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HomeMy WebLinkAboutNORTH SLOPE #1 BLK 4 LT 2I Northslope #1 Block 4 Lot 2 #050-511-02 Municipality of Anchorage :';:',:• Development Services Department Building Safety Division `• — - On-Site Water and Wastewater Program. 4700 S. Bragaw SL P.O. Box 196650 Anchorage. AK 995196650 Page of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5 W D 10 0 Cl't7 PID Number. 050 — S 11 — 0 Q Name grad (e 'A G L4!•/ c'Or+er Wastewater System: ❑ New Q Upgrade Ku r . Ga arc 6-q�BSORPTION FIELD 6 9 — 635 9 NUMr tl B.troam' 0 Dip Twch 14 Snrlow 7 r.0 O Bad O MOW O on K Sod RCWq De ToW Depth am wgral grade. •d•. LEGAL DESCRIPTION , ,r Fe BloOk Lol� �e4 0P"�IMMW"91FI.Gr�a��athpa: I FI Tawamp Rove* Fe added ab" r7^r?•d•'�.}- Gravel Length: ,TO AI I 5I\tIo(/,= I QO FI. 7 FI. Well: ❑ New ❑ upgm Gravel 5 of Me: pnrce t"eases lrws: FL Ft. 0 CWsukabor,(PMale. AB�t, sn TbWI Depm: Casedw T" pdn area, �/7 rr� ! ✓Fi, Ppa Halsor X3031/ F 1 T C 4 YQ a FI. Ft DM.r Owe Dated SMbCWrr L"* Riraw Owner Data kw Wad S-S— 01 FI vola p",Wa CurpHegaAb Gr TANK GPM FI. FL SEPARATION DISTANCES CESeptic []Holding ❑ S.T.E.P. ❑ Other. To Septic Lift Holding PublWPrlvat "am'fa`9`r , L capaaly. 60 ar_ From Tank Station Tank Sewerllne Cul s n I I, ��Gt�Nu of C ms"sWedLIFT NField STATION Lot L.» q5% Gr I �' 03q% 'Poop On' le.el K •Pump tlr al Hien wale Yarm n FauM n K vv Puny Make a EWUCW lrwpecbau tNAamed by C~ lx," o✓te hon n Rrn'"a BENCH MARK Loouan rw fesrnpbOn T , 0 0 / . l/U" bms 6 Ft 0 / ©O i�s� 'A r - 5 & S ENGINEERING�" 17034 Eagle River Loop Road, No.2" r . — _{u -01 r Inspections performed by: Dates: 1 2we KIM, A182 Z ndI n ROBERT C. COWAN 1,C Development Services Department Approval;1, ` CE • 8801 i 1t ter•.. Reviewed and approved by: Date: 3 2'f•Ol �. tt; _,-: _ :'. (Rev IPOO)oFs`Z'•(•••�,�•�ti4 PERMIT N0. SWO1 0094 PACE 2 OF 3 Municipalit of Anchorage DEPARTMENT OF HEATH 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 LEGAL LOT 2, BLOCK 4, NORTH SLOPE #1 P.I.D. NO. 050-511-02 LOT 3 LOT 16 EXISTING \0, 1000 GALLON UT�CITy SEPTIC TANK "As (INTEGRITY VERIFIED) f'NE HT FC Dv VALVE) fp C 0 CO (FLOW TRENCHES 1'_ 40' .e' ROBERT C. COWAN i.� CE • 8801 PERMIT NO. SWO10094 PAGE 3 OF 3 Municipalityof Anchorage DEPARTMENT OF HEATH 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 LEGAL LOT 2, BLOCK 4, NORTH SLOPE #1 P.I.D. NO. 050-511-02 STI FINAL GRADE 91.7'X I Fx,sr)�G 1000 GALLON SEPTIC TANK COl hlTl CO2 MT2 C01 = 92.2' MT3 CO2 = 92.7' FINAL GRADE 2" INSULATION COI = 89.3' r ASRJC02 = 89.4'' I MT1 = 88.0' MT2 = 88.0' MT3 = 87.2' 97.6' 91.5' CO3 A WATER FOUND ® 82.0' 74.8' B.O.H. MT4JC03 = 91.1' C04 = 90.7' CO3 = 88.2' C04 = 88.2' MT4 = 86.9' N. T. S. May 1, 2001 S&S Engineering 17034 Eagle River Loop Road Eagle River, Alaska 99577 To Whom It May Concern I will be installing my septic system on my property at North Slope Nl Lot 2, Block 4, street address 31027 Kuparuk, Ave. Eagle River Alaska. This system will be installed with the guidance of site plans prepared for me by S&S Engineering of Eagle River. S&S Engineering will be inspecting the installation at intervals assigned by S&S. I have worked as a licensed Aviation Engineer for the past 33 years using Blue Prints extensive through my career. I have assisted with installing three septic systems during the past thirty years and understand how to install this system. Sincerely, Z. /e - brad carter MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SWO10094 Legal Description: NORTH SLOPE #1 BLOCK 4 LOT 2 Date Issued: May 01, 2001 Expiration Date: May 01, 2002 Parcel ID: 050-511-02 Design Engineer: 0003 S & S Engineering Site Address: 31207 KUPARUK STREET Owner Name: BRADELY & LAURI CARTER Lot Size: 43260 SO. FT. Owner Address: 31207 KUPARUK STREET Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER. AK 99577-9711 This permit is for the construction of: ❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. 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 DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 (24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Z Date: -r— / — U 1 Date: Municipality of Anchorage Development Services Department / Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ek.us (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 670 —,5-1 / — 0?�-- Permit Number SW 010024 Property owners) V_A0 Lei !�t Lam12 / 4*e7F-1- Day phone le 9.1 -6 3 SB Mailing address (1&1ZQ Mailing address (2) pp �Zip Code Legal description (Lot, Block & Sub'd.) L- Ot a b 04- k- f-{0 IVO/th S�D� Legal description (Section, Township & Range) Lot Size ^'' I Acres q.Ft. Number of Bedrooms 3 43, 2 GO St. ft THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ER THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 97// 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. S b S ENGINEERING // I�C �fZ✓'ti� 17034 Eagle River Loop Road No. 204 X99597 (Signature of property owner or authorized agent) Permit Fees: 3 .10. Waiver Fees: Date of Payment: q /t 7/ 'p, Date of Payment: Receipt Number: (Rev. 12/00) oo 305-3 Receipt Number: S& NEneepInG ROBERT C. COWAN, P.E. CML ENGINEERS (907)694-2979 FAX(907)694-1211 April 12,2001 APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 &ER MAANECTE SOM Anchorage, AK. 99519 REFERENCE: Lot 2, Block 4, North Slope Subdivision # 1 SEWER& WATER 04PECTIOR It is requested that you issue a permit to upgrade the septic system serving the existing three bedroom dwelling on the referenced property. AAWREM"R,510ES One test hole was excavated and a percolation test was performed on 4/2/01. The approximate location of the test hole is located on the attached site plan. Ground water was monitored and after seven days water was found at 6'9" as shown on the attached soils logs. WELLWSPECIM & FLOW TEST We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent SITEPIINs properties. If you require additional information, please contact us. ROAD CESM Sincerely, /J SOILTEST 11WtC /owan, E. RCC/bjj PERCOLAnON TEST Enclosure STRVCTLEVL& MCNAM M NSPEcrl" ONSITE WASTEWATER OtSPOSALSRSTEM EESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 I" = 50DESIGN SITE-PLAN 0 aH� r 9 e^A ys m0 z"yN m t-y r, iuTa �.fl �1 V• God , L N M m Cin L4 o Ell K:C II C) 11 1 � o` DRIVfKAY / rn p _0Cn O ci / p a / / W Zino / NOO ? w / J\v N p w110 � n / a 5H= wl y ." / / D '\ Ct w / mmo r / a O m 'o~ yca o Y s.Z.. rr o San 'o ra_ � wO x a a^yo 2 0 / o"o 1-3 a O � / 0y7J�1, n I fin,+ m? a f� I' •' a: ice, ot�£ / / 11+x, •" _ D v : !i<�I �•� 1 S (ENGINEER'S SEAL) OF AL ����.•M,,...., ,.., o ... Municipality of Anchorage � � , '• DEPARTMENT OF HEALTH & HUMAN SERVICES .� 825 "L" Street, Anchorage, Alaska 99502-0650 4 SOILS LOG — PERCOLATION TEST PERFORMED FOR:::F;4p"0 CA -&7&7L DATE PERFORMEI LZ • f�4' nl •ScoP� ► '' • , LEGAL DESCRIPTION: a Township, Range, Section: •`=cam ,-_- := SLOPE rDEPTM (FEET"• OGzG�}'NfLs 1 ^ N 15- 16- 17- is - 191 516171a19 20 COMMENTS y� WAS GROUND WATER N� ENCOUNTERED? W�sa�+� 6r�wcL IF YES, AT WHAT f 5T8Nb I DEPTH? a P 6'Gy" y/D7/o/ E Depth b Water Nler / Cf ^ Monitoring? w F • Date: PERCOLATION RATE /Z— (mmutevmch( PERC HOLE DIAMETER IV � TEST RUN BETWEEN �•7/ FTAND04-15' FT PERFORMED BY: S & S ENGINEERINGI l• lir .-- " CERTIFY THAT HIS TEST WAS PERFORMED IN 17034 Eagle River Loo Road No. 20 ACCORDANCE WI1hWW%jEMMtffWL GUIDELIN S IN EFFECT ON THIS DATE. DATE-' �4/0, 72-008 (Rev. 4185) �cs�✓�noos-iav PERCOLATION RATE /Z— (mmutevmch( PERC HOLE DIAMETER IV � TEST RUN BETWEEN �•7/ FTAND04-15' FT PERFORMED BY: S & S ENGINEERINGI l• lir .-- " CERTIFY THAT HIS TEST WAS PERFORMED IN 17034 Eagle River Loo Road No. 20 ACCORDANCE WI1hWW%jEMMtffWL GUIDELIN S IN EFFECT ON THIS DATE. DATE-' �4/0, 72-008 (Rev. 4185) IEALTHAUTHORITY APPROVALS SEWERBWATER MANIXTENSIONS SEWERILWATER HSPECTION ' ENGINEENNGSTUOES ANGREPORTS WELLINSPECTION & PLOWIEST SITEPLANS RDAD DESIGN SOILTEST PERCOLATION TEST STRUCRfVL& WCNANICK INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 11G ROBERT C. COWAN, P.E. CMLENGINEERS (907)694-2979 FAX(907)694-1211 ON-SITE NVASTEIVATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 4, Block 2, North Slope Subdivision #1 April 12, 2001 GENERAL: The scope of this project includes the verification of the 1000 gallon septic tank, replacement with a 1000 gallon minimum septic tank if required, and installation of new trenchsto serve the existing three bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER. ALASKA 99577 Pogo 2 Lot 4, Block 2, North Slope BIO N1 April 12, 2001 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCIUDRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page 3 Lot 4, Block 2, North Slope SID #1 April 12, 2001 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: I. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (IiDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. Page 4 Lot 4, Block 2, North Slope S/D 01 April 12, 2001 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the ownees representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER \ - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION NAME /i u / 1/J�( /REE/P/ORRT[ GPHONE � G. NEW UPGRADE MAILING ADDRESS f , /–+/a LEGAL DESCRIPTION 0 ✓�/ G 2� lF4e`l— C.\J�` JI �%/•�, LOCATION O /Y NO.OF BEDROOMS Well f ,.(_ �Z Absorpuor ea / ,� D ding ( .7c- �Z PERMIT NO. DISTANCE TO: / Q" 10"WemVelf 05, O E2 W Q Manufacturerl` Q �„ ` Material (s CJ No. of compartments N ~ Liq. caypjty,ysgallons /!/CJ (J IF HOMEMADE: inside length Width Liquid depth le DISTANCE TO: Well Dwelling PERMIT NO. —ioz6 0 Z f Manufacturer- - - Material Liquid capacity in gallons 0 = DISTANCE TO: Well (.� %2 Foundation 4g Nearest lot fine I,± tSZ — W u.2 No. of lines / Length of eaphfne /,� Total len th off lined Tre width Distance boXIn li as 2 W .� inches /f/ �7 ~ ¢ r Top of tile to finish grade I , Maierr I be ash tilZ� rPL / Total el ti 2 s7ptigrf area 0 L uhes Length Width Depth PERMIT NO. W a t F Type of crib Crib diamet depth Total at fective absorption area Z)qCrib W[L lu Well Building foundation Nearest lot line DISTANCE TO: J J Class Depth Oriller Distance to lot line PERMIT NO. 'u Building foundation Sewer line Septic tank Absorption areals) DISTANCE TO: OTHER � PIPE MATERIALS v 7 SOILTESTRATING /DD 4 fA /G INSTALLER i n/✓ REMARKS app /�4`4i I • Robert A.•5 afar W� y�F •��'••.......•' .��_ G . 9fp �1P APPHOV ED DDAT/E//' LEGAL ---------- 72-013?ev. 3/78) r I P'AL_ I T'T 0F t=114CH0F:A13E �� \ DEPARTMENT OF,"•"EALTH AND'ENVIRONMENTAL P�Pb'ECTION s 825 'LI—iTPEET, ANCHORAGE, AK. 9350.. 26'4-4720 V rJr4 I TE = EWEF? FPEFz I T PERMIT -140 Zty 6yv a8yf APPLICANT to V I Q Co• r4 -e J' LOCATION Frei. 1 b £X• Cc(. LEGAL L 2 (3 4 Nori-h 5 (ope 1+ I LOT SIZE6 'L oo D SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: MAXIMUM NUMBER OF BEDROOMS 3 SOIL RATING CSO FTlBR)= /00 THE REQUIRED SIZE OF THE SOIL PBSOR.PTION SYSTEM IS: F7EF=•TH= .3 L_Er•JGTH= SO %3F�_A%,: EL C�EF'TH= 3 THE LENGTH DIMENSION IS THE LEFJGTH (In FEET) OF THE TRENCH OR, DR,AINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTAFJCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES, THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATIO14 CIN FEET). F?,E:QU I REGI = EP T I C TAriK S I �E_ (O �' U GALL4r�_ PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- Tt4o <2* ? I r•+1-7-F`ECT I QFJS AF?E F=,e0U I FREL' --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTAFJCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC I -JELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER: LINE IS 25 FEET AND TO A COMMUNITY SEWER. LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER. R.EQUIR.EMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGR..AMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F= EF=:M I T MXF3 I F?E'� DECEMBEFZ 3'1.• yS ::F: t I CERTIFY THAT 1: 1 AM FAMILIAR.. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I IJILL INS3 THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDER' tD H T THE S TE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE F.ESIDEFJCE S R _ LED IFJ�2LUDE MORE THAN 3 BEDROOMS. S I Gt IEC/:1 - - �_ 1. y�------------------ 1� PPLICANT .y p ISSUED BY -DATE-- fS�-�__ V4. 0 r. % TL- SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION ' TEST Pouch 6650, Anchwape, Alaska 99602 2762711 SOILS LOG - PERCOLATION TEST PERFORMED FOR: 1,Q wr/ DATE Date L Z 13 (4 d LEGAL DESCRIPTION: MEN P, S/[.Ty S�3NJ o 2- •0_ •r MENNEN �— 3 `�C 0 d �• (r21�}tJ7�G . _ 4 o Sotn� Roe% Ta �p 5 O •� /0 4Y,/�/C ME ON 6• d . 7 �a 8a77 -014f oIV Hai-) 8- 9- s10 10 - DATE PERFORMED: �'/ope 0 .....� :c DI AM 11 WAS GROUND WATER , yeJ ENCOUNTERED? 12 IF YES. AT WHAT/ DEPTH? 13 r\ • .. • �� 15- 16- 17- 5 1617 ^ �^ . Robert A. S o r s+, iT �• Ho. IUES ?� `E 1s �-- N C I I - Reading Date Gross Time Net Time Depth to Water MEN rr i MENNEN 0 ME ON ONE SEEMS I I - Reading Date Gross Time Net Time Depth to Water Net Drop rr i 0 20 PERCOLATION RATE (minutes/inch) 72006(7/76) 4Y z fA LIJwi i Fi hi Or oa i < m Vli W of ri Q Q • O a Y i V C a ci a � U J J � ZMA a W � I > g W N % Q W 3 u 0 0 4Y z fA LIJwi i Fi hi Or oa i < �C a eq Vli W of ri � t"'-• IW - o w ; Z p„ �.0 G 4a U cn ❑ ❑ U z Q CC z fA LIJwi o F N I ❑ F iF/1 I 'LQ YJ I W � t"'-• IW - o : O O O O O O O O OO O H i p O O O O o O O O O 09 � w it d {s co N M <v 0 rti ci .; 1� +n .o c. ao I.O. I.O.., I.O.. I.O.. F I.O.. I.O.. I.O.. I.O.... 0I.., 0I.. I.O.. h1 C, CO Q r� a A .4 44 %o w ti O O O O O o o O O O O O a a cd w� w1e w z L6 w re a w L6 w L6 w L6 L6 w a Z 0 i : O O O O O O O O OO O H i p O O O O o O O O O 09 � w it d {s co N M <v 0 rti ci .; 1� +n .o c. ao I.O. I.O.., I.O.. I.O.. F I.O.. I.O.. I.O.. I.O.... 0I.., 0I.. I.O.. h1 C, CO Q r� a A .4 44 %o w ti O O O O O o o O O O O O a a cd w� w1e w z L6 w re a w L6 w L6 w L6 L6 w a Z 0 1-1Ur-4I C I F'FiL I TY OF FIFJCHQFZn0E DEPARTMENT !'`,HEALTH AND ENVIRONMENTAL "?OTECTION 825 STREET, ANCHORAGE, AK. 9S_ d1 264-4720 WELL F'EFSM I T PERMIT NO. t 800280 > APPLICANT BRAD CARTER GEN DEL'VY EAGLE RIVER AK LOCATION LEGAL L2 B4 NORTH SLOPE #1 LOT SIZE 23260 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER. LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER, REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER. INSTALLATION. F ERtYI I T EXP I FEES} E>a CEME3EFt 31 s 1 "?8E� I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED:-oL4."- _d. (__!!'}z.u---------------- APPLICANT So CARTER. // A ISSUED BY- -- Z' Com"` ` DATE-- 7./(d 4 _d_ V4. 0 V2 @ • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 8A ETY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-511-02 Expiration Date: (D - 1. GENERAL INFORMATION Complete legal description NORTH SLOPE #1 BLOCK 4, LOT 2 Location (site address) 31027 KUPARUK AVE, EAGLE RIVER AK 99577 Current Property owner(s) ARUN J. JAIN Day phone Mailing address PMB 33712110 BUSINESS BLVD. STE. 6 EAGLE RIVER AK 99577, Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: E/� Date: v COSA to be released to the engineer, unless olherw re A sled by the engineer. COSA Fee Date of Payment(�f /yam Receipt Number 0051,90 COSA# 05cic/ 4 -b Waiver Fee $ Date of Payment Receipt Number Waiver * 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage 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 ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 12/15/14 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen i �F 1�L\S , encroachments, deficiencies or discrepancies exist. �v / 9Til p # 6. DSD SIGNATURE V System #1 Approved for bedrooms. ��`" '"'" °QF ' tr 71,L6 $F. System #2 Approved for bedrooms. �' essro^A� i Disapproved. Conditional approval for bedrooms, with the following stipulations: OF WATER AND '�i'FN �SER� *, By: Original Certificate Date: — —� i A ge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only The ML�nrclp /ity,,,0 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Cosa blue:beec_io-iai2.da If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: NORTH SLOPE #1 BLOCK 4, LOT 2 Parcel ID: 050.511.02 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Date completed 71911980 Sanitary seal (Y/N) Y Total depth 80 ft. Cased to 76 ft. FROM WELL LOG Date of test 719/1980 Static water level 15 ft. Well production 4 g.p.m. WATER SAMPLE RESULTS: Well Log (Y/N) Wires properly protected (Y/N) Y Casing height (above ground) 12+ in. AT INSPECTION 1219114 in Coliform NEG colonies/100 mL Nitrate 0.181 mg/L Arsenic: ND ug/L Date of sample: 12/0912014 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC 1 STEEL Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping 12108114 Pumper JR's C. ABSORPTION FIELD DATA Date installed 711980 Cleanouts (Y/N) Y High water alarm (Y/N) N Date installed 5/512001 Soil rating (g.p.d./ftz or ftz/bdrm) 0.80 System type TRENCH Length 51'&49'=100 ft. Width 5 ft. Gravel below pipe 1 ft. Total depth 4.1- 4.6 ft. (Measured 12/09/14) Eff. absorption area 575 ft2 Monitoring tube Y Depression over field N Date of adequacy test 12/0912014 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 010 in. Water added 760 gal. New depth 419 in. Elapsed Time: 40 min. Final fluid depth 010 in. Absorption rate >= 450+ g.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 —in. Datum Size in gallons "Pump off' level at _ in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 1001+ Absorption field on lot 1004 Public sewer main 75'+ Sewer /septic service line 25'+ Animal containment areas 504 SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) High wateralarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout 100'+ Holding tank Manure/animal excrete storage areas 1001+ Building foundation 54 Property line 51+ Absorption field 54 Water main 10'+ Water service line 101+ Surface water 1001+ Wells on adjacent lots 1004 ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 104 Water main 104 Water Service line 101+ Surface water, 1001+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 1001+ F. COMMENTS Tested 2001 double trench system. 1980 system's (521 x 25W x TED) monitorinq tube was found as shown in MOA docs but cut G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date COSA brown sheet 10-10-12.doc �-k OF ALS A 0 TN A[U.N''NETH U F w AOr �f1f�SSlO�'aL in. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEM j S APPROVAL /� FOR A SINGLE FAMILY DWELLING Parcel I.D. C; 50 - 511 - � 2 COSA# Def 0306 1. GENERAL INFORMATION Expiration Date: /,2 ' O Complete legal description NORTH SLOPE #1. LOT 2. BLOCK 4 ❑ Public Water System ❑ Location (site address) 31027 KUPARUK AVE ► EAGLE RIVER, AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address ARUN JAIN Day phone 632-5246 12110 BUSINESS BLVD STE 6 * EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well E Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone 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 On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my 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 (les 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. Date 1 D9 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 6 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to 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 3 bedrooms. Disapproved. 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 Report Other PROGRAM By: CLQ/!G % az �� Original Certificate Date: )Rov 1105) Municipality of Anchorage I� Development Services Department Building Safety Division 4 ­'. On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: NORTH SLOPE #1, BLOCK 4, LOT 2 Parcel ID: Q5'0—S11'C1.:2- t A. WELL DATA Well'type PRIVATE If A. B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 7/g/1980 Sanitary seal (YIN) YES Wires properly protected (YIN) YES Total depth 80 ft. Cased to 76 ft. Casing height (above ground) 12+ in. Date of test Static water level Well production FROM WELL LOG 7/9/1980 15 4 AT INSPECTION 8/21/2009 ft. 28 ft. g.p.m. 1.06 g.p.m. WATER SAMPLE RESULTS: Coliform! colonies/100 ml. Nitrate�•7�g./L. Other bacteria colonies/100 ml. Arsenic: Lv () ug./L. Date of sample: 8/24/2009 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/1980 Tank size 1000 gal Number of Compartments 3 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 9/16/2008 Pumper JR'S PUMPNG C. ABSORPTION FIELD DATA ow EXISTING CRADEI 7/11/1980/ Date installed 5/5/2001 Soil rating .p.d./ <EEO r/EE100/0.8 System type TRENCH/TRENCH Length 52/100(49 & 51) ft, Width 2.5/5 ft. Gravel below pipe 3/1 ft. 312/ -Total depth 03.4-4.5 ft. Eff. absorption area 575 ft' Monitoring tube "YES Depression over field NO Date of adequacy test ""8/21 /2009 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY In. Water added 480 gal. New depth DRY in, Elapsed Time: 0 mini. Final fluid depth DRY in. Absorption rate >= 450+ 6.p,d, Any rejuvenation treatment (past 12 me.) (YIN & type) NONE KNOWN If yes, give date — **MONITORING TUBE FOR 1980 TRENCH IS MISSING ***TESTED UPPER TRENCH OF THE 2001 DRIANFIELD LOWER TRENCH OF THE 2001 DRIANFIELD WAS FOUND DRY D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on' level at in. "Pump off" level High 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 lots 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/cleanout . N/A Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line '10'+ Surface water 100'+ Welts 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, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS "PER S&S ENGINEERING HAA IN 2001 G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are In conformance with MOA COSA guidelines In effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date `1111091 COSA Fee 3 `I ell� Date of Payment I / / 01 Receipt Number 666313 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SGS RcLN 1094387001 Client Name Gamess Engineering Group, Ltd Project \amc/b North Slope #I 134,L2 Client Sample 10 North Slope as 134,L2 Matrix Drinking Water Sample Remarks: Printed Daterl'ime Collected Date/time Rccehed Date/time Technical Director 08.1312009 15:15 08242009 8:30 08242009 13:40 Stephen C. Ede Allowable Prep Anallzis Parameter Results PQL Units Method Container ID Limits Date Date Intl Metals by ICP/MS Arsenic ND 5.00 ug/l. EP200.8 C (<10) 0827109 0828/09 NRB Waters Department Total Nitrate/Nitrite-N Microbiology Laboratory Colony Count Total Coliform Fecal Coliform 0.243 0.100 mg(L SM204500NO3-F D (<10) 0824/09 R3T 0 coVI00mL SM209222B A (<200) 08.24/09 DLC 0 col/100mL SM209222B A I<1) 0824/09 DLC 0 col/100ml. SN1209222B A 1<1) 0824/09 DLC L JRs Pumping PO Dux 773415 Eagle River, AK 99577 (907)694-6454 Billing Information Arun Jain 12110 Business Blvd. Suite 6 PMB 337 Eagle River, AK 99577 (907) 632-5246 'Job sLte Information Arun 31027 Kuparuk Avenue Eagle River, AK 99577 (907) 632-5245 Job Description: 10008 P O Number: Order Date: Terms' Net 30 Salesrep. Dawn -Dawn Map Book: Cross streets: Harea Streel Service Agreement Number: 027101 Order Date: 08 -Sep -2008 Service Date: 16 -Sep -2008 12:0 Technician: Butch & Mike Tax %: 0 Job Type: New Map Grid: 145- - Job Comments: Last Srvice '04/28/2006' 1003g 'New Customer' Additional Location Comments Diagram: Uniaarams\16624 bm 1st house on right- Red house w /black trim WS on house, red bam t bottom of dw. Tank is in dw in front of carport - Field is below house. Ta.k � it No �- • �e/o Service Type Qty Price Each Tax? Septic Service 15K 1 $165.00 No Gallons Planned: 1000 Gal. Actual: Hose Length: 1 Double Tank: 0 Pump System: ;7- Baffles ✓Baffles Inlet: ❑ Baffles Outlet: Extension Actua 5165.00_ r and Title of Customer Representative 6-d Date Accepted by JRs Pumping Date Accepted For your added convenience we accept: American Express. Dicover. Visa and Master Card payments over the phone. After 30 Days account will be turned over to COLLECTIONS. $30.00 For NSF Checks Returned. NonTaxabte Total Taxable Total Tax Total Grand Total Estimated Charges: SIPS 00 $0 00 Actual Che,ges: &5 $0.00 $165.00 Customer agrees to the terms and conditions shown. THIS 1S A BINDING AGREEMENT. and Title of Customer Representative 6-d Date Accepted by JRs Pumping Date Accepted For your added convenience we accept: American Express. Dicover. Visa and Master Card payments over the phone. After 30 Days account will be turned over to COLLECTIONS. $30.00 For NSF Checks Returned. Jim Sullivan 688-2510 or 258-2510 745-2510 Fax 688.2543 apw®gci.net N° 10%68 3 COMPETE. WATER SYSTEMS SALFS k SER% ICL .00-4111— 1 N ARCTIC C44PUMP & WELL . NWWA CERTIFIED PUMP INSTALLER Alaska Distributor .0�5> P.O. Box 770197 Eagle River, Alaska 99577 Payment due on receipt of invoice unless other arrangemer)ts ma0e. Customer Order No. Phone. Name 5W, Address v IUKG,i.PGC"U F— . 'p Oty. Description Price Amount flloict J9 nO l /._.lJ od) 1 4- U -tc I ? 5 Q6 00 S� Ks Received in Satisfactory Condition TOTAL • Please pay by invoice. All account Past Due will be charged I ire%. $25 second billing charge THANK YOU \ Municipality of Anchorage • Development Services Department Building Safety Division: , On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orWonsite h (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. f)rn ()Z COSA# 1. GENERAL INFORMATION Expiration Date:_W• r y 07 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address NORTH SLOPE N1• LOT 2 BLOCK 4 31027 KUPARUK AVENUE ' ANCHORAGE. AK 99577 DARYL WACHOB Day phone 622-3610 31027 KUPARUK AVENUE ' ANCHORAGE, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 1 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my 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 (les 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 Address 3701 E. TUDOR ROAD, SUITE 101 " ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational fife of all wells and septic systems depend on the local sols 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 solo 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 SIG TURE Approved for bedrooms Disapproved. Conditional approval for 337-6179 Date to/Z5-/0& OFrgjljrrr-r bedrooms, with the Illowing stipulations; _ ON SITE C^ s %AIeTFRAND : m= Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory By: w_ V/ Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: f �G Municipality of Anchorage Development Services Department Building Safety Division On.SRe water 6 Wastewater Program 47W Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6850 www.muni.ayons6e (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: NORTH SLOPE /1; LOT 2. BLOCK 4 Parcel ID: A. WELL DATA Well type PRNATE If A, B, or C provide PWSID# N A Date completed 7/9/1980 Sanitary seal (YM) YES Total depth 80 ft. Cased to 76 ft. FROM WELL LOG Date of test 7/9/1980 Static water level 15 ft. Well production 4 — 9 -p.m - WATER SAMPLE RESULTS: Coldorm _0 colonies/100 ml. Nitrate x,16 mgdL. Well Log (YM) YES Wires properly protected (YM) YES Casing height (above ground) 12+ in. AT INSPECTION 9/12/2006 16 ft. 1.4 g.p.m. Other bacteria 2 colonies/100 ml. Arsenic. _N2--ug./L. Date of sample: 9/12/2006 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Materlal SEPTIC/STEEL Date Installed 7/1980 Tank size 1000 gat. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (YM) YES Depression over tank (YM) NO High water alar (YM) N/A Date of pumping 4/28/2006 Pumper JRs PUMPING C. ABSORPTION FIELD DATA Date Installed 5/5,12001 Soil rating (g.p.ddit'or� 00=8 System type SHALLOW TRENCH Length 49 do 51 ft. Width 5 ft. Gravel below pipe 1 ft. Total depth 04.33 ft. Eft. absorption area 575 ft' Monitoring tube YES Depression over field NO Date of adequacy test 9/12/2006 Results (Pass/Fail) PASS For E bedrooms Fluid depth in absorption field before test "0 In. Water added 460 gal. New depth 6 in. Elapsed Tkne: 0 min. Final fluid depth E in. Absorption rate >: 450+ g,p.d. Any rejuvenation treatment (past 12 mo.) (YM d type) NONE KNOWN If yes, give date •• TESTED THE UPPER TRENCH OF THE 2001 DRAINFIELD D. UFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N) "Pump ofi le igh water alarm level at in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Meets alarm 8 circuit requirements?. Septic tankAiR station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/deanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line UNKNOWN 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 UNKNOWN Surface water 100'+ Driveway, parking/vehicie storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS MT FOR OLD TRENCH MISSING. H2O SERVICE LINE LOCATION IS NOT DOCUMENTED. 10'+ PER S&S ENG. HAA IN 2001 G. ENGINEERS CERTIFICATION I certify that I have detemdned through field inspections and review of Municipal records that the above systems are in A10 conformance with MOA COSH guidelines in effect on thisdate. ....ass :Engineer's Printed Name JEFFREY A. GARNESS Vht�9,XS,G''�• Date ' COSA Fee 5 A y ?/r • () n Waiver Fee $ _ Date of Payment a t 0c Date of Payment Receipt Number SO C> L Receipt Number (Rev. 11/05) #IVAJ 10-23-06 16:43 MA FROM-Pudentlal Jack White Eaale River 9076896499 T-115 P.002/002 F-150 ASHUILT SEWARD.& ASSOCIATES LAND SURVEYING 694-082 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE,i` FOLLOWING DESCRIBED PROPERTY, y DATE, . ,q�l yv./ �or� ae !� AND THAT NO ENEROACHMENffS EXIST EXCEPT AS t Q S 6 c,�. -r .r INDICATED. IT IS THE RESPONSIBILITY OF THE 'w + ; 4r�rH . # GRID: OWNER TO DETERMINE THE EXISTENCE OF ANY j""""' •. •. EASEMENTS, COVENANTS, OR RESTRICTIONS f6�o7 �, �� ��� •• a- 'BCH DO NOT APPEAR ON THE RECORDED SUBDI- �j 0...�. mark e. rat i FB:k5,�1B % �,. ION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION `t 0 �Bt�'$r�slf�' r OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN, o`P �a4ti►wM� ARY LINES. po� wofttil�] SGS RcUl 1065465001 Client Name Gamess Engineering Group, Ltd. Project Name/N North Slope 1134 L2 Client Sample ID North Slope 1134 L2 tltatriv Drinking Water Sample Remark: All Dateslrimes are Alaska Standard Time Printed Date?ime 09/27/2006 9:31 Collected Datefrime 09/12/2006 16:15 Received Date?ime 09/13/2006 14:45 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 u8/L EP200.8 C (<10) 09/18/06 09/23/06 Nil Waters Department Nitrate -N 0.158 0.100 Microbiology Laboratory Total Coliform <2 00, No Coli m8/L EPA 353.2 D (<10) 09/13/06 AZS col/IOOmL SN1209222D A (q) 09/13/06 TLF NE 09/13/2006 15:31 9073449821 JRS SEPTIC ■ ow 8E0 . %E JRs Pumping PO Box 773415 Ea0eRivsr,AK 99577 (907)694-6454 Blliln Information Gail Wachob Job Description: 1000g 31027 Kuparuk Avenue P.O. Number: Terms' Net 30 Eagle River, AK 99577 Salesrap: Kania (907) 622.3610 Map Book: Job Slte Streets: Info tTnatl—on Crow Gail Job Comments: 31027 Kuparuk Avenue Eagle River, AK 99577 (907) 662-3610 Harca Street Additional Location Comments Diagram: 5'1Dfarnams\16e24 DMD 1st house on right - Red house w /black trim U'S on house, red barn t bottom of dw. Tank Is In dw In front of carport - Field is below house. • PAGE 01 Service Agreement Number: 019680 Order Date: 27 -Apr -2006 Service Date: 28 -Apr -2006 12:00 Technician: Tony & Gene And Cked Tank Service Type Oty Price Each Tax? Septic Service 15K 1 $0.00 No Tax %: 0 Job Type: New Map Grid: 145- - Gallons Planned: 1000 Gal. Actual: Hose Length: 1 Double Tank: D Pump System: ❑ Baffles Inlet: O Baffles Outlet: D Extension Actual $0.00 Actual Chagas: _ Customer agrees to the terms end eonditime shown. THIS IS A BINDING AGREEMENT. Signature and Title of Customer Reprssentottve Date Accepted by JR* Pumping Date Accepted For your added ew~lwice we accept. American Expren. Dicmer. Visa end Master Cad payments"the phone. Ane, 30 Days acccunte will be turned over to conectons. $25.00 For NSF Chocks Rehxned. NonTaxoble Total TaxaMoTotal Tax Total Grand Total Estimated Chargee: $0.00 $0.00 $0.00 $0.00 Actual Chagas: _ Customer agrees to the terms end eonditime shown. THIS IS A BINDING AGREEMENT. Signature and Title of Customer Reprssentottve Date Accepted by JR* Pumping Date Accepted For your added ew~lwice we accept. American Expren. Dicmer. Visa end Master Cad payments"the phone. Ane, 30 Days acccunte will be turned over to conectons. $25.00 For NSF Chocks Rehxned. Municipality of Anchorage .� Development Services Department Building Safety Division *A9 On-Site Water and Wastewater Program - `4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel LD. 050-511-02 HAA ?n Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 2, Block 4, Northslope Subdivision /11 Location (site address ordirectiongJ1207 Kunaruk Avenue Current Property owner(s) Bradley d Lauri Carter Dayphone 694-6358 Mailing address Lending agency Mailing address Real Estate Agent Mailino Address 31207 Kuparuk Avenue, Eagle River.AK 99577 HarEe Acree/Gallery Homes Day phone Dayphone 277-5227 3120 Denali St., Ste 8, Anchorage, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well El Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Q Individual Holding tank ❑ Community On-site ❑ 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 ser.ed 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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage 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. S & S ENGINEERING Name of Firm 034 Address Eagle River, Alaska 99577 Engineer's Printed Name' Robert C. Cowan. P.F. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Phone 6'°1`1—_19"73 Date S` /}; //o 414«Z,Z� OF Ari,. Tit ROEr27 C. CGC:AN Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: (r% Original Certificate Date: S .2 41,' 01 (Rev. IZC0( 'J Municipality of Anchorage Development Services Department Budding Safety Division • a r on -Site Water 6 Wastewater Program 4700 South Bragaw St. P.O. Box 1966W Anchorage, AK 99519-66W www.d.anchorage.sk.us (907) 343-79W HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LZ 7- Z .FLOC -L N124IFfSL4VPE '' Parcel ID: Q e5 -/ 2- A. A. WELL DATA Well type Pn-t-✓/A'rl- If A, B, or C provide PWSID # = Well LoX�N) CS Date completed F Sanitary seal OV) 4r Wir" Property P(Otoctao) F S Total depth( ft/. Cased to�i ft• Casing height (above ground) I Z'' -in. FROM WELL LOG AT INSPECTION Date of test --7 n Static water level /` ft. - Z4 ft Well production 4 g•P•m• 3 g.p.m. WATER SAMPLE RESULTS: Coliform colonies1100 ml. Nitrate O- X- mg -A- Other bacteria colonies/100 ml. Date of sample: r�az 0 Collected by: sT S B. SEPTIWHOLDING TANK DATA / Tank Type/Matenei �7C� el f C- Date installed Tank size —/Cf r�' gal. Number of Compartments Z Cleanouts (YIN) Eh Foundation deanout�) Depression over tank (YM) �High water alarm (Y/N) Date of pumping O/ r Pumper 72 5 C. ABSORPTION FIELD DATA Date installed ? Soil rating (g.p.d./W or ft 1bdrm)12e System type Len tro ft. Width S ft. c Gravel below pipe ft. / �'Pth / � absorption L Total de Z ft. Eft. a/bso tt n areaSft Monitoring tube Depression over field A/ O Date of adequacy test /�! 6-w Res slFaii) For 3 bedrooms Fluid depth in abs=(past _ in. Water added_ gal. New depth_ in. Elapsed Time: uid depth _ in. Absorption rate >= g.p.d. Any rejuvenation) (Y/N 8 type) If yes, give date D. UFT STATION Date installed "Pump on" level at Datum ®� in. `Pump ofr level at — in. E. SEPARATION DISTANCES Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/l on lot 4Q D 1 Absorption field on lot r^ Public sewer main Ad Sirolfteptic service line Z �5- rf Manhole/Access (YM) High water alarm level at Meets alarm d circuit requirements? On adjacent lots /00 �'– On adjacent lots 100 �– Public sewer manholeldearwut A,i 1A Holding tank n! /,A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation �5 Property line 5 *- Absorption field T T11 Water main -A- Water service line Surface water Or-) Wells on adjacent lots / 00 4 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / O + Building foundation lo r Water main A Water Service Ilin/e /Q Surface water 00 r* Driveway, parking/vehicle storage / O /r Curtain drain NOA/E.- KN!/sJw/ Wells an adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that lite above systems are in � µ� conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name801 Date P1 1 3 % G r :,: .,. HAA Fee Date of Payment 300. I–/;. 3/d / Waiver Fee E Date of Payment Receipt Number 0 0 4 110 Receipt Number (Rev. 12(00) C?d E 8nvirarmcr.•�i lieyices tno. �4 aIA' vi rntr.- r� Ipt r CfdERertt 1012818001 ClfeatPOa giant Tame Project Name/N S & S Engineering L2134 N Slope 01 Printed Daterrlme 05/23/2001 16:44 I Cheat Sample ID L2 D4 N Slope #I Ca0ected Aalc/flme Received Datemme OS/224001 14:30 05/2712001 16:35 Matrix Ordered By DrUing Witty .. Teehnical Director Stephen C Ed PH'sID 0 . 'YReleased Rf�/LS�/� :1 a, Sample Remarks Parameter ResultspQL Unita Meraad Allowable Prep Analyair Limits Dau Date /nit Katare ti6yltS1aC31L Nitmic-N 0.500 U 0.500 mg/L EPA 300.0 (c10) 05121101 SCL Microbieleev Lehorator,_y � . Total Coliform 0 0 rol/100ml. SM18 92220 05/12/01 KAP