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Home My WebLink AboutRABBIT CREEK VIEW & HEIGHTS BLK 2H LT 14ARabbit Creek View Heights Block 2H Lot 14A #020-551-13 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: OSP241393 Work Type: Septic Upgrade Effective Date: Expiration Date: Tax Code Number: 02055113000 Site Legal Address: RABBIT CREEK VIEW & HEIGHTS BLK 2H LT 14A G:3340 Site Mailing Address: 8021 MARINO DR, Anchorage Owner: VAN DER VEN ILONA 50% & Design Engineer: FORGE ENGINEERING This permit is for the construction of: Q Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy 5/12/2025 5/12/2026 Lot Size in Sq Ft: 20954 Total Bedrooms: 4 ❑ 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: Issued By: rr Date: r Date: �> 2 _ 2 ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 020-551-13 Property owner(s) David Fredenberg & Ilona Van Der Ven Day phone Mailing address 8021 Marino Drive, Anchorage, AK 99516 Site address 8021 Marino Drive, Anchorage, AK 99516 Legal description Rabbit Creek View & Heights Block 2H Lot 14A Number of Bedrooms 4 Engineering Firm Forge Engineering Building Permit Number Not Applicable OR APPLICATION IS FOR: APPLICATION IS AN: 0 all that apply) Absorption Field M Initial El Septic Tank I -XI Upgrade M Holding Tank El Renewal ❑ Privy ❑ Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees: Date of Payment: 2 20 2- Permit No. 2 3 9 Waiver Fees: Date of Payment: Waiver No. Distance: December 2, 2024 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Rabbit Creek V&H Block 2H Lot 14A – 8021 Marino Dr Septic system design Dear On-Site Services Engineer: The owner of the above lot wants to replace his existing older septic system and prepare for future home expansion. This permit is for a new Biobarrier advanced treatment septic system. The attached site plan identifies the location of the home, well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The test hole that we dug showed some organic overburden, then a few feet of silty gravelly material that seemed like it may have been placed as fill at some point. Under that was a layer of clayey gravel that did not perk, although part of that seemed to be due to the high groundwater levels. We are designing this as a pressurized advanced treatment system to take advantage of reduced separation to impermeable layers as well as groundwater. The ground surface on the lot slopes mildly toward the back of the lot. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Contours are shown on the site plan showing the grade and direction of flow. Stormwater 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 a minimum of 50’ from all wells and surface water and more than 5’ away from the septic tank. The alternate site is located more than 6’ away. Please refer to the attached test hole log, plan and section pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241393, Curtis Townsend, 05/12/25 X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 1"=30' 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 RABBIT CREEK V&H BLOCK 2H LOT 14A FEET 0 30 60 SEPTIC PLAN 12/2/24 10' UTILITY EASEMENT 5' U T IL I T Y E A S E M E N T GARAGE EXISTING WELL W/ 50' RADIUS GRAVEL DRIVEWAY TH#1 EXISTING 2000-GAL STEEL HOLDING TANK TO BE DECOMMISSIONED HOME NEIGHBORING WELL W/ 50' RADIUS NEIGHBORING WELL W/ 50' RADIUS 1205 1200 1195 1190 1185 SINGLE-COMPARTMENT INFILTRATOR 1M-1060 TREATMENT TANK w/ LIFT STATION MT MT VERIFY FCO INTEGRITY 25' LONG x 5' WIDE, 6" EFFECTIVE DEPTH ABSORPTION TRENCH w/ EXTENT OF MOUND >5' SINGLE-COMPARTMENT INFILTRATOR IM-1060 SETTLING TANK w/ TWO 20" MANWAYS ALTERNATE SITE w/ EXTENT OF MOUND APPROXIMATE LOCATION OF 1983 SEPTIC TRENCH w/ 5' EFFECTIVE DEPTH 13' Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241393, Curtis Townsend, 05/12/25 RABBIT CREEK V&H BLOCK 2H LOT 14A TYPICAL TRENCH SECTION (NO SCALE) 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 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 12/2/24 DRAINFIELD ROCK5' 6" 1' DESIGN FACTORS:SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 6.8 MIN/IN (USE 31-60 TO BE CONSERVATIVE) APPLICATION RATE: 5 GPD/SF 5' WIDE TRENCH SYSTEM BIOBARRIER SYSTEM IM-1060 SETTLING TANK AND IM-1060 TREATMENT TANK W/ LIFT STATION BOTTOM OF TRENCH: AT GRADE FLOW LINE ELEVATION: 6" ABOVE GRADE TOP OF TRENCH: 3' ABOVE GRADE 600 GPD / 5 GPD/SF / 5' WIDE * 1.0 RED FACTOR [0.5' DEEP] = 24 LF TRENCH REQUIRED (25 LF SPECIFIED) GEOTEXTILE FABRIC AND 2" INSULATION 2' MOA APPROVED SAND 6" 1.25" PVC w/ 5 - 1 8" ORIFICES EVENLY SPACED @ 5' o.c. 3:1 SIDE SLOPES w/ TOPSOIL AND SEEDING PROVIDE ADDITIONAL 6" COVER TO ALLOW FOR SETTLEMENT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241393, Curtis Townsend, 05/12/25 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 6.8 10/23 1 2 3 *CL (LEAN CLAY W/ GRAVEL) Professional Engineers Stamp: YES Rabbit Creek V&H Block 2H LOT 14A 10/23/24 020-551-13 Dave Fredenberg 12:11 1 0 16 12:41 1:13 SILTY GRAVEL w/ SOME ORGANICS AND ROCKS 30 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: J. Opheim 6 14 16 3' 4.5' 10/30/24 COMMENTS: SITE PLAN 5 14 16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 11/7/24 1 0 1630 5 8 16 4 8 16 1 0 1630 5 7 16 4 7 16 *CLAY LAYER @ 4' TESTED AS IMPERMEABLE O/B Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241393, Curtis Townsend, 05/12/25 iIMU'NICIPAIATI OF _ANCHORAGE ADVANCED `A'A.STEWATER TREATNIENT S'4'4TEN'I 1\1AINTEINANCE A\D I EI'AII2 :IC;RI;I;1tII=,1\T THIS M AIN'FFNANC'l. AND 1�I:('A1R rACi(�l::I 1(I �`), herein the ":AGRE.E,itlE NT" made and enterer( into as of this , Dav of trU c _ <? I" Zt) 25. by and between herein tiieand the A(unicipa(it\' 0t' Anchorage.. herein the in accordance x ith :lnchoraoc Municipal C'ilde (AMC') 15.65. 65. In consideration of the mutual covenants contained herein. the pal'ties to this A reement a`(t'ee as 1611ows: 1. Advanced Wastewater Tmatment St'stellls. The N'ILill lClplllta1\l)i1SS1o1 to the Owner to utilize and operatc an Advanced AVast.e\\ater I reatnicnt System (AW AN, "I S ). described as BIOBARRIER located at (le4gal description) Rabbit Creek View & Heights, Block 2, Lot 14A ?. Maintenance, Repairs and Alterations. (Owner is required to read under stand and initial each section;) hhrou0hout the tel'nl of this ,Agreement. the Owner shall enter into a service aorcement with all AAA AVTS service and m allitenance provider approved b) the Municipality or the mane aCturer"s representative. The .AAVAA"f5 shall be maintained in a satisfactory condition capable ol'performin4g as di:sig,�ned gild pl'oduCingI treated septic effluent in accordance with the, egiliplllent"s approy°al 1101- operation in the t\lilnicipalitv _. ` It shall be the responsibility oi�the C)vvllcl' during thin: term of this :Aor4clnent to patiIor all repair(s). maintenance. adjustnlent(s). replacement costs. and inspection costs. This tncltldes all annual maintenance lee (tN pically S400 to S600). Zr--Owner a€,rees that otily maintenance and r.palr personneI approved by the MLin icipat ty or the maTlt1111Ctnl-el"S I'el)resentative \vill inspect and make any necessary maintenance. repairs or permitted alterations to the sA stem. ,` Z )\�ner ackno\vledg�es that regular maintenance ol'an �1V� Al'"I'S reduces the potential fiailt.lre ofthe system. Which Could include SCvVt)C backup and costly repairs or drainlield replacement. (rev. 45i18;2018) Pa+0e I of 3 ()caner ackno"yledges that the klwlicipality may raluest records ornmintenance and repairs froth tilt::' manUtaetUrer s represcntatryc or maintenance proV,ider. C. "mer acknovdcdges duct the One fur 111ing to nuh-nain and repair an A\V\N, -FS niav be assessed in accordance with .1 1C 14.60M30. L honer agrees to grant the VlUniCipality reasonable access to test and inspect the :'AWAk"l'S. The 1.lunicipality will give at least 24-hour notice. �(hvner agrees that any We or transfer ortitic of the property will not occur «ithout a ne« cco ncate oron-Site Systems Appawal. 15 nymner agrees that the :AA1'WTS installation and maintenance requirements as provitled .74 by the AtVAV TS vendor installer and approved by the M wAcipality are the governing :tuideiines for the construedon. maintenance and repair of the (hyner's YAwwrs )cvner a<grees to maintain remote monitoring oWthe _AWW"I'S as re(luired by the rANN"W "I'S approval. 3. Terup '['he term of this Agreement shall begin on the. (late orapproval by the \lunicipality to operate the installed system. or upon transfer of title. and shall continue while the 1AW\,VTS is operational or until title is transFerred. d. Nonivaiver. The thilurc ofthe Municipality at any tinge to enlbrce a provision of this Agreement shall In no "uy cmisduite a waiver of the proyrsrons. nor in any way alto"ct the validity ofthe Agreement or any part hereof. or the right orthe Municipality thereafter to enforce every provision hereof. 3. Amendment. This .Agreement shall only be amended b) authorized representatives of the (honer and Municipality. ,Any attempt to aniend this agreement by either an Unauthorized representative or unauthorized means shall be void. b. Jurisdiction: Choke of Lam. :Any civil action arising from this givement shall be brought in the Superior Court for the Third Judicial District ofthe State of:Alaskaat .-Anchorage. Tile la" s or the State of :Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severabifity. Any provisions orris Agreement decreed invalid by a court ofconlpetent jurisdiction shall not invalidate the remaining provisions ofthe Agreement. (rev. 05/18/2(18) lNge 2 or3 Ow N E'R. (signal ure) w Ne (print name) STATE' 01: ALASK.A ) ss. 'Il IIRD J LANCIAL DISTRICT The fioregoing instrument was ackno"Wedued before me this CklY Of 202C; by Ll G)t�A_ Ant XL 'My C oninlis" loll expires: Stair of Alsska MUNICIPALITY B) \'l 0l Isignaiure) Date: (-z-/ 2-o 2. (print 11,1111c) Title: L_ '2 (rex% (15/18/2(H 8) INge 3 of 3 BLOC K 2 H RABB I T C R E E K V I E W & HEIGH T S S U B D I V I S I O N MARINO DRIVE Taylor L. Dosch No. 189892 R E GISTEREDPROFESSIO N A L L A N D S U R VEYOR Municipality of Anchorage ARL 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 Page 1 of 2 www.ci.anchorage.sk.us (907) 3434744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW990180 PID Number: 020-112-51 wm. & Daniel Larson Wastewater System: ❑ New ® Upgrade A"rm ABSORPTION FIELD Nuhba al B 2 ®om.r O Deep Tn SIITrIn BO Mures5-61R5 LEGAL DESCRIPTION aoe Ramp Twat Depth can"Inal grade GPD�FII FI. Block: Lot / 1I. swXhAt on: Dept, b p * Wean, front orig." prW. GrnM depth beneath qq: / Rabbit Creek Hts R. Ft lr w ,p'. Fargo: S.claon: FA Mdse slawm, aginel grMa: Gwel Lenpt,: FI. Ft. Well: ❑ New ❑ Upgrade (3malwgt,: NumO.r of Wes: Dnbnu beb..n lxwa: Clna.lMaeon Mrhnb. A S. C): Total Dept,:Gus b: Taal sbaorpoon up: Ppa MalarrL EXISTING Private Fl. Ft Fl 3034 Driller Data Dn[W: staeo Water L" "81W Date tnuatw A+ Home Services 1 7/22/1999 Fl Y.Ne pump Soo Caug hlaghl Aboea GrouM'. TANK GPM Fl. Ft. SEPARATION DISTANCES ❑ Septic ® Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding PubbrlPnvat Anchorage Tank wdy 2000" Fran Tank Field Station Tank Sewer Line wt, 100 95 Ma.rul'. hsenla.r of canpMm.nb: Steel 1 sumo. Wates 100+ LIFT STATION Lot Lim L 37 N/A Gal -Pump on- I.w1 at. w iov st Htoh eels slat'" Foundation20 b. in b N. 100 Penn Mak. a MMel EMeeRM lrwp.ceons pM W Cumin Drain Rwwks: Existingtank & field abandoned in lace. BENCH MARK Location ane D.xnpecn: FRONT DOOR THRESHOLD Asauar.d El.vaoon: 500.00 Fl. Engineer's Stamp',..'. SOFA �s1f Inspections performed by: Pannone Eng. Svc Dates: 1M 7/22/1999 2nd 8/13/1999 Department of Health and Human Services approval sr a.avan R. ►,nen. /� Reviewed and approved by�/� fit/ . _� Date: oZ - l D -0 D �iJ, 8149 f` • „s h�e4F0Q(�, ter!? ROIESe1011.r!-Fr �Lt:. PERMIT NO, SW990180 AS -BUILT P.I.D. NO, 020-112-51 WASTEWATER ABSORPTION SYSTEM LOT 14, BLOCK 2 RABBIT CREEK HTS S/D •OO \ ................... . Ng9140'55'E 300.00 100.00 100.00 NEW 2000 9 HOLDING TANK W/ ALARM SYSTEM W LOCATED GREATER IHAN 75' FROM ANY W LL. WI ,_...... ,r�.d.. co o EX EX ST G EXIST'G O ELL HOLDIN TANK n/ //I Q '. 70.00 ON�J MARINO DR. 30.00 100,00 EXIST'G DRAIN F] IN FAILURE TO B REUSED. EXIST'G1000 9 SEPTIC TANK ABANDONED IN PLACE. \LOT 13 IS NDEVEL❑PED, NO WELLS OR SEPTICS WITHIN 200'. 495.7 RAI CO A B DC 17.6 6.0 C4 17.9 14.6 C5 20.1 20.3 C6 22.6 24.5 EI 28.6 16.5 E2 33.9 22.4 ••PSE Ur `y� •y DESIGN IN NEW 491.34* 1 !�Gj�f.....,,,�•�•k 4931 GROUNDATEWATER W/IN OF SUFAC 'a 2000g HOLDING TANK HOLDINGLTANK E n WITH ALARM SYSTEM _ ••PSE Ur `y� •y DESIGN IN NEW 491.34* !�Gj�f.....,,,�•�•k 4931 GROUNDATEWATER W/IN OF SUFAC f 2000g HOLDING TANK HOLDINGLTANK x„........... ..8 1 WITH ALARM SYSTEM Q � ... ... � -••••. �• ••• � �'teven R. Pannone .r PREPARED FOR, PANNONE ENG, SVC �S� Jin 6 Danlelt Larson P. O. BOX 102954 No CE 8149 1� 4 .rte 8021 Marina Drive Anchorage, AK 99516 ANCHORAGE, ALASKA 99510 272-8218 Phone 8 Fax MM #�',f, C907) 345-6135 •�•• ulgIsk DATE, 9-1-99 AS -BUILT Permit Number: SW990180 MUNICIPALITY OF ANCHORAGE Department o1 Health and Human Services % ZZ 9 On-Sge Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 08, 1999 Expiration Date: Jul 07, 2000 Parcel ID: 020-112-51 Legal Description: RABBIT CREEK HEIGHTS BLK 2 LT 14 Design Engineer. 0062 Pannone Engineering Services Site Address: 008021 MARINO DR Owner Name: Jim & Daniell Larson Lot Size: 21000 SO. FT. Owner Address: 8021 MARINO DRIVE Total Bedrooms: 2 Permit Bedrooms: 2 ANCHORAGE. AK 99516-5523 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank E 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. 5. The following special provisions. EXISTING SEPTIC TANK SHALL BE DECOMMISSIONED PURSUANT TO AMC 15.65 AND THE 1997 U.P.C. Received Issued By: Date: *'/ / 6 tree, Date: 7— ' 19 Steven R. Pannone, P.E. P.O. Box 142025 Consulting Engineer Anchorage, Alaska, 99514 (907)272-8218 (907)272-8218 Fax July 5, 1999 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 14, Block 2 Rabbit Creek Heights Subdivision, Septic System Permit Request Ladies and Gentlemen: My firm was contacted to design and install a replacement septic system for the referenced lot. The existing drainf ield is in failure, with sewage flowing to the surface at the extream end of the trench. I conducted a field investigation to locate existing wells and septic system as well as a record search before designing the proposed system. 1 found extensive soil exploration on lot 15 in an attempt to design a replacement system. The soils discovered that on lot 15 indicated ground water within four feet of the surface and soils with percolation rates greater than 60 minutes per inch. A holding tank was installed on lot 15 as the replacement system. Since the lots have similar soils, it can be expected that we will find similar conditions on lot 14. Therefore, I recommend using the soil information found on lot 15, and apply them to lot 14 for this design. I propose installing a 2000 -gallon holding tank on the referenced lot. The holding tank will have an alarm system, as well as a concrete balast mat to prevent the tank from floating. The lot is approximately 18,000 square feet in size. Lot 14 slopes to the north at a rate of approximately 3 to 5 percent with rolling hils throughout the lot. The proposed holding tank installation will be located in the northern portion of the lot on a relatively flat area North of the existing house. There will be easy access to the tank for pumping trucks. The proposed location is greater than 75 feet away from any wells. The proposed system will be greater than 10 feet from the water service lines The proposed installation will not affect the future development of the surrounding or existing lots. See the attached design. Please contact me at 272-8218 or 227-3522 if you have any questions about the proposed installation. Sincerely, q6 OF ,r; _ Steven R. annbne, P.E. Attachments: p, tirw.n R. r«non. �Q. c CE C:Xw0ata14-2RAI113rrCRr.I:K1rrs.001.IXx f�oROTE�S:ON*�� E 4< PERMIT NOi SW99meo AS—BUILT P.I.D. NO, 020-112-51 WASTEWATER ABSORPTION SYSTEM Z /.Z LOT 14, BLOCK 2 RABBIT CREEK HTS S/D ` Na9mb'55'E 300.00 100.00 ............................. ............_ 100.00................ NEW 2000 g -- HOLDING TANK W/ ALARM SYS EM. W OCATED GREATER THAN 75' FROM ANY W LL. / LLJ C) O m v J EXIST'G ST'G HOLDIN /ELL TANK ' Q � ORu stj "p 1 70.00 i1 1'bom ARINFl R. Pannone? = Jln6 Danlell Larson CE 8149/4� 8021 Marino Drive �OQOI�• Anchorage, AK 99516 • ^ • ��D1.�r (907) 345-6135 130 30.001 ............. _.. _100.00 __ -_ ---I ...... ..... ..I EXIST'G DRAIN FIE�D IN FAILURE TO BE REUSED. EXIST'G 1000 g SEPTIC TANK TO BE REUSED DESIGN PERC RATEo <60 MIN/IN, GROUND WATER W/IN 4' OF SURFACE. 2000g HOLDING TANK WITH ALARM SYSTEM 13 IS EVEL❑PED. WELLS OR TICS WITHIN X00' WEL� RA lbo.00 RI 1A o. 'E PANNONE ENG. SVC P. ❑. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 Phone L Fax NTE, 9-1-99AS-BUILT ^ei c. i•-cn• PERMIT NOt SV DESIGN P.I.D. NOi WASTEWATER ABSORPTION SYSTEM LOT 14, BLOCK 2 RABBIT CREEK HTS S/D A, N9714 71 ZW414"VE .. ...... ... .. ...... .. ... NF1914"4,M 170.00 —.. ——.. .. M7 .. ... .. ... l.. . ..... .. ....1 V-1 PROM== E)aSTG DRAIN FIE -D -iN FAILURE TO BE LLJ AW HOLDING T W/ AUAQM ABANDONED IN PU SYN LOCATE A NI 1 " j 75', FROM MY 4 J Exim t= a -SEPTIC TAW TO BE ABANDONED EXISJTC 13 IS ..4t \Z.. NO WELLS S 13R Eya) SEPTICS VITHIN I XIST I L V eaw. OW WELL RAD VELL7 MAR 0 DR. 9 '3 3 6 C,\Work\1l-2RCH.DVGCP yj C� IlFRTQN ATEi <60 MIN/lNi PERC RGROUND WATER W/IN 4' OF SURFACE. 41 TANK V** 20008 HOLDING 41 49M WITH ALARM SYSTEM „„,,,„,,,„„„,,,,°s..... 16'x5'x1.5' CONCRETE MAT 0 .Steven R. Pannone. a JR nnnft RAI ART PREPARED FOR, Jlm L Danlett Larson PANNONE ENG. SVC P. O. BOX 102954 No. CE 8149 Arm 8021 Marino DrIve Anchorage, AK 99516 ANCHORAGE, ALASKA 99510 . 272-8218 Phone L Fax „••••• ...`& � P -M (907) 345-6135 DATE, 7-5-99 DESIGN SrALF, 1'=100' rt MUNICIPALITY OF ANCHORAGE r4' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME,1 M 1 S` V PHONE OUPGRACE MAI LI GAO SS .O. o 29 GIRDWOOD AtA-qi<A c79S?7- LEGAL DESCRIPTION LT 14 B 2 8i C CK ffetG�S U LOCATION I NO. OF BEDROOMS ANc H A k 2— Well/�0� / Absorption area Dwelling /r� PE HMI �SS o DISTANCE TO: .7 _ a 22 Manufacturer6! Te_ E eMat qj_ No. of compartments 2— W F t� Liq. capacitin gallons Inside length Width Liquid depth C/ IF HOMEMADE: A//d. .t/�d- .V fid. NO in" Crib dep Building / LEGAL / 1 YEHMI 1 111 i Distance between lines .Iee1Tf- Total effective absorpt inches PERMIT NO. bsorption area me PERMIT NO. Absorption steals) wrafrom DISTANCE TO: Well –1OZ _?� Manufacturer w= DISTANCE TO: Well INNEENNNN■NE Z Z No. of lines Length f e It F2W H Top of the to finish grade MMERNM.M.. O Length Width W Typo of crib Crib diameter Q H Wd W w DISTANCE TO: Well J Class Depth J W DISTANCE TO: Building foundatil OTHER NO in" Crib dep Building / LEGAL / 1 YEHMI 1 111 i Distance between lines .Iee1Tf- Total effective absorpt inches PERMIT NO. bsorption area me PERMIT NO. Absorption steals) wrafrom . �■■■■ray■ 1�3�'■ n■��N■■■■■Na�■■ I4"E■ 1 ONO INNEENNNN■NE ■■■■■■NEEM E■ENEENEEN IWORMNNEEMENN ER t" ENNE■■E■ I MMERNM.M.. i�lUt�l I C I�`FiL I TY iGF= F=l NGh~PFiGE ✓ q DEPARTPIE14T ur' HEALTH AND ENVIRONMENTAL rROTECTION V 825 'L' STREET, ANCHORAGE, AK. 99501 (f 264-4720 t4ELL F=ttaE> GtJ— ITE �7,E44ER FJEF<i•1 I T PERMIT NO. ( 830554 ) APPLICANT FORREST HETSKER 7125 OLD SEWARD HIGHWAY 349-6561 LOCATION C/O S&S ENGINEERS INC LEGAL L14B2 RABBIT CREED: HTS LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH -MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSO FT/BP.)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E>EF•TH= �4 LENGTH= 2G (3FRnVE:L. OEF'TH= !3 THE LENGTH DIMENSION IS THE LENGTH (IPJ 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 EXCAVATIOPj CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). F2EG!U I FZEO 1EFJT I G TF: N"K S I Z�_E= 1f2l@93 GFIILLQt11G PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DUPING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER. OF RESIDENCES THAT THE WELL WILL SERVE. --- TWG C.2? I NSF}ECT I ONE3 nFcE FSEG!U I FSE© --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. HINII'JUN 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 I -JELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE 14ELL TO A PRIVATE SEWER. LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. 'ELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS THE WELL COMPLETION. 'HEP. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE 9ILABLE TO INSURE PROPER INSTALLATION. = EF{1'1 I T EXP I PES fE}ECEMEEFR as L1 1S)S ',P.TIFY THAT AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SE14ERS AND WELLS AS SET i BY THE MUNICIPALITY OF ANCHORAGE. WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. JMDERSTANU HAT E ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE JCE ODELEU T NCLUDE M01 E T ' 3 BEDROOMS. ------------ - `----- ------ ------- G c APPLICAN ORREST METSKER __--_DATE__a� -- V4.0 S n� 7125 OLD SEWARD HWY. ','$F 'ENGINEERS, INC. ANCHORAGE, ALASKA 99503 S _ 1w 349-6561 i , ..nr:. LOs. /` PIi11COLATION [EST SOILS LOG PERCOLATION TEST PCHIOHMEU F011 IIAIl l'I III 0HMI;U LEGAL UESCHIPTIOPI 47-/4_./3(_kot-XA0f31T_._C u7-�C--/L/6775 SLOPI DO rH CKLalMi w.it- I.�•V1l �Na i. IFEI'fl �lac., r SILT, w 1714 scmc 2 .� G-,RAVtZ TVIC- : SALAD - - -- - 3 0 -cam"^ o .• �5= GreAVcz j wITHSMA -14 °491 SI W" SOMC SAND 5 P6 SAA/r-7 ifiA 0 r-1-10 6 7 B 10 11 12 13 14 15 16 17 LII 19 SITE PLAN -- uI WASGROUND WATER L ENCOUNTERED) O P IF YES. AT WHAT DEPTH) I a• S Reading Date Gross T.me Nei Time Depth to Water Net Drop G i/2J5 0O m/ II 1 IL 11 1.1 . __ ' • Vh IQ. a• w 07 1.Ll.—� lAt Is FF A 20 I +�PgOFESSION*� I� FI PERCOLATION RATE , /L�%'N /n _/ Iminoles/inehl TEST RUN BETWEEN FT AND Z FT COMMENTS LL- CL?-V_J- L-3/7 f/l./L / /? GOB O4//'ll & ENGINEERS, INC. S NW 7125 OLD SEWARD HIGHWAY • ANCHORAGE, ALASKA 99502 October 28, 1983 Municipality of Anchorage Department of Health do Environmental Protection 825 L. Street Anchorage, AK 99501 Re: Lot 14, Block 2, Rabbit Creek Heights Gentlemen: On October 28, 1983 our company collected a water sample from the house located on Lot 14, Block 2, Rabbit Creek Heights. The property owner is Alyeska Contractors. The water analysis was satisfactory. A copy of the report Is attached. The well is located 100 feet from the septic tank and 1-0D+ feet from the leach field. —TfFe electrical wires are encased in conduit. All the standpipes are capped. The well casing stands over 1 foot above ground and has a sanitary seal. OF 9, JOHN E SWA 1834E WASILLA ANCHORAGE SOLDOTNA (907) 376-3770 (907) 349.6561 (907) 262.9534 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Septic Tank Advisory Certificate of On‐Site Systems Approval # OSC201134 Subdivision: Rabbit Creek View & Heights Block:2H, Lot: 14A The septic tank for this property is 21 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. 61 9. / • • t0 7 E a 4 ¢" • Y7 Municipality of Anch . : : _ `a On-Site Water and Wastewater Pri,gr:m oil'a (907) 343-7904 c AUG, 3 0 2017 5. Ely . a ti Certificate of On-Site Systems A e eroval ^� Parcel I.D. 020-551-13 Expiration Dateg l 1 7 1. GENERAL INFORMATION Complete legal description Rabbit Creek View and Heights, Block 2H Lot 14A Location (site address) 8021 Marino Drive Current Property owner(s) Sean E. Brown, Kevin E. Kristof Day phone Mailing address 8021 Marino Drive Real Estate Agent Erica Sourivong Day phone 907-202-0400 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual ❑ Individual Water Storage ❑ Holding Tank Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: (L/A P 2 )} h/ /1 /')ti Date: q/H/17 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 5-2 '' Waiver Fee $ Date of Payment .g131, ( (1. Date of Payment Receipt Number O?�Rq'oC Receipt Number COSA# O ILO() 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 Forge Engineering Phone (907)522-7773 Address 1399 W. 34th Ave. Engineer's Printed Name Benjamin Schiller Date 08/28/17 gee 4 ,) .04d 6. DSD SIGNATUREga 7._ ._ •, s� System#1 Approved for Z bedrooms r. -• / %W -a i Sci't:a'�►: System#2 Approved for bedrooms *�% .pc Disapproved 4 e. 3611,) Conditional approval for bedrooms, with the following stipulations:`,'' , ;kst,''"` •' p,LtTY411/1 OF ON =� INAlR�TE c� r2 WASTE AND oo PROGRgm R Qe RV►C�5��5= By: Original Certificate Date: l � 1 -1 7 • 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 engineers 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# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Rabbit Creek V&H Block 2H Lot 14A Parcel ID- 020-551-13 A. WELL DATA Well type Private If A. B, or C provide PWSID# Well Log (Y/N) N Date completed 1963? Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth >54 ft. Cased to >40 ft. Casing height(above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test N/A 08/26/17 Static water level ft. 29 ft. Well production g p.m. 1 .01 g.p.m. WATER SAMPLE RESULTS Coliform NA colonies/100 mL Nitrate klP mg/L Arsenic ND ug/L Date of sample: $1 aall r7 Collected by: F0eLae G . B. SEPTIC/HOLDING TANK DATA Tank Type/Material HOlding/Steel Date installed 07/22/99 Tank size 2000 gal. Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping 08/07/17Pumper Northland Pumping Services C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "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 >1001 On adjacent lots >100' Absorption field on lot 100 On adjacent lots 100 Public sewer main '751 Public sewer manhole/cleanout >100' Sewer/septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas 100 SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5 Property line >5 Absorption field �5 Water main >101 Water service line >10'01 Surface water >100' Wells on adjacent lots 100' ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Water Service line _ Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS High level alarm in holding tank was tested and functional. G. ENGINEER'S CERTIFICATION apr "4 ;.PE.6.r.4141.. 1 certify that I have determined through field inspections and '�.441: %` it review of Municipal records that the above systems are iniir* '' 49 TN it 0 conformance with MOA COSA guidelines in effect on this date. 0 Engineer's Printed Name Benjamin Schiller 14 1; . j / i Weir :'"'.$ Date 08/28/17 VA11, Yr u COSA brown sheet 10-10-12.doc Parcel I.D. 020-551-13 Municipality of Anchorage j"! On -Site Water and Wastewater Program (907)343-7904 sae,x Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: 0 a - q/ 4 Complete legal description Rabbit Creek View & Heights, Block 2H, Lot 14A Location (site address) 8021 Marino Dr. Current Property owner(s) Todd & Laurie Marstall Day phone Mailing address Real Estate Agent 8021 Marino Dr. 2. TYPE OF DWELLING: Fx] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well i] Individual ❑ Individual Water Storage ❑ Holding Tank ll Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request Received by: COSA to be released to the unless otherwise requested by the engineer. COSA Fee $ 5 a o — Date of Payment qLA//It Receipt Number (1C & COSA# 0SOINN59 Date: 'T /'7 Yd1 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 flies 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 6. DSD SIGNATURE Date 8/22/2014 System #1 Approved for bedrooms A/�ven RJ �a�St CE -8149 System #2 Approved for bedrooms Disapproved ��NOFES Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: Th nicjp of orage Development Services Division (DSD) issues Certificates of Onsite 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 Septic System Advisory Well Flow Advisory COSA blue sheet_E .., c Nitrate Advisory Arsenic Advisory Other (, /IVC- LF L C 77 51� If more than 1 septic system is on the lot: COSA Checklist # I of Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Rabbit Creek View & Heights, Block 2H, Lot 14A Parcel ID: 020-551-13 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) N Date completed Unknown Sanitary seal (Y/N) Y Total depth 58 ft. Cased to Unknown ft FROM WELL LOG Date of test Unknown Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 8/20/2014 Static water level Unknown ft 30 ft. Well production Unknown gpm 1.0 g p m WATER SAMPLE RESULTS: Coliform jt1%� colonies/100 mL Nitrate V mg/L Arsenic N ug/L Date of sample: 8/20/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Holding/Steel Tank size 2,000 gal. Number of Compartments Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping C. ABSORPTION FIELD DATA Pumper Collected by: PES Date installed 7/22/1999 Cleanouts(Y/N) Y High water alarm (Y/N) Y Date installed Soil rating (g.p.d./ftZ or ftZ/bdrm) stetype Length ft. Width Gravel below pipe ft. Total depth ft. Eff. absorption area ft Monitoring tube Depression over field _ Date of adequacy test Results (Pass/Fail) For _ bedrooms Fluid depth in absor ield before test in. Water added gal. New depth in. Elapsed T' min. Final fluid depth in. Absorption rate >= g.p.d. rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in. " p off" level at in. Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot _ Absorption field on lot Public sewer main Sewer /septic service nc� Ani ontainment areas Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots m Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line _ Water Service line Curtain drain F. COMMENTS See attached letter Building foundation Surface water Wells on adjacent lots Absorption field 5+ Surface water 100+ Water main Driveway, parking/vehicle storage G. ENGINEER'S CERTIFICATION r� Aji.' I certify that 1 have determined through field inspections and , r"�P•Alf;onnnn-, �'9 review of Municipal records that the above systems are in �# conformance with MOA COSA guidelines in effect on this date.Engineer's Printed Name Steven R. Pannone ••.S1... .0... Date 8/22/2014I E-8149 COSA brown sheet 10-10-12.doc in. Pannone Engineering Services, LLC P.O. Box 100217 Consulting Engineers Anchorage, Alaska 99510 Ph (907) 272-8218 Fax (907) 272-8211 Legal: Owner: Residence: Number of Bedrooms: Septic System Tank Size (Holding): Absorption System Type: Absorption Area: Soil Rating: Installation Date: WELL & SEPTIC SYSTEM ADEQUACY INVESTIGATION Rabbit Creek View & Heights, B2H, L14A 8021 Marino Dr. Todd & Laurie Marstall House Septic 2,000 N/A N/A N/A 7/22/1999 (All background info taken from MoA records) Date of Investigation: 8/25/2014 Test Procedure: Septic System: System was inspected visually and measured. The holding tank was found to have 4+ feet of cover. Separation distances were measured and found to meet MoA Onsite requirements. Well: This property is served by a private well. The well is 58 feet deep, with a static water level of 30 feet. We were able to pull water out of the well at 4.6 gallons per minute (GPM) for 10 minutes. Water production dropped after 10 minutes to 2.5 GPM for 25 minutes then production stopped. We believe this was because of a low flow shut off. During this period of time, we performed a recovery test on the well and found the well was recovering at 1.0 GPM. After 10 minutes of recovery, the well turned back on and was able to produce 100 more gallons in the following 35 minutes. Water samples were taken on 8/20/2014 and analyzed at SGS. Conclusion: Based on the test this septic system appears to meet the code and operational requirements of the MoA for a 2 bedroom house. We recommend the addition of a 300 gallon water holding tank be added to the system. SPECIAL NOTE: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA 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. Page 1 of 2 Inspector's Qualifications Mr. Pannone is a registered Civil Engineer specializing in the planning, design and construction of sanitation facilities. He is a life long Alaskan with more than 20 years of engineering and construction experience. Mr. Pannone's background includes experience in survey, design, construction, testing, and monitoring of engineered projects. He has worked all over the state of Alaska, including extensive time in the arctic and remote regions. He takes a practical approach to design, taking into account how and who is going to be doing the construction. He has hands on experience in the construction of water and wastewater systems, buildings and large earth works projects. Mr. Pannone is a certified ADEC water/wastewater designer and sanitary surveyor. Mr. Pannone is the founder of Pannone Engineering Services. This privately owned company was founded in February of 1991. The company has specialized in the design, testing and installation of on-site water and wastewater systems. Pannone Engineering Services have performed engineering designs, analysis and evaluations of water and wastewater systems throughout Alaska. The types of systems have ranged from small single-family wells and septic systems to large commercial systems serving greater than 100 people daily. Page 2 of 2 Municipality of Anchorage Development Services Department '6`` Building Safety Division le, a,'r`'' i On -Site Water and Wastewater Program S A I I r T 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 e7laoz_,.� CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. o ZG -sSl - 13 COSA # D�ID574_1 Expiration Date: - 2 - 00 1. GENERAL INFORMATION Complete legal description _4ef IVA, Qfacic 2N, R«tid;,4 Crelc MezAh- -CID Location (site address) 6 a 2 f Ma r'^o D r 1;'e Current Property owner(s) :7-04 ,n Pcgfi Day phone `/0 9s 2 -9 116 Z Mailing address 32-36 w 31 $fA-C-t .4�ret4n A_h• 99X4/ 7 Lending agency Mailing address Real Estate Agent Mailing Address P�Mes{a/r /`rC'*-*9e Day phone FetF4i !f t{iC/.A✓ Cf` 95 L — A YB L wAtn C�� r an o! n(toft Prvdtn r~4 f Day phone 3G0 -2S'G7 38G1 C.enAlft-nG,nf Individual Well Dr�vtt 14- c4r_r go, A-tr 99Sy3 Unless otherwise requested, COSA will be held by DSD for pickup. PI ecv a eci l / r.. tT, N�,n�/uncQ 2. NUMBER OF BEDROOMS: �_ Cf` 95 L — A YB L wAtn C�� r an o! n(toft 11rttc-.417, pn0yoAe rrf"efAin if, Pleew e 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATE)i DISPOSAL: Individual Well ® Individual On-site ❑ Individual Water Storage ❑ Individual Holding Tank Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ it ✓rc�/y CCL64 k e( try Cel r I AepIA�r(f. 3GG-2X46/ when Card ✓t>etory. The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION 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. NameofFirm F(ccf/an TccAnrcar Sery%ev Phone 3yS r3ss- Address /`1.-30 r-ctio l�.+roo Rods. A -h eh, kir 99slC Engineer's Printed Name 7-A<ao/u-e F. /-re v -v Date ra izfla f 17 �• +71 cn F. ASoORE T=• - 5. DSD SIGNATURE 5. ,- 5r"? it Approved for � bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental Engineer's Report Other By: a,�4�el �, �P-'' 6 Original Certificate Date: 1 N - D- q - 09 (Rev 11/05) 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: Lof 1YA,R/� Ra4liil- CK. Aelghb- Parcel ID: 020-55'1-rJ A. WELL DATA Well type _�✓ f Datecompleted— 1963 Total depth>? ft. If A. B, or C provide PWSID # u' A . Well Log (Y/N) N Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Cased to 2±0 ft. FROM WELL LOG Date of test _ Static water level Well production WATER SAMPLE RESULTS: Coliform O -colonies/100 mL Arsenic:, o.a0.fmgll B. SEPTIC/HOLDING TANK DATA ft. Casing height (above ground) 12 in. AT INSPECTION to/ ry /06 2B ft. 9 -P.M. 1.7 g.p.m. Nitrate <v. r mg/L Other bacteria —_ colonies/100 mL Date of sample: 10/ 1Y/06 Collected by: F/aFI�4 iKS Sic Tank Type[ Material Hvleyj /skeet Tank size 2000 gal. Number of Compartments I Foundation cleanout (YIN) Y Depression over tank (YIN) N Date of pumping 9 /9 / O 8 Pumper A -1- C. ABSORPTION FIELD DATA N• .4. Date Installed Cleanouts (Y/N) High water alarm (Y/N) Y Date installed Soil rating (g.p.d./fe or f?/bdrm) System type Length ft. Width ft. Gravel below pipe Total depth_ ft. Eff. absorption area _ft2 Monitoring tube _ Depression over field _ Date of adequacy test Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test _ in. Water added_ gal New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFTSTATION N• �. Date installed "Pump on" level at_ in. Datum Size in gallons "Pump off" level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot M. A. Absorption field on lot N. A. Public sewer main N. A. Sewer /septic service line > 2S' Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots > roc, On adjacent lots too' Public sewer manhole/cleanout N • A . Holding tank /01, Animal containment areas VDAC Manure/animal excrete storage areas Nun e SEPARATION DISTANCES FROM SEPTIC OLDING TAN ON LOT TO: Building foundation to' Property line 'YO _' Absorption field M. k. Water main N.A. Water service line 7 to, Surface water > ra01 Wells on adjacent lots > 75-' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: N.A. Property line Water Service line Curtain drain F. COMMENTS FkldJnir funi.. G. ENGINEER'S CERTIFICATION Building foundation Surface water Wells on adjacent lots I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name I h eooDo�e F. t-ro c, .e Date to /27 y 2-00,5 COSA Fee $ 1-70 =� Date of Payment toy? -61 off p, Receipt Number 55 q 3 J (Rev. 11/05) Water main Driveway, parking/vehicle storage Waiver Fee $ Date of Payment Receipt Number reeoeay arheaCheor in. 4q : TNiODJVr f. L'CCRL � w� ..pj CC -3539 - PRELIMINARY- SGS RELIMINARY- SCS ReLN 1085635001 Client Name Flattop Technical Srv. Printed Dater! ime 10282008 10:23 Project Name/N L14A,B211,Rabbit Creek Hts Collected Daterl'ime 10/142008 12:30 Client Sample IU L14A,B21I.Rabbit Creek [its Received Date/time 10/142008 15:50 Matrix Drinking Water Technical Director Stephen C. tide P\\'SID 0 Sample Remarks: Allowable Prep Analysis Parameter Results POL Units Method Container ID Limits Dam Date Init Metals by ICP/M3 IlardncssasCaCO3 149 5.00 mg/L SM202340B D 1021/08 1021'08 NRB Waters Department Total Nitmtc/Nitrite-N ND 0.100 mgfl. SM204500NO3-P 11 10/17/08 JIM Private Individual Analysis Aluminum ND 20.0 ug'L EP200.8 D 1021/08 1022108 NRB Antimony ND 1.00 ug'L EP200.8 D (<6) 1021/08 1022'08 NRB Arsenic ND 5.01) ug/L EP200.8 D (<10) 1021/08 10.22/08 NRB Barium 55.8 3.00 ug/l. EP200.8 D (<2000) 1021/08 1022'08 NRR Cadmium ND 0.500 ug/L EP200.8 D (<5) 10.21/08 1022/08 NRB Calcium 46000 500 ug/l. EP200.8 D 1021/08 1022'08 NRB Chromium ND 2.00 ug/L EP200.8 D (<100) 1021108 1022108 NRB Copper 35.2 1.00 ug/L EP200.8 1) I<1300) 1021/08 1022'08 NRB Iron 2980 * 250 ug/l. EP200.8 D (<300) 1021108 1022/08 NRB Lead 126 0.200 ug/L EP200.8 D (<15) 1021/08 1022'08 NRB Magnesium 8380 50.0 ug/L EP200.8 D 1021i08 10.'21'08 NRB Manganese 553 * 1.00 ug/L EP200.8 D (<50) 1021/08 1022108 NRB Selenium ND 5.00 ug/L EP200.8 D (<50) 1021/081022'08 NRB Sodium 6910 500 ug/L EP200.8 D (a50txxn 1021108 1022'08 NRB Sihcr ND 1.00 ug/L EP200.8 1) I<100) 1021/08 1022108 NRB Thallium ND 1.00 ug/L EP200.8 D (Q) 1021/08 1022/08 NRB Zinc 155 5.00 ug/L EP200.8 D (<5000) 1021/08 1022/08 NRB Total Dissolved Solids 160 10.0 mg,]. SM202540C E (<500) 1014/08 EIIC Nickel ND 2.00 ug/L EP200.8 D (<100) 1021/08 10'22'08 NRB IIC03Alkalinity 145 10.0 mg`I. SN120232011 E 10.2008 SYII SG9 -PRELIMINARV- SCS Ret# 1085635001 Client Name Flattop Technical Srv. Project Name/# L14A,B2tl,Rabbit Creek tits Client Sample 11) L14A,U2tl,Rabbit Creek tits Matrix Drinking; Water PWSID 0 Printed Date/time Collected DatJtime Received Date/time Technical Director 10282008 10:23 10/14,7008 12:30 10/142008 15:50 Stephen C. Ede Allowahle Prep Anal)sis Parameter Results 1'QL Units Method Container I Limits Date Date Init Private Individual Analvaia CO3 Alkalinity ND 011 Alkalinity ND Conducthily 328 pl l 7.30 Alkalinity 145 Colony Count 0 Total Coliform 0 Fecal Coliform 0 10.0 mg/l. SM2023201) E 10.0 mg/l, SN120232013 E 1.00 umhovcm SM20251013 E 0.100 piIunits SM204500-1113 E (6.5-8.5) 10.0 mgyl. SM20 232013 1: col/100mL SM20922213 A col/100ml, S%120 922211 A (<I) col!100ml. S%120 92221) A 1020108 SYll I020/O8 SYll 10/14/08 SYll 10/14/08 BIC 1020/08 SY11 10/14%(18 DLC 10114;08 DLC 10/14/08 DLC OrT=22-2008 07:55A FROM: 70:3451355 P:111 A` HOME SERVICES 7501 E. 140th Avenue Anchorage, Alaska 995 16 (907) 34x185)0 October 22.2008 TO: Flattop Fngineering RE: 8021 Marino Drive Dear Ted, Please find below a list of compiled dates for the last year regarding the servicing of the holding tank at the address listed above. 8-24-07 1-30-08 5.5-08 7-2-08 9-9-08 If you have any father questions or concerns, please do not hesitate to contact me at the number listed above. A+ Home Savices.loc. Beverly T. Blakeslee Your Septic System, Holding Tank. Excavation Professional Service Company Jim Nordlund 3230 W 31" Ave Anchorage, AK 99517 October 24, 2008 Ted Moore Flattop Technical Services 14530 Echo Canyon Road Anchorage, AK 99516 ' RE: 8021 Marino Drive Dear Mr. Moore: 1 am part owner of the residence at 8021 Marino Drive, Anchorage AK, and manage the property for the owner of record, John Pugh. For the past twelve months, the house has been rented to single person with no roommates or family. He works for Crowley Maritime as the chief engineer for fuel barge shipments to rural Alaska, necessitating travel from Anchorage much of the time. The holding tank pumping records for the residence should reflect limited water usage due to the absences of the tenant. Sincerely, O\W) Jim Nordlund -� Municipality of Anchora Development Services Department , Building Safety Division On -Site Water and Wastewater Program s A r 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. OX G — .h'S 1- 13 COSA #_M041 Expiration Date: t— I Lf - O G 1. GENERAL INFORMATION Complete legal description t& f /Y A, (31aele 2 H. Rub 63i Creete 14elfl+&- Location (site address) Boz/ P-rGrino ❑ D.-#oe Current Property owners) Steven At/& fes Day phone 3 77 —28/ T Mailing address Lending agency Mailing address Real Estate Agent Mailing Address $02/ Marina Ar.. Anel, 9957/'f A Ictl ka 1<SA Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. f Peale call T r M Nord Ikha! 2. NUMBER OF BEDROOMS: & 9s -Z - 9 9 S 2 u heA CcLrA rmacVy .G.- p i c 4 -w` 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site ❑ Individual Water Storage ❑ Individual Holding Tank 19 Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 Onsite Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers 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 Onsite 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 Flaffe-p T.chn tcof Phone 3 VS-- 13 ss Address I HS3 O EcAa ea m yob, h ? e 4 99,5-1 Engineers Printed Name -Theo doer r=. r'roore Date Toner 13, 2apG «.!rte• •.�f .��. .................. 5. DSD SIGNATUREOR: F. R 0YE ,•✓ Approved for % bedrooms. C2- -9 '� ; �- °•.,,• Disapproved. ' `,�; <• ; ,� -, ; � Conditional approval for bedrooms, with the following stipulations. Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report Other By. &d Original Certificate Date:'oro (Rw.1 LOS) 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/onske (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST /- 13 Legal Description: ko f 1 `/ .4, P 1uc k 2-H, Ru 4 yf/ Gk. Parcel ID: O 20 A. WELL DATA Well type _jEwf If A, B, or C provide PWSID # Date completed— 1983 Sanitary seal (Y/N) 'r Total depth 75y ft. Cased to > da -ft. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: ft. Well Log (YIN) Wires properly protected (YIN) Y Casing height (above ground) /'X n. AT INSPECTION 6i�/o6 26 ft. g.p.m. I. -7y g.p.m. Coiiform _colonies/100 mL Nitrate 40.1 mg/L Arsenic: 5..,J_ ppb dale of sample:. / B. SEPTIC/HOLDING TANK DATA Other bacteria 0 colonies/100 mL Collected by: F[afdfex Tac% Sc -c. Tank Type/Material %ia1Ory�S�+yr tt Date installed 8/ 13 /9,p Tank size 5004'? gal. Number of Compartments Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) High water alarm (Y/N) Y Date of pumping 11 /03- Pumper At C ✓ot crn t C 14ee last tt+�irM.� -'hank u/Mavf �in�/>, C. ABSORPTION FIELD DATA N..4. Date installed Soil rating (g.p.d./ft= or ftZ/bdrm) Length ft. Width ft. Total depth _ ft. Elf. absorption area _ft= Monitoring tube System type Gravel below pipe ft. Depression over field Date of adequacy test Results (Pass/Fail) Fluid depth in absorption field before test _ in. Water added_ gal. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= For _ bedrooms New depth_ in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date ... D. LIFT STATION N• A. Date installed "Pump on' level at —in. Datum Size in gallons Manhole/Access (Y/N) 'Pump off Ievel at _ in. High water alarm level at Cycles tested Meets alarm 8 circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot _*9W Absorption field on lot N• A Public sewer main N• r/. Sewer /septic service line 2Sr Animal containment areas N - Ii. On adjacent lots '> 106 On adjacent lots > /4V ' Public sewer manhole/cleanout N• .4. Holding tank /,010 Manure/animal excrete storage areas N• .1. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10 Property line "' U Absorption field N• A. Water main N• !• Water service line > 10 Surface water > 14-o Wells on adjacent lots 7 7S SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: N.A. Property line Water Service line Curtain drain F. COMMENTS G. ENGINEER'S CERTIFICATION Building foundation Water main Surface water Wells on adjacent lots -& -to anc! 1 certify that 1 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—%hooz-AN'C F- /`+0o.-4 Date Tune 130 WO6 COSA Fee $ $Y3 O �` Date of Payment 6 �O/3 % O el Receipt Number (Rev. 11/05) Driveway, parking/vehicle storage in. %y /9�mjr n ✓� Ih lh� A� t �•" .1. ORE r. ALOOR: ft Waiver Fee $ Date of Payment Receipt Number LOT 14A, BLACK 2H HAS 20,954 SQ.rT. OF AREA 1 I L-------------- L ----------- L___ N89'31 X40"E 99 15A MARINO FOR: STEVEN AVALOS LanMark r„d..mw a AW"Y ar. &+ $330 vanguard Drive. suite 203 I• 10 Z I I I I I I (� ,o• rae 1 6wr. I I I I I I N89'31'44"E 99.91 GRAPHIC SCALE: I Inch = 40 Feet DRIVE s0 22"10 40 Bo 1-17-06 1" = 40' Grid ASBUB.T 3240 2600118 Drawn by field Book DHB 220 I hereby certify that the property described hereon bas been surveyed by me, or at my direction, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto unless otherwise shown. That no Improvements on the property lying adjacent thereto encroach on the premises In question and that there are no roadways, transmission lines or other easements on said property except as shown. It is the responsibility of the owner or builder, prior to construction, to verity proposed building grade relative to finish grede and utility connections and to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Listed distances prevail over scaling. Reproduction may cause distortion. Lot 14A I Block 2H RABBIT CREEK VIEW k RABBIT CREEK HEIGHTS SUBDIVISION REPI.AT *; 4 CHARLES E. FORBES LS -7326 a� Municipality of Anchorabe �- Department of Health and Human Services Division of Environmental Services On -Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci. anchorage. a k. us (907) 3434744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-112-51 HAA # Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 14 Block 2 Rabbit Creek Hts SID Location (site address or directions) 8021 Marino Drive Current Property owner(s) Mr. Jim & Danniel Larson Day phone 345-6135 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 8021 Marino Drive. Anch AK 99516 Day phone Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class We!I ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank Community On-site ❑ Public Sewer ❑ 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 prefessicnal civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between soouses) on properties served by a sirele family on-site wastewater d!<_pcsal ardlcr water supply system. DHHS also Issues HAAS upon request to home owners. Certificates cf Health Authcrty Approval are valid for 90 days from the date of issue for properties served by a private or Class C well 3rd may to re!SSCed %vith re:v,Nater sample resu!ts less than 30 days c!d. C) mficates are valid fC. „r,e year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is nct res"Cns't!e sc.r errors cr.T(Es!Cns it the prefessicnal ern'ree%s'Ncrk. Ao. !..-- 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 this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 Stale codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Eng. Svc. Phone 272.8218 Address P.O. Box 102954, Anch, AK 99510 Engineers Printed Name _Steven R. Pannone, P.E. Date 311912000 Oricinal Certificate Date: 3 — '.�— 0 d Ezniraticn Date: 0 O Reissue Date: 6. DHHS SIGNATURE • = • "' '` Approved for 2 bedrooms. �#� •'••��'3(�, •. _ Disapproved. � Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineers Report Other Ey: Oricinal Certificate Date: 3 — '.�— 0 d Ezniraticn Date: 0 O Reissue Date: . C" 1 vi) "-5 Municipality of Anchorage Department of Health and Human Services Iffim Division of Environmental Services WNW On -Site Services Section 825'1' Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-1744 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT 14, BLOCK 2 RABBIT CREEK HTS Parcel I.D.: 020-112-51 A. WELL DATA Well type PRIVATE if A, B, or C provide PWSID # _ Date completed _ Sanitary seal Y Total depth _UNKNOWN ft Cased to 40+ ft FROM WELL LOG Date of test Static water level Well production UNKNOWN It WATER SAMPLE RESULTS: Well Log N Wires properly protected _Y Casing height (above ground) 12" in. AT INSPECTION 8/13/2000 47 It g P.m 5 g.p.m Coliform —9—colonies/100 ml Nitrate 0.548 mg/I Other bacteria 0 colonies/100 ml Date of sample: 3/15/2000 Collected by: SRP B. SEPTI:/HOLDING TANK DATA Tank Type/Material STEEL Date installed 7/22/1999 Tank size 2000 gal Number of Compartments 1 Cleanouts Y Foundation cleanout Y Depression over tank N High water alarm Y Date of pumping 3/10/2000 Pumper A+ HOME SERVICE C. ABSORPTION FIELD DATA Date installed _ Soil rating (g.p.d./ft' or ft2/bdrn) _ System type Length ft Width ft Gravel below pipe ft Total depth _ It Effective absorption area _ft2 Monitoring tube _ Depression over field Date of adequacy test Results (Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test in Water added_ gal. New depth_ in. Elapsed Time: _ min Final fluid depth in Absorption rate >= _ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) (Rev. 11/99) If yes, give date D. LIFT STATION Date installed Size in gallons 'Pump on" level at _ in'Pump off" level at Datum E. SEPARATION DISTANCES Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: r Manhole/Access in High water alar level at _ in Meets alarm 8 circuit requirements? Septic tank/lift station on lot 100 On adjacent lots 100+ Absorption field on lot N/A On adjacent lots 100+ Public sewer main N/A Sewer /septic service line 95 Public sewer manhole/cleanout N/A Holding tank 100 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 20 Property line 37 Absorption field N/A Water main NIA Water service line 40 Surface water 100+ Drainage 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line N/A Building foundation Water main Water Service line Surface water Curtain drain Wells on adjacent tots 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��ven R. Panner, P.E.R. Panner, P.E. Date 3-19400 HAA Fee $V� Date of Payment Receipt Number L (Rev. 11199) Driveway, parking/vehicle storage Waiver Fee $ Date of Payment Receipt Number � F pNpa«..••yyY' •� f q9L! St^v^n R. P-rnon