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DAFOE BLK 1 LT 1A
bafoe Block 1 Lot 1 A #015-491-09 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191516 PID Number: 015-491-09 Dwelling: ❑® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name CARL WHITE ABSORPTION FIELD ❑ Deep Trench El Wide Trench El Bed El Mound Site Address 6420 ROCKRIDGE DRIVE, ANCHROAGE AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot DAFOE 1 1A Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 113.3 25'+ TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE Capacity 1250 Gal. Surface Water 100+ Material Number of compartments Lot Line 10+ NA STEEL 2 Foundation 10+ LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer NORTHERN CONTRACTING Drainfield CO/MT3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 100 ft Inspection v ectio11/27/19 Location and description 2 w 3°' 4", House Trim ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date .. ..... s'�vein ' "Fnnnoi;e Septic System , ���rk &I/ZS ��$ ' ` a =`=� ��° Approved Date Note: this approval does not include well permit requirements. kmev uoruu io) --K -nno-':�� =CD I Dmx�W�m VZ X0 CD Z I= 0 C) rrl t Z Z• FTI Y%i xwcKzr- fn T`co (� >MK O-<D-a cnm> �pf=prn-x � m I OC7m�< 0-ID 5-*z>�4m MM 0_o : mocnZ >ocnD z 0 =-I O�DZ -i-i=i - Omp OG�mr� CODZ>➢0D0 tv=i> Obi o m O I OzTr-Z�z Z cn.p C7 �' co z Z C-) m O to ^ (n ^� ��o z � �r�im�=N�m '3 U) o z r- t minD 4(1) 0 O-moi o r-rrl mmZ5 nZX m Cr D '- CD U. m m �-i a -i n �rn r �n��z rn� D O 0 O �( • z - 1d' UTILITY E1�5EyE 00 > i � FOUNDATION TI CLEAN OUT i / \ CLEAN OUT mQ ca 12 p � �s ;; —1' / ITI zm „ ` 1 1 / CLEAN our m (z w� o= DOUBLE / CLEAN OUT '� DD p (,r / m rD / / rn Lo Lo X oc 1 ( �— \ vi Lrr f // N j C — �m \ z In = ' �zD L ! / i c - " — — - �- 10' UTILITY EASEMENT 0)0), NOTES: PANNONE ENG SVC LLC REVISIONS DATE RECORD DRAWING P.O. BOX 1807 PALMER, AK 99645 ..... 09DEC2019 PHONE 907 745-8200 FAX 907 745-8201 `S¢9 I TANK RE-INSTALLATION ��P�.'.1N .� SCALE - 60' f DAFOE, BLOCK 1, LOT 1A ,,, _, ,,,,,, P.I.D. NO DRAWN JRL SITE ADDRESS: 6420 ROCKRIDGE DRIVE 015-491-09 CARL WHITE �}°V°" 0n d?e PERMIT N0. CE 8149 OSP191516 SITE PLAN Po Box 2106 SHEET NOME, AK 99762 1 OF 1 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191516 Work Type: SepticTank Upgrade Tax Code Number: 01549109000 Site Legal Address: DAFOE BLK 1 LT 1A G:2638 Site Mailing Address: 6420 ROCKRIDGE DR, Anchorage Owner: WHITE CARL SYMONS Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank. ❑ Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: C� U 1?epartment 11/25/2019 11/24/2020 99095 ❑ 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 Received By: Issued By: � r_a�� Date: Date: 105/0 4 MUNICIPALITY OF ANCHORAGE 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. 015-491-09 Property owner(s) Steven & Marilyn Borell Mailing address 6420 Rockridge Drive, Anchorage, AK 99516 Site address 6420 Rockridge Drive Legal description (Sub'd., Block & Lot) Dafoe, Block 1, Lot 1A Day phone Legal description (Township, Range & Section) Lot Size 99095 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X Septic Tank ❑X Upgrade x (w/wo ADU) pg ❑ Holding Tank El ❑ (D) Renewal ❑ Renewal Privy ❑ Multiple Dwellings ❑ (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: oZ 5 Waiver Fees: Date of Payment: %;?P.I 19 Date of Payment: Receipt Number: � 11 X356 Receipt Number: Permit No.�� plq� Jam% Waiver No. Permit App__- :- :...:c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191516, Rebecca Carroll, 11/25/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191516, Rebecca Carroll, 11/25/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191516, Rebecca Carroll, 11/25/19 m a N U Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181395 PID Number: 015-491-09 ❑ New ✓❑ Upgrade Name: STEVEN & MARILYN BORELL ABSORPTION FIELD EJ Deep Trench ❑ Shallow Trench ZBed ❑ Mound ❑ Other Address 6420 ROCKRIDGE DRIVE Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.5 GPD/SF 4.0 FL LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot DAFOE 1 1A Fill added above original grade ± 0.5 Ft. Gravel length 80 Ft. Township Range Section Gravel width 15FL Beds: Number of Lines 3 Distance between lines 5.0 FL SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 1200Ft2 Number of trenches Dist. between trenches N/A Ft. Well 113.2 155.1 N/A ( N/A 76.4 TANK El Septic ❑ S.T.E.P. [:]Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1 1250Gal. Surface Water 100+ 100+ N/A N/A Material Number of compartments Lot Line 88.3 28.0 N/A i N/A NA STEEL 2 Foundation 66.6 124.3 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain 100+ I 50+ N/A N/A --Gal. Remarks Pump on level at Pump off level at in. igh water alarm at in. Pump make a odel Electrical Inspections performed by Installer PIPE MATERIAL House to tank 3034 Tank to drainfield 3034 DOUG GREY Drainfield 3034 CO/MT 3034 Inspector PANNONE ENGINEERING SERVICES BENCH MARK (Assumed elevation) 100.Oft Inspection ��' 11/19/18 dates: 2^d 11/20/18 Td 11/20/18 4"' 12/3/18 Location and description BOTTOM TRIM AT HOUSE POINT B COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date OF At, ;��s�i �t TH A f • tteven E3annonee W CE 8149 l �26 '.ow 11 �o�ss+�A .-". Approved 1 .:Yt Date DESIGN PARAMETERS 0 UPGRADE SEPTIC SYSTEM ROCKRIDGE DRIVE ,NO. BEDROOM: 4(600 gpd) TANK SIZE: 1250g INSTALLED DRAIN FIELD -4 'PERC RATE: 6-15 MPI 8OLF x 15'W x 05ED x 4.0'TD Jj SOIL RATING: 0.5 GPD/SF INSTALLED MONITOR TUBE AREA ROD: 1,200 SF IN EACH CORNER. INSTALLED SYS. TYPE: BED 15'W CLEAN OUT AT ENDS OF EACH LATERAL RF: 0.50 CONNECTED TO MIDPOINT OF LATERALS MIN LENGTH: 80 LF TRUE NORTH S ALE I C3 USED: APPROXIAMTE LOCATION OF '�801-1`x 1 5'WxO.5' E.D., 4.0' TD PREVIOUSLY ABANDONED DRAIN FIELD TOTAL AREA: 1,200 SF \ \ REMOVED 1250g SEPTIC TANK E m 1 PER MOA CODE 157.3 m TO WELL H-2 M H-1 -8 T1 12\ 1 1 1 I" rr 'COT 1 A\ TH- 1989 (LEROY REID) WELL (E) 100 '00 ,errA 4BR HOUSE (E) -� I 50, INSTALLED 1250Q SEPTIC TANK 92 W1 DCO AFTER z. 96 I A B T1 103.1 68.5 T2 109.7 j 70,6 DCO 111.2 71.2 C I 153.8 13�.B M 1 153.6 129.6 11 C2 158.8 135,7 1 C3 164.2 140.9 M2 165.0 141.1 C4 186.9 134.5 M3 184.3 132.6 C5 191.6 139.7 C6 195.4 144.4 M4 194.8 144.4 rr 'COT 1 A\ TH- 1989 (LEROY REID) WELL (E) 100 '00 ,errA 4BR HOUSE (E) -� I 50, INSTALLED 1250Q SEPTIC TANK 92 W1 DCO AFTER z. 96 I NNECT MIDDLE DRY: EACH PROFILE 6- GIIII 6_ St Gf� 11/19118 SCALE: NTS S. LATERAL 7- DRY: 7- 8- 10129118 8- 75.0 75.O 9 971 - BOH 1t -90-H DATE PERFORMED: DATE PERFORMED: 1012212018 1111912018 NOTES: PAMONE ENG SVC, LLC Date OF 12/14/2018 RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 Scale DRAWN BY: PHONE (907) 272 -8218 FAX (907) 272-8211 ---- ACP P.I.D. NO DAFOE, BLOCK 1, LOT 1A -015-491-09 STEVEN & MARILYN BORELL Steven R. annone 'PERMIT NO. 6420 ROCKRIDGE DRIVE Ps, CE 8149 OSPI81395 PLAN ANCHORAGE, AK 99516 Sheet PPOFESS0 2 OF 3 Z= 0, Z < 0 z z < D0 FILTER FABRIC 0W O Oz V O.G./F.G. fl C) n n n g-�- z RAIN ROCK 6* ABOVE PIPE INV 0 0 DRAIN PIPE I NNECT MIDDLE DRY: EACH PROFILE 6- GIIII 6_ St Gf� 11/19118 SCALE: NTS S. LATERAL 7- DRY: 7- 8- 10129118 8- 75.0 75.O 9 971 - BOH 1t -90-H DATE PERFORMED: DATE PERFORMED: 1012212018 1111912018 NOTES: PAMONE ENG SVC, LLC Date OF 12/14/2018 RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 Scale DRAWN BY: PHONE (907) 272 -8218 FAX (907) 272-8211 ---- ACP P.I.D. NO DAFOE, BLOCK 1, LOT 1A -015-491-09 STEVEN & MARILYN BORELL Steven R. annone 'PERMIT NO. 6420 ROCKRIDGE DRIVE Ps, CE 8149 OSPI81395 PLAN ANCHORAGE, AK 99516 Sheet PPOFESS0 2 OF 3 9 10 11 BOH 2 13 14 — 15 — 16 17 18 19 20 DATE PERFORMED: 11/1912018 SOILS LOG - PERCOLATION TEST SLOPE X TH WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? -DRY DEPTH TO WATER AFTER MONITORING? DATE: C� �H- H-2 TH-1989- yf (LEROY REID) 92 77, 100 3; SLOPE TH X READING TEST HOLE 2 CLOCK TIME OR I ORGANICS 1 1 11/19/18 2 Sm SILTY SAND 3 2 10:05 4 9.220 3.32 5 10:05 6 -- 5.900 -- 4 SILTY GRAVEL 7 GM/ AND SAND 5 Sm WITH SEAMS 8 5.900 OF WELL 6 GRADED SAND 9 10 11 BOH 2 13 14 — 15 — 16 17 18 19 20 DATE PERFORMED: 11/1912018 SOILS LOG - PERCOLATION TEST SLOPE X TH WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? -DRY DEPTH TO WATER AFTER MONITORING? DATE: C� �H- H-2 TH-1989- yf (LEROY REID) 92 77, 100 3; SLOPE TH X READING DATE CLOCK TIME NETTIME WATER LEVEL READING NET DROP 1 11/19/18 35 DAFOE, BLOCK 1, LOT 1A . STEVEN & MARILYN BORELL 6420 ROCKRIDGE DRIVE, ANCHORAGE, AK 99516 5.900 --- 2 10:05 30 MIN 9.220 3.32 3 10:05 --- -- 5.900 -- 4 10:35 30 MIN 8.950 3.05 5 10:35 5.900 --- 6 11:05 30 MIN 8.870 2.97 5 � 11:05 --- 5.90' --- 6 _-T 11:35 30 MIN 8.85 E EOE] 2.95 PEROLATION RATE 10.2 (min/inch) PERC; HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by DOUG GREY PERFORMED BY: Dan Moran. 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 ENG WC, LLC P .O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 OF. A�, 9 TH .... ... . ............. ...... -teven R. 6' nnone I -P, - CE 8149 63 - A, "9?tS*S�I:01- — kk� All".-, Dote 12/4/2018 RECORD DRAWING Scale NTS DRAWN BY: DAFOE, BLOCK 1, LOT 1A . STEVEN & MARILYN BORELL 6420 ROCKRIDGE DRIVE, ANCHORAGE, AK 99516 ACP P.—I D. 110 -615-491-09 PERMIT No. OSP181395 _sheet SOILS LOG 3 OF 3 w nn nl' 40" E 299.59 10 UIMIYEPSEMENT ----------------------- ---------- ---------- ------------ ----------- ------------------ -------------- -------------- ------ --------- ----------- ---------------------- o m --i < > resX > 0 --I 1,-I M Ap (-) Q _X Ln 0 M>OOM> > m T 3 Do :c m m 0 CU r 71 TO n c rcno < m > �o --, r) O:E --i Qo ozrm > N) > z Ln ul IQ m , z C', 12, m :.- o --i -> OA �11 m m m > > LA -n� w > 0 0 4 - 0 =ZIX rn w --i --um .zo m t -i m " Ln Q C U) Ln " r > 00 >—T O < 81� O m M;l� 3: It ZO O n z" m N 'nam -------------- ---------- --------------------------------------------- ------------- Ft,,M,,JT I OOH O > 0 r) m X:) X. tt7 -4 ill 0 > to n > m z> nii z�l 0(z 1 0 --4 1 m z > rn rn w nn nl' 40" E 299.59 10 UIMIYEPSEMENT ----------------------- ---------- ---------- ------------ ----------- ------------------ -------------- -------------- ------ --------- ----------- ---------------------- o m --i < > resX > 0 --I 1,-I M Ap (-) Q _X Ln 0 M>OOM> > m T 3 Do :c m m 0 CU ---------- ----------- 71 TO n c rcno < m t,I C) :;a �o --, r) O:E --i Qo ozrm > N) > z Ln ul IQ m , z C', 12, m :.- o --i -> OA �11 m m m > > LA -n� w > 0 0 4 - 0 OD rn w --i --um iii m t -i m " Ln Q C U) Ln " r > IT" m M;l� 3: It ZO O n z" m --------------- --------------- ------------------ --------------------------------------------------- -------------- ---------- --------------------------------------------- ------------- Ft,,M,,JT 0 > > > x z > r) m X:) X. tt7 -4 ill 0 > > m z> < a) oz < 0 --4 1 m Ln rn < 11, z w nn nl' 40" E 299.59 N 00 () () L .b.3 10 UIMIYEPSEMENT ----------------------- ---------- ---------- ------------ ----------- ------------------ -------------- -------------- ------ --------- ----------- ---------------------- Jf ---------- ----------- Ul co N) Ln (,q 4 - OD rn iii U) r --------------- --------------- ------------------ --------------------------------------------------- -------------- ---------- --------------------------------------------- ------------- Ft,,M,,JT N 00 () () L .b.3 2y44- iI -Z3 MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program •S,. PO Box 196650 4700 Elmore Road ° r Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 y = http://www.muni.org/onsite I/epartrn en On-Site Wastewater Disposal System Permit Permit Number: OSP181395 Effective Date: 11/5/2018 Work Type: Septic Upgrade Expiration Date: 11/5/2019 Tax Code Number: 01549109000 Site Legal Address: DAFOE BLK 1 LT 1A G:2638 Site Mailing Address: 6420 ROCKRIDGE DR, Anchorage Owner: BORELL STEVEN C & MARILYN N Lot Size in Sq Ft: 99095 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4 This permit is for the construction of: Q Disposal Field Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 Special Provisions: The entire subsurface disposal field and/or alternate is not within a 30 foot radius of a percolation test.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. •• /VV Received By: , l,�ilia Date: a.it Issued By: • Date: /1/54 E4A !S MUNICIPALITY OF ANCHORAGE 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. 015-491-09 Property owner(s) Steven & Marilyn Borell Day phone Mailing address 6420 Rockridge Drive, Anchorage, AK 99516 Site address 6420 Rockridge Drive Legal description (Sub'd., Block & Lot) Dafoe, Block 1, Lot 1A Legal description (Township, Range & Section) Lot Size 99,095 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field LJ Initial ❑ Single Family (SF) n (w/wo ADU) Septic Tank ❑X Upgrade ❑ Duplex (D) (� Holding 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 Cods. IIP (Signature of property owner or authorized agent) Permit/Rush Fees: ,5(4,9 Waiver Fees: Date of Payment: /0/3/ /i S Date of Payment: Receipt Number: 0 7gU3 Ej Receipt Number: Permit No. O S PI 7/395 Waiver No. Permit App_:-: :_....c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181395, Deb Wockenfuss, 11/05/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181395, Deb Wockenfuss, 11/05/18 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 AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 2, SCOPE OF WORK: VERIFY CONDITION OF SEPTIC TANK AND REPLACE IF NECESSARY. INSTALL SOIL ABSORPTION SYSTEM, 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 1 1.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 11.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 12. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: BY: TITLE: DATE: NOTES: PANNONE ENG �.1 Y C LLR. ���`+��`@��ty��� Dote FOR CONSTRUCTION ' OF A 11/2/2018 -- P.O. BOX 100217 ANCHORAGE, AK 99510 4S PHONE (907) 272-8218 FAX (907) 272-8211 �[j�4 fiy� Scale DRAWN BY: 0, ti75 DRM NO DAFOE, BLOCK 1, LOT 1 A P.I.D.1- STEVEN & MARILYN BORELL Steven R. Pannone PERMIT N0. 6420 ROCKRIDGE DRIVE ¢''• GE 13149 • ��� OSP181395 PLAN ANCHORAGE, AK 99516 FpatiQN',ti� Sheet 2 OF 3 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181395, Deb Wockenfuss, 11/05/18 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT DISTANCES Name .~-'/~0 ~/:. y.¢ BO lt.~ // SEPTIC ABSORPTION .Address ~ WELL ~y~ TANK FIELD Phone(s)~ y ~ ~ ~ ~ ( ~ ,'l J~l ~ermit No. < ~ ~' v'~- I~°' °' B~°ms WELL ' / / ~o~.~scm.~.o. LOT LINE ICC ~ Lot ~ ~ Block ] Subdivision , I / 1~4~: FOUNDATION 7C,' Township, Range, Section ~/~ ~:~':~ ~ ~ ~'~J ~'~'1~' ' driveway,AS'BUILT DIAGRAM (Showlocation of well, septic system, prope.ylines, foundatiOn,water bodies, etc,) TANKS N Manufacturer Capacity in gallons ~ rs Material No. of Compa~ments ~ ~ -- ~'~ ][ / TY~E OF SYSTEM E~ ~ TRENCH ~ BED ~ W. DRAIN ~ OTHER ~ _ Depth to pipe bottom from Total depth from original grade j~ ~ ~' original grade / / FT ~ / FT Filladded above original grade Gravel depth beneath pipe ~//~ ~ )~ '.~ ~ ~3.~ FI ~,5'-/' FI 0/~ ~q: ~, t ~ ~, :~,~e~ Gravel length Gravel width , Total absorption area , ,, '~- ~ ~ Distance between lines~ ~_ ~;~'~ SQ FI ~ ~ FT Number of lines Soil rating ~ Pipe material Installer ~/(]~ ,~ ~ ~1 Datelnstalled -~l~e~' ~t.~r /,~ WELLS .~, ~-. ~ PRIVATE ~ OTHER (Identifv) / Classification (A,B,C) Total Depth ~~ ~ FT Installer ~ Date Installed: '~ ~ REMARKS: ~$[e: ENGIN[ER'S SEAL Da~: / / I ~ ' ~ ~ c ~ cedify that this inspe~ion was pedormed a~ording to all ~ - Municipal and State guidelines in eflm on - V Health De adment Ap royal p p ~/ ~ ~ ~ ~ Date: . 72-013 (3~85) ;[ l',l i:::' O F:;: h! :0 ,, i-"!,, H ,, :!!~; ,, i:::'i-:;~ ;[ OR 'I' IZi ;i. SF ~i..: ;2N);) ;}; I',ISI::'IECT .'!: [::)NS E',"/ E:I',tG ;t NEE;F':'. ~, :!: F:' /:d:::"T'IEF.; OI:::F;~iCE H[:%.I!::?.S~, EXJN"I"¢IC'T' :%¢ ;:5 ...- xl. 6jB;!. F'.:ND L.EiP~V!!E /::~ C:: O N E; T F;: U C: 'f' ~:::' ~:i: F;: }iii; N(:'i ;!; lq lie IE F'R :!.:.~ f:z'~ T T ¢~ !::; H E D ¢:! F:' F:' Fit E) V IE]i':' D E:::.:i; 1[ E') N, '['H :[ :;ii; F::'liii:l::;:t"l ;[ i" lEX F::' ;[ t::;'. E; '.!!!~ :1. ;;:I/::5:1..,"i!!b:.;* ;.':::r',i.D 'v'f::fi.... :1; ):) t:::' E) I::?. O. S ;[ i,,IGL~Z I::'RJ'"! :IZ L'Y i'IEit'qlE ,, .~ED 1412 W6b'I; 331;'0 Av6nu6 · AnchoR&ci6, A[&sk& 99503 · (907) 279-5553 ........ ~ ........ ~ .... ~ .i.. ~ .... i- ~ ........ il:.'t a (i i.:; I"~ C:~({'.? i. '~ .... , .... ' · : :, ,'-. ,.:: ;..~ v ,, ..*.. ,... ~ ~ ~... ~ ~ ~;':: ~...~ .L ,':i ."...i ;::': 'h ~'"'~ ~"? .'".'. 'H5 i...t.."" ({.} '!l J"l ."q 'ill '? i'i }11} ~"} 'ill 'h {11) [!'i i"i a'L ~ii!. r'i el) 'i.. J: ) (((-? (-'.{-} i'i (i -:.11~ ['i'i !1:) ~'..i c: '~" ~'::~ i--i d i i i.'-- 'i i"i V'i ~:::: 5f V" ..',:'~ ',.,' ,;;'~ 'ill .'.'i:.. (11) ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO. OF CALCULATEO BY Z. re~./ DATE CHECKED BY DATE SCALE . ~ ,~i ~ ~.~.~i ~ z,~.~ ~ ........ .~,..,~.....~.~J ............. ~ .............. , .............. i ........................... , ............ i ........ i .............. ! ........... ! ............. ! ............. ............................ ~.~?......~..~....~.~.~.......~.. ,~.~ ,~1,.,.~ '/ ~.,~ Z~ ~ · i ................ ~.~ X..,~.i: i iii i i ........ L~.r~'./...~,~ ~ J:~/..r'"-- ~- it)~.,~ i i ! ! i . i ~ ............ ~ ....... : ........ ~ ..... ~ ......: .... r .......... ~ ............ ".'--'" .......... ! ........... i ............. i ................. i ' ~ f ? ~ ~ ....... i - ........................................ ~. ............. ~. ............. ,..P~......~.~.......~..~f..~.~.~..~..,......~..~.~..........~......~,. ~.~.....~ ~. i ..~x.~.,..~.~..~.......~..~ ...................... ~. ...... PRO[XJCT204-! ~ I~c., G~oton, Ma~ 01471. ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB SHEET NO. CALCULATED BY DATE CHECKED BY SCALE / //~ / ~ / DATE - / I hereby certify that I have suzveyed the following described property: ~z- /~ and that no encroa~s exist except as indicated. Exclusion Note: It is the responsibility of the owner to datermime the existence of any eas~vmnts, covenants, or restrictions which do r~t appear on the recorded subdivision plat. Under no circunstances should any data hereon be used for construction or for establishing boundary or ferce lines. Dated at Anchorage, Alaska, this /~2 day of O~-~M~ 79~8 · # 8220 Briarwcx~ Street ASBUILT Art_borage, Alaska 99502 Phone (907)349-2407 PERFORMED FOR: LEGAL DESCRIPTION: Municipality of Anchorage 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE Township, Range, Section:~-/~.~ ~_~z.3 ,5' SLOPE SITE PLAN DEPTH (FEET) J 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS WAS GROUND WATER ENCOUNTERED? ,-'7'~-~' · V S IF YES, AT WHAT ___~ DEPTH? . .."~, ~ p /'"' ' ,-// E Depth to Water ~ / ' - - ~,f'/& ~!~"~ mAo.itori.,? ! \ ~G~oss Net Depth tO Net Reading ~ Time Time Water ~L Drop(-7~) l/fig ~~ ~~ ...... ~ ..... i PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER __ FT AND /7~' ~) FT PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. 72-008 (Rev. 4/85) MUNICIPALITY OF DEPT. OF. HEALTH & - ENVIEONMENTAL PROTECTION .-RECEIVED 5'1 .i <_., _z ,,.,. cE I hereby certify that I have surveyed the foll~rirg described property: ~- ./,9 and that no e~croa~s exist except as indicated. Exclusion Note: It is the responsibility of the owner to determine the existeno~ of amy 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 establishing boundary or fer~e lines. Dated at Anchorage, Alaska, this I ' /~ day of O=~-~Mg~ )9~8 - ASBUILT ~h~r~e, ^laska 995O2 Phone (9O7)349-2/407 I~UNICIPALITY OF ANCHORAGE HeaI and Environmental Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM N A M E - -_~' ~_ _-~¢~_' ./ LOCATION MAILING ADDRESS2 X LEGAL DESCRIPTION PHONE SEPTIC TANK: DISTANCE FROM W E L L~f//~'' - INSIDE LENGTH MANUFACTURE INSIDE WIDTH M ATERI AL LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPAClTY/~-~~;~ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL,,~t,t" FOUNDATION--~'~ # of Lines .... /___ DISTANCE BETWEEN LINES ABSORPTION AREA DEPTtt: TOP OF TILE TO FINIS~t GRADE ~. 7~..~ TOTAL LENGTH NEAREST LOT LINE /~ .OF LINE N//~ TRENCt4 WIDTI-L.~~ IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE ~ I ~ ~ DEPTH OF FILTER , MATERIAL BENEATH TILE__ ,,~. ABOVE TILE ~ IN. SEEPAGE PIT: Lo9 Crib Rings BUILDING FOUNDATION___ DIAMETER __ OR WIDTH ____ Crib Size:] DIAMETER .... NEAREST LOT LINE lENGTH__, DEPTH DEPTH ,,, DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. Well Class: Depth: Well Distance To: Lot Line Bldg: Sewer'Line: Pipe Materials: ~/~c. ~ of Bedrooms: ,,~ Installer: Remarks: O AT E/~'¢~-7?Ap p R OV E D F EF..I'I ]..] 1'.'1f::L RF'F'I... ]: I:::R N"t' I.... t:::i C FI T :[ ET1'.4 L..E:GRI.. T'T'F'E: OF '.2.';O ]:1 .... RE:?:;ORE:T ]: O1'.'1 ::.-':;'.r'?.;.]"Er'l :1: :E; ' 'FF:.'.E:1'.,ICH r,IRXI. I',IU1',I 1'.~I..If,IE:IER OF E:EI::,ROOr,I'.5 = 4 :50 1 l... RFI'T' ]: 1'.,IG ,' :56! F.]",..-'BR ::, = .1 .... ........ ..-:, T ..:,TE.I"I 1:5 ' .]"HE E:EC:!U I E'.E:[::' '...E; :1: ZE: F F' THE: '-]'-" :[ L. RE:?,ORF'T 1 O1'"1 '-' "- 'THE t....E1'4G]"H [::,.T.r,tE1'.'1'..-.-.,:I:O1'4 ]:'.E; THE L.E:1'4GTH (]:1'4 FEETi:, OF 'THE TREI'.'1C:H OR E:, F;.: R :[ N I:::' :I: E L. I:::, . 'THE I::,EPTH OF R TRE:NCH OR. P]:'f' ]:S THE [::,.I::]TR1'.'1CE E:ETP.IEEN THE ?,URFRE:E r::d:: THE GROI..IN[::, RN[::, .]"HIE BOTTOI',I OF THE EXCR',,,'RTI. ON (:t:1'.,1 FEE.]'::,. 'THERE :IS NO SET L4ID'T'H Fi:]R TRENCHES. ]"HE G~'.RVE:I .... [::,EF'.]"H I'..-:; THE i',l:[N:[I',ll..Jt',l DEPTH OF GRFIVEI._ BE.]"I.4EEN ]"HE: CH...ITFFII._I .... P]:F'E: RN[::, ]''HE 8OTTOf,1 L3F ]"HE E',:.:,E:R',/R]"IO1'"1 ,:: ]:N FEET). F" R i::: t'::7: I::::t ,:::::.:i E:: F" L... R I"-.11 '-I1" ,:, F" T ..']: "::, F:I F'FICI<:FIGE PL. FI1'.'1T I"IFI'T' E:E ]:1'-,I:..-T, TFIL. LEI:'.:, RT THE F'EIE:I"I.'[TTE:E'"S OF'T]:01'.,I SUEL:rr.cc:.] .... r'o THE: F'OI_L..CiI.,.I :[ 1'.'1(:.i CO1'.'1E:, ]: .]" .T. ONL:.,: :1.. E:[THER R C:I....RSL:., :1: OF: ]: ]: I'.'1'.'..C, F:' RPPF.'-.'v'E[', PI_R1'-'1T I"lR"r' BE :[1'-,1:~TFI[_t....EI::'. 2. FI L-:I::I1'.,1T ]: 1'-,1U1'::11...1'..':] I"IFI ]: N].'E1'-'1FI1",1CE RGREEr,IE!'.,1T I :_=; F..tE(;:!I_I IRE[:,. I F R I"lR ]: 1'-,1T E!:1",1FI1",1C: E FIGREEr,IE1'.,1T IS NOT I<:EF'T 7' .RRENT 'T': I'"IFI'T' BE RE(.:.!UIRE[:, TO E1'-'11....RE'.GE THE: :50:[t .... RE:SE~R.F'T:[Ed'.4 '.'.-.]"r'STEt"I FI1'"1[:' ,.-" ~3 R '-r': .I I"IFI'T' BE '.~..E :'L='CT TO F'RE~?.]E:E:I...IT]:ON. 'T &-Jt [::, ,( ............ ;;.'i: ':,, ]: r-.It .'..:..'.-..; F' E: i:Z:: -'1t- ...].[.. I:, I'-.t ":-. R F-: E: F-: E: [..-.:.,. I1_11 ::11:: I:-~.'. liE-_: It:::, E:RC:k::F :[ L.I.... ]: I'.41:3 I::IF FI1"'1'T' ?.,'T':.:::;.]-E'f'I L,'1 ]: THCII...IT F .T. 1",IRL. :[ 1'-,1'.SF'ECT ]: I.-JN FIN[::, FIF'F'R.O',,,'FIL. B'T' TH .t:. '.i.:.; [::,EF'RR.]"I"IENT P.I:I:LI .... E:E '.~;LIE:..TE:CT TO PRO'_:,EC:I...IT]:Ot'.,I. hl:[ N ]: r'lI.Jhl I:.'.".'[':.-~;-f'RNC:E E:ETI. qEE1'"1 R L4EI.,..t .... RNI) RN'T' ON-S :f ]"E SENRC:iE D ]: SPOSRt .... :.--..;"r'?f'E:1"l :[ :~; :.I..C~C~ FEET FOR. R PR ]: ","FITE: I.,.IEt...I .... OR 2C~E1 FEE']' FOR FI PI...IBL.I.C: HELL. HELl.._ L..OG'.:.-.] FIRE RE6!UI. RE[.':' FINE:' I"IUST BE RETURNED TO OF THE HE[..L CCd"IF'LET]:C[1"'1. CFf'HER RE:(;:!U I REr,IENT$ I"IR'T' RPPI...'¢. SPEC :[ F :1: (:::FI'r' 1 OI.4'_--., R1'.'1E:, C:ON?.,TE:I...ICT I O1'-,1 E:, ]: RGF.:FIr,IS RRE.'. FI',,,'R]:L..FIE:I....E 'f'O .T.N'.E;L.IRE F'RC~PE:.R .T. 1'.'1S]"RL..L. FI"I'.T. ON. :[ C: E R T ]: F'T' T H R T :1..: :[ FIM F'RI"I]:I..]:RR I.,.I]:TH THE REQU]:RE:I'"IE:1",1T:.-.-., FOR ON-S]:TE ::.C, EHER.'..:., R1",1E:' I.,.IEL. I....'.5 R'..'.-'.; SET FORTH B'T' THE htU1"J :[ C ]: PRI... ]: T'r' (:)F R1",1C:HORFIE'iE. 2: ]: 1.4]:1....I.....T. NS]"RL..t .... THE: :.::.':'T".STE:i"I ]:1"4 RCCOR. E:'FINC:E: I.,,1]:TH THE C:O[::'EL=.;. .-.~4: I UNDERSTRNI:::' THRT ]"HIE [:)1",I'-SI'I"E: '.':-'.;EI.,'1ER S'T'S'TEf'I f'IR'T' R[.:.:(;!U :[ RE: E1"'11.... R R [:ii E: hl E: N ].' ]:F THE: RES I[:'E1"'1CE: :1:?.; REI"IODEL. ED TO ]:NE:I....U[::'E i"IORE .]"HFIN 4 8E:[:'F.:OOP1S. :-.'; :,: ,::, ' .......... ............................. - .rT'-' ' FIF'PL. :[ C:FI1'-,1T R0[.:.':'ERT HFI~.4~-::: ]: 1'-,1'..:.: 01'.,1 ,,/~ 1 ~ ~ "7 CONSULTING GEOLOGIST BOX 476-M, STAR ROUTE A ' ANCHORAGE, ALASKA 99507 · PHONE 344-7071 SOILS LOG -'16- -20- Total Depth /~ feet in Was gro:mcIwater encou_nterecl ~ m Wha-b depth Depth to bedrock ~2-0~ . How determined spectfu!ly Gary ~:o :Player Consulting Geologist DEP ANCHORAGE AREA BORO NT OF EN\tIRONMENTAL QU 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 P~erformed For__'T-~_~ "~fo~_~ Date Performed Leaal Description: Lot__~ Block ~ Subdivision This Form Reoorts Soils Log_2< Percolation Test Oeoth Feet Soil Characteristics 5-- 6, 7__ 8 10__ Was Ground Water Encountered? I? Yes, At what Depth? Reading Date Gross Time Net Time ~ Depth to H20 Net Drop -Percotation Rate Minute Proposed Installation' Seepaoe Pit Drain Field Deeth of Inlet Deoth To Bottom Of Pit Or Trench Cn'~!MENTS'..- ¢00 ~c~-/--z/ ~__-.-~_c~o~ , ~¢,a~Z_ "~~S(:~ Test Performed By k/~',-- ,:~CC' ~F~_~j~ , Data Certified By: Date: We'll Log Distance to water while pumping .... ,.../...~?~2....o~ ................ at rate Formation [from[ to Driller DELTA DRILLING COMPANY SRA BOX 394 19 ANt GREA iiR ANCHORAGE AREA BOR Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 H INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME PO/3 ~ '~'- /-/~ ~t~2 5~l~l LING ADDRESS LOCATION /~O C-i~/~//2~g I~. LEGAL DESCRIPTION PHONE ._~A/A/- ~Z'2~ ~ '/./, , SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER INSIDE WIDTH S~ A/~f (~-Z' MATERIAL LIQUID DEPTH NUMBER OF ~-~ ~ ~ COMPARTMENTS LIQUID CAPACITY. /~ ~ GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER__OR WIDTH /~ ! LENGTHen! DEPTH /~1 LINING MATERIAL~;/~g"~d~:RIB SIZE: DIAMETER DEPTH ~ DISTANCE FROM: BUILDING FOUNDATION Z'~ /ff~ NEAREST LOT LINE ~ /-~' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) WELL /~/At) ,'~ ~ "~'Z-- SQ. FT. ADDITIONAL ABSORPTION WELL: ,/r]~7-' ,~"7~--E-'r' ~, ,~.~,,~. ,~-~"wT~,~/~_~~ /~-~:,~,~--~,,'~,,~lz~. TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC .~2~ FOUNDATION LOT LINE SEWER LINE , TANK /~ ¢' SEEPAGE ~g)~2z~ , __, SYSTEM / ~ / CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: ~7~/~/ PIPE MATERIAL: LOT SLOPE: REMARKS: bI Form No. EQ-031 DATE APPROVED G.A.A.B. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. INSTALLATION OF: SePTiC TANK ¢ SEEPAGE PIT DRAIN FIELD TYPe and SiZeOf facllltyto be SERVED ~ ~~ ~/~ FINANCED THROUGH TO BE INSTALLED bY COMPLETION DATE ANTICIPATED PHONE OTHER NOTE: THIS PERMIT IS NOT VALID WITHOUT BOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE / ~'"~f "~)~/~ TYPe / DRAIN FIELD ~"¢'/J) '/' DRAIN FIELD /¢ / SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT / ~ / DRAIN FIELD MINIMUM DISTANCES, REQUIREMENTB FOUNDATION TO SEPTIC TANK '~ '/ FOUNDATION TO SEEPAGE Pit ?f ~? SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ~ SEEPAGE PIT TO NEAREST LOT Line. / WELL TO SEPTIC TANK / ¢ 0 DRAIN FIELD / ~'~"~ / WATER MAIN TO SEPTIC TANK DRAin FIELD SEPTIC TANK, /'t?~ / , SEEPAGE PIT TO river, LAKE. STREAM. CAST lEON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of EXCAVATION 5 FEET INTO UNDISTURBED SOil. 4 inCH Diameter CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit Fitted WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER SEEPAGE AREA SiZE TYPE DIAGRAM OF SYSTEM I CERTIFY THAT [ AM FAMILIAR WITH THE REQUIremENTS OF GREATER ANCHORAGE AREA bOROUGH ORDINANCE NO. 28-68 AND THAT THE abOVE DATE (~--'-~ /-- 7¢ APPLICANT'S SIGNATURE ~ ~.__ FORM NO. EGI-0*I 6 Performed for '~ Legal Description' This form reports: jGREATER ANCHORAGE AREA BOROU( epartment of Environmental Qu~ 3330 "C" Street Anchorage, Alaska 99503 SOILS LOG - PEROLATION TEST c~..~<.~: . Date Performed Depth Feet 7- 8- 9- 12 Was ground water encountered? if yes, at what depth? Reading l Date Gross Time Percolation rate minute. , ' <-",, 'i Pi · Proposed installation ~ [. pa,.,e t :J~pth of Inlet COM?",EflTS° Net Time Drain Field Oept[i---t~--~-O~-t~d-[~--o~=-~)it or trenci~ EQ-- 040 (6/74) Municipality of Anchorage On -Site Water and Wastewater Program W (907) 343-7904 '*,< :E Certificate of On -Site Systems Approval Parcel I.D. 015-491-09 1. GENERAL INFORMATION Complete legal description Location (site address) Dafoe BI UA 6420 Rockridge Drive Expiration Date: 0q0U-GQ:k Current Property owner(s) Steven & Marilyn Borell Day phone Mailing address 6420 Rockridge Drive Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: nx Single Family (w/wo ADU) F1 Duplex El Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual n. Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer El 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation dale shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R Pannone Date OF hj 6. DSD SIGNATURE . i System #1 Approved for bedrooms ' SIev R.' 6 0 e • j �.•. CE -8149. System #2 Approved for bedrooms Disapproved11 �OFESCa Conditional approval for bedrooms, with the following stipulations: �Q J ON-SITE ' rfI WASTEWAT,Er�� PROGRAM o By: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet f c L' Legal �1/\ Lega|DesohpUon: A.WELL DATA Well type Private |fA.B.urCprovide PVVS|D# Date completed 10/4/1977 Sanitary seal (YYN)Y Total depth 178 ft. Cased to -ft. FROM WELL LOG Date oftest 10/4/77 Static water level 103 11) ft. Well production 9 -p.m. WATER SAMPLE RESULTS: Coliform _co|onieo/100 mL Nitrate ND mg/L Arsenic 649 11/20/18 - ug/L Date of sample: B.SEPTIC/HOLDING TANK DATA TankType/[Nuhoho| Septic/Steel Tankoize1250 ga|. Number ofCompartments 2 Foundation cleanout (Y/N)Y Depression over tank (Y7N)N Date ofpumping NewPumper Ifmore than 1septic system isonthe lot: COSACheokist#1of_�__ Structure served by this system I Parcel ID: O15 -4g1-09 Well Log (Y/N)Y Wires properly protected (Y/N)Y Casnghoight(obovogmund)- 24" jn. AT INSPECTION 10/9/2018 /1.3 Collected by: PES ft. am j1/1�V1� Date installed ~ Cleammts (Y/N)Y |ghwah*ra|orm(Y/N) N//\ C.ABSORPTION FIELD DATA Date installed 11/20/18 Soil rating (g.pd./ft2orft2 /bdnm)0.5 System type Bed Length 80 ft. Width 15 ft. Gravel below pipe O. 5 ft. Total depth 4]0 ft. Ef[absorption area 1200 zN1onihohngtube `/ Depression over field N NewDa1eofodequaoy\ao( �2Raou|1o(Pana/FmU)For bedrooms Fluid depth inabsorption field before test in. Water uddnd_______gal. New depth_____in. Elapsed Time: min. Final fluid depth in. Absorption rate g.pd. Any rejuvenation treatment (past 12mo.)(YYN&type) |fyes, give date _______ D. LIFT STATION Date installed Size ingallons K4anho|e/Aooens(YYN) "Pump on" level at in. "Pump oM^ |mve| at in. High water alarm |ews| at in. Datum Cycles tested Meets alarm 8circuit requirements? _______ E. SEPARATION DISTANCES WELL ONLOT TO: Septic tank0� tank/lift 1O0'f d ~~ Onadjacent lots 100'+ Absorption field onlot 100'f On adjacent lots 10{)1f Public sewer main 75'f Public sewer manhole/cleanout 1004' ' Sewer /septic oem25f 1OO'+ service Holding tank '~~ Animal containment 5O'f 1�O'f onaao ~ K4anura/nima|excrete storage areas _���� SEPTIC8HDLO|NGTANK ONLOT TO: Building foundation 10'f Property line 10'+ Water main 25'+ Water service line 254' Wells onadjacent lots 100'f ABSORPTION FIELD ONLOT TO: Property line 10'f Building foundation 104' Water Service line 2 5'f Surface water 100'+ Curtain drain 50'f Wells onadjacent lots 1004' F. COMMENTS G. ENGINEER'S CERTIFICATION / certify that /havo determined through field inspections and review ofMunicipal records that the above systems are in conformance with MOA CDSAguidelines /neffect onthis date. Engineer's Printed Name Steven Pannone Date cOSA canary sheeL2-6-15.doc Absorption field 10'+ Surface water 1�D'+ r ' ` Water1O'f man ` Dhvovay, pankingNehidox8urago 104' MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address Telephone · (home) 3c/(¢- 2..5'~'? Business (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here'~ if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Number of bedrooms Single-Family ]~[ 3. WATER SUPPLY ~ndividual Well ~ii~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site~!~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ,~"~5 Telephone ~' ? ~-~.5"5".,(~ Address ICrc" ~ ~:)'~ /47J~, ~ ?'¢.¢'o.J Date 6. DHHS APPROVAL Approved for z~ Approved Terms of ConditiOnal Approval bedroomsby ~"~'/ /' '~~Date /~-- -~- / Disapproved Conditional 'f-'1,'l i I'll The Municipality of Anchorage Department of Health and Human Services (DH HS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72¢25 (Rev: 7/88) Back Page 2 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ,~"~5 Telephone ~' ? ~-~.5"5".,(~ Address ICrc" ~ ~:)'~ /47J~, ~ ?'¢.¢'o.J Date 6. DHHS APPROVAL Approved for z~ Approved Terms of ConditiOnal Approval bedroomsby ~"~'/ /' '~~Date /~-- -~- / Disapproved Conditional 'f-'1,'l i I'll The Municipality of Anchorage Department of Health and Human Services (DH HS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72¢25 (Rev: 7/88) Back Page 2 of 2 A. WE L~ MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: Well Classification Well Log Present ON) Date Completed t Total Depth / ~'~ Cased to >~c~ t Depth of Grouting Static Water Level t~ / Casing Height Above Ground Electrical Wiring in Conduit(~/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot If A, B, C, D.E.C. Approved (Y/N) Yield (~ ~ ~ Pump Set At Sanitary Seal on Casing Depression Around Wellhead (Y~ ; On Adjoining Lots ,! To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results /7,~ 7' Comments ~ ~ ! ?'~ ~bk#~ ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ;Date B. SEPTIC/HOLDING TANK DATA Date Installed /O-~o-7 7 Size Standpipes ~)'N) Depression over Tank (Y~___.) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) 4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line To Water Main/Service Line /o ~-~- /~"~ No. of Compartments Air-tight Caps ~N) Foundation Cleanout ON) Date Last Pumped /~-~-'~'~'~' /~/~ ~///'/4~ ;for ~///~ Temporary Holding Tank Permit (Y/N) ~//~' To Stream, Pond, Lake or Major Drainage Course To Building Foundation To Disposal Field ~ '~' Comments 72-026 (Rev. 7/88) Front Page I of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /0 .-/o - 77 Width of Field Square Feet of Absortion Area Type of System Design Length of Field Depth of Field / Gravel Bed Thickness Depression over Field (Y~ Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well /o:~ ,~'~ -.~7''~6M~/'~8. To Building Foundation Lot /J l To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Statndpipes Present QN) Date of Last Adequacy Test To Property Line To Existing. or Abandoned System on ; On Adjoining Lots / To Cutback (if present) /00 D. LIFT STATION Date"~~ Dimensions Manhole/Access (Y/N) ,Size in Gallons'~- Pump On" Level a~_ "Pump Off" Level at High Water Alarm Level at -~~_ Vent (Y/N) Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments '~'""~. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, v~rified, or conformed to all MOA and HAA guide~i~e.~jn effect on the date of this inspection. Signed _ Company ~C2 ~.~,~~~~ ~,noers Seal Date of Payment /[-- bO ~ ~ Waiver Fee: $ Amount: $ .~ O ~ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 unicipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. BOX 196650 Anchorage, Alaska 99519-6650 343-4744 December 5, 1988 Lee Reid, P.E. Alaska Environmental Control Serivces, Inc. 1412 West 33 Avenue Anchorage, Alaska 99503 Sub-j ec t: Waiver Request for Lot 1 Block 1 Dafoe Subdivision Waiver Request ~WR88-071 Dear Mr. Reid: Your request for waiver of the required 100 foot separation of a septic system to a private well has been approved. The .approved separation distance is 91.5 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Civil Engineer On-site Services DJR/ljw~6 ALASKA FIUIROFImI FITAL COFITROL SERUICE$, IFIC. I~nqineerincI 6 I~nuironmental $~udies November 29, 1988 Municipa!.ity of Anchorase Department of Health & Human Services 825 L Streets 5th Floor Anchorage ~ "AK °~5n~ ATTN: Dait~ Ro th RE: Lot ? Block i, Dafoe Subdivision From the Health Authority inspection, we find the separation distance from well to septic 'tank cleanout to be 91.5 feet. The we!! !o$ shows the well was drilled October 4, 1977~ The sewer as-built shows the installation date to be October !0, 1.977~ and that the well was not in at that time. The well is ~78 feet deep and would be cased to the bottom accordins to soil formations indicahed on -t:h~ well loS. On November 28, 1988, a flow 'test was performed show!n~ static level at 108 feet, yield of 5.3 GPM, and total drawdown of 30 The septic tank is a ~250 ~ailons, steel, 2 compartment tank. The 'tank is downstope from tile well. casin$. Surface drainage from the tank area is away :[rom the well.. Water sampies taken November 22, 1988 are sahisfactory~ i do not think this separation distance poses a threat of contamJnati,on to the well. I request -that you ~rant a waiver of 92.5 fleet :from well to ~'ep::!c 1tank.. if you have any questions, please call. AC W/ s r Sincerei~, Alan C. Wien En$ineerin$ Technician 1412 W~S-~C 331~ch cXv~nur~ · ~nchoR&G6, ~[aska 99503 t (907) 279-5553 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PJ~OPE~TY OV)~NEI~ ~_~_..7,~ P~PE~TYRESIDENT(Ifdifferentfr0~ab°~e) ~ ' ' PHONE 2. BUYER PHONE MAI LING ADDR ESS LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT ~ PHONE I MAI LING ADDRESS STRE~/~ION~ ~', ~ 6. TYPE OF RESIDEN/~CE~' ~ ~]-~SI N G LE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One ~ Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY [~-tN DI VI DUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log i~ available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **1 f individual/on-site, give installation date ~ //t~ ~ If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) o¥ GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality ~,.~ 3330 "C" Street, Anchorage Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR C,© bJ ~1 1. Approval requested by: ~'~5~- IVq~-t'ono/ /5on/~ OG Mailing Address: ~,0 ~o~ 7~0 Phone: ~-~/ 2. Property Owner:~o~er% L,~o~[nsOo~%~o~G ~. Phone: Mailing Address: ~~ ~o~ ~ ~0~ ~ ~ Legal ~scription: ~ ~ I~Y~ ~ y~ ~ '/~ 1~ ~ S~, 3, 4. Location: 5. Type of facility to be inspected 6. Well Data: A. Type /'nd/'o/'c~ o } C. Construction 7. Sewage Bisposal System: A, Installed on~ No; of bedrooms . B. Depth B. Installer C. Septic Tank: D. Seepage Pit: 1. Size 1. Absorption Area 2. Manufacturer 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank Nearest lot line , Absorption area , Other contamination , Sewer Lines B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages GREAI':;i AHC}tO~AGE Alii.:,' BOROUG~I ,"'~ DeI~artment of Enviro'nm~:i',~al Quality ,4,~p- . 3330 "g" 5(,, Anchorage, Alaska 99503 - 274-4B61 x RI:-QUEST FOR APPROVAE OF INDIVIDUAL SEWER & Wt\'FER FACILITIES Type of Inspection' CMP, O ' VA FHA Property Owner- Robert _L...Hawklnson and Gladys C. Hawkinson CONV x Mailing Address: Star Route A Box 22H ~!!% Pt~one 344-8834 Name of Buyer: same Mailing Address: same D_~:~/ Phone same " me of Lending Institut-ion: First National Bank of Anchorage flail ing Address- P.o. Box 720 Phone 279-4481 Hame of Realtor ~r Agent' Hailing Address: -- n/a P '~lo Fie Legal Description- S½ NW¼ SE¼ SE¼ NW¼ Sect. 23 T12N R3W SM L o c a t i o n · corner of Elies Drive and Hampton Type of Facility 'to be inspe, cted: Single Family Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 140 Sewage Disposal. System Type .oF S~ysteFn' P'ublic Utility individual IF Individual, date of installation No. Bdrms. 3 X one (on-si te) two pages - for Approval of ~ndividual ~ & Water Facilities Legal Descri p~ion Comments Approved .~~i~ Disapproved A~Zroval Valid for one year from date signed Greater Anchorage Area Borough, DepartJnent of Enviromental Quality Date y/~- ~ ~,~- DIAGRAM OF SYSTEM I certify that the information contained, in this request for approval to be a .tru~~ and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) -,~