Loading...
HomeMy WebLinkAboutMINSCH LT 1Minsch Lot 1 #051- 081- 37 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Elmore Road P.O. Box #96650 Anchorage, AK 99507 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP101180 PID Number: 051-081-037 Name: Corey Houston Wastewater System: ✓❑ New ❑ Upgrade Address: PO Box 67053, Chugiak, AK 99567 ABSORPTION FIELD Phone: Number of Bedrooms: 227-9419 3 ❑Deep Trench [I Shallow Trench 14 Bed ❑Mound ❑ Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 0.7 GPD/Ft2 6.3' to bottom of septic rock Ft. Block:1 Lot: Subdivision: Minsch Depth to pipe bottom from original grade: Gravel depth beneath pipe: 5.8 minimum Ft. 0.5 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 0.4 Ft. 43 Ft. Well: El New ❑Upgrade Gravel width: Number of lines: Distance between lines: 15 Ft. 3 5 Ft. Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Ft. Ft. 645 Fe HDPE Driller: Date Drilled: Static Water Level: Installer: Date Installed: Ft. Corey Houston 9/4/2010 Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Private Manufacturer: Capacity: From Tank Field Station Tank Sewer Line Anchorage Tank 1250 Gal. Well 103' 160' - 77' Material: Steel Number of Compartments: 2 Surface Water >100' >100' _ _ LIFT STATION Size: Manufacturer: Lot Line 22' 6' - Gal. None Present Foundation 56' 126' - - "Pump on" level at: in. "Pump off' level at: n. High water alarm at: in. Curtain Drain - - - _ Pump Make & Model Electrical Inspections performed by: Remarks: Septic system is replacement system including new BENCH MARK Location and Description: septic tank and drainfield. No change to existing Top of Sanitary Cap on Water Well (across driveway east of house) water well. Assumed Elevation: 100.0 Ft. np Inspections performed by: Rodney P. Kinney Associates, Inc. Dates: 1St 9/4/2010 o • • ... .... 2nd 9/4/2010 Development Services Department Approval /AW ���• /��� 49TH Conditional Approval Date: """" """!� 11 eco Mark A. Alder 00 �',- ' • • CE9992 ,qF' / Reviewed and approved by: Date: (Rev. 04/06) 0 F .�� ' ?: 419TH vo Mark A. Alder a� jj%r CE9992 `i\ p'otessicto�%J�" WELL 30' \ I EXISTING3 �I BEDROOM I HOUSE A IDECK EXISTING LOT 1 CLEANOUT ' I 1,250 GALLON SEPTIC TANK SWING TIE DISTANCE STRUCTURE WELL CORNER A ST1 106.1' 57.5' ST2 110.8' 65.0' C01 114.7' 68.6' CO2 115.4' 69.7' CO3 164.5' 129.4' C04 170.0' 130.3' C05 197.9' 165.2' MT1 187.4' 1 150.2' 15'x43' DRAINFIELD C05 � I ALLUVIAL STREET GRAPHIC SCALE — — — — — — — — — — — — — — — — — — — — 0 15 30 LOT 95 1 inch = 30 feet ST1 ST2 IC01 LOT 1, MINSCH SUBDIVISION SEPTIC REPLACEMENT DESIGN SITE PLAN AS -BUILT Sept. 8, 2010 CO2 ABANDONED TRENCH DRAINFIELD �L I I 15'x43' DRAINFIELD C05 � I ALLUVIAL STREET GRAPHIC SCALE — — — — — — — — — — — — — — — — — — — — 0 15 30 LOT 95 1 inch = 30 feet RwA�Yp���NB®yE. ��`� "" tmwmi „ m -sm"""` LOT 1, MINSCH SUBDIVISION SEPTIC REPLACEMENT DESIGN SITE PLAN AS -BUILT Sept. 8, 2010 FIGURE 1 15' MOUNDED 0.4' ABOVE EXISTING ORIGINAL GROUND SURFACE. GROUND in (V t6 WATER LEVEL ON 9/8/2010 1 12" SEPTIC ROCK 2.5' 0 5', TYP. O EL.=99.4' N ST1 ST2 000 1,250 GALLON SEPTIC TANK EL.=95.2' TEMPORARY MONITORING WELL TOP OF PIPE EL.=104.6' WATER EL.=89.0' (9/8/2010) BOTTOM OF PIPE EL.=88.8' —' 2' FILTER MATERIAL �— 4" PERFORATED PIPE, PORTS DOWN, TYP. 6' MINIMUM VERTICAL SEPERATION TO IMPERMEABLE SOIL OR BEDROCK rwv3nr_U UMMUt tL.=1U1.0 ORIGINAL GRADE EL.=101.4' CO3 C04 //MT1 C05 1' SEPTIC ROCK, BOTTOM EL.=94.2' 2' FILTER LAYER, BOTTOM EL.=92.2' NOTES DRAINFIELD PROFILE 1. ELEVATIONS ARE BASED ON AN ASSUMED DATUM OF 100.0' ON TOP OF WATER WELL CASING. 2. ALL PIPE ELEVATIONS ARE TO INVERT. OF AL%,��I ►* :. 49* _17vtlaaz Mark A. Alder . -4 �y '• CE9992 q ti J-0 essicOt.-' Me➢'*�pI80ybud ftliC. .� 'ww.„ � ""a&= -mm mom LOT 1, MINSCH SUBDIVISION SEPTIC REPLACEMENT DESIGN DRAINFIELD AS -BUILT Sept. 8, 2010 FIGURE 2 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchorage.ak.us (907)343-7904 Soils Log - Percolation Test Performed For: Corey Houston Legal Description: Lot 1, Minsch Subdivision 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- _FaPsvi>_ /5/L 0 �N1SY (i JtIyEC TE5 r e0)71)/" OF 1fi0's) Date Performed: Township, Range, Section: Site Plan WAS GROUND WATER Date ENCOUNTERED? No Net Time Depth to Water s IF YES, AT WHAT DEPTH? L Depth to Water After P P Monitoring? E Date: ' 'A Li 9/3/10 b 1c Reading Date Gross Time Net Time Depth to Water Net Drop 9/3/10 40 seconds 3" PERCOLATION RATE <<1 (minutes/inch) PERC HOLE DIAMETER 6" TEST RUN BETWEEN C1 FT AND 10 FT COMMENTS Percolation test only at this location. Tested receiving soil in southerly portion of drainage field. Soil was well -graded gravel. Unable to completely fill hole with water due to fast percolation rate. Estimated rate of 13 seconds per inch. PERFORMED BY: Mark Alder I Mark Alder CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9/$/2010 �- Rodney Pe Kinney Associates, inc. Consulting Engineers a Surveyors September 8, 2010 Municipality of Anchorage Development Service Department Onsite Water & Wastewater Program 4700 Elmore Street Anchorage, Alaska 99519 Attention: Ms. Deborah Wockenfuss Subject: Onsite Wastewater System, As -built Submittal Minsch Subdivision, Lot 1 Dear Ms. Wockenfuss: Enclosed are my inspection report and as -built drawings for the wastewater disposal system on the above property. The system is completed. I measured the monitoring well today, and found no change in groundwater level since it was installed 6 days ago. As we discussed, I will measure it again tomorrow for the 7 -day measurement, and call you with the results. A second percolation test was also completed as required, so the entire bed is less than 30' from a percolation test locations. Test results were as expected, with a measured rate of far less than one minute per inch. The percolation test form is also enclosed. Please feel free to contact me if you have any questions or comments at 694-2332, or via email at markakEpka.net. Sincerely, Mark Alder, P.E. Enclosures 16515 Centerlield Drive 907.694.2332 Suite 101 Fax 907.694.1807 Eagle River, Alaska www.roka.net 99577 mark's eE it 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 =C� Z 1 C� ci C"Telephone: (907) 343-7904 Permit Number: OSP101180 Tax Code Number: 05108137000 Work Type: Septic Upgrade Permit Effective Dates: September 02, 2010 to September 02, 2011 Design Engineer: RODNEY P KINNEY ASSOC INC Subdivision: MINSCH 0A ?'gm Site Legal Address: MINSCH LT 1 G:1457 Owner/Address: HOUSTON COREY A PO BOX 670533 CHUGIAK AK 995670533 Site Mailing Address: 21025 ALLUVIAL ST, Chugiak Lot Size in Sq Ft: 45026 Total Bedrooms: 3 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: 1. Minimum 7 day water monitoring must be provided. Construction may proceed at your own risk before the 7 day monitoring is complete. Please submit stamped and signed results with the as -built inspection report. If the results require a design change, construction of the system will stop pending on-site review and approval. AMC 15.65.060.B.4 2. Our files show that the existing trench is 45' long Prior to consruction, an investigation at the end of the field is to be done to determine the actual end. If the end of the trench differs from the approved plan, call the MOA Onsite department for a design change. 3. The entire subsurface disposal field and/or alternate is not within a 30 foot radius of a percolation test. 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.3 Received By: Issued By: Date: Z �� Date: ��/ Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (907)343-7904 s Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Program Dent S, Department **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP101182 COSA#: PID#: 051-081-37 Legal Description: Minsch Lot 1 Engineer: Mark Alder Applicant: Cory Houston Permit#: OSP101180 Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 6.0 feet. In addition, the separation between the existing field and the proposed is approved to be 6 feet. This waiver approval applies to the proposed absorption field. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: Ct ho Approved by: k'_'Z 4� Name of Reviewer ............................................................. ................. Rec#: 135299 Amount: $320.00 Date Paid: 9/2/10 **** VARIAN C E/WAIVER REVIEW **** Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite « , (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION I�Jalvo� psPlDllSZ FOR A SINGLE FAMILY DWELLING 05P l®ll b® Parcel I.D. 051-081-37 Property owner(s) Corey Houston .'� au �G tS''s'r Day phone 227-9419 Mailing address PO Box 670533, Chugiak, AK Zip Code 99567 Site address 21025 Alluvial Street Legal description (Sub'd., Block & Lot) Minsch Subdivision, Lot 1 Legal description (Township, Range & Section) T15N, R1W, Sec. 5 Lot Size 45,027 Sq. Ft. THIS APPLICATION IS FOR (® all that apply) Absorption Field FI Septic Tank Q Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Zip Code 99567 Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal Z I 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. Permit/Rush Fees: Waiver Fees: ZOO f /Z,.C) Date of Payment: [ "— " / L) Date of Payment: Receipt Number: 13-6 a- 5 Receipt Number: 3 5 ZR (Rev. 11/05) �- Rodney P. Kinney Associates, inc. Consulting Engineers a Surveyors .-August 31, 2010 Municipality of Anchorage Development Service Department Onsite Water & Wastewater Program 4700 Elmore Street Anchorage, Alaska 99519 Attention: Onsite System Reviewer Subject: Onsite Wastewater System, Request for Permit to Construct Minsch Subdivision, Lot 1 Dear Reviewer: The subject property is the location of an existing three-bedroom home. The septic drainfield recently failed an adequacy test and requires replacement. The site plan shows the proposed locations of the new septic system components, as well as existing nearby septic systems, water wells, and buildings The adjacent property to the east currently contains a home and onsite water and septic, both of which are shown on the site plan. The adjacent property to the west currently contains a home and is assumed to have a well and septic system, however, there are no records available through the MOA Onsite Department. The property boundary is greater than 100' from this proposed septic system. The property to the south has a septic system on the front of their lot, approximately 145' from this proposed system, with their well (location undocumented in MOA Onsite records) further away. The area within 100 feet of the proposed system is generally flat, with the exception of a small depression in the vicinity of the old failed drainfield. There are no excessive slopes within 100 feet of the proposed system. No impacts to surrounding properties are expected as a result of the placement of this system. We are requesting your approval of reduced setbacks of 6' from both the side lot line and the failed drainfield, as shown on the site plan. These reduced setbacks are needed to avoid crossing the driveway. There is adequate room for the system across the driveway, but we hope to avoid the potential freezing problems associated with a driveway. Please feel free to contact me if you have any questions or comments at 694-2332. Sincerely, -M 140C Mark Alder, P.E. 16515 Centeriield Drive ■ Suite 101 ■ Eagle River, Alaska ■ 99517 907.694.2332 0 Fax 907.694.1807 ■ www.rpka.aet �- Rodney P. Kinney Associates, inc. Consulting Engineers a Surveyors September 1, 2010 Municipality of Anchorage Development Service Department Onsite Water & Wastewater Program 4700 Elmore Street Anchorage, Alaska 99519 Attention: Ms. Deborah Wockenfuss Subject: Onsite Wastewater System, Request for Permit to Construct Minsch Subdivision, Lot 1 Responses to 9/1/10 Review Comments Dear Ms. Wockenfuss: Thank you for your quick review. The following information is supplied to address your review comments of this date: 1. 7 -day monitoring will be completed as required, and submitted with as -built report. 2. Waiver fee will be paid by Mr. Houston on submittal of this letter. 3. Requirement for existing tank to be decommissioned per code has been added to site plan, Note 2. 4. We will confirm existing disposal field ends as shown on site plan. If end is closer to proposed system, we will call as requested. 5. We believe the requested waiver of setback distances are justified for the following reasons: a) Wells on adjacent properties are already established, and will not be affected by the reduced setbacks. b) Reserved replacement area for septic system on Lot 2 is approximately 30 feet away from the proposed system, and will not be affected by the reduced setbacks. Existing septic systems will likewise not be affected. c) Drainage will not be affected by the reduced setbacks. d) The reduced setback from the failed drainfield on Lot 1 is still greater than two times the effective depth of the new system. With the measured high percolation rates, it is not expected that the flows from the new system will reach the old system, even with the reduced setback requested. 6.. Specifications have been corrected to indicate 43' bed length and are attached. 7. Labels showing flat terrain have been added to site plan. Ditch along Alluvial Street has also been added. This ditch is greater than 25% slope (approximate 3:1 slope) but is only about 30 inches deep and is higher than the top of the proposed distribution pipes. 8. Total depth of field is expected to be approximately 5 feet from existing ground surface to bottom of septic rock (or 7 feet to bottom of sand liner). This has been added to Figure 2. 16515 Centerfleld Drive ■ S0110 101 ■ Eagle River, Alaska ■ 99577 907.694.2332 1 Fax 907.694.1807 1 www.rpka.net 9. The header has been shown on bed drawing 10. See number 7 above. 11. Additional percolation test will be completed and submitted as requested. We believe these items address your review comments and questions. Enclosed are stamped revised drawings and revised specifications. We request approval of the setback waivers and also conditional approval to construct. Please feel free to contact me if you have any questions or comments at 694-2332, or via email at markag pka.net. Sincerely, Mark Alder, P.E. I s J CA SEAN STREET I /N00.06'08"W 300.06' 30' ---------------1--------------------- -- IooLf) yI MM0M I r-cn mom I o- D i > nm r. U) I M= rD = D O r O cn z 00 I Im I 0� r` Km CA O I � cn y M> vl MI 1' M zz �I z � mom; �z \ S���d �1 I M y O cn 0 cn C CA mO QU=O 017 m 0 I� �pv 0;u 7- D� o oo� o M. D' \ zZ m c�z 0��0 I N Z E& mew Cli c o / \ I M — - D I 1.5� L _ -- - - ,ZL-00� 3.09,99 -COS 1 D 1 D z-0 �D � (7 D m M 00_ D D M C) oN z CNr�� �Zxz 7M>c p m / GtJ� z c� �,zpZ ZO:ZIrg: COG)=� -0nr= D = c� D0�•• C COOOm z o O x> 1'U'C� pp��O o I M N x mzw 0 ;u Omm o� Dp < D>z�Cc) o Z7 -U ;u M rp a 0)F p rnn�D�) N� Cn � � o� M. 00 v 0)cn w N� = DOA XK pD WIM0 M Dp m�Ocn 0K:> 1 m �zno.. CO I r Mpri DD Cox XDxm 0Cr I M zC W C» 0> 0nz -u 0 0 W DD-' W 00Q WN nOz �< .ZO7Z ={T. j� �C7C� •• o rn I i o Mme �o �i0 rm pm 0�c �Z -(>Do c� z 0 C r0 Dr D --I DN M D< M DAN z z p � r r D r W �m z m z � hoz D� nz x> cN m,n zN�� �c X m �p 'Up Dm= --j --j `L—r ON 00 I D N .zmly �� pmr aom �m N=<= -q --j M O- mm or mcn =� =Dpi D0 < 0 0 m x -u m m z ;aM r D r D X o pm p X>M co rno �D r T�Zao == m -z•I D N 0 0 M s.-. -u --i Q m X Z r fD (� Dp D zoz z :Um °m°c� OD z- X m z M m N �O OX XC> ;a� g Om0m—iz 0 0 z(n m mD� o D z <D p z D m C � \ -n= 0 r�D mr mn QM r D z M Z.i Fri > Pyr cD ptn nmO= mm r z m r r C m 00 �0 OD O�zx DZ m rzrr z N �xhr Nr m /A0— I? i.1 •.?'�.- -4 : I.� '..�1' N = O� nD O NOm mcg m n m O D y 0 S r > coM z M Z z> > 0 O �] G� m— 02 m -=z mp z �° cI w I� O� m ao Oz ND - 0=mX �D m m� .�/ p m zz cnr m m z �z mcnm- �m z t ` : �`�// z N zp 0Dn0 o* \ er �}� �! M MM z z nodneyPi,NinneyAsSociates,inc. SITE PLAN - LOT 1, MINSCH SUBDIVISION (REVISED) — I lr.� SEPTIC REPLACEMENT DESIGN September 1, 2010 FIGURE 1 ftftmftmwb[Wswnn 0 swunftm N O \ N \V/ x I 0 o � o� m N �v E&T E&T —\—� M \ \ G G G O O � o \ -0U'- � I cn — — O — N _ — m — v - - 0 z T z OT -z v xg-n Dz �zM -Z 00 CA 'v! 0 rn0 M < im 0 D Dmm < DO M x ZMOZ N GO <0 � v— D z*"a nD CA D xw mcmq p D O DD �m Dmv M> D� _m n F �o n=oma m F ym �F vc $m NF y^,m NF �c� A 0 N� � �z v 0 �0 �w D N-U� rnv mNom m� O� DD_ vja a Fi 0 M� � D �C z0x_ 0 �o Ovm 0ODD� Z cn mil �� D^ ��� nm ODS C0 Tm :3 E; 0vm �m m� vy n=G zn Nz0 ami m� Dmmz D mm � m v � � � � z 2�OD 70C A N i,i ��� z 0-U; O Fri7C o c GOD c � mog oX v O v J Z f�a O ; v 0 N 0 cn 0 U) ZZ (oz;z vz vDK D M:* Z� 5' ;O_ o� D2 D ca C7 D - VI m� m r Dc D N gc:Z n L mmn Mom o;u O �Do z vmv M v U o �rn o rl �Z ZON C r O M r, (A aDor�* �'� 0u M cD F� Nn rn� coO D X_ gr- ,D Or r A D 0 M N �� ca ;u m aDN O> WO OZ <o az -� 00 :ol Z� O "D/ m c MRA i �08 II1A;,�e , �wAW m N \\ er � 0 O 05 AM X RedueyP.M118VASSocilletinc. LOT 1, MINSCH SUBDIVISION SEPTIC SYSTEM PLAN (REVISED) �,�:� SEPTIC REPLACEMENT DESIGN amuann •...nhm September 1, 2010 FIGURE 2 Municipality of Anchorage Development Services Department Building Safety Division y� On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchorage.ak.us (907) 343-7904 Soils Log - Percolation Test Performed For: Corey Houston Legal Description: Minsch Subdivision, Lot 1 '%.NGIP4EER7 GW_'8% ?. 49TH .............................. '. Mark A. Alder l aaj. ' • CE99 /2 q AW Date Performed: Au ���0W -tAl.0 g,-? �,Z1� i D Township, Range, Section: T15N, R1 W, Sec. 5 Site Plan FA WAS GROUND WATER ENCOUNTERED? Yes s IF YES, AT WHAT DEPTH? 11.8' BGL L Depth to Water After P P Monitoring? 11.8' E Date: 8/30/10 Reading Depth Gross Time Net Time (Feet) Net Drop 8/30/10 1- 2" 2- T D?..�OsL /SILT 3- 4- 5- a 6- Z. Tea r 7- -8-9- 8- 9- 10- 10- 11- 11- 12- 12-13- 13- tt'T 11 0 '%.NGIP4EER7 GW_'8% ?. 49TH .............................. '. Mark A. Alder l aaj. ' • CE99 /2 q AW Date Performed: Au ���0W -tAl.0 g,-? �,Z1� i D Township, Range, Section: T15N, R1 W, Sec. 5 Site Plan FA WAS GROUND WATER ENCOUNTERED? Yes s IF YES, AT WHAT DEPTH? 11.8' BGL L Depth to Water After P P Monitoring? 11.8' E Date: 8/30/10 Reading Date Gross Time Net Time Depth to Water Net Drop 8/30/10 20 seconds 2" PERCOLATION RATE <<1 (minutes/inch) PERC HOLE DIAMETER 6" TEST RUN BETWEEN 6 FT AND 7 FT COMMENTS Unable to completely fill hole with water due to fast percolation rate. Estimated rate of 10 seconds per inch. Sand filter liner required. Ground water monitored 2 days after test hole dug - no change. Due to high permeability of soils, believe water level stabilized in that time. PERFORMED BY: Mark Alder I Mark Alder CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: August 31, 2010 ON-SITE WASTEWATER DISPOSAL SYSTEM GENERAL The scope of this project includes the installation of a new on-site wastewater system serving an existing 3 -bedroom residence. The new on-site system will include a new 1,250 gallon septic tank as shown on the Site Plan. The system will also include installation of a 43' long by 15' wide drainfield bed as shown on the site plan. The new drainfield shall be placed a minimum of 1 00'from all wells in the area and 100' from any surface water in the area. A minimum of 3' of cover is required over the drain field and 4' of cover over the septic tank. The septic tank must be constructed of 10 gauge steel if it is to have more than 4' of cover. The existing tank shall be decommissioned per Code. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions and all applicable State and Municipal Wastewater Regulations. 3. The Installer shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verifications of the locations of all lot lines. The Installer must also verify the location of wells in the area and assure the separation distances are met. The Installer must provide field survey notes to verify the layout of the septic system and to ensure no encroachment into easements or lot line setbacks, unless otherwise approved in the permit. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Building Safety On -Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the On -Site Water and Wastewater Program before beginning system installation. SEPTIC TANK INSTALLATION A new 1,250 gallon septic tank must be procured from an approved source and installed at the location shown on the site plan. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above the final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. The tank shall be connected to the existing 4" cast iron sewer service line. A foundation cleanout is present in this line, immediately adjacent to the house deck. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the bed shall be level throughout. Minsch Subdivision, Lot 1 9/1/2010 1 of 2 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock extending 6" minimum below the bottom of the piping. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below the distribution line must be perforated. 5. Installer shall verify the septic tank and drainfield are a minimum of 100' away from any private water wells in the area, 150' from a Class C well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the drainfield to drain away. 8. A minimum 2' of native accepting soil stratum must be present below the bed bottom. MATERIAL SPECIFICATIONS 1. Septic tanks must be constructed by a municipality approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage. Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated but not solid) and ASTM D2662 or A.B.S. (perforated or solid). 3. Insulation, if required, shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be 0.5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. In addition, the property owner must furnish an as built of the lot showing the location of the house, septic system and other above ground features for use in preparation of the septic system as built. Minsch Subdivision, Lot 1 9/1/2010 2 of 2 s., p 4- < c ► N o a .- 4) lav, C EA,y 18C , /�J( l C vv-- -4 4bv-14-ov\j i, v be c r -s LI sQ P � I -C S �-/ s -4-e evi s _ 4ic, 1 e 4- b t ct s y,54 -e- m t z s 4-- yezv Ce) I hzVt VIA`( Uwe (4� mLVL4-- � P I 3 1-�(�s� n w Cvv e� I ( 6c row c j �c cvkCL (VI CiZ)I, � J sys-�e� V, C-)�- P2yIY,y obtie 5 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Health Division CASE REVIEW WORKSHEET CASE NUMBER: - S-7795 'DATE RECEIVED: August 2, 1984 COMMENTS DUE BY: August 17, 1984 SUBDIVISION OR PR ECT TI E: Lots 1, 2 T is Subdivision r ( ) PUBLIC WATER AVAILABLE O PUBLIC SEWER AVAILABLE COMMUNITY WATER AVAILABLE COMMENTS: I 'f ,) _ I � UGGe(5,-L4' 5? 1.�G^ `� V r S a s /� 71-014 (Rev. 5/83) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST r-Z PERFORMED FOR: �j M lso�N DATE PERF RMED: lk v / \ LEGAL DESCRIPTION: Scc'_ � �/ � 0 ! f! L-A SLOPE SITE PLAN PT F E 1 2 ^� 2 vs. Vc2. 3 C1 4 %o a' L� U -A 5 6 8 ®a j l�,y �� 2"N, vsz' 9 a `P'> 10 •�� / D �/p fL WAS GROUND WATER L 11 tT • ��L�/ ENCOUNTERED? O �• x �- 12 IF YES, AT WHAT DEPTH? LLLL//// 13 g CST'jZ� �`R fjF" /'d— SOILS LOG ❑ PERCOLATION TEST k+ LA V 1 Reading Date Gross Time 14- 41s Depth to Water Net Drop ^ / V 15- ��� ~• eta 16- or r.%I• 6g 17 :r. 18 bb■A A. L1.■1■t w • No. 1I51•E �'++t'� •• t� .�� Reading Date Gross Time Net Depth to Water Net Drop ^ / V Q 20 ��..aa..a.'�" PERCOLATION RATE (minutes/ inch) TEST RUN BETWEEN F AND FT COMME VAZ)V IV PERFORMED BY: X961. 13, CERTIFIED B `l/ DATE: 1 72-008 (6/79) .. . MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 i� SOILS LOG - PERCOLATION TEST PERFORMED FOR: 1 i 1 ISL -o DATE PER LEGAL DESCRIPTION: r�,- Jac- !S L � �`4 SISI nP COMMENTS SOILS LOG ❑ PERCOLATION TEST .Jr' ( . SITE PLAN Read' Date Gross Time 2 Depth to Water Net Drop / !V 4-% /%C- 5 6 Q m i 8- o'a SA">`( 1>1 Cq 2A 9- 10 10 d „ der 0 12 13-2 r 14 15 _w.~ A4 4. 40 6"s �a ... 1457 19 Q49FOPR•f` .c 20 t0.Cr. COMMENTS SOILS LOG ❑ PERCOLATION TEST .Jr' ( . SITE PLAN Read' Date Gross Time Time Depth to Water Net Drop / !V n H PERCOLATION RATE Al (minutes/inch) TEST RUN BETWEEN F AND FT PERFORMED BY: 72.008 (6/79) T• ' � r -, SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST OLArION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �1r1 ISC -N DATE PERFORMED: l r' v / LEGAL DESCRIPTION: Jac S /t "IIA/ �' T—% cnoof CITF PI AN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS 6e4A-T'A 1 c' S�^Ic C12✓r:�L— OT7-a 1lR 01= } rot- •. No. 1457.5nor ' •. : ��. ` PAO� t�,S�` #4• M WAS GROUND WATER A L ENCOUNTERED? �'� O P E IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop �li■ii■���i■ ^ / V Ali■■■■■■■■ A w■■i■■■■i■ 111EFESEEN■W M KIM■■■■11■ ■■N■■■■■IN■ MMMEN■■■��■ 11■■■■■■■E■ tl■■■■■■■■■ M■M■■■■■■■ Nuffim .MEM■■ Reading Date Gross Time Net Time Depth to Water Net Drop ^ / V A PERCOLATION RATE / (minutes/inch) TEST RUN BETWEEN F AND FT PERFORMEDBY: 72.008 (6179) — SOILS LOG MUNICIPALITY OF ANCHORAGE ❑ PERCOLATION %•I DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST II 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: �I`�� r' I `SC -N DATE PERFORMED: /• LEGAL DESCRIPTION: �A/ 5117,f SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 C5v-CSP-r'l I L Iia 2 A, VEL - L1 4�1 v� �Ay / SV Sart >� U 2Av� k r IR,,- WAS GROUND WATER A , ENCOUNTERED? L P F IF YES, AT WHAT DEPTH? T Reading WEN "1 1ION Gross Time Net Time Depth to Water tl■■�■S-i =W fir■■ ^ l ■■■Cry'■'■■■■■ on NINE tl■!r I■■ ■■■■■■■■■■ T Reading Date Gross Time Net Time Depth to Water Net Drop ^ l PERCOLATION RATE �� (minutes/inch) TEST RUN BETWEEN F AND FT "s�jy wAi>V IV 9tiS ,• PERFORMED BY: CERTIFIED 72-008 (6/79) 'a - MTJNICIPALITY OF ANCHORAGE Heal, and Environmental Protec+ n Fourth Floor West may_ 825 Z, Street Anchorage, Alaska 99501 279-2511, x 224, 225 ----____----INSPECTION REPORT C)N--Slit; U WAGE DISPOSAI_ SYSTEM dr3& 7v 1. MAILING ADDRESS-�--- - ----- --- PHONE LEGAL DLSCRIPTION __ L-_.g'_�{---- C_. r IS N rA! co SEPTIC TANK: DISTANCE/ / NUMBER OF FROM WELL.! 1 U_-___- MANUFAC:TURFR---��r� E,1AI_FRIAL �\_�--_-__----_COMPARTMENTS_. INSIDE LENGTH-_----- INSIDE WIDTH. _._ -_-_ LIQUID DEPTH LIQUID CAPACITY—LO-00'ALLONS. TILE DRAIN FIEI_D:��-P � �1 E ( TOTAL LENGTH / DISTANCE FROM WELL J -1047 -FOUNDATION �. _NFAREST LOT LINE _ _ _-.-_OF" LINE # of Lines --A DISTANCE BET'WEEi,l LINES _-Alk____TRENCH WIDTH! IN. TOTAL EFFECTIVE ABSORPTION AREA _ ____O ----SQ. FT. LENGTH OF EACH LINE- _ i DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE _ _ __._ MATERIAL BENEATH TILE ___ � IN. ABOVE TILE SEEPAGE Pi r: DIAMETER _—_._OR WIDTH._-., LENGTH_.., DEPTH _.__-f Log Crib - �Rings� Crib Size: DIAMETER ____-DEPTH- DISTANCE FROM: WELL-_�_��_. - TOTAL EFFECTIVE BUILDING FOUNDATION__. , NEAREST LOT LINE ABSORPTION AREA (WALL AREA) - SC. FT. Well p Class Depth: _ Well Distance To: Lot Line _ Bldg: -f Sewer Line: Pipe Materials:� (� � # of Bedrooms: —' � _ Installer: Remarks: _ DATE �����_�__ APPROVED " ����������� �� ��������� DEPHRTTel ENT OEHLTH AND ENVIRONMENTHL R^~ ECTION ~^ ` 825 'L' STREET/ HNCHORHGE/ HK99501 - 279�2511 . . �E'. F� P.,11 EE lFe ��IF 11-1 f� PERMIT NO. ( 77840 ) HPPLICANT LOCHTION LEGAL L84 SEC F. If R114 PO BOX 651 CHUQIHK LOT SIZE 108900 SQUHRE FEET TYPE OF SOIL HBSQRBTION SYSTEM IS: TRENCH MHXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)� 85 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� E.- 6.'E P��= � �t���������� CK kHU�' F11-11:= "� THE LENGTH DIMEN5ION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFHCE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN F'EET'). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ������� ������ ����� �����= ����� ������� H PHCKHGE PLANT' MHY BE INSTALLED HT THE PERMITTEE'S OPTION SUBJECT TO THE � FOLLOWING CONDITIONS: � 1. EITHER H CLASS I 8R II NSF APPROVED PLFiNT MAY BE INSTFILLED. � 2. H CUNTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF H MHINTENHNCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL HBSORPTION SYSTEM HND/OR YOU MAY BE SUBJECT TO PROSECUTIOr.l. ���� ��� ��������������� ������ �����������M: BACKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION HND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. �MINIMUM DI STANCE BETWEEN H WELL HND ANY ON—SITE SEWAGE DISPOSHL SYSTEM IS 100 FEET FOR H PRI VATE WELL OR 200 FEET FOR H PUBLIC WELL OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE.- TO INSURE PROPER INSTALLATION. I CERTIFY THHT 1: I HM FHMILIHR WITH THE REQUIREMENTS FOR ON~SITE SEWERS HND WELLS AS SET FORTH BY THE MUNICIPHLITY OF HNCHORHGE. 2: I WILL INSTALL THE SYSTEM IN HCCORDHNCE WITH THE CODES. � ]� l UNDERSTHND THAT THE ON—SITE SEWER SYSTEM MHY REQUIRE ENLARGEMENT IF THE B ROQMS � RESIDENCE 15 K��VuE" . � SIGNED ,pt � r�` ISSUED B �^ ___DHTE_z 0 Ft E GEO%11.,CHNI CAL Ef DEVEL�._,'MENT CO. \� Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Earl Ellis Russell Oyster SOIL LOG 688-2280 694-2774 Land Development Soils Er Foundations Performed for: Name: `�\ \ �\��>"�= Tel. No. Mailing Address:-, Legal Description: Depth (feet) Soil Characteristics ,- �, �� L_ j t'o ti> �h �y i� >;�('i_✓ \r-1 i-C l=� \?.:sY�"> ,` V:�� `Y�'i.`! 2 L 3 4 5 6 ( �' "`� "- � °� •~` r'7 -_ , 1, �'� P. `i t \---- \i 'i.s`-'Y �� �� , � �� 1".��'s�l `i L -'' �t/�z 7 8 9. 10 11- 12-- 13 11213 1L 15 16 Ground Water Encountered: YesNo If yes, what depth Proposed Installation: Seepage Pit Draln.Field- Comments : �j + n Performed by: �� ,� -�f k- Date:_I yfA4, C�o IC6 CAD .it�t� ,..c�rLr�i by A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 TELEPHONE 694-2588 OWNER OF LAND r/-/ (.0 s c ADDRESS r"'„ DEPTH OF WELL Ft. to (:!4 STATIC LEVEL OF WATER FT. LEGAL DESCRIPTION±'J6'l' Ft. �,)t:7 TcA.) 4teltj /2•Y Crzi 6 4 DATE -Started. Ended 2_2 DRAW DOWN FT. PERMIT NUMBER 1r7� Ft. to Ft. GALS. PER HR _�/V r /0 KIND OF CASING KIND OF FORMATION: From Ft. to _Ft. CJ VfZV,',J,) gwy,:,,�j From - Ft. to (:!4 From—Ft. to Ft. ky i,-' r q - From — Ft. to Ft. From- j4" Ft. to Ft. Aeu,�7 From Ft. t0�/)_,2Ft,&."/:- From —Ft. to Ft. From Ft. tO,---Ft–. From L -) Ll Ft. t0–LY—C)Ft..a_6cJC ee4r' From Ft. t0l�_�Ft. From Ft. to. ,Ft. 3T- C4._)4- From Ft. to From L Ft. to Ft. � 7—Ft. From Ft. tQ_Ft. From —Ft. tQ�Ft, From Ft. From—Ft. tO�Ft. to Ft From Ft. to Ft. From —Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to—Ft. From —Ft. to Ft. From Ft. to Ft. From Ft. to Ft. � From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft, From Ft. to— rt MISCL. INFORMATION: DRILLER'S NAME M tj P4 DEPAP;qVIENT HEnLTH AND EPTy'IRI-INMENTAL czj F 825 JTECTION TREET., ANCHORI:!IGE., 99561 1:-_'ERVfIT NO. F_=7 264­47`20 AF"PLICANT LEESl 11 1 1 ".,/HAp LOCA-1-ION P F_'O Fz"X. 1-977 E. R. LEGAL S5T15NRlfJLT. 84 69-4-258,6: MINIp11-il-.1 L:,,- LO T 100 FEET A - F'R. 1 '-00000 SQUARE FEET . _;TANC-E BETWEEN A WELL AND A NY HTE WELL OR 2CU-3 E SEWAGE [JI�SFI-ISRL SYS TEUl WELL LOG-s; ARE REUL11" FEET FOR PUBLIC WELL-,. 'REC, Apg-, MUST BIE RETURNED TO OF THE WELL C.01,11PLETION. TPIE DEPi-qRTMENT OTHER REC.-UIREMENTS t,-IA,.r, 1-4 .1 TH I N ]. 0 [,jAVS AVAILAF=,LE To AF.F.1 ­ Y. _SPEl_-*IFTCATIj-jp4c; INSURE PROPER INSTALLATION, AND CONSTRUCTION DIAGRI-_IMS, FIRE CERTIFY, THAT FZE P1 U=. El FAMILIAR wjf,l-1 THE REGUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE M1IP-411 IPALIP-r- OF ANCHORAGE. 2: 1 WILL IN-STA-LU'THE SYSTEM IN ACCOR4DANCE WITH THE CODES. SIGNED: fiPPLICANT LEE SULLIVAN ISSUED EY--__ ---DATE 0 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4567 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED MAILING ADDRESS PAF SEEPAGE PIT PERMIT NO. PHONE DRAIN FIELD .__ OTHER^ -D By NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TE FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY T DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT _ TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, SEEPAGE PIT TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARI If G.A.A.B. OR LICENSED DESIG 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUI DESCRIBED SYSTEM IS IN ACCORDANCE WITH SA DATE r / APPLICANT'S FORM NO, EQ -016 SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM • Municipality ®f Anchorage n On -Site Water and Wastewater Program Will 061 (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 051-081-37 Expiration Date: 1. GENERAL INFORMATION 2. Complete legal description MINSHC LOT 1 Locatlar'(stte address) 21025 ALLUVIAL STREET Current..Property owners) RENE AND JULEE TRUDEAU Day phone 538-3889 Mailing address; 21025 ALLUVIAL STREET CHUGIAK AK 99567 Real Estate Agent TYPE OF DWELLING: Single, Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE. OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well x❑ Individual K Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: NONE Received by: Date: 6Z2=31l6 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment / T 6 Receipt Number Waiver Fee $ Date of Payment Receipt Number COSH# DSS/6/ZY3 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm C&M ENGINEERING Address 30840 PRUDHOE BAY AVE Engineer's Printed Name CHARLES BALZARINI 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Phone 854-5558 Date 06/15/16 bedrooms, with the followir By `^ �r� Original Certificate Date: (9^23 6 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAbluesheel f c if more than 1 septic system is on the lot: COSA Checklist # f of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: M J NP f Cy 1-07- 1 Parcel ID: ©Jct - 001 —3 7 A. WELL DATA _ Well type '7 If A, B, or C provide PWSID ## Well Log 49N) J,'//G 5 Date completed /to�ta?Sanitary seal �N)_)g7 Wires properly protected ION) Yts Total depth j 5 7 ft. Date of test Static water level ..Well production Cased to i!�Lo__ft. FROM WELL LOG ft /to/ tK 71 MIA' g.p.m. Casing height (above ground) o;7-q_in. AT INSPECTION 6/©f /16 WATER SAMPLE RESULTS: Coliform N�( colonies/100 mL Nitrate AJO mg/L Arsenic+f 1s O ug/L Date of sample: of /Ib Collected by: B. SEPTIC/HOLDING TANK DATA G Tank Type/Material �%L Dateinstalled 't n '1(9e4/st0%d Tank size to 5D .- gal. Number of Compartments Cleanouts 49N) YES Foundation cleanoutj'N) )� Depression over tank (Y69 eO High water alarm (YQ9 1,10 Date of pumping5/do / i% Pumper 5*N_ri 4R Y (P011 A_ 5 C. ABSORPTION FIELD DATA Date installed 1114 o1910 Soil rating (g.p.d./fe orltiffi�) 0-7 System type i�c_ D Length 14 3 ft. Width Jc ft. Gravel below pipe Total depth 16 . ft. Eff. absorption area b LlS fl? Monitoring tube )(65 Depression over field N© Date of adequacy test ©6/01 1/lb Results ( a-�5 /Fail) For 3 bedrooms Fluid.depth in absorption field before test ® in. Water added gal. New depth 0 in. Elapsed Time: i© min. Final fluid depth Or in. Absorption rate >= NS© g.p.d. Any rejuvenatibh treatment (past 12 mo.) (Yl4j�, type) NONC iGMx✓� If yes, give date A,/y4 D. LIFT STATION No 4TF7- Date installed — Size in gallons "Pump on" level at ' in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Manhole/Access (Y/N) "Pump oft"level at in. High water alarm level at '1 in. Cycles tested . Meets alarm & circuit requirements? ^- Septic tank/lift station on lot 4 lm Absorption field on lot 4100 Public sewer main -F loo' Sewer /septic service line -h 5o' Animal containment areas -F 16b' SEPTIC/HOLDING TANK ON LOT TO: On adjacent lots t t w - On adjacent lots * tclp- Public sewer manhole/cleanout -Hw' Holding tank +lay' Manure/animal excrete storage areas -f-tav' Building foundation r 5 r Property line +S— Absorption field 15 Water main $10' Water service line 4 lo'` Surface water 4 fw Wells on adjacent lots 4100' ABSORPTION FIELD ON LOT TO: Property line 1�' 6 Building foundation +15 Water main + lo' Water Service line 4-1 Surface water Driveway, parking/vehicle storage Curtain drain 4 50' Wells on adjacent lots +lto' F. COMMENTS + AR5L'A1.-tG 142 -2522 l ZECoarrr ,,P -N ED G. ENGINEER'S CERTIFICATION l 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 C HARIS5 l-7 41-H4pXxg-, Date 96/17//,40112 COSA canary sheet_2-6-16.doc Municipality of Anchorage Development Services Department z _ Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC 161243 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1 of Minshc Subdivision. This inspection revealed an arsenic concentration of 11.6 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsi ) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 05108137 COSA# 05C L 1 l d(v-7 1. GENERAL INFORMATION Expiration Date: Complete legal description MINSCH LOT 1 Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address 21025 ALLUVIAL STREET *CHUGIAK AK 99567 SAM BRUCE & DEBORAH BONTEMS Day phone 21025 ALLUVIAL STREET *CHUGIAK AK 99567 Day phone PATRICK JAMES W/ KELLER WILLIAMS Day phone 242-7653 101 W. BENSON BLVD SUITE 503 ANCHORAGE AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 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 On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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 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 andlor wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LfD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Phone 337-6179 Date tit QQ�DO 4 .::.. .9 ffA. arne s: VE -7953 v� ofessio�°o OF ON -VE `X: WATER AND bedrooms, with the following stipulations = ; WASTEWATER _ PROGRAM Attaenrr:ents. COSA Checklist L✓ Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory r,!� . / vu icy f By: ` ��� Original Certificate Date: P (Rev. 11/05) Municipality of Anchorage �F By • Development Services Department` ........... Building Safety Division On -Site Water & Wastewater Program S R i 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: MINSCH LOT 1 Parcel ID: 05108137 A. WELL DATA *BASED UPON SURROUNDING WELL LOGS. Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (Y/N) Y Date completed 11 /10/77 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 157.16 ft. Cased to *40'+ ft. Casing height (above ground) 12+ in. FROM WELL LOG Date of test 11/10/77 Static water level UNK ft. Well production UNK g,p,m. WATER SAMPLE RESULTS: AT INSPECTION 8/26/2010 23 ft. 2.3 9 -p.m. Coliform � colonies/100 ml. Nitrate N mg./L. Other bacteria V Arsenic:&�E ug./L. Date of sample: 3/2/2011 Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping NEW Pumper C. ABSORPTION FIELD DATA BELOW EXISTING GRADE Date installed 9/4/2010 Soil rating (g.p.d./ft2o /bdr 0.7 -colonies/100 ml. GEG Ltd. Date installed 9/4/2010 Cleanouts (Y/N) YES High water alarm (Y/N) N/A System type BED Length 43 ft. Width 15 ft. Gravel below pipe 0.5 ft. Total depth *7.6 ft. Eff. absorption area 645 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) 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 >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump ofP' level ater alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *6'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WAIVER GRANTED WITH PERMIT G. ENGINEER'S CERTIFICATION � I certify that 1 have determined through field inspections and ,� • q- • ,� QQ review of Municipal records that the above systems are in ...... "' ' ' ...... ......... conformance with MOA COSA guidelines in effect on this date. QO • • Gar ss.: Y Engineer's Print d Name JEFFREY A. GARNESS X49 CE 7 53 0�`d 0 ' • do G> Date Ir �, , ./r 0 '' Ak�ofessiov%o\ COSA Fee $ +;'5' Waiver Fee $ Date of Payment '3101/11 Date of Payment Receipt Number 'S- Receipt Number (Rev. 11/05) SGS Ref.# 1110729001 Client Name Garness Engineering Group, Ltd Project Name/i# Minsch S/D Lot I Client Sample ID Minsch S/D Lot 1 Matrix Drinking Water Printed Date/Time 03/08/2011 14:01 Collected Date/Time 03/02/2011 8:02 Received Date/Time 03/02/2011 13:15 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date [nit Metals by ICP/MS Arsenic 8.86 5.00 ug/L EP200.8 C (<10) 03/02/11 03/07/11 NRB Waters Department Total Nitrate/Nitrite-N ND 0.100 mg/L SM20 4500NO3-F B (<10) 03/03/11 LCE Microbiology Laboratory E. Coli Negative 1 100ml- SM20 9223B A 03/02/11 DLC Total Coliform Negative 1 I OOmL SM20 9223B A 03/02/11 DLC ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENCRO�(CHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE TKEXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION FLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONs,'TRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. S.EWARD & ASSOCIATES LAND SURVEYING A g 4 -r) (; ) ,: SCALE: DATE. GRID: - - I - ���y_sI- F S: DRAWN: _ .*:,*, v OF Al .f ;ry Du Mgri n•rr I;�nb�9 v `'s — k,3 d X Municipality Of Anchorage ® Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite V (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL NI. FOR A SINGLE FAMILY DWELLING Parcel I.D. 05108137 1. GENERAL INFORMATION COSA# DSC, I©JZ.DI Expiration Date: / 1,12 - / Q _/ O Complete legal description MINSCH LOT 1 Location (site address) 21025 ALLUVIAL STREET *CHUGIAK, AK 99567 Current Property owner(s) COREY HOUSTON Day phone 227-9419 Mailing address Lending agency Mailing address Real Estate Agent Mailing address PO BOX 670533 *CHUGIAK, AK 99567 Day phone PATRICK JAMES W/ KELLER WILLIAMS Day phone 242-7653 101 W. BENSON BLVD SUITE 503 ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 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 On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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 seal affixed hCiCe`G an as of the 'validation date sl 107i" belwv'v, i veli y LlI �"y investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the, an- `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. l further verify that based on the information 'obtained from the Municipality of Anchorage files and from my investigation and inspection, the r 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 Address GARNESS ENGINEERING GROUP, Ltd. 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE _1 Approved for bedrooms. Disapproved. Phone 337-6179 Date ,i l !d �. OF.A� �s�4 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report P11MtraL AdviSCiy Other CE 77-o _•' vp C' rA�� eapro f essio�o\ �o �00000�YtOFf�f��� ON-SITE : c WATERAND ; in= : WASTEWATER PROGRAM ; `0 '�ENi'SE� By:— ? Original Certificate Date: (Rev. 11/05) Municipality of Anchorage Developments Services Department Building Safety Division Y. . On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: MINSCH LOT 1 A. WELL DATA *BASED UPON SURROUNDING WELL LOGS. Parcel ID: 05108137 Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (Y/N) Y Date completed 11/10/77 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 157.16 ft. Cased to *40'+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 11/10/77 8/26/2010 Static water level UNK ft. 23 ft. Well production UNK g.p.m. 2.3 9— p.m-WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate _ND mg./L. Other bacteria 0 colonies/100 ml. Arsenic: 10.4 ug./L. Date of sample: 8/24/2010 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 9/4/2010 Tank size 1250 gal. Number of Compartments 2 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 *BELOW EXISTING GRADE Date installed 9/4/2010 Soil rating (g.p.d./ftZor Z/bdrm 0.7 System type BED Length 43 ft. Width 15 ft. Gravel below pipe 0.5 ft. Total depth *7.6 ft. Eff. absorption area 645 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) 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 >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — D. LIFT S iATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main NSA Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *6'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WAIVER GRANTED WITH PERMIT G. ENGINEER'S CERTIFICATION o �F I certify that I have determined through field inspections and 4 T review of Municipal records that the above systems are in �' . . . . . • .. • ' . . . . . . . . . . . . . conformance with MOA COSA guidelines in effect on this Q date. J r A. Gar ess., Engineer's Printed Name JEFFREY A. GARNESS Q Et79P3 Date g I d O�� e^eoc • � � . \foo _rofesslo� COSA Fee $ C" f I S a Date of Payment �I Receipt Number 0-7s'775' (Rev. 11/05) Waiver ISO Date offPPaym t® Cl /0 R> ipt Number 0-751-1 i SGS Ref.# 1104372001 LOQ Units Client Name Garness Engineering Group, Ltd Printed Date/Time 08/27/2010 8:35 Project Name/# Minsch S/D Lot 1 Collected Date/Time 08/24/2010 9:00 Client Sample ID Minsch S/D Lot 1 Received Date/Time 08/24/2010 10:20 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Parameter Results LOQ Units Method Container ID Allowable Limits Prep Analysis Date Date Init Metals by ICP/MS Arsenic 10.4 * 5.00 ug/L EP200.8 C (<10) 08/24/10 08/26/10 KDC Waters Department Total Nitrate/Nitrite-N ND 0.100 mg/L SM20 4500NO3-F B (<10) 08/25/10 AYC Microbiology Laboratory E. Coli Negative I 100mL SM20 9223B A 08/24/10 DLC Total Coliform Negative 1 I OOmL SM20 9223B A 08/24/10 DLC Municipality of Anchorage • �"� Development Services Department ` x, Building Safety Division SQA EFY On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # 101201 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1 of Minsch Subdivision. This inspection revealed an arsenic concentration of 10.4 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. ASBUI i_T SPUART) � AggnCTATFc TAAm QiT-Dw;vrnTrr cni. r�(I�- I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: o'�' OF A 4ao DATE" AND THAT NO ENCRO�CHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE H 1 y OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: ! ' ' EASEMENTS, COVENANTS, OR RESTRICTIONS�i�Y-'- WHICH DO NOT APPEAR ON THE RECORDED SUBDI- — � o,,,,,,„ Mt.,; 'e Ald • � VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB` / 1�L s - h . -3X ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- Di2AWN ��'r�'�1k� `sM•x j ARY LINES. rk�F MUNICIPALITY OF ANCHORAGE A�9A DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.#HAA# 1. GENERAL INFORMATION Complete ;legal descriptionLn � �� CjCr'.• 5 F-1 J � A2 l� J Cill/Lq Location (site address or directions) Property owner �� �/� VC Nr"%��%l� Day phone Mailing address' / 7 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will behheld for pickup 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 921 5. STATEMENT OF INSPECTION BY ENGINEER - As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. / Name of Firm ::? �(l �/7%if�� c� &�GG Phone Address Z f Engineer's signature Date — ' ZZ e.,, r e 8izz re WGJ (._� ° -'t'."9pROFrS: r_— 6. DHHS SIGNATURE /\ Approved for //+�'� '" bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments t Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA N21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: >l l M(✓ISGbSud 557 tSI� Parcel LID A. WELL DATA I Well type rflU 6 If A, B, or C, attach ADEC letter. ADEECj water system number [ J� Log present (Y/N) X / / Date completed ��� — 2 ? Driller g k Or, �( / ���C^� Total depth t 5 Cased to —Casing height Z Sanitary seal (Y/N) Wires properly protected (Y/N) r WATER SAMPLE RESULTS: J // Coliform OI Nitrate �' / P�" /% Other bacteria Date of sample: L - C2 '—�9 Z7 Collectedby: B. SEPTIC/HOLDING TANK DATA Date installed dTank size \/ G� /Compartments Cleanouts (Y/N) J �FoJu/ndation cleanout (Y/N) Depression (Y/N) A, High water alarm (Y/N)/ /v l Alarm tested (Y/N) Date of pumping f C� �i Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot l 1 0 , On adjacent lots Foundation To property line _2_0 Absorption field Water main/service line 12-0 Surface water/drainage © /?,f/e�ld,f v L !1 O Moi1 72-026 (Rev. 7/91) Front ( CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION M � l / — 10 `J7 2 f � � v : Date of test f/ Static water level Ltj m b 107 N Well flow 9.p.m. g.p.m. t N % < n Pump level rn coo w CmL SEPARATION DISTANCES FROM WELL TO: / �C�CT p rn Septic/holding tank on lot / ; On adjacent lots Absorption field on lot C 7,P; On adjacent lots AZZA Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: J // Coliform OI Nitrate �' / P�" /% Other bacteria Date of sample: L - C2 '—�9 Z7 Collectedby: B. SEPTIC/HOLDING TANK DATA Date installed dTank size \/ G� /Compartments Cleanouts (Y/N) J �FoJu/ndation cleanout (Y/N) Depression (Y/N) A, High water alarm (Y/N)/ /v l Alarm tested (Y/N) Date of pumping f C� �i Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot l 1 0 , On adjacent lots Foundation To property line _2_0 Absorption field Water main/service line 12-0 Surface water/drainage © /?,f/e�ld,f v L !1 O Moi1 72-026 (Rev. 7/91) Front ( CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) ---_-----_.__.-- Vent (Y/N) "Pu p on" level at "Pump off' level at High water alarm level \!� Cycles tested Meets MOA electrical�od sc� (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA '7 C / Date installed I /T ( Soil rating s l((%� System type Length ¢� Width Gravel thickness �1�e3 / Total depth % \, Total absorption area r J 7o P Cleanouts present (Y/N) y Depression over field (Y71D /Q Date of adequacy test��` C Results (pass/fail) � 6�)\ I for 3 bedrooms Pery}xideGre,Latme(t (past 12�mont c (Y/N) ��/ If yes, give date CC!!// v e - ( S;, SEPARATION DISTANCE FROM ABSORPTION FIELD TO: 1 Well on lot Oadjacent lots /�� —Propertyline To building foundation 7 2� k� To existing or abandoned system on lot � On adjacent lots-� /Co�<"Cutbank 0/'� 6—f Water main/service line 2" ✓ Surface water _/ (0 n ,�f / Driveway, parking/vehicle storage area Curtain drain iV oll) e E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signa Engin V�y �19op °°oO Jnnoo9oo •'�ogy�—��e 61v Co `—' r,�/Wn�o aor�3o o .�(dennid�au,°e Date �— ,-o- ue lames F. Sizemore e W J °° #1517E o ( 80FCs��, �u �� HAA Fee $ t' -7 `U` Waiver Fee: $ Date of Payment sZ 9� Date of Payment Receipt Numbers % Z%d Receipt Number 72-026 (Rev. 3/91) Back MOA 21 NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 • FAX 456-3125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 • FAX 274-9645 Sizemore & Associates Report Date: 01/28/93 6410 Switzerland Drive Anchorage AK 99516 Date Arrived: 01/25/93 1 d• 01/25/93 Attn: James Sizemore Our Lab #: A122094 Location/Project: - your Sample ID: L1 Minch Sample Matrix: Water Comments: Lab Number Method Parameter Units ------------------------------------------------- A122094 EPA 353.3 Nitrate -N mg/1 C ak:�L) Reported By: Susan C. tkfental Microbiology Supervisor Date Samp e : Time Sampled: 1120 Collected By: JS * Definitions * B = Below Regulatory Min. H = Above Regulatory Max. E = Estimated Value M = Matrix Interference D = Lost to Dilution MDL = Method Detection Limit Result * MDL --------------- 0.1 0.1 Date Date PreparedAnalyzed - 01/26/93 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES . Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# QSI-091-32 HAA# NA�t�DSSb 1. GENERAL INFORMATION M i/01C /J Complete legal description d J� tI -�C T l5ly l IA/' s M. Location (site address or directions) Z- ��� �`� Property owner /�A r, Da[Ie Afl')-77,3h iJ Day phone 0 6 7/ �-� Z Ch u'or 2lY Mailing address � ! � --T— -zglj Lending agency Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup, 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation`` from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER:,DISPOSAL: Individual on-site l/ Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my 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 JO 02&— �T� �/ G�r"x • Phone Address Engineer's signature, G Dated%�� .� Ciffe"'d f` qtG� t �F S• 4). •.g. 1 Size oro 6. DHHS SIGNATURE j��•' # t5t7 .• f Approved for bedrooms. 7��a�„ Disapproved. Conditional approval for bedrooms, with the following stipulations: By: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omisslons in the professional engineer's work. 72-025 (Rev. 1/81) Back MOA 021 ® Municipality of Anchorage rWm Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LJ M, T) �--h &-,( k1) �-_G Parcel I.D. A. Well Data " Well type Pf i V a If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed 77 Driller L Total depth (�p Cased to Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) V WATER SAMPLE RESULTS: Coliform A)06 Nitrate 0 2 Other bacteria %6/ /1(!? Date of sample: %� `f Collected by: J 5 C ?_2G e?Of2e7 � B. SEPTIC/HOLDING TANK DATA Date installed �_l4 Tank size 1000 6OZ Compartments Z Cleanouts (Y/N) it Foundation cleanout (Y/N) -Depression (Y/N) High water alarm (Y/N) `U Alarm tested (Y/N) Date of pumping �� :� 2- ) Pumper ! 'S LLLW f SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot f I (D On adjacent lots -,-' 1 a 0 Foundation I To property line Z U Absorption field 47- ( Water main/service line Surface water/drainage Q O f � 72-026(3W)•Front CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION �' 77 e Date of test C 0 Z Static water level �. Well flow_ g.p.m. g.p.m. 5 ^, Pump levell cfl Q n SEPARATION DISTANCES FROM WELL TO: ° Septic/holding tank on lot C C� ; On adjacent lots > //I� d N o Absorption field on lot Z ; On adjacent lots - Public sewer main rot � Public sewer manhole/cleanout��� Sewer service line Petroleum tank A/ 0/7 WATER SAMPLE RESULTS: Coliform A)06 Nitrate 0 2 Other bacteria %6/ /1(!? Date of sample: %� `f Collected by: J 5 C ?_2G e?Of2e7 � B. SEPTIC/HOLDING TANK DATA Date installed �_l4 Tank size 1000 6OZ Compartments Z Cleanouts (Y/N) it Foundation cleanout (Y/N) -Depression (Y/N) High water alarm (Y/N) `U Alarm tested (Y/N) Date of pumping �� :� 2- ) Pumper ! 'S LLLW f SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot f I (D On adjacent lots -,-' 1 a 0 Foundation I To property line Z U Absorption field 47- ( Water main/service line Surface water/drainage Q O f � 72-026(3W)•Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (YIN) High water alarm level Meets MOA electrical codes level at SEPARATION [QISTANCE FROM LIFT STATION TO: Manufacturer (Y/N) "Pump off" Level at Cycles tested Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA ( �- �, 0,/ 6 pi Date installed`7 Soil rating (GPD/Ft') System type f u i Length Width 3 Gravel thickness �� .-5 ,Total depth 71 ' Total absorption area 3 -2 Cleanout present (Y/N) Depression over field (Y/N) A Date of adequacy test i0 G Results (pass/fail) h' = J _ for Bedrooms p- Water level in absorption field before test NO o &--- Aft r test U ���'�� If s� give date Peroxide treatment (past 12 months) (Y/N) N v 9 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I ��� On adjacent lots `1-,/0o Property line To building foundation 7 � To existing or abandoned system on lot _ A)Cn E' On adjacent lots rU0 ( Cutbank N On e Water main/service line ( v Surface water —Driveway, parking/vehicle storage area Curtain drainlJ� � 116(12 E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MDA and HAA guidelines in effect on the date of this inspection. / • ee \ Signature Engineers Name J �� �C-' �( �2C,�= 2 —) C JamesF.j'LZ .01") a "`VAX Date ,o e, r :sii c : c,;; r�ll eeo.. �>e HAA Fee $ �3 Ob Date of Payment Receipt Number elJ 3 C252.3'�) _ 72-026 (3199)' Back Waiver Fee $ Date of Payment Receipt Number ztL SINCE 1908 CT&ERef.# Client Sample ID Matrix ClientName Ordered By Project Name Project# PWSID Commercial Testing & Engineering Co. Environmental Laboratory Services LABORATORY ANALYSIS REPORT 94.5185-1 Ll MINSCHS/D WATER SIZEMORE, JAMES UA Sample Remarks: SAMPLECOLLECTEDBY: J.SIZEMORE. QC Parameter Results Qual Nitrate -N 0.10 U WORK Order 82995 PrintedDate 10/12/94 @17:06 hrs. Collected Date 10/10/94 @11:20 hrs. Received Date 10/10/94 @14:30 hrs. Technical Director STEPHEN C. EDE Released By: S / Allowable Ext. Anal Units Method Limits Date Date Init mg/L EPA 353.2/300.0 10 10/12/94 MCE * See Special Instructions Above UA = Unavailable ** See Sample Remarks Above NA=Not Analyzed U=Undetected, Reported value is the practical quantification limit. IT= Less Than r D= Secondary dilution. GT= Greater Than 0 5633 B Street, Anchorage, AK 99518-1600 — Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA