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WILLIAMSON BLK 2 LT 8
Williamson Block 2 Lot 8 #015-073-17 Municipality of Anchorage Page 1 of 3_ DEPARTMENT OF HEALTH AND. HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW970279 PID Number' 01507317 Gary & Elizabeth Prosser Wastewater System: 0 New 0 Upgrade 5310 Woodcrest circle ABSORPTION FIELD 346-2433 Nd. oFo r 0 Deep Trench C Shallow Trench O ew O mound t] otter LEGAL DESCRIPTION soil Raring: 1.2 Total Depth from original grade: Ft . 13 Lot Block: Subdiviawn: o"MalpipationomddeoripwW grWc Grave depth beneath pips 8 2 Williamson 3 Ft 10 Ft Township: Retitle: Secddn: Fill added abode Original grade.. Gravel engdt: cr 2 Fr. WELL ONew t7 Upgrade GffviiiNdth: 3 Nurnderofllnes: osunwpw..nwe 1 Ft 1 Ft cl s llcadon (Private. ".c): Total Doom: Caved To: Total absorption ane:Pipe material: Existin Ft. FL 600 Fr ASTM D-3034 F810' Diner. Date Drilled: static wear Lent inawer. Dae Installed: FL Acrea e Systems 9110/97 Tet¢ pump set at cewrot• c sale TANK GPM Ft. Ft SEPARATION DISTANCES clSeptic 0Holding aS.T.EP. To Soppy Aaanrppert lift npravq Manufacturer. Capacity In gallons: From T" Mad statbti Twr 8~1.1rwe Anchorage Tank 1 250 well >1001 >100' N/A N/A >50' Mar.rl.L Steel NumterorrTwp.rdn.net Surface >100' >100' N/A N/A >100' LIFT STATION Water Lot site in gallons: Manufacturer. Una >51 3,101 N A N A2 5' I Foundation'Pump on, w.* at 'Pump air eve et High water alarm at: 3,10' cun None n LO ^pep Msat &mom tome Electrical inspections ped W. Drain Remarks: Septic tank and drainfield BENCH MARK Location and Description: replaced under this permit. poor Threshold Existing line from house to tank reused. Assumed Elevation: 1009 F ENGINEERS SEAL �. . f � ! w•p •roe. tIr,a�.f S. Gilbert9/10/97 Dates: A. ;1°"�T"' 1 ••• Inspections performed by: 1st 2nd_ 9/10/97 t�1 - w Department of Health and Human Services approval f Reviewed and approved by. L"�' Date: e 9 4l A.rhnge�X37 :xta m... ren tqw a Municipality of Anchorage Page _tot 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES . ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW970279 PID Number. 01507317 .1 \� C* 5 4 HOME OM 1,250 GALLON SEPTIC TANK 26' X 16' CRIB SPI 5m ZABEL FLOW DIVERTER � CS G`} o MT1 AS -BUILT PLAN SCALE 1" a 20' f l _ •gyp Y 1 'G. l ,L::t.t a IT.9zc 551 - Bs ,14 $bc f l _ •gyp Y 1 'G. l ,L::t.t Municipality of Anchorage Page 3 of3' DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 9 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW970279 PI0 Number. 01507317 GAF MTI -r-++ A•.I 050 .e %A R► L 5Pl L = SPZ- GL _ �Agcs- F&Okj M� .e %A R► L 5Pl L = SPZ- GL _ �Agcs- F&Okj 1aaJnass 9 -\O -c1 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 ^L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970279 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:SMITH HOWARD LEE & OWNER ADDRESS:5310 WOODCREST CIR ANCHORAGE, AK 99516 PARCEL ID:01507317 LEGAL DESCRIPTION: WILLIAMSON BLK 2 LT 8 LOT SIZE: 14824 (SQ. FT.) YUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 8/27/97 EXPIRATION DATE: 8/27/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: r/r1� ✓-�` DATE: $Z7 g ISSUED BY: , 4 u DATE: d S ANDERSON E GINEERING P4. +BMX 0-0173 aANCIMORAO, AK09524 August 16, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 8, Block 2, Williamson Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: The existing absorption crib on the subject lot is near failure and the owner wishes to upgrade the system prior to sale of the property. We therefore are applying for a permit to upgrade the septic system on Lot 8, Block 2, Williamson Subdivision. The attached site plan and backup documentation identify the location, size and components of the new absorption trench proposed to serve the 4 bedroom home on the lot. The existing concrete septic tank will be uncovered and inspected and verified for continued use. In the event the tank is found unsuitable it will be replaced with a new 1,250 gallon tank. In addition, a diversion valve w i I be placed to tie in the existing absorption crib for future use if necessary. The testhole placed in the area of the proposed absorption trench revealed poorly to well graded sands with a percolation rate of 1.6 minutes per inch. No groundwater was noted during excavation nor during the ensuing monitoring period. We are therefore proposing placement of a 25' long by 10' effective depth deep absorption trench for disposal of septic effluent. The ground surface of the lot slopes from north to south at a grade ranging from 1% to 3%. The surface of the ground in the area of the new trench is fairly flat. No conflicts were noted between the new trench and any wells in the area. If the system is constructed as designed the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in Lot 8, Block 2, Williamson August 16, 1997 Page Two the area. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. atr l '3",N Sincerely, j"Q�t f•�..r..,,,;� Michael E. Anderson, P.E. Attachments AREA MAP SCALE 1" = 50' LOT 8, BLOCK 2, WILLIAMSON $MEET NO. OF CALCULATED $Y DATE CHECKED BY DATE / !- J4D 141C1AIr�%IrL6�lYIR1O1 f,Or110(1p�pQ10R0 I I I ! I I I i I I I I r �' CONFLICTS WITH EXISTING y _- -,- I WELLS OR SEPTIC SYSTEMS 1 � r r I I VACANT i r r : 1 I i t . 1 i f i I ! l i l I I I I I j ' I I I I I• I I I; I I I� i i i I I %?,;I .%:ri•!�tiq� I I I I � I I �4'Z'9 I i 77 I I I I ! I I I 1 I ft �� �: I �Ky �! .•i 1 I I 1 II I I ; I I L_ 1 I - 18 f!��J[Sp,�1�,„,,r 1.4 ��*� I I 1 I _ -r 'MF r4\.�q,..�t6YB•�A;(� -j ' 1 i I I I I� •111- _ •__••_ N�•p i 1 ' I I 141C1AIr�%IrL6�lYIR1O1 f,Or110(1p�pQ10R0 . •® EXISTING WELL M \ EXISTING 25' X 16' CRIB cats GREENHOUSE RpU9 eF0 _ Hpk 9ppM EXISTING CONCRETE SEPTIC TANK 0 DIVERSION VALVE O TH NO.1 \ 25' LONG X 10' EFFECTIVE DEPTH ABSORPTION TRENCH *O Ob L S�. c'9c�c° VERIFY INTEGRITY OF EXISTING TANK SITE PLAN SCALE 1" = 20' LOT S, BLOCK 2, WILLIAMSON SUBDIVISION DESIGN FACTORS: Four Bedroom Home Pere. Rate: 2 MinJlnch Application Rate: 1.2 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System Verify Existing Septic Tank 10' Drainfleld Rock 4 Bedrooms X 150 GPD / 1.2 GPD/SF = 500 SF of Absorption Area 500 SF/20 SF/LF (Absorption Area) = 25 LF Trench Length Therefore: Construct a Deep Absorption Trench With One Lateral 25' In Length with 10' of Drainfield Rock Beneath the Lateral. Distribution Pipe In Trench Placed at 3.5' ' Below the Original Ground Surface. 1777 BAU&7LL j G=nrxsi LE 3=0' TYPICAL DEEP TRENCH SECTION (NO SCALE) 4+9K...•...,,y.?,. NOTE: Grade Area Over Trench to Drain Away. £ KLA Minimum 3' of Cover over Septic System. 4� a y"j NGINEER'S SEAL) r �!.y�yL�,.a..,; Vis..•` r • if `��.� �� 4�•,, ,.., • ]f'� Municipality of Anchorage 2° t DEPARTMENT OF HEALTH & HUMAN SERVICES ✓�iy:1 % 825'L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST w.,a L A # r PERFORMED FOR: Howard Smith DATE PER _ RM LEGAL DESCRIPTION: T.n R P R1ock 2 Township, Range, Section: DEeZM Williamson Subdivision SLOPE SITE PLAN 1 �... PT/OL 2- 3 4- 5- 6- 7 5 67 8 9- to- 12- 13 - 14 10121314 i 15 16 17 18 19 SP/SW Bottom of Hole WAS GROUND WATER No ENCOUNTERED? . IF YES, AT WHAT DEPTH? BWtp b Wax Aper lawAving7 None fift 8/17 20 -{ IL_ JI PERCOLATION RATE I &_ (mmutesimcn) PERC MOLE DIAMETER 6tv TEST RUN BETWEEN 7 FT AND 8 FT COMMENTS Testhole presoaked prior to test. Materials encountered in PERFORMED BY: etLa+'t ri lbcrt I p • TIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 8/16/97 72-008 (Rev. 445) GRE''ER ANCHORAGE AREA BO`+`UGH �I I�Y/ Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCATION MAILING ADDRESS p0>L T/H f�j //Xl Sr/1'L7 PHONE �- 949 Y&' LEGAL DESCRIPTION /er Lr,� �C�L�C/!.[�Y7V72. �+,G'• SEPTIC TANK: DISTANCE NUMBER OF FROM WELL /[)0 MANUFACTURER h(Vn. mR'(-c MATERIAL &/'1CtLett, COMPARTMENTS INSIDE LENGTH P / INSIDE WIDTH y / LIQUID DEPTH 5 / 1 (QUID CAPACITY 1-26 O GALLONS. SEEPAGE PIT: _ I / NUMBER OF PITS DIAMETER OR WIDTH, LENGTH —e?S DEPTH �I , LINING MATERIAL CRIB SIZE: DIAMETEReLf DEPTH `5 /r DISTANCE FROM: WELL �c�- let) 1"r IF TOTAL EFFECTIVE BUILDING FOUNDATION Aa� NEAREST LOT LINE as ABSORPTION AREA (WALL AREA) '�%O SQ. FT. ADDITIONAL ABSORPTION WELL: -propo.,td - )KAAz-{ mtuLF 61) c6-o,la,1ca Gttxlumc4,:;'s TYPE LNattr CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION—,LOT LINE , SEWER LINE , TANK , SYSTEM , CESSPOOL , OTHERSOURCES APPROVED DISAPPROVED REMARKS , DISTANCES: d4,sDIAGRAM OF SYSTEM INSTALLED BY: ' C l Ilct wn PIPE MATERIAL: aL � ' r°- _, Q , ao' c -•,jai✓ • �i LOT SLOPE - REMARKS: �rnei StplxaTn.x.k" N � DATE % ,3/ 7`l APPROVED 3 aatf G.A.A.B. Form No. EQ -031 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4551 O.%s- PERMIT NO. INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: I TYPE AND SIZE OF FAQ FINANCED THROUGH SOIL TEST RESULTS I COMPLETION DATE ANTICIPATED 4. /v C /pi FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL SE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE . n TYPES FI. 610-cco-'e4ghnE AREA SIZE ��fly�)4 X TYPE —/� Go se,1U MINIMUM DISTANCES, REQUIREMENTS / DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT e2O DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL r'�q I a SEPTIC TANKV=;"' SEEPAGE PIT cs?C) DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK /OO SEEPAGE PIT DRAIN FIELD /0 C) .ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT �O / DRAIN FIELD SEPTIC TANK, 00 SEEPAGE PIT 0 DRAIN FIELD JSL� TO RIVER. LAKE, STREAM. CAST IRON INTO AN TO CRIB CROSSING GAP OF EXCAVATION B FEET INTO UNDISTURBED SOIL. INCH DIAMETER CAST IRON 61PHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. ON LICENSED DCSIGN 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER A� AREA BOROUGH GROIN 4—'t NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. �' �q��Z DATEr.`�APPLICANT'6 SIGNATURE I FORM NO. EO -OI DISPOSAL SYSTEM — APPLICATION AND PERMIT 1`ST��E�WAGE "'✓"A%��yyU�' ` k MAILING` ADDRESS !1 �`9 ' "" I Ie'bL0CC0 \ •�/�.Fy, PMONE� NAME OF APPLICANT AL1! to�4 �.w.....� �Gn�l1 4'.' f 76A- <elJ? //,7% INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: I TYPE AND SIZE OF FAQ FINANCED THROUGH SOIL TEST RESULTS I COMPLETION DATE ANTICIPATED 4. /v C /pi FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL SE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE . n TYPES FI. 610-cco-'e4ghnE AREA SIZE ��fly�)4 X TYPE —/� Go se,1U MINIMUM DISTANCES, REQUIREMENTS / DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT e2O DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL r'�q I a SEPTIC TANKV=;"' SEEPAGE PIT cs?C) DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK /OO SEEPAGE PIT DRAIN FIELD /0 C) .ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT �O / DRAIN FIELD SEPTIC TANK, 00 SEEPAGE PIT 0 DRAIN FIELD JSL� TO RIVER. LAKE, STREAM. CAST IRON INTO AN TO CRIB CROSSING GAP OF EXCAVATION B FEET INTO UNDISTURBED SOIL. INCH DIAMETER CAST IRON 61PHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. ON LICENSED DCSIGN 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER A� AREA BOROUGH GROIN 4—'t NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. �' �q��Z DATEr.`�APPLICANT'6 SIGNATURE I FORM NO. EO -OI Performed for Legal DescriptTon: This form reports: E GREATER ANCHORAGE AREA HOROUC ti T.L4;iIVED Department of Environmental Qua..ty 3330 "C" Street J U- , - 1974 PM Anchorage, Alaska 99503 SOILS LOG - PEROLATION TEST >, ulocx e, wittiamson s log es Depth Feet Eeddish Sllt-& "Grg&ftn= Gray Silty Sand 250 .F. B.R. 3- 4- 5- 6- 7- 8- 9- 10 - 11 - 12 - 13 - 14 - Gray Gravelly Sand (SW) 125 S.F./B.R. Bottom of Test Pit 81 S Iope on G.eNIER ANCHORAGE AREA BUNOU(.'H Dlrt. Or IN"'' VEHIAE Qu tjt! Date Performed 6/25/74 Was ground water encountered? No _ If yes, at what depth? Reading Date Gross Time Net Time Depth to Water Net Drop Percolation rate minute. Proposed installation: Seepage Pit Yes Drain Field Depth of Inlet _ Deptii f Udttom of pit or trench CUIUIENTS: — _No ground watQf o_r sock-encw.,r.exed_______ Performed Cy:_1Vea1 Hausam _ Certified Dy n_Uatc:-6/-35/74 LQ -040 (6/74) Conit¢uctlon grist -fat "One test is worth a thousand npim•;Rs" . 0629 TUDOR ROAD. ANCHORAGE. ALASKA 99507 • Ttu..0Wv 272.6172 Performed For. Mike Scitacltle Date Performed 5-i7-73 Leval Description: Loth—Rloc)•. ,2 Subdivision W 1/11Arls.(i This Form Renorts Soils Lon YAs Percolation Test_ nenth rent Soil Characteristics --- ✓ Overburden 2 slit •:;;zn y ,.",�•,. - u' �_ !. l .l-_. i --� i -: - - _- - ^ 1 -�- 5I In d j �— ------ I Vas Crcund 4:ater Fncr,r r-r1?17_-- ' Vc.;. la Yes, At what Pent'I'-- --- -- - — T _.--- etc s it rt ;i r -'I '_,t;ntr to H Net kea�ltrv„j � in� --r. Tin Percolation Rate _ nLte r Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth To !.ettom Of Pit Or french Cn"?VENTS: 122 sq. t. rainaFe area requi,•ed per bedroov, No bedrock or water table i'our t. e; seepa c pit Test Performed By Jim Mack, Lab Manager Data Certified By:Construction ToatI,t Date:5-17-7_3 __ r-- �' [��%nrNS/Ori1S /iS �DR.I.ecoS: .Cdr � BL,C �. l{J�(,l/arrJ� s¢cb . i IinFT I --� i e.J. Ualtowt-, JJOT �- �Ct 1'� Ell, NIR IT��' PET'C11[;IC FIVT E E I�IKei�S1oNSS RAM 5' - LIcuID DEPTH 4' - INSIDE WIDTH OF TANK 8' - INSIDE LENRH OF TANK & 5' APBtc�FE T USIC FT, Z0* 16f1' 1200,p _ M GALLON SEPTIC TA1IK Ell, NIR IT��' PET'C11[;IC FIVT E E I�IKei�S1oNSS RAM 5' - LIcuID DEPTH 4' - INSIDE WIDTH OF TANK 8' - INSIDE LENRH OF TANK & _ APBtc�FE T USIC FT, Z0* 16f1' 1200,p _ M GALLON SEPTIC TA1IK I LIQUID DEPTH OF r43FATER THAD! E' NOT P CONSIBIERED IN IOUI�2 ACITY, IOUID DEPTH -10 �SS THAN 3a ha -Te : AAkJ wcdd e,K i uuc4 Oh 7-i uA (fop) fo hx- /scn d , 0 • Municipality of Anchorage = On -Site Water and Wastewater Program (907)343-7904 Sl Err Certificate of On -Site Systems Approval Parcel I.D. 015-073-17 Expiration Date: 1 GENERAL INFORMATION Complete legal description WILLIAMSON BLOCK 2 LOT 8 Location (site address) 5310 WOODCREST CIR, ANCHORAGE AK 99507 Current Property oviner(s) TONY CANGE Mailing address,# Real Estate Agent SHAWN CANGE 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 223-2984 Day phone 3. NUMBER OF BEDROOMS: 4 Waiver Fee $ Date of Payment I I 4. TYPE OF WATER SUPPLY: Receipt Number 6 � SAO �f TYPE OF WASTEWATER DISPOSAL: Individual Well F Individual F Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request far NONE Distance: Receivedby: `` cN�V Date: �r' I i' `' —� COSA to be released to t g neer, unless otherwise requested by the engineer. COSA Fee $ '9 �— Waiver Fee $ Date of Payment I I Date of Payment Receipt Number 6 � SAO �f Receipt Number COSA# ©SC-� t J Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm SPIJRKLAND ENGINEERING Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND 6. DSD SIGNATURE _,IGSystem #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms Phone 279-3916 Date 10/3/2012 O O F ,L tf%., .A1 `1), bedrooms, with the following .411.. S SPUR CLA JD; PIP'. (1 R By: az z2',±1Original Certificate Date: 11 -6 -12 - The un' p ty nchorage 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 r , c If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: WILLIAMSON BLOCK 2 LOT 8 A. WELL DATA Well type PRIVATE Date completed 1974 Total depth 310 ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (YIN) Y Cased to 40+ ft. FROM WELL LOG 1997 HAA 273 ft. 6 9 - p.m - WATER SAMPLE RESULTS Coliform NEG colonies/100 mL Nitrate 0.430 mg/L Arsenic NEG ug/L Date of sample: 10/10/12 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping 10/19/12 Pumper A+ Home Services Parcel ID. 015-073-17 Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION 8/6/12 270 ft. 4.4 g.p.m. Collected by: ANSON MOXNESS Date installed 9/10197 Cleanouts(Y/N) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 9/10/97 Soil rating (g.p.d./flz or ft2/bdrm) 1.2 System type TRENCH Length 25 ft. Width 3 ft. Gravel below pipe 10 ft Total depth 13 ft. Eff. absorption area 600 ftz Monitoring tube Y Depression over field N Date of adequacy test 8/6/12 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 630 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 630 9 p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off' level at E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot >100, Absorption field on lot '100' Public sewer main NA Sewer /septic service line >25 Animal containment areas '50' Manhole/Access (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots '100' On adjacent lots >100, Public sewer manhole/cleanout NA Holding tank NA Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation 'S Property line >5 Water main NA Water service line '10' Wells on adjacent lots '100' ABSORPTION FIELD ON LOT TO: Property line >10 Building foundation >10, Water Service line >10' Curtain drain >50' (N.O.) F. COMMENTS G. ENGINEER'S CERTIFICATION Surface water >100' (N.O.) Wells on adjacent lots >100' I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name LARS SPURKAND Date 10/23/12 COSA brown sheet_10.10.12.doc Absorption field >5' Surface water '100' (N.O.) Water main NA Driveway, parking/vehicle storage >10 \ 1� arrest \ Wood Retaining Wall Lot 7 V�S�9�1 49LH 7* m - Thomas H. Dr ,.. 0 - LS -7625 LS -7625 Lot 10 N89`55'45"E 57.51' Ordered by: Tony Cange Legal Description: Asbuilt Lot 8, Block 2, am Williamson Subdivision Survey Certification: I hereby certify that a Mortgagee's Inspection was performed on the described property. Notes: It is the owners responsibility to determine the existence of any easements, covenants, or restriction which are not on the recorded subdivision plot. This asbuilt shall not be used for construction or for establishing property lines. Checked by: THD Drawn by: CB Scale 1" = 30' Job 2012-73 Field Book: 114 Plat 70-22 Legend: Set Rebar with Cap O AL. Monument Found Rebar Monument Well Septic Q Pavement Overhang Wood Deck Concrete Grid SW2437 Date: 9/27/2012 Municipality of Anchorage • Development Services Department B R: Building Safety Division .. On -Site Water 8 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. - I � COSA# �7U. 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address WILLIAMSON S/D: LOT 8. BLOCK 2 5310 WOODCREST CIRCLE • ANCHORAGE. AK 99507 DARRYLL MITCHELL Day phone 265-6012 5310 WOODCREST CIRCLE • ANCHORAGE. AK 99507 Day phone LINDWOOD PARKER w/NORTHERN TRUST Day phone 205 E. BENSON BLVD. * ANCHORAGE. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 884-6255 TYPE OF WASTEWATER DISPOSAL: Individual On-site N 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 and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of Onsite 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 engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD 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 life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ✓ Approved for _ bedrooms. Disapproved. Date o6 Conditional approval for bedrooms, with the flowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other PROGRAM . lam'••...... i)1 By: &Z !/ Original Certificate Date: IRw, I'M Municipality of Anchorage • Development Services Department Building Safety Division OnSba Water & Wastewater Program 4700 Bragaw Street P.O. am 198650 Anchorage. AK 99519.8850 www.muni.org/onsft (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: WILLIAMSON S/D: LOT 8 Parcel ID: D / 5'- 0 % 3 -/7 A. WELL DATA Well type MATE If A. B, or C provide PWSIDff N/A Date completed 1974 Sanitary seal (YIN) YES Total depth 310 ft. Cased to 40+ ft. FROM WELL LOG Date of test 1997 HAA Static water level 273 ft. Web production 6 g.p.m. WATER SAMPLE RESULTS: Well Log (YM) YES Wires properly protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION 8/9/2006 279 ft. 5.8 g.p.m. Coliform _.' ^0 colonies/100 ml. Nttrate Q.�_ mgJL. Other bacteria Q colonies/100 ml. r� Arsenic: u ugJL. Date of sample: 8/9/2006 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 9/10/1997 Tank size 1250 gal. Number of Compartments E Foundation cleanout (YM) YES Depression over tank (YIN) NO Cleanouts (YM) YES High water alarm (Y/N) N/A Date of pumping 8/9/2006 Pumper McDONALDS PUMPING C. ABSORPTION FIELD DATA 7/31/1974 122 CRIB Date installed 9/10/1997 Sob rating .p.d 1_2 System type DEEP TRENCH 25 16 10 fl. Length 25 ft. Width 3 ft. Gravel below pipe 488 Total depth '129A ft. E0. absorption area 600 fe Monitoring tube YES Depression over field NO Date of adequacy test 8/9/2006 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test E in. Water added 6011 gal. New depth U in. Elapsed Time: U min. Final fluid depth U in. Absorption rate >-- 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date -tCS-r45-D I9 9 -q- S`ri,,&A-+. D. LIFT STATION Date installed Size in gallons Manhole/Acoess (Y/N) "Pump on" level at _lo. "Pump otP111, 1 igh water alarm level at in. Cycles tested Meets alarm & circuit requirements?, E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ On adjacent lob 100'+ Absorption field on lot 100,+ On adjacent kits 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/deanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animai excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 56+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkinglvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent kits 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I cert ly that I have determined through Beld inspecUlons and review of Municipal records that the above systems are in conformance with MOA COSA guidel in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date s)/7/0& COSA Fee S y_3 Cr • y u Date of PaymentT . & Receipt Number tlGl'Yq (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number .1 I •.Y..L"0� 01FAMAM � y A. Gameas.• VM -795x3 0 ! ... SGS Rer.N 1064562001 Client Name Garness Engineering Group, Ltd. Project Name/ft Williamson SD L8 D2 Client Sample ID Williamson SD L8 B2 Matrix Drinking Water Sample Remarks: All Dates/Times are Alaska Standard Time Printed Date?ime 08/21/2006 16:55 Collected Date/rime 08/09/2006 10:40 Received Date rime 08/09/2006 12:07 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Metlwd Container ID Limits Date Date [nit Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 08/15/06 08/17/06 M11 Waters Department Nitrate -N Microbiology Laboratory Total Colirorm 0.495 0.100 mg/L EPA 153.2 D (<IO) 08/09/06 ALR 0 col/IOOmL SN1209222B A (<I) 08/09/06 TLF J%/GO E'V4,C044/I!Y 015'3!' -a- �G c WELL ; 0 7± 4;c. 'a FSM LEL�.L l9i '� J \ —IO- 0 SNfD , b i E.JSE/�fF•vT � L F',se-Aar Su6d. �O�c C4 r� Com' C`F t: 8zz6x ASEMENTS OF RECORD, OTHER THAN HOSE SHOWN ON THE RECORDED not -2 LAT ARE NOT SHOWN HEREON. ply. orl EE Za ,gvd X00 A�IVW SCALE /,� 30, AS -BUILT - NO CORNERS SET THIS DATE 1 hereby certify that 1 have performed a Mortgagee's inspection of the following described property: —Lor E LLeCK 7 wl L/ N Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated et Anchorage. Alaska this --Z--l—day Of —LELY2001 FRED WALATKA d ASSOCIATES (907) 248.1666 Engineers and Surveyors 00ET89Z hT:ZT T00Z/50/L0 Municipality of Anchorage • Development Services Department Building Safety Division - Onsite Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6650 www.d.anchorage.ok.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL . FOR A SINGLE FAMILY DWELLING Parcell.D. 015-073-17 HAA#����3`7 7" 1. GENERAL INFORMATION Expiration Date: . / Complete legal description WILLIAMSON SUBDIVISION: LOT 8, BLOCK 2 Location (site address or directions) 5310 WOODCREST CIR, ANCHORAGE, AK 99516 - Current Property owner(s) GARY & ELIZABETH PROSSER Day phone '(304) 262-4104 Mailing address Lending agency Mailing address Real Estate Agent Mailing address Day phone MATTHEW ROYER FOR MARY COX ® REMAX Dayphone 257-0118 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 sample results less than 30 days old. (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. Note., Alaska Water and Wastewater Consultants, Inc. shall be paid $1,110.00 at, orprior to closing for the engineering seMces provided. 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 AuthorityApproval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is(aro) 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 MunlGpality of Anchorage riles and from my Investigation and Inspection, the on-site water supply and/or wastewater disposal system ls(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of Installation. Name of Finn ALASKA WATER & WASTEWATER CONSULTANTS. INC. Address 6901 DEBARR ROAD, SUITE 2B • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AMVC, Inc. attempted to provfde a thorough, conscientious engineering anatysls 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 lost, and separation distances measured to readily Identifiable features. The operational Me of all wells and septic systems depend on the local sells condition, groundwater levels that may .. fluctuate during the year, and the water usage of the famiy being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future porfornu nce of the system, nor do theyguamntee that there are no hidden defects or encroachments. AIMNC, Inc. can therefore not pro0do any warranty or future estimate of how long Me system will continue to moot the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will It confer any legal right whatsoever. S. DSD SIGNATURE Ll_� Approved for _'__L+ ._ bedrooms. Disapproved. Phone 337-6179 Date 7 Conditional approval for bedrooms, with the tllowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory 6lanitenance Agreements Supplemental Engineers Reort Other �,��(t0 F A J=:ON-SITE �c : WATERAND :OR WASTEWATER PROGRAM By-_ / f D �// Original Certificate Date: � % V / Municipality of Anchorage Development Services Department OnSlte Wastewatx Pmpnun 4700 Soulh Bragew SL PA. Bax 198850 An"We. AK M19 -MM wwwt inctwralle akue (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Deception: WILLIAMSON SUBDIVISION: LOT 8, BLOCK 2 Parcel ID: 015-073-17 A. WELL DATA Well type P ATE NA, B, or C provide PWSID# N/A Dale Completed 01974 Sanitary seal (Y/N) YES Total depth *310 R Cased to •<262 fL FROM WELL LOG 081e of test 1997 HAA Static water level 273.8 R Well production 6 0 - p.m -WATER SAMPLE RESULTS: WOO Log (Y/N) NO Wires properly protected (YIN) YES Casing height (above ground)1S+ In. AT INSPECTION 6/11/01 275 R 6.2 9.p.m. Coftrrn 0 colonies/100 ml. Nitrate 0.500 mgJL. Other bacteria 0 colonlesl100 ml. Date of sample: 6/11/01 Collected by: AWWC. INC. B. SEPTICIHOLDING TANK DATA Tank Type/Materlel STEEL Date Installed 9/10/97 Tank gbW 1250 gal. Number of Compartments 2 Clearwuts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 6/11/01 Pumper A+ HOME SERVICES "THE LAST 392 GALLONS C. ABSORPTION FIELD DATA INTRODUCED PRODUCED NO RISE Date installed 9/10/97 Sol rating.pA rfP/bdrrn) 1_2 System type DEEP TRENCH Length 25 R Witt 3 R Gravel below pipe 10 iL Total depth—LZ-41 EN. absorption area 600 R' Monitoring tube YES repression aver Aeld NO Date of adequacy fast 6/11/01 Results (Pass/Fafl) PASS For 4 bedrooms Fluid depth In absorption field before test DRY in. Water added 14799x1. New depth 3_5 in. Elapsed Time: a' min. Final fluid depth 3_5 In. Absorption rate >= 600+ g.p,d. Any rejuvenation treatment (past 12 mo.) (Y/N 6 type) NONE KNOWN If yes, give date – D. LIFT STATION Data Installed 'Pump on' level at n. EzW,1#X _I1*Rt,1EY0 -Eli*] Size in gallons High water alarm level at in. Cycles tested Meets alarm 6 circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot 100'+ Absorption told on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Sewer /septic sellae tine 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption Reid 5'+ Water main N/A Water service One --M•+— Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT M. Property am 10'+ Building foundation 10'+ Water main N/A Water service One 10'+ Surface water 100'+ Driveway. parking/vehlde storage 50'+ Curtain drain NONE KNOWN Wells on adjacent lots-LD-0'.+— F. ots 100'+ F. COMMENTS G. ENGINEER'S I certffy that I have determined through Geld Inspections and review ofMurdc/pal records that the above systems are In ....... .. . .......... conformance with MOA HAA guidelines In effed on 6Ys date. ' e . ..Gamsae;'.. Engineers Printed NJEFFREY A GARNESS 953 • Data ?� D! `•.�oP•.......••��.o HAA Fees 300.400 Date of Payment Receipt Number >T y8 F". IMM Walver Fee $ Date of Payment Recelpt Number E MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES AiML Division of Environmental Services ME 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. # 015-073-17 HAA # C -1K1 `i 29,1 1. GENERAL INFORMATION Complete legal description Lot 8, Block 2, Williamson Location (site address or directions) 5310 Woodcrest Circle Anchorage, AK Property owner Gary & Elizabeth Prosser Day phone 346-2433 Mailing address 5310 Woodcrest Circle Anchorage, AK Lending agency Day phone Mailing address Agent _ Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-0251R..11911 From MOA821 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance'with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Anderson Engineering P.O. Box 240773 Phone 563-7155 Anchorage, AK 99524 Engineer's signature 'V1tfA vL �u �` Date 9 /7 9 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments bedrooms, with the following stipulations: Date in/6 /92_ ..— ter—. 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. 72-025M..1/91) Swk MOA 121 i Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVIRECEIVED Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) -47-M997 i. Health Authority Approval Checklist Municipality of Anchorage Dept. Health & Human Services Legal Description: Lot 8, Block 2, Williamson Parcell D: 015-073-17 A. WELL DATA Well type Private It A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N) — Total depth 310' Sanitary seal (Y/N) Date of test Static water level Well production N Date completed Cased to >262' Y FROM WELL LOG Unknown WATER SAMPLE RESULTS: rWur� 0 g.p.m. 1974 _ Casing height (above ground) 8 � Wires property protected (Y/N) Y AT INSPECTION 6/5/97 273.8 Flow 6 - Yield >6 g,p,m, a Ls 'f -rAf,Q.. Nitrate w-Jlr mg/L Date of sample: 5/12/97 Collected by: 10 ,c 9Y IAXUZ B. SEPTIC/HOLDING TANK DATA _ Other bacteria Stuart 9 Date installed Tank Tank size 1250 Number of Compartments Two Cleanouts (Y/N) Y Foundation cleanout (YM) Y Depression (YM) N High water alarm (Y/N) N Date of Pumping new Pumper Construction C. ABSORPTION FIELD DATA Date installed 9110/97 Soil rating (g.p.dJfts or f */bdrm) 1 •2 System" Deep trench Length _15—'_—Width 31 Gravel thickness below pipe 10' Total depth 13' Effective absorption area 600 S . F Monitoring Tube present (YM) Y Depression over field (Y/N) N Date of adequacy testNer��aw ,QA Results (Pass/Fall) Pass For 4 bedrooms Fluid depth in absorption field before test (in.); 0 Immediately after_ gat, water added (in.): Fluid depth (ins) Minutes later. Absorption rate = > 600' c.p.d. Peroxide treatment (past 12 months) (Y/N) N If yes, give date 72-026 (Rev. 3196)' D. UFT STATION None on Lot. Date installed Size in gallons Manhole/Access (Y/N) `Pump on" level at' "Pump off' level at' High water alarm level at' *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot >100, On adjacent lots >110' Absorption field on lot >120' On adjacent lots >110, Public sewer main None Sewer /septic service line >50' Public sewer manhole/cleanout Lit station None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: None Foundation > 5 9 Property line >51 Absorption field >51 Water main/service line >50' Surface water/drainage None Wells on adjacent lots >110, SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main/service line >50' Surface water None Driveway, parking/vehicle storage area _ Curtain drain one Wells on adjacent lots >110' >75' F. ENGINEER'S CERTIFICATION .- I certify that I have determined thru Held Inspections and review of Municipal r>eco are in cordonnance with -M/OA HAA guidelines in effect on this date. ,� ` ;•;'' P 1. .,'' Signature Engineer's Name Michael E. Anderson r.•, Dateg&127 P& T r, — -l- HAA Fee S Date of Payment Receipt Number 72-026 (Rev. 3/98)' Waiver Fee S Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH k 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. # 015-073-17 1. GENERAL INFORMATION Complete legal description Lot 8, Block 2, Williamson Location (site address or directions) 5310 Woodcrest Circle Anchorage, AK Property owner Hnwnrd Rmii-h Dayphone 276-4044 i Mallino address S110 T7nndC_=,;t'Anchoragp, Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. M-0231RN. 1N1) Fm1 MOA/21 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. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this Inspection. Name of Firm- Anderson Engineering Phone 563-7155 Address P.O. Box 240773 Engineer's signature Date - ZAS 67 ane ` 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments .See A+fac�w.e.-� By:Date s 9 • 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 order to 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. rzaam«.u91) 6.k Mwm e Municipality of Anchorage RECEIVED DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division JUL 14199T 825 L Street, Room 502 • Anchorage, Alaska 99501 • (9& bYAnchorage Dept. Health Human Services Health Authority Approval Checklist Legal Description: Lot 8, Block 2, Williamson parcel I D: 015-073-17 A. WELL DATA Well type Private if A. B, or C, attach ADEC letter. ADEC water system number N/A Log present (YM) N Date completed 1974 Total depth 310' Cased to >262' Casing height (above ground) 811 Sanitary seal (YM) Y Wires properly protected (Y/N) Y FROM WELL LOO AT INSPECTION Date of test Unknown 6/5/97 Static water level 273.8 Well production g,p,m, Flow 6 - Yield >6 9 - p.m - WATER SAMPLE RESULTS: Date of sample: 5/12/97 B. SEPTIWHOLDING TANK DATA Nitrate .38 mg/L Other bacteria 0 Collected by: Stuart Data installed 7/3104 Tank size 1200 Number of Compartments One Cleanouts (YM) Y Foundation cleanout (YM) Y Depression (Y/N) N High water alarm (YM) N DateofPumping 7/1/97 Pumper Pacific Rehab C. ABSORPTION FIELD DATA Data installed 7/31/74 Soil rating (g.p.d./W or tt'/bdrm) 125 S . F System we Crib Length 25' Width 16' Gravel thidmess below pipe 51 Total depth 91 Effective absorption area 410 S . F . Monitoring Tube present (Y/N) Y Depression over field (YM) N Data of adequacy test 6/5/97 Results (PasyFail) Pass For 4 bedrooms Fluid depth In absorption field before fast (in.); 55„ Immediately after 50 gal. water added (in.): 56 1 /2" Fluid depth 55" (ins) Minutes later: 120 Absorption rate = 600 a.p.d* Percodde treatment (past 12 months) (YM) N If yes, give date 72-026 (Rev. 3/98). * See attached letter. D. UFT STATION Data installed Manhole/Access (YM) None on Lot High water alarm level at' Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at' *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 119, "Pump off" level at' On adjacent lots >110 Absorption Held on lot >1201 On adjacent lots >110 Public sewer main None Public sewer manhole%leanout None Sewer /septic service line >750' Lift station None SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 371 Property line 48' Absorption >19' Water main/service line >50' Surface water/drainage None Wells on adjacent lots > 110' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 24' Surface water None Curtain drain F. ENGINEER'S None Building foundation >551 Water maln/service line > 50' Driveway, parking/vehicle storage area >75' Wells on adjacent lots >110, 1 car* that I have determined thru field inspections and review of Municipal 0ms are in conformance with MOA HAA guidelines in effect on this date. = V Signature „ ; Engineers Name /✓1 mc4)Avu 4N.ou Ue J t. i,, ;�lYi4i 4 Air •,� Date 14 7 �! HAA Fee $ ' frn' C`o Waiver Fee S Date of Payment 1- 1 L\ Cl1 Receipt Number 72-026 (Rev. 3/96)' Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE M E M O R A N D U M SEPTIC SYSTEM ADVISORY HEALTH AUTHORITY APPROVAL NO. Hp9q bt8J Prior to a recent adequacy test on the septic system for this lot, SS inches of standing water was observed in the absorption field. This indicates that approximately 9 % of the absorption area is inundated. Although this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject Health Authority Approval. July 13, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Attention: Onsite Services Engineer Subject: Lot 8, Block 2, Williamson Subdivision Septic System Adequacy Test Dear Onsite Services Engineer: Information in the Municipal files indicates the absorption crib on the subject lot has a total of 5' of drainfield rock below the' distribution piping. Our Inspection and testing on July 1, 1997, Indicated however, that water started backing into the distribution piping at a level of 56.5". Initial probing found the water level at 55". The system is therefore 97% plugged and nearing the end of its useful life. We Injected a total of 50 gallons of water Into the crib which raised the water level from 55" to 56.5". Two hours later the level was back at 55". We repeated this process 4 times and found the system was capable of absorbing 200 gallons of water In an 8 hour period. Interpolating this to 24 hours indicates the crib will absorb 600 gallons of water over a 24 hour period and therefore passes the adequacy test. It must be noted, however, the crib is operating in the last 1.5" of its absorption area. We have discussed this with both the buyer and seller of the property and they are aware of the situation. A warning should be placed on the Certificate of Health Authority document reiterating the absorption crib is nearing the end of its useful life. Sincerely, %v� C n Michael E. Anderson, P.E. MEMORANDUM DATE: August 15, 1997 TO: Anthony Kim, MOA- DIMS FROM: Mike Anderson, P.E. mEa-- SUBJECT: Lot 8, Block 2, Williamson Subdivision Septic System Adequacy Test A retest of the septic system absorption crib was completed on August 13 and 14, at Lot 8, Block 2, Williamson Subdivision. Water was injected directly into the crib at a rate of .4 gallons per minute and monitored over a 16 hour period. Water flow was restricted because previous tests indicated the crib was capable of absorbing only 25 gallons per hour before becoming surcharged. The water level was monitored during the first four hours of the test and did not exceed the level of the distribution pipe. It was then allowed to flow through the night at the rate of .4 gallons per minute. An observation made early the next morning indicated it was still at the elevation of the distribution pipe. It had therefore absorbed more than 400 gallons of water without surpassing the elevation of the distribution piping. It appears the absorption crib is capable of absorbing at least 600 gallons of water without becoming surcharged. The absorption is taking place in the last 1.5' of absorption area available in the crib. A septic system advisory is therefore warranted for this system. The owner of the property has decided to proceed with upgrading the system and field work has been completed. The design for the upgrade and permit application package will be submitted for review on Monday. August 18. We are requesting, however, that the Health Authority Certification be issued so the property closure transaction may take place. Construction of the new septic system will take place with the new owner present in the house. Attached is the field report completed during the testing of the absorption crib. Please let me know if you have further questions. MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH 8 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. N Q 1!;"— O -71 —fes HAA k AA. 9;-0 77cD 1. GENERAL INFORMATION Complete legal description K Location (site address or directions) 5S Ir) Crr Property owner P owQ.WJ �--L Day phone Mailing address y 3 In lXi00o0e'tap C; r Lendingagency Ca'z Y"as? dc. 11 uNa (� Day phone Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: ✓ Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rm.1/91) Front MOAF21 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 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 furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 0�b cvg Qto v r LcIA uAk*7 T k Phone 971-391 b Address �Lo 3 t.Z/ 1.5-" „ Engineer's signature 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Date "10114 bedrooms, with the following stipulations: Additional Comments this is a re—issue of the original HAA that was issued o,p November 16, IA92. By: �L-F " (--' 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 order to 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. 72 -=(FW A/91) e.a MOAm MUNICIPALITY ANCHORAGE O DEPARTMENT OF HEALTH d HUMAN SERVICES �p 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 Parcell.D.# 17147) -f -D-1-11 HAA# �111�I�r•��C ��- GENERAL INFORMATION Complete legal description Location (site address or directions) 5310 ooe�'AL &k 04% Property owner 44 o uJ oa-ap 2'� 1"t, t n Day phone Mailing address 5 Lending agency Day phone Mailing address I i Agents �Cr.�'i� Day phone 3l —53 Address �•-eG ��� Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72.025(A. 191) Front MOA821 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm �r'oe�t �pyAd aC - Phone 97R'3g1fo Address Engineer's signature 6. DHHS SIGNATURE _ Approved for Disapproved. Conditional approval for Additional Comments 0 14 'QV L bedrooms. Date—' I log I4Z bedrooms, with the following stipulations: Date Al' 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 order to 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 engineers work. 72425(A..1/91) Br Moi M Municipality of Anchorage Aga Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A8/3k A di 111 &AAI 5 Parcel I.D. A. WELL DATA Well type If A. B, or C, attach ADEC letter. ADEC water system number N/A Log present(Y/N) Date completed Igo Driller (%H Total depth 3 10 Cased to 5 Z, 2 Casing height 49 tt Sanitary seal (Y/N) y Wires property protected (Y/N) V FROM WELL LOG AT INSPECTION Date of test 'Fly" i . Q 3 • t; Z. MUNICIPALITY OF ANCHORAGE ENTAL SERVICES DIVISION Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: to 2. (oV13 1332 g.p.m. g.p.m. RECEIVED Septic/hokh g4ank on lot i 1 l ; On adjacent lots % 12C) Absorption field on lot On adjacent lots f Z a Public sewer main N�A Public sewer manhole/cleanout Sewer service line / D Petroleum tank N f t�l WATER SAMPLE RESULTS: Coliform Nitrate 0. a'y Other bacteria, Date of sample: "I l D t 112- Collected by: S e B. SEPTIC/HOLDING TANK DATA Date installed 7/ SI /7'i Tank size 1 ;-0-0 Compartments t4 e- Cleanouts (Y/N) —Foundation cleanout (Y/N) —,� Depression (Y/N) N High water alarm (Y/N) N /A Alarm tested (Y/N) Date of pumping I I �0 �� 9 L Pumper Wtx SEPARATION DISTANCES FROM SEPTIC/P40tg" -TANK TO: Well (s)onlot II Onadjacentlots —Foundation 4D To property line ,Z?�a Absorption field Water main/service line Surface water/drainage /t7 72-026 (Rev. A91) From CONTINUED ON BACK PAGE C. LIFT STATION N/A Date installed �"t Size In gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) _ SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA l ' On adjacent lois - "Pump off" level at Cycles tested Surface water Date installed 3/�7y Soil rating System type i Length Width 9 Gravel thickness ----'5-Total depth 9 Total absorption area 41 c> Cleanouts present (Y/N) Depression over field (Y/N) Date of adequacy test - (( 1t7 3 la Z Results'(pass/fail) for bedrooms Peroxide treatment (past 12 months) (Y/N) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot (.3 On adjacent lots % /wo Pro ert Iii P Y To building foundation (03 To existing or abandoned system on lot NIA On adjacent lots�51-6 Cutbank IAouP Water main/service line > 6110 A Surface water Kin Id p Driveway, parking/vehicle storage area Curtain drain �'17 E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature g lo�o�vt Sat7r �nc�GK �L fi J En ineer's Name Date Nt)✓ 1 1 1942 � " ,a o r:. 1- o� CL - HAA Fee $ /22 Waiver Fee: $ Date of Payment - �� 3 %i Date of Payment Receipt Number Receipt Number 72 -WO (Rev. 391) Beck MOA 21