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HomeMy WebLinkAboutSCIMITAR #2 BLK 4 LT 11AOnsite File #051 1344SM07 Charles A.Leet May 25, 2022 MUNICIPALITY OF ANCHORAGE Development Services Departments Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 05113407 Property owner(s) Matthew & Pamela Smith Mailing address 20385 Tulwar Dr. Site address 20385 Tulwar Dr. Day phone 9079039739 Legal description (Sub'd., Block & Lot) Scimitar #2, Blk 4, Lot 11 a Legal description (Township, Range & Section) Lot Size 138563 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic.Tank Q Upgrade ❑X Duplex (D) El Holding Tank El Renewal � Multiple Dwellings ❑ Privy ❑ (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: - S Date of Payment: Receipt Number: CST© (9.33 Permit No. 0_!�2/02Z l 13Z Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Professional Consulting --- Practical Solutions Page 1 of 1 ARE, LLC dba ALASKA RIM ENGINEERING CIVIL ENGINEERS – PLANNERS 1920 Kentucky Derby Dr. Palmer, Alaska 99645 Telephone (907) 775-2347 Email: alaskarinmengineering.llc@gmail.com May 12, 2022 (Revised 5/25/2022) Deb Wockenfuss Onsite Water and Wastewater Municipality of Anchorage P.O Box 196550 4700 Elmore Road Anchorage, Alaska 99519-6650 RE: Scimitar #2, Block 4, Lot 11A Subject: Tank Replacement Dear Ms. Wockenfuss; This narrative is to request approval to replace the existing tank. Tank Replacement We propose to pump the existing tank and then smashed and bury the tank in-place. Septic Tank A 1250-gallon steel septic tank is proposed to replace the existing 1250-gallon tank. The new tank will meet the septic tank requirements: Plastic or steel with the new coating requirements and manhole configuration. We are proposing a tank manufactured by Anchorage Tank and Welding. We will verify that the appropriate cover is placed over the tank. Upon completion, we will provide record drawing of the installation. If there are any questions, please contact me. Sincerely, ARE, LLC. Charles A. Leet, PE Principle CC: ARE File No. 202281002 ENCL: On-site water and wastewater fees On-site septic /well permit application MAY 12, 2022 Site Plan Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221132, Rebecca Carroll, 05/25/22 Charles A.Leet Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221132, Rebecca Carroll, 05/25/22 Charles A.Leet Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221132, Rebecca Carroll, 05/25/22 Municipality of Anchorage Page 1 of 3 '• „ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. BOX 196650 • Anchorage, Alaska 99519-6650 a Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SY r 8005--t) PIO Number. 40 i 113z" Name. MMBM Contracting Wastewater System: New 13 Upgrade Address: P.O. Box 670495 'Anch ABSORPTION FIELD Phone: 688-1236 No. of eadroomL ❑Deep Trench hallow Trench ❑Bed O Mound O Other LEGAL DESCRIPTION Soil Ratite Total Depth from original grade: lotGPOrS Block: Subdivision: I/ Z Ft Depth b pipe bottom from original grade O( Ft -7.0 Gravel depth beneath pipe �� 0 Township:Range: Section: FU added above anginal gradao Ft. Gravel length: Ff. rj' O Ft. WELL: = RNew ❑Upgrade Gravel wWth. Number of lines: oiwnce between lines CWattiptloa (Prnats, ",c):Total Depth: Cased Ta v R. Total absorption avec 1 Ft. Plpamater'atA5TH D-50!"f/ Yta/ 460t R C11 Ft SOo O. Ft. f0 +'wi Ondar: Oats OnikKtStant water taw[ Sullivan 4/19/981115 InayMr: .. JVtwliyM Datehmll • $-131¢_98 pL Yield: 2 Pump Set at Ca"H"m z Abnae GMWF&L TANK GPM FL FL � SEPARATION DISTANCES Weptic 0Holding l7S.T.EP. ' To From saptic Tank Atparpt w FWd 6th Sudan Hudinq T1ant s--u— hliknufaclurer: Capacity in gallon 1,7-50 Welt i/DD' %/,00' > /00' Iwt.riat� Nut of Compartments Waters >rso' >150 d1A AN >15.0 LIFT STATION NIA LOt^, Line f /c7 i 11 �l�f /J/� � 11 l2' Size in gallons: Manufacturer. Foundation 7 ' / 2 ' (CCS 11A , `r r/A I If/� /Y 'Pump on' levet at: 'Pump ofP Isvel High water alarm at: Curtain Drain /t Nit "Jitaae I WdN E tWl Ina pectiona performed Ey, Remarks: BENCH MARK Loca� tand Description: Assumed Elevation: ENq SqL QF'AC'q�,ll i Inspections performed b-� Y' Dates:lst 3"9F� ��' :4gTM ..:*• '• 2 a 5-(4---;Ix Department of Health and Human Services approval .4 t• j• ZMWaL /11 j Reviewed and approved by: � 2L't0<-C� Date:5Z ����• 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 SW980059 PID No. 051-132-57 A I B SI 32111di.-i C3 46.2 46.1 C4 86.5 90.8 M1 86.2 90.6 C5 82.1 86.2 V a c� S 00'04'00- E 200.00• 33' SECTIO14 LINE EASEMENT --------------------------- 3 9 Four Bedroom r` .House itet* TH1 S2 CS\ 7 H�-- C4---- \ OQOXS L=17.39• IC6 Ar M �nl 0 0 J Weli PLAN AS -BUILT SCALE 1" = 80' 3;yi1. r3s�� Q FA 4. 'trr„49.?N......� drWaE M _ ME .; 0 0 T � N J K z 6 O ;=w W a � =) G -m Z O 0 W Z Z V O W �v�''iara � p ,J W ao*oF (1OJ .- W Zw� W ..a W m Z a Z 0 O 701Z Z 6W �aVtFU1- ZWZ006, J J W O U Ix F J <<W a< J a Z O .. IL W<_< 3;yi1. r3s�� Q FA 4. 'trr„49.?N......� drWaE M _ ME .; 0 0 Permit No.SV� Bocs93 Page of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION F.O. Box 1966:0 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/,,or Well Inspection Report Legal Description: "�M Ir—tk PID Na.• a 5113LS-7 t 1 i�,,� ..C9 • 9`'L Al septic ga septic LEGEND SPISeptic Pump, compartment 1 C Clean out M Z MT Monitor Tube Note:,2' hi -density__, insulation lies _ -. . -•- • lj��N _.•- i1 — _ ..._ above -septic tank ELEVATION AS -BLT lei = 10 11 , � ii .� 11— Som ei5 '1 _ cr < U O F V) S 00.04.00' E 200.00' 33' SECTION UNE EASEMENT -------------------------------- OOm Zm rc o0&0I u w U' J N �o�oogp Op Pa: 0,q,•p4 I I�II a x WII Z WRy�30 < + miyWy u0 OUZF N mu 221.0 �n U<VI'Z o o ate' 0 1 z Z J < -.4y 00 a uv W> W - r. c x O 4� J.".t. Yl n ALL; =I I I: I 00 Y�L SE's Yoh= "00 OQOV'. v' ' ' s i 5c'. u c °. /•' AO`J� p� y�•.: .• ' v o Q o o a n F o Er s « G Y y E . O Opoa U) YcE y ] p V ce 0" X LL O' 0 Y O V .: a ♦� y0Y hV N t0 N c CO�il� {O .1 V 1� n a U1 Z ZO u OCZ U to Uj C) Q Q A C Y V JV �C ¢ 00. y o co 2:c aWOYOY O VO WJ Wt - U 7 Uuoa `u� ]•v a Zn ,d V) y AA oM,,�jW y S oY dcaY N �3w >¢ WS ai✓1 u w Gu:c 1- Q:oo • U Ozz CV U ¢ O ¢ Z V) m Z O C a Z r 5 W R zi w Zvi waaz o Z D 10 O U Z U W Q V y Z O O) + VI a F --1 v O F- 0 W 2 W O M Z NJ Z Qo00F 0 O o m W m 1-UNw�m f•1 Zw . a F N oZ t(L w > Z¢ Z O J 8Y E • - �' stl �f IL4 0 1 I18 O IJV)=0 ck: Z �¢tnF U)- •�-- Q 0wzoo z 1 • J4Zl< �¢ r Q$ F -Jia VI U.az o lnw a'-w¢N¢ Q J N W Owv VI ti K N LI l0 1¢- W Z L t OV1 (Cl _ _ _ W L=170.39' `�00S 3ry"l rc 0 rn ' • 6p •bZ h / �^ �/ 'I/vo d U] N �ibM� V) Z o 017°),� o 0 Of ° u) V)O 0pj 1 >- W O m < UJ Z Z UZ LnQ Q w wVO)� M �za'" O' Q o(LL; a) rn o$= zoo 7r ova 3 FROM MMM CONTRACTING PHONE NO. : 6881238 May. 24 1999 01:37PM P3 ... 11 'D Irti5uJ IASi=MENT ArjRFIM rM' '1'I IIS FASEMENT AGREEMENT is made by and between Gregory S. Lyall and Monica Jenicek Lyall, husband and wife (hereafter the "I.yalls'), whose address is 20227 Seiha Drive, Chugiah, Alaska 99567, and M M & M Contracting, Inc., an Alaska corporation (hereafter "M M & M"), whose address is 20935 Eastside Drive, Chugiak, Alaska 99567. The parties recite that: A. The Lyalls own real property located at 20227 Seika Drive, Chugiak, Alaska, and legally described as: Lot 10, Block 4, SCIMITAR SUBDIVISION, UNIT NO. 2, according to Plat No. 74.190, records of the Anchorage Recording District, Third Judicial District, State of Alaska. The Lyalls property as so described is hereafter referred to as the "I.yall Parcel." B. M M & M owns real property in Chugiak, Alaska, located adjacent to the Lyall Parcel. M M & M's adjacent property is legally described as: Lot 11, Block 4, SCIMITAR SUBDIVISION, UNIT NO. 2, according to Plat No. 74.190, records of the Anchorage Recording District, Third Judicial District, State of Alaska. M M & M's property as so described is hereafter referred to as the "M M & M Parcel." C. M M & M desires to obtain from the Lyalls, and the Lyalls desire to grant to M M & M, a driveway casement and an easement for a parking and turnaround area nn the Lyall Parcel. M M & M also desires to obtain from the I.yalls, and the Lyalls desire to grant to M M & M, an water well easement on the I.yall Parcel, the waters rights of which shall be appurtenant to the M M & M Parcel. D. The Lyalls desire to obtain from M M & M. and M M & M desires to grant to the Lyalls, a driveway and garden area easement on the M M & M Parcel. FROM 11.91 CONTRACT 1 NG PHONE NO. : 6881238 May. 24 1999 01: 38PM P4 n-ro* 3Ii57Nc5U4 NOW, TI E-REFORE, in consideration of the promises made hcrein, and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged, the parties agree as follows: 1 • -GiratitiCThe l.yalls, as • Grantors, hereby grant and convey to M M & M, as Grantee, and to its successors and assigns, a driveway Casement in and on the Lyall Parcel, which easement is particularly described as: An casement of 20 feet total width, running from and to Tulwar Drive to and from the M M & M Parcel, as depicted on the attached survey prepared by Seward & Associates Land Surveying, dates! January 28, 1999, with a center line as described by the line data for notations Ll and L2 on the attached survey. This driveway casement shall be the purposes of constructing, improving, maintaining, inspecting, repairing and using a private driveway that provides ingress and egress to and from the M M & M Parcel from and to ,rulwar Drive. Within this easement, soil, rock, sand, gravel, and vegetation may be excavated and removed to construct, improve, maintain and repair the private driveway. rhe use of this driveway casement shall he exclusive to the M M & M Parcel. The driveway easement shall not in any manner be dedicated for, or subject to, use by the public. 2. Grant of Parking antlTurnground Easement on 1, A P.a". The Lyalls, as Grantors, hereby grant and convey to M M & M, as Grantee, and to its successors and assigns, an casement in and on the Lyall Parcel for a parking and turnaround arca with dimensions of 25 feet by 125 feet, which easement is particularly described as; Beginning at the northwest corner of the Lyall Parcel, thence to the East 53 feet on the north line of the Lyall Parcel to the True Point of Beginning of this description; thence continuing to the East 125 feet on said north line; thence due South 25 feet; thence to the West 125 feet on a line that parallels said north line; then to the North 25 feet more or less, on a straight line that is at a sufficient angle to connect to the True Point of Beginning. This casement shall he for the purposes of constructing, improving, maintaining, inspecting, repairing and using a private parking and turnaround area. Within'this casement, soil, tock, sand, gravel, curd vegetation may excavated and removed to -2- Received Time May -24. 1:29PM FROM M"1 CONTRACTING PHONE NO. : 6SeI23e May. 24 1999 01:38PM PS ne031'571'G50b construct, improve, maintain and repair the parking and turnaround area. Also within this area, a retaining wall with supporting structures may be constructed, improved, maintained, inspected and repaired. The use of the parking and turnaround area casement shall be exclusive to the M M & M Parcel. The parking and turnaround arca easement shall not in any manner be dedicated for, or subject to, use by the public. The parties acknowledge that this casement overlaps to a certain extent the driveway cascnlent. un the Lyall Parcel. M M & M and its successnrs and assigns may use the arca Of overlap for either a driveway or a parking and turnaround arca, or both. Watyr WC11 Elimm IlI' lccl. (a) The Lyalls, as Grantors, hereby grant and convey to M M & M, as Grant cc, and to its successors and assigns, an easement in and on the Lyall Parcel for a water well. 'I'lte water well shall be located as depicted ort the attached survey prepared by Seward & Associates Land Surveying, dated January 28, 1999. The water well casement shall extend to the circular area that surrounds the existing water well location depicted on the attached survey, with the circular area having a radius of eight feet seven inches. 'rhe water well casement shall be used for installing, improving, deepening, maintaining, inspecting and repairing a water well and its associated piping, pumps and wiring. The water well shall only serve a single family residence located on the M M & M Parcel. The use of the water well easement shall be exclusive to the M M & M Parcel. The parties acknowledge that the water well casement overlaps to a certain extent the driveway casement and the parking and turnaround area casement on the Lyall Parcel. M M & Mand its successors and assigns may use the arca of Overlap for either the water well, or for a driveway, or for a parking and turnaround area, or for all those. purposes. (b) The Lyalls acknowledge that neither they nor their predecessors in interest have made beneficial use of any water from the well located on the water well casement. The Lyalls agree that all rights to the appropriation of water from the water well casement shall belong solely to M M & Mand its successors and assigns, and that such rights shall be appurtenant to and transfer with the M M & M Parcel. S. czren[A P—riveway. Parkineanti _luranrunsLAr d Garden Aren Tisentcnl� lyi�t Parc . M M & M, as Grantor, hereby grants and conveys to the Lyalls, al Grantees, and to their successors and assigns, a driveway, parking and wroarnund area and garden area easement in and on the M M & M Parcel, which casement is particularly described as: .3 - Received Time May.24. 1:29PM FROM MM CONTRACTING PHONE NO. 6881236 May. 24 1999 01:39PM P6 • t1K��1151PG:�llb An easement depicted on the attached survey prepared by Seward & Associates Land Surveying, dated January 28, 1999, having the dimensions as indicated by the line data for notations 1.5, 1.6, L7, L8, L9 and L10 on the attached survey. Y'bis driveway and garden area casement shall be the purposes of constructing, improving, maintaining, inspecting, repairing and using a private driveway, parking and turnaround area, and garden arca. Within this casement, soil, rock, sand, gravel, and vegetation tnay be excavated and removed to construct, improve, maintain and repair the private driveway, parking and turnaround area and garden arca. The use of this casement shall be exclusive to the Lyall Parcel. 'Phis easement shall not in any manner be dedicated for, or subject to, use bythc public. 6. Cwt of Constructinil and Niii)l-cnincc. M M & M, and its successors and assigns, shall be solely responsible for all costs of constructing, improving, maintaining, inspecting, and repairing all improvements on and to easements granted and created by this Agreement that benefit the M M & M Parcel. 7'he Lyalls, and their successors and assigns, shall be solely responsible for all costs of constructing, improving, maintaining, inspecting, and repairing all improvements ort and to the easentent granted and created by this Agreement that benefit the Lyall Parccl 7. Bun With i.and. All the easements granted and created by this Agrccmcnt are intended to and shall run with the land, with the benefit of each casement appurtenant to the respective dominant parcel arid the burden of each casement appurtenant to the respective servient parcel. 8. Duration of Fa num. The easements granted and created by this Agreement 'shall be perpetual. 9. Zrior EasctluI1115 1pundgd. This Agrccmcnt entirely supersedes that certain Easement slated March 5, 1984, created by M M & M's predecessors -in -interest for the benefit of the Lyalls' predecessors -in -interest, and recorded at Book 574, Page 0377, records of the Anchorage Recording District, This Agreement also entirely supersedes that certain Easement dated March 5, 1981, created by the Lyalls' predecessors -in -interest for the benefit of M M & M's predecessors -in - interest, and recorded at hook 574, Page 0378, records of the Anchorage Itecording District. -4- Received Time May.24. 1:29PM MMM CONTRRCTING PHONE NO. : 6881238 May. 24 1999 01:40PM P7 nr L13115 I1'G5u I IN WITNESS WIVRFOF, the parties have executed this Easement Agreement on the dates indicated below. THE LYALI.S Dated:_ r0 _ fly( (' eg y S. Lyall Dated -.—!V,199 �j ttr �ce/G Go Mon 1'ca Jenicek T.y'all M M & M CONTRACTING, INC. Dated:1 ! !/ 91 �i Byv� Mc esident STATE OF ALASKA ss. TNIRD JUDICIAL DISTRICT The foregoing instrument was acknowledged before the tbis /:rO day of �� , 1999, by Gregory S. Lyall and Monica Jenicek Lyall. No ry Public in and for State of Alaska My Commission Expires:.S .T9 00 -S- Received Time May -24. 1:29PM FROM hBYI CONTRACTING PHONE NO. : 6881238 May. 24 1999 01:40PM P8 tir.H 344 lrUZ)Llb S'I'A'I'E OF ALASKA ) ) ss. '1'IiIRD JUDICIAL DISTRICT ) 71'he foregoing instrument was acknowledged before nue this 12tlay of e ,1999, by Michelle Myers, president of M M & M Cont acting, Inc., an Alaska corporation, on behalf of the corporation. • J Notary Publi6 in and My Commission Expi AFTER h DING RETURN TO: Jerome Ii. Juday, Esq. Atkinson, Conway & Gagnon 4201. Street, Fifth Floor Anchorage, Alaska 99501 0030238.01/7098.1 ,6, Received Time Mar.24. 1:29PM State c Q.- J•1 0 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: January 27, 1999 TO: Dan Roth , ^ 1-/J FROM: Mike Anderson, P.E. Y/ lam` SUBJECT: Lot 11, Block 4, Scimitar Subdivision No. 2 Certificate of Health Authority Approval RECEIVED JAN 271999 Municipality of Anchorage Dept. Health & Human Services We have revised the plan as -built for the recently completed septic system on Lot 11, Block 4, Scimitar Subdivision No. 2. It is now in agreement with the surveyed as -built for the lot. The revisions were completed at your request and we are hopeful the Certificate of Health Authority can now be issued. Please let me know if you have further questions. 11-16-1998 10:12PM 9-J CORP. BOB JOHNSON P.01 Jk +7L. Z7 ap t 1 \ O i 1 ' \ r 7 Y l .n ►ere. M 4 M 4 .R ! �...._.. _ C L, r 'I .• �.� i t Ift I r 7 r 2� `w-- --._......_ ...._.—._. i / LrT Ie � / � Drrvw-wavy is e� i 02,. Lo w: f< Di-iv.u.,.►�. 94W.4 AS -BUILT i I hereby cnfdy that I havesuweyed r r the tokwint dearn'bed property: " 1, I►/ee.k !F . y��'v 1i.nro,7"rs-u.IRtw'IAnchLM• .W Re .: QF A(,q ^' al -I sh td thereon o� p"r � a ado m ••••'••j•••.tiSi� �1 , Y overtop or encroach on the p•op" lyl adjacent thereto. that . n /�7.• •.`' t�0 ro impreeearetrb on tlrcrzro encroach t� on the prembw in qua m;,d" tF - owl an no roadways, irs"o 49th >• �w es" -0 a trarrmio .? Wm or oder -bible eareerento on acrid propany _ rt ."'.I•Y- Dated at Ygie Mer, AlaskaAlaskaRebell C. Jso fl �r.a IBM" � thio =qday oC lac.•Z`_"'__ 1948 !L ROBERT C.1.1OHN OW *-43 V '�.�rrwr�•'` _w ` SCALS; ReBblewd Land Surveyor No. MLS` �.qle"�.�!" 1" ik ' Sm774M£mak Rrver, Aiaata 99511 �1e._`� ♦►n Mona (M690M. TOTAL P.01 FROM MtII1 CONTRRCTINO PHONE NO. 6881238 Nov. 20 1998 08:49AM P1 xtxY�e:. iIZt 5ULL I dLa VANWATER IELI S ::. • .. ' P.O. BOX 87027!, CHUOIAK; ALASKA 99667,6 TELEPHONE 666-t769`'';':i,.E: ,r ; `.. ;;.' •`: .. :.. GORE HOLE DATA . ' : ; ' i : r:ti:.:.', ••c',,., :.: r :. OWNER OF LAND M :'. ,"' •DEPTH,:' ♦,, i' '•:%: ADDRESS LEGAL DESCRIPTION �L,, o r, pate gt.lssue 4 fig'' PERMIT NUMBER,�� nS�.. • . -J�-' TAX INDENTIFICATION NUMBERS=ei/ Is well located at approved permit locati n? . ❑N ❑ No Method of Drilling: r rotary A cable tool Depth of well: !d ( %^ Casing Type .ST�i,•,_Wall Thickness i Inches ...... Diameter • � �� Inches, depth feet Casing Stickup Above Ground: r� ' '` feet. Static water Level (from ground Tave: �l feet. Pumping level: feet after hrs: pumping ___OPrn. Recover Rate: Mett 68 of Testingr-„�ILA� ` Well Intake Opening Type: ❑ Open End . pen Hoie' ❑ :Screened; Start feet Stopped .(3 Perforations Start feet ,Stopped '"';-" 'teen. Grout Ty*e'A&7-440r6o volume vh> A- - t Depth: from _ feet, fo ''', ' :feet Pump Intake Depth: Meet Pump Size ^___hp , Brand Nam We11 Disinfected UponCompletion? :. es C3No : Method of Dlalnfectlon: CIA -: .,,n ' SM P/Zi l Comments: / / 'p �I .:; : ;.'. • : . . 46 ' ''' :: i ::�.....i )'•,•:Y'a ,. . st. i �, +. n s1. ,•, }S'. - , - y 4Y,: 1 1 J ,r ATTENTION: it Is the responsibifdy of the property owner to submh s .00py.of the well .lop tothe proper authority Municipality of Anchorage: Department of Health & Human Services incl/or Department of Environmental Conservation. MstSu Borough: Department of Environmental Conservation. ::,: r. . a : r 1 tTiiF2�vF .y, — `.. 14 Comments: / / 'p �I .:; : ;.'. • : . . 46 ' ''' :: i ::�.....i )'•,•:Y'a ,. . st. i �, +. n s1. ,•, }S'. - , - y 4Y,: 1 1 J ,r ATTENTION: it Is the responsibifdy of the property owner to submh s .00py.of the well .lop tothe proper authority Municipality of Anchorage: Department of Health & Human Services incl/or Department of Environmental Conservation. MstSu Borough: Department of Environmental Conservation. ::,: r. . a MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON—SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980059 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:STEPHENS DONALD B d KARI J OWNER ADDRESS:P.O. BOX 671409 CHUGIAK, ALASKA 99567-1409 PARCEL ID:05113257 LEGAL DESCRIPTION: SCIMITAR #2 BLK 4 IT 11 LOT SIZE: 138563 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 4/13/98 EXPIRATION DATE: 4/13/99 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 MUST 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: RECEIVED BY: / ' cmc ISSUED BY: DATE: yligt?f3 DATE: ¢ — ���.70 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX March 26, 1998 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 11, Block 4, Scimitar Subdivision No. 2 Septic System Design Impacts to Adjacent Properties Dear Onsite Services Engineer: We hereby apply for a permit to construct a well and an onsite septic system on Lot 11, Block 4, Scimitar Subdivision No. 2. The attached site plan and backup documentation identify the size and location of the well and new septic system to serve the four bedroom home to be constructed on the lot. The 100' protective radius is also shown on the plan. The surface of the lot slopes dramatically from east to west at a grade up to 30%. A bench exists, however, near Tulwar Drive where the house w i I I be placed and the septic tank constructed. A testhole placed in this area revealed a gravelly silt which percolated at a rate of 12 minutes per inch. Another testhole placed near the road consisted primarily of well graded gravel which percolated at a rate less than a minute .per inch. The majority of the material found in the testhole passes the No. 4 Sieve. The primary absorption trench will be constructed in this area with a service line running across the slope from the septic tank. The ground surface in this area is fairly flat and the absorption trench will be constructed at the toe of the slope. No conflicts exist between the new septic system and the protective radii of adjacent wells. The lot to the south is currently vacant and the west lot line is more than 600' away. No development to the north is closer than 300'. Lot 11, Block 4, Scimitar Subdivision No. 2 March 26, 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, OF '444 TH Michael E. Anderson, P.E. % ? 49. 7n •n • •r,n • •;Z Attachments MICHAEL E. ANDERSON 4381-E 4 I— z a U >;a, A� 9TH T.' MICR TELL E. ==1301; 4381-E i� ,c r� r " ~ b z ..g a v •: « o « O P ' • s rd 1L'S6 • v O •�♦ i g .nl� o \i a 010.CCY � x.200. f \ \ 0-�'• C• 00 i9 �! o \ Or \ • VACANT crrrt `� o[ ')r, e rO.yOy -� /:�� ZZ'L;Z 3.0040.00M- A P M ► \ \\o AREA \\ Sy o � SCALE 1" = 100' N 1.4 N N � 4 B 1,250 Gallon Septic ;Tank Alt. Sit H1 0 O y ~ 50'I[mg AYS" Wide Well 4'Eff. Depth THS 1 /000\ TgLWAR. ,• RIVE cr '..TF1 `'`. SITE PLAN •T,4�rn` !� SCALE 1" err 4381•E i EN 15 (tolls) LOT 11, BLOCK 4, SCIMITAR SUBDIVISION NO. 2 DESIGN FACTORS: Four Bedroom Home Perc. Rate: LT 1 MinJlnch Application' Rate: 1.2 GPD/SF SYSTEM REQUIREMENTS: 5' Wide Trench System 1,250 Galton Septic Tank 4' Drainfield Rock 4 Bedrooms X 150 GPD / 1.2 GPD/SF = 500 SF of Absorption Area 500 SF/5 LF (Width) X .5 (Red. Factor) = 50 LF Trench Length Therefore: Construct a 5' Wide Absorption Trench System With One Lateral 50' in Length with 4' of Drainfleld Rock Beneath the Lateral. Distribution Pipe in Trench Placed at 3.0' Below the Original Ground Surface. Ti Z -G � (aEortxrlt.E i� i W PJL 01 �� O F �'.�� 11 TYPICAL WIDE TRENCH SECTION �P• s`it (NO SCALE) *tt�TH • irl// NOTE: Grade Area Over Trench to Drain Away. .?.. ....... ..�(,lt .:• Minimum 3' of Cover over Septic System. • Minimum 4' Separation From Groundwater. //�` 11CNAELE.R"O[RSO,J: % , Minimum 10' Separation From Lot Line. /rte� ', 4391-E (I c� ; ��- !\3 Munk3paBlu A C DEPARTMENT OF HEALTH d HUMAN SERVICES 825'L7 Street, Anehorape, Alaska 99502-0850 SOILS LOG — PERCOLATION TEST PERFORMED FOR: MM&M Contracting DATE LEGAL DESCRIPnow Lot 1 1 , Block -4 Township, Range. Section: osenr Scimitar Sub. No. 2 SLOPE SITE PLAN 01, 2- ENCOUNTERED? 3- 3 IF YES• AT WHAT DEPn/T s to196 goo to 3/19/9 Now"�'i�ne 4- 7 T GM 9 •. 10 o. 12- 13- 14- 17- is - 19 -4 21314 B yTrofn o r - go t.0 Tsr 4C nio. WAS GROUND WATER ENCOUNTERED? NO IF YES• AT WHAT DEPn/T s to196 goo to 3/19/9 Now"�'i�ne C 2D I PERCOLATION RATE /Z' (m utesn rch) PERC HOLE DIAMETER •, . TEST RUN BETWEEN FTAND FT COMMENTS Testhole presoaked prior to test. PERFORMED BY: MFA 1 LtvhFY THATITHIA TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE �• �4 U TZ -MS (Rev. 4131 ' Munk4uty DEPARTMENT OF HEALTH b HUMAN SERVICES 825 'L' Steet. Anchorage, ALuM 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: MM&M Contracting DATE % LEGAL DESCRIPTION: Lot 11 , Block '4 Township. Range. Secsiorr t-l—m-Er-w-1nl_ Scimitar Sub. No. 2 SLOPE SITE PLAN �T .1 2 3 • p4 Ip( 5 . B 7 a 9 t0 tt :12 13 14 15 16 17 1s 19 GW PASSES /Ja . 4 5G1VE —> Ver r -&Ar 4o 7- WAS GROUND WATER ENCOUNTERED? No IF YES. AT WHAT DEPTH? Sam Ill WSW ' ?hTlgd mFn "ne DM3/19/98 • .1 20 20 -{ I UPERCOLATION RATE � ' (mvUwuch) PFAC MOLE DIAMETERy TEST RUN BETWEEN 1' PTAND S rr COMMENTS Testhole presoaked prior to test. PERFORMED BY: MFA I FY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE 3`J��gb T21ri6IR�v. mail • ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 11, BLOCK 4, SCIMITAR SUBDIVISION NO. 2 GENERAL: 1. The scope of this project includes furnishing and installing a new 1,250 gallon septic tank. It also includes the construction of a new 50' total length by 5' wide by 4' effective depth absorption trench. The distribution piping must be placed at 3.0' below the ground surface. Mounding over the trench may be required to provide a minimum of 3' of protective cover. 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 1,250 gallon septic tank must be procured from an approved source and installed at the location shown on the plans. Lot 11, Block 4, Scimitar Subdivision No. 2 March 27, 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 11, Block 4, Scimitar Subdivision No. 2 March 27, 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 11, Block 4, Scimitar Subdivision No. 2 March 27, 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. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 1 522-6779 MEMORANDUM DATE: April 7, 1998 TO: Donaa-Mea�''J::>AQ EA /1 FROINI: Mike Anderson, P.E. `M EA SUBJECT: Lot 11, Block 4, Scimitar Subdivision No. 2 Well and Septic System Permit The owner of Lot 11, Block 4, Scimitar Subdivision No. 2 has decided to construct a four bedroom home on the lot. Unfortunately, the application for the well and septic system was submitted for a three bedroom home. I have modified the necessary portions of the application package to reflect a four bedroom home. Please replace the paperwork to reflect the four bedroom home and issue the well and septic system accordingly. Thank you. h7ur-4 IC:r"i:�i ITV CDF RIVCF��FZ�AGE DEPARTMENT wr HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK,. 99501 264-4720 Ot+i— ITE SEWEF;: F='EFSM I T PERMIT NO. C 830656 ) APPLICANT PEGGY O'NEIL PO BOX 4-6333 ANCHORAGE 99502 344-5666 LOCATION LEGAL L11B4 SCIMITAR, #2 LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS MAXIHUM NUMBER OF BEDROOMS = 4 DRAINFIELD SOIL RATING CSQ FT/BR)= 175 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: 1-3 GtiEF--r"= $ FLEt-4C3-r -1= 14la GF;ZAk'EL_ G+EF='TH= S THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IPJ FEET). THE TFRE"C" l4I C}TH I _�, S. �+✓_+k� FEET_ THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). F<EG!1J I F<:EO SEF?T I C Tr=tt-►F< S I .cE= 125 E+ GFiLLOr-IS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER. OF RESIDENCES THAT THE WELL (JILL SERVE. --- TWO C 2� > I "+ F}ECT 10 t4 S RFZE F:.EGtiu I FREL7 BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIHUN DISTANCE BETWEEN A WELL AND ANY ON-SITE SE14AGE 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. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F=^EF,:M I T E:XFJ I REE3 GECEME3EF_ ::�:JLs I CERTIFY THAT 1: I AN FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SE14ERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IPJ ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. 1. SIGNED: _ ::f ! _____------ APPLICANT PEGGY O'NEIL ISSUED BY-- �------------- /Lte�'-L__DATE----.-------- G' :JL:E-:L:s AND WELLS AS SET ENLARGEMENT IF THE & ENGINEERS. INC. S 1W S6 c7-4 r'`I 7125 ULD SEWARD HWY. ANCHORAGE, ALASKA 99503 349 - 6561 ; SOIL51.0(; 1lh.M:(KAIION ll.Sl ix..1. . 1111. 1.1141:01 AfNIN 11:4 I•I III NIIMI U 1 (114 PE/ GGY V /! IEI L {� a IIM L I'RIII UIIMI U 7/1�.V 3 4 EI;AI III.SCIIII•TION Go f JZ ✓/�G A 1 L JL'1 L rAt� .S �l��J 10/x/ UAV /T •Z SLUI.1 SITE PLAN SIL—TW/TRACE ' f-» Some FINE SAND NON- 2 COHESIVE, R'ND., OR6AN1C5 PER G F125T J.Sa-NUwIERoVs TEsr BOULDERS 4`1.0' A• is 5 6- 7 0 •� 9 T DIQ 10 9.0' ON 12 1:1 IG 1s I 16 `§ 17 :91 Ro =9.0' .Tto4 GRAY S/Lr w/Some 5AND, TJ:;Acc GRAVEL, coH651UE 5m e WAS GROUND WATER ,`A S ENCOUNTERED— L O P E IF YES. AT WHAT DEPTH' i MEN DOE ■,1i�1�t1�■. -U . SS _.... Z . m, J.• P_ .� _. - MEIN MEIN mollm e WAS GROUND WATER ,`A S ENCOUNTERED— L O P E IF YES. AT WHAT DEPTH' E i�ONE i MEN DOE ■,1i�1�t1�■. -U . SS _.... Z . m, J.• P_ .� _. - • 6 _ -- -- 3S0'_ : W`w •,•• 1834Er••.� �.1� -g _- 1.2:_25 10 1 •n, 11 _!2LS_ _.10.rr.^ _ .4.�.. NONE E i�ONE MEN DOE ■,1i�1�t1�■. -U . SS _.... Z . m, J.• P_ G.oaa Nei Dellth 10 R<.O�ng On1e T.me Tmme Wste, OF Ads •l \ 3.. -U . SS _.... Z . m, J.• P_ .� _. - JOHN ESWANSON: m a 6 _ -- -- 3S0'_ : W`w •,•• 1834Er••.� �.1� -g _- 1.2:_25 10 1 •n, _!2LS_ _.10.rr.^ _ .4.�.. Net D'oP O :z5 20 1 I PERCOLATION RATE ,�J..�---Lwnoical nthl IL—JI TEST RUN BETWEEN FT AND FT COMMENTS HI- $EpROCK Ar 9.S?At -'EGGomEnrD__SHq-�.L,O.Stl_.'L�ENDN._-Df�'A1N.F_1E�D._-_ i.e RFTwF&rJ '.I 1. r PERFORMED BY K/. �[��i'„ SC15 G�I��nee1-s CERT•FIED UY —_—__ O�TC— Municipality of Anchorage A`00 7jAA .� Development Services Department Building Safety Division On-Site Water and Wastewater Program s . 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. 7) 343-7/onsite (907)343-7904 , CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 05/ - 13 -O -7 COSA # D 8 O 3 O q Expiration Date: i9 — Cl 1. GENERAL INFORMATION Complete legal description Scimitar #2 Block 4 Lot iiA Location (site address) 2o•;B; Tulwar Drive Chugiak. AK ggs67 Current Property owner(s) Tom & Marylee Melius Day phone 688-2254 Mailing address 2038sTulwarDrive Chugiak AK9gs67 Lending agency Day phone Mailing address Real Estate Agent Joy Moses/PrudlWVista Relo Day phone T -7M Mailing Address .3S0 ( � ��r— n �(, � ` .2W Zf_Q 73 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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. b. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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. Phone 272-8218 Name of Firm Pannone Enoineering Services LLC Address _E_.0_Boxjo29SA Anchors a AK 10 Engineer's Printed Name Steven R. Pannone PE Date 040 Engineers Comments: In conducting an adequacy test,/ attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & 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. �������aa The operational life of all wells and septic systems depend on the local soil condition, ground water .��•`� IF /V a!a4_♦ 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 49IM_ there are no hidden defects or encroachments. PES can therefore not provide any warranty for future —00 • performance nor give any estimate of how long the system will continue to meet the operational r�, c}f� requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed `5 Steven R Ponnone above. Any reliance upon or use of this report by any other person or party is not authorized nor will it #1J, \ No CE 8149 confer any legal right whatsoever. # i 5. DSD SIGNATURE ♦ 4� ata%E ��• _j -�� Approved for ___4 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other 19-09 By: r Original Certificate Date: 3 rpw 11/05 Municipality of Anchorage o • Development Services Department ` j 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: Scimitar #2 Block 6 Lot 2 Parcel ID: A. WELL DATA Well type P If A. B, or C provide PWSID # _ Well Log (Y/N) Y Date completed &1%q12Qq8 Sanitary seal (Y/N)y Wires propedy protected (YM) Y Total depth 46o ft. Cased to sj_ft. Casing height (above ground) 24+ In. FROM WELL LOG AT INSPECTION Date of lest 411g1Zgg8 8118f2008 Static water levet uc ft, i26 ft. Well production 2 g.p.m. 2.7 9 - p.m -WATER SAMPLE RESULTS: Coliform --G� colonies/100 mL Nitrate ' mg Other bacteria colonies/100 mL Arsenic:0'd 8 mA Date of sample: I19 Collected by: Mike Wehr B. SEPTIC/HOLDING TANK DATA Tank Type/Material Anchorage Tank Steel Date installed c1ia12ao8 Tank size 12So gal. Number of Compartments g Cleanouts (YIN) Y Foundation cleanout (YM) Y Depression over tank (Y/N) N High water alarm (YM) N/A Date of pumping 8/t8hoo8 Pumper JR's Pumping C. ABSORPTION FIELD DATA Date installed 5 2Llagg8 Soil rating (g.p.dJfe or ft2/bdrm) z2S System type Shallow Trench Length 5o ft. Width S ft. Gravel below pipe t. ft. Total depth ao.S ft. Eff. absorption area S.00 ft2 Monitoring lube Y Depression over field N Date of adequacy test 812812oo8 Results (Pass/Fail) Pass For 6 bedrooms Fluid depth In absorption field before test ft in. Water added600 gal. New depthft in. Elapsed Time: g min. Final fluid depth pry in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed 'Pump on' level at _ in. 'Pump off Datum E. SEPARATION DISTANCES Cycles Manhole/Access (Y/N) In. High water alarm level at in. V Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfift station on lot aoo+ On adjacent lots aoo+ Absorption field on lot aoo+ On adjacent lots aoo+ Public Sewer main NIA i I Public sewer manhole/cleanout NIA Sewer /septic service line zc+ Holding tank soo+ Animal containment areas soo+ Manure/animal excrete storage areas %oo+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation c+ Property line iLo+ Absorption field 20+ Water main N/A Water service line aS+ Surface water aoo: Wells on adjacent tots aoo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ao+ Building foundation ao+ Water main NIA Water Service line aS+ Surface water zoo+ Driveway, parking/vehicle storage ao+ Curtain drain _None Observed Wells on adjacent lots aoo+ F. COMMENTS Tank underdeck. Loose boards allow access. too+ Gallons storage in well casing. G. ENGINEER'S CERTIFICATION �J•\t �., ... �,4• I certify that I have determined through field inspections and ,,,•• , review of Municipal records that the above systems are in `�'" • ...F...«. 0 conformance with MOA COSA guidelines in effect on this date. ; i �........ _... ... .... ..«—.-- j.�+'�Sirven RRill nn<W lti� Engineer's Printed Name Steven R. Pannone, P.E. 00% NO ••�•• ,• �f�� Date a4O?s 44 ..... .... COSA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 11/05) CTBE Ref. M Client Name: Project Name: Client Sample ID: Matrix: PWSID 1090878 Pannone Engineering LT 11A BK 4 Scimitar #2 LT 11A BK 4 Scimitar #2 Drinking Water n/a Sample Remarks: Nitrate, Coliform data SGS Environmental Services 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 Client PO#: Printed Date/Time: Collected Date/Time: Received Date/Time: Technical Director. Released By: n/a 03/19/09 12:50 03/08/09 15:00 PM 03/09/09 12:45 Stephen Ede Deanna Crump Allowable Prep Analysis Parameter Results POL Units Method Limits Date Date Init Nitrate 0.144 mg/L SM204500 10 3/10/2009 03/11/09 JDH Colony Count 0.00 CoV100ml SM9222B 10.0 3/9/2009 03/10/09 DLC Total Coliform 0.00 CoV100ml SM9222B 0.0 3/9/2009 03/10/09 DLC Municipality of Anchorage fi.By • -� Development Services Department r-, Building Safety Division ` On -Site Water and Wastewater Program 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. (115-1 — I+'f�y -D71- COSA # n g Expiration Date: 1Z '�20%S 1. GENERAL INFORMATION Complete legal description _Scimitar #2 Block 4 Lot "A Location (site address) 2oa8s Tulwar Drive, Chugiak. AK aas67 Current Property owner(s) Tom & Marylee Melius Day phone 688-'1254 Mailing address 20-48S Tulwar Drive. Chugiak. AK49567 Lending agency Day phone Mailing address Real Estate Agent Claire Ramsey Day phone 26'1-7552 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site ED Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 seat 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 Pannone Engineering Services. LLC Phone 272-8218 Address P.O. Box 1029s4 Anchorage AK g9510 Engineer's Printed Name Steven R. Pannone P.E. Date 199?r9�_ Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & 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 oran 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 arc no hidden defects or encroachments. PFS can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for t4 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: : tAIACTGWATFR Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: -',=�"'Original Certificate Date:_2 O (Rev. 1tm) .11/1 � Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program "' e 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: _Scimitar#2 Block 6 Lot 2 Parcel ID: 051-13ul -07 A. WELL DATA Well type E If A, B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 4J1q/iqq8 Sanitary seal (Y/N) y Total depth j 6o ft. Cased to -s3—ft. FROM WELL LOG Date of test 6/2q/i998 Static water level 115 ft. Well production 2 9.p -m. Wires properly protected (Y/N) Y Casing height (above ground) 24+ in. AT INSPECTION 8/1812oo8 226 ft. 1.7 9— p.m-WATER SAMPLE RESULTS: Coliform `� colonies/100 mL Nitrate 0*(6 mg/L Other bacteria -6;�-1— colonies/100 mL Arsenic: AJI) mgA Date of sample: 8 8 o8 Collected by: Laura Pannone B. SEPTIC/HOLDING TANK DATA Tank Type/Material _Anchorage Tank Steel Date Installed Sha/aog8 Tank size 1250 gal. Number of Compartments a Cleanouts'(Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YM) t( High water alarm (Y/N) N/A Date of pumping 8/18hoo8 Pumper JR's Pumping C. ABSORPTION FIELD DATA I Date Installed ShrJiao8 Soil rating (g.p.d.e or Obdrm)12S System type Shallow Trench Length so ft. Width S ft. Gravel below pipe 4 ft. Total depth. 2oS ft. Eff, absorption area Soo ft? Monitoring tube Y Depression over field N Date of adequacy test 8/1812oo8 Results (Pass/Fail) pass For & bedrooms Fluid depth, in absorption field before test pry In. Water added600 gal. New depthft in. Elapsed Time: o min. Final fluid depth ppt in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Mn !If yes, give date D. LIFT STATION Date Installed Size "Pump on" level at _ In. `Pump Datum at —In. E. SEPARATION DISTANCES I 1 4 SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot zoo+ Absorption field on lot _zoo+ Public sewer main N/A Sewer /septic service line zc+ Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots ioo+ On adjacent lots ioo+ Public sewer manhole/cleanout N/A Holding tank ioo+ Animal containment areas ioo+ Manure/animal excrete storage areas zoo+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation c+ Property line o+ Absorption field ao+ Water main NIA Water service line 2s+ Surface water _zoo+ Wells on adjacent lots ioo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line zo+ Building foundation io+ Water main N/A Water Service line zc+ Surface water ioo+ Driveway, parking/vehicle storage io+ Curtain drain None Observed Wells on adjacent lots aoo+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inspections and s e4 review of Municipal records that the above systems are In 49'"'� conformance with MOA COSA guidelines In effect on this date. ;" s .... ............. _.......... Engineer's Printed Name Steven R. Pannone. P.E. ♦ rh ssiry?n ��� Nn CE 8149 + . Date r S'. COSA Fee $ Date of Payment 5 �� Receipt Number 3I (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number SGS Ref. M 1084331 Client Name: Pannone Engineering Project Name: Scimitar #2, Ll 1A, B4 Client Sample ID: Scimitar #2, Ll 1A, 84 Matrix: Drinking Water I40lV l SGS Environmental Services Inc 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 All dates/ imes are Alaska Standard Time Printed DaleMme: 09/03/08 14:25 Collected DateMme: 08/18/08 12:30 Received Date/rime: 08/18/08 13:58 Technical Directo-r,./ /S/tephen Released Be7`/�. Allowable Prep Analysis Parameter Results POL Units Method Limits Date Date Init Colony Count 0.00 9222B 08/18/08 08/18/08 die Total Coliform Count 0.00 9222B 08/18/08 08/18/08 die Fecal Coliform Count 0.00 9222B 08/18/08 08/18/08 die Nitrate 0.65 0.10 mg/L EPA 300.0 10.00 0827108 0827/08 jdz Arsenic ND 5.00 ug1L 200.8 .10.00 0820108 0820108 nrb r '- r r \rT �O•M, ASBUILT SEWARD & I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALE+ r FOLLOWING DESCRIBED PROPERTY, srierirorludcµ�r tlor//.fl•Y. EXIST EXCEPT AS DATE+ AND THAT NO ENCROACHMENTS 7�o/i INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID EASEMENTS, COVENANTS, OR RESTRICTIONS Nw WHICH DO NOT APPEAR ON THE RECORDED SUBDI- FB VISION PLAT: UNDER ND CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BCUND- DRAWN+ ARY LINES. 0 o Duane Mark 3dwstd LS -6918 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519519 -6650 n www.muni.org/onsite J f (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. DJr/— /3y_O7 COSA# Oto D?m 1. GENERAL INFORMATION Expiration Date: /0 — / 9 — 0 G Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address SCIMITAR H2: LOT 11A. BLOCK 4 20385 TULWAR DRIVE • CHUGIAK. AK 99567 DON & KARI STEPHENS Day phone 20385 TULWAR DRIVE • CHUGIAK. AK 99567 Day phone LYNETTE w/REMAX PROPERTIES Day phone 16600 CENTERFIELD DRIVE • EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 688-3555 694-4804 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational file of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for L4' bedrooms. Disapproved. 337-6179 Date )13 XXI Conditional approval for bedrooms, with the tllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory �G Arsenic Advisory Maintenance Agreements Supplemental Engineers Reort Other ON SITE WATER AND VASTEWATfR : PROGRAM By: Original Certificate Date: 7_/C) - 06 fpr I,RK, Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program ` 47W Bragaw Street P.O. Box 196850 Anchorage, AK 995198650 www.murd.org/waft (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SCIMITAR SUBDIWSION /2: LOT I I& BLOCK 4 Parcel ID: D Jr' -1 "13 V -e % A. WELL DATA Well type PRIVATE H A. B, or C provide PWSID# N/A Data completed 4/17/1998 Sanitary seal (YIN) YES Total depth 460 ft. Cased to 53 ft. FROM WELL LOG Date of test 4/17/1998 Static water level 115 ft. Web production 2 g.p.m. WATER SAMPLE RESULTS: Coliform a colonies/100 ml. Nitrate 0.118 mg./L. Well Log (YM) YES Wires property protected (YIN) YES Casing height (above ground) 18+ in. AT INSPECTION 6/22/2006 94 ft. 1.29 g.p.m. Other bacteria 0 colonies/100 ml. Arsenic: NQ_ ug1L. Date of sample: 6/22/2006 Collected by: GEG Ltd. B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 5/13-14/1998 Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (VIN) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 7/l/2006 Pumper SANITARY PUMPING C. ABSORPTION FIELD DATA Date instabed 5/13-14/1990 Sob rating (g.p.d./R'ort� 1_2 System type SHALLOW TRENCH Length 50 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth OSP38 ft. ER. absorption area 500 fe Monitoring tube YES Depression over field NO Date of adequacy test 6/22/2006 Results (Pass/Pab) PASS For 4 bedrooms Fluid depth in absorption field before test 2 in. Water added 623 gal. New depth E in. Elapsed Time: 17 min. Final fluid depth E in. Absorption rate >- 600+ g.p.d, Any rejuvenation treatment (past 12 mo.) (YM 8 type) NONE KNOWN If yes, give date is D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons "Pump off" High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankfiift station on lot 100,+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer menhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingtvahicie storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through held inspections and review of Municipal records that the above systems are in . • • • •. • • • ... ""'.""" conformance whir MOA COSH guidelines in effect on this date. y . rness.. Engineer's Printed Name JEFFREY A GARNESS �$ ' , CE -79 3 Date 7113 /� u �Wh.Pro/endo^d' COSA Fee E rz 36 n!2 Date of Payment Z�Z 2V0 C Receipt Number 0 7a (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number SCS Rel.a 1063379001 Client Name Garness Engineering Group, Ltd. Project Name/a Scimitar SD Lot I IA Block 4 Client Sample ID Scimitar SD Lot I IA Block 4 Nlatris Drinking Water Sample Remarks: All Dates/rimes are Alaska Standard Time Printed Date/time 07/07/2006 15:26 Collected Date/rime 06/22/2006 14:30 Received Date/time 06/23/2006 13:35 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results POL Units Method Container ID Limits Date Date [nit Metals by ICP/MS Arsenic Waters Department Nitmtc-N M.icrobiolocv Laboratory Total Coliform ND 5.00 0.118 0.100 0 ug/L EP200.8 mg/L EPA 353.2 C (<10) 06/26/06 06/30/06 Ml I 0 (<10) col/IOOmL SX1209222B A (<I) 06/23/06 ALR 06/23/06 TLF i ; fN-16-2006 12:49 From: �.r To:9073383246 �Yco ASBUILT SEWARD d I I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: ��'•��" •aat�ori/.�.�f � GATE: AS AD THAT NO OTHE EXISTCOFrTHE INDI ATED, IT IIS RESPONSIBIILLITYENTs OWNER TO DETERMINE THE EXISTENCE OF ANY GRID EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SMDI- �•.�,.r�i VISION PLAT. UNDER NO CIRCUMSTANCES SHOLI D FBl ANY DATA HEREON BE USED FOR CONSTRUCTION %'•� /� OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN, 0 I i OF AZA%bubma USA S.. a � fa91e ad• Ls- • i + + v, ; P.1/1 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICESA=�� Division of Environmental Services .�cn . On -Site Services Section !' P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.O. a 051-13-i57 HAA # k1(19`N1QnQ1 1. GENERAL INFORMATION Complete legal description Lot 11, Block 4, scimitar Subdivision No. 2 Location (site address or directions) Property owner Mailing address Lending agency —MM&M Contracting Dayphone-6RA-1716 P.O. Box 670495 Chugiak, AK 99567 Day phone Mailing address ' Agent Day phone Address - Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS:. Four t 41 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE. If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer '�ni1 � x)11'\•\�� NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. r 72-025MW.7N1) Fm FOAM f 5. STATEMENT OF INSPECTION BY ENGINEER -Ascertified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I f urtherverify 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's signatureDate 11/19/98 6. DHHS SIGNATURE Approved for SSLk= bedrooms. Disapproved. Conditional approval for Additional Comments By. i bedrooms, with the following stipulations: Date 4572_6 J99 The Municipality of AiQl;orage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates,'6ased only upon the representations given in paragraph 5 above by an independent professional engiNeetregistered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is Issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. rZ=Mw uv+r e.k MOA MI Municipality of Anchorage R E C E DEPARTMENT OF HEALTH & HUMAN SERVICES e6Environmental Services Division 4I 0v 2 0 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-47 MUNICYALITy OF ANCHOUGe Health Authority Approval Checklist ENvuon"4 N Au SERVCES DIVISION Legal Description: Lot 11, Block 4, Scimitar No. 2parcel I.D.: 051-13-257 A. WELL DATA Well type Private If A, 8, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed 4/19/98 Total depth 460' Cased to 53' Casing height (above ground) 21 Sanitary seal (YM) F*77 1 Static water level Well production Y FROM WELL LOG 4/19/98 115' 2 9 - P.m - WATER SAMPLE RESULTS: Coliform Date of sample: 10/12/98 B. SEPTIClHOLDING TANK DATA Wires property protected (Y/N) AT INSPECTION Nitrate .348 mq/L Otherbacteria Collected by: A. Harala Y 0 Dale inatatled 5/13/98 Tank size 1,250 Number of Compartments 2 Cleanouts (YM) Y Foundation cleanout (YM) Y Depression (YM) N High water alar (YM) N Date of Pumping New Pumper Construction C. ABSORPTION FIELD DATA Dat9 instailed 5/14/98 Soil rating (g.p.dAr or f */bdr) 1.2 Systam type 5' Wide Trench Length 50Width 5' Gravel thickness below pipe 4 Total depth 9' Effective absorption area 500 Monitoring Tube present (Y/N) Y Depression over field (YM) Y N Data of adequacy tog New Const. Results(Pass/Fain Pass For 4 bedrooms Fluid depth in absorption field before test (in.); Immediately atter_ gal. water added (in.): Fluid depth (ins) Minutes later. Absorption rate = a.p.d. Peraodde beatment (past 12 months) (Y/N) N if yes, give date 1 72,E (Rev. W). i D. LIFT STATION - Date Installed None on Lot Manhole/Access (YM) High water alarm level at• Cycles tested E. SEPARATION DISTANCES Size In gallons `Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septle/hoiding tank on lot >100' Absorption field on lot Public sewer main Sewer /septic service line >100, N/A >25' On adjacent lots On adjacent lots 'Pump off" level at* >100' >100' Public sewer manhole/cleanout Litt station N / A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: N/A Foundation >51 Property line >51 Absorption field >5' Water maintservice line —.L1 0 -'Surface water/drainage > 100Wells on adjacent lots > 100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property fine >10' Building foundation >10' Water maintservice line >10' Surface water >100' Driveway, parking/vehicle storage area >25' Curtain drain Nnno nn Lot Wells on adjacent lots >100' F. ENGINEER'S J cer* that I have determined thru Held inspections and review of Munidpal reQ**t , ¢via stems are in conformanceswilh,MOA'HAA guiiddelines yin effect on this date . ,4Qt• "Y� �� Signature. r h� 64a4^-�^ oo*' dQ . •.. ,/ Engineer's Name Michael E. Anderson. P.E. •t. 10 Date 11/19/98 � f 43M • r> HAA Fee $ ' a& `'vim Data of Payment/ 1 Receipt Number 72-026 (Rev. "6)- Waiver Fee $ Date of Payment Receipt Number