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HomeMy WebLinkAboutNORTH SLOPE #2 BLK 6 LT 3North Slope #2 Block 6 Lot 3 #050-581-01 Municipality of Anchorage " Development Services Department Building Safety Division Onsite Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 Page 1 of 2 www.ci.anchorage.sk.us (907) 3417904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO50150 PID Number: 050-561-01 N«"' ONNENBOURG Wastewater System: ❑ New ® Upgrade Faa«. HARCA ST ABSORPTION FIELD Ph" Nu"'°" Of a.dmdma 0 Dep TrWKh ® Shap" Tr«ch a Bed o Mand Dom« LEGAL DESCRIPTION saR,ua TOM Depth rmm«awF.d. 11.6 GPDIFF 313 FI. Blxk W BhObxean Depth to P'pe edeoln eom ogeh" anode Craw depth b.m«h ppe 6 3 NORTH SLOPE #2 0.410.3 FI. 0.610.7 Ft Towh"up R«hp. swa Fa.ddad roo". ahprw tF.de Grave Larpm 14N IF: 32 3.5.11.5 Ft. 43180 Ft. Well: []New ❑ Upgrade eri" o'0ND"10,00D"10,00 5 2 a. between ler. 15 Ft. FL CMumcatwn (Pmm.. A B. C) TOM Depth cooed to T"" tweapo«h.re. Pp. M««w EXISTING Ft. I Ft 615 F2 I ASTM -3034 Dryer Do. Ur.Md Swawar Lew 11"M W DN knurled FL GUARANTEED SERVICES I 613012005 Yna Pu s«" C..na"hah" Abpee Crp TANK GPM FI. FI SEPARATION DISTANCES ® septic ❑ Holding ❑ S.T.E.P. ❑ Other. To From I Septic Tank Absorption Field Lift Station Holding Tank ublxu?rlvate sewer Line ANCHORAGETANK 1000GM well v. +100' +100' — — +2s STEEL wGdn°«t. W 2 sur.c.wa« +100' +100' — — LIFT STATION L"LM +5' +10' — — NO LIFT Gel •« +5' +10' — — Perp m're«M 'Pump ar le".lM MphwM«el«m" Fowdelan N N in C�rry� +Jy' +50' — — h« PV Mek. a Model Elaaneal NW.coons p«r«m d by Carlen Oran Area below drelnfields requires more fill to create proper setback Area BENCH MARK Lwwn.r" DeooWtan See attatched Slope detail. FINISH FLOOR AT GARAGE 7 sand below sewer rock nd `0 F 100.00 FL Inspections performed by: ERES Dates: 1" 6129/2005S�`� 2nd 6130/2005 "' 9TH 9,`t Development Services Department Approval Conditional Approval Date: 95 CHRISTOPHERRWOOD., F� ' CE:10381 ;. 6-0 ss Reviewed and approved by: GV Dater!—/ GC (Ra OW6) Permit No. SW050150 Page 2 of 2 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ON—SITE WATER & WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650 On—Site Wastewater Disposol System and/or Well Inspection Report Legal Description: NORTH SLOPE #2 BLOCK 6 LOT 3 050-581-01 Rs��. I amu• RAD1U5 ADO WELL \ 0 s� _ O - CLEANOUT -¢ - WELL • - MONITOR TUBE ELEVATIONS (NOT TO SCALE) TANK 1000 GAL 80.1 MT -1 FILL MT -2 MT -3 SCALE 1'-50' 1 OBILIA ILL -SEE AT A ED SLOPE DETAIL 1' 11 9/2007 ENGINEER'S SEAL 00000p�4 MT -4 TM ........... -q��4 ' JAOff: 9 Q 4 x-69.0 0 0 64.3 Q •, CHRISTOPHER R. %VOO57. , BOTTOM OF Qo�04 10J87�A� oppO JW 0<< I �U m 0C/ -)( N w0 n LLJ OI - n JO O cf)z � 1 V ) rV O z c i in u \a I w a J X O Z Er p IL w az 0 In] 0 M2 7 \3 a LI E Eagle River Engineering Services Christopher R. Wood, P.E. PO box 773664 Eagle River, AK 99577 September 16, 2008 Jeff Poet MOA Development Services Department On -Site Water and Wastewater Program 4700 Elmore St. Re: North Slope 42 Block 6 Lot 3 Dear Mr. Poet, (907) 694-5195 tel (907) 694-3297 fax The area below the leachfields at North Slope #2 Block 6 Lot 3 has had imported organic fill installed so as to create the required slopes. Please contact us if you have any questions or require additional information. Sincerely, EAGLE RteENGINEERING SERVICES 4/ " l Christopher R. Wood, P.E. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW050150 Legal Description: NORTH SLOPE #2 BLK 6 LT 3 Design Engineer: 0848 Eagle River Engineering Services Owner Name: DAVID & WANDA SONNENBURG Owner Address: 4143 HARCA STREET EAGLE RIVER. AK 99577-0000 Date Issued: Jun 01, 2005 Expiration Date: Jun 01, 2006 Parcel ID: 050-581-01 Site Address: 004143 HARCA ST Lot Size: 175506 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: Q✓ Disposal Field Z✓ Septic Tank ❑ Holding Tank [] Privy Private Well F1 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 catling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, seated, and heated to prevent freezing. Received Issued By: Date: G o Date: I 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 SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OS_'D• S'?,/ -D I Permit Number SW Propertyowner(sti'=0Bu1Z4 Dayphone 622-a324 Mailing address (1) 9 CtI3 H-4Rc' Si - Mailing address (2) EA-QL C R_rVtrA ,-A- K `i 12 77 Zip Code `19 V'7 7 Legal description (Lot, Block & Sub'd.) 228114 StoPE 07 13 6 Z_ 3 Legal description (Section, Township & Range) T- 1 cl 2 I L" SEG 3 z Lot Size /L5 5D6 Acres q.FL Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well 1 Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Fami!$ Dwelling and is in accordance withypplicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: tos3 Waiver Fees: Date of Payment: tv7'� Z 7 Date of Payment: Receipt Number: �� 0 Receipt Number: (Rev. 12/00) Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD. Suite 201 Eagle River, AK 99577 May 26, 2005 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: North Slope #2 L3 B6 Narrative & Permit Application Dear Mr. Roth: (907) 694-5195 tel (907) 694-3297 fax Eagle River Engineering Services (ERES) was contracted to obtain a septic upgrade permit for a 3 bedroom single family home at the above referenced property. The proposed septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots on 3 sides are all very large lots. 2. Immediate neighboring septic systems are all +30' distance, and no private (or community) wells within 200' of the proposed septic system. 3. This permit is for a septic system upgrade only. 4. Drainage will not be affected and is not a major consideration in our design. Installation of this leachfield will not adversely affect the wells or septic systems or reserve areas on adjacent developed lots. The existing dminfteld will be connected to the new drainfteld, but temporarily kept off-line with use of a bull run diverter valve. We are requesting that the new drainfield be installed within 50' of a steep slope, but no greater less than 35'. The thickness and composition of the topsoil layer will make a good barrier to prevent any effluent from ever daylighting on this slope. If you have any questions please call our office at 694-5195. Sincerely, DE R ENGIN SERVICES phcr R. Wood, P.E. Principal \2003\05-058SEPTICNARRATIV E II k er, Ci SHED HOU S Rs00, 1 SSs 1 �f4 F\� INSTALL NEW p 5'x75' AND 5'x40 0 °A� ;TRENCHES \ \.6,0 s� � LEGEND sr + — WELL ® — TEST HOLE • — DIVERTER VALVE — EASEMENT — PROPOSED LEACH FIELD EXISTING LEACH FIELD —^ — DRIVEWAY • — MONITOR TUBE 0 — SEWER CLEAN OUT WELL/SEPTIC LEGAL: NORTHSLOPE#2 LOT3, OWNER: SCOTT SONNENBURG CONTRACTOR: UNKNOWN JOB# 05-058 1 DATE: 05) ON w ` ' 3 1 I I I 00 N 'y' TANK WITH NEW 1000 GAL EPTIC TTK Z e I 11% X1 C' X 'p00,\ N 89'56 %-10.79.40' SITE PLAN BLOCK6 25/05 I SCALE 1"- 100' EAGLE RIVER ENGINEERING P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX. • (907) SERVICES 694-3297 WELL+200' SEP11C+30' 3' E NOTES 1. NO KNOWN CURTAIN DRAINS 2. NO PRIVATE WELLS WITHIN 2 3. NO KNOWN SURFACE WATER tQ . • . In I r r % '.CHRISTOPHER R.. WOW! '�. �� �, CE -10387 ` i °0. �9 INSTALL NEW s 5'X75' AND 5'X40' TRENCHES -I- /< REPLACE EXISTING DIVERTER/ TANK WITH NEW / 1000 GAL 059 SEPTIC TANK MIN .7 STFF,o LEGEND S� O + - WELL nQ ® - TEST HOLE • - DIVERTER VALVE EASEMENT PROPOSED LEACH FIELD EXISTING LEACH FIELD ^'+ - DRIVEWAY • - MONITOR TUBE o - SEWER CLEAN OUT WELL/SEPTIC LEGAL: NORTH SLOPE #2 LOT OWNER: SCOTT SONNENBURG CONTRACTOR: UNKNOWN JOB# 05-058 1 DATE: 05/2 DETAIL 3 BL0CK6 51 SCALE 1"= 30' EACLE RIVER ENGINEERING AP.O. Box 773294 EACLE RIVER, AK. 99577 (907) 694-5195 FAX. • (907) SERVICES 694-329 EXISTING FIELD NOTES 1. NO KNOWN CURTAIN DRAINS 2. NO PRIVATE WELLS WITHIN 200- 3. NO KNOWN SURFACE WATER OF u�ff'MA&Y®N .CHRISTOPHER R. WOOD CE -10387 _' EAGLE RIVER ENGINEERING JOB A/o(ZTH 61 10421 VFW Rd., Suite 201 SHEETNO. � OF Eagle River, Alaska 99577 CALCULATED BY ---6J DATE (907) 694-5195 Fax (907) 694.3297 CHECKED BY DATE SCALE I RST "0 C, 14-k Z( Z LL p T L4.1 I 2N �11 Ic r TOT4A EAGLE RIVER ENGINEERING SERVICES 10421 VFW RD Suite 201 Eagle River, Alaska 99577 (907)894-5195 ERES Project No.: 05-058 Calculated By. CW Date: 5/28/2005 Legal: North Slope #2 BB L3 TEST HOLE 1 Single Family 3 Bedroom Dwelling Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = 0 minutes per inch Wastewater application rate = 0.8 gallons per day per square foot Required absorption area = 583 square feet Trench width (W) = 5 feet Gravel depth (D) = 0.5 feet t QEQ Zr Fri-itk S+Vb Required length - Shallow trench factor • Required absorption area / W Shallow trench factor = (W + 2) / (W + 1 +2 D) Shallow trench factor = 1.00 Total Excavation Depth = 3.0 feet Required length - 113 feet 05-058_drainfieldCalc 4:55 PM5/28/2005 Municipality of Anchorage Development Services Department SLOdklp Safety Division Onsite Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196M Anchorage, AK 995tM5( , Wmd.andwraae.sk.us (907) 543-7904 Soils Log - Percolation Te Performed For. _SC.A Sonnenbur() Legal Description: LO}361 k&A1or1K1yPe 546d; 5ron Townshlr Depth 0 61M- 7-11ni - ARA -1 SILT`( gowb GQAOtL 1 1s- 16- 17- 18- 19- 20 - COMMENTS PERFORMED BY: ►CRFORMED INR N WAS GROUND WATER l", ENCOUNTERED? Je!; J. te IFYES,ATWHAT DEMO 7. L Depth toYMerAR„ D Uonaorlrlg7 S.o ' F B qlc 5/26/of Reeding Date Gross Time Net Tkne Depth to Water Net Drop 1 Iq 0 3 4 O3 y' a 5 06 Ll: IS 3o Li=7 6 3_- 3 /1Q/o5 4�aa 0 u:3. y 5/14/o; ; 5a o . 3- 5 5fiq 106 LI; 55 b 5/i q/o5 : a5 30 Ib 16 ^-sz• 1^-��noe PERC HOLE DIAMETER 1j�- TEST RUN BETWEEN L FT AND FT Q1 7(1r: 011, t CERTIFY THAT THIS T€ T W ALLSTATE AND MI NICIPA GUIDELINES IN EFFECT ON THIS DATE. DATE: Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW Rd. Suite 201 Eagle River, AK 99577 (907) 694-5195 tel (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: NORTH SLOPE #2 L3 B6 May 2, 2005 A. GENERAL 1. The well and septic plan is for a 3 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. B. SEPTIC TANK 1. The sewer piping from the house shall be 4" PVC 3034 laid at 2% grade maximum — 1% minimum and insulated with 2" of burial foam if shallower than 3 ft., with 2 ft. minimum. 2. Septic Tank shall be a minimum of 1,000 gallon tank of MOA approved construction, insulated, or place with 4' of soil cover, min. C. DRARMELD 1. The drainfield is to be placed as shown on the site plan. Contractor shall take extreme care ensure that 10'separtation distance is maintained between trenches, from the existing trench, and 35' from the steep slope below. 2. The bottom of the drainfield excavation shall be level, plus or minus 1.5", prior to placing gravel. 3. The total depth of the drainfield excavation shall not exceed 3 fl. at any point in relation to natural ground surface. 4. Two feet (2.01) of filter sand shall shall be imported to obtain separation from the GM material to the bottom of the drainfield sewer rock once the organic topsoil layer is removed. 5. The drainfield gravel shall be covered with typar fabric material. 6. Soil or a combination of soil and extruded board insulation to at depth of 3' or equivalent is to be placed over the leachfield. 7. The area over the drainfield is to be finish graded or mounded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. \\Ercs\docs\W PDOCS\2005\05-058dminficld- spcc.doc Eagle River Engineering Services Christopher R. Wood, P.E. RECOMMENDED LEACIIFIELD DIMENSIONS: TOTAL DEPTII = 3' maximum GRAVEL DEPTH = 0.5' under pipe, 2" over pipe (1' total) DRAWMELD LENGTH =115' total DRAINFIELD WIDTH = 5' SOIL RATING - 0.8 GPDlfe BEDROOM CAPACITY = 3 total SEPTIC TANK = 1000 gallons min. Twenty-four (24) hours notice required for all inspections. \\Eres\docs\WPDOCS\2005\05-058dminfield- spec.doc Eagle River Engineering Services Christopher PL Wood, P.E. 10421 VFW RD. Suite 201 (9o7) 694-5195 tel Eagle River, AK 99577 (9o7) 694-3297 fax May 31, 2005 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: North Slope #2 L3 B6 Slope Waiver Justification, Septic Upgrade Narrative and Permit Application Dear Mr. Roth: Eagle River Engineering Services (ERES) was contracted to obtain a septic upgrade permit for a 3 bedroom single family home at the above referenced property. The leachfield was found to be in a surcharged state upon inspection during a Health Authority Approval Inspection. The sump at the end of the leachfield had heavy sludge, leading us to believe that the septic tank baffles might have corroded, allowing solids to clog the leachfield. We are requesting that the new leachfield be installed with portions closer than 50' to an existing steep slope at the grade break above Harca Street, but no closer than 35'. We offer the following facts in support of this request: 1. The septic system was installed in 1985, prior to the current method of slope setback calculation. 2. No effluent appears to have ever daylighted on the slope in question, despite the surcharged condition of the leachfield. 3. Utilizing the method of calculation of slope in the memo dated April 7, 2004 will not work with this system, as it is on a 25% slope to begin with, and the invert of the pipe level with original grade. 4. Heavy visqueen is specified to be installed on the downhill side of the leachfield, from top of the sewer rock, to 2' below, at the bottom of the specified sand filter layer. 5. The upper portions of this lot have natural springs and shallow groundwater, as well as steeper slope than where we are requesting, effectively eliminating any other location in which to install a leachfield. 6. A thick, silty topsoil layer acts as a natural barrier to prevent effluent from surfacing on the slope below the leachfield. The proposed septic system will have very limited impact on adjacent properties for the following reasons: The surrounding lots on 3 sides are all very large lots. \2003%05.058S LOPELE7TER Eagle River Engineering Services Christopher R Wood, P.E. 10421 VFW RD. Suite 201 Eagle River, AK 99577 (907) 694-5195 tel (907) 694-3297 fax 2. Immediate neighboring septic systems are all +30' distance, and no private (or community) wells within 200' of the proposed septic system. 3. This permit is for a septic system upgrade only. 4. Drainage will not be affected and is not a major consideration in our design. Installation of this leachfield will not adversely affect the wells or septic systems or reserve areas on adjacent developed lots. The existing drainfield will be connected to the new drainfield, but temporarily kept off-line with use of a bull run diverter valve. If you have any questions please call our office at 694-5195. Sincerely, EAGLE RIVE NGINE NGS VICES C stopher R. Wood, P.E. Principal \2003\05-058SLOPELEiTER 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 SEWER/WELL SUBMITTAL COMMENT SHEET To: Eagle River Engineering Legal description: North Slope #2 Block 6 Lot 3 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on _ ❑ Calculation error in design. _ ❑ Additional soils information needed. ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ❑ Incomplete; missing ❑ Incomplete; missing ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. _ ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field.— E] Other. SITE PLAN SHOWS PROPOSED TRENCH IS TOO CLOSE TO TOP OF CUT BANK OR SLOPE GREATER THAN 25%. TRENCH NEEDS TO MAINTAIN 50 FOOT SETBACK FROM SLOPE GREATER THAN 25%. OR 35 FOOT HORIZONTAL SEPARATION USING INSTRUCTIONS ON ATTACHED MEMO DATED APRIL 7.2004 Name of reviewer: JOE GOODALL Date: 5/31/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Post -it* Fax Note 7671 Date 14gas 01 Z Art-- From �— COJDept. Co. Ptme c (� cr arme c Fax 1 Fax a DATE: April 7, 2004 3 Z-7 7 MUNICIPALITY OF ANCHORAGE Building Safety Division MEMORANDUM TO: On - Site Services Program FR s oss, P.E. ger, On -Site Water Wastewater Program SUBJ:' Slope setbacks from >25% ZD In situations where slope conditions will not allow a wastewater disposal field to be located 50 feet horizontally up gradient from a change in slope to greater than 25%, as required in AMC 15.65.060A.1.b the following requirements apply: (As allowed by AMC 15.65.030.G) 1. A point shall be determined two and one half feet above the Invert of the distribution piping of the septic field at the field's closest point to the slope greater than 25%. 2. A line shall be drawn from this point and perpendicular to the distribution piping at a down slope of 25% in the direction towards the slope greater than 25%. 3. The intersection of this hypothetical line and the actual slope shall be a minimum of 35 feet horizontally from the point established In #1. 4. This 35 foot horizontal separation shall be the minimum allowed between a disposal field and a slope of greater than 25%. If a property has a wastewater disposal system that was constructed prior to 1986 and the absorption field encroaches a change In slope greater than 25%, an upgrade of the failed system may be approved in the same location If the following applies: 1. No other location exists on the property to construct an upgrade drain field with proper separations. 2. The engineer field verifies that no effluent ever surfaced on the slope surface. 3. The engineer maximizes the separation from the field to the slope as much as t possible. Art-- ZD In situations where slope conditions will not allow a wastewater disposal field to be located 50 feet horizontally up gradient from a change in slope to greater than 25%, as required in AMC 15.65.060A.1.b the following requirements apply: (As allowed by AMC 15.65.030.G) 1. A point shall be determined two and one half feet above the Invert of the distribution piping of the septic field at the field's closest point to the slope greater than 25%. 2. A line shall be drawn from this point and perpendicular to the distribution piping at a down slope of 25% in the direction towards the slope greater than 25%. 3. The intersection of this hypothetical line and the actual slope shall be a minimum of 35 feet horizontally from the point established In #1. 4. This 35 foot horizontal separation shall be the minimum allowed between a disposal field and a slope of greater than 25%. If a property has a wastewater disposal system that was constructed prior to 1986 and the absorption field encroaches a change In slope greater than 25%, an upgrade of the failed system may be approved in the same location If the following applies: 1. No other location exists on the property to construct an upgrade drain field with proper separations. 2. The engineer field verifies that no effluent ever surfaced on the slope surface. 3. The engineer maximizes the separation from the field to the slope as much as t possible. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 2844720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE tiidNEW y!r--„ GH„ �..;� 65v -a;7 ❑UPGRADE MAILING ADDRESS 5 n - ,r 7 7 .3 2 q !- 7 S.t� LEGAL DESCRIPTION Lv 7' 3 If 1,,r 6 /U S /e e J4 -2 T/ yiv It /r' S« 3 t LOCATION NO. OF BEDROOMS C 4 �C /�s ✓Y/% (/G DISTANCE TO: Well .y IOD Absorption area 73s-' Dwelling i3 PERMIT NO. VY .moi t7 ao 2 W< Manufacturer GrrGr Material ,$7«./ No, of Compartments a a Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth / 000 d O DISTANCE TO: Well Dwelling PERMIT NO. O Manufacturer Material Liquid capacity in gallons O W DISTANCE TO: Well �QpT Foundation /[/p Nearest lot line 3 PERMIT NO. E Fjs OviO H 2 No. of lines Length of each line v Total length of lines / Trench width / Distance between lines 7S' 7k aaaker /!/ A Top of tile to finish grade Material beneath the . Total effective absorp ion area cc cl aZ NIC0"I -inches' S'S J Length Width Depth PERMIT NO. W < a Type of crib Crib diameter Crib depth Total effective absorption area w Well Building foundation Nearest lot line DISTANCE TO: Class r. ✓L %C Depth Driller Distance to lot line PERMIT NO. � W �+ DISTANCE TO: Building foundation Sewer line r /�� Septic tank y. Absorption area(s) /O• /iot OTHER PIPE MATERIALS A ro yr [/C SOIL EST RATING /77 `6 INSTALLER REMARKS N•t r q 01 Ait �1 rtk 1 •1 . / a•a.........................«:. • Lt i fi louts A. Butertt W C •. CE -6736 4? 00 I��F�p'•.»-E010 se APPROVED DATE LEGAL �y-IQ+•' 4/ter-8t lot 3 t 1'ffe MIt< s/. '- 72-013 (Rev. 3/78) IN MU1`! I C I F="d'%L I -F'N.' Cir- 6L% TFCGF--F�'E�:f`: F� ,% DEPARTMENT !N HEALTH AND ENVIRONMENTAL �?OTECTION J1/ 025 STREET,•ANCHORAGE, AK 99b01 261-47:0 G CD VA —rte. I T F= c F✓ 1j.,7 F_ r? F-` En n F` i I -r (O PERMIT NO: 050209 DATE ISSUED: 05/21/05 /tlore: Sj iCx. 4/A& a"SSIn!(,�, APPLICANT: HAMANN CONSTR CO I.cNOE.c. Z)PQ-4 Bz�J -*xurr /3E ADDRESS: P 0 BOX 617 /AlSuA.Ih7L�D lvl77{ L EAGLE RIVER, AK 995771S77/4*Ae l n • ToT,}L AD,+,n 4,yam CONTACT PHONE: 694-2776 A901- OA LEGAL DESCRIP: SUBDIVISION: NORTH SLOPE #k2 LOT: C BLOCK: b SECTION: 32 TOWNSHIP: 14N IF LOT SIZE: IA (SQ.FT`. OR ACRES) LOT LOCATION: BEAUFORT WAY MAX BEDROOMS: Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. *x DEPTH TO PIPE BOTTOM C 1.5 FT. REQUIRES INSULATION ** DEPTH TO PIPE BOTTOM < 4.0 FT. MAY REQUIRE A LIFT STATION ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MCA codes and regulations, and in compliance with the design criteria of this permit. 3. I' will adhere to all MOA and State of Alaska requirements for the set back: distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 3 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT;.AND 0) THE: ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED DATE: - -� -- ----------- ---------------- APPLICANT: HAMANN CONSTR CO ISSUED BY- DATE, _----------•----- -- DATE, 0 W _ IJ F--< iT% I t�F DEPTH TO PIPE BOTTOM (FT.) 2.0`x* GRAVEL DEPTH (FT.) 2.0` TOTAL DEPTH (FT.) 4.0- GRAVEL WIDTH AFT.) 5.0• GRAVEL LENGTH (FT.) 75.0• GRAVEL VOLUME (CU.YDS.) '4.Q TANK SIZE (GALS) 1,000.0 SOIL RATING (SQ.FT./DR) 177r *x DEPTH TO PIPE BOTTOM C 1.5 FT. REQUIRES INSULATION ** DEPTH TO PIPE BOTTOM < 4.0 FT. MAY REQUIRE A LIFT STATION ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MCA codes and regulations, and in compliance with the design criteria of this permit. 3. I' will adhere to all MOA and State of Alaska requirements for the set back: distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 3 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT;.AND 0) THE: ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED DATE: - -� -- ----------- ---------------- APPLICANT: HAMANN CONSTR CO ISSUED BY- DATE, _----------•----- -- DATE, 0 SOILS LOG gSo;L0 MUNICIPALITY OF ANCHORAGE �r \ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION /ti PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: r/4 ws a. cf'^ S r ri. c t-,.' DATE PERFORMED: 9/fr LEGAL DESCRIPTION:1ne 54 1.&;, .4etdw -# z rly 1y R /E _Sac 32 SLOPE SITE PLAN i � ORGAN/�c 2 3- 4 4 ,o• .- :cr�, Gross Time Net Time 5 Pe'x C 177 �-••� 3 6- COMMENTS Perc. H.CJ.•.-. TEST RUN BETWEEN G •. .74� . a'!- 7ct Y• FT AND FT he /C 3=/o a ly Ricco .e^-1 w44 O. :. ie/✓ S..,, S/' T r./ �'of Gra tet/ PERFORMEDBY: Azvvq 8 8- ..c�,.r DATE: 10 10 Nalc 11 12 m�e �'L` ! % % Cr 13- t`• ea+r•••eott f• c1 �!'�� . � .!'..�'•.� •.x.11 14 Frse•: o.••• . is 15- �)f Y .lra; 0.° cGutcra ..' L 16 g i S w� f s a . res . r 17 r;�P�OFcSS1G 18 19 WAS GROUND WATER YES ENCOUNTERED? IF YES, AT WHAT y�° S�y/rc- DEPTH7 8.0 SP Reading Date Gross Time Net Time Depth to Water Net Drop SaaK �-••� 3 COMMENTS Perc. H.CJ.•.-. TEST RUN BETWEEN G •. .74� . a'!- 7ct Y• FT AND FT he /C 3=/o a ly Ricco .e^-1 w44 O. :. ie/✓ S..,, S/' T r./ �'of Gra tet/ PERFORMEDBY: Azvvq CERTIFIED BY�•-CCS- ..c�,.r DATE: 20 is �• .: 1` PERCOLATION RATE (minutes/inch) 3 COMMENTS Perc. H.CJ.•.-. TEST RUN BETWEEN G •. .74� . a'!- 7ct Y• FT AND FT he /C Ricco .e^-1 w44 O. :. ie/✓ S..,, S/' T r./ �'of Gra tet/ PERFORMEDBY: Azvvq CERTIFIED BY�•-CCS- ..c�,.r DATE: 72.008 (6/79) i August 3, 1977 476421 George Wood 4110 De Darr Road Anchorage, Alaska 99504 Subjects Permitrrpiration Dear Mr. Woods A permit issued by this department for well and/or on-site sewer installation on Lot 3 Block 6 North Slope Subdivision has expired since the issue date exceeds one (1) year. In the event you still plan to install the well and/or on- site sewer system, a new permit is required. The original soil test may be used to obtain a current permit. if the well has bean drilled, a well log should be sent to this department to docunent the installation date. If you have any questions regarding the above matter, please do not hesitate to contact this office immediately at 279- 25116, extension 224.or 225. Sincerely, Les 11. Buchholz, R.S. Sanitarian V%M.ljh Mur_4I C I^AL I TY OF= rpt-JCF �:�RFiGE �. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION " 2510 E. TUDOR. RD. , ANCHORAGE, At'. 99507 276-2221 WELL_ AtJC• Oto—S I TE SEWER PERM I T PERMIT NO. ( 76421 ) APPLICANT GEORGE WOOD 4110 DEBRRR RD 333-4761 LOCATION BENUFUFc_TTY LEGAL L3 Bo' NORTH SLOPE SUBD LOT SIZE 175000 SQUARE FEET TYPE OF SOIL ASSORBTION SYSTEM IS: MAXIMUM NUMBER OF BEDROOMS = 3 THE REQUIRED SIZE OF THE SOIL RBSOPIPTI C�EPTH= ? L_E"c3-r"= THE LENGTH DIMENSION IS THE LENGTH THE DEPTH OF R TRENCHOR PIT I THE GROUND AND THE BOTTOM OF THE E: AV THERE IS NO SET WIDTH FOR T EN H S. THE GRAVEL DEPTH IS THE It tUP E ' AND THE BOTTOM OF THE E CFVR OF r RE(; t!U I REO EAC{:FILLING OF ANY SYS -{TEM WIT DEPARTMENT WILL BE SUB ECT TO TING CSQ FT/BR)= 250 IS: FiVEL G>EF�'TH= Z5 'IN FEET) OF THE TRENCH OR DRAINFIELD. ISTRNCE BETWEEN THE SURFACE OF THE T h7 CIN FEET). TH OF GRAVEL BETWEEN THE OUTFALL PIPE N FEET). K S 12: EE :JL I-a43r3 GnL_L(Dr-4 L INSPECTION AND APPROVAL BY THIS ION. MINIMUM DISTANCE BETWEER WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I5 100 FEET FOP. A PRIVATE LL OR '00 FEET FOR R PUBLIC WELL. WELL LOGS ARE REQUIRED AF MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUC N DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F•ERM I T VnL_ I O FOR Ot-JE keEE: nFZ FROM I SSIJE I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SE14ER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE I5 REMODELED TO I14CLUDE MORE THAN 3 BEDROOMS. SI GNED : ------------- APPLICANT ------------ R PLIC NN\T1 GEORGE •IOOD V�------ r r ISSUED BY_1�,,.t_ ----DRTE__�_ Q A VreVc,N DRAIN Mvsr Bc /NST�LLPb 7a i4 App �Po/juT AT `eAsr 5-D" uph,ll civ 7;WNctl AIJI, TM VWGH% 7-P IN 7e1-pcc�oR,07er-) ' Af /i, o F 3 AS i�vDicA7ek . Soles 5 /aq009l(70- e 11.4 , 3 = J� C>ti5T ,�ioN .7ol+.v �/A�tJSvi/lG �''! psos�N%-S� 35 Sewee pipe n (Ponsiruction gesi oC5 at "ONE TESTIS WORT. A THOUSAND OPINIONS" n YW 2204 CLEVELAND AVENUE • ANCHORAGE. ALASKA 99503 • 277.0231 June 24, 1976 Mr. Rolf Strickland Dept. of Environmental Quality Municipality of Anchorage 3500 Tudor Road Anchorage, Alaska jgt Re: Lot 3, North Slope Subdivision "12 (George Wood Property) Gentlemen: Per our telephone conversation on June 23, 1976, we were not able to run a percolation test due to water moving on top of a relatively impervious thin clayey layer and entering the test hole. A mechanical analysis of the percolation zone sample taken shows that it is a silty gravelly sand with a rating of 250 square feet per bedroom. Ground water was found in one test hole at a depth of 11 feet below the ground surface. Any on-site septic system installed on the property should provide a cut-off trench to the impervious layer on the up- hill side of the system to direct the water positively away from the system. If you have any questions, please contact our office. very truly yours, CONSTRjEST LAB OF A���@ .zr ®iNew A. jv No. 1686-E Neal A. rHa�C[usam, P.E., L.S. NAH/ss neonittuction Beit lag "one "$I is worth • thousand opinions" 2204 Cleveland Anchorage, Alaska 99503 Performed For George Wood Date Performed 6/21/76 Lenal nescrintion: Lot Blocl: Subdivision North Slope Subdivision This Form Renorts Soils Lon yes Percolation Test_ Death Feet Q 4.— haracterist' 6 — Silty Gravelly Sand groundg water level11pp 12- 2- 14- 16- 18- 20— 14-16- 16- 20— Was Was Ground Nater Encountered? yes If Yes, At what Depth? — it Feet 7 m�t�i• �jw�rwMAA � rte=_ Readinq Date Gross Time Net Time Depth to H2O Net Dron' r -- Percolation Rate M nute Prnrosed Insta a non: Seenaae Pit Drain Field Deeth of Inlet Dept TiT o Fo tom Of Pit Or Trench CnsAmENTS: Surface water on top of clay laver. Ground water at —11 feet. Test Performed By James D Mack _ Data Certified By: CONSTRUCTI N Date: VffT 76 Parcel I.D. 050-581-01 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Nk, 5 A k E* r Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: North Slope #2, Block 6, Lot 3 4143 Harca St. Current Property owner(,) Katherine & Adam Newhouse Mailing address Real Estate Agent Day phone. PO Box 1407 Carmel Valley, CA 93924 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNahance Received by: � nA k L(/ `"' - Date: 2� J COSA to be released to the engi a r, unless otherwise requested by the engineer. COSA Fee $ .J Waiver Fee $ Date of Payment 3 �� S t/ Date of Payment Receipt Number M651 56N Receipt Number COSA# QSc1SiZ)515� 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. l®cal 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. - - Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Alk. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE —IzSystem #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 5121/2015 Conditional approval for bedrooms, with the following stipulations: By: ziz Original Certificate Date: /0 The Muniipali o orage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only - upon the representations given in paragraph 5 by an independent professional civil engineer registered in tate State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory_ Other COSA bluesheelt ... .. If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: North Slope #2, Block 6, Lot 3 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed Unknown Sanitary seal (Y/N) Y Total depth 460* ft. Cased to 40+* ft. FROM WELL LOG Date of test Unknown Static water level 201* ft. * Well production 0.6 g.p.m. Parcel ID: 050-581-01 Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) /q+ + in. AT INSPECTION 5/20/2015 293 ft. 1 . WATER SAMPLE RESULTS: Coliform �e colonies/100 mL Nitrate a• 33 mg/L Arsenic AJ t> ug/L Date of sample: 5/20/2015 Collected by: B. SEPTIC/HOLDING TANK DATA PES M Tank Type/Material Septic/Steel Date installed 6/30/2005 Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N)_ Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 11/20/2014 pumper JR's Pumping C. ABSORPTION FIELD DATA - Date (g•p• installp d 6/30/2005 Soil ratingd./ft) S type 2 or ftz/bdrm 0.8 GPD/SF a Shallow Trenches System Length 8043 ft. Width 5-5 - ft. Gravel below pipe 0.7-0.6 ft Total depth S'8 5'4 ft. Eff. absorption area 615 ftz Monitoring tube Y Depression over field N Date of adequacy test 5/20/2015 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 7 - 0 in. Water added 459 gal. New depth 8**- 0 in. Elapsed Time: 245. min. Final fluid depth 7**- 0 in. Absorption rate >= 450+ g•p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer/septic service -line 25+ Animal containment areas 50+ SEPTIC/HOLDING TANK ON LOT TO: On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Curtain drain 50+ Surface water 100+ Wells on adjacent lots 100+ Water main 10+ Driveway, parkingNehicle storage 10+ F. COMMENTS *Per 2008 COSA '"Water depth of MT on trench where cine from tank -ties into field. MT on opposite side of the same trench dry. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date l COSA canary sheet 2815.doc NAM Municipality of Anchorage s Development Services Department?Y^'� Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ei.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 151255 During a recent COSA on-site inspection and test of the potable water supply well on Block 6, Lot 3 of North Slope #2 subdivision, the well's productivity was determined to be 0.6 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage Development Services Department ^*'�'TB Building Safety Division 14 +tet, On -Site Water and Wastewater Program , A 91, 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING G Parcel I.D._-��� — n / COSA # h g7 Expiration Date: 3— q 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address '41 Z. a�oe lZ T Day phone _ Day phone 1aurra. C;yHifil/i, y Day phone 6 9G -X357 T7G leln✓ l G 14/1- G i9iv.C.0 Unless otherwise requested, COSA will be held by DSO for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 1 TYPE OF WASTEWATER DISPOSAL: Individual On-site 1❑ 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 SY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name o Address f Firm A I f awr �— 9 Phone _1< TF41-702 d' Engineer's Printed Name Date 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By:^� , Original Certificate Date: (Rev 1b05) Municipality of Anchorage Development Services Department Building Safety Division s On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST cc '' std Legal Description:�jlr,d 86 / _� ParcelID: ,��S(�1��—af A. WELL DATA Well type r If A, B, or C provide PWSID # _ Well Log (YIN) Date completed nLY 76 Sanitary seal (YIN) Wires properly protected (YIN) Total depth q_4_0 ft. Cased to Oft. I- Casing height (above ground) n. FROM WELL LOG AT INSPECTION � Date of test n/a Z L�'-� Static water level ft. 20/ ft. Well production g.p.m. 0. g.p.m. WATER SAMPLE O RESULTS: �� f � I Coliform colonies/100 mL Nitrate w, mg/L Other bacteria 0—/-colonies/100 mL Arsenic: Gy_�w� Lf tg/L date of sample: �Collected by: i 44191?f B. SEPTIC/HOLDING TANK DATA Tank TypelMaterial S 9/%C-/c� %F:EL Date Installed�a�aS Tank size /003 gal. Number of Compartments 2 Cleanouts (YIN) Foundation cleanout (YIN) Depression over tank (YIN) A( High water alarm (YIN) % Date of pumping—���7 Pumper 2 C. ABSORPTION FIELD DATA Date installed .4 3a 40 S Soil rating (g.p.d./ftz or felbdrm) Q f' System type T/2�.t/Cff Length O ft. Width s ft. Gravel below pipe d. % ft. Total depth 4f4 ft. Eff. absorption area 65fz Monitoring tube Depression over field A% Date of adequacy test al—sG F Results (Pass/Fail) For 3 bedrooms Fluid depth in absorption field before test t3 in. Water added LOO gal. New depth O in. Elapsed Time:min. Final fluid depth 0 in. Absorption rate >= SO O g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) (J1%(t 4 If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) i 'Pump on" lev at _ in. 'Pump off" level _in. High water alarm le at in. Datum Cycles te5 Meets alarm rcuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot _/G O y f On adjacent lots /D Or Absorption field on lot /0(7 't On adjacent lots /00 0',0- Public 't Public sewer main Public sewer manhole/cleanout _Lt/%`i r Sewer /septic service line % Lab#: A0812049-0IA Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 92228 (Aqueous)-TCbyMembFilt-Enumerat Test was conducted by: Analytica - Anchorage Bacteria, Other e.MRL CFU/IOOml- 1.0 12/32008 12/3/2008 DL Total Coliform c10111- CFU/IOOmL 1.0 1 12/3/2008 12/32008 DL Lab#: A0812049.01B Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 200.82(1).8 (Aqueous) - Family Well Water I Test was conducted by: Analytica - Thornton Arsenic 0.249 ug/L 0.15 10 200.8 12/10/200812/16/200K;Y Lab#: A0812049-0IC Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 4500-NO3E (Aqueous) - Nitrate+Nitrite Pres Teri Nitrate -Nitrite as Nitrogen <MRL mg(L 0.10 10 Page 3 of 3 was conducted by: Analytica - Anchorage 12/32008 12/3/2008 JQ SP-Analytica, Inc. -Anchorage 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 ANALYTICA GROUP Northrim Eng Report Date: 12/17/2008 Attn: Steve Eng Receipt Date: 12/3/2008 17237 Bear Paw Circle Sample Date: 12/3/2008 Eagle River, AK 99577 Sample Time: 10:00:00AM 907-694-7028 Collected By: SE Fax: 907-694-7026 Flap Definitions: MRL= Method Reporting Limit Client Sample ID: 4143 Flarca MCL= Maximum Contaminant Limit Sampling Location: 414311arca B = Present also in Method Blank Client Project: Northrim Eng 11= Exceeds Regulatory Limit Sample Matrix: Aqueous h1= Matrix Interference COC#: J = Estimated Value PWS4: D = Lost to Dilution Residual Chlorine: " = RL higher than MCL; target not detected Comments: TNC = Too Numerous to Count - result rejected CF = Confluent Growth - result rejected TCNG = Turbid Culture No Growth - rejected Lab#: A0812049-0IA Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 92228 (Aqueous)-TCbyMembFilt-Enumerat Test was conducted by: Analytica - Anchorage Bacteria, Other e.MRL CFU/IOOml- 1.0 12/32008 12/3/2008 DL Total Coliform c10111- CFU/IOOmL 1.0 1 12/3/2008 12/32008 DL Lab#: A0812049.01B Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 200.82(1).8 (Aqueous) - Family Well Water I Test was conducted by: Analytica - Thornton Arsenic 0.249 ug/L 0.15 10 200.8 12/10/200812/16/200K;Y Lab#: A0812049-0IC Analysis Method Prep Prep Analysis Parameter Result Units Flags MRL MCL Method Date Date Analyst 4500-NO3E (Aqueous) - Nitrate+Nitrite Pres Teri Nitrate -Nitrite as Nitrogen <MRL mg(L 0.10 10 Page 3 of 3 was conducted by: Analytica - Anchorage 12/32008 12/3/2008 JQ Municipality of Anchorage ; .. Development Services Department �j- •.;>�; Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 080425 During a recent COSA on-site inspection and test of the potable water supply well on Block 6, Lot 3 of North Slope #2 subdivision, the well's productivity was determined to be 0.6 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.3 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. eo•mRR mwn<o w •.•.�Nvarn.o< M[A•<ONO.. ftl=ao PLAT lmm ON MO "u.,o OONN[•• As @NOWN N[R[ON. AN [;T•N•IV[ •OYNOMY •Y a OOYW MODYO[ N of Y . tNTa mo MOR RP/ YN[ THAT Ol o MON TMoog eIMOMN cw• . su 1• •IYONO tMt •00•t Oe TNI• •Y RV[Y. *� 49=-H� : ............................... a SHANE A. HOLT. a � • L9-6914 TT � OJ nr.<'p •••• ..... •.O d I ) \ I1 ) � � IVYMp I �9 I l7 7 S 89.46'22°E 79.171(MEAS.) 79.41 (RECORD) A4[IAli BLeiVEY BfuT1'�SO 1 MAfFBY CERTIF'I TMT I IMYE PE16CR1EDA IgRTGACEFB NS{FCfgN Of TIE F01EON1Nf. DESQNBED eAOfFRTY EOT a T[oo[a NORTH elolf No 3 TIE•fORw NEREOII B Fan TIE IIDE OF IBIORq•6TIITYIlole9 IPEOICILLY MSIgWANY CO1fI1OT8 ETIREN ' �{p T. 4lA5RA M�TNIT pusTWD[rRYCTYRE9 KArTDLOTU OREATiELENT[A *D TTo[EIBEDTORfVORR)raq ADpTIpML TEeYNI0.EMFNf881TWTED TEItEON I4E YAneN iNE STRYCT[ MPEN WES AiOfERIY lME9 All)MO NB(aE FNOi0eL1•EHTS FAST OTER ITINI NOTED. F/SUOM1 RECORD.OTER TVN 11108E SNOAR ON TE RECORDED PIAT.ARE MOf SNONN IIFTIEOII MTEDATANLNORAf.EALASeATes a _ MY DECEPWEN 3001., NOIF. ANY iENC611Es8N01M1ARE lOMImAPOROlOYA/HYAND ARE NOT TO BE MYDID OElFRM11E PROOERlY 11NEs HOLT IAIID 9[nE Tislsew MR ATESTiuc M WLUSM13 I I I � 1 1 • ( I I I � I ( I � + ( t I I •� I I ) \ I1 ) � � IVYMp I �9 I l7 7 S 89.46'22°E 79.171(MEAS.) 79.41 (RECORD) A4[IAli BLeiVEY BfuT1'�SO 1 MAfFBY CERTIF'I TMT I IMYE PE16CR1EDA IgRTGACEFB NS{FCfgN Of TIE F01EON1Nf. DESQNBED eAOfFRTY EOT a T[oo[a NORTH elolf No 3 TIE•fORw NEREOII B Fan TIE IIDE OF IBIORq•6TIITYIlole9 IPEOICILLY MSIgWANY CO1fI1OT8 ETIREN ' �{p T. 4lA5RA M�TNIT pusTWD[rRYCTYRE9 KArTDLOTU OREATiELENT[A *D TTo[EIBEDTORfVORR)raq ADpTIpML TEeYNI0.EMFNf881TWTED TEItEON I4E YAneN iNE STRYCT[ MPEN WES AiOfERIY lME9 All)MO NB(aE FNOi0eL1•EHTS FAST OTER ITINI NOTED. F/SUOM1 RECORD.OTER TVN 11108E SNOAR ON TE RECORDED PIAT.ARE MOf SNONN IIFTIEOII MTEDATANLNORAf.EALASeATes a _ MY DECEPWEN 3001., NOIF. ANY iENC611Es8N01M1ARE lOMImAPOROlOYA/HYAND ARE NOT TO BE MYDID OElFRM11E PROOERlY 11NEs HOLT IAIID 9[nE Tislsew MR ATESTiuc M WLUSM13 Municipality of. Anchorage Development Services Department •��' Building Safety Division j On -Site Water and Wastewater Program SA r 4700 South Bragaw St. 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. Deo - s�i-or 1. GENERAL INFORMATION HAA# liq 0/0 gJrS Expiration Date: /I- 3 b - O t Complete legal description re "-1 AO r 3 rig E . Location (site address or directions) -/,/ 4-.? H41« .el Current Property owner(s) 4410�/ Day phone 69v - 31 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address F ; r or7e tr, Day phone A„I,A,4 � Gre4t/A-w X-,- /42 -s„/z, Dayphone cyY-�z,Dr %�<4• i2.. -ems � f9 K Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLYs TYPE OF WASTEWATER DISPOSAL: Individual Well © Individual On-site El Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a sincle family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (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 ureter system. The Municipality of Anchorage is not responsible for errors or omissions in the professional encineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Eagle River Engineering S'erv;rP9 Phone 69a-s-i5i Address P:{�-"Ox 3 e�ORi.AK 99577.3294 Engineer's Printed Namefa -le-A Date 6-30-,01 r•�.s eeelMYe�e..M�i7iNe.e e. 5. DSD SIGNATURE ?,1 Louts AButera %r. li Approved for bedrooms. CE -6736 Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: �. o+ Original Certificate Date:g - 3 /- 0 1 (Rev. 12CO) Municipality of Anchorage ,,.� •�, Development Services Department Building Safety Division ` on-site water b wastewater Program ' • r 4700 South BnQm St. P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchomge.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A r A Sig ge- W2, Ln f 30 Bleck 4 Parcel l D: W- -T91-01 A. WELL DATA Weil type ftjD fe- if A, B, or C provide PWSID # !A- Date completed Pr;a& to shlhs Sanitary seal (Y/N))�U - Affe". 1176 , Total depth 4 6 0 , ft. Cased to MO ft. Date of test Static water level Well production FROM WELL LOG /✓o 1-02 WATER SAMPLE RESULTS: Well Log (YIN) No Wires properly protected (Y/N) Y Casing height (above ground) 42 in. AT INSPECTION �'lz2lo l g.p.m. 0176 g.p.m. Coliform _-0--colonies/100 ml. Nitrate 0.5'0 mg./l. Other bacteria 0 colonies/100 ml. Date of sample:81t4 /o f Collected by: E. R _ S B. SEPTICIHOLDINO TANK DATA TankType/Material .Sfeei Dateinstalled S/26135 Tank size 1000 gal. Number of Compartments Cieanouts (YIN) )(e5 Foundation cleanout (YIN) _Yes Depression over tank (YIN) NO High water alarm (YIN) NO Date of pumping C. ABSORPTION FIELD DATA Date installed f/25 /F S Length 781 ft. Total depth it %n, ft. Pumper J!C s Sol rating (g•p•dJfF or ft2/bdrm)1_7 7 System type Sk Ito w Tr a ht 6 Width 51 ft. Gravel below pipe 2 r ft. Eff. absorption area 5S7 iF Monitoring tube Depression over field Date of adequacy test W 22 /01 Results (Pass/Fail) P9S5 For 3 bedrooms Fluid depth in absorption field before test d' k in. Water added 400 gal. New depth&L' in. Elapsed Time: M min. Final fluid depth o1 1 in. Absorption rate >= `fSD g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NIA If yes, give date D. ) .IFT STATION installed on" leve( at _ in. E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N) "Pump offlevel at j in.High water alarm level at in. Cycles tested Meets alarm b circul requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /041 Absorption field on lot ►1 31 Public sewer main *1110 %y Sewer /septic service line —±2 S 1 On adjacent lots +1617, On adjacent lots t 1001 Public sewer manhole/cleanout A -W'- AIA Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 9 6 / Property line + 101 Absorption field i 3 Water main + 10' Water service line +100' Surface water 41001 Wells on adjacent lots + 1001 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 4 10 1 Building foundation 11 11 Water main 110' Water Service line + 101 Surface water 11001 Driveway, parkinglvehide storage I Curtain drain WA Wells on adjacent lots t 1041 F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and �t j4� review of Municipal records that the above systems are in .,'.«. » ....... conformance with MOA HAA guidelines In efled on this dale. ..............«......�. Engineer's Printed Name Lou;s Rl.irr9_ �� M f Date 2/13101 r HAA Fee $ Date of Payment Receipt Number Q 7r• (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage ' Development Services Department dpi Building Safety Division s.... On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Nater Well Advisory Health Authority Approval # 010458 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 6, Lot 3 of North Slope #2 subdivision, the well's productivity was determined to be 0.76 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. CT&E Environmental Services Inc. CT&E Ret.N 1015339001 Client Name Eagle River Engineering Project Name/# North Slope N2, Lot 3, Blk 6 Client Sample ID North Slope 42, Lot 3, Blk 6 Matrix Drinking Water Ordered By PWSID 0 Client PON Printed Date/time Collected Date/time Received Date/time Technical Director Released ByAy,,, 0822/2001 16:38 08/142001 16:05 08/152001 8:40 Stephen C. Edee���% Allowable Prep Analysis Puamcter Results PQL Units Method Limits Date Date [nit Waters Department Nitrate -N 0.500 U Microbiolow Laboratory Total Coliform 0 0.500 mg/L EPA 300.0 (<10) 08/15/01 SCL 0 coU100mL SM18922213 (<1) 08/15/01 SKW GE MUNICIPALITYHEALTH & HUMAN •� i/T/'r DEPARTMENT OF HEALTH 6 HUMAN SERVICES dy4 Division of Environmental Services S` �r1 �e1 y On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0 SP - -5'$1 - o d • HAA # 9'1 o 187 1. GENERAL INFORMATION Complete legal description Lot 3, Block 6, Northslope #2 Location (site address or directions) 4143 Harca Road Property owner ''George Wood Day phone 1-907-225-5082 Mailing address Ketchikan Lending agency Alaska USA/Ann Morris Day phone 694-7030 Mailing address 12832 Old Glenn Hwy, Suite C-2, Eagle River, AK 99577 Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3- 3. TYPE OF WATER SUPPLY: Individual well Xn Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: XXX Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72m5 (A,.. 1/91) Front MDA 121 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 5 a 5 ENGINEERING Phone ;L `f 7 5 c�^ - : iv•. Loop Road No. 204 Address Eacls River, Alaska 77577 Engineer's signature 6. DHHS SIGNATURE Approved for 7 & F r bedrooms. Disapproved. Conditional approval for Additional Comments M Date / / ` C/ 01= 4%�RC2ST C. CV. -VAN / n y CE-EoGI ,i bedrooms, with the following stipulations: Date s=12- 99 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an Independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and thei r lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. rzc2s R+«. uvp S Kk MOA /21 RECEIVfu - 9 Municipality Anchorage APR 2 y 199 DEPARTMENT OF HEALTH &HUMAN SERV�'=n' OF Services Division �SWKXso 825 L Street, Room 502 a Anchorage, Alaska 99501 a (907) 343-4744 Health Authority Approval Checklist Legal Description: lei 3 Usk C IWA rN S" P- tl 2 Parcel I.D.: O 9'0 —Sb / - 0 1 A. WELL DATA Well type P R I v A r E If A, B, or C, attach ADEC letter. ADEC water system number Log present (Yo ^10 Date completed PR, o A To ,r/ 19 1 Y S -1i.4,0.2. v, r '17 b Total depth '— Y 4 o Cased to 40`t Casing height (above ground) t ,+ Sanitary seal &N) YES Wires property protected &N) "'IS FROM WELL LOG Date of test 1 Static water level Well production g.p•m• WATER SAMPLE RESULTS: Coliform O Nitrate AT INSPECTION Li/a-7/a9 2x9' O. (0 g.p.m. 0-447 Other bacteria 0 Date of sample: 3 7/ 4 °! Collected by: Sit _s r:mGlN6ntN9 17014 Eag!,t River Loop Road No. 204 B. SEPTICIHOLDING�'TANK `DATA Eagle River, Alaska 99577 Date installed sem_ Tank sae 1 0 o fl Number of CornpartmeMs -X Cleanouts STI) y f f Foundation deanout6/N) Y E f Depression (Y& ^'O High water alarm (YAO 'v 0 Date of Pumping z+4-4 / 91 Pumper Tit J C. ABSORPTION FIELD DATA Date installed S/d s'18 3- Soil ratin g.p dJftp r tt2/bdrm) )-77 System type T R t w c -N Length 7 8 Width s Gravel thickness below pipe a ' Total depth 4 �i Effective absorption area 1r)33'7i r' M ring Tube present ON)yKf Depression over field (Y4Q ^' v Data of adequacy test 4� 1 l I A q Results (Pass/Fall) P /E S s For -3 bedrooms Fluid depth In absorption field before test (in.): I' 4 " Immediately afterys Ygal, water added (in.): I' 6 r' Fluid depth I � (ins) Minutes later: S 0 Absorption rate = y SO f a.p.d. Perwdde treatment (past 12 months) (YM) N a N b K wu w ,✓ if yes, give date 72-026 (Rev. 3196)• D. LIFT STATION Date installed Manhole/Access (V/N) High water alarm level at" E. SEPARATION DISTANCES "Pump on" 'Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 1 0 0 F Absorption field on lot Public sewer main Sewer /septic service line /00 `r Size in gallons "Pump otP level at* On adjacent lots / 0 O � On adjacent lots 100 nr /. Public sewer manhole/cleanout A// �L S f Lift station v / A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation q 0 1 Property line /0 / Absorption Held S r I Water main/servioe line /0 '/' Surface water/drainage / 0 ° �� Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10 t Building foundation loo f Water main/service line /0 '/ Surface water / 0 0 �+ Driveway, parking/vehicle storage area t Curtain drain N o N r K N u"✓ Wells on adjacent lots /00 F. ENGINEER'S CERTIFICATION 1 certiy that I have determined thru Meld inspections and review of Municipal in conformance w!Nj1�1�/$ddell� s in affect on this date. Signature (��p��'/ C. , r�iZr'-- Engineer'sName )fJQf.R C_ Cpw4•./ Date . Y/ a 4 / 9 °) HAA Fee $ 3 b -p • xz Date of Payment Al J 7q Receipt Number. 46�T11 ( �� 72-026 (Rev. 3/86)• Waiver Fee $ Date of Payment Receipt Number U at00M C. C©WAN .... 7Z I! t cl=-aeof f / are MUNICIPALITY OF ANCHORAGE M E M O R A N D U M EATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. I o!g 7 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot 3 Block of _A16A7-H-54 o10,t ;v-.2 Subdivision, the well's productivity was determined to be 0.6 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 bedroom residence is 0.312 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies bf the subject Health Authority Approval. j ME Environmental Services Inc. CT&E Rer.# Client Name Project Name/k Client Sample ID Matrix Ordered By PWSID Parameter Total Coliform Nitrate -N 991735001 S & S Engineering Lot 3 Blk 6 Northslope No. 2 Lot 3 Blk 6 Northslope No. 2 Drinking Water 19 Client POA' Printed Date/Time 05/04/99 14:20 Collected Date/Time 04/27/99 15:30 Received Date/Time 04/28/99 10:50 Technical Director: Stephen C. Ede Released By Results POL Units Method 0 col/100mt. SM18 92228 0.647 0.500 mg/L EPA 300.0 Allowable Prep Analysis Limits Date Date Init 04/28/99 KAP 10 max 04/28/99 04/28/99 SCL