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Home My WebLink AboutMCMAHON #1 BLK 7 LT 13McMahon #1 Block 7 Lot 13 #017-361-63 Development Services Department , Building Safety Division On-✓tie Water J; Wastewater Program _ ... i 4700 Brogaw Street P.O. Box: 196650 Mark Begich Anchorace, AIV. 99519-6650 Mayor %vm,v.mimi rr9i on5it (907)343.7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Legal Description /Y1 rr /✓l a� h o h ! - /---/3 Pr�opperty Owner Name & Address: �! 1' TTro 21A V aj>m o �' 1 290 k t; if 15+ 99,S�G A�el1 e ra Pump Installation Date: 0,0V Pump Intake Depth Below Top of Well Casing: 70 feet Pump Manufacturer's Name:' -g —13-0L ' Pump Model fZ 5'8 Pump Size hp Pitless Adapter Burial Depth: / v feet Pitless Adapter Manufacturer's Name: k4t4are.0 Pitless Adapter Installer: N) A Well Disinfected Upon Completion? F4'Tes ❑ No Method of Disinfection: Comments: 4 Anchorage Pump & Vlell Serene Pump Installer Name: 330 East 76th Avenue Anchorage, Alaska 99513 Phone: 907-243-0740 Fax: 907-243-0742 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. n-: A A. erne.. Approved: 'r'��%+1 Date: Q o r 0�0� Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131120 PID Number: 017-361-63 ❑ New ®Upgrade Name: KIRK BUTCHER ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ® Bed ❑ Mound ® Other Address: 12901 KILLEY STREET, ANCHORAGE, AK Phone: (907) 345-3167 No. of Bedrooms: 4 Sall Rating: 2.0 (IDSF) GpDisq. Ft. Total Depth from onginal grade: SEE DWG Ft. LEGAL DESCRIPTION Depth to pipe invert from original grace: Gravel depth beneath pipe: SEE DWG. Ft. 0.25' Ft. Subdivision: MCMAHON #1 Township: — Range: — Block: Lot: 7 13 Section; — Fill added strove original grade: SEE DWG. Ft. Gravel width: Gravel length: 30+ Ft. Bads Number -of Distance between linea: / L 12 Ft. 4 2.5 Ft. SEPARATION DISTANCES Taal absorption area: 360+ 50. R. Amber of trenches: Det. between trenahea. Ft. TO From Septic Tank Absorption Field Lift Station Holding Tank Publicr/Private Sewer Lines 11�wen y — 100'+ — — 25'+ TANK ❑ Septic ❑ S.T.E.P. ❑Holdin ❑Other Surface Water — 100'+ — — Manufacturer: Capacity: (l Zt Col. Lot Line _ 10'+ — _ I V /� Material: Number a comportments: �Q Foundation — 10'+ — — LIFT STATION T Curtain Drain NONE KNOWN Manufacturer: .y: Gal. Remarks: EXCAVATION LIMITED TO REMOVAL OF "Pump on" level at: "Pump off" Is Hyh water ala al: lI CONTAMINATED MATERIAL AND REBUILDING OF IDSF Pump Make & Electrical Inspections performed by: TO ORIGINAL SPECIFICATIONS. E: INSULATED PER CONTRACTOR. PIPE MATERIAL SCH 40 House to tank — Tank to PVC drainfield ler A+ HOME SERVICES rInspector Drainfield SCH 40 PVC CO/MT D3034 GEG, Ltd. BENCH MARK (Assumed elevation) Dates: 1st 7/17/2013 2nd 7/18/2013 Inspection 100.00 Ft. Location and Descnptlon: 3rd 7Z].812013 4th — TOP OF STORM DRAIN MANHOLE LID Community Development Department Approval Conditional approval: Date: ENGINEER'S SEAL oo�o0 L n-: A A. erne.. Approved: 'r'��%+1 Date: Q o r 0�0� ON I. PtRMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: OSP -017-361-63 1 2 T,3 MT4 100' WELL RADIUS EXISTING AIR LINE EXPOSED, INTE VERIFIED, SLEEVED, ENCASED IN PVC PIPE, INSULATED AND REGO* FC MTI MT2 EXISTING 12'x3( MT3 MT4 RE -BUILT IN I TAIGA DRIVE rl GARNESS ENGINEERING GROUP,, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3701 E. MDOR ROAD, WffE IDI - "MME. M 99507 - NNE (07)337-6179 - FM (907)338-3245 - WS - PREPARED FOR: PHONE NUMBER PAGE NUMBER: KIRK BUTCHER 907-345-3167 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: IVICIVAHON S/D #1; BLOCK 7. LOT 13 1 A.J.G. OF WORK: AS -BUILT DRAWING OF SEPTIC UPGRADE 7/23/201 A 86.16 PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: — OSP131120 017-361-63 INVERT OF DISTRIBUTION LINE = 95.75 — TOP OF NEW SAND = 96.50 BOTTOM OF EXCAVATION— (REMOVAL OF CONTAMINATED MATERIAL) = 95.91 NOTE: TOP OF OLD SAND VARIED BY NEARLY 0.5'. NEW SAND BUILT UP TO EXCEED ELEVATION OF PREVIOUS SAND, INVERT OF OLD PVC LATERAL AT HIGHEST POINT WAS 96.75. FILTER FABRIC GRADE = 7 / —100.22 � 2" INSULATION GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS. 3701 E. 1000R ROPO. SORE 101 a MCHOWL M 9950) a PHONE (907)337-8179 a FM (907)338-3246 a WERSRE: xxw.gomevewpineMnq.Pom PREPARED FOR: - PHONE NUMBER: PAGE NUMBER: KIRK BUTCHER 1 907-345-3167 1 2 OF 3 LEGAL DESCRIPTION: MCMAHON S/D #1; BLOCK 7, LOT 13 NPE OF WORK: PROFILE AS -BUILT DRAWING OF SEPTIC UPGRADE (Rev. 01/05) A.J.G. 7/23/201 EXACTLY 3" OF PEA GRAVEL EXISTING AIR LINE 3/4" DIA. SCH. 40 PVC LATERALS W/ 1/8" ORIFICES AT 24" ON CENTER r- - - - - - - - - - - - - - - - - - - - - - - - - - - - - w • MT3 MT1I 3 1.25" DIA. SCH 40 PVC I DISCHARGE LINE EXISTING AIR LINE �¢ FROM STEP TANK. I > MT4 MT2 j L— — — — — — — — — — — — — — — — — — — — — — — — — — — — J LL 30'+ INVERT OF DISTRIBUTION LINE = 95.75 — TOP OF NEW SAND = 96.50 BOTTOM OF EXCAVATION— (REMOVAL OF CONTAMINATED MATERIAL) = 95.91 NOTE: TOP OF OLD SAND VARIED BY NEARLY 0.5'. NEW SAND BUILT UP TO EXCEED ELEVATION OF PREVIOUS SAND, INVERT OF OLD PVC LATERAL AT HIGHEST POINT WAS 96.75. FILTER FABRIC GRADE = 7 / —100.22 � 2" INSULATION GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS. 3701 E. 1000R ROPO. SORE 101 a MCHOWL M 9950) a PHONE (907)337-8179 a FM (907)338-3246 a WERSRE: xxw.gomevewpineMnq.Pom PREPARED FOR: - PHONE NUMBER: PAGE NUMBER: KIRK BUTCHER 1 907-345-3167 1 2 OF 3 LEGAL DESCRIPTION: MCMAHON S/D #1; BLOCK 7, LOT 13 NPE OF WORK: PROFILE AS -BUILT DRAWING OF SEPTIC UPGRADE (Rev. 01/05) A.J.G. 7/23/201 EXACTLY 3" OF PEA GRAVEL EXISTING AIR LINE A. HOME SERVICES 7501 E. 140th Avenue Anchorage. Alaska 99516 (907) 345-1890 JanuarvO, 2016 To: GamessEngineering Group Re: 17901 Killey Street Let it he known that A+ Home Services, Inc. has installed the required amount of insulation of the drainfield during the inmlis-lion of their new septic sg ytem. A+ i-iome Services, Inc - Michael Blakeslee, President Your Septic System, Holding Tank, Pxcavation Professional Service Company On -Site Wastewater Disposal System Permit Permit Number: OSP131120 Tax Code Number: 01736163000 Work Type: Septic Permit Effective Dates: June 11, 2013 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 to June 11, 2014 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: MCMAHON #1 Site Legal Address: MCMAHON #1 BILK 7 LT 13 G:2835 Owner/Address: BUTCHER KIRKA & REBECCA F PO BOX 112413 ANCHORAGE AK 995112413 Site Mailing Address: 12901 KILLEY ST, Anchorage This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy All construction must be in accordance with: Lot Size in Sq Ft: 36366 Total Bedrooms: 4 N Private Well N Water Storage 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: By: If]Date: 1 Date: 0 / MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 017-361-63 Propertyowner(s) KIRK & REBECCA BUTCHER Dayphone 345-3167 Mailing address 12901 KILLEY STREET, ANCHORAGE, AK 99516 Site address 12901 KILLEY STREET, ANCHORAGE AK 99516 Legal description (Sub'd, Block & Lot) MCMAHON S/D #1; BLOCK 7, LOT 13 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (® all that apply) Absorption ® Initial ❑ Single Family (SF) Field Upgrade ® (w/No ADU) Septic Tank ❑ El Duplex (D) ElRenewal Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: Distance: — I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of properly owner or authorized agent) Permit/RushFees: ().W Waiver Fees: Date of Payment:Date of Payment: Receipt Number. a U 6 Receipt Number: Permit No. Qs PI3Ila 0 Waiver No. (Rev. 09/12) May 16, 2013 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for McMahon S/D #1; Block 7, Lot 13; To whom it may concern: The existing 4 bedroom house is served by a private well and septic system consisting of a bottomless intermittent sand filter. Several factors may have contributed to the failure. First, the IDSF was only equipped with a standard Orenco liftstation panel; therefore, no intermittent dosing was possible. Secondly, the air supply line is compromised between the IDSF and the air compressor. We are proposing to excavate the IDSF, remove all contaminated sand, repair the air supply line and re -build the IDSF to MOA standards. 1. SOILS: See the 2005 log which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The average topography around the IDSF is relatively flat. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any qucsf�ns, please contact us at 337-6179. Thank you for your assistance. .E., M.S. 3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com UtJKiN l:Kl I tKIH: (PER 2005 DESIGN & INSPECTION REPORT' NUMBER OF BEDROOMS: 4 GALLONS PER DAY (GPD): 600 PERCOLATION RATE/S: 6.7 MIN/IN PROPOSED APPLICATION RATE: 2.0 Lw. nno n 7 rnUD areurn.nllUry LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY NOTE: ELECTRICAL CONTROL PANEL TO BE REPLACED WITH ORENCO IDSF PANEL OR EQUAL. PEA GRAVEL: 100% PASSING 3/8" SIEVE, LESS / THAN 20% PASSING THE 1/4" SIEVE, AND LESS THAN 1% PASSING THE #8 SIEVE. MINIMUM DRAINFIELD SO.FT.: HAVE READ THESE SPECIFICATIONS AND DRAINFIELD DESIGN: AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. MAXIMUM DEPTH: LIMITED TO REMOVAL NOTES: THE AIR COMPRESSOR SHALL BE LOCATED WITHIN THE BASEMENT OR THE GARAGE. TH OF CONTAMINATED MATERIAL ONLY CONTRACTOR SHALL PROVIDE A 0-10 PSI PRESSURE GAUGE AT A LOCATION WHICH IS READIL' WIDTH: 12' ACCESSIBLE FROM WITHIN THE HOUSE . NOTE: A 30 PSI GAUGE WILL NOT WORK. LENGTH: 30' THE AIR COMPRESSOR SHALL BE A THOMAS INDUSTRIES MODEL 5070, AS SUPPLIED BY M.O.A. APPROVED SAND FILTER: 2'+ ANCHORAGE TANK. THE AIR LINE SHALL BE 1/2 INCH DIA. HDPE (1 PIECE), INSIDE A 2 INCH EFFECTIVE: 0.25' SCHAD PVC JACKET. THE LINE SHALL BE BURIED TO A MINIMUM DEPTH OF 3 FEET. REDUCTION FACTOR: N/A - THE CONTROL PANEL FOR THE STEP TANK SHALL BE INSTALLED OUTSIDE THE RESIDENCE WITF ACTUAL SQ.FT.: 360 AN AUDIBLE/VISUAL INDICATOR INSIDE THE HOUSE. _ I _ .,�.;. 100' WELL RADIUS 411 �.. I= 1 NRMPMO�OR(SEE EXISTING BOTTOMLESS y� (/ //'' REPLACE THE AIR IDSF TO BE EXCAVATED FCO ` /SUPPLY LINE FROM THS AND RE—BUILT IN PLACE j// AIR COMPRESSOR j0 PROVIDE LATERALS PER \ \ 1 THE IDSF./ ATTA ED DESIGN. INSU�TEO MR l UNE (SEE NOTES) 1 \c \'sl0 EXISTING 1500 GALLON N,� S.T.E.P. TANK \O,p. N TAIGA DRIVE GARNESS ENGINEERING GROUP, Ltd. p, CONSULTANTS & GENERAL CONTRACTORS . . . . • • • • • . . . . • • • • 3701 E. TUDOR ROM, SUITE 191 • PHCNORME, NC NW7 • PHONE (907)337-6179 • FM (997)3]6-3416 • WEBSITE wxxgome n99rcPM9x PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••••• KIRK BUCHER 907-345-3167 1 of 2 QO '.J f A. Go esS,: LEGAL DESCRIPTION: DRAWN BY: MCMAHON S/D #1; BLOCK 7, LOT 13 A.J.G. TYPE OF WORK: DATE: 4�oO4rOQ OfessWl DESIGN FOR SEPTIC UPGRADE 5/11/2013 EXISTING AIRLINE LSH 3/4" DIA. SCH. 40 PVC LATERALS (HOLES, SHIELDS, AND FLUSHING VALVES PER ORENCO DESIGN) - 30' �— 4" DIA. MONITORING TUBE AT - 1.25" DIA. SCH 40 HDPE EACH CORNER. PERFORATED DISCHARGE LINE FROM STEP BETWEEN TOP OF SAND AND TANK. DISTRIBUTION PIPE INVERT. (DRILL 1/4 INCH DIA. HOLES) PLAN VIEW ORIGINAL 3/4" PVC LATERALS (TYP4) SOIL & SEED � FINAL GRADE 2' MIN. OF COVER 12'x30' BOTTOMLESS ISF'No LINER ON BOTTOM. PRESSURE LINES PER ATTACHED ANCHORAGE TANK/ORENCO DESIGN. 1 FLUSHING VALVES WITH PROTECTIVE COVERS (EXTEND ABOVE GRADE) INSULATION FILTER FABRIC OVER PEA GRAVEL SYpF S(Op FS 6" LAYER OF 3/8" PEANEW TOP OF GRAVEL WITH THE PVC SAND ELEVATION LATERALS BURIED MIDWAY IN.: THE STRATUM. (GRAVEL BELOW ... ;":?•=^'"L�'"LL'i .f+,E> `'''i r'x'�'--•', *„�;`Y 4t<<�};i.'a,.,, *_:,";' 1O SHALL BE EQUAL TO OR HIGHER .. :4>w ;�,.,,, �;. Y,.,7) a;, ya:--•�`<;�.., h. THAN THE PIPE = 3"+ .:; �:::`y'z Fi"' '"+L:7,; ,. r)r,'"�' ;+4, �c^,.<-; `b;•;"':••,jt `, ELEVATION OF . .... w •7)c;,., �;;...•"at".;. n: t,>,.• ¢ THE TOP OF THE r0:r :?�;;S,S„-°;;;�.;, ”: •c%,.;i�x.•.;w.• e. -j! EXISTING SAND. .3 z z 2 FEET MIN. OF M.O.A.� 12 APPROVED IDSF SAND arc FILTER o EXISTING AIR LINE PROFILE VIEW GARNESS ENGINEERING GROUP, Ltd. p *A' CONSULTANTS & GENERAL CONTRACTORS p• • • • • • • • .. . ..... ..... ...... 3901 E MMR R .SURE 101 • MCMWE, M 99509 • WME (907)317-81'!8 • FAC (909)3WB- • MSX - PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •••.. . . . ....... ........... KIRK BUTCHER 907-345-3167 2 OF 2fre A. G rness.: LEGAL DESCRIPTION: DRAWN BY: oOo•'•. CE—cm4� MCMAHON S/D #1; BLOCK 7, LOT 13 A.J.G. TYPE OF WORK: DATE: 400d P�ofessio0°oma DETAIL DRAWING OF ISF SYSTEM 5/13/2013 W, Anchorage Tank & Welding, Inc. Intermittent Sand Filter SAND FILTER CONFIGURATIONS F AIF I LOM'IYJ.aOF 1 a TOP VIEW 12 x 30 SAND FILTER w/ GRAVITY DISCHARGE Page 37 VALVE wx SE LINE mlE i 125 6LO p PVC WOE SLOTS ]-1/]' 4. 06J LA1 RAL ORIFICES) .. Municipality of Anchorage „'°•. Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 97519-6650 Page:. of Z www cl anchorage.ek.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: S W O SO I T I PID Number: _O/ 7— 3 G If 6? N«•r V11my, c _ Q Wastewater System: []New % Upgrade i zct o i K 11 St ABSORPTION FIELD 21o3-tcoA O N. ire.w• D sn••o,. rrwrcn D,r L•rl.d O ferry LEGAL DESCRIPTION amno" �•�! IMM DWT Mon«yn.r pr" CrUrrr' -4 n. BI•rM la bAJNron 3 DWrorID. E•e•rn nom n,. arinew.m M+ o*S �S Ft. oz5 rl 1°rn.IW R«y. 8•ce.m t•MMM •°°.. «Ipinr P.e• Gr•vJ L"M 3o rr. We New ❑Upgrade ""°"° ""' U"Irrc•°rr..n."' 1 z rr. "2.5 Clnr•wwnrrr•.«•. I.IJ D.M C•..•ro rr Ielr wrrrrm r.r ry. wl«Ir ' n. rLgyo` y Orly« Sbw WN« l.N• InNNM: Ur• b•IMM rr Tw vs.o M '+2.Zr 0 5 YMJ Punp bN •I C•w •° Aw &r TANK crM rr• rL SEPARATION DISTANCES ❑ Septic ❑ (folding 14 S.T.E.P. ❑ Other: to Septic Absorption Lift NOldmg uMuralvale "'• °�"" "'.4From Tank Field Station Tank Serer line FAMCAdoRAC.G -VtAV,' 1500cr w" i 00t 10U1' j OL}} -.7s,+ M.IN1J S-c C,rGL N.n q Cbn"N.A. too % (00'+o — LIFT LIFT STATION Lot LM.• �}•3' 31' '43 1500 Gr Ar,chzyr „TANk rardrbn Ali' 1,.O (g o O1 ^ Punym 1•.r.l X12. 'rung ar Lw•r mp. Wr«r.no 1, z C••r Dr.Mr /� 14' l' [ r q P"•y M•••a Mnd.l 05 "" EIIrUrcJ Y•M..r°n. P,•ro•mE by M.o ,A R•r�wb 15�1rs4 SE fs S BENCH MARK LL 6tJ L 13 oN(D Down rd D.w�Pwn SA M 160'C50M 5%Z%N5C•, Q N'if37N ' 6 L .S iQo rr g V'S <Sat EO11IpaaTFr F 'N 3 ENGINEERING e i" �- 2 Q Inspections perlormed�b Dal s: S If M« \ c».... Eapb River, Alaska 99577 2"d 2 O$ '' .. " ie Develo ment S Ices De artment Approval P P PP ROBERT G COWAN , i +2 rfF; L Reviewed and approved b r 1 Reviewed pp Y: Date: 0�' •'�f (_ ,......;•� PERMIT NO. SW050181 PACE 2 OF 3 Municipality of Anchorage DEVELOPMENT P SERVICES DEPARTMENT 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 13, BLOCK 7, McMAHON S/D #1 P.I.D. NO. 017-361-63 ------ 10' UTILITY EASEMENT 10. P40 CC SWATERE • f�i b yOp°°O1c E-� J,,T FR fTB�Cf w ,ck 124 TOM FCO ybp�"" L C� �y\ �/ FV1 FLATt b MTI FV4 I / / / O W m b / TI W T2 o F•� FLAT±b H - ,...� �/ H 'MT2 FLAT± 1 FZI NEW 1500 GALLON b S.T.EP. T.ANK \ b NI I \ NI b I TAIGA DRIVE MANHOLE EsTAM tt ... /i/'' .•••.... r . . -..... A �•;n ROBERT G COWAN ••�2� It`^o,' 801 SCALE r . w• PERMIT NO. SW050181 PAGE 3 OF 3 Municipality of Anchora e DEVELOPMENT p SERVICES DOARTMENT 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 13, BLOCK 7, McMAHON S/D #1 P.I.D. NO. 017-361-63 MT1�101.8• �•1 FINAL GRADE ORIGINAL GRADE INSULATION t ears, YTI X98.2' BOTTOM OF SAND -98.2' DIST. LINE -98.5• A GROUNDWATER AT 94.2' 88.2' B.O.H. 101.6 STI ST2 A rt FINAL GRADE MH �% C.) + NEW 1500_.,a� 9s CALLON SYS EM E P 9q.9 �I ?� y ROBERT C. COWAN f�C fI \ i I� Ilt/s. SCALE . A.T.S. A 8 FCO 4,0 --- STI 43.2 71.0 ST2 49.7 75.5 MANHOLE 52.5 77.5 FV 1 67.0 65.0 FV4 77.0 72.5 MT1 66.5 64.0 MT2 83.0 92.0 From +19078308507 Tu• Sul 26 16;31:37 2005 Page 1 of 1 INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 4700 SOUTH BRAGAW i INSPECTION INFORMATION &HELP: 343-7962 INSPECTION: VOICE 343300 INSPECTION: FAX (907)249-7777 www.muni.org/BSD/Inspectlons.cfm NAME Kevin PERMIT#: 05-8639 COMPANY Rising Son Electric INSPECT DATE: 7/27/2005 AM PHONE # 250-1100 PHONE # PHONE # ADDRESS 12901 KILLEY ST LOT 13 BLOCK 7 SUBDIVISION MCMAHON #1 GRID # SW2835 r COMMENTS or DIRECTIONS TYPE OF INSPECTION: Retro Electrical I COMMENTS: (FOR INSPECTOR USE ONLY) I � / � PRINTED NAME v(/i " v USI �G (' DATE: y I Municipality of Anchorage Development Services Department ut*) Building Safety Division *AE Onsite Water and Wastewater Program4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Bob Cowan Legal description: McMahon #1 Block 7 Lot 13 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on _ ❑ Calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results Inadequate. ❑ Discrepancy in information submitted. _ ❑ Topographic information missing or inadequate. ® Incomplete; missing Was old trench left in place or abandoned ® Incomplete; missing Maintenance Agreement 4 -jt+by ❑ Additional adequacy test information needed. _ ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. Distances Bed to foundation and propgrty line,, ❑ Locations of all soils, percolation and water monitoring tests not shown. _ ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. ❑ Omission in narrative. _ ® Insufficient fill over tank or fieldfill needed around lift station ® Other. Need to use new forms Name of reviewer: Jeff Date: 2/8/06 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 17, 2005 Expiration Date: Jun 17, 2006 Permit Number: SWO50181 Parcel ID: 017-361-63 Legal Description: MCMAHON #1 BLK 7 LT 13 Design Engineer: 0003 S & S Engineering Site Address: 012901 KILLEY ST Owner Name: KIRK BUTCHER Lot Size: 36366 SO. FT. Owner Address: PO BOX 112413 Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99511-2413 This permit is for the construction of: ❑✓ Disposal Field ❑Q 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 catling (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. 5. The following special provisions. -THE PROPOSED SUBSURFACE DISPOSAL FIELD MAY NOT BE LOCATED LESS THAN FIFTY FEET UPGRADIENT OR 20 FEET DOWNGRADIENT FROM ANY PORTION OF A SUBSURFACE DRAIN. -THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. Received By. Date: A Lr7os Issued By f I'St`r Date: G i7 sr ala► 1560 MUNICIPALITYOFANCHOR4GE rt pq_ rat Development Services Department f On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 17, 2005 Expiration Date: Jun 17, 2006 Permit Number: SWO50181 Parcel ID: 017-361-63 Legal Description: MCMAHON #1 BLK 7 LT 13 Design Engineer: 0003 S & S Engineering Site Address: 012901 KILLEY ST Owner Name: KIRK BUTCHER Lot Size: 36366 SO. FT. Owner Address: PO BOX 112413 Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99511-2413 This permit is for the construction of: ❑✓ Disposal Field ❑Q 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 catling (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. 5. The following special provisions. -THE PROPOSED SUBSURFACE DISPOSAL FIELD MAY NOT BE LOCATED LESS THAN FIFTY FEET UPGRADIENT OR 20 FEET DOWNGRADIENT FROM ANY PORTION OF A SUBSURFACE DRAIN. -THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. Received By. Date: A Lr7os Issued By f I'St`r Date: G i7 sr 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.anchorage.ek.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 011 _&V(_ &3 Permit Number SW Property owner(s) K I R K 6 u 7 C H t R Day phone Mailing address (1) 1 ')-ci o I k i `L C Y 57.4 c4. 7 - 3N5-- 367 Mailing Mailing address (2) AA, Cjgo& CG 'L�1g-K� p Zip Code 9 `1 r-16 % Legal description (Lot, Block & Sub'd.) n7 �_, ll /C�k 7i /�I'/gl A � ►ri'1 Legal description (Section, Township & Range) Lot Size 3(0.3a(o Aces Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 4 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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 & S ENGINEERING 17034 Eagle River Loop Road No. 204 (Signature of property owner or authorized agent) Permit Fees: /) Date of Payment: Receipt Number: ,3122 (Rev. 12/00) Waiver Fees: Dale of Payment: Receipt Number: PODBERM COWAK PE. WEIE RTA. SHAFER PE. CMLENGINEERS (907)694-2979 FAX (907) 694-1211 June 9, 2005 APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWERAWATER IAMEXTENSI0119 REFERENCE: Lot 13, Block 7, McMahon Subdivision SEWER& WATER HSPECnON It is requested that you issue a permit to install a septic system upgrade to serve the existing four bedroom dwelling on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of ENGINEER.ao9rwrt9 MIDREPORTS the test hole is located on the attached site plan. At the time of excavation 5/10/04, water was found at 7 feet. After monitoring, ground water was found at 6.5 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WELLMPErrION AFLONTEST 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 properties. SITE PLANS If you require additional information, please contact us. Sincerely, ROAD DESIGN oRobert �,E,T C. CoAnP.E. RCC/bjj Enclosure PERCDIATgN TEST STRUCRSiALA LCCWHtCAL SaPECT1@a DNS" WASTEWATER USP08A MTW DESIGN t7004 Nonh4 tAad hrAA L.00P - 6utrE 204 % W E "P, ALASKA 99677 1'• — DESIGN KILLEY STREET SITE -PLAN oZ W -40 rn O-qr r (' NO A o 'D- Boz UT § DEIGN | m«IJ qG+ � ..o D S§§ � 3Rq� /rn k ) § | / > n E r 3 K � | Ln0�— � e 2� ! r 7 e w \\ 0k%oq � �G/\k .4 ;2 § C ` |& 6 | ,G 3 w c ;9 w w w « • . /5' @x r 3 K � | Ln0�— � e 2� m b 7 e w \\ r 3 /q 0 000 in#CO | Ln0�— 2� m b 7 e w \\ 0k%oq �G/\k .4 ;2 § C ` 6 w ,G 3 w c P w w w « • . @x C) ® g ° 2 m _ 2 0 /q 0 Municipality of Anchorage Development Services Department Building Safety Division yr onsite Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 www cianchorage ak us (907) 343.7904 Performed For. Legal Description: 6- 7- 9- 10 -7-9-10 -. 12- ,'0, 13- 6- .a 16- 17 19 - Soils Log - Pe ation Test ern. -C2 Date_Perfc L.OT 13; 13LNex 9-//IC)l gHeA-) rs/ipwnship.Range. Section: _ ciZ&ptu IC -S -- "I C.. TM14YU06 10 601 S ( Cty 1.5,qD WAS GROUND WATER ENCOUNTERED? ` CA%/6t_ %rtilC / t IF YES, AT WHAT DEPTH? Depth to Water After �• ✓ r Monitoring? Date: OF ya >� ROBERT C COWAN !� hP •. CE -8801 : �`•; ........... •.. Reading Date Gross Time Net Time Depth to Water Net Drop 4�60A-V— OS Sb 00 q h O • n o 33/ " o 5.0'. it D PERCOLATION RATE' mwteearxAl PERC HOLE DIAMETER tp• . TEST RUN BETWEEN �FT AND r Fr COMMENTS c [1 12o II Ll �srl PERFORMED BY: •,4'�'`' 1 ! CERTIFY THAT THIS TESX WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL UI INES IN EFFECT ON THIS DATE. DATE: 6 /O/ o s— Municipality of Anchorage Building Safety Division On -Site Water & Wastewater Program Field Audit Report Date:.—%— D 6 Time: 1: J O Document Type: 7'v S,r, Al ei_.,o'1_f Legal Description: 7 / /3-2 L—/ 3 Site Address: Engineer/Firm: S at-- S Excavator: Td c d4 Follow-up Notes: r1 Initials: 7 /% MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Nan" DISTANCES AtIV6 FflOM TO TANK ABSORPTION TANKWELL e i cJ 33'� 99SJ Pnarels) Perm° No. No. of Beorooms WELL /z,4' 2�-sssi 8'�fo23� Z y ta"L 0E6CRDM1OM 1.3LOT LINE 3 l.ol Block sumnson ltlelwo6l FOUNDATION S3 Township, Range, sedan s TL / p � f�L •La AS -BUILT DIAGRAM (Show txanon of well. gen , wpuc system, progeny ones. foun°aoon, •Y )V d'.., ay. water both , CC) TANKS SEPTIC ❑ HOLDING Manubdurer capaaty m 97; 1-1-1 J//(ikutenat No. of Domponments TYPE OF SYSTEM TRENCH ❑ BED ❑ W. DRAIN ❑ OTHERDepth a ppe bottom from Tow oepm from orpmat grapeongmn gra°e FT ,� ��' FTfm a°°° aoow ap.nY pra°a Gravel Oeptn beneam WWFT S � FTt ■■wlw'�ii�i� PRIVATE 0 OTHER ildentlfv ■■IN?JS95AM l■I ®®■■■■U■■EE1 REMARKS: Municipal and State guidelines In Elea on this daft — Health Department Approval: Inspecttonos ormed D : ENGINEER'S REAL �a A. AYW_ Date C£8&- oa'Ll /z -"-VV cartily Na thisInspection was performed according b all _ C� ///G�.L✓ A M U N I C I P A L I T Y O F A N C H O R A G E Department of Health & Human Services 825 L Street, Anchorage, Alaska 99501 343-4720 O N- S I Z E S E W E R P E R M I T N:-rnit Number: 680236 Upgrade Date Is.rr:rd; 10/18/88 Enginver Designed Owner Name: ALASKA HOUSING FINANCE CORPORATION Day Phone: Uwnur !Address: 1412 WEST 33RD AVENUE 561-5040 ANCHORAGE, AK 99503 Parcel id: 017-361-63 Lot Legal: Subdivision: MC MAHON SUBDIVISION Lot: 13 Block: 7. Section: 28 Township: 12N Range: 3W Lot. Size .4A (sq,ft. or acres) Max B„drooms: This Permit: 2 Total Capacity: 4 lPPIIC law!': Minimum total septic tank capacity: 1,250 gallons. Each septic ,."I mast have at least 2 compartments. Depth to top of septic tank (s) < 4.0 fc ! n h iinmI atian ovor tank(s). INFO!:M D.H.H.S. PRIOR TO IST & 2ND INSPECTIONS BY ENGINLLR, IF AP I Let t I- III Inv . :, CALL 343-4681 AND LEAVE A MESSAGE. C(1N73TRUCT PER ENGINEERS ATTACHED APPROVED DESIGN. THIS PLI:,11 I 1x4'lltf_S 12/31/88 AND VALID FOR A SINGLE FAMILY HOME. 1 CLHTIFY THAT: 1.. I am fami)iar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. 1 will insLall the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 1. 1 will Ad h"re to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 2 bedrooms. I also understand that the capacity of the total system is 4 bedrooms and e y enlargement will require an additional permit. Signed: --- ----- - ----- / DATE: 1----------------- /g--- (Ownc,r) Al_rr`KA IIOLI',ING F%IINNXCCEE CORPORATION ply ed By: A�'�W�- � _ '`-------------- DATE: ALASKA EIIUIROflmMAL COnTROL SCRUICES, InC. Engineering 6 Enuironmental Studies SPECIFICATIONS FOR A TRENCIT-TYPE WASTEWATER DISPOSAL SYSTEM - MCMA110N SUBDIVISION, LOT 13, BLOCK 7 1.0 GENERAL 1.1 The drawings, sheets 1 through 4, shall be a part of this specification. 1.2 All materials and workmanship shall meet the requirements of the Municipality of Anchorage, Department of Health & Human Services (DIMS), the conditions of the permit, and all applicable rules and regulations currently in effect. 1.3 All elevations and depths are advisory, and are to be verified or modified in the field by the engineer or inspecting agency. 1.4 It is the responsibility of the owner or installer to adhere to approved designs for installation, maintain the specified separation distances, and have the appropriate inspections. 1.5 If the installation is not inspected by an AECS engineer, AECS will not be responsible for the installed system. An engineer at AECS should be consulted prior to construction to determine the number of Inspections that will be required and to explain what these inspections will involve. 2.0 SEPTIC TANK 2.1 If there is an existing septic tank, it may be used if it meets the capacity requirement for the residence and the approval of the MOA. 2.2 The septic tank shall be a UPC -Approved two-compartment tank, constructed of 12 -gauge steel with bitumastic coating and set level on undisturbed soil. If the tank is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inti: burial type polystrene rigid board insulation. 2.3 The septic tank and trench shall be a minimum of 100 feet from any private well or body of water, 150 feet from Class C wells, and 200 feet from Class A or B wells, unless otherwise specified. Less than the required separation distance must have prior approval or waiver by ADEC or MOA. 2.4 The septic tank shall be a minimum of 5 feet from the house foundation, and a minimum of 5 feet from the absorption area. 2.5 Piping shall be fitted with a mechanical watertight colder coupling on the outlet and inlet of the septic tank. Piping shall be 4 -inch solid PVC ASTM D3034 or cast iron, sloped a minimum of 1/4 inch per lineal foot. If the piping is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystrene rigid board insulation. 2.G Cleanouts shall be installed as designated and capped with air -tight 1200 West 33rd Auenue, Suite Q • Anchorage, Alosla 99503 • (901) 216-1361 rain caps (Jim caps or equivalent), and extended a minimum of 1 foot above ground level. 2.7 If a lift station is required it shall be n corhination lift station septic tank per Anchorage Tank and welding, Inc. design. Specifications are attached. 3.0 Absorption Area 3.1 The gravel for the trench shall be 0.5 to 2.5 inch, screened rock with less than 39 passing x200 sieve residual. All substitutes must have prior DUDS approval. 3.2 The bottom and sides of the excavation shall be raked with the backhoe blade to insure that it has not been compacted during excavation.. The bottom elevation shall be level. 3.3 Monitor standpipe(s) shall be placed as shown in the drawings, and shall be 4 inch rigid PVC ASTX D3034, or cast iron.. The section shown with holes may be 0.5 inch holes drilled on 6 -inch centers on opposing sides of the pipe, or a regular section of perforated sewer pipe clamped to a solid section with either a no hub coupling or a solvent joint. A rubber rain cap (Jim cap or equivalent) shall be Installed over the top of the pipe. 3.4 The distribution pipe shall be perforated 4 inch rigid PVC with a minimum crush strength of 1500 lbs and shall meet the approval of DIMS for use as drainfield pipe. All distribution pipes shall be laid level. 3.5 Trenches may be paralleled, but must have a minimum separation distance between the trenches of 10 feet or 2 times the gravel depth (whichever is greater). 75 feet is the maximum allowed linear length of any trench. 3.6 If the final grade over the trench is less than 4 feet above gravel, insulation is required, using burial type polystyrene rigid board insulation. There shall be i inch of insulation for every foot of soil less than the required 4 feet of cover, but there must be at least 21 inches of soil cover even though insulation is used. The solid pipe extending from the septic tank to the drainfield shall also have 4 feet of cover or an equivalent layer of Insulation to prevent freezing of the line. 3.7 If insulation is not necessary, the gravel shall be covered with a layer of nonwoven Ceotextile fabric (such as Mirafai, ribretex 200 grade, Poly Filter X or equivalent). 4.0 INSPECTION'S 4.1 1 minimum of two inspections are required for the installation of the trench. The first inspection will be of the open excavation to assure that the system is installed in the proper soil strata, correct depth and meet minimum specified design parameters. 4.2 The second inspection will be after placement of the gravel, monitor standpipe and distribution pipe to verify proper installation and position prior to backfill. 4.3 The inspection of the septic tank installation can be incorporated with any one of the above listed inspections. SEAL) .0 co; 1H tfi MuniclpalltyofAnchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 / �� oY C acro, Je ` if SOILS LOG — PERCOLATION TEST f,L CE -2251 �� PERFORMED FOR: ..W Orfsl —. -. f..iskA%4 —DATE PER`OS2S �'��• - LEGAL DESCRIPTION: L 13 B7 _/fe M#ACm Township, Range, Section: 'T/LA/ Rite 16t 29 ' 4 h 2 f/�� J�J� h,PA✓afL 3 4- 5 • O: 6 9 ] I I lA+�D� �,@4✓GG 10- 11 12 13 14 15 16 ESD 17 18 19 20 SLOPE WASGROUND WATER ENCOUNTERED? A IF YES, AT WHAT DEPTH? Depth to Water Atter gyp./ Monitoring? � Date: �O f 1i Reading Date Gross Time Net Time Depth to Water Net Drop L. S 7- b/ ,Z7 -.S9 .o 3 • */7— 7 ex c.c Se PERCOLATION RATE L -Zi (mmuteYmch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 245� FTPD FT COMMENTS X214' / /��// / Te /G �/ITc'J A'l 7'5.0 TO 4,f,91 4150210 PERFORMED BY. �s°Ci G��d� I - ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: - 72-008 (Rev. 4/65) ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite 8 ANCHORAGE. ALASKA 99503 (907) 561.5040 JOB LOT 13 04�qN 7 SHEET NO. — OF IV CALCULATED BY A DATE /0 —/0 -,F;r CHECKED BY SCALE ,�' 1,41,4.1 _0 I;r Ph 7 7, _7Z ell T 73 *wk To /P W I 14AJ6 1 dr-ri ac1AW I SAJ5 6 1 P,47fb %+7 2<3 iAV7nr2 To x?, 5- 7p i 14 19i14 t rh 1,z 73 :50 iEA,16 7W- 1 q I --I T— i f I 17— 'all 7W 46AIMPI 17)/hr '20 ex ---------- - .36 ly i .340 � Ilzmff, ----------- - T_ --7 -T -T 41- ie,4fl el 7-' IA7;f -'c C ri 71W I.Fee _7 OF T f6 Ar 0* :4 off..: so . jo w E;2251 7.4 Jr. .--. I- - , v- .m i \, V Sit NN jr vP• •., PT LL ; • .O : k 6 AF MJ 1 1Y n u v y � •• J y 1'I.f Yu 1.. t c ru ru VI IL V -= .a ci xao ►» W 1•• 1 • i � � \ V ;�� Y!••tL inSOL 1 �zw • .�� .i�.•.a•.ii t� u W an b F. dA Dyiy,Y W O N O► �—r u- �►Jw0 1 1Y n u v y � Y. •{� I 1'I.f Yu 1.. � IL V w u �z- 1•• 1 • i � \ V ,L i• Y!••tL inSOL 1 �zw .i�.•.a•.ii t� ^:,tea"� �►Jw0 V �y^,enr z p C SO Y o u w • -u IOC i ALASKA ENVIRONMENTAL ,OB LoT 4 as 7 1-le//IPWW CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B SHEET NO. av ANCHORAGE. ALASKA 99503 CALCULATED BY kliE� DATE (907) 561.5040 CHECKED BY DATE SCALE TS . i Pr Ayl ' t/iEc�-- 1 I I I hoA rR 744i I I I I r T- 4 JW P/PE I I I -r _�- 1I I I I --- �—��--I r - —• i — -* li hid -• --�I—�-- -` PiPEr I 7ZW&W i I I�_� cmwrcT T ex�srid4._sou�_P��E; T _AucuJ !Dis�x� ,.77 i— I_ I 71 NO 7Z&/6&1. 1 I CPO53 � tEG7Jr►� I I' � 1� '� J I I I j a 1 ; t r I Hw�7Di�14 • � — - ; —, -- — I i i I I I — —7--!-------- --.._._ _....._�_.. i I i 1 r 0/3.37 PAO,iW S/iEET � o/'" tl 2 0� M r U N L L H O u z N o r u u N N L M 2 U �`_ V G O u a A ti V j < L < c C O � O 0 z °O • u : o°c;o X ¢ �! o < u /0 :R >a iu o 0 0 0 o c o C Q, 0 CO 0 0 00 O 0 1 J < O ti ¢ O 2 O w L M < L ¢ < o � A O rl ° H D ou = Y H to It < a U u ¢ m < L• z L \ °O a jr ° r ° N O Z L U 7 ¢ n w O z H a 1 J L• U 0/3.37 PAO,iW S/iEET � o/'" tl 2 0� M r U N L L H O u z N o r u u N N L M 2 U �`_ V G O u a A ti V j < L < c C O � O 0 z °O • u : o°c;o X ¢ �! o < u /0 :R >a iu o 0 0 0 o c o C Q, 0 CO 0 0 00 O 0 1 MUNICIPALITY OF ANCHORAGE . Her`1h and Environmental Proteaion Fourth Floor West 825 L Street Anchorage, Alaska 99501 279-2511, x 224, 225 1 „� INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME_. lsc� LLI-f MAILING ADDRESS _SPLA eer[ ISS/ R PP/H�,O.,N'nE!� 3`4`�-3SS'� LOCATION �.� ti K E LI_ LEGAL DESCRIPTION -- L I � �L' ' "�` Qh SEPTIC TANK: EKLS4I'`q DISTANCE NUMBER OF FROM WELL MANUFACTURER MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH_ LIQUID DEPTH LIQUID CAPACITY GALLONS. TILE DRAIN FIELD: TOTAL LENGTH f DISTANCE FROM WELL. 00 FOUNDATION–JJ t NEAREST LOT LINO OF LINE J'2S DISTANCE BETWEEN LINES -44TRENCH WIDTH3� IN. TOTAL EFFECTIVE ABSORPTION AREA J -v SQ. FT. LENGTH OF EACH LINE �S DEPTII OF FILTER � DEPTH: TOP OF TILE TO FINISH GRADE 3.5 '��/t MATLRIAL BENEATH TILE_ IN. ABOVE TILE IN. SEEPAGE PIT: DIAMETER OR WIDTH_, LENGTH_, DEPTH Log Crib Rings/'RIB SIZE: DIAMETER —DEPTH— DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SO. FT. Well Class:-�`S"�"" Depth: Well Distance To: Lot Line _ Bldg: Sewer Line: Pipe Materials: # of Bedrooms: Installer: 91L Remarks: _g.,I Leogr DATE APPROVED r i I _ DATE APPROVED r .•ii _.P+. J a - DFr-'HNTPir"rJr iiv- HFHr.TH HrJfi F?JVIF'OIJPIFIIIHI, F'k1.lIFi:TTIiPJ rl.G>J Anl �;r �l ''� tiTkF.F'1. HNI:HIIFw.'HI�F• HF;. y'�y - 1 -1r -J —'=: T -F - F=. L: F-= LJ F=: /=• 1 _ 1 F=' 1 � N' H I :• F=. F=' 1=_ F=' r•'1 7. 7- PFFrtrr H"Pl IF:HNI RFix It'5:1 F.' 544 7«557 I.I'ii'H 1 I AN T I HI iH A- K.FFI-Y 1.FI.iH1. 1.1.<: R?' t•11't•1HHilrJ Si C1 L.IIT SirF -�5r' 0 SOIIHF'F. FEET IYPF flF •1-11Tl. HH'�1IRRTJ1lrJ SYSIFl•I IS'IF:F.IJi::H Mr-aX l H, 1i,i f-0- = 4 SOIL_ kAT I NG (SC -1 F r1RP:i= A 50 IHr k,'HAIIFFr! '�IZF OF THr tillil. WSI-IRPFION SYSTFPI IS: I- F<: ►=i tir F= : [ _. f F=. f =^ T F� = F THr I_FNi TH GItI-N-A(irJ I i THr I_VNi TH CIN FEFI'? OF TNF. TPFPICH OF' DRHTNFTFI_rj' ]Hr IIFPTH ]IF H TFFIU:H flew., PTI IS 1 -HF. DISTHNI'.F RFTL,WFIJ THF SIJPFHCF OF THE I:r.'iillNri HM, 1HF F;iiTTOH lir= THF F :t1Hs;ATIt"IIJ (mFFET). - THrAF 1S NO SFT WTDTH FfiK TRFNi_HFS 1HF 6rhR' FL DEPTH IS 1HF PITNINIIN fiFF'TH OF fiRFWFL RFTL•JFFN THF A ITFHI-L_ PIPE HNO lHF RI.111r1W IIF IW FXi-iz'dH1T0tJ CIN FFFT). F -'►-i1 _: Fes. /-11 �F-. F-'1 ._1/ryl i 1_I F=^ I ].1_11,1 H F'Hi:F�:Po;F. r9_Hrll MH") RF TPJ THI_LFD Hr THF. FF_RPIITTFF'S fIPTIfUJ SHR:TECT TO THE FY)i I.iIIJTF.L; I':irrdriTITOLJ: 9. FTIHr�k' H I I_iiSS I OF' 11 N=F HPPRC1VFD PL.HNT P1HY RF JIJSTHLLFD H CfuJTINl.lil05 r•IHTFJTFNrPJi:F R6'FFOrINf IS RF.f-AIIFFD. IF H MH1N"rFW1NC:F Hi RFF:PIFt1T IS NiIT I FF'T C.11wRFNT YCIU UVi',' RE RFOITRFD TA FNI_RRGF THE SOIL. HRtiili='F•"r1i1tJ '�r'�•T EM HIJiii Ok' YOU P1H'r' RF TO PPit-, FLITION. ---------------------------------------- --- ': All ._. ] i'-3tiF•1=:G::-1" l 1Dt-JL: HF -:F F='F=1 !1_I J RFr-, - kHJ-J:+D l.1Ni; OF HNY SYSTFr'1 WI1Hili1f FTNNI_ 1PJSF'PC:TICrtJ HIJD HF'F'RIlWiL RY THIS iiFF'Hrl61r.NT WIl_I_ R'r SIJR.TFCT TO FROSPi':IITION 191I41tlfll•I DPI THNCF RFTWFFN H L•JF_LI_ HNO HrJY ON-SITF. SF.WHIIF DISF'Cj'_HI_ SYSTEM IS :Erin Fr FT FOR H F'F.:IVtHIF WFI_L Ak' 2Ot7l FFFT PIP H PURI_Ih WELL. I17HF kFI.NIF.FhIFFJT'S NRY APPLY. SFFC:TFIi:NTIOhJ'= RNO CONSTRI1t T1 DN DIFGRHMS HRF H'JHILHRI_F' TfI TN41_IRF F'F.'CtPFR INSINLLHTION F=• F=. F=^ 1 1 "F "f' F=�:.L-' F=• 1 F=' F= 1 s F=� 1. F-. F.1 F=: F=: F? =-: i... _1 _ ^_'=� .7 . 1 f:FkTIFY THHT 'I I WI FHt•ITi.IFII Wil -H THF F'FfdIIIF'Ft•IrtdTti. FIIF:' fIN-SITFSFWFRS HNfi WFLl.S HS SET "rlil-'lH R'+' lHr M�IFJi1':I F'HI..TTY' IIF HNC:HfIk'HGF !' r T WTI I_. IIJc,TRiI_ THF SYtiIFPI TN FiCCIiF.'IiHrfi F LJITH THE CODFS I ik'OFF.•STHW) THHT THF IiIJ-SITE SFIJFF' 4YSTFM NHY F'Ffa.IIIF'F' FNi_HPw.'GFrIFNT IF THE r..rSTDr.NI;F_ 11; PF1900FLEri TO ItJi_:I_IIDF PliiRF/THFiN 4 RF[iR00MS. HN�r.i .rIPJ F'fL;Fk SF.TFFFF:'T 7 a� -------------- J Iv El _ GRE'' -TER ANCHORAGE AREA BORA,UGH yll�� Department of Environmental Quality' 3330 C Street Anchorage, Alaska 99503 QQ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM 1�� NAME OQrY' SF'%6-,/A- MAILING ADDRESS 51t,20-1, T 0-1, %50� .I PHONEN/4- $S2. LOCATION T V Yr0 W \,Yf_CK RO. LEGAL DESCRIPTIONL.OT 1 2P .AI K 1 SU1fflWZd4 SEPTIC TANK: DISTANCE 'kSol MIN •YE,'y) NUMBER OF FROM WELL�V1ANUFACTURER YE Lf MATERIALAEf ` -COMPARTMENTS- INSIDE INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH --I IQUID CAPACITY JC,,�GALLONS. SEEPAGE PIT: I NUMBER OF PITS �-. \DIAMETER OR WIDTH Jam, LENGTHS �1, DEPTH LINING MATERIAL\tay CRIB SIZE: DIAMETER_LDEPTH� DISTANCE FROM: WELL _ �. TOTAL EFFECTIVE �(� BUILDING FOUNDATION I%, NEAREST LOT LINE ABSORPTION AREA (WALL AREA)J_J_SL—SQ. FT. ADDITIONAL ABSORPTION pLNF N114411! TYPE DY\V1,kC c�M��fO CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE NEAREST SEWER LINE CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: S k*lw o INSTALLED BY: WAt U 'Ir F olc� PIPE MATERIAL: LOT SLOPE: _Cxl�rA REMARKS:AY KmE\ \r, KaL. 11 1t1SDECT�Oa Form No. EQ -031 DEPTH DISTANCE FROM: SEPTIC(�d M`N\14EEPAGE \001'n,N-M�) TANK-?J=J-q,SQ SYSTEM,..P1roqoSED DIAGRAM OF SYSTEM DATE G.A.A.B. GREATER ANCHORAGE AREA BOROUGH jd DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 �O"O'O ONE 274-4551 /_ ) Ce Ws /, Nom((/ (_(/ J SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT KOs 02� ��/g��/T' M/AILIN,GG ADDRESS �1`-� PHONE y�3st7 INSTALLATION LOCATION LEGAL DESCRIPTION /5 ;3 '7 INSTALLATION OF: SEPTIC TANK SEEPAGE PIT— DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED BY CST LE SOIL TEST RESULTS - NOTEI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED Su FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY'SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE 17-s-0 TYPE C"''JG' 62C Sp51-SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES. REOUIREMENTS FOUNDATION TO SEPTIC TANK / FOUNDATION TO SEEPAGE PIT 701 DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK S SEEPAGE PIT �-O GRAIN FIELD TO NEAREST LOT LINE. A.A WELL TO SEPTIC TANK / SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD / SEPTIC TANK. _L^ SEEPAGE PIT /W DRAIN FIELD TO RIVER. LAKE..STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOIL. A INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. T G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE ILI -�� APPLICANT'S SIGNATURE FORM NO. E0-014 DIAGRAM OF SYSTEM ANCHORAGE AREA BOROUGH ORDINANCE NO. 26.68 AND THAT THE ABOVE • • • Municipality of Anchorage GE 8�" _ On-Site Water and Wastewater Program . (907) 343-7904 stl'T� CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-361-63 Expiration Date: — 7- 11 1. GENERAL INFORMATION Complete legal description McMAHON#1 BLOCK 7, LOT 13 Location (site address) 12901 KILLEY STREET, ANCHORAGE,AK 99516 Current Property owner(s) ADAM &VITTORIA DEDMORE Day phone Mailing address 12901 KILLEY STREET,ANCHORAGE,AK 99516 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: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: Date: P' 7- /7 COSA to be released to t • , unless otherwise requested by the engineer. COSA Fee $ 52(6.— Waiver Fee $ Date of Payment 12[) !l' Date of Payment Receipt Number CLi7-3Cal) Receipt Number COSA# C�`JC l r36(1- 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 7/18/2017 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. 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 ��\ , • encroachments,deficiencies or discrepancies exist. / ��' OF'.A T s - � *`4• TF� � �� * 6. DSD SIGNATURE 0° rfogorre, )C_J System #1 Approved for II bedrooms. KENNETH off 16 System #2 Approved for bedrooms. 4 e � P� b'F'SSSOs,"� Disapproved. � `_ter Conditional approval for bedrooms, with the following stipulations: • ON-SITE f WATER AND T' WASTEWATER PROGRAM G` By: - Original Certificate Date: (Z7) 7 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well How Advisory Other COSA blue sheet_10-1012.doc 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: McMAHON#1 BLOCK 7, LOT 13 Parcel ID: 017-361-63 A. WELL DATA Well type PRVT If A, B, or C provide PWSID# Well Log (Y/N) N Date completed PRE-1977 Sanitary seal (YIN)Y Wires properly protected (Y/N) Y Total depth `68 ft. *(PER MOA Docs) Cased to '43.5 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test -- 7/11117 Static water level -- ft. 45 ft. Well production -- g.p.m. 3.8 g.p m. WATER SAMPLE RESULTS: Coliform NEG _ colonies/100 mL Nitrate 14.2 mg/L Arsenic: ND ug/L Date of sample: 7/11122017 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP 1 STEEL Date installed 7/22/2005 Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping 7/10/2017 Pumper A+HOME SERVICES C. ABSORPTION FIELD DATA Date installed 7/18/2013 Soil rating (g.p.d./ft2 or ft2/bdrm) 2 System type IDSF BED Length 30+ ft. Width 12 ft. Gravel below pipe 0.25 ft. Total depth 3.4 ft. (Measured 7/11/17) Eff. absorption area 360+ft2 Monitoring tube Y Depression over field N Date of adequacy test 7/11/2017 Results (Pass/Fail) PASS _ For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 615 gal. New depth 1 in. Elapsed Time: 15 min. Final fluid depth 0 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed 7/22/2005 Size in gallons 1500 Manhole/Access(YIN) Y "Pump on" level at TIMER in. "Pump off level at TIMER in. High water alarm level at 44 in. Datum BOTTOM OF TANK Cycles tested 2 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+___ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS Per MOA docs-field insulated with 2'+of cover 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. S� OFA�, \ Engineer's Printed Name KENNETH M.DUFFUS �`S Date 7118/2017 _ * 4 9 rr_ * COSA canary sheet_2-6-15.doc �IIJ� `` KENNI7Avyr Asf %.css ' Aar ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND Christopher& Candice Kotyk THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this (1 Day of J frf) of 2017 , by and between Christopher& Candice Kotyk herein the"OWNER,"and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1 . Advanced !Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as IDSF(Intermitten Dosing Sand Filter) located at(legal description). McMAHON #1 BLOCK 7, LOT 13 — 12901 KILLEY ST, ANCH. 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts,components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval(COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code(hereinafter,"AMC") 15.65. These approvals certify that service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and(5)inspection costs. B. Owner agrees to comply with all applicable ordinance, laws,regulations,rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor,the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction,maintenance and repair of the Owner's AWWTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended,modified or changed by a writing, executed by authorized representatives of the parties,with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: a. Owner: Christopher&Candice Kotyk b. Municipality: Director,Community Development or designated authority C. Any attempt to amend,modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. SWAM By: eKg-- (signature) Date: d /'//2"'/>7 Chrfl >t / 1< (print name) (signature) Date: /VI_7 (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICTri ) The foregoing instrument was acknowledged before me this • 'day of 1/4,71) 2011 ,by Cl (r fth C4,413/CE kOTykbifr'ATT O/MMiC/( )1(0.# 0 State of Alaskar� NOTARY PUBLIC FOR ALASKA Notary Public 44, My Commission expires: 3 -2 2 - 201d' Matt Dimmick �� My Commission Expires 3-22-201 MUNICIPALITY: By: (signature) Date: (print name) Title: - �0-1;ii 7'.t, --—Nit' ,--,-": ,:li , _, RESIDENTIAL &COMMERCIAL WATER AND WELL SERVICES 24HR EMERGENCY SERVICES AVAILABLE FREE ESTIMATES John Netherton P.O Box 210249 Anchorage,AK 99521 907-230- 78 6 In regards to property 12901 Killey St. Anchorage AK the camera results are as follows: The casing has a high mineral build up on the inner walls, however, no breaks, cracks or perforations were inspected. Per the COSA from 2014 it states casing ends at 43.5' however camera results show that it is cased to at least 70' where the pump is sitting.The water level would not draw down all the way to the pump due to the well recharge rate being faster than the pump output. Camera cannot go past the pump at 70'. Static Water level 40' If you have any question please feel free to call John at 907-230-1868 or Katie at 907-230-7019 Thanks, John and Katie Netherton 907 Water Well Services • • Municipality of Anchorage Development Services Department ..- Building Safety Division SA ETY On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # OSC 171304 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 7, Lot 13 of McMahon #1 subdivision. This inspection revealed a nitrate concentration of 14.2 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. u Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 �•__ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-361-63 Expiration Date: t 1. GENERAL INFORMATION Complete legal description MCMAHON S/D #1; BLOCK 7, LOT 13 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 12901 KILLEY STREET, ANCHORAGE, AK, 99516 KIRK BUCHER Day phone P.O. BOX 112413, ANCHORAGE, AK, 99511 RAY DAHL W/ RAY DAHL GROUP Day phone Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: 242-2160 244-7611 TYPE OF WASTEWATER DISPOSAL: Individual Well E Individual On-site M Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ i Received by COSA to be released to the engineer, unless otherwise requested by the engineer. Date:; COSA Fee $ $ aims JU Waiver Fee $ Date of Payment (O[ i / Date of Payment Receipt Number oq a & &6 Receipt Number COSA # QS� i�P V C� aiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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 GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineefs Comments: In conducting this evaluation, GEG, UD. 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 madilyidentifiable features. The operational fife of all weds and septic systems depend on the local soils condition, groundwaterlevels 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 Trot 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 wamanty 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 reports for the sole benefit of the owner listed above. Any reliance upon or use of this report by any offer person or party is not authorized, nor will it confer any legal right whatsoever 6. DSD SIGNATURE System #1 Approved for A_ bedrooms. System #2 Approved for Disapproved. Conditional approval for By: bedrooms - 337 -6179 Date j le 64 bedrooms, with the following stipulations: Original Certificate Date: The Municipality or Anchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: _ COSA Checklist j l Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 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: MCMAHON S/D #1; BLOCK 7, LOT 13 ParcellD: 017-361-63 A. WELL DATA *PER AAROW PUMP AND WELL INSPECTION. SEE ATTACHED. Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed PRE -1977 Sanitary seal (Y/N) YES Total depth *68 ft. Cased to *43.5 ft, FROM WELL LOG Date of test �E Static water level uNPJP\�g ft. Well production 9.p -m. WATER SAMPLE RESULTS: Coliform U colonies/100 ml. Nitrate t� • mg./L. Arsenic: bO ug./L. B. SEPTIC/HOLDING TANK DATA Well Log (Y/N) NO Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION Date of sample: 1/3/2014 12/24/2013 EVA 3.22+ g.p.m. Collected by: GEG, Ltd. Tank Type/Material S.T.E.P./STEEL Date installed 7/21-22/2005 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES r� Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) �rS� Date of pumping (�li ev Pumper A+ c,rm 52rv1 uls- fs c C. ABSORPTION FIELD DATA Date installed 7/17-18/13 Soil rating .p.d./ r ft'/bdrm)***E.0 System type **BED Length 30+ ft, Width 12 ft. Gravel below pipe 0.25 ft. Total depth *3.4-3.7 ft. Eff. absorption area 360+ ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) — For — bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: min. Final fluid depth = in. Absorption rate >= — g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date **I.D.S.F. NOTE: ENTIRE SYSTEM WAS INSULATED. 24" SOIL COVER SATISFIED. a D. LIFTSTATION *NEW PUMP, PANEL, TIMER AND AIR COMPRESSOR INSTALLED SUMMER 2013. Date installed 7/21-22/05 Size in gallons 1500 Manhole/Access (Y/N) YES "Pump on" level at TIMER in. "Pump off' level at TIMER in. High water alarm level at 44 in. Datum BOTTOM OF TANK Cycles tested - * Meets alarm & circuit requirements? YES E!-. SEPARATION DISTANCES , SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent Absorption field on Public sewer main Sewer /septic service line 25' Animal containment areas 50'+ + On adjacent lots 100'+ 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5' Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Prined Name JEFFREY A. GARNESS Date 1 � . (Rev. 11105) Municipality of Anchorage Community Development Department Development Services Division . On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 141004 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 7, Lot 13 of McMahon #1 subdivision. This inspection revealed a nitrate concentration of 11.1 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Pact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. AAROW PUMP & WEH §ERODE, LLC R.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 - Fax (907) 345-0202 Eagle River: (907) 622-9335 k � PwL CHLORINATED PUMP DEPTH SALE�SON QUANTITY DESCRIPTION PRICE AMOUNT XV r �} JOB SITE d ' _e , No. 10054 INVOICE DATE %YELL DEPTH PwL CHLORINATED PUMP DEPTH SALE�SON QUANTITY DESCRIPTION PRICE AMOUNT / �. (,.-.. LABOR HOURS RATE AMOUNT TOTAL MATER IAL TOTAL LABOR s/ rf ,,. WORK ORDERED BY TOTAL LABOR PAY THIS AMOUNT Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion at the Above Described Work and agree that If above work is not paid for in 99 days I agree to allow Aarow Pump & Well Service. L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.) TERMS: ACCOUNTS PAYABLE AT 19TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. 20 13 04:06p Ray Dahl 907-348-2597 P.1 m 30' 30, 75" CO to cn CA O O F C4 O 0 3 "00,10.00 s EA > ri A J,: > Z 0 M -0 0 > 0 27,0i 0 0 0 0 > E0 Z y m CA 0 cp 70 (Do 003 0 00 13OD C> 0 0 rA z CA o 0 C (A ;u VO CT 0- 0 O;u Ow > m co 0 co 3 rq Co 7 0 �u m Lh 1 U LN > w m m M C) z U, m 71 m 30' 30, 75" CO to cn CA O O F C4 O 0 3 "00,10.00 s EA ri A J,: m 30' 30, 75" CO to cn CA O O F C4 O 0 3 "00,10.00 s LANTECH—(��M�� KILLEy STREET L=172.97' 2`27n c'� EA ri A > 0 M -0 0 0 27,0i 0 0 0 I cp 003 00 13OD LANTECH—(��M�� KILLEy STREET L=172.97' 2`27n c'� 783,37 I -4V A 0 27,0i I 003 00 13OD OG tiC 0 Lr) 39.8 0 m co 0 co 3 Co a 1 > w M C) OD II 783,37 I MUNICIPALITY OF ANCHORAGE O Department of Health & Human Services a DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # CA-) - ?4-^ 1- ,. HAA # k� � Rn CCI Ll-) 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) -t Location (address or directions) /, K3a1 See. (b) Property owner ATFL Telephone: (home) Business Mailing Address PL t.� v 1^•tr��r� r�i 1-�r.<nr_Y k�l�� G<�r�- I>=Y� (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address 2!-4e0 eeRbW,4 A MW lK Telephone 716, - 2,76 (e) Mail the HAA to the following address: (or check here if hold for pick up.) List contact person and day phone number below: hee' 5 T Plea: uP. 2. TYPE OF RESIDENCE Single -Family Number of bedrooms 3. WATER SUPPLY Individual Welr)� Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site`4 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 JR". 71") Page 1 of 2 Z 1 Z abed -Xiom sjaaul6ua Ieuolssalold aq1 ul suo!sslwojosioijajololq!suodsaijou s! a6ejogouy;oAl!lEd!olunlry ag1•panssl s! aleoglUao eajo;aq elgpazAlEuejo suo!loadsul lonpuoo lou op SHHO to saaAojdw3 •sluawai!nbai alels pus lejapa; ule;rao A;s!1es oliapio u! suo!lnl!isu! 6u!pual J!aql pus sawoq;o siasegomd of Asalinoo a se s!yi saop SHHO 0141 •eMsely;o OIBIS 0141 Ul paJais!6aJ iaau!6ua leuolssalad luepuedepul ueAq anoge S gdei6ejed u! UaA!6 suo!leluasaidai ayl uodn Aluo paseq paleo!;!iao IenaddyAI!joglny glleaH sanssl (SHH(3) saolAiaS uewnH pug 0eaH;o;uaw3JEda0 a6ejog3uy;o Al!Igdlolunyy 0141 NOI1nV0 . leuoglpUo3 �• aleQ,4�T G` .... ..... . 0 ..... .�...s l6b:y i •a- Ienaddy leuoippuoO;o swa1 panaddes!O—� panaddy Aq swoojpaq Jo; panaddy IVAOHddV SHHa '9 OLEO (stili >v /Q !r C!c / 'z/ ssaippV 6L< euogdalal C3lv wl!j;o aweN vo!loadsui s!ql;o elep 0141 uo;oa;;a u! SUoileln6ai pus 'saoueu!pio'sapoo alelS pus ledlownyy Ile yl!m eoue!Idwoo ul si walsAs lesods!p jalemalsem jo/pue Alddns jalem eps-uo aq1 'uolloodsul Pug uo!1E61)sanu! Aw woj; pus sal!; e6ejogouy;o A3!IEdlolunyy eql wa; pau!elgo uollewjo;u! 0141 uo paseq ;e141 A;!JaA jagUn; I •Malay poleo!pul ainlonuls;o odAl pus swoojpaq;o jagwnu eql jo; elenbaps pus Ieuo!loun; ,ales sl walsAs JesodS!p Jalemalsem jo/pue Alddns jalem ells-uo 041 legl smo14S IEAaddy Al!joglnV 411eaH s!g110 U01le61lsanul Aw legl A;!JaA I'molaq umoqs 91Ep Uollepl!eA ag110 se pue OlaJaq pax!;;e leas Aw Aq pall!Uao sy NOI1VWUOdNI aNV VlVO'HOEMS 311d'S1S31'SN01103dSNl ONIOIAOHd WHId ONIH33NION3 'S t,,ffgvq ZY Fig !'3� MUNICIPALITY OF ANCHORAGE (MOA) MUNiaaA�n !/ +oaACE Health Authority Approval (HAA) ENvi, ONM.ENTA�S DrviSIONCHECKLIST - FEBRUARY 1984 343-4744 ri 1939 Legal Description:yr /3 XX 7 r/ehflI&I F Tzd r1jJ See- Z8" A. WELL DATARECEI •1/ ED Well Classification ��A✓kT� If A, B. C, D.E.C. Approved (Y/N) Well Log Present (Y6)—,Date Completed GAIKA)AJAI Yield® 3• i 6PH ir Total Depth 70 Case_ d to Depth of Grouting A Static Water Level t. � Pump Set At A) A Casing Height Above Ground Sanitary Seat on Casing Y N) Electrical Wiring in Conduit (Y N) Depression Around Wellhead (Ye SEPARATION DISTANCES FROM WELL: A � To Septic/Holding Tank on Lot T /4 ; On Adjoining Lots r To Nearest Edge of Absorption Field on Lot //D ; On Adjoining Lots — ZOd 1 To Nearest Public Sewer Line—eA To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot LS ; Water Sample Collected by AEGS fi, t�/6Af ; Date Z -'Z - Water Sample Test Results .J/7v-rs_•5 aA7- Comments) _6�Ect 2+�P7R ts&H /979 , IAS+. B. SEPTIC/HOLDING TANK DATA Date Installed Size No. of Compartments Standpipes 6N) Air -tight Caps&N) Foundation Cleanout) Depression over Tank (Y© Date Last Pumped /6.40 Sf /SAAB -S Pumping/Maintenance Contact on File (Y/N) 41A ; for 1 Holding Tank HrdhyWaterAlarm (Y/N) A�IA Temporary Holding Tank Permit (Y/N) �% A SEPARATION DISTANC)=S FROM SEPTIC/HOLDING TANK: a� i To Water-Supply,Well,- '' g9 � y To Building Foundation Z/ z FiCoH yo `: ix•. 7 i To Property Line"""' '• "fid t To Disposal Field f To Water Main%Service'Line" To Stream, Pond, Lake or Major Drainage Course /'ero -)I- Comments Comments 72-M (R". T/M) From Page 1 of 2 G13 67 Re11la C. ABSORPTION FIELD DATA Soils Rating in Absorptiontrata Z 7-93 Type of System Design �'�6y) Date Installed Length of Field 33r •h uiG - 3(0 Width of Pield 31, Depth of Field Gravel Bed Thickness r t 4fi6 Square Feet of Absortion Area %r0 Statndpipes Presentl&l N) Depression over Field (Y0 Date of Last Adequacy Test 10-62F7 LDS °,P161,J-4Z 7RE)e9 Results of Last Adequacy Test A,,MaATE fid Z•8 ADChl 4-• SEPARATION DISTANCE FROM ABSORPTION FIELD: 1 i To Water -Supply Well To Property Line To Building Foundation �� To Existing or Abandoned System on Lot 18 r BET�� 7Z�/tr�J ; On Adjoining Lots 70 •f` To Water Main/Service Line �Gr'J To Cutback (if present) AYE r To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. "Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, v rified, or conformed to all MOA and HAA guidelines in effect on Inspection. —�W4&1L1 Signed t- OF�i CompanyCS i�Q.•'•• Date -949 %* 4 T" MOA No. OZ Receipt No. a oZ� �SS Date of Payment OL Amount: $ O the date of this Y G REID, JR:(r/` �•, CE -2251 ter ll+ p • •u•••• �C�r Receipt No. , %professlo�3;% ♦zs Waiver Fee: $ Date of Payment 72-M (R". TIM) Back Page 2 of 2 S. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS C n Jc STREET LOCATIO TIME TIME TIME i DATE DATE DATE- E3 3 - --INSPECTOR INSPECTOR INSPECTOR INSPECTOR �R1aTC ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SU�PPLY MUNICIPALITY OF ANCHORAGE *ATTACH WELL LOG. A well log is required for all wells drilled DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT14WNICIPALITY OF ANCHORAGE 826 L Street - Anchorage, Alaska 89601 DEPT. OF HEALTH & since June 1975. For wells drilled prior to that date, give well ENVIRONMENTAL KOTECTION ENVIRONMENTAL SANITATION DIVISION 1981 Telephone 264.4720 MAR 3 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWERTIE'EIM. D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. es1OyERTYOWNER ^ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. PHONE `J` L S MAILING ADDRESS S+12+ PROPERTY RESIDENT (If different IUabove) PHONE 2. BUYER PHONE Nwkvo V 72— 77 MAILING ADDRESS W, i w �� r ✓1,J (1-t?,4�e L, 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS as C)CI A 4�. (r) 9s v S. LEGAL DESCRIPTION C n Jc STREET LOCATIO << <e i 6. TYPE OF RESIDEN E NUMBER OF,BEDROOMS G3�SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SU�PPLY INDIVIDUAL' *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM l 'INDIVIDUAL/ON-SITE-4- 8 -- _YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72 010(Rev. 6/79) .–�%.�0'� �}�Or.b�{ ,J �'�'C'u j 72010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX ❑ OTHER 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMITNUMBER DEPTH OF WELL GATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑SepticTankor ❑Holding Tank Size: 1ZSZI If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL (\ _ 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE3 I 1341 BY�� 72010 (Rev. 6/79) LT,� flUA March 4, 1981 r 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 21;44111 GEORGr M. S'.)LLIVA?J, MAYOn rJUARTMENTOF IIFALT11 AND ENVIRO":.:ENTAL MOTECMN Roger J. Seidert Star Route A Box 1735I Anchorage, Alaska 99507 Subject: Lot 13 Block 7 Me Mahon Subdivision Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: 1) The water analysis report needs to be delivered to this office from the Chem Lab, 5633 B Street, for our review. (2) Locate and expose the standpipe to the seepage pit for our inspection. This is to insure the minimum distance requirements are met between your well and sewer system. Please call for a reinspection. �L3) An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. If there are any further questions, please call this office at 264-4720. Sincerely, C- Robert C. Pratt, R.S. Associate Specialist RCP/ljw ?'1 MUNICIPALITY OF ANCHORAGE MUNICIPALITY C' ANCHORAGE _ DEPARTMENT OF HEALTH Ill ENVIRONMENTAL PROTECTION DEPT. C. !.:'-:^!8, S25 L Street • A chorep, Make 59501 • f. ; Pa'-NG,lZNTAL F.-',XXTION ENVIRONMENTAL ENGINEERING DIVISION JUN 1 1979 Telephone 2644720 5. TYPE OF RESIDENCE p� �//^^ CC LL nn REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW�FLR0��1IIY ED DIRECTIONS: Complete all pans on page 1. Ineot to a" requab wilt not he preewetl. Plaw4flow ten (10) deal for ptocoWnS. 1. RTY OWNERPHONE J SO ❑ Two ❑ Five le ia R zt- ❑ Three ❑ Six 7. WATER SUPPLY MAILING ADDRESS et A Nll( ss >z E^t INDIVIDUAL' PROPERTY RESIDENT (If different from above) ❑ COMMUNITY PHONE 2. BUYER depth (attach log if available.) 2 PHONE leemp -y^no 0 MAILING ADDRESS give ,% ;21 L - AJ ' T- AVL If system is over two (2) years old an adequacy tW Is required 3. LENDING T T—UVON by this Department. PHONE ae Mor 7 .ns 3 - MAI LING AODRE33 a� C 51- R OR AGENT 5f PHONE �t -tea a-rryr ]R MAILING ADDRESS L S. LEGAL DESCRIPTION -1 S-+ o 3 C M44Pa ie STREELOCATION K", U -t -.4C -TA - 5. TYPE OF RESIDENCE NUMBER la' SINGLE FAMILY ❑ One 12- Four ❑ Other ❑ Two ❑ Five ❑ 'MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY E^t INDIVIDUAL' 'ATTACH WELL LOG. Awell log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 2 S. SEWAGE DISPOSAL SYSTEM "If individual/on-site, installation date - +-' [Fr INDIVIDUAL/ON-SITE" give ,% If system is over two (2) years old an adequacy tW Is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72U1013/7S1 S� 1 72-010 (Rev. 3178) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE Cl THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER SOILS RATING it ❑SepticTankor [:]HoldingTank Size: IaS"o If Tank is homemade give dimensions: TYPE OFTANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 7 4. DISTANCES WELL TO: SWIG/ (ding Tank Absorpb n A a Line ren a Lina Absorption Area to nearest Lot Line 5. COMMENTS m- APPROVED FOR _- BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE I q BY Title) LEGAL DESCRIPTION 72-010 (Rev. 3178)