HomeMy WebLinkAboutBRUIN PARK BLK 2 LT 6Bruin Park
Block 2
Lot 6
#016-102-13
Municipality of Anchorage
Development Services Department
Building Safety Division �
On -Site Water 8 Wastewater Program, 4700 Bragaw St. W
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SWO80122 PID Number. 016-102-13
Name: GARY WESOLOWSKI
Wastewater System: O New ■ Upgrade
Address:
26045 LOG CABIN CIRCLE a EAGLE RIVER, AK
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 696-0477 4
O Deep Trench ■ Shallow Trench O Bed Cl Mound ODther
LEGAL DESCRIPTION
soil Rabq:
0.8
Taal Depth from orlea,a rode:
GPD/se. FL
6 MAX rL
Block: Lot: Subdivision:
Depth b P" bottom horn adynal srod.:
Grovel depth bennih plpe:
2 6 BRUIN PARK
SEE DWG. P.
3.02 PL
Township: Range: Section:
r° added oeove erlpina rode:
Gravy Nneth:
— — —
SEE DWG.
n 88 (2 ® 44) FL
WELL: O New O Upgrade
Gpwl wish:
5
Name« of w.:
z
D1.tanae ba...n
15
PL
R
Cb..dK.4pn PMate. A•B.0 : To1W Get
Ceeed Te: (BmeMY1)
Taal obearptlon area:
P'qe mol.dol:
`\v` n.
Daw C�\\ Da. Drew:
R
758 sD.
n D 3034/ F-810
slak water Lava:
kw`~
X�
Dote MDaNd:
GREY CONSTRUCTION 7/22-24/2008
r<
TAN K
r»�:
Pump sat 'u'
Gain, "ht Above G band:
IP-
n
rt
SEPARATION
DISTANCES
.Septic OHolding OS.T.E.P. Gather
To
rrom
Septic
Tank
Absorption
Field
Lift
station
Holding
Tank
pvbcc/Prlwte
sew« Lkus
M rKdoaunn
ANCHORAGE TANK
Cepodls h eauNw:
1250
Well
100'+
100'+
—
—
25'+
lral«la:
STEEL
Nwnb.r a eorrperbnenb:2
Surface water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
10'+
—
—
—
54e in sasonK
Y«wfaa««:
Foundation
5'+
10'+
—
—
—
on I.vN a1:
,enp al a:
Npn water alarm ot:
Curtain Drain
NO KNOWN
P,enp abbe .I:
D.avtaa awp.c0oee perfanned by:
Remarks: OLD DRAINFILED AND SEPTIC TANK WAS
BENCH MARK
l otan and D.ecripaon:
PUMPED, FILLED AND COMPLETELY ABANDONED
BOTTOM OF TANK
IN PLACE
A..unwd Venation:
91.98 pt
GEG Ltd.
Inspections performed by: r Dates: 1st 7/22/2008
ENGINEER AL
2nd _7/23/2008
3rd 7/24/2008
Development Services Department Approvald'?
4
............. ........... �
Conditional approval: Date:
•••• •• ............
O ey Go ess.- ��
° C/E-7 e`
000 °. •�+?.9. o`�'ogd��
Reviewed and approved by: Date: '3 -O
(R.r. 4/06)
d4edprofesalO�
OO�OO�p00
PERMIT NUMBER: PARCEL ID NUMBER:
SWO80122 AS -BUILT DRAWING 016-102-13
mB�
ST1
51.86 74.4
ST2
51.32 78 9
DBL1
52.61 82.15
DBL2
53.33 83.22
FS
90.47 114.16
C01
87.76 96.24
MT1
89.24 97.60
CO2
106.68 1132.14
MT2104.64
130.15
CO3
104.92 114.23
MT3
107.08F116.65
C04
123.52 1146.75
MT4
121.24 1144.39.
NEW
CO ST
STI �.
TNj1+ /
C( /
T
/
I FCLEANOU /
I
I
I
I
1
1
BRUIN PARK; BLOCK 2. LOT 7 1
1 0.�
li
BRUIN PARK;
BLOCK 2. LOT 6A
DBL2 ��--'—
DBL1
O
/
—NEW 1250 GALLON
SEPTIC TANK
I
1
I
A
I
.Y
EXISTING
'''-.'.•?••i
4 BEDROOM .. }
HOUSE \`` ,^, ' •.�� :: j.i:. .
GARNESS ENGINEERING GROUP, Ltd. 4 �*
• CONSULTANTS S GENERAL CONTRACTORS �.•••. .... ...... .........
JAI L T.OM IIWO. WX 101. MOIQNL. M W W7 • .11°( (M7)M7- 1" . IM (007)3Y " • �X. w.ysn,+wyMwMyan
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: Q ••• •...... ..........
GARY WESOLOWSKI 696-0477 2 OF 2 O ey G ness:
LEGAL DESCRIPTION: DRAWN BY: Q ° CE -795541
BRUIN PARK, LOT 6, BLOCK 2 K.D.M. 0% ' %Iy'd
TWE OF WORK: DATE: P"
AS -BUILT DRAWING 7/28/2008 �D�O�opOo
1
I
�I
GARNESS ENGINEERING GROUP, Ltd. 4 �*
• CONSULTANTS S GENERAL CONTRACTORS �.•••. .... ...... .........
JAI L T.OM IIWO. WX 101. MOIQNL. M W W7 • .11°( (M7)M7- 1" . IM (007)3Y " • �X. w.ysn,+wyMwMyan
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: Q ••• •...... ..........
GARY WESOLOWSKI 696-0477 2 OF 2 O ey G ness:
LEGAL DESCRIPTION: DRAWN BY: Q ° CE -795541
BRUIN PARK, LOT 6, BLOCK 2 K.D.M. 0% ' %Iy'd
TWE OF WORK: DATE: P"
AS -BUILT DRAWING 7/28/2008 �D�O�opOo
TOP OF TANK
AT INLET = 96.84
INVERT OF BUNG
AT INLET - 96.21
FILTER
INSULATION P R TRA
FINAL GRADE = 100.25-100.36
S/T2
TOP OF TANK
AT OUTLET = 96.85
NEW 1250 GALLON
SEPTIC TANK
FILTER
1
INVERT OF BUNG
AT OUTLET = 96.00
UL .
F.44
INAL GRADE
97.11 TH12
BOTTOM 5,
TRENCH - 91.11
0l�
RELATIVE ELEVATION OF BOTTOM OF
TEST HOLE - 83.11 (H20 O 84.53)
GARNESSGo NGINEER SULTANTS& GENERAL�oNG GROUP,_Ltd.
�f
............................
nm c nioo„ ■a WX ,m • "K"W"L w (w>)z U" • n X- �w.,s•«.y`rpaw
PREPARED FOR: PHONE NUMBER: PACE NUMBER: ••• • •.... ........
GARY WESOLOWSKI 696-0477 3 OF 3 '.J e A Gar ess•:
LEGAL DESCRIPTION: DRAWN 8Y: oOo y. E-7 ei
BRUIN PARK, BLOCK 2, LOT 6 K.D.M. 04r • �� ,?tj `F`
TYPE OF WORK: DATE: OQOd "rOfesa1000o�
AS -BUILT PROFILE DRAWING 7/28/2008 �DO000�c
04/14/2006 01:57 6960485
Gess Engineering
GREYSCONSTRUCTION
Bruin Park, we insulated the'1250gl tank to the flow splitter and continued onto the trench
nearest to the tank the upper trench, all with Y blue board
PAGE 01/01
T H J 10:15 A;! 3WPi;S
T1 907 762 4652 P-001
ENCROACHMENT PERMIT 1203-20A
G-2633
EN08022
016-102-13
This permit is between Chugach Electric Association, Inc., an Alasla non-profit electric
cooperative, (herein "Chugach', whose address is P. O. Box 196300, Anchorage, Alaska 99519 and
Sid Richards (herein "Permittee"),w3uose address is 1200 South Jewel Street, Palmer, Alaska 99645.
1, Easement. Chugach is the grantee or user of an easement for the construction and
maintenance of electrical facilities, as follows:
Described in that certaia written instrument recorded on the 164' day of July 1952, at
Volume 75, Page 191, on file in the office of the District Recorder, Anchorage Recording
Distad, Seward Meridian, Alaska,
Described in that certain written instrument recorded on the 21" day of March 1952, at
Volume 69, Page 304, on file in the office of the District Recorder, Anchorage Recording
District, Seward Meridian, Alaska,
herein "Easement") which pertains to the following described real propert3^
ATwenty-foot (20') -wide strip of land, running nordueastto southwest across the northwest
portion of Lot Six (6), Block Two (2), Bruin Park Subdivision, according to Plat P -222B,
recorded on the 0' day of September 1952, on $Ie in the office of the District Recorder,
Anchorage Recording District, Seward Meridian, Alaska.
Permittee acknowledges the validity of the Easement. Permittee wwra its and represents that
Permittee is the owner of the fee simple interest in the land subject to the Easement and the
following described real property to which the Easement is adjacent:
Lot Six (6), Block Two (2), Bruin Park Subdivision, according to Plat P -222B, recorded on
the 4h day of September 1952 on file in the office of the.District Recorder, Anchorage
Recording District, Seward Meridian, Alaska,
(herein "Parcel")
Encroachment Permit - Page 1 of 4
,;Ct-17-2008 TH 10:15 AN DIASIS
21 907 752 48x2 P.002
2. E_ncroaclarn . Permittee. has. proposed to construct and purchased the following
improvements on or within the real property subject to said Easement:
An existing septic drain field, that encroaches into said Easement a distance of
approximately Two Feet (2') for a distance of approximately Sixty-seven Feet (67'), a
proposed sewer pipe, approximately One Foot (1') in diameter, buried at an appro dmate
depth of Six Feet (6'), that encroaches across the entire width of said Easement
(herein "Encroachment").
3. )crit Chugach hereby authorizes Pemtittee to construct and to continue the
existence of the Encroachment in its existing location subject to the covenants set forth in this
permit
4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any
claims for personal injury, property damage or other loss arising in any way from the continuation of
the Encroachment.
5. No Expansion or Increase. Permittee shall not in any way expand or increase the
extent to which the Encroachment occupies any of the real property encumbered by the Easement
without the prior written consent of Chugach. Chugach has no obligation to provide such consent.
6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the
Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in
the future give rise to any interest or estate in the real property subject to the Easement or any other
real property. Without in any way limiting the foregoing, Permittee acknowledges that the
Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the
permission of Chugach for purposes of the common law doctrine of adverse possession. Thispermit
creates no interest in the real property subject to the easement
7. Modification of Utility Facilities. If the electric utility facilities located within the
Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of
Chugach's total costs for such modification which is reasonably attributable to accommodating or
preserving the Encroachment If such payment is not made within thirty (3 0) days of written demand
for same, Chugach may terminate this permit in accordance with paragraph 9, below.
8. Covenants Runnirrtt with the Land. The obligations ofthePermittee arising from this
permit shall be covenants running with the land which shall burden the Parcel and the Permittee's
interest in the land subj cot to the Easement and shall benefit the Easement
9. Termination. Chugach may terminate this permit after the giving of thirty (30) days
written notice of such termination if:
.Encroachment Permit - Page 2 of 4
M-11-2COE THJ 10:16 AM 0!RC:S113
"al 907 702 4652 P.003
a. The Encroachment is enlarged, increased or extended within the real property
affected by the Easement.
b. The Encroachment is damaged by anymeans to an extent of more than thirty percent
(30%) of its replacement cost at the time of destruction
C. Pemtittee fails to make the payment described in paragraph 7, above.
10. Tom. This permit shall, ifnot sooner terminated by Chugach, expire forty (40) years
from the date hereof.
11. Entire A=cr rent. This written permit corstitutes the entire agreement between the
parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous
agreements, oral or written, between the parties. No modifications, amendments, deletions, additions
or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto.
CHUGACH ELECTRIC ASSOCUTION, D;C.
By: &. ,4km Oe
Dora Gropp, Acting D' for
Engineering Services Division
Data: q (7l .9 .
www"I Am
; '' /
Encroachment Permit - Page 3 of 4
2
-1 7-20H THO 10:16 AM (£4lMEBM 11 007 762 4652
STATE Of ALASKA )
ss:
THIRD JUDICIAL DISTRICT )
41
The foregoing instrument was acknowledged before me this � d y of
2008,by S� Ri G I�RDs
(PRINT NAME OF PEILN TTTEE)
L
HOZ A
pUBUt,
Notary Public in and for the She �, asJSa O f
My commission expires:
�I/IIry11111NNN,
STATE OF ALASKA )
ss:
THIRD JUDICIAL DISTRICT )
The oregoing instrument was acknowledg;Q before me this 7 day of
2008, by j,) o RA L. &RD P
e rl Dircctor, Engineering Services Division of Chugach Electric Association, Inc., an
Alaska corporation, on behalf of the corporation. "o"
Notary Publ' I and for the State of Alaska n
My commi expires: 6' 7
114
AFTER RECORMG RETURN TO_f0 P
Churaeb Electric Association, Ina ^ i
P.O. Box 196300{ , 'ss P
Anchorage, Alaska 99519-6300 • r UB
i,� •.,F 0 P r i
",wit rill i0l"
Encroachment Permit - Page 4 of 4
F. 004
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water d Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SWO80122
Legal Description: BRUIN PARK BLK 2 LT 6
Design Engineer: 0855 GARNESS ENGINEERING GROUF
Owner Name: GARY WESOLOWSKI
Owner Address: 11016 FOREST DR
ANCHORAGE. AK 99516-1336
'4011a
Iia
T1991b
TI_3(og (�
Date Issued: Jul 11, 2008
Expiration Date: Jul 11, 2009
Parcel ID: 016-102-13
Site Address: 011016 FOREST DR
Lot Size: 42075 SO. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
All construction must be in accordance with:
1. The attached approved design.
❑ Private Well ❑ Water Storage
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: D
Date:1L'��
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water $ Wastewater Program
4700 Bragaw SL
P.O. Box 196650
Anchorage, AK 99519-6650
www.oi.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. niLQJ 10,�L' 13
Property owner(s) GARY WESOLOWSKI Z SSD k C hnit_ I S Day phone 696-0477
Mailing address 26045 LOG CABIN CIRCL *EAGLE RN R. AK 99577
Site address _I 101 In FD12.G-_,!rT VKW6 Zip Code 99645
Legal description (Sub'd, Block & Lot ) BRUIN PARK, BLOCK 2. LOT 6
Legal description (Township, Section & Range) _NZA
Lot Size 49,of S Sq.FL
THIS APPLICATION IS FOR ((D all that apply):
Absorption Field
❑
Septic Tank
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms
THIS APPLICATION IS AN:
Initial
❑
Upgrade
Renewal
❑
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.
GARNESS ENGINEERING GROUP, Ltd.
).
Permit/Rush Fees: '-/6,0 + 1 %.5
Date of Payment l/ l
Receipt Number. 1J 7 /�2
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number.
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS I' :- I -
-
July 8, 2008
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Septic System Upgrade for Bruin Park; Lot 6, Block 2,
To whom it may concern:
The existing 4 bedroom house is served by a private well and septic system. The septic system is in a state
of failure and needs to be upgraded. We are proposing to install a 1250 gallon septic tank and a dual 5 -
wide trench type drainficld. Two test holes were excavated on the property. The drainfield will be
designed around the 30 foot radius of test hole tet. Comments regarding the design are summarized as
follows:
1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: GEG engineer technician Susan Oswalt inspected the area below the
drainfield and found it to be boggy. Based upon her assessment she deemed the area within 100 feet of the
proposed septic system to be free of surface water. We are asking the MOA to do their own assessment of
the terrain to determine what the classification should be, before issuance of the permit.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography below the
drainfield is a 15-20 percent slope running approximately southeast to northwest.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have annuestions, please contact us at 337-6179. Thank you for your assistance.
M.S.
NOTEV,1 ftached is a site plan drawing, a design drawing, one soil log, which are aU part of the design package for
this septic system. (Contact G.E.G. Ltd. for 7 page construction specification letter.)
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 0 Website: www.gamessenginecring.com
OF BEDROOMS: 4
PER DAY (CPD): 600
ION RATE/S: 6.66 MIN./INCH
D APPLICATION RATE: 0.8
DRAINFIELD SO.FT.: 750
MAXIMUM DEPTH: 6 FEET
WIDTH: 5 FEET
LENGTH: 88 (2 O 44) FEET
M.O.A. APPROVED SAND FILTER: N/A
EFFECTIVE: 3 FEET
REDUCTION FACTOR: 0.58
ACTUAL SO.FT.: 758
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT GEC. BY PROCEEDING FORWARDAA
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
�J
X70;
7J` IS RESPONSIBLE FOR
70
IDENTIMNG ANY EASEMENTS
'; JHAT MAY BE ON RECORD.
EXISTING DRAINFIELD TO BE
USED AS RESERVE -
EXISTING 1000 GALLON
SEPTIC TANK IS TO BE
PUMPED, CRUSHED, AND
COMPLETELY ABANDONED
BRUIN PARK; BLOCK 2, LOT 7
NOTE: THE CONTRACTOR SHALL HAVE
?oma POWER LINE EASEMENT, AND ALL WELT
RADII FLAGGED BY A�REGISTERED TLANI
TH/f
m
i
O
60 I
' EXISTING
4 BEDROOM
HOUSE /
GARNGSS ENGINLLRING GROUP, Ltd.
CONSULTANTS d GENERAL CONTRACTORS-,,------ %
SMI C TLYR LIMO, 11AC 101 • AKIO L Mf FM
PREPARED FOR: PHONE NUMBER: PACE NUMBER:••
GARY WESOLOWSKI 696-0477 2 OF 2 (�
LEGAL DESCRIPTION: DRAWN BY: oOo°c,•
BRUIN PARK, BLOCK 2, LOT 6 K.D.M.
TYPE OF WORK: DATE'
PROPOSED SEPTIC SYSTEM DESIGN 1 7/7/2008
(R. 01105)
Si E:
(.f"/
INSTALL FLOW
SPLITTER BRUIN PARK;
INSTALL FLOW BLOCK 2, LOT 6A
DNERTER /,,,�
`'"
IED
INSTALL DOUBLE /
:ILD
CLEANOVTS
?O
PROPOSED 1250 GALLON
SEPTIC TANK II
6-9 II
II
THJ
/ IJ
II
60
O
60 I
' EXISTING
4 BEDROOM
HOUSE /
GARNGSS ENGINLLRING GROUP, Ltd.
CONSULTANTS d GENERAL CONTRACTORS-,,------ %
SMI C TLYR LIMO, 11AC 101 • AKIO L Mf FM
PREPARED FOR: PHONE NUMBER: PACE NUMBER:••
GARY WESOLOWSKI 696-0477 2 OF 2 (�
LEGAL DESCRIPTION: DRAWN BY: oOo°c,•
BRUIN PARK, BLOCK 2, LOT 6 K.D.M.
TYPE OF WORK: DATE'
PROPOSED SEPTIC SYSTEM DESIGN 1 7/7/2008
(R. 01105)
Si E:
BRUIN PARK; BLOCK 2. LOT 3
BRUIN PARK; BLOCK 3. LOT 2
BRUIN PARK; BLOCK 2, LOT 4
BRUIN PARK; BLOCK 2, LOT S
BRUIN PARK; BLOCK 3, LOT 3
BRUIN PARK; /n
BLOCK 2. LOT SA \Q/
r\
PROPOSED
SEPTIC _
S'YSTE /7/
7
Cpl / / / \ \ r BRUIN PARK;
TH01 f (C BLOCK 4, LOT
BRUIN PARK;
LOT BLOCK 4, i0T 2
r BRUIN
^tel BLOCK 2. LOT 7 O\\ 1 �!—� /\�— APPROXIMATE
—BRUIN.ARK; LOCATION
BLOCK •LDT 3 /
C • APPROXIMATE
BRUIN PARK; LOCA ON
BLOCK 4, LOT
BRUIN PARK:
BLOCK 2, LOT 8 1 r / 1\ WP—R IMATE /
ELL
\� r/
BRUIN
PAR LOCATION //
I S \ / BLOCK 4, LOY\S
1' . 100'
(Rev. 01/05)
..s O
GARNliSS ENGINEERING
GROUP, Ltd.
CONSULTANTS 6 GENERAL CONTRACTORS
1101 C TIP'R IIbU. Ar1F 101 N1MOMf,[ m IAV ] 32"
..••••
••••• ••••••D
PREPARED FOR: PHONE NUMBER:
WESOLOWSKI 696-0477
PACE NUMBER:
... •:� . .. Gar CSS'
GARY
1 OF 2
00
O0
E—
LEGAL DESCRIPTION:
BRUIN PARK; BLOCK 2, LOT 6
DRAWN BY:
K.D.M.
•' `ip`��
o.c�9' X00
TYPE WORK:
6/16/08
0
4%04000000
oprolae4lo(,o\
T
SITE PLAN
(Rev. 01/05)
_oo600pp0
GARNESS ENGINEERING GROUP Ltd.
p� Stwr[ • CONSULTANTS 3 GENERAL CONTRACTORS +u.-W��, «...=r..".«.... y',• 1 00
MCNgWOW YO
4L AC YG• PN ] I- 179 • FM WI b • YFHL]L ymrrrq+r•rNq.•o,n • • • • • • • • • • • • • • • • • • • • • •
]m C 101 • •.O
SOIL LOG - PERCOLATION TEST 0
LEGAL DESCRIPTION: BRUIN PARK, LOT 6, BLOCK 2 }I •.Je y arness: O
PERFORMED FOR: GARY WESOLOWSKI DATE: 6 27 2008 v'.• CE �715� e`QO
DEPTH =__=
(feet) _yya ORGANICS TEST HOLE #1 UPPER BENCH ��4p0000��
1 r REDDISH LOOSE
SAND k GRAVEL SOIL CLASSIFICATIONS
2
GW =_== ORG
GP ML
GM CL
4GC OL ti
SM o• •o• o SW MH
5
• : SP CH
SM i OH
6 SC
SEE SITE PLAN FOR
7 DEPTH GROUNDWATER DATE TEST HOLE LOCATIONS
8 SM/ML DRY 6/27/2008
TIGHTER 12,83 7/72008
9
SCALE:
10 1 • - 100'
11
12
SM
13
14
&QH.
15
16
17
18
19 PERCOLATION RATE 24 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 3 FT. AND 4 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: DAVID GARNESS
COMMENTS:
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: t72
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
7 2/08
1
8:38
—
6"
—
2
9:08
30
4.75'
1.25'
3
9:08
—
6"
—
4
9:38
30
5"
1"
5
9:38
—
6"
—
6
10:08
30
4.75"
1.25"
GROUNDWATER
DATE
DRY
6/27/2008
12.83
4
7/2/08
GARNESS
0
ENGINEERING GROUP, Ltd.
—
•
; 9y*0�0
CONSULTANTS R GENERAL CONTRACTORS••••*•=••-•-W--•-•••,-w•-�-• O
101 • AW -40k 0L N 99307 • h101{: 90) 1-11)9 • � .. • • • • • • • • • • • • • • • • • • .D
3701 L )0009
9'YU. SUITE
9:09
30
SOIL LOG - PERCOLATION TEST ... •.
LEGAL
DESCRIPTION:
BRUIN PARK, LOT 6, BLOCK 2 •.J f y G rness.- QO
PERFORMED
FOR:
GARY WESOLOWSKI DATE: -6/27/2008 '�i E 3 8
DEPTH
4p olp 400
—:��
(feet)
yay_
ORGANICSrofes loft
TEST HOLE #1 LOWER BENCH �D�000��oo
1
r
REDDISH LOOSE
9:39
—
SAND do GRAVEL SOIL CLASSIFICATIONS
2
GW cccc ORG
3
30
z,GP ML
1.25"
GM CL
4
GC OL N
SM
9e 100 o SW MH
sip5
• SP CH
SM i OH
6
SC SEE SITE PLAN FOR
TEST HOLE LOCATIONS
DEPTH TO
8
SM/ML
TIGHTER
9—
SCALE:
1' 100'
10
11
12
SM
13
14
B4O.tI.
15
16
17
18
PERCOLATION RATE 24 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19
TEST RUN BETWEEN 3 FT. AND 4 FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS
LOGGED
BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: DAVID GARNESS
COMMENTS:
GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PRF RMED IN ACCORDANCE
PERFORMED
BY
WITH ALL
STATE
AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: F.
GROUNDWATER
DATE
DRY
6/27/2008
12.83
7/7/2008
7/2/08
1
8:39
—
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
7/2/08
1
8:39
—
6"
—
2
9:09
30
4.25'
1.75'
3
9:09
—
6"
—
4
9:39
30
4.75'
1.25'
5
9:39
—
6"
—
6
10:09
30
4.75"
1.25"
GARNESS ENGINEERING GROUP, Ltd.
• CONSULTANTS 6 GENERAL CONTRACTORS "- »��-'.»••�...».,®,. ¢ •'.� D
........ . . ..... .. ..........
01 pp•D, SIIf[ 101 • ANGgINOC, AK pG501 • � p0] ]-611p • NC YO] 32M • IRB51fL ,s,r•.rgn•wlrp.aom O
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: BRUIN PARK, LOT 6, BLOCK 2 '•.Je ness;'
13
PERFORMED FOR: GARY WESOLOWSKI DATE: 6/27/2008 v�'• E 7j� 5
DEPTH no�F.od
(feet) �77y ORGANICS TEST HOLE#21���40Of 000��a
1 REDDISH LOOSE
SAND k GRAVEL SOIL CLASSIFICATIONS
2
GW ORG
GM CL
q GC OL n
SM 00 00000, SW MH
5 ' SP CH
SM . OH
6 SC SEE SITE PLAN FOR
7 DEPTH TO DATE TEST HOLE LOCATIONS
GROUNDWATER
8 DRY 6/27/2008
SM/ML 12.58 7/7/2008
B TIGHTER
SCALE:
11
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
12 SM
13 B.O.I1.
14
15
16
17
18
19 PERCOLATION RATE 6.7 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5 FT. AND 6 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: DAVID GARNESS
COMMENTS:
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS �gROD IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: I
TIME
(MINUTES)
READING
(INCHES)
7 2/08
1
8:33
—
6"
—
2
9:03
30
1"
5"
3
9:03
—
6"
—
4
9:33
30
1.5"
4.5"
5
9:33
—
6"
—
6
10:03
30
1.5"
4.5'
Municipality of Anchorage
Development Services Department
` Building Safety Division
On -Site Water and Wastewater Program
4700 South Elmore St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: GEG
Legal description: Bruin Park: Block 2. Lot 6
®Permit QC.O.S.A. Dinspection Report
The attached paperwork has been reviewed and Is being returned for the following reasons:
1. Slopes Greater Than 25%: The topography appears to possibly be greater than 25% within 50
feet of the drainfield. Please substantiate that the system has 35 feet horizontal separation from
an imaginary 25% slope drawn from a point 2.5 feet above the drainfield pipe invert.
2. Drainfield Monitor Tubes and Cleanouts: The design shows the drainfield monitor tubes and
cleanouts but does not call them out. Please call them out.
Name of reviewer: Jay
Date: 7/10108
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
!0 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH
& ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage. Alaska 99501 Telephone 264-4720
/
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
2t — ^ PHONE ❑I�GW
!/7Ln�SJxl ✓UPGRADE
MAILING ADDRESS
s oX 77y -� ,r,
LEGAL DESCRIPTION
W4 .F
LOCATION 7 4-_
NO.OF BEDR OOMS�
Well Absorption area
DISTANCE TO:
Duuelling
PERMIT NO.
O Y
�0O;;? fA
h -Z
W F
Manufacturer
Material
No, of campartmegjs
H
Lat. ca a ityOgallons Insiticlength
�� IF HOMEMADE:
Width
L•
Liquid depth
Y
JOZ
DISTANCE TO: Well Dwelling
PERMIT NO.
x t--
Manufacturer Material
Liquid capacity gagallons
�=I
W
Well r Foundation Nearest lot Ime
DISTANCE TO: /O0 /
PERMIT NO.
u. 2
No. of lines
Length of each /live
Total length of h es
Trench w r
inches
Orstance between li e
G
H
O
,
Total effective a�sorp area
Top of rile to finish grade
Material beneath file /
W
Length Width
Depth
PEHMIT NO.
0
ma
Type of crib
Crib diameterCrib
depth
Total effective absorption area
rn
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
W
3
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
N
PIPE MATERIALS ✓
SOIL TEST RATING
330
INSTALLER
g
REMARKS
Lf
s
N
-
y
3'
4+1
APPROVED DATE LEGAL
J
C —
»-nta tao„ anvt
l
PERMIT. N0.
I iC I F>nL- I TY OF= i=i "1="cAzRGE
DEPARTMENT f" HEALTH AND ENVIRONMENTAL ^7TECTION
825 -L STREET, BNCHORAGE, AK. 99;,.,1
' 264-4720
CA r4 I TE n5EWFE: FZ FP'EFZM I T
800282 )
11
:14
AN � • �vayo
�) A
APPLICANT RICHARD HUFF SRA BOX 17746
LOCATION 3RD HOUSE'ON RT..& FOREST:DRIVE''
LEGAL L6 B2 BRUIN PARK SUB LOT SIZE
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
n 1 1KS. I-StL-i
AACAPAV44-6850
39200 SQUARE FEET
MAXIMUM NUMBER. OF BEDROOMS = 3 SOIL RATING CSO FT/BR)= 330
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
OEF}TH= 1.CA LENGTH= n>gy C!FZIlN{ELL F3EF"TH= its
THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET).
JHEP,E IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
F2EGU I FRED n3aP•T I C= Tf=l NK S~ I =E= :jLEjQCA 13HILLCINS
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
--- TWCti C 2 7 I t45~F?EC=T I CtiNno FiFZE RECOt3I FZEE —
BACKFILLINO OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER. LINE IS 25 FEET AND
TO A COMMUNITY SEWER, LINE I5 75 FEET.
OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
FIERM I T E14F} I FZES []EC=EME3EFZ 31r
I CERTIFY THAT
1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR'ON-SITE SEWERS
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE
RESIDENC I5 REM TO INC UDE MORE THAN 3 BEDROOMS.
SIGNED:_ /elle,416 - �z
ISSUED
APPLICANT P,
15T5IED
AND WELLS AS SET
ENLARGEMENT IF THE
V4. 0
I t• 1 v 1 I_ A t- "L_ 1 1 17, C-1 t- H r-4 v-:"t_i i-. Fi i_j E_
GEPAP,Tgr NT�OEQ-VF��-+iLL--77N�j
SG,
L^ TF:EEI,
AUCn EEN'�IRnNNTgTA6 A"TFCTION
HtlCHu'HGE, HI,. �A..
264-4720
20
`-or4-_. I TE
PEF.MIT 110. '! 700762 )
APPLICANT LILAC CONSTRUCTION
LOCATION FORREST DR.
_ F=1•Ij_—
1605 SANYA
F -M .L T
�re � 510 l
a..
CR 337 6310
LEGAL LE B2 BRUIN PARK
S/D
LOT SIZE I'F 20000 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAKIMUN NUMBER OF BEDROOMS = 3 SOIL RATING, (SG. FT/BR)= 20
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
L?F0F lFV4= 2n LLEt4C317H=
THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DPRINFIELO.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
F _"FE:G!t_1 I F!EC• ~EF=
PERMIT AP'P'LICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
1NSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
--- TW1_1 C. 2 ] I ra F�EGT I L-1 r-4 nr;;, F<Et IJ I REQ
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL; OR
150 TO 200 FEET FROM R PUBLIC WELL DEPENDING,• UPON THE TYPE OF PUBLIC WELL.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
H'•iHILABLE TO INSURE PROPER INSTALLATION.
F•EF?rl I T F_=XF I FEE'S 0-U- CEr'1E_tFEE F? :
I CERTIFY THAT
1: I AN FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MOPE THAN 3 BEDROOMS.
SIGNED:
APPLICANT LINC CONSTRUCTION
ISSUED BY -----
--
�`p Q
'7s 0) (� 2)
l^' ❑ SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Df PERCOLATION
\.
Pouch 6.650, Anchorage, Alaska 89602 276-2221 TEST
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: �'AA=%flL7hM // DATE PERFORMED: 140,
Q / n
LEGAL DESCRIPTION: LO/Y E ,C/ 104 Ir
oI FPrw1 SLOPE SITE PLAN
(FEET) n
121
%
I<1
�- 4
5 Santit 3
hl L �° eo,ti, c ,
Co -4"
7
$ no� Co 4"i Uuou "7 )
9
'-�0
11
12 (
oo:
13 s4 'fsZ.
14
15
16
17
18
19
20
PERFORM
t.-� «�
WAS GROUND WATERS
ENCOUNTERED? /�G<1 LOli
IF YES, AT WHAT / E!
DEPTH)
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
-I I�
j•
WAS GROUND WATERS
ENCOUNTERED? /�G<1 LOli
IF YES, AT WHAT / E!
DEPTH)
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
j•
q tiro
4D &W
�
I �q
r
s
is 4
I o' P
PERCOLATION RATE �y (minutes/inch)
TEST,RUN BETWEEN _� FT AND FT w
72006 (7/76)
b'2S-rL 0 sf. !7;y el- n4.
CERTIFIED
DATE:
Im
Municipality of Anchorage
Development Services Department
/ Building Safety Division
On -Site Water & Wastewater Program •
4700 Bragaw Street
P.O. Box 196650 (V"�
Anchorage, AK 99519.6650
rJ www.muni.org/onsite m „Q►
"'Oe (907) 343-7904
(�?
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. bl(P_1C1A_ 13 COSA# Ogoa✓3
1. GENERAL INFORMATION Expiration Date:
Complete legal description BRUIN PARK, LOT 6, BLOCK 2
Location (site address) 11016 FOREST DRIVER • ANCHORAGE. AK 99516
Current Property owner(s) SID RICHARDS Day phone
Mailing address 1200 SOUTH JEWEL STREET *PALMER, AK 99645-0000
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
E
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 On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixedhereto and as of the validation date shown below, l 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 (les and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system Js(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Finn GARNESS ENGINEERING GROUP, Lid. Phone
Address 3701 E. TUDOR ROAD. SUITE 101-' ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, Lto. 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 Me conditions encountered at the time of the test, and sqeQaretion
distances measured to readily identifiable features. The operational fifebf all wells and
septic systems depend on the local soils condition, groundwater levels Mat 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. Satisfactorytest
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system wilt continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for _ bedrooms.
Disapproved.
337-6179
Date D 8 _
Conditional approval for bedrooms, with the filowing stipulations:
Attachments: /
COSA Checklist l/
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
M_ I'M
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
Certificate Date: l.'
t/
Municipality of Anchorage
Development Services Department
Building Safety Division
- On -Site Water 8 Wastewater Program `
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL ,CHECKLIST
Legal Description: BRUIN PARK, LOT 6, BLOCK 2 Parcel I D:0/19 - /0243
A. WELL DATA "SEE ATTACTHED LETTER FROM
AAROW PUMP AND WELL
Well type PRIVATE If A. B, or C provide PWSID# N/A
Date completed 1964 Sanitary seal (Y/N) YES
Total depth '98 ft. Cased to '98 ft.
FROM WELL LOG
Date of test Ot j
L
Static water level _ ���,� ft.
Well production g.p,m,
WATER SAMPLE RESULTS:
Well Log (Y/N) NO
Wires properly protected (Y/N) YES
Casing height (above ground) 18+ in.
AT INSPECTION
6/4/2008
28, ft.
1.2'. g.p.m.
Coliform _0 colonies/100 ml. Nitrate NO mg./L. Other bacteria _0 colonies/100 ml.
Arsenic: 49.3 ug./L. Date of sample: 6/4/2008 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 7/22-24/2008
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping NEW Pumper
C. ABSORPTION FIELD DATA PBELOW FiNAL GRADE
Date installed 7/22-24/0e Soil rating (g.p.ddit'o /bd 0.8 System type 5 -WADES
Length 88 (2 ® 44) ft, Width 5 ft. Gravel below pipe 3.02 ft,
►7.16/
Total depth 6.11 ft. Eff. absorption area 758 ft' Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test= in. Water added=gal New depth =1n.
Elapsed Time: = min. Final fluid depth = in. Absorption rate >= 600+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (Y/N S type) NONE KNOWN 'If yes, give date-
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at in. "Pump off" level High water at
level at In•
Dat u Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM 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 N/A Public sewer manholelcleanout N/A
Sewer /septic service line 25'+ Holding tank N/A
Animal containment areas -20- '+ 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 t0'+ 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 I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date -712"3106
COSA Fee e Y 10 1 ( ?
Date of Payment 3,0 j 0?
Receipt Number c-IL41 lots
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
Municipality of Anchorage
Development Services Department
Building Safety Division 'if^
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Arsenic Advisory
Certificate of On -Site Systems Approval # 080253
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 2, Lot 6 of
Bruin Park Subdivision. This inspection revealed an arsenic concentration of
49.3 micrograms per liter (ug/L) for the property's well water sample. The
Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 ug/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. information on arsenic is
available from the On -Site Water and Wastewater Program website
(www.muni.or /og nsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
�S�
SGS MIN
1082466001
Client Name
Garness Engineering Group, Ltd.
Project Name/N
Bruin Park B2 L6
Client Sample ID
Bruin Park 132 L6
Matrix
Drinking Water
PIVSID
0
Sample Remarks
All Dates/Times are Alaska Standard Time
Printed Date?ime
06/192008 14:43
Collected Date/Time
06/042008 15:40
Received Date/Time
06/052008 10:20
Technical Director
Stephen C. Ede
Allowable Prep Analysis
Parameter Results PQL Units Medved Container ID Limits Date Date
Init
Metals by ICP/MS
Arsenic 49.3 • 5.00 ug/L EP200.8 C (<10) 06/12/08 06/19/08 NRB
Waters Department
Total Nitmtc/Nitritc-N ND
Microbiology Laboratory
Colony Count 0
Total Coliform 0
Fecal Coliform 0
0.100 mg/L SM20 4500NO3-F B (<I0)
coV100mL SM209222D
col/100mL SM209222B
coVIOOmL SM209222D
06/17/08 JDZ
06/05/08 DLC
06/05/08 DLC
06/05/08 DLC
ARROW PUMP & WER SERVICE, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 • Fax (907) 333-8976
Eagle River: (907) 622.9335
CUSTOMER
Ak 99 77
W(DOCE
N° 08094
JOB SITE
71-
I
Sid -G a-a5'��
Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that If above work Is not paid for in 90 days I agree to allow Aarow
Pump a Well Service. L.LC, are right to remove unpaid for equipment and charge for labor already performed a labor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
mvpceD O
/
WELL D.PTy.,�/
�O/
SWL
CMORILTEO
PIMP OEM
BALE N
QUANTITY
DESCRIPTION
PRICE
AMOUNT
N
I •i,
37
6
eq
LABOR
HOURS
RATE
AMOUNT
TOTAL MATERIAL
TOTALLABOR
WORK ORDERED BY
DATE COMP. I
TOTAL
LABOR
PAY THIS AMOUNT
7s -
Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that If above work Is not paid for in 90 days I agree to allow Aarow
Pump a Well Service. L.LC, are right to remove unpaid for equipment and charge for labor already performed a labor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME II
0uA-,Lc(-f tj 0
TIME
j
DATE
DAT
DATE
INSPECTOR
INSPEI R
INSPECTO
drt
❑ Two ❑ Five
lel Three ❑ Six
ce
(� INDIVIDUAL'
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH& ENVIRONMENTAL PROTECTIO DEPT.MJItCN1LEMNI i'."'.Gil G
825 L Street• Anchorage, Alaska 99501A�:..��CTION
•
ENVIRONMENTAL SANITATION DIVISION AUG 15 1980
� Telephone 2643720
R F (F I v
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACTCITIESL D
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
I. PROP RTV OWNER PH NE
e AK�� /%/-d�sa
MAILING ADDRESS
1&a5- /) L
PROPERTY RESIDENT (lI different fr r above)
eita Xevia 60
PHONE
/P;zz
&
2. B ER //
b
FHUNE
el DOL
MAILING ADDRESS
S ,Bo.r 1-7'7&
3. LE ING INSTITUTION /
/�J/(—Kn G 1
PHONE
MAILING ADDRESS
117' 5-7 l�7/S7i/PSS Q f C
4. RE LTOR/AGEN7 „^ PHONE
,41ee ///JJ//�7/i/ a79 a
MAILING ADDRES,S
-/yy��
�� C USr
5. LEGAL DESCRIPTION
ell �, &1,/N
441
STREET LOCATION
Sty w e zjKl!l
/
eGv-i/
O/) O/I
iet r O tor//
6. TYPE OF RESIDENCE
NUMBER OF, EDROOMS
IZ SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ MULTIPLE FAMILY
❑ Two ❑ Five
lel Three ❑ Six
7. WATER SUPPLY
(� 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.)
8. SEWAGE DISPOSAL SYSTEM
I51,r INDIVIDUAL/ON-SITE" Z/f-& YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLICUTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
%'J
s
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
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: POO If Tank is homemade
give dimensions:
SOILS RATING
33
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELLTO:
SepdclHoUng Tank
(6�
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
ta-�APPROVEDFOR BEDROOMS ✓ /
❑ CONDITIONAL APPROVAL (letter must accompany certificate) r ((l
❑ DISAPPROVED -Th1ej
DATE BY _Ln _. /L tc..
ck- 1-loId-t-
(,(� .5!!
72010 (Rev. 6/79)
I
MUNICIPALITY OF ANCHORAGE
5.
• '\ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
N<� S'�i�✓'SicN
L Street -Anchorage, Alaska 99501
5�e, en
/825
i ENVIRONMENTAL ENGINEERING DIVISION
6. TYPE OF RESIDENCE
�- Telephone 264-4720
t
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES' '
DIRECTIONS: Complete all parts on page 1. InccmPlete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER-j /G—F
PHONE
Lf INDIVIDUAL'
MAILING ADDFj ESS
❑ COMMUNITY
S"XI
❑ PUBLIC UTILITY
PROPERTY RESIDENT 111 tlillerant from above)
8. SEWAGE DISPOSAL SYSTEM
PHONE
.rn"
"If individual/on-site, give installation date_ l%G% ,
❑ PUBLIC UTILITY
2. BUYER_ PPHONE
by this Department.
MAILING ADDRESS
72.01012f7RI
3. LENDING INSTITUTION
-SVolG W
PHONE
MAILING ADDRESS
,^ •' ✓ 24) lig
4. REyyLTOR AGE T«
C l
PHONE
P
MAI LI N G A D DRESS
St�o/ 4 -x -
z
5. LEGAL DESCRIPTION
!�
N<� S'�i�✓'SicN
STREET LOCA//ION I\\
W elell
5�e, en
we
6. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
ET SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ MULTIPLE FAMILY
❑ Two ❑ Five
fR'�Three ❑ Six
7. WATER SUPPLY
Lf INDIVIDUAL'
' ATTACH WELL LOG. A well fog is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach fog if available.)
8. SEWAGE DISPOSAL SYSTEM
❑ INDIVIDUAL/ON-SITE"
"If individual/on-site, give installation date_ l%G% ,
❑ PUBLIC UTILITY
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATED.
72.01012f7RI
e 1—at_u s
� w�ty;a C°d`"y
Pte- a� �- «,�,� Sx 0 v
An
(wla
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 ❑ 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 -.
❑Septic Tank or ❑Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Hold, Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
6. COMMENTS -
or'4mc, to
❑ APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE -
BY Titlel..
i
LEGAL DESCRIPTION
i
72-010 (Rev. 3/78)