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HomeMy WebLinkAboutJUHNKE LT 2Jahnke Lot 2 #051-171-34 , Mumc~pahty of Anchorage Page / of ~', DEPARTMENT OF HEALTH AND HUMAN SERVICES ' ENVIRONMENTAL SERVICES DIVISION P O Box 196650 · Anchorage, Alaska 99519-6650 · Telephone 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number ~/' ~(~' ~/~ Z- PID Number ~5/~/~/ Name Wastewater System: ~ New ~Upgrade Ho.~oy~g3 ~prx~A& ~7o5 ABSORPTION FIELD ~h ~' 5J~ ~ ~ Deep Trench ~ShallowTrench ~Bed ~Mound ~Other Total Depth from original grade LEGAL DESCRIPTION so,,.=~,.~ ~.~ ~.~s..~ Lot Block Submv~on Depth to p~pe bosom from original grade Gravel depth beneath p~pe ~ Gravel w~dth Number o~mes D~sanc~n WELL: ~ New ~/ST C Upgrade/ ~ Ft Ft Cla~d~cat~on (Private A,B,C) Total Dep~ ~o ~Total absorption area P~pe material Driller ~ Date Dr,lied Stat,c Water Level Installer Date,ns~l~ ~ Yield/ Pump Set at J Casing Height Above G~ound TAN K ~pB FtJ Ft SEPARATION DISTANCES ~pt,c ' ~ Holding ~ S T E P From Tank F,eld Stat,on Tank ~wer Lines ~ ~ ( su,=ce ' W/~ LIFT STATION Lot ~0 ~O s,z. ,. ga,.o.s J Manueacturer Line Foundat,on j~' ,,0 ~,/~ Pumpon leveiat ~,at ' IH,ghwateralarmat Drmn Remarks ~/~ ~ I ~ ~,.~ ~x BENCH MARK Location and Descnpbon J A~um~ Elevatmn Inspections pedormed by ~Z Dates 1st 0~/0~/~(~ ~""~~'"~" Depa~ment of Heal m ap ..... , ~* ,,-, 72-013 (Rev 9/91) MOA 25 Page 2 of 2 Mun~c~pol~ty of Anchoroge DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION PO Box 196650 · Anchor(]ge, Alask(~ 99519-6650 · Telephone 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Descnpton JUHNKE LOT 2 to' uum~ ~ 1000 150' Z JUHNKE DRIVE ELEVATIONS (NOT TO SCALE) Claes C WeLl/ D Mu, · - MONITOR TUBE q - SEWER CLEANOUT ~% - WELL -- - LEACHFIELD EASEMENT NO STREAMS +100' NO KNOWN CURTAIN DRAINS SCALE 1"=60' 8/13/96 ENGINEER'8 SEAL' ~=? ~- A.7~ ,~. ~ou~s ~ ~u~,~. ~, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960192 DESIGN ENGINEER'EAGLE RIVER ENGINEERING SERVICES OWNER NAME:BONFOEY BYRL D & JOYCE E OWNER ADDRESS:19911 JUHNKE DR CHUGIAK, ALASKA 99567 DATE ISSUED: 7/12/96 EXPIRATION DATE- 7/12/97 PARCEL ID:05117134 LEGAL DESCRIPTION: JUHNKE LT 2 LOT SIZE: 37596 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 4 o 5 o THE ATTACHED APPROVED DESIGN. 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 (18AACS0) . THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE. Eagle River Engineering Services Lores Butera, P E P o Box 773294 (907) 694-5195 t¢I Eagle R~ver, AK 99577-3294 (907) 694-3297 June 27, 1996 J~m Cross, P E Manager, On-S~te Servaces Mumc~pahty of Anchorage P O Box 196650 Anchorage, AK 99519 Re Juhnke Lot 2 Narrauve & Permat Apphcat~on Dear Mr Cross The proposed septac system upgrade will have very hmated ~mpact on adjacent propemes for the following reasons 1 The surrounding lots are large, allowang sufficaent room for septac s~tes 2 Immediate ne~ghbonng septac systems are all +30' dastance 3 Reserve space as adequate, due to absorptaon capamty 4 Drmnage wall not be affected and as not a major cons~derataon an our desagn If you have any questions please call our office at 694-5195 Sincerely, Lores Butera, P E \1996\90-080^-NA~ DOC SPECIFICATIONS FOR ON-SITE SYSTEM LEGAL: Junhke Lot 2 June 27, 1996 Ae 1 2 3 4 5 6 7 8 9 B. 1 2 C. 1 2 3 4 5 6 7 8 9 GENERAL The septic plan is for a single famdy residence only The drawing and/or site plan shall be a part ofth~s specification All materials and workmanship shall meet the Anchorage Department of Health (MOA- DHHS) reqmrements All soil tests are advisory to the design and are to verified or modified in the field by the Engineer All excavations and depths are advisory and are to be verified in the field by the Contractor to meet MOA-DHHS reqmrements It is the responsibility of the Owner to obtain all necessary permits or easements and to locate any adjacent multl-famdy wells It ~s the responsibility of the Contractor to secure all utility locates prior to construction The excavation is to be exactly m the area shown on the site plan, any deviation requires Engineer approval It is always recommended that a surveyor locate the nearest lot line position and the location of any easements SEPTIC TANK The ex~stmg septic tank shall be pumped and then either crushed and buried, or removed and properly disposed of off-site The replacement tank shall be located as shown on the site plan The new tank shall be 1,000 gallon mmtmum MOA approved septic tank LEACHFIELD The existing leachplt shall be pumped, crushed and filled The leachfield ~s to follow the natural contour to mmntmn uniform total depth of the trench bottom The bottom of the leachfield shall be level, plus or minus 1 5" The total depth of the leachfield excavation ~s not to exceed 6' at any point The sewer line is to replace the existing sewer line that leads to the existing leaching system The effluent line in the trench shall be lind level w~th~n 0 03' The leach gravel is to be covered with typar fabric material Soil or comb~nation of sod and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield The area over the trench is to be finish graded to prevent pondlng of surface water runoff The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200~ to any community well RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH = 6' GRAVEL DEPTH = 3' under pipe, 2" over pipe GRAVEL LENGTH = 66' GRAVEL WIDTH = 5' SOIL RATING = 0 8 gpd/ft2 BEDROOM CAPACITY = 3 SEPTIC TANK SIZE = 1,000 gallons minimum Twenty-four (24) hours notice required for all inspections \1996\90-080a-spc doc 06/26/96 S 89 49'38" E 1:~5 00' [ 10' Utility Easement I REMOVE AND [ ~o~ WITH NEW 1( 00 GAL TANK 150'~ ] I abandon ~ Neighbor's ~] as per recor~~ Well +100' ~ ~ ~ Seepaie p~t ~ Same Eleva~on [ ~ ~ Nmghbor's septic leach ~ +30' I ~A I - ~ ~ - TEST HOLE · - MONITOR TUBE o - SEWER CLEANOUT JUHNKE DRIVE + - W~LL ~0 SX~ga~S +~00' ~ovos[o NO KNOWN CURTAIN DRAINS EASEMENT S E P TI C S ~T E P LA N .-'I~~- OWNER: Bonfoe~ Bo~d ~:~9TH~~/~' -"- '"~'~ C0Nm~Acm0~: N/, ". *'" .... 3os ~ ~o-oao/DA,[: o/~o/oc I SCA~E ~" = S0' ..~..- ............... A EAGLE RIVER ENGINEERING SERVICES '~¢. P 0 Box 773294 EAGLE RIVER, AK 99577 (907) 694-5~95 FAX (907) 694-3297 EAGLE RIVER ENGINEERING SERVICES P O Box 773294 Eagle R~ver, Alaska 99577 (907) 694-5195 ERES Project No 90-080 Calculated By LB Date 6/21/96 Legal JUHNKE LOT 2 Single Fam,ly 3 Bedroom Dwelling TEST HOLE 1 Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons ~ Percolation rate = 14 5 m~nutes per ~nch Wastewater apphcat~on rate = 0 8 gallons per day per square foot Reqmred absorption area = 563 square feet Trench w~dth (W) = 5 feet Gravel depth (D) = 3 feet Required length = Shallow trench factor * Reqmred absorpbon area / W Shallow trench factor = (W + 2) / (W + 1 +2 D) Shallow trench factor = 0 58 Total Excavation Depth = 6 0 feet Reqmred length = 66 feet SINGLE FAMILY ON-SITE WORKSHEET ERES PROJECT NUMBER 90-080 LEGAL DESCRIPTION JUHNKE LOT 2 NUMBER OF BEDROOMS 3 WATER USE PER BEDROOM 150 PERCOLATION RATE 145 DEPTH TO GROUNDWATER 12 DEPTH TO IMPERMEABLE LAYER 12 ANTICIPATED DEPTH OF COVER 3 MOUND OR BED SYSTEM CALCULATED BY LB WASTEWATER APPLICATION RATE ABSORPTION AREA REQUIREMENT MINIMUM BED LENGTH t2 FEET WIDE BED 15 FEET WIDE BED TRENCH SYSTEM WASTEWATER APPLICATION RATE ABSORPTION AREA REQUIREMENT SHALLOW TRENCH OPTIONS 5 FEET WIDE TRENCH GALLONS MINUTES PER INCH FEET FEET USABLE SOIL STRATA FEET TOTAL USABLE DEPTH USABLE SOIL STRATA DEPTH 0 5 GAL/SQ FT 900 SQ FT 75 FEET 60 FEET 0 8 GAUSQ FT 562 5 SQ FT DEEP TRENCH OPTIONS 3 FEET WIDE TRENCH EFFECTIVE REQUIRED TRENCH EFFECTIVE REQUIRED TRENCH DEPTH (FT) ENGTH (FT) DEPTH (FT) ENGTH (FT) 1 98 4 NA 2 79 4 5 NA 2 5 72 5 NA 3 66 5 5 NA 3 5 NA 6 NA 4 NA 7 NA 8 NA 9 NA DESIGN SPECIFICS FIELD SYSTEM S GRAVEL DEPTH 3 TRENCH OR BED WIDTH 5 LENGTH TOTAL EXCAVATION DEPTH 6 0 FEET (B=BED, S=SHALLOWTRENCH & D=DEEP TRENCH) FEET FEET FEET Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR DATE PERFORMED LEGAL DESCRIPTION 6 7 8 9 10 11 12 13 ?"~ P$o/ Township, Range, Section SITE PLAN ill SLOPE WAS GROUND WATER ENCOUNTERED~ IF YES ATWHAT Deplh to Water Alter Monitoring? D~Y Date Gross Net Depth to Net Reading Date T~me T~me Water Drop ~ ~ 9 ~5~ ,So ~ /~/1~" - /~,/? '~ (~ x/tb" ~ ~ lO/Z?.~oI~ /~1/~" I~//~" 14 15 16 17 18- 19- 20- PERCOLATION RATE /~/J ~ tmmuteshnch) PERC HOLE DIAMETER ~,~ /! TEST RUN BETWEEN '~ FT AND 5 FT COMMENTS PERFORMED BY~~-- ""~'--'- ""- '~'~' -- , /~.¢--F----..g¢~.~,~ CERT,F, THAT TH,S TEST WAS PERFORMED ,N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE <5"-- ~ ~'-- ~' ¢ 72-008 (Rev 4/85) Tom Fink Mayor unicip l t of nchora ¢ Department of Health and Human Services 825 "L" Street P O Box 196650 Anchorage, Alaska 99519-6650 January 8, 1991 Boyd Bonfoey PO Box 1149 Fairbanks, Alaska 99707 Subject: Lot 2 Juhnke Subdivision Permit #900233, PID #051-171-34 The subject permit, issued by this office for a single family well and/or on-site wastewater system has expired as of December 31, 1990. A new permit must be obtained from this office for a well and/or on-site wastewater system not installed by the expzratzon date. If you have drzlled the well, a well log needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the lnstallatzon of the on-site wastewater system, the origznal as-built Inspection report (three-part form) must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permzt, the fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-s~te wastewater and well permit. If you have any quest;ons Si~'ler~''/ ~ , please call this offzce at 343-4744. JW/1]m:200 enc: Copy of Permit "K~ds Are Our Future" 0 N !~ I t ~ S E W 1 I r",¢m ~'t Nurnl:::,c~r' ,I ':~()()~ ~ '". LJt::iqrad'[~ ['hate ts%uc',d,~ (')H/C)9 /gt) t r'w.'.J~e("P Pes~ kjr'i(::~d O~/,~r"~c'r' Namo: !3C)V'(} B[ff',ll O1 Y LIW, I(..'.H" AcldPe"'~¢5~ l"() I"¢ilX J (] ] I ~'t3 A Iq k S ,, f'~l,,. 9 '9; 0 ? [:)ay Par(e] ld,i (>UI Sr, c t Lc:n~: 18 ro~H'~%hJl'.:)~ LW t<anqe~ 15N t i:)l S ~,:'c' 3/t,96 (~:.,q,, t I' ,, of ac r("~s) [:~l I'"I [(, l(]Nt'..i~ M lllm~u'n t,Hul sc, pi t~ ~ anl.. m~u~:.~ havc~ a~ Ioa,A d compar Cmmn~ ,~,, Dep L h I' o ~ c,p of s~.'~p L~ ~ 'k~r'tk is) llq'31Fd I [Jf"t.)RA[)I D SI t. I I[.5 SY%I~It F'LR [NL~IN[kRS HO ! 11 ~ DHHS I'l..<llil< i(.J FAEII I N~F:'I:I,T tON, TI-ItS PEId¥11 I [S ] SSIII. D rub' fi.Il. I XJSI INL) t }31 DRtKJN SINE:ii [ I AMiLY DNEI LiNG IINI. Y,, ANO LXI [I.<1 {~ [}Ixl OI I:LI'flDt I..~ ',1, 19'¢O, I Ci I,:llFY ItlAI," 't, ftlr 1' h by 't !"t¢, l"lllr'~ i c..Lpa] .~ t y of Ar'ir hc~rage (I"I[:)(..'~) ,~:',.~lIJ t he, Si ate, of (',J I ~,,,~.~] t ~nnl:al t iht, ~,ys~em ~l~ ac( or, dance ,/,~z'th a.t L M{:}A codc,~ ami ar~,:::l 1ri ('"t:.')mpl Idd"l('"'('.'''* ~.,'.:~ .~h Cl"u:, qlL-'~.iqr! t:.r'J'~er'l,a of i1'1t':5 ] w~ 1J atlher',`..~ ti::) a] J ldO(] arid !.it<lie" Df (]Ja,:.l,,.:,. r,e, qu.Lr'em,y',nl: .... ~tgr Lhc se.'t ball. .:"J l%1 ,;:).l']t C'u~'~ J r"ofll <:.,'dl~/ .~-.,%': J %'J ;I flCJ ~AJ(:::' ] [ ~ W.;4'-~.t et,~at~',l" d 'J %[,~Q~,5.L I %¥,":5~' c'.m C:)l" [,)LTD t J f ,::~ 1 '.:.,o undc, rs, t at'mi L hal f t-'~e calh::~( '~ t y at f he t i..lt t t sysl:lmm I ,, 5 b~=dr'c~(::~m', ar'at -w'W cm [,.]r,c;j(:::,n'iarFt wi t J r,c_,qulrr~, ~'2f] a/i:JdI J' 1c)l"h.4J jDC~PmJ ~' , rt.-., _ I /~sf j ---~' /_ Abandon/tank ~ J/" ]lno~nOgt ~Pap~ r aal°io[on~n?Ra'-I° aC~ t ~1' I f Claes C Well Neighbors :~[ I abandon Well +100' ~, ~1 ~page pR ~ I ] ~ eepUc I~ch ] 3' +30' · - MON~OR TUBE o - S~R JUHNKE DRIVE NO KNOWN CURTNN D~INS ~EME~ SEPTIC SITE PLAN CONTRACTOR: N/A JOB ~ 90-080~ DATE: 08/06/90J SCALE 1" = 50' I yvs~ ----1 ~ Abondo ' ~ necessa~ or cross at 9' Neighbod, ~ ~) , , ' obandon ~ Well +100' ~, ~ ~ Seepoge mepflc le~ch 3' - +30' , E · - UONFOR TUBE o - S~ER CL~O~ JUHNKE DRIVE + - w~ NO KNOWN CURTAIN D~INS ~SEME~ S E PT i C S ! TE P LA N LEGAL: Lot 2 Juhnke Subdv. -~-.., -.,,~L OWNER: Bonfoey Boyd JoB ¢ 90-0801 PATE: 08/06/901 SCALE 1" = S0' ~-.,,'~ .... ~'"'r;~ EAGLE RIVER ENGINEERING SERVICES EAGLE RIVER, A~ 99577 (907) 694-5~95 FAX: (907) 694-3297 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST TEST SLOPE SITE PLAN 1 2 3 4 7- 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER S ENCOUNTERED? /~/0 L o IF YES, AT WHAT 7 ~'~/,'~ y~ DEPTH? Gross Net Depth to Net Reading Date T~me Time Water Drop ~o^~4 '~/~/~ ~ 'lC oD ' io, O1 O0 ~ PERCOLATION RATE TEST RUN BETWEEN · / ~/$' {m~nutes/mch) , FT AND ~ FT PERFORMED BY 72-008 (6/79) Eagle River Engineering Services Eagle Rive~ AK 99577 694.5195 CERTIFIED BY DATE SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL= LOT 2, Juhnke GENE£4L 1 2 3 The well and septic plan are for a sangle famaly resadence only. The drawing and or s~te plan shall be a part of this specafacataon All materials and workmanshap shall meet the Anchorage Department of Health and State Department of Environmental Conservataon requirements. 4 All soal tests are advasory to the design and are to be veraf~ed or modified an the faeld by the engineer. 5 All excavations and depths are advisory and are to be verifted or mod~faed in the fteld by the contractor to meet Munucapal~ty ~f Anchorage, Department of Environmental Conservatuon requirements. 6. It us the responsibalaty of the owner to obtaun all necessary permits or easements. ? The excavation as to be exactly tn the area shown on the ~*~te plan any deviation requures e,aganeer approval E/ED 5 6. ?. 8 Tke bed ts to follow tho -atural land c ,*~cu,* to .~ qftl,n uP]form total depth of the bed bottom The bottom of the bed shall be level, plus or manus 1 5" The total depth of the bed excavataon is not to exceed 4 ' at any point The sewer line as to repUace the extsttng sewer lane that leads to the exastang pat Exastqng septac tank to be abandone¢ to code. The bed grave] ts to be covered wuth typar fabric material. Sotl or combinatuon of soul and extruded board insulation to a depth of 4' or equqvalent as to be pUaced over the leachfield The area ove~ the bed qs to be f~nash graded to prevent pondtng of surface water runoff The septtc tank and leachfle]d must not bo clo~er than 100' to any exqstang pruvate well, ~50' to any Class "C" well, or 230 feet to any communaty well RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH = 4' GRAVEL DEPTH = 6" BED LENGTH = 35.5' BED WIDTH = 24' Sca] Ratang = 188 Bedroom Capactty= 3 Septac Tank Saze = 1000 gallon · ~NOTE INSTALL NEW SEPTIC TANK IN LOCATION SHOWN. m~NOTE ~BANDON 2 TANKS AND PIT TO CODE REGULATIONS · ~NOTE- LOCATE AND VERIFY WATER LINE SEmARATION ~EETS CODE REGULATIONS $RE~.~ANCHORAGE AREA Department of Enwronmental ~uahty 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME SEPTIC TANK DISTANCE FROM WELl UL'~ ~0 2. INSIDE LENGTH MAILING ADDRESS. PHONE LEGAL DESCRIPTION ~)~ INSIDE WIDTH LIQUID DEPTH ST NUMBER OF ~-- e f~- COMPARTMENTS I LIQUID CAPACITY /000 GALLONS SEEPAGE Pit NUMBER OF PITS ~ LINING MATERIAL DIAMETER (~"~ bt~'~R,. S,ZE ... OR WIDTH i~r-; LENGTH/~'1, DEPTH DIAMETER bO DEPTH ~:~f DISTANCE FROM TOTAL EFFECTIVE WELL BUILDING FOUNDATION~-f~ , NEAREST LOT LINE__ ABSORPTION AREA (WALL AREA) .?~)0 SQ FT ADDITIONAL ABSORPTION WELL BUILDING FOUNDATION -- CESSPOOl APPROVED. CONSTRUCTION NEAREST , LOT LINE , OTHER SOURCES DISAPPROVED ~0'TOJ4~Q ~d DEPTH DISTANCE FROM NEAREST SEPTIC ~) ~/~¢ SEEPAGE SEWER LINE TANK ~-~'~' , SYSTEM ~'00~ REMARKS DISTANCES INSTALLED BY PIPE MATERIAL LOT SLOPE REMARKS Form No EQ-O31 DIAGRAM Of SYSTEM , , ,,'"),~ ...~ APPROV E,~./r'~ DATE ~/~//73 ~GAAB Municipality of Anchorage Development Services Department Building Safety Division -/ On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 k 4 , s s• {}♦ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D._Cl, COSA # l✓ OM $- 1. GENERAL INFORMATION Expiration Date: 7— L 0— e) Q Complete legal description Lot 2; Juhnke Subdivision Location (site address) 19q I I Juhnke Dr. Chugiak, AK 99567 Current Property owner(s) BYrI d Joyce Sonfoey Day phone 907466-7262 Mailing address Lending agency Day phone Mailing address Real Estate Agent Greafland Realty Day phone 694-9125 Mailing Address 11411 Old Glenn Hwy. Eagle River, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: l 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class C Well ❑✓ Community On-site ❑ Public Water System , ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown b Guidelines for this that my application, based on procedures outlined in the Certificate of Onsite Systems Approval shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S Engineering Address 15861 s. Birchwood Looi Engineer's Printed Name 5. DSD SIGNATURE Approved for 3 bedrooms. _ 1� Phone !t22 2 Dal Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ' Original Certificate Date: —� Q—/ 8 (Rev 17105) Municipality of Anchorage °•, Development Services Department � �• `: Building Safety Division _ — On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: t✓ C7f i J UttiUl Parcel ID: Dom' —/7/— -3 �1 A. WELL DATA Well typd(ass .0 „ If A, B, or C provide PWSID # Well Log (Y/N) Date completed _ Sanitary seat (Y/N) _ Wires properly protected syv;��f Total depth ft. Cased to ft. Casing heigWabove ground) in. FROM WELL LOG �wcaG'eTinu Date of test Static water level ft. Weld ctieltf on g.p.m WATER SAMPLE RESULTS: Coliform d colonies/100 mL Nitrate 047 mg1L Arsenic: 0 ug/L date of sample Lys B. SEPTIC/HOLDING TANK DATA ft. 9.p -m. Other bacteriay colonies/100 mL Collected by: S4 -S fayoev,Fa2t& r Tank Type/MaterialDate installed `�'i Tank size '/� gal. Number of Compartments Cleanout _ Y Foundation cleano 9.115 G5 De .ression over tank 'Ys N�.Highwateralarm f- Pumper o f�L9rNT'LKX„ C. ABSORPTION FI LD DATA Date installed I y %Soil rating g.p.d.lft ftZ/bdrm) �e g System type Length _ ft. Width 5 ft. Gravel below pipe 3 ft. Total depth oft. Eff. absorption area 50t2 Monitoring tube it;.$ Depression over field �a Date of adequacy test Result(Pa s/Fail) For bedrooms Fluid depth in absorption field before test in. Water addedjo gal. New depth Elapsed Time: V min. Final fluid depth in. Absorption rate >= ©-t- g.p.d. Any rejuvenation treatment (past 12 mo.) r type) _ Lc) If yes, give date ^ D. LIFT STATION IJ'C Date installed Size in gallons 'Pump on' level at _ in. 'Pump otf Datum -ycles tested Manhole/Access water alarm level at in. Meets alarm 8 circuit requirements? E. SEPARATION DISTANCES C eh C" C'er J 1 fit✓ S/� SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main On adjacent adjacent lots Public sewer manhole/cleanout Sewer /septic servi a Holding tank areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: I r r Absorption field S � Building foundation S '� Property line 5 "F / tion P Water main /} Water service line /D f Surface water �QD f Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property tine �D Building foundation Water main �� / r!D 4- Water Service line �� Surface water %� Driveway, parkinglvehicle storage Curtain drain iJ0V6 W'00wells on adjacent lots /� t F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determir review of Municipal records conformance with MOA COST Engineers Printed Date COSA Fee $ Date of Payment! Receipt Number D55asb (Rev. 11105) h field inspections and above sysle(rls areA Waiver Fee $ Date of Payment Receipt Number k. shot. 1457.1 Sw SCS ReEM 1081141001 Client Name S & S Engineering Project NameIN Lot 2 Juhnke SD Client Sample 11) Lot 2 Juhnke SD hlatrix Drinking Water PIVSID 0 Smnple All Dales/r6nes are Alaska Standard Time Printed Dale/rine 04/092008 10:35 Collected Dale/rime 03202008 12:15 Received Dale/rine 03202008 15:10 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PVI. Units Medved Container ll) Limits Date IMIe Inil Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) Waters Department Total Nivate/Nitritc-N 0.486 0.100 mg/L SM204500NO3-1: D (<10) Microbiology Laboratory Colony Count 0 col/100nd- SN1209222B A (<200) Total Culironn 0 col/100nd. S11,12092221) A (<I) Fecal Coliform 0 col/100nd. SM209222D A (<I) 0325/08 04/04/08 NRII 04/02/08 l.Cp 0320/08 DLC 0320/08 DLC 0320/08 DLC vlLvu"at uls rtes FAX No. Y I r Y UUL/UUt ari tf-Nl trF Irl{Qyl, i'4rli,�,Af i''�I)LF f ty. • f.., t i rift 7•I 5'.r 17 I 17.• FII 'i.JQ�I , w a - iy) r M.1 5 1 £V' f!. h..! J• R;ur •rY -. a.r,T-• tt/,�+ =i4, a a'I14t ,•r r4rh �I 1, }. a.. t , 77, 16 3 s r• ,s s , ''. t � IQs � iJr tr•�1 r � ♦' a , : £ , , d i t i a t •. J ; , i i t` j L( t [ �e• n.et r :. - f � fisc �e �"' C n.i).A Vit. . , ... t•I I , 1 I]J ! I .may * -.• ,` a ` AS BUILT' , lfl9-t! , TcsN � a p su i • �ebyre�Jy l]t�t 1 Neyed the roUdwutg gescdbea ,° '. `�.. 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