE07C AcAD "L'04031.DWG J'a mm: 04031 TH 10, M-1. Scale, 1'= 20' PAGE 2 OF 3 K, L"11 LU) ENGINEERING 20441 PTARMIGAN BLVD. ZALiLt; RIVER, AK 99577-8736 fit WASTEWATER DISPOSAL SYSTEM DETAILS North Slope Addn. #1, Block 3, Lot 4 4' MONITORING TUBE FROM SPLITTER PLAN VIEW LEACHFIELD DETAILS A)aTe' rnu Jkept4 0fr s-euje'r OrItWAJ- d3rU.Ae, 4' MONITORING TUBE --I BRACING AS NEEDED— PLYWOOD BARRIER AROUND TRENCH �7 13RIGINAL GRADE 1.5' TO 2' DEEP —J REMOVE ALL ORGANICS & LOAM .Aw, OF A TE*t9 '1'" "' ..... ........ ..... ...... 0 .. . ....... ............ ...... KEN CE-71il(I . ............ .. -%onSS10� -AV Nk 4' 4' MONITORING 'I-Oc-�F- kc- 6,LoLj F4' CLEANOUT 2' MIN C13VER FINAL GRADE GRADE -�.5' SEVER ROCK ------ t5Z� MIN M.O.A. 5' WIDE I SAND FILTER FRUF ILE VIEW LEACHFIELD DETAILS NOTE, BOTTOM OF SEWER DRAINROCK MUST BE 4+ FEET ABOVE GROUND WATER DURING HIGH GROUND WATER SEASON AND 6+ FEET ABOVE BEDF PREPARED FOR: Jim Bickman 4316 UPPER KOGRU DR. EAGLE RIVER, AK. 99577 (907) 694-9694 FIELD BOOKS COWUTM. 9�w ORAW MM 3TAM112: A�f: DATE 7/20j owr� ML CFaD-. SE07 4M'LL 04031.[)WG I joa �: 04031 SCALE, NTS PAGE 3 OF 3 L"11 LW ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 KVIDENGINEERING, INC. Date G!oss Time Net I Time Depth to Water 20441 PTARMIGAN BLVD. 1 6/21/04 EAGLE RIVER, AK 99577-8736 101, —Drop - nneia 1:10 CE 71 V. SOILS PERCOLATION TEST 3 Performed for: Royce Martin Date Performed: 6/14/04 Project: North Slope 91, Lot 4, Block 3 TEST HOLE # 04-1 Depth (Feet) SEE ATTACHED SITE PLANJ JM ORG/OL FOR HOLE LOCATION GM/SM density increasing w/ depth, clay & silt - grey NMW B.O.H. 10- 11- 12 - Water Monitoring 13 - Date Depth 14- 717/2004 5.85, is- 7/1912004 6.05' 16- 17- 18- 19 - HOLE PRESOAKED 20- PRIOR TO TEST Was Groundwater encountered? YES What depth? 6' Depth to water after monitoring? 4' Date? 6/21/04 Reading Date G!oss Time Net I Time Depth to Water Net 1 6/21/04 1:00 101, —Drop - 2 1:10 10 min V. 2" 3 1:20 10 min 61/4" 13/4- 4 1:30 10 min 51/4" 1� 5 1:31 101, - 6 1:41 10 min 811. 2" 7 1:51 10min 61/4" 13/4" 8 2:01 10 min 51/4- 1. 9 2:02 101, - 10 2:12 10 min 8" 21, 11 2:22 10 min 61/4" 13/4" 12 2:32 10 min 51/4" Water Added Percolation Rate 10 (min/ in) Pere Hole Diameter 6" Test Run Between 2 feet and 3 feet 1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. INKINIDENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST Performed for: Royce Martin - Date Performed: 6/14/04 Project: North Slope :1, Lot 4, Block 3 TEST HOLE 9 04-2 Depth (Feet) ORG/OL SEE ATTACHED SITE PLAi4--J I FOR HOLE LOCATION GMISM density increasing w/ depth, clay & silt - grey 12 - Water Monitoring 13 - Date Depth 14- 7/7/2004 6.98' 15- V19/2004 7.53' 16- 17- 18- 19- 11OLEPRESOAKED 20- PRIOR TO TEST Was Groundwater encountered? YES Whatdcpth? 7 Depth to water after monitoring? 5.5' Date? 6/21/04 Reading Date Gross Time Net Time Depth to Water Net Drop 1 6/21/04 1:00 101, - 2 1:10 10 min 71/2" 21/2" 3 1:20 10 min 6- 11/2" 4 1:30 10 min 51/4" 3/4" 5 1:31 10- 6 1:41 10 min 71/2- 21/2" 7 1:51 10min 6- 11/2" 8 2:01 10 min 51/4- 3/4- 9 2:02 101, - 10 2:12 10 min 71/2- 21/2" 11 2:22 10 min 6" 11/2" 12 2:32 -F, 0 —m i n 51/4" 3/4" * , Water Added I Percolation Rate 13.3 (min/in) Perc Hole Diameter 6" Test Run Between 2 feet and 3 feet 1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. OF A '"'*'NDENGINEERING, INC. It 2044117ARMIGAN BLVD. CO EAGLE RIVER, AK 99577-8736 14– SOILS PERCOLATION TEST Kennel M. Du CE 7116 Performed for: Royce Martin Date Performed: 6130/2004 14V ."v— OFESSO*'. Project: North Slope :1, Lot 4, Block 3 TEST HOLE # 04-3 Depth (Feet) SEE ATTACHED SITE PLA JIM ORG/01. FOR HOLE LOCATION 1 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- GM/SM density increasing w/ depth, clay & silt & sandy – grey B.O.H. Water Monitoring Date Depth 7/7/2004 4.89' 7/1912004 6.46' Was Groundwater encountered? YES Whatdepth? 8' Depth to water after monitoring? 4.89' Date? 7/7/2OD4 Reading Date Gross Time Net Time Depth to Water Net Drop 1 2 3 4 5 6 7 8 9 10 11 12 Percolation Rate _ (min/in) Perc Hole Diameter 6" Test Run Between — – feet and feet L Kenneth N1. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. OF AL "It "'KNIDENGINEERING, INC. i6i to 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST CE7116 Performed for: Royce Martin Date Performed: 6/30/2004 44-VPROFE - SSII�� Project: North Slope 91, Lot 4, Block 3 ---TEST HOLE # 04-4 Depth --I (Feet) ORG/01. SEE ATTACHED SITE PLM4 in I FOR HOLE LOCATION 11- 12- GMISM density increasing w/ depth, clay & silt & sandy -grey B.O.H. Water Monitoring 13 - Date Depth 14- 7/7/2004 7.19' 15- 7/19/2004 BAY 16- 17- 18- 19- 20 - Was Groundwater encountered? YES Whatdepth? 7.5' Depth to water after monitoring? 7.1cY Date? 7/7/2004 Reading Date Gross Time Net Time Depth to Water Net Drop 1 3/4/03 1:00 9 1/4" - 2 1:10 10 min 41/2- 5 3/4" 3 1:11 9 1/4" 4 1:21 10 min 4 1/2" 1 53/4" 5 1:22 9 1/4" - 6 1:32 10 min 43/4- 5 1/2" 7 1:33 91/4" - 8 1:43 10 min 43/4- 5 1/2" 9 1:44 91/4- - 10 1:54 10 min 43/4" 5 1/2" 11 1:55 91/4" - 12 2:0-51 10 min 4 3/4" Water Added I PercolationRate 1.82 (min/ in) Perc Hole Diameter 6" Test Run Between 2.5 feet and 3.5 feet 1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. 13OX 196650 Anchorage, AK 99519-6650 www-cl-anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. HAA -" f) an 1. GENERAL INFORMATION Expiration Date: 9 — / 0 — C),6 - Complete legal Location (site address or directionsj__3j0DD_Kjupanjk,_Ayp _Fagle gLyp r AK qq 1;77 Current Property owner(s) Day phone _fi9jj=2_j_qB. Mailing address 4-'4 1 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY. Individual Well Individual Water Storage CommunityClass_ Well Public Water System _R 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 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for he transfer of title (except between spouses) for properties served by a single-family on-site wastewater dispo t sal 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 Fir Phone .(907) (;qF;-Gl Address _qn441 ptarM1gan_BJVd,_FaglP River, AK qq-977 Engineer's Printed Nam Kenneth jg.,DUffus_� Date GIELU— Engineer's Comments: This Investigation was completed In compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The now and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes In land use ' local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE _-JeL'00' Approved for bedrooms. Disapproved. Conditional approval for _ bedrooms, With the following stipulations: A Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineers Report Other Original Certificate Date: C, _/0 -05, By: 1c), MunicipaUty of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 9951"650 www.cl.anchorage.ak.us (907) 343-79" HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: North Slope #1 B3, I A - ParcelID: 050-Sil-IS A. WELL DATA Weil type-orlylu Date completed 8/5/04 If A, B, or C provide PWSID # Sanitary seal (Y/NLY_ Total depth -JjQl_ft. Cased to -IQI_ft. FROM WELL LOG Date of test 8/5/04 Static water level 68 ft. Well production 6 9 -p -m WATER SAMPLE RESULTS: Well Log (Y/N)y Wires property protected (Y/N) Y Casing height (above ground) 2 4 1 AT INSPECTION ft. g-p-m- Collform -Q�--_colonles/100 ml.Nitrate 0.1 mg./I.Other bacteria 0 colonies/100 ml. Arsenic: M mgA. Date of sample: 5/26/05 Collected by: KND Engineering B. SEPTIC/HOLOING TANK DATA Tank Type/Material SEPTIC/SnEL _Date installed 9 / 16 / 0 4 Jank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) -Y Foundation deanout (Y/N) I-J:)epression over tank (Y/N) N High water alarm (YM) N Date of pumping NA - New Tank - Pumper C. ABSORPTION FIELD DATA Date installed 9/16/04 oil rating (g.p.d./fe or fe/bdrm) AU System type Mound Length 114 (2 X 571 ft. Width S ft. Gravel below pipe 0. 5 Total depth 2,94113,19* ft. Eff. absorption area 5M-te Monitoring tube Y Depression over field Date of adequacy test NA - New SMern Results (Pass/Fall) PASS For J_ bedrooms Fluid depth In absorption field before tesL_in. Water addeO-_ gal. New depth In. Elapsed Time:----jnin. Final fluid depth n. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) — If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Aecess (YIN) 'Pump on' level at— in. *Pump off" level at— in.High water alarm level at in. Datum — Cycles tested Meets alarrn & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 7S'+ Sewer /septic service line 2 5'+ Onadjacentlots 100'+ Onadjacentlots 100'+ Public sewer manhole/cleanout 10 0'+ Holding tank 10 0'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5 ' + Absorption field 5 ' + Water main 10'+ Water service line 10'+ Surfacewater 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surfacewater 100'+ Driveway, parkingivehicle storage 10 ' + Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS 01�_A4 G. ENGINEER'S CERTIFICATION I certffy that I have determined through field inspections and review of Municipal records that the above systems are k, conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Kenneth M, Duffus 194A, HAA Fee S430-00 Waiver Fee $ — Date of Payment Ulob5 Date of Payment Receipt Number Receipt Number (Rev. 12101) 6- 6-05; 2:24PM; ;007 581530, 2/ SGS Ref.9 1052936001 All Dates/Times.are Alas" Standard Time Cli=tN&me KND Engineering Printed Datefriene 061OU2005 10:14 Project Name/# N. Slope B3. 1A Collected DateMme 'OV2612005 16:10 Client Sample ID N. Slope B3, LA Received DatelTime OR2612005 16:58 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Pwamcw Results PQL Units medw ContainerlD Limits Date Date wt Private Zrictividual A�alysls Ahnninum 1156 20.0 Ug/L EP200.8 D 05/31,105 OUO2/05 TK Antimony 1.00 U 1.00 Willi, EP200.8 D (<--6) 05/31/05 061=5 TK Ar=ic 5.00 U 5.00 og/l. EP2DO.8 D (<-50) 05131105 06/02105 TK Barium 34,11 3.00 Ug/L EP200.8 D (<-2DOO) 05/31105 06102105 TK Cadmium 0.500 U 6.500 ug/L EP200.8 D (<-5) 05/31/Oi 06=05 TK Chromiturt 4.70 1.00 ug/L EP200.8 D (<-IDO) 05131105 061=5 TK Copper 19.0 1.00 ug/L EP200.9 D (<-1300) 05/31/05 06/02to5 TK Iron 2730 250 UgIL EP200.8 D (<-300) 05/31105 06WOS TK L,ead 2.55 0.2DO us/L EP200.9 D (<-'I 5) 05/31105 061=5 TK Manganese 92.3 i.00 ug/L EP200.8 D (<-56) 05/31/05 06102/o5 TK Chloride 5.51 0.100 mg/L EPA 300.0 B (<-ZO) 05127105 JJB Phosphorus 200 U 200 uA EP200.9 D 05/31/05 06102105 TK Fluoride 0.100 U O.IDO mg/l. EPA 300.0 B (<-2) 05/27105 JJB Potmium 1080 560 uA EP200.8 D 05131/05 OGWM5 TK Nitrate -N 0.100 U. 0.100 mg/l. EPA 300.0 B (<-10) OV27/05 JJB Selenium 5.00 U 5.00 uvL EP200.9 D (<-50) 05/31105 061=5 TK Nitritc-N 0.100 U 6.IDO mg/l. EPA300.0 B (�O 05127/05 JJR Sodium 4580 5()0 ug/L EP200.8 D (<-250000) 05/31105 06=5 TK Silicon 5720 200 ug/L EP200.9 D 05/31/05 06W05 TK Silver 1.00 U 1.00 ug/l. EP200.9 D ("100) 05/31105 O&WA5 TK Thallium 1.00 U 1.00 tigil- EP200.8 D (<-2) 05/31/05 06/020 TK Sulfate 14.0 0.100 ing/l, EPA 300.0 B (<-00) 05/27/05 JIB Zinc 684 5.00 ug/L EP200.9 D (<-SDOO) 05/31/05 06/OMS TK Total Diswived Solids 186 10.0 mg/l. SM20 2540C C (<-5DO) 05/27/05 KP Nickel 2.67 .2.00 ug/L EP200.9 D (<-100) 05/31105 06102/05 TK HCO3 Alkalinity 129 10.0 mg/L SM20 2320B C 05/27/05 kP CO3 Alkalinity 10.0 U 10.0 mg/l. SM20 2320D C 05/27/05 KP OH Alkalinity 10.01.1 10.0 mg/L SM20 2320B C 05/27/05 KP 6- 6-05; 2:24PM; SGS Rcf.# 1052936001 Clicut Name KND Engineering ProjectNamef# N. Slone B3. LA Client Sample ID N. Slope B3, LA Matrix Drinking Water ;907 5815301 a 3/ 4 All D21csiTimeso re Ataki Standard T' ime PrinterlDste/Time 0610612005 10:14 Collected Datdrimit 'OR26J2005 16:10 I RectivedDateMme OV2612005 16:58 TeebuicalDirector Stephen Q Edt Parameter Reswts PQL Units mcum Cwtainef ID AJ10wable Prep Ufnits Date Analysis Dre Init Privato Individual Analysis Conductivity 260 3.00 umhos/cm SNUO2510a C 0512M5 Kp P11 7.80 O.IDO pflunits EPA150.1 C (6.54.5) 051205 KP Alkalinity 129. 10.0 mg/L - SM202320D C 05/27/05 KP Total Coliform 0 col/lODmL SM2092220 A (<-I) 0&26105 TLF $U 11500 Daryl Avenue, Anchorage. Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fox .WWW.Iangsurvoyars.com / tnfoOlangeurveyors.com I hereby certify that I have surveyed the following described property. LOT 4. BLOCK 3. NORTH SLOPE SUBDIVISION, No. I (PLAT No. 70-110) Anchorage Recording District. Alaska. and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto. that no Improvements on the property lying adjacent thereto encroach on the survoyod promises and that there are no roadways, transmission lines or other visible oasoments an said property except as Indicated hereon. Dated this the 4-'�' Day of M1 . S,.*,QS at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements. covenants. or restrictions which do not appear on the recorded subdivision plat. kup Zoe 00 8.91 X COVERED ENTRY LOT 5 Z. GRAVEL DRIVE WAY: 0 W, 67 2.0' CANT LOT 4 844CON), 2.0' CANT 43,260 s.f. SEPTIC CLEANOUTS ;0 LOT 3 -C Z06 00. 10' UTILITY EASEMENT LOT 7 PLOT PLAN AS BUILT X SCALEI" —=40' GRID -LE 703 Project No. 04-092 11500 Daryl Avenue, Anchorage. Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fox .WWW.Iangsurvoyars.com / tnfoOlangeurveyors.com I hereby certify that I have surveyed the following described property. LOT 4. BLOCK 3. NORTH SLOPE SUBDIVISION, No. I (PLAT No. 70-110) Anchorage Recording District. Alaska. and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto. that no Improvements on the property lying adjacent thereto encroach on the survoyod promises and that there are no roadways, transmission lines or other visible oasoments an said property except as Indicated hereon. Dated this the 4-'�' Day of M1 . S,.*,QS at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements. covenants. or restrictions which do not appear on the recorded subdivision plat.