HomeMy WebLinkAboutARNETT BLK 1 LT 2A rnett Block i Lot 2 #015-471-22 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw Sl. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.cienchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP111239 PID Number: 015-472-20 Name'. April Anne Arnett Wastewater System: ❑✓ New ❑ Upgrade Address 3504 Heartwood Place Anchorage, AK 99503 ABSORPTION FIELD Phone: Numberof Bedrooms: Four V Deep Trench 11 Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grams: .6 GPDVp' 11.7-12.1 Block: l Lot, Subdivision : Arnett Depth to pipe bottom from original grade: Gravel depth beneaN pipe: 3.7-4.1 FL $ Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 0-1 Ft. 63 Ft. Well: ZNew El Upgrade Gravelvidth: Number of lines: Distance between lines: 3 Ft 1 Ft Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Private 106 Ft 74 FL 1,008 Ft' ASTM D3034 PVC Driller Date Drilled Static Water Level: Installer Data Installed: Alpine Drilling 9/27/11 33 Ft. Red Dog Excavating 9/7/11 YieldPump Set at Casing Height Above Ground, 6 GPM Ft.2 Ft_ TANK SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Private Manufacturer. Capacity: From Tank Field Station Tank Sewer Line Anchorage Tank 1,250 Gal, wet >100' >100, N/A N/A >25' Material: Steel Numberof Compartments: Two (2) Surtace Water >100• >100' N/A N/A LIFT STATION Size: Manufacturer Lot Line >5. >10' N/A NIA Gal. Foundation >5' >10' N/A N/A "Pumper"level at: in. 'Pump off' level at in. High water alarm at' in. Curtain Drain None Noted Pump Make & Model Electrical Inspectrons performed by: Remarks: BENCH MARK Location and Description: Garage Slab. Assumed Elevation: 100.00 Ft. Inspections performed by: A. Harala Dates: 1a' 9/7/11 �.® ..,q..' u�+ Intl 9/7/11 0 e •S °� s (owl Development Services Department Approval •go 4918* Conditional Approval Date: . p fr.�1�•l��t�F� ' •.NMlH1NlON..........• :MICHAEL &ANDERSON -.. E. 81 !� SEP•., � �-.if ,•�a�e �//�� Reviewed and approved by: 0 Date: Z N 00'04'20"E 164.93' Q (D 10' UTIL. ESMT. _______________________ �...S-..p _____-__-__- O rn O (1) I II I I m y oo z > Opj... 0' W F- j n 3 O O° 0 g << D <y 0 .+� 0 03 - z 0 � m 0 r O n l 5 D c V U) z O O w C � V m r 3 � ® O _0 - o -�3 < ° CD (n °m m r — a O D �0 >T� Z m� z \ s z 0 Z (Q cn 0% m w IU MT O 3 N A N y N OD N 0 q DC m mD .p • O fJ fO N J A D \ W (fl cn 0 m01 C / n N D CD m / I y ® m 0.1 m0' L / l �$ F F 1 ��'j�'• '� ••'••.,S'J.1� N 00.02'40"E 164.93' - %y:�n . 0 O N CD :�� m m@ �i HIDEAWAY TRAIL o oar Y, 14 ME R �� � �•• N Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP111239 93.55 N 1,250 Gallon Septic Tank 98.4 N UU U) Page 3 of 3 PID No. 015-471-22 8126/11 49th PROFILE AS -BUILT ;� MICHAELE. CEQ 438RSON No Scale 93.1 u Alp, -.,e Drilling & Enterprises Well Log Permit Number: #SWOSP111239 Date of Issue: 9-2-11 Parcel Identification Number: 0154722000 Date Started: 9-27-11 Date Completed: 9-27-11 Is well located at approved permit location? x Yes ❑ No Legal Description: Arnett Block .I Lot 2 Property Owner Name & Address: Arnett April Anne 3504 Heartwood Place Anchors e, Alaska 99503 Borehole Data: Depth (ft) Method of Drilling x air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Pump: Intake Depth _ feet Pump size _ hp Brand Name IIWell Disinfected Upon Completion? x Yes ❑ No II Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 a r l� Casing type: steel Stick-up 0 2 Wall Thickness:.250 inches silt 2 5 Diameter: 6 inches Depth: 74 feet gravelly cobbly silt 5 11 Liner Type: Diameter: —inches Depth: feet silty gravel 11 14 _ Casing stickup above ground: 2 feet sandy silt 14 33 Static water level (from ground level): 33 feet silt 33 50 Pumping level: 106 feet after silty sandy gravel H2O 50 54 4 hours pumping 6 gpm sandy gravelly silt 54 64 Recovery Rate: 6 gpm Method of Testing:ir li a —� silty water sand & gravel 64 66 Well Intake Opening Type: gravelly silt 66 73 ❑ Open End ❑ Open Hole bedrock 73 106 ❑ Screened Start _ feet Stopped _ feet x Perforations Start 51 feet Stopped 54 feet Grout Type: bentonite Volume: 1 Pump: Intake Depth _ feet Pump size _ hp Brand Name IIWell Disinfected Upon Completion? x Yes ❑ No II Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 a r l� Development Services Department Building Safety Division On -Site Water & Wastewater program *AE 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW OSP111239 Date of Issue• 9/2/11 Parcel Identification Number: 0154722000 Legal Description Arnett Block 1, Lot 2 Property Owner Name & Address: April Anne Arnett 3504 Heartwood PI. Anchorage, AK 99503 Pump Installation Date: 12 21/11 Pump Intake Depth Below Top of Well Casing: 94" feet Pump Manufacturer's Name: Grundtos Pump Model: 1-SOE-07-200 Pump Size 314 hp Pitless Adapter Burial Depth: NA feet Pitless Adapter Manufacturer's Name: NA Pitless Adapter Installer: Red Dog Masonry Well Disinfected Upon Completion? 0 Yes ❑ No Method of Disinfection: chlorine tablets Comments: Pump Installer Name: John Netherton Aarow Pump & Well Service, LLC P.O. Box 110496, Anchorage, AK 99511-0496 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 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: OSP111239 Tax Code Number: 01547122000 Work Type: WellSeptic Initial Permit Effective Dates: September 02, 2011 to September 01, 2012 Design Engineer: ANDERSON ENGINEERING Subdivision: ARNETT Site Legal Address: ARNETT BLK 1 LT 2 G:2640 Owner/Address: ARNETT APRIL ANNE 3504 HEARTWOOD PL ANCHORAGE AK 995033902 Site Mailing Address: 11020 HIDEAWAY TRL, Anchorage Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of: 49683 4 Y Disposal Field Y Septic Tank 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. Received By: •; 3 iy , Date: / 9 Issued By:� (if/ �_�y Date: y ON-SITE SEWER/WELL PERMIT APPLICATION RL, %� FOR A SINGLE FAMILY DWELLING �' Parcel I.D. OP5 - `f 7i ` Z L Property owner(s) cii A epi Day phone Mailing address 3-:>_04 dc-Awr& o o o P6 i -c 4jL-- cmgo3 Site address 110 7 -re- t, Av (:,,ot26'L,/4 c A-%- -? i s7 i I. Legal description (Sub'd., Block & Lot) AIA& Legal description (Township, Range & Section) Lot Size q1 � f' 3 Sq. Ft. Number of Bedrooms 1 THIS APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank a Holding Tank ❑ Privy ❑ Private Well Water Storage ❑ THIS APPLICATION IS AN: Initial 9 Upgrade ❑ Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. 1 (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. GABuilding\On Site\Forms\Client Forms\Permit App_01 041 1.doc (Rev. 1/11) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) August 27, 2011 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 2, Block 1, Arnett Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 2, Block 1, Arnett Subdivision intends to construct a new four- bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. Also identified on the plans are the existing wells and septic systems on surrounding lots. No conflicts exist between the proposed well and septic system and wells or septic systems on adjacent lots. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test holes placed on the lot in the area of the absorption trench and alternate site indicates silty sand (SM). The percolation rate of the soil was determined to be between 12 and 17 minutes per inch. No groundwater was found during the placement of the test hole and none was noted during the monitoring period. An application rate of .6 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,250 -gallon septic tank and a 63' long by 3' wide by 8' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trenches will be 4' below the surface and the total depth will be 12'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the septic system slopes to the northeast at a 10% grade. The new trench will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and Lot 2, Block 1, Arnett Subdivision August 27, 2011 Page Two 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments 2 4� )63 Existing Well I I C:1 -744 ..c��P�E OF /1< q •���i 49th 4 .MICHAEL E. ANDERSON : 4 P • NO. CE-4381AN ' 'P, • �1��pRpFESSI4N�i�� 5 'NoweH-�� S��p« Pr EA / N89'56'10"E 301.20 Proposed Well 1 1 �1\ Existing Well VA\9 1 � N', , �II Existing Well AREA MAP SCALE 1" = 100' no \ 2 2 41 Ar "�2' • a cn i ��y . o m V11 1- S 00 1v':'� m D.� cis Vm m n g—i�cnrtzZ r cI C 0 O ?o�cn CD 0 CD O D.'0 (D O O z -aNv O O pID 0 N (n cn .+ r+ CD o 4 (D C 3O 3 0 O S W CD N CD 3 o zO - o-0 o c U —L: o CD 0:' a f o CD Z a v c C a N 00'04'9n"F7 1 R4 QR' 10' -Ti ��-Ti (nn <�=p<O m I I I I I I m � � cf) -Tl o rt0-0 io =:3 OOp —a<c < CD _rt CD rr O O O O rt� O rt CD (D C) a ZF O z 7 Dx p O O U woo C o rt r Amo o���o P. x i �mw n 5m •Vo` b 0 /O` D 0-4 = o N 1 N J 7 v / 01 � /.V N / 0 CO 0 (n r rn W J v ll O C) I n C 00 O O m' z / m 0Co0 f Q6 n ' O IM 1 0 rn 0 o® m o. I 1 m N 00'02'40"F 164. Q3' z b 0 n D � O 1 --1-0 J 7 � N � 00C cC/-)z 0 CO (n r rn W J v ll O C) I n C 00 O z M.8 W O HIDEAWAY TRAIL — — umrxsox sro�xssww LOT 2, BLOCK 1, ARNETT SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Perc. Rate: 12-17 Min./Inch 1,250 Gallon Septic Tank Application Rate: .6 GPD/SF 8' Drainfield Rock 4 Bedrooms X 150 GPD/.6 GPD/SF (Application Rate) = 1,000 SF Absorption Area 1,000 SF/16 SF/LF = 62.5 LF Trench Length THEREFORE: Construct A 63' Long x 3' Wide x 8' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 12' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. Drainfield Rock 3' L � r TYPICAL DEEP TRENCH SECTION + (NO SCALE) �R�+�E ............... ��., .41C NOTE: Grade Area Over Trench to Drain Away. , Minimum 6' Separation From Bedrock. 49th ■.....:.................., Minimum 4' Separation From Groundwater. i.. ............. Minimum 100' Separation From Wells in the Area. s 0 MICHAELE ANDERSON Minimum 100' Separation From Surface Water or Streams: A� NO. CE4381 ••♦♦� FESS\tl�i�:=ice Natural Backfill 3'6" Geotextile Fabric 6" O 4" Perforated PVC (Holes Down) Drainfield Rock 3' L � r TYPICAL DEEP TRENCH SECTION + (NO SCALE) �R�+�E ............... ��., .41C NOTE: Grade Area Over Trench to Drain Away. , Minimum 6' Separation From Bedrock. 49th ■.....:.................., Minimum 4' Separation From Groundwater. i.. ............. Minimum 100' Separation From Wells in the Area. s 0 MICHAELE ANDERSON Minimum 100' Separation From Surface Water or Streams: A� NO. CE4381 ••♦♦� FESS\tl�i�:=ice Municipality of Anchorage Development Services Department Building Safety Division 0 On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchorage.ak.us (907) 343-7904 Soils Log - Percolation Test Performed For: Red Dog Masonry Legal Description: Arnett Subdivision, Block 2, Lot 1 Town: Slope �,/ f It 'r.5 1= fGXZ- �6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- zl 0 2 COMMENTS TH # 1 # 4918 •Y� Y MKHAK �,•,�•Y.' ....UIIY YON • L ANDSWN � Or0 CE , 4381 AW tre•••i s•:•'•t �014* Date Performed: ?� ZO 11 WAS WAS GROUND WATER ENCOUNTERED? No S IF YES, AT WHAT DEPTH? xxx L Depth to Water After O P Monitoring? No Water E Date: R' ( (0 1I Nan.- 9�//// Y)tr P'1E/} Reading Date Gross Time Net Time Depth to Water Net Drop Aug 24, '11 g s9 � 1 ®M+►VS f " 1. 6 U y rijOKI Ak,, it'd PERCOLATION RATE 1 -V (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN -6.0 FT AND -6.5 FT —+— Perc Cavity was pre-soaked on Aug 23, 2011 PERFORMED BY: A. Harala i CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: L_ i Municipality of Anchorage •. �� �R' •)�© Development Services Department �� ® ��� Building Safety Division ; 4918 � On -Site Water and Wastewater Program ✓ • • N * 4700 Elmore Road g / • , •• •••••• F P.O. Box 196650 Anchorage, AK 99507 • ,• •�S www.ci.anchorage.ak.us r^ ; a ANDERSON �•� rr (907) 343-7904 i� CE • 4381 �� rr AW Soils Log - Percolation Test ♦�,e p•FES : �• r����`r,` Performed For: Red Dog Masonry Date Performed: Aug73%2"%% Legal Description: Arnett Subdivision, Block 2, Lot 1 Township, Ranqe, Section: T12N,R3W,SEC 24 Slope N i De t 1-� 2-I�' I �/ 3 0 � WAS GROUND WATER ENCOUNTERED? No S IF YES, AT WHAT DEPTH? XXX L Depth to Water After O P Monitoring? No Water E Date: 8/26/11 A;C,lL q/l/I/ dor n��f Reading Date 7 M Net Time Depth to Water Net 8- Aug 24,'11 ��:1'� 9- �j•yj r -Drop / 10- 11- , 5,19 " 12- 13- 1---- 14- 15- 16- 11, I 30 M►�l5 �� �� 17- 18- 19- r' 20- t' WAS GROUND WATER ENCOUNTERED? No S IF YES, AT WHAT DEPTH? XXX L Depth to Water After O P Monitoring? No Water E Date: 8/26/11 A;C,lL q/l/I/ dor n��f Reading Date Gross Time Net Time Depth to Water Net Aug 24,'11 ��:1'� �j•yj r -Drop / SVA+ 15a MtV4 5,19 " I.�� �► 1---- 1 11, I 30 M►�l5 �� �� t' I', Iv'' PERCOLATION RATE_ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN - 5.5 FT AND - 6.0 FT COMMENTS TH # 2 Perc Cavity was pre-soaked on Auq 23. 2011 PERFORMED BY: A. Harala I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program a 4700 Bragaw Street e P.O. Box 196650 R Anchorage, AK 99519 6650 www.muni.org/onsite (907) 343-7904 ZD CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. b 15g71 a.O COSA # OSC I a 1 ON Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 2, Block 1, Arnett subdivision Location (site address) 11020 Hideaway Trail Anchorage, AK 99503 Current Property owner(s) April Anne Arnett Mailing address Lending agency Mailing address Real Estate Agent 3504 Heartwood Place Anchorage, AK 99503 Mailing Address dlnless otherwise 4pquested, COSA will be held by DSO for pickup. 2. -NUMBER OF BEDROOMS: Four (4) Day phone Day phone Day phone 3. TYPE ORWATERSUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well.✓❑ Individual On-site ✓❑ Individual Water'..Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained fro tk9•fviunicipality of Anchorage files and from my investigation and inspection, the on-site water supply 0 tater disposal system is(are) in compliance with all applicable Municipal and State codes, orcregulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 1/4 /2012 ®� OF w (7:• -V ----: -------- / � . Auaim B ANomorl : w c 5. DSD SIGNATURE 4I�c'i CSE` •( ...���aa / Approved for bedrooms. +4 AR `�5H-laO dw Disapproved. Conditional approval for bedrooms, with the following stipulations: rnacnrnencs: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory_ Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By; , �� Original Certificate Date: 1 i' 12 (Rev. 11105) Municipality of Anchorage Development Services Department Building Safety Division \_ on -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lott Arnett subdivision 0 1, � k -' Parcel ID: 015-472-20 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Well Log (YIN) Y Date completed 9/27/11 Sanitary seal (YIN) Y Wires properly protected (YIN) Y Total depth 106 ft. Cased to 74 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 9/27/11 Static water level 33 Well production 6 9-p m g.p.m. WATER SAMPLE RESULTS: --- Coliform 0 colonies1100mL Nitrate � mg/L Arsenic: 2U mg/I Date of sample: 112/12 Collected by: A. Harala B. SEPTIC/HOLDING TANK DATA Tank Type/Material SeptiriSteei Date installed 917/11 Tank size 1,250 gal. Number of Compartments Two Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N Date of pumping New construction Pumper C. ABSORPTION FIELD DATA Date installed 917111 Soil rating (g.p.d./ftz or ftzlbdrm).5 GPD15F System type Deep Trench Length 63 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 12 ft. Eff. absorption area 1,006 ftz Monitoring tube Y Depression over field N Date of adequacy test New const. Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test in. Water added_ gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on' level at _ in. "Pump off' level at_ in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot > 100' acent lots >100' adjacent On J Absorption field on lot >100' On adjacent lots >100' N/A Public sewer manhole/cleanout N/A Public sewer main Sewer /septic service line >25' Holding tank N/A Animal containment areas >50' Manure/animal excrete storage areas >1004 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: >5' Property line >5_ Building foundation P Y Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >19 Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: Or r,cF e .:4��4Q• G. ENGINEER'S CERTIFICATION"LJ,• d 0 49� * v6 l certify that / have determined through field inspections and 00.:.,•..ry »y •-•• � � '® review of Municipal records that the above systems are in i7 F ......... conformance with MOA COSA guidelines in effect on this date. / zo .�r,AtcHnsl-F. " • "GE• 4381 ; Engineer's Printed Name Michael E. Anderson, P.E. ,Isli,� _y_/I•�•.•�a�'s Date COSA Fee $ I� Date of Payment C �12— Receipt Number U— / (Rev. 11/05) Waiver Fee $ _ Date of Payment Receipt Number Municipality of Anchorage Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 121004 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 2 of Arnett subdivision. This inspection revealed a nitrate concentration of 6.81 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. yy N � ZO e c- 091 D =8= g < m a) `0tpDD g a2zb C CD _v D Z En 0 N V pp r*mxc00� - z — '0�0 (1) ;00 m 0� z z 2 m n w 2m�z mA2 0 oz m OCC oMm30m mwx mm_O o m CDC��Qz1+t � m z 'D 00 Z�o:d o��2 m g zZy 0yq"'m D i 0900 orri va 0 Uf z Z O .O-Uz'^R O, n m n o1�-0-1 A D_:i G rn Wo"n. mitts ♦Q'9••''• �1 ♦ : ;•'STq A • :�. io ■ ��p. :1= poi /4Ego AV • FR N 00°04'20"E 164.93' 10' UTIL. ESMT. N z cn o 00 o m w O 0 W N O. Off'` 61.7'cb BG/ST iso. Nc owti "�i-F� 87.5' O� � r C4 O Y 1VT.DJ N O HIDEAWAY TRAIL D r� OZ �N Z W� C (n r V ono I ` ` co T �` Z SGS Ret.# 1120016001 Client Name Anderson Engineering Project Name/# Water Samples Client Sample ID Arnett Subd Lot 2 Block 1 Matrix Drinking Water Sample Remarks: Parameter Results LOQ Metals by ICP/MS 01/06/2012 13:13 Collected Date/Time Arsenic 251 * 5.00 Waters Department Stephen C. Ede B Total Nitrate/Nitrite•N 6.81 0.100 Microbiology Laboratory E. Coli Negative 1 Total Coliform Negative 1 Printed Date/Time 01/06/2012 13:13 Collected Date/Time 01/02/2012 14:15 Received Date/Time 01/03/2012 12:00 Technical Director Stephen C. Ede Allowable Prep Analysis I Units Method Container ID Limits Date Date Init ug/L EP200.8 C (Q0) 01/03/12 01/05/12 SCL mg/L SM20 4500NO3-F B (<10) 01/03/12 CMA 100mL SM20 9223B A 100mL SM20 9223B A 01/03/12 MEM 01/03/12 MEM 2of7