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HomeMy WebLinkAboutHUNDRED HILLS BLK 1 LT 4B<Z111i4. 41.91/ RA 46 g\b,i2. -1' Old-1�1-D\ Terti r.tb 71:ix g by OOC CO. dba S' ULLI VAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 68B-2759 OWNER OF LAND JD(b' 7ribwtSowJ " C a'T BORE HOLE DATA ADDRESS.% 343 S " ,& kali Qii E' LEGAL DESCRIPTION /Liejt3 9,1 h'k&r /:k "'I 4 3 PERMIT NUMBER 7 C 3.29 Date of Issue 9 -a,Z Q" ' TAX INDENTIFICATION NUMBER 0 %? JJ o) - Is well located at approved permit location?s Q No Method of Drilling: ` air rotary Q cable tool Depth of well: I c) b Casing Type 4STeBc- Wall Thickness 1(25-'0 inches Diameter 6 Q inches, depth tr4 l 7 yl feet Liner Type: • 7 c2 t/L Fk5.vt �i i)r TO F0 � C Casing Stickup Above Ground: feet Static Water Level (from ground level): feet Pumping level: feet after hrs. pumping gpm Recover Rate: gpm Method of Testing: Well Intake Opening Type: Q Open End Q Open Hole Screened; Start feet Stopped feet trrerforations Start `0 -feet Stopped /? 0 feet Grout Type: Ag„4i1'0 4.0--E. Volume /SID &gs Depth: from Q _ feet, to feet Pump Intake Depth: feet Pump Size hp Brand Name DEPTH Pro To b 41 1 IS- Sq S 110 Sy u0 ti ,3 113 /,1a Well Disinfected Upon Completion? ff s Q No Method of Disinfection: ! d,<tWit obi 61) P/r4 Comments: *¢ri= 1941'4'5Q Driller's Name aedI4 6Q4r RECEIVED JUL 17 1998 Municipality et Anchorage Dept. Health & Human Services jivrtSklltvan. Said s a vn Sam. 5 i-�rar�t P P ��m yy kor5.4 Pi" , dz,i 52 fp "6e2 ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW970329 DESIGN ENGINEER: OWNER NAME:THOMSON, JOHN B OWNER ADDRESS:17343 SANTA MARIA DRIVE EAGLE RIVER, ALASKA PARCEL ID:07818101 LEGAL DESCRIPTION: HUNDRED HILLS BLK 1 LT 4B LOT SIZE: 98984 (SQ. FT.) NUMBER OF BEDROOMS: 6 THIS PERMIT: 6 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 MDA Copy DATE ISSUED: 9/22/97 EXPIRATION DATE: 9/22/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: sey�� / • ,4" ----hi Cid DATE: � d2._? - F7 DATE: `23_ 97 = 60' SCALE Q CDC) 00 0 trj 0i 70 II 1-. u -J opo i/ t jQ"�iJ .OHb /-1 H C7 .0 d pivio M?y h.f-e �l SITE PLAN 0>>x oZza( G'4 09 ndo tri z-.cZr.d [7 DESIGN UNSUBDIVIDED ‹-i-r- > D a,\��� �( ( 7 m UNSUBDIVIDED 0 --1 0 m z I. \ z \ r0 \9 -i0pNz \-- c oo= >t n Z _ 0 m 0 O N _ m(7- Vim - 4-\ \0D« >�C c m .. cis \ -1 z m �ljN z Z D =OZ \ cm v) �czm% Z=2Zm \ODm m�-ri-I� �Tl >mZ>0 zzv>,u)�Nm x�� r�lDOr� oKoy�vN > �7 > -0 m Z < vl m „ -I 27)D-- z� ri -{� m DpZ�D --OvviC°C�jmr J m u) m -<pi › > - w 0 ZKGCD / rpmcDCzZ0\I co 77 23 i Z Tl H h --i CD A m a) A� 1 / ��2J-<m Z� z/ m N m NI A r- xi mi > 1 � - O>z 10 ------ A> 21 / • �oa� zZ / z0 - oN m z rj m Z 5 OC C m�7m 0>mrn ivm2Jp na4-iDC < 0 53 m --r Nrm�0 mor D m Z D D r m D z Z r m c) —w 0 f-- 7 o / -000) O 70 CO 0 a7 E z •U z 21 Z > H Oce D r o Z N m 0 A 0 >eo < c > m z 0 O 0 Z H 0 3 Municipality of Anchorage Page / of c2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW 91�0a // PID Number. Q7 R-/81 -0/ Name: ,691711-7 ThiloAASO-41 Wastewater System: 8 New 0 Upgrade Address: / 73 r/ 3 �Ra7-ty Al A,e/4 5:2 EA s tc R/ v -.e A -e 99577 ABSORPTION FIELD Phone: c)(/ a-a0ao rp No. of Bedrooms: Deep Trench ❑Shallow Trench 0 Bed 0 Mound ❑Other LEGAL DESCRIPTION Soil Rating:/ GPD/Sg. Ft. Total Depth from original grade: N Lot: �/ 55�� Block: Subdivision: 7 8 I�GlKfir RE'[X /1 LAS Depth to pipe bottom from original grade: �� Ft. Gravel depth beneath pipe - i Ft. Township: Range: I Section: Fill added above original grade: 3 Ft. Gravel length: Yo2 of lines: Ft. Distance between lines: '� Ft. WELL: El New ❑Upgrade Gravel width: Ft. Classification (Private, A,B,C): iRt✓oc Total Depth: /3o Ft. Cased To: g'S Ft. Total absorption area: �,,I1�� 75CP -1- SQ. Ft. Pipe material: cy 431/VI 3o3//itch/0 Driller: Sec LL/ ✓A� Date Dr'll d: 94/3/9 17 Static Water Level: efi-tkNow t. Installer: 6iso r!Ee- caNsr- Date installed: 9-a3 - 96 Yield: /0 GPM Pump Set at: / / 5 Ft. Casing Height Above Ground: t Ft. TANK SEPARATION DISTANCES n Septic 0 Holding 0 S.T.E.P. To From Septic Tank Absorption Field Litt Station Holding Tank Public/Private Sewer Lines Manufacturer: Age. k 174,1- // � Capacity in gallons: dO 0 0 Weft /Oat too f ---- / 11571- Material: STEED- Number of Compartments: `— Surface Water /00'1- loG f �� LIFT STATION Lot Line 381 / 33 i Size in gallons: Mannfa turer: Foundation / J / J`�p / OO "Pump on" level at: "Pump off" leve ;\gh water alarm at: Curtain Drain ///bt/E 4Nob.2./," _ Pump Make & Model Electrical Inspections performed by: 1� Remarks: BENCH MARK Location and Description: 1-13/1-13/Y\5&TVA, of s,'Q/,mac. IT Po /N* A Assumed Elevation: /a. U Ft E 4. • o/ a .., .::,....�. A ROBERT C. COWAN /9Eagle `4' :' CE -8801 J.a``' +itz�``w^,'.:..y .� if; "� �"`. Inspections by: $ & s ENGINEERING Dates* 1st 9-d3-<, 9 performed 17034 Eagle River Loop Road Ne. 2nd 9' 3S " 9iv /nF River, Alaska 99577 /‘7-ii.-9,? Department of Health and Human Services approval l d /' t Reviewed and approved by: V. F Date. 7.24(,18 72-013 (Rev. 9/91) MOA 25 PERMIT NO SW960211 PAGE 2 OF 2 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 .Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPOR LEGAL LOT 48, BLOCK 1, HUNDRED HILLS S/D P.I.D. NO. 078-181-01 / ST1 ST2 DBL1 DBL2 CO1 MT1 CO2 ST1 ST2 80.8' A 41.0' 46.0' 48.0' 49.5 60.0' 76.0' 92.0' B 53.0' 53.0' 53.0' 54.5' 63.0' 71.5' 82.5' FINAL GRADE gL./ArJ Sae,/asap'; /-4.0.4k ST2 DBL1 DBL2 CO2 78.5' MT = 78.9' 78.3' C01 MT CO2 CO1 = 78.9' CO2 = 78.7' C01 = 73.5' CO2 = 73.4' MT = 64.5' THg BOH 58.5' NO WATER FOUND SCALE 1" = 40' �� '°.e S&S � EngineeRinq RMR. AtAA91A )> , HEALTH AUTHORITY APPROVALS SEWER& WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, P.E. ROBERT A. SHAFER, P.E. Date: q —26 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 RECEIVED SEP 2096 Mt. Health Huma Services Dept. Health & REFERENCE: Lo -r LIS en-oct; I 1-tusor j Wu.i.. Jo The septic inspections for the referenced property were performed on 9-23 ~°j (. and - z5- 6 . Prior to submitting the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for the { ox.10A-rici4/14.IELt. to be completed. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 10m ras-"lea ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT l S �1� ) DATE ISSUED: 8/01/96 EXPIRATION DATE: 8/01/97 PERMIT NUMBER:SW960211 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:CARL DISOTEL CONSTRUCTION OWNER ADDRESS:P.O. BOX 770210 EAGLE RIVER, AK. 99577 PARCEL ID:07818101 LEGAL DESCRIPTION: HUNDRED HILLS BLK 1 LT 4B LOT SIZE: 98984 (SQ. FT.) NUMBER OF BEDROOMS: 6 THIS PERMIT: 6 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: DATE: 06)/10 /71 S&S Engrneeiztnq ALASI HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, P.E. ROBERT A. SHAFER, P.E. July 10, 1996 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 4-B, Block 1, Hundred Hills S/D CIVIL ENGINEERS (907) 694-2979 FAX(907)694-1211 Request you issue a permit to drill a well and install a septic system to serve the proposed six bedroom house on the referenced property. Test holes were excavated and percolation tests performed. The approximate location of the test holes are located on the attached site plan. At the time of excavation no water was encountered in test holes and after seven day ground water monitoring, the monitoring tubes were found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 = 60' SCALE SITE PLAN DESIGN t -a OZZ UNSUBDIVIDED zzeJ yd� y /11� zm'� 0 trico n ✓ \� \ o / \ \ \ ,-,o\\ w \\-4'0O \ / o / \T�JFS�T \ \ , \ r, *\ r\ t-0 0 • r m 00 laa 71V1SN 0 0\ 0XN\� \ 0 0-= =-IooX-' \0z m0 -<�P Z'Z cm1\ < W > .-1zmtnzo �I'' O ( to / m 0m Do Zamv�N�> cft y'x nnmZ x�CO4 'O 77) 0z > Ai l Ps O-Iao(��mm� n0Z_n -ov,- Z J rrqu)iO�m ,- �m� xDy1i t h i -n n z 4,4 Z�OCD rp�ozym • D 0'm�. 0 2"55 Z x1,.14 x m ri M/ � o = y• • > 0 � ��Zm 'o v1mC%11 uni�A+ xmC) Ors -� ODZO UI >(' / x>7) o Z OO N 73 Z UNSUBDIVIDED ✓ rn1 r r 0 -4 03 r 0 n Z 4 OOC) oow0 z • D H O C Z r 0 O 0 <pc = O 0 Z 0 0 cn S 0 tr S&S .�.L lfRlflG ROBERT C. COWAN, P.E. ROBERT A. SHAFER, RE. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 PERFORMED FOR: 6.21— 1SeTE4L. Coru1S-TRVC,TIaAf LEGAL DESCRIPTION: LoT 1 4 5 6 8 9 11 DEPTH (E§19 $SS 16 18 19 20 COMMENTS DATE PERFORMED: dtt' t's0 14- g 1 g Loc)G 1 1. Township, Range, Section: SLOPE u A Oftsy 14IL•1-S s/D 0ft, 6ArrtcS TES11-1oLE 1 Atki WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After 7 -5 -9L Monitoring? OA`f at SITE PLAN N S L O E Reading Date Gross Time Net Time Depth to Water Net Drop •—' Pff.ESoINK. pER.Ioid • w t,-zt 1L 2:o0 3r/z" 2:01 1 Mla t11/y 11 3/'t `1 `L OZ H 511 /1 11 Z :03 II 5�/y l` 11 PERCOLATION RATE 1 ` 3 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN q FT AND 6 FT PERFORMED BY: S & S ENGINEERING) ��� CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River Loop Road No. 2 / ACCORDANCE WITH Eih8'R'i 1WMAKIdd1 11 GUIDELINES IN EFFECT ON THIS DATE. DATE: �0 / g C' / "E tneeRtng.Et..; PERFORMED FOR: ROBERT C. COWAN, P.E. ROBERT A. SHAFER, P.E., CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 ROBERT C. COWAN lil� 8 ta"-- DISotEL+-- Co+4STRuc'rib DATE PERFORMEIIa p F rr e 12so 4e � LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS. LoT 4 _ $ /31--0cl0 11 Township, Range, Section: ]FELL S/0 SLOPE F) -v t102 E t7 TesrNoLe 4* Z cat (DANA s 6 LJ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN T N S L 0 P E Depth to Water Atter Monitoring? 01" Date: 1 -6 -Re St Te `PL VTH qd EAsr 7 )OiC Reading Date Gross Time Net Time Depth o Water Net Drop — AESontl< es A.tor) G -29-9L Li'. 30 '_' 33/84 —_ -ye lZ4 4:32 t. 4 "3/8 n IF Li : 33 `t Li ?/e'+ PERCOLATION RATE iminutesiinch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT S & S ENGINEERING//, L CERTIFY THAI'THIS TEST WAS PERFORMED IN PERFORMED BY: 1/U34 Eagle River Loop Road No. 204 ACCORDANCE WITFaalgICRkxRWItIa61id stile t GUIDELINES IN EFFECT ON THIS DATE. DATE /� 0 / 6 • %yam, ":� f � S & S �_" EnginEERinq AWICAEAGLE WER HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN IXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, P.E. ROBERT A. SHAFER, P.E. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 4-B, Block 1, Hundred Hills S/D July 10 ,1996 GENERAL: 1. 2. 3. 4. 5. EPTIC 1. 2. 3. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 02 LA4c-ER The scope of tbTs project includes the installation of a 1750 gallonAseptic tank and a leachfield trench to serve the proposed six bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 4-B, Block 1, Hundred Hills S/D July 10, 1996 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 4-B, Block 1, Hundred Hills S/D July 10, 1996 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 4-B, Block 1, Hundred Hills SSD July 10, 1996 INSPECTIONS: Typically there will be a. minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 4-B, Block 1, Hundred Hills S/D July 10, 1996 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 078-181-01 Expiration Date: g` j 9—I 67 1. GENERAL INFORMATION Complete legal description HUNDRED HILLS BLOCK 1, LOT 4B Location (site address) 1135 HILAND ROAD, EAGLE RIVER, AK 99577 Current Property owner(s) MICHAEL & ARLENE WILSON Day phone Mailing address 1135 HILAND ROAD, EAGLE RIVER, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: Z Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 6 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class _ Well Public Water System TYPE OF WASTEWATER DISPOSAL: ® Individual ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ WaiverNariance request for: Distance: !Received -by: COSA to be released to the engineer, unless requested by the engineer. Date: c-/9-74 7fp COSA Fee $ 42 Date of Payment 6/240, Receipt Number Of7(o(o b COSA# i5ti-1(41(15 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that -my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, -functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 4/21/16 Engineer's Comments: This investigation was completed in compliance with AMC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. 6. DSD SIGNATURE yy^^ K3 System #1 Approved for 4o bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: 0 s' OFAi, TE Bye we WATER AND �: p r 1 � �: •2 PROGRAM JFoTI t�\�o. LNrsER ---Orig inal-Certific-ate-Date==i 1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory. Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc If more than 1.septic system Is on the lot: COSA Checklist # _of Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: HUNDRED HILLS BLOCK 1, LOT 4B Parcel ID: 078.181-01 A. WELL DATA Well type PRVT If A, 8, or C provide PWSID # _ Well Log (Y/N) Y Date competed 912311997 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 120 ft. Cased to 40+ ft. Casing height (above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 9/23197 3-28-2016 Static water level UNKNOWN ft. 81 ft. Well production 10 g.p.m. - 5;6 g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate D,/58 mg/L Arsenic: ND ug/L Date of sample: 4/19/16 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC 1 STEEL Collected by: ARCTERRA Date installed 9/23/1996 Tank size 2000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (WN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 5-(0-02N 4- Pumper C. ABSORPTION FIELD DATA Date installed 9/25/1996 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 System type DEEP TRENCH Length 42 ft. Width 2 5 ft. Gravel'below pipe 9 ft. Total depth 12.5 ft, (Measured 3128116) Eff. absorption area 756 ft2 Monitoring tube Y' Depression over field N Date of adequacy test 3128/_16- Results (Pass/Fail) PASS For 6 bedrooms Fluid depth in absorption field before test 0 in. Water added 900 gal. New depth 7 in. Elapsed Time: 15 min.' Final fluid depth 0 in. Absorption rate >= 900+ g.p.d: Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at _ in. "Pump off' level at _ in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 1001+ Sewer /septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ _ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 1001+ Driveway, parkingNehicle storage 10'+ Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and - ,. a ,, . . / •. • : .' .. �.. with MOA -COSH guidelines in effect on this date. Engineer's Printed Name Date 4121116 COSA canary sheetj-6-15.doc - -4:V r, 4c#Jia / ,..52,2% 47/6 ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: _ //it/df�EE!! ///<LS fl/� Gor,/e4,7,p(!/ AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HCTION OF FENCE LINES,NOR FOBE USRESTABLIISHIFOR INNG BOUND- ARY LINES. SEWARD & ASSOCIATES LAND SURVEYING 694-0829 SCALE: /'= Ga DATE: GRID: Slims/e�GG F13:69z> DRAWN: 0 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us l�l� �-t (907) 343-7904 . CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 078-181-01 1. GENERAL INFORMATION Complete legal description 3'23j0�- HAA # DCG Cp . Expiration Date: - 2 .2, -- Lot - Lot 4B; Block 1; Hundred Hills Subdivision Location (site address or directions) 1135 Hiland Rd. Eagle River, AK 99577 Current Property owner(s) Penny Crammer Day phone 696-1649 Mailing address PO Box 141845 Anchorage, AK 99514 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 6 3. TYPE OF WATER SUPPLY: • • Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank 0 Community On-site 0 Public Sewer 0 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HM) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water &Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Parcel ID: t W3 - / R/ 01 Legal Description: pbon:48l giIVD/2E-.0 �/wSS A. WELL DATA Well type GJF If A, B, or C provide PWSID # Date completed /AV/ c 77 Total depth . )'7-0 ft. Cased to 40 -t- ft. Well Log (Y/N) Sanitary seal (Y/N) `'/ Wires properly protected (Y/N) Casing height (above ground) 1 ( in.' Date of test Static water level FROM WELL LOG U ISI J.e ft. Well production / tO g.p.m. AT INSPECTION . 3/5/04 • P7 ft. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate QH}mg./1. Arsenic: mg.A. Date of sample:4Z 7/04 B. SEPTICIHOLDING TANK DATA Tank Type/Materiall L ( '57 Tank size '%cD gal. Number of Compartments Foundation cleanout (YIN) y Depression over tank (Y/N) Date of pumping 3 1 sl rt'>4 Pumper J2 t S l C. ABSORPTION FIELD DATA 9 -11m - Other bacteria 0 colonies/100'MI. Collected by: 'S 16/JG/A/�-Cit.�, Date installed 9/7 b Cleanouts (Y/N) High water alarm (Y/N) ', '� Date installed //2.5/t)‘• Soil rating (g.p.dJft2 or ft2/bdrm) f. Z System type /26-71G Gravel below pipe Length 4 2 f. Width 2 t .5 ft. Cl . Total depth it.'(ft. Eff. absorption areal ft2 Monitoring tube Y Depression over field Date of adequacy test 3 For iw bedrooms Fluid depth in absorption field before test in. New depth l in. Elapsed Time: G t7 min: 0 in. 0-0 COMA-et/a'fth^) if •res. c;ve date Results (Pass/Fail) Water added gal. Final fluid decth Any rejuvenation treatment (past 12 mo.) (Y/N & type) Absorption rate >_ c'o.d. SGS/CTE ENVIRONMENTAL SERVICES Drinking Water Analysis Report for Total Coliform Bacteria READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE MUST BE COMPLETED BY WATER SUPPLIER PUBLIC WATER SYSTEM IDP Vij PRIVATE WATER SYSTEM t -1Y• Send iesults cd Send Invoice •200 W. POTTER DRIVE ANCHORAGE, ALASKA 99518 • Tel: 907-562-2343 Fax: 907-561-5301 Lab Rei No. 1040994` ' Water System Nan./Cotrpany flame 5 & S E? GJNSE4It:SG •• Plane Number r Contact Name s 17034 Eagle .liver Loop Road, No.204 E?l4• n.iv-'• til.'Urn 99577 Mailing Fax Number i Address • Cal, State Zip code SAMPLE COLLECTION: F. wild antes analysis m sl b. , within SO hn or semen collodion. Date: I . 7 J U0 Month Day Year Time: • Q 5 AM (cede one) Location: CO j �OGkI uvl/l�rP �7 �15 S Collector. Rln� n �f���eK gate •ma Slpn • 119 SAMPLE TYPE: Pi Routine ❑ Repeat Sample V' Untreated Water (refer to lab no ) ❑ Special Purpose Transported . to Lab By: 0 Same as collector Other: (2013,44.7- c. Lo k.Ih,. Nailed Nan. &enahaa TO BE COMPLETED BY LABORATORY Sample Receiving: Date: !. 2 - - 0 Sample over 30 hours old; Results may be unreliable Tim Temp: Delivery Method: 7( 5 tit : w4� Received By: Comments: Printed Name ❑ 48 Hour Waiver For Remo tions 0 Treated Water 0 :RUSH SAMPLE Phone #: Fax #: Bacteriological Water Analysis Record: Analysis Began: -y/y-/ to 11 l-' L(O Analyst: " MMO-MUG IP/A) RESULTS: Total Coliform: E. CoA: Analytical Method: MEMBRANE FILTER RESULTS: Reported By: ® Membrane Filter 0 MMO-MUG (P/A) Stpnature Direct Count: O Colonies/100ml Verification: TeW C.•lorm LTB: BGB: IP/ Sent to ADEC: ANC FBK JUN Date./Time: Sent to Client: Pnor-1ed ❑ Date/Time: Spoked with: Faxed ❑ { ®Satisfactory final EC: ❑ Unsatisfact ory Date/Time: 4elralpubIic10O.CUMEN T\FOP.MS\Micro\Coli Form.xls iiimmisimimmilsommimialinsimit• sow gii I" TNTC w Too Numerous to Count 013 •other Bacteria Form # FW- 0053 10/24/03 SGS Ref.# Client Name Project Name/fl Client Sample ID Matrix PWSID 1040994002 S & S Engineering N/A L4B, BI, Hundred Hills S/D Drinking Water 0 All Dates/Tintes are Alaska Standard Time Printed Date/Time Collected Date/Tirne Received Date/Time Technical Director Released By, 03/02/2004 7:51 02/27/2004 14:05 02/27/2004 17:15 Stephen . Ede 6/ i Sample Remarks: Parameter Results PQL Units Method Container ID Allowable Prep Limits Date Analysis Date !nit Waters Department Nitrate -N Microbiology Laboratory Total Coliform 0.177 0.100 mg/L EPA 300.0 B (<=10) 02/27/04 JJI3 0 coUl00mL SM18 9222B A (<=1) 02/27/04 DKC .11.11-14:-90 flUN 14:03 SEc WARL & ASSOC LAFID SURV 90r 6940830 • ti b R. 01 JAN -12-98 MON 14;03 SEWARD E. ASSOC LAND SVRV 907 6940830 P.01 ASBUILT I HEREBY CERTIFY .THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY; ,44/N.sr# f4',f'/!<S "Pe GO7 -4 egret/ ANO THAT NO F.'NCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SCALE; SEWARD & ASSOCIATES LAND SURVEYING 694-082 DATE' GRID: FB: '9 Z7 DRAWN= • r ye • .. s. 4 V % Oven, Mark Aero$ ¢ •. 1S-69113 0