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RABBIT CREEK VIEW & HEIGHTS BLK 7H LT 11A
Rabbit Creek View & Heights Block 7H Lot 11A #020 - 571 -12 ^_3Y 0 MUNICIPALITY OF ANCHORAGE nr On -Site Water &Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 f http://www.muni.org/onsite f Uepart lent On -Site Wastewater Disposal System Permit Permit Number: OSP191192 Work Type: Septic Upgrade Tax Code Number: 02057112000 Effective Date: Expiration Date Site Legal Address: RABBIT CREEK VIEW & HEIGHTS BLK 7H LT 11A G:3340 Site Mailing Address: 7801 SUSAN CIR, Anchorage Owner: MORRIS JAVAN ANDREW & Design Engineer: FORGE ENGINEERING This permit is for the construction of: Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Lot Size in Sq Ft: Total Bedrooms: 6/6/2019 6/5/2020 43327 ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing CO s 1ad%(J � X Co # 2: E/ J -i * 8P +k YtA 4-o 6", Lis J Received By: Date: q Issued By: Date: 6 % 5 MUNICIPALITY OF ANCHORAGE t� Community Development Department `` - - Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-571-12 Property owner(s) Javan Morris Mailing address 7801 Susan Circle Anchorage, AK Site address Same Day phone 947-4193 Legal description (Sub'd., Block & Lot) Rabbit Creek View & Heights, Block 7H, Lot 11A Legal description (Township, Range & Section) Lot Size 43,327 Sq. Ft. Number of Bedrooms Five APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑x Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ElUpgrade 1ZDuplex (D) ElHolding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Sg51" Waiver Fees: Date of Payment: 5/A,3/ l9 Date of Payment: Receipt Number: 49(e5L?Z4 Receipt Number: Permit No. o5p l4C I qa Waiver No. Permit App_'- :- :' .. c; PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) June 3, 2019 MOA Development Services Department of On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Rabbit Creek View & Heights, Block 7H, Lot 11A – 7801 Susan Circle Septic System Design Dear On-Site Services Engineer: The absorption trench on the subject lot has failed and must be replaced. We are submitting this permit application for the construction of a new absorption trench. The existing Advantex Treatment System will remain in service. The attached site plan identifies the location of the home and the existing well and septic system along with the proposed location for the new absorption trench. No conflicts exist between this proposed trench and any other well or septic system on this lot or adjacent lots. The ground surface on the lot slopes to the north at grades approximating 20% in the area of the proposed trench. There are no slopes greater than 25% within 50 feet downslope of the trench. Ground surface contours are shown on the site plan indicating the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. The new system will be a minimum of 100’ from all wells and surface water, 10’ from any water service and more than 5’ away from the septic tank. Please refer to the attached test hole log and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 6/3/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191192, Rebecca Carroll, 06/06/19 1420 1425 1430 1435 1440 10050 0 FEET 1"=50' 5-BDRM HOME NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TH1 RABBIT CREEK V&H, BLOCK 7H LOT 11A SLOPES > 25% SLOPES > 46% SUSAN CIRCLE 5/23/19 10' UTILITY EASEMENTEXISTING 2,000-GAL ADVANTEX TANK W/2- AX20 POD EXISTING ABSORPTION TRNCH 45' LONG X 5' WIDE X 1' EFFECTIVE DEPTH ABSORPTION TRNCH EXISTING WELL PLACE 3 BALL VALVES IN IRRIGATION VAULT TO CONTROL FLOW TO EACH TRENCH MT MT EXISTING WELL EXISTING WELL Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191192, Rebecca Carroll, 06/06/19 RABBIT CREEK V & H, BLOCK 7H, LOT 11A DESIGN FACTORS: SYSTEM REQUIREMENTS: 750 GPD PEAK FLOW PERK RATE: 3 MIN/IN APPLICATION RATE: 5 GPD/SF 5' WIDE TRENCH SYSTEM EXISTING ADVANTEX TREATMENT SYSTEM TYPICAL TRENCH SECTION (NO SCALE) 1" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 5' 2' 1' NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY BOTTOM OF TRENCH: 2.5' BELOW GRADE FLOW LINE ELEVATION: 1.5' BELOW GRADE TOP OF TRENCH: 2.0' ABOVE GRADE 750 GPD / 5 GPD/SF /5' WIDE * .87 RED. FACTOR = 26.1 LF TRENCH REQUIRED (45 LF SPECIFIED) 5/23/19 3 1 4" TOPSOIL AND REVEGETATION 3 1 1' 6" 30 -3/16" HOLES @ 1.5' SPACING Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191192, Rebecca Carroll, 06/06/19 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN See Site Plan DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP TEST HOLE PRESOAKED PRIOR TO TESTING: PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) rabbit creek v&h b7h l11a 7/20/18 n. shafer DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH OF WATER AFTER MONITORING: IF YES @ WHAT DEPTH? NO - 4.5' 3.0 6 2 3 020-571-12 CLIENT 17:10 / 17:20 2/21 1 2 3 4 5 6 10 4" - 7 6 16 " 3 6 16 "17:21 / 17:31 17:32 / 17:42 17:43 / 17:53 17:55 / 18:05 18:06 / 18:16 1' OB 5/22/19 Professional Engineers Stamp: 5/23/19 10 4" - 7 8 16 " 3 8 16 " 10 4" - 7 5 16 " 3 5 16 " 10 4" - 7 6 16 " 3 6 16 " 10 4" - 7 6 16 " 3 6 16 " 10 4" - 7 6 16 " 3 6 16 " SILTY SAND w/GRAVEL SM/GM BOH Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191192, Rebecca Carroll, 06/06/19 ,~ar~ ~egich Mayor P.O. ~x (907) :q~-7904 Pump Installation Log V~zeI1 Drilling Permit D~te of Issue: parcel Iclentific.~tion Number: t351,2 B~ Pump Size g~' hp Pidess AdapC~r Buriml Depth: /5"' feet Pirtess _~clapter Installer: Property Ovuer Ma~. e & Address: Pump O Municipality of Anchorage ';~ ~ Development Services Department ~~: Building Safety Division~.~ ,, ,.,: ;,~,f On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 4 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND]OR WELL INSPECTION REPORT Permit Number: OSP101126 PID Number: 020-571-12 Name: Javan Morris Wastewater System: [] New [] Upgrade Address: Susan Circle ABSORPTION FIELD Phone: Number of Bedrooms: §47-4193 ~; [] DeepTrench [] Shallow Trench [] Bed [] Mound [] Other: LEGAL DESCRIPTION Sei, Rating: Total Depth from original grade: 5 GPD~F,2 1.5 Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 7H 11A Rabbit Creek Hei!lhts 1 Ft. 0.5 Township: Range: Section: Fill added above original grade: Gravel Length: 2.5 Ft. 50 Ft. Well: [] New [] Upgrade Gravelwidth: Number of ,nes: I Distan~bet~een,nes: 5 Ft. 1 - I Classification (Private, A, B, C): Total Depth: Cased to: Total absorption ama: Pipe Material: Private 200 Ft., 84 Ft. 250 Ft2 3034 PVC Driller: Date Drilled: Static Water Level: Installer: Date Installed: Sullivan Water Wells 9/1/2010 0 Ft. Spinell Homes Inc. 9/23/2010 Yield: I Pump Set at: Casing Height Above Ground: 10 GPMI 175 Pt.2 Ft. TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity: From~ Tank Field Station Tank Sewer Line Anchorage Tank 2000 Ga~. Material: Number of Compartments: we, 153.9 142.1 166.4 133.5 Steel w/2Ea. AX20 pod & lift station 2 Su~aoeWater 100+ 100+ 100+ ~ / LIFT STATION Lot Lin~ 54.2 11.4 53.5.~ B~e: Menufaeturer: 250 ~. Orenco/Anchorage Tank "Pump on' level at: "Pump oW level at: in. High water ala~ at: ,o~a~o~ 19.5 20.5 31.9 +40 i~. +36 +45 cu~. ~ra~ N/A N/A N/A "~ ~"~ ~ uoo.~ S,*~,,.,pe~,o.,pe~o~m.O P2005.1 Allied Alaska Electric Rema~s: BENCH MARK Location and Description: Spike in tree near tank Assumed Elevation: 100.0 Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1'~ 9/23/2010 Development Se~ices Depa~ment Approval E ~ ." ~ 'Y , "-- ~ Conditional Approval Date: ; :' 49th ~ ': Reviewed A B C D E LOTS UNDEVELOPED '"-,, FC 4.4 17.0 NO WELLS OR SEPTICS WITHIN 200 rr ' T1 22.7 45.5 '. LS 5'1.9 51.1 ~M ~ M1 66.7 69.7 ~ WELL 66.7 69.7 · : r ~ ~ ........ ~ %~ Z'""'"~--=..=..~..F ......... :z.=_.: __ t "X .... / ~J 50L~X 5'WX 0.5'~ .. ~. '~ ~ ' / ~2000g STEP TANK ~ ~ ~ '/ AREA ~ · ;/~ 1 F ..... ~ / / W/aEA. AX ~0 ~O~S a ~' .~ '. ~ . , AUX ~u~ VAULT , ~ ~~ ~ p~+.'~ ~ ~-.~~... 5BR HOUSE .~ ........... ~ .... ~ o ~.... .~':~E:u..' ~ ,' ~ ' ......... ,.'~.;~;:..;: D ............ : . ~.~ .SSLF X 5'W X O.5'ED X 2.5'TD ~ ' '".. LOT UNDE~LOPED · "'.. ' NO WELLS OR SEPTICS~ITHIN 200 ~ / NOTES: P~O~ ~T~_ ~Z~ T J ~ -'?~' OF ' hh, Date RECORD DRAWNG ~v~ ~1~ ~ ~ - ~ AL~ ll~ 04/07/11 P.O. BOX 100217 ANCHORAGE, AK 99510 ~.- ............ .~ PHON~ (~o~)~z~-82~ tAX (~0~) ~2-8~ g~-'" ~-~?,, Sc~,~ ~.'~9th ~ '-.~$ 1"=so' : ................... ~ P.I.D. NO RABBIT CREEK HTS BLK 7H LT 11A~ Javan Morris ~NO~'.'Z'~°2°-571-1: ~ ~ -. 0E-8149 .'~w: PERMIT NO. ~ez'.. .." ~ 0SP101126 ANCHORAGE, AK 99515 ~e,X.. .......... .~ Sheet PLAN (907) 559-6427 "~.~Ess,~,- ,~~ 2 OF 4 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. ,3. SCOPE OF WORK: INSTALLED NEW 2000 GALLON STEP TANK, 2 EA AX20 AND NEW SOIL ABSORPTION SYSTEM. 4-. GROUNDWATER WAS OBSERVED AT A DEPTH OF 7.5' AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 7.0 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. /,/2.5 FILL TOP SOIL & VEGITATE 103.7 FG ....----FILTER FABRIC PES TH-2 / , ~DRAIN R'~3K 6" ABOVE PIPE INV 001.2) ~0!.20c ~ 0.5'-t ,..~F~,~-~ OR OR 1.0'~;¢~_ ~ '~ SM/ BROWN SILTY 0'5'J I ~.__5.0~%i~['-~..~.~__1 ~" DIA DRAIN PIPE W/.~"O -4.5 -- GM/ SILT W/SOME GRAVEL ML SOME SAND -~3 BB.7 SEO¥10N nO ~' ~ ,,z, ~-FILTER FABRIC //--DRA,NROO 'ABOVEP,PE,.¥ o ~ o ~ ~ ~ ~" HOLES < 103.7 FG C 24" O.C. ~ 00.2 0.5' 95.~ ~0 ~CH TRENCHES ~ ' NEW 1500g 95.4~ STEP 95.2 TANK _ WI1 ~20 POD PROFILE DESIGN PARAMETERS ABBREVIATIONS LEGEND PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 5 (750 ~pd) CU COPPER ~ W WATER LINE/ TANK SIZE: 2000g DIP DUCTILE IRON PIPE WELL RADIUS PERC RATE = 6-15 MPI TH TEST HOLE SOIL RATING: 5 GPD/SF FC FOUNDATION CLEAN OUT SS NEW SEPTIC AREA RQD: 150 SF T¢ TANK CLEAN OUT NO. SYS. ~PE: WIDE TRENCH 0.5' E.D. C¢ CLEAN OUT NO. MIN LENGTH: 50 LF M~ MONITOR TUBE NO. R.I. RIGID INSU~TION USE: DCO DOUBLE CLEAN OUT 50 LF X 5' WIDE, 0.5' E.D., DV DIVERTER VALVE 1.5' TD FS FLOW SPLICER TOTAL AREA: 250 SF No s: '"; ff~> .. .......... ~2~ o4/~ ~/~ RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510~ '--~'"'~':¢'"~, PHONE (907) 272-8218 FAX (907) 272-8211 ~.""~9th ~ '"'* '~:'" Sco,eNTS RABBIT CREEK HTS BLK 7H LT 11A ~ ................... CP.LD. NO A -~020-571-1 Jewn Morris z¢¢'-, cE-8~4e ."~: ~t~ ¢~'.. ,.'.~: 0SP101126 ANCHORAGE, AK 99515 ~t~e~" .......... '4~ sh~t DESIGN DETAILS (907) 539-6427 q'",~Ess~''4 50F 4 SOILS LOG - PERCOLATION TEST TEST HOLE 3 SLOPE I ~, Sn'E PLAN ~ '~ \ I EXISTNG ~ 'x \ ii ] PEAT/ROOT OR MASS .......... BaH WAS GROUND WATER SLOPE ENCOUNTERED? N TH 1 IF YES, AT WHAT DEPTH? -0-' X DEPTH TO WATER AFTER MONITORING? DRY DATE: -- I WATER CLOCK READING DATE ; TIME NET TIME LEVEL NET DROP ' READING '~ 11:29 --- 2.71 0 2 11:39 10 5.37 2.66 3 11:40 --- 2.71 0 4 11:50 10 5.12 2.41 5 ! 11:51 --- 2.71 0 6 12:01 10 5.02 2.31 WATER CLOCK READING DATE TIME NET TIME LEVEL NET DROP READING '~ 11:29 --- 2.71 0 2 11:39 10 5.37 2.66 3 11:40 --- 2.71 0 4 11:50 10 5.12 2.41 5 11:51 --- 2.71 0 6 12:01 10 5.02 2.31 PEROLATION RATE 4.3 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 2 FT AND 3 FT DATE PERFORMED: 9/23/2010 COMMENTS: Test hole excavated by Spinell Home Inc. Prec hole was presoaked. PERFORMED BY: Steven R. Pannone~ P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNONE BNG SVC, LLC .?:.,--~,~ ......~.r..../t/..~"'l',ll, Dote RECORD DRAWING P.O. BOX 102954 ANCHORAGE, AK 99510 ._---~'x.?.'" ',"..747~¢ o4/o7/1~ PHONE (907) 272-8218 FAX (907) 272-8211 :-~ .-" ~".~m5¢ Scele ~ ..' 49th ~ .: ¢ NTS RABBIT CREEK HTS BLK 7H LT 11A ................. ,¢P.I.D. NO Jovan Morris ~6~'~' ' ,~ o,'. CE-8~4-9 .'¢ . PERMIT NO. 'I,%"... ....:~.4.?__: 0SP101126 ANCHORAGE, AK 99515 '"~,,,~c~.. (?~%'~'" Sheet SOILS LOG (907) 359-6427 tt~,~,~,,,,,~.,,- 4 OF 4 SULLIVAN Phone Well Log Permit Number: OSP 101125 Date of Issue tu17/2OlO Date Started: 8t31~20~0 Date Completed: 9t112olo Property Description RABBrr CREEK HGTS Lot 11 Block 7 Property Owner Name & Address: ' Borehole Data: Soil Type, Thickness & Water Strata Casing Stickup Fill Peat Sand & Gravel W/Clay Hardpan W/Clay Yellow Bedrock Broken Gray Bedrock Brown Bedrock Green Bedrock Brown Bedrock Gray Bedrock Dark Gray Bedrock Gray Bedrock Dark Gray Bedrock Gray Bedrock Parcel Identification Number: Is well located at approved permit location? Section: Town: SPINELL HOMES 1900 W. NORTHERN LIGHTS BLVD. SUITE 200 ANCHORAGE, AK 99517 Depth From To 0 2 2 5 7 22 71 87' 87 91 91 99 99 123 123 149 149 164 164 170 170 173 173 184 184 200 F FCE1VED Homes, ~nc. Water Sample Results: Arsenic: Nitrates Total Coliform Bacteria colonies/100mL Other bacteria: col/1 00mL 02057112000 [~¥es L2}No Range: Method of Drilling [3 air rotary [i_i cable tool Casing type: Wall thickness 0.28 inches Diameter 6 inches Total: 114 feet Liner type: Dian~eter 4.5 inches Depth: 120 feet Casing stick-up above ground: 2 feet Static Water Level(f~om top of casing) Pumping Level: feet after 1 hours pumping gpm Recovery Rate 10 gpm Method of Testing: Air 0 feet Well Intake Opening Type Ii_il Open End [_X.t Open Hole [-] Screened Start feet Stopped feet [~I Perforations Start feet Stopped feet Grout Type: Bo~nt~lte dry granula[ ... Volurae: 50 Pounds Depth 44 Start 0 feet Stopped 44 feet Pump Intake Depth: feet Pump size: HP brand name Well disinfected upon Completion? ~Xl Yes I ! No Method of disinfection CHLORINE 50 PPM Comments: WELL IS FLOWING OVER THE TOP. Well Driller: Cole Sullivan Sullivan Water Wells P.O. Box 670272 Chugiak, AK 99567 (so7) ~-2750 Attention: The property owner shall provide thislog to DSD (onsite) and DNR within 30 days of completion. 156 M~ycr Pump Installation Log We]2 D~2L~g Permit Number: D~te of Issue: ,,, parcel Identification Number: . Ptu~p L~t~ke Depth Be[owTop Property Owuer b~ame & .&ddreas: pt, rap Siz~ ¢~" hp p~tless .,-kctap~r Buff~ Depth: /5"'~ ?ir!ess ~_d2n~az Zn~nJ2~r: Pump Lu~znLIer ~r~me: April 7. 2011 FAX: !'907) 694-7026 Arm: Spinell }'tomes Sul,~icc!: Lift Statim~ Inspection at prope:rLv staled belm~. This le. ttc) ts ~, con:iSrm [:t]a[ t:he lift sta;tion(s) at: * iLot 11A,. BloCk 7H - iRabbit C.:reek }{eigh:t~s ~:as wired by. a l:icensed J{)umcx:nlan,.:: ~" ' Electrician in acc(~rdan.ce with thc' 2008 Natiomd if~vou x~:ould like am. :lhrlher infbnnalion. Please lke] fi'ce to call. our c lhcc'~ ": ' ' al the nut:hbe:rs Iisi:ed belOx~'. ~Iiiank yom Smcerely~ ALLIED ALASKA ELECTRIC, Martin D. Brown. President cc; file On-Site Water & Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP101126 Tax Code Number: 02057112000 Work Type: WellSeptic Initial Permit Effective Dates: August 17, 2010 Design Engineer: Subdivision: to August 17, 2011 PANNONE ENGINEERING SERVICE RABBIT CREEK VIEW & HEIGHTS Site Legal Address: RABBIT CREEK VIEW & HEIGHTS BLK 7H LT 11A G:3340 Owner/Address: MORRIS JAVAN A & MELODY 2404 LUSARDI POINT CIRCLE ANCHORAGE AK 995153151 Site Mailing Address: 7801 Susan CIR, Anchorage Lot Size in Sq Ft: 43327 Total Bedrooms: 5 This permit is for the construction of: Y Disposal Field Y SepticTank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: ~/)") ~n ,".Fe C'~- ,~e lm The proposed system is in a diffeJent soil stratum than the strata that was tested. The Engineer needs to do an additional percolation test prior to the construction of the septic field. Please submit stamped and signed results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. AMC 15.65.060.B.2 Date: Date: Municipality of Anchorage ONSITE ~VAT'E.R & WASTEVFATE'R 'PROGRAM CHANGE O~ER PERMIT # PID SUBD k.(:i,'~)b'~Jr c/%~_,,".~ ~'-(=-(_~ TRACT BLOCK'? /-[ LOT i(/'~ CONTACT PERSON PLEASE GIVE A DESCRIPTION OF THE CHANGE CUSTOMER SIGNATURE On-Site Comments Review Reviewer: Issued Time (date) (hours) APPROVED (date) TOTAL HOURS HOURLY RATE $130 TOTAL TO BE PAID~ ~ REcEz, r # O71 e_ q I Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www. muni.org/onsite (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SIN~L~© F FAMILY DWELLING ? SI?'/~?/i.2 d~ Parcel I.D. ~c ~ ~ 7 l- /.~2 Property owner(s) Javan Morris Mailing address Site address NHN Susan Circle Day phone 339-6472 Zip Code Zip Code 99516 Legal description (Sub'd., Block & Lot) Rabbit Creek Hei,qhts, Block 7H, Lot 11A Legal description (Township, Range & Section) Lot Size ~'~ ._'~'7~'~ Sq. Ft. Number of Bedrooms 5 THIS APPLICATION IS FOR ([~ all that apply): Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] I certify that the above information is correct. ! further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable. Municipal Codes. Pannone Engineering Services, LLC ~~:~>. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: Pannone Engineering Services LLC Steven R. Pannone, Principal Re§istered Professional En§ineer E-maih steve~panengak.com Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 September 21, 2010 Subject: Rabbit Creek Heights S/D, Block 7H, Lot 1 lA Septic System Permit Request CHANGE ORDER Ladies and Gentlemen: I am writing to request change in the existing permit issued for this property (OSP101126). The requested change is to modify the permitted conventional system to an advanced wastewater system. This change is necessary due to higher than expected ground water in the area of the primary system. The ground water was measuredat seven and a half feet (7.5') below ground level on September 10, 2010 when we were preparing to install the permitted system. Work was stopped and we modified the design (see attached) to reflect the proposed change. 1. Soils. A test hole was excavated by PES on May 11, 2010. See the attached soil log. Ground water was monitored for over seven days and through the May high water period. Ground water was monitored to a depth of 11 feet below ground level after the monitoring period. Bedrock was not encountered in the test hole. A second test hole was excavated by PES on July 26, 2010. See the attached soil log. Ground water was monitored through September 10th. Ground water was monitored to a depth of 7.5 feet below ground level after monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 5 gpd/sf for a category III system with a pressurized discharge should be used for the primary and reserve systems. e Soil Absorption System Design. See Design Drawings sheet 2 of 3 for the design calculations. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately 15 percent. The area the septic system will be installed is approximately 20 percent. There are no steep slopes within 50 feet of the proposed septic system. Maiting: f~O~ Box ~00217~ Anchorage~ AK Physical: 61.5 East 82~'~/Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-.,82~8 [.AX: (907} 272-82~ Page 2 of 2 The proposed change will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, .......... _. c~ ~... ~ .....-~**. ~ TH . 49-- Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Mailing: P~O. Box ~002J, 7, Anchorage~ Physical: 615 East 82~''d Ave, Cuil:e B6, Anc,horage~ AK 99505 Telephone: (907) 272~.821.8 FAX: (907) I LOTS UNDEVELOPED I NO WELLS OR SEPTICS WITHIN 200 FI- ' 50LF X 5 W X 0.5 ED W ~ "'~ .... N/ , x ~.~'~ / -~ ~ ~ ...... ~ ~ ~ ~ .... TH .f~ , ~"'/ ~ ~ .~ ~ ~ ~ ~AREA o ~ . ' .... ~ o ~ r/ / ~/ ~ Z ~ ® ~ '"" ~' ":: ' ........ 10 ~~ / "'"N L2BR HOUSE ............ ..:. .. (E) ' .................. { ~~ ~~g}~TAN K ' ~ '~ri .. ...... .o~ u,A~w,o~ / ............ ~ _ _, '~ Date 0 A ,0~s: P~O~ ~G ~C, ISSUED FOR CONSTRUCTION p.0. BOX 100217 ANCHORAGE, AK 995~0 i~-- .....L ~ 9/21/10 REV1 PHONE (907) 272-8218 F~X (907) 272-8211 ~.. ~:]W~ Scale ~...~m~ ...,~ ~"=~o' RABBIT CREEK HTS BLK 7H LT 11A ~-'~~ ......... ~ P.I.D. NO ~~~- ~ ~xx-xxx-x: Jovan Morris ~-~ ~i, ~-. c~ 81~9 .~ ~ ~o. ANCHORAGE, AK 99515 ~.. ,,~ 0SP101126 PLAN (907) 559-6~27 , i~ gO~~ Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE A17ACHED SPECIFICATIONS. 5. SCOPE OF WORK: INSTALL NEW t-ra~B{~GALLON STEP TANK, 2 EA AX20 AND NEW SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS OBSERVED AT A DEPTH OF 7.5' AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 7.0 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. ./.-~ 2.5 FILL TOP S01L & VEGITATE ./--FILTER FABRIC SM/ BROWN SIL~ 0.5" ML ~ND TO SILT ~ --7.5 SM/ G~Y SIL~ SAND ML SOME G~VEL _~; SECTION ~ POD 0.5' ~0 ~CH TRENCHES PROFILE DESIGN PARAMETERS ABBREVIATIONS LEGEND PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 5 (750 gpd) CU COPPER -- W WATER LINE/ DIP DUCTILE IRON PIPE WELL RADIUS TANK SIZE: PERC RATE = 6-15 MPI~ TH TEST HOLE SOIL RATING: 5 GPD/SF FC FOUNDATION CLEAN OUT SS NEW SEPTIC AREA RQD: 150 SF T~ TANK CLEAN OUT NO. SYS. ~PE: WIDE TRENCH 0.5' E.D. C¢ CLEAN OUT NO. MIN LENGTH: 50 LF M~ MONITOR TUBE NO. R.I. RIGID INSU~TION USE: DCO DOUBLE CLEAN OUT 50 LF X 5' WIDE, 0.5' E.D., DV DIVERTER VALVE 2.5' TD FS FLOW SPLICER TOTAL AREA: 250 SF ISSUED FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ~.~%~ ..... REV~ PHONE (907) 272-8218 FAX (907) 272-8211 J~ w n M orris ~~--~~'F~~ '~: 'P~6~;~ <xx-xxx-x~ r~.. CE 8149 -~ PERMIT NO. ANCHORAGE, AK 99515 f~ ... ... DESIGN DETAILS (907) 559-6427 t~¢~o~¢{o~ Sh~t ADVANTEX SYSTEM DESIGN 2EA. ADVANTEX 2Zl.'' 4" JIM CAP~Ax20 POD~ INSULATED AUXILIARY PASSIVEAiR 4" PUMP-OUT/ : /_ SLIDE SECTION OVER THIS CONNECTION . TO PROVIDE SHEER PROTECTION- 14' EXTEND TO BRIDGE EXCAVATION ~~. D a t e P.O. ~ox ~oo~z ANCHORAge, AK ~S~O ~" '~~. ISSUED FOR CONSTRUCTION PHONE (907) 272-8218 FAX (907) 272-8211~ ~=~J~. Scale RABBIT CREEK HTS BLK 7H LT 11A ~~~ P.I.D. NO ~~~~ (XX-XXX-X) Javan Morris~i~'. c 49 ri, ~evenE~lvan~' .... PERMIT NO. ANCHORAGE, AK 99515 ,~.. .~ swxxxxxx I1~'~ ~' ..... ~k~ Sheet DESIGN NOTES (907) 339-6427 'l~:~m°E~ll~TX~~ ~ 5 OF5 TEST HOLE OR SM/ ML 9 I 13 BOH 14 15 -- 16 -- ~8 PEAT BROWN SILTY SAND TO SILT. SOILS LOG ~ P:.RCO'LA, tU.N TEST SLOPE . .. ',, X TEST .HOLE WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? -0-' DEPTH TO WATER AFTER MONITOR.NG9 - ll DATE: 5-18-10 9/10/10 DRY READING 7 DATE SLOPE TH I X OLOOK WATER NET DROP I RATE I TIME I NET TIME READING LEVEL (MPI) 10:20 II 30 6.76 , 18.07 10:20 ! --- 5.2! I 0 10:50 30 10:50 1t:20 j 30 7.22 2.01 5.21 0 7.!9 ! .98 PEROLATION RATE 15.1 (min/inciq) PERC HOLE DIAMETER 6 inches TEST RUN BE-Rt,/EEN 4 FTAND 5 FT DATE PERFORMED.,: 5/11/2010 COMMENTS: Test hole excavated by FLINSTONE SERVICES~ t:~ec hole was ~resoak_ed. PERFORMED BY: Steven R. Pamnone, P.E. ! CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON TIlE DATE OF THIS TEST. NOTES: ISSUED FOR CONSTRUCTION ;REV 1 SOILS LOG PANNONE ENG SVC, LLC P,Oo BOX ' ~¢L ~ , ~0293. ANCHORAGE, AK a'9510 PHONE (907) 272-8218 FAX (907) 272-8211 RABBIT CREEK HTS BLK 7H LT 11A Jovan Morris ANCHORAGE, AK 99515 (907) 359-6427 TEST HOLE 2 F 1 --1 .O R 3 SM/ I ML GM/ ML 10 11 12 13 BOH PEAT/ROOT MASS BROWN SILTY SAND TO SILT. GRAY SILTY SAND/SOME GRAVEL SOILS LOG - PERCOLATION TEST sLOPE i ...... S:~FE Pt.AN PFS TH2 X TEST HOLE WAS GROUND WATER ENCOUNTERED? N ~F YES, AT WHAT DEPTH? DEPTH TO WATER AFTER MONITORING? DRY DATE: 8-3-i 0 9/i 0/10 7.5 i CLOCK READING i DATE TIME j 1:11 2 [ 1:21 3 t ,, i 1:22 5 SLOPE J 1:32 I ! :33 RATE 3.85 4.05 TH 1 X 'WATER i NETTtME LEVEL i NET DROP j READ!NG , --- j 3.53 0 i '~ 0 ! 2.60 6.i3~ , j 10 6.1, 2.47 ! ---I 3.5 :43 i 10 I 6.09 2.58 3.88 PEROLATION RATE 4.05 (rain/inch) PERC HOLE DIAMETER 6 inches TEST RUN BE ~-P~VEEN 5 FTAND 6 FT DATE PERFORV,,ED: 7/28/2010 COMMENTS: Test hole excavated by FLINSTONE SERVICES, Prec hole was presoaked. PERFORMED BY: Steven R. Pannone, P.E~ i CERTIFY TS-I._AT THIS TEST WAS PERFORMED IN ACCORDANCE r, . S _,ES:. WITH ALL STATE AND MUNICIPAL GUiDLINES tN EFFECT ON THE DATE OF mHi ,-r, n. NOTES: iSSUED FOR CONSTRUCTION REV 1 SOILS LOG PANNONE ENG' LLi3 P.O. BOX 102954 ANOHORAC-.E, AK ~93.0 PHONE (907) 272-8218 FAX [gu/) 272-821! RABBIT CREEK HTS BLK 7H LT !1A davan Morris ANCHORAGE, AK 99515 (907} 339-8427 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND ~T'otv'o. ux fVlOr, r~'j THIS MEMORANDUM OF UNDERSTANDING made and emered imo as of this /7~Dayof ~<e/o~-em.~)e(' of 20 / 0 ., by and between ,~Ta.v'~Jq j~0v'lr'l'j , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants comained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grams permission to Owner to milize and operate an Advanced Wastewater Treatment System (AWWTS), described as /{o/ifa ~ ~ X located at LO'I" IfA~ t~LO51,(, 7[4, t~tJBBIT CI~E~ 14~16-~ 5/,/ff~, Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that Includes the installation or removal of any parts, componems or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuam to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On-Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On-Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On-Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of 1~ ($ ~/.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On-Site approval is issued to the new owner or transferee of the property. 5. Alterations~ Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner' s AWWTS Operating Permit is: yCO6t£1~ C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: MUNICIPALITY: By: ..,.,~ By: -"'" Title: Date~.' 7///7//~' Date: STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoing instrument was acknowledged before me this l '7 day of ~ J~ 20/0, by ~ o.~x~x~_ V'~ ~ NOTARY PUBLIC FOR ALASKA My Commission expires: ~_ ~1: ~:~ ~q Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and 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 FOR A SINGLE FAMILY DWELLING Parcel I.D. COSA# ~..~ ~ ill J (~,p~, Expiration Date: ~'~ - ~ -/,/ GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Day phone Lending agency Mailing address Day phone Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: ~" Day phone TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: ~ Individual On-site [] 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 omsite 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 s~"'a;ffixed hereto and as of the validation date shown below I verify that my investigation based on procedure~ OL~;t~ed in the Certificate of On-Site Systems Approval GuidelineS:for this application, shows that the on-site vCa~[.supply and/or wastewater disposal system is (are) safe, functi°-~qal ~nd adequate for the number o[ibi~roo~'~nd type of structure indicated herein. I further verify that based o~'tlie ~formd{ion obtaini[d fmm~,th~niCipality of Anchorage files and from my investigation and inspection, thb o~'L~ite water supplyr ~nd/o!F~as~e~water disposal system is(are) in compliance with all applicable Municipal and St~e cod~s, ordinance§, ~n~l regulations in effect at the time of installation. Name of Firm Pannone Engineering Services, LLC Phone ~7~-8~8 Address P.O. Box zoo~7, Anchorage, AK 995~-o Engineer's Printed Name Steven R. Pannone, P.E. Date Engineers Comments: In conducting an adequacy test, I 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 ~ystems 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. Ail 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. 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 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. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: -// Municipality of Anchorage Developmnt 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: J2~'~_~'!.~'~-t~="l(~t-/'T'.~ ~ "/1~.; Zz~ !1,~ Parcel ID: A. WELL DATA Well type A,~ Date completed Total depth 2.00 ft. If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to ~ ft. Well Log (Y/N) Y Wires properly protected (Y/N) ~ Casing height (above groUnd) Z.4.// in. FROM WELL LOG Date of test Static water level 0 ft. - Well production ~O g.p.m. AT INSPECTION g.p.m. WATER SAMPLE RESULTS: Coliform/I](a~ colonies/100'mL Arsenic: ~ ug/I SEPTIC/HOLDING TANI( DATA Tank Type/Material/)rA~-~ Tank size 2z:~o~ gal. Number of Compartments Foundation cleanout (Y/N) I~ Depression over tank (Y/N) Date of pumping -- A)~"I,J -- Pumper ---- Nitrate ~,~0~ mg/L Date of sample: Collected by: _.D~--~ Date installed ~__ Cleanouts (Y/N) /I/ High water alarm (Y/N) ouiunies/i G0 ,,,L ABSORPTION FIELD DATA Date installed ~/'/-~/ZOIO Soil rating (g.p.d./ft2 or ft2/bdrm) ~"'~?1/~---/-z' System type~~ Length ~ ft. Width Total depth~,~'- ft. Eft. absorption area'Z.~ ft2 Date of adequacy test' ,~'1~/--" Results (Pass/Fail) tion field before test in. Elapsed Time: min. FIn-~~h __ ft. Gravel below pipe (~,~'-- ft. Monitoring tube, ~ Depression over field A/ For ~-' bedrooms Water added gal New depth in. in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) LIFT STATION Date installed I0/1:~/~310 "Pump on" level at ~D in, Datum ~o'r~Te~vl SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ~*--_'_~, c~ Absorption field on lot, , ~:Z, t Public sewer main '~ Sewer/septic service line It5:~,$~ Animal containment areas '5'-0 ~- Size in gallons '~ "Pump off" level at '~G in. Cycles tested Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. On'adjadent lots 100/- On adjacent lots Public sewer manhole/cleanout IO,~-- Holding tank IOO,/-- Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation !~. ~-" Property line ~'/-//, Water main ~-'/'- Water service line Wells on adjacent lots )~-~,'";~"- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Water Service line Curtain drain ~"~'/- COMMENTS Building foundation Surface water Wells on adjacent lots Absorption field Surface water Water main Driveway, parking/vehicle storage ~'~, %"- 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 Date Steven R. PannOne, P.E. COSAFee $ (-,O~"'~le~'3-~-~- ./~'~ Date of Payment ~/~>'/// Receipt Number (~ql/'"~ (~O Waiver Fee $ Date of Payment Receipt Number (Rev. 11/05) SGS Ref.# Client Name Project Name/# Client Sample ID Matrix 1111029001 Pannone Eng. Srv. Rabbit Creek Hts B7H L1 IA Rabbit Creek Hts B7H L1 lA Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 03/30/2011 11:36 03/22/2011 9:40 03/23/2011 13:05 Stel~hen C. Ede Sample Remarks: 4500NO3-F - Nitrate/Nitrite - MS recovery is outside of QC criteria. Refer to LCS for accuracy requirements. 300.0 - Sulfate - MS recovery for sulfate was outside of acceptance criteria. The LCS is within QC criteria. Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Hardness as CaCO3 94.6 5.00 mg/L SM202340B C 03/22/11 03/24/11 SCL Waters Department Total Nitrate/Nitrite-N 2.06 0. I00 mg/L SM20 4500NO3-F B 03/24/1! AYC Microbiolog~ Laboratory E. Coli Total Coliform Negative I 100mL SM20 9223B A 03/22/11 DLC Negative I 100mL SM20 9223B A 03/22/11 DLC Private Individual Analysis Alkalinity 85.2 10.0 mg/L SM20 2320B D 03/22/11 SDP Aluminum ND 20.0 ug/L EP200.8 C 03/22/11 03/24/11 SCL Antimony ND 1.00 ug/L EP200.8 C (<6) 03/22/11 03/24/11 SCL Arsenic ND 5.00 ug/L EP200.8 C (<10) 03/22/11 03/24/11 SC[, Barium 36.5 3.00 ug/L EP200.8 C (<2000) 03/22/11 03/24/11 SCL Cadmium ND 0.500 ug/L EP200.8 C (<5) 03/22/11 03/24/11 SCL Calcium 27400 500 ug/L EP200.8 C 03/22/11 03/24/I1 SCL Chloride 0.651 0. I00 mg/L EPA 300.0 D (<250) 03/28/11 03/28/11 LCE Chromium ND 2.00 ug/L EP200.8 C (<100) 03/22/11 03/24/11 SCL CO3 Alkalinity ND 10.0 mg/L SM20 2320B D 03/22/11 SDP Conductivity 226 1.00 umhos/cm SM20 2510B D 03/22/11 ATJ Copper 19.8 1.00 ug/L EP200.8 C (<1300) 03/22/11 03/24/11 SCL Fluoride ND 0.100 mg/L EPA 300.0 D (<2) 03/28/11 03/28/11 LCE HCO3 Alkalinity 85.2 10.0 mg/L SM20 2320B D 03/22/11 SDP PLAT NO. 200¢-91 RABBIT CREEK VIEW &: RABBIT CREEK HEIGHTS SUBDIVISION REPLAT LOT 1 lA, BLOCK 7H 43,327 S.F. N 89°23'06"E 100.39' 10' UTIL ESMT. 1"=30' GRAVEL DRIVE N 89°32'28"E 200.03' 81.6' SUSAN CIRCLE GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.LS. 2000 F_.. DOWLI~ RD., SUITE 8. ANCHORAGE, ALASKA 99507 PHONE 248-~ GRID DATE 3240,Z3241 3540/3341 11/15/2010 F.B. ,JOB NO. 10-08 RC1 lATH DETERMINE THE EXISTENCE OF ANY EASEMENTS COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABMSHINO BOUNDARY OR FENCE UNES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE.