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ARANT LT 2
Arant Lot 2 #015-163-72 Municipality of Anchorage ",� •. Development Services Department - Building Safety Division - On•Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5 L4/ OI O Z 70 PID Number. N•""— John lit Sand O' l3r:in Wastewater System: []New ® Upgrade "°° " 11 501 Snow f rn� Drr•.t ABSORPTION FIELD P -a . 6 2 - G9 y 9 N~ a e.a-a-. IlDw T ane o snMw Tr«w Dew O Mar" 00~ DESCRIPTION sw RabV I.2 Ta. Depth "m aw"M, b.. 7. LEGAL Gpotre Baa ta: SuDJtm.bt DepO+n Pw Oman ft- WWW ate•: 2.0 Grave O.pm br".m PPC S: O 2 ^ J F,. F, Tpwap Ranp1' S«aa" Fi aaJ1e mow aq Papa: r. o Gww L••Cft YU F,. F,. Well: ❑ New ❑ Upgrade Grave «ah 2.S M«e« a r..: I D•.a-�. f.rr..-r.,.. - F,. EXrSr F,. cw.afa 1Pm1110. P. e. cY TOW DOME Da.IC a: Taar aPaaO•ar «ate /,/ F,r Pp I- ?$"'064Z SC�?Gr Yo 10v FI A I00 D.+« Da,1 DN*d Swr"Wnr laws OmaMr. [[ �rll Earccrvorin Dnafwalla0: 87 10( Fl P"SMK cau"".a"u""Gaav TANK GPM FI. FL SEPARATION DISTANCES ❑ septic ❑ Holding ®S.T.E.P. ❑ Other. To Septic Absorption Lift Holding PubliciPrivate SewerLlne AnehorQ %Zink GrYnro Cw rf lSGbeM From Tank Field Station Tank 13y' - >Zsr, M•11-•1' Seel N.n"ar a 2 ww Isy' 170' LIFT STATION S.-raa wa,.r >I &0 1 > rc• > loo' — M.nJaa•-« W L.w 70' I S' 70' - ,rn k •'� r Gr. O rYn to 'Pump At IavM M. 'Pin" prr N•11 «'. Nprl vwl« Y«m al Fou"«an y I t�-• 79 r 6/.i' •' 2 2 i., (E1 M. is in. P rro MW t Moan EWW" h.p« pwicr-ed Or C,na., Dan - - - - OS f '/L l+ M.O• A R.'•"", O r tee.( hi n k eL b a n cion ! 1. BENCH MARK t ac Ilr 14 nl.( 'Tvcnr-ee/ Foo ne cc,,-Pe,-cc,,-Pe,cc,,-Pe,- 0= ccncrrit wA.r . 0,1C4 ✓Prr 7eVVCArr o ow^• no(aftun .a rtoca/ inr,d r,rfrlrr�rc nor -em e_Peelc r o. -t /e"O FL 6" rtyr a&7 A(uctc! to ee STEP tun ACTe -C N.z' Sot/ covin o•Knktnk Lq KMp Con ern Q c.rn ox mown atn e- a leercr nic.n Engineer's Stamp roer rw. to Gl. (F.!•ee:/ on Sh.ef 2. ?nab olve%e+ /rn �.,orutnnOp7C tns/-a(eat TTho frihic to erllaw re S ,)'cA , t�e,r elm rt rna/ Item es>< olrJCr'K 10/ ,CfOeu er 6.rfi4ia`C�. w«4o t Inspections performed by: Flafftin Ted. C"c Dates: 1" 81710I'`' :1�F i1TH''> ,Y t4�-•-�'`� h1 2ne'rT Development Services Department Approval p p PP • • IM :"•"'• . THE�DOrr, F. gOCRE j I O C /�• Date: -2 3- "`.�� C:.3539 Reviewed and approved by: ./ 1� ra.. r.ml ,•,,. . a}�tiw=. PERMIT NO: SWO10270 PAGE 2 OF 2 ------ ---------------- NEW 40' LONG SOIL ABS. TRENCH PID NO: 015-163-72`, r W. 5.0' GRAVEL BELOW DIST. PIPE. ; DIST PIPE HAS 3116" HOLES @ 18". H #1 DRAINAGE \ SWALE �\ (DRY) \ SWING TIES: FROM: COR. "A" COR. "B" COR. "C" TO: OF At 1114 C.O. "E" 24' 13' S.T. C.O. "F" 68' 47' 71' S.T. C.O. "G" 76.5' 57' 81' TR. M.T. "H" 105.5' 82' 102' TR. M.T.'T' 134.5' 115.5' 138' BED M.T. "J" 55' 28' 49.5' BED M.T. "K" 56.5' 27.5' 47' PVC PLAN VIEW SCALE: 1" = 30' STEP TANK TBM DECK 'E \ NEW C.O. 1.25" DIA SCHED 40 PVC LOT 2 ARANT SID ORIGINAL X —SOIL ABS. BED M X 1 I OF At 1114 .......... .. .....:. 2' SOIL COVER i'.:: .................. Q �2"RIGID INSULATION r"��;� T`"'^'"" •= '. THEODORE F. 6fOORE.• •a c CE -3589 -INV. 98.0' (--� �' ••.IGID L4.1' SOIL1.25'PVC 5.0' SEWER GRAVEL! ;' 1 V'r INS ; r^•V .. V,.. __ J1500 -GALLON 1.25" DIA J ;1500-GA INV. INV. BOTTOM TRENCH ELEV. 93.0' STEP TANK SCHED 40 927 92 8' PVC LOT 2, ARANT SID wake in SEPTIC SYSTEM UPGRADE T'. H. #t I AS -BUILT INSPECTION REPORT EI« bs s' PROFILE VIEW 7/fb/Of NOT TO SCALE FLATTOPTECFINICALSC•RVICES SCALE: AS NOTED 14530 ECIIO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 AUGUST, 2001 Rub 20 01 03:51p John L Sandy O'Brien 907-346-3936 p.l - 1 ix4 .onr.Zg INSPECTMNRF,P0fiT �''•'"' °''�'' "UNICIPALITY OF ANCHORAGE - BUILDING SAFETY DIVISION 4700 SOUTH DFACAW STREET, ANCIIORACE. ALASKA 'PEC MONS: Voice: (907) 343-8300 Fax: (907) 2430-7777 INFOR AL4770N.• (907) 343-8211 NAM A' ( ) W ;,R ... _ i'L'XM/T M/AfBCX: 01-8461 �oRsss: 11501 %NOW-j.(NF, r.)R D,111: 8/17/0) P110M 01: MOAT 1i7: lT. 2 BLOCK SUBDIi7SION. RAND !Ai4fF.h'/J" SEFI7C 562-69.19 PF. Of-, � 4 SPF.C770N.- Electrical 1 -mal i.0 nuu•t:uwpliuoce obsen W. (] !w nut cunwtl 0001 te-c!.p.xtcJ. c] C.-. ry,F:c��ed........ - _, ,_ ... Cortectionr evtj 611 n explained below (:J Will raexamne u next lnspettimr I_J � � J. oypn,rnl ;v�um!ents below. n NTDRS (9tom!waurl 141.11: - ��i�•1 L S�'S�EM f t..E.C.-r1Z�u�-i- 1=1►Jn�i_- I,,�'f`�� 192 __ �. - srrc7tu;: 1 f Np �l �, .�� .._.._..... DA. 1z:: 01 O .t...._.. Slom wafer Ircal ent pbmiq,-C. on .file. —_ C S1mmw Rer rc rmd imp1mitnted — •—_---_—_-- - -- SAvolYade J!ainago i.Vnut being Bunn uilal (} tnzvlbeol lett svaw baits. 1rm%lLmrreU silt kntcs. (.J Otter bem management prunwn on aire!needed See anache,t deviled notWmanjceioata 17 Faihlre to comply mov resift in t}ncs Ta':e achue nnw KcfmT=inn will br. mad: an: ��....__...—_ 1i71FNC0RRE n0NSARF. bfADF.; PLEARECACI• FY)R IN.SPF.'C770N 0970 DO NOT PE.1101 • ' 7.I1S .'Y077C g/7 MUNICIPALITY OF ANCHORAGE �/-7 SFlvl Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 27, 2001 Expiration Date: Jul 27, 2002 Permit Number: SWO102TO Parcel ID: 015-163-72 Legal Description: ARANT LT 2 Design Engineer: 0019 Flattop Technical Services Site Address: Owner Name: John & Sandy O'Brien Lot Size: 52227 SQ. FT. Owner Address: 11501 Snowline Dr. Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE . AK 99516-1185 This permit is for the construction of: ✓: Disposal Field [�—j Septic Tank Holding Tank ❑ Privy El 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. Received By: '�""� Date: 7./ 2- 7 / 0 Issued By: 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.a nchorage.ak.us (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. o i' Permit Number SW O/O 270 Property owners) %�/'Sa^o(yi Q��r^ Day phone S6 2. -679'/9 Mailing address (1) 1 f SG / Cnow /�^• ��' Mailing address (2) t}nctior c Zip Code 99s'/6 Legal description (Lot, Block & Sub'd.) Loa` 'ZArlen f SI.p Legal description (Section, Township & Range) Lot Size 52 aa -7 Acres/q.F Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 9 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: .415.20 Waiver Fees: Date of Payment: 7/ 0 / o/ Date of Payment: Receipt Number: Receipt Number: (Rev. 12100) CIM & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION 6 ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 3454355 July 19, 2001 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: 14530 ECHO ST. ANCHORAGE, ALASKA 99516 The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 2, Arant S/D, located at 11501 Snowline Drive. The original soil absorption bed is no longer able to accept wastewater at the rate generated in the residence, and the house now has 3 bedrooms. A soils log, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole 4 1. As can be seen from the soil log, the native material between 2.5 and 7 feet below ground level is sand with a measured perc rate of less than one minute per inch. A sandy gravel stratum, which will also perc at faster than one minute per inch, overlies this. Despite the rapid perc rate, no filter sand should be necessary, since the native material is predominantly sand. In my opinion the silt stratum encountered between 7 and 9 feet is not impermeable because moisture is able to travel through it into lower strata. Using the soil application rate of 1.2 gpd/square foot specified in the wastewater ordinance, this 3 -bedroom residence requires a total absorption area of (3x150)/1.2 = 375 square feet. The proposed 40 -foot long trench design with an effective gravel depth of 5.0 feet has a total absorption area of 400 square feet. The topography of the lot in the area of proposed construction slopes gently towards the west at approximately 5%. A STEP tank will be utilized to access the shallow, well -drained strata, and a secondary discharge from the STEP tank will be installed allowing the homeowner to switch the discharge back to the original bed, as desired, to enhance the longevity of the system. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space -surface and subsurface, or on drainage. A site for a similarly configured replacement system is designated on the site plan. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ix Ted Moore, P.E. LOT 2LOT 1, STONEVIEW S/D STONEVIEW S/D (SEPTIC 80' N OF P/L, WELL FURTHER) (VACANT) ----- ----------------------- ------------ LOT 1 ARANT S/D ; (VACANT) r--- T.----------------------------- •, SITE FOR SIM. ' #1 �REPL.TRENCH \ CONSTRUCT 40' INSTALL NEW SOIL ABS. TRENCH 1250 GALLON W. 5.0' GRAVEL STEP TANK ABANDON EXIST. 1000 GAL. --- SEPTIC TANK NSTALL DBL. C.O KLATT ROAD R.O.W. DRIVE _EXISTING SOIL ABS. BED „DRAINAGE' \ SWALE WELL LOT 2, ARANT SID LOT 13, CLEARVIEW S/D LOT 6, BLK 2 SUNNY S/D i i UNSUBDIVIDED LOT 1, BROWN S/D (NO WELL OR SEPTIC WITHIN 100') LOT 2, BROWN S/D (NO WELL OR SEPTIC WITHIN 100') ur Aj g iti. '. T:IEOnORf F. 1100RE : t CL -3559 •. .• iy 1250 GALLON STEP TANK ..A.. 40' LONG SOIL ABSORPTION TRENCH WITH 5.0' GRAVEL BELOW DIST. PIPE 40 --------- ;................................ 1.25" DIA. `M.T. � SCHED 40 1,25" DIA SCHED. 40 PVC M.T. PVC W. 3/16" DIA HOLES IN BOTTOM @ 18" SPACING TIE SECONDARY DISCHARGE LINE INTO 4" DIA PERF. PIPE IN ORIGINAL SOIL ABS. BED PLAN VIEW 4" DIA SCALE: 1" =10' D-3034 FROM HOUSE 2' SOIL COVER CROSS SECTION "A - A" SCALE: 1" = 5' f -MONITOR TUBE / OF At ORIGINAL GROUND ...:..................:...4 ��-FILTER FABRIC : T!i[^n0ec F. yOORE 7' RIGID INSULATION 4, f; •, CE - 3502 •' 1.25"DIA SCHED 40 PVC `�;T+-�.;'• •• '��`w W. 3/16" HOLES 0 18" + 12"-21R" SEWER GRAVEL BOTTOM OF EXCAVATION CROSS SECTION "A - A" SCALE: 1" = 5' FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 TEST HOLE # I SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: I ot2_&ant$A] DATE PERFORMED: ___.,[yty 10. 2Q01 PERFORMED FOR: John and Sandy O'Brien 0 SM Reddish sandy loam GP Reddish sandy gravel SP Black, coarse sand Loose, dry Becomes coarser w. depth ML Graysilt Dense, damp Not impermeable GP/GM Silty gravel Dense, cobbles ML Gray, gravelly sift Dense, Seeps B.H. SLOPE 5% Depth to Groundwater Date _See ps 15' Water 4. ' 1 /01 8ro 8 _06 50 273/8 142 —17-1/4 Resoak S7;5 28 IeSI �fad'LRQ� OF As'`�>r E G' K 'r 41 C TME;DC;E F. MOORE: A' CE - 3587 b',y�'J'r�'••,. wllAl/:.�t:?4� SITE PLAN ---------------------------- p i T.H. �Il #1 PROPERTY LINE 0 rn 0 O 0 ;.HOUSE ' 10°/ 10% 5% Date Reading Clock Time Net Time Percometer Net Drop (minutes) Reading (Inches) Q 12'TLesoak P.T. holed 8 _06 50 273/8 142 —17-1/4 Resoak S7;5 28 IeSI PERCOLATION RATE «1 (minutesAnch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 3.5 FTAND 4.0_ FT COMMENTS:�espResapidrrleaeured rc rate of «1 mintiinch. no sand tter should beLquired becausesati_vgLnaten is sand. Overlvino loose gravel GP stratum will perc even faster, can be used in trench sidewall at same application rate. PERFORMED BY FLATTOP TECHNICAL SERVICES. I�sX CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 71191,0t MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 264-4720 \\' ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE N NEW C-CR C04S.T0LICTZ0,J ❑UPGRADE MAILING ADDRESS 10II Amlveo- 24 Loo A IJGVi0z0.6E qr, 9q,5-oz LEGAL DESCRIPTION L-T 2 9K 4134dT 59b 1 Il V-31v SiFC24/ LOCATION r NO. OF BEDROOMS COfLId=p_ KLA-TT2D� 'St.1ow LsuE 2- Well r Absorptionarea Dwelling r PERMIT NO. O Y DISTANCE TO: q, L I• 1 8 _ I i Q Manufacturer A —RrJ Material S7cEL No. of Compartments W f. kleR � L to Li Ocgpasity' Jg ns oOCU/ IF HOMEMADE: Inside length Width Liquid depth _ d y DISTANCE TO: Well Dwelling PERMIT NO. -10Z O Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Wellr Foundation r Al Nearest lot line PERMIT NO. W = / Z of0157 J LL Z No. of lines Len th of each line Total length of lines �raaeM vwfltlt' Distance betwitn lines s FZw 3 a C H Top of tile to finish grade t (v•o Material beneath tile / Total effective absorption V4a O inches .29 /x(72. Length Width Depth PERMIT NO. A/4- 1- Type of crib Crib diameter Crib depth Total effective absorption area W aWell DISTANCE TO. ,_ Building foundation Nearest lot line Class -s DepthDriller — — Distance to lot line PERMIT NO. — — N W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) i — OTHER PIPE MATERIALS GI SOIL TEST RATING 95 gLlsz 3• ,� INSTALLER A 18 E%CAU473-01, Ex -SV-208 x , REMARKSTIT �•, N Ulu •lin •E4 St i�C nt / / Vier—n,4 Sc"IL,EJboPben=S S•.LtA PIJc. WAYV� Q- Fort sc-O'ricTaU✓.-WEL�s� F+s�rr.c-t 3 / Is h� TncbrJ � / Lf o '¢l / 0r Z7)>p!YTeP R • iZgrl 6d Crnl W04 d - " o r/(l APPROVED DATE LEGAL RAOT a4Ad64`f LT Z GKO h Sub q.'f 72-013 (Rev. 3178) MUM I C I PAL I TY OF= 9'2:bM4--H0F7AC3E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 MM—t3 I TE SEWEF4Z Le WELL F}EFRM I T PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: 840615 07/24/84 CCR CONSTRUCTION 3611 AMBER BAY LOOP ANCHORAGE, AK, 99502 345-2094 LEGAL DESCRIP: SUBDIVISION: (WILL BE L 2 ARANT) LOT: NA BLOCK.: NA SECTION: 24 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 2.5A (SQ.FT. OR ACRES) LOT LOCATION: SWI/4,SE1/4, SE1/49 NW1/4 MAX BEDROOMS: 2 Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. ** TANK: MUST HAVE AT LEAST TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 2 bedrooms and any enlargement will require an additional permit. IFA LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUTAN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK. MUST ,BE DOGE 4Y A LICENSED ELECTRICIAN. SIGNED I! /i% 2/ DATE: APPLICANT: CCF CONSTRUCTION ISSUED BY !I. , _ . _ — DATE: --------`------------------------------------- T EMC H:ED W - DFiA I" DEPTH TO PIPE BOTTOM (FT.) 6.0 6.0 6.0 GRAVEL DEPTH (FT.) 2. 0.5 2.0 TOTAL DEPTH (FT.) 6.5 8.0 GRAVEL WIDTH (FT.) 12.0 5.0 GRAVEL LENGTH (FT.) /.5 22.0 24.0 GRAVEL VOLUME (CU.YDS.) 9.7 11.1 TANI" SIZE (GALS) 1 * 10000.0 ** 1,000.0 ** SOIL RATING (SQ.FT./BR) 85 85 85 ** TANK: MUST HAVE AT LEAST TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 2 bedrooms and any enlargement will require an additional permit. IFA LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUTAN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK. MUST ,BE DOGE 4Y A LICENSED ELECTRICIAN. SIGNED I! /i% 2/ DATE: APPLICANT: CCF CONSTRUCTION ISSUED BY !I. , _ . _ — DATE: --------`------------------------------------- . n STATE OuF ALASKA BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAI. CONSERVATION SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 August 14, 1984 Ronald E. Godden Environmental Engineer Alaska Envrionmental Control Services, Inc. 1200 West 33rd Avenue, Suite B Anchorage, Alaska 99503 SUBJECT: Waiver Horizontal Separation between Well and Septic Tank, Lot 2, Arant S/D, Anchorage (8521 -WA -016) Dear Mr. Godden: 274-2533 The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 99.2 feet on the subject property for a two bedroom single familey residence only. Sincerely, le -8ruce E. Erickson District Engineer BEE/dd rAQ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION y, 825 L. Street. Anchorage, Alaska 99501 264.4720 SOILS LOG — PERCOLATION TEST SOILS LOG ❑ PERCOLATION TEST PERFORMED FOR: JOYCE Agog' --T DATE PERFORMED: -J"Y ZI "at/ V LEGAL DESCRIPTION: SW / 4 Z'f 7-/2-A/ Q 3 vv M SLOPE SITE PLAN (FEET) 1 ME 2 3- 4- SH 5- &r4 6- 7 8 9 Gut 10- 11 12 , 13 14- vs •i It 15 � ' ••'i .o 69TH ; 16 ..::..:...........� /.ee 066000. 00. 17 �:o' No 1814•E 18 '%Mtt MARCH 8.196-;0 19 20 COMME WAS GROUNDWATER ENCOUNTERED? IF YES, AT WHAT DEPTH? ND L O P E Reading Date Gross Time Net Time Depth to Water Net Drop .o r PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: poye, Sr*'+2G CERTIFIED BY: toVV IT�-121`' DATE: r'ZI'd 4L 4--S)I-A d MArv4--r(.ME"7- f&TzVi CeS 72-008 (6/79) n r—. ALAS._.. ENGINEERING & MANAGEMENT S. VICES 957 Westbury Drive • Ancborage, Alaska 99503 • PGone: 561-2332 Soil Test Date of Te t: April 51 1984 Parcel: SG",S_SEj4-SE M1% Section 241 T12N1 R3W11 SM Test locations: 1. west edge property 2. southwest corner east half of property Test method: 1. visual last summer and April 5th of cut slope 2. backhoe hole dug to 161 e� yz TF, . 1 Gn-ID 2640 t J II Q l .L v D o ? T M Ib� � t ! � 1 � zo ' ..»,e -s 4 Or At 1% }- w�ti_,.......f,I >,a ,r�A�••, A ARiN d,1d6E '4, 2 .5T6.vC:,V1C,W rve I V> R t3 CLC -A--2 V1[M/ Sid Management • Engineering • Surveying • Planning S 75 8 0 APR 3 01984 %3 c. z Ler f it VA/Y SvB r �1 /V SOILS LOG , MUNICIPALITY OF ANCHORAGE PERCOLATION .,,\ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST '� ' 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: .I t y G F A-1zI+N/T DATE PERFORMED: 'q 19,fc/ Cor I LEGAL D ESCR I PTION: f3 /K'4f.-r sye. Swl/.f S C 4 µ S t,,jlr. n/ w% SK• Zy', 7,11—N 23 M/sM 1 SLOPE SITE PLAN 1 2 3 4 5 6 aGw l/ U✓ 47 10 11 Date WASGROUNDWATER' "N 0 Net Time Depth to Water ENCOUNTERED? i 12 IF YES, AT WHAT DEPTH? 13 -� 14 15- 5 Date Gross Time Net Time Depth to Water ,.;'� (•.t: .: mss,* 16- 1,r a''". � •, r to 17 1 r;.[CTFf �. 18- 8 '.(. j-;* tip. 23:4-E• 19 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE Iminutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: DOVU SrR•RK CERTIFIED BY: j)GV(r s742A' DATE:NOY 13 191y 72-008 (6/79) t n e�_ Vf SOILS LOG MUNICIPALITY OF ANCHORAGE ..; DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION \V* . /. 825 L. Stmt, Anchorage, Alaska 99501 2644720 SOILS LOG — PERCOLATION TEST ❑ PERCOLATION TEST PERFORMED FOR: .JO "1 Cklp� /}]i/AI�r DATE PERFORMEb: � Z— LEGALDESCRIPTION: P/uplS(sp /FYL/?N% SSB.: Swyy SC'ly Selly MwYlr- f-1 SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMME WASGROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? E =c—'25�-T /ziV 2gwS� Reading Date Gross Time Net Time Depth to Water Net Drop .1 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: D01/(s $7-4-&4 CERTIFIED BY: DOVH SDATE: PPV 13 )9gv 72.006 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Health Division CASE REVIEW WORKSHEET CASE NUMBER: S-7580 DATE RECEIVED: April 14, 1984 / C9MMENTS DUE BY: April 27, 1984 i SUBDIVISION OR PROJECT TITLE: Lots 1, 2 Arant Subdivision - 1117) ( PUBLIC WATER AVAILABLE ( )COMMUNITY WATER AVAILABLE ( UBLIC SEWER AVAILABLE COMMENTS: UZ s ln 9 -a' i crr Ci@ I r( n-0u(ne..s�'�t'a�"E' .`�"t ��``�!.-�,'�.cr_+c. ��-a-C 1.�...�,-r.� c.s.-•.-.-�. ��,.i,c.�l� �, 3�7 /mss � MUNICIPALITY CHO AGE Development Services Department 1 `� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel 1. D. 015-163-72-000 1. GENERAL INFORMATION Complete legal description Arant L2 Location (site address) 8035 Frostline Current property owner(s) Pere Davison Mailing address Real estate agent 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Expiration Date: 2— 7--ao ZO Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55D Waiver Fee $ _ Date of Payment Date of Payment Receipt Number���tt 011(4 Wp67 Receipt Number U COSA # _6"3o _'l 1559 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Phone (907) 745-8200 Date �I ireven k. 'r'cnr o;ae }} °• CE 5149 iii: �•�:�,rc,.�� .. bedrooms, with the following stipulations: . d1', x1%4 `OF t& k P .p`- R .,tom .e 1 Original Certificate Date:_ The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Arant L2 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 711184 Total depth '208 ft Cased to 40 ft ❑® Sanitary seal is functioning correctly R Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 3122/19 Static water level at beginning of test 102 ft. Comments B. TANK DATA Age of tank(s) 18 years Tank type/material St Ql STEP Measured operating fluid level in septic tank 52" FE1 Standpipes/foundation cleanout per record drawing Date of pumping 4/1/19 D. ABSORPTION FIELD DATA Which system tested (date installed) WYNN X ALL standpipes present per record drawing Total measured depth from grade 3.3 ft (max) Measured depth to pipe invert from grade ft (min) ❑Q N/A — pressurized field FN Monitor tubes go to bottom of effective. If not, state depth into effective X Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-163-72 Structure served by this system Well production at time of test 3.2+ gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ Nc OR Coliform bacteria is Negative Nitrate 1.63 mg/L EJNitrate less than MRL (ND) Arsenic ug/L N Arsenic less than MRL (ND) Collected by PES Date of Sample 10118/19 C. LIFT STATION X Required maintenance completed Age of lift station 18 years Lift station material Steel Comments: Adequacy test date 3122)2019 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 11 in Water added 450 gal New depth 18 in Elapsed time 1440 min Final fluid depth 11 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes Community Sewer Manhole/Cleanout > 100' [j✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' F/1 Yes if No ft Private Sewer/Septic Line > 25'M Yes if No ft Absorption Field on Lot > 100' E] Yes if No ft Holding Tank > 100' Z✓ Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' M Yes if No ft 0 Yes if No ft [] Yes if No ft Water Service Line > 10' ✓l Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' MYes if No ft F/� Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' F-71 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100'✓� Yes if No ft Water Main > 10' ✓0 Yes if No ft Community Wells > 200' [] Yes if No ft Water Service Line > 10' ✓l Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10'✓0 Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10'✓� Yes if No ft Community Wells > 200' R✓ Yes if No ft Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with 3 MOA COSA guidelines in effect on this date. z�z t s COSA Checklist yellow sheet 10/23/2019 08:46 8686770 APLUS PAGE 01 MUNICIPALITY OF ANUMORAGE �Phon�w90777R�, 7904 Development Services Department Fax: 907-314'2;-7997 On -Site Water & Wastewater Section _X0 Lift Stationtpump Vault Maintenance Log Street Address Phone Legal Desc. pljh)ping completed nches -PUmping: required Y_@-� -Sludge level ;LovT Lft,=i2m -Effluent filter cleaned -pump basket cleaned -Proper float settings, confirmed -Control floats cleaned -operation satisfactory -Audiblcl* and visual alarm inside dwelling (B�m -Dedicated electrical alarm circuit .Alarm system operation .Ground water intrusion at riser to tank connection -Weep hole functional CYE! .Ground water intrusion around pipe penetrations Insulated lea Properly Secured (a_rUA -Manhole lid: Functional CY95)-lM .All manufacturer required inspections and maintenance completed yes tto ...................... ...................................... I ........ I ....................... ........................ I ......................................... ... ...................................... ................... I ................ I—— ....................................................... . .... ................. ........................................... ................ ............................ .... ..... ................. : .......................................................... ........................................................ Date oY_-9_c_ f maintenances -9 Technician pay Company Signature Date ly 'D: 49 TH* SHANE A. HOLT.:' 'j.W UGC F'rr8Al0,^!Ta ?143-7—BWL r SURVEY 1 30, N. cop"Ells SET THIS DAZE y r IF C. P, EO s tOT2, ARANTSUS. int 4TH OC7 . OSER 9 CRO DRLV£ 744,15, FB 201-23 xxcnoRAu:,AR 99507 Municipality of Anchorage Development Services Departmer Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsit6 (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING rI Parcel I.D. 015-163-72 COSA # Expiration Date: 3 —/:7– © 8 1. GENERAL INFORMATION Complete legal description Arant S/D, Lot 2 Location (site address) 8035 Frostline Drive Current Property owner(s) James Monegan & Teresa High Day phone 261-2005 Mailing address 8035 Frostline Drive Anch AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSH will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 19 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-siteV N1 Individual Holding Tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water 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 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 _Pannone Engineering Services, LLC Phone 272-8218 Address _P.O. Box 102954, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date _ 12/11/07 Engineers Comments: In conducting an adequacy test,l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions arc outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the hfOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 5. DSD SIGNATURE _j_/ Approved for 3 bedrooms. 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: L2—/7-07 (R«.,,A5) 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: Arant S/D Lot 2 Parcel ID: 015-163-72 A. WELL DATA Well type Private It A, B. or C provide PWSID q _ Well Log (Y/N) No Date completed 7/1/1984 Sanitary seal (Y/N) Yes Wires properly protected (YM) Yes Total depth >208 ft. Cased to 40+ ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 11/21/2007 Static water level ft. 96 ft. Well production g.p.m. 5+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 1.23 mg/L Other bacteria 0 colonies/100 mL Arsenic: ND ugA Date of sample: 11/26/2007 Collected by. SRP B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/Steel Date installed 8/8/2001 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping 12/12/2007 Pumper A+ Home Svc C. ABSORPTION FIELD DATA Date installed 8/7/2001 Soil rating (g.p.d.e or fe/bdrm) 1.2 System type DT Length 40 ft. Width 2 ft. Gravel below pipe 5.0 ft. Total depth$` 76VII Eff. absorption area 400 ftz. Monitoring tube 1'g$ Depression over field No Date of adequacy test 11/21/2007 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 16 In. Water added4S0 gal. New depth30 in. Elapsed Time: 60 min. Final fluid depth 16 In. Absorption rate >=450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) N If yes, give date D. LIFT STATION Date Installed 8/7/2001 Size in gallons 250 Manhole/Access (YM) Yes `Pump on" level at 22 in. "Pump off' Ievei at 18 in. High water alarm level at 15 in. Datum Top of Tank Cycles tested 5 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 134 Absorption field on lot 170 Public sewer main N/A Sewer /septic service line 25+ Animal containment areas 100+ Meets alarm & circuit requirements? Yes On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout N/A Holding tank 75+ Manure/animal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 45 Property line 70 Absorption field 10+ Water main N/A Water service line 100+ Surface water 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 15 Building foundation 79 Water main N/A Water Service line 100+ Surface water 100+ Driveway, parking/vehicle storage 50+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS i G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inspections and a,�^9_ —�1[� `.1% review of Municipal records that the above systems are in . '" ' ` h,,,• conformance with MOA COSA guidelines in effect on this date. � y 0 j fK . kste�en R. onnonef Engineer's Printed Name Steven R. Pannone, P.E. �+g�, n Ce 8149 Date 12/11/2007 �444,1wal; ;' .•� COSA Fee $ Waiver Fee S Date of Payment / �3 ow Date of Payment Receipt Number I -3 / J Receipt Number (Rev. 11105) tM%Ty COMMArON Ret PLAN •••1,'.MA w .H.� Al V M Y ..w +.i •moi. �ii 'r�i .�i.'�{w. Idk1aA:1011 AI-6ULT �•YR lMrY rK y 1 wYYN•.1�• .R�w• W 1,v.w . �N. •�. r= ��.w.wwY r1 wr NAL MTRJMRE ASitLT IINI RUGATM AHULT FK%L V I ORIR AMl1T mr? RU1 ... AhRM.T , CJ UNM NC O ThE SLItKYOR TAIc2S ©' T � •.S� V i I � � I i i I i I i FROSTUNE CT. EI FMO OEA1C. j i V TOM h mw � y �4 i i i M ----------� Tr amo EMR Robert E. 111 - .601 O ��r•��awd�� A_znt Subdivision E s, Jr. & Assoc. and $UrV9yom 2640 • SET RMAR •••► DRANAOC ASPHALT pepRyRT O FOUND BAR ;.,p,a, . 0 F[NOE COI:CRETE m RE WK 00, 00 A33UYC.N. .R.IL—y. y TA ►Ei1 WOOD BUILDER CR OWNrR, RRICR TO Ob2NLY THOSE IMOROVIEUENTS A90YE GROUND AND NSIMU WILL ME kW *U:LLINO CRAZE RELATIVE MNpp..i. Fo CIM MR" A 0CP710 GLAANOVT2. }D6wALMR DRIKw^M wNMCTONO AND TO DETERMINE ETC.. APE KNOWN IN THEIR APPROXIMATE LOCATION ONLY • SNOW COVENANTS OR 59221,421 RSYRICTICNS MAY PREVENT DOMEINPROVEAICImn FROM MONO S[EH1 AMC LOCATED. I S SHOULD AN AS-MUILT BE ULED FOR CONMUIC!IOV OR FOR ESTABLISHING BOUNOARY OR FENCE LINES. RY rOR THE WIr.AL T'tNMSACTION ONLY AND AS"= FNANCAL LIABILITY ONLY FOR THE COST OF THE SUR.TY. TARLES PREVAIL OVER BCALINB. RE•RODUCTIOM MAY CAUSE ERRORS N SCALL SCS Ret# 1076203001 Client Name Pannone Eng. Srv. Project Name/# Frost Line Dr. Client Sample ID Frost Linc Dr. Matrix Drinking Water PN'SID 0 Sample Remarks: Parameter Results POL (<10) 1127/07 12/06/07 TK Motals by ICP/MS SN120 4500NO3-F D Arsenic ND 5.00 Waters Department Total Nitrate/Nitritc-N 1.23 0.100 Microbiology Laboratory Total Coliform 0 All Dates/rimes arc Alaska Standard Time Printed Date/time 12/10/2007 8:31 Collected Date/time 11/26/2007 12:00 Received Date/time 11126/2007 12:30 Technical Director Stephen C. Ede Allowable Prep Analysis Units Method Container ID Limits Date Date Init ug/L EP200.8 C (<10) 1127/07 12/06/07 TK mg/L SN120 4500NO3-F D (<10) 1127/07 LCP col/IOOmL SM209222B A (<I) 1126/07 SDP Municipality of Anchorage Development Services Department Building Safety Division r1 On -Site Water and Wastewater Program o� 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 iP 0 �E/SSUE CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. C1 (,S" -/63 ^7Z HAA# H/-? Q IO 41',q Expiration Date: S I - O 2 1. GENERAL INFORMATION Complete legal description ^t—c,f '2,4rreA f S i p, Location (site address or directions) I is -0) Sri a w tr Ae D r, � e Current Propertyowner(s) actin E Sctndv 12't3ncn Day phone S62-69 Y9 Mailing address Lending agency 2yYo E iuc�oi Re/. .6csill-7i /fk' 99S-07 N&„ a Day phone Mailing address PuAk�� Fvih.ne Real Estate Agent C nit a 149 k -,Z CdldWelc n Day phone 2 29 - Y793 Mailing Address 2SzS c" SF f}�. i3- 99so3 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Alunicipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single farnily on-site wastewater disposal and/cr water supply system. CSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for progenies served by a private or Gass C weil and may be reissued with r.e:w water sample results less than 30 days old. (Ceniflcates may be reissued fcr a period of up to one year with valid water samcles.) Certificates are valid for one year for prcoenies served by Class A or B wells or a public water system. The kluricipality of Anchcrce is not responsible fcr errors or omissions in the professional engineer's wcrk. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of FirmF luil�p ��cG1n; �U / Sv�� Phone Address 0-5-30 Ec-4o S/ ArcAor raa 995/ Engineer's Printed Name �%se�.e F• �`ruo�� Date FeL V. 21>22 ENGINEER'S _ STAMP ........... 5. DSD SIGNATURE? ..... a _ r.• ccR= Approved for bedrooms. c ;� Disapproved. ;'•'- Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ,,% ,�� �' _ )�� v� Original Certificate Date:.' ' -� / " C Z (Rev. 1=0) 1p�d52". Municipality of Anchorage ' O 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.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ParcelLD. OIS-l63 -7Z HAA# D Expiration Date: 1. GENERAL INFORMATION Complete legal description l-ot 2 Ara n04 S/0 Location (site address or directions) IISo/ $516,e,_7 lone Dre�e_ Current Property owner(s) Jol+_ n_ € SQay o' 6esan Day phone S6Z-69Y9 Mailing address Lending agency Mailing address IISO1 Snow line DriL-d. Ame-l'.y At< 995-/,< Gln le Day phone Real Estate Agent Connie f/e MfFa Colalu.ell &Ake -Day phone 2 Z9 -1763 ForA4nd Mailing Address 26-2S Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site 19 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Fla >LMp l -echn i ca ( Servi c f Phone 3 VS- r3 S'3- Address SAddress )yS36' Ectiv A hn�chqn�P. A! -c 99s16, Engineer's Printed Name 'ThevoCore F. Ptcbre Date Lkccr f 2Z Zc>nf f it�b f. � � ,+• �+V n N �" `f'�t�ycv •: s' ENGINEER'S STAMP ] •ewe••eee•ee eeeeeeee••w•.0 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: G ��.,/ �. / ��� Original Certificate Date: (Rev. 1200) Municipality of Anchorage • Development Services Department Building Safety Division ` � s• rrr On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L c'F 2 14 M^ f S /p Parcel ID: OI S— ►6 3 —? 2 A. WELL DATA Well type F -F If A, B, or C provide PWSID # _ Well Log (YIN) N Date completed 196Y Sanitary seat (YIN) 11' Wires property protected (YIN) y' Total depth ft. Cased t0212 J. Casing height (above ground) lin. FROM WELL LOG AT INSPECTION Date of test 6/7 / G Static water level ft. 9h ft. Well production g.p.m. 9.9 t g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate 0.82y mg.0. Other bacteria _0 colonies/100 ml. Date of sample: ux I Collected by: T F ho o= B. SEPTICIHOLDING TANK DATA Tank Type/Material Sep fic /S% e I Date installed 8�8 zoo 1 Tank size IS00 gal Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over lank (YIN) K High water alarm (YIN) Y Dateofpumping N.,+. (New) Pumper N• �► C. ABSORPTION FIELD DATA Date Installed /7/2001 Soil rating (g.p.dJft2 or ft2/bdrm) I,Z t System type 7"rc^c-i Length *1 ft. Width 2 S ft. Gravel below pipe 15" ft. Total depth 7.0 ft. Eff. absorption area YCV W Monitoring tube Y Depression over field N Date of adequacy test N• A. Ntw) Results (Pass/Fail) Pvti For 3 bedrooms Fluid depth in absorption field before lest 0 in. Water added_12 gal. New depth—0 in. Elapsed Time: 0 min. Final fluid depth tel_ in. Absorption rate >= iso g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date V. A D. LIFT STATION 01,912-00( Date installed 8/ 1-1,00t Size in gallonss� Manhole/Access (YIN) `r 'Pump on" level at g? in. 'Pump ofr level at 16. in. High water alarm level at /r_ in. Datum _ VgLt If r i o, Cycles tested N. A. CNrwMeets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 13y, On adjacent lots > 1 QQ Absorption field on lot 1,70, On adjacent lots _ > Ic'o Public sewer main N. A. Public sewer manholetcleanout V. A. Sewer /septic service line > L S' Holding tank N• A. SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation NS' Property line %G' Absorption field 2 It. Water main N.A. Water service line > too' Surface water loo' Wells on adjacent lots 1 uo' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 16" Building foundation '7 9 ' Water main N• A. Water Service line > (0o' Surface water > 100' Driveway, parking/vehicle storage >$101 Curtain drain Nene Seen Wells on adjacent lots F. COMMENTS f` s OF A. G. ENGINEER'S CERTIFICATION (t'O ^' •• ..:4 •' �'F 4 I certify that I have determined through field inspections and � ........... •C review of Municipal records that the above systems are in d�:�`^� ;;.•••• •• conformance with MOA HAA guidelines In effect on this date. ENGINEERS' F. asocae 8 STA Fs[ - 3"9 • Engineer's Printed Name TAeoeAo re (= 1`tWf� M • • •e V,g, 4 • c Date ur f 22 2o0r HAA Fee $_ 300 =:P— Waiver Fee $ Date of Payment at 7-1(e-, f Date of Payment Receipt Number 90-7" Receipt Number (Rev. 12/00)