HomeMy WebLinkAboutSEA TURN BLK 2 LT 8Sea Turn
Block 2
Lot 8
#017-121-32
\
. .,,
Municipality of Anchorage
Development Services Department
Building Division
:
On-Site Water 8 Wastewaterr Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ei.anchorage.ak.us (907) 343-7904
age 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
I
Permit Number. SW040384 PID Number —Y]J% -Iai' X507
NOTe`
ESTATE OF
DAVID LEACH C/O CHARLOTTE W/ REMAX
Wastewater System: ❑New ■ Upgrade
y
Address:
15040 PLATINUM CIRCLE a ANCHORAGE, AK. 99516
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 257-0106 3
O Deep Trench ■ Shallow Trench 0 Bed O Mound I OOther
LEGAL DESCRIPTION
Sea RaY,p:
0.8
Total Depth horn wyael po :
6.0 (MAX)
GPD/sa. R
R
Block: Lot:
Subdivision:
D.ah to pipe bottom horn or" pod.:
C,p W depth benwth lliW
2 8
SEA TURN
SEE DWG. R
1 2.5 R
Township:
Range: Section:
n edeas avow od9 pod.:
G,aa 1.0h:
—
— —
SEE DWG. R
I 73 R
WELL:
❑ New [IUpgrode
c.a a wrath:
5
NumWr of Ikre:
1
Dbat...n
Yoncs —
FL
R
cb.Ylcaba„ P,+wl.. AUX I Tota
ra.w To:
Tow ob.agp ona:
563+
PV. meleda: i
D 3034/ F-810
fX\S(\N .
R
so. rL
Wa4r:
G oats oruw:
smtc water resat:
u,.t~..
G.E.G. Ltd.
Oat. Wt
9/20-21 /2004
R
YI.Id:
Pamp sat w.
Cc" Ner9ht IW a,. mane.
TANK I
CPY
R
R
SEPARATION
DISTANCES
aseptic []Holding CIS.T.E.P. I C) Other
To
Septic
Tank
Absorption
Field
Ufl
Station
Holding
Tank
/Prhot.
$seer units
Yp1N4acl~.
ANCHORAGE TANK
capacity k' Mea^«
1000
Froin
Well
too'+
100'+
—
—
25'+
Yat«ta: STEEL
NoniOi a aampert I X
Surface water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
10'+
—
—
—
S" in Me«m
Yanala :
Foundation
5'+
10'+
—
—
—
on I.,N a:
at at:
K9h eater awm a:
Curtain Drain
NONE
KNOWN
Puna Yo4 e1:
aacbka YweclC,M Perlamwd br.
Remarks:
BENCH MARK
Lacotw, ane De.cripbw:
OLD DRAINFIELD TO BE USED AS ALTERNATE SITE
TOP OF SILL ® GARAGE MAN DOOR.
OLD TANK
IS COMPLETELY ABANDONED PER UPC.
� 100.00
R
ENGINEER? 39L
OOQO�
Inspections
performed by: GEG, Ltd. Dates: 1st 9/20/2004
*.::... .....°oo��
2nd 9/21/2004D
...
3rd 9/22/2004
0' f' a ass.
oOp�4p-e
Development ervices Department Approval
,
�v �S
Reviewed and approved by: �ate:1�
(R.v. 12/01)
p
%, rofesstan o
QQOf sslo
PERMIT NUMBER: AS -BUILT DRAWING ^,�A, i Do- W.-IER:I
SW040384
I \
I\
A B C \ \ \ \
I FCOI 19.18 6.08 19.18 �\ \
FCO2 18.68 5.95 9.14
I
'FTI 19.37 10.03 15.61 \ \
ST2 23.68 15.84 20.59
DBLI 25.15 17.50 21.99 \
DBL2 26.08 18.63 23.00 100 WELL RADIUS \
BV 126.781 19.39 123.67 1\
I C01 42.16 49.95 60.40 I EXISTING
MTI 39.80 47.36 57.80 WELL
I CO2 79.01 72.42 73.58
I MT2 73.30 67.00 68.56
�W\
h
FCO ST ••�•- ..\.. /
NEW 1000 CO \ /
�9 I GALLON TANK LII •, "' • \
rl
EXISTING DRAINFIELD ` -
TOBE USED AS A
RESERVE SITE
i
o I TH/ `
I
INSTALLEDDIVERTER /
Oi` /
NEW DRAINFlELD
I � /
J 9/29/2004
DRAWN BY:
GARNESS ENGINEERING GROUP, Ltd. SCALE: R.A.L.
CONSULTANTS 8 GENERAL CONTRACTORS 1. = 40'
3701 F TUDOR ROAD. SUITE 101 • ANCHORAGF. AK 99507 • FHONF !9071331.6179 • FAX f907133R-3TL9
PREPARED FOR: ESTATE OF DAVID LEACH PHONE NUMBER: PAGE NUMBER:
C/O CHARLOTTE W/ REMAX 257-0106 (AGENT) 2 OF 3
LEGAL DESCRIPTION:
SEA TURN SUBDIVISION; LOT 8, BLOCK 2
AS -BUILT FOR NEW SEPTIC SYSTEM
m1y1rm
I
SW04O384' AS -BUILT DRAWING PARCEL ID NUMBER:
FINAL GRADE
101.22-101.32
5T1 ST2 r2' OF INSULATION
TOP OF TANK AT
INLET - 97.56 •
INVERT OF BUNG
AT INLET - 97.0:
n
------fir--
u
NEW 1000 GALLON
SEPTIC TANK
INSULATION
FILTER FABRIC
T
2.5'
TOP OF TANK AT
OUTLET - 97.56
FINAL GRADE
99.74-99.86
ORIGINAL GRADE
98.56-100.07
BOTTOM OF TRENCH (.� 5' 1
OF
1
INVERT OF PIPE
96.56
VERT OF BUNG 'I
OUTLET - 96.77
TH/1
RELATIVE ELEVATION OF BOTTOM
TESTHOLE O 85.74 (TESTHOLE DOF
DATE: 06044
9/29/2004 oao C 0
DRAWN BY: v0�! .Or.I .�S14p
�_ __----- ------ — - -..__ .--_ . - __._ . G •' '• �V
GARNESS ENGINEERING GROUP, Ltd. R.A 4
CONSULTANTS& GENERAL CONTRACTORS I SCALE:n — 40' O
_ ...... .
... .. ......
901 F TlD(W eOAD. SNTF 101 • ANCNOFEf,F. AR 00501' PHpNF f00A131dA4...... .0 • FAX f00)131M
TG0 I
PREPARED FOR: ESTATE OF DAVID LEACH PHONE NUMBER: PACE NUMBER: I Q
C/O CHARLOTTE W/ REMAX 257-0106 3 OF 3 Q ff y �G esS,:
LEGAL DESCRIPTION: Q C79 3 iQ
SEA TURN SUBDIVISION; LOT B. BLOCK 2 pp4�e' • ..(A D�oAv�
TYPE OF WORK: 4�edPlofessfo0\�
AS—BUILT PROFILE DRAWING OF NEW SEPTIC SYSTEM DOpp00poo�
MUNICIPALITY OF ANCHORAGE
Development Services Department
Onsite Water 6 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number. SW040384
Legal Description: SEA TURN BLK 2 LT 8
Design Engineer: 0855 Garness Engineering Group, LTD
Owner Name: DAVID LEACH
Date Issued: Sep 14, 2004
1
Expiration Date: Sep 14, 2005
Parcel ID: 017-121-32
Site Address: 015040 PLATINUM CIR
Lot Size: 50083 SO. FT.
Owner Address: 15040 PLATINUM CIRCLE Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 99516-4333
This permit is for the construction of:
❑✓ Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be In accordance with:
1. The attached approved design.
2.
3.
4.
All requirements specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
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, seated, and heated to prevent freezing.
Received By:
Issued By:
Date:
Date:
I
Municipality of Anchorage
• /, Development Services Department
Building Safety Division
Onsite Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650
www.cl.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. Q/ 9 - /'/- i�L Permit Number
Property owner(s) ESTATE OF DAVID LEACH Day phone GENT) 1257-0106
Mailing address (1) 15040 PLATINUM CIRCLE • ANCHORAGE. AK
Mailing address (2) Zip Code 99516
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range) N/A
Lot Size 5aDR3 Acre Sq.Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only E Well Only
Sewer and Well ❑ Water Storage
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi
Swimming Pool ❑ Water Softening Unit
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being
Single Family Dwelling and is in accordance with applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
Permit Fees: 4L.WI-,
Date of Payment: c? )�;Joq
Waiver Fees,
Date of Payment:
Receipt Number: 519 N (a . Receipt Number.
a
f
for a
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
September 9, 2004
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bmgaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Septic System for Sea Turn Subdivision; Lot 8, Block 2
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. The septic system is
currently in a state of failure and needs to be replaced. We are proposing to install a new 1000
gallon septic tank and 5 -wide trench type drainfield. One test hole was excavated on the property.
The drainfield will be designed around the 30 foot radius of this test hole. Comments regarding
the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring,
and the percolation test results. It is our opinion that an application rate of 0.8 gallons/day/ft'
should be used.
2. TRENCH DESIGN:
a. Percolation Rate: 12 minutes/inch
b. Proposed Application Rate: 0.8 gallons/day/ft'
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 563 ft=
f. Total Depth: 6 feet (maximum)
g. Effective Depth: 3 feet (minimum)
h. Width: 5 feet
i. Reduction Factor: .58
j. Minimum Length: 66+ feet long
k. Effective absorption area = 563+ ft'
3. SURFACE WATERS: There are no surface waters within 100 feet of the
system.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: gamessengineering.com
septic
4. TOPOGRAPHY: As can be seen on the attached topography site plan the average slope in
the area is approximately 5 to 10 percent running northeast to southwest. In short, there are no
slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you'
ve any questions, please contact us at 337-6179. Thank you for your
assistance.
M.S.
NOTE: A site plan drawing, a design drawing, one soil log, and a 7 page
specification letter which are all part of the design package for this septic system.
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: gamessengineering.com
n, � �� _ r,T,✓�S
EXISTING 3
BEDROOM
HOUSE —
SEPTIC ARF�\1 —_
/ SEA TURN S/D;
/ LOT B. BLOCK 2.
I
EM�1
SEA TURN S/D:
7 LOT 3, BLOCK 2,
I 1
I 1
1 1
I 1
I 1
1
I
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I I
I I
I
I
\1 1
II I
II 1
11 I
II I
/ 1 I
I
1
I
1
SEA URN S/D:
LOT 9, BLOCK 2,
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS i GENERAL CONTRACTORS
pnl F TIF1nG OnAn 1111TF 101 • ANfN Al,- At 00107 . P.ONF (00711q -M)0 • FAX (007)WAN.A
'REPARED FOR PHONE NUMBER:
ESTATE OF DAVID LEACH 257-0106 (AGENT)
ECAL DESCRIPTION:
SEA TURN SUBDIVISION; LOT 8, BLOCK 2
TYPE OF WORK:
SITE PLAN FOR SEPTIC SYSTEM UPGRADE
SEA TURN
LOT 5, BLC
I
NN BY:
C.J.G.
LE:
1e= 100'
E NUMBER:
1 OF 2
1 PROPOSED SEPTIC
1 SYSTEM UPGRADE (SEE
I DESIGN PACE 2 OF 2)
\ SEA NRN S/D;
LOT 12. BLOCK 2.
. .. ..................
' f ey SS.:
e C 953
I
I
YI
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INSTALL FLOW
OIVERTER -
INSTALL DOUBLE
CLEANOUTS
'T
PROPOSED DRANFIELD. EXCAVATE A TRENCH
THAT 6 6 FEET DEEP MAXIMUM BY S FEET
WIDE BY 66+ FEET LONG. ADD 3 FEET OF
CLEAN, WASHED SEWER DRANROCK. INSTALL
TRENCH PARALLEL TO SLOPE CONTOURS.
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS& GENERAL CONTRACTORS
5101 F 1106P POAO. eUITF 101 • ANfM09A0F. AS 99507' FNONF (90)1537- 179 • FAX (907)Ab3)45
PREPARED FOR: PHONE NUMBER:
ESTATE OF DAVID LEACH 257-0106 (AGENT)
LEGAL DESCRIPTION:
SEA TURN SUBDIVISION; LOT 8, BLOCK 2
DESIGN DRAWING FOR SEPTIC SYSTEM UPGRADE
9/7/2004
C.J.G.
1»=40•.... ..
NUMBER:
2 OF 2 (f arne
QQO j •, E 795 Fo
NOTE: THE CONTRACTOR
SHALL HAVE THE SOUTH LOT
LIINE FLAGGED BY A
I�
REGISTERED LAND SURVEYOR
PRIOR TO CONSTRUCTION.
I \
I
�\
I
100' WELL RADIUS
I EXISTING
WELL
I
I
�
\
I
I EXISTING O SEPTIC TANK
TO BE COMPLETELY
W
,�+o
02
I ABANDONED
ry
INSTALL FLOW
OIVERTER -
INSTALL DOUBLE
CLEANOUTS
'T
PROPOSED DRANFIELD. EXCAVATE A TRENCH
THAT 6 6 FEET DEEP MAXIMUM BY S FEET
WIDE BY 66+ FEET LONG. ADD 3 FEET OF
CLEAN, WASHED SEWER DRANROCK. INSTALL
TRENCH PARALLEL TO SLOPE CONTOURS.
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS& GENERAL CONTRACTORS
5101 F 1106P POAO. eUITF 101 • ANfM09A0F. AS 99507' FNONF (90)1537- 179 • FAX (907)Ab3)45
PREPARED FOR: PHONE NUMBER:
ESTATE OF DAVID LEACH 257-0106 (AGENT)
LEGAL DESCRIPTION:
SEA TURN SUBDIVISION; LOT 8, BLOCK 2
DESIGN DRAWING FOR SEPTIC SYSTEM UPGRADE
9/7/2004
C.J.G.
1»=40•.... ..
NUMBER:
2 OF 2 (f arne
QQO j •, E 795 Fo
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS E GENERAL CONTRACTORS
3701 L T1.000 IIYD, fUR 101 • ANCKWAGE. N 00307 (00I)M7-61)0 • FN CW732" • F[OSR - p w MWw ".a
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: SEATURN LOT 8, BLOCK 2
PERFORMED FOR: ESTATE OF DAVID W LEACH DATE: 8/30/2004
DEPTH__—_
(feet) ---- ORGANICS TEST HOLET11
1 - LOWER BENCH
1
sM
SM
SP/GP
11 CM/ML
21314 12-
13-
14-
B.O.H.
15-
16-
17-
18
5161718
1-1111WIl• • •g
DATE
oil
1�
NET DROP
(INCHES)
� o
3:46
—
6"
—
2
3:56
Lmm
3.5'
LIM
E
RARPI
1111111c
V",
6.
—
4
4:06
DEPTH TO
GROUNDWATER
DATE
SEEP 0 7.0
8/30/2004
NET DROP
(INCHES)
� o
3:46
—
6"
—
®s/nsl®:
1
I 1
{ 1 I loo• WELL RAVI, ,
f �
49
I �
i
1 �
1 1 1
i TH)1
1 1
{ 1 SITE PLAN
I ; / 1'.100•
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
9/2/2004 1
3:46
—
6"
—
2
3:56
10
3.5'
2.5"
3
3:56
—
6.
—
4
4:06
10
3.5"
2.5"
5
4:06
—
6"
—
6
4:16
10
3.5"
2.5"
7
4:16
—
6"
—
8
4:26
10
3.5"
2.5"
9
4:26
—
6"
—
10
4:36
10
3.5"
2.5"
11
4:36
—
6"
—
12
4:46
1 10
1 3.5"
2.5"
19� PERCOLATION RATE 4.0 (MIN./INCH) PERC. HOLE DIA. 16 (INCHES)
TEST RUN BETWEEN 4.0 FT. AND 4.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ROB CAMPBELL
COMMENTS:
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS RF RMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:4
GARNESS ENGINEER ING GROUP, Ltd.
TANTS & GENERAL
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: SEATURN LOT 8. BLOCK 2
PERFORMED FOR: ESTATE OF DAVID W LEACH DATE: 8/30/2004
EPTj TEST HOLE11
1T UPPER BENCH
2 Z
O
3-
4—
a U
LL-
5-
6-
7-
6 7 C)
8 J
9 �
10 ry
11 O
12-4 N
13 LL -
0
14
r
15 Ld
16 n
17
LLI
18 w
(/')
DEPTH TODATE
GROUNDWATER
CLOCK
TIME
OF 2
EON•-
1111111m
SEE
9/2/2004 1
112113
WWI
6'
OMP,
NNE•
111111111
- %//%
4:15
lam
'RAt
�111i11;
I��e
•
—
6'
—
DEPTH TODATE
GROUNDWATER
CLOCK
TIME
OF 2
P POE 1
SEE
9/2/2004 1
{ I 1ao' WELL RADIUS ,
„
I,
TH/
SITE PLAN
/ 1'-100'
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
!NET DROP
(INCHES)
9/2/2004 1
3:45
—
6'
—
2
4:15
30
3.5'
2.5'
3
4:15
—
6'
—
4
4:45
30
3.5"
2.5w
5
4:45
—
6-
6
5:15
30
3.5'
2.5'
t9 PERCOLATION RATE 12 (MIN./INCH) PERC. HOLE DIA. '6 (INCHES)
TEST RUN BETWEEN 2.0 FT. AND 2.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: ROB CAMPBELL
COMMENTS:
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASJJERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: d I
MUNICIPALITY OF ANCHORAGE ( )
1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 i
\ ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
lpep
- d.(.��
PHONE. EW
3- UPGRADE
MAILING ADDRESS
LEGA �OESCRIPTION
� ' Se R Q �' I
/l/VJCC�_�)TT 1
LOCATION
NO. OF BkQTOOMS
U
DISTANCETO:
Well (6)0
Absorpti area
/
Dwelling
PERMIT � //
tOG
�Y
as
WF
Manufacturer �Q-
Materi, Q�
No. of comps ments
w
Li nnin gai ons
IF HOMEMADE:
Inside length
Width
Liquid depth
i
(3 le
DISTANCE TO:
Well
Dwelling
PERMIT NO. I
S? Ciz
4
Manufacturer
Material
Liquid capacity in gallons
0
W=
DISTANCE TO:
Well
Q
Foundation
/7-
Nearest lothy a
1 /Q/i'�
PERMIT NO.
��
-1 LL Z
f. W
No. of lines
Length ofI ne
Total h of ,nes
Trenc idt
inches
Distance bet en li e
F
O
Top of tale to finish grade
Material beneath tile
inches
Total elfectiv sorption area
U
Length
W dth
Depth
PERMIT NO. i
a M
W S
Type of crib
Crib diameter
Crib depth
Total effective absorption area I
W
DISTANCE TO:
Well
Building foundation
Nearest lot line
i
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption areals)
OTHER
PIPE MATj[{tIALS
SOIL TEST RATING
INSTALLER
REMARK
-;uJ
I
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APPHOV D DATE LEGAL
J !-d
72013 1RUA178) Ic
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER. OF BEDROOMS 3 SOIL RATING CSQ FT/BR)= 100
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
O E PTH = 9 L E N G T H= 3 4 G R A %6 -PEEL- O E P TH = Z5
THE LENGTH DIMENSION I5 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 CIN FEET).
THERE IS NO SET WIDTH FOR TRENCHES. i
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
REG2FJ I REO SEPTIC TAtJY SIZE= 1400 GALLOtJS
I
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 <2> I NSPECT I OtJS ARE REG2U I REO ---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
I
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL. I
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION. I
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
i
PERM I T EXP I RES OECEMF3ER 31� 15304
I CERTIFY THAT I
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE
RESIDED
SIGNED
IF THE
15SUED BYV4. 0
dog �cV
wOv Q.�J
; 3U
'
I
5 -►to a0
-� MN I C I r -AL I TY
IJ
O FO
ANCF-►F2A GE
J �-
' DEPARTMENT OF HEALTH
AND ENVIRONMENTAL PROTECTION
' 825 'L' STREET,
ANCHORAGE, AK. 99501
1 1
264-4720
I
WELL t=i tJO ON -S
I TE
SEWER PERM
I
T S
PERMIT NO. C 800066 )
,I ,
APPLICANT HOWARD HEADLEY
1327 W 25
#23 ANCH
243-4575
LOCATION RABBIT CREEK P.D.
i
LEGAL "LTG -B= 'SERTURN S7D`
LOT SIZE 20000
SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER. OF BEDROOMS 3 SOIL RATING CSQ FT/BR)= 100
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
O E PTH = 9 L E N G T H= 3 4 G R A %6 -PEEL- O E P TH = Z5
THE LENGTH DIMENSION I5 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 CIN FEET).
THERE IS NO SET WIDTH FOR TRENCHES. i
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
REG2FJ I REO SEPTIC TAtJY SIZE= 1400 GALLOtJS
I
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 <2> I NSPECT I OtJS ARE REG2U I REO ---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
I
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL. I
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION. I
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
i
PERM I T EXP I RES OECEMF3ER 31� 15304
I CERTIFY THAT I
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE
RESIDED
SIGNED
IF THE
15SUED BYV4. 0
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
1'\ TEST
Pouch 8650, Anchorage, Alaska 99602 276.2221
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: rrow'0 0 NE%gnGy DATE PERFORMED: A�/Z�L
LEGAL DESCRIPTION: L S' IS Z 519474-PrZAJ S•b
(FEET) 1 Q—/ O/Zy'fIUIGS
1
i -z saNay slc.r
41 I Z-`/ GLGAAJ
SANGV 622i4VEL
5-
6- ,OO
7
8
9
10
WAS GROUND WATER s/ESL
ENCOUNTERED? 7
O
P
12
IF YES, AT WHAT / E
13 /T / ,sZ%� DEPTH? 1�
14i I So roe- $//T
15*Ise$)
161 I S o *3.1 4- sa .7 d
19
20
Reading
Date
Gross
Time
Net
Time
Depth to I
Water
Net
Drop
PERCOLATION RATE
�II TEST RUN BETWEEN FT AND FT
t/
COMMENTS .SE GLEA.nJ Ml1TL F(LOW1 -L' "TO R!
PERFORMED BY: CONST E NG), t WC-CERTIFIEDBY:
DATE:
72008 (7/76)
1
z
v IV, Gousu UL 0,,, Oma.
�lLLA u ('\br YdU�U> s�oac� da lsl 2cceci rn
R.1 LIha - ALL r Q,
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4
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� ( � chorale.chorale.e, AIUMa1950t
1
TIME DRILL LOG CASING
DRILLING
1A • + ✓ 107,744.001! 1 C - DIV.
AY I '�r1 c ' �� 107/17P1001
•• .. it .1 rcc Su�.(nrF. 7 71
A fFr, START / , iI v nO COMPLETE /p ,4
/� !S DAT14
i n J l A P' , NAME 110('1pirli=la Dg y No.
1
;Z0 ADDRESS pLV �? ,�
n'Tj/• PLY ' CITY l�i ' gS0J PHONE q3 ;
f" nAyr {„ CiIA'!'rM.�4M k. " �I JOB LOCATION �7J� ,SrA T*UrlI.
'
TIME
WELL LOG
DEPTH
I WELL LOG
C fn w�
17P
f
i
"6
I
Su n �A% •�� �.
W AMO,
I
In v
f% wA
z '
I
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STATIC LEVEL
g�
IGPM-YIELDe/—f
L
0
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
9e-- 7'ssv-c-
Parcel 1. D. 017-121-32 Expiration Date:. ! a, -11 - j_, ,
1. GENERAL INFORMATION
Complete legal description Sea Turn Blk 2 Lt 8
Location (site address) 15040 Platinum Cir., Anchorage, Ak.
Current Property owner(s) Hubert & Camille Hegtvedt Day phone
Mailing address 401 Starlifter Way, Warner Robbins, Ga. 31098
Real Estate Agent
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
F-1
Individual
(]
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ Waiver Fee $ _
Date of Payment Date of Payment
Receipt Number Receipt Number,
COSA#S C� / ( r�i 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 Certif icate of On -Site System s 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 100217, Anchorage, AK 99510
Engineer's Printed Name Steven R. Pannone Date 9/10/12
6. DSD SIGNATURE
3 System #1 Approved for. bedrooms.
System #2 Approved for, bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
By: Original Certificate Date:
The Municipality of Anchorage Development Sery ices Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet -9,1-12.d.
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: Sea Turn Blk 2 Lt 8 Parcel ID: 017-121-32
A. WELL DATA
Well typePava'e
Date completed 519'80
Total depth 130 ft
Date of test
If A, B, or C provide PWSID #
Sanitary seal (Y/N) Y
Cased to 130 ft
FROM WELL LOG
8/18/80
Static water level 48
Well production 5.2
10
g. p. m.
WATER SAMPLE RESULTS:
Coliform Neg colonies/100 mL Nitrate ND mg/L
Arsenic: ND ug/L date of sample: B130n2
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Steel
Tank size 1000 gal. Number of Compartments 2
Foundation cleanout (YIN) Y
Date of pumping 6/31/12
C. ABSORPTION FIELD DATA
Date installed 9/21/04
Length 73 ft
Well Log (Y/N) Y
Wires properly protected (YIN) Y
Casing height (above ground) 18 in.
AT INSPECTION
5/18/12
44 ft
4.0
g.p.m.
Other bacteria ND
Collected by: PES
colonies/100 mL
Date installed 9/21/04
Cleanouts (Y/N) Y
Depression over tank (Y/N) N High water alarm (Y/N) N/A
Pumper A+ Home Services
Soil rating (g.p.d./ft2orft2/bdrm) 0.8gpolsf
System type Trench
Width 5 ft. Gravel below pipe 2.5 ft.
Total depth 5_5 ft. Eff. absorption area 563 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 5/18/12 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0 in.
Elapsed Time: 120 min. Final fluid depth 0 in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N
Water added 485 gal. New depth 0 in.
Absorption rate , 450+ g.p.d.
If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at _ in.
Datum
E. SEPARATION DISTANCES
WELL ON LOT TO:
Size in gallons
"Pump off' level at _ in.
Cycles tested
Septic tank/lift station on lot 100+
Absorption field on lot 100+
Public sewer main 75+
Sewer /septic service line 25+
Animal containment areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+
Manhole/Access (Y/N) _
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout 100+
Holding tank 100+
Manure/animal excrete storage areas 100+
Water main 10+ Water service line 10+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+
Water Service line 10+ Surface water 100+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through meld 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 Steven R. Pannone
Date 9/10/12
COSA brown sheet s-1-12.doe
Absorption field 5+
Surface water 100+
Water main 10+
Driveway, parking/vehicle storage 10+
in.
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater PrograPUS.' I l
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
�vww.muni.org/onsite
i USH+ J (907)343-7904
CERTIFICATE 6F ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. _017-121-32
1. GENERAL INFORMATION
Complete legal description Sea Turn Blk z Lot 8
Location (site address) 1so4o Platinum Cr.
COSA# OSC.lattBq
Expiration Date: S
Current Property owner(s) Hubert & Camille A Hegtvedt Day phone
Mailing address 4oi Starlifter Way Warner Robbins GA. 3io48
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup
2. NUMBER OF BEDROOMS:
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.
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 procedufers 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 100217, Anchorage AK g4510 / )
Engineer's Printed Name Steven R. Pannone, P.E. Date
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 of all wells and septic systems depend on the local soil condition, ground water • OF q� ��ff
levels that may fluctuate during the year, and the water usage of the family being served by the system. ��,`P•,............ ,�, (��1,
These conditions are outside the control of the evaluator of this system. All systems eventually fail and r?.•••• 'T9 0
satisfactory test results do not guarantee future performance of the system, nor do they guarantee that.• 49 rn •••••°_'t'
there are no hidden defects or encroachments. PES can therefore not provide any warranty for future ..... • •• •• ••• ••••• ••h••••• j
performance nor give any estimate of how long the system will continue to meet the operational .... I ,•„ ........ ......„�
requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed ♦ :Steven R. Pannone: i
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it�1�No. CE 8149•••• ?
%�
confer any legal right whatsoever. �j
5. DSD SIGNATURE ♦4�� ��`�0•�
i/ Approved for 3 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
By: /Lvi//.• ✓ Original Certificate Date:` Z
(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: Sea Turn Blk z Lt 8 Parcel ID: o1ZAz2.-32
A. WELL DATA
Well type Private
Date completed SL19L I Jt t,
If A, B, or C provide PWSID #
Sanitary seal (YIN) Y
Total depth Sao ft. Cased to _& o ft.
FROM WELL LOG
Date of test
Static water level
Well production
81181 a'SO
WATER SAMPLE RESULTS:
Coliform +.�sRt,Le colonies/100 mL
ft.
Nitrate Vt mg/L
Well Log (Y/N)
Wires properly protected (Y/N) Y
Casing height (above ground) 18 in.
AT INSPECTION
5/18/202.2
ft.
4.0 9.p -m.
Arsenic: 1001S ug/l Date of sample: 5-01- I a Collected by: PCS
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Steel Date installed 9122./2004
Tank size 2.000 gal. Number of Compartments z Cleanouts (Y/N)
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N/A
Date of pumping I Pumper 4f 6{21/= 56A✓I4tS
C. ABSORPTION FIELD DATA
Date installed 9/22/2004 Soil rating (g.p.d./ftz or ft2/bdrm) o.8 gpolsf System type Shallow Trench
Length 73 ft. Width c ft. Gravel below pipe 2.c ft.
Total depth 5.5 ft. Eff. absorption area 561 ftz Monitoring tube Y Depression over field N
Date of adequacy test 5118/2012 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test o_o in.
Elapsed Time: lzo min. Final fluid depth o_o in.
Water adder JS gal. New deptho_o in.
Absorption rate >= 45o+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date ins a
"Pump on" level at _ in.
Datum
Size in gallons
"Pump
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot ioo+
Absorption field on lot ioo+
Public sewer main 75+
Sewer /septic service line 25+
Animal containment areas ioo+
Manhole/Access (Y/N)
High water alarm level at
Meets
On adjacent lots zoo+
On adjacent lots loo+
Public sewer manhole/cleanout
Holding tank loo+
Manure/animal excrete storage areas ioo+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation c+ Property line q+ Absorption field 5+
Water main io+ Water service line io+ Surface water loo+
Wells on adjacent lots ioo+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line io+ Building foundation zo+ Water main io+
Water Service line 2.o+ Surface water ioo+ Driveway, parking/vehicle storage io+
Curtain drain
F. COMMENTS
G. ENGINEER'S CERTIFICATION
Wells on adjacent lots zoo+
I certify that l 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 Steven R. Pannone, P.E.
Date 6!f `f7
COSA Fee $ qQb . d t?q%W Waiver Fee $ _
Date of Payment _ (A 141 Date of Payment
Receipt Number Q 25as Y
P Receipt Number,
(Rev. 11/05)
N
yen R. Panni
No. CE 8149
T11
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and 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
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-12132
1. GENERAL INFORMATION
Complete legal description Lot 6; Bade 2; Sea Tum Subdivision
Location (site address) 15040 Platinum Cir. Anchorage. AK 99516
COSA # _ up 0 ;,3
Expiration Date: U —1 S — O 7
Current Property owner(s) Paul Able Day phone 770-5900
Mailing address same
Lending agency Day phone
Mailing address
Real Estate Agent Usa Herrington / Sean Day phone 350.1673
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
Q
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 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 8 S Engineering Phone 6942979
Address 15861 S. Birchwood Loop Rd. Chugiak, AK 99567
Engineer's Printed Name Robert C. Cowan
Date 1/17 /O
_.- .fc
rb y { ROBERT C. COWAN f 'k-
5.
5. DSD SIGNATURE qy-�`lc�;� CE -8801 r���•,
Approved for 3 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
By: / t Original Certificate Date: /—/9 " 07
rRw 11051
01-16-07;17:55 ; ;907 561 5301 # 2/ 4
SCS Rcf.0
1070143001
Clicat None
S & S Enginecring
Project Namcm
L8 A2 Sea Turn SD
Client Suaple ID
LS D2 Sea Tum SD
Matrix
Drinking Waw
PWSTD 0
Samola Remarks:
AL DstesMwo are Aloka Standard Time
Printed DatclTune
01/1612007 13:13
Collected Datefrima
01/082007 13:20
ReceivedDat&Tlme
01/08200713:55
Technical Director
Stephen C• Ede
PammeterAllowable
Raulu PQL
Units Mcowd
ComainerM Limits
Prep Andysis
Due Date Init
metals by SCP/MS
••
Arsenic
ND 5.00
ug/L Emu
C &10)
01/09/07 01/11/07 TK
Waters Dopartaant
ToolNbri itrite-N
Miarobioloov Laboratory
Total Coliform
ND 0.100 m8/L. E•PA3S3.2 B MO)
0 eo1/100mL SM209222B A (<I)
01/08!07 IDS
01108/07 DPT
Municipality of Anchorage
Development Services Department
Building Safety Division
\ _ / On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.orglonsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROV
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-121-32
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
COSA #
Expiration Date:
Lot 8• Blank 2- SPn Tnrn Snhdi_viainn
15040 Platinum Cir. Anchorage, AK 99516
Paul Able Dayphone 770-5900
same
Day phone I
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well TJX
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
Day phone I
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Ey
Individual Holding tank
❑
Community On-site
❑
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-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 sand/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.
Name of Firm S & S FnninArrino Phone 6q4-7g7q
Address
Engineer's Printed Name
iver, AK 99577
Date R�31�0
\,a
ti sr.o.
5. DSD SIGNATURE �0'
Approved for 3 bedrooms.�t
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments ����c�QP' • ...
ON-SITE
WASTEWATER
PROURAM
..'"tzi_••...••- 'ay.
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineers Report
Nittate-Advisory thet
By: Aj i/� Original Certificate Date: — Ce "
(RW.11*5)
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
Legal Description: °T $ ! '6cae C- Z g &n—(-ve&) s/p Parcel ID: 917 ' f zi - 3-2-
A.
zA. WELL DATA
Well type Ra-WrTIV If A. 8, or C provide PWSID #= Well Log (T)N) Nis-%
I
Date completed ISA1166 Sanitary seal ®I) S Wires properly protected &) %.S
' �r
Total depth J2L& : Cased to t �! ft. Casing height (above ground) � fin.
Date of test
Static water level
Well production
FROM WELL LOG
AT INSPECTION
5 I r9
/ e6
ig-s g.p.m.
5.2 g.p.m.
WATER SAMPLE RESULTS:
Coliform D colonies/100 mL
Arsenic: Q mgH
B. SEPTICIHOLDING TANK DATA
Nitrate Q mg/L Other bacteria n_ colonies 100 mL
Date of sample: 9 I e6 Collected by: �' 6041x7$E�K7b
Tank Type/Material SEP-ne- I/ STwtL� Date installed _V e - 7-1 / a4
7
Tank size _.I QLV gal. Number of Compartments Z Cleanouts
Foundation cleanout MN) -1iLy- Depression over tank (Yo No High water alarm (YM No
Date of pumping PJ 04
C. ABSORPTION FIELD DATA
Date installed m -I' oy Soil rating
Length i 3 ft.
PumperhiAr1E 3Uic�
(g.p.d./ft2orfe/bdrm) O, a Systemtype `--'r�+►ttow ►max -H
Width _�> ft. Gravel below pipe 2.5 ft.
Total depth S•Wft. Eff. absorption area
Date of adequacy test 5&e&
I
Monitoring tube -S Depression over field 06
Resu (Pas ail) PA -;S For 3 bedrooms
u
Fluid depth in absorption field before test 6' in. Water added�gai. New depth in.
n
Elapsed Time: -66 min. Final fluid depthQ in. Absorption rate >= g.p.d.
I
Any rejuvenation treatment (past 12 mo.) (Y(5 & type) 0e If yes, give date "'
D. LIFTSTATION M/A
Date installed Size in gallons
'Pump on' level at _ in. 'Pump otr le
Datum Cycles tested.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot / 00 4
Absorption field on lot /O® r�
Public sewer main N 1A
Sewer /septic service line 2S 1+
Animal containment areas SD 14
High water alarm level at
Meets alar & circuit requirements?
On adjacent lots /00 '4.
On adjacent lots leo 41
Public sewer manhole/cleanout /J Ln
Holding tank A
Manureianimal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation .64- Property line S f Absorption field S /�
Water main u A Water service line i,n ¢ Surface water / 00 /f
Wells on adjacent lots ice f
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10 1+Building foundation /o 1Y- Water main fo/W
Water Service line /0 f Surfacewater /68, 14 Driveway, parking/vehicle storage 3 r4'
Curtain drain NCyW >4� Wells on adjacent lots /00 14
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that 1 have determined through field inspections and
review of Municipal records t e above systems ere
conformance with MOA COS4 quid Ines%n e,�ect OIs d
Engineer's Printed
Date
COSA Fee $ ra30
Date of Payment Cf /06
Receipt Number g55`�7
(Rev. I IM)
Waiver Fee $ _
Date of Payment
Receipt Number,
IL w
140.4
in.
Municipality of Anchorage •.
• Development Services Department
Building Safety Division ..
Onsite Water & Wastewater Program
4700 SouthS
P.O. Box 196650 Anchorage,
L
AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
1 c li qla K
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel l.D. ni=p' lzl� 3� HAA#;t- 0531!
1. GENERAL INFORMATION Expiration Date: I —
Complete legal description SEA TURN SUBDIVISION: LOT Y. 13LOCK A Z
I
Location (site address or directions) 15040 PLATNUM CIRCLE • ANCHORAGE. AK. 99516
Current Property owner(s)
ESTATE OF DAVID LEACH C/O
AGENT
Day phone 275-0106
Mailing address
2600 CORDOVA STREET •
ANCHORAGE.
AK. 99503
Lending agency
Day phone
Mailing address
Real Estate Agent
CHARLOTTE SCHLOSSTEIN W/
REMAX
I
Day phone 257-0106
Mailing address
2600 CORDOVA STREET •
ANCHORAGE.
AK. 99503
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well 0 Individual On-site 0
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 Health Authority
Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
Investigation, based on procedures outlined In the Health Authority 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 337-6179
Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507
Engineers Printed Name JEFFREY A. GARNESS, P.E. Date 112 1, D
Engineers Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines 6 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 readilyldentirrable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwaterlevels that may
guctuate 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 ownerpsted 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
_I/ Approved for -'7)_ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the filowing stipulations:
Attachments:
HAA Checklist _
Septic System Advisory
Well Flow Advisory
�r
J
�i
Manitenance,
Supplemental
Other _
k2eort
By: i ®�LLa_ aI Original Certificate Date:
(Ref. 17A7)
Municipality of Anchorage
i= Development Services Department
{i Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 1911650 Anchorage, AK 99519.66W
www.ci.anehomge.ak.us
1� (907) 343.7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: SEA TURN SUBDIVISION, LOT 8. BLOCK 2. Parcel ID:
A. WELL DATA
Well type PfWAh If A. B, or C provide PWSID# N/A
Date completed 5/19/1980 Sanitary seal (YM) YES
Total depth 130 ft. Cased to 130 ft.
FROM WELL LOG
Date of test 5/19/1980
Static water level 48 ft.
Well production 4-5 g.p m.
WATER SAMPLE RESULTS:
Coldbrm 0 colonies/100 ml.
Arsenic: N/A mg./L.
B. SEPTIC/HOLDING TANK DATA
Nitrate 40.1 mg./L.
Well Log (YM)
Wires properly protecto
Casing height (above ground) 12+ in.
AT INSPECTION
8/26/2004
48 ft.
6.06 g.p.m
I
Other bacteria 0 colonies/100 ml.
Date of sample: 8/26/2004 Collected by: GEG. LtD.
Tank Type/Materkd STEEL
Tank size 1000 gal. Number of Compartments 2
Date installed
Cleanouts (YA
Foundation cleanout (YM) YES Depression over tank (YM) NO High water al
Date of pumping NEW Pumper
C. ABSORPTION FIELD DATA
Date Installed 9/20-21/2004 Son rating .p.d ft%drm) 0_8
Length 73 ft. Width
System type
Gravel belot
Total depth *6.67 ft. Eft. absorption area 563+ ft' Monitoring tube YES
Daft of adequacy test NEN► Results (Pass/Fan)
Fluid depth in absorption field before test _ in. Water a
Elapsed Time: _ min.
(past 12 mo.) (YM S type)
in.
Depression Over field N V
For A 9dFaMW
New depth _in.
Absorption rate »�_g.p.d.
I
If yes, give date
D. LIFT STATION
Date installed Size in gallons
"Pump on" level at _fin.
E. SEPARATION DISTANCES
High water alarm level at in.
Cycles tested Meets alarm ti circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tenkilift station on lot 100'+
Absorption field on lot 1001+
Public sewer main N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/deanout N/A
Sewer /septic service line 25'+ Holding tank N/A
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 51+ - Property tine 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water----122:±-
Wells
ater100'+Wells on adjacent lots t00'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property One 106+ Building foundation 10'+ Water main N/A
Water service line t0'+ Surface water 100'+ Driveway, parldng/vehide storage 10'+
Curtain drain NONE KNOWN Wells on adjacent Iota 100'+
F. COMMENTS
G. ENGINEERS CERTIFICATION
I cattily that I have determined through field inspections and *
review of Muni*a► records that the above systems are in
conformance wfth MOA HAA guidelines in effect on this date.
Engineers Printed Name JEFFREY A. CARNESS p. •. —7853
t A �L �A': .s
............. • • ...... • '
Date , fc
rer...ar
HAA Fee $ y Walver Fee $
Data of Payment : ) i cAi Date of Payment
Recelpt Number Receipt Number
M". +ztoI)
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ENCROACHMENT PERAUT
G-3138
EN04062
017-121-32
This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric
cooperative, (herein "Chugach'), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and
The Estate of David W. Leach, (herein "Permittee"), whose address is 15040 Platinum Circle,
Anchorage, AK 99516.
1. ement. Chugach is the grantee or user of an easement for the construction and
mainfenance of electrical facilities, as follows:
Dedicated by the plat of the subdivision known as Sea Tum Subdivision, according to Plat
Number 79-197, recorded on the 26th day of October 1979, on file in the office of the
District Recorder, Anchorage Recording District, Seward Meridian, Alaska, . '
Described in that certain written instrument recorded on the 15th day of September 1953, in
Volume 96, Page 38, on file in the office of the District Recorder, Anchorage Recording
District, Seward Meridian, Alaska,
(herein "Easement") which pertains to the following described real property:
The Northeast Ten Feet (NE 10') of Lot Eight (8), Block Two (2), Sea Tum Subdivision,
according to Plat Number 79-197, recorded on the 26th day of October 1979, on file in the
office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska,
Permittee acknowledges the validity of the Easement. Permittee warrants and represents that
Permittee is the owner of the fee simple interest in the land subject to the Easement and the
following described real property to which the Easement is adjacent:
Lot Eight (8), Block Two (2), Sea Tum Subdivision, according to Plat Number
79-197, recorded on the 26th day of October 1979, on file in the office of the District
Recorder, Anchorage Recording District, Seward Meridian, Alaska,
(herein "Parcel").
Page 1 of 4
2. Encroachment. Permittee has constructed or purchased the following improvements
on or within the real property subject to said Easement:
A water well that encroaches approximately One Foot (1') into said Easement for a
distance of approximately One Foot (1'), a warning sign is to be installed by the
Permittee, adjacent to the well, to warn of the danger of working near the overhead
electric lines in the area, Chugach will supply the warning sticker,
(herein "Encroachment").
3. Permit. Chugach hereby authorizes Permittee to continue the existence of the
Encroachment in its location subject to the covenants set forth in this permit
4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any
claims for personal injury, property damage or other loss arising in any way from the continuation of
the encroachment
5. No Expansion or Increase. Permittee shall not in anyway expand or increase the
extent to which the Encroachment occupies any of the real property encumbered by the Easement
without the prior written consent of Chugach. Chugach has no obligation to provide such consent
6. No Interest in Real Estate Aeguired. Permittee hereby acknowledgesthat the
Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in
The future give rise to any interest or estate in the real property subject to the Easement or any other
real property. Without in any way limiting the foregoing, Permittee acknowledges that the
Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the
permission of Chugach forpurposes of the common law doctrine ofadverse possession. Thispermit
creates no interest in the real property subject to the easement•
7. Modification of Utility Facilities. If the electric utility facilities located within the
Easement are upgraded, added to, replaced or reconstructed. Permittee shall pay that portion of
Chugach's total costs for such modification which is reasonably attributable to accommodating or
preserving the Encroachment If such payment is not made within thirty (30) days of written demand
for same, Chugach may terminate this permit in accordance with paragraph 9, below.
S. Covenants Runnine with the Land. The obligations of the Permittee arising from this
permit shall be covenants running with the land which shall burden the Parcel and the Permittee's
interest in the land subject to the Easement and shall benefit the Easement
9. Termination. Chugach may terminate this permit after the giving of thirty (3 0) days
written notice of such termination if:
a. The Encroachment is enlarged, increased or extended within the real property
affected by the Easement
Encroachment Permit - Page 2 of 4
b. The Encroachment is damaged by any means to an extent of more than thirty percent
(30%) of its replacement cost at the time of destruction.
C. Permittee fails to make the payment described in paragraph 7, above.
10. Term. This permit shall, if not sooner terminated by Chugach; expire forty (40) years
from the date hereof.
11. Entire Aereement This written permit constitutes the entire agreement between the
parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous
agreements, oral or written, between the parties. No modifications, amendments, deletions, additions
or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto.
CHUGACH ELECTRIC
ASSOCIATION, INC.
By
Edward M. J P.E., Director
Engineering Services Division
Date:
i� ; „trrrri
The Estate of David W. Leach
Authorized Representative
Date: //- a 4 — O 41
Encroachment Permit - Page 3 of 4
STATE OF ALASKA )
) ss:
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this 3'- day of
N BYt w �bo,— 2004, by erc, G1 o P.r t"c. I
PRINT PERMITTEES(S) NAME(S)
FFICIAL L f
State o/Alaska
NOTARY PUBLIC
LYNN oNWAY 111CK Public in and fo a State of Alaska
M' c0" " P�°` A piat 9' My commission expires: 2/11102:
STATE OF ALASKA - � )
ss:
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this :3v -JI
_ day of
aVeh•,6er 2004, by Edward M. Je k
I
Director, Engineering Services Division of Chugach Electric Association, Inc., an
Alaska corporation, on behalf of the corporation.
No Public in and for the State of Alaska
ttU ural My commission expires:/t^7 T/o r-�
PUBLIC i
fm• .�. AFTER RECORDING RETURN TO:
ijillt�jttl>>` Chugach Electric Association, Inc.
P.O. Boz 196300
Anchorage, Alaska 99519-6300
Encroachment Permit - Page 4 of 4
September 30, 2004
David W. Leach
15040 Platinum Circle
Anchorage, Alaska 99516
Dear Mr. Leach,
Subject to your agreement to indemnify the company as set forth below, GC1 Cable Inc.
of Alaska has no objection to the well encroaching into the 10' utility easement on the
north property line of Lot 8, Block 2, Sea Tum Subdivision. Known as 15040 Platinum
Circle located in Anchorage city grid 3138.
This letter of non -objection in no way precludes GCI Cable from full use and enjoyment
of any rights it may have within any portion of the utility easement and or the right-of-
way, including unlimited access for servicing its facilities. Also any additional and
extraordinary costs incurred during any future required construction, repair or
reconstruction of GCI's facilities to accommodate any or all of the encroachments shall
be paid by the property owner.
By signing below, you agree to indemnify and hold GCI Cable harmless, now and
forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities
and injury to any person or property occurring as a result of the ronlunent.
Please indicate your acceptance by signing d retu is I er to myself at the
address below.
Sincerely, Ge'rE�
Rebecca o ton
OSP Project Manager Date
5151 Fairbanks Street • Anchorage, Alaska 99503 • 907 /
P -d dST1:10 bD Oc dag
ACi SM
Alaska Communications Systems
October 4, 2004
Gamess Engineering Group Ltd.
Jeffrey A. Gamess
3701 E. Tudor Rd., Suite 101
Anchorage, Alaska 99507
i
ACS has no objection to the encroachment of the well into a platted easement located oni Lot B,
Block 2, Seatum Subdivision, as depicted on the as -built drawing submitted.
Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your
successors, will constitute agreement to the following stipulations:
1. ACS will be held harmless, now and forever, for any damages or injury, to any
person or property as a result of this encroachment.
2. Any ACS facility damaged or destroyed as a result of this encroachment will be
repaired at no cost to ACS.
3. Any costs incurred by ACS for special construction necessitated by this
encroachment will be bome by the property owner.
4. All applicable safety code regulations will be observed and maintained.
5. This letter of non -objection will in no way preclude ACS from full use and
enjoyment of its rights within any portion of its right-of-way.
Sincerely,
Greg chmid, For n
Outside Plant Frig ring
i
i
2CET�'^��2 DATE: i
c t_.k ° I
KIDeprt,rl De1eLLEC.OSP.Engrow%Ergrmr'CORRESPOW0NOSECTSs SdAv DOC
600 Telephone Avenue Anchorage, Alaska 99503-6091 tel 907.564.1000 www.acsalaska.com
aINMOct 13 2004 9:26AM
�IN
�f
10/13/2004
ENSTRR En6ineerin6
Jeffrey A. Garness
Gayness Engineering Grou
3701 E. Tudor Road, Suite
Anchorage, AK 99507
To whom it may concern:
ENSTAR Natural Gas Com
the 10 foot utility easement
See attached as -built surve,
Acceptance and use of thi
assigns, or your successors,
ENSTAR will be held
any person or propert
Any ENSTAR facility
will be repaired at no
Any costs incurred bt
encroachment will be'
All applicable safety c
This letter of non-obje
enjoyment of its rights
Sincerely,
ENSTAR Natural Gas
Dave Taus, Engineer
cc: File
Ltd.
907-562-0053
ENSTAR Natural On Company
Engirnerhp Deperbnent
401 E. Inteme8onal Airport Road
P. O. Box 190288 1
Anchorage. Alaska 99519-0288
(907) 2843740
FAX (907) 583-4085
Iny has no objection to the encroachment of the well in
n the north side of Lot 8, Block 2, Seatum Subdivision.
fated 9/21/04.
letter of non -objection by yourself, your heirs, your
vill constitute agreement to the following stipulations:
armless, now and forever for any damages or injury to
as a result of this encroachment.
amaged or destroyed, as a result of this encroachment
)st to ENSTAR.
ENSTAR for special construction necessitated Iby this
orne by the property owner.
Je regulations will be observed and maintained.
tion will in no way preclude ENSTAR from full use and
vithin any portion of its right-of-way.
P.1
ANCHORAGE WATER & WASTEWATER UTILITY
"A New Standard of Excellence"
Owned by the
Municipatihj of Anchorage
Engineering Division
3000 Arctic Boulevard
Anchorage, Alaska 99503-3898
fax 907.562.0824
http://www.awwu.biz
October 11, 2004
Garness Engineering Group, Ltd.
3701 E. Tudor Road, Suite 101
Anchorage, Alaska 99507
Re: Sea Turn, Block 2, Lot 8 (Grid 3138) Encroachment into Easement
Dear Property Owner:
Anchorage
All -America City
I200
Mark Begich,
The Anchorage Water & Wastewater Utility received your request for a letter addressing
AWWU's position regarding the existing well that encroaches into a utility easement
located on the north property line of the referenced lot. An as -built drawing with well
location was submitted with the request.
The referenced area is controlled by and located within the Hillside Wastewater
Management Plan.
The referenced lot is outside the AWWU certificated water service area.
AWWU has no objection to the encroachment.
Please include grid numbers on future requests for research and correspondence.
If you have any questions, please call me at 343-8009 or the AWWU Planning Section at
564-2739. 1
Sincerely,
Hallie Stewart
Engineering Technician
Voted Best Tasting Water in America . 1998 U.S. Conference of Mayors
CHUGAZU
POWERING AIAEKA'E MURE
September 28, 2004
Gayness Engineering Group, Ltd.
3701 East Tudor Road, Suite 101
Anchorage, Alaska 99507
Attention: Jeffrey A. Garness
Subject: Encroachment Permit Request for a Well
Lot 8, Block 2, Sea Turn Subdivision
Grid 3138,1203-25C, EN04062
Dear Mr. Gamess:
Chugach has received your request for an Encroachment Permit on the above referenced
property. Please note that Chugach will be reviewing the well that is located on the north
property line, rather than the south property line that is referenced in your letter dated
September 28, 2004.
Your request is being reviewed by Chugach's Distribution Standards and Engineering
Department. I anticipate having a response to you within the next ten (10) working da
time frame is tentative and may be extended if additional review is required.
If you have any questions, please call me at 762-4738.
Sincerely,
Chuck Couts, SR/WA
Right -of -Way Agent II
cc: (via: E -Mail) Louis Mass, Standards Engineer
(via: E -Mail) James Wilson, Manager, Dist. Standards & Support
Chugach Electric Association, Inc.
5601 Mmnesoro Drive, F.O. 80. 196300, Anchorage, Alaska 995196300 • (907) 5637494
www.chugoche1ec1ric.com • inloechugocheleunc.com
Fax (9071 56 200 2 7 • (800) 4787494
r
Chugach Electric Association, Inc.
5601 Mmnesoro Drive, F.O. 80. 196300, Anchorage, Alaska 995196300 • (907) 5637494
www.chugoche1ec1ric.com • inloechugocheleunc.com
Fax (9071 56 200 2 7 • (800) 4787494
MUNICIPALANCHORAGE
• -- DEPARTMENT OF HEALTH
& HUMAN SERVICES
Division of Environmental Services
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.D. # nli — i Q t - 12, HAA #
1. GENERAL INFORMATION
Complete legal description L-07 - BK.
Location (site address or directions) 1-15 C L4 l.1 t_A10y I.1
i
Property owner RIC UAIM 1AAIS' 5 t+r,Li_ Day phone 145— 14 7
Mailing address ) ;:;C 4 i:• PLA-rI I.it' tut
Lending agency A Lµ S 1: A i i= b Day phone
Mailing address
Agent Day phone iLOSo I
Ad"
177-i�/P-
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY: /
Individual welly
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC
Ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from
attesting to the legality and status of system.
MM(R«.1/91) F=t MOA021
ADEC
S. 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 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. l furtherverifythat 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 li6t.1 Sa',r(C1AH0/ int= Phone
Address
Engineer's signature
6. DHHS SIGNATURE
.�_ Approved for 3
Disapproved.
Conditional approval for
Additional Comments
9
bedrooms.
Date 61441^
bedrooms, with the following
` /Li
By: ../' -4r -6 L7.*- �L,.—� Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an: independent
professional engineer registered 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.
® Municipality of Anchorage AL
dam
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: 1 $1G 2 Parcel I.D.
A. Well Data $EA TU r NJ
Well type If A, B. or C, attach ADEC letter. ADEC water system number N// -k -
Log present (YIN) !::;z Date completed 614 8 O Driller 7—/A (Il�lr C
Total depth 1 37 Cased to 1317 Casing height 2 �I
Sanitary seal (YM) Wires property protected (Y/N) �z
FROM WELL LOG
Date of test 'r19 i& O
Static water level M� _
Well flow 5 g.p.m.
Pump levell ao 7Y o^vv1
SEPARATION DISTANCES FROM WELL TO:
AT INSPECTION
X14Arn
o�
g.p.m.
J
Septicthotding lank on lot 143 ; On adjacent lots
m C o
t C7t' +
z
Absorption field on lot 15 4 ; On adjacent lots 1&0 *T I
Public sewer main 0/.4 Public sewer manhole/cleanout A
Sewer service line 7o Petroleum tank N 12
WATER SAMPLE RESULTS:
Coliform 9 Nitrate t`` Other bacteria
Date of sample: (D 1 q 19s Collected by: T7 --s
B. SEPTIC/HOLDING TANK DATA
Date Installed 517 / $O Tank size I o7-5 0 • Compartments
Cleanouts (YIN) Foundation cleanout (YIN) Depression (Y/N) Ig
High water alarm (YRJ) WIA Alarm tested (YM)
Date of pumping�� � ri 9 4 Pumper 0 7-4
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 14 3 On adjacent lots I" -t Foundation 13 �1
To property line > / 0 Absorption field L /o Water mairvservice line > e D
Surface water/drainage IJ to
72.Mr-93)1F,d„ CONTINUED ON BACK PAGE
C. LIFT STATION NIA
Date Installed Manufacturer
Size In gallons Manhole/Access (Y/N)
Vent (YM) 'Pump on' level at 'Pump off" Level at
High water alarm levet Cycles tested
Meets MOA electrical codes (YIN)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots Surface water
D. ABSORPTION FIELD DATA
Date Installed 51740 Soil rating (GPD/Ft2) 10-0 System type 1P_ 1= N C (�
Length 3 i Width 3 I Gravel thickness 5 r Total depth R I
Total absorption area :310 Cleanout present (Y/N) Depression over field (YM)
Date of adequacy test b l q [ R 5 Results (pass/fail) 7' for 3 Bedrooms
7j-7 n. tiol0li ,y'7Lcetle
Water level In absorption field before test .Z y After test a
a a 70k�.��
Peroxide treatment (past 12 months) (YM) N If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot i 5 q On adjacent lots 1&0 4 Property line > / 0
To building foundation S1 To existing or abandoned system on lot t`r' 1A,
On adjacent lots 5O Cutbank No "-e Water maintservice line 7 S 0
Surface water Driveway, parking/vehicle storage area
Curtain drain
E. ENGINEERS CERTIFICATION
1 certify Mat I have checked, verified, or conformed to all MOA and HAA guidelines in effect on Me�ral*1 inspection.
Apr,i csTFf t .r��
Signature `
Engineers Name1 010 !ten Sp u riC�[uCt% - e�. Til
s: • ,. aye ..��
ee-2M:S
Date �1AAAA
�oF
HAA Fee $ U 0W 'V?
Date of Payment
Receipt Number `l "/� fiG Z?�
72 -MB (9rW Ba*
Waiver Fee $
Date of Payment
Receipt Number
.
r �
MUNICIPALITY OF ANICHORACE
DIVISION OF ENVIRON:IENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIROR4ENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICA1
1. General Information Application Date
(a) Legal Description (include lot, block, subdivision, section,
Location (address or directions)
�
s-� yf;
(b) Applicants Name �� L-) A A/l1 1)Teleph3 one - tiome
Applicants Address /5080 /'- 44TIN014
i
(e) Applicant is (check one) Lending Institution ; Owner/builder ;
Buyer [= ; Other E:=j (explain);
(d) Lending Institution Telephone
Address '+ it
(e) Real Estate Co. b Agent �%z : 44 ov.,.cPr is I Zt rr.lc
Address Zo-7 L- !\/e �� ilei. L : aU
Telephone 276-/ 13 3>
(f) rail the HAA to the following address:
2. Type of Residence
Single-Fa=11y Uci Multi -Family Other (describe)
Nuaber of Eedroc=s
3. Cater Supply
Individual Well 1E] Community Public
5ote: If community well system, must have written confirmation from the State
Depart=eat of Environmental Conservation attesting to the legality and status.
b. Serage Disposal
Onsite = Public [= Community Q Holding Tank Q
Note: If co=..inity well system, mutt have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 21
5.
Engineering Firm Providing Inspections, Tests, File Search, Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that my investigation of this Health Authority Approval shows thatlthe 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 furtheriverify 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 regula-
tions in effects on the date of this inspection.
Name of Firm S nPor lcIE Telephone a79-3ci /b
Address
Date /� ! 5 l 98- �� �: is , I
'
(ENGINEER SEAL) *:
4;I!•,._
Pta•2225-E �. .
6. DHEP Approval / PT JUN'_ 2S, 1971
Approved for. bedrooms By
Approved Disapprove Condi ional
Terms of Conditional Approval
i
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIROIZENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOSES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DREP 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2] 1 7-19-84
11
�t�NE E�b�Gl
of
PEPS. ENSPI pROSE010� n
oivo�t , 5 MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
V Ef� CHECKLIST - FEBRUARY 1984
284-4720
RLegal Description: A, 120 K 2
SC -C 35�T11NIR'Su(/
A. WELL DATA
Well Classification S If A, B, C, D.E.C. Approved (Y/N) ly/A
I
Well Log Present (Y/N) Date Completed t4 9A 10180 Yield �� Hurt z��
Total Depth Cased to Depth of Grouting
Static Water Level lis Pump Set At
Casing Height Above Ground 3 f f Sanitary Seal on Casing (Y/N) r '
Electrical Wiring, in Conduit (Y/N) Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/I told iw t.ank on Lot y3 ; On Adjoining Lots 4 0
To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots 7 ��
To Nearest Public Sewer Line N D N ^ To Nearest Public Sewer
Cleanout/Manhole N O N C To Nearest Sewer Service Line on Lot > 10
Water Sample Collected by r , , ;Date EVA 6 4
"—
Water Sample Test Results
Comments
B. SEPTIC/We*=Sfa TANK DATA
Date Installed HcL*- ftf) Size _ 1,2_ E; P No. of Compartments r WD
Standpipes (Y/N) _ QI F- Air -tight Caps (Y/N) Foundation Cleanout (Y/N)
Depression over Tank (Y/N) —N Date Last Pumped ' �✓�iQ19b I J
Pumping/Maintenance Contract on File (Y/N) WA ; for Y&
Holding Tank High -Water Alarm (Y/N) NIA Temporary Holding Tank Permit (Y/N) I WA
Separation Distances from Septic/Holding Tank:
To Water -Supply Well 141-9 L�
r
To Property Line 1 461
To Building Foundation 1A.1 /
To Disposal Field 10
I
To Water Main/Service Line ��0 To Stream, Pond, Lake, or Major Drainage
Course 1y0i!C—
Comments
I
Page 1 of 2
72.026(11,84)
C. ABSORPTION FIELD DATA
c/ AF
Soils Rating in Absorption
Strata 10 Type of System Design 'T12AF/YCfI
Date Installed r1ra Length of Field
Width of Field 36 N Depth of Field O i2f
Gravel Bed Thickness �5 / c___
Square Feet of Absorption Area ' 19 J Standpipes Present(Y/N) /% W)O
Depression over Field (Y/N) N Date of Last Adequacy Test
Results of Last Adequacy Test �1 J
Separation Distance from Absorption Field:
To Water -Supply Well 41 To Property Line > I n
To Building Foundation '✓' 17 '� To Existing or Abandoned System on
Lot IIID N L ; On Adjoining Lots i Oc;�
To Water Main/Service Line > 10 To Cutbank (if present) N O NL5
To Stream/Pond/Lake/or Major Drainage Course N O N t5
To Driveway, Parking Area, or Vehicle Storage Area 7 SO
Comments
D. LIFT STATION No1q
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at _
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
'• Check Permitted Bedroom Rating Against HAA Request '•
Pumping Cycles during Adequacy Test. Meets MOA
Icertify th15
at Ihave checked, ven d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection
Signed � n Date lSi !4
Company _ ft/s.G CI� MOA No.T— II
Receipt No. 521 lb :
p: `/j1 ,!t
Date of Payment
�h:
q5 , L0 > Engineer's Seal
Amount:5
*:.4 4T,
0. ..
-0. 2225-E
Page 2 of 2 I' JUN': 2% 1911
72-026111, Bal
Vent [Y/N)
WELL LOG AVAILABLE: NO, DRILL LOG
INSTALLATION REQUIREMENTS MET: YES
WELL YIELD FROM WELL LOG: 4-5 GPM FROM DRILL LOG
PUMP YIELD:
DATE OF INSPECTION:
TEST PROCEDURE:
8 GPM.
AUGUST 14, 1985
WELL WAS PUMPED AT A CONSTANT RATE OF 8
GALLONS PER MINUTE. WATER LEVEL IN WELL WAS
MONITORED. STATIC LEVEL WAS 44 IFEET
DRAWDOWN AFTER 60 MINUTES AT 8 GPM WAS 91
FEET. TOTAL DEPTH OF WELL IS 125 FEET.;
TEST FOR COLIFORMS: TEST WAS NEGATIVE
TEST RESULT:
OF its
.-t ... d(
� T r
i�'•aSTF �J .f
I .4 ..... �r
2
.225-E • "•�
2i. 1971 /
••fir,
.,,--
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPAL CODE.
The Municipal requirement for well flow is 150
gallons of water per bedroom per 241 hours.This
well surpasses this requirement. I
The assessment of the condition of this well
applies only to the conditions as of this date.
The flow rate of the well may change due to
subsurface conditions that may not be observed
from the surface, and changes in land use and
other factors that may impact the conditions of
the aquifer feeding the well.
C
GJ
�P
G3daaD9
G°PvCv
3 W. 15th AVE "C" SUITE 203
.0ANCHORAGE.
ll'0
ALASKA 99501
CONSULTING ENGINEER
TELEPHONE: (907)279-3916
i
R E S
I D E N T I A L W
E L L I
N S P E C T I O;N
LEGAL:
LOT 8, BLOCK 2,
SEATURN
LOCATION:
f
15040 PLATINUM
t
OWNER:
DENNIS HELFAND
TYPE OF WELL:
PRIVATE
WELL LOG AVAILABLE: NO, DRILL LOG
INSTALLATION REQUIREMENTS MET: YES
WELL YIELD FROM WELL LOG: 4-5 GPM FROM DRILL LOG
PUMP YIELD:
DATE OF INSPECTION:
TEST PROCEDURE:
8 GPM.
AUGUST 14, 1985
WELL WAS PUMPED AT A CONSTANT RATE OF 8
GALLONS PER MINUTE. WATER LEVEL IN WELL WAS
MONITORED. STATIC LEVEL WAS 44 IFEET
DRAWDOWN AFTER 60 MINUTES AT 8 GPM WAS 91
FEET. TOTAL DEPTH OF WELL IS 125 FEET.;
TEST FOR COLIFORMS: TEST WAS NEGATIVE
TEST RESULT:
OF its
.-t ... d(
� T r
i�'•aSTF �J .f
I .4 ..... �r
2
.225-E • "•�
2i. 1971 /
••fir,
.,,--
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPAL CODE.
The Municipal requirement for well flow is 150
gallons of water per bedroom per 241 hours.This
well surpasses this requirement. I
The assessment of the condition of this well
applies only to the conditions as of this date.
The flow rate of the well may change due to
subsurface conditions that may not be observed
from the surface, and changes in land use and
other factors that may impact the conditions of
the aquifer feeding the well.
CONSULTING ENGINEER �p��3adQaD9
Poco
203 W. 15th AVE "C" SUITE 203
AN EPRAGE HONEALASKA 938 8
S E P
— — —
T I C S Y S T E M
— — — — — — — — —
A D E
— — —
Q U A C Y T E S T
— — — — — — — — —
LEGAL:
LOT 8, BLOCK 2,
SEATURN
r+• • • "�
LOCATION:
15040 PLATINUM
i
171' 1U... 2L. t311
14 11%
+�ii�s.^;;^
OWNER:
DENNIS HELFAND
•,�`t��::'
RESIDENCE: SINGLE FAMILY, THREE BEDROOMS
WATER SYSTEM: ON SITE WELL
SEPTIC SYSTEM: FROM MUNICIPAL RECORDS:
TANK: GREER STEEL, 1250 GAL.
TWO COMP.
ABSORPTION SYSTEM: TRENCH
ABSORPTION AREA: 310 SQ. FT. /
SOIL RATING: 100
INSTALLATION DATE: MAY 1980
DATE OF PUMPING: MAY 19, 1985''_
DATE OF TEST: AUGUST 14, 1985
TEST PROCEDURE: SYSTEM WAS INSPECTED ON AUGUST 9, 1985.
LIQUID LEVEL IN TANK WAS FOUND TO BE 46 INCHES. LIQUID LEVELIIN 4
INCH SUMP WAS FOUND TO BE 64 INCHES. SUMP WAS FILLED WITH SLUDGE
4 INCH CLEAN OUT WAS DRY.
ON AUGUST 14 WATER WAS ADDED TO THE TRENCH ART A CONSTANT RATE OF
8 GALLONS PER MINUTE. THE WATER LEVEL IN BOTH SUMP AND TANKjWERE
MONITORED. AFTER THE A DITIION OF 450 GALLONS THE WATER LEVELS
HAD NOT CHANGED. kb�"
/v► 4"
TEST RESULT: / THE PRESENCE OF SLUDGE IN THE SUMP INDICATES
THAT THE SUM IS NOT PERFORATED. THEREFORE THE WATERLEVEL IN THE
TRENCH CAN NOT BE MONITORED. THE SYSTEM ACCEPTED 450 GALLONS OF
WATER IN THE TIME OF ONE HOUR. IT WILL THEREFORE BE CONCLUDED
THAT THE SYSTEM MEETS THE MUNICIPAL REQUIREMENTS.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served bye the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
Time
APPLK~NT FILLS OUT UPPER HAC,ONLY
Time
Time
Prdoeitrowmer
Howard Headley and Cheryl ChipmanPnone
p
C/O Century 21 -Heritage homes
45-2525
Mailing Address'
207 E. Northern Lights (DOUTHIT) zip Code 99503
I
Buyer
Helfnad, Dennis and Judy
Inspector
SAME AS ABOVE
Address
Zip Code
Lending Institution
Home Savings and Loan
Phone
535 D Street CONTACT: DONNA NAIL
272-1451
Address
Anchorage,Alaska 99502 zip Code
ENVIRO+I:NTAL
Realty Co. d Agent
Carol J. Douthit
Phone
( ) DISAPPROVED
Century 21 Heritage Homes and Investments
( ) COPITIONAL APPROVAL'
DATE Y-4,-443
BY:
Address
207 E. Northern Lights Blvd, zip Code 99503
263-2404
Legal Description
Lot 8, Block 2, SeaTurn Subdivision
Septic Tank Size
Street Location
S 80
'
Type of Residence
SFR
n Single Family
3
❑ Multiple Family No. of Bedrooms
❑ Other
Water Supply
IX Individual
n
ATTACH WELL LOG. A well log Is required for all welts drilled
since June 1975.
❑ Communitycn`S
D�v�
For wells drilled prior to that date, give well depth (attach log
It avallahle).
❑ Public Utility
Sewer Disposal
$7 tndividual
1980
�(�QDfL �O Year Individual Installed:
I
❑ Public Utility
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
p
Date
Date
Date
Date
L\ -L\
Inspector
Inspector
Inspector
Inspector
J \
Field Notes: I i
(x-21
MUNICIPALITY OF ANCHORAGE
CEPT. OF H`.t.LTH ?,
PROTECTION
/Jn
JCJ��
ENVIRO+I:NTAL
APR 11r60'
( 3) APPROVED BEDROOMS *CONDITIONS OF APPROVAL '
( ) DISAPPROVED
-
i
( ) COPITIONAL APPROVAL'
DATE Y-4,-443
BY:
Solis Rating
Date Sewer Installed
Well To Absorption Area (( 4
Well Log Received
Septic Tank Size
S 80
Well to Tank lazi
rzara Iran
April 7, 1983
!toward Headley and Cheryl Chipnan
c/o Century 21 - Heritage Homes
207 E. Northern Lights (DOUTHIT)
Anchorage, Ak. 99503
Subject: Lot 8, Block 2, SeaTurn Subdivision
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
° T1ie top of the well casing should be sealed so that it is
Pater tight.
The water analysis report needs to be submitted to this
�Al-ackoffice from the Chen Lab, 5633 B Street, for our review.
t`bZ The septic tank, pumped with a receipt submitted to this
1 department.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 2G4-4720.
Sincerely,
Robert C. Pratt
Associate Environmental Specialist
RPE/ej/E1
Enclosure
DATE RECEIVED
INSPECTION APPOINTMENTS
Q'
TIME
TIME TIME
• (,�,
STREET LOCATION
r�.� � / rte:
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
DATE
DATE r DAIL
' SINGLE FAMILY
❑ Two ❑ Five !
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
INSPECTOR
INSPECTOR INSPECTO -
\� /
-0 COMMUNITY
since June 1975. For wells drilled prior to that date, give well
I�1
ALjCWQ%, Be
V) ��) D MUNICIPALITY OF ANCHORAGE
ENVIRO "el' CF 1d ALT, I d
NMENT,4L '
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
':;I_RION
• 825 L Street • Anchorage, Alaska 99501
JUL ?, 1980
ENVIRONMENTAL SANITATION DIVISION���
Telephone 264-4720
• VES
R 1
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten 1101 days for processing.
1. PROPERTYOW R
PHONE
MAILING ADDRESS
9'TU
go ,c 60
PROPERTY RESIDENT (It different from above)
PHUNL,
2. BUYER
PHONE
i
MAILING ADDRESS
j
3. LENDING I STITUTION
PHONE
V ry
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
i
MAILING ADDRESS 6 �1
7
i
5. LEGAL DESCRIPTION
Q'
STREET LOCATION
C.
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
}�
❑ One ❑ Four ❑ Other
' SINGLE FAMILY
❑ Two ❑ Five !
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
� INDIVIDUAL'
' ATTACH WELL LOG. A well log is required for all wells drilled
-0 COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
I
)C INDIVIDUAL/ON-SITE"
_/YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
• 72010 (Rev. 6/79)
JK1��
An
C
72010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE
❑ TWO
❑ THREE ❑ FIVE ❑ OTHER
❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLICUTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
— �D
INSTALLER
❑Septic Tank or ❑Holding Tank
Size: I n If Tank is homemade
give dimensions:
SOILS RATING
/
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
t-
4. DISTANCES
WELL TO:
SePtiC/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
Cl DISAPPROVED
DATE
BY
72010 (Rev. 6/79)