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HomeMy WebLinkAboutUS SURVEY 3042 LT 92C T10N R2E SEC 19SSS #3ova # 076- /390a - so MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program ,",cnI S�f' PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite DepaYtIllent On -Site Wastewater Disposal System Permit Permit Number: OSP241035 Effective Date: 3/18/2024 Work Type: SepticTank Upgrade Expiration Date: 3/18/2025 Tax Code Number: 07513250000 Site Legal Address: US SURVEY 3042 LT 92C T10N R2E SEC 19 G:5012 Site Mailing Address: 201 TREASURE BOX MINE RD, DUPL B, Girdwood Owner: DAY WILLIAM M IV Lot Size in Sq Ft: 35793 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: 5 -� TO C-1 f✓ Q Date: Issued By: Date: 3 z. y MUNMPA STY OF ANCHORAGE Development Services Department -' - P P Est. Phone. 907 343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 075-132-50 Property owner(s) WILLIAM DAY C/O ARM SEPTIC SERVICES Day phone 907-688-9433 Mailing address P.O. BOX 536, GIRDWOOD, AK 99587 Site address 201 TREASURE MINE ROAD, GIRDWOOD, AK 99587 Legal description (Sub'd., Block & Lot) U.S. SURVEY 3042, LOT 92C Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Septic Tank ❑X Upgrade ❑X (w/wo ADU) Holding Tank ❑ Renewal ElDuplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A 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- 22 5 Waiver Fees: Date of Payment: 3Z13 1 1 70 2 y Date of Payment: Receipt Number: Receipt Number: Permit No. 6�_DP2y1035 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241035, Curtis Townsend, 03/18/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241035, Curtis Townsend, 03/18/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241035, Curtis Townsend, 03/18/24 Municipality of Anchorage Page 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 19666650 • Anchorage, Alaska 99519-6650 * Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW980193 P10 Number. 075-132-50 N1Te1 Mike Everett House Wastewater S stem: - ❑ New Upgrade Y � Pg ABSORPTION FIELD P.O.Pox' 347 Girdwood. AK 99587 Pnane: No. of Bearoomc Three 3 n% Deep Trench C Snanow Trench C Bea C Mound Comer LEGAL DESCRIPTION soil Rating: • aal Ceotn from anginal grace: 6 GPOfso. s• 15' 0C9 2 C USS 81p" 3 0 4 2 Suoarvuion: cem m 0.00 oo"M tram orgmal grace ( Gavel asom ceneam Pico 10i!. Towmmo:I Range: I Section: Fa aaaaa acove anginal gnat I Gravel lengm: 40 0 s. s. WELL: Existing -.. Grav N."am: 3 NumOer of unic Ocana oereeen ire 1 s.l Cafadiaation (Pnvale. A.B.Ck I Total 0e0m: I Cassa To: TOW aosarotion vex: I Pia Malone. it. i4 Ans0 i• Driller. (Cateonllea: IStati:Walartrwc Installer. - Caamalanea: 6/25,26/98 Pt. Acreage Systems YIetc Puma Set ac ea+uw NeKnt AW"'creole: I TAN K GPM it. it. - SEPARATION DISTANCESESeptic 0Molding cs.T.E.P. 7a( Aesaito eeww rt in00 ItUtUflift `'a from T."W I A� I saneUlf I � lae- un. Anch. Tank - 1 Well I>100'1 >100'1 N/A I N/A I N/A Melenic NumOer of GmOartmer tc Steel Two Surface I>100'1 >100'I N/A I N/A I N/A LIFT STATION - N/AWater 1 Lot I >5' I >10, I N/A I N/A I N/A Size in gallons: (manufacturer. Line Foundation I>5' 1 >10' I NIA ( N/A I N/A -P"'"oon- levMac 'Puma otri"oiac 1Nignwater aarmac Curtain I None1 on Lott I I Pump Make &mocio I CKLncal Ina0eati0na performed or. Drain Remarks: Existing Septic Tank was BENCH MARK Crushed, Backfilled and Abandoned LOeationanacefenptiore Concrete Slab Northwest On Site. Existing Sewer Service Corner of House. Line Intercepted at Old Tank. Asf"med &"410011:100 F l �~p•.�yllll Inspections performed by: MEA Dates: is ✓ ^. ..:../ 2nd 6/26/98. ............. /'• IN1010( L AiJ�i80f! ' /111 40h Department of Health and Human Services approval �•Date:� • r reviewed and approved by: -'- e. w '.r. :3 Municipality of Anchorage Page 2 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744 On -Site Wastewater Disposal System or Well Inspection Report Permit Number SW980193 1,000 Septic v Three Home NOTE* Existing Septic Tank Ir Was Crushed, Backfilled and Buried On Site. Well PID No. 075-132-50 TRFg3 � propert` VR e0X MANE R O'40 S2 C2 C3TH 1 40' Long X 3' Wide X 10' Effective Depth � Absorption C MT PLAN AS -BUILT SCALE 1" = 20' C4 A B S1 17.7 36.7 S2 21.7 37.5 C1 22.9 37.0 . C4 45.4 26.0 MT 42.3 27.7 PLAN AS -BUILT SCALE 1" = 20' C4 To Hol Municipality bf Anchorage Page 3 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744 On -Site Wastewater Disposal System or Well Inspection Report Permit Number SW980193 v1 4 v) UU U E %4 PID No. 075-132-50 1/0 PROFILE AS -BUILT SCALE 1" = 10' �v®oaoe� e . t �..: N, p,y � ,�FIA0.EAt�ERS�P, � (ENGINEER'S SEAQ Municipality of Anchorage DEPARTMENT OF HEALTH 3 HUMAN SERVICES 825 •Lw Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: <� - I /,l�c� %td USE DATE PERFORMED: 03198 LEGAL DESCRIPTION:_ 1T 32 C , U55 '304Z— Township, Range, Section: _ OE►TM " O L. SLOPE - SITE PLAN 3 _ 4- 6- 7 6 7WITTJ. SADA E f:LLLL .. .. ,•: WAS GROUND WATER ENCOUNTERED? - r t «t Sf Jo"' /Joti•t; D, GfO�t .. N•t . Depth to.!,,. ,.• Nn Warr -r: Drop. IF YES, AT WHAT �':-L t�l�a�aa>.aa>•i�� DEPTH? .;:.. .. P :. /O —E Dep to Waw Attu �ilvii!•i!•� /Joti•t; D, GfO�t .. N•t . Depth to.!,,. ,.• Nn Warr -r: Drop. 4 t�l�a�aa>.aa>•i�� aiL Z: -/V' :. /O Z. • t .. �ilvii!•i!•� o tYz" 'z• tl'fI taS to « ILw - 17' 3: r 10 /e•7 '{} ' QOT1.OM O>_ 19 /Joti•t; D, Reading Date :..,. GfO�t .. N•t . Depth to.!,,. ,.• Nn Warr -r: Drop. t�l�a�aa>.aa>•i�� aiL Z: -/V' :. /O Z. • t .. �ilvii!•i!•� o tYz" 'z• tl'fI taS to « ILw L 3: r 10 /e•7 Reading Date :..,. GfO�t .. N•t . Depth to.!,,. ,.• Nn Warr -r: Drop. .. aiL Z: -/V' :. /O Z. • t .. ztss o tYz" 'z• tl'fI taS to « ILw L 3: r 10 /e•7 PERCOLATION RATE Z -O (nunutevoch) PERC HOLE DIAMETER '.T . ' TEST RUN BETWEEN 7 FT AND ' ... 8 FT ' -COMMENTS. ST %JfTy 71L�504V.at't) Ploo L. ,-D 7;-:5y— PERFORMED srPERFORMED CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE,WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE 72-008 (Rev. HES) . .paTc ° ALI Of Ax .s��� Municipality of Anchorage /l�' • �y' DEPARTMENT OF HEALTH 3 HUMAN SERVICES 825 -L7 Street. Anchorage. Alaska 99502-0650 Z ' �� SOILS LOG — PERCOLATION TEST �, *.";eocrw PERFORMED FOR: Mike HOUSe DATE PERFOR - ��`'•, "��' Section: Range, e. LEGALDESC� RIP710N: T^eo^ T172 -10479d9 Townsg -- •. ..•• erTc Of su 1 2 3- 5- 6• 7- 8• 9• 10• 11� 12 13 14 15 16 17 18 19 GM TESTHOLE NO. 2 WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEP H? De;m m Wsr Mr 1lontmnng7 0m Re"Inq I Dan I Gross Time Net Tum I DO= to I Water Net Droe ik I G LS BI /0:17 1 — I / Y-/" I — *z- I I D:47 1 SO 1 eIS 1 17 I 30 1 CA," I/ OIL tt1 I I /r 7 1 D 1 15 71AI " I I 1 I I I I I I I I 1 I I 1 I I I I I I I I I t I I 20 -{ 1 UPERCOLATION RATE ZO t�Utml^w.�I PEAC MOLE DIAMETER • TEST RUN BETWEEN & FT AND 7 FT COMMENTS TP4f- rttn to verify—Zm=irrntc tnc4• Trac* CaaZit-Y^rrp^naked prior to t.aef-. _ PERFORMED Sr. _ MFA I HAT THIS TPST WASS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS OAT E. DATE: 9 b ?2-CC8 IF 4rt91 Iq alq C GP `; &-25.98 v\.ct)yl PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE 4� T ccck M DEPARTMENT OF HEALTH AND HUMAN SERVICES co-aLo ri� P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW980193 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:HOUSE EVERETT MIKE OWNER ADDRESS:P.O. BOX 347 GIRDWOOD, ALASKA 99587 PARCEL ID:07513250 LEGAL DESCRIPTION: IIS SURVEY 3042 IT 92C LOT SIZE: 35793 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 6/22/98 EXPIRATION DATE: 6/22/99 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 MOST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS:' :AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL PERCOLATION TEST IN CONFORMANCE WITH THE EPA GUIDELINE MANUAL ATTA�CHED./) /l n RECEIVED BY: -n 4- DATE: G LZ -A A � DATE�7 G ISSIIED BY :' L ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522 - June 12, 1998 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 32C, USS 3042 (Girdwood) Septic System Design Impacts to Adjacent Properties Dear Onsite Services Engineer: The absorption trench on Lot 32C, USS 3042 has failed and must be replaced. We are therefore applying for a permit to construct a new septic system on the lot to serve the house. The existing system is in a state of total failure and the residents of the house are inconvenienced by the lack of septic facilities. We appreciate your prompt review of this application and issuance of the construction permit. The attached site plan and backup documentation identify the size and location of the new absorption trench to serve the home. It also shows the location of the existing well and the 100' protective radius. No wells on adjacent lots are within 200' of the new septic system. A testhole was placed on the lot by Acreage Systems to a depth of 19' which revealed silty gravel with a percolation rate of 20 minutes per inch. The results are similar to those obtained for the design of the original system in 1978. No groundwater was noted during excavation nor was any found during the monitoring period. We are therefore proposing to construct a deep trench system with 10' effective depth. Total length will be 40' with the distribution piping at 4' below the existing ground surface. A new 1,000 gallon septic tank will be placed outside the 100' protective radius. The surface of the lot is relatively flat with a slight slope from northwest to southeast. The drainage patterns will not be affected by the construction of the new septic system. Lot 32C, USS 3042 June 12, 1998 Page Two If the system is constructed as designed the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments TREASURE BOX MINE ROAD Shed Abandon Existing and Tank New 40' Long X 10' Effective DepthoTz Existing Well I w 1,0¢0 Gallon Senti¢ Tank 17 Utility Easement NOTE: No Wells Within 100' of 1 New Septic System Existing Septic Tank to be Pumped, Crushed & Backfilled. .� gP•�� Q � •�' C.?�^� Vit! SITE PLAN 10'j kTH ..... a SCALE 1" a 30'�• ... !wC.- • I' s, ; A1iCHAEL E. WD[noG?l ..+� �1�� '• 4381•E c a LOT 32C, USS 3042 DESIGN FACTORS: Three Bedroom Home Perc. Rate: 20 MinJlnch Application Rate: .6 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System 1,000 Septic Tank 10' Drainfield Rock 3 Bedrooms X 150 GPD / .5 GPD/SF = 750 SF of Absorption Area 750 SF/20 SF/ LF of Trench = 37.5 LF Trench Length Therefore: Construct a Deep Absorption Trench System With One Lateral 40' in Length with 10' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed at 4' Below the Original Ground Surface. BACiLML . 0 1- r Gear, -m" tc FASalc. j12AJ63FIG 4 IW CL,. OC TYPICAL DEEP TRENCH SECTION (NO SCALE) c?V • 4 TH -1 NOTE: Grade Area Over Trench to Drain Away. Minimum 3' of Cover over Septic System. ®'•.. .................. Minimum 4' Separation From Groundwater. �f �c ;AiICiiA:l E /s'G:RSGii ; it I�aaat ;X.5��1P� r Municipality of Anchorage :t, ryr DEPARTMENT OF HEALTH & HUMAN SERVICES { ; 4. {I 825 "L" Street -06 Anchorage, Alaska 9950250 ..........)) .�. � ..:. SOILS LOG — PERCOLATION TEST • UCHAEI.E.PIDERkS !;�?; PERFORMED FOR: /i� 'r bl%SE DATE PERFORPopDi"r• •T8a' LEGAL DESCRIPTION: ✓ -r 32C DEPTH O L t 2- 3- 44 34 - -- - I.1 1.9 FA 8 12' U'_l W,7-9 SAaD 3044_ SLOPE % Section: WAS GROUND WATER :L./..::• -=s%:.` y - _.-_ �a-'= - - • ENCOUNTERED? /V A yYsYµo iC /Jo. I 16 _ _ .,. .- Da. . Tuna T�'£t Daze 'Nat :Time ... .. iFYES.ATWHAT '. --"±-L _ ,.. ...::.. DEPTH?."::; ... .:.: .:._ _..p 17 t0 Z' L •• +� A yYsYµo iC /Jo. I 16 _ _ .,. .- Da. . Tuna T�'£t Daze 'Nat :Time ; Water I>mp = •: -' #1 2:35— aF1' 17 t0 Z' L •• +� Z SS tD vhr- 'L to 64 v+O S.• to a COMMENTS.' 'TEST to I .. 19. s: c- 410 LAEr ,1 �` //! Ki:1 �L�L SOLI a!®_®_u_mR_®®_®. _ _ .,. .- Da. . Tuna T�'£t Daze 'Nat :Time ; Water I>mp = •: -' #1 2:35— aF1' Z• •/5- t0 Z' L •• +� Z SS tD vhr- 'L to 64 v+O S.• to a COMMENTS.' 'TEST to I .. ®®®®®®®®®® s: c- to 4^ �` //! Ki:1 �L�L SOLI ,,-?...PERFORMED BY: 1 IFY THAT THJS/ TEST WAS PERFORMED IN -,• ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE ,:y 72-0DS fRev. U05 •)`�;:.r.. ..Rwd'.. • _ _ .,. .- Da. . Tuna T�'£t Daze 'Nat :Time ; Water I>mp = •: -' #1 2:35— aF1' Z• •/5- t0 Z' L •• +� Z SS tD vhr- 'L to 64 v+O S.• to a COMMENTS.' 'TEST to I .. s: c- to 4^ �` //! Ki:1 �L�L SOLI ,,-?...PERFORMED BY: 1 IFY THAT THJS/ TEST WAS PERFORMED IN -,• ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE ,:y 72-0DS fRev. U05 •)`�;:.r.. .. .";t. :i _ . _Y .20 1 - ..,.,.. . PERCOLATION RATE 2-O irtunutesiuvr) PERC HOLE DIAMETER 8 a TEST RUN BETWEEN ' 7 FT.ANS FT Gq Jfry Rz<spAuwm �EE :,7 NDD COMMENTS.' 'TEST Ort•- TD /7Sr �` //! Ki:1 �L�L SOLI ,,-?...PERFORMED BY: 1 IFY THAT THJS/ TEST WAS PERFORMED IN -,• ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE ,:y 72-0DS fRev. U05 •)`�;:.r.. .. .";t. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 32C, USS 3042 GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,000 gallon septic tank. It also includes the construction of a new 40' long by 3' wide by 10' effective depth absorption trench at the location shown on the site plan. Fill will be required over the trench to provide a minimum of 3' of cover. The existing septic system must be abandoned in place. The tank must be pumped, crushed and backfilled. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,000 gallon septic tank must be procured from an approved source and installed at the location shown. The existing tank must be pumped, crushed and backfilled. V Lot 32C, USS 3042 June 12, 1998 Page Two 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. . 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Lot 32C, USS 3042 June 12, 1998 Page Three 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Lot 32C, USS 3042 June 12, 1998 Page Four 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. �\ MUNICIPALITY OF ANCHORAGE a`re� DEPARTMENT OF HEALTH & ENVIRONMFNTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION IJP L Street - Anchorage, Alaska 99501 Telephone 264-4720 �I825 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE XNEW V ❑UPGRADE • MAILING ADDRESS Df{Z Dd Alas LEGAL DESCRIPTION 5�41i2 t154Sac roo —Rwe—SEsl9 LOCATION NO.OF BEDROOMS .Tawe /1�rnG f'd 1 Well Absorption area Dwelling PEHMIT NO. uDISTANCE TO: OOr Y a2 WI- Manufacturer /QEE� U Material No. ofcompartments 0 Liq. Capacity in gallons IF HOMEMADE: inside length Width Liquid depth d O Z _ DISTANCE TO: Wen Dwelling PERMIT NO. _ _ Manufacturer Material Liquid capacity in gallons D DISTANCE TO: Well f I03 Fo edation DpS Nearest lot line I•f1� PERMIT NO. Lux No. of lines Length of each line Total leng n oto fines M Z Trench width Distance be1v,*� lines r./ F z W / .?•S final.+ WH Top of tile to finish gr de Material beneath tile r Total effective absorption area 0 Al 6.1'es 372 ix Length Witlth Depth PEHM11 NO. W u i 1- Type of crib Crib diameter Crib depth Total effective absorption area W rn Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to let line PERMIT NO. J J W Building foundation Sewer line Septic tank Absorption areals) DISTANCE TO: OTHER PIPE MATERIALS CASt XE-60 AL, SOIL TEST RATING 3b8 at ��' INSTALLER —Cork �CordRA6-:li-j_Ex.85-P_%, REMARKS e 1ud.:��sc>"o-Q>wlnuw.a�crlp�S+��4:GDiciEci `t w uE62—a�ns�c1�. r k. .z 1— Mr r 1 LEGAL Lb* Ne'IC `&SC 3"'X APPROVED DATE LEGAL Ila I °`fie I0.1 6 72-013 (Rev. 3178) J Mu"Ic-Ir=nl_I_FY ED 1- (a"C1-lc:r,EaG!_ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 025 L STREET, ANCHORAGE, AK 99501 2264-4720 (r7 C3PA—S I TI-- �IC4.) 1-i 1 T PERMIT NO: 050250 DATE ISSUED: 05/31/85 ArPLICANT: MIKE HOUSE ADDRESS: FOX 347 3.5 GIRDWOOD, AK: 99587 . LEGAL DESCRIP: SUBDIVISION: USS 304 LOT: 9-'C BLOCK: NA GRAVEL WIDTH (f7T.) SECTION: 19 TOWNSHIP: ION RANGE: 2z LOT SIZE: .75A (60 -FT. OR ACRES) LOT LOCATION: GIRDWOOD SMALL TRACTS MAX BEDROOMS: 1 Lioted below are the options available to.you in designing your s'2rltic system. Choose .the option that bolt fits your site. * TANI : ML15T HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. I am familiar with tha req_ciremcntc; for on-site oewar -,nd wells: acs set forth by the M;.cnieipal.ity of Anchorage (MOA) and th^ Stzte of Alcsr,r- . �. I will install the system in acccrda.nce with all MOA codex and rCgu.lations, and in compliance with the deign criteria of this p-rmit. I will adhere to all MOA and State of Alaska require^cents far the pct bac!: distances from any cxisting well, wastewater disposal oyntem or public sewerage system oh this or any adjacent or nearby lot. 4. I understand that this permit is valid for e, maximum. of 1 bedrooms: and any enlargement will regUire an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE 03T4INED; (') AS-DUILTS WILL NOT BE ArrROVED WITHOUT AN ELECTRICAL INSPECTION RETORT; AND (3) THE ELECTRICAL WORRK. MUST /BE�DCh,E E:Y A LICENSED ELECTRICIAN. -.C-_�nfx�K, d.' `"---- DATE: SIGNED ArFLICANT: MIKE HOUSE ISSUED FY - wd DATE: 3�/ - r-! c r.l C 1-1 t J_ IDS 1-1 n- Di_rTH TO PIPE BOTTOM (FT.) 4.0 4.0 GRAVEL DEPTH (FT.) 6.0 3.5 TOTAL DEPTH (FT. ) lii•0 . 7.5 GRAVEL WIDTH (f7T.) C GAVEL LENGTH (FT.) 31.0 40.0 GAVEL VOLUME (CU. YDS. 18.7 29.7 TAN!" SIZE (GALS) 1,000'.0 * r 1,000.0 SOIL RATING (SGI.FT./BR) 360 368 * TANI : ML15T HAVE AT LEAST TWO COMPARTMENTS I certify that: 1. I am familiar with tha req_ciremcntc; for on-site oewar -,nd wells: acs set forth by the M;.cnieipal.ity of Anchorage (MOA) and th^ Stzte of Alcsr,r- . �. I will install the system in acccrda.nce with all MOA codex and rCgu.lations, and in compliance with the deign criteria of this p-rmit. I will adhere to all MOA and State of Alaska require^cents far the pct bac!: distances from any cxisting well, wastewater disposal oyntem or public sewerage system oh this or any adjacent or nearby lot. 4. I understand that this permit is valid for e, maximum. of 1 bedrooms: and any enlargement will regUire an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE 03T4INED; (') AS-DUILTS WILL NOT BE ArrROVED WITHOUT AN ELECTRICAL INSPECTION RETORT; AND (3) THE ELECTRICAL WORRK. MUST /BE�DCh,E E:Y A LICENSED ELECTRICIAN. -.C-_�nfx�K, d.' `"---- DATE: SIGNED ArFLICANT: MIKE HOUSE ISSUED FY - wd DATE: 3�/ - SOILS LOG C' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION si TEST Pouch &650, Anchorage, Alaska 99602 276-2221 SOILS LOG - PERCOLATION TEST A, I 7� o��, ,ez� Soils log 25/7/78 PERFORMED FOR: Nike Houses BOX 347, Girdwood Alaska D&MIFORMEO: Perc test 30/7/78 LEGAL DESCRIPTION: LUb 7f.V,JUVLL1Vrolpi, vi DEPTH Small tracts group (FEET) SOILS LOG 1 0-1 ft; Pt, neat 2 3 -I 1 4 5 6 1-11I Sandy silty gravelsGEl 71 tan-2,re s tight formation 8 9 10 12 13 11 1 Dott is 1s 17 18 11 eo ots 92&-64,' SLOPE SITE PLAN WASGROUND WATER no S E 4eedMFEREBt O P F IF YES, AT WHAT Sandy gravel,(P_PPTH7 GP, some silt of hole 14ft dry l' A y 2 Reading Date Gross Time Net Time Depth t Waterrst Net Drop 1 30/7/7 2:10 10min le— y �f, 0.0375 " It 9. O ;Rn R7q 0 095" 3 of 2:30 o- 90.125 0.03125" b 5 It it -T-1 0.0375 " . t. , " 3:10 10min 91.312 0.025 " 91.75 " 3:3010 in 0.025" - r -1 WASGROUND WATER no S E 4eedMFEREBt O P F IF YES, AT WHAT Sandy gravel,(P_PPTH7 GP, some silt of hole 14ft dry l' A y 2 Reading Date Gross Time Net Time Depth t Waterrst Net Drop 1 30/7/7 2:10 10min 89.5" 0.0375 " It 9. O ;Rn R7q 0 095" 3 of 2:30 10min 90.125 0.03125" t,031:25", 5 It 2:50 10min 90.75 0.0375 " t. , " 3:10 10min 91.312 0.025 " 91.75 " 3:3010 in 0.025" min min min min min min min min min min /ELATION RATE 3:50 10IIjrP 0.025 "/m1.n 11!7 1 TEST RUN BETWEEN FT AND FT I for pert n test. Use 300 ft` per bedroom for conservative value. Ptwe be4reeR PERFORMED BY:�u"e nee 50 ft trench CERTIFIEDBY: Bruss & Assoc. DATE: JOJ ? {{IAI A" , .F os oaa, nchoruge 1 279-5033 q 72 008 (7/76) /^^_ / / 9 Municipality of Anchorage r^ 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION M December 31, 1980 i Mike House Post Office Box 347 Girdwood, Alaska 99587 Permit # 800324 Subject: U.S. Survey #3042 Lot 92C A permit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental cialist. LNB/ljw enc: Copy of Permit SWP/057 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 TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER. LINE 15 75 FEET. 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. F'EFRM I T EXP I REE [7ECEMGEFt 31 . 1�csi n- 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: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED: ---------------------- APPLICANT MIKE HOUSE ISSUED BY------------------------------DATE_Z_` �=_ n --- V4.0 M�Jt�7 I iC I PFIL I TY OF= ANN: H"a12nGE DEPARTMENT e" HEALTH AND. ENVIP.ONMENTAL/'^OTECTION 825 STREET, ANCHORAGE, AK. 9%l -d1 ..• 264-4720 44ELL F=E: FZ rl I T PERMIT NO. ! 800324 ) APPLICANT MIKE HOUSE PO BOX 347 GIRDWOOD 99587 243-2326 W LOCATION GIRDWOOD _ ._,_.._,_ 3042 LOT 92C LOT SIZE 10000 SQUARE FEET LEGAL I:USS# 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 TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER. LINE 15 75 FEET. 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. F'EFRM I T EXP I REE [7ECEMGEFt 31 . 1�csi n- 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: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED: ---------------------- APPLICANT MIKE HOUSE ISSUED BY------------------------------DATE_Z_` �=_ n --- V4.0 f•11 1 t•J i o I F=• 1=1 L- I -r 'T - O F= F," 1-:: H ' F=:"13 t DEPARTMENT OF HEALTH. AND'EUVIRONMENTAL PROTECTION 825 ^�, 4TPEET. ANCHOPAGE, AK. 99"L 20'4-4720 W E L_ L_ FI P -1 PERMIT 140. ( > -Z L4 .3,�-G APPLICANT JIllk-e pottse- - CO tgd-Y- 347 �71FrD Wow LOCATION LEGAL 3o" Z LL LOT SIZE 4006t, SQUARE FEET !- o Z S S TYPE OF SOIL ABSORPTION SYSTEM IS: MAXIMUM NUMBER OF BEDROOMS = SOIL RATING <SO FT/BR)= 36a THE REQUIRED SIZE OF THE SOIL FBSORPTION SYSTEM IS: C,EPTH= L_EPJGTH= 0FR_ Rtir'EL_ CryEPTH= THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DF.AINFIELD. THE DEPTH OF A TRENCH OR PIT IS 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 <IN FEET). RE.0 I AEC? S E =• r I C TRt JK I E_ PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE LNSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. -- TWO < "a' > I NSF=*er'T I Ot45 RRE F= E:QU I REL, --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY OH -SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER. LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETUPNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER. P.EQUIP.EMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS APE AVAILABLE TO INSURE PROPER, INSTALLATION. BERM I T EXP I REc C+ECEMBER 3:I._ yc,e►D I CERTIFY THAT is I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS 814D WELLS AS SET FORTH BY THE MUNICIPALITY OF RNCHORRGE. 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 3 BEDROOMS. SI GtJEG1/l�lLL�� ------ ------------ APPLICANTT ISSUED By _. '.` -----------DATE_- -d-- V4.0 C � r+ d m h a oo V io D O h I q N m n .N§ .m.�. ! ! 0 I OtOYO2at 0. C s�y � r r tio V� Cd W4 H 2� 00 V 4w as I q N m n .N§ .m.�. ! ! 0 I • - rMUNICIPALITY OF ANCHORAGE (0�1 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 11 t%1,"t 1 yjPG 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) us u�veo z to Y- Y 2 C Location (address or directions) (b) Applicant NarOr P !t' /« %7Tele hone: Home Z/ y 3Business Applicar)t:Address/ rpA 3y-�L G:�r(�**••f �I� el4S—k � (c) Applicant ii (check one):.Lending Institution ❑ ; Owner/builde ; Buyer 13; Other ❑ (explain); (dk Lending Institution Telephone t Address (e) 4�eal'Eslate Company and Agent Address • 7 " ' •+ ^ r „y At Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-Famww Multi -Family ❑ Other Number of Pedrooms 3. WATER SUPPLY Individual Wee Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72.025 (11,84) Page 1 of 2 t 5. ENGINEERING FIRM PROVIDINv INSPECTIONS, TESTS, FILE SEARCH, DAIA AND INFORMATION 6. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm x r -C S ("c Telephone S 6 L s -o YO Address /20c> GJeo9 33 �d f�K �rl�o,afr /`J� `7Yta3 Date / r J,'".° /f fi. G Ar con�r (i'crlu is rnr"f�'a�F� on �wvt ct(f �ee•2 re�rso.Y� HSR h',tAP _�,o ,..� �p. • ;s�-, J►"�r meer' Y AfR Y G REID, JR $r if tE-2251 AF I •1._ >,ItlRa�.� DHEP APPROVA Approved for bedrooms by Approved Disapprov d Conditional Terms of Conditional Approval nm CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an Independent prolessional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsibly for erors or omissions in the professional engineer's work. Page 2 of 2 72-025((144) �1I MUNICIPALITY OF ANCHORAGE J DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROT�CjlArt.tl Y OF ANCHORAGE: DIVISION OF ENVIRONMENTAL HEALTH tEPT. OF HEP -LTH & t - AL FkOTECTIONPIT CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY AfR'W6W OF ON-SITE SEWER AND WATER FACILITY otU L (1 1985 2644720 Application DateZ- T. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Cirrdo� (b) Applicant Name �%j Telephone: Home�y�y�l� / _ Business dr�ZO�T� Applicant Address ///pe Sag�'� (c) Applicant is (check one): Lending Institution ❑ ; Owner/build erSd; Buyer ❑ ; Other [I(explain); /l t d).1 LtnQng Inhtutib'n L i Address ` (a).:P a ent Address• • Telephonif (t} , MaiF the ;AA` o the following address: 2. TYPE OF RESIDENCE Single -Family g Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Telephone Individual Well k Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsi4 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025111,641 Page 1 of 2 5. ENGINEERING FIRM PROVIDING, 1OSPECTIONS, TESTS, FILE SEARCH, DA's" AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. c- 6701-5a S/O Name of Firm �-� ��-`�= Telephone Address Date 71i. v� Wzria ,r»%.c�s�I`!� ayw,�l e,z cfa,.c�c7� 7/0 Ile- _z !c_-eoeo0eez.-e_ Approved Disapproved Conditional Terms of Conditional Approval 6. DHEP APPROVAL Approved fore bedrooms by E A CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Pago 2 of 2 72-025 (11/84) i, w ALASKA CfI ROfI nTAL COnTROL SMICCS, IX Engineering 6 Enuironmental Studits MIKE HOUSE P 0 BOX 347 GIRDWOOD ALASKA 99587 50827 12/20/85 SELLER—MIKE HOUSE MIKE HOUSE P 0 BOX 347 GIRDWOOD ALASKA 99587 LEGAL:USS SURVEY 3042 TION R2E SEC19 LOT 92C FLOW TEST ON WELL WELL FLOW DATE -12/18/85 A FLOW TEST WAS PERFORMED ON THE WELL. 585 GALLONS OF WATER WAS PUMPED AT A RATE OF 4.9 GPM OVER A DURATION OF 2 HOURS. THE DRAWDOWN WAS 6 ' WITH A RECOVERY TINE OF 10 MINUTES AND THE STATIC WATER LEVEL WAS 29 FEET. THE WELL IS ADEQUATE FOR THIS 1 BEDROOM HOME. 1200 West 33rd Autnut, Suitt 6 • Anchorage, Alaska 99503 • (907) 5615040 �1 n MUNICIPALITY OF ANCHORAGE (L"CipAUTy OF ANCHORAGE HEALTH AUTHORITY APPROVAL (HAA) DEPT. OF HEALTH & FNyIROrydENTAL PROTECTION CHECKLIST -FEBRUARY 1984 2844720 ' C,, 10 �e Legal Description: 55 ✓c54t/ Q[f Gni zL A. WELL DATA Well Classification YQ I VATa< — If A. B. C, D.E.C. Approved (Y/N) 441— �`L- Well Log Present ) Date Completed ' Yield S122in!_ UUP r ,` Total Depth �� Cased to �� Depth of Grouting n/14= Static Water Level fig. Pump Set At A'_#L'dP -7� i Casing Height Above Ground / Sanitary Seal on CasingION) 1W Electrical Wiring in Conduit (Yo Depression Around Wellhead (Y19 Separation Distances from Well: �f1Ot� / w6— Or To Septic/Holding Tank on Lot X03 'F : On Adjoining Lots j* To Nearest Edge of Absorption Field on Lot On Adjoining Lots f / OD To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole �� To Nearest Sewer Service Line L Water Sample Collected by : Date It Water Sample Test Results �p���,,�� Comments a'0�.{�� /Z r5__ B. SEPTIC/HOLDING TANK DATA - Date Installed Size /9f719 No. of Compartments Cleanout( N Slandpipes�N) , IY Air -tight Cap &) Foundation Clea� ) Depression over Tank (Y© Date Last Pumped fi Pumping/Maintenance Contract on File (Y/N) 41J*t—�/ ; for Holding Tank High -Water Alarm (Y/N) emporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well �D3 / To Building Foundation �y i To; Prop erty.Lineday To Disposal Field .To Water Me in/Sewice Line ��� To Stream, Pond. Lake, or Major Drainage ` Course '...- Comments .. �111/A�{Ir1LIMlnt 9 r_1'Q� s. � Page 1 of? 72-026(1 LB4) Uss 30Ya- to��tac C. ABSORPTION FIELD DATA Soils Rating in Absorption Str to g Type of System Design T�'F.tJCT� Date Installed e2- Length of Field — 3/ 41' Width of Field L� S Depth of Field INE Gravel Bed Thickness �► Square Feet of Absorption Area Standpipes m Present©1 N) Depression over Field (Y/N) Date of Last Adequacy Test ✓y�/1 Results of Last Adequacy Test ��i9 itJtrlJ Separation Distance from Absorption Field: To Water -Supply Well � /D To Property Line I$- 2O To Building Foundation �� To Existing or Abandoned System on Lot .��A ;On Adjoining Lots y _Z10 / vt- To Water Main/Service Line To Cutbank (i1 present) To Stream/Pond/Lake/or Major Drainage Course 7"/00 ,:e .1>? To Driveway, Parking Area, or Vehicle StorageArea Comments at 1111! � G�+over%ris,�ase. •.� eTrr si+ss+ci � © �i.a/h A: /.;..dam,, D. LIFT STATION Date Installed Dimensions Size in Gallons / KA. ,hM- ,,,,, "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Check Permitted Bedroom Rating Against HAA Request " Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that 1 ha gchecked, y tied, or conformed to all M A and AA guidelines in effect on the date of this inspection. Signed Date�— Company MOA No. Receipt N D Date of Payment 12- -O Amount: $ �S Qa Page 2 of 2 cep-te��s;.s 7� {/%a�+.� ���e.�s.».✓/ © l!% Gr to >� ���^ 60W Aek 72-026111,84- /' .611es,E✓70+�'„`,7 �"'.,r� Litt m-�-� PDQ [lp�.�'ri` k.ox' 7897 Municipality of Anchorage 4 ' ,c \ `%) 5. •t � On-Site Water and Wastewater Program ;_��'fl � (907) 343-7904cu 1U18 Certificate of On-Site Systems Approval s 8 L g c, Parcel I.D. 075-132-50 Expiration Date: O 7 1. GENERAL INFORMATION Complete legal description US Survey 3042 Lot 92C, T10N R2E Sec 19 Location (site address) 201 Treasure Box Mine Road Current Property owner(s) Michael Everett House Day phone Mailing address PO Box 347 Girdwood,AK 99587 Real Estate Agent Day phone 2. TYPE OF DWELLING: E 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 Q Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received b . _i(__& A. (kit 4 �� Date: COSA to be released to the engineer,unless, se requested .1 e engineer. COSA Fee $ 5J?-c — Waiver Fee $ Date of Payment L1-2-6--le) Date of Payment Receipt Number_ Off' 1 Receipt Number COSA# oScAEcll 5-1 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at the time of installation. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 4/19/2018 7 o j•k: 49TM /\ '.*fr 6. DSD SIGNATURE "' '''• e=1 System#1 Approved for bedrooms R. Pannone Y pp System#2 Approved for bedrooms4 1�� 9• CE-8149 Disapproved �<<U'PROFESS\V ?" Conditional approval for bedrooms, with the following stipulations: J - S i s - - I S Z D A,'PAYS 6 1.-3 . ik v2 .� G sem) Sic 4-,A.,.v ; Zoo/ .vs o(4 ��\�. of A yoI I Q S\1E © 0 \N PEER P R o �F -o WI\�GRPM v' QR c By: Original Certif cavil afg:: -- r iC 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other cOSA blue sheet '- c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: US Survey 3042 Lot 92C, TION R2E Sec 19 Parcel ID: 075-132-50 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 8/4/1980 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 192 ft. Cased to 192 ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 8/4/1980 3/13/2018 Static water level 27 ft. 29.1 ft. Well production 50 g.p.m. 2.2 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic 6.39 ug/L Date of sample: 4/10/18 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 6/25/1998 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A Date of pumping 3/26/2018 Pumper Isaac's Pumping Service _ C. ABSORPTION FIELD DATA Date installed 6/25/1998 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.6 GPD/SF System type Deep Trench Length 40 ft. Width 3 ft. Gravel below pipe 10 ft. Total depth 15 ft. Eff. absorption area 800 ft2 Monitoring tube Y Depression over field N Date of adequacy test 3/13/2018Results(Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 3 in. Water added 450 gal. New depth 8 in. Elapsed Time: 90 min. Final fluid depth 3 in. Absorption rate >= 450+ g.p.d. N Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on"level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ 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 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION ,�+���"\\� I certify that / have determined through field inspections and j p'c. `4, • 19�r' review of Municipal records that the above systems are in F*: 1. i' •.* 4 conformance with MOA COSA guidelines in effect on this date. •••••• 17 •• • •••• Engineer's Printed Name Steven Pannone •tle%%eri .•06nriorie:••e 41 Date 4/19/2018 'fit..• CE-8149 •• '� COSA canary sheet_2-6-15.doc . - . . - • . / . • . , / Ppea; 6111Pe p ' onaeke'l0.1- iti. N : , Opou 11?0 IL)0• S 1 00, 99.liyl, I 98.3• IV cl(/ ..T.,..!9, ..k.v .. .,.. .-.• . . Rittiti) // ••• N• NV"'°'— • <//7 / ---- " ‘,... 4.... ,,,..--( ON! / . (S Chainlink-- /. .0 • ,,... "-NI(F.::.ce N .• 0) CO .0 CY :1 V.' .\- \ . IN, Driveway/Parking ..2. '5c..oipts..1' ," , \ • \ , , \ lip. .‘b -4). S. ,s• `.rl i I 2-Story --)- 6 ' • \---- .0-... House Lot 92C ..' /.\\\ 1 .• k.t,,i,, , 2Ød Sto Deck • - 'e". • „s) /1 .... . / ,44 i,........„671 ......... 15.6' s.0 tic, kOstej,-...„ Zalin I / V 470 0. (0 I ij Elec. ' / • --....„ ---.._ / 4, /.......... / \ . \ .6 .Si b0^ , n, i i 98.3, "-----.. ••••••,, •-...... / / .. I . . / . ... ...-. .., ...' --... ..-., i I `--.. .....,......,..... ...../._._„...„.....„ 0 I i 1 CJ( 41). 4.I).... ,.. ......,..........„ \ f I ' .:.' 1.1 , ,................/ NOTES 1. Burial/5 and distances are record per referenced plat unless Otherwise noted. 2. Sufficient boundary evidence was recovered to establish the subject parcel on the ground.Nor all controlling evdence is shown hereon I,KGEND —:---oF At Nkk ,c farpoint Land Services, LLC --"'"-c .• -Is ki t; SURVEYING. MAPPING. LAND PLANNING. GIS 0 fteco‘ered Ret,sr ......TrA.,‘,..:. .... t. • ...,_co.•; .7 fa u .e.:re.,.-.rent *.•49TH %itv 1131 E. 76th Ave..5uste 101 Anchorage.Alaska 99516,7 /Wk ,-,. ParpointAlccom•(907)522-7770•surveyefarpointak.com 1/1 •(--47 • 14 .,... ASBUILT SURVEY OF: SURVEY CERTIFICATION:FARPOIN1 has conducted a physical ..****** " •• •• :••,/ Lot 92C,US Survey No.3042, survey of the subject property,die improvements situated Girdwood,Alaska thereon are within the property Imes as shown. 4 64.4.' l.S4(1fV(3S' EXCLUSION NOTES:It is the owners responsibility to deter mire PREPARED MR t..46-... ***.•1;4 ...., the existence of any easements,covenants,or restriction;which „e 23,2018 f„ ,,; Ik‘:.&iiSIOWATIA," WORK ORDER No DM SCAtE, 20RING: do not appear on the Plat used for this survey.NOTE:114,1e,no po is„ii-0217 ,,, , "L'ILVOZZ.-- APil GR2 circumstances should any data hereon to.i.ded for co:struct:.•in • i ,• c, 18029 CRA 'WM CREcKED:GRID No: f1160(Xt/PAGE: for - Al'-',5•. or Tthe establishing of property lines. JD ME SE 5012 142/56