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STONY BROOK BLK 1 LT 2
Stony Brook Block 1 Lot 2 #015-511-05 SUBMI TAA [CD 1 n 7018 - - Inspection Report_1-1-12.doc 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: OSP151070 PID Number: 015-181-67 ❑ New ❑✓ Upgrade Name: Vonjia Thorson ABSORPTION FIELD ❑✓ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 11161 Briggs Ct. ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.8GPDfsF 10.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from origtfial grade 4.0 Ft. Gravel depth beneath pipe 6.0 Ft. Subdivision Block Lot Stoney Brook 1 2 Fill added above original grade 0 Ft Gravel length 63 Ft. Township Range Section Gravel width 2.51Ft. Beds: Number of Lines N/A 1DIstanoe between lines I N/A Ft. SEPARATION DISTANCES TO Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 756 Ft - 2 13.8 Ft. Well 109.2 125.0 N/A N/A Exst TANK Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1250Gal. Surface Water 100+ 100+ N/A N/A Material Number of compartments Lot Line 59.4 17.2 N/A N/A Steel 2 NA Foundation 17.4 34.0 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ 50.0 N/A N/A Gal. Remarks - Pump on level at in. Pump off level at - in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer drainfieltl A+ Home Services Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100ft Inspection „ 1 04/28/15 5/03/15 Location and description dates 2- COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp OF A(;gE�t"iuq Conditional Approval: Date r * �TH .teven •11. 00 norle 1 CE 6149 Cr � Approve ii,,,� Date - S' Inspection Report_1-1-12.doc 1 / I I / I � NO WELLS W/I 200' OF PROPOSED SEPTIC ya W=w� \ \ REUSE AS RESERVE — — — FLOW SPLITTER REMOVED 1250q TANK _ i DV REPLACED W/ NEW 1250g TANK- DCO W/ DCO , DV, AND FS B // I /D)dJVEWAY\ I -109. 1 11 1 1 103.1 - - - - / / NO 25% SLOPES WITHIN 50' / P ROPOSED DRAIN FIELD (N, N - 92' CONTOUR LINE IS A 3' T C —THE DOWNHILL SIDE - AREA BETWEEN 88' AND 92' RELATIVELY /LEVEL -2 y W i�2� / I se `CL -NEW DRAINFIELD A �M (2 EA) --31 .5LF, 25W, 6'ED, 10'TD. R 3 \ 1 EXISTING WELL 1 � \ -- / _� �1OO�l til Esme y E��12E TH AVENUE 4' NOTES _ I RECORD DRAWING: PANONE ENG SVC, LLC C P.O. BOX 100217 ANCHORAGE, 99510 r�Q'��• PHONE (907) 272-8218 FAX 907) 272-8211 /oj•' STONY BROOK B1 L2 DRAWN JRL VONJIA THORSON 11161 BRIGGS COURT PLAN ANCHORAGE, AK 99516 1 1 1 \ EC 8.1 Ti 43.7 19.0 T2 49.5 26.4 DCO 51.0 28.1 DV 52.6 30.3 CI 35.8 49.4 / 34.7 49.1 C2 46.5 75.5 M1 34.7 49.1 C3 52.2 63.3 M3 51.6 _ 62.9 C4 p- l 88.0 M4 / 87.7 II 103.1 - - - - / / NO 25% SLOPES WITHIN 50' / P ROPOSED DRAIN FIELD (N, N - 92' CONTOUR LINE IS A 3' T C —THE DOWNHILL SIDE - AREA BETWEEN 88' AND 92' RELATIVELY /LEVEL -2 y W i�2� / I se `CL -NEW DRAINFIELD A �M (2 EA) --31 .5LF, 25W, 6'ED, 10'TD. R 3 \ 1 EXISTING WELL 1 � \ -- / _� �1OO�l til Esme y E��12E TH AVENUE 4' NOTES _ I RECORD DRAWING: PANONE ENG SVC, LLC C P.O. BOX 100217 ANCHORAGE, 99510 r�Q'��• PHONE (907) 272-8218 FAX 907) 272-8211 /oj•' STONY BROOK B1 L2 DRAWN JRL VONJIA THORSON 11161 BRIGGS COURT PLAN ANCHORAGE, AK 99516 FA(golII 02/11/16 *II� P.J.D.NO •,•„•„_,,.• 915-181-67 even R. Pannone _ PERMIT NC CE 8149 �� OPS151070 r ��FROFESSIONP�'� Sheet 2 OF 5 A B EC 8.1 Ti 43.7 19.0 T2 49.5 26.4 DCO 51.0 28.1 DV 52.6 30.3 CI 35.8 49.4 M1 34.7 49.1 C2 46.5 75.5 M1 34.7 49.1 C3 52.2 63.3 M3 51.6 _ 62.9 C4 63.5 88.0 M4 63.6 87.7 FA(golII 02/11/16 *II� P.J.D.NO •,•„•„_,,.• 915-181-67 even R. Pannone _ PERMIT NC CE 8149 �� OPS151070 r ��FROFESSIONP�'� Sheet 2 OF 5 SPECIAL PROVISIONS TO SPECIFICATIONS 1. 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 AND ATTACHED PES SPECIAL PROVISIONS. - 3, SCOPE OF WORK: INSTALLED NEW SOIL ABSORPTION SYSTEM & SEPTIC TANK. 4. GROUNDWATER WAS NOT ENCOUNTERED BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 16 FEET BELOW EXISTING GRADE. U1'1090'ERVIAN �IIIIIIMM PRIMARY/RESERVE SEPTIC SYSTEM NO, BEDROOM: 4(600 gpd) TANK SIZE: 12509 PERC RATE = 10.14 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 750 SF SYS. TYPE: DEEP TRENCH 6.0' E.D. MIN LENGTH: 62.5 LF LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC USED: (2 EA) 31.5 LF X 2.5' WIDE, 6' E.D., 10.0' TO TOTAL AREA: 756 SF - NOTES: RECORD DRAWING DRAWN I JRL I DESIGN DETAILS 'ANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 )NE (907) 272-8218 FAX (907) 272-8211 STONY BROOK B1 1_2 VONJIA THORSON 11161 BRIGGS COURT ANCHORAGE, AK 99516 ABBREVIATIONS Vr• ryLgS�� i �� FILTER FABRIC COPPER DIP DUCTILE IRON PIPE 4" 0 DRAIN PIPE - TEST HOLE FC FOUNDATION CLEAN OUT - L.92.02 O.G. k F.G. TANK CLEAN OUT NO. C# CLEAN OUT NO, DRAIN ROCK 6" ABOVE PIPE INV MONITOR TUBE NO. R. 1. RIGID INSULATION EL.89.5t O.G. & F.G. DOUBLE CLEAN OUT - DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE -L5 a1 ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE - GN SS EL85.5 DRAIN ROCK SM 2.5 �t39--I o -16'0 SECTION 0 oS FILTER FABRIC o 0 0 ORNN PIPE EL.92.0 DRAIN ROCK ". ABOVE PIPE INV EL.89.5 ELe7,08 NEW 1250g SEPTIC TANK RAN ROCK 6.88 .85. EL.85.5 PROFILE U1'1090'ERVIAN �IIIIIIMM PRIMARY/RESERVE SEPTIC SYSTEM NO, BEDROOM: 4(600 gpd) TANK SIZE: 12509 PERC RATE = 10.14 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 750 SF SYS. TYPE: DEEP TRENCH 6.0' E.D. MIN LENGTH: 62.5 LF LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC USED: (2 EA) 31.5 LF X 2.5' WIDE, 6' E.D., 10.0' TO TOTAL AREA: 756 SF - NOTES: RECORD DRAWING DRAWN I JRL I DESIGN DETAILS 'ANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 )NE (907) 272-8218 FAX (907) 272-8211 STONY BROOK B1 1_2 VONJIA THORSON 11161 BRIGGS COURT ANCHORAGE, AK 99516 ABBREVIATIONS Vr• ryLgS�� i �� CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT - T# TANK CLEAN OUT NO. C# CLEAN OUT NO, M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE - 08/11/16 I Scale NTS •'•"•• ' .. I P.I.D. NO ............. ... 015-181-67 Steven R. P / PERMIT NO. 1PF,'. CE 81499 .'� OSP151070 I+ Vis' ND". . •' �r N•'- E'er Sheet `,k\ ����� 3 OF 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 TEST HOLE 2 OR ORGANICS GRAVEL SILT GM SAND MIXTURE -ORANGE SANDY SILT. SM MIXTURE - LT GRAY DATE PERFORMED: 05/21/2015 SOILS LOG - PERCOLATION TEST SLOPE X TH I/ SITE PLAN I 1 WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? NONE' DEPTH TO WATER AFTER MONITORING? DRY - DATE: 0 5/2 81201 5 READING DATE CLOCK NET TIME WATER LEVEL READING NETDROP RATE (MPI) 1 21MAY15 1002 7.087" 2 1012 10MIN 11.125" 4.033". 2.48" 3 1014 7 087" 4 1024 - 10 MIN 10979" 3.892" 2.57' 5 1026 7987' 6 1036 10 MIN 10952" 3.865" 2.58" SLOPE TH X SOIL TEST RESULTS/ANALYSIS • PERCOLATION RATE 2.6 (min/inch) (Hydrologic Soils Group: HSG A) • PERC HOLE DIAMETER 6" • TEST RUN BETWEEN 3.5 FT AND 4.5 FT. • TEST RUN FOR OVER AN HOUR, LAST THREE READINGS PROVIDED. COMMENTS: Test hole excavated by A+ HOME SERVICES. Test Hale was presoaked before Perc test. PERFORMED BY: Joseph Lawendowski. I CERTIFY THATTHIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: RECORD DRAWING DRAWN I JRL SOILS LOG PANNONE ING SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 STONY BROOK 131 1_2 VONJIA THORSON 11161 BRIGGS COURT ANCHORAGE, AK 99516 Scale *' 49 TM .:* �r/ P.I. NTNO 01s-181-67 Steven R'. Ponnone / PERMIT NO. I CE 8149 OSPI51070 tt1�%.... 51.. Sheet 5 OF 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 TEST HOLE 1 OR IORGANICS GRAVEL SILT GM SAND MIXTURE ORANGE SANDY SILT SM MIXTURE - LT GRAY DATE PERFORMED: 03/31/2015 SOILS LOG - PERCOLATION TEST SLOPE X TH SITE PLAN WAS GROUNDWATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? NONE' DEPTH TO WATER AFTER MONITORING? DRY' - DATE: 04/07/2015 SLOPE TH X READING GATE CLOCK NETTIME WATERTIME LEVEL READING NETDROP 1 03/31/15 16:37 4.64 Steven R. PannonePERMIT 2 17:07 30 MIN 9.67 5.03 3 17:10 4.64 4 17:40 - 30 MIN 8.75 4.11 5 17:42 4.64 6 18:12 30 MIN 7.62 2.98 7 18:15 - 4.64 a 18:45 30 MIN 7.60 2.96 PERCOLATION RATE OF 10.1 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 6.5 FT AND 7.5 FT WILL CONDUCT SECOND TEST IN GM STRATA AT TIME OF CONSTRUCTION COMMENTS: Test hole excavated by A+ HOME SERVICES. Prec hole was presoaked. Test run for three hours. Last 4 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFO WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS' NOTES: PANNONE ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 STONY BROOK 81 L2 DRAWN JRL VONJIA THORSON 11161 BRIGGS COURT SOILS LOG ANCHORAGE, AK 99516 ......... r � 02/11/16 scams ,4 NTS " P.I.D. NO 5-181-67 Steven R. PannonePERMIT NO. +lc�Tf CE 8149 O 51070 Sheet4 OF 5 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: OSP151070 Tax Code Number: 01551105000 Work Type: Septic Upgrade Permit Effective Dates: April 22, 2015 to April 21, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: STONY BROOK Site Legal Address: STONY BROOK BLK 1 LT 2 G:2639 Owner/Address: THORSON VONJIA B 50% & BREDEHOFT-THORSON VONJIA 50% 11161 BRIGGS COURT ANCHORAGE AK 995161861 Site Mailing Address: 11161 BRIGGS CT, Anchorage Lot Size in Sq Ft: 79809 Total Bedrooms: 4 This permit is for the 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. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The proposed system is in a different soil stratum than the strata that was tested. The Engineer needs to do an additional percolation test prior to the construction of the septic field. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. AMC 15.65.060.B.2 Received By: VIP3 MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program USMITTA ANCHORAG9 APR 08 2015 Gretchen Stuller Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I_ D. 015-511-05 Property owner(s) Vonjia Thorson Mailing address 11161 Briggs Court, Anchorage AK 99516 Day phone Site address 11161 Briggs Court, Anchorage AK 99516 Legal description (Sub'd., Block & Lot) STONY BROOK B1 L2 Legal description (Township, Range & Section) Lot Size 79809 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial F-1 Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade ❑X Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 4 67aq Waiver Fees: Date of Payment: /I'S of Payment: Receipt Number:Q(Gaan2,e]4 Receipt Number: Permit No. oSPA's 16?0 Waiver No. Permit App_:- Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panenRak.com 07 April 2015 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. 0. Box 196650 Anchorage, Alaska 99519 Subject: STONY BROOK 131 L2 Septic System Permit Request Ladies and Gentlemen: I am writing to request a permit to install an upgrade septic system be issued for this property. The proposed systems will serve an existing four (4) bedroom house. Currently the lot is developed. The existing system serves an existing four (4) bedroom house. The proposed system will utilize a 1250g septic tank and conventional drain field. The surrounding developed lots are served by private wells. There are no wells on surrounding lots within 100 feet of this system. Soils. A test hole were performed by R&M Consultants in May of 1977, and one test hole was excavated in the area of this drain filed by Pannone Engineering Services in April of 2015, and groundwater was monitored for seven days. Ground water was not encountered in the test hole after the seven day monitoring period. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.8 gallons/day/square feet should be used for a conventional wastewater system. 1. Soil Absorption System Design. a. See Sheet 3 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The existing topography slopes from the south to north at approximately 1%-2% in the area of the proposed drain field. The slope of the property is approximately 25% to the south of the proposed drain field up towards the house. 4. Drawing Markings: The Drawings are marked "For MoA Review Only'. When written notification that the review is complete and that there are no further comments is received from MoA On -Site Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 Department, the note will be removed and "Issued for Construction" drawings will be issued. 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. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 � I I sy v NO WELLS W/1 200' OF a PROPOSED SEPTIC W NEW DRAINFIELD P TH-1 NO 25% SLOPES WITHIN 50' OF \\ (2 EA) - 31.51-F, 2.5'W, 6'ED, IO'TD. PROPOSED DRAIN FIELD (N, E & W) 92' CONTOUR LINE IS A 3'CUT ON DRAIN FI AS R S RV / THE DOWNHILL SIDE - AREA _ - BETWEEN 88' AND 92' RELATIVELY REMOVE 1250q TANK E LEVEL _ - _ - - _ � REPLACE W/ 12509 TANK W/ DCO AND 3 -WAY VALVE (P) LOW SPLITTER M Al 5@I 4 BR I HOUSE (E I � � \ EXISTING WELL -1,0] Util Esmy- / �v Al .n NOTES: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 _-'�� OF A ��l i '(� • • • " •�'q5+1�� /rg�e ?y+f Date 04/07/15 FOR CONSTRUCTION Scale 1..=50' STONY BROOK B1 L2 VONJIA THORSON 11161 BRIGGS COURT .... .. —. .......... Steven Ponnome j ����c*'• 81//49 • tIiT�Fp P.I.D. NO 015-181-87 DRAWN JRL PERMIT No. OPS151070 Sheet PLAN ANCHORAGE, AK 99516 �..`. �� FROFESSIOH��. 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS. 3. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM & SEPTIC TANK. 4. GROUNDWATER WAS NOT ENCOUNTERED BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 11 FEET BELOW EXISTING GRADE THE ENGINEER IMMEDIATELY. DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 4(600 gpd) TANK SIZE: 1250g PERC RATE = 10.14 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 750 SF SYS. TYPE: DEEP TRENCH 6.0' E.D. MIN LENGTH: 62.5 LF USE: (2 EA) 31.5 LF X 2.5' WIDE, 6' E.D., 10.0' TD TOTAL AREA: 756 SF LEGEND _ W WATERLINE/ WELL RADIUS SS NEW SEPTIC ABBREVIATIONS Cu COPPER DIP FILTER FABRIC 4" 0 DRAIN PIPE DRAIN ROCK 6" ABOVE PIPE INV TH TEST HOLE FC I.5 T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER GM BELOW FINISH GRADE OG .ORIGINAL GRADE FG FINISH GRADE -5.5 TOPSOIL & VEGETATE GRAIN ROCK SM } -16,01I SECTION 0 00� 3 O Q FILTER FABRIC O Q O ~ 4" 0 DRNN PIPE ~ _ V DRAIN ROCK 6" 3 ABOVE PIPE INV 1250 GAL f 't� z TANK (E) _ llRNry RocK PROFILE DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM: 4(600 gpd) TANK SIZE: 1250g PERC RATE = 10.14 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 750 SF SYS. TYPE: DEEP TRENCH 6.0' E.D. MIN LENGTH: 62.5 LF USE: (2 EA) 31.5 LF X 2.5' WIDE, 6' E.D., 10.0' TD TOTAL AREA: 756 SF LEGEND _ W WATERLINE/ WELL RADIUS SS NEW SEPTIC ABBREVIATIONS Cu COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG .ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE NOTES: O E : PANNONE ENG SVC, LLC 3�oF AC ill 04/ FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 J �� qs 11 PHONE (907) 272-8218 FAX (907) 272-8211/�g�P �y++ Scale j*:49TH .*�/ NTS ..... ... .. ..... P.I.D. NO STONY BROOK 31 L2 / . on .. w 015-181-67 -- Steven R. PannoNe VONJIA THORSON `` /PERMIT No. DRAWN JRL I ��"�., E 8149 . F2% OSP151070 11161 BRIGGS COURT ti+ J• �,�K�t�,�r DESIGN DETAILS ANCHORAGE, AK 99516 til FYD' soNa" Sheet i��\""�' 2 OF 3 1 — 2- 3- 4- 5 — 6- 7- 8- 9 — 10 — 11 — 12 — 13 — 14 — 15 — 16 — TEST HOLE 1 OR IORGANICS GRAVEL SILT GM SAND MIXTURE ORANGE SOILS LOG - PERCOLATION TEST SLOPE X TH 1 SITE PLAN / 5S / TH-1 / aL 7 � 1 SANDY SILT SM MIXTURE - HO / / LT GRAY Ctf 4 BE /' �'L1 UE E S ( _ \ --- I 1 / DATE PERFORMED: 0313112015 WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? NONE' DEPTH TO WATER AFTER MONITORING? DRY' - DATE: 04/0712015 SLOPE TH X READING DATE CLOCK NET TIME WATERTIME LEVEL READING NET DROP 1 03/31/15 16:37 4.64 2 17:07 30 MIN 9.67 5.03 3 17:10 4.64 4 17:40 30 MIN 8.75 4.11 5 17:42 4.64 6 18:12 30 MIN 7.62 2.98 7 18:15 4.64 8 18:45 30 MIN 7.60 2.96 PERCOLATION RATE OF 10.1 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 6.5 FT AND 7.5 FT - WILL CONDUCT SECOND TEST IN GM STRATA AT TIME OF CONSTRUCTION COMMENTS: Test hole excavated by A+ HOME SERVICES. Prec hole was presoaked. Test run for three hours. Last 4 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNO NE EN _��� \\ Date FOR CONSTRUCTION P,Q vBQXO1010217 ANCHORAGE, CK 990 J'����-A�'gS`ko 04/07/15 PHONE (907) 272-8218 FAX (907) 272-8211 1 ... �9f0 scale DRAWN JRL SOILS LOG STONY BROOK B1 L2 VONJIA THORSON 11161 BRIGGS COURT ANCHORAGE, AK 99516 �� NTS ' � P.I.D. NO '..: 015-181-67 Steven fK^ Pannone PERMIT N0. 3 OF `MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION (0* ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99507 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW p 3A(< L A V E 3 J— �J� 1 ❑UPGRADE MAILING ADDRESS _ BogI Y &G A kNic" q 5 U"1 LEGAL DESCRIPTION LOT ST® N ' no VC LOCATION NO. OF BED RQOMS Well Absorption area Dwelling PERMIT NO. DISTANCE TO: IO _Y a zManufacturer wQ G' = Material G; EL' No, of compartments rn Lin. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth 0 YDISTANCE TO: Well Dwelling PERMIT NO. _i(9Z = z F Manufacturer Material Liquid capacity in gallons Well Foundation Nearest lot I ne PERMIT NO. w= DISTANCE TO:.�- J LL z F z w No. of lines Length of ea ne � Total length of I as Trench width 6 O inches Distance between lines Fes- Top of tile to finish grade_ Material beneath tile _ Total effective absor tion area p 5 F / _ (r9 �' / & 8 Length Width Depth PERMIT NO. w C7 Q F Type of crib Crib diameter Crib depth Total effective absorption area wa y Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. J DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS OT �1 - SOIL TEST RATING) /50 °" INSTALLER REMARKS f3� _ ••' OA YH if �' - ..�.� o. 2225-E �® P'. UNE 25, 4971 yk •��,.•�,�o`o APPROVED DATELEGAL lA� J n Iii ® t )_ /J YC1d q 72-013 (Rev. 3/78) 1 v POUoH 6-650 �e 'L'R°�1'(f' 11061-ft ' " " E : \ ANCHORAGE ALASKA 99502-0650 6';} ,t i�) (907) 264-4111 ;1 3; � TONY KNO C4f !-S. %,r'b DEPARTMLNI OF HEALTH AND F N!VIRONMEN'FAL PROTECTION <Permit #: 820734 :January 31, 1983 TO: Permit Applicant Subject: Lot 2 Block 1 Stoney Brook Subdivision A permit issued by this department for an individual well and/or on-site sewer system has expired as of December 31, 1982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent to this department for documentation of the installation date and to close the permit. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4720. Sincerel �:i"4j- Robert C. Pratt, R.S. Acting Program Manager Sewer and Water Program RCP/ljw enc: Copy of Permit SWP/057 ������Z��1�� �F_� �r�- C-* r-? C:i K -'E - DEPARTMENT 9E,HERLTH AND ENVIRONMENTAL PRPTECTION ' � � ' 825 '� STREET. ANCHORAGE, HK. 91 1 264^4720 PERMIT NO� ( 820734 > /APPLICANT JACK D LHYERTY SRR BOX 1566H 99507 344^4414 LOCHTION LEGAL L2 B1 STONEY BROOK LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM @UMBER OF BEDROOMS - 4 SOIL RATING (50 FT/BR)- 200 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ���??-!�= &.4 �EE, ph! Kay �10 —, d.3jFQF4NAEEL. ��1"�-41— �� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHIHFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES� ]: I UNDERSTAND TH9T THE THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). flE0-F-1Y0 A-1010107 0512TEE7— :1.12T,ED ������� PERMIT APPLICANT HHS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. 7' 9-l"4 C:o �101FZEE BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTHNCE BETWEEN H WELL- HND HNY ON-SITE SEWAGE DISPOSAL SYSTEM I.S. 108 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH MINIMUM DISTANCE FROM H PRIVATE ]: I UNDERSTAND TH9T THE WELL TO H PRIVATE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED HND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. To' EEL GZ Tvl 1 -11- EEL 1-1 l" 1: TR EE S3 E)����IEPE., L :H- ��"-'D� I CERTIFY THAT i: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES, ]: I UNDERSTAND TH9T THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED �HPPLICHNT K D LHVERTY ISSUED .. _..... Y4.0 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 31, 1980 Jack D. Laverty Star Route A Box 1566A Anchorage, Alaska 99507 Permit # 800513 Subject: Lot 2 Block 1 Stoney Brook Subdivision A permit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. if an engineer inspected the installation of the on-site sewer system, please have them send us the as-built3 for our files. If there are any, further questions, please call this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental cialist_ LNB/ljw enc: Copy of Permit SWP/057 !`^'Et_1" I 1 I F�t=9!_ I'Ver i_j F= 9=4"a :!-!cA F=: F=91:3E DEPARTMENT ,��, HEALTH AND Etd'•f lRONMENTAL �"-IDTEC:TI ON 825 STREET, ANCHORAGE, AK. _aL 1 264-472O . 14E—=!_L PERMIT NO. C 80051]: APPLICANT JACK G. LAVERTY SRA BOX 156E.H ANCHORAGE 99507 344-4414 LOCATION LL2TH & STONEYBROOK LEGAL L2 B1 STONEY BROOK, LOT SIZE 79860 '_QUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (50 FT/BR:)= 200 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: L: EEF='-r!-! _'' ::L^4 !-EPAfl-r"_ -*Ci1 0:3FRnVE!_ E�°EF�-FF-!= -lf-7-1 THE LENGTH DIMEN'ION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR: PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN 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 E>iCAVATION CIN FEET). !_-_Ea=!U I FR^EC-a E=F"-IF 117 -IF t=tNta-_ f_, I =a_ '.o °ARD ®3C=t1�1 CH N'_:'; PERMIT APPLICANT HAS, THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENC:E'S THAT THE kdELL WILL SERVE. --- "F -W1=/ a :% I ! ! F}Er_r' I RDC ! t=tF>E= FK E=AU I F=`E=CA --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIEF DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON -':ITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR: A PRIVATE WELL OR: 150 TO 200 FEET FROM A PUBLIC: WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER: LINE IS. 75 FEET. WELL LOG= ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAY= OF THE WELL COMPLETION. OTHER R:EQUIR:EMENT'.= MAY APPLY. SPECIFICATION': AND CONSTRUCTION DIAGRAMS, ARE AVAILABLE TO INSURE PROPER INSTALLATION. F='EF-*M 1'r EEX! I F='E 5 C4=r_E:ME-El: =:I_ :j_Sal v e_ -e I CERTIFY THAT 1: I AM FAMILIAR: WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. : I UNDERSTAND THAT THE ON-SITE_ SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. '= I GNED 0 ISSUED B4 vii/2�, r�sL `J -7 7«D V4. 0 April 13, 1975 ;77150 Jack Laverty 702 North Park 07 Anchorage, Alaska 99504 Subjoats Permit Expiration A permit issued by this department for well and/or on -rite sewer installation on Lot 2 dock 1 Stoney Brook Subdivision has expired since the issue: date exceeds one(l) year. In the event you still plan to install the well and/or on- site sewer system, a new permit is required. W original roil gest may be used to obtain a current permit. If the well has been drilled, a well log should be sent to this department to document the installation date. if you have any questions regarding the MOW matter, please contact this office immediately at 269®4720. Sincerely,, Les N. Duchholz„ R.S. Senior. Environmental Specialist l�T�/1j1� TYPE OF SOIL ABSORGTIONd SYSTEM IS: TRENCH CH MAXIMUM NUMBER OF BEDROOMS = .T THE REQUIRED SIZE OF THE _OIL ABSORPTION N.Y .TEI'1 IS: 0-A E:=_ I=" IF' a -H = _1_ u_I• L__ & W'-• 8 r -:i -IF H--9 =_ :B_. N a" . """ if =- P_._ III III=" 1='-F- 1-1 -- ::1.1-2 THE LENGTH DIMENSION I_� THE: LENGTH FEET) �_-- THE TRENCH OR GRAT.NdFIEI_.D. THE DEPTH OF A TRENdCH XT F'II" .: THE 1315TANCE: BETWEEN THE SURFACE OF THE GR:Cu_IpdC: HPdC: THE E:CiT FCit'1 OF THE _'";Cti'S'1` T i_ p.l ' I I'd FEET). THERE l:'. I'd0 SET WIDTH FOR TF:Epd'1dE ,. THE GRAVEL DEPTH 1 THE MINIMUL'1 f. .PTH Oh GR:AVEL.. BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION : T.I`d FEET: L7 " IEE CA e.- H 1 F P" L =. V-" " IF= F= `T I L .Aq_ u rf -" _'E Lr I" E= CS 11 1 C-9 BACKFILLING OF ANY SYSTEM WITHOUT F I Ndp DEPARTMENT WILL BE SU ;.JEC:T TO F'ROSEC:IIT. O MINIMUM C:I ST"AP+U=F.. B'EfLQE.Pd H WELL AND ANd'r' 1-00 FEET FOR A PRIVATE ELL OR r'00 FEET WELL LOG_: ARE REQUIRED HIL) MUST BE RE'TUR OF 'I HE WELL COMPLETION. SPECIFICATIONS AND C:ONSTRL-TION DIAGRAM INSTALLATION. \\ C33=110— J._;:="��, u _gin w... -o p=u L.....- L-. a -b PJ 10e F E= Ca LJ ]E. IF1 EE IEC-. I Nd=•F'EC:T I ON•I AND APPROVAL BY THIS _SITE SEWAGE. DISPOSAL_SYSTEM1IS R A PUBLIC WELL.. D TO THE: DEPARTMENT WITHIN :_r DAYS: AVAILABLE TO INSURE: PROPER: L=- f3X F-- jo L" -.L E�_ / v F F=P Lm_' F- F:' e_ aim :1, " I CERTIFY THAT 1..: I AM FAMILIAR WITH THE REQUIRF_'L FOR ON—SITE SEWERS AND WE.L..1....S AS SET F'OR'TH BY THE. MUNICIPALITY OF ANCHORAGE. I WILL INd=,TALL. THE SYSTEM IN ACCORDANdCE. WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON—SITE SEWER: SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED ISSUED ..A L -"-L k_ 0 T41 1 Y_: I . n L__. T. T a'v" (D F-_ F -u L° --L C L- . J IF<' F=u Ci IE` a DEPARTMENT CII= HEALTH AND ENVIRONdMENdTAL F'F:OTECFIONd 25 'L.' STREET, ANCHORAGE, AK. 99501 279--2511. 41 Il= I-- L. p=11 L' -A I_--• w ='u L .L —'-_ I .T.. EE L-A IF = @9 : PERMIT NO. 77150 27 7 APPLICANT JACK LAVERTY 702 NORTH PARI'`. #7 276-1654 LOCATION L'.. '. E' BROOK DR: L.Ei_iAL L.:' 81 STONEY BROOK SURD LOT SIZE 19810 SQUARE FEET TYPE OF SOIL ABSORGTIONd SYSTEM IS: TRENCH CH MAXIMUM NUMBER OF BEDROOMS = .T THE REQUIRED SIZE OF THE _OIL ABSORPTION N.Y .TEI'1 IS: 0-A E:=_ I=" IF' a -H = _1_ u_I• L__ & W'-• 8 r -:i -IF H--9 =_ :B_. N a" . """ if =- P_._ III III=" 1='-F- 1-1 -- ::1.1-2 THE LENGTH DIMENSION I_� THE: LENGTH FEET) �_-- THE TRENCH OR GRAT.NdFIEI_.D. THE DEPTH OF A TRENdCH XT F'II" .: THE 1315TANCE: BETWEEN THE SURFACE OF THE GR:Cu_IpdC: HPdC: THE E:CiT FCit'1 OF THE _'";Cti'S'1` T i_ p.l ' I I'd FEET). THERE l:'. I'd0 SET WIDTH FOR TF:Epd'1dE ,. THE GRAVEL DEPTH 1 THE MINIMUL'1 f. .PTH Oh GR:AVEL.. BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION : T.I`d FEET: L7 " IEE CA e.- H 1 F P" L =. V-" " IF= F= `T I L .Aq_ u rf -" _'E Lr I" E= CS 11 1 C-9 BACKFILLING OF ANY SYSTEM WITHOUT F I Ndp DEPARTMENT WILL BE SU ;.JEC:T TO F'ROSEC:IIT. O MINIMUM C:I ST"AP+U=F.. B'EfLQE.Pd H WELL AND ANd'r' 1-00 FEET FOR A PRIVATE ELL OR r'00 FEET WELL LOG_: ARE REQUIRED HIL) MUST BE RE'TUR OF 'I HE WELL COMPLETION. SPECIFICATIONS AND C:ONSTRL-TION DIAGRAM INSTALLATION. \\ C33=110— J._;:="��, u _gin w... -o p=u L.....- L-. a -b PJ 10e F E= Ca LJ ]E. IF1 EE IEC-. I Nd=•F'EC:T I ON•I AND APPROVAL BY THIS _SITE SEWAGE. DISPOSAL_SYSTEM1IS R A PUBLIC WELL.. D TO THE: DEPARTMENT WITHIN :_r DAYS: AVAILABLE TO INSURE: PROPER: L=- f3X F-- jo L" -.L E�_ / v F F=P Lm_' F- F:' e_ aim :1, " I CERTIFY THAT 1..: I AM FAMILIAR WITH THE REQUIRF_'L FOR ON—SITE SEWERS AND WE.L..1....S AS SET F'OR'TH BY THE. MUNICIPALITY OF ANCHORAGE. I WILL INd=,TALL. THE SYSTEM IN ACCORDANdCE. WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON—SITE SEWER: SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED ISSUED RSM CONSULTANTS. INC. 5024 CORDOVA • BOX 6087 B ANCHORAGE. ALASKA 99502 • PH. 90 -2 - 83 • TLX. 09025360 ENGINEERS GEOLOGISTS PLANNERS SORVEYO RS April 6, 1977 Mr. Jack Laverty 702 North Park Street, Apt. 7 Anchorage, Alaska 99504 R & M No. 751133 RE: Test Hole and Soil Log Report for Sanitary System Lot 2, Block 1, Stoney Brook Subdivision, Anchorage, Alaska Dear Mr. Laverty: We are submitting herewith the test boring results and our comments regarding soil conditions enocuntered at the subject site. This in- vestigation was performed in accordance with your request of April 1, 1977, and those procedures outlined in a letter dated July 15, 1975, by Mr. Rolf Strickland of the Municipality of Anchorage, Department of Environmental Quality. A single test hole was drilled within the subject site area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Drilling was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 20 feet below ground surface. The final log of the test hole has been included in Drawing A-01. Groundwater was not encountered in the test hole while drilling. A percolation test was performed from a depth indicated on the attached table and reflects average infiltration from that depth to the bottom of the hole. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & MM �CONSULTANTS, INC. Edward Yarmak, Jr. Geotechnical Engineer EY/pe ANCHORAGE FAIRBANKS JUNEAU VALOEZ WASILLA e/ T. H. 7 0.01 ORGANIC 14ATERIAL Brown, Soft — 5, °e bo SILTY GRAVEL W/SOi•IE o °. o'D SAND ;° 4Some Cobbles Boulder @ 6.0' 6.0' - ® TH_1 SILTY SAND J Brown, Loose, Moist Lot 2, Block 10 Stoney Brook Subd. 112th Avenue The Test Hole location is approximate and has not been located by survey methods. D'vJ N: V&?_ CKD DATE: 4-5-77 SCALE: 1,, = 4' °.; SILTY SAND W/SOME GRAVEL .° Brown, Moist, Medium Dense5/ 25-J 16.0' SILTY SAND Brown, Medium Dense - - Moist_ _ _ _ _18.0' - SILTY SAND W/TRACE GRAVEL Brown, very Moist •o••' Medium Dense 20.0' T.D. Groundwater Table Not Encountered .This log represents subsurface soil conditions within Lot 2,'Block -1 Stoney Brook Subdivision, Anchorage, ,Alaska /1 F. e. LOG OF TEST HOLE< GRID: 2639 Ft E.M C01+35ULiAiVTS, INC. :& - LOCATION DIAGRAM PROJ.NO- 751133 ANCHORAGE, ALASKA DOVG.NO- A-01 TIME 11:06 11:07 11:08 11:09 11:10 11:11 11:12 11:13 11:14 11:15 11:16 11:21 11:26 11:31 11:36 11:46 11:56 12:06 TOTAL DROP 66.5 INCHES OR 0.90 MINUTES PER INCH PERCOLATION TEST LOT 2, BLOCK 1 STONEY BROOK SUBDIVISION R & M No. 751133 ELAPSED DROP IN TIME INCHES INCHES 0 26.75 0.00 1 30.25 3.50 2 32.50 5.75 3 35.00 8.25 4 36.75 10.00 5 38.00 11.25 6 39.75 13.00 7 41.50 14.75 8 42.75 16.00 9 44.25 17.50 10 45.75 19.00 15 - 50.00 23.25 20 53.50 26.75 25 58.50 31.75 30 63.00 36.25 40 73.50 46._75 50 82.75 56.D0 60 93.25 66.50 TOTAL DROP 66.5 INCHES OR 0.90 MINUTES PER INCH M -W DRILLING, Inc. P.O. Box 10-378 • 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner Dan Zan Location (address of: Township, Range, Section, if known; or distance main road Lot 2 Block 1 StoneyBrook Size of casing 6 Depth of Hole 204 feet Cased to 203 48 feet of Well Domestic Static water level 137 ft. (IL) (below) land surface. Finish of well (check one) open end ( xxx ); Screen ( ); Perforated ( ). Describe screen or perforation None Well pumping test at 5 gallons per ) (minute) for 1 ----hours with 1 0D Ik of drawdown from static level. Date of completion Ontnb 2 198 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of maWOO L21or and hardness X4 Olm Pl61IER A 6c' 2 TO 5 --a—TO so 120 120 m 133 133 Tn 145 145 rn 155 _L5 5 TO183 183 TO 201 __LO1 TO 204 aa0.,L.1 V LL! Brown silty cand .Brown silty sand (damp) Gray silty sand & gravel (damn) Gray `sandy clay (damn) Gray sandyclay_& gravel (damn) Gray silt sand x. clay w/gravel (siamn) . - 4 .. ..l3SFr:7� A h� i - 1 —CUSTOMER MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-511-05 1. GENERAL INFORMATION Expiration Date: 2 .zs "z© 2 Complete legal description Stony Brook, Block 1, Lot 2 Location (site address) 11161 Briggs Court Anchrage, AK Current property owner(s) Leigh Welling Day phone (907)290-6475 Mailing address Real estate agent 11161 Briggs Court, Anchorage, AK 99516 Rona Floria 2. TYPE OF DWELLING: ■❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone (907) 748-4500 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑■ Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ H 12,.50 CO I/1 Date of Payment // /2040 Receipt Number. 019 6.'3.D COSA # 0JC_, 2016 q 8 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 11/19/2020 6. DSD SIGNATURE System #1 Approved for q —bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: «nuiuuri� U, J J) TS � SERv� ��N , By: 1 w Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Stony Brook Block 1 Lot 2 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 10/22/1982 Total depth 204 ft Cased to 203.48 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '24 in. Date of flow test for COSA 11/12/20 Static water level at beginning of test 145 ft Comments B. TANK DATA Age of tank(s) 5 years Tank type/material Septic/Steel Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 6/25/20 - McDonald's Pumping D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 5/3/2015 ❑ ALL standpipes present per record drawing Total measured depth from grade 10'"0" ft (max) Measured depth to pipe invert from grade 4.7/4.2 ft (min) ❑ N/A — pressurized field OR Monitor tubes go to bottom of effective. If not, state depth into effective OR Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced N/A gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-511-05 of Structure served by this system Well production at time of test 4.6 gpm Water storage tank volume None gallons 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 FORGE ENGINEERING Date of Sample 11/11/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Gravity flow septic system. Adequacy test date 11/12/20 Results 2✓ Pass For 4 bedrooms Fluid depth prior to test 9/16 in Water added 623 gal New depth 12/29 in Elapsed time 1,345 min Final fluid depth 9116 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) None 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' E✓ Yes Community Sewer Manhole/Cleanout > 100' M Yes if No ft M Yes if No ft Neighboring Tank > 100' F/� Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Fv� Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment? 50' ❑✓ Yes if No ft 0 Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F/� Yes if No ft Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' P/1 Yes if No ft Surface Water > 100' ®✓ Yes if No ft Property Line > 5' E✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F✓ Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' F-11 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' FV -1 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' F✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ED Yes if No ft Private Wells > 100' ®✓ Yes if No Water Service Line > 10' F/� Yes if No ft Community Wells > 200' Yes if No Surface Water > 100'✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION � US t734��� I certify that I have determined through field inspections and review 't °''• '•••., of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. s 't * 49th I MICHAEL E. ANDERSON No. CE -4381 °�'�_ 11 /18/20 COSA Checklist yellow sheet® PROFESS '�4®� ft w 111=50' PLAT NO. 73-248 STONY BROOK SUBDIVISION LOT 2, BLOCK 1 79,848 S.F. N 89°55 10"E 330.11' I HEREBY CERi1FY THAT I HAVE SURVEYED THE GASTALDI LAND PROPERTY DEPICTED ABOVE AND THAT NO 90.D' O C, ` SfYIx N W Lf'+1L" R IS THE RESPONSIBILITY OF THE OWNER TO JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, srzo—� COVENANTS OR RESTRICTIONS WHICH DO NOT CG� cl xZ (D c`o c HEREON BE USED FOR CONSTRUCTION OR FOR rt;t1 8/23/2016 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA F, B. JOB - ------------------------- 10' UTILITY ESfMT. N 89'55'10- 329.79' NOTE: NO CORNERS SET THIS DATE O 5852115 S21 9 M _ E. 112TH AVENUE BUILDING DETAIL SCALE: 1"=20' AS -13U I LT I HEREBY CERi1FY THAT I HAVE SURVEYED THE GASTALDI LAND PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENT'S EXIST EXCEPT AS INDICATED. SURVEYING, LLC R IS THE RESPONSIBILITY OF THE OWNER TO JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, 2000 E DOWLING RD., SUTTE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPS ON THE RECORDED SUBDIVISION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR SN2639 8/23/2016 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA F, B. JOB NOTE: NO CORNERS SET THIS DATE 16-03 5852115 S21 9 OF. 44 s �: sfi4 a * : 491(1 1. * I X'— ..................... m i 6 ..kfftlY A Gogo;!; i p $Q tartaaa,a Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 aI SEP o 8 2016 CERTIFICATE OF ON-SITE SYSTEMS Parcel I.D. 015-511-05 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: Expiration Date: STONYBROOK; BLOCK 1, LOT 2 11161 BRIGGS COURT `ANCHORAGE, AK VONJIA THORSON Day phone 11161 BRIGGS COURT 'ANCHORAGE, AK TAMI TAYLOR Day phone E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaiverNadance request for. N/A Distance: Received by: _ Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $a �gWaiver Fee $ Date of Payment ���211to� / Date of Payment Receipt Number �i �3TcL Y1 i Receipt Number COSA # (15�%lBl �o� Waiver # 5. 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 On -Site Systems Approval Guidelines for this application, shows that the on-site watersupply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. l 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. Phone Address 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG pmvidedan engineering evaluation of the well andbr septicsystem in accoo'ance with the guidelines andmgulafions established by the MunicipaltiyofAnchorage and industry practices. The mpodedresuffs desmbe the condition of the systemis on the datelsof the evaluation. Separation distances were measured to madityidentirmble features. Hidden defects orenovachments may exist that were not identified during the evaluatfon.The operational Ida of all weNsand seplic systems depend on a variety ofvadables including, but not limited to, soil oondi'fions, groundwater levels (that may fluctuate during the yeal), quality ofconshuction (materials and workmanship), and the wafer usage of fine family utilizing the syshiaV& These condkionson vary, and are outside the ambul of GEG. Safisfachorytest results do not gamantee future performance of the systgr(A therefore, GEG makes no wananty (express aimpl al) regarding the fuWre perfommnce ofthe well orseplic system. GEG makes no representation whether an aftemath a wadorseptic system can be Installed on the properly in the m entedherofMe cunentsystems fail. The content oflbisrepodisfor the sole benegf of the persoNparly who retained GEG. Reliance upon the informafionpmvided in this report by any otherpemon orparty, including but not limited to subsequent properlypumhasem isnot authorized. In short GEG dfsawws anylegal duty to anyone other than The persaNpadywho paid for this repot. 6. DSD SIGNATURE By: System #1 Approved for � bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following 337-6179 Date `) xveUuonn Original Certificate Date: I ' S L The Municipality or Anchorage Develop,emt 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 engineerregistered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory (Rev. 10112M) Nitrate Advisory f: , Arsenic Advisory Other " 1^ • \9 li'. •i' S E9 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: STONYBROOK; BLOCK 1, LOT Parcel ID: 015-511-05 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) Date completed 10122/1982 Sanitary seal (Y/N)7__ Wires properly protected (Y/N) Total depth 204 ft. Cased to 203.48 ft. FROM WELL LOG Date of test 10122/1982 Static water level 137 g, Well production 5 — 9 -p.m - WATER SAMPLE RESULTS YES YES Casing height (above ground) 12+ in. AT INSPECTION 8/1 212 01 6 151.6 ft, 5.5+ n Coliform —.4 colonies/100 ml. Nitrate ND mg./L. Collected by: GEG, Ltd. *PULUED BY PUMP AND Arsenic: NDS ug./L. Date of sample: 6/10/2016 & *8/1912016 SERVICE AFT RROW C OR NATIONLL B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 4/28/2015 - 5/3/2015 i Tank size 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper C. ABSORPTION FIELD DATA I -BELOW EXISTING GRADE -1 NORTH TRENCH/SOUTH TRENCH Date installed 4/28/2015 5/3/2015 Soil rating 4E> ft2/bdrm) 0_8 System type DUAL DEEP TRENCH Length 63 (TOTAL) ft. Width 2.5 & 2.5 ft. Gravel below pipe 6&6 ft, Total depth *10.7+ & *11.5 ft. EO. absorption area 756 fe Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) For 4 bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time:. min. Final fluid depth = in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN - If yes, give date PER GEG INSPECTION ON 8112/2016, THE NORTH TRENCH HAD APPROXIMATELY 8 INCHES OF LIQUID AND THE SOUTH TRENCH HAD APPROXIMATELY 6 INCHES OF LIQUID IN THE MONITORING TUBE, HOWEVER, ABSORPTION RATE IS UNKNOWN D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in. "Pump ofP E. SEPARATION DISTANCES level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot lar+ On adjacent lots 1001+ Public sewer main Public sewer manhole/cleanout 100'+ Sewer !septic service line 2S+ Holding tank 7g'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5 * Property line V+ Absorption field t,+ Water main 10'+ Water service line 101+ Surrace water 1W+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 101+ Water main 101+ Water service line 104 Surrace water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent Iota 100'+ F. COMMENTS G. ENGINEER'S I certify that l have determined through field inspections and review of Municipal records that ttre above systems are In conformance with MOA COSH guidelines in effect on this date. Engineer's Prin Name JEFFREY A. GARNESS Date Cf$ 1/6 (ROV. 10MV12) LJ *A ___ __PLAT NO. 73-2.48 STONY BROOK SUBDIVISION LOT 2, BLOCK 1 78,848 S.F. 60-s�,i e t. IFH AVENUE BUILDING DETAIL SCALE: 1 "=20' • MUNICIPALITY OF ANCHORAGE f Services Department of Health & Human ServiM} { DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel l.D. # °y 1/gL 6 7 HAA # yAi% 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) L or `7 / 51�vN,, lsIzad Location (address or directions) 9nn r - /l Z (b) Property owner 1i4 -"-j Telephone : (home) Business j1_4 Mailing Address (c) Lending Institution E I—G Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here, if hold for pick up.) List contact person and day phone number below: TA PAA-V.A Ag -4 b.�50(,J A-GRAEA-cam 5ys;.S 2. TYPE OF RESIDENCE Single -Family IX Number of bedrooms 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 jRev. 7188) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION - As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm G^ N 1 C7� Telephone 3 4, — z , Zz_ Address G—v " SvS 1_� A Date - Z 3 90 6. DHHS APPROVAL Approved for bedrooms by ZDate / CA✓��i zd/ `��� Approved 4K Conditional Terms of Conditional Approval CAUTION: ' The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 o /,�- 191 6 7 G" � 0P,\S\O � O NO F A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) 401) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: Zy %f a,,X J T7Jn�� %32aa,e 14 Well Classification 11)04-t- If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) I C 5 Date Completed %Z) - z z f Yield Total Depth 7-1 00- Cased to Zoj Depth of Grouting _ Static Water Level 13-7 Pump Set At Casing Height Above Ground Z__ Sanitary Seal on Casing (Y/N) ' tyS Electrical Wiring in Conduit (Y/N) yt%� Depression Around Wellhead (Y/N) N SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot On Adjoining Lots *7 to (D To Nearest Edge of Absorption Field on Lot / 4J ; On Adjoining Lots O To Nearest Public Sewer Line — To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot�� Water Sample Collected by iGN 1'Z- ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DtgA Date Installed iii 93 6 Size I ? S__0 No. of Compartments z Standpipes (Y/N) Air -tight Caps (Y/N) Yum Foundation Cleanout (Y/N) Depression over Tank (Y/N) " ° Date Last Pumped 7-v-& Pumping/Maintenance Contact on File (Y/N) Holding Tank High -Water Alarm (Y/N) rC ;for Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well " f U9 To Building Foundation To Property Line To Water Main/Service Line -- To To Stream, Pond, Lake or Major Drainage Course Comments To Disposal Field Z 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design f r O" Date Installed (h i� =� ��.�,�� Length of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absortion Area 6,84- Statndpipes Present (Y/N) — Yu S Depression over Field (Y/N) 11J.0 Date of Last Adequacy Test 3 '- " Z 3 b Results of Last Adequacy Test i=:. 4- t!b R -o o wt SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well �r To Property Line To Building Foundation _ To Existing or Abandoned System on Lot ; On Adjoining Lots 7 ty 0 To Water Main/Service Line T Z1 To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons —_ "Pump On" Level at QI A High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access(Y/N) —' Pump Off' L ere ent (Y/N) k Permitted Bedroom Rating Against HAA Request" Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ' Signed --<< n Company _ St/S /nm r Date �'L7' S) (L Engineer's Seal �i=a / MOA No. - U —00j O Receipt No. 011 Date of Payment Amount: $ Receipt No Waiver Fee: $ Date of Payment 72-020(Rm7/88) Back Page 2 of 2 ROBERT KNIEFEL, P.E. 8441 MILES COURT ANCHORAGE, ALASKA 99504 (907) 337-6560 HEALTH AU'THORIT'Y RESULTS AND ANALYSIS Date; of 'Testing: March 23, 1990 Legal Description: Lot: 2 Block: i Subdivision; Stony Brook Address: 0000 V 1121h. Avenue Results of Well Testing: The well produced a flow rate of greater than 3.5 gpm for a period of fours hours. The -tell was equipped with a. sanitary seal and the pump power cable was enclosed in a buried conduit. The well casing, was approximately 2 feet above the ground with no sign of a ground depression. Snow covered the ground at about the two foot depth. Results of Water Testing: Passed (Reports attached) Coliform 0 colonies Nitrate --N --- <0.1 nag/I Laboratory ---- Northern Testing Laboratories Results of Septic System Testing: The house oas occupied at Che time of testing and no pre—soak of the field was necessaTW Thz-) field absorbed the test water and returned to its pre --test level within 30 minutes of stopping the flow of water. Approvals: The well and septic system are approved and certified for a four bedroom home, These -nest results are based upon conditions present at the time of the test. The testing procedures followed Municipality of Anchorage recommendations. OA/^ P0114 `1 _ Time APPLIC. `JT FILLS OUT UPPER HAL `ONLY Time ftoPertY Ow !�<: ♦ 7:.:a7.7�r'c, Date Phonener Date Date , Mailing Address <� -� _ z._i Zip Code Inspector Inspect Buyer ! 4Ya.JCi'3 MUNICIPALITY OF ANCHORAGE Field Notes: Address DEPT. OF HEALTH 7; Zip Code Lending Institution Phone l'A RECEIVED ( j APPROVED BEDROOMS - -Address j✓I/° t-"$ /4 s,*!'.2r'-r :�.- '-;i Zip Code Realty Co. & Agent J -.. Phone DATE ti Address �j�-,� Zip Code Legal Description T'GNE Soils Rating. Street Location Well To Absorption Area f /�'S - Well Log Received Type of Residence (;�eSingle Family J S o — Well to Tank Z p y ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply F;/—Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal (Individual Year Individual Installed: ❑ Public Utility When Connected to Public U ility: ❑ Holding Tank - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time ,,I Date Date Date Date , Inspector Inspector Inspector Inspect ! MUNICIPALITY OF ANCHORAGE Field Notes: DEPT. OF HEALTH 7; ENVIRONMENTAL PROTECTION JUL I 1 W3 RECEIVED ( j APPROVED BEDROOMS - - 'CONDITIONS OF APPROVAL - - ( I DISAPPROVED ( J CONDITIONAL APPROVAL' DATE BY: ' D rayo Soils Rating. Date Sewer Installed Well To Absorption Area f /�'S - Well Log Received Septic Tank Size J S o % _ o Well to Tank Z p y 72 023