No preview available
HomeMy WebLinkAboutT12N R3W SEC 22 LT 30Onsite File T 0% IL & R 0% W ge N go IC 0 OLCA". e. cem Nab, 0 1"� e Prior to issuing a new COSA, a new survey is • • Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221480 PID Number: 015-521-25 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New n Upgrade Name BENJAMIN SHELTON ABSORPTION FIELD Site Address ❑ Deep Trench ❑ Wide Trench ❑ Bed ound 5531 EAST 112TH AVE. ANCHORAGE, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grad Gravel depth beneath pipe Subdivision Block Lot T1 2N R3W SECTION 22 LOT 30 Ft Ft. Fill added above original gr Gravel length Township Range Section _ Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ft2 Ft.' Well 100'+ 25r+ TANK ❑ Septic N S.T.E.P. ❑ Holding ❑ Other 011— Manufacturer Capacity Surface Water 100'+ GREER TANK 1500 Gal. Material Number of compartments Lot Line 5'+ NA HDPE 2 Foundation 10'-x-. LIFT STATION Manufacturer Capacity Remarks PER CONTRACTOR OLD TANK DECOMMISSIONED PER UPC G R E E R *500 Gal. 'SECOND COMPARTMENT OF STEP TANK Alla}jrm,location L c,�-kri c r,.A g Electrical Installed by -40'�z Si - PIPE MATERIAL House to tank D3034 '—Tankto D 1 %85 Installer drainfield ARM SEPTIC SERVICES Drainfield - CO/MT D3034 Inspector GEG AND MOA BENCH MARK (Assumed elevation) 97.34 ft Inspection 18` 4/17/2023 2� - Location and description 3rd - 4`" _ TOP OF MW 1 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's tamp conditional Approval: Date Septic Syst Approved Gt/ Date --gz- Z Note: this app val does not include well permit requirements. (Rev 05/02/18) r-0 �. 9 J orness.- QQ49 CE 7953 m� 4 Pre ' • � .I � Z� �<`�'\O a4 rofessio'oa� #AEccsa °4od000�o 8 PERMIT NUMBER: OSP221480 A B DBL1 74.8 84.5 DBL2 75.5 84.6 MH1 76.6 84.7 Fm -H2 79.4 85.1 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. DBL 1 & 2- 1 t NEW 1500 GALLON HDPE GREER TANK UTILIZED AS STEP TANK - NEW 1.25" PVC CONNECTED TO EXISTING PVC EXISTING DRAINFIELDS AND BALL VAL BOYD; LOT 3 BOYD; LT2] VACANT BV PARCEL ID NUMBER: 015-521-25 EXISTING 4 BEDROOM HOUSE I PREPARED FOR: PHONE NUMBER: PAGE NUMBER: N - 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: T12N R3W SECTION 22 LOT 30 D.J.G. TYPE OF WORK: DATE: ,._ SEPTIC TANK RECORD DRAWINGS 5/3/2023 \ J 0 o \ \ 1 EXISTING DRAINFIELD N SCALE: 1"=40' * -.. ENGINEERING - SALES - CONSULTING 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507' PHONE (907) 33M179 - FAX (907) 330-3246 - WEBSITE: www garnessenginoenng com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BENJAMIN SHELTON - 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: T12N R3W SECTION 22 LOT 30 D.J.G. TYPE OF WORK: DATE: ,._ SEPTIC TANK RECORD DRAWINGS 5/3/2023 PERMIT NUMBER: I PARCEL ID NUMBER: -OSP221480 RECORD DRAWING 015-521-25 TOP OF MHI = 97.34 TOP OF MH2 = 97.24 MH1 MH2 =�( /-FINAL GRADE = 96,82-96.99 TOP OF TANK AT INTLET = 91.42 INVERT OF PIPE AT INLET = 90.78 NEW 1500 GREER TANK WITH ANCHORAGE TANK COMPONENTS TO BE USED AS LIFT STATION TANK HOLE WAS DRY DURING EXCAVATION - GROUNDWATER WAS NOT ENCOUNTERED TOP OF TANK AT OUTLET = 91.38 't-'XAI"mN'jr"aS'Z"5'jr"-iN'k-'141NE'V"JRING GRO P, Ltd - ---- ---& ENGINEERING o SALES - CONSULTING mom-wamm, ow,-. m-m-mumansomm 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK99507' PHONE (907)337-6179' FAX (907)338-3246'WEBSITE:—.g–�...gi�..6.g.�.� PREPARED FOR:E NE NUMBER: NUMBER: PAG30F3 BENJAMIN SHELTON To LEGAL DESCRIPTION: DRAWN BY: T12N R3W SECTION 22 LOT 30 D.J.G. TYPE OF WORK: DATE: � PROFILE OF NEW S.T.E.P. TANK 4/2712023 OF AV c :,*c' -* r -, �* �.-* 1 4 J rey A. Ga—mess F Q ir- CF-53 N 23 4 cs ## 7 1 'N ............ Z LICENSE tit-ROF #AECC884 4 it 1A vii�i*** 5/3/2023 Inspection Report License/AP#: RETROE231187 Parent AP#: Inspection #: 757670 Type: Municipality of Anchorage Status: Development Services Department A36 "ah P.O. Box 196650 - 4700 Elmore Road 9W, Anchorage, Alaska 99519-6650 Info and Help: (907) 343-8211 4 'v, NG INSPECTIONS: Voice: (907) 343-8300 Fax: (907) 249-7777 5/3/2023 Inspection Report License/AP#: RETROE231187 Parent AP#: Inspection #: 757670 Type: DPRETRO Status: Closed Address: 5531 E 112TH AVE Parcel: 01552125000 Inspector: N.Holland Project: Resp Party: Descr: wiring for lift station -used existing wiring, just need exterior inspected Inspection Electrical (Electrical Inspection) Item: Evaluation: Approved Result Notes: Electrical Install Approved Inspection Item Item Description Evaluation MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221480 Work Type: SepticTank Initial Tax Code Number: 01552125000 Site Legal Address: T1 2N R3W SEC 22 LT 30 G:2637 Site Mailing Address: 5531 E 112TH AVE, Anchorage Owner: SHELTON BENJAMIN T & BROOKS RE Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date n , Deparhnent Lot Size in Sq Ft: Total Bedrooms: 12/8/2022 12/8/2023 222775 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: Date: Z Q 20z Z 4 MUMUPAUTY OF ANCHORAGE 0 Z4 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-521-25 Property owner(s) REGAN BROOKS & BEN SHELTON Day phone 907-602-7428 Mailing address 5531 EAST 112TH AVENUE *ANCHORAGE, AK 99516 Site address 5531 EAST 112TH AVENUE *ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) T1 2N R3W SECTION 22 LOT 30 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank p x ❑ Upgrade ® ❑ (D)Multiple Holding Tank ❑ Renewal ElDuplex Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: It o2?o Waiver Fees: Date of Payment: oda 66- Date of Payment: Receipt Number: 02(A5Receipt Number: Permit No. 05 p9 2 21g gd Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221480, Curtis Townsend, 12/08/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221480, Curtis Townsend, 12/08/22 Nhy.25.2022 11:27 AM A+ 9078686770 c�� eoueue}u!ew {o a;eq Ik- ain}euft au`sen pa}aldwoa aoueua;ulew pue suol;oadsui peal SO painoeg �tliadoad ou pa}elnsul ou se u a leuol}ou oleuolloun} eloq daeM. ee suoliageued edld punoje uo!sr ou s uol}oauum Nue} o} aesu;e uo!sr o;OeJsl}es;ou Ve4lniojl�owuefeou se uo1;i 6u!llemp ep!sul wiele lenslA pue olglpnd. ou ou sa pewiWOO Oulges;eolJ aadoad. ou s OU 9ou se peueap �a}l!J;uenl}}3. Vl.DN )W OU 81,71 out pe;eldwoo 6uldwnd. ou sa pajlnbaj :6uldwnd. -?6UT 1 I�2_5 ssa�ppV }eaa}S 60-1 eoueue4uiew }Ines dwnd/uo!;e;S IJ! -I L66L-Eti£-L06 :xe-J uol}aeS .ie;emalse b06L-£bE-L06 :eu04d }uewpedep se: 39tlJOHONd =10 A-LIlVdIOINnw P 2/ 2 tut dwoo ueiolugoe., a}uwwoO jain;oeJnuFw pd. -10440 d :pll elo4UeW !aalem pynoap. I ae;em pwnaE). JOSIN elo4uaw we;sAs waeld• )619 pa}eplpea. ;eNseq pwnd. lanal a6pnlS• :duel l} S Jeumo '8 aa;em Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141273 PID Number: 015-521-25 ❑ New ✓❑ Upgrade Name: William and Doreen Long ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench El Bed El Mound Address 5531 East 112th Avenue Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 •6GPD/SF 8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3 Ft. Gravel depth beneath pipe 5Ft. Subdivision Block Lot 30 Fill added above original grade ©— Z $1 -Ft, Gravel length 1 100 Ft. Township Range Section T12N 3W 22 Gravel width 3Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 1,000 Ftp 2 >10Ft. well >100' >100' N/A N/A >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity I 1,250Gal. Surface water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A Steel Two NA Foundation >5' >10' NIA NIA LIFT STATION Manufacturer Capacity Curtain Drain None Noted Existing Gal. Remarks Existing Septic Tank Decommissioned in Pump on level at n. Pump off level at in. High water alarm at in. Accordance with Municipal Code. Ball Valves Placed to Control Flow to New System or Pump make and model Electrical Inspections performed by Old System. Lift Station Refurbished. Installer PIPE MATERIAL Housetotank D3034 Tankto D3034 drainfeld G & R Excavating Drainfield HDPE COIMT D3034 Inspector A. Harala BENCH MARK (Assumed elevation) 100.0ft Inspection, dates: 1` 8/10/14 2� 8/11/14 Location and description 3" 8/12/14 a" 1 Lower Level of House. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date(j �'•;� �� r ---------- --------- - - -------- Approved f Date l �MF{SN4�� �l► inspection Kepert_rt-tz.oac n Permit Number: OSP141273 4700 South Bragaw Street Anchorage, AIC 99519-6655 - 343-7904 Lot 2 1 r W:.l RDUMDER IAT 23 Tref A eM wx uwr \0 Ddaen9 1.25D Gallon Salado Tank Dseammknonea in Accordance with Munieipal Coda. Lot 3 I � � ND - M2 GO l Ow �_ onowt Lot x fC0 - Hole cbanad MT - Tact title k1f - Sam TUM eJ - BOX Valw 4 ILUVA ' 49th 4:., 'MICHAEL E. ANDER EAST 1121h AVENUE "' lel 3 Lel u PLAN AS BUILT SCALE V = 100' Page 2 of 3 PID No. 015-521-25 ra I let 3 Lot 1 Lot 2 for 33 Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 Onsite Wastewater Disposal System or Well Inspection Report Permit No.: OSP141273 PID No. 015-521-25 NOTE: Septic Tank Replaced Under this Permit. Existing Lift Station Refurbished. &1&14 r _PROFILE AS -BUILT Scale: NONE MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM 4700 ELMORE ROAD, ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR: William and Doreen Lona DATE PERFORMED: 8/10/14 LEGAL DESCRIPTION: T12N R3W Section 10 Lot 30 TEST HOLE # A SLOPE SITE PLAN OG/OL d' e"d Silty Gravel da GW/GM a e d n a BOH WAS GROUNDWATER ENCOUNTERED? No S L IF YES, WHAT DEPTHS 0 DEPTH OF WATER None P AFTER MONITORING: E DATE: 8/18/14 49th •''s MICHAEL E ANDERSON No. CE -4381 See Site Plan READING DATE GROSS TIME NET TIME DEPTH TO WATER NET DROP 1 8/10 3:14 1.38" 2 3:44 30 3.88" 2.50" 3 3:45 1.25" 4 4:15 30 3.7S" 2.50" 5 1 4:16 1.13" 6 4:46 30 3.63" 7,5c" PERC RATE: 12 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 4.0 FT. AND 5.0 T. COMMENTS: Test Hole Pre Soaked Prior To Percolation Test. TEST PERFORMED BY: AH I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 8/29/14 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: OSP141273 Tax Code Number: 01552125000 Work Type: Septic Upgrade Permit Effective.Dates: August 07, 2014 to August 07, 2015 Design Engineer: ANDERSON ENGINEERING Subdivision: T1 2N R3W SEC 22 Site Legal Address: T12N R3W SEC 22 LT 30 G:2637 Owner/Address: LONG WILLIAM W & DOREEN A 5531 E 112TH AVENUE ANCHORAGE AK 995161722 Site Mailing Address: 5531 E 112TH AVE, Anchorage Lot Size in Sq Ft: 222775 Total Bedrooms: 4 This permit is forthe construction of: Y Disposal Field Y Septic Tank N Holding Tank 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. y B. Covered, sealed, and heated to pent free inn ------ Special Provisions: The Engineer needs to do an additional test hole prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. Received Issued By MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-521-25 Property owner(s) William & Doreen Long Mailing address 5531 E. 112th Avenue Anchorage, AK 99516 Day phone Site address Same Legal description (Sub'd., Block & Lot) T12N, R3W, Section 22, Lot 30 Legal description (Township, Range & Section) Lot Size 222,775 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade RDuplex (D) ❑ Holding Tank ❑ Renewal F1Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: j I certify that the above information is correct. I further certify that t UdMa�cl g applicable Municipal Codes. L JUL 2 4 2014 property owner or authorized agent) Permit/Rush Fees: 51A — - I Date of Payment: 11 25 IN (� � Receipt Number: 64451 t Permit No. o5y1'4 I Z1,5 Permit App_:: Waiver Fees: Date of Payment: Receipt Number: Waiver No. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) July 24, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 30, T12N, R3W, Section 22 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The absorption system on the subject lot has failed and must be replaced prior to the issuance of a COSA. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the four-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system and lift station. The existing Septic Tank will be decommissioned in accordance with Municipal Code. A new 1,250 gallon septic tank will be placed. The lift station on the lot will be inspected, tested and refurbished as necessary for continued use. The existing absorption trench system will be left intact and tied to the new system with a ball valve. Also identified on the plans are the locations of the existing well on this and adjacent lots and adjacent septic systems. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole placed on the lot when the initial system was constructed indicated Silty Sand (SM) in the absorption zone of the trench. The percolation rate was determined to be between 16 minutes per inch. We have designed the new trench with an application rate of .6 gallons per day per square foot. We are proposing to place 2-50' long trenches by 3' wide with a 5' effective depth. The total depth of the system will be 8' with the distribution line at 3' below the existing surface. A test hole will be placed prior to construction and the groundwater monitored for a minimum of 7 days. We do not anticipate the presence of groundwater based on the test holes placed previously on this and the adjacent lot. If conditions are found other than those anticipated work will stop and a change order will be drafted and submitted for approval. Lot 30, T12N, R3W, Section 22 July 24, 2014 Page Two The ground surface on the lot slopes slightly to the west in the area of the absorption trenches. The trenches will be placed parallel to the contours of the ground as much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the proposed well and from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: 1. 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, , z a's' Michael E. Anderson, P.E. Attachments 0 49th ,vv MICHAEL E. ANDERSON . No. CE -4381 . T1 2N, R3W, SECTION 22, LOT 30 222,775 S.F. NOTE: Contractor to Furnish Wrench to Operate Ball Valves. Handle Length Shall be a Minimum of 4'. Decommission \ Gallon Septic T Accordance witl Code. Place N Gallon Septic 'Fr W O M M O O N Exiatir, Absorption Trench System. m� .' 49th AEL E. ANDERSON No. CE -4381 rig 1,250 \ in nicipal 1,250 Four Bedroom \1 Home Well I 0 Inspect, Teat and\ Recd T11 as Necessary Existing Lif \ Stoton Place 1.5' Ball Valves \\ in Vault as Shown end Connect Existing \ Trenches for Future \ Used Construct 2-50' Long x 3' Me x 5' Effective Depth Absorption Trenehes. No. THA We, to Conshuotian. Results May Require Redesign. W NOTE: No Areas of Excessive Slope Within 50' or Surface Water Within 100' of Any Part of the New Septic System, No Conflicts with Adjacent Wells or Septic Systems. ------------------- 33' ROAD EASEMENT 112TH AVENUE SITE PLAN SCALE 1e = 60' a LEGEND CO — Cleanout SV — Septic Vent FCO — Foundation Cleanout TH — Test Hole MT — Monitor Tube BV — Ball Valve T12N, RM, SECTION 22, LOT 30 DESIGN FACTORS: SYSTEM REQUIREMENTS Four Bedroom Home Deep Trench System Perc. Rate: 16-30 Min./Inch 1,250 Gallon Septic Tank Application Rate: .6 GPD/SF Refurbish Existing Lift Station 5' Drainfield Rock 4 Bedrooms X 150 GPD/.6 GPD/SF (Application Rate) = 1,000 SF Absorption Area 1,000 SF/10 SF/LF = 100 LF Trench Length THEREFORE: Construct 2-50' Long x T Wide x 5' Effective Depth Absorption Trenches at the Location Shown. Flow Line Elevation in the Trenches to be 3' Below Original Ground. Total Depth to Be 8' Below Existing Ground. Provide 4' of Cover Over Septic Tank and a Minimum of 3' Cover OverAbsorpiton Trenches. Maintain 100' Separation from Wells in the Area. Place Ball Valves as Shown and Connect Exiting Absorption Trench for Future Use. Natural Backfill 2'6" 6 Geotextile Fabric 6" O 1" Perforated PVC (Holes Down) 15 - 3/16" Diameter per Lateral (3.33' O.C.) 5'0" 1 1—Drainfield Rock 3' TYPICAL DEEP TRENCH SECTIOP' NOTE: (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams APPROVED as being in Compliance with Title 21, AMC, for the following use(s):_____ �J- Date: SECTION LOT 30 LOCATED IN NE 1/4, S22, T12N, R3W, SEWARD MERIDIAN CONTAINING 217,800 S.F 5 ACRES Z o- m 1F nq' GO�RP� 207.02' UBMITTA JUN 2 1 2005 0 5o3 7�— PFS 101.5' PROPOSED FINISH GRADE DRAINAGE orsneaEo sv: EXCLUSION NOTES: It is the owners responsibility to determine LEGEND: SET FND BILL DOREfEN LONG the ON of any easements, covenants, or restrictions 5/8"RB W/CAPD 5/8" RB O which do not appear on the recorded subdivision plat. NOTE: It 3.25" AL.MON. MONUMENT is the contractor's reapansit, I ty to check top of foundation grade and building setbacks in relation to lotlines and esmts. HUB 8c TACK p FENCE— —x—_ x _ T �T SURVEY CERTIFICATION: SLANA has conducted a OVERHANG— SLANA SURVEYS INC, physical survey the this property as shown on this WOOD DECKS— drawing and to the best of our knowledge and CONCRETE— [ abilities, all dimensions have been measured true ASPHALT— and correct. SEPTIC STANDPIPES— (3) CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERSWATER WELL— LEGAL DESCRIPTION: 440 WEST BENSON BLVD. /j 103 (fax) 561-6626 ELEV.(NO 100.0 DATUM)— ANCHORAGE, ALASKA 99503 (907) 562-6103 SECTION LOT 3 0 1 o c a t e d n T12N, R3W, S22, S.M. ALASKA )RK ORDER NUMBER: 9-L-999AJDNE,6,2Do5 DATE: SCALE: =6° GUT NUMBER; DRAWN BY: CHECKED .. CRI. NUMBER: AGE: ,5W gq/ggBOOK E. 112th /6J_y Municipality of Anchorage Page —I—of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744-- 43-4744-On-Site On-SiteWastewater Disposal System and/or Well Inspection Report Permit Number: S\Y/ 94D 3A6 PID Number: dls - 6a!–o2S Name. S+I� B i S �oN/� Wastewater System: ❑ New Y Upgrade Address: 55 3 I E 11 4- ve ABSORPTION FIELD Phone: No. of Betlrooms: Deep Trench El Shallow Trench 11 Bed ❑Mound 11 Other LEGAL DESCRIPTION soil Rating: 0.L Total Depth from original grade: GPD/S . Ft. 01 Lot Block: Subdivision: 30 Depth to pipe bottom from original grade: Gravel depth beneath pipe 3 Fl Ft. Townshi �f e: 3 Ran ,,' / Section: Fill added above original grade : Gravel length: _ WA Z Ft. s7 a F1. WELL: ❑ New ❑ Upgrade Gravel width: Number of lines: Distance between lines: Ft. ! 'Jr Ft. Classification (Private, A, B,C): Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. I O-tr0 SD. Ft. �L y O Driller: Date Drilled: Static Water Level: Ft. Installer. /TCEf��r`t S Date inslalle Q 8tl — l Yield:Pump Set at: Casing Height Above Ground TANK GPM Ft. Ft SEPARATION DISTANCES El Septic ❑Holding )A.T.E.P. To From Septic Absorplion LiuHolding Public/Private Manufacturer: Capacity in gallons: Tank Field station Tank Sewer Lines (/—1 4 aA f 2{(/� 0--c), Well I rz ; h I &o : -6 0 1-60 Material: S Number of Com arlments: Surface Water 0 j.4� LIFT STATION Lot Line �J[7 1 5 z+ D Size in ggaHons: - ot7 Manufacturer: I / / yLa fi4 Foundation t t y 140 u; O "Pump on" level- "Pump off" � al: High watt alarm at: Curtain Drain t to`gi.-. `�4 Pump Make &Model OA&44 t,p Electrical Inspectio s performed by: Remarks: BENCH MARK Location and Description: Assumed Elevation: 1� F ' ENGINEER'S SEAL Inspections performed by: Dates: 1st $ 8 4� 2nd 04 Department of Healt -a ma vices approval Reviewed and approved by: Date; 72-013 (Rev. 9/91) MDA 25, I -C�- Testhole 1 I Testhole I I I 1 I I I I I � Test ole #2 + 1 EXI AL TANK + +.+. 1 I ' _ + ++*+ + + + + + + + NE 500 GAL LIFT STATION STEP +I* 1+1+++++++++++ 1j Te thole #1 ++ I 1-1/4 PVC SCHEDULE 50 ++++++++++ ++ + ++ + + 30 +*+*' I � I15 1 Y +++ REBAR 2 TRENCHES 1 `1 Testhole #8 50 FT LONG 8 FT, DEEP I 5 FT. ROCK 1 Testhole #7 6-9 I + 1 UTILITY POLE ++ #5 REBAR + 25 725 50 75 100 125 + 150+ I ANCH. AK. 99501ENUE t I I 5531 2, F12H.oAVE. I I SHEET: 213 GI GRID:I 2637 I • , Li ni in , /✓' -- 1 ro 500 GAL STEP 2' Wide o 50' Long 8' Deep 5' Sewer rock I250 gal Septic tank 3' Cover NO SCALE EXIS71NG Mira F; 140 99.3 IL 94.2 5 Ft of Septic Rock LIFT STATION monitor Yf f NQ SCALE 94.4 94.2 500 GAL STEP LIFT STATION 1250.ga1. septicrl BENCH MARK BASEMENT FINISH FLOOR ASSUMED ELEVATION. 100.00 FT. TOBBEN SPURKLAND P.E. LOT 30 SEC 22 T12N R3W SEPTIC SYSTEM ASBUILT 203 W15th Ave DATE: SEPT. 6, 1994 Anchora e Ak 99501 5531 E. 112TH. AVE ��o_:o�a DONNE G. SHEETS ESTATE SHEET.• 3/3 GRID: 2637 �w,re Ovi)� Municipality of Anc orage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Y��r� 6 \ DATE PER LEGAL DESCRIPTION: Le -L— 3 y Township, Range, Section: Se 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: S L O P E SITE Reading Date Gross Time Net Time Depth to: ' Water - Net, Drop LL h7 94 D: 70 p� 0 4 V %. �✓ : 0a 14:36 D,, 5 40 t 5 yJ& tJ q/b... fo 7/B 6 10 3 1 4( 0 5 I D 5 -511164 20 I G /( IL_,I PERCOLATION RATE S2� (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN /J' FT AND .J /LFT COMMENTS PERFORMED BY: (-- I (— CERTIFY THAT THIS TEST WAS %PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE I sr t f) oI 9 4 10 .60 DEPARTMENT OF HEALTH AND HUMAN SERVICES -164 P.O. BOX 196650, 825 "L" STREET, ROOM 50 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940325 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:SHEETS DONALD G & OWNER ADDRESS:5531 E 113TH AV ANCHORAGE, ALASKA 99516 PARCEL ID:01552125 LEGAL DESCRIPTION: °, = R3Wb,SEC 2Q TuT 30 LOT SIZE: 222775 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 8/30/94 EXPIRATION DATE: 8/30/95 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 343-4744 (24 HOURS) . 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: AT THE TIME OF CONSTRUCTION OF THE SUBJECT WASTEWATER SYSTEM THE ENGINEER SHALL PERFORM AN ADDITIONAL PERCOLATION TEST IN THE ABSORPTION FIELD AREA WITH THE EQUIRED MINIMUM FOUR (4) HOUR PRESOAK PERIOD IOR TO THE T T. RECEIVED BY: DATE: r 3 d _` ISSUED BY: DATE: 9-3e— /4 T.SPURKLAND P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 30 Sec. 22 T12N R3W Donnie G. Sheet Estate No Ground Water or Impervious Layer to 16 ft. Use Standard Trench Soil Rating. From test August 4, 1994 16 min/in = 0.6 gal / sq. ft. No. of Bedrooms 4 Required Area per Bedroom: 150/.6 = 250 sq.ft.. Total area required: 4 x 250 = 1000 sq. ft. Existing tank 7 feet deep. Use 500 gal STEP Testhole Total Depth 15 Less 6 feet 9 Less 3 feet Cover 6 Rock Depth 5 Length of Trench 1000 / 10 = 100 [Ft.] SYSTEM CONFIGURATION 2 STANDARD TRENCHES AT 50 FT TOTAL LENGTH 100 FT TOTAL DEPTH 8 FT. ROCK DEPTH 5 FT. COVER 3 FT. SEPTIC TANK 1250 GAL. CHECK INTEGRITY STEP TANK 500 GAL. ABANDON EXISTING TRENCH it Td66en SPurldand C �, iP. •. C1+2225 ........ �. "POFESS0!!' J The installation of this septic system will not prevent wells from be installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface ranoff will not result from this installation. Septic System Design Lot 30, Sec. 22, T12N R3 W .����r a• sas ••ua •S' h i� I i3a a . y s°s s sa as°a to LOT 29 . .... i �� in; •o CE-2225 V• LOT I I I I I 50 0 1 50 100 150 200 II 250 300 1 I SCALE1'= 100 FT, I LOT 3 will I I I I :. I LOT I O Lar 2 I II a14 AVE TH, LOT 2 I LOT 3 1 LOT 4 Carl JO1�IE ESITA TE iS D C� Well TOBBEN SP URE. LOT 3O SEPTIC SYSTEM DESIGN EP. 203 W 15TH. AVENUE ANCH. AK. 99501 SEC. 22, T12N R3W DATE: AUGUST 12, 1994 (907) 279-3916 5531 E. 112TH. AVE. SHEET: 1/3 GRID: 2637 Testhole I ' Testhole esthole #2 I +'+ +'+' +++ - EXISTING 1250 GA . TANK '+`,`.+ +`+ +'+ + + NEW 500 GAL LIFT STA + ++ + I -P/4" PVC SCHEDULE 50 + + + + + +++ esthole #1 ++++ I+ ++ 1 + +++ + + + + I 1 + + + I ++ ++ I + + Test ole #8 +++ ++ ++++ 1 + + + 2 TRENCHES 50 FT LONG r 1 Te ole #/ 8 FT, DEEP 5 FL ROCK. C+ S C 5% 4A"a Cr a 30 SEPTIC SYSTEM DESIGN I W 15H. AV ANNCH. AK. 9950'ENUE E I I SEC. 2�� 112TH. AVE. f. I I SHEET: GRID: AUGUST 11994 2637 I = 50 Monitor 1-1/4" PVC 1/4' ROLES ® 18•• Standard Trenches 2 2' Wide 50' Long 8' Deep 10 S' Sewer rock 3' Co ver Monitor 1-1/4" PVC 1/4' HOLES ® 18" NO SCALE Mira PI 140 5 ft of Septic Rock Monitor 4' Topsoil 3' Cover NO SCALE —�00 O O 1250 gal Septic tank 500 GAL STEP EXISTING UFT STATION 500 GAL STEP LIFT STATION c<<zzs ,•°��� 1250 gal. septic ITOBBEN SPURKLAND P.E. I I LOT 30 SEC 22 T12N K3W I ( SEPTIC SYSTEM DESIGN I 203 W151h Ave 5531 E.112TH. AVE DATE: AUGUST 12, 1994 A7Qho=Q�� Ak 99501 DONNE G. SHEETS ESTATE SHEET. 3/3 GRID: 2637 jLSEA app Municipality of Anchorage r< L� DEPARTMENT OF HEALTH & HUMAN SERVICES Es 826 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST °°°° ' ^` ". T PERFORMED FOR: ,VONL"7 H G-2 - S Ll e-�i� £3 MIC� DATE PER LEGAL DESCRIPTION: Lc� i 3D Township, Range, Section: $C n�a_T_"7 SLOPE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER 1 ENCOUNTERED? Nk D S ;F YES, AT WHAT L O DEPTH? p E GepthMontt to Water Alfat �y Monitoring? _I'�`.,`•,7,,_ Date: 9 12—;2 SITE PLAN PERCOLATION RATE (M—ilesimCh) PPERC HOLE DIAMETER TEST RUN RETWEEt! FT AND/FT IV. Q r2.rC'= PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUICEUNES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4185) •�V� Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: T)coN IA ! L h tG� ES td�� DATE PER LEGAL DESCRIPTION: L.o % .1 d Township, Range, Section: 1 2 3 4 5 6 Ar �i Zi 7 N M 70 O o e 11 l 12- 13- 14-' 2 13 74 ' 4 � 15 r 16 17 81920 18- 19- 20 COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? O St.rt Q S �� IF YES, AT WHAT OL t DEPTH? p E g Depth to Water Atte // Monitoring? _ pate: — )RIME[i v 1 Reading Date Gross Net Depth to Net Time Time Water Drop 121 IZ D PERCOLATION RATE (mmuteslmch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND OL—FT PERFORMED BY: S I _ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GADELINES IN EFFECT ON THIS DAA TE. DATE: .�/� /,z• 72-008 (Rev. 4/85) (((JJJ �-- #L TR Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: lo HH I L 6 - SL— I ES Ld�40-- DATE PER LEGAL DESCRIPTION: LO r 3 D Township, Range, Section: Ce- c, d -Q t TI2,N DEPTH SLOPE SITE PLAN 2 3 4- 5 6 7 8 9 10 11 12 13 14- 16- 16- 17 4151617 18- 19- 20- COMMENTS 81920 COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? Date: SS I I I I ±F= L P E 1 Reading Date Gross Time Net Time Depth to Water Net Drop qq _Li ,S- 2- C) b' ' PERCOLATION RATE (minuteslinch) PERC HOLE DIAMETER IO TEST RUN BETWEEN FT AND y •� FT PERFORMED BY: - S I _ _ i CERTIFY THAT THIS TEST WAS aaPERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT' ON THIS DATE.- DATE: ALL 2, l 2' 72-008 (Rev. 4185) 0 , ' TH -7 - Municipality of Anchorage DEPARTMENT DF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: -Do NN ;e- 6 , &4 dt4 ES Lje_ DATE PER LEGAL DESCRIPTION: _ LO 1 30 Township, Range, Section: S F _ 2_.2_.I t2M , e 3 tY/ SLOPE SITE PLAN I4 - COMMENTS WAS GROUND WATER ENCOUNTERED? b S IF YES, AT WHAT L DEPTH? 0--j— I I P E Id Depth to Waley r` S t(t q� Monitoring? _.v I)Irt ._ Z_nate: l Reading Date Grass Net Depth to Net Time Time Water Drop 8 q q,. 40. + 6l 40 ID'• io' 7 z 1. _ t 40a t'/ - PERCOLATION RATE 116_1( (minutes/inch)/PERC HOLE DIAMETER 1"EST RUN BETWEEN (P FT AND !9 `' FT PERFORMED BY: T,'S 1 1 -C. CERTIFY THATTHUS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Igt 12f 72-008 (Rev. 4185) n 144 g -�j �{ e o Municipality of Anchorage ; 49 DEPARTMENT OF HEALTH & HUMAN SERVICES e 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST sT •_ Tr DoNNi t_ Lam. JNtC cr� _ DATE PERFORMED.` PERFORMED FOR: `°� LEGAL DESCRIPTION: LoT 3o__. Township, Range, Section: S4t,GZ,2 T-1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS SLOPE i I I j WAS GROUND WATER ENCOUNTERED? S T WHAT L O P E rAe Date: OX 11 q IF YES, A DEPTH? Depth to Wate Monitoring? N' b on SPnrldond CE 2225 LV/ Reading Date _-� Goss Time Net Time Depth to Water Net Drop ll & -41 4:0o y •j _ -t-- I LI —iZ YJ I_ __ ll '•�J 20 (o' ' lL :4S 20 S3/ l IN PERCOLATION RATE __12— (minutes/inch) PERC HOLE DIAMETER to TEST RUN BETWEEN S FT AND $ FT PERFORMED BY: 7�7S 1 __= CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:f 72-008 (Rev. 4/85) r•-1 W MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHHOIN ❑NEW FF??r— O /a DL+VL/ Scr\ U)JCT— 1 t D S-' S J'E'4 G(S(iI ,UPGRADE MAILING ADDRESS I � OLD 5,2lZ2,D W LEGAL DESCRIPTION EG L2 -1-1 2A LOCATION - NO. OF BED OOMS U Y DISTANCE TO: Well /'� Absorption area Dwelling I D O. PERMIT N76 Qw�. Cfi QManufacturer 1:2 V i Material No. of commants L Liq.c ac- n gallons IF HOMEMADE: Inside length �f Width Liquid depth 0 Y DISTANCE TO:. Well-� 7 .Dwelling PERMIT NO. JVZ Oz FQ- Manufacturer Material Liquid capacity in gallons DISTANCE TO: Well / ,.33 Foundation ( Nearest I t lin %) / PERMIT NO. —T�. = Z No. of lines I Length &AOfine Total lenh oft fes Tre d_th Dista c twean lines w F G ICJ inches Top of rile to finish grade Matc ?neath the I ri tfr Total effe 've absor ion area J }v _ rT es gs, 6P L5 Length Width Depth PERMIT NO. W l7 i F- wa Type of crib Crib diameter Crib d14 Total effective absorption area LA -.DISTANCE TO: Well Building ngundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J DISTANCE TO: Building foundaliM f Sewer line Septic tank Absorption areals) OTHER PIPE MATERIALS 16 I' tvr 4-a&x4b P G C.45T jeat/ SOIL TEST RATING 150 INSTALLER C REMARKS 12011! aus& 10 vw yj LUL, 47 t am �,v Z ' le oang 0 i ae .• ..,.,.g mNO �f V YTV; NIS OMAS R. IT a i PPROVED ® °a ° • LEGAL 72-013 (Rev. 3178) A I (� SOIL LOG r0 -& rl 1 C/J 3 ENGINEERS, INC. �/PERCOLATION V S SOIL LOG TEST 7125 OLD SEWARD HIGHWAY PERCOLATION TEST 43EDROOMS ANCHORAGE, ALASKA 99502 (907) 3496561 qq JOB NUMBER: PERFORMED FOR:_ DAVE BQZQ u i -s r - _—�DtATE PERFORMED: -� 8 spgr 4 LEGAL DESCRIPTION: L.07 _30 SEG 22_ -if ZN SLOPE SITE PLAN 12- 13- 14- 15- 16- 17- 18- 19 2-13141516,7 1819 20 0-1,0 savvy 5iti-C&M-1 ML Mo1.sr c0"CstvE_ LD-S,D Gif4vE2.tV Sta.T W IT14 SOAAC- s4Naf EIeAY A4L- 5Lf6HTLy MOISr ctgkf&5 NE 6,0 -1(,D, sig SAA1D w ITx1 M 1N o L',,. s f LT DAMP t MEa 10001 770 ENCOUNTERED? GROUND WATER ♦ �� S ENCOUNTERED? L FtNe 6&AtNt� D P E "OsLr—C�. ...? IF YES, AT WHAT E6{L�°� DEPTHS Reading Date Gross Net Depth to Net Time Time Water Drop p 61 W E THOMAS R. SMITH. pt DEPTH 'PERCOLATION RATE_ U*414�(minuteshnch) (FEET) _ TEST RUN BETWEEN —(6L5 FT AND /;2,n FT COMMENTSk'LCOMMltND '�ISMCM t fS0 t2i/4YZ .50it_ �SP�_ 2DW .& n� p ,1`I 77 C PERFORMED BY: M L7 AJAJ1.S' rT __. CERTIFIED BY: _ __—_____ DATE: ]2L88 0831 oil Parcel I.D. 015-521-25 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION: M'' I W�,, Expiration Date: Cl- 69 - 2-0 2 Z Complete legal description _ T1 2N, R3W, Sec 22 Lot 30 Location (site address) 5531 E 112th *Anchorage AK 99516 Current Property owner(s) Richard & Stacey Minkler Day phone 907-727-5011 Mailing address Real Estate Agent 5531 E 112th *Anchorage AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $550 + O / Waiver Fee $ Date of Payment 664 na,< Date of Payment Receipt Number OF %`/0 Receipt Number COSA # 0 SC a a Q 5 ( Waiver # 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:�� L� 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 ��?(-.•• I �l industry practices. The reported results describe the condition of the system/s on the date/s of the ri. ��• ' :; ,' 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 ✓ u �• !.'� '- 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 � l� • • • (. "6 .. , . r c y /•, are outside the control of GEG. Satisfactory test results do not guarantee future performance of the v , i.arrCS system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of ���� R f c 5 ir�.o �G the well or septic system. GEG makes no representation whether an alternative well or septic system t!l� `„ •••• j E-79 can be installed on the property in the event either of the current systems fail to perform adequately in i . ......... 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 �-�h`�cof ess%c'_� " party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. �#AECC884 6. DSD SIGNATURE �`� O 1� rim System #1 Approved for bedrooms System #2 Approved for bedrooms ` o A Disapproved Conditional approval for bedrooms, with thea ng stip%flatio\���� BY 4 Original Certificate Date:- (,z, — 2 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 engineers work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc Legal Description: T12N, R3W, Sec 22, Lot 30 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1965(?) Total depth *73.4+ ft Cased to LINK ft NOW Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 517/22 Static water level at beginning of test 64.6 ft. Comments "*Per GEGwell-test - - - B. TANK DATA Age of tank(s) 8 years Tank type/material septWU Wel Measured operating fluid level in septic tank n/a ❑ Standpipes/foundation cleanout per record drawing Date of pumping Not required see lift station report D. ABSORPTION FIELD DATA Which system tested (date installed) '2014 ❑ ALL standpipes present per record drawing Total measured depth from grade 9.3 ft (max) Measured depth to pipe invert from grade ' ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective " Parcel ID: 015-521-25 Structure served by this system Well production at time of test 7.8+ qpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 6.02 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by GEG, Ltd. Date of Sample 5/6/22 C. LIFT STATION Vj Required maintenance completed Age of lift station 28 years Lift station material l Comments( ee attached letter regarding de"iicieenncies�� Am, Adequacy test date 5/7/22 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 31 in Water added 899 gal New depth 47 in Elapsed time 120 min - ❑ Code -required soil cover over field Final fluid depth 37 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) n/a Gallons introduced n/a gallons If yes, enter date Comments/Deficiencies: '2014 west trench tested only. The 2014 east trench had 29" of liquid in it 1994 trenches were dry. •2014 trench only appears tohave about 1.5 of cover. COSA Checklist yellow sheet L [`w -t /tet^ !leis 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' Q Yes Neighboring Tank > 100' Q Yes Absorption Field on Lot > 100' Q Yes Neighboring Absorption Fields > 100' R Yes Community Sewer Main > 75' R Yes From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5 ft Surface Water > 100' Property Line > 5' Q Yes Community Sewer Manhole/Cleanout > 100' if No ft M Yes if No ft if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft if No ft Holding Tank > 100' 0 Yes if No ft Water Service Line > 10' Yes Animal Containment > 50' RYes if No ft if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5 ft Surface Water > 100' Property Line > 5' Q Yes if No ft Absorption Field > 5' R Yes if No ft Water Main > 10' Q Yes if No ft Water Service Line > 10' Yes if No ft Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' ❑✓ Yes if No ft Q Yes if No ft, Q 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' E 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' Q Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' El Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *Me# eode-at-t-ime-of-iris-tallation G. ENGINEER'S CERTIFICATION' 1 certify that I have determined through field inspec 'Qn� ar�d review of Municipal records that the above systems are i conformance with 4 MOA COSA guidelines in effect on this date. /J. COSA Checklist yellow sheet ##AECC884 qJ Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC 221256 Subdivision: T12N R3W Sec 22 lot 30 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks and or lift stations The lift station for this"COSA / propertV is 28 wears old Aleaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $5,000 to $7,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank in failure and should be replaced. MaW'Add ress P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org Nitrate Advisory Certificate of On -Site Systems Approval # OSC 221256 Subdivision: T12N R3W Sec. 22 lot 30 Awater sample revealed nitrate concentration of 6.02 milligrams per liter 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. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. ' NESS ENGINEERING GROIJ 9 Ltd. ENGINEERING , SALES � CONSULTING June 3rd, 2022 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Lift -Station located at 5531 E 112th Ave — T1 2N, R3W, Sec 22, L30 To whom it may concern: -4 As part of the COSA inspection for the subject property we (GEG) noted that the lid on the lift - station serving thesepticsystem was not secured.--Pictures-of the lift -station were taken for my review. Upon looking at the photos several deficiencies were noted. The lift -station was later inspected by A+ Home Services and they prepared an inspection report. Comments are as follows: 1. A+ secured the lid on the morning of 6/3/22. GEG inspected it and it appeared to be',-' J secure; however, there is a section of all -thread sticking up about 6 inches that is a safety concern. This should be reduced in height (cut-off) to reduce the risk for injury. ) 2. The riser is not insulated, as required by code. 3. The electrical wires were initially exposed in an open junction box — A+ put cover on junction box. 4. Per conversation with Larry Bettis (with A+) the filter basket is old and cannot be removed for cleaning without compromising it. 5. It appears that a riser extension was welded onto the riser. The extension is a thicker steel and appears to be structurally sound. 6. The portion of the riser below the extension is badly corroded and is likely near (or at) the end of its useful life. 7. The steel lift -station tank is almost 28 years old; therefore, it is reasonable to believe that it is near (or at) the end of its useful life. If you have any questions, please contact us at 337-6179 Thank you for your assistance. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com I Owner Septic Tank: -Sludge level K inches Lift Station/Pump Vault Maintenance Lo Street Address _j-�-3 1 E. 1 )1 4 V& -Pumping: required es nom •Pumping completedey s no i *Pump basket cleaned es no �6 Effluent filter cleaned yes no ,Control floats -cleaned es no •Proper float settings confirmed es 1 no *Operation satisfactoryesi no Alarm System: -Dedicated electrical alarm circuit 6 es, no -Audible, and visual alarm inside dwellingesi no -Alarm system operation satisfacto , not satisfacto Manhole Riser -Ground water intrusion at riser to tank connection yes no -Ground water intrusion around pipe penetrations esno -Weep hole functionalves_ i no -Manhole lid: Functional es no Insulated gno Properly Secured es no Other -All manufacturer required inspections and maintenance completed yes no Comments: V c: v 1'1!'�Pc ( Qualified Maintenance Provider: Technician _I. o. u^ y 13 c?--Vk 5 Date of maintenance )-3 f2, Company ' Zr Signature _ Date 9,3x .1, 111 I 1 i { S 00'QO'44" E 660.00' N A.-• O Q. (0 32.4' 0 1,v�v!. R... P U 40.3' GRPV�� N x11: C' m p \ 26.3 b RppiUs -�" t O a 13.6 v l o, o, w H TO N 2 I v co LLJ a49.6 N W _ O � 3� w LLI O gU N _ N / X o N 3 w w O J Z ¢ U O W Q v):2 — N 00'00'02"W 659.97' f w I o N I ( I I a CN I ® I I 0 I 1 I i t a; N iry ri fD N M cn h a cr co C? Z 0 Z it j T J ! N N xI V- I-- 5 m F � Le 1 a I a - O 4 a • Q�000©�c' Q0,� • �4 • SOY m O 0. NO PA • J. 4 a1 �.� � Zoa; Q U m Q) } Q o x 4 a Q�000©�c' 01 O m O a w � O ►., y a ~ O 4 U m G} m } Q o x 0La+ w oa O '*• q •A .0 q G cq m > O 0.2 m m > n N Q +- C •O �N aLi o � a 0.0 N DUN3tNA O 0 q p O CL Oeq- ;w O y A OYa s L q O _ _ ON r, Ls a a9 O q Sm J� 0 C L r- UDOC� .^- •div 7 Via® C •� C O g. Q1 = ® O v O D a O C C 'o o:2 E4'02 -a Le - Le m r U a O r y �- c >` a v� .. 0. 0• eg o o L C fl vv c ovm i (D CUv>.0 C a t'hJ va +- p o 3aa J:" E 0 oO M0 a >. -p �gci L cZ a °Q� 3v x v qd N O < a 0TvCLQ > L v Q v A ❑ .y-� 124 C;il x NO -C 0. t.2 }"0 C CO ►. i7 3 1i aai �uoa.E+0 C� Q 2 ��n=gECO = w0 �1 v o 1 o> a q q L AMp.-C°qr .a 1•- L OA -C " ac -C ❑ .- oe O. m 0 U Ale - Gert • '� Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 2 [ Parcel I.D. 015-521-25 Expiration Date: �/ / �✓ 1. GENERAL INFORMATION Complete legal description T1 2N, RM, Section 22, Lot 30 Location (site address) 5531 East 112th Avenue Anchorage, AK 99516 Current Property owner(s) William & Doreen Long Day phone Mailing address 5531 East 112th Avenue Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: - El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for:. Date: ' 1s COSA Fee $ U1e,eec tic l,,Q— Waiver Fee $ Date of Payment Receipt Number � COSA# Date of Payment Receipt Number Waiver # 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for __ _ bedrooms System #2 Approved for bedrooms Disapproved Phone 522-7773 Date 211 4 9 14 r A ' Conditional approval for bedrooms, with the following stipulations: 1,AEL_E: ANDERSON -2381 "RO FES SkUO ®®Q° \0®ate®®® M Original Certificate TV Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Mue sheet f :, c 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: T1 2N R3W Section 22 Lot 30 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Date completed 1965 Sanitary seal (Y/N) Y Total depth >63 ft. Cased to '63 ft. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: ft. E!12M Coliform 0 colonies/100 mL Nitrate 1.07 mg/L Arsenic ND ug/L Dateofsample: 1/29/2015 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping New Const. Pumper C. ABSORPTION FIELD DATA Parcel ID: 015-521-25 Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 6/5/14 63' ft. 5.7 g.p.m. Collected by: Anderson Engrg. Date installed 8/10/14 Cleanouts (Y/N) Y High water alarm (Y/N) _ Y Date installed 8/11/14 Soil rating (g.p.d./ft2 or ft2/bdrm) .6 GPD/SF System type Deep Trench Length 2 @ 50 ft. Width 3 ft. Gravel below pipe 5 ft. Total depth 8-9 ft. Eff. absorption area 1,000 ft2 Monitoring tube Y Depression over Feld 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.) (Y/N & type) N If yes, give date D. LIFT STATION No Add On Manhole - Gravity Flow to Absorption Trench. Date installed 9/11/94 Size in gallons 500 Manhole/Access (YIN) Y "Pump on" level at 28 in. "Pump off' level at 24 in. High water alarm level at 34 Datum Bottom of Tank Cycles tested 3 Meets alarm & circuit requirements? _ E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot _ Absorption field on lot >100' >100' Public sewer main N/A Sewer /septic service line >25' Animal containment areas >50' SEPTIC/HOLDING TANK ON LOT TO On adjacent lots > 100' On adjacent lots >100' Public sewer manhole/cleanout _ Holding tank NIA Manure/animal excrete storage areas >100' N/A INA Building foundation >51 Property line >5, Water main >10 Water service line >10 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10, Building foundation >10' Water Service line > Surface water >100 Curtain drain None Noted Wells on adjacent lots >100, Absorption field >51 Surface water >100' Water main N/A Driveway, parking/vehicle storage >10, F. COMMENTS **A resample of the water was taken on 8/25/14 by Anderson Engineering. G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 8/27/14 COSA brown sheet 10-1D-12.doc llk .q _C.n �. MICHAEL E. ANDERSON CE -4381 in. • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 015-521-25 Expiration Date: — LL 1. GENERAL INFORMATION Complete legal description T1 2N, R3W, Section 22, Lot 30 Location (site address) 5531 East 112th Avenue Anchorage, AK 99516 Current Property owner(s) William & Doreen Long Day phone Mailing address 5531 East 112th Avenue Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU)�� ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) U679141 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Waiver/Variance request for:. Four Received by: ?2�Z (.%% e�--� Date: % -z- COSA COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number(?323��i COSA # Waiver Fee $ Date of Payment Receipt Number Waiver # TYPE OF WASTEWATER DISPOSAL: 0 Individual ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Received by: ?2�Z (.%% e�--� Date: % -z- COSA COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number(?323��i COSA # Waiver Fee $ Date of Payment Receipt Number Waiver # 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 Anderson Engineering Phone Address P.O. Box 240773 Anchorage, AK 99524 522-7773 Engineer's Printed Name Michael E. Anderson, P.E. Date 8/27/14 et• 49m _,� 6. DSD SIGNATURE p�� System #1 Approved for `f bedrooms I c . C8.4391 e p System #2 Approved for bedrooms Disapproved dp1£a F O�fF55tONa e+ Conditional approval for bedrooms, with the following stipulations By: �� //fry ` a Original Certificate Date: The M6rrfcipali-. o f nchoc. e Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheett :n c 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: T12N R3W Section 22 Lot 30 A. WELL DATA Well type Private If A, B, or C provide PWSID #, Date completed 1965 Sanitary seal (Y/N) Y Total depth >63 ft. Cased to '63 fl. FROM WELL LOG Date of test Static water level ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 1.04 mg/L Arsenic ND ug/L Date of sample: 6/4/14 "* B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (YIN) Y Depression over tank (Y/N) N Date of pumping New Const. Pumper Parcel ID: 015-521-25 Well tog (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 6/5/14 63' n. 5.7 g.p.m. Collected by: Spurkland Engrg. Date installed 8/10/14 Cleanouts(Y/N) Y High water alarm (Y/N) _ Y C. ABSORPTION FIELD DATA Date installed 8/11/14 Soil rating (g.p.d./ft2 or ft2/bdrm) .6 GPD/SF System type Deep Trench Length 2 @ 50 ft. Width 3 ft. Gravel below pipe 5 ft. Total depth 8-9 ft. Eff. absorption area 1,000ft2 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.) (Y/N & type) N If yes, give date D. LIFT STATION No Add On Manhole - Gravity Flow to Absorption Trench. Date installed 9/1/94 Size in gallons 500 Manhole/Access (Y/N) Y "Pump on" level at 28 in. "Pump off' level at 24 in. High water alarm level at 34 in. Datum Bottom of Tank Cycles tested 3 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank NIA Animal containment areas >50 Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main >10, Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10, Building foundation >10, Water Service line Surface water Curtain drain None Noted Wells on adjacent lots >100' Absorption field >5' Surface water > 100' Water main N/A Driveway, parking/vehicle storage F. COMMENTS **A resample of the water was taken on 8/25/14 by Anderson Engineering. G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 8/27/14 COSA brown sheet_10-10-12.doc k,%.•>,a .OF.A y° K71A4 • A1D W V AV Z7—,�' E �ortss�oa�.� Lot 2 REMAINDE LOT 29 Lot 3 Lot 2 EAST 112th AVENUE PLOT PLAN AS BUILT X SCALE 1" = 50' GRID SW 2637 Project No. 14-145 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone 000Op p Registered Land Surveyors (907) 522-4625 Fox o�oF A�ppp kenOlangsurvey.com / jonothanOlangsurvey.com Q�P`�• 5040 I hereby certify that I have surveyed the following described property: 0� .•' LOT 30, Section 22, T 12 N, R 3 W, Seward Meridian, Alaska 0 e .9TH* ••,v�. Anchorage Recording District, Alaska, and that the improvements situated thereon are ........................... within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are roadways, transmission Imes or other visible O m •KENNETH................ G. LANG easements an said property except ept as indicated hereon. 01 0 ss k•< Dated this the Day of at Anchorage, Alaska Op4Fo "°•LS -5202.•'` y�pG • �OpRO' - SS10NA"- It is the responsibility of the owner to determine the existence of any easements, pOp���000 covenants, or restrictions which do not appear on the recorded subdivision plat. MUNICIPALITY OF ANCHORAGE Lj • DEPARTMENT OF HEALTH & HUMAN SERVICE$ Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650IT " J/ 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING " Parcel I.D. # 0 IS- 521-- 2S- HAA # 4-0 4-�tt. 1. GENERAL INFORMATION Complete legal description hb i 3 o SES :;2 Z Location (site address or directions) 55 112 Property owner S44 F_e5 —iS , _0014AL. D Day phone `Mailing address Lending agency Day phone Mailing address Agent Jl, -Doi fe,y %�_V444a Q42.4t4Peg Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS:_ 77 3. TYPE OF WATER SUPPLY: Individual welly Community well Public water 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: `r} Inoivfdual on-site' Holding tank Cominunityon-site r= Public sewer h X`' a Jh .3 r NOTE . v _!f community wastewater system, provide w attesting to the legality and status of systerr �. V81) Frmt MOA 021 c3a�,ee:. d ,ch 225 6 QH/HyQ/ SIGNATURE .a.... �P4S�.'i':, 3 � r r..3'.. F+ ': i.., R �«: ��'�++. •� �r�a0'wt`�' �.,r,J Approved for bedrooms Disapproved.,-,�y MIS ty of Anchorage Department of Health and F ficatee based only upon the representations Municipality of Anchorage ARM Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L.4 3c:> Se -r— 2 L Parcel I.D. A. Well Data 77,2 N t L 3 Well type If A, B, or C, attach ADEC letter. ADEC water system number r Log present (Y/N) !y Date completed /46 6 t Driller Total depth L 3 Cased to 3 Casing height t% Sanitary seal (Y/N) Wires properly protected (YIN) FROM WELL LOG AT INSPECTION Date of test rn a Static water level G 3 r Well flow g.p.m. 3 5 g•p•m• Pump levell20 3 v SEPARATION DISTANCES FROM WELL TO: $ m Septic/holding tank on lot On adjacent lots i 1,5-l) Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout / Sewer service line i �� Petroleum tank , Y o tt WATER SAMPLE RESULTS: Coliform—� Nitrate Other bacteria Date of sample: p/�/ 9 y Collected by: S B. SEPTIC/HOLDING TANK DATA Date installed ��z�/e `� Tank size 12dy Compartments 02 Cleanouts (Y/N) Foundation cleanout (Y/N) �Z Depression (Y/N) N High water alarm (Y/N) r�///A Alarm tested (Y/N) Date of pumping /S2 ¢ &A Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I AS- On adjacent lots > Foundation To property line 3D Absorption field JPyo t Water main/service line Surface water/drainage L X o i[ Q 72.028(3/93)• Front CONTINUED ON BACK PAGE C. LIFT STATION g Date installed ;/! 9 Ll Manufacturer A., (h Size in gallons 5 00� Manhole/Access (Y/N) Vent (Y/N) _�"Pump on" level at 7-9 "Pump off" Level at a y High water alarm level 3 L Cycles tested Meets MOA electrical codes (Y/N) X SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot / 2, O On adjacent lots i /0-e::, Surface water N/4 41 P— D. D. ABSORPTION FIELD DATA Date installed 813�/g Soil rating (GPD/Ft2) System type Length /0-0 Width % Gravel thickness / Total depth c� , t_1 / Total absorption area /Dm O Cleanout present (Y/N) / 7 Depression over field (Y/N) ' Z Date of adequacy test i4 Results (pass/fail) for Bedrooms Water level in absorption field before test TY After test TT Peroxide treatment (past 12 months) (Y/N) /'% If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /GO On adjacent lots 7 10-67' Property line To building foundation _2�_ To existing or abandoned system on lot _ 0 On adjacent lots > 5 L� Cutbank NO K IP -Water main/service line (S - y Surface water /N 7 0 if -e_ Driveway, parking/vehicle storage area Curtain drain No K e E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to a# MOA and HAA guidelines rig effect oche date of this inspection. Signature Engineer's Name (© U7 Y W a u o Q Date _2e_ HAA Fee $ DD ` Waiver Fee $ Date of Payment %- Receipt Number oz%1 72-026 (3M)` Back Date of Payment Receipt Number