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STUCKAGAIN HEIGHTS BLK 3 LT 1
tuckagain Heights Block 3 Lot 1 #041-021-22 Municipality of Anchorage ;� '' '` •• 1 _ Development Services Department ' '• Building Safety Division - OnSfle Water and Wastewater Program. 4700 S. Bragaw St. P.O. Box 196650 Anchorage. AK 9951M650 Page / ar3 www.d.enchorage.sk.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO50287 PID Number. 041-021.22 1,is" Lawrence & Josephine Huskey Wastewater system: []New E] Upgrade Awl. 9660 Basher Dr ABSORPTION FIELD Phare aAreer el e.dmaa. 3 9Ow'ro A 0 shrnwrt.cto06W [3Wrd ❑om.w LEGAL DESCRIPTION soa Remo 0.8 Taal D" Ilam prlg^a" pale apcwe 12.5 Ft. ei d LM subdw 3 1 Stuckagain Heights Dom"pp Eagan Ean, drr w gree. Or" demEowtlr im" 5.0 Ft 7.5 Ft Ttr Nq Rope set FA add.d.Ede spial grade ar"Lerpm 0.1 Ft. 40 Ft. Well: ❑New ❑Upgrade am«wm3 Nap ;see D.onEavesnwae FI. Fl C1eaalcaxn (Pilau, A, B. Q Tau" DOM e.ad Co. Tml Stmorpom o. Pee Mebrrrl Ft. fl 600 FII ASTM D3034 / F610 Draw DeteDnad stxw.1,1 .0 1e 10 DeanConslruction Dele1r 1*,! 9/14/2005 FL Y� amp saa Ceaee tte.am AEde cuaw TANK avM n. FL SEPARATION DISTANCES El Septic ❑ Hosing ❑ S.T.E.P. ❑ Other. To I Septic Absorption Lin Holding dbfr/PrIvate 'a""' p'all' From Tank Field Station Tank sever Line Anchorage Tank & Welding 1000 cal vap 109 145 N/A N/A 100 Mme«." Steel Na 2 Ca ea a anu s,,,%eVftW 100+ 100+ N/A N/A LIFT STATION La Lea 50+ 18 N/A NIA NA cM nu Wu.o Faandaxn 89' 110 N/A N/A 'Pump an' law./ et Torre Wwe" a � � Hph "W alarm et in M Cueon onv I WA N/A I N/A N/A purr. Maw a Mow" el.rneal ImpaaapM polarr.d M Rene,lm Old tank removed from site. BENCH MARK Loulnrr end Dwrnpaan. Garage slab ..unr. 101.02 FL Engineer's Stamp F sF Inspections performed by: Cindy W. Ellis. P.E. Dates: 1d 9/13/05 49TH 2"a 9/14/05 * Developm nt Services Department Approval Reviewed and approved by: Date: Q�07 `•; C dy W. Ellis „� (It". 12W) CE -losn ; ��{3 F q•••.................... "�fSSIONA�c, —fir. FINAL. GRADE _ FCO DCOI STI 96.9 ST2 DCO2 DV \0M Z —IMM7— _72= 93.62 2" INSULATION 1000 GALLON a STEEL SEPTIC TANK \_92 801 old field C01 FINAL GRADE = 92.39-92.61 NITI CO2 NOTE: ORIGINAL GRADE _ 1" 0 PIPE 90.88-92.52 FILTER FABRIC 87.90 i OMM SEWER ROCK 80.05 Dolom of AIT 0 80.05 87.55 NOTE: 40.0 RELATIVE DEPTH OF TEST HOLE = 73.82 TRENCH NO NATER AS -BUILT Stuckagain Heights Bik 3 Lot 1 _000pppp OF At �04G Record Drawing of Septic Upgrade Lawrence &Josephine Huskey ooQ� ............... S p0 Watkins Engineering Inc p10.491H ' Parcel ID: 041-021-22 Permit No. SW050287 j.•.D p••••� .;:,�••:`U• p....:..........................p W. ELLIS Q :; •., c • 10577 o0 Cindy W. Ellis, P.E. P.O. Box 110443°� November 15, 2005 Anchorage, Alaska 99511-0443 Not to Scale Phone: (907) 349-1851, Fax: (907) 349-1934 oopppoo MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SfTE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 15, 2005 Expiration Date: Aug 15, 2006 Permit Number: SWO50287 Parcel ID: 041-021-22 Legal Description: STUCKAGAIN HEIGHTS BLK 3 LT 1 Design Engineer: 0844 Watkins Engineering, Inc Site Address: Owner Name: LAWRENCE & JOSEPHINE HUSKEY Lot Size: 87120 SO. FT. Owner Address: 9660 BASHER DR Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99507-1202 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 41zav1. Received By. Date: Issued By: Date: 115 e.1' Municipality of Anchorage Development Services Department � tit j Building Safety Division _ On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 041-021-22 Permit Number SW Property owner(s) Lawrence & Josephine Huskey Day phone ailing address (1) RCO riU 1,1E 01 rr) PSA 99502 address (2)41clrD 'lar. ASA RqEQ'? Zip Code Legal description (Lot, Block & Sub'd.) Stuckagain Heights, Block 3, Lot 1 Legal description (Section, Township & Range) Lot Size 87.120 Acre /S . t. THIS APPLICATION IS FOR: Number of Bedrooms 3 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade El THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. P66 (Signature of property ciivner or authorized agent) Permit Fees: !� ylt?(] .clo Waiver Fees: Date of Payment: HT1 Date of Payment: Receipt Number. —1.�A�Y�' (�(} Receipt Number. (Rev. 12/00) Watkins Engineering, Inc. P.0 Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net August 10, 2005 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Stuckagain Blk 3, Lot 1 Septic System Upgrade To Whom It May Concern: Attached please find the application and supporting documentation to upgrade the septic system for the referenced 3 bedroom house. The existing septic system was installed in 1987 and the drainfield is now surcharged. It is proposed to retain the drainfield for future use, inspect the 1250 gallon steel septic tank, and re -use the tank if possible. If the tank is not in good condition, a new 1000 gallon steel tank will be installed. The proposed design is based upon a test hole dug on July 14, 2005. The hole was dug to 18.7 ft with no water encountered. After a 7 day monitoring period, no water was detected. The proposed drainfield will be installed in a sand and gravel layer between 5.2 ft and 12.7 ft. A percolation test conducted between 7.5 ft and 8.0 ft resulted in a rate of 8.0 minutes per inch. An application rate of 0.8 gpd/ft? is used in the design. The soil log is attached. Proposed Soil Absorption System: 3 Bedrooms x 150 GPD/BR = 450 GPD System Type: Deep trench Application rate: 0.8 gpd/ ft' 450 GPD / 0.8 gpd/ft' = 563 ft? required Maximum Depth: 12.7 ft Effective Depth: 7.5 ft Proposed Length: 40 ft Absorption Area: 600 fe Sewer Upgrade Permit Application for Stuckagain Hts, Blk 3, Lot 1 Watkins Engineering, Inc.; August 10, 2005; page 2 There are no surface waters or private wells within 100 ft of the proposed septic system. There are no slope concerns. am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851. Yours truly, X614 Cindy Ellis, P.E. President IWell 100',�� / Stuckagain Manor Blk 2, Lot 14 / / septic Area �a�i � / t,,,. epticAre � Existing Septic \ COT2 \ System \ I Proposed Thi Well 100' I3 Septic I \ ' System I I Well 00• 36R house \ / I � � I OTt / I I Q s J0 / Stuckagain Hts Bik 3 Lot 1 �' OF A Proposed Septic Upgrade - Site Plan Watkins Engineering, Inc Lawrence & Josephine Husky'0: 49 TH Parcel ID: 041-021-22 ....... i�.�I ..........` P.O. Box 110443 D . Cl r W. ELLIS C Cindy W. Ellis, P.E. E - 10577 August 3, 2005 Anchorage, AK 99511-0443 4��, Scale 1' - 100' Phone: (907) 349-1851 Fax (907) 349-1934 ��. Test Hole 7/14/05 MLu2.0 SM/ GP �1,jo Existing fordra to e. retained for future use. CO&MT Test Hole CO & Proposed Trench 4• pert 2 pipe 7.5 It sewer rock 12.7 No Water 18.7 BOHG�O��OyGP 3 bedroom house valve — DCO T2 ILOT 1 I� 100' Well Radius Existing 1259_ga1-� septic taa c- /to bOnsp cted and tts€€d, If in�ood / /condition. \ Proposed 1000 gal steel septic tank (d old tank is abaondoned) DESIGN DETAILS 3 BR, 450 GPD 0.8 gpd/ft2 Requires 563 ft2 Deep Trench 7.5 ft effective 40 ft long Max 12.7 ft deep Stuckagain Hts Bik 3 Lot 1 Proposed Septic Upgrade & Josephine Huskeye Watkins Engineering, Inc. Lawrence o�0 49T"H 0� o, 491 Parcel ID No- 041-021-22 2 Ra4.:' ., CIN w05n is �0�.,'' ' Cindy W. Ellis, RE P.O. Box 110443 August 3, 2005 Anchorage, Alaska 99511-0443 ••....... Scale 1 Inch - 30 ft Phone: (907) 349-1851, Fax: (907) 349-193400'• •••.••• a' aOpO�oo" Municipality of Anchorage Development Services Department Building Safety DlvWon yt On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.munl.orglonsite (907) 343.7904 Soils Log - Percolation Test Jiy W Ellis CE • 1os77 Performed For. Pete Huskey Date Performed: July 14, 2005 Net Drop Legal Description: Stuc kagain Heights. Block 3, Lot 1 Township, Range, Section: Depth to Water After None Z.D Depth Date (Feet) �r�Q11iCS Net Drop 0.5 n1 L L O Depth to Water After None Z.D sm E ra P 2.25 1 14- 15- 18- �OFI WAS GROUND WATER NO Date ENCOUNTERED? Depth to Water Net Drop a IF YES, AT WHAT DEPTH? NA L O Depth to Water After None p Monitoring? E Dale: O :I� 2.25 Reading Date Gross Time Net Time Depth to Water Net Drop 7/14/05 1:50 0 6 2 2:20 30 2.25 3.75 3 2:21 0 6 4 2:51 30 2.25 3.75 5 2:53 0 6 g 3:23 30 2.25 3.75 PERCOLATION RATE e.0 (mngdncn) ron., n..�. .• - TESTRUNSETWEEN 7.5 SFT AND 8.0 FT COMMENTS Pres k prior PERFORMED BY: ClndyEliislRockyTrainor I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. GATE: $�3'p5 MUNICIPALITY OF ANCHORAGE DEI TMENT OF HEALTH AND HUMAN SEFIX :S U Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES Peke Ifs fAOM TO SEPTIC TANK ABSORPTION FIELD WELL Address y 2 y o (fie IceA Drf'/e Phones) Permit No. No. of Bedrooms WELL l 0 q, 1 2 y! 337-&3y-3 I 870062 3 LOT LINE I So LEGAL DESCRIPTION Lot f BlockSubtlimsion 3 S{ ,, ee can iiFOUNDATION 9 y ! / 1 3 ! SO 1 t Township, Range, Section AS -BUILT DIAGRAM (Show location of well. septic system. property Imes, foundation, T I Z N pp 3 (� S2C 6 l driveway. water bodies. etc.1 TANKS M SEPTIC ❑ HOLDING Manufacturer Capacity m gallons All cho/' P junk I Material No. of Compartments S!ee/ 2 > TYPE OF SYSTEM ❑ TRENCH ❑ BED N W. DRAIN ❑ OTHER Depth to pipe bottom from original grade Total depth from original grade 75 !2 C- 6p./ ry..5 FT 7,0 FT ! I n6 Fill added above original grade Gravel depth beneath pipe FT O,S FT C) l✓ Gravel length Gravel width 80 FT 67 0 FT t� P v\ Total absorption area Distance between lines `j(io SO FT to FT cat 0 Number of lines Soil rating Pipe material 0 12.6- SOFT F-9(0 Installer/ ,�tt 'ram wairffen — �Tr S uAll/nr Date Installed _5'_/20 /,57 — .i 12916 % WELLS ® PRIVATE ❑ OTHER (Identifvl Classification (A,9.C) Total Depth Cased to FT FT Installer Dale Installed. Re, ml7 arl- ArI.l II.� REMARKS: 2 Ft SanoC Q.��Peof beneath §ewr "Ve% 2r �•U.'i �IIYclz v t, e "S6ale.- jrr `—'76� * Inspections Performed by: rljet 6y Tech Svcs ENGINEER'S SEAL Date 2" St co o ver fun (^, aAd L 09: arl've of Secuer line uno(ar- , ty /'i' ?:iI I certify that this inspection was performed according to all ©• a .. . ° ° •� �"� °. Municipal and State guidelines in effect on this date: THEODORE F. PA00RE y^ 4e.••. CE - 3A9 •' '+� Date: Health Department Approval: 72-013 (3/85) 4Y3�1F'm'�* PAV 'SIX INCH WATER WELL DRILLed ' DRillED AT The RATE of PROPERTY oWNER "' :' DRILLER ., -.:~ .0_'__,14~- ~ ~. ...... : ~.'. .. "~'. :../'36---72 ~ ~ ~ 35~ ~ ~~. ' 72--~4~ ~ ~t 84---86~ ~ b~ ~. . ;.:, ~- -. . MUNI¢tPAU'tY OF 'DEPT. OF HEALTH & ENVIRONMENTAL PROTEC'T1OI~ RECEIVED $1,548.00 C_.,A~.cL // 316 COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYaBLE. TO RAMPART~ DRILLING WORKS FOR THE SUM OF -- THANK YOU VERY MUCH. ~.' ' BERNIE CLAUS OF RAMPART DRILLING WORKS ' ' SERVICE CHARGE0 F I~% PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNT$. � owl ����1 F-" 4�!2 L_ ]"-� -o If C1 Fr �p. -1 j, ; q LE DEPARTMENT OF HFHiTH AND ENVIRONMENTAL PROTECTION 925 L STREET, ANCHORAGE, 4K 99501 264-4720 1:1 PQ_oil 1:'k EK 114 &XOEEL.L. PERMIT NP: 970062 ENGINEERED DESIGN DATE 1SSUED: 04/27/87 APP(lEANT: PETER MUSKY ADDRESS: 4240 REKA DR. 4NrHORAGE, AK 99508 CONTACT PHONE: 269-1206 LEGAL DECCRTP:A AWIVIBIONvjIN.HTS.`��^� ��LU[F:.1� . . BLOCK;3���.� ACTION: 6TnWNAHIP:12N� � RAWVOEN2u ` !' LOT SIZE: 2 O SQ,�T. OR ACRES) I certi[j that: 1" I am familiar with the requirements for on-site sewers and wells as seL forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with tke design criteria of this permit. 3. 1 will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot, IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST DE OBTAINED; (2) AS-BUILT3 WILL NOT B All SPECTICN REPORT; AND (3) THE: ELECTRICAL ECTRICIAN^ SIGNEDDATE: APPLICANT: PETER K Y ISSUED BY DATE: --u~----------~�---------------------- � -�'z�----------- ,.$.L.OP tWAc.uNrION : t - .THE 9Ro PoS CQ. DRANy FI eLll I I rot -f owS A t-evF/- Rf DGLF, 17 -06 (,AND DROPS orG AT 015 P44c E-^ I 20.E ON TFf6(i :S.DE NGNi 7S LuNff xS wi . A65- I Dti A�NAtCt-t 0o0 (rAc $.f �REPM Ac�HENT SrTG; ,l'/ i . Dtsr6H/!-T�p ARBA\ { SIS 751x185`= r3,_6rs"®� 1 dor AHa_ )z6 o VabRi4 ori C068SE.R. THEriar;ai I.' \ kuvS6 ,YMC-li L� �S _/thPML Rvorf -I, Foft SE/vC (iI}G. fit?Nt-ACC-- ,m,c-Nr SITE! UI J. ? PrioP LOT Z a u I I l �a r i p (3Fa A4�z�d Ix—Y,4 91-H •. .r .. ...........i•�d} . THEODORE F. MOORE d��e°:• CE - 3589 4 ' ��Rrote ss iaaza� �" �•4r L07 P- oc • q.T�� l > G3 _ 16s` NCTIF Ala, FAcrFlrl' 4ucArroNs SO4OWN ON 1-07 1 Arima PROPa-c D EWST.NG Flattop Technical Services 14530 Echo Street sFPnc Anchorage, Alaska 99518 S rs tEr G-07' 1/ - 57-U C IT A6- A r N ffFfl HTS SID S 17 E PI -A N SCALE; 111 �-- 76 1 DATE: q120167 �i X SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION • TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST TEST HoI-E # 4 PERFORMED FOR: pafe H E-11 f DATE PERFORMED: q1 13 187 LEGAL DESCRIPTION: lot rc 3 SluclTa QPE rn %ler hAt S /D DEPTH SLOSITE PLAN os Pr 11 OL Reddts4 Orryariic S`rlf S 2 3 4 6 Date Gross Time 16- 16 Depth to Water 6P S;GIWr sroy Sandy G -m ve t 8 Sonne Cobble/ g lenses oi(SwtCPW 10 (1 IS D' / acerin) U S WAS GROUND WATER S 11 ENCOUNTERED? N L O SE C- Pti N I, P 12 IF YES, AT WHAT Absence of OL, E DEPTH? VerrtiroC N/20/a7 13 In rhenr%r i*4be 14 15- 5 Date Gross Time 16- 16 Depth to Water �� O.F. At 44 *� 18 ........ 19 '. THEODORE F. MOORE`� CE -3589 e 20 �� srN �° ....... •°��ap'l, ®� ®aprofen-soz�� ®® Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) T. H. +FA TEST RUN BETWEEN FT AND FT COMMENTS See CYC erb 4n ra (if *er rVk eg rctj 02ax a1 cvt-ken? G�P1 r4.n PERFORMEDBY: F1a4ap Technrcat' S?rare c- CERTIFIED BY: DATE: H1/21 /B% 72-008 (6/79) l / 19 SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION El PERCOLATION +.[ TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST T'65T (401.fi—F #2 PERFORMED FOR: Peke 14(4.s kV DATE PERFORMED: yl 13 16 % LEGAL DESCRIPTION: I-ofE /ocIT .3 11 Sfuct Orn >fh SID DEPTH S OPE SITE PLAN a.sPt I S OC. RecFofrsb orgrrnrc srl� 2 V 3 4 5 6 S LLI 7 J GCrY grravelly Sana( lifFle or no Siff 8 Some cobbf-S 9 FS 110 11 12 13 14 15 16 'j mct aC( f fran,rti+bn f-roM )0mac fble 6:P /� WAS GROUND WATER S of )�r ENCOUNTERED? N LO 5(li IL P S = 5 r PSH e j b0 fjyfi IF YES, AT WHAT Aisence of #r O E DEPTH? In Mon rfe�/ac6E veU Ncd Wzo/8 2S a�/DDRr't 17 - to * :' 4SIyw . •. 19 THEODORE F. MOORE �• '•, CE - 3589 y� QOZwprolessiona,:ow T: -K /f. z COMMENTS See ctCmv t'0%P Reading Date Gross Time Net Time Depth t0 Water Net Drop PERCOLATION RATE (minutes, TEST RUN BETWEEN FT AND FT Fe/ - u 01a I 5 y km '-JegG �n � PERFORMED BY: Fia�" 7PChOfCori 'ertlit of � /7tCERTIFIEDBY:T4w1%L DATE: V241-97 72-008 (6/79) CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 April 21, 1987 M.O.A. Dept. of Health and Human Services P.O. Box 6-650 Anchorage, AK 99502 14530 ECHO ST. ANCHORAGE, ALASKA 99516 RE: On—site Sewer Permit — L1, B3, Stuckagain Hts. S/D Dear Sirs: While observing the excavation of the test holes for the subject wastewater disposal system, it was visually obvious both that the soil would Derc faster than 5 minutes per inch, and that greater than 25% of the soil would be retained on a #10 C;PVP, unless a sample were selectively chosen. Thus, according to your guidelines, a two foot sand filter would be required. However, this entire area is extremely well drained, with no indication of a shallow water table, which it is the purpose of a sand filter to protect. Accordingly, for a three bedroom system on this lot, I recommend a 75' long by 5' wide drainfield with no sand filter, and the bottom of the gravel no deeper than 7 feet to guarantee a minimum of 8' vertical separation from any possible water table. Thank you for your consideration of this recommendation which would save the homeowner unnecessary expense. Sincerely, Ted Moore, P.E. cc: Pete Husky /rug a,.7 Ht1 fy = 7,5 C s 'C' = 7 IL lov 'n. o A P e ,L Ay c January 5, 1978 Charles Deming Box 41945 Anchorage, Alaska 99509 Subgect: Lot 1 Block 3 Stuckagain Heights Subdivision Permit #77630 A permit issued by this department for well and/or sewer system has expired. 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 there are any further questions, please contact this office at 264-4720, Sincerely, Health and Environmental Protection Sewer and Water Section t•l 1-i ty T a== "i. F=F :11- krx 10 F" 11 VA CD V4 CA F' FA CA F DEPARTMENT 1,,,,' HEALTH AND ENV IRONMENTAL..j:OTECTION 825 'L' STREET, ANCHORAGE, AK:. 99501 279-2511 F-4ErB_..A_. FA VAE> CA V4—_=i I -T-� E {�E F " �_'6 '�"_� � � T PERMIT NO. 77630 ) APPLICANT CHARLES DEMMING E:r_X 41945 274-4602 LOCATION STUCK:AGAIN LEGAL Li 82 STUCK:AGAIN HGTS LOT 512E 90000 SQUARE TARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 125 THE REQUIRED SIZE OF THE _,OIL ABSORPTION SYSTEM IS: F=-.EwF°TVA= =-= 9_E_VArti1_.fA= o>M E>E_.F•-Fhl= _. THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF H.TRENCH OR PIT I_. 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 OOTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). FQEwCALJ T F'EEC> _. FEE F' -IF T ®___-T'F:it,aF-=' _= T ;;--F= =:lLClv_e10 F_3F-AL.F_wAPA F' F A F_ VN F=F C 3 E=. F' L-. F= F t-A H PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER A CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. 2, A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE AGREEMENT 15 NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL. ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. ----------------------------------------- •-F-F.ge� ^= ' T F I�.F°E a==! T CA d°= F-1F`E= F'EwCALJ T F'E=E> BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPEC:TIt iN AND APPROVAL_ BY THIS DEPARTMENT WILL_ BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELJ,:, WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 [NAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAM'= ARE AVAILABLE TO INSURE PROPER INSTALLATION. F° Ew F=d t•l T T F= < F° T F' E= ", E> Ew F_- E= tl E e E= FT MfLy 'L 09 e -" I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. E: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS REjPDEL_Ey,TO INCLUDE MORE THAN BEDROOMS. ISSUED F'(v --C.I NT C:HALz:L.__: DEMt9It4F AND WELLS AS SET ENLARGEMENT IF THE V3. 0 B 22 July 77 To Whom It May Concern: On 13 Juty I accompanied ChaAtes Demmdng to W phopWtl, which a Lot 1, Block 3, Stuchagain Heights subdivision, wh"e I exam"i"ned a test pit which he had dug with a backhoe, at the location o4 his phoposed on-site sewage system. The lot " heav,ty wooded with vaAying slopes. It has neveA been developed, and aU o4 the soVA eneountehed cute oxigina2 ghound. The maximum depth ob the pit was detekmined, to be twO-ve Deet. The uppeh give 5eet o4 mateAia2 exposed was ohganie oveAbunden coveAing s.iPty sandy ghavel with some cobbles, (GM). The hest o4 the depth o4 the pit was .in loose poohly ghaded sandy ghavee with cobbles, (GP), with no in- dication ndices ion that there .i/,, any change to matehiat Uoh some depth below that. No wateA was encountered within the depth ob the excavation. In my opinion, the materiae eneountehed .in the toweA ,aaht o4 the pit i,s the type contemplated by the Municira ity o{ Anchohage to hegwUce 125 squW—Jett o4 absohpti"on aAea peh bedhoom. y6'60 Satuhn Ci&cte Anchohage 99504 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 041-021-22 ANCHORAGE Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Location (site address) Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: C, _Z Z —2_ 0 2 STUCKAGAIN HEIGHTS BLK 3 LT 1 9660 Basher Dr Current property owner(s) GRIFFITH Mailing address Real estate agent Sherrilynn 2. TYPE OF DWELLING: Fx� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 230-9336 Day phone 230-9336 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic E 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 $ ,5 5_0 Waiver Fee $ Date of Payment V gAi Date of Payment Receipt Number Q % 15 Q Receipt Number COSA # QSG Z l till 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 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 NorthRim Eng. Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng 6. DSD SIGNATURE System #1 Approved for bedrooms System 412 Approved for bedrooms Disapproved Phone 694-7028 Date 3/4/20 OF `* .49 TH *' F Steve En l� CE=szss !J, 4/2. 1*_ Conditional approval for bedrooms, with the following stipulations: .,rttttfrrf/�,. 2 nN-SITE g ATER AND r 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 Legal Description: STUCKAGAIN HEIGHTS BLK 3 LT 1 Parcel ID: 041-021-22 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 5N3/87 Total depth 86 ft Cased to 86 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 20 in. Date of flow test for COSA 3'10'21 Static water level at beginning of test 59 Comments B. TANK DATA Age of tank(s) 15.5 years Tank type/material septicSB ft. Measured operating fluid level in septic tank 50 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 3/19/21 D. ABSORPTION FIELD DATA 9/14/05 Which system tested (date installed) same ❑ ALL standpipes present per record drawing Total measured depth from grade 12.5 ft (max) Measured depth to pipe invert from grade 5 ft (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 production at time of test 6+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 2.65 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRimEng Date of Sample 3,10'21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 3110121 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 1 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date E. SEPARATION DISTANCES From Private Well onLot to: (Please enter distances Kless than required orifcommunity vmA) Septic Tank/Lift Station onLot >10O Yes Community Sewer yWanhohe,'C|eonnut >10O MYmu PmpoUyUne>1O' JNo8 Yes MYea ifNoft Neighboring Tank >10D^ Water Main >1O' Yes ifNoft ifNok Private Sewer/Septic Line >25'ElYes i(Noh Absorption Field onLot >1OO' Yes i[Noh Holding Taok>100' 21 Yes i(Noh Neighboring Absorption Fields > 100 iYNoM Animal Containment > 50' ��YeS i|Noh F, -,l Yes ifNoh Manure/Animal Excreta Storage 100' (�onnmunitySewer K3ain>�75' R1 Yes UNoh [-,-/l Yes i(Nuh From SepticlHolding Tank on Lot to: (Please enter distances if less than required) Building Foundations >10' Yeo ifNoh Surface VVate/>1U0' Yea ifNnh Property Line > 5' Yes ifNuh Wells 0nAdjacent Lots: Absorption Field >5` Yes itNoh, Private Wells >1UU' Yes itNoft Water Main >1O' Yeo ifNoft Community Wells > 200' Fv�YSm ifNnh Water Service Line >10' EYmn ifNVM |fseptic tank iaunder driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes i/Noh |fabsorption field iaunder driveway comment below PmpoUyUne>1O' Yes ifWnM Wells nnAdjacent Lots: Water Main >1O' Yes ifNok Private Wells >10O` Yea i/NpO Water Service Line >10' R-1 YesifNoft Community Wells > 200' Yea ifNoh Surface VVoter>�10n" F, -,l Yes iYNoM F. ENGINEER'S COMMENTS Ar Ar Ar G. ENGINEER'S CERTIFICATION 4 ..... certify that / have determined through field inspections and o*vie,v 0f&4unicipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. ' �Aw Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 041-021-22 1. GENERAL INFORMATION Expiration Date: —! 10 Complete legal description Stuckagain Heights Block 3 Lot 1 Location (site address) 9660 Basher Drive Anchorage AK Current Property owner(s) McDonald Day phone 230-6132 Mailing address Same Real Estate Agent Latosha Williams Day phone 678-8945780 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class C Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ Received by: Date: Z C 6 COSA to be released to the engineer, unless othe ise requested by the engineer. . COSA Fee $J to Date of Payment +t Receipt Number O COSA # %cf 6 Date of Payment Receipt Number Waiver # aa4l0 /UOSlnpy OluaSJy luOSlnpy ales;IN �oP'ZL-L-6 laa4s anl9 tlS00 AJCSlnpy MOIH IIaM AjOslnpy walsAS olldaS lSINOa40 VS00 S1N3WH0Vlly 'L ,Njom s,iaau!6ue leuoissa;wd aql ul suolsslwo jo siaja jop a!q!suodsea lou sl a6eiogouypo 61!led!3!unW agl '"Se!ypo alelS aql ul paials!6ei Jaau!6u9 11n!o leuolssop id luepuedepu! ue Rq g gdei6eied ui uan!6 suolleluesaudej aql uodn !!uo paseq (HSOO) IenoJddy swelsRS 91!S -u0 po saleoy!poo sanss! (QSO) uo!s!nl0 seolniaS luawdolnap abejogouy po Rl!led!o!unn eql /— 2—� :ale(] a;eOl;l}aa01eul6ia0 r7o,:E- , 2� :fig I jJJNG S :suo(;elndils 6uimollol ay; Ullm 'swooapaq aol leno.!dde leuolllpuo0 -panaddesld -swoapeq sol panoaddy Z# walslS Sl,uoa!paq sol panoaddy l# Ovals (S 32 nIVNJIS aSO '9 9i0Z £` a;ed ug ana;g aweN paluud s,aaaul6u3 zantg alzuH 1ZLOLL XOg Od SsaJppy SZOL-%69 auNd utxaauT ua uIRMPoN wai:j 10 aweN uollellelsul;o awl; ay; le loage ul suollelnBei pue 'saouewpio 'sepoo alelS pue ledlolunw algeolidde Ile gum aouelldwoo ul (eae)sI wa;s/s lesodslp aalemalsem po/pue Alddns Jalenn a;Is-uo aql 'uogoadsul pue u011e61ls9nu1 (w wa} pue sag 96epogouy to l;gedlolunW ay; wal paule;go uolle!wolul ay; uo paseq;eq;!yuan jegpn; l -uiejeq peleolpul ainlonj;s to adA; pue swoapaq;o jagwnu ay; jol alenbape pue leuogounl 'apes (aje) sl welsAs lesodslp aalema;sem jo/pue Alddns ja;ern alls-uo aql;eq; smogs 'uolleolldde slgl jo; saullapin0 lenoaddy swalsAS allg-up po aleollllia0 eql ul paulllno seinpaooid uo paseq 'uo1;e61;S9nu1 /w ;eq; f4!J9A I 'moloq umogs elep u011ep!Ien aql to se pus olaJaq paXl}}e leas (w /q paglliao sy N33NION3 AS N01103dSN1 JO 1N3W31`d1S '9 if more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by this system Certificate ofOn-Site Systems Approval Checklist Legal Description: t5,MX' %CA 6AZd //?W 63 L / Parcel ID: Oa / 02) 2 ZZ A. WELL DATA Well type If A, B, or C provide PWSID # Well Log (Y/N) Date completed J/ /� 8 7 Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to _$�_ft. Casing height (above ground) 20 in. FROM. WELL LOG AT INSPECTION Date of test'S-113117 2 - Static water level Y ft. tiS� ft• Well production g. p. m. WATER SAMPLE'RESULTS: Coliform 11 olonies/100 mL Nitrate � mg/�-- - --------- - - Arsenic ug/L Date of sample: / l6 Collected by: o., E _ B. SEPTICIHOLDING TANK DATA. Tank Type/Material <Srel Z __q Z7 &64. Date installed Y Tank size 1066 gal._ Number of Compartments 2 Cleanouts (Yltl) Foundation cleanout (Y/N) Depression over tank (Y/N)High water alarm (Y/N) / lV Date of pumping a Pumper A G a4 eyt c a s C. ABSORPTION FIELD DATA A ee.� Date installed .Za� Soil rating (g.p-d./ftZ or elbdrm) �. g System type -1-,-AL.. c Length �10 ft. Width 3 ft. Gravel below pipe 7S ft Total depth 12, 5ft. Eff. absorption area 690 ft2 Monitoring tube Depression over field ,. Date of adequacy test Results (Pass/Fail) 10 For 3 bedrooms Fluid depth in absorption field before test 6 in. Water added Sod gal. New depth, Z in: Elapsed Time: 30 min. Final fluid depth 4 in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo:) (Y/N & type) /✓ O If yes, give date D. LIFT STATIONA%A Date installed "Pump on" level at Datum TM E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons Manhole/Access (YIN) "Pump off' level at in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? Septic tank/lift station on lot //T 6 i� On adjacent lots lO D rf �. Absorption field on lot Z-jQ G �t On adjacent lots !f O 9f Public sewer main %B f Public sewer manhole/cleanout Sewer /septic service line 0 / t Holding tank 413 Animal containment areas �` Manure/animal excrete storage areas /0® f SEPTIC/HOLDING TANK ON LOTTO: Building foundation O Property line i(y �4� Absorption field ..S 6 Water main Water service line /_ Surface water Wells on adjacent lots /p 0 ABSORPTION FIELD ON LOT TO`. r Property line Al) �`" Building foundation /61 Y—� Water main r Water Service line A91 Surface water r/06 �'Y" Drivewayr perking/vehicle storage ,f!i C � Curtain drain '* Wells on adjacent lots—,4W,"- F. ots—,4W«F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that"I have determined through field inspections and review of Municipal records that.the above systems are in -„ conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date IM14C 4 COSA yellow sheet_2-6-15.doc t ' 'rT K' k(e&IXJZJ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcell.D. 041-021-22 FOR A SINGLE FAMILY DWELLING 0703`13 COSA ,'.' 1- I - ��� .,,`•., Expiration Date: O R 1. GENERAL INFORMATION 1. Complete legal description tuckagain Heights Block 3 Lot 1 tit 4vcation (site address) 9660 Basher Drive Oyrrent Property owners) Lawrence 3 Josephine Huskey Day phone Mailing address 7100 Cline Cir, Anchorage, AK 99507 Lending agency. •� Mailing address Real Estate Agent Mailing Address Day phone Margaret Nelson / Prudential Day phone 632-4594 3801 Centerpoint Dr., Suite 200, Anchorage, AK 99503 Unless otherwise fequested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. 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 ❑ 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 Onsite Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-slte wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat 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 Islam) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Watkins Engineering, Inc. Phone 907-349-1851 Address PO Box 110443, Anchorage, AK 99511.0443 Engineer's Printed Name Cindy W. Ellis 6. DSD SIGNATURE �C Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the Date October 1, 2007 49LH* Cino W. Ellis CE.1osn .i Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report [oili�T� By. (/ Original Certificate Date: — 0 7 mw 11W) Municipality of Anchorage • Development Services Department Building Safety Division OnSke Water R Wastewater Program 4700 Bragew Street P.O. Box 196650 Anchorage, AK 99519650 www.muni.orglonsbe (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Stuckagain Heights Bleck 3 Lot 1 Parcel to: 041-021-22 A. WELL DATA Wen type Pi If A 8, or C provide PWSID rF = Web Log (YIN) yes Date completed X13187 Sanitary seal (YIN) yes Wires property protected (YM) Yes Total depth 86 R. Cased tD 88 ft. FROM WELL LOG Date of test 5113187 Stack water level 46 R. Web production 10.12 V.P.M. WATER SAMPLE RESULTS: Coliform 0 coloniesMWml. Nitrate 3.65 mg/L Arsenic: �.� u911 Date of sample: 9X3107 B. SEPTICIHOLDING TANK DATA Casing height (above ground) 21 in. AT INSPECTION 9113107 58 ft. 3.3 9 -p.m - Other bacterie 0 colonleaM00 ml- Collected L Collected by: Rocky Trainor Tank Type/Material steel septic tank Date installed 9114105 Tanksfze 1000 gat ` •. Number of Compartments 2 Cleanords (YIN) Yes F4rrndation cleanout (YIN) Yew Depression over tank (YM) No High water alarm (YIN) NA. late of pt rMM9 NA - new i Pumper NA. House has been vacant since tank installation. ABSORPTION FIELD DATA ate installed 9114105 011 rating (9.p.dAe or ftslbdrm) 0.8 System typo deep trench 'n Lejip 40 ft. -.'Width 3 R Gravel below pipe 7.5 ft. Total di;` h a Eff. absorption area 800 4' Monitoring tube Yes Depression over field No Date of adequacy test NA - new Results (PasslFaiq Pass For 3 bedrooms Fluid depth in absorption field before test in. Water added_ gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= 9.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Data lostaOed NA Site in gallons 'Pump on' level at _in. 'Pump or level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: MaMole/Access (YIN) High water alarm level at in. Meets alarm b circuit nmuirertronts4 Septic tank/lift station on lot 109 On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent kits 100'+ Public sewer main 100'+ Public sewer manhole/cleanout 100'+ Sewer /septic service One 100'+ Holding tank 100'+ Animal containment areas 100'+ Manure/animal excreta storage areas 1017+ SEPARATION DISTANCES FROM SEPTICIHOLDINO TANK ON LOT TO: Building foundatkm 89 Property line 50+ Absorption field 10+ Water main 100'+ Water service line 100'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 100'+ Water main 109+ Water Service One 100'+ Surface water 100'+ Driveway, PO*UWvehk* storage 50+ Curtain drain NA Wells on adjacent lots 10(r+ F. COMMENTS: A new drairAleld and tank were installed 9/14/05, and the house has been vacant since then. The old drainfleld (1987) was retained, and a diverter valve installed. 0. ENGINEER'S CERTIFICATION A7 49TH 1 certify that I have determined through flea inspections and p� review of Municipal records that the above systems are in ZQdde conformance witty MOA COSA guidelines in effect on MIS date. ' Cl dy W. Ellis Engineer's Printed Name Cindy W- Ellis CE. loan ; Date October 1. 2007 `rON►+ COSA Fee $ 44 --)0 i / W )'zsa YM - Date of Payment O /01107 Receipt Number Q01008 (Rev.11MM f h� Waiver Fee $ Date of Payment Receipt Number SGS Ret# 1074830001 Client name Watkins Engineering Project Name/# Stuckagain I(eights Blk3 Lott Client Sample ID Stuckagain I[eights Dlk3 Lot Matrix Drinking Water PN'SID 0 Sample Remarks: All DatesMmes in Alaska Standard Time Printed Date/Pime 09/282007 12:02 Collected Date/1'ime 09/132007 14:30 Received Datdl'ime 09/132007 13:13 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results POL Units Mcdw Container ID Limits Date Date Init Metals by ICP/MS Arsenio ND 5.00 og/L EP200.8 C (<10) 0921/07 0927107 TK Waters Department Total Nitrate/Nitrite-N 3.65 Microbiology Laboratory Total Coliform 0 Vie.. i u 0.100 mg/L SM20 4500NO3-F D cot/100mL SM209222D A (<I) 09/18/07 JDS 09/13/07 SDP I. Stuckagain Manor Lot 14 Lot 2 Nss's . 8eptk yrq. E1 LOT 1 c' 829OW s OmN WU sa 4 _ . SCALE: LWDM� E.«ryMt P /0^ At 30 ,w 4. 4(� .war MotwMteMstnn.aoATa i2a25.00 41 - * SLGtw.w Me�wre u.zerw L'68.99 rm....rrr�eawn�wmw•wrMs p mem.r•mMerrrmmmw.PM�MMc A4 / _?_FA erew..ie1arr.. wim.mnw..w U.xt i, ineauattTsa Mecato.oTMaM Hurt l\,.•, �•'tV•F~ Mrw'�pe'e'"r`m r_pe TMWIaMONt OM 1MaI1ECOPMD Rm1.nP aeO.. A®wNATxAa Mf0OgP1 PIAT Aal MDT YlON111EPEOM. w�.MYY�. BE 1•aT �� �O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION CERTIFICATE OFINSPECTION OR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) le TI 8 k r l_" 3 !-kc':ZO.0 G:in l°�✓.'/ S%f7 Location (address or directions) a,�-CfJ /}n c,<i :9-3✓7 (b) Property Owner Telephone: Home � Business Mailing Address . 14-i c1ron2y✓2 114- 2'9,5__C-7 (c) Lending institution ��Cy (icrr�t C."L Telephone G`1 -02.n9 Mailing Address tot 66? 13ei2v4 R(ut� /�i/c1i 975 n, (d) Real Estate Company and Agent /Yr Address Telephone (e) Mail the HAA to the followina address: or: Check here,*,, if hold for pick up. List contact person and day phone number below. 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms 9 3. WATER SUPPLY Individual Well M Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public ❑ Community ❑ Holding Tank ❑ Note: If community weft system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 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MUNICIPALITY OF ANCHORAGE (MOA) y�tN1N, HEALTH AUTHORITY APPROVAL (HAA) EN�t2CtdJ fi CHECKLIST - FEBRUARY 1984 1 � '' 264-4744 Legal Description: HAY WELL DATA Well Classification pf &or` -Q If A, B, C, D.E.C. Approved (Y/N) Off Well Log Present (Y/N) r Date Completed rl t2 -1,9`j Yield le Pon �d ' Total Depth �'G r Cased to Depth of Grouting 91 4, Static Water Level '�� / Pump Set At ` r It Casing Height Above Ground 7,/ Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot _ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots rm > lea / To Nearest Edge of Absorption Field on Lot l 2 q i ; On Adjoining Lots > To Nearest Public Sewer Line ALA To Nearest Public Sewer Cleanout/Manhole N� A To Nearest Sewer Service Line on Lot N'�• Water Sample Collected by r' /-' ; Date 1 />q /8'F Water Sample Test Results 561 %'J jl c 162 y O Cao Orn / toom'Q ��� J Comments B. SEPTIC/HOLDING TANK DATA Date Installed ' ! Sizef— 24 _0 qcRI No. of Compartments c! Standpipes (Y/N) Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) Depression over Tank (Y/N) Date Last Pumped N'1¢' Pumping/Maintenance Contract on File (Y/N) At. li< ; for Holding Tank High -Water Alarm (Y/N) ' /1, Temporary Holding Tank Permit (Y/N) 'V' /1 Separation Distances from Septic/Holding Tank: To Water -Supply Well 10 Y To Property Line 'y -r f To Water Main/Service. Line` Course too ` Comments Page 1 of 2 72-026 IRP, 8/861 Front To Building Foundation To Disposal Field — 951, VJ To Stream, Pond, Lake, or Major Drainage I C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata f 7-5 M are, Type of System Design Wile Date Installed 5 Pl ✓ E1 Length of Field ��� / Width of Field S c' / Depth of Field 710 Gravel Bed Thickness / Square Feet of Absorption Area 4VI0 10 Standpipes Present (Y/N) Depression over Field (Y/N) -. N Date of Last Adequacy Test /V.//,. Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well ''--IV" To Property Line to To Building Foundation l f 3 / To Existing or Abandoned System on Lot N, A . ; On Adjoining Lots > S-Z� ' To Water Main/Service Line IV, /i To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course --- C00 ' _ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION N' A' Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) 'Pump Off' Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and•HAA guidelines in effect on the date of this inspection. Signed ,17 Date f &9/'196 Company I'(tcf/en 7`-11 (vcz� MOA No. 6'7U.S2 Receipt No. a ^y U d �� Date of Payment Amount: $ Z % O �- ��';t�° e°5, ~•`'.-� Engineer's Seal Page 2 of 2 72-026 (Rev 8/861 Beck ;r ° THEODORE F. N,Qof?E I CF - 3509 ti ®�a�a'io;cssiona�