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THOMAS L BOYLE BLK 2 LT 4B1
Thomas L. Boyle Block 2 Lot 4B1 #015-282-45 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water & 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: OSP131452 PID Number: 015-282-45 ❑ New ®Upgrade Name: ART & BRENDA MILAN ABSORPTION FIELD ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound Address: 12201 WAGNER ST, ANCHORAGE, AK, 99516 ElOther Soil Rating: Total Depth from original grads: Phone: No. of Bedrooms: (772) 485-7458 4 0.6 GPD/Sq. R. SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe: SEE DWG. R. 3.51/3.83 Ft. Subdivision: Block: Lot: FII added above original grade: Gravel length: THOMAS L BOYLE 2 46-1 SEE DWG. R. 54/54 Ft. Township: Range: Section: — Gravel width: Bede Number of lines: Distance between lines: — 6/6 Ft. — Ft. SEPARATION DISTANCES Total absorption area: 1000+ SD. R. Number of trenches: 2 Dist. between lrenchea: 10+ Ft. To Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Lines From Well — 100'+ — — 25'+TANK EISeptic ❑ S.T.E.P. ❑Holdin 1:10 r Manufacturer: Capacity: Surface Water — 100'+ — — Gol. Lot Line — 10'+ - - N/A Material: Number of comp K isms: Foundation — 10'+ — — AA\\ LIFT STATION Manufacturer: ��\� Capacity: Curtain Drain NONE KNOWN cal. 'Pump on' level aL Pump off- level at: High water alarm at: Remarks: Pump M & Model: Electrical Inspections performed by: PIPE MATERIAL SGH 40 House to tank EXISTING Tank to PVC drainfield SCH 40 Installer Drainfield PVC CO/MT D3034 WILCO CONTRACTORS Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.93 Ft. Inspection Dates: 1st 12/11/13 2nd 12/12/13 Location and Description: 3rd 12/13/13 4th — TOP OF S.T.E.P. TANK MANHOLE LID ENGINEER'S SEAL Community Development Department Approval oo�o p4 Conditional approval: Date: 4 p....:. ...... ............. VVI oo._. ..f Y.....Gor ess.•...� CE -7951 O� Approved: Date:aro f esslooaq: PERMIT NUMBER; AS BUILT DRAWING 1 ING PARCEL ID NUMBER: OSP131452 015-282-45 A B MT1 86.91 96.25 MT2 1104.59 83.01 MT3 106.96 115.74 MT4 118.91 100.85 REBUILT \ rOLD DRAINFIELD TO BE J USED AS A RESERVE SITE EXISTING FOUR BEDROOM HOUSE � II gr -J F L ---J / EXISTING 1500 GALLON S.T.E.P. TANK WITH / DUAL OUTLETS GARNESS ENGINEERING GROUP, Ltd. 3701 E. TUDOR ROAD, SUITE 101 • ANOHORACE. M 99307 - PHONE (907)33%-9179 • FM (907)359-3298 • gff95RE: www.gamenenglnwring.com PREPARED FOR: PHONENUMBER: PAGE NUMBER: ART & BRENDA MILAN 772-485-7458 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: THOMAS L. BOYLE; BLOCK 2, LOT 461 A.J.G. TYPE OF WORK: DATE: AS—BUILT DRAWING OF SEPTIC UPGRADE 12/17/: (Rev. 01105) i lu MT2 13 T. ..... ............. ( A. arness.- PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: I OSP131452 015-282-45 FILTER FABRIC 2" INSULATION - TOP BOTTOM OFJ EXCAVATION (REMOVAL OF CONTAMINATED MATERIAL) = 97.00 WEST TRENCH FINAL GRADE = 103.90-105.24 FILTER FABRIC 2" INSULATION - TOP OF SAND = 98.61 INVERT OF PIPE / 101.28 J BOTTOM OF 61� EXCAVATION AL OFCONTAMINATED MATERIAL) = 97.53 NOTE: BOTH PRESSURE LINES ARE 1.25" DIAMETER SCH 4( PVC WITH 1/4" HOLES SPACED 46" ON CENTER EAST TRENCH AT GARNESS ENGINEERING 01(90])33)-6199- RGROUP, Ltd. /(p -- - CONSULTANTS & GENEAL CONTF2ACTORS " l 3701 E. IDOOR ROAD. SORE 1 - ANCHORAGE, AK 99507 " PHONE (90])33)-6199 • FM (907)336-3246 , MSM:m 0amewangimetlnp.com PREPARED FOR: PHONENUMBER: PAGE NUMBER: ART & BRENDA MILAN 772-485-7458 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: THOMAS L BOYLE S/D; BLOCK 1, LOT 46-1 A.J.G. TYPE OF WORK: DATE: PROFILE AS -BUILT OF SEPTIC UPGRADE 12/17/2013 (Rev_ 01/05) FINAL GRADE = 104.86-105.86 INVERT OF P = 102.12 61—I OF ... T e f Ga ess: CE -7 m,e •1 Z,�J,?. �1�E�°� 'Pr o f e s sion_o On -Site Wastewater Disposal 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: OSP131452 Tax Code Number: 01528245000 Work Type: Septic Permit Effective Dates: December 09, 2013 to December 09, 2014 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: THOMAS L BOYLE Site Legal Address: THOMAS L BOYLE BLK 2 LT 4131 G:2734 Owner/Address: MILAN ARTHUR & BRENDA 12201 WAGNER STREET ANCHORAGE AK 995162026 Site Mailing Address: 12201 WAGNER ST, Anchorage This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank 2_ Lot Size in Sq Ft: 98999 Total Bedrooms: 4 N Privy N 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 Issued By: Date: Date: ?r N IT.A MUNICIPALITY OF ANCHO GEEC 9 201 Community Development Department Development Services Water & Wastewater Program Mayor Dan Sullivan Phone: 907-343-7904 SUMITTAIDEC 6 2013 On -Site SewerMell Permit Application For A Single Family Dwelling rty owner(s) ART & BRENDA MILAN Day phone 772-485-7458 Mailing address 12201 WAGNER STREET *ANCHORAGE, AK Site address 12201 WAGNER STREET *ANCHORAGE, AK Legal description (Sub'd, Block & Lot) THOMAS L. BOYLE; BLOCK 2, LOT 4B1 Legal description (Township, Section & Range) Lot Size APPLICATION IS FOR: ( Pall that apply) Absorption Field Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Sq. Ft. Number of Bedrooms 4 APPLICATION IS AN: TYPE OF DEWELLING: Initial ❑ Single Family (SF) Upgrade ® (w/wo ADU) El F-1Duplex(D) Multiple Dwellings ❑ (SF and/or D) 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. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 53b — "13 Waiver Fees: Date of Payment: 1 1 Receipt Number: _ 615 1`j�' Permit No. OSr13ly5i;1 / � Date of Payment: Number. Waiver No, (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS December 2, 2013 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for Thomas L. Boyle; Block 2, Lot 4B1 To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. All of the drainfields are in a state of failure, so an upgraded is required. We are proposing to rebuild the existing dual 5 -wide drainfields and utilize the existing 1500 gallon STEP tank. We are proposing to excavate 1 foot below the bottom of the existing 5 -wide trenches, so as to remove all contaminated soil, and replace it with 1 foot of MOA approved sand. During construction, the drainfields will likely be widened to 6 or 7 feet to remove contaminated soil from the sidewalls. The design will only provide credit for five (5) feet of trench width. 1. SOILS & GROUNDWATER LEVELS: See the 2000 soil log (attached) which shows the soil classifications, groundwater monitoring, and the percolation results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: The proposed re -built drainfields will be installed greater then 100' from any surface waters. 4. TOPOGRAPHY: The average topography around the drainfield is 5-10% running east to west. In short, there are no slope concerns. We are unaware of any adverse impacts this installation and granting of the waiver request would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com F- W W BOYLE S/D LOT 13A, BK 2, (~1) BOYLE D i LOT4A, BK2, 0_ W Z � QI BOYLE S/D LOT 13B, BK 2, I / I / 1100' WELD RADIUS I I I I CARE4 1 tD BOYLE %D LOT 12A, K 2. BOYLE S/D BOYLE S/D LOT 12B, BK 2, I LOT 5B, BK 2, ENG. HOLE GARNESS ENGINEERING GROUP, Ltd. p CONSULTANTS & GENERAL CONTRACTORS 1701 E. NDOR ROJD. 5011E 101 • INCWWFM M N%7 • MONE (907)3]]-0179 • FM (907)330-3818 • NE090E; www.9amman9lnnNn9.9om i) PREPARED FOR: PHONE NUMBER: PAGE NUMBER: (� ART & BRENDA MILAN 772-485-7458 1 OF 2 Q LEGAL DESCRIPTION: DRAWN BY: THOMAS L. BOYLE; BLOCK 2, LOT 481 PNB TYPE OF WORK: DATE: SITE PLAN FOR SEPTIC SYSTEM UPGRADE 11/27/13 BOYLE S/D LOT 3A, BK 2, BOYLE S/D LOT 38, BK 2, WELL ON EAST SIDE OF LOT AND SEPTIC ON WEST SIDE OF LOT I BOYLE S/O AREA LOT 6A, BK 2, N 1/2 I I I � BOYLE S/D LOT 6A, SK 2, S 1 BOYLE S/D LOT 66, BK 2, P e Gar esq. Q4® CE -79 .13'E�avvi PION FACTOR: -0.54 EVERY 46 INCHES ON EXISTING FOUR BEDROOM HOUSE \ 55-10% 5-10% / 3N CRITERIA: GEG, Ltd. HAS A 7 PAGE SPECIFICATION NOTE: THE CONTRACTOR R OF BEDROOMS: 4 LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER SHALL HAVE THE SOUTH LO IS PER DAY (GPD): 600 GPD CONTACT GEG. BY PROCEEDING FORWARD LINE, AND ALL WELL RADII ATION RATE/S: 12.6 WITH THIS INSTALLATION, THE ENGINEER, SED APPLICATION RATE: 0.6 WELL DRILLER, CONTRACTOR AND FLAGGED BY A REGISTERED M DRAINFIELD SO.FT.: 1000 PROPERTY OWNER AGREE THAT THEY LAND SURVEYOR PRIOR TO HAVE READ THESE SPECIFICATIONS AND VFIELD DESIGN: AGREE TO ACCEPT THE TERMS AND CONSTRUCTION. IM DEPTH OF EXCAVATION: 1 FOOT CONDITIONS OUTLINED. THE BOTTOM OF THE EXISTING TRENCH THE DISTRIBUTION LINE IS 6 FEET I: 2 ® 54 FEET = 108 FEET I I TO BE 1-1/4" IN DIAMETER APPROVED SAND FILTER: 1 FOOT IVE: 3.5 FEET & 1/4 HOLES SPACED PION FACTOR: -0.54 EVERY 46 INCHES ON EXISTING FOUR BEDROOM HOUSE \ 55-10% 5-10% / 5-10% / ryls K`* " `"`Y3'r" I I—u �I II u f�s,A EXISTING DRAINFIELD TO BE USED AS A r RESERVE SITE 1 i} b�_j S&STH 5-10% 5-10% 'ISTING 1500 GALLON S.T.E.P, TANK WITH DUAL OUTLETS PROPOSED RE -BUILT GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS G 1101 E. TUWR RO 6 161 • MCHO E, W 9959] • PHONE (90))331-61]9 • FAR (901)336-3246 • WEBSITE: �...9ermawngRaenng.Pem G PREPARED FOR: PHONE NUMBER: PAGE NUMBER: (� ART & BRENDA MILAN 772-485-7458 2 OF 2 LEGAL DESCRIPTION: DRAWN BY: THOMAS L. BOYLE; BLOCK 2, LOT 481 PNB TYPE OF WORK: DATE: REVISED SEPTIC SYSTEM DESIGN UPGRADE 12/9/2013 (Rev. 01105) 1 MT2 I � 0 FA Garn s: CE-7..�0� �•2 .� aScoAM, Municipality of Anchorage Page 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISIGIX P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW000409 PID Number: 015-282-43 Name: AURTHER MILAN Wastewater System: ❑New ■Upgrade Address: 12201 WAGNER ST. ANCH AK 99516 [WEST/uzi ABSORPTION FIELD [wEST/EAsn Phone: No. of Bedrooms: (907) 345-7893 4 O Deep Trench ■Shallow Trench D Bed ❑Mound ❑Other LEGAL DESCRIPTION Son Rating: 0.6 Total Depth from original grade: GPD/Sq. Ft 6' MAX. FL Lot: Block: Subdivision: 5A 2 THaRpS L. BOYLE Depth to pips bottom from original grads: 2.4/2.5 Gravel depth beneath pips: 3.6/3.5 Ft. FL Township: Range: Section: Fill added above original grade: Gravel length: 0 — 2.3 Ft. 54/54.5 FL WELL: ❑New ❑Upgrade Gravel width: 5 Number of lines: 2 Distanoe between lines: 15'+ Ft Ft. ClaseiDcoUm (Pnlate, AB,C):Total Ds Cased To: Total absorption am: Pipe material:Ft. I Ft. 1005 so, pt. D 3034/ F—B10 Drills.. Date Drilled: Staaa Water Level: Installer. Dab Installed: A+ HOME SERVICES 10/5/00 — 10/6/00 tleM:Pump Set At Ca.Mg Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑Septic El Holding ■S.T.E.P. To Septic Absorption Lift Holding Public/PHva% Manufacturer: Capacity in gallon.: From Tank Field Station Tank sewer Lines ANCHORAGE TANK 1500 Well 100'+ 100'+ too'+ — 25'+ Material: STEEL Number of compartments: 2 Surfac100'+ Water Water 100'+ 100'+ - - LIFT STATION Lot 5'+ *3' 5'+ _ — Size in gallons: Manufacturer. Line 1500 ANCHORAGE TANK Foundation 5'+ 10'+ 5'+ — Pump on' level at Pump level at High water alarm at 1 — 42" 42" 46" Curtain NONE KNOWN Pump Mala k Model: EI,*Wal Inspection. performed by: Drain #20 OSI 05 HHF M.O.A. Remarks: •3 FOOT LOT LINE WAIVER GRANTED BENCH MARK Location and Description: WITH ISSUANCE OF PERMIT CONCRETE SLAB, SOUTHEAST CORNER OF HOUSE. EXISTING TANK WAS ABANDOND PER UPC. Assumed Devatlm: 100.00 Ft. ENGINEERS 0 _o Inspections performed by: AWWC, INC. Dates: 1st 10/5/2000 .*..:.. 9*J, 2nd 10/6/2000 D 3rd 10/12/2000 "' ............ Ere A. Garness; epartment of red H n Services 7953a\�c�o0p� Revewed and approved byth Doteo/all-0/ ppedp•.-00 rofesslo" 00 00�00K�Flzz� 72-013 Rev. 9/91) Mat 25 PERMITNUMBER: AS—BUILT DRAWING PARCEL ID NUMBER: SWO — SW000409 015-282-43 A B ST1 52.7 12.0 ST2 54.3 19.0 MH 55.0 21.2 DBL1 55.7 26.2 \ DBL2 56.6 29.2 MT1 86.9 55.1 \ MT2 105.8 64.6 \ MT3 102.7 80.3 MT4 120.7 101.9 EXISTING GRAINFIELD TO BE USED AS A ' P _ _ RESERVE SITE 2V 1 o I r�) r1MT2 S&STH I J I I I I EXISTING FOUR I BEDROOM HOUSE I 152 I -------J TH#i ITD I I I I BI I I I I I MT3L° J e MT4 J n- _U 100 NEW 1500 GALLON S RH DUAL OUTLETS NEW DRAINFIELDS i I � DATE: oo6p fl^ E I•�II��"�, 10/23/2000 o F .. DRAWN BY: ALASKA WATER & WASTEWATER K.D.W. pO \ X00, SCALE: � 30 — CONSULTANTS, INC. 6901 DE9ARR ROAD, SUITE 29 •ANCHORAGE AK 99304 •PHONE (907)337-6179 •FAX (907)339-3246 T • • • • • • • "•' .... . .. • • •� PREPARED FOR: PAGE PHONE NUMBER: NUMBER: .... D AURTHER MILAN (907) 345-7893 2 OF 3 _ yn e re A. Gaess;' 0D QO @ •• C —7953 4 f7 ��� ' LEGAL DESCRIPTION: BOYLE SUBDIVISION; NORTH 1/2 OF LOT 5A BLOCK 2• •., ��� a \ ASG ���040vo��6o TYPE OF WORK: AS-BUILT OF SEPTIC SYSTEM UPGRADE PERMITNUMBER: AS—BUILT DRAWING PARCEL ID NUMBER: SWO SW000409 015-282-43 FINAL cim TOP OF m"OLE ;\L-100.5 r-100.95 5fl 5f2 fOP OF TANK - fOP OF fANK A7IMEf 96,6 / AfOLnlL f-96bh FINN. CKAJ7F -1053+ Mom Of - fITIZH - 91,5 NVW OF PUNI I NSW 1500 GAU.ON IflWf-96.1G 5.f., .P. TANK AT INLET - 96,11 WEST TRENCH N511AIION ALONG NOt?M 24', Fift LMNAI 6KN7E am - 104,21+ - 1023 -105.5 NWff or MIT -101.14 N511A110N FINN. C - ALONG5aNH 30,5'OF 1RENCH - 105,2+ DOFfoM of - nNIGH - 985 11/8/200 54.5' EAST TRENCH �ORIGINN. Gm - 102.9 -104.5 IN= OF PIT -102,03 104.2+ OVER INSULATED PORTION. 105.2'+ OVER NON—INSULATED PORTION. DRAWN BY: p` v. ... 'U ALASKA WATER & WASTEWATER K.D.W. O� SrO CONSULTANTS, INC. SCALE: „ _ ...:.... 6901 DEBARR ROAD, SUITE 28 `ANCHORAGE, AK 99504 •PHONE (907)3a7-6179 •FAX (907)330-3246 1 _ 30. ... ........... 'REPARED FOR: PHONE NUMBER: PAGE NUMBER: Q AURTHER MILAN (907) 345-7893 3 OF 3. .... •.•• • • •••• �O P •.J f ey G rn ss; .EGAL DESCRIPTION: 9r ' , CE 7953 BOYLE SUBDIVISION; NORTH 1/2 OF LOT 5A, BLOCK 2, 'YPE OF WORK: 4�@rea pr.. ..... o05\��� AS -BUILT PROFILE OF SEPTIC SYSTEM UPGRADE ��Op' o'fgf � 399 P61 OCT -13-2000 06:36 PM EDS. ELECTRIC - 1 . 272 .: 45go P.01 PW 2 of 20 INSPECHON REPORT MUNICIPALITY OF ANCHORAGE -- BUILD.ING SAFETY DIVISION 4700 SOUTH BRAGAW STREET, ANCIiURAC,E, ALASKA INSPECI7OM.- VWm. (997) 343-83M Far: (907) 343-8235 INFORM4770N.- (907)343-9211 MAW: EDS ELECTRIC reeaarNOMe�n: 00-9243 AIIDRE9S: 12201 WAGNER ST DATE: 10/1/100 PROM 01: 272-4591_ MONE'N2: LIUBDIPM10N:^'1HOMAS BOYLE COMMENTS AM -SEPTIC SYSTEM -CALL FSE WILL WTT TYPE OF INSPBC770N.• Electalcal FhW No non-cempNma obsoved. ❑ Com ions essential es explained bet,,w ❑ WN to -examine atnext inapeotion. ❑ Do not conceal until re -inspected. COMMENTS: 5r i'T1c Vis- -CIA rLfC--r;z,r✓ �(A)AI, L -S ❑ CO. annoved. ❑ C.C.U. approved (connments below). Reinspection? U.. NOV 09 2000 aIlunrcipality of Anchorage Dept. Hsalth & Human Services i I `0 - I 1 - 7.Ot:XJ rQNhEI. EF,P% DATE: s WREN CORREC17ONSAREMADE, PEMSFC11.1 FOR INSPECITON ems= DO NOTREMOVE 77I1S N077C'E. oil Ef 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.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: 010005 PID#: 015-282-43 HA#: Permit#: SW000409 Date Received: 11109/00 Legal Description: THOMAS L. BOYLE BLOCK 2 LOT 5A Engineer: ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B, ANCHORAGE, ALASKA 99504 Applicant: AURTHER MILAN Waiver Requested: 3 FEET FROM THE SOUTH LOT LINE ADJOINING LOT 513 Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ..............................................................................1 Waiver is Granted: X— Waiver is not Granted: List Conditions or Reasons for above: SEE EryGtNFE1?�s N%Tit} HED LE?EiP OF ,TkSr/F1r*T/oN rwrw 9_ (¢ -D(J' Date:./— 2f— 0/ By: AI& Name of Reviewer ..............................................................................1 Rec#: 06275 Amount: 115.00 Date Paid: 09/18/00 Permit Number: SW000409 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade &a+ _ /j j -- Date Issued: Oct 02, 2000 Expiration Date: Oct 02, 2001 Parcel ID: 015-28243 Legal Description: THOMAS L BOYLE BLK 2 LT 5A N2 P -244B Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: 012201 WAGNER ST Owner Name: AURTHER MILAN Lot Size: 23400 SQ. FT. Owner Address: 12201 WAGNER STREET Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE , AK 99516-2033 This permit is for the construction of: E,/j Disposal Field K Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: `D - oZ-- X Date: /0-2 •00 ALASKA WATER & WASTEWATER CONSULTANTS, INC. .. ,,.,, - October 3, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Attn: Dan Roth Ref: Septic Design for North 1/2 of Lot 5A, Block 2, Boyle Subdivision. Dear Mr. Roth: Our original design for this septic system called for a maximum excavation depth of 5 feet, in spite of the fact that our test hole is was 16 feet deep and dry. We proposed limiting the total depth to 5 feet because prior groundwater monitoring, performed by S&S Engineering (June 14th, 1991), indicated groundwater at 9 feet below grade. Based upon MOA records, it appears that the S&S test hole was approximately 65 feet west of the test hole we excavated. During our preconstruction layout on 10/2/00 it was noted that the test hole was still dry, even though the hole was left open (to the bench depth) during a period of relatively heavy rainfall. This leads me to believe that the groundwater monitoring done in June of 1991 may have been adversely influenced by spring runoff, or rainfall, into an open test hole. AW WC, Inc. performed the septic system design for the recent upgrade on Boyle S/D, L6A, Bk 2, South 1/2. Groundwater was monitored at 13 feet below grade on 11/18/98. Based upon these facts, we are proposing to modify the design to allow for a maximum excavation depth of 6.0 feet. This would place the system at least 10 feet above groundwater (given that the 16 fRot deep test hole is currently dry). If you h4vjt ai 'u�stions, please contact us at 337-6179. Thank you for your assistance. M.S. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com ALASKA WATER & WASTEWATER emsxuri :ax a„nma.,,U 11-1, 1 1 1CONSULTANTS. INC. September 14, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Design for North 1/2 of lot 5A, Block 2, Boyle Subdivision. To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system consists of a 1250 gallon septic tank and a bed type drainfield. The existing drainfield is in a state of failure and is in need of a upgrade. One test hole was excavated on the property. The proposed septic system will be designed around the 30 foot radius of this test hole. We are proposing that a 1500 gallon S.T.E.P. tank and two five foot wide drainfields be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: A soil log which shows the soil classifications, groundwater monitoring, and the percolation test results is attached. It is our opinion that due to the overall appearance of the soils, an application rate of 0.6 gallons/day/ft2 should be used. No groundwater was encountered to a depth of 16 feet; however we are going to limit the system,to 5 feet because S&S Engineering encountered water at 9 feet in June of 1991. C©el)k 2. TRENCH DESIGN: a. Percolation Rate: 12.6 minutes/inch b. Allowable Application Rate: 0.6 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 1000 ft2 f Total Depth: 5.0 feet (max.) g. Effective Depth: 3.5 feet h. Width: 5 feet i. Reduction Factor: 0.54 j. Minimum Length: 108 feet total lengih (2 @ 54 feet long each) k. Effective absorption area = 1000 ft 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There is no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The area for the proposed septic system has a 5% to 10% slope running from east to west; in short, there are no slope concerns. S. LOT LINE WAIVER REQUEST: We request that you issue a 3 foot property line waiver from the proposed septic system to the southern lot line. We are aware of any adverse affects it would have on the adjacent properties. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. h .E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, two soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com i Ld BOYLE S/D � BOYLE S/D LOT 13A, BK 2, (n I LOT 4A, BK 2, BOYLE S/D LOT 3A, BK 2, �j w Z Q II BOYLE S II II II BOYLE S/I D I I I LOT 13B, BKK 2, LOT 4B, BK 2 , ( I BOYLE S/D I ��--►► ( ( LOT 3B, BK 2, `-VACANT I E WELL ON EAST SIDE _ - �'e i OF LOT AND SEPTIC I ON WEST SIDE OF LOT &S ENG 1 STING SEPTIC TEST HOLEIgYSTEM BOYLE S/D ARAE �/ 1 i'�_ i LOT 5A, BK 2, N 1/2__ �/ \�� 1100' WELL RADIUS /I { ii� 1 ,i'� (h (:'SEPTICE�D i i / -------- (� \\ >' \ 11 \ PROPOSED S.T.E.P. TANK -4/ SEE DESIGN, PAGE 2 OF 2) / 1 PROPOSED PAGEDRAINFIEUDS (SEE DESIGN, PAGE 2 OF 2) 1 III\ �.► US \\ BOYLE S/D �\ ��.�- i 100. {y 1 AREA ] •��- PRD �Lp B1/2 SEPTIC+ 0 W L AREA LOT 12A, BK 2, ,11,.{� 1�5 1S LOOYLE T 5A,� I /S 1 LBOYLE 1/2 11 \ BOYLE S/D , BOYLE S/D \` LOT 5B, BK 2, BOYLE S/D LOT 12B, BK 2, LOT 69, BK 2, � ' FIELD VERIFY I II II I II II I II II lI II I! DATE: 9/14/2000 u �� DRAWN BY: ALASKA WATER & WASTEWATER C.J.G. V !1 k ii °ri SCALE: ft „y " , CONSULTANTS, INC., K _,,,, ,u wn, 1" — 100' ........ ................ .P 6901 OEBARR ROAD, SUITE 213 'ANCHORAGE, AK 99504' PHONE(907)337-6179' FAX (907)338-3246 PREPARED FOR PHONE NUMBER: PAGE NUMBER: AURTHER MILAN (907) 345-7893 1 OF 2,J ffr A. GOmess:. vI, P '• -7953 •' u %: LEGAL DESCRIPTION: BOYLE SUBDIVISION; NORTH 1/2 OF LOT 5A, BLOCK 2, 6 D`' TYPE OF WORK: SITE PLAN FOR SEPTIC SYSTEM UPGRADE <.<�--- NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH PROPERTY LINE FLAGGED BY A REGISTERED LAND SUVEYOR PRIOR TO CONSTRUCTION I I I I EXISTING DRAINFIELD TO BE USED AS A RESERVE SITE INSTALL FOUDAMON CLEANOUT ' -IMTRI MTF I I I I I I EXISTING I 4 BEDROOM {f} I I I I I HOUSE S&S TH I I I I 1 ° 1 1 I I I HIII1 1 I - °0 I 1 1 I I t EXISTING SEPTIC TANK TO BE ABANDONED IN PLACE I I I1 LJMT LJMT .1. 1 3FOOT LOT UNE WAIVER REQUEST PROPOSED 1500 GALLON / S.T.E.P. TANK WITH / ' DUAL OUTLETSPROPOSED / � I � ILA4A / TRENCHES TWO THATAIFEET LONG EACH, 5 FEET DEEP, 5 FEET ' WIDE, ADD 3.5 FEET OF CLEAN WASHED SEWER DRAINROCK. THE DISTRIBUTION UNE IS TO BE 1-1/4 INCH DIAMEER HOLES SPACED /• EVERY 46 INCHES ON CENTER. INSTALL TRENCHES PARRELLEL TO SLOPE CONTOURS DATE: oo6oOp 9/14/2000° F X04 DRAWN BY: ALASKA WATER &WASTEWATER G � = CONSULTANTS, INC.— _ ..:::__ . ,�,w, :;:, .'�.::.. .....7c,* SCALE: » • • _ 30, 1 — 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504 PHONE (907)337-6179 FAX (907)338-3246 D PREPARED FOR: PHONE NUMBER: PAGE NUMBER: AURTHER MILAN (907) 345-7893 2 OF 2 f YA. arness: P 9 '• E-7953 ;'lc0op te^ '• cA�p V�ea Profess!00\ ��ppp0009 LEGAL DESCRIPTION: BOYLE SUBDIVISION; NORTH 1/2 OF LOT 5A, BLOCK 2, TYPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE I ALASKA WATERe &WASTEWATER CONSULTANTS, IN SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: BOYLE S/D; NORTH 1/2 OF LOT 5A, BLOCK 2 PERFORMED FOR: AURTHER MILAN DATE PERFORMED: 9/1/00 DEPTH _ TEST HOLE 1 (feet] ORGANICS 2 3 4 5— 6 DATE i NET TIME (MINUTES) DRY SOIL CLASSIFICATIONS ML ORG ML CL OL MH CH OH GW GP GM GC SW SP SC N T,L I ty I 91011 9- o:ry N 41 TH#1 11 oag a G 3 3/8" 1� 11 i � I1 - 7 DEPTH DATE GROUNDWATER NET TIME (MINUTES) DRY 9/1/00 DRY ML 8- - 30 - 30 - N T,L I ty I 91011 9- N 41 TH#1 11 10- 3 3/8" 1� 11 7 � I1 - 12- 213141516B.O.H. - ,.� BOYLE S/D I �' S 1/2 LOT 5A, 11 I 13- 7:15 30 3 3/8" 14- 15- 16— B.O.H. 17- 718 18— DEPTH TO DATE GROUNDWATER NET TIME (MINUTES) DRY 9/1/00 DRY 9/8/00 SITE PLAN READING 1l = 100' BOYLE S/D I NET TIME (MINUTES) LOT 4B, BK 2, NET DROP (INCHES) 'I(` TACANT li [I 1 2 3 4 5 1 - 30 - 30 - N T,L I ty I N 41 TH#1 11 f to it 3 3/8" 1� J I1 II 7 � I1 - I - ,.� BOYLE S/D I �' S 1/2 LOT 5A, 11 I II ii ii ii 11 7:15 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 9/7/00 1 2 3 4 5 5:15 5:45 5:45 6:15 6:15 - 30 - 30 - 6" 3 1/2' 6" 3 7/16" 6" - 2 1/2" - 2 9/16" - 6 6:45 30 3 3/8" 2 5/8" 7 6:45 - 6" - 8 7:15 30 3 3/8" 2 5/8" 19 PERCOLATION RATE 12.6 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES) 20 TEST RUN BETWEEN 6.5 FT. 7.0 FT. COMMENTS: PRE-SOAKED FOR 4+ HOURS. SOIL VISU LY E�R D E A .6 GPD/FT. SQ. RATING PERFORMED BY ALASKA WATER & WASTEWATER I, THIS WAS PERFORqED IN ACCORDANCE WITH ALL DATE. DATE: `114.1CD CERTIFY THAT I ,T ON THIS Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: I 14n gZ PID Number: IN ep:�, ' I Wastewater System: XNew ❑ Upgrade Address: I d GA-I..l .fes �T ABSORPTION FIELD Phone No. of Bedrooms: ❑ Deep Trench ❑ Shallow Trench Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: 0'—I Total Depth from origina}grade GPD/Sq. Ft. Lot. t/Z Block'. Subdivision: t,j1:5Ft. Depth to pipe bottom from original grade: Gravel depth beneath pipe e Township. Range: Section: Fill added above original grade: / Gra el length: 0— 1Ft. Ft. WELL: �g New LI Upgrade Gravel width: Number of lines: Distance between lines Ft. � Ft. C ��//ficatio/n (Private, A, B,C)'. Total Depth: Casse�d Tor: v r Total absorption area Pipe material: f7$IU �AEWZ `r V Ft. ? Ft. SO . SQ. Ft. Driller: 4ILRS IC, N6W —V`Et-L Date Drilled: Static Water Lev el: Install r. Date installed 1 (r N1�-� s A.0 Ft. Yield: Cp \/ Pump Set at I II SZGPM4B 4' Casing Height Above Ground: fJ 1Z �I�% 'TANK `o Ft. l.i) Ft. SEPARATION DISTANCES Septic El Holding ❑S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines C '� V_ Well IQ�.>� i iQt+ �_ �_ !� 2 � Material. C� �� Number of Compartments: Surfac Watere 100' LIFT STATION LotI / _/ A Size in gallons: Manufacturer: Line W Foundation 101 �— _ "Pump on" level at: "Pump off' High water alarm at Curtain Pump Ma oriel Electrical Inspections performed by: Drain W Remarks: BENCH MARK sf� cs� Z Location and Description: T C = a G S,t, i=i�TIRR2-C-20 INIuLZVZLO t t _ Assumed Elevation: _ JO0O — ENGINEER'S SEAL Of qit,gs1i! • �a S & S ENGINEERING s 96� 0* 4�7� •SS k Inspections performed by: 17934 Eagle River 1040 Road, NIDM: 1st 2 saaa Eagle River, Alaska 99577 2nd ®®•seas u+ N ire o e�eQneo od ea asaaa w Department of Health and Human Services approval SH flOGER APER a kai i`���.6ea No.8215 : 01,0 do Reviewed and approved by: &'1a V4 Date: .y y.Z- a,AFon'•`• e� SSO*A� 72-013 (Rev. 9/91) NI 25 Permit No. G `!� I 0 Page �" of —17— Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: AL. l ✓� {' COP G NEwI "atwn rNWL�-2 ou COCA) r 3� 32 I � r IK ,1jvll�� MEF��r� N f o� \D1 pl M "cR �SHAFER No. 215 Well Log RECEIVED Alaska Now-WelllVern's Driilling 12241 Avion Anchorage, Alaska 99516 AUG 1 81992 Well Owner (907) 345-4417 Municipality o1 Anchorage James & Vinitchai Hollenbeck AA3327 Dept. Health & Human Services Location Of Well PERMIT x SW910999 Borough Subdivision Lot I 81ock Section No I Township IN Range E gravel Merdian 35 Anchorage I Boyle BLK 215A N2 I 41 S 41 W hard brn till 1 451 51 Well Log Material Type Ft. Below Surface Top Bottom brn till 01 12 hard pan, rocky 12 15 silty, damp 15 29 gravel 29 35 ravel, silty, H2O 35 39 brn till 39 41 brn till W/seeps a 41 45 hard brn till 1 451 51 hard pan, dark brn 1 511 68 hard pan, med brn, seepage 1 681 75 hard pan, lenses gravel, H2O 1 751 78 10-15 gpm Well Depth (ft) 78 Date of Completion 11/7/91 Drilling Method Use jr-otary I Idomestic Casing Type welded Diameter (in.) Depth (ft,) Weight Obs/ft) 6 to 76' 6" 17 to Finish of Well Type Diameter open end Static Water Level Level (ft.) Date 16 1/2' TOC 11/7/91 Pumping Level BelowE-J After (hrs) Pumping (g.p.m) Grouting Yes Material No HX C= Pump H.P. Capacity Type submersible Setting (ft) Remarks blowing with rig, well was producing 10-15 gpm and was clearing very fast well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief. Date MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910229 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:HOLLENBECK JAMES & VINITCHAI OWNER ADDRESS:12200 CANGE ST. ANCHORAGE. AK 99516 PARCEL ID:01528243 LEGAL DESCRIPTION: BOYLE BLK 2 LT 5A N2 LOT SIZE: 23400 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 PAGE 1 OF 1 DATE ISSUED: 8/05/91 EXPIRATION DATE: 8/05/92 lfz THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / WELL SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: WELL ON LOT 4B MUST BE ABANDONED IN ACCORDANCE WITH DNR REGULATIONS PRIOR TC"INSTALLATION OF SEPTIC SYSTEM ON LOT 5A. / RECEIVED BY:CDATE: ISSUED BY: ���'� DATE: Juty 4, 1991 ROBERT SHAFER, P.E. ROGERSHAFER CIVIL ENGINEERS (907) 6942979 FAX 6941211 HEALTH AUTHORITY APPROVALS Mun.icipa2ity ob Ancho)tage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L St)teet SEWER &WATER P.O. Box 196650 MAIN EXTENSIONS Ancho)tage, Ata,5ka 99519-6650 REFERENCE: N Z, Lot 5A; Btock 2; Boyie Subdivision; SEWER &WATER INSPECTION Re ue6t you .c66ue Q ekwit to dkitt a we22 and �(mtaa a Septic 6y6tem pen%. ou)t de6.ign dated Juty 4, 1991. A6 can be been b)tom .the Site. plan, the neighbo)t.ing we.t2 senv.ing Lot 4B; Btock 2; Boyte Subdiv.i,6.ion; enc)toacheb .the LequiAed sepaution di6tance. ENGINEERING STUDIES REEPOORTSRIS AND R to the ptopozed 4e tLCA. 4 6.tem. However, ,the wett is eu,%untty not in u6e and ,the ownex iib the wet have Qg)teed to p)topetty abandon the wett . WELL Atthough we do not bo)te6ee any adveue ebbeet on ne..i.ghbon-ing p4open'ie6 TION &FLOW TEST by .the .ina.tatta.tion ob .the p)topo,6ed wet and 6eptic, due to .the smati tot sizes and .the eonb.igunation ab W" and septic6 .in .the area, .the. neighboring tot6 may atso be 2,i.m.i ted to ptac ing weW by the )toad and 6eptic6 to the ea6t ob the tot. SITE PLANS I you haven an ue6tion6 o)t )te u.i)te additi.onat in o)tmatian on YJ y y k k b b yau)t )tev iew 2eue contact u6. Si CeX y, ROAD DESIGN SOIL TEST /I> gm A. SHAFER, P.E. PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 -"p ,-SPRY (-?OMS - 12EX N . e2Ps76 0 MAOSiE D; EPPS_ �' ��-�ff _ x �j`�' LST lr� •-�a'- `�/ ■ a SCALE _A-T-� Ga I -MT N I � �ev, o D r `7 So S �-c-� - t✓fnry i�-�r� ��. �-��-fix.-- Jv �lap- 41 1 _A-T-� Ga I -MT N I � �ev, PERFORMED LEGAL DESCRIPTION 1 2 O, 3 4 V f 6 ..r . 7 8 9 / 10 !I 11 /c <o 12 1I t 13 14 15 16 17 18 19 20 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Aller Monitoring? gate: 11•zl-lti SITE PLAN H PERCOLATION RATE (minutes/inch)PERC HOLE DIAMETER ¢ TEST RUN BETWEEN FT AND FT ,/J�lJa PERFORMED BYA ZQ'ki `a;L- Eagle River Alaslea $$gggg77 4 ACCORDANCE WITH ALL STATE AND (v1UAIIPAL GUIDELI 72-008 (Rev. 4/85) I / CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: � 'rMEN-c January 31, 1983 TO: Permit Applicant <Permit #: 820181 Subject: Lot 5A Block 2 Boyle Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerely �c, - Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 6-650 10RAGE. ,4 LA ,I i'I (9 1 ?64_::11? ES SNVIRONVEhITA_ ., '3CTIOFA <Permit #: 820181 Subject: Lot 5A Block 2 Boyle Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerely �c, - Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 MINIMUM DISTANCE BETWEEN H WELL FINE) ANY ON-SITE SEWAGE DISPOSAL SYSTEM I-- 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM A PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET HWD TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT HIT��IN Z0 PHYS (}F THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS HND CONSTRUCTION DIAGRAMS ARE. AVAILABLE TO INSURE PROPER INSTHLLHTI8M, WE" Fit tel I & ��: F�, I FQ Em no ��CT E= Al E3 EE: Fi�_ll I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS AS SET FORTH BY THE MUNICIPALITY OF HMCHORHSE� 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED: (WAKA, APPLICANT L.- RLTSELL WELLS ����:1 C:, YK 1111��_T_ "-, �5�-- ��!1-1 -�� 5 . F I Ci EE DEPHRTPIENT ��'HEHLTH AND ENVIRONMENTHL���QTECTION ~^ 825 'L' STREET, ANCHORAGE, HK. 99501. ~ 264-472(,-.1 PERMIT NO. ( 820l81 ) � APPLICANT L RUSSELL WELLS SRH 1548F HNCH 145~2802 LOCHTIQN CHNGE ST � _ LEGAL L5H B2 �OYL� ' LOT SIZE 50000 SQUARE FEET MINIMUM DISTANCE BETWEEN H WELL FINE) ANY ON-SITE SEWAGE DISPOSAL SYSTEM I-- 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM A PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET HWD TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT HIT��IN Z0 PHYS (}F THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS HND CONSTRUCTION DIAGRAMS ARE. AVAILABLE TO INSURE PROPER INSTHLLHTI8M, WE" Fit tel I & ��: F�, I FQ Em no ��CT E= Al E3 EE: Fi�_ll I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS AS SET FORTH BY THE MUNICIPALITY OF HMCHORHSE� 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED: (WAKA, APPLICANT L.- RLTSELL WELLS Municipality of Anchorage 411,11 a On -Site Water and Wastewater Program - (907) 343-7904 5 E T Y Certificate of On -Site Systems Approval Parcel I.D. 015-282-45 1. GENERAL INFORMATION: Complete legal description Thomas L Boyle; Block 2, Lot 461 Expiration Date: J -- 1 Y-2-0ZQ Location (site address) 12201 Waqner Street *Anchorage, AK 99516 Current Property owner(s) Daren Munro Day phone 907-440-4444 Mailing address Real Estate Agent 12201 Wagner Street *Anchorage, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 4 Day phone WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ "JSO Date of Payment 10—L4 -16N (:o� Receipt Number 0_1 COSA # OSQ!� I Waiver Fee $ Date of Payment Receipt Number Waiver # rj TYPE OF WASTEWATER DISPOSAL: ® Individual Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ "JSO Date of Payment 10—L4 -16N (:o� Receipt Number 0_1 COSA # OSQ!� I Waiver Fee $ Date of Payment Receipt Number Waiver # rj 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrool s e- e l4tf c^ i r a= 7= n� 1 with the following stipulations: A ✓i C i 0\,/ .;Q d 1-- JVI 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc COSA Checklist Legal Description: THOMAS L BOYLE; B2, 1_4131 Parcel ID: 015-282-45 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 4.6+ gpm Date drilled 11m91 Water storage tank volume N/A gallons Total depth 78 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to 76.5 ft ❑ Coliform bacteria is Negative 09 Sanitary seal is functioning correctly Nitrate 10.6 mg/L ❑ Nitrate less than MRL (ND) in Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground)12-'i_in. Collected by GEG, LTD. Date.of.flow test for COSA 10/219 Date of Sample 9/18/19 Static water level at beginning of test 22.1 ft. Comments *SEE ATTACHED EMAIL FROM AAROW PUMP & WELL SERVICE B. TANK DATA Age of tank(s) 19 years Tank type/material STEEL Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 10/4/19 D. ABSORPTION FIELD DATA TESTED WEST TRENCH ONLY C. LIFT STATION ❑ Required maintenance completed Age of lift station 19 years Lift station material STEEL Comments: 'UNABLE TO MEASURE FLUID LEVEL IN TANK WITH MEASURING TAPE BECAUSE SOLIDS WERE TOO DENSE Which system tested (date installed) I2JI'.I3113 Adequacy test date 10/2/19 ❑ ALL standpipes present per record drawing Results QPass For 4 bedrooms Total measured depth from grade 6+ ft (max) Fluid depth prior to test 29 in Measured depth to pipe invert from grade ft (min) Water added 700 gal ❑ N/A — pressurized field 34 New depth in ❑ Monitor tubes go to bottom of effective. If not, state 135 depth into effective " Elapsed tune min ❑ Code -required soil cover over field Final fluid depth 31 in ❑ System presoaked Absorption rate 600+ gpd . (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N/A date of test) Gallons introduced gallons If yes, enter date NIA Comments/Deficiencies: "SEE ATTACHED REPORT. DATA IS FOR 2013 DRAINFIELD ONLY. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft 0 Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' Q Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Yes if No ft Q Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft E] Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water> 100' ❑✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' El Yes if No ft Private Wells > 100'❑ Yes if No ft Water Main > 10' r❑ Yes if No ft Community Wells > 200' r❑ Yes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' E] Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS *5'+ FROM SEPTIC TANK TO FOUNDATION - MET CODE AT TIME OF INSTALL "ASSUMED SEE ATTACHED REPORT FOR ADDITIONAL INFORMATION. G. ENGINEER'S CERTIFICATION 1 certify that l 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. COSA Checklist yellow sheet \10 E -7T • \�000 ��4Oaplu�iF,�o �ofes#AECC884�O� MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT On -Site water and wastewater Section 4 ; www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC191493 Subdivision: Thomas L Boyle, Block: 2, Lot: 4B1 A water sample revealed a nitrate concentration of 10.6 milligrams per liter (mg/Q. 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. GARNESS ENGINEERING GROUP, Ltd -- —— --- -- -- : ENGINEERING oSALES oCONSULTING: —------------. October 10, 2019 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Q unflies e Advanced Ticatmcnt System unmv REFERENCE: Thomas L. Boyle; Block 2, Lot 4B1; Well & Septic System Evaluation To whom it may concern, i. jopmeyrA cneruarness � PR ESS1�` We recently performed an inspection and adequacy tests on the well and septic system which serve the subject property. The following findings are supplemental to the information provided on the COSA paperwork: 1. While onsite to test the well and septic system we attempted to measure the liquid depth in the first compartment of the STEP tank using a steel measuring tape. The sludge and or scum layer in the tank were so think that we could. not push it to the bottom of the tank. The STEP tank has since been pumped. It is our understanding that the tank had not been pumped for a number of years. The STEP tank is made of steel and is 19 years old; therefore, it is reasonable to believe that it is approaching the end of its useful life. 2. The 2013 trench (re -build of the 2000 trenches) consist of an east segment that is 54 feet long and a west segment that is 54 feet long. We only tested the west segment of the 2013 trenches. The west trench has an effective depth of 46 inches. Prior to the start of our test there was 29 inches of standing liquid in one monitoring tube (MT2) and there was 24 inches of liquid in MTI. In short, the elevation at the bottom of the two MT's vary by 5 inches. The average elevation at the bottom of the two MT's is 97.43. According to the 2013 inspection report, the bottom (top of sand) in the west trench is at elevation 97.45. 3. All water for the adequacy test was introduced directly into the west 2013 segment via the monitoring tubes. 4. The east segment of the 2013 trenches was dry throughout the test. The MT's in the east 2013 trench segment are smaller diameter driven steel pipes. The two monitoring do not appear to go to the bottom of the trench. They are driven to a depth that is 9-10 inches above the bottom of the trench, which has a effective depth of 42 inches. 5. It is unknown why the east segment of the 2013 trench is dry and the west segment has 24-29 inch of liquid in it. It is possible that the water level is not high enough to be measured in the monitoring tubes. It is also possible that there are more porous soils in the east trench and a lower liquid level. It is also possible that the pressure line to the upper (east) trench segment is compromised, preventing liquid from reaching the upper (east) trench segment. 6. The northwestern most cleanout (or MT) in the 1992 bed is not present. It was not shown on the 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Page 2 of 2 12/15/2013 asbuilt survey, so it is likely that the pipe was not present in 2013. All other septic system pipes appear to be present. GEG did not evaluate the condition or functionality of the 1982 bed It is our understanding that the property owner has been operating on the 2013 trenches since purchasing the property 6 years ago. It is our recommendation that the flow be diverted to the 1992 bed for several years to allow for a reasonable recovery of the 2013 system. After that the flow should be switched annually between the 1992 and 2013 drainfield systems. If you have any questions, please contact me via phone or email. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessengineering.com MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - - Fax: 947-343-7997 Lift Station/Pump Vault Maintenance Log Owner f )Jn Street Address I aa'o � Wr'S Septic Tank: Sludge level ,inches -Pumping: required es o -Pumping completed es ng Lift station: -Pump basket cleaned tiyg� no -Effluent filter cleaned no -Control floats cleane no Proper float settings confirmed no -Operation satisfactory Q no Alarm System: -Dedicated electrical alarm circuit a no Audible and visual alarm inside dwelling Q no -Alarm system operation '�_satisfactory) not satisfact Manhole Riser -Ground water intrusion at riser to tank connection yes Ground water intrusion around pipe penetrations yes -9 -Weep hole functionai�Yes7 no -Manhole lid: Functional no Insulated a no Properly Secured no Other -All manufacturer required inspections and maintenance completed es no Comments: Q� 22v+notaea CA- w awls' 4 VW P- ,'_ Qualified Maintenance Provider: Technician f��,-Q.A S Date of maintenance k6131 t 5 CompanyV 70< C60c Signature Date �� i LJ Jeff Garness From: David Harper <dlharper2@gmail.com> Sent: Thursday, October 3, 2019 6:32 AM To: Jeff Garness Subject: 12201 Wagner Street Jeff, the well at the above location was checked to a depth of 70 feet with camera and no imperfections, breaks or incoming water were notated. David Harper Aarow Pump & Well Service, LLC Municipality of Anchorage g On -Site Water & Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-282-45 Expiration Date: -3-1:7- 1. GENERAL INFORMATION Complete legal description THOMAS L BOYLE S/D; BLOCK 2, LOT 413-1 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING 12201 WAGNER STREET, ANCHORAGE, AK, 99516 ART MILAN Day phone 772-485-7458 12201 WAGNER STREET, ANCHORAGE, AK, 99516 DERRICK SUITER W/ KELLER WILLIAMS Day phone 830-6235 Single Family (w/woADU)z�yr ❑ Duplex __, ❑ Multiple Dwellings (Single Family and/or Duplex) DEC 1 7 ?L113 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: COSA to be released to the engineer, unless otherwise COSA Fee $ a5'T) 1522 l (�h Date of Payment l p- k--� Receipt Number zz��bT COSA # OrDc Date: Waiver Fee $ _ Date of Payment Receipt Number Waiver # 5. STATEMENT OFylNSFECTION BY ENGINEER As certified by trop seal affixedrherpto and:=as of the validation date shown below, I verify that my investigation, based on procedures Outlined in tete Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply ar dlor petewater disposal system is (are) safe, functional and adequate for the number of bedrooms and typ'e of sthLctdre indicated herein. I further verify that based on the information obtained from the Municipality of Inchorage files and from my investigation and inspection, the on-site watersupply andlor wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date tZ r7 13 Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under 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 soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MCA DSD. The content of this report is for the sale 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. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for Disapproved. Conditional approval for bedrooms bedrooms, OF �l Gar ess: �G tOFt 1AiVC�y1�lrrir ON-SITE Ty,� with the following stipulations: =Z WATER AND �o WASTEWATER os Original Certificate Date: / 0- - 17 - / -13 TheUAunip(pali�ror Asi6horage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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, ATTCHMENTS: COSA Checklist V Nitrate Advisory V Septic System Advisory Arsenic Advisory Well Flow Advisory Other ,Rov iwna, If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: A. WELL DATA THOMAS L BOYLE S/D; BLOCK 2, LOT 413-1 Well type PRIVATE If A. B, or C provide PWSID# N/A Date completed 11 /7/1991 Sanitary seal (YIN) YES Total depth 78 ft. Cased to 76.5 ft. Date of test Static water level FROM WELL LOG 11/7/1991 16.5 Well production WATER SAMPLE RESULTS: 10-15 g.p.m. Parcel ID: 015-282-45 Well Log (Y/N) Wires properly protected (YIN) Casing height (above ground) AT INSPECTION 10/29/2013 11 5.64+ g,p,m. YES YES 12+ in. Coliform 0 colonies/100 ml. Nitrate 8.91 mg./L. Collected by: GEG, Ltd. Arsenic: ND ug./L. Date of sample: 10/11/201 B. SEPTICIHOLDING TANK DATA Tank Type/Material S.T.E.P./STEEL Date installed 10/5-12/2000 Tank size 1500 gal. Number of Compartments E Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES Date of pumping 11/15/2013 Pumper ONE STOP SERVICES C. ABSORPTION FIELD DATA <eELow FINAL GRADE Date installed 12/11-13/13 Soil rating (g.p.d./ft cr /bdrm 0.6 System type DUAL TRENCH 54/54 Length 108 TOTAL ft. Width 6/6 ft. Gravel below pipe 3.51/3.83 ft, •ss-zs/ Total depth -6.3-7.3 ft. Eff. absorption area 1000+ ft Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For=bedrooms Fluid depth in absorption field before test — in. Water added =gal. New depth in. G Elapsed Time: = min, Ninal fluid depth = in. Absorption rate >= - g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date D. LIFT STATION *APPROXIMATE. Date installed 10/5-12/2000 Size in gallons 1500 "Pump on" level at *44 in. Datum BOTTOM OF TANK E. SEPARATION DISTANCES "Pump off"level at *40 in. Manhole/Access (Y/N) YES High water alarm level at 46 in. Cycles tested 3 Meets alarm & circuit requirements? YES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS THERE IS AN INTERIOR ALARM N THE HOUSE G. ENGINEER'S CERTIFICATION 1 certify that l 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 Nare JEFFREY A. GARNESS Date I Z�t9 !13 F (Rev. 11/05) Municipality of Anchorage Community Development Department Development Services Division s 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 # 131649 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 4B-1 of Thomas L. Boyle subdivision. This inspection revealed a nitrate concentration of 8.91 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. Lu s'OCC m z a , ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ol � \ 236(Z & H &sV >; %,a% f�-s 2l8F Egg |;! ,Erlr.r! HT § ZMH-§§:�;,:| ®,,■;;E§ - �I } §§ . §) } §t� \;; ! �■& }\§( 2\\ (\/ § .\E +aM )} N 2! OLO ][/w\ \ wz §m ; §§2§kw %,a% f�-s 2l8F Egg |;! ,Erlr.r! HT § ZMH-§§:�;,:| ®,,■;;E§ - �I } §§ . §) \��\2� MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES M Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. # 0159294-3 \' HAA # tA Q 2-j 1. GENERAL INFORMATION Complete legal description Lot Nz 5A, Plock 2, Boyle Subdivision Location (site address or directions) Wagner Street Property owner Tamar F7nl 1 anhark Day phone 265-0682 Mailing address 12200 Canoe Street, Anchorage, Alaska 99516 Lending agency Day phone Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 1 4 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. IA 1) Front MOA 021 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application 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 furtherverify 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 Phone Address 77()=4 7a9le River loop Road No. 204 ag a rver, Alaska 99577 Engineer's signature 6. DHHS SIGNATURE Approved for 4 bedrooms. Disapproved. Conditional approval for Additional Comments Date 13-1G bedrooms, with the following stipulations: By: J C H tQ '�_/VI I T7 f Date Z %Z %UTIC The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates 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. 72-025(Rev.191) Back MOA421 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST C/ Legal Description: AZY2- Gu7 SA, &LZF 7p Parcel,I,D. A. WELL DATA Well type aIOLM If A, B, or,C, attach ADEC letter. AD EC water system number IUA Log present (Y 1) YDS Date completed II- -9 1 Driller: rWw WI:GC - Total depth g r Cased to?� m LtrvG- �CasirSgheight- ��rt�` Sanitary seal (SYN) Y+=S Wires properly protected (9N) YFZ FROM WELL LOG AT INSPECTION Date of test' Static water level Well flow Esq ` Id - f9' g.p:m. g.p.m. Pump level Uel= - P, ' 6 6?' SEPARATION DISTANCES FROM WELL T0: Septic/kniiiog tank on lot /n 5 r On adjacent lots t� _ Absorption field on lot - lin "4- ; On adjacent lots ioa r /J Public sewer main �� Pubtic sewer manhole/cleaan/out Sewer service line W." Petroleum tank /I/a VE Cn�OWN WATER SAMPLE RESULTS: Coliform Nitrate �•�Other bacteria 8 Date ofsaritpler f, tr -Collected by: _ S S !`NGtN�E Rinw B. 819PTICXFIOLDING TANK DATA Date installed _Tank size Compartments Cleanouts0N) Fourldetion cleanout ON) �lt�apr�ssaan (Y/ 1� � i High wa#�r alarm (Y/Z ;.N .� Alarm testd'dZ(YX@h. Et( Date of�pumpltfg'"" N %/) '* -]%VI! IRNK Pumper / v , SEPAR#'ION Dj$TANd S FROM s tEPTIC/ G TANK TO: p�- WBII(5) On lot t i On adlacent lots /06 r f' PnnnAsNn.. To property Surfacewateuarainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE STATION Date installi3 Size in gallons Vent(Y/N) High water alarm level "Pump Meets MOA electrical codes Manufacturer Manhole/Access (Y/N) at Pump off' level at Cycles tested SEPARATION DISTAWCE FROM LIFT STATION TO: On adjacent lots D. ABSORPTION FIELD DATA Surface water Date installed -�"3-'�Z Soil rating GPD System type 6E0 Length Width Gravel thickness -6r Total depth - `1' Total absorption area SE Cleanouts present &N) YES Depression over field (Y/& Y�)o Date of adequacy test /t%//4 Results (pass/fail) N for I- bedrooms Peroxide treatment (Past 12 months) (Y/V N6 If yes, give date N/A SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 110 '4- On adjacent lots loo �- Property line To building foundation a.0 To existing or abandoned system on lot IJA On adjacent lots f Cutbank W/A Water main/service line a S f Surface water 166 �- Driveway, parking/vehicle storage area Curtain drain AJONEE IWownr SEF_ I:r,j UN IZE=�vaT CSHT a� OF a7 E. ENGINEER'S CERTIFICATION FOR RCzut-*c.t_ t3EA t%I MFNSiU� S a iv I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S ENG!N:ERING Signature ;7014 Sagle River Loop Road No. 204 Eagle River; Alaska Engineer's Name Date 0— 18— HAA Fee $ ) Date of Payment cv C Receipt Number iA o 72-026 (Rev. 3/91) Beck MOA 21 C)/ ) Waiver Fee: $ Date of Payment Receipt Number No.