HomeMy WebLinkAboutPROSPECT HEIGHTS #1 BLK 5 LT 16Prospect
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Heig
Block 5
Lot 16
#015�091�36
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Inspection Report_1-1-12.doc
Municipality of Anchorage `'' r- s,
`" Page
Community Development Department '�' 1 of 2
On -Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP151164
PID Number: 015-091-36 ❑ New ❑✓ Upgrade
Name:
Paul & Cynthia Vanderweide
ABSORPTION FIELD
❑ Deep Trench El Shallow Trench El Bed ❑Mound
Address
9910 Schuss Dr
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision
Block Lot
Prospect Heights #1
5 16
Fill added above original grade
Ft.
Gravel length
Ft.
Township Range
Section
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift
Station
Tank
Line
FtZ
Ft.
Well
100+
N/A
N/A
N/A
N/A
TANK p Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Acnhorage Tank
Capacity
1,250Ga1.
Surface Water
100+
N/A
N/A
N/A
Material
Steel
Number of compartments
2
Lot Line
10+
N/A
N/A
N/A
NA
Foundation
5+
N/A
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
50+
N/A
N/A
N/A
RemarksNew Tank Only
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
Installer
Drainfield CO/MT 3034
Inspector Pannone Engineering Services
BENCHMARK (Assumed elevation) 100ft
Inspection 1s, i
Location and description
dates: �!/(� S/�S 2"d
Top of trim at point A
3rd 4'h
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
Conditional Approval:
Date
• •
��G. '9s ,�
/_N4: • : f,9,��
• TH
Steven • •f�annorae• j
��,• CE 8149
Approved { �
Date t 1 0 C ] 7
Inspection Report_1-1-12.doc
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/ DRAIN FIELD (E)-
45
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ISEPTIC AREA (E)
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DESIGN PARAMETERS
PRIMARY SEPTIC SYSTEM
TANK SIZE: 1,250g TANK
USED:
1,250g NEW SEPTIC TANK
LOT
ABBREVIATIONS
M#
TH
TEST HOLE
R. 1.
FC
FOUNDATION CLEAN OUT
DCO
T#
TANK CLEAN OUT NO.
OG
C#
CLEAN OUT NO.
FG
REMOVED & REPLACED
1250g SEPTIC TANK
WITH DOUBLE CLEAN
OUT AFTER TANK
X, \
FC (E)
.Vl\�41 u'
LEGEND
W WATERLINE/
WELL RADIUS
SS NEW SEPTIC
MONITOR TUBE NO.
RIGID INSULATION
DOUBLE CLEAN OUT
ORIGINAL GRADE
FINISH GRADE
A B
T1 10.0 27.3
T2 12.5 34.6
z
o�
PANNONE ENG SVC, LLC
P.O. BOX 100217 ANCHORAGE, AK 99510'��
PHONE (907) 272-8218 FAX (907) 272-8211
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Steven R. 'Pannone
(✓ �Fc/, CE 8149 j
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P.I.D. NO
015-091-36
PERMIT N0.
OSP151164
UJ
0
0
0 OG FG 0
0
EL. 99.30
t:
4i2'•
R.I.
3I2
EL. 95> 3
1,250g SEPTIC
EL.95.1
TANK NEW
PROFILE
NOTES:
PANNONE ENG SVC, LLC
P.O. BOX 100217 ANCHORAGE, AK 99510'��
PHONE (907) 272-8218 FAX (907) 272-8211
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Steven R. 'Pannone
(✓ �Fc/, CE 8149 j
(�,��
ll�k.�\\` `am
Date
Date
9/13/2017
RECORD DRAING
Scale
1"=50'
DRAWN BY:
PROSPECT HEIGHTS #1, BLOCK 5, LOT 16
PAUL & CYNTHIA VANDERWEIDE
9910 SCHUSS DRIVEs����Ul
ANCHORAGE, AK 99507
NJC
P.I.D. NO
015-091-36
PERMIT N0.
OSP151164
PLAN
Sheet
2
On -Site Water and/or Wastewater System
Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSPI51164
Tax Code Number: 01509136000
Work Type: SepticTank Upgrade
Permit Effective Dates: June 12, 2015 to Junell,2016
Design Engineer:
Subdivision: PROSPECT HEIGHTS #1
Site Legal Address: PROSPECT HEIGHTS #1 BILK 5 LT 16 G:2440
Owner/Address: VANDERWEIDE PAUL N &
CYNTHIA K 9910 SCHUSS DR ANCHORAGE AK 995161066
Site Mailing Address: 9920 SCHUSS DR, Anchorage
This permit is for the construction of:
N Disposal Field Y Septic Tank N Holding Tank N Privy
All construction must be in accordance with:
Lot Size in Sq Ft: 87556
Total Bedrooms: 4
N Private Well N Water Storage
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing -
Received
Issued By
MUNICIPALITY OF
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWERIWELL PERMIT APPLICATION
Parcel I.D. 015-091-36
Property owner(s) Paul & Cynthia Vanderwelde - Day phone
Mailing address 9910 Schuss Drive, Anchorage, AK 99507
Site address 9910 Sch uss Drive
Legal description (Sub'd., Block & Lot) Prospect Heights #11, Block 5, Lot 16
Legal description (Township, Range & Section)
Lot Size 87,556 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(0 all that apply)
Absorption Field F-1 Initial Single Family (SF)
Septic Tank [9 Upgrade FX1 (w/wo ADU)
Holding Tank El - Renewal Duplex (D)
Multiple Dwellings
Privy F� (SF and/or D)
Private Well
Water Storage
THIS APPLICATION INCLUDES A VARIANCE I 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:
Waiver Fees:
Date of Payment: (a
157116- d:;l�
Date of Payment:
Receipt Number:
0510,11,4
Receipt Number:
Permit No. 0-5e[6i
I L.*4
Waiver No.
Permit App_-'- :- � L.a z
Pannone Engineering ServiceS LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steveApanengak.-com
June 3, 2015
Subject: Prospect Heights #1, Block 5, Lot 16
Tank Replace Permit Request
Design Narrative
This is a design narrative for a permit to install a new 1250g septic tank to be issued for this property. The
proposed systems will serve an existing four (4) bedroom house. Currently the lot is developed. The
surrounding developed lots are served by private wells. There are no wells on surrounding lots within 100
feet of this system and there are no septic systems installed on the surrounding lots within 100 feet of the
proposed well.
1. Tank Design.
a. See Sheet 2 of the design package.
2. Surface Water: There is no surface water within 100 feet of the proposed septic tank. The proposed
septic tank will maintain at least 100 feet from all surface water and drainage ditches.
3. Topography: The existing topography slopes from the southeast to the northwest at
approximately 10% in the area of the tank replacement.
4. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that
the review is complete and that there are no further comments is received from MoA On -Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no surrounding wells within 100 feet of the proposed septic location or septics within 100 feet of the
proposed well location.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
I
(E)
W—�
DRAIN FIELD (E)
I
LOT 16
7
S EPTIC AREA (E)
v
1250g SEPTIC TANK (E)
DECOMMISSION PER CODE AND
INSTALL 1250g WTIC TANK (P)
WITH DOUBLE C L N OUT
w
41
NOTES PAMONE ENG SVC, LLC Dote
TANK REPLACE 6/3/2015
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211 Scole
1 -50
41 TH
....... ... PJ,D. NO
PROSPECT HEIGHTS #1, BLOCK 5, LOT 16 �,ver� R: 6n -015-091-36
PAUL & CYNTHIA VANDERWEIDE '6.n PERMIT NO.
CE 8149 Ospxxxxxx
9910 SCHUSS DRIVE
PLAN ANCHORAGE, AK 99507
S'eet
1 OF 1
bwoml 1 1 #%L
OCT IS 2013
Inspection Report 1-1-12.doc
Municipality of Anchorage
Community Development Department Page I of 3
On -Site Water and Wastewater Program
4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.muni.org/onsite - (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP121209
PID Number: 015-091-36 El New V1 Upgrade
Name:
ABSORPTION FIELD
Paul and Cynthia Vanderwelde
El Deep Trench [Z] Shallow Trench [:] Bed Ej Mound
Address
9910 Schuss Drive Anchorage,
AK 99516
El Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
1 3
1.2GPD/SF
ITotal
10 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
6 Ft.
Gravel depth beneath pipe
4-OFt.
Subdivision
Block Lot
Prospect Heights No. 1
5 16
Fill added above original grade
1-2 Ft.
Gravel length
50 Ft.
Township Range Section
Gravel width
5FTT
ads: Number of Lines
I
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
LiftStardion
Tank
Line
500 W1
One
I Ft.
well
>100'
>100'
N/A
N/A
>25'
IANK [71 Septic 0 ST.E.P. [I Holding 0 Other
Manufacturer
Anchorage Tank
Capacity
I I 000G31.
Surface Water
>100'
>1 00'
Material
Steel
Number of compartments
Two
Lot Line
>5'
>10'
NA
Foundation
>51
>10'
LIFT STATION
Manufacturer
Capacity
I Gal.
Curtain Drain
None
_Noted
Pump on level at
Pump off level at
High water alarm at
Remarks
in.
in.
in.
Fump -make and model
Electrical Inspections performed by
PIPEMATERIAL Housetotank D3034 Tankto
drainfield D3034
Installer
Red Dog Excavation
Drainfield HDPE CO/MT D3034
Inspector MEA
BENCH MARK (Assumed elevation) 100.0ft
Inspeciion 8127/12
8/27/12
Location and description
dates: - 2
Back Deck Door.
Sd 8/28/12 4th
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
E
A 111to
Conditional Approval:
Date
9TH
.. ...........
HM F ANDERSON
-4381
Approved i
Date/0
"ROFES
Inspection Report 1-1-12.doc
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT Page 2 of 3
4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 PID No. 015-091-36
Permit No.: OSP121209 On -Site Wastewater Dispos System or Well Inspection Report
PROSPECT HEIGHTS
SUBDIVISION NO. 1
LOT 16, BLOCK 5
Aj .6_� 17 87,556 Square Feet
Existin 250
WIon9Scp.rc Tonk
E.isting 52.V' Lee,
6' Ella?��. =Pg,
Absorption Trench.,
A,
0,
EXISTING
HOUSE
Existing
Well
17,5' '�3. 1— ParkinV(Driveway
S2 27.5' �0.0'
C4 21.8! 132
C5 74.5' 64.2'
MI 23.5' 15.5'
M2 30.7' 32.0' 3 Bedroom
HOUSO
C6 B
C)
co
C5
SI
Lij M2 S2 A Nr6
ao 'Z
6) TH 11
0 C F it
. .................
M 1 C4
7" 49th
30; * I .....
0 ........ ........... ...... I ... .......
0 e_
0 ............... I ................. ..........
Oo, MICHAEL E. ANDERSON
No CE4381
...... ....
LEGEND FESS\
Isk
MI — Monitor be
hd.ju
FCO — Fou 0. CIc.n out
TH — Test Hole PLAN AS BUILT
C4 — Clean Out
Sl — Septic Vent SCALE 1 50'
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP121209
PID No. 015-091-36
50' (Trench Length)
PROFILE AS -BUILT
No Scale
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP121209
Tax Code Number: 01509136000
Work Type: Septic Initial
Permit Effective Dates: July 27. 2012 to July27,2013
Design Engineer: ANDERSON ENGINEERING
Subdivision: PROSPECT HEIGHTS #1
Site Legal Address: PROSPECT HEIGHTS #11 BLK 5 LT 16 G:2440
Owner/Address: VANDERWEIDE PAUL N &
CYNTHIA K 9910 SCHUSS DR ANCHORAGE AK 995161066
Site Mailing Address: 9920 SCHUSS DR, Anchorage Lot Size in Sq Ft: 87556
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy N PrivateWell N WaterStorage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-79G4 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued By
MUNICIPALITY OF
Community Development Department
Development Services Division C*w
On -Site Water & Wastewater Program
ANCHORAGE
Mayor Dan Sullivan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.: 01"91-36
Phone: 907-343-7904
Fax: 907-343-7997
Property owner(s): Paul & Cynthia Vanderwelde Day phone:
Mailing address: 9910 Schuss Drive Anchorage, AK 99516
Site address: Same
Legal description (Sub'd., Block & Lot): Prospect Heights No. 1, Block 5, Lot 16
Legal description (Township, Range & Section)
Lot Size: 87,556 Sq. Ft. Number of Bedrooms: Three (3)
THIS APPLICATION IS FOR: THIS APPLICATION IS AN:
(E] all that apply) Initial X
Absorption Field X Upgrade
Septic Tank X Renewal
Holding Tank F
Privy
Private Well
Water Storage
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Family Dwelling and is in accordance with applicable Municipal Codes.
-X4� E ct'j"
(Signature of property owner or authorized agent)
Permit/Rush Fees: 4 5 3.0 -1& Waiver Fees: —
Date of Payment: V91311'a Date of Payment:
inn q2 1 /9
Receipt Number: - Lg_(;;I__ Receipt Number:
Permit No. 6SPIRI P,69 Waiver No.
C:kUsers�AndEng\Desktop\Mike\Sleepy HollowlPermit Application Lot 8.docC:�Users\AndEng\Desktop\Mike\Sleepy Hollow\Permit
Application Lot 8.doc
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
July 23, 2012
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 16, Block 5, Prospect Heights Subdivision No. I
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer
The owner of Lot 16, Block 5, Prospect Heights Subdivision No. 1 intends to construct a
second home on the lot. We are therefore requesting a permit be issued for the
construction of the septic system to accommodate the three-bedroom home. The
existing well on the lot will be used to service both houses and will become a Class C
Well. The attached Site Plan and backup documentation identify the location and
configuration of the proposed septic system and the existing septic system on the lot.
Also identified on the plans are the locations of the existing well on this and adjacent
lots. No conflicts exist between the proposed septic system and the wells on this or in
the area. Drainage arrows are shown indicating the current drainage patterns. The
drainage patterns will be maintained after construction.
The test hole placed on the lot at the location of the new absorption trench indicated
sandy gravel with some silt (GM). The percolation rate was determined to be less than
5 minutes per inch. Previous test holes completed in the past are similar to our results.
We are proposing to construct a 1,000 gallon septic tank and a 38' long by 5' wide
absorption trench with 4' of gravel beneath the distribution pipe. The distribution pipe in
the trenches will be placed at 4' below the surface with the total depth at 8'. No
groundwater was encountered during placement of the test hole and none has
developed over the past several weeks since the test hole was placed.
The ground surface on the lot slopes slightly to the southwest in the area of the
absorption trench. The trench will be placed parallel to the contours of the ground as
much as possible and in conformance with design criteria. A minimum of 150' will be
maintained between all components of the septic system and the existing well and 100'
Lot 16, Block 5, Prospect Heights No. I
July 23, 2012
Page Two
from any surface water in the area.
If the system is constructed in accordance with our design 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 reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
49th
MICHAEL E. ANDERSON
I.. Nom CE�4381 J
PROSPECT HEIGHTS
Cb
05 SUBDIVISION NO. 1
04� LOT 16, BLOCK 5
87,556 Square Feet
"e"09 sc An"o
1
LEGEND
/
MT — Monitor Tube
MH — Man Hole
FCO Foundation Clean Out
SITE PLAN
0
1
41�i
-17,
1
UWN 52.5' �g
x 6' Effecive Daptfi
Absorption Twat.
4!� A,
EXISTING
HOUSE
Exeing
W.11
c.
0
A
z
30,
3 Bedroom
House
NO,
Go
wJJ
2
1,!IV lgws�
OF
. .............
x 5 Vele
49th *#0
Amarption Trench.
NOTE: lie ..... I ....... ....... ^
No Area, of Excessive Slope or Surface ........ . ........ �..
Water are Within 100' of Any Part of the j4. MICHAEL E. ANOERSON
New Septic System. No Wells or Waste oter
Systems on Adjacent Lots Conflict withwthe NO CE4381 M
Proposed Septic System.
LEGEND
MT — Monitor Tube
MH — Man Hole
FCO Foundation Clean Out
SITE PLAN
TH Test Hole
CO Clean Out
SCALE 1" = 50'
LOT 16, BLOCK 5, PROSPECT HEIGHTS SUB. NO. I
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Three Bedroom Home 5'Wide Trench System
Perc. Rate: 1-5 Min./Inch 1,000 Gallon Septic Tank
Application Rate: 1.2 GPD/SF 4'Drainfield Rock
3 Bedrooms * 150 GPD/Bedroom = 450 SF Absorption Area
450 SF11.2 GPD/SF/5 SF (Width) *.5 (Red. Factor)= 37.5 LF Trench Length
THEREFORE: Construct a 38' Long x 5'Wide x 4' Effective Depth Absorption Trench.
Flow Line Elevation in Trench to be 4'Below Original Ground Surface. Total Depth to be
8' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over
Septic Tank.
lin
91
EN
5'
Fabric
4" Perforated
PVC (Holes Down)
Drainfield Rock
Coarse Sand (See Specification)
TYPICAL 5'WIDE TRENCH SECTION
(NO SCALE)
A
NOTE: Grade Area Over Trench to Drain Away.
0�4
Minimum 6'Separation From Bedrock.
Minimum 4'Separation From Groundwater.
.....
Minimum 100'Separation From Private Wells in the Area .
Minimum 100'Separation From Surface Water or StrearnsAt
#� 'e
MI -E!"11,
MIC�L E. ANDERWN
1 No. CE4381
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICEs DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
DEPTI I
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: PROSPECT HEIGHTs, BLOCK 5, LOT 16
PERFORMED FOR: JoHN's ExcAvATiNG
DATE: 7/13/2012 PROJECT No.:
PARCELID#: TECHNICIAN: J- BERKRAM
I TEST HOLE I
ME OB/OG
SILTY GRAVEL
WITH SAND
4 GM
A
4
4
BOH @ 18'
(7)
49th
MICHAEL E, ANDERSON
No, CE -4381
S I I I- Fjl-AN
SEE SITE PLAN sa
WAS GROUND WATER ENCOUNTERED? !No
IF YES @ WHAT DEPTH?
DEPTH OF WATER AFTER MONITORING: HOME
DATE OF MONITORING:4—�3'62' SEE SITE PLAN
llejlzu!6
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
INET DROP
I (INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
7/16
1
3:20
5.0011
2
3:50
30
12.501,
7.50"
3
3:51
4.751t
4
4:21
30
12.00FI
7.25"
5
4:22
5.0011
6
4:52
30
12.2511
7.25"
PERCOLATION RATE: 4.1 (MINANCH) PERC. HOLE DIA.�(INCHFS)
TEST RUN BETWEEN: 3 .0 FT. and 4.0 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR To TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 7/23/2012
bevelorment] Services Departl ment
CBuilding 5cfety Division
on-site Water& was+�Wc er prograrn
470(D Bragaw STreet
P.O. Sax 196650
Mark Begich Arir�ioraqc, AK 90519-6650
Mayor lv�wjnjr. orqIoni �e
(9n7; 343-7904
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue:
Parcel Identification Number:
Legal Description
Fr-
8
Property Oii ner )ame & Address:
i�u v Pq AJ -D r5r� to ZZ I V ff
Pump Installation Date: r7—
Pump I ntake Depth Below Top of Well Casing: 2SVfeet
pump Manufacturer's Name: ej--Z� —D,�dc-e-A-
Pump Model:
Pump Size 3Vq hp
Pitless Adapter Burial Depth: feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer: AJ VA -
Well Disinfected Upon Cornpletion?fw:� Yes F No
Method of Disinfection:
Comments:
Anchorage Pump & Well Service
Pump Installer Name: 330 East 76th Avenue
Anchorage, Alaska 99518
Phone: 907-243-0740
Fax: 907-243-0742
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
I
V11
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH& ENVIRONMFNTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
$25 L Street- Anchorage, Afaska 99501 Tefephonsi
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
LKINEW
6 ROC E T A E)qsn IZ74—eifiI.90
I
EDUPGRADE
MAILING ADDRESS
324 I-IANOr A Mc C? 9--c-0 I
LEGAL DESCRIPTION
L.nT /6 in iv r PROSPCC-r TIZ-'U /?3.LJ SZC-. 13
LOCATION
NO. OF HEIVOMS
-'� C
-Jq AI A r T- b R,
ell
Absorption arpa
Dwelling F
PERMIT NO.
oy
DISTANCE TO.77190
21
9
P46 8946
;:z
Manufacturer
Material
No. of cor%Zrtments
Lig. capacity in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
6 le
DISTANCE TO:
Well
I
Dwelling
I
PERMIT NO.
-10Z
Manufacturer
Mate ial
Liquid capacity in gallons
DISTANCE TO:
Well
1'7)
Foundation
Nearest lot his of
OS3
P'9�8`8e,-6
Total len h I lia"
%`i
Trench wc! Is
4
Distance I enlines
P: Z
. b
MZY-1
4P
Top finish
Material beneath
Toutleffectl
of tile to grade 41
tile
ah,orp1blarea
Length
ffidth
Depth
PERMIT NO.
V
1-
Type of crib
Crib diameter
Crib depth
Total effective absorption area
Well
Building foundation
Nearest lot line
DISTANCE TO:
Class
PX'iVATi5
Depth
Driller
Distance to lot line
:7T
MIT NO.
DISTANCE TO. .
Building foundation
I
Sewer line
Septic lank
I
Absorption areas)
/-), .0
OTHER
PIPE MATERIALS
I
ILI
CA S7 if& A) -ec jp 3o34
SOIL TEST RATING
t
INSTALLER
G 0A5rAHC- r-AALf- 139 -
2.0 It
40
A:w
REMARKS
ivsLILAr' 13Q;LniA/e�
T
t
,5�fcic< -t&s A Y Z 0 14AJ 6ATC!�'
-jL�U-1-
(.7" ;ycenovelli Our to I'Less, Gorislyril.
DATE LEGAL 171
'T WC, PC,—'r 14 T
ICA31g it L 16 SS' P,,�os I? 1? 3 40 S-rc- 1-3
I
72-013 (Rev. 3/78)
MU" I C-- I F�AL_ I -rN' C3 F= N1 Q F,: i=� C3 F_-_
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, At- 99501
264-4720
C3 E; I -r E=- IIS I-- W I-- F�% F� I —_- FZ4 M I -r
PERMIT NO: 840896
DATE ISSUED: 10/22/84
APPLICANT: BRUCE.T. ANDERSON
ADDRESS: 324 E. MANOR
ANCHORAGE9.AK 99501
CONTACT PHONE: 274-6490
LEGAL DESCRIP: SUBDIVISION:
PROSPECT HTS. #1
LOT: 16
BLOCK: 5
SECTION: 13
TOWNSHIP: 12N
RANGE: 3W
LOT SIZE: 2.01A (SQ.FT.
OR ACRES)
MAX BEDROOMS: 4
Listed below are the options
available to you
in designing
your septic
system. Choose the option that
best fits your,site.
- - - - - - - - -
- - - -- - -
- - - - - - - - - - -
- - - - - - - - - - - - - -
_r F -,:z I=- t\J (__ 1-1
n I—_- 3:3
LAJ ID r -;Z ink I
DEPTH TO PIPE BOTTOM (FT.).
��.o
4.0
4.0
GRAVEL DEPTH (FT.)
-7.0
0.5
3.5
TOTAL DEPTH (FT.)
10.0
.4.5
7.5
GRAVEL WIDTH (FT.)
2 5
5.0
GRAVEL LENGTH (FT.)
:43�:o
41.0
65.0
GRAVEL VOLUME (CU.YDS.)
29.9
33.5
48.2
TANK SIZE (GALS)
1,250.0
lo250.0
10250.0
SOIL RATING (SQ.FT./BR)
150
150
150
DEPTH TO PIPE BOTTOM <
3.5 FT. REQUIRES INSULATION
DEP TH TO PIPE BOTTOM <
4.0 FT. MAY REQUIRE A LIFT STATION
TANI' MUST HAVE AT LEAST
- - - - - - - - - - - - - -
TWO COMPARTMENTS
- - - - - - - - -
- - - - - -
- - - - - - - - - - -
I certif-y that:
1. 1 am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. 1 will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of.this permit.
3. 1 will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal -system or public
sewerage system on this or any adjacent or nearby lot.
4. 1 understand that this permit is valid for a maximum of 4 bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BED N BY A LICENSED ELECTRICIAN.
SIGNED DATE:
APPLICANT: BRUCF'�r,�. ANDERSON'
IS�UED
BY
DATE: RZY
I- —
V7 g..
I
MU" I (-- I F='03bIL_ I -r%l Ml= ic� C:) FZ tcb (!; f -E
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREETp ANCHORAGE9 AK 99501
264-4720
C3P,J—!3X-r1-= E3FZW1-=FZ
PERMIT NO: 840513
DATE ISSUED: 06/27/134
APPLICANT: BRADISON REMODELING P4 P-6
ADDRESS: 4601 VAN BUREN
ANCHORAGEt At" 99503
CONTACT PHONE: 561-1813
-r-'ec
o`�Ac
LEGAL DESCRIP: SUBDIVISION: PROSPECTS HTS. -LOT: 16 Plmrw: 5
SECTION:.13 TOWNSHIP: 12N_ RAtJGE:,3W
LOT SIZE: 2.01A (SO.FT. OR ACRES),,4a, 6��. �� &��"Je
MAX BEDROOMS: 3 :E zz.�
Listed below are the options available to you in designing your sep�t=�p
system. Choose the option that best fits your site.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
F- FZ E: " (-_ " EDI I -E 13 W - ID Fz hl!:�h 1 P4
DEPTH TO PIPE.BOTTOM (FT.) 4.0 4.0 4.0
GRAVEL DEPTH (FT.) 5.0 0.5 2.0
TOTAL DEPTH (FT.) 9.0 6.0
GRAVEL WIDTH (FT.) 2.5 14.0 5.0
GRAVEL LENGTH (FT.) 34.0 28.0 36.0
GRAVEL VOLUME (CU.YDS.) 17.3 14.5 2.1.9
TANI" SIZE (GALS) IP000.0 1,000.0 1,000.0
SOIL RATING (SQ.FT./BR) ill 85 85
** TANI" MUST HAVE AT LEAST TWO COMPARTMENTS
- - - - - - - --- - - - - - - - --- - - - - - - - - - - - - - - - - - - - - - -
1. 1 am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. 1 will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. 1 will adhere to all MOA and State of Alaska requirements for -the set -back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. 1 understand that this permit is valid for a maximum of 3 bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
SIGNED DATE:
----------- —
APPLICANT: BRADIS REMODELING
ISSUED BY DATE
- -- ---- --- �A_
MUMXr_-1F=*jPk.L_1-r%e MF= if4M(—_"C3F7Z6AC31=_
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
�825 L STREETt ANCHORAGE, AK 99501
264-4720
C3 P-1 — f�3 X -T- FE: E; [-= W 1-= F;Z 9� W FEE L_ L_
PERMIT NO:
DATE ISSUED:
APPLICANT:
ADDRESS:
CONTACT PHONE:
840034
06/26/84
BRADISON REMODELING
4601 VAN BUREN
ANCHORAGE, AK 99SO3
561-1813
F� I-= FZ M X -r
LEGAL DESCRIP: SUBDIVISION: PROSPECT HTS. LOT: 16 BLOCK: 5
SECTION: 13 TOWNSHIP: 12N RANGE: ZW
LOT SIZE: 2.01A (SQ.FT. OR ACRES)
MAX BEDROOMS: 3
Listed below are the options available to you in designing your septic
system. Choose the option that best (its your site.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
-r F;Z 1= P4 4-- L%J - ID FzZ d!214 7: P4
DEPTH TO PIPE BOTTOM%(FT.) 4.0 4.0 0
GRAVEL DEPTH (FT.) 5.0 0.5 2.0
TOTAL DEPTH (FT.) 9.0 4.5 6.0
GRAVEL WIDTH (FT.) 5 14.0 5.0
GRAVEL LENGTH .(FT.) :0 28.0 Z6.0
GRAVEL VOLUME (CU.YDS.) :�7
0> 14.5 21.9
TANK SIZE (GALS) 10 1,000.0 1,000:0
SOIL RATING (SQ.FT./BR) 135
TANK MUST HAVE AT LEAST,TWPZOM77 - - - - - - - - - - - -
-I ce-rt-if-y th-at: - - - - - - - - r
1. 1 am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of -Anchorage (MOA) and the State of Alaska.
2. 1 will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria,of this permit. -
3. 1 will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing welly wastewater disposal system or public
sewerage system an this or any adjacent or nearby lot.
4. 1 understand that this permit is valid (or a maximum or 3 bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, .
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED,WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
SIGNED
APPLICANT:
ISSUED BY
DA TE:
R D REMODELING
DATE:
rffi�)
S;ILS !.Oj�
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
825 L Street, Anchors". Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
ipt I
PERFORMED FOR: 4L&e�y c -NO DATE PERFORMED: Oct 70
I
LEGAL DESCRIPTION: Lot 16 MOCIZ 5- 74)
SLOPE SITE PLAN
MW rZOIN r-T—r—T--1 I I I i I I I I 1 7-1
2-
3-
4-
5-
6-
7-
4
10 -
12 -
13 -IR
14-
15-
16-
17-
18-
19-
201
M(nw- ScIl lale-
WASGROUNDWATER
C-1 ri Sf ENCOUNTERED? -AD
IF YES, AT WHAT
DEPTH7
%,j cld��
5 cf-'e I
IGL�y
T
3
L
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE
TEST RUN BETWEEN
40M -fu I I "I
PERFORMED BY'04=y INOA T7--tYO'ZV CERTIFIED BY:
I
72-008 (6/79)
FT AND - FT
e d nc- f S: -t-3 T7
DATE: /0/2
r -'N 50ILS LOU
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 0 PERCOLATION
1 40j-:� 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: c GINNIS DATE PERFORMED: (0/2 -
LEGAL DESCRIPTION: L07 1(,.I�K 5 ?(Z.0,cPEC-T HEI�HTS SEC -13,112o' 3L
MEMO MMENERNOME
M
0
MMEN OMMMENOMMIN
No 0091000
ryl =I
'As
No OFAME 11113
mono NNOMN3MOMM
is
ERME REMMONSMNE
MMOO
7 -
8- Poo e L �1 A C t -e c.J-0
9 C AN
10 -
WAS GROUND WATER
ENCOUNTERED?
12-
13 -TT -1 --[- P
14-
Date
Gross
Time
15-
Depth to
Watar
Net
Drop
16-
ii000.1.,
0
17 -
18 -
Nil
19-
20 -
COMMENTS
PERFORMED BY:
4
72-005 16/79)
IF YES, AT WHAT
Li —AULF`LqTH7
y6T V 3Nnr
3-9ZZZ ON
........ 0.00".
ST (gy—o"
ONO UNIONME
NEREENNEEN
Readtnq
Date
Gross
Time
Net
Time
Depth to
Watar
Net
Drop
PERCOLATION RATE
TEST RUN BETWEEN
(minutes/inch)
FT AND — FT
� C'
CERTIFIED BY: I . —
DATE
Type Material Drilleds
0 feet
18
Cravel
18 feet
to
.25
Sand
�25 feet
to
37
Sandv
Of HaLni
V.ONMENIA V?,OTE I CTOA
37 feet to 40 Cravel/water EWI
ID ZQ�
40 fek to 70 Clav, vravel
70 feet to 82 gravel, damn sand
R2 feet to 83 Water, at I Rpm.
83 feet to 90 rravel, clay
90 feet to 95 Sand, gravel
Hefty Drilling
95 feet to clax, gravel
S.R.A. Box 1553 R
99 feet to 309 Bedrock
AnchoragepAlwgm
Perforated casinp at 82 and 83 feet.
99507
•
q-•
Municipality of Anchorage s ,o
F �p ,•�l�r—. �
On-Site Water and Wastewater Program ^ �� l tri . r,
(907) 343-7904 ._
e. ��2 018
Certificate of On-Site Systems Approval �J
015-091-36 --ZF-er`='
Parcel I.D. Expiration Dat:. �' r;� 6 : • S
IL(— 1 s.
1. GENERAL INFORMATION
Complete legal description Prospect Heights #1 Block 5 Lot 16
Location (site address) 9910 Schuss Drive
Current Property owner(s) Paul & Cynthia Vanderweide Day phone
Mailing address 9910 Schuss Drive Anchorage, AK 99507
Real Estate Agent Day phone
2. TYPE OF DWELLING:
❑ Single Family (w/wo ADU)
❑ Duplex
0 Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4/3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Q Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by. c /AL I All -.I t , Date: 2/14418
COSA to be released to the engineer,unless otherwise requested by the engine-r. {
COSA Fee $ Waiver Fee $
Date of Payment a/Gii� Date of Payment
Receipt Number a110146 Receipt Number
COSA# Q&A/G.3 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined
in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply
and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at
the time of installation.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 2/2/2018
.�`~OF 4(� kk
r • A
*• 49 .*
6. DSD SIGNATURE ... /
K‘ � 2f____......--
System #1 Approved for f7 r.bedrooms r�' Steven iR.•f�annorie:
System #2 Approved for bedrooms •1�� 9�, CE-8149 •\,,���
Disapproved ��kU,.PROFESSIONA\- �
Conditional approval for bedrooms, with the following stipulations:
.,` pF ANrh`O
Q, /P-9,-..
EN'S\Ce
Nr SN'
=.o�� PC�OG\�P�
e7
By: C "`-�- 1' Original Certificate Date: 2--I 14, ^(S?
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory •
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other .
COSA blue sheet_f .. c
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 2
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Prospect Heights #1 Block 5 Lot 16 Parcel ID:015-091-36
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed 9/25/1984 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 309 ft. Cased to 100 ft Casing height(above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 9/25/1984 1/26/2018
Static water level 35 ft. 100.9 ft
Well production 2.5 g.p.m. 3.5 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 1.53 mg/L
Arsenic
ND D ug/L Date of sample: 1/26/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 6/15/2015
Tank size 1250 gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N/A
Date of pumping
1/29/2018 Pumper A+ Home Services
C. ABSORPTION FIELD DATA
Date installed 10/23/1984 Soil rating (g.p.d./ft2 or ft2/bdrm) 150 SF/BORN System type Deep Trench
Length 52.5 t. Width 3 ft. Gravel below pipe 6 ft.
Tottaal�de • ft. Eff. absorption area 630 ft' Monitoring tube Y Depression over field N
Date of adequacy test 1/26/2018 Results(Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 6 in. Water added 600 gal. New depth 33 in.
Elapsed Time: 240 min. Final fluid depth 6 in. Absorption rate >= 600+ g.p.d.
N
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 1 00+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
Survey on file.
G. ENGINEER'S CERTIFICATION ���'�"`xx
O F A
I certify that I have determined through field inspections and r�''p>' - j ..y+�0
review of Municipal records that the above systems are in ;7*; ,4. i. /\ •* i
conformance with MOA COSA guidelines in effect on this date. ....4*..k.ji — —. '
Engineer's Printed Name Steven Pannone —i�'••'Slaver;1R, Pannone
: ilert
Date
2/2/2018 1t4. CE-8149 .
il�j`�`��o�s9c*
COSA canary sheet_2-6-15.doc
If more than 1 septic system is on the lot:
COSA Checklist# 2 of 2
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Prospect Heights #1 Block 5 Lot 16 Parcel ID:015-091-36
A. WELL DATA
Well type If A, B, or C provide PWSID# Well Log (Y/N)
Date completed Sanitary seal (Y/N) Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height(above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic ug/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 8/27/2012
Tank size 1000gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N/A
Date of pumping 1/30/2018 Pumper A+ Home Services
C. ABSORPTION FIELD DATA
Date installed 8/27/2012 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type Shallow Trench
Length 50 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth 10 ft. Eff. absorption area 500 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 1/30/2018 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in.
Elapsed Time: 60 _min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d.
N
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 00+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+ •
F. COMMENTS
Survey on file.
G. ENGINEER'S CERTIFICATION +~ OF 4,Q
�P)• sly
I certify that l have determined through field inspections and j o'�.• `4` y,��
review of Municipal records that the above systems are in 0*: -I\ •.
conformance with MOA COSA guidelines in effect on this date. •••• 0`0 • ••• 0
Steven Pannone -I
Engineer's Printed Name 1 •eleven . Pannone
Date 2/2/2018 ' CE-8149 , 'i
COSA canary sheet_2-6-15.doc
PROPOSED MSNED FLOOR
ELEV.(ASSUMED) /
PROPOSED BONDING CORNER /
'REV.(ASSUMED) /• /
ZONING ORIRCT
FRONT BINDING 4IBACX %
•
sloe emetic SETBAa( /..S\
REAR RUI DING SE1BACx /�*
/ h
/r.,4?
/ C- .
', 1,
/O i /, a
o /
I :" / >
I /'/
/'
/
I /
7
I A' o� /
% �.�6� /'
% 30
.
% G�JSS./
I Si
7
I •"74.
/./
/,
r
/'
% /-
1 :/.
UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABUSHING BOUNDARY OR FENCE UNES.
THE SURVEYOR TAKES RESPONSIBIUTY FOR THE INITIAL TRANSACTION ONLY APD ASSUMES FINANCIAL UABILITY ONLY FOR THE COST OF THE SURVEY.
USTED DISTANCES PREVAIL OVER SCAUNG. REPRODLCTION MAY CAUSE ERRORS IN SCALE.
❑ or SURVEY SURVEY TYPE SYMBOLS
0 FOUNDATION AS-BUILTa PeMvO®
0 FINAL STRUCTURE AS-BUILT SET REBAR 6.11110. DRAINAGE k`'"'"""1 ASPHALT
C FOUND REBAR °R-9—e: WOOD FENCE t. ..°..41 CONCRETE
❑ PLOT PLAN. . . AS-BUILT. . . LOT SURVEY. . . TOPOGRAPHY �l� ASSUMED ELEV. X X X METAL FENCE WWI WOOD DECK
® AS-BUILT. . . NO CORNERS SET 0 RECERTIFICATION AS-BUILT . . . NO CORNERS SET
PLOT PLANS & LOT SURVEYS NOTE:
IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS.
TO FINISHED GRADE AND UTIUTY CONNECTIONS AND TO DETERMINE ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCATION. ONLY. SNOW
THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS M<.Y PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. AL L DISTANCES ARE RECORD UNLESS OTHERWISE NOTED.
SURVEY CERTIFICATION .',.,.0int�4,, Prepared by
PLOT PLAN �P-\E ,r te Robert E. Johns, Jr. & Assoc.
Ibusby orwyealNm.py.mey-�• 4,� •�`{'�je Professional Land Surveyors
the lot droen and deserted herote.old that I �^ (y
how'coed or esed.lIN.ed dl of the Rot comers ir vl o° . 1700 Brink Drive.
m wen o,the pen end to deotbest of my � ' . ANCHORAGE, ALASKA 99504
Imoofedge and abeam dl etnendms haw bees. t M •. K .
meso red tale and:meetY Y
N • .•e 7 Scele: n t Rec. Lot S.F. Rec. Plot File No.
(FOUNDATION AS-BUILT �• '� Qi'•"°'•� 1 1 _ 100
I.Rabert E Jannm Jr..hereby oertfry that I
t / 0 Surveyed: Drown b Checked J A K
have porn: ad m -Butt envoy of B.. a �` 10/03/13 Y REJ J'VI
tonelotlan o,MY lot and that at the
dm.m.00.o and Intomoton os thank aro• RO: RT..JON ,JR.
we boo and no eneraodonmte hoer.+aloe d •- Dote Drown: Grid: W.O.
-�•.aeeel- 1�. '• 41 _� `',„ 10/04/13 2440 13-517
FINAL STRUCTURE AS-BUILT .A.,4* •• Ap
I.Robert E Jahnm Jr..hereby certify that I ., ® ., , Lego; Description:
h;:ee pc/w-+Nd m Am-Bolt coney of IM el the a Or.
• ...........••� dye LOT 16 BLOCK 5
I
a.mds.duro Gad thieflot
os dMoon heroes. i ♦"a. pores aiona`0���
�cm het seoereade.t.e.N.tad«a �ornilauwei.�V"'s I PROSPECT HEIGHTS
,yw:m otherwise.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Brag3W 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. COSA# citlowol
1. GENERAL INFORMATION Expiration Date: / 01- -.9-19 0 6
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
PROSPECT HEIGHTS SUBDIVISION #11: LOT 16, BLOCK 5
9910 SCHUSS DRIVE 0 ANCHORAGE, AK 99516
MICHAEL & JANICE MARSH — Day phone 346-1158
9910 SCHUSS ORWE * ANCHORAGE, AK 99516
Day phone
Real Estate Agent CAROL BUTLER w/ RFMAX PROPERTIES Day phone 257-0116
Mailing address 110 W. 38th SUITE 100 * ANCHORAGE. AK 99503
Unless otherwise requested, COSA will be held by DSD forpickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
N
Individual Water Storage
El
Community Class—Well
El
Public Water System
13
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
Individual Holding tank
13
Community On-site
1:1
Public Sewer
11
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 AJaska. 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 andlor 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 andlor 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 CARNESS ENGINEERING GROUP, Ltd. Phone
Address 370 1 E. TUDOR ROAD. SUITE 101 * ANCHORAGE. AK 99507
Engineers Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSO Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational fife 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 ofthe system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate othow long the system will continue to meet the
operational requirements ofthe ADEC or MOA DSD. The content of this report is for
the sole benefil ofthe owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will It confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
337-6179
Date 9 /Z (WOL,
Conditional approval for — bedrooms, with the filowing stipulations:
WATER AND
PROGRAM
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineers Reort
Other —
By: zm/ �P�4- Original Certificate Date:
Municipality of Anchorage
Development ServIces Department
Building Safety Division
O"Ite Water & Wastewater Program
47W Bragaw Street
P.O. BOX 196M
Andxnge, AK 9951 9 -WW
www.muni.orgionsits
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEms APPROVAL CHECKLIST
Z
Legal Description: PROSPECT HEIGHTS SUBDIVISIo ;'Lar 16, BLOCK 5 Parcel ID: Q Jf- () 01/- 3 6
A. WELL DATA
Well type PWATE If A, B, or C provide PW`SID# NIA
Date completed 9/25/1984 Sanitary, goal (yjN) YES
Total depth 309 ft. Casedto 100 ft.
FROM WELL LOG
Date of test 9/25/1984
Static water level 35 ft.
Well production 2.5 O.P.M.
WATER SAMPLE RESULTS:
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 12+ in.
AT INSPECTION
9/8/2006
100
6.62 g.p.m.
Collform 0 coloniWI00 rnI. Nitrate _2&�j_mQA. Other bacteria 0 colmiesiloo rrd.
Arsenic: -AM_ugjL. Date of sample: 9/8/2005 Collected by: GEG, Ltd.
B. SEFTICIHOLDING TANK DATA
Tank TypelfMaterial SEP7IC/STEEL Date Installed 10/23/1984
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation deanout (Y/N) YES Depression over tank (Y/N) NO Ngh water alarm (YIN) NIA
Date of pumping 9/8/2006 Pumper ROTO ROOTER
C. A13SORPTION FIELD DATA RINDWISMOR1�1
Date Installed 10/23/1984 Soil rating (g.p.dAbr((� 150 system type TRENCH
Length 515 ft. Width 3 ft. Gravel below pipe 6 ft.
Total depth Eff. absorption area 630 fe Monitoring tube YES Depression over field NO
Date of adequacy test 9/812006 Results (Pass/Fall) kSS For 4 bedrooms
Fluid depth In absorption field before test DRY In. Water added 838 gal. Now depth 17 In.
Elapsed Tom: 38 min. Final fluld depth 3 In. Absorption rate >z 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN — If yes. give date
D. LIFT STATION
Date installed
"Pump ono level at _in.
E. SEPARATION DISTANCES
Size In gallons
High water alarm level at
Cycles tested— Meats alarm & circuit requirements?—
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankfitft station on lot 100!+ On adjacent lots 1001+
Absorption field on lot 10V+ On adjacent lots 100,+
Public sewer main N/A
Sewer /septic service line 25'+
Animal containment areas 50'+
Public sewer rrianhole/deenout N/A
Holding tank N/A
Manure/anunal excrete storage areas 10V+
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5'+ Property Une 5'+ Absorption fleld 5'+
Water main I N/A — Water service One 10'+ Surface water----J22:+—
Wells on adjacent lots 1001+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main NIA
Water service line 106+ Surface water 100'+ Driveway, parkingMshicle storage 10'+
Curtain drain NONE KNOWN Wells an adjacent lots 100'+
F. COMMENTS
0. ENGINEER1 CERTIFICATION
I cer* that I have determined ftough #old inspections and
review of Muniopat records that Me above systems are in
conformance with MCA COSA guidefines in effed on this
date.
Engineses Printed Name JEFFREY A. GARNESS
Date , /,z (0 )a /0
COSA Fee 9 '13 6. <30
Date of Payment Z,2�/C4
Receipt Number
(Rev. I V05)
Waiver Fee $
Date of Payment
Receipt Number
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
Nitrate Advisory
Certificate of On -Site Systems Approval # 060467
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 5, Lot 16 of
Prospect Heights-'�/subdivision. This inspection revealed a nitrate
concentration of 7.27 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/L for
public drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
02
4v, t%
4� // r2
Of
< �N
.Es;— [3F A "V��
-7 I -q
r,< . ............
47.
49MH
............... * ..........
SHANE A. HOLT.-
LS-6914
...... .... 0 It
A
q..,
COP
DCALK 1' 50'
AS -BUILT SURVEY
NO CORNERS SET THIS DATE
I WREW CERTWY �T I MVE KRFORWD A
NOTE: LOT 10. IULOCK 5. PRO�Cl W�S W. I
NO eASE.ENTS APPEAR
0
THI LOT ON THE RECORD PLAT.
7TE "OfflWbk� WREO� M FOR � L*E OF LE� VVTTLFT� IIPSCF�y TO
EMSTWO STRL0CTINES MD ��O LOT LAES OR �EKTS MO W WT TO IX
8TRLCTLPESORFEW0.WfS
EMEME� OF RECORD. O�R � �SE � O� TVIE RECORMO RAT. ME WT � WREOfk
NOTE ��E�S�MEL�MD��MLY�MEWTTOMMOTO�RM��W�3
OR L�TE STRMTLRES
O�R T� WTED
WED AT ��F � MS _19TH_
MYOF WPTEMWR
HOLTLN��Y*47-161"!TFTY�W —
TELU&6513
PAV
IF 9
es]
SGS ReEN
1065388001
Client Name
Gamcss Engineering Group, Ltd.
Project Name/11
Lot 16 Blk 5 Prospect I Its #I
Client Sample ID
Lot 16 Blk 5 Prospect I Its N I
Matrix
Drinking Water
All Dateiffirnes; are Alaska Standard Time
Printed Datdrime 09/20/2006 8:27
Collected Date/Time 09/11/2006 8:33
Received DAtelTime 091IM006 14:10
Technical Director Stephen C. Ede
Saniple Remarks:
Allo"ble
Prep Analysis
Parunctcr
Results
PQL Units Method
Containff ID
Limits
Date Date
]nit
Metals by XCP/MS
Arsenic
ND
5.00 ug/L EP200.8
C
(<10)
09/12/06 09114/06
Mll
Waters Department
Nitratc-N
7.27
0.100 mg/L EPA 353.2
B
(<10)
09/11/06
ALR
Microbiology Laboratory
Total Colilarm
0
col/100ml- SM209222B
A
(<I)
09/11/06
TLF
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date _
(a) Legal Description (include lot, block, subdivision, section township, range)
i-711POA95- , PWC5j2C-C+ ATS4.1 'T I z K) rL 3 Lk -1 S ft ]I
Location (address or directions)
-!Cf-Cej4-TT -D(L
Address
(a) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. Type of -Residence
Single -Family t�R Multi -Family
Number of Bedrooms
3. Water Supply
Individual Well cs� Community =
Other (describe)
Public M
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite 4?1z r_
.2S�r Public
Community Holding Tank
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
472-bg&V
(b) Applicants
Name �nL4CF
AV1t>CrV50-j
Telephone Home Business
Applicants
Address
zoo W-30�1
V931'
Ave 4)t qqe:,<)?
(c) Applicant is (check
one) Lending Institution OwnerAbuilder
-::l
Buyer [-::[
; Other E
(explain);
(d) Lending Institution
Telephone
Address
(a) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. Type of -Residence
Single -Family t�R Multi -Family
Number of Bedrooms
3. Water Supply
Individual Well cs� Community =
Other (describe)
Public M
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite 4?1z r_
.2S�r Public
Community Holding Tank
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
t'r j('0 �fcr
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 that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein, I further verify that,
based on the information obtained from the Municipality of Anchorage files and from my
investigation and inspection, the otr-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and.regula-
tions in effect on the date of this inspection.
Name of Firm AFC!5 Telephone 5(01-50440
Address
Date— 16 -1 c-� R 5�
6. DEEP Approval
Approved for
Approved t—
Terms of Co itional
(ENGINEER EFAL)
bedrooms By �Datj
Disapproved Conditional
Approval
A F-1-
61#CIR
C. Rald, Jr.
. 2251-E ..,
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL 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 ALASXA- THE MEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. E!4FLOYEES OF VUEP 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.
(DUEP SEAL)
RR4/ej/Dl8
[Page 2 of 21 7-19-84
ki
1.
eol�
ALASKA CIIJIMUTAL COnTROL S66US, InC.
Enqinterinq 6 Enuironmental Studies
July 12, 1983 MUNICIPAUTY OF ANCHOPAGE
DEPT Of H-ALTH &
Department of Health and Environmental Protection ENV1RO,',:,4-ZNTAL PROTECTION
825 L. Street JUL 14 1900
Anchorage, Alaska 99503
Attn: John Lynn RECEIVED
Dear John:
As per Municipal Regulations we have taken water level
readings in the water monitors installed in the testholes at
Prospect Heights Subdivision # The results are presented
in Table 1. AY
Although the water levels have fluctuated since the testholes have been
drilled, suitability of the lots for on—site systems has not been
affected.
Structural Engineer
Approved by:
eeroy C Reid Ph
P resident
1200 West 33rd Avenue, Suite B * Anchoraqe, Alaska 99503 e (907) 276-1361
Table 1. Water Monitoring at Prospect Heights Subdivision #4
Date T.H.NO. Block 1!90 Depth
LOt
6/22/83
9
1
1
5. 0'
6/22/83
7
2
1
5.01
6/22/83
8
3
1
10.01
6/22/83
20
4
1
15.01
6/22/83
19
5
1
11.5'
6/22/83
18
6
1
8.5'
6/9/83
10-B
7
1
8.51
6/22/83
17-C
1
2
11.01
6/22/83
16-B
2
2
11.01
6/22183
6
3
2
7.5'
6/22/83
5
4
2
8.01
6/22/83
4
5
2
7.0'
6/22/83
3
7
2
None
6/22/83
I -B
8
2
9.01
6/22/83
2B(IO)
9
2
8.0'
6/9/83
11
2
None
6/22/82
14
12
2
10.01
6/22/83
13
13
2
9.5'
6/22/83
12
14
2
5.01
6/22/83
11-B
15
2
None
A. WML DM
M',;.N!-V PALIT Y OF /
DEPT. OF HE,!
MUNICIPALITY OF ANCHORAGE INTAL F
HEMM AUTHDPM APPF40M (HAA') J Ali 16
CHECKLIST - FEBRUARY 1984 . RECEI\
Legal Description:. /-,07
V**
I V
well classification J)ri 62;4 If A, B, cr C. D.E.C. Approved(YM)
Won Log Present ry*) Date ompleted Yield
Total Depth
—aaaZ— Cased to_ Depth 'of drouti
Static Water Level 555' � P=p Sat At &/h�00-v�
Casing Height Above Ground ',X/ Sanitary Seal on Casing 6N)
Electrical wiring in Conduit (,ON) Depression Around wellhead (YA)
So paration Distances from wells
To septic/Holding Tank on L*t i 4ro - _.r On Adjoining Lots ALLgo
To Nearest Edge of Absorption Field on Lot 21' ; On Adjoining Lots 6TXO
To Nearest Pk2blic Sewer Line 1-i To Newest Public Sewer
Cleanout/Manhole #JA Th Nearest Sewer Service Line on Lot V+
Date I
Water Sample Collected By I
Water Sample Test Results '--�)An5rwme�� A
B. SEPTIC/93LDING UNK =h
Date Installed /0 iU 174 __ Size 1 -1 *f 0 No. of Caqpewtmanta — �L —
Standpipes &i)- Air -tight Caps "Y) Foundaticn Cleancut
Depression over Tank Date East Pumped k4c-10
Pumping/Mainteranca Contract cn File for d4E----
Holding Tank High-Mter Alarm (Y/N) Al porary Holding Tank Permit (IN),44—
i) fty) �-mnlx
Separaticn Distances fran Septic/Holding Tanks f
To Water -Supply Well I TO To Building F0undaticn1_Ak_q_
Th Prcperty Line &Yat -- To Disposal Field V- 'z I I
To water mairV%ervice Line PiA. To Stream, Pando Laker or Major Drainage
course rx:fod%(
Cclmma
Receipt # lt� a
Date Paid: i -
Amount:
r1 of 21 2-15-84
4or 14o
(a "04 ODIJI In 47d
Soils Rating in Abscrpticn Strata *-I Q al -j A x - Type of System Design C h
Date Insta 11 d 4- 41� Iz -4 1 R q Length of Field )1� �J,S- /
Width of Field 4:- Depth of Field J;--JbO
Gravel Bed Thickness (0 (
Square Feet ct Abscrpticn Area 4- 1,30117-- — standpipes Presentlev-
Depression cver Field (Y& Date of Last Adequacy Test
Results of Last Adequacy Test 7-11
Separation Distance fran Abscrpticn Field:
TO water -supply Well "L I-),, To Property Line 4-
ToBuildingFwidation I- pit To Existing cr Abandcred System cn
Lot .. &IAI.�y On Adjoining Lots #. 6-T(po'
To Water MairAlService Line N 4 To Cutbank
To Strew/Pmd/Lake/cr Major Drainage Ccwsa_ ,p./Vb
To Driveway, Parking Area, cr Vehicle Stcraga Area
cc=ents-b( Aft'f.-- AFR'-C� AS -R%.14 --
D. LIFT' STRITON
Date Install d
Size in Gallans
opump Ono Level at
High Water Alarm Level at
Tested for
Electrical
Level at
ell� Vent (YAN)
Cycles dwing Adequacy Test. Meets MOA
Check Permitted Bedrocm Rating Against HAA RqqMSt
I certify that I have chackedl verified, cr cenfcrmed to all mM HAA Widalinss in effect
on the date of this irmnacticn.
Signed, C6U,%-, Date
Cmpany I JP -C-5- MOR No. ry- 0 7-
V
KBl/d5/s
[Page 2 of 21
. . . . . . . . . . . . . . . . . . . .
L" C. &W J,
NM 225 1 -E
2-15-84