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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES #2 BLK 4 LT 5Mountain Park Estates #2 Block 4 Lot 5 #017-023-05 Jun 13 22 07:40p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Departmentu 4 ,� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Parcel Identification Number. 017 023 05 Date of Issue: _- Legal Description Block Lot Property owner Name & Address: FLANAGANM ROBERT F 50% & FUENTES LESLIE A 50% MOUNTAIN PARK ESTATES #2 4 5 12920 FOSTER ROAD ANCHORAGE, AK 99516 Pump Installation Date: 05 _ 28 - 2022 Pump Intake Depth Below Top of Well Casing: 255 feet Pump Manufacturer's Name: A.Y. MCDONALD Pump Model: 24075V3LB Pump Size: .75 hp Pitless Adapter Burial Depth: 12 Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: feet MARTI NSON Well Disinfected Upon Completion? fk Yes ❑ No Method of Disinfection: PELLETS Comments: Pump Installer Name: ANCHORAGE WELL &PUMP SERVICE Company: 7640 KING STREET ANCHORAGE, AK 99518 Mailing Address: _ 907-243-0740 City: State: Zip: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage IIT/ Development Services Department Building Safety Division On-Site Water and Wastewater Program. 4700 Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 Page of www. ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 1000D_06549 x:23-05 PID Number: I - Name' 6GO Q N C1196TOPIAR Wastewater System: ❑ New ❑ Upgrade Address IZ920 T05iEtL ROQ0 ABSORPTION FIELD Phcna lel M aewoams 9 O Deep Trercn O Snanow Tr.rcn p e.a D Moved p Dlrw LEGAL DESCRIPTION Sal Rakn9 T"DeMk mmpnmlp doe Block Lo J/C�Ars ` .S'UCWr s,w T�104 T 1,, MILK I GPD,T DWh b ppe bdtom edn dgr 7adr Ft. 13 a" dWh a fli p" Townsn�p'. R" Setlian. Ft. Fit added mpow orginvl Vade FI Grsvat Length: Fi. Ft. Well: ❑New❑Upgrade G,8v i,iVh lhlO Wm le. Distill oet aan im, DlmefdlCalKKl (Proal n . cC Tdat Depen: Lased m. FI' Tole) wsdptm rem FI Fm Maung FL FI Flt dicer Date DNbd. Slaw wens L" IM181W. Dale trimlaw lO/ FL L B Yroid Pump $el at. Damg Hegm Adore damrd. E V!5-+ 017-1GMn FL R l-/Y TANK SEPARATION DISTANCES XSeptic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding lubliCIFinvate Marerlaauer nr From Field Station Tank Sewer Line „ Aiyc Gal 125p yTank 1 00 s MaIxW Nuniwr a Do^Cmnmaes 2 At. 0. LIFT STATION dHm f 101 ua ".W l�1 vrqonbranW t •P.elan Warm atn in N. A. Pm Naie a Model Ebarirai nspectrorM peddroed by ;, Remarks BENCH MARK Louleon mnkl DOMIPlwi ; f N �er D Nous ASfWllad Nvmkm FL 100 ' F,t)piDeef's'Sl'aMp. � � JIr tt>.. 40� fovea rl.��.hTy c� 11,el Inspections performed by: _��,'� SDur W d�n� Dates: 1" lLS BFf ~mar' 2n Developm Services it Department Approvals Reviewed and approved by: Date:' 1► 'y2t'yoe te.,aet?.,;y 21 I I I I Wel I I I I 4 I � I I \ SW O 1105 I I A 20 AC=40' W-JJQ� I \ t I AD=IO DD=J7.S' Ac=47=43' I Yell t/ AI -8::2 AG=u' ec=sg.s' I I I e 5 `4 1 1 t Q WWD LZ'WG use CAL =n TAw t O I I �P -© N Y 19 I I iY I I S 6 I I I�I Q i}ell 18 P� Q I I �; ,A• 49th 5 I I 7 �...»1....... ..... .»..»...._ ...., .. � _ TOBBE SPURKIIAND n `� I I I �� f'•: No. CE-22x5'.�-� 2s0 25 50 75 10o 1125 150 ••� '1 .�r�• 1/ ^�d L SCALES 1' = 50 FT •4.•.• T08BEN SAVND P.E. 203 W 15TH.TH. AVENUE MOUNTAIN PARR ESTATE 12 BX 4 LOT 5 SEPTIC SYSTEM ASBUILT ANCH. AK. 99501 JOHN CHRISTOPHER DATE: OCTOBER 19, 1005 907 179-3916 11920 FOSTER SHUT. 1/3 GRID: 2839 PERMIT k SV050349 PID # 017-023-05 MPE204052.DVG 4� .. o O a c °' a V y � V ,moo 0 A 3 Connect to Existing Trench O 4 1250 gat Septic tank Connect to Existing MCH w)r BOTTOM SIDING ASSUMED RRADON PoO mT "' """`""" J;' I r"NTAIN PARK ESTATE 203 V. 15th Ave, Suite 203 12 BK 4 LT SEPTIC SYSTEM ASBUILT Anchorage Ak 99501 JOHN CHRISTOPHER DATE, EICTOBER i9, 2005 279-3916 11920 lDSEIR SHEET 3/J GRID 2839 I PERMIT I SWO50349 PARCEL ID f 017-023-05 UPE204053 DWC MUNICIPALITY OF ANCHOR4GE 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 PERMIT Upgrade Permit Number: SWO50349 Legal Description: MOUNTAIN PARK ESTATES #2 BLK Design Engineer: 0007 Tobben Spurkland, PE Owner Name: DEBORAH CHRISTOPHER Owner Address: 12920 FOSTER RD ANCHORAGE, AK 99516-3231 Date Issued: Sep 16, 2005 Expiration Date: Sep 16, 2006 Parcel ID: 017-023-05 4 LT 5 Site Address: 012920 FOSTER RD Lot Size: 20130 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. ❑ Disposal Field ❑✓ Septic Tank ❑ 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 day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: �19 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 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. 1)1 q- 6a 3-06- Permit Number SW 0 s, C" Property owner(s) De era 1, CHrislo Ae.. Day phone 22-3-9518 Mailing address \ Zip Code Site address _ 2920 Fm4c'.— POad Zip Code Legal description (Lot, Block & Sub'd.) IA,o k ej. GAK 9s14e- "2 B 4 L 5 Legal description (Section, Township & Range) Lot Size &d 130 Acre /Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 4 Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees:'9\!U1 on C�0 Waiver Fees: Date of Payment: qb-S /A� Date of Payment: Receipt Number: -7 n9(1,1 p �ij�M Receipt Number. (Rev. 09/04) Environmental Consulting and Design L Municipality of Anchorage September 14, 2005 Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Septic Tank Permit Mountain Park Estate #2 Block 4 Lot 5 The septic tank installed on December 29, 2003 permit # SW030500 was installed 95 feet from the water supply well on the subject property. We are applying for a permit to move this existing tank out of the well radius. The submittal consists of two (2) drawings; Sheet 1 showing the present and proposed improvements on the lot and the adjoining properties, of which only the septic tank is subject to this permit application, and Sheet 2 a schematic of the tank. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. (Sincerely, �J Lars Spurkland 203 West 15" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng(a�gci.nct 21 1 I I I -© I I I I 4 I I 25 0 25 W 115 1, 1 `5 150 SCALD I' = 50 FT.. _ .�- iYe1� I I READ 1250 CAL S.T. I 5 � STALL 1250 CAL S T. ' 49th a Q 0 ar AM 1,C Z? SEPTIC D ION ANCH. AX 99501 I I mvunintn rlOH �fOS W R �� 4 �DA 7r. AUGUST ' I I SHEET 2/3ST 2210 005 I (907) 279-3916 12920 PERMIT / SV050XXX PID # 017-023-05 NPE204052.DWG I IA O a o m V d v It o v O � Connect to Ex/st/ng Trench O O ` 1250 gal Septic tank Connect to Existing 1250 gat septic tank `!on ' 49th SFua1CLnMD 03 W. 5th Avet I MyOUNTAIN PARK ESTATE 2 BK 4 LT SEPTIC SYSTEM DESIGN 203 W. 15th Ae Suite 203 I Anchorage Ak 01 01 JOHN CHRISTOPHER 11 DATEi ALG a 2W 279-7916 12920 FOSM SMEETs " GRID. a" P£RAOT / SWOSOOXX PARCEL 1D j 017-023-05 UP£204053 DWC ISABELLE CONSTRUCTION & EXCAVATING April 11, 2005 Ms. Julie Makela, P.E. Civil Engineer II On -Site Water & Wastewater Program Municipality of Anchorage 4700 Bragaw Street Anchorage, AK 99507 RE: Notice of Violation — Certified Letter 7004-0750-0000-7036-1479 Legal Description: Mountain Park Estates #2, Block 4, Lot 5 Parcel ID: 017-023-05 Dear Ms. Makela: This acknowledges receipt of the subject letter. Upon receipt of your letter, I called you immediately to discuss this issue. I advised that this was the first notice I have received informing us there was any problem regarding the repair we performed in December 2003 at this property. The property owner contacted us back in December 2003 to get a septic pipe repaired. In the process of exposing and repairing the pipe, we discovered that the existing steel septic tank was in the advanced stages of decomposition and ready to collapse. We notified the engineer immediately who in turn contacted your offices explaining the physical circumstances. We therefore made the most practical and common sense repair available at the time under the supervision of the engineer with the physical conditions of the existing system, the property grade elevations, existing utilities and the frozen ground. We decommissioned the old leaking tank and installed a new steel tank as far away from the well as possible without encroaching the existing functioning leech field. The new tank replacement created a greater distance between the existing well than there was with the old tank, provided continued service for the property owner that was the most practical for the property conditions and eliminated a potentially hazardous condition. I contacted Mr. William Rieth from ADEC and discussed the circumstances surrounding the request for the 5' waiver by the engineer. fie advised me that even though the time period had expired, he would reconsider the waiver if resubmitted by the engineer because of receiving the additional information we encountered in the field which he had not been aware of previously. I would appreciate the Municipality reconsidering its position as well regarding the Notice of Violation and the waiver. As you are aware, not all situations in the field are -2— Apr1111, 2005 ideal and many properties have unique situations requiring waivers. We believe this was a reasonable request regarding the existing field conditions. Sincerely, Del Isabelle Owner _ DUs Cc: John Christopher William Rieth, ADEC Tobben Spurkland P. O. BOX 220021 • ANCHORAGE, AK • 99522-0021 PHONE: (907) 243-5845 • FAX: (907) 248.0004 l Environmental Consulting and Design April 11, 2005 Julie Makela, P.E. Civil Engineer 11 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw St. Anchorage, Alaska 99516 Subject: MOUNTAIN PARK ESTATE 42 BLOCK 4 LOT 5 PID N 017-023-05 Notice of Violation Dear Ms. Makela; On April 8, 2005 our office was contacted by Mrs. Christopher and asked to provide assistance in resolving a violation of Anchorage Municipality Code (AMC) 15.65.040 A. The separation distance between the septic tank and the well on lot 5 is approximately 95 feet. On December 23, 2003 a wavier of the 100 -foot separation was applied for and denied. Due to changes in municipal policy, several of the reasons cited for denial of the wavier are no longer valid. 1 am requesting that this case be re -reviewed and that a waiver be granted. On December 9' , 2003 a new 1250 gal steel tank manufactured by Anchorage Tank was installed to replace the original tank, which had collapsed. The new tank was installed as far from the well as was practical. Using the ADEC Separation Distance Wavier Guidelines a point value of 18.3 was calculated. This indicates that the well is "Almost sure to be free from any form of contamination from house hold sewage". Waiver Request: 95 feet from septic tank to well. Attached: Well log for MPEN2 B4 L5, Water Samplcs for MPE 42 B4 L5 and L3, the method used to determine the ADEC point's value. 203 West 151° Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEngCagci.net _ Environmental Consulting and Design REF.: "ADEC Separation distance wavier guidelines." Water Table Points Depth of well 140 feet Total depth of septic tank -8.5 feet 131.5 feet 7.1 Soil Sorption Soil descriptions from well log Gravel 0-20 feet 20 feet Sand 20-34 feet 15 feet Clay 34-60 feet 26 feet Sand 60-72 feet 12 feet Clay 72-88 feet 16 feet Sand 89-110 feet 21 feet Silt (cemented) 110-28 feet I8 feet Sand/ Gravel 128-140 feet 12 feet (20/140.0)+(15/140.1.5)+(26/140.6)+(12/140.1.5)+(16/140.6)+(21/140.1.5) +(18/140.3.5)+(12/140.1) Permeabili Soil descriptions from well log Gravel 0-20 feet 20 feet Sand 20-34 feet 15 feet Clay 34-60 feet 26 feet Sand 60-72 feet 12 feet Clay 72-88 feet 16 feet Sand 89-110 feet 21 feet Silt (cemented) 110-28 feet 18 feet Sand/ Gravel 128-140 feet 12 feet (20/140'0)+(15/140'1.5)+(26/140'0)+(12/140' 1.5)+(16/140'0)+(21/140'1.5) +(18/140.3)+(12/140'1) Water Table Gradient Subject property generally slopes from the well towards the septic tank 0-5 % Assume 5% Slope 2.9 IRO Ml 203 West 15'h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gcLnet _ Environmental Consulting and Design Horizontal Separation 95 feet between well and septic tank on subject property 0.2 - 3-X 2.8 Total Points 183 Special Considerations: Total coliform and other bacteria were not detected for the water sample collected from the well on the subject lot. A nitrate result of 7A5 mg/l was reported for the water sample collected from the well on the subject lot. This is below the required standard. A water sample collected from MPE #2134 1.3 shows 7.89 mg/I nitrate, indicating that the nitrate level is common in this area and cannot be attributed to the septic system on this lot. Moving the septic tank will not have any influence on the nitrate levels of the subject well. The municipality no longer recommends that high Density Polyethylene septic tanks be installed if a separation distance wavier must be applied for. The ground surface slopes away from the well towards the septic tank, so contamination of the well due to septic system overflow is not possible. At this time we request that a formal waiver be granted. Sincerely, Tobben Spurkland 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279.3916 Fax: (907) 276-6013, SpurklantlEng@gci.net w vva ' •35 o?LD .5 Pr1jC�� 35 35 AIILC -Ma—Ll aha c, %UA 6-,,surns, -t 5`;D _�-_ K+aab q LoA, S 3.y Wim o. -P 09 -1I.9 ca\ Ao :!.�)5 �" C hp�C6. d. `-•fYl4�p 1�l lx3 c�\ Ao `A{1a APR -08-2005 09:57 AM T SPURKLAND 907 276 6013 P.01 �7i'it`� . S�urkl�•jnd Enc�ineeiin� r Julie Makela PX Civil Engineer 11 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South BragaW St. Anchorage, Alaska 99519 Subject: Mountain Park Estate M2 PID017-023-05 Notice of Violation Dear Ms. Makels; Thank you very much for notifying me about this code violation. April 7, 2005 I have not been contacted by the property owner regarding this mater, and can therefore not be of any assistance to you In having It resolved. Yours 1- T. Spurkl d P.E. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, phone: (907) 279-3916 Fa:: (907) 276.60139 Spur1dandEn9@gc1.net Municipality ofAnchorage e \\� �i�J// P.O. Box 19W -A • Anchorage, Alaska W519 -M50 • Telephone (907) 9-1&&101 • rar (9()7) 313-8M) \\\��j /�' 4700 6mgnw Street • Anchorage, Alaska 99.107 Mayor Alark Bcyich BmmilaMW.munl.org ding Safety Division March 8, 2005 John & Deborah Christopher 12920 Foster Road Anchorage, Alaska 99516 RE: NOTICE -OF -VIOLATION On -Site Wastewater Disposal System / Water Supply Permit Number SW030500 Legal Description: Mountain Park Estates #2, Block 4, Lot 5 Parcel ID: 017-023-05 Dear Mr. & Mrs. Christopher, On December 8, 2003, a permit was issued by this office for the installation of a septic tank on the subject property. On December 29, 2003, an Inspection Report for the septic tank installation was submitted to this office by Spurkland Engineering. This Inspection Report indicates that the septic tank was installed by on your property 95 feet from the water supply well. A request was -also submitted on December 29, 2003, for a waiver of the 100 foot separation required between the septic tank and the water supply well on the subject property. The waiver was not granted by this office. A review of the :waiver request by the Alaska Department of Environmental Conservation (ADEC) concurred with this offices determination to not grant the waiver, as indicated in the April 23, 2004 letter from Mr. William Rieth. Installation of the septic tank 95 feet from the private well oa the subject lot is a violation of Anchorage Municipality Code (AMC) 95.65.040 A. This code citation states in part, "A person may not construct, install or use an on-site wastewater disposal system except in accordance with the provisions of this chapter or other ordinances,`regulations or statues in effect at the time of system construction." This letter will serve as your "notice of violation" of the above stated code citation. If this compliance matter is not resolved within 30 days of receipt of this letter, you will be issued a Complaint of Municipal Code I lolation. If you have questions regarding this letter, please contact me at 343-7904. Sincerely, Julie Makela, P.E. Civil Engineer II On -Site Water & Wastewater Program Community, Security, Prosperity M I D•' Mr OFFICIAL USE C3 r' Poft" t C3 CerdW Fee C3 O Here rPsem�m RsdW Fee P He alk O (ErWl Pa4ue.C) C3 Rsetrvbd DetlwyFM Ln (EtMorwewe MpYW) M1 C3 Tcr.r w,r.n. a Fr .Pi c . John & Deborah Christopher r` x; 12920 Foster Road Anchorage, AK 99516 • Complete items 1, 2, and 3. Also complete Rem 4 if Flestdcled Delivery is desired. • Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mallplece, or on the front R space permits. 1. Ankle Addressed to John & Deborah Christopher 12920 Foster Road Anchorage, AK 99516 a o.w.eceNea Dy (Panted Nomal/ C. OT of D it " D. Is d*a y addrma different from item 11 0 Vee R VES, anter delivery address below: 0 No 3. Service Type . 0 Cererred Mee 0 Express Mall 0 Re&lered 0 Return Peoapt for Merchandise O Insured Mall 0 C.O.D. 4. Restricted Delivery? (F+na Feel 0 Yes 2. AnicleNumtrx _ 71104 0750 0000 7036 1493 ` (!Mash aom "'IL a I . i PS Form 3811, February 2004 Domestic Retum Receipt 10259542a 1540 Municipality ofAnchorage P.O. Box MUM • Anchorage, Alaska 9D519.6650 • Telephone (907) 343-&901 • Pas (907) 348-8200 4700 Oragaw• Street ° Anchomge, Alaska 99007 xrx.munl.org Mayor Mark Bcyicil Bullding Safety Division March 8, 2005 Isabelle Construction & Excavating P.O. Box 220021 Anchorage, Alaska 99522 RE: NOTICE -OF -VIOLATION On -Site Wastewater Disposal System / Water Supply Permit Number SW030500 Legal Description: Mountain Park Estates #2, Block 4, Lot 5 Parcel ID: 017-023-05 Dear Mr. Delido Isabelle, On December 8, 2003, a permit was issued by this office for the installation of a septic tank on the subject property. On December 29, 2003, an Inspection Report for the septic tank installation was submitted to this office by Spurkland Engineering. This Inspection Report indicates that the septic tank was installed by Isabelle Construction & Excavating 95 feet from the water supply well on the subject property. A request was also submitted on December 29, 2003, for a waiver of the 100 foot separation required bctween.the septic tank and the water supply well on the subject property. A review of the waiver request by the Alaska Department of Environmental Conservation (ADEC) concurred with this offices determination to not grant the waiver, as indicated in the April 23, 2004 letter from Mr. William Rieth. Installing the septic tank 95 fect-from the private"well on the subject lot is a violation of Anchorage Municipality Code (AMC) 15.65.040 A. This code citation states in part, "A person may not construct, install or use an on-site wastewater disposal system except in accordance with the provisions of this chapter or other ordinances; regulations or statues in effect at the time of system construction." This letter will serve as your "notice of violation" of the above stated code citation. If this compliance matter is not resolved within 30 days of receipt of this letter, you will be issued a Complaint of Municipal Code Violation. If you have questions regarding this letter, please contact me at 343-7904. %Sincerely, Julie Makela, P.E. Civil Engineer II On -Site Water & Wastewater Program Community, Security, Prosperity I, .rWOO . f M1 W, MWWAP4 m OFFICIAL USE 0 r- Poop! t C3 cerew Fee O G PGelnurk C3 Rahn RodW Fee Ilene (Errdenwrwd RN*W) O Assinc dDerkwy Pee Ln (EMaw^wM ReVukeE) M1 C - v C3 , : Isabelle Construction P.O. Box 220021 t Anchoragc, AK =99522 , ---• ■ Complete Hems 1, 2, and 3. Also complete Hem 4 H Restricted Delivery Is desired. • Print your name and address on the reverse so that we can return the card to you. • Attach this card to the back of the mailPlece, or on the front H space permits. 1. Article Addressed to: k 2. Article Number y (rm w hom service iew _ I.PS Form 3811, February 2004 A. Slgl' lu / l i . t An 4,41' E3 Agent Of D. b delivery address d#ffent hom Rem 1T u res H YES, enler delivery address below: 0 No 3. Service Type 0 certified Mail 0 Express Mall 0 Registered 0 Return Receipt for Merchandles 0 Insured Mai O C.O.D. 4. Restrkied DeNve^/! IEahs Fee) 0 Yes 7004 0750 0000 7036 1479 Domestic: Return Receipt 102595-02-WIS/0 a Municipality ofAnchorage P.O. nos 196650 • Anchorage, Alaska 9'9519-f UN) • Telephone (907) 333-9301 • Pac (907) 343.82W 4700 6ragaw Street • Anchorage, Alaska 99507 Mayor Mark Bcgich %' w.munl.org Building Safcty Division March 8, 2005 Spurkland Engineering, Inc. 203 West 15l" Avenue, Suite 203 Anchorage, Alaska 99501 RE: NOTICE -OF -VIOLATION On -Site Wastewater Disposal System / Water Supply Permit Number SW030500 Legal Description: Mountain Park Estates #2, Block 4, Lot 5 Parcel ID: 017-023-05 -Dear Mr. Tobben Spurkland, •neT On December 8, 2003, a permit was issued by this office for the installation of a septic tank on the subject property. On December 29, 2003, an Inspection Report for the septic tank installation was submitted to this office by you. This Inspection Report indicates that the septic tank was installed 95 feet from the water supply well on the subject property. A request was also submitted on December 29, 2003, for a waiver of the 100 foot separation required between the septic tank and the water supply well on the subject property. The waiver was not granted by this office. A review of the waiver ,request by the Alaska Department of Environmental Conservation (ADEC) concurred with this offices determination to not grant the waiver, as indicated in the April 23, 2004 letter from Mr. William Rieth. Installing the septic tank 95 feet from the private well on the � subject lot is a violation of Anchorage Municipality Code (AMC) 15.65.040 A.- This'code citation states in part, "A person may not construct, install or use an on-site wastewater disposal system except in accordance with the provisions of this chapter or other ordinances; regulations or statues in effect at the time of system construction.,, This letter will serve as your "notice of violation" of the above stated code citation. If this compliance matter is not resolved within 30 days of receipt of this letter, you will be issued a Complaint of Municipal Code Holation. If you have questions regarding this letter, please contact me at 343-7904. Sincerely, 4JUlie Makela, P.E. Civil Engineer II On -Site Water & Wastewater Program Community, Security, Prosperity CERTIFIEC {alrnser<Usti a m 0FFI 0 0 Express Mall M1 POW&GO_ C3 C3 G tlAsd F» C3 11. um 1letlepl Fee G Reatrlde0 De4,erY Fse Ln ( Ra7uYed7 M1 IAL USE P H" O C3 -.Spurkland Engineering, Inc rr- &i '203 W."15th Ave. Ste 203 of �;. Anchorage, AK 99501. ■ Complete Rema 1, 2, and 3. Also complete Rem 4 It Restricted Delivery Is desired. ■ Print your name and address on the reverse so that can return the card to you. ■ Attach card to the beck of the mailplece, or on t R space permits. 1. Article Alllipt sed to: _ rr_ Spurkland Engineering, Inc. 203 West 15th Ave. , Ste 203 :Anchorage, AK 99501 ; X [µn B. Recetvedb1r(Pdnted Name) C. Dale of Delivery S fLk l< n h N I -0R D. Is delivery afteSS Oiserent from Item 17 ❑ Yea RYES. enter davwyaddress below. 0 No Service Type . 0 Certified Mail 0 Express Mall 13. 0 Registered 0 Return Receipt for Memilandiss ❑ Insured Mail 0 C.O.D. 4. Restrlctad Delivery? (Extra Fee) 0 Yea 2. ArticleN.Mber 7004 0750 0000 7036 1486 (nester from cervica law i i PS Form 3811, February 2004 Domestic Return Receipt 102595o2xls40 l DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF WATER WASTEWATER DISCHARGE PROGRAM Tobben Spurkland P.E. 203 West 150'Avenue, Suite 203 Anchorage, Alaska 99501 FRANK A MURKOWSKI, GOVERNOR April 23,.2004 Re: [t:et 5. Block 4. -Mountain Park Estates'.Request for a Waiver for a Single Family Home Within the Municipality of Anchorage, ADEC Project # 3796 P►o� Ot�-0,73-Cb Dear Mr. Spurkland: 555 CORDOVA ANCHORAGE, AK 99501 Phone: (907)269-7519 Fax: (907)269-7650 httpJ/www.state.ak.us/dec/ This is in response to the submittal regarding a septic tank which was installed at Lot 5, Block 4 Mountain Park Estates # 2 received in this office on February 3, 2003. 1 have reviewed the engineering drawings, the well logs, the sample results, and the actions that took place concerning the replacement of a failed septic system at this location. The review of the engineering waiver concurs'that the Municipalities determination is justified. No waiver will be issued because of the following: 1. The installation did not include the required High Density Polyethylene septic tank in accordance with the policy that the Municipality of Anchorage has established for the area. 2. As the septic tank can be located beyond the need for a waiver this should be accomplished. 3. Sampling indicates that public health is an issue in the area, the nitrate levels of 7.45 mg/1 and 7.89 mg/I have been observed, continued monitoring to be protective of public health is advised. This determination does not imply the granting of any authorizations nor obligate any state, federal or local regulatory body to grant any required authorizations. Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC 15.195- 18 AAC 15.340 or an informal review by the Division Director in accordance with 18 AAC 15.185. Informal review requests must be delivered to the Division Director, 555 Cordova St., Anchorage, Alaska 99501, within 15 days of the permit decision. Adjudicatory hearings requests must be delivered to the Commissioner of the Department of Environmental Conservation, 410 Wiloughby Avenue, Suite 303, Juneau, Alaska 99801, within 30 days of the permit decision. If a hearing is not requested within 30 days, the right to appeal is waived. Thank you for your cooperation. If you have any question please do not hesitate to contact me at 269-7519. Respectfully, William R. Rieth, P.E. Environmental Engineer cc: David Johnson, WW James Cross, MOA T. SPURKLAND P.E. 203 WEST 15TI1. AVENUE SURE 203 ANCHORAGE, ALASKA 99501 (907)279-3916 F.x (907) 2766013 T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage February 2, 2004 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw St. Anchorage, Alaska 99519 Subject: Waiver Request Lot 5, Block 4 Mountain Park Estate N2 Gentlemen; On December 29, 2003, I applied for a Well to Septic Tank waiver for this property. 1 contacted ADEC as you suggested and was told that ADEC would review the waiver application and issue an waiver if it was justifiable. 1 therefore request a refund of the $ 800.001 paid on December 29. The original receipt for the waiver fee is attached. Yours' truly, Tobbe Spurkland P.E. 1 01 T.SPURKLAND P.E. 203 WEST I5Tt1. AVENUE SUrfE 203 ANQIORAGE, ALASKA 99501 (907) 279.3916 Fuc (907) 276-6013 T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage February 2, 2004 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw St. Anchorage, Alaska 99S 19 Subject: Waiver Request Lot S, Block 4 Mountain Park Estate p2 Gentlemen; On December 29, 2003, I applied for a Well to Septic Tank waiver for this property. 1 contacted ADEC as you suggested and was told that ADEC would review the waiver application and issue an waiver if it was justifiable. 1 therefore request a refund of the S 800.001 paid on December 29. The original receipt for the waiver fee is attached. Yours truly, Tobbe Spurkland P.E. Y.unicipalltY of Anchorage Sa AM 01 12ding 045077fety 12/29/03sio11.35A11 well/$ewc Systeas $800.00 ----- ------ Total Due: 5800.00 Credit Card: 5800.00 17029008 \ Cnange:30.00 Keep Pecalot for your records 1 ��-IT-�- Municipality of Anchorage Development Services Department Building Safety Division On•Sitc Water and Waste" atcr Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.c i.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#: 040001 PID#: 017-023-05 HA#: _ Permit#: Date Received: 12/29/03 Legal Description: Mountain Park Estates #2 8 L O CK 4 Engineer: Tobben Spurkland 203 W 15" Avenue Suite 203 Applicant: John Christooher Waiver Requested: 95 foot waiver from the Septic to the Well Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation LOT 5— Total: Points: Points: ..........................................................................mass. Waiver is Granted: Waiver is not Granted: X List Conditions or Reasons for above: Date: By: Name of Reviewer .............. ............................m.a.999906............... ............ Rec#: 45077 Amount: $800.00 Date Paid: 1/6/2004 2G�04 T0806Av 3'/M .` DAti MET ToQl�6,v 60lav6 70 77we S%/Q"1'�i TQ ry�T /g�Fl:/KE/V%S w1iN G�14/✓f_/P, T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw St. Anchorage, Alaska 99519 Subject: Waiver Request Lot 5, Block 4 Mountain Park Estate #2 PID 017-023-05 Gentlemen; December 23, 2003 We are applying for a 5 foot waiver of the separation distance required between the septic tank and the well serving this lot. This lot was developed in 1977. The as built of the septic system was prepared before the well was installed. During the installation of the new septic tank the location of the drain fields were found and it was discovered that there was not sufficient space to install the tank with the required 100 feet separation to the well. The original tank was 90 feet from the well., this new tank is 95 ft. Water samples collected on December 17, 2003 did not show any bacteria, but did show 7.45 mg/1 of Nitrate —N. However, a sample collected on 2-16-94 from the well on lot 3 also shows 7.89 mg/1 of Nitrate, indicating that a high Nitrate level is common in this area and can not be traced to an individual well. Copies of well logs from Lots 4,5, and 6 of Block 4, Mountain Park Estate #2 can be used to evaluate the contamination potential for Lot 5. Two of the well logs show a restraining layer of clay and sand which protects the well from local contamination. The topography prevents overland flow of surface contaminants from the septic system to the well. Please issue a waiver for this property. Yours T. Spu land P.E. r sr�`-D ^t a RF S7-/F/C0-7-/0/L, FOR /4Gvr+ivE� � t„#y s k,,4/ vtR 0t/I=,EQrl7 1A, -,yr 1c)A S 7- f/LI4GF_ tNHY G/,pA,-,T A t�.041 iAr- a u r- s r C OMA. /,t. Pn/OR TO 714ti/C ; f IV ST/} Lt,yg TIO,Vt IPTG. C1✓ I I I ISI .�- I I I BaamU ED 1250 I � ' 49th ' TOBBEN SPORKLAND , No. CE -2225 50 0 50 100 150 200 SCALES 1' = 100 FT. 1250 GAL. SEPTIC TANK I t FOUNTAIN PBK 4 LOT 5 NU£SEPTIC SYSTEM AS BUILT ANC. 2990JOHN CHRISTOPHER C.8.203 157H. 3II f 11 SHEET IIJ 02839 I PERMIT # SV030500 PID # 017-023-05 MPE04051.BVG Zocatian:Blk.: 4 lot 4 �tunoain P ~1 Weec"ription:: 6" well ark-Estate Materials:. 2@ to llJjRsed to 57 Zt.. approx. 65 f ., east of house l 22 41 sand,surpaaewater '42 53 weathered rock(water bearing) Static water levela45cft8torage) Yield: 2-5 gpm 150 gallon cavitated.storage Drilled by:Thomas Drillers P.O.. box Ian-516 Anchorage,Alaskm 99511 .344-3133 Completed.Mayc12Se19 g 78020 .:400at oii.Lot i;lk 4 Mountain Park Estat,.x Descri;tinn: 8, well cased to .:35' approx. 40' oas-� of nou::o Materials: . topsoil - 201•;ravel 21'33 c.na,surf ace roster j4 60 clay 61 72 a n. %3 88 clay 89 I.10 sLxd, small amt. crater 111 128 silt(cemeted) 129 I110 Gand,gravel(water bear3.n.: ) Yield: 6i1z G114 Static %•later 'Level:I09' Drilled by:Tho.:tus Drillers 1'.U. Lox I0-516 Anchora,;e,Alaska 99511 7,icense,y WD 78020 Phone 344-3133 Completed August 21,1978 • Well :�ogr,... A Locatipn:B11c.4 Lot 'ow iin 'ark Estates Matejption:6'Jwell cased to I60 ft. approx.51 Pt. east of house Matgp? h :topsoil IZ I19gsand 20 '24 boulders 25 83 sand 84 I25 brown clay 126 155 brown clay4sand Yield: 6 156 1'15 gr'avel(water bearing) Static water level:. Drilled by:Thomas Drillers P.O.. box I0-526 Anchorage,Alaska 99511 X44-3233 e 'Completed June 12,1978 18020 Commercial Testing & Engineering Co. Environmental Laboratory Services REPORT of ANALYSIS CTSE Ref.# 194.0673-1 Client Sample ID :L3 B4 MT PARK EST 412 BACK ROSE BIB Matrix tNATER Client Name sET,ATTOP TECHNICAL SRV Ordered By :TED MOORS Project Name t Project# s PWSID :UA Remarks: ROUTINE Parameter Nitrate -N BY: Allowable Ext. Anal Results 6633 8 Street Anchorage, AK 99519-1000 Tel: (907) 662-2349 Fax: (907) 661-5301 WORK Order :75791 Printed Date :02/16/94 @ 09:43 hrs. Collected Date s02/11/94 @ 1Ot00 hrS. Received Date :02/11/94 @ 14:30 hrs. Technical Director :C. EDE Released By t cc Units Method Limits Date Date Init 7.89 mg/L EPA 353.2/300.0 10 02/14 ILR au_saa=nrsasaaasasas= aaaaaauasyssas=zasaaassusz�zuaaaaaaaasnasaausaas-ssassas ==ua * See Special Instructions Above UA a Unavailable ** See Sample Remarks Above NA a Not Analyzed U a Undetected, Reported value is the practical quantification limit. LT a Less Than D a Secondary dilutlon. /}u�.±�. GT a Greater Than ��l� Member of tha SGS Group lSoelAtA GAn6rak de Survelllanee) ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA 12-29-091 atar PM; 'SG dnkirig Water Analysis Repott for Total Coliform Bacteria READ INSTRUCTIONS ON REVERSE SIDE !!PORE COLLECTINS SAMPLE MUST BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM IDs (-LRIVATE WATER 3YSTEM ❑ SeroltesWs Q Sand bww teOT se15301 • a/ 9 200 W. POTTER DRIVE ANCHORAGE. ALASKA 99518 Tel: 907-662-2343 Fax: 907-581-5301 1q0�3p]96ry9{4 tlEtl��10�I SAMPLE COLLECTION: _ SAMPLE TYP,E-:� Det.: b 12.E 17 1. a &/Routine ❑ Treated Water e.... tw v.. Time; I f & J ` PM deb.M.t ❑ Repeat8alnple ❑ Untreated Water L«ema: i+ u Ll HIP C 4 2 (reror to lab no. L Collado: t -IpuP29 kA NII N ❑ 3peGat Purpose Transported . to ub ey: Same as collectDr Other: "O BE COMPLETED BY LABORATORY Sample Recelvina• Date: _It -t ❑s"PlaowrSohomaalt ❑ RUSH SAMPLE T'rtte: Rau4 MY to ~bbl, Tamp: ❑ ae li" Walwr Phone N Delivery Method: r� Fax N: Recelved 6v. �...1.a..i �.I�a,.,r r?T2LLLi-A ..........................................................................................:...............r................................... .... Baeterloloalcal Water Analvsla Record: tree to ADCC MMO-MUG (PIA) RESULTS: ANC FSK JUN Ana"Is B.gen, 17-11Z,jp7� � ispia To'.d Conomc Datenn" Analyst�[, E. Cog Sand b Client Analytical Method: MEMBRANE FILTER RESULTS; Phoned Q Faxed Q Mod Cwnt:CtloNeWO]^II Date rime Mert"Orane Filter, vedgcedon: sooke .rpt MMO-MUG (PIA) we..... LTa. (aOS: X Satisfactory {EC Q Unsatisfactory rave.Tw eun.wu.ts C..n RaportedBy: Date/Time: 1T4,Cl V7, (I7i0 a-Oana.er... _. J:IFORMSLtc(ol0 Cdl FIXmxtt FormNFW-0063 10124)03 r .n.np u.eu r SAMPLE COLLECTION: _ SAMPLE TYP,E-:� Det.: b 12.E 17 1. a &/Routine ❑ Treated Water e.... tw v.. Time; I f & J ` PM deb.M.t ❑ Repeat8alnple ❑ Untreated Water L«ema: i+ u Ll HIP C 4 2 (reror to lab no. L Collado: t -IpuP29 kA NII N ❑ 3peGat Purpose Transported . to ub ey: Same as collectDr Other: "O BE COMPLETED BY LABORATORY Sample Recelvina• Date: _It -t ❑s"PlaowrSohomaalt ❑ RUSH SAMPLE T'rtte: Rau4 MY to ~bbl, Tamp: ❑ ae li" Walwr Phone N Delivery Method: r� Fax N: Recelved 6v. �...1.a..i �.I�a,.,r r?T2LLLi-A ..........................................................................................:...............r................................... .... Baeterloloalcal Water Analvsla Record: tree to ADCC MMO-MUG (PIA) RESULTS: ANC FSK JUN Ana"Is B.gen, 17-11Z,jp7� � ispia To'.d Conomc Datenn" Analyst�[, E. Cog Sand b Client Analytical Method: MEMBRANE FILTER RESULTS; Phoned Q Faxed Q Mod Cwnt:CtloNeWO]^II Date rime Mert"Orane Filter, vedgcedon: sooke .rpt MMO-MUG (PIA) we..... LTa. (aOS: X Satisfactory {EC Q Unsatisfactory rave.Tw eun.wu.ts C..n RaportedBy: Date/Time: 1T4,Cl V7, (I7i0 a-Oana.er... _. J:IFORMSLtc(ol0 Cdl FIXmxtt FormNFW-0063 10124)03 12-23-03: alai PMt SCS Ref -4 1037969001 CllentName Tobben Spurkland P.E. ProjectNan✓M Lot 5,Bk4MPEh2 Client Sample ID Lot 5,13k 4 WE N2 Matrix Drinking Water Samek Remarks: tsar se1ts301 All Dates/rlmm are Alaska Standard Time Printed Date7ime 12/232003 9:38 Colketed Date/Time 12/17/2003 11:13 Received Date/rime 12/172003 11J0 Tecknlcal Director St/l/epke' . Ede Rekated�l Paetmeter Rmlo; L Units Method Cortair" ED Allowable Prep Analysis �� snit DweDate hit 1Nt Waters Department Nitrate -N 7.45 0.100 mg/L EPA 300.0 B ("10) 12/17/03 JIB Microbiology Laboratory Toml Coliform 0 coUl00mL SM189222B A (c=1) 12/17/03 DKC N L O L-, Municipality of Anchorage ;+ ': 1' Development Services Department r"' Building Safety Division Onsite Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK 9951M650 Page I of Z www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. Sv(io D PID Number. 00— — !:� "e""' Wastewater System: ❑ New ❑ Upgrade � Aftaee 19COV Jc t,- Poe, of ABSORPTION FIELD PMro: FaaMer a Batroanc O Deep TraNl D SIWbwTnrwil O Bb O Maar1 O OIMr LEGAL DESCRIPTION SW RWna TOMDepth kom W" Waft p lh o Lm aWEtNebrc 1'Z- Depth PM ba tam phial Vaee: Gr*ra depth bwrath poe: r 6 r3k L4 Ft. Ft lr w .p Rvpe'. aaaien: Fa added stow arVW pads: Wars Large[ Ft. Ft. Well:G New ❑Upgrade aw w a o / Fnaa aMaKa ba •aM M.: 4t F Caas�M1rauon (PMala, A B, C} Tata Depth` CSW b Taal *beorpnorl wa , Poo Mr .. FI. R fle 0 3 Dtlnar. S Date D~ aMoowa"r L»rt ksl~. Dm R ab,(�,.� IL 03 n.m. Pwroaaab C" h' TANK GPM Ft. R SEPARATION DISTANCES septic ❑ Holding ❑ S.T.E.P. ❑ Other. ToISepticlAbsorption Lift Holding PublklPdvat mvasOARw. 1 II GaPeotf From Field station Tank Sewer Line GIS. 0.1ti V� 1 5DG*L wen M"enY; Nwro*r a G nblwma: S.I.Wmer LIFT STATION acklM.La L"* Get •p'"M•Mvei •Pwm OT Nraa' "pll wars aYm H'. FpaMMibn t �. ". In. cwl." a.n N Pump Mak* a Mo" EMMuI perra•»A br O Ramnke BENCH MARK . 11 Loon a W a scM /uewnea ENr*»n. 10-0 d�iL rV Q' K1 A iVd 1 s A� 49Ii! Inspections performed by: � Dates: 1" 11/q/01 2n° _ 6pvt}IoR/ G; f?eve4o ent Services De art rova Reviewed and approved by: Date: E � P1 '<k�tams. M I ISI I I I REDUCED1150 S Ak- h ! Wbll i AC 2211'1 BC 34 I — l — — I — — BERCR MARk1 ¢ Well I (Yell-- --791 I��, -- ---- II i G '� 1� 5 — — L L` I III Q I I 49th ... .......................... r TODD SPURKLRND � f,'•., No. CE -2225 • ��•• 1250 50 0 50 100 150 700 250 3x SCALES 1'= 100 FT. GAL. SEPTIC TANK I[08HEN/omt '270-1014C 5PURKLAND P.L. I I MOUNTAIN PARK ESTATE /2 BK 4 LOT 5 I I SEPTIC SYSTEM AS BUILT I 203 W 157H. AV£NU£ JOHN CHR/STOPHfR DATE. DEC. 8, 2003 ANCH. AK. 99501 11920 FOSTER SHEET. 1/3 CRID: 2839 I PERMIT # SVO30500 PID A 017-023-05 MPE04051.DVG 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 Initial Date Issued: Dec 08, 2003 Expiration Date: Dec 07, 2004 Permit Number: SW030500 Parcel ID: 017-023-05 Legal Description: [MOUNTAIN PARK ESTATES #2 BLK :'4 LT :5' Design Engineer: 0007 Tobben Spurkland, PE Site Address: 012920 FOSTER RD Owner Name: John Foster Road Lot Size: 20130 SO. FT. Owner Address: 12920 FOSTER RD Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99516-3231 This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 2. All requirements specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by 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 dosed on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued Date: 12-'V (DY Date: Z 8 Zoo CoLAPstD I AN11-1, 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.enchorage.ek.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Dii — 0,23^ D ! Permit Number SW OVUO - Property owner(s) 432 k K C r; s Fe o b'f✓ Day phone Mailing address (1) )Mgo % osi, 2 12—uA1-> 945t(o Mailing address (2) Zip Cade S Legal description (Lot, Block & SuVd.) L.e T 51 13 K q. (v(o 0r I -A i t,l FSA YZIL al L �T'— Legal description (Section, Township & Range) Lot Size AcreFe Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above Information Is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authlbrized agent) Permit Fees: it HD Waiver Fees: Date of Payment: f /8403 Date of Payment: Receipt Number: 7 3�� [ '� Receipt Number: (Rev. 12/00) 3 I I , 11(e I I I 2� I RM CE 1250 '51 ow s 2d I ell I 0 I I I I I¢ Well_ _ _,� I _ o _ — _ — — hell-- II� o �I 8 I �! I � III Q P III -- I I II II 2 I 2 I I II 19 --- I I II O—� I 1 I II 1� 1250 GAL SEPTIC TANK 50 0 50 Ix 150 av 250 300 SCALE, I' = 100 FT. 1USIMN W'UNXLANU P.L. MOUNTAIN PARR ESTATE 12 BK 4 LOT 5 SEPTIC SYSTEM DESIGN 203 907. 277 K.TH.9-391166 AVENUE JOHN CHRISTOPHER DATE: DEC. 8, 2003 ANCA 99 11 12920 FOSTER SHEET. 1/3 GRID: 2839 PERMIT # SV030XX PID 11 017-023-05 HPE04051.OVG Municipality of Anchorage DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION POUCH 6-650 ANCHORAGE, ALASKA 99501 INSPECTION REPORT ON ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL NAME4�$k-V- g�F LOCATION-f::o;kQ.riW 17ojjG ADDRESS SQA '3crY fS$S -A �1 Z PERMIT NUMBER .11 LEGAL DESCRIPTION 11 t�1 1 PHONE(S) 3yY'yaly LS % v T• f�>J� �SWICS *OF BEDROOMS SEPTIC TANK kaco MANUFACTURER CV &, CAPACITY IN GALS. MATERIAL #OF COMPARTMENTS INSIDE DIMENSIORle LENGTH WIOTH DEPTH SEEPAGE SYSTEM �J TILE GRAINFIELD �o1aa,'lS NUMBER TOTAL LENGTH 1 +%0 -16, DISTANCE BETWEEN LINES TRENCH WIDTH DEPTHS: 1 IFILLBELOWTILE I TILE TO GRADE FILL ABOVE TILE SEEPAGE TRENCH OR ❑ PIT WIDTH LENGTH DEPTH ❑ LOG CRIB 1 ❑ RINGS - DIA. FILL MATERIAL DEPTH pp OU EFFECTIVE 8SORPTION RE SO. FT. PION ER WELL REMARKS- GR -0v Z Wo -a" (P S-!9@ 601 '1Jj� SYSTEM DIAGRAM I DATE APPROVED BY �`^-^^"' LOT: BLOCK: SUBDIVISION:W-'��Xe 73013(9 77) UrlL_ VJ I Cl I L I IF 9r1 CA r__ =ir.4(--F-e^ a01 7--7% DEPARTMENT G HEALTH AND ENVIRONMENTAL r, :TECTION lzb PYVL 025 'L' STREET, ANCHORAGE, AK. 99501 Cu& 264-4720 WELL F=r r-4 E> CA V.1 I TE 1EWEF=l EFzM I T PERMIT NO. C 770962 ) APPLICANT DICT: WRIGHT SRA BOX 1585A 344-4214 LOCATION FOSIER ROAD LEGAL L 5 B 4 MT PARI: EST LOT SIZE 20100 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING <50 FTiBR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: F3EF= TH= 4. LEr�IG F'H= :3_2 c7, GF'F•TH= 2 THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT I5 THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). r"�F=L-�!F-F I r,: I=- n3aF'T I C IF f=l r+ll;� 53 312: 1 A 2!t!;., L7 r_;r=1LF_CAr-11 F F rG1.:F7=j0E r-L_n"IF CAF -JT I nr4 A PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER A CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — --- TWCA C ;> 7 I rJs"F,ECT I CAhJ"T FAF?E FS ErILJ I F_EG• --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. V -I=F -:r•1 I IF E>cf�- I FZ:E� L)EI:--EryC:CfZ --Z1 s ::LS r .— 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 SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNE=D ICANT DICT: ISSUED IED BY GHT "-mw ---------- DATE -L9 _ V3. 0 Ori SOILS LOG I MUNICIPALITY OF ANCHORAGE 1 .., DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST Pouch 6650, Anchorepe, Aloka 99602 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: r-/ �C' r"" �y /e H T%J DATE PERFORMED: �0 1Y,72 " LEGAL DESCRIPTION: R iC n^� x r ` /� `') C / 1 SLOPE SITE PLAN (FEET) 1 D (FEET) I P N/ G I I I I I 2 1 3 4 5 s G CLQ^ .Sccl /ZS 7 10 WAS GROUND WATER L S L ENCOUNTERED? O 125 l L'r o H IF YES, AT WHAT 4s S 13 DEPTH? 14, 15 16 17 18 19 20 1_ PERCOLATION RATE (minutes/imh) TEST RUN BETWEENFT AND FT _ _ 1 COMMENTS LVA T C 2 4! AJ TC p of= S/ �Y M A-rL r L) S C- M ii' ( G ¢ 1 A AelI w A -'it= (2 }FO f T (S 7c5/} C . E PERFORMED BY: ` LI SIJ r F`lC7/k- 5 CERTIFIEDBY: 0'v/ 14 L DATE: /O' 7• 7/ a ¢¢—O9i7 72.008 (7/76) t-✓� ;v e E' :'40ceti1Dn:Lot 5 Llk 4 Ciountain 'Park :atjt ._ Deseripti�n: 6" well cc. ,ed to 3,' approx. 40' oc:e.t of `jouco Materials: . topsoil - 20'gravel 2I"33 s:nd,surfaco rater A 60 clay 61 72 s n: 73 83 clay 89 IIO s::nd, small amt. water III 128 silt(cemeted) 129 I40 !�and,cravcl(water bear'n-.) Yield: 6Y GPM Static Water Lovel:I09' Drilled by:Tho=:as Driller; I' -C- kox 10-516 Anchorae,Alaska 99513 Licensees WD 7d02O i'hono 344-3133 Completed du-ust 21,1978 V S r ' Municipality of Anchorage � On-Site Water and Wastewater Program f ; (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 017-023-05 Expiration Date: I- 5 —?Z0 Z Z 1. GENERAL INFORMATION: Complete legal description MOUNTAIN PARK ESTATES # 2: BLOCK 4, LOT 5 Location (site address) 12920 Foster Road "Anchorage 99516 Current Property owner(s) Michael Nero Day phone 719-659-2584 Mailing address Real Estate Agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class_Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ VVaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer, COSA Fee $-!550 (0330 Date of Payment Receipt Number 007q I rr 2.6g23q COSA # 0J %Z 1 15 0 5 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained frorn 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: Garness Engineering Group, Ltd (GEG}Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 (24 Engineer's Printed Name: Jeffrey A. Garness Date: ``j � `t In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden de`ects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained 13EG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for L( bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, A 77 6 CF 7 #AECC884 �kkkk IT12�11 (((((((, with the foliowittlpu(�I� PDQ z, �1'�� ' Aj ER o X r— y: Original Certificate Date:^ 2© 27_ The Municipality of Anchorage 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 the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: �� , COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other VOA Checklist Legal Description: MOUNTAIN PARK ESTATES # 2; BLOCK 4, LOT 5 if more than I septic system on lot: COSA Checklist # of A. WELL DATA W Well log is filed with Onsite (or attached) Date drilled 8/21/78 Total depth 140 ft Cased to 135 rt Sanitary sea['- functioning correctly VVires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 9/17/21 Static water level at beginning of test 57.6 ft. Comments B. TANK DATA Age of tank(s) 16 years r �' c>- i0.1 L�J 2 t Tank type/material Measured operating fluid level in septic tank ad'r Standpipes/foundation cleanout per record drawing Date of pumping 513�z( e - A :?trRr 5s �{cjw D. r BSOR PTION FIELD DATA SHALLOW TRENCH Which system tested (date installed) 1977 � ALL standpipes present per record drawing Total measured depth from grade 5.91 ft (max) Measured depth to pipe invert from grade 3.75 ft (min) ❑ N/A — pressurized field XA lvionitor tubes go to bottom of effective. If not, state depth into effective A-1 Code -required soil cover over field it', System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced *2153 gallons Comments/Deficiencies: `PRE-SOAK PERFORMED ON 9/17/21 COSA Checklist yellow sheet Parcel ID: 017-023-05 Structure served by this system Well production at time of test 0.8+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ME No A Coliform bacteria is Negative Nitrate'mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ([,Arsenic less than MRL (ND) Collected by GEG, LTD. 1 4 Date of Sample �1 1- zz- t C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Adequacy test date 9/18/21 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 607 gal New depth 0 in Elapsed time 0 min Final fluid depth 0 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) NONE If yes, enter date N/A q9 E. SEPf\F��T[)@D!STA�CES FrmmP1`vateVA,/eUor) Lot to: (Please distances i[less than requiredcxilommnunkveeN �emicTank8-|l-L SLadononLot >1NI ConnnunbySe��.Kdanho|e/C�onoUi>1OD' Yes if � ` - [�Yes if IN NeiQhbpr111yTank_>100' 71 Yes i�Noft Private Sewe�SeuhuLine >25'F7lYes |fNo_____� AhoorpUo11Fe|donLoi>100' rv�Yeo ifNoft Holding Tank:,1OO' 21 Yes |�No -fi Neighboring Absorption Fie/ds > 100' An|ma|Containment '5O' 171Y Fa ��Yen ifNm____� - =x ' o_____|i Co»-in/uniLySewerMain /75' ��yen if � W1anure/4ninia|Exc/�eia Storage >1OO _ �� 0Yes ifNoft From Septic/Holding Tank on Lot to: (Plea e en|e/dioianoeu i�|ess ihan required) 13;ui|diny1O' Yes iiNo-t 3urhsceWater >1OD' ��Yea ij No____.h Prope/iy Line Fv� Yes if No IL Wells on Adjacent Loh;: AbsoqpdonFie/d�G' �1Y�s _ �� i�N ' o� Private Wells >1DO' F/Iyea if No Water main >1D' ED Yes i[Noft Commumh/Wells >2OO' P/1Yes if No V,1s�erServicaLine > O' Fv�Yao if0oft /fseptic tank iounder drivowaycomment be|oa Fron� Abxori4ion Field on Lot to: (Please, enterUistanoas if less thon required) Dui/dingFoundaU�n�1O' ��Yea if No � h |fabsorption field isonderd/ivewaycommeniba|om Property Li:e�1O' ��Ye� _ if * o n Wells on Adjacent Lots., Wa\a/ IV) ain > 10' Yes if No ft Private VVeUs> 100' Yes if No____ VVaterServioe'Line>1O' Fv�Yes KNof, CommunityVVe|ls >2OO' El Yes if No Yes if No F� ENG}NEER'S CO&lNIENT3 *ASSUMED [�' EN�iNEEiR,'SCFRT|F|CAT0N //have de/onn�od8nonew o/»a / //ecVo/�t�//8/ea6ows krnxlaos/ncuofoxnnancew8h /nu/ cu6*�ux/e0neSit! Offentnnthis dale, � '11AEc(s84 Municipality of Anchorage Development Services Department r Building Safety Division S.n T On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # OSC211586 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 4, Lot 5 of Mountain Park Estates #2 subdivision. This inspection revealed a nitrate concentration of 9.48 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. 1141itrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form kriown as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Municipality of Anchorage Development Services Department Building Safety Division j A F E TyY n 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) # OSC211586 During a recent COSA on-site inspection and test of the potable water supply well on Block 4, Lot 5 of Mountain Park Estates #2 subdivision, the well's productivity was determined to be .8 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4 -bedroom residence is .41 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 j Building Safety Division Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519519 -6650 www.muni.org/onsit6' (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FORA SINGLE FAMILY DWELLING Parcel I.D. od_3 —os- COSA# 1000 -'LN 1. GENERAL INFORMATION Expiration Date: co — /a— Complete a— Complete legal description MOUNTAIN PARK ESTATES N2: BLOCK 4, LOT 5 Location (site address) 12920 FOSTER ROAD . ANCHORAGE. AK • 99516 Current Property owner(s) DEBORAH CHRISTOPHER Day phone 223-5518 Mailing address 12920 FOSTER ROAD • ANCHORAGE. AK • 99516 Lending agency Day phone Mailing address Real Estate Agent SCOTT ANDREWS w/HOME SOLUTION Day phone 770-2893 Mailing address 10219 TARTAN CIRCLE* ANCHORAGE. AK • 99507 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE. AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines B Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. 337-6179 Date I D Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory Other By: I �. (Rw. HNS) PROGRAM ; •'4 1. n **•••••0,GO_-� Original Certificate Date: 3 —/a—/ a Municipality of Anchorage �-1 Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: MOUNTAIN PARK ESTATES #2; BLOCK '4, LOT 5 Parcel ID: 0 17 - Q7 2-7'0 f A. WELL DATA Well type MATE if A. B, or C provide PWSID# N/A Date completed 8/21/1978 Sanitary seal (Y/N)-Y— Total depth 140 ft. Date of test Static water level Well production Cased to 135 ft. FROM WELL LOG 8/21/1978 109 ft, 6.5 — 9 -p.m - Well Log (Y/N) YES Wires properly protected (YIN) YES Casing height (above ground) 12+ In. AT INSPECTION 6/9/2009 130 ft, 1.3 g.p.m. WATER SAMPLE RESULTS: q Coliform : d colonies/100 ml. Nitrate 'Urng./L. Other bacteria d colonies/100 ml. Arsenic -<_5- ug./L. Date of sample:oZ $ OCollected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 10/19/2005 Tank size 1250 gat. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A Date of pumping 6/3/2009 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA w EXISTING GRADE Date installed 10/27/1977 Soil rating (g.p.d./ft'o t /bd 125 System type TRENCH Length 127 TOTAL ft, Width 3 ft. Gravel below pipe 2 ft. Total depth •s.25-s.e ft. Eft. absorption area 508 ft' Monitoring tube YES Depression over field NO Date of adequacy test 6/3/2009 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 19 in. Water added 680 gal. New depth 22 in. Elapsed Time: 1070 min. Final fluid depth19 in. Absorption rate >= 600+ g.p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on' level at in. "Pump off leve .. High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line O 1+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 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 JEFFREY A. GARNESS Date ?110 110 COSA Fee 5 y7O Waiver Fee $ Date of Payment 3� 10' 1 0 Receipt Number 01 1 `i S b (Rev. 11105) Date of Payment Receipt Number Municipality of Anchorage ; • Development Services Department Building Safety Division ' On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 100054 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 4, Lot 5 of Mountain Park Estates #2 subdivision. This inspection revealed a nitrate concentration of 9.94 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. r• ' -5-2009 01:4:47P FF11: e� AAROW PU0.1P & WER SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346.9355 • Fax (907) 333-8976 Eagle River: (907) 622-9335 T0:�32�210 P.1 CUSTOMER JOB SITE F DY,4ra c° rf'sf���o► —� r Soc� p JTo _/�C� /tr�� 57rr F- d A <'f, Ake% _%�f5 OHMOCE, E N2 X3453 L _p I L - J N OICED TE WELL DEPTH rte— ewL T � cKnaw4T�D PUMP DEPTH SA E1160N l I C h GUANTI Y DESCRIPTION PRICE AMOUNT �-7— / U CoJ PQ l i i KC/U l% - D WYPE4 OA o b Lutle "f' r u 9 ryr% u Lt r u IF c �r LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED BY DATE COMP, I TOTAL LABOR PAY THIS AMOUNT (/ S Thank You . SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that If above work Is not paid for In 90 days I agree to allow Asrow Pump d Well Service. L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equtpment.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. SGS ReL# 1100694001 Client Name Garncss Engineering Group, Ltd Project Namd# MPE #2 B4,1.5 Client Sample ID MPE #2 B415 Matrix Drinking Watcr Sample Remarks: Printed Dale/Fime 03/09/2010 12:08 Collected Dale/Time 0226/2010 11:00 Received Date/time 02262010 12:15 Technical Director Stephen C. Ede Parameter Results --- LOQ Units blcAnd Contain" ID Allowable Limits Prep Analysis Date Date Init Metals by ICP/MS Arsenic 5.00 U 5.00 ug/L EP200.8 C (<10) 03/01/10 03108/10 NRB Watera Department Tota) NitratcNitritc-N 9.94 0.100 mg/L SM204500NO3-F B (<10) 0226/10 RJT Microbiology Laboratory Colony Count 0 coV100mL SM209222B A (Q00) 0226/10 DLC Total Coliform 0 coVI OOmL SM20 92228 A (<I) 0226/10 DLC Fecal Coliform 0 col/100mL SM209222D A (<I) 0226110 DLC 0 n M Op M [IONC G � m WUU z QW ! B _c F- Q N JmO 19 cn dosmf 8 s „ , m.1 N J D N= m Q K N mui o adoa b31SoXI o � € y �W Y 9 g q N Cl) M Cl) t� g�a5c `o m 00'0L L MwSY,£Oo00N 5 r <z 'E b m I 4 roZ �o cSoo m e taas�m� I v I I I = `o � a` E m m m fi i c 0 I I m h/ I I _`\ J n LO cn o LL.. ` j N . GJen � ----� I w %O 1/ xf\ LL o0 CD j M co o 24.0 0 y, i+i 1� Q v I Z 6.0 0 0 o R I M F6 ^ 20.0 CO m O co p l u o I a J z I m N I O ap CC) 78 �" 50.0 .z 9 L I m m z9:6 of Z ofLOU WZ U Q $ I bow NO I oux I 0Wz —_—_ o LZ wZp 1N3W3SH3 .tman w shed LL Q N _ z fn 00.OL L M.,Sb,£Oo00N r I z =w U) w Ncli C. N M W Q H N I tnQ~ n 1'% MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information (a) legal Descripticp ( Location (address or,directions) (b) Applicants Name Application Date N subdivision, section, towns ip, range) mk q Applicants Address /6;? I. -JD 7cc�.)7t/ S' (c) Applicant is (check ore) Lending Institution [_�j ; Owner/buildarjZ:j ; Buyer [::� ; Other f:::l (explain); (d) Lending Institution Telephone Address (e) Ictal Estate Co. 6 Agent Address Telephone 2. Type of residence Single -Family � Multi -Family Number of Bedrooms q 3. Water Supply Individual Flall [�Zj Ccrmnity Q Other (describe) Public Note: If eomunity cell system, must have written confirmation frau the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedrooms specified in this HAA (Y)N) 4. Sewage Disposal Onsite fEM Public � C =wnity [-:::I Holding Tank Is the wastewater disposal system adequate fcr the number of bedrooms ( .) [Page 1 of 21 2-15-84 l n n 5. Engineering Firm Providing Inspections, Tests, Data and Information I certify that I have checked, verified, or conformed to all FDA HAA Guidelines in effect on the date of this inspection. / p/, Date tl2.4. �70 Name of Firm Signed by / Date Teleohcne ..�E�Os'a: y-���...... a �roy C. Raid, Jr. • No. 2231E . (ENGINEER SEAL) Qeae dLtFEc�`�b' 6.DHEP Approval / Approved for bedrooms By Date Approved 00 Disapproved �—j Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Envircrriental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shown above, based on the data and infksmation furnished by an engineer registered it the State of Alaska, the water supply and wastewater disposal system is safe and fun: tional for the rumber of bedrooms and type of structure indicated. (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Pakp 2 of 21 2-15-84 A. WELL DATA MUNIOPALTTY OF ANCHOoft: 1 DEPT. OF HEALTH t MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECli:;N HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST — FEBRUARY 1984 Legal Well Classification i cLJ C. If A, B, ar C Well Log Present (Y/N) hp Date Completed Total Depth Cased to — MAY 101981- D C n N D.E.C. Approved(Y/N) Yie d Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Z t Sanitary Seal on Casing (Y Electrical Wiring in Conduit (YIN) k" Depression Around Wellhead (Y ) 96 Separation Distances from Well: I To septic/Holding Tank on Lot �CO� On Adjoining Lots +1Qd To Nearest Edge of Absorption Field on Lot I)LT ; On Adjoining Lcts It 100 To Nearest Public Sewer Lire 4P To Nearest Public Sewer Cleanout/Manhole hJA To Nearest Sewer Service Line on Lot _ Water Sample Collected By A.Tugli l2 ; Date H :30-8Y Water Sample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed 16 "Z ?-!1'7 * Size 1Z0 Standpipes (YIN) jgA Air -tight Caps Depression over T (YM) to Last �•� Fr-undation Clearodt (YM) Pumping/Mainterance Contract or. File (Y ) ;for Holding Tark High -Water Alarm (YM) 41N Temporary Holding Tank Permit (YIN) Seoaratior. Distances from Septic/Holding Tank: To Water -Supply Well ImI To Building Foundation To Property Linc +10, To Disposal Field To Water Main/Service Line 10' To Stream, Pond, Lake, or Major Drainage Course Com+ent [Page 1 of 21 2-15-84 Soils Rating in Absorption Strata 1 Z5 4 If Type of System Design IrCnC'k Date Installed lo -z7 --7r7 Length of Field In' 1` Width of Field Depth of Field y' r Gravel Bed Thickness Z1 Square Feet of Absorption Area _ !;Q6'3 'r Standpipes Present (Y/N) Depression over.Field (YIN) NO Date of Last Adequacy Test 5-?- Results '2Results of Last Adequacy Test Q�Qctte Separation Distance from Absorptions keld: To Water -Supply ibll 105' To Property Line 10' To Building Foundation Zi' To Existing or Abandoned System on Lot 4) A - ; On Adjoining Lots o To Water Main/Service Line 101 To Cutbank(if present) N To Stream/Pond/Lake/or Major Drainage Course 4100' To Driveway, Parking Area, or Vehicle Storage Area 3o' Comments D. LIFT STATION Date Installed Dimensions Sine in Gallons Manhole/Access _(Y/N) "Ramp Off" Level at "Rump On" Level at High Water Alarm Level at Vested for Electrical Codes(YM) Comments Vent (YIN) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. O Signed Q ca f Date :57 -1 -Ag _ i ��P'�• •,����91I n,� G r o i °4 ColQany f�k�QSI'A !-AtA lhla.r7n.X MOA No. a -- '. ,..., .. �.... ;- .. 4 KBl/d5/s ti ...�. .. s a� ..... R`c ; oy C. Reid, Jr. �. J'.' No. 2251E (Page 2 of 21 2-15-84 ALASKA bUIR0fl nTRL WOOL S6140, InC. Enginccrinq 6 Enuironmental SNdics MAY 7 1984 MIKE MARSH 12920 FOSTER ROAD ANCHORAGE AK 99516 SELLER — MIKE MARSH BUYER — SUBDIVISION — MOUNTAIN PARK ESTATES D#2 BLOCK — 4 LOT — 5 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 508 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 600 GALLONS. BASED—UPON—THEE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A <2 BEDROOM HOME.— THE OME.THE SEPTIC TANK WAS PUMPED ON 5/8/84 . FLOW TEST ON WELL THE WELL FLOW RATE AS 1. GPM FOR 4. HOURS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. West 334 Aucnuc. Suitc B • Anchorage. Alaska 99503 •(907) 5615040 MIASCIP" OF MUNICIPALITY OF ANCHORAGE rE DEPT. of HEALTH s \ DEPARTMENT OF HEALTH e: ENVIRONMENTAL PROTECTION ENVIRONMENTAL P;0TCEilQN E2E L Srteat • AnMorapa, AWb 99501 1 ENVIRONMENTAL ENGINEERING DIVISION NOV 2 Telephone 2644720 F �( C REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER��WE5 L D DIRECTIONS: Complete dl perp on page 1. 1 mai eplam requests will not M pr«awed. Please allow ten 110) days for proving. t. PROP RTY ER PHONE ❑ One Four ❑ Other 3 - MAILING ADDRESS U - a Qi PROPERTY REST ENT (If difhnnt from &bowl H JV INDIVIDUAL' 2. BUYER PHONE MAILING ADDRESS VENDiNGINSTITUVON PHONE 4 SEWAGE DISPOSAL SYSTEM MAILING ADORESS- 6d 4. REALTOR/AOE PHONE MAILING ADDRESS S d bd< M S. LE*L DESCRIPTION STREET LOCATION IL TYPE OF RESIDENCE NUMBER ❑ One Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY �. ❑ Three ❑ Six 7. WATER SUPPLY JV INDIVIDUAL' -ATTACH WELL LO well log is required for all walls drilled ❑ COMMUNITY since u or wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth lattach log if available.) 4 SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE" *If individual/on•si[e,give installation date /978' If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72d10t8 * Al THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED _ TIME YIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPEUTOR DIRECTIONS: t. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2 WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3 SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED 0 - - " i INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemadeSOILS give dimensions: RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Sapck d+ Tank Absorption Ares iM of ne Absorption Ara to mama Lm Lina S. COMMENTS U' APPROVED FOR 4— BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany Certificate) ❑ DISAPPROVED DATE 1(-at---) BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/78)