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SUMMIT ESTATES BLK 3 LT 8
Onsite File Summit Estates Block 3 Lot 8 #015-071-24 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211186 PID Number: 015-071-24 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Q Upgrade Name JULIE GOFORTH ABSORPTION FIELD Site Address ❑ Deep Trench M Wide Trench ❑ Bed ❑ Mound 5500 EAST 98TH AVENUE ANCHORAGE, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 1-478-960-2801 3 1.0 GPD/SF 2.82 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot SEE DWG. Ft. 0.5 Ft. SUMMIT ESTATES; BLOCK 3, LOT 8 Fill added above original grade Gravel length Township Range Section SEE DWG. Ft. 90 Ft. N/A Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. - - Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches Tank Field Lift Station Tank Line 450+ Ft2 - From - Ft. Well 1001+ TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer >Number Surface Water 100,+ iGal. Material mpartments Lot Line � 0'-}- I I NA Foundation 10'+ LIFT STATION Manufacturer Capacity Remarks NEW INLET BAFFLE AND INSULATION Gal, WAS INSTALLED BY CONTRACTOR ON EXISTING CONCRETE SEPTIC TANK. Alarm IOC Electrical Installed by PIPE MATERIAL House to tank EXISIT Tank to D3034 Installer b drainfield NORTHERN EXCACATION Drainfield D3034 CO/MTD3034 Inspector TIM ECKLUND AND GEG BENCH MARK (Assumed elevation) 100.00 ft Inspect ectioes: 1s 7/13/21 2nd 7/14/21 Location and description 3° 7/14/21 41t N/A BACK DOOR THRESHOLD ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date 4 y��p .............. D Septic System Q ,l et re A. Go ness.•• Approv 1n,, %-;;;-2_S-2(0 9 - °�3 Date O�" f Note: this approval does not include well permit requirements. MaECCssa,��l ofe o�Qo (Rev 05/02/18) PERMIT NUMBER: PARCEL ID NUMBER: OSP201047 RECORD DRAWING 015-071-24 SUMMIT ESTATES; BLOCK 2, LOT 10 —�"1 A I B DBL1 35.3 17.8 DBL2 36.2 18.4 DBL3 42.3 26.1 BL4 42.7 27.2 FD 43.1 29.8 COI 72.5 90.8 MTI 71.2 89.9 CO2 89.0 .8 MT2 85.8 ].1 • CONTRACTOR HAD 100' WELL RADII, 10' UTILITY EASEMENT AND LOT LINES FLAGGED BY A PLS PRIOR TO CONSTRUCTION • SWING TIES OBTAINED FROM AS -BUILT SURVEY 100' WELL RADIUS EXISTING SEEPAGE PITS SUMMIT ESTA?E! ; BLOCK 3, LOT 9 SUMMIT ESTATES; BLOCK 3, LOT 10 Li 7 �---_._J SUMMIT ESTATES; BLOCK 2, LOT 12 SUMMIT ESTATES; BLOCK 2, LOT 11 EAST 98TH AVENUE MGM 't EXISTING HOUSE e \ FD \ --------------------- 10' UTILITY EASEMENT SUMMIT ESTATES; BLOCK 3, LOT 11 'ARNES1S l� Ltd 9 Oki ENGINEERING- SALES CONSULT ENG 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE. AK 99507 -PHONE (907)3376179- FAX (907)338J246 - Y.EESITE: .w.w,gnmessen9ineerv,g.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JULIE GOFORTH 1-478-960-2801 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SUMMIT ESTATES; BLOCK 3, LOT 8 D.J.G. TYPE OF WORK: DATE: - SEPTIC SYSTEM RECORD DRAWINGS 7/21/2021 1 DBL 1 & 2 I EXISTING 1000 GALLON CONCRETE SEPTIC TANK; NEW INLET BAFFLE WAS INSTALLED AND SEPTIC TANK WAS INSULATED —DBL 3 & 4 — PIPE TO ABANDONED TRENCH —NEW DRAINFIELD / SUMMIT ESTATES; BLOCK 3, LOT 7 ATES; ' 1" 40' AW t .......,. �•7C /LLf ,' 0 �! �l i6y A. G --ss : � m CE -795 Ar AV LICENSE®� O��®®S®® #AECC884 / PERMIT NUMBER: + PARCEL ID NUMBER: OSP2111W RECORD DRAWING 015-071-24 MT CO FINAL GRADE = 97,3-97.9 ORIGINAL GRADE AT HIGHEST POINT = 97.27 2" INSULATION F? w r, FILTER FABRIC _ z i TOP OF SAND FILTER =94.45 0.5 FEET it�"�•a� INVERT OF PIPE = 94.95 I— 5 BOTTOM OF TRENCH = 92.45 �®®'®� �® �TT ' l�TT ) > E G—VI 4 . ...........�0 P G .,, SU IT ING 3701E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507'PHONE(907) 337.6179'FAX(907)338-324a 4\cB51TE. }�n.,.gamessengineering cam '�•••••.+� . i••........•...•.,..........••0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER:�'•+ ffre Garn )ss .', kQ JULIE GOFORTH 1-478-960-2801 3 OF 3 ®�•• CE-7953- PROJECT/LEGAL DESCRIPTION:DRAWN BY: �� SUMMIT ESTATES; BLOCK 3, LOT 8 D.J.G. �0 Fp '' .......••''' TYPE OF WORK: DATE: 4444p' O F ESS\0LICENSE 4 RECORD DRAV�IING 7/21/2021 AECC884 �� _j=moi J.�4.�1!�' IV 257 -,)/ -1u t 1L1j.(ifi AS -BUILT SURVEY 1 " = 20' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT B, BLOCK. 3, SU1417IT ESTATES THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND IS ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT. ARE NOT SHOWN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS HEREON( UNLESS INDICATED) EXIST OTHER THAN NOTED. NOTE! FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERR.NE DATED AT ANCHORAGE, ALASKA THIS _19 TH DAY OF PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. _JULY 2021. ANY PAVINS SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. HOLT LAND SURVEYING 9309 GROVEER DRIVE ANCHORAGE,AK 99507 13193, FB 175-39.180-15 907.223.8615 MUNICIPALITY OF ANCHORAGE On -Site Woter& Wastewater Program POBox 18065O 47OOElmore Road Anchorage, Alaska au519-6650Phone: 904 Fax: (907) 343-7997http://wv,fw.muni.org/onsite | ___W Permit Number: D8P211186 Effective Date: 6/4/2021 Work Type: Septic Upgrade Expiration Date: 8/4/2023 Tax Code Number: 01507124000 Site Legal Address: SUMMIT ESTATES 8LK 3 L 8 G:2437 Site Mailing Address: 55QOES8THAVE, Anchorage Owner: GQF[>RTHGREGORY S&JULIE S Lot Size in Sq Ft: 16218 Design Engineer: [3ARNESSENGINEERING GROUP LTD Total Bedrooms: 3 This permit iefor the construction of: 2 Disposal Field [] Septic Tank [lHolding Tank [3 Privy [] Private Well [] Water Storage All construction shall beinaccordance 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 (10AAC72) and Drinking Water Regulations (18AAC8O) 3. The wastewater code requires inspections during the installation. The engineer shall ' the Development t Services Department per AMC 15.G5.Provide notification bycalling (QO7)343'7Q04(2417). 4 From October 15toApril 15. asubsurface soil absorption system under construction during frmmdogmmotho r shall beeithec a. Opened and Closed onthe same day, or b. Covered, sealed, and heated 8nprevent freezing Special Provisions: Scope of permit includes installing an inlet baffle on existing concrete tank. Received By�_ Issued By: m,&kx Municipality n.as ai$ «. Anchorage gf: P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section x x x'IT Av.,L-vRIANCrE/WAIVER REVIEW x X X X Waiver#: OSV211033 COSA#: Permit#:OSP211186 PID#: 015-071-24 Legal Description: Summit Estates Block 3 Lot 8 Engineer: Garness Engineering Group Applicant: Julie Goforth Your request for a waiver of the required horizontal separation from the proposed absorption field to the existing/abandoned absorption field has been approved. The approved separation distance is 0.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. as as as aa■ 92 a a a a a a a a a a a a a a a a a aaaaeaaaaaaaaaaaaaaaIII aaoaaaaaaaaaaavaaaaaeaaaaaaaaI Waiver is Granted: X Waiver is not Granted: 2o9-1 �^ f,, 6v`eW Date. `� Approved by: ���r� Name of Reviewer ■ a a a a a a a a a a a a a a a a v a a a a a a a[ a a a a a a a a a a 9 a a i a a In a a a a a C a a a a a a a a 9 a a a a a a a a a a a a a IS a a a a a a I 11, 11,12 t7VT, "Ji ,W J1111111 �rt;. MUNICIPALITY OF ANCHORAGE :: -4, Development Services Department ° Phone: 907-343-7904 On -Site Water & Wastewater Section Fax. 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-071-24 Property owner(s) JULIE GOFORTH Day phone Mailino address 5500 EAST 98TH AVENUE *ANCHORAGE, AK Site address 5500 EAST 98TH AVENUE *ANCHORAGE, AK 1-478-960-2801 Legal description (Sub'd., Block & Lot) SUMMIT ESTATES; BLOCK 3, LOT 8 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field F Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank ❑ Upgrade Q Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A'WAIVER REQUEST FOR: Distance: ©r"� I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: �-, 51 Waiver Fees: <Itw -� 5 Date of Payment:6� /Z ( Date of Payment: Receipt Number: 095 �6 G Receipt Number: Q 5 3� Permit No. (9 S P) I 1 1 &% Waiver No. OS Val 1 0 3� G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211186, Rebecca Carroll, 06/04/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211186, Rebecca Carroll, 06/04/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211186, Rebecca Carroll, 06/04/21 N 89 57' 39" E 129.99 !Y) lD ti � 04� o - ....... "yON TH 00 NP SHANE A. HOLT G 04 P LS -6914 O %Na �a o 14�" Tessiona\ \moo AS -BUILT SURVEY 1" = 20' survey ordered by: NO CORNERS SET THIS DATE JULIE ERICKSON REMAI HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY 2.3.2 016 PROPERTIESS . OF THE FOLLOWING DESCRIBED PROPERTY 2.3.2 LOT 8, BLOCK 3, SUMMIT ESTATES THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLv TO SHOW ANY CONFLTCTS BCTWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASrAGNT5; APID TS ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT. ARE NOT SHOWN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS HEREON (UNLESS INDICATED) EXIST OTHER THAN NOTED. NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE DATED AT ANCHORAGE, ALASKA THIS _4TH DAY OF PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. _FEBRUARY 2016. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICG HOLT LAND SURVEYING 600 HIGHVIEW DRIVE ANCHORAGE AK 99515 __.. 23193. FB 175-39 345-5513 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [] NEW ~:) ~::~ ~'~1 ~-~ ~)¢..~-~,~--* ~ I~ I~'. ?0~ ~UPGRADE MAI LING ADDRESS LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS Monu[actur0r Material ~o. of compartments ~ k~q. capacltg in ~allons IF HOMfi~DE: Inslde length ~idth kiquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO, O ~ ( Manufacturer Material Liquid capacity in gallons Q Well ~ Foundatio~ I Nearest lot line PERMIT NO. ~ DISTANCE TO: ~Z~ No-ofEnesI Length of each, line TotaJlengthoflin~& Trench width Distance between lineSeffectlve -- ~2 ~O inches Total a~n O ~ -- Top of tile to finish grade~ ~ ~ i Material beneath tile/~, ¢~/ ~ ¢ inches area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot llne ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER ~ REMARKS ~,~.. JUNE 25, 1971 .~;~y ~ . ' ' APPROVED DATE LEGAL 72-013 (Rev, 3/78 " E:,EF'FiRTHEN'[' OF !-IERLTF! i::ib,!D E,~.,i'v"~RONi"~ENTFIL F:'RO!'EC:]"ION 825 "L." 'LSTREET'., RN(Si--!ORF!GE., F!K. L.OCRTZ ON BIRCH RORC' L. EGRL. L8 E~]~ SUH?I!T EE;T L. OT SiZE ZE[SE~¢ SCCURRE FEE'T ...................., .,P~.. OF ':;f"iTI F!EC"E'PTT'"f'J ,_~._,IE.r, , I':,E'FffTNF]'F'I I't, Hf~',:4Zb!UH NLIHBER OF BEDROOt'i~5 = 3 SOIL. RFITZNG <SCi F'T?'BI;;:>= :~.25 THE LENGTH [:,I'HENS:D3N iS THE LENGTH ,::IN FEE:T::, OF THE TRENCH q? DRFIZNFiEL[:,. THE [:,EF'TFI OF' FI TREN;:H OR PIT Z'5 THE [:,IST!~HE:E BETFiEEN THE SURFFICE OF THE GROUN[:, RN[:, THE E~OTTOH OF THE E'/.:;CF?,,,'FiTZON ,:: ZN 'T ~] EE 'T ~:~:: E: ~-.~ ~: ~.~ ~.~-~ Z E...~ 'T ~ % ~; THE GRRVEL DEPTH IS THE MINIHLIH DEF'TH OF GRF!VE:~klb.~.N ¢~h,i[:, THE E:OTTOH OF THE ENCFWRTZON ':Z.'.~ FEET>. F'ERHZT F~F'PLIEFII'.IT fIRS THE RE"!:,POi'.~SIE:iLITff' TO INF"JRH THi~.; [:,E:PRRTHE:NT E,...R'£HC THE r ..... f.4I:, F'ROPERT'¢ FIN[:, '['HE tNSTFiLLFtT!LqN _II::FEE. F.._i%: OF R!'.4~,.' [4ELL~; F!D,J'RCENT TE! "'1 '"' NUHE~ER _-IF F'F-'C:I[:,E'NF'F'::; ............. THRT THE I,.IEL.L k!IL.L --,ER',,,'E. EFIL-:.,'<:F:[L[.ING OF RN"? :'5,?STEf'I 14_TTHOtlT F'INFIL _..I',,..,~ E,._, ILr~ F'IN£:, MFI-RL!,v!L E,: THIS DEF'FtRTHENT 1.41LL E,E ::,UE, J,-L.t T- F'ROSECUTION. HINIHUH [~IS'rF~NCE DETI-,.IEEN R P.!ELL RND F~N'-¢ ON-.SITE :SEP.IRGE [:,ISPOSRL 'L.?¢?['EH ;[:5 J..88 FEET FOR R PRIVFITE NELL OR ::1..5C~ T0 2E;E~ FEET FROH R PUBLIC NELL DEPENDING UPON THE 'T'¢F'E OF PUBLIC !.4ELL. HZNIHUH DiSTRNE:E FROH R F'RZ'¢RTE NELL TO FI PRIVR'TE SEF.!ER [_ZNE ZS 25 FEET RND TO R COHHUNiT¥ SE!.4ER LINE 15 75 FEET. OTHER REQUIREHENTS HR'~.' RPPL'.?, SF'ECIF'ICRTIONS RHI:> CONSTRUCTION Dlfl~GRRHS RRE R',,,'RILRBLE TO INSURE PROPER INSTRLLRTION. I ±: FORTH I'-:.~'T' THE MUN:I:C'tPFIL!T'¢ OF FINCHORRGE. 2: I 1.4!LL INSTFILL THE S'T'STEH IN RE:CORC'BNCE I-4ITH THE CODES. 3: I UN[:,E:RSTFIN[:,.)I"IdRT THE ON--*SI]'E 5EP.IER E;'¢2;TEM 7!F1'¢ RE~;~LtZRE ENLF!REiEMENT IF ]'HE RESIDENCE l~; F%MOZ~..ED TO ZNCLU[:,E ?10F:E THRN 3: MEE:,ROOHS. ~F'L I C~NT E:ER.~,~ VOCKNER - - - -..---~..~-. .... ~: ............... V'~. · EF. FIF T THFIT _T Rf'1 F'FiM:[LIRR [,.tITH ]"FIE RE:;LZRE.'dENTS FC~R O,N-S!TE SENERE; R~",![:' ['.!ELLS F!S SE-f' G£-~TER ANCHORAGE AREA BORO~,'~H ~,~,/ HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 N9 693 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION GO y''; ADDRESS LEGAL DESCRIPTION ~('~/ "~ SEPTIC TANK: D~STANCE FROM WEL~ ~ / LIQUID CAPACITY /./G~{) MATERIAl GALLONS· INSIDE LENGTH NUMBER OF / COMPARTMENTS· /-~//~/("~'~Z)~ ~'/) LIQUID INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS ./J OUTSIDE DIAMETER L,N,NG MATER,A NEAREST LOT LINE ~'~ '~ /d DISTANCE FROM WELL //-~ · TOTAL EFFECTIVE ABSORPTION AREA (WALL AREAl . LENGTH /'~ / , DEPTH! · BUILDING FOUNDATION SQ. ET. TILE DRAIN FIELD: DISTANCE FROM WELt .~/~[J)~iON~ , NEAREST LOT LINE NUMBER OF LINES r/'/~DISTANCE BETWEEN LINES ~ TRENCH WIDTH ABSORPTION AR~''/' .SQ. FT. LENGTH OF EACH LINE ~ ~ DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES . IN. TOT~EFFECTIVE IN. ABOVE TILE /~/7/~]~) 1~7 / DISTANCE FROM ~ ' WATER WELL: TYPE , DEPTH , BUILDING FOUNDATION. SAMPLE ., NEAREST LOT LINE ?~/-~ ~/~j NEAREST SEPTIC ~ / SEEPAGE /t~; / OTHER · , SEWER LINE ~ , TANK , SYSTEM //J , CESSPOOL "~ , SOURCES DISTANCES: DATE DIAGRAM OF SYSTEM GREA~ER ANCHORAGE AREA BO~OJUGH ANCHORAGE, ALASKA 99502 SEWAGE DISPOSAL SYSTEM ~ APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK ~ SEEPAGE Pit ~ DRAIN FIELD ., OTHER FINANCED THROUGH / TO BE INSTALLED BY- SOIL TEST RESULTS ~~ NOTE= THi~ PERMIT i~ NOT VALID WITHOUT ~OIL SEPTIC TANK SIZE .///~ TYPE WATER MAIN TO SEPTIC TANK .-- , SEEPAGE PIT DRAIN FIELD SEPTIC TANK, ~~-~ SEEPAGE PIT /~ /'., DRAIN FIELD 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVE:L BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE -68 AND THAT THE ABOVE Legal bescz'~P This Form Reports a~ bo~,s Deo'th ...... : ~.¢ Location Sketch ' Soll Was Ground Water Encmmtered?~ if Yes~ At What Depth Da~e Drain F~eld Kus� • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I. D.015-071-24 1. GENERAL INFORMATION: Expiration Date: 10 ` 23 -- Zl Complete legal description _SUMMIT ESTATES; BLOCK 3, LOT 8 Location (site address) 5500 EAST 98TH AVENUE *ANCHORAGE, AK Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Weil ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 2 -FDO 0,- Waiver Waiver Fee $ Date of Payment Date of Payment Receipt Number V C -D Receipt Number COSA # 05 C2 14 2 ij Waiver # M 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 / 6 Engineer's Printed Name: Jeffrey A. Garness Date: 2,j In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE —�X'•` System #1 Approved for - bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, #AECC884 \S\KUTYf QF����f�r�. O/V_S,T o WgTE E �� r with the follc8ta arlsqIVL) rr? �m FIAT R - 577 JJ%�l SERVICES,; - Original Certificate Date: –7—ZZ The 7—Z3 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other M Legal Description: SUMMIT ESTATES; BLOCK 3, LOT 8 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled PRE 1971 Total depth *87 ft Cased to *87 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 5/18/21 Parcel ID: 015-071-24 Structure served by this system Well production at time of test 6.4+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes OR N ❑ Coliform bacteria is Negative Nitrate 4.66 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by GEG Date of Sample 5/19/21 Static water level at beginning of test 30.9 ft. Comments *PER ALPINE DRILLING INVOICE IN MOA RECORDS INLET BAFFLE WAS REPLACED 712021 - OUTLET BAFFLE WAS FOUND TO BE FUNCTIONAL DURING CAMERA INSPECTION BY ARCTIC EFFLUENT (SEE ATTACHED EMAIL) -SEE ATTACHED B. TANK DATA EMAIL WITH TIM ECKLUND AT MOA ONSITE Age of tank(s) 50 years Tank type/material SEPTVCON� * Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 7/14/2021 D. ABSORPTION FIELD DATA Which system tested (date installed) 7/2021 ❑ ALL standpipes present per record drawing Total measured depth from grade 3.45 ft (max) Measured depth to pipe invert from grade 2.35 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ❑ Required maintenance completed Age of lift station yea Lift station material Comments: Adequacy test date NEW Results 2 Pass For 3 bedrooms Fluid depth prior to test - in Water added - gal New depth - in Elapsed time - min ❑ Code -required soil cover over field Final fluid depth - in Absorption rate 460+ gpd F-1 System presoaked (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N/A date of test) Gallons introduced N/A gallons If yes, enter date - Comments/Deficiencies: 1.85' OF COVER 2" ABOVE CROWN OF DRAINPIPE, EXACTLY 2' OF COVER OVER TOP OF PIPE i�J COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑Yes *50 Community Sewer Manhole/Cleanout > 100' ❑ Yes if No + ft 7 Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' F,-/� Yes if No ft Absorption Field on Lot > 100' F71 Yes if No 9� + ft Holding Tank > 100' ED Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Yes if No ft ❑✓ Yes if No 90* ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft 7 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑Yes if No *51+ ft Surface Water > 100'�]✓ Yes if No ft Property Line > 5'✓71 Yes if No ft Wells on Adjacent Lots: Wells on Adjacent Lots: Absorption Field > 5' 7 Yes if No ft Private Wells > 100' 0✓ Yes if No ** ft Water Main > 10' ❑✓ Yes if No ft Community Wells > 200'✓0 Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' F/-1 Yes if No ft If absorption field is under driveway comment below Property Line > 10' F/1 Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' R Yes if No ft Surface Water > 100' Yes if No ft F. ENGINEER'S COMMENTS 'CODE AT TIME OF INSTALLATION "WELL TO EAST (SUMMIT ESTATES; BLOCK 3, LOT 7) IS 50'+, BOTH PRE 1973 AND MET CODE AT TIME OF INSTALLATION ***WR#87-060 ****WR#0SV151017 G. ENGINEER'S CERTIFICATION I certify that i have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet e ... ....� �Q (frJ y A. Gorness_•' DQ Q 9. li CE -79 3 Q O ;.%2Z �rotfession�oo #AECC884 �DD�p�Oo - .~:::;~?-~.i_:!~.~C0~'islete legal'.description MUNICIPALITY OFANCHORAGE DEP ENT OF HEALTH & HUMAN SERViCEs., On-S~te Seduces Secho <-~ .;.. ,-, ~-~ ,7.' '.¥-. - · ': -. - -' ' · APPROVAL FOR ASINGLE FAMILY DWELLING u ;;;/;:<, _..%~,..:.G ENERAL IN FO R MATIO N Lot 8; Block 5~ Summit Estates ordirections) 5500 E. 98th - / "k .'.%2~'~'~'.~-~ . - ,*,~ ~;. ~-- : ' '~ .. ~00 E. 98th Avg. An~oraq~; AK' 99516 : '~ _.-:~ .Ma ~ address. -- .;-~ Eenaina aaencw ~-'-~" ~--' ~ : · .,..- .,~amnuauuress .~ .. _.,-.-:_ ~:~.4Z41,:~ B;::S~e~.: ~n~o~¢,.,,~AK 99503 ...... · : State ADEC attest- ~;~:':~:~.~':~ ..,. ENGINEERING STATEMENT OF iNSPECTION-BY;,E-NGINEER. ~-~ ,~ , ., · ..... ~.. · ' - As certified by my seal affixed hereto and as ot the validation date shown below, I verify that my. investigation of this Health Authority Approval application shows that the on-site water and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms · : and'type of structure ~ndlcated herein..I further verif'/that basec on the informatio~ obtained from _ the'Municipality of Anchorage files and from my investigation and inspection, the on-site water . supply and/or wastewate'f:disposal system is in compliance with all Municipal anc State codes, . ordinances, and regulations in effect or~ the date of this insl3ection. ~'~) ~ - ~ ~/.7 ~ _ Phone '- Eagle Rlv~, Alaska Address ~. ~2: Engin~es signature Date -~Additionai~Comments . _ ' ,.__ Municipality of An~l~~'~ge' 0~)~ment'~)~ Health and h' 's based only~0Pon the representations given in peragrap ,: royal Ce~lflcate ~.. -~: .;.-:~;~h~ HHSdoestt s essional engin~r reglster~ In the ~tate o~ ~--- D . . ~[°~t~eir lendi.g i~stitutio"sin order t° ~fls~ cedi" f~era~ a"d State r~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 343-4744 Legal Description: ~,,' A. WELL DATA Health Authority Approval Checklist Well type Log present (Y~ A/o Total depth ~ ~z / Sanitary seal OrN) J/e3 Date completed Cased to ~' ~ / If A, B, or C. attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected ~q) /40.4 ~ AT INSPECTION 3o/ Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 Date of sample: /o [5 / alS-- g.p.m. ~' - 0 g.p.m. Nitrate q-' ' ~) Other bacteria ~- '7//~ 3~ Collected by: $ & S ENGINEERING SEPTIC/H[GLD~4G TANK DATA Date installed ~z - ~. :7./ Tank size ,/00 O 17034 Eagle River I. eep Road No. 204 Eagle River, Alaska 99577 Number of Compartments Fo,u.n'da'$~;'n'~i:a"n~'t[t'{~/N) 3/~ 5' Depression (Y~) t///O High water alarm (Y~) l~a~;6~umping';7 t · ',..~-7, ~ 'ajS'- Pumper .-Z'~-s'atco- Date installed *~ ~ - _ Soil rating ~r~2&drO ~- System ~e '.~ngh ~/q / ' Width. / q / Gravel thickness below pipe~ ~V 'Total depth Efffi~tivo abso~tion'flr~a ~ fro ~ 0 ~onitoring Tube present~ ~T Depression over field (Y~ Date of adequacy test y-So- V~ Results~ail) ~ For ~ bedrooms Fluid depth in absoCtion field before test (in.); ff~//Imme~ately afieggO gal. water added (in.): Fluid depth ~ ~ (ins.) M~nutes later: ~ 0 AbsoCtion rate = 3' g g _g.p.~q Pei'oxide treat~nent (past 12 months) (Y/N) w0,v,* ~: ,~ o~.,~o If yes, give date D. LIlT STATION Date installed Manhole/Access (Y/N) High water alarm Icvc~ *Datum Size in galloas ~ "Pnmp ofF' level E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/h~ldi.g tank oa lot ( ,.A.o ~ q ~ 5 /; On adjaceat lots / Absorption field on Io~ ~ ~ ~ ; On adjaceat lots Pablic sexver main ~ ~ / ~ Public sewer maahole/cleanout Sewer/septic semice line ~ ~ ~ Lift statioa SEPARA~ON DISTANCES FROM SE~C~ TANK ON LOT TO: Building foaadatioa ~ /~ Property line ~ rff Abso~tion field Water maflfservice line /O ~ Surface water/drainage / ~ o ~PWells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation / 0 · "/- Water main/service linc / O ".../L Surface water / Driveway, parking/vehicle storage area ;:;2, O Curtain drain 6t'~/-, oO2~ Wells on adjacent lots / O0 F. ENGINEER'S CERTIFICATION I certiJy that 1 have determined thrufield inspections and review of Municipal record~ O~411re ia con/brmance with MOA If~gt del~es i ~ e~kct o ~ this date " C~-8801 t .,,)',2.: ?.,.,.,z~ ............................................................................................................... ...... · HAA Fee $ 3aO ~ Waiver Fee * Date of Piyme~t /~ ~ ~ Date of Pavment Receipt Namber Rev. 8/95 eSS: haa,wk.doc Receipt Namber CT&E Environmental Services Inc. Laboratory Division ~.~-~ Laboratory Analysis Report WATSR L8 BLK~ ~UMMIT EST Sampla Re~a~ks: S~4PL~ COLLECTED BY: BOB C. QC Allowable EX2. knal N£~rate-N 2.2 m~/L EPA 353.2 10, 09/27/9~ DJS 200 W. Potter Drive, Anchorage, AK 99818-1605 -- Teh (907) $62-2343 Fax; (907) ~6! ]5301 ENVIRONMENTAL I;ACILITIES iN ALASKA, CALIFORNIA, ~LORIDA, ILLINO[S. MARYLAND, MICHIGAN, MISSOURi, NEW JERSEY, OHIO, WEST VIRGINIA EO~ L~9'ON ~P69L06 ~ ~NIl$~l q~13~NNO3 6£:60i c6/EO/0~ un c pantyof Anchorage p.o. 65o ANCHORAGE, ALASKA 99502-0650 (907) 264-6508 TONY KNOWLES, MA YOR October 14, 1987 DEPARTMENT OF HEALTH & HUMAN SERVICES Project Development & Assessment Division 825 "L" Street. Suite 209 Alan C. Wien, Engineering Technician Alaska Environmental Control Services, Inc. 1200 West 33rd Avenue, Suite B Anchorage, Alaska 99503 Subject: Waiver Request for Lot 8 Block 3 Slam, it Estates Subd. Waiver Request Number WR87-060 Dear Mr. Wien: Your request for waiver of the required separation distance between well and absorption field has been approved. The required 100 foot separation has been waived to 91 feet. According to a well log for lot 10 summit estates, there is a confined aquifer at about 90 feet, with a dense clay layer at 50 feet. Your study of the subject well shows that the well is 87 feet deep and cased to83 feet. It can be safely assumed that this well draws from the confined aquifer and the same dense clay layer would prevent any contamination to enter the aquifer. This waiver approval applies to the existing absorption trench and any future upgrade would require another approval from D.H.H.S. Sincerely, Daniel J..Roth civil Engineer On-Site Services cc: Gus Andress, P.E., Manager, On-Site Services/Water Quality Programs AL^$KA TIUlROnrnenTAL CONTROL S 91CeS, Inc. ~n§in¢~dn§ F~ ~nuironmcnlal $1uc[i~s Municipality of Anchorage Department of Health & Human Services 825 L Street - 5th Floor Anchorage, Alaska 99§01 198 September 90, i,j,L]Ni~.ipALiTY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL pROT~.CTION Re: Lot 8, Block 3, Summit Estates Subdivision Waiver Request - Well to Absorption Field 1987 RECEIVED On 9/24/87, a adequacy test, well flow test, and Health Authority inspection were performed. Adequacy test results are adequate. The well flow test was run fo~ 4 hours at 5.2 GPM, The well seal could not be removed, so static water level, drawdown and recovery time are unknown. There is no well log available. The attached drillers report shows the total depth to be 87 feet and static level at 29 feet. From the HAA inspection, we find the separation distance from well to absorption field is 98.6 feet. This is measured to the standpipe. This portion of the absorption field is a ~ foot wide drainfield. If the standpipe is centered in the dratnfield, the distance to the nearest edge could be 91 feet. The inspection report for the drainfield shows 96 feet from the well and apparently a waiver was never issued. The absorption field is downslope from the well. Water samples taken 9/24/87 are satisfactory. We feel that this 9% reduction of the required separation distance will not pose a threat of contamination to the well. We request that you grant the appropriate waiver. If you have any questions, please call. Sincerely, Alan C. Wien Engineering Technician Approved by: 1200 LLJes! 33r~ J~u~no~. Suil¢ J~* J~nchoraq¢. J~las~o 99503-[907) 561-5040 ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) (c) Applicant Name ~''~' '~/'~'~/'~/~' Telephone: Home Business APpiicantAddress .~o~'~ ~ ~'7':..~-./-r'~' /,o/ .,,¢-~//..g~' Applicant is (ch~ck one): Lending Institution []; Owner/builder'J[~; Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent ,~,~"7~x/~'~;)¢-~'-~'"~'~'"'/~r~/~ Address (f) Telephone TYPE OF RESIDENCE Single-Family'S' Multi-Family [] Number of Bedrooms -~ Other WATER SUPPLY Individual Well~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~r, Public [] Community [] Holding Tank [] Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Heal[h Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in co_mpliance with all Municipal and State codes, ordinances, and regulations~in effect on the date of this inspection. Name of Firm /~ 5 Telephone Address /~'¢~ ¢J '~'~ ~,v'~' 5'u/?~ ~ ,,,~. Date /¢" ~' ~' ~ Approved for ,.~ bedrooms by r te Approved~.~ I I,' .,~, Disapproved Conditional Terms of Conditional Approval CAUTION 'rhe Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72.025 (11/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) ~LiHtCI~ALI~Y OF H£At~Tflc~UTHORITY APPROVAL (HAA) ~N,,/i~,OH~./,~HTAL SE~'"I[C;E~G'~i~I'LL~IST ' FEBRUARY 1984 ~-~ 264-4720 (.i)~.~ ~ ~ J"~':'~'~ Legal Description: ~'~' ~' Well Classification Well Log Present (YN~, Total Depth L~ Static Water Level ~) ~'~ Casing Height Above Ground Electrical Wiring in ConduitS) Separation Distances from Well: · To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot ~1~ ~,~, Date Comfileted ~c~.~¢ /¢~' ,l_Yield Cased to ~ ~'~ -- Depth of Grouting Pump Set At Sanitary Seal on Casing~.~/N) Depression Around Wellhead (Y(~ ; On Adjoining Lots · ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by Water Sample Test Results To Nearest Sewer Service Line on Lot ~, /~//Zr',,~ ; Date B. SEPTIC/HOLDING TANK DATA Date Installed StandpipeseN) - Air-tight Caps~N) Depression over Tank (Ye Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~) ~'~' To Property Line To Water Main/Service Line Course Comments ~ Size /,~ro No. of Compartments Foundation Cleanout (Y~) Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) ,'~//~ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026( 11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date installed ~,~'/'¢' Width of Field ~R/'~ Square Feet of Absorption Area over Field (Yg Depression Results of Last Adequacy Test Type of System Design Depth of Field ~/~ Gravel Bed Thickness ~/~ Standpipes Present ~N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation To Water Main/Service Line /~ ¢' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) ~//~ D. LIFT STATION ~ i/ Dimensions S,,~ze in G~al, l.o. ns~,.~ ~¢//'4 Manhole/Access (Y/N) Pump On" Level at ~ "Pump Off" Level at High Water Alarm Level at ~ Vent (Y/N) Tested for ~~les during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I~,~,~c~ckedTerified, or conformed to all MOA and Signed /-'~-':----&' '~/~- Date Company /~'~¢ MOA No. ReceiptNo. ~(.L~C~I --' ~%,~C,)'[ \ Date of Payment ~Q.~ '-'~ ~ ?~""~ Amount: $ ,9~4-t.C%/z2.L~ / ~(2Y.~, Page 2 of 2 HAA guidelines in effect on the date of this inspection. 72-026 (11/84) i Alpine Drilling & Enterprises Domestic -- Commercial Pump & Water Systems P.O Box 110495 horage, Alaska 99511 Job Name / Location (907) 345-0202 / £CS INVOICE No_ '2404 ; zoo QUANTITY DE~CfllPTION AMOUNT Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of {he Above Described Work.} TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. ALASKA ll'UlROnmenTAL CONTROL Ill[ KAREN GRIFFIN C/O FORTUNE PROPERTIES ANCHORAGE AK 10/06/87 SELLER-AK HOUSING FINANCE KAREN GRIFFIN C/O FORTUNE PROPERTIES ANCHORAGE AK 70261 LEGAL:SUMMIT ESTATES SUBDIVISION BLOCK 3 LOT 8 FLOW TEST ON WELL WELL FLOW DATE-09~24~87 T~E WELL FLOW RATE WAS 5.2 GPM FOR 4 HOURS. THE WELL IS AOEQUATE FOR THIS 3 BEDROOb~ HOME. 1209 U, Jes! 33rd Auenuc. Suilg B ,,Anchoraq¢. Alaska 99503 .{907) 561-50z10 ALASKA ENVlROt~tENTAL CONTROL SERVICES, INC. ].200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO, OF CALCULATED BY /~'-° ~J/~"~ DATE CHECKED SY DATE SCALF CHEMICAL & GEOLOGICAL ~ORATORIES OF ALASKA, ~ INC. ~ 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ,~',~,8'o~;T~,~'t,,~ FEDERAL TAX ID # 92-0040440 ,Up,) ,~ ,0. a.6,) ~;a~ame~er ?ested [~esu i r/Ur~ ts [~e [ boil L ~',~ t s Property Owner Mailing Address APPLI'i FILLS OUT UPPER HA: 'ONLY z~p Code _~.¢ Zip Code Phone Lending Institution Realty Co. & A~nt Address Phone Zip Code Phone Zip Code Legal Descript[°n ,,~// 0(~ ~,//o ¢ ,~ y Type of Resi~nce Single Family ~Uultiple Family No. of Bedroo~ ~ ~ Other Water Supply lndividua~ A~ACH WELL LOG. A w~ log is required for all wells drilled since June 1975, Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ~ ~.dividu~l Voar ~.divUu~ In~ta.ed: ~ -- ~ 2 ~4. ~ ~ Public Utility When Connected to Public ~tility: z / ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time /' ~ .'~--~ 3 Date Date Date Inspector inspector Inspector Inspector Field Notes: (.~ ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) D~SAPPROVED ( ) CONDITIONAL APPROVAL* Soils RaBng Date ~wer Installed Well To Absorption Area ~ Well Log Received W~ 8"~ Well to Tank ~G Septic T~k Size · : "Time ~,. 'Time Date Date Date Inspector Inspector Inspector Comments Conditional Approval ~ / (~ ~.3erovedBedrooms Date Sewer Installed Permit No. Septic Tank Size' ~--~ ~ Holding Tank Size Soils Rating Well To Absorption Area [ [ ~ Well Log Received APPLICANT FILLS OUT LOWER HALF ONLY Propedy Owner ~¢Y~ ;¢ ~¢C~ ' , 'Phone Mailing Address ~/ ~ ~ Buyer Address Lending Institution Phone Address Realty Co. & Agent Phone Address Legal Description ~ ~' ~ ~ /~' ~ Street Location ~¢ O ~¢ F Typecf Residence ~ Single Family B Multiple Family . No. of Bedrooms B Other Wat~Supply ~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June ~ Community 1975. For wells drilled prior to that date, give well depth (attach log if ~ Public Utility available.) Sew~e Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility:_ B Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. PENINSULA ENGiNEERiNG March 24, 1982 Harold Hornet c/o Alpine General Contractors P.O. Box 3-3985 Anchorage, Alaska 99501 RE: Adequacy Test 82-E-6 Lot 8, Block 3, Summit Estates Dear Mr. Horner: As per your request, I have performed an adequacy test on the absorp- tion sewage system for the above lot. The system consists of a septic tank (10OO gals. approx.) and a seep- age pit with two standpipes, one of which needs to be resecured ap- proximately 1.5' below grade. The system was tested in accordance with the standard Municipality of Anchorage recommended procedure with the following results. The levels in tank and pit were monitored and the septic tank was then pumped (approx. 1000 gals) and water was then added to the pit at 5GPM. The level in the pit started rising rapidly and after approx- imately 75 gals had been added it began backing up into the septic tank. The test was terminated after 150 gals had been added and a significant amount of water was building up in the septic tank. The test results (see attached sheet) indicate that the seepage system accepted less than 100 gals before backing up which is far less than the required 450 gals total load required by the Municipality for a three bedroom home. Therefore, I conclude that the absorption system is inadequate. If I can be of any further assistance, please call. Sincerely, Professional Engineer Enclosures - 2 WH:ph 2820 'C' Street~ #3,. Anchorage, AK 99503 PENINSULA ENGINEERING CONSULTING ENGINEERS 2820"C"STREET, SUITE NO. 3 ANCHORAGE, ALASKA 99503 PHONE: (907) 276-4855 TO: Re: Engineering [] Other [] Project No.: ?,;!~i~ ,.'~ LEGAL DESCRIPTION: ~.o~'. r~ Bloc!< SERVICES: ;:hrpir~g $ 55.50 Tota( $ 3o5.o0 All accounts are due upon receipt of services by PENINSULA ENGINEERING. Credit accounts not paid within thirty {30) days following receipt of service will be charged 2% per month on the unpaid balance. I hereby acknowledge receipt of the payment terms stated above. PLEASE PAY PROMPTLY copies of the above described Report and understand Signed Date PENINSULA ENGINEERING ADEQUACY TEST 82-E-6 Client: Address: 5500 East 98th Avenue Legal: "Lot 8 Block 3,' Summit Estates System: Septic Tank with seepage pit 1~ I)EPTII DEPTII TlblE(inii~) SEI'T[C TANK SEI~PA(;E PiT 0 54~" 64" Alpine General Contractors/Harold Hornet WA'J' F,R ADDEI) (gpm) EATE After pmpg 5" Start test 5" lO'min 5" 64" 0 64" 5 7O 5 20' min 30 min mi.n · min min min min min mir min min m±n rain Test termina in seepage [ being added into septic 83 88 ted after 30 . it was near gz to seepage pit tank. 5 Lnutes when wa ound l~el and was f l:6wing '['O'['AL ADDEI) (gal) 0 0 0 50 100 150 erlevel water :eadily back Date Date Date Inspector Inspector Inspector Comments Conditional Approval Date Sewer Installed Permit No. Septic Tank Size ~ Holding Tank Size Soils Rating Well To Absorption Area/~ We~l Log Received Well to Tank ~ ~ APPLICANT FILLS OUT LOWER HALF ONLY Property Own Lending Institutio~~ '~ ~~~ ~~ ~Phone Address~ ~ ~~~~ ~ ~_~ Realty Co. & Agent /~ Phone Address: ~/~/ Legal DoscHpt,o; ~~ X ~ ~ ~ ~~ S treetLocation ~ ~ ~ ~ ~~ /~ Type~sidence ~Single Family ~ Multiple Family No. of Bedrooms ~ Other Wat~pply ~ Individual a A~ACH WELL LOG. A well log is required for all wells drilled since June ~ Community 1975. For wells drilled prior to that date, give well depth (attach tog if ~ Public Utility available.) Sew~ DJsposa~ ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. December 16, 1981 Fred Rosenburg 2616 Sorbus Circle Anchorage, AK 99504 Subject: Blo.k 3, Lot 8, Summit Estates E 90th off Birch Road Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: ~he water analysis repert needs to be sub~itted to this office from the Chem Lab, 5633 B Street, for our review° The septic tank pumped ~ith a receipt submitted to this department. An adequacy test needs to be performed on the existing leaching area. This test w%ll determine if the system adequate according to National Standards° A listing of private firms performing the test is enclOSed~ This re.'port needs to be submitted to this office for our ~%f~9o Please notify this department for a reinspection when the noted discrepancies have been corrected. If there are any further ~uestions, please call this office at 264-4720. Sincerely, Enclosure Robert C. Pratt Associate ~ ' - ~.nvlronmental Specialist