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SEA TURN BLK 2 LT 11
Sen Turn Block 2 Lot I I #017-121-37 Inspection Report _1-1-12.doC A 72 Municipality of Anchorage F�'age Community Development Department 1 On -Site Water and Wastewater Program 6 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99518-6650 • http://www.muni.org/onsite • (907) 3434 4' ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161145 PID Number: 017-121-37 ❑ New El Upgrade Name: Jerome & Constance Weisenfelder ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 6000 Azalea Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Sea Turn 2 11 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines I FL SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ft' I Ft, Well 115.5 100+ N/A N/A 25+ TANK ❑+ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank 1 Capacity 1000Ga1. Surface Water 100+ 100+ N/A N/A Material Steel Number of compartments 2 Lot Line 53.0 10+ N/A N/A NA Foundation 42.6 10+ N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ 50+ N/A N/A Gal. Pump on level at Pump off level at High water alarm at RemarksTank Replace Only in. in. in. Pump make and model Electdcal Inspections performed by PIPE MATERIAL Housetotank 3034 Tankto 3034 drainfietd Installer A+ Home Services Drainfield CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100« Inspdales:ec j7 ,on 1° 7/26/16 Location and description 2"° Garage FF T" 4m COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date /iy�POF'A(gsW9''+) even ESanri ire j ApprOlg& ../ Date j' '�-( ��+�• � 8149�� �'�1_`►� Inspection Report _1-1-12.doC A 72 SPECIAL PROVISIONS TO SPECIFICATIONS ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: INSTALLED NEW 1,000g SEPTIC TANK WITH DOUBLE CLEAN OUT AND DECOMMISSIONED EXISTING TANK PER CODE. A B Tl 49.1 44.3 1 M �M � \ 1 �� / _ \ \ T2\ 54.6 50.7 '9 WELL (EIS ) \ 1 3 - I \ 1 WELL (E) \� UT2 ; SUMP (EE) W��W�\�`\14 \ \ CgTy FSMT \ Al \ APPROXIMATE LOCATION DCO PA'�— - OF DRAIN FIELD (E) T2 Ti �%I, \ I COLLAPSING 1000,g SEPTIC TANK \/� A \ 1 \ W�_V DECOMMISSIONED PER CODE / \ 8 HOUSE \ \ \\ INSTALLED NEW 10009 SEPTIC TANK (\ WITH DOUBLE CLEAN OUT \ 4F (E) L6 T11 M ' Zi I � � zz< 4 z wo A �.��• WELL(E) OV U U V Q NOTES: PAM 7�� �7�� _�������\i Date RECORD DRAWING P,Q BQXO100217 1ANC ORA CK 995LL0 .��OF A�,gSlk' 12/5/2016 PHONE (907) 272-8218 FAX (907) 272-8211 j g�p �y'�I Scale DRAWN BY: DRM ..... .. P.I.D. NO SEA TURN, BLOCK 2, LOT11 121-37 JEROME & CONSTANCE WEISENFELDER Steven R. an'n,n, PERMIT NO. 6000 AZALEA DRIVE CE 8149 x,/ OSPI61145 PLAN ANCHORAGE, AK 995161�1\�� PROFESS Sheet h2 eOF 2 ABBREVIATIONS r LEGEND FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. NEW 1,000g 89.7 W WATER LINE/ C# CLEAN OUT NO. IEPTIC TANK WELL RADIUS DCO DOUBLE CLEAN OUT OG ORIGINAL GRADE PROFII F SS NEW SEPTIC E EXISTING NOTES: PAM 7�� �7�� _�������\i Date RECORD DRAWING P,Q BQXO100217 1ANC ORA CK 995LL0 .��OF A�,gSlk' 12/5/2016 PHONE (907) 272-8218 FAX (907) 272-8211 j g�p �y'�I Scale DRAWN BY: DRM ..... .. P.I.D. NO SEA TURN, BLOCK 2, LOT11 121-37 JEROME & CONSTANCE WEISENFELDER Steven R. an'n,n, PERMIT NO. 6000 AZALEA DRIVE CE 8149 x,/ OSPI61145 PLAN ANCHORAGE, AK 995161�1\�� PROFESS Sheet h2 eOF 2 On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161145 Tax Code Number: 01712137000 Work Type: SepticTank Upgrade Permit Effective Dates: June 20, 2016 to June 20, 2017 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: SEATURN Site Legal Address: SEA TURN BLK 2 LT 11 G:3138 Owner/Address: WEISENFELDER JEROME G & CONSTANCE H 7218 ROLLING MEADOW DR RICHMOND TX 774697333 Site Mailing Address: 6000 AZALEA DR, Anchorage This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy All construction must be in accordance with: Lot Size in Sq Ft: 40887 Total Bedrooms: 3 N Private Well N Water Storage 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 B� Issued By: 6 MUNICIPALITY OF Community Development Department Development Services Division QD On -Site Water & Wastewater Program ANCHORAGE IMI JUN 01 2016 Phone: 907 Fax: 907 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-121-37 Property owner(s) Jerome & Constance Weisenfelder Day phone Mailing address 7218 Rolling Meadow Drive, Richmond, TX 77469 Site address 6000 Azalea Drive Legal description (Sub'd., Block & Lot) Sea Turn, Block 2, Lot 11 Legal description (Township, Range & Section) Lot Size 40,887 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: (M all that apply) Absorption Field ❑ Septic Tank ❑X Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) ❑X Upgrade ❑X (w/wo ADU) D ❑ Renewal El Duplex (D) Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST Foo. Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. or propeny owner or autnonzed agent) Permit/Rush Fees: 12 _ Waiver Fees: Date of Payment: (o It I (S- Date of Payment: Receipt Number: — 0�15,1y Receipt Number: Permit No. 6'beh - 1145 Waiver No. Permit App_, > 3 PI Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com May 27, 2016 Subject: Sea Turn, Block 2, Lot 11 Tank Replace Permit Request Design Narrative This is a design narrative for a permit to install an upgrade 10008 Septic Tank to be issued for this property. The existing 10008 tank is collapsing placing the outlet out of service. It will be decommissioned per code and replaced. Currently the lot is developed. The proposed system will utilize a replacement 10008 septic tank that will be connected to the existing drain field. This lot and the surrounding lots are served by private wells. There are no wells within 100 feet of this system. 1. Upgrade Tank Design. a. See Sheet 1 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank. The proposed septic tank upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The existing topography slopes from the east to the west at an approximately 20% slope. There are no steep slopes within 50' of the system and the replacement of the tank will not change the slopes in the area surrounding the system. The proposed installation will not affect the future development of the surrounding or existing lots. There are no surrounding wells within 100 feet of the proposed septic location. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 SPECIAL PROVISIONS TO SPECIFICATIONS ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. - 2. SCOPE OF WORK: INSTALL NEW 1,000g SEPTIC TANK WITH DOUBLE CLEAN OUT AND DECOMMISSION EXISTING TANK PER CODE. AA WELL (E) AA � 1 1 3' \ \ \ \ WELL (E) - w v� ` 1 i \ \ APPROXIMATE LOCATION\ ,1 OF DRAIN FIELD (E) \\ COLLAPSING 10009 SEPTIC TANK (E) WET, DECOMMISSION PER CODE \ 3BR \ \ INSTALL 1000g SEPTIC TANK (P) \ HOUSE \ \ ' \ MI WITH DO% (E) DOUBLE Am, OUT �1, \ OT 11 � \\ 00 r I 1 �WELL\(E) ABBREVIATIONS LEGEND FC FOUNDATIONCLEANOUT W WATER LINE/ T# - TANK CLEAN OUT N0, WELL RADIUS C CLEAN OUT DCO -DOUBLE CLEAN OUT AN — SS — NEW SEPTIC -- OG ORIGINAL GRADE E EXISTING NOTES: PANNONE ENG SVC, LLC OF A(` 1 Date TANK REPLACE P.O. BOX 100217 ANCHORAGE, AK 99510 _ '(�•'• q 1� s9,+) 5/22/2016 PHONE (907) 272-8218 FAX (907) 272-8211 %6j�P "" . . '• "' '. / , Steven R. Pannome 1, CE 81492/ +III Scale P.LD. NO On -121-37 PERMIT N0. OSPXXXXXX DRAWN BY: SEA TURN, BLOCK 2, LOT 11 JEROME & CONSTANCE WEISENFELDER 6000 AZALEA DRIVE DRM Sheet PLAN ANCHORAGE, AK 99516 eD"-FES-- ' �� "�� 1 OF 1 MUNICIPALII Y OF ANCHUHAGL DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I� ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/Ott WELL INSPECTION REPORT NAME PHONE NFW IJ UPGRADE MAILINGADDRESS Dl- �./� ` GJNz/ /ri��li� r - - -- LEGAL LEGAL DESCRIPTION ` 1 LOCATION ,+ NO. OF BEDROOMS Wellw i Absorption arca Dwelling DISTANCE TO: IQ�7J` JY 7L_ UY PERMIT NO. L� a Q Manufacturer �� Material l�. No. of compartments w Liq. cap c ty in gallons Inside length Width � ) IF HOMEMADE: Liquid depth DISTANCE TO: WellDwelling PERMIT NO. D z Q .t F- Manufacturer Material Liquid capacity in gallons w s �J LL z w DISTANCE TO: No. of lines Well J 14<� /- Length of each h9r�. Foundation _ i .) - Total length o Vines _ Nearest lot line Trench width PERMIT O. eJO C/ %C' �— -- Distance between lines _ inches F-QC O Top of the to//finish grade �� /l ai'�' &© �J.v- 2 Material beneath tile % inches Total effective absorption area � CJ -PERMIT Length Width Depth NO. w Q H a0. w Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: Well Building foundation Nearest lot line W Class DISTANCE TO: Depth Building foundation Driller Sewer line m Distance to lot line Septic tank PERMIT NO. Absorption amals) OTHER PIPE MATERIALS I/e--pepP'oiii1eUi- SOILTESTRATIN(3 7 INSTALLER 7o—� REMARKS / A;4) Q tt a No !J e. —s`�_ peweeo•„� I-- 0or ;091 r fOGDtVe y4160"®• ® - .r fA APPROVED DA'/TE ``,, we;)V LEGAL 72-013 (Rev. 3/78) I F:"07 1 IL.- I -T- r:K F:- ��1 -41 CH F�2. f:: -,l 1.,31 F—:- DEPHRTMENT OP' HEA[ TH AND ENVIRONMENTAL P�OTECTION 825 'L STREET, ANCHORAGE.- AK. 99 l 264-4720 ---9 KE" L- 1— ��� ��wH. 1. "T- E:-" S U- I A E -F. F-' �EF, �r-1 3E -Y N[i ( E00479 ) HPPLICR&r LOREN UHLENKOTT 1621 DIMOND DR 276 55�6 LOCHTI0N F.8 NUM & A , 41000 SQUHRE FEET LEGAL LL`�Al Bt 2SEHTOF{N SD' LOT SIZE TYPE OF SOIL HBSORPTION SYSTEM IS MHXIMUM NUMBER OF BEDROOMS = ] TRENCH S8I1- RATING ('5Q FT/13R)= 275 THE REQUIRED SIZE HE SOIL ABSORPTION�1 I�: � . ������������� ��F��U�� �� ���������� ���H� THE LENGTH DIMENSION IS THE LENGTH (IW FEET) OF THE T�ENCH OR DRHINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). �EEOII-ll I FZEZF--u I ll:�: -ir F1 1�4 u< �: I Z-�- F.- C-1���� ����rA n -:E7. PERMIT APPLICANT HAS THE RES-PONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF THAT THE WELL WILL SERVE. ��� ��� �������I ���� ��� ����I ��� BACKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSEOUTI8K4. MINIMUM 1 I5THNCE BETWEEN H WELL HND RNY ON-SITE SEWAGE DISPOSAL SYSTEM IS 1@0 FEET F()R H PRIVATE WE -ill OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DIsTHNcE FROM H PRIVATE WELL TO A PRIYHTE SEWER LTNE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE. REQUIRED AND MUST DE RETURNED TO THE DEPARTMENT WITHIN ]0 DHfS OF 114E COMPLETIC)N. OTHER REQUIREMENTS MAY HP�LY SPECIFICHTIONS AND CONSTRUCTIONDIAGRHMS ARE HYHILHBLE TO INSURE PROPER INSTALLATION. ���orz rz'.." 0D I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND NELLS AS SET FORTH BY THE OF ANCHORAGE. 2: I WILL INSTALL THE SY5TEM IN HCQ]RDHNCE WITH THE CODES. ]� I UNDERSTHND TMHT THE DN -SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROO����� SIGNED:f�f��_~���~����������_�~~~---~ H L R NKOTT �� ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE �/ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION !Y PERCOLATION TEST Pouch 6.650, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: Z-01-e-lu (�le-)v &Q ff C DATEPERFORMED: 7 7 - e - LEGAL DESCRIPTION:_c �� L3IOC.(4 � .G� .�J f�Cl.�(,��Al � C`A✓ d elli Fi/r DEPTH SLOPE SITE PLAN � �- � - / .10> .- /a 'P -f 20 COMMENTS_ PERFORMED BY: 72-008 (7/76) C :85E. Reading PERCOLATION Data r � 1 Net Time 2- t� 3 - 4-- 6-( 6 < _ 7 15 - 5 7` 10 - r` C I13-- 3 16 16 r, 17 o� 18 / .10> .- /a 'P -f 20 COMMENTS_ PERFORMED BY: 72-008 (7/76) C :85E. Reading PERCOLATION Data Gross Time Net Time Depth to Water Net Drop .7 15 - 5 PERCOLATION RATE %-(minutes/inch) TEST RUN BETWEEN FT AND —.fa— FT CERTIFIED BY: DA jaox 13691P SWAB ltouTE A ANCHORAGE, ALASKA 00502 344-71714 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF _�'��:_? ems• DRILLED AT THE RATE OF X19.00 PER FOOT. PROPERTY OWNER 11" Lwiert Uluen.kott— 349.53,2�3-� 276-5566 LOCATION OF WELL SITE ft -0 // Fmk° o, sto. L DRILLER BeAn,te- Ctam o9 PamlwJLt J)A i,(. aq, WELL LOG: 0---a--26' S4A t j, gAauet. 30% c tw,,. 26-----68' Sandy, n� uet. 1551 cta�P. 689--113' lla;td.pan.. A center te-cl gltaue.L. 113-142' g&aue-t. Seuvtat 4mait hou,Ldelw. 142--•148' ldateJ& bexvr i.n.a. fine, cycaue,t. good clean couJz,.)e (pw-ueet fAorm 146 to 148'. Tlmi4 c>Jt.ea pn,adaca.rtg 15ciPill o f good cteoA urat.ve.. 80 f ee�f, o,,' waAtvz, .3tart Uag in. «,irtg. 3/4 1laue Ott kr viAthte pum1Z ihouW .be trwtaLted :tm f-ee% off- bo:ttorn. Coot of JN.LLLin.g: 32812.00 Co4d- al- Ne�U Sea.L: 322.50 MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & ENVIRONMENTAL PROTECTION SET 3 0 1980 RECEIVED v' ri /�.� . COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 92834.50 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE Sept 22ru1_, 1980 \ SERVICE CHARGE O F t%z%. PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNTS. MUMCIPALITY OF ANCHORAGE Deveio ment Services Department -343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017-121-37 1. GENERAL INFORMATION Complete legal description Seaturn 132 L11 Location (site address) 6000 Azalea Drive Expiration Date: /Z, F 0z0 r_ Current property owner(s) Jerome & Constance Weisenfelder Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic F71 Water Storage ❑ Holding Tank ❑ Community. Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distan Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Li 2. 50 rt9 LJ 10 Waiver Fee $ Date of Payment g --2- C'? — 2 Q Date of Payment Receipt Number c)G i 1 q (i Receipt Number COSA# 05G2Dj4r,Z 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date AW OF ALgs�. TH 6. DSD SIGNATURE k' �►�� System #1 Approved for• • • o . 3 bedrooms � � •Steven R. Pannone CE 8149 System #2 Approved for bedrooms DisapprovedF�'or�;S�O`�` Conditional approval for bedrooms, with the following stipulations: OF u r� OW AST�r=��tAT A r° �` PR 4C' "�*IVr SEFZ��G By: Original Certificate Date: The Municipality of Anc a<gDevelopment 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 Checklist blue sheet Legal Description: Seaturn B2 L11 Parcel ID: 017-121-37 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system I A" A. WELL DATA r: f ❑ Well log is filed with Onsite (or attached) Well production at time of test 3.62 gpm Date drilled 912211980 Water storage tank volume9 allons Total depth 148 ft Cased to 148 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 71012020 Static water level at beginning of test 41.9 ft. Comments B. TANK DATA Age of tank(s) 4 years Tank type/material S°Puws` ] Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 7/13/20 D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 9124"980 ❑ ALL standpipes present per record drawing Total measured depth from grade 13.8 ft (max) Measured depth to pipe invert from grade Oft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Well disinfected for coliform test? ❑ Yes ❑✓ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 8/18/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 7/10/2020 Results D Pass For 3 bedrooms Fluid depth prior to test 56 in Water added 450 gal New depth 74 in Elapsed time 1440 min Final fluid depth 56 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) No If yes, enter date 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' M Yes if No ft Q Yes if No Neighboring Tank > 100' F71 Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' F/� Yes if No ft Holding Tank > 100' 0 Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' n✓ Yes if No ❑✓ Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q✓ Yes if No ft r/J Yes if No ft ft ft ft I From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' P/ Yes if No ft Surface Water > 100' M Yes if No ft Property Line > 5' 0✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100'✓0 Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' E] Yes if No ft Water Service Line > 10' 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' (�✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' Q✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION - OF-A(,qkkk 1 certify that l have determined through field inspections and review. of Municipal records that the above systems are in conformance with T - 1 MOA COSHguidelines in effect on this date.—k, V7.5io .. Steven R. P1arnn6ne % rF 814-9 • c- R [ '�Y�it�CSivlVc COSA Checklist yellow sheet 8479L 0 Op a > � 5 Ram O f � She Q 10 mtrii�y � o' 0 Septic vent f 7 79 deck (' .200 �s LOT 11 �p 0 0 ---4.8 off Ret. wal qe �v moo p o nj 2.0 Chim. OH N O N O well \ �ygp°02'55„� 258.73 25 LOT 12 Revised 9-03-20 Added septic vent AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection .%,OF ® of the following described property: LOT 11, BLOCK 2, ,�� • • , ° & SEA TURN SUBDIVISION 49th •'.�9 Anchorage Recording Precinct, Alaska, and that the t4 improvements situated thereon are within the property lines ` • and do not overlap or encroach on the property lying 00 , 7> e.1 adjacent thereto, that no improvements on the property lying A • adjacent thereto encroach on the premises in question and 1 . Elizabeth L. Walatka , o AO that there are no roadways, transmission lines or other ��� • • 8036 — LS •' e' visible easements on said property except as indicated AW SCALE: 1 "= 50' F • ' • • ' C3MWhereon. oR0 • • • ° '�pe�� Dated at Anchorage, Alaska EASEMENTS OF RECORD, OTHER THAN FESStONA4 �® this 15th day of November , 2018. THOSE SHOWN ON THE RECORDED � ®,�$��a FRED WALATKA & ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON � 3 - 9--cL-0 Engineers and Surveyors UNLESS OTHERWISE NOTED. FH, FB 18-7, pg 73 BE 907-248-1666 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. NI -191-31 1. GENERAL INFORMATION Complete legal description lot 11 Bk 2 Sea Tum Location (site address) 6000 Azalea. Anchorage, AK 99516 COSA Expiration Date: // — 6; — O Z Current Property owner(s) Glenn & Betsy Ladewig Day phone 345-9053 Mailing address Lending agency Mailing address 6000 Azalea. Anchorage AK 99516 Day phone Real Estate Agent Claire Ramsey Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my Investigation, based on procedures outlined in the Certificate of Onsite 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 Pannone Engineering Services LLC Phone 272-8218 Address P.O. Box 102954 Anchorage AK 99510 Engineer's Printed Name Steven R. Pannone P.E. Dated t 1.0 Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water ••.� OF 4/ gags levels that may fluctuate during the year, and the water usage of the family being served by the system. .•.� .�'"'""`^..t�� Pr These conditions arc outside the control of the evaluator of this system. All systems eventually fail and ��* satisfactory test results do not guarantee future performance of the system, nor do they guarantee that 1° �� there are no hidden defects or encroachments. PES can therefore not provide any warranty for future 6 ^ "^ ^ 0_ performance nor give any estimate of how long the system will continue to meet the operational requirements of the hl0A DSD. The content of this report is for the sole benefit of the owner listed i tk Steven R.Ponnone� above. Any reliance upon or use of this report by any other person or party is not authorized nor will it e�:/,�No.Fr :1„9 %V� .• confer any legal right whatsoever. baa, 7�Y�—✓.`••• 5. DSD SIGNATURE ��■,^ Approved for �_ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: WASTFWATFR Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. ' Original Certificate Date: Cfl=Q % (Rev 1IMS) Municipality of Anchorage Development Services Department Building Safety Division Ork Ste Water & Wastewater Program 4700 Bragaw Street P.O. Boa 196650 Anchorage, AK 99519-6650 www.munLorglonsite (907)343-7904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL CHECKLIST Legal Description: lot 11 Bk 2 Sea Tum Paroel ID: O 17 — /21— 3 % A. WELL DATA Well type t? if A. B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 111/1980 Sanitary seal (Y/N) Y Wires Property protected (Y/N)_ Total depth _eft. Cased to _4+ ft. Casing height (above ground) 17+ in. FROM WELL LOG AT INSPECTION Date of test 9f2211980 61212006 Static water level 68 R 45 ft. Well production 13 g.p.m. 4.5+ 9— p.m- WATER SAMPLE RESULTS Coliform cal'�colonies/100 mL Nitrate NO O m�gr/�L� Other bad •;- colonies/100 ml. Arsenic: %� mgn Date of sample: /! tol� Collected by: B. SEPTICIHOLDING TANK DATA I Tank Type/Material Greer Steel Date installed 912471980 Tank size _1000 gal. Number of Compartments j Cleanout (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) H High water alarm (Y/N) WA Date of pumping 41772006 Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed 04NOSO Soil rating (g.p.d./fte or fe/bdrm) M System type Deep Trench Length -65 ft. Width 3 ft. Gravel below pipe 9 ft. Total depth in ft. Eff. absorption area Mfl? Monitoring tube Y Depression over field iK Date of adequacy test _6812006 Results (Pass/Fall) Pest For j bedrooms Fluid depth in absorption field before test 19 in. Water added4N gal. New depth1e in. Elapsed Time: 1440 min. Final fluid depth ZU in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed S in a n 'Pump on" level at _ in. 'Pump 1 et _ in. Datum Cycles E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAlfl station on lot 100+ Absorption field on lot 100+ Public sewer main 100+ Sewer /septic service line 25+ Animal containment areas 100+ Manhole/Access (YIN) High water alarm level at Meets alarm & circuit requirements? On adjacent kft 100+ On adjacent lata 100► Public sewer manhole/cleanout 100+ Holding tank 100+ Manureianimal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10+ Property line JQ+ Absorption field 10+ Water main 100+ Water service line 25+ Surface water 100+ Wells on adjacent lits 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 50+ Water main 100+ Water Service line 25+ Surface; water 100+ Driveway, parking/vehide storage 25+ Curtain drain None Observed Wells on adjacent kNs1100+� 1 F. COMMENTS -(IA0-j T10A bzgkv,� �il M,1 0 r G. ENGINEER'S CERTIFICATION ............. I car* that I have determined through field inspecf m and review o/ Municipal records that Me shave systems are in „ conformance with MOA COSH guidelines in effect on this date. • Engineer's Printed Name Steven R Pannone. P.E. air st, �J- cc e 14,1 �13t ( o •••;; Data COSA Fee $ . tNv ' Waiver Fee $ _ Date of Payment 911 Date of Payment Receipt Number Receipt Number (Rev. 1IM) K in. A. Swat EASEMENTS �F RECORD, OTHER THAN THOSE SHO'::N ON THE RECORDED FIAT, ARE NOT SHOWN HEREON. No Coro•n LI Th., Dm Soot No. Peso No. Ale 1 MrOoy OOrtily tMl 1 Iwo MMyOO IIM (OnO••iry dowltied pOArN. LOt �� SI«. 2 SeA T'tl¢N SuaD AncnorOp• rOeore.q, D/11r1/a; AIMS, and tMt too IrnapwMontS Iitul Md tMrOOn 414 •wtnio the IMopoeIy Ilnw Ono 00 Ret 9• lop M OncrOOM on TM property IV" odpowI tnMOte, t%di no hmwr .Ilona On pro" v ty.n1 OONcMi thVOIO Ingr000t. On the promm In duO•tien Ono IMt tnwS "no roOe•wOy1, TrOMnYM.M I.n" W Otno' V'4M4 A••rw•R" On Mb MOAT/ e•ppt M 1nO.0Otoo n•rO A%cMrq•, A"* 6 ✓CfAIf 2006 ,S% PIS. I�OFJ F Parcel I.D. # MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES 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 017-121-37 1. GENERAL INFORMATION Complete legal description HAA # Sea Turn Lot 11, Block 2 Location (site address or directions) 6000 Azalea Drive, Property owner Loren Uhlenkott & Shirley Harmon Day phone 345-0017 Mailing address P.O. Box 111242, Anchorage, AK 99511-1242 Sa T 1 '0 Lending agencyPremier Mortgage/Kevin Breland Day phone 563-7736 `A\ -tl Mailing address3000 A Street Suite 102, Anchorage, AK 99503 Agent Fortune Properties/Debbie Clark Day phone 562-7653 Address 2525 C Street, Suite 100, Anchorage, AK 99503 `aXtoe, - otILA - NUUb\Q� Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 v 3. TYPE OF WATER SUPPLY: Individual well X 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: Individual on-site X 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. 1/91) Front MOA X21 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 further verify that based on the information obtained from the Municipality of Anchorage files and from my invest!qation 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 Eagle River Engineering Services Phone 694-5195 Address P.O. Box 773294 Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for 0 bedrooms. AK 99577 Date Of �aO f YY Ie Nfi'. on U-6736 bedrooms, with the following stipulations: Additional Comments JFf A T7X011e0 JC'277c L 1)� AOLWY WTIC The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Cortiflcatos basod only upon tho roprosontnlions glvon In paragraph 5 abovo by an Indopondont 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. 1/91) Back MOA e21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: S611 TU72N GUT l/ SLK 2 Parcell.D. 0 l'7—/2/-37 A. Well Data Well type RelV.t76 _If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) YE 5 Date completed _ D 91?U Driller eAMPnR/ r Total depth Cased to / yF ' Casing height Z/ " Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell FROM WELL LOG Wires properly protected (Y/N) AT INSPECTION D �7/N 94, q' /5 9.p -m. C4, D g.p.m. SEPARATION DISTANCES FROM WELL TO: Se ticJ p heldirrg tank on lot _ l0� ; On adjacent lots _ �"/UU / Absorption field on lot _ J3J7 ; On adjacent lots Public sewer main Public sewer manhole/cleanout__//� �} Sewer service line _ t s Petroleum tank /\J 0 I—V �5 C --//T WATER SAMPLE RESULTS: Coliform -6�Nitrate /q. / /4&ZL— Other bacteria ZL- Date of sample: 09 /y19 4 Collected by: !2 B. SEPTIC/He1=911 G TANK DATA Date installed e q/ 8'D Tank size /000 Compartments Z Cleanouts (Y _Foundation cleanout (Y/N) _ _YG- S Depression (Y/N) A/0 High water alarm (Y/N) /Y/�Pq _Alarm tested (Y/N) _ LILA- Date of pumping 0 9.Z2 -2/23 Pumper /q -/' SEPARATION DISTANCES FROM SEPTIC/H9tOtNG TANK TO: Well(s) on lot / b On adjacent lots ;�-/D0 Foundation t 1 , To property line _Absorption field i' ZD Water n4e4n/service line —1.10 ' Surface water/drainage ./(q 1Z 0 72-026(3/93)• Front CONTINUED ON BACK PAGE m7 7 � oz rn r" m Y z Cul a % Z m C Public sewer main Public sewer manhole/cleanout__//� �} Sewer service line _ t s Petroleum tank /\J 0 I—V �5 C --//T WATER SAMPLE RESULTS: Coliform -6�Nitrate /q. / /4&ZL— Other bacteria ZL- Date of sample: 09 /y19 4 Collected by: !2 B. SEPTIC/He1=911 G TANK DATA Date installed e q/ 8'D Tank size /000 Compartments Z Cleanouts (Y _Foundation cleanout (Y/N) _ _YG- S Depression (Y/N) A/0 High water alarm (Y/N) /Y/�Pq _Alarm tested (Y/N) _ LILA- Date of pumping 0 9.Z2 -2/23 Pumper /q -/' SEPARATION DISTANCES FROM SEPTIC/H9tOtNG TANK TO: Well(s) on lot / b On adjacent lots ;�-/D0 Foundation t 1 , To property line _Absorption field i' ZD Water n4e4n/service line —1.10 ' Surface water/drainage ./(q 1Z 0 72-026(3/93)• Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" High water alarm level Meets MOA electrical codes (Y/ SEPARATION DIST Well on lot FROM LIFT STATION TO: D. ABSORPTION FIELD DATA On adjacent lots (Y/N) "Pump off" Level at Cycles tested Surface water Date installed Soil rating (GPD/Ft2) -Z_ 75 tX ZRr System type D. Length S S ' Width 3 ' Gravel thickness 9 Total depth /-?/ Total absorption area 99�0� Cleanout present (Y/N) �/G 5 Depression over field (Y/N) _/D Date of adequacy test 6.7 Results (pass/fail) f /gS S for 3 Bedrooms Water level in absorption field before test G y• s' After test Peroxide treatment (past 12 months) (Y/N) IVIA if yes, give date IVIA SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Property Well on lot � 3 D On adjacent lots a'/DU Pro p Y � line - To building foundation t S0 To existing or abandoned system on lot On adjacent lots f" -30' Cutbank /V/A4 Watera4Wservice line Surface water NIA Driveway, parking/vehicle storage area )klo t Curtain drain _N01Y6 /9PPnP-6LI% E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and NAA guidelines in effect on the date of this inspection. 3t ' - h < k Signature, Engineer's Name GOti �1 inti Date > a HAA Fee $ �W,dD Date of Payment �� o'ZD Receipt Number / 5 Z 0? / 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE M E M O R A N D U M SEPTIC SYSTEM ADVISORY HEALTH AUTHORITY APPROVAL NO.HA940364 Prior to a recent adequacy test on the septic system for this lot, 69.5 inches of standing water was observed in the absorption field. This indicates that approximately 64 % of the absorption area is inundated. Although . this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject health Authority Approval.