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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES #2 BLK 4 LT 7Mountain Park Estates #2 Block 4 Lot 7 #017-023-07 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191197 PID Number: 017-023-07 Dwelling: ■❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade Name Chris Kostlin ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑E Bed ❑ Mound Site Address 13000 Foster Road, Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907) 317-9695 4 2.0 GPD/SF 1.6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1 ._1 _ — Ft. Gravel depth beneath pipe 0.5 _ Ft. Subdivision Block Lot Mountain Park Estates #2 4 7 Fill added above original grade 2.2 Ft. Gravel length 20 Ft. Township Range Section Gravel width 15 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 300 Ft2 Ft. Well >50' >50' N/A N/A >25 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding X Other Manufacturer Orenco (Advantex F.A.P.) Capacity 1500 Gal. Surface Water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Fiberglass 2 Foundation >1 0' >1 0' N/A N/A LIFT STATION Manufacturer Capacity Remarks Orenco/Anchorage Tank 100 Gal. Alarm location Exterior (on control panel for FAP) Electrical installed by Capstone PIPE MATERIAL House to tank D3034 Tank to D1785 drainfield Installer A+ Home Services Drainfield D1785 CO/MT D3034 Inspector J. Millette / J. Williams BENCH MARK (Assumed elevation) 100 ft Inspection151 8/21/19 8/26/19 Location and description dates: 2�a Bottom of shed siding. aro 4th ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Or - Conditional Approval: Date ®®�P,.,••°"°"`°'°"°°••qS/��®i� • •` ��d 49th ®!u°°nu......u!u!n!°lluu.un......a :, MICHAEL E. ANDERSON ° �� �^ No. CE -4381 ,•• �� Septic System %) �%� /�(�' F Approved I �, CC1� (. Date � g � i ° ®�TFQ°°.° °10/22/19 +,.+' �C'® 4W 4W Note: this approval does not include well permit requirements.P/TUs�e�� tKev u5iuuits) MOUNTAIN PARK ESTATES #2 B4 L7 PERMIT # OSP 191197 / / / / LOT 6 EXISTING WELL PID # 017-023-07 I I I NEW 20' ONG x 15' WIDE x 0.5' LOT 19 I ( EFFECT�E DEPTH ABSORPTION BED ! W/ 2' SAO FILTER --------- I MT2 MT1 ! ® MH2 MH1 \ : - -- \ ! •T3 MT4 PV 2C0 / ; \ I A �I /10- M I �0 LOT 18 r PERC#2 EXISTING WELL / I (100' WELL RADIUS \ 50' WELL RADIUS LOT 17 I \ I LOT 8 �� I I ! I I 1 ! EXISTING WELL I I I I ENGINEERING I I ' PLAN AS -BUILT 0 40 80 WIN ME im FEET 111=40' A B 2CO 29.1 12.1. MH1 31.2 10.9 MI -12 41.4 10.0 PV 44.4 11.3 MT1 60.55 21.4 MT2 76.2 37.85 MT3 74.3 39.35 MT4 57.75 23.2 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT PV - PUMP VAULT MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE MOUNTAIN PARK ESTATES #2 B4 L7 PERMIT # OSP191197 75 96.6 - 96.1 94.1 F- YNGIXEE 0.INC PID #017-023-07 N = _ > n 5 o - m 92.0 Ax -20 POD & MANHOLES 1500 GAL F.A.P. TANK 99.9 FINISH GRADE z- 97.7 ORIGINAL GRADE 20' GROUNDWATER @ 90.7 5/17/1.9 89.2 PROFILE AS -BUILT (NO SCALE) F- 96.6 96.1 94.1 'e• 49th uaa°s� .,. .h.,, y°8. n ; MICHAEL E. ANDERSON s 4 No. CE -4381 r' FE Ila 00000�O OF A t %%ao TCO 4g TH�� 0 ��D CD 0 -a O�O`gN� SHANE A. HOLT �Oa Q� LS -6914 5�� Otessionao00 DO000 0 N 89 56'04 " W 183.00 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. AS -BUILT SURVEY 1" =201 NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT7 &OCK4, MOUNTA/NPARKESTATESNO. 2 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS DAY OF ocTOBER , 2019 14200, F8 196-7201-18 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 345-5513 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191197 Work Type: Septic Upgrade Effective Date Expiration Date: Tax Code Number: 01702307000 Site Legal Address: MOUNTAIN PARK ESTATES #2 BLK 4 LT 7 G:2839 Site Mailing Address: 13000 FOSTER RD, Anchorage Owner: KOSTLIN CHRISTOPHER L & Design Engineer: FORGE ENGINEERING This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy I S S' P� i)ehartment 6/4/2019 6/3/2020 Lot Size in Sq Ft: 20130 Total Bedrooms: 3 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Date: 1411lq Date: S� % MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program FPLRNJ ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-023-07 Property owner(s) Chris Kostlin Mailing address 13000 Foster Road, Anchorage, AK 99516 Site address Same Day phone (907) 317-9695 Legal description (Sub'd., Block & Lot) Mountain Park Estates #2 B4 L7 Legal description (Township, Range & Section) Lot Size 20,130 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank 1ZUpgrade RXDuplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 6q6- /J Date of Payment: JW 31 i7 Receipt Number: ©gtl q D Permit No. QS pjq I Permit App_.;- :- , .mac: Waiver Fees: Date of Payment: Receipt Number: Waiver No. PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) June 4, 2019 MOA Development Services Dept, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Mountain Park Estates #2, Block 4, Lot 7 – 13000 Foster Rd Septic System Design Dear On-Site Services Engineer: The I.D.S.F. septic system on the subject lot has failed and must be replaced. We are submitting this design and permit application for the construction of a new septic system. The attached site plan identifies the location of the home and the existing well and septic system along with the new septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes at an approximate 5% grade toward the west. There are no slopes greater than 25% within 50 feet downslope of the new absorption bed. Drainage arrows are shown on the site plan indicating the grade and direction of flow. Storm water drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be constructed a minimum of 50’ from the existing well on the lot. It will also be 100’ from all adjacent wells and surface water and more than 5’ from the septic tank. Please refer to the attached test hole logs and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 6/4/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191197, Rebecca Carroll, 06/04/19 EXISTING WELL 8040 0 FEET 1"=40' INSTALL NEW 20' LONG x 15' WIDE x 0.5' EFFECTIVE DEPTH ABSORPTION BED w/ 2' SAND FILTER 3-BDRM HOME1500-GALLON ADVANTEX TANK W/ AX20 POD NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND 2CO TH#2 MOUNTAIN PARK ESTATES #2, BLOCK 4, LOT 7 FOSTER ROAD6/4/19 ADJACENT WELL EXISTING WELL 100' WELL RADIUS TH#1 DECOMMISSION EXISTING S.T.E.P. TANK PER MOA CODE PUMP VAULT REMOVE EXISTING ABSORPTION BED AND CONTAMINATED MATERIAL IN ITS ENTIRETY TO UNDERLYING ACCEPTING SOIL. DISPOSE OF CONTAMINATED MATERIAL PER MOA CODE. 50' WELL RADIUS MT MT MT MT PERC#2 2% 2% 2% 2%2% 2%10' UTILITY EASEMENT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191197, Rebecca Carroll, 06/04/19 MOUNTAIN PARK ESTATES #2, BLOCK 4, LOT 7 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 30 - 60 MIN/IN APPLICATION RATE: 2.0 GPD/SF SHALLOW BED SYSTEM 1500-GAL F.A.P. ADVANTEX TANK w/PUMP VAULT AND AX-20 FILTER POD TYPICAL TRENCH SECTION (NO SCALE) 1" PVC w/ 10 - 3 16" HOLES PER LATERAL @ 2.0' SPACING (HOLES DOWN) DRAINFIELD ROCK 5' 6" 2' 2' NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY BOTTOM OF TRENCH: 1' 6" BELOW GRADE BOTTOM OF FILTER SAND: 3' 6" BELOW GRADE FLOW LINE ELEVATION: 1' BELOW GRADE TOP OF TRENCH: 2' ABOVE GRADE 600 GPD / 2 GPD/SF /15' WIDE= 20 LF BED REQUIRED (20 LF SPECIFIED) 6/4/19 6" 2" INSULATION 6" MOA APPROVED FILTER SAND 5' 2.5' 2.5' REMOVE CONTAMINATED MATERIAL TO UNDERLYING RECEIVING SOIL AND REPLACE WITH TYPE II SELECT BACKFILL TO BOTTOM OF SAND LAYER. 4.5' Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191197, Rebecca Carroll, 06/04/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) MOUNTAIN PARK ESTATES #2, B4, L7 4/19/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - 7' 7.1 6 1.5 2.5 017-023-07 CHRIS KOSTLIN 1:05 5/17/19 1 2 3 4 5 6 30 30 30 6 0 16 11 0 16 5 0 16 10 5 16 4 5 16 10 4 16 4 4 16 1:35 1:36 2:06 2:07 2:37 1.5' OB ML / GM (SILTY MATERIAL WITH SOME SAND & GRAVEL) 5/17/19 Professional Engineers Stamp: 6/4/19 6 0 16 6 0 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191197, Rebecca Carroll, 06/04/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 2 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) MOUNTAIN PARK ESTATES #2, B4, L7 4/25/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - 3' 017-023-07 CHRIS KOSTLIN 1 2 3 4 5 6 1.5' OB ML / GM (SILTY MATERIAL WITH SOME SAND & GRAVEL) 5/17/19 Professional Engineers Stamp: 6/4/19 SOILS WERE TOO SATURATED FOR A PERCOLATION TEST. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191197, Rebecca Carroll, 06/04/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: PERK # 2 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) MOUNTAIN PARK ESTATES #2, B4, L7 5/17/19 J. Millette DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? 30 6 2 3 017-023-07 CHRIS KOSTLIN 1:08 5/17/19 1 2 3 4 5 6 30 30 30 4 0 16 5 0 16 1 0 161:38 1:39 2:09 2:10 2:40 Professional Engineers Stamp: 6/4/19 4 0 16 5 0 16 1 0 16 4 0 16 5 0 16 1 0 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191197, Rebecca Carroll, 06/04/19 111. -AN C P ALIT' OF ANCHORAGE DDVANC ED � ASPIEWATE.R TREATIMENI' SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTE\ANCE .AND REPAIR AGIZEENIIEN , herein the -AGREEMENT" made and entered into as of this -�' Day of AA -Y' of) 0 M . by and between 6 TO PRE m 14-06 TI:A�, herein the "OWNER." and the Municipality of Anchorage, herein the `'vIL�NICII'�IL�ITZ"', in accordance lvith Anchorage Nfunicipal Code (_A��-IC) 15.6S.36S. In consideration of the mutual co<,enants contained herein; the parties to this Aar cement agree as follows: 1. Ad--anced Wastewater Treatment Systems. The rants permission to the Chaner to utilize and operate an Advanced Wastcava.tcr Treatment S} -stem (AWWTS), described as Advantex Waste Water Treatment System I ocated at (legal description) Mountain Park Estates #2 Block 4 Lot 7 2. '✓Iaintenance. Repairs and Alterations. (Owner is required to read, understand and initial each section) Throuahoot the terns of this Agreement. the Owner shall enter into a service agreement with an AW-WTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The A7 TS shall be maintained in a satisfactory condition capable of performingas designed and producing- treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s). inainter,ance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically _S400 to $600). 0,,ner agrees that only inairltenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. acknowledges that regular maintenance of an AV V, -'TS reduces the potential failure of the system, which could include setivage backup and costly repairs or drainleld replacement. (rev. 0-5 181201`3) Page I of 3 Owner acknowledoes that the Municipality may request records of maintenance and �,.�repairs from the manu,l'acturer's representative or maintenance provider. e! , Owner aclmov ledoes that the fine for failing to maintain and repair arl Aft N TS mav be assessed in accordance with AMC 14.60.0')0. Owiicr agrees to grant the Municipality reasonable access to test and inspect the f1WWTS. The Mmicipality will give at least 24-hour notice. S.� 0),v ;er agrees that ai v sale or transfer of title of the prof -rorty will not occur \vlthout a tic Certificate of On -Site Systems Approval. Owiicr aurees that the AW\N'TS installation and maintenance requirements as provided by the AIW WTS vendorlinstallet- and approved by the. Mfunicipality are the governing . 'defines for the construction, maintenance anti repair of the Owner's AWtVTS. Owner aurees to maintain remote monitoring of the AWA."TS as required b;Y the A,.VWTS approval. v. Term. The term of this Agreement shall begin on the date of approval by the lilunicipality to operate the installed system; or upon transfer of title. and shall continue while the AWIAITS is operational or until title is transferred. M. Noriwaivcr. The failure of the tiTunicipality at an-,, time to enforce a provision of this Aoreenient shall m no way Constitute a waiver of the orovistons. nor in ariv wiay affect the validity of the Agreement or ant part hereof, or the right of the Municipality thereafter Io enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and 'Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law- Any civil action arising from this Agreeinent shall be bronoht in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties finder this Agreement. 7. Severability. Any provisions of this ,agreement decreed invalid by a court of competent jurisdiction shall not Hivalidate the remaining provisiorts of the Agreement. (rev. 0111" 18!2018 ) Page 2 of 3 B,,: QW.,"NER- (siona turc) Date: C AP-IsTbMF—�ZDtvj (print name) STATE- OF ALASKA TITIRF) JUDICTAT, DISTRICT The rbrc�omQ instrument was acknowledged before me this -VdaNr of 10 - -w Of 047 A 9& Ilk" y Pubft Notar B I .. .�(�ARY PUT LTC FOR ALASKA RJ REPUYA Strom ()f My Conii-nission expires: AlAY 7,Q,Zao State of Akske My CGmmission go= May 20,2020 MUNICIPALITY: B i(signature) eA � ro l ( (print name) Date: June Title: (rev. H/ 18/'201 S) Page 3 of 3 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On -Site Services Section 825 "L" Street Room 502 CEM P.O. Box 196650 Anchorage, AK 99519-6650 Page / of 2, www.ci.anchorage.alims (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permiit Number: 5 W C7[MO f-IcR $' PID Number: —O 23 ^ O Name: „ `� C u, t 4 o I�J Wastewater System: ElNew Upgrade Address: V( r(•Mv 54,. ABSORPTION FIELD Phone: Number of Bedrooms: 3 fjy.-1 ODeep Trench ❑Shall. Trench Owed ❑Mound $ipga Va LEGAL DESCRIPTION Soil Rating.Total 3,o Depth from original grWa: GPD/Fi' Ft. Bock Lo[ Subdmsion: # o d/ k'B ix{ t Deptll to pipe W. from '"I grade: 5'.O Ft. Gravel depth beneath pipe: 2.0 5alr — G �r r4w Tovmship: Range: Sechon: Fill added above anginal grade: Gravel Length: ! �( (3-r f V Ft. ZO t Well: e'E+54jiri New ED Upgrade Grevel Width' � 1 NumbeQr°� linea: Dietetics beMeen lirr: 20" Clasti/ication (Private, A. S. C): rtvc Total;tg �qCJ Cased to' 2(p0 Total absorption area: 3(po Ftp Pipe Material: `301 Lf Grille[ L( (1 or,L`1 Dab 'll Static WMer Level: Inatalb 5 Data Instal GP�L % I F rtr 1; IGS. 12 2 VV Yield: % Pump Set at KHY:,,t7 Casing Height Above Ground' TANK 1 GPM t11N Ft. r Ft. SEPARATION DISTANCES ❑ Septic ❑Holding S.T.E.P. Other: To From n Absorption Field Lift Station Holding Publicllorival Sewer Line "'Ti1-.4 � / / i t o K„ Cepacaf. ZOaDO Gal. Well ! IIL (ur)(+ /(��� NIA A to014- t Matenal: lr Number d Nenta: Compan 7 LC ` 1 Sudaoe Water too ?+ fou (4 LIFT STATION Lot Line Z f� tooI {- �• Size: 'LV b p Gal. Manufa uret hIc INP Foundation W t ^go /� 1 '70 Pump on" level at 3191 in. Pump ofd' l"I at 2 High wap ter alarm at 1 l3l k 4 2 Curam Drain /_�Tl Pump Make 8 Model Electrical lnsp ons pertaJmed "a y. p / Dv 7Fa a(D-I- ? Remaos. . . d BENCH MARK r e a .i Location appe DeunpDon: rr Assumed Elevation: �oO FL s .. h. i,A � 49TH ^ Inspections performed by: j�/ Adr(/ Ad Irr*va Dates: 1a` 12M2_01 �d .2nd ♦,Q ,L 08 Department Health � .° MICHAEL N. ANDERSON, �4 �+ CE- " 9 of and Human Services approval \� '' �` "'" •st��� Reviewed and approved to Date: 0 p Fl? (Rev.11/99) Permit No. SW000495 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: L 7, BK 4, MOUNTAIN PARK EST. #2 S/D PID No.: 017-023-07 SEPTIC IEIELD i XISTING WELL -------..i 7l i I VT3 SHED 1 \ AR LINE W/ ELECT. �\ / / RErAI \\ i a 1 Z _ 1 EXISTING WELL / 100' RADIUS N / \ S 89'56'06" E 183.0' o / BACKFILLED SEPTIC TANK / 11,259 GAUQN SEPTIC TANK \\ ,1 I I I® II I i ASSUILT / SCALE: 1 "=50' ea nam rear w wn un rz n Y - 8 CIEAX WT CRYERS nn* 44. ni[Y treat �\ � R,�. G, • ' r'i• ;"n` `f 4� r ter.• �`�' �.'°•,�� 9r 4P 8008 4N. L 1 41FY TW ] Y�' OF rILTEX %W ° 49T" e �_- °• Y R 9 R 4 4 4 4 4 4 9 Y9 D II7T •• f 9�9 H lME IM 9RI10 BEO a • • P lcx;,ei N. tnR)L Sc vq P�ppE^s. CE 94. SEPTIC SECTION Y °r'l �j• • /����. O , MARK r98.077.0 GAND, PIPE ELEV. ELEV, C01 0 102.1 95.8 CO2 100.0 95.6 TCOt 99.9 TCO2 99.7 MT1 99.2 MT2 98.9 MT3 99.1 MT4 99.4 IN'SPm ry ? r -f- 4700 SW,- 6.H R -RA e�'Y.W S % 3 6•.F''+s. tsd`kt� s6JSiik�.:C:.' . aS •fa.�°.lu:� 1,MKIIEa:,':{IeONS., Moire (9Vl34J-83ao FEar::• e-907) ti4X3735rVFn'sP,314d70,v' e7)343,921 DA TC. -LOT.'- COMMEM''s TFPF OF 1ASPEC7YON. No non-compliance o?3seroed. F3 Ccs=.?e ions essential as mq)lained heiow. E 1 C.O. approved. C tivv til re••e hnszie a_•e. naa t inspecuc7. £so not owiceal until re-insperled. E i G �..J. approved (eozn armts belmi). ------- -- — ----- --- ----- - C Reinsy-whon? C i•k$f'LF'C7'f?R.. —�_� �___—.�^ iii S/ ?V —� RWEA' CORREMEINSARE ARDS, PLEASE CALL ORD SP C770tsi MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade la/a./c� @i lam Date Issued: Dec 01, 2000 Expiration Date: Dec 01, 2001 Permit Number: SW000495 Parcel ID: 017-023-07 Legal Description:,,_ M{ ,PWft'A BLit 4 LT 7 Design Engineer: 0088 Anderson Construction & Eng'g Site Address: 013000 FOSTER RD Owner Name: Don Carlson Lot Size: 20130 SQ. FT. Owner Address: 7801 Arlene St. Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99502 - This permit is for the construction of: ✓❑ Disposal Field Z 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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: Z Issued By: (/��/ '�ew. p�� Date: a Michael N. Anderson, P.E. 4640 Shoshoni Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 November 22, 2000 Department of Health and Human Services P.O. Box 6650 Anchorage, Alaska 99519-6650 Re: Lot 7 Block 4 Mountain Park S/D 92 To Whom it may concern: This is a request for a permit to upgrade the existing three bedroom system which was tested and failed. The original system was installed in the early 70's then the owner added an additional trench for more capacity sometime after that. The additional trench was undocumented and will be abandoned in place. Two test holes were excavated with very consistent results. The top layer consisted of stiff silts from 2 feet to approximately 5 feet, then the soils get much softer (ML maybe SM) to about 15 feet. Peres were run in both layers, one at 3 feet and another at 8 feet. The 3 foot perc was greater than 60 minutes per inch while the deeper 8 feet layer perced at 36 minutes per inch. A new bottomless sand filter will be installed due to the slow percing soils. None of the surrounding properties will be effected by this new upgrade. If you have any question please call me at 345-3377 Sincerely c ael Anderson, P.E. I LOT 20 I I LOT 5 I I LOT 20, BLOCK 3 I I I - I --------J I L-------- _ I --------J I L- - ------U- ----�-- ------- LOT 19 d I a N /LOT 6 \\ LOT 19, BLOCK 3 N I I i t 1 \ 1 / LOT 18 / LOT 18, BLOCK 3 I I 2�� W 1 LOT 7 I I LOT 17 / I LOT 8 \��� \ �� LOT 17, BLOCK 3 I I I I i I I 1 i i I I '�o• i 1 I I Cee 9/ LOT 16 ��\ I I LOT 16, BLOCK 3 II LOT 9 � I II I ADJACENT W LL-L/I LOT 15 II II II I LOT 10 � 1 LOT 15, BLOCK 3 II II II II II LOT 14 I II I I LOT 11A I I II II LOT 14, BLOCK 3 II I I I I II II II II SEPTIC DESIGN PREPARED FOR ? $. DON CARLSON LOT 7, BLOCK 4.°® MOUNTAIN PARK ESTATES SUBDIVISION, ADDITION NO. 2 PREPARED BY MICHAEL N. ANDERSON, P.E. N,Ic Aei N. ,nrocescu 14250 N. GOLDENVIEW DRIVE C -94;9 \' /D� (907) 345-3377 / FAX (907) 345-1391 d, .�z� SCALE: 1"=100' NOVEMBER 20, 2000 I I LOT 6 I I i I I I SHED iI L TH#1 III III Z%D \� w I I I i l I j i I I z I / I -NEW 1,250 j�'�,/ ' �' GALLON 1ANK- ' �. I � I I TH#2 I .f. -------- / wOOD RETAINING WALL P \ 90 � S \ \ \\ GRAVEL DRIVE \ 2 STORY HOUSE —EXISTING TANK TO BE REMOVED NEW PIPING AS REQUIRED tt EXISTING DRAINFIELD AND t� PIPING TO BE ABANDONED \ S 89'56'06 SEPTIC DESIGN PREPARED FOR DON CARLSON LOT 7, BLOCK 4 MOUNTAIN PARK ESTATES SUBDIVISION, ADDITION NO. 2 PREPARED BY MICHAEL N. ANDERSON, P.E. 14250 N. GOLDENVIEW DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: 1 "=30' NOVEMBER 20, 2000 LOT 7 ® O • A, • 44 T ti, r ..; • �r roes•. P• MICHAEL N. ANDERSON ;; AIR LINE COIL SPACED AT APPROX. 24". ORENCO "WASTEFLOW" TYPE PROVIDED BYANCHORAGETANK, INC. 3/4"0 SCHEDULE 40 PVC. LATERALS (HOLES, SHIELDS, AND FLUSHING VALVES PER ORENCO DESING) —12' X 30' BOTTOMLESS ISF, NO LINER ON BOTTOM. PRESSURE PIPING DESIGNED BY ORENCO AND SUPPLIED BY ANCHORAGE TANK, INC. 4"0 MONITORING TUBE AT EACH CORNER TYPFLUSHING VALVES . 1 1/4"0 SCHEDULE 40 HDPE PROTECTIVE COV DISCHARGE LINE FROM STEP EXTEND ABOVE GF TANK AND MANIFOLD 0 INSULATION IF REQUIRED MONITORING FILTER FABRIC TUBE 3/4"0 PVC LATERALS, , IN OVER PEAC GRAVEL SEE ABOVE /-FINAL GRADE /- GRADE 6" LAYER OF 3/8" PEA GRAVEL W/ THE PVC LATERALS BURIED MIDWAY IN THE STRATUM (GRAVEL BELOW PIPE = 3"+) I 12'-0" SEPTIC DESIGN PREPARED FOR DON CARLSON LOT 7, BLOCK 4 MOUNTAIN PARK ESTATES SUBDIVISION, ADDITION NO. 2 PREPARED BY MICHAEL N. ANDERSON, P.E. 14250 N. GOLDENVIEW DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: NONE NOVEMBER 20, 2000 X24" MINIMUM OF FILTER SAND AIR LINE 18" BELOW TOP OF SAND a OF At sd9� A Fl: • Q •e MICHAEL N. ANDERS0 ;•� °. CE 94G 'B e 4 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 " U' Street. Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 00 Y-\ t0.✓ \ iI DYi,,//II I_ DATE LEGAL DESCRIPTION: L �' �2{ N(o,w-:aln VY( K -OZ Township, Range, Section: DEPTH ' fir, J % J 1 SLOPE (FEET) I i- (/ � b I IIj—'I I 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17 18 19. 2C COMMENTS Tri h � zfi1 14 /'< t Su �-+ Sr 141 15 5 M °i- m c_ yom U 4 OV6, up 2.. WAS GROUND WATER ENCOUNTERED? N'0hCG IF YES, AT WHAT DEPTH? BepO to Wrier Alt r Monienng7 Br>2 lul / / D ,:r,��,cyrumeentiar�n�yv a MICHAR N. Ati'Jt?,SCN qC'c� rr PERCOLATION RATE 31b (mmu)evinen) PERC HOLE DIAMETER 4 rESZ RUN BETWEEN Z FT AND B FT _ PERFORMED BY: I1 tL-- ' Vr. e- rT+wt ( CERTIFY THAT HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4,851 --�-&' rr PERCOLATION RATE 31b (mmu)evinen) PERC HOLE DIAMETER 4 rESZ RUN BETWEEN Z FT AND B FT _ PERFORMED BY: I1 tL-- ' Vr. e- rT+wt ( CERTIFY THAT HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4,851 e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: DOiI (�UY � S 0 r) . DATE LEGAL DESCRIPTION: 1-9- If M°nm4,p; i? .Itisi i Township, Range, Section: (FEETI SSP °tee°hrrt go(e# z_ 2 3 rrG. -r , . i- Cit (-s M L- 4 5 6 81 I sn i- "', Sj 1� 4 �an� 1 s m M I 9 Loyr.a I I I I I 70 WAS GROUND WATER •, ENCOUNTERED? IV ONCi 11 S IFYES,ATWHAT L DEPTH? C 12 P \0 i'`Ont TOJ 110WWaer Atter E 13 h e 1 fr /�% iL �e-�nS�[A0 �`4 Y7C Zh4s'Pot I.�eol Malitunng7 Balt 14 1 16 17 18 19 20 .OMMENTS 49 TH MICHAEL ',; P ,9,4%.9e i PLAN PERCOLATION RATE OC (mmutesmch) PERC HOLE DIAMETER 4 TEST RUN BETWEEN FT AND .--I—FT PERFORMED BY: W ! r kr r7 CERTIFY THA TH S TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �� 1, 72-008 (Rev. 4185) MUNICIPALITY OF ANCHORAGE 40 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAM s�{' V rlJ (/�� _ PHONE ��f NEW ❑UPGRADE MAILINGADDRESS A LEGAL DESCRIPTION Le 7- 7 oy r- #:.:z- LOCATION NO. OF BEDR�TS V Id DISTANCE TO: W Absorren�rea /CCDD Dwelling p,j. PERMIT N Q r� H Z Manufacturer Mate ' No. of compartments Liqc ppcity in gallons IF HOMEMADE: Inside length Width Liquid depth 6 V Z DISTANCE TO: Well Dwelling PERMIT NO. =ZF Manufacturer Material Liquid capacity in gallons W = DISTANCE TO: Well Foundatio Nearest lot Ii� PERMIT N h w� Cf j" � LL Z F- No. of lines Length of h line Total lent cf tines Trench i. h inches Distance betvupeP nes Cl MI_ Top of tile to finish grade , Materi beneath til (y a inches Total effect so tion area W Length Width Depth PERMIT NO. Qa F w� Type of crib Crib diameter Crib depth Total effective absorption area w DISTANCE TO: Well Buildingfoundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. w 3 DISTANCE TO: Buildin foundation g Sewer line Septic tank p Absorption area(s) p OTHER PIPE MATERIALS e,45; SOIL TEST RATING INSTALLER I ' - ClJ�LC, 7 T e LLREMARKS ztw epi; .Xj . /� APPROVE DATE LEGAL - 2W3 (Rev. 3/78) < 7r YIl L� L.o is C���nAcroR s '��C�CC �R)Zcf�G C��P��vy PD. hw`x ID- 1976 Ape wo 01 ,4m5" 5j�5 lJC,97l4Pn" : ��T `I "a>� f� Y rAwf'�yJZ• < J STA -7J -S45 y r , 07- • 4 A fir_ / j .R r� rte. 7 AT 7 f, jJAJti 1? ; G• �rJ� 1 17 T . VV W4/ ,4 NARK PI Ja -) GLA,Y 6)44— i o C W� 5r p� 1 1-7I G;«/ J- 6X;4z_rL_ I ? J - i? 8 C ter 4 vxi - 1?3 &AAIXL3 C 4 c Ley aktf - 24O rztp 4,rc'K - MA ;IMUN NUMBER OF BEDROOMS _ _ =OIL RATING (SO FTiBR)= 2:7.5 30 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: JK L_• FT F=• T F-1= _1 01 L_. E t-4 C:3 T F-1== a*. :1L n.3 FQ FA V? E L- E. a E F= -F L 1 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH"OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXC:AVATION (IN FEET) - THERE I'. NO _,ET WIDTH FOR: TRENCHES. THE GRAVEL. DEPTH I_ THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE E>;C:A'vATION (IN FEET). t*^ n a 1_F I �' E C• -. E F=• T I (0 T e=it 1 k-_ -. I v E— _1-E_c IN a=® PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION .INSPEC:TIONS OF ANY WELL, ADJACENT TO THIS PROPERTY AND THE: NUMBER OF RESIDENCES THAT THE WELL WILL_ SERVE. -- ------ T l •J CA T 1`4 On F"1107 n_- -T- I ®_n 1`44 = H Fv' E FQ E CA 6_1 I FQ Ems. & — -- 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 150 TO 200 FEET FROM A PUBLIC: WELL DEPENDING UPON THE T1PE OF PUBLIC: WFE..L... WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPEC:IFIC:ATIONS AND CONSTRUCTION DIAGRAMS ARE FtVAILABLE TO INSURE PROPER INSTALLATION. F= E F<^ r•1 I T" E I<F' I FQ E ON Eti E= CD E= 01 E3 E= FQ _ _2.. e JL no v " e I CERTIFY THAT L: I HM FAMILIAR: WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS _.ET =QRTH BY THE MUNICIPALITY OF ANCHORAGE. _: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. -: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE ESIDENCE IS REMODELED T.1 INCLUDE MORE THAN 3 BEDROOMS. I GNED : -�L�� •<�L_ ;1 LICANT DOP LDttCARt_SON - - - SSUED BY__!Z;1j>j0yA,__ l 7 .. - ...- .,.- . . . ` a e . . . r DEPARTMENT OF HEALTH AND El'dVIRONMENTAL. F' ''TECTI N j i iS 25 'I�TREET, ANCHORAGE, AK. 95- � 264-4720 i 1...1 E L_ L_. FI VA Es CA t -J — -. I T- E E FJ E = FQ F=• E= FF -'."1`w1 -E -1-- �Ji iC PERMIT NO. ( 790151 ) O`i 30 APPLICANT DONALD CARLSON =01 ARLENE CSR' 4:�2 ;,_,t)L - --1LEGAL CATION FO_�TER RD /0�7OUFRE Lr B4 MT PARK EST #;_ LOT SIZE �0 FEET'(,�� TYPE OF SOIL ABSORBTION _•Y'ST-EM IS: TRENCH MA ;IMUN NUMBER OF BEDROOMS _ _ =OIL RATING (SO FTiBR)= 2:7.5 30 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: JK L_• FT F=• T F-1= _1 01 L_. E t-4 C:3 T F-1== a*. :1L n.3 FQ FA V? E L- E. a E F= -F L 1 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH"OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXC:AVATION (IN FEET) - THERE I'. NO _,ET WIDTH FOR: TRENCHES. THE GRAVEL. DEPTH I_ THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE E>;C:A'vATION (IN FEET). t*^ n a 1_F I �' E C• -. E F=• T I (0 T e=it 1 k-_ -. I v E— _1-E_c IN a=® PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION .INSPEC:TIONS OF ANY WELL, ADJACENT TO THIS PROPERTY AND THE: NUMBER OF RESIDENCES THAT THE WELL WILL_ SERVE. -- ------ T l •J CA T 1`4 On F"1107 n_- -T- I ®_n 1`44 = H Fv' E FQ E CA 6_1 I FQ Ems. & — -- 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 150 TO 200 FEET FROM A PUBLIC: WELL DEPENDING UPON THE T1PE OF PUBLIC: WFE..L... WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPEC:IFIC:ATIONS AND CONSTRUCTION DIAGRAMS ARE FtVAILABLE TO INSURE PROPER INSTALLATION. F= E F<^ r•1 I T" E I<F' I FQ E ON Eti E= CD E= 01 E3 E= FQ _ _2.. e JL no v " e I CERTIFY THAT L: I HM FAMILIAR: WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS _.ET =QRTH BY THE MUNICIPALITY OF ANCHORAGE. _: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. -: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE ESIDENCE IS REMODELED T.1 INCLUDE MORE THAN 3 BEDROOMS. I GNED : -�L�� •<�L_ ;1 LICANT DOP LDttCARt_SON - - - SSUED BY__!Z;1j>j0yA,__ l 7 n t'"'01_A C -a I A_ I E_ I T' -r e_A F-- ti P•.1®_= H 1==11 E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 `'L' STREET, ANCHORAGE, AK. _99501 64-47'20 WEA L L_ F=1"E� / _Awa — :S I 7 E = E E,a E F" F" E F° C°7 I - f- PER:MIT NO. < 780752 APPLICANT DONALD CARLSON 7801 ARLENE DR: 243 0285LOCATION FOSTER: RD OFF DEARMOUN LEGAL L7 B4 MT PARK SfD LOT SIZE 0 SQUARE F'EEI TYPE OF SOIL ABSORBTION SYSTEM I_: TRENCH MAXIMUM rM NUMBER OF BEDROOMS = = SOIL RATId; K' S Q FT'ER, _ x:15 THE REQUIRED RED S 17E i �F THE SOIL. ABSORPTION SYSTEM I S : O qo -sI, L_E_ r -A c73 T F'"1 = ( 13 �""°' 1"'1 e^.'' 1 Eo E F` T F" 1 –_ 091 ©k �,L d Z 7- 8-16- w THE LEPdGIn ClIMErq=,luPd IS THE LENGTH CIN FEET) OF. THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL. F'IF'E AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING .THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. _..- — -- T W A- <:2 > I "ti"• FF= r: T I A._A "!E3 FE F"- F= F^:: E Cl U I F;_� E E -o 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 SY_=TEN I_=; 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. WELL LOGS AREREQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER R:EQUIR:EMENTS MAY APPLY. _,PECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE 9VAILABLE TO INSURE PROPER INSTALLATION. F"EB* i`1 I T EF_ F_ �_=® r I CERTIFY THAT I: I AM FAMILIAR: WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET =ORTH BY THE MUNICIPALIT'T OF ANCHORAGE. ?: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT,THE ON—SITE SEWER 'SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. IGNED:—e _i% --------------------------- APPLICANT -------------------- APPLICANT DONALD CARL S ON :S=UED BY--Y-O�v— ! _ 7�—----C;HTE-,G�--- —�1--- V3. ® SOILS LOG VNICIPALITY OF ANCHORAGE %' • ar DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION i� Pouch 6650, Anchorage, Alaska 99502 276-2221 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR: L JfiN 6 /V DATE PERFORMED: S— 0`23' %F LEGAL DESCRIPTION: L cr—f 7 J3.L[fC F PTI - & 54a7d�( 6i /f- &L -5H) SLOPE SITE PLAN -C -C `.SGnlJc� C/rQ.uG/u'r J//f"�ML Conf�.::� ,some Gohh/e 6/z rnate..�./o Nra/oC 10 V Gross Time Net Time Depth to Water 11 / -X',,/7F WAS GROUND WATER S SyZs /, 2s- Ss7 ENCOUNTERED? /✓O L ee 12 V /�iC..JP�rG/5 O(rYJ2 L:J O P 0 4hUve IF YES, AT WHAT E 13 /c ,,. DEPTH? 0. s' �iIOM OF EXCF7V_ /c r,,'r G7, 75 v .91&0 17at 18- G_� ova 19 20 ^UWp 41-7 PERFORMED 72-006 (7/76) I Reading Date Gross Time Net Time Depth to Water Net Drop / -X',,/7F c O SyZs /, 2s- Ss7 0.5- s;7 O.s" /c ,,. 57. S 0. s' /c r,,'r G7, 75 O `S deo" 3.o I I PERCOLATION RATE (minutes/inch) -- TEST RUN BETWEEN y. C' FT AND 7 6 FT CERTIFIED BY: M m GREATER ANCHORAGE AREA Department of Environmental 3500 Tudor Road — Pouch SEPTIC TANK: ANCHORAGE AREA INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM Annop" 7a/(' N° 910 DISTANCE FROM WELL MATERIAL SIQ(Ae :STESZ NUMBER OF COMPARTMENTS Ut # 17 OZ-, "2— LIQUID CAPACITY Z666 GALLONS. INSIDE LENGTHINSIDE WIDTH -- LIQUIDDEPTH — SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH ��`'� LENGTH —2 , , DEPTH & / LINING MATERIAL- LLg CI`!b . DISTANCE FROM WELL II BUILDING FOUNDATION 4S� NEAREST LOT LINE �4- TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) vT 2 -SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL—, FOUNDATIONTOTAL LENGTH , NEAREST LOT LINE ______QF LINES NUMBER OF LINES DISTANCE BETNtg TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA - SQ. FT. LENGTH OF EACH LINE DEPTH; TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: 110i� DISTANCE FROM P WATER TYPE DEPTH ,BUILDING FOUNDATION. SAMPLE , NEAREST NEAREST SEPTIC1 SEEPAGE i LOT LINE SEWER UNE—,TANK OP 75 , SYSTEM 113 , CESSPOOL 1V646. OTHER SOURCES,cAckw>� DISTANCES: Aec C-fnST ICON INSMLI-el) 8V P IT Ib 8e emuTL Tb nt-3P�7ttcrnri kfLT3�,sT zoo by Nai-IZ. T£sTiA, S,1s . T w_ DIAGRAM OF SYSTEM DATE -5-1z2172 APPROVED LPIV,4Z C)- 6dJ/ P -L"_ HEALTH AUTHORITY GRE ANCHORAGE AREA BO H • DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE, ALASKA 99502 TELEPHONE 279.8686 NAME OF APPLICANT INSTALLATION LOCAT LEGAL DESCRIPTION SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT PERMIT NO.19713 INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED C� _ SEEPAGE PIT TO BE INSTALLED BY DRAIN FIELD OTHER NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE- L', TYPE MINIMUM DISTANCES, REQUIREMENTS i SEPTIC TANK , SEEPAGE PIT. DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK '�") SEEPAGE PIT zz O DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANKy SEEPAGE PIT (� , DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT. �� DRAIN FIELD , TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. C7 V , HEALTH AUTHORITY OR LICENSED DESIGNER AREA SIZE TYPE DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2868 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE' APPLICANT'S SIGNATURE FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL l i SEPTIC TANK , SEEPAGE PIT. DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK '�") SEEPAGE PIT zz O DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANKy SEEPAGE PIT (� , DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT. �� DRAIN FIELD , TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. C7 V , HEALTH AUTHORITY OR LICENSED DESIGNER AREA SIZE TYPE DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2868 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE' APPLICANT'S SIGNATURE GR-LATER,ANCHORAGE AREA BOROUG}j�� DEP T OF Fw'IRO.NM1rNTAL QU N. 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 CASE' N Performed For Bill Zubeck 5/9/72 Legal Description: Lot Block Subdivision Performed s a es g p Mountain z This Form Reports Soils Cog X ` erco at on iest Depth t Soil Characteristics i Gray Sand and Silty Sand (SP) & (SM) with fine gravel and sand seams Gray Sand - Silt Mix Was Ground Water Encountered? No If Yes, At What Depth? - 04 �o rrvpvsea installation: Seepage PitDepn th04faet Drain Field COMMET2squrQsperuire�peroed9ponp.it r Trenc ormed By x. ar is e d a er 7 111 DY:National Testing Sys Dater j Municipality of Anchorage On -Site Water and Wastewater Program ^ . - (907) 343-7904 >' Certificate of On -Site Systems Approval Parcel I.D. 017-023-07 Expiration Date: 1. GENERAL INFORMATION Complete legal description MOUNTIAN PARK ESTATES #2; BLOCK 4, LOT 7 Location (site address) 13000 FOSTER ROAD, *ANCHORAGE 99516 Current Property owner(s) BEN WILLIAMS Day phone 602-8553 Mailing address Real Estate Agent _ Day phone __ 2. TYPE OF DWELLING: © Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑u Individual Q Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: N/A Distance: N/A Received by: Date: CCSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number ��f st 1�563� COSA# 0,5c- {`i 22 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 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 Garness Engineering Group, Ltd. (GEG) Phone _(907) 337-6179 Address 3701 E. Tudor Road Suite 101, Anchorage AK 99507-1259 Engineer's Printed Name Jeffrey A. Garness In conducting this evaluation, GEG provided an engineering evaluation of the welt 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 defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on 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 systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guammt,e• future,performance of the system/s; therefore, GEG makes no warranty (express or implieu) tag- %ting 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. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/party who paid for this report. 6. DSD SIGNATURE _System.#1 Approved for bedrooms -32 System #2 Approved for bedrooms Disapproved Date Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: Y tOF4,iVf1t ON-SITE% WATER AND r"^ WASTEWATER oz PROGRAM The Milipieip$lity of�.R ge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represent i", 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 L Septic System Advisory Well Flow Advisory COSA blue sheet e-1-12.doc Nitrate Advisory V Arsenic Advisory Other If more than 7 septic system Is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: MOUNTAIN PARK ESTATES /{2; LOT 7, BLOCK 4 Parcel ID: 017-023-07 A. WELL DATA Wall type PRIVATE If A, B, or C provide PWSID# N A Well Log (Y/N) YES Date completed AUG—SEPT 1979 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES Total depth 260 ft. Cased to 247 ft. FROM WELL LOG Date of test AUG—SEPT 1979 Static water level 194 ft. Well production 5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 oolonies/100 ml. Nitrate 6.82 mgJL. Arsenic: 5.0 ug./L. Date of sample: 6 /16/15 Casing height (above ground) 18"+ in. AT INSPECTION 6/24/15 196.8 ft. 1.5+ g.p.m. Collected by: GEG, Ltd. B. SEPTIC/HOLDING TANK DATA *15 FEET FROM THE HOUSE Tank Type/Matedal S.T.E.P./STEEL Date installed 12/2/00 Tank size 2000 gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout (Y/N)*YES Depression over tank (YIN) NO High water alarm (Y/N) YES Date of pumping 8/29/2014 Pumper A+ HOME SERVICES, INC. C. ABSORPTION FIELD DATA *BELOW EXISTING GRAD Date installed 12/2/00 Soil rating (g.p.dJftzo /bd 2_0 System type BOTTOMLESS IDSF Length 20 ft. Width 18 ft. Gravel below pipe ***0.25 ft. Total depth **4.0+ fL Eff. absorption area 360 ftZ Monitoring tube YES Depression over field NO Date of adequacy test 6/24/15 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added5� 77 gal. New depth 2 in. Elapsed Time: 170 min. Final fluid depth 0 in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date ***ASSUMED PER 12/11/2000 COSA PREPARED BY THE ENGINEER THAT DESIGNED THE SYSTEM AND INSPECTED THE INSTALLATION. GEG ELEVATION SHOTS AT BOTTOM OF MT1 AND MT4 ARE 94.33 & 94.25; MT2 AND MT3 ARE NON—FUNCTIONAL. —WATER WAS INTRODUCED FROM THE LIFT STATION 1 Xou LC-- w.: V0,4Nt" rVC a- 4/t / **PER 2000 ELECTRICAL INSPECTION REPORT *SYSTEM SERVICED BY A+ HOME SERVICES ON 7/10/2015.3EE 46GARDING AIRLINE PRESSURE. SEE 10/16/06 REPAIR I lid' AA1I ANDERSON, P.E. IN MOA RECORDS. IDSF D. LIFT STATION Date installed 12/2/2000 Size in gallons 2000 Manhole/Access (YIN) YES "Pump on" level at * in. "Pump off' level at ` in. High water alarm level at 44 in. Datum BOTTOM OF MANHOLE Cycles tested * Meets alar & circuit requirements? **YES 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 75'+ Public sewer manhole/cleanout 100'+ Sewer /septic service line 25'+ Holding tank Animal containment areas -----5-0'+ Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parldng/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS MT2 BELIEVED TO BE SET AT THE TOP OF THE PEA GRAVEL, HOWEVER LIQUID LEVEL SPIKED UP TO A DEPTH OF 7" IN MT2 DURING ADEQUACY TEST; HOWEVER FUNCTIONAL MTS NEVER GOT ABOVE 2" G. ENGINEER'S CERTIFICATION I certfly 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 (Rev. 11105) Municipality of Anchorage ' Community Development Department Development Services 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 # 151422 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 7 of Mountain Park Estates #2 subdivision. This inspection revealed a nitrate concentration of 6.82 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. 07/1:'/2015 Y t 07:39 8686770 APLUS PAGE 01 awzw NOW 1v1UNICIPALITY OF ANCHOuA6P. Comm�.,Oity DMlOPn,&ntpepertatotk • Oa-91te WBt p 8c �,wtnuni.o gfbug m p: 907-3A3.79 ' • P: 907.343.7999 • P.O. Aox 196650 Aaohomp, AX 99514 6650 • htt�:llw � u•muni.or�/bv ]ditis Intermittent Dosing Sand Filter Maintenance Log Owner a_�_ Street Address�,�.� �- plD Phone uLegal Desc. 99-940—l",^d2 -Sludge level _ o -inches •Pumping: required e 'pumping completed o Abao do Feld: .Liquid level _inches .f -Flushing valves per approved designSe o -All flushing valves operi; d, distribution lines flushed, and flushing valves closed n L s tion' I 131olube effluent fiher cleaned veq _ r i •(imeriioa.sniiingincTes -High levelfivats�tiiyinches econds •rump,off__�_o�minutes 'Pump o `� jhoui's •C,umulative lifetime cycles 2,Z o Cumulative run time -operation satisfactory (5DIL101 AMY11-00-1 1-00'. -Air pump filter cleaned (a_no -Date of latest Install or rebuild AI®Yltl XSS OM .Dedicated etectrioal ciluuit Ye .Float setting nches Comments: s -Air pressure `S psi -Air system operation sa 'sfacto o -Audible and visual, alarm Inside dweili CR_D -t m. i• c, -Alarm system operation a F �! t ..... :.............:• } ..........f1'1 ax ....... W. cr�orl.4r.,..... Awe.... �u1:...... at. �{tty.S.Q........%7i, ... ;. KIf-....vsir� i.n ...k(�.:..... ................... � .......... ............... .<..................... aLr,++ance p2ovider� Technician Company 3.dcc Date of maintenance_ Signature Date_j_LQ.,_6._ t Municipality of Anchorage P.O Box 196550 4700 Elmore Road Anchorage, Alaska 99519-6650 (907) 343-7904 Fax (907) 343-7997 hftp:llwww.muni.org/onsite Planning and Development Services Department Onsite Water and Wastewater Program On -Site Sewer/Well Submittal Comment Sheet Engineer: GARNESS ENGINEERING GROUP LTD -egal Description: MOUNTAIN PARK ESTATES #2 BILK 4 LT 7 'ermit: OSC151422 WellSeptic teport Type: COSA Completed By: 8/12/2015 J.Poet -he attached paperwork has been reviewed and is being returned for the following reasons: Avi'�'t�-G41•�--D 1. Per Maintenance Log dated 7110115 air system is'not satisfactory' [airline at max pressure]. 2. System must have a foundation cleanout within 4 feet of foundation or one inside the home. F C O G r C.uJZR�� T w C_& -n a' 3. Maintenance Agreement from Buyer. L,/,Of '.pol�v60 t� fir, -P Z000 P� 4.4OFJu of Cog Cv2 S-wEa? Th wUwwf Jeff Garness From: Jeff Garness Sent: Wednesday, August 12, 2015 10:04 AM To: 'Poet, Jeff W.' Subject: RE: CrystalReportViewer[2].doc Hello Jeff. This is the one that I called you on regarding the air pressure gauge and you said that you would accept it given the system performance. Based upon A+ Home Services troubleshooting, if there is a crimp/obstruction in the line, it is under the ISF. The system installation and the FCO location were approved on the MOA 12/19/2000 inspection report submitted by Michael N Anderson, P.E.........................jeff Jeffrey A Garness, P.E., M.S. President Garness Engineering Group, Ltd 3701 East Tudor Road, Suite 101 Anchorage, Alaska 99507 Ph: (907) 337-6179 Cell: (907) 244-9612 Fax: (907) 338-3246 Website: www.garnessengineering.com From: Poet, Jeff W.[mailto:Poet1W@ci.anchorage.ak.us] Sent: Wednesday, August 12, 2015 9:43 AM To: Jeff Garness <1eff@garnessengineering.com> Subject: CrystalReportViewer[2].doc 07/01/2015 13:35 e 8686770 APLUS 9�'NAGHT F4 Us eFA7SA FUIi NJJ A+ HOME SERVICES , INC. 7501 E. 140th Avenue **** Anchorage, Alaska 9951.6 345-1890 Apt CUSTOMER • Ben Williams 13000 Foster Road Block Lot DATE & Lift 07/0$1250 gallons 2 standpipes, Tanklocated 50' S of SW corner PAGE 01 INVOICE # 4 7 6 2 6 DESCRIPTION�� i d.. . 1) TOTAL REIIiGARKS -—(� .. 1 - 'Gallons � ` Septic Leach Area Holding Tank Standpipes PROBLEM AREA — CALL FOR MORE INFORMATION ❑ NEEDS TO BE DONE AGAIN 1 MONTHS Q Good Shape EVSludge buildup on bottom ❑ Jim cap missing or ❑ Cut standpipe to 1' above ground needs replacing AMOUNT Floater on top ❑ Needs Septictrine 02/08/3006' 14:44 � RSL 1LGuc.ti/ 7625495 4 t -b.// ,-. 1,.. A&) 17 noel-iC Fax Nc1a 7671 Date3 L c`ese8 1%Z2 From -. •-• 52,8 - colDarL T31POD 7 '' Co. 4 FSXe /YO ��ZT� FFKF /1•n.ZJ� n 0 r r SIF i } �L• elk aSGPTIL 6tfqt .rj 1 M1� 0 EASEMENTS OF RECORD, OTHER THAN THOSE:>HOwN ON THE RECORDED PLAT, fJIE NOT SHOWN HEREON. "ASSUILT" PACIFIC RIM PROPERTI r4 ��jPAGE 0 /01 toA �o.o t -. •-• 52,8 - 4 Q g cE r Q /8 3. VALL ' S_dy„_ It pep 34,1 2- 3 ro$Y FR4FtE -+ HO 113& 1 , 06 W No corners set dD �o.o t -. •-• 52,8 - 4 Q r Q 44, DRIVt WA( • uNnrR i j)4cv� U •- JJI/CLL O' d• �J ° U .,. a o THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTrTUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTtNG STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND 1S NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCEUNES. I rtereoy cenifr that I have surveyed the roaawtng desorlbed property. Lot Block - rt Alv ,a:N mpk e5mrr•S -0 Anoncrage recording 641fict Alaska, and that the Improvements aftualed hereon are wltnln the property Ilnes and do not overlap or encroach on the property lyng adjacent tharNa, that no ftrovemeMIS an property Veit adjacent Ineretn QM1CrO och on tlld premises in quesllon and that there are no roadways, transmission nines Or other visible lassm kxe on said property except ea k+dloated Denson. .At*Wsoe;Aeaka J Fa.'g• 200(0 Book pg PILE of ak.qs1to � * 49L.............I.. • ::�:•...•. •............... Franc[ Hctdon"n00 ,o s •. No. 12084 • Y€W �,a eprrS5i011►1t� ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE ANDc)4165 g- kENDa4 KosTLIW THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this jrDay of SCFEH BPR of 2015, by and between GNR f5 4r kJrNP## kP57L t N herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AW WTS), described as S.'Id �16cl- located at (legal description). Mit Vu;n iw k �S�� s A-,1 L -4-- 2. Definitions. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC') 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7.. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: Li b. Municipality: Director. Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. O WNE - 7By:. 6 _(signature) Date: 2cs 21.J (print name) STATE OF ALASKA THIRD JUDICIAL DISTRICT The foreg 2016_ by My MUNICIPALITY: was ) ss. ad before me this day of mP2 , By: (signature) STATF OF ALASKA NOTARY PUBLIC�� b@idi Swan t� My `C'dYdlfll��idf1 EOOW-August 21.2017 Date: (print name) Title: 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER o q By: ` —(signature) Date: I S (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was ayknowledged before me this tday of n !-,e2 , 20 S by ��P�n i ✓Gt K D SSI �NI STATE OF ALASKA NOTARY PUBLIC NOT RY PUB FOR AL SK Heidi Swan z My Commission expires: _*/ My Commission Expires: August 21, 2017 MUNICIPALITY: By: (signature) Date: name) Title: Municipality of Anchorage 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 i2��� v>; Cot.�n�-rc4r.le-c l'oSA E B� S C 5• CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ® 2 3 - 07 COSA# QG Q0 3 % 1. GENERAL INFORMATION Expiration Date: G ' 8 Complete legal description MOUNTAIN PARK EST. #2: LOT 7, BLOCK 4, Location (site address) 13000 FOSTER ROAD. * ANCHORAGE. AK 99516 Current Property owner(s) COLLEEN STANHOPE Day phone C/O AGENT Mailing address Lending agency Mailing address Real Estate Agent Mailing address Day phone BARBARA BLOCK w/ PACIFIC RIM Day phone 762-5417 3000 C STREET * ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 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 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, l 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. l 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 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 / / Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 1 2Q! D.6 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 & 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 -3 bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance. Agreements Supplemental Engineer's Reort Other i+tt, Jam': ON-SITE %:v WATER AND ; m= WASTEWATER PROGRAM By: � ZZ Original Certificate Date: © .. G l 6 (Rev. 11/05) Municipality of Anchorage a ' Development Services Department A_ Building Safety Division s. E On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite x ,0�` (907)343-7904 f,C tC CERTIFICATE OF ON-SITE SYSTEMS APPROVAL v `Y �1 FO�RZ A SINGLE FAMILY DWELLING Parcel I.D. i�� T - 0 ' 07 COSA# /--, J 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MOUNTAIN PARK EST. #2; LOT 7, BLOCK 4, 13000 FOSTER ROAD. * ANCHORAGE, AK 99516 COLLEEN STANHOPE Day phone C/O AGENT BARBARA BLOCK w/ PACIFIC RIM Day phone Day phone 762-5417 3000 C STREET * ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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. l 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 GARNESS ENGINEERING GROUP, Ltd. 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 & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwaterlevels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory 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. 337-6179 Date Z , O.G �X� H*( ....... ...... ev A. rness.: Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: VVP WP�ER W pROGFtPM ,�,a'• .... 'mac`,` until this office has given final approval This work shall be comnleted no later than Irene Attachmpts2006. COSA Checldist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other By: Original Certificate Date: IV IR_ •lms Municipality of Anchorage ' 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 EST. #2; LOT 7, BLOCK 4, Parcel ID: 0 / % " D 2 3 " 0 % I_1111111119 MI 11114 r7_A V_1 Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 9/4/1979 Sanitary seal (Y/N) YES Total depth 260 ft. Date of test Static water level Well production Cased to 247 ft. FROM WELL LOG 9/4/1979 194 ft. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml Arsenic: <5.0 ug./L. B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) YES Wires properly protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION 2/1/2006 194 ft. g.p.m. 2.5 — 9 -p.m -Nitrate 4.27 mg./L. Other bacteria 1.0 colonies/100 ml. 1/31/2006 Date of sample: 2/3/2006 Collected by: GEG Ltd. Tank Type/Material ANCHORAGE TANK / STEEL Date installed 12/2/2000 Tank size 1250+ gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES Date of pumping 2/3/2006 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA Date installed 12/2/2000 Soil rating .p.d./ r ft2/bdrm) 3_0 System type ISF Length 20 ft. Width 1$ ft. Gravel below pipe <% • 2 ft. Total depth 6.4 ft. Eff. absorption area 360 ft' Monitoring tube YES Depression over field NO Date of adequacy test 2/1/2006 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test *DRY in. Water added **509 gal. New depth *Dm" in. Elapsed Time: 182 min. Final fluid depth *DRY in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date – * THREE MONITERING TUBES WERE DRY THROUGHOUT ENTIRE TEST. ONE MONITERING TUBE HAD 6" OF LIQUID LEVEL PRIOR TO TEST AND DID NOT CHANGE THROUGHOUT TEST. ** SYSTEM PRESOAK WITH 1007 GALLONS ON 1/31/2006. D. LIFT STATION Date installed 12/2/2000 "Pump on" level at TIMERin. Datum BOTTOM OF TANK E. SEPARATION DISTANCES Size in gallons 1250+ Manhole/Access (Y/N) YES "Pump off" level atTIMERin. High water alarm level at 44 in. Cycles tested * Meets alarm & circuit requirements? YES SEPARATION DISTANCES FROM WELL ON LOT TO Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 10D'+ On adjacent lots 100'+ 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 10'+ Building foundation 10'+ Water main N/A P Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS * SYSTEM CHECKED BY A+ HOME SERVICES. SEE ATTACHED LETTER. n G. ENGINEER'S CERTIFICATION i certify that / have determined through field inspections and Q a :. - �a review of Municipal records that the above systems are in �. . . . . . ` .. conformance with MOA COSA guidelines in effect on this date. QO '•;' f rey . orness.r Engineer's Printed Name JEFFREY A. GARNESS 009 CE 79 276 �o3G Date 7-/1.f°6 ��nd Ornreesio°°��� COSA Fee S `t rJ C(� JNaiver Fee $ I Date of Payment 1,02-1 Date of Payment � %0(J Receipt Number Receipt Number C, Ll (Rev. 11105) ° 02/03/2006 14:44 IVost-it• Fax Not s 7671 # Wi 1 7625495 PACIFIC RIM PROPERTI l3 n b' t p 5.;1. r . 148915'x'06"W vO 1 8 EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. PAGE 01/01 3e+.a THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIPrCALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELINES. "ASBUBLT" No corners set Book pg LIGE I hereby cerlifr that I have surveyed the (allowing described property. Lot Block �k�ck rN; A,'N frlV k,' ESrgrPS b"2Anchorage recording district Alaska, and that the improvemenlS 0tualed thereon are within the property Imes and do not overlap or encroach on Ins property lying adjacent tharsta, that no improvements on property lying adjacent thereto encroach on tint pramises In question and that there are no roadways, transmission Imes or other visible easam ams on sold property except as Indicated hereon. Aaeholage, A:aaka 3 BCW 1 2.00 G -• • rR f49L ` # e,.jsae•eve or.e e.�u• ave••amaa•ya•••...eeaa =erg a`e•+ t P sr•. No. 13OR-S 4"- '0 110 �ROFFSS IONAI `pN+ � tiJP9`S6 06"'W /,&-.' i Dp• I V L" µi' A'r . •�y' rf/F'' r p�pttc 34,1 �, UW�eR V1,. Ap p 2-SrouY �c 0 I n b' t p 5.;1. r . 148915'x'06"W vO 1 8 EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON. PAGE 01/01 3e+.a THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIPrCALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELINES. "ASBUBLT" No corners set Book pg LIGE I hereby cerlifr that I have surveyed the (allowing described property. Lot Block �k�ck rN; A,'N frlV k,' ESrgrPS b"2Anchorage recording district Alaska, and that the improvemenlS 0tualed thereon are within the property Imes and do not overlap or encroach on Ins property lying adjacent tharsta, that no improvements on property lying adjacent thereto encroach on tint pramises In question and that there are no roadways, transmission Imes or other visible easam ams on sold property except as Indicated hereon. Aaeholage, A:aaka 3 BCW 1 2.00 G -• • rR f49L ` # e,.jsae•eve or.e e.�u• ave••amaa•ya•••...eeaa =erg a`e•+ t P sr•. No. 13OR-S 4"- '0 110 �ROFFSS IONAI `pN+ � Ems,- S 1 f -c— q�oC7 A 1� �V(C9� Municipality of Anchorage �J • � Department of Health and Human Services Division of Environmental Services' On -Site Services Section 825 "V' Street Room 502 P.O. Box 196650 Anchorage, AK -99519-6650 www.cl.anchorage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A`SINGLE -FAMILY DWELLING Parcel I.D. d( 4-' -6 23 - n �- HAA# D p D � Expiration Date: 1. GENERAL INFORMATION Complete legal 'description (-off Location (site address or directions) n n oo Foe 4/z Current Property owner(s) - 01911 (fay (Svn Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: _?)_ 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [ Individual On-site l�( Individual Water Storage ❑ Individual Holding Tank IEl Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer El The Municipality of Anchorage Department of Health and Human Services (DHHS) 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 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 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. 72-025 (Rev. 01/00)' 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 Health Authority Approval Guidelines for the Health Authority Approval application show 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 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 in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm M( *V( f t•/S.ai7 0. 4=-,_ Phone 34S-33 �;. L-4 O 5 h Address q G LOS Aal, r j( Engineer's Printed Name %e p Ems_ Date / /0 0 q�Q L � K 6. DHHS SIGNATURE �� rMICHAEL N. A D CE 9 I/ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other_ By: �A �• �a c�- Original Certificate Date: l - / 9 - 0 0 Expiration Date:_ 6(-) _ Reissue Date: 75-025 (Rev. 01100)' •Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On -Site Services Section 825'1" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST O(}, 023 Legal Description: Lvn�- rZ ��� mvu,6;` Ywk. G tv�e5 # L Parcel l.D.: A. WELL DATA Well type Date completed q1'6 If A, B, or C provide PWSID # Sanitary seal _�K_ Total depth 200 ft Cased to "2. (ev ft FROM WELL LOG Date of test 4/y Static water level Jkf 'i It Well production 3,0 g.p.m WATER SAMjPLE RESULTS: Coliform 0/ colonies/100 ml Nitrate Q' mg/I Date of sample: ( Z 00 a Collected by: M&4' B. SEPTIC/HOLDING TANK DATA ink Type/Material Date instalre Cleanouts oundation cif of pumping Well Log %S Wires properly protected Casing height (above ground) /8 in. AT INSPECTION 7/44/60 0 ft weI� dal. ?1rr Owner petper i-t-,a.p� Ovic�,notI a.et 2. $c�.o. g .p.m It/, q/l oa Other bacteria colonies/100 ml size gal Number of Compartments ression over tank High water alarm Pumper C. ABSORPTION FIELD DATA Date installed (?-/?0 o Soil rating ..d./ft r ft2/bdrm) 3.0 System type _'Gane(. Length ZO ft Width 11b ft Gravel below pipe 1 ft Total depth _�L —ft Effective absorption areal (go ft2 Monitoring tube Depression over field r.t' Date of adequacy test % Results (Pass/Fail) /- For 3 bedrooms Fluid depth in absorption field before test e-- in Water added � gal. New depth / in. Elapsed Time: min Final fluid depth l" in Absorption rate >=f p' Any rejuvenation treatment (past 12 mo.) (Y/N & type)—,--' If yes, give date 72-026 (Rev. 01/00) D. LIFT STATION • • Date installed 12 i no v Size in gallons 20 ao Manhole/Access "Pump on" level at 01'31 -7 1fL "Pump off" level at i 3, 2 fo High water alarm level at Na 2/its Datum 'P� p o%L; Cycles tested M 11Meets alarm & circuit requirements E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: /lift station on lot foo 1a - Absorption field on lot /an Public sewer main I`, 14 - Sewer /septic service line t n o r �. On adjacent lots /✓o { On adjacent lots r o I t= Public sewer manhole/cleanout N Holding tank n//2, SEPARATION DISTANCES FROM SEPTICLNGH"40 TANK ON LOT TO: Building foundation G40 rf Property line 1+0 (1( Absorption field /01 Water main NL, Water service line /Gv f f Surface water Drainage dVo` f Wells on adjacent lots loo SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /d 1 � Building foundation IIO "A Water main ��- Water Service line l o& 1v/ Surface water row r -f Driveway, parking/vehicle storage_!/00 Curtain drain N 14. Wells on adjacent lots too 14 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 HAA guidelines in effect /on this date. Engineer's Printed Name M<<G.aP�A�,�(n elsoq Date HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)' Waiver Fee $ Date of Payment Receipt Number y. • ••IW�YP.MY IY.f f(i. •� 1 A •• MICHAEL N. ANDERSON : O �•, CE- Ido 5. LEGAL DESCRIPTION STREET LOC;610N DATE RECEIVED *. INSPECTION APPOINTMENTS -- _ 'l TIME TIME CC<���. ; TIME CA �., ��: c�� lSJ �i�L,3e 11' m�sr� DATE C DATE (/��' _ --19 DATE (] I 1 - INSPECTQR ❑ COMMUNITY I �1.G INSP CTOR INSPECTOR Lj- v depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM L MUNICIPALITY OF ANCHORAGE YEAR ON-SITE SYSTEM WAS INSTALLED. MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION _ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 q . ,. 1979 N OV •� 1 ENVIRONMENTAL Teephone2644720NDIVISION RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten If 0) days for processing. 1. PROPERTY OWNER PHONE MAI LINGtADDR ESS PROPERTY RE (DENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOC;610N 6. TYPE OF RESIDENCE NUMBER OF,B EDROOMS LJ SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY C1 Three ❑ Six 7. WATER SUPPLY I2 INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY _ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE '0 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 -EIINDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER Septic Tank or ❑ Holding Tank Size: 1 C)C)C) If Tank is homemade give dimensions: SOILS RATING al� TYPE OF TANK MANUFACTURER yL2 2 TOTAL ABSORPTION AREA Co �2 CQ I MATERIAL'` dlsiuc_� 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line f 5. COMMENTS APPROVED FOR 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE q BY 72-010 (Rev. 6/79) DeA(moort �)d CIO up Pe moorl RcA 3/ I`�i�l. Turn Leff onto F6sk�r Rcl, POWn 00 Le F7