The URL can be used to link to this page

Home My WebLink AboutSKYWAY PARK ESTATES BLK 3 LT 2A a C's oa I- Municipality of Anchorage Page _L_ of 3 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. SW990053 — PID Number ___L1 9 —141 —12 Name: RUSS—KELLER c/o L & R ENTERPRISES Wastewater System: 0 New [I Upgrade Address: P.O. BOX 91871 ANCHORAGE, AK 99509 ABSORPTION FIELD Phone; (907) 694-6296/440— Bedrooms: 3 C3 Deep Trench 0 Shallow Trench 13 Bed [3 Mound 13 Other LEGAL DESCRI13TION sa Mfg: 0.8 TOW Depth ftm oftlital Waft 7.1 — 7.3 WDISq. FL Ft. — Lot. Black: Subdivision: Depth to pipe Wtorn ftm *NWA grodw GraM depth berwath pips: 2 3 SKYWAY PARK ESTATES 4.1 — 4.3 FL 3-0 Ft, Townshlp: section: FRI added above wFOW grado 0.5 — 1.5 Drove! length: 66 It FL OroM wkKh; Number of ll� Distance be~ il� WELL: 0 New [j Upgrade 5.0 Ft. 1 5;�-97prw* A.97oT-- Tow Doptn: Cased To: Total aboorptlan area: I Plps matedal: PR TE 43.6 43.6 M 569 ASTM D -3034/F-810 —k.WWF- Wien ALPINE DRILLING & ENT, Date Ddled; 4/7/199 Statle, water Lzoeh 16 6 Installer. _RS __PF-� WHIITTE EXC. 4/16/99—4/19/99 GPMTPWP —St—z.— I U- - Fj coming H&jht Abm 0mod: 2 Ft TANK SEPARATION DISTANCES E Saptio 13 Holding 0 S.T.E.P. 79p.—otly In gallom 'A'NCHORAGE TANK 1000 TO S p!k1c Abso tIon Uft Holdlng 'u"'c/p= From ,f o Fad Station Tank s.. Well 100'+ 100,+ — 25'+ Material: STEEL WNW of cornpaftwft- 2 Surface 100'+ 100'+ - - LIFT STATION Water Ode Lot 5'+ 10,+ She In sallow Momfoolum Une an. HVII VOW 050M M Foundation 5'+ 10,+ 1 —4 Curtain punts MGM Moubioal kepecum peftaned by: p Drain KNOWr ____ 2� BENCH MARK Remarks: Location "A DeswIptiont B01 -TOM OF SIDING AT FOUNDATION CLEANOUT Assumed IEWvatlon: 98.86 ENGINEER1 6 Inspections performed by:-- AWWC, INC. Dates: JSt _ 4/16/99 (Al .... .......... V1 2nd -1 .. . . .. .... ........... P 3rd 5/24/99 J ffi-0 A. rness.: Department of Health and Human Services approval 7953 Reviewed and approved by: A//- Date: 2-Z 3 11 4 (Y� ......... 10141 ;�-- �f o/ - __ 4:V;_05; 12—DI3 (Rev. gill MOA 25 — PERMIT NUMBER: PARCEL ID NUMBER: SW990053 AS -BUILT DRAWING 019-141-12 WEST KLATT ROAD lw -UTILITY E—ASEMEwT---"_____._ \US �00' NEW WELLG—�_�� NEW 1000 GALLON % SEPTIC TANK MT2 CO2 I I -ALILKNA t'_ TH#2 � I 1� ki/ o k k "+TH#3 !i O�Slf' Tx� ol DBL2 i B I k I I I AMT1 LJ C Col NEW DRAINFIELD ALASKA WATER AlM WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 OF PHONE: (907) 337-6179/FAXi (907) 338-3246 SKYWAY PARK ESTATES SUBDIVISION, LOT 2, BLOCK 3, OF WORK: AS -BUILT OF SEPTIC SYSTEM AND WELL LOCATION . ..... ....... r ess: f PARED FOR: PHONE: NUMBER: RUSS KELLER (907)240-3868 -AC_ "7�953 .............. PAGE: ProfesswoG\ 1�z 8/31/ 9 7077 L. M. 40' 2 OF 3 _77 '�ZA=ll A_T___ff_ c- ST1 25.6 20.5 - ST2 29.5 20.6 - DQL1 31.3 21.2 - DBL2 33.0 22.5 - Col - 2_8tO 4T.-5 MT1 - 25.3 43.3 CO2 33.2 MT2 ;0:4:�- .9.5 B I k I I I AMT1 LJ C Col NEW DRAINFIELD ALASKA WATER AlM WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 OF PHONE: (907) 337-6179/FAXi (907) 338-3246 SKYWAY PARK ESTATES SUBDIVISION, LOT 2, BLOCK 3, OF WORK: AS -BUILT OF SEPTIC SYSTEM AND WELL LOCATION . ..... ....... r ess: f PARED FOR: PHONE: NUMBER: RUSS KELLER (907)240-3868 -AC_ "7�953 .............. PAGE: ProfesswoG\ 1�z 8/31/ 9 7077 L. M. 40' 2 OF 3 _77 '�ZA=ll PERMIT NUMBER: PARCEL ID NUMBER: SW990053 AS -BUILT DRAWING 019-141-12 f0? 9 W - Af Wf - 94,21 lNwff 0� PLN6-/ AT WT - 95bB alcil" 6M 96,90 (NO"l et 5f2 NM 1000 6&LON 5�PVC TANK Ml col MOM OV TlTNCH - 69BO(AWRAa) — f0l' 9 fMK Af OMFf - 94,21 or PuNcl AT OXI�f - 95.41 MAIL 6M 1 MIN& 6M —.971100"M INwff or rim 9 2 DO (AV6.) ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 SKYWAY PARK ESTATES SUBDIVISION, LOT 2, 13LOCK 3, PROFILE AS -BUILT OF SEPTIC SYSTEM PREPARED FOR: PHONE NUMBER: RUSS KELLER (907) 240-3868 8/31/99 1 J. L. M. I N.T.S. 1 3 OF 3 —7953 o f e 9 Fi,om : ALPINE DRTLL 907 345 0202 Maj. 21. 1999 04; 11G AM Pol Municipality of Anchorage Department of Health and HLIman Services 825 1" Vroot R10k Mystrom P-0-BOX198660 Anchorage, Alaska 90619-8650 Mayor PcrmltN"mber;4SW22-0M Date of Issue: Parcel Identification Number: 019-141-12 Date Slarted: k-Z,�99 Date Is woll located at approved permit location? — -- Legal peseription: �Park Ekfqtpp Ves D N Property Owner Name & Adtims. Russ Kellor P.O. Ba)(91871 chorage4, Ak 99509 111101'ehole Datai —5-0ptil —01), sell T�pe, Thiokneqq & water struta Froin Stick up 0 2 oigardo 2 9 gravelly slit 9 15 silty gravel 15 23 gravelly sill wet 23 37 Water sand & gravel 37 44 RE CE I VE D SEP 10 1999 Municipality ot Anenorige Dept. Health & Human Services Method of Drllll rig Z air rotary Ocabletool Casing type: fIgg/ Wall Thickness: 150 inchP3 Diameter: 6 inche8 Depth: 43, 6 t�et Liner Type: n/a Diameter: -- inchas Depth: — feet Casing stlokup above ground: 2 fact Static water level (from ground level): 16fibot Pumping levelijkfect after 2 hours pumping Lo gpni Recovery Rate; a &prn Method oure8ting: gU/ t Well Intake Opening Type: 0 Open Frid [j Ojvn I-Iole El Sureened S'tart— feel Stopped feet Ej Ilerforations Start_feef Stopped_—feei Grout Type: bggtp6Ug.VB. Volume: ZLYS Depth: Start 0 feet Stopped? foot Pump. Intake Depth x feet Pump8ize.X.I1I)Rraj1dN4I)),a x Well Disinfected Upon Completion? [9 YesEj No Method of Disinfection: QLQM Comments: Well Driller: Alpine Drilling &E."nterprises P.O. Box 110496 Anchorage, Ak 99511 AK Zip Altentlon: the property owno' "� fh. d.'11IAV 01"11 nm,Arl� 1�,, t� ih. Ilpw nf I lo.101 & I It .... a,, '.Ith!�' AO ,I . ......... Municipality of Anchorage Community Development Department On -Site Water and Wastewater Program 4700 Elmore St.. P.O. Box 196650 Anchorage, AK 99519-6650 - hftp://www.muni.org/onsite ® (907) 343-7904 Legal Address: Subdivision Skyway Park Estates Block 3 Lot 2 T R_ Section Lot5 — 8 62L, cz-,!; // S On-site Water & Wastewater Program certified contractor performing the well decommissioning: Name: Gary Witt Signature: Company: GLW Enterprises, Lic Well decommissioning date :r -A Method of decommissioning: AMC 15.55.0601-1 a. C. rV1 Location: Use the space below to provide a drawing of the property showing the following items; ® North arrow ® Decommissioned well, ® Other water wells on the property, Nddg� ® Two separate swing -tie distances for each well shown on the drawing, Note: The swing -fie distances shall be measured from either permanent structures or the property corners. H I I I N IY Services\Building Q IY Services\Building Permit Number: SW990053 Parcel ID: 019-141-12 Legal Description: SKYWAY PARK ESTATES BLK 3 LT 2 Design Engineer: 0041 AK Water & Wastewater Consulta Site Address: Owner Name: Russ Keller Lot Size� 60233 SQ. FT. Owner Address: PO Box 91871 Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99509-0000 This permit is for the construction of: Y] Disposal Field [V] Septic Tank Holding Tank 0 Privy Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2, All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: \a 'C�'6y-\ MUNICIPALITY OF ANCHORAGE -cn Department of Health and Human Services On -Site Services Program ',,zL) cL cv, 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Apr 06, 1999 Expiration Date: Apr 05. 2000 Permit Number: SW990053 Parcel ID: 019-141-12 Legal Description: SKYWAY PARK ESTATES BLK 3 LT 2 Design Engineer: 0041 AK Water & Wastewater Consulta Site Address: Owner Name: Russ Keller Lot Size� 60233 SQ. FT. Owner Address: PO Box 91871 Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99509-0000 This permit is for the construction of: Y] Disposal Field [V] Septic Tank Holding Tank 0 Privy Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2, All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: Alaska Water & Wastewater Consultants, Ince 6901 Debarr Road, Suite 2B — Anchorage — Alaska 99504 (907) 337-6179 -- Fax (907) 338-3246 Consulting Engineers March 29, 1999 Municipality of Anchorage Department of Health & Human Set -vices Division of Environmental Services On. -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 i'a-U! V LL) MAR 3 ! 1999 MUNICIPALITY OF ANCHOPAGE ENVIRONMENTAL SERVICES DIVISION Ref. Septic Design for Lot 2, Block 3, Skyway Park Estates Subdivision To whom it may concern: The proposed 3 bedroom house will be served by a private septic system and a private well. Three test holes were excavated on the property. Comments regarding the proposed design are summarized as follows: 1. SOILS: Test hole 41 was found to be unsuitable for a septic system. Test holes 42 and #3 will be used for the septic area design. Attached are logs which shows the soil profile, and the percolation test results for TH#2 and TH#3. In both test holes, the soils below the organic layers are a ML material a depth of 2.5 feet in TH#2 and 3.0 feet in TI -1#3. At 2.5 and 3.0 feet the soils transition to a GM/ML material to a depth of 13 feet in TH#2 and 13.5 feet in TH#3 (bottom of test holes). No groundwater was encountered during the excavation of the test holes. Two percolation tests were performed in TH#2, between the depth of 3.5 feet to 4.0 feet, and 5.0 feet to 5.5 feet. The percolation rates were 120+ minute/inch and 4 minute/inch. Two percolation tests were performed in TH#3, between the depth of 2.0 feet to 2.5 feet, and 5.0 feet to 5.5 feet. The percolation rates of 34.3 minute/inch and 3.6 minute/inch. Due to wide variations in the . -'LWW'e percolation tests, it is our opinion that a 0.8 application rate be used. 2. TRENCH DESIGN: a. Percolation Rate: 3.6, 4, 34.3, & 120+ minutes/inch b. Allowable Application Rate: 0.8gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day 2 e. Minimum Absorption Area: 563 - f. Total Depth: 7 feet (maximum) g. Effective Depth: 3 feet It. Width: 5 feet minimum i. Reduction Factor: 0.58 i, Minimum Length: 66 feet long j Effective absorption area = 569 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The average topography of this property is mostly flat; in short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. A President P.E., M.S. NOTE: Attached is a site plan, a design drawing, flve soils logs, and a 4 page construction specification letter which are all part of the design package for this septic system. LOT 3, BLOCK 2 SKYWAY PARK EST. NO COKM5 L - - 1 LOT 4, BLOCK 2 SKYWAY PARK EST. KIO CONM5 WE�ST KLATT ROAD Z 777— PROPOSED SEPTIC SYSTEM— (SEE DESIGN, PAGE 2 Lmlus PROPOSED PIZ WELLL 3 E 6, 1- PROPOSED SEPTIC SYSTEM— (SEE DESIGN, PAGE 2 Lmlus THE ALTERNATE SITE - LOT 3, BLOCK 3 SKYWAY PARK EST. MASKA VATM AND WASTEVAUR CONSULTANTS, INC. 6001 DE13ARR ROAD. SUITE 28, ANCHORAGE, AK. 99504 PHONE: (07) 337-13170/FAX: (907) 138-3246 LEGAL DESCRIPTION: SKYWAY PARK ESTATES S/D; LOT 2, BLOCK 3. E F WORK: I SITE PLAN FOR WELL AND SEPTIC DESIGN RUSS KELLER 3/29/99 NE NUMBER: 240-38613 100, 1 1 OF 2 LOT 1. BLOCK 3 SKYWAY PARK EST,- CkAq6D k,_LOW WELL RADIUS LOT 4, BLOCK 3 SKYWAY PARK EST.,-" 1A x tr r Z .7 ... A. Garnessi :U7953 ........... PIZ 3 E 1- --- 4tj ryi LLJ n �S� Q THE ALTERNATE SITE - LOT 3, BLOCK 3 SKYWAY PARK EST. MASKA VATM AND WASTEVAUR CONSULTANTS, INC. 6001 DE13ARR ROAD. SUITE 28, ANCHORAGE, AK. 99504 PHONE: (07) 337-13170/FAX: (907) 138-3246 LEGAL DESCRIPTION: SKYWAY PARK ESTATES S/D; LOT 2, BLOCK 3. E F WORK: I SITE PLAN FOR WELL AND SEPTIC DESIGN RUSS KELLER 3/29/99 NE NUMBER: 240-38613 100, 1 1 OF 2 LOT 1. BLOCK 3 SKYWAY PARK EST,- CkAq6D k,_LOW WELL RADIUS LOT 4, BLOCK 3 SKYWAY PARK EST.,-" 1A x tr r Z .7 ... A. Garnessi :U7953 ........... WEST KLATT ROAD PROPOSED DRAINFIELD. EXCAVATE 7 FEET DEEP MAXIMUM BY 5 FEET WIDE MINIMUM BY 66 FEET LONG. ADD 3 FEET OF CLEAN, WASHED SEWER DRAINROCK. INSTALL TRENCH PARALLEL TO ALL SLOPE CONTOURS. "uu/ PROPOSED 100' WELL RADIUS WELL PROPOSED 1000 GALLON SEPTIC TANK— PROPOSED DRRIEWAY INSTALL DBL CO *TH#1 0 Q GO MT ---- — — — — — — -- o MT +-TH#2 +TH#3 ALTERNATE SITE- NOIE: 1. THE CONTRACTOR SHALL HAVE THE EAST PROPERTY LINE FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO ANY CONSTRUCTION. 2. fHE CONTRACTOR SHALL FIELD VERIFY THAT ALL SEPAR— ATION DISTANCES WILL CIE MPr PRIOR TO CONSTRUCTION. AIASIU VAM AND WASTEWAM CONSULTANT% INC. 6901 DEGARR ROAD SUITE 2B. ANCHORAGE, AK 90504 OF A PHONE: (907) 337-6179/FA)C: (OD7) 338-3246 /-A." SKYWAY PARK ESTATES S/D; LOT 2. BLOCK 3, OF WORX: DESIGN OF SEPTIC SYSTEM AND WELL LOCATION e fr y rness- . PARED FOR: PHONE NUMBER: 7953 RUSS KELLER 240-3868 'p 4 — PAGE: 3/29/99 ___r N F. J. L. M. SCALE: 1 = 4W7 2 OF 2 Profaaawlo ALASKA WATER & WASTEWATER CONSUMANT&PLq. I SOIL LOG - PERCOLATION TEST] LEGAL DESCRIPTION: SKYWAY PARK ESTATES, LOT 2, BLOCK 3 PERFORMED FOR: CHRIS AND MARIE CURRY DATE PERFORMED: 11/24/98 DEPT =# (f cc 1 . .... ORGANICS SOIL CLASSIFICATIONS 4 5]M CH 6 BLUE CLAY 7 9 RAW/ 11 -M B.O.H. 12- 13- 14- 15- 16- 17- 18— DEPTH TO GW GP GM Till ORG ML CL DRY ll E DRY 12/3/98 �Il GC OL SW MH 9 SP CH REISm OH M' Sc DEPTH TO DATE GROUNDWATER NEI' TIM—E (MINUTES) DRY 11/24/98 DRY 12/3/98 WEST t<LATT ROAD PROPOSED PROPOED SEPTIC SYSTEM WEILLZ (SEE DESIGN, PACE 2 OF 21 I Do� WELL RADIUS < - �H#2 ALTERNAIL —1— mSITE-P-L&N] ill- 100, DATE READING CLOCK TIME NEI' TIM—E (MINUTES) __WAT F -R LEVEL READING NETDROP (INCHES) 19— PERCOLATION RATE N/A —(MIN./INCH) 20-- - TEST RUN BETWEEN N/A —FT. AND COMMENTS: NO PERC. TEST PERFORMED DUE TO UNSUIA�Kj SAIL$. & I � / ZIL PERFOMED BY ALASKA WATER & WASTEWATER 1. THIS WAS PERFORM�t N/ACCORDANCE WITH ALL DATE. DATE: HOLE DIA. N/A (INCHES) FT. .E FOR ON—SITE SEPTIC. —, CERTIFY THATI IN EFFECT ON THIS w1. . ; %. vi � �, �W PHONE (007) 337-6170 * FAX (007) 338-3246 [-SOIL LOG - PERCOLATION LEGAL DESCRIPTION: SKYWAY PARK ESTATES, LOT 2, BLOCK 3 PERFORMED FOR:– CHRIS AND MARIE CURRY DATE PERFORMED:_ 11/24/98 DEPTH (f ee ORGANICS -E #2 1 T PAGE I OF 2 2 ML SOIL CLAS IFICATIONS 2 4 f-i� pill''ll GM/ML I Li I 13 — 1: 11111 TIGHT, SILTY, 1! SANDY GRAVEL. 12- 13— B.O.H 14 ] 15 16 20 ' COMMENTS: PERC. FOR LOWER BENC PERFOMED BY ALASKA THIS WAS PERFOR)AED DATE. DATE: 34 2,9 o GW GP GM GROUNDWATER ORG ML CIL Q 7 Lu t114 DRY 12/3/98 GC I OL C, .0.1" S W +T H#1 MH SP +�Hj2 -efi#31 CH 1:56 2:06 2:06 2:16 sM 7qz OH 2 1/2 SIC 11 12 2:16 2:26 DEPTH TO DATE GROUNDWATER 1 DRY 11/24/98 DRY 12/3/98 OF �=Wff�7 (ft -7953 WEST KLA'rf ROAD CLOCK TIME 1 WATER LEVEL READING PROPOSED PROP0\'ED SEPTIC SYSTEM E Wltll'N, ' A WELL (SEE DESIGN, PAGE 2 OF 2) 12/l/08 ----- L'S /1—aw WELL RADIUS 1 1:26 1:36 1:36 10 3 1/4- 3 1/4" 6" --2 +T H#1 2 3/4" 2, 3/4"- 1/2"- 1:46 1:46 1:56, +�Hj2 -efi#31 1:56 2:06 2:06 2:16 — 10 — 10 -3 1/2" 3 1/2' 2 1/2 11 12 2:16 2:26 10 PROPOSED 3 1/2' 2 1/2" J BEDROOM ALTERNATE SfTEJ 1 HOUSE 1 FS—ITE PLAN DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 12/l/08 ----- - 1 1:26 1:36 1:36 10 3 1/4- 3 1/4" 6" --2 - 2- 3 4 5 6- 7 8 9 10 2 3/4" 2, 3/4"- 1/2"- 1:46 1:46 1:56, 10 — 10 1:56 2:06 2:06 2:16 — 10 — 10 -3 1/2" 3 1/2' 2 1/2 11 12 2:16 2:26 10 3 1/2' 2 1/2" PERCOLATION RATE 4 (MIN./INCH) TEST RUN BETWEEN 5.0 FT AND HOLE WAS PRESOAKED 4.1- HOURS RIO T T1 ;H PERC. HOLE ONLY. TEST HOLU LOCA110 RE XATER & WASTEWATER 11 ACCORDANCE WITH ALL S E NICH L HOLE DIA. 6 (INCHES) I DATA ON THIS PAGE , CERTIFY THATI IN EFFECT ON THIS I ATER & W I SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: SKYWAY PARK ESTATES, LOT 2, BLOCK 3 PERFORMED FOR: CHRIS AND MARIE CURRY DATE PERFORMED: 11/24/98 DEPTH _�T H 0 [K�� (fe I c T-1 PAGE 2 OF 2 2 3 5- 6- 0 7— CID In 9 ''1 Ld 11 Q 13 14 15 16 17 is SOIL CLASSIFICATIONS o uVV GP _____S_EE_PAGE ML - "jj GM CL 30 SOlLS 101, GC OL sw SP 2 MH CH SM OH SC DEPTH TO GROUNDWATER DATE _____S_EE_PAGE 1 OF 2 - NET DROP (INCHES) T2_/T/-9-8 SEE PAGE 1 OF 2 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READR NET DROP (INCHES) T2_/T/-9-8 1:27, 30 SOlLS 101, 2 1:57 IMPERMEABLE 19 PERCOLATION RATE: 120+ -(MIN./INCH) 201 —1 TEST RUN BETWEEN 3-5 — FT. AND VT COMMENTS: PERC. HOLE WAS PRESOAKED 4+ HOURS 10 /E'STJNII FOR U13PER BENCH PERC. HOLE ONLY. — zilu PERFOMED BY ALAS J�A , VATER & WASTEWATER 1, THIS WAS PERFORMED IIN ACCORDANCE WITH ALL STATE N ICIPAL DATE. DATE: I a) PERC. HOLE DIA. 6 (INCHES) FT. DATA ON THIS PAGE . CERTIFY THATI ES IN EFFECT ON T WATER& WASTEWATER CONSULTANTS INC. I_ I SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: SKYWAY PARK ESTATES, LOT 2, BLOCK 3 PERFORMED FOR:- CHRIS AND MARIE CURRY DATE PERFORMED: 11/24/98 DEPTH 7 -- (feet) -- ORGANICS TEST HOLE #3 PAGE I OF 2 2— w!! 1 ML SOIL CLASSIFICATIONS DRY- 1 1/24/9B DRY 12/3/9B 1:24 ii;iilii GW ORG IQ I 1:34 10- GP J 1/2" ML 3 1:34 GM 6" CIL 4— 1:44 GC OL 3" 5 Sw MH — -- 5— SP 1:54 CH 3 1/4" 6" 2 3/4" SIM 2:04 CH 6-11 M 7 Sc 3 1/4" H 2:04 6' 7 GM/ML TIGHT, SILTY, I SANDY GRAVEL. 9 1 10. 11 12 13 14 15 16 17 18 .O.H. DEPTH TO DATE GROUNDWATER NET TIME (MINUTES) DRY- 1 1/24/9B DRY 12/3/9B I f953 ........... WEST KLATT ROAD PROPOSED PROPO�ED SEPTIC SYSTEM WELL (SEE DESIGN, PAGE 2 OF 2) 1OW-WELL RADIUS +TH#I H#2 PROPOSEO 3 BEDROOM ALTERNATE SITEJ on[ 11:r NTS- 1100N DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READIWG NET DROP (INCHES) 12/1/9B 1 1:24 6" 2 1:34 10- 2-1/2" J 1/2" 3 1:34 6" — 1:44 3" 5 1:44 6" — -- 6 7 1:54 10 3 1/4" 6" 2 3/4" 1:54 2:04 2 3/4" 8 10 3 1/4" 9 2:04 6' 10 2:14 10 3 114 -2 3/4"-- 11 2:14 6' 2 3/4" 12 2:24 10 1/4' 10 PERCOLATION RATE 3.6 —(MIN./INCH) E 20 TEST RUN BETWEEN 5.0 —FT. AND 5 COMMENTS: PERC. HOLE WAS PRESOAKED 4+ HOURS I R 0 T TI. 13 RC I FOR LOWER BENCH PI- RC. HnI F ONLY. TEST HOLE OC I RE P OXII PERFOMED BY ALASKA WATER & WASTEWATER I.. THIS WAS PERFORMED 10 ACCORDANCE WITH ALL S JNICIPA GUID DATE. DATE: HOLE DIA. 6 JNCHES) I DATA ON THIS PAGE , CERTIFY THAT IN EFFECT ON THIS 'ATER CONSULTANTS. INC. I SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: _SKYWAY PARK ESTATES, LOT 2, BLOCK 3 PERFORMED FOR:- CHRIS AND MARIE CURRY DATE PERFORMED: 11/24/98 DEPTH Ei�T �HOLE 1 -1 PAGE 2 OF 2 (f ee T oj SOIL CLASSIFICATIONS 13 14 Is 16 17— is— DATE READING CLOCK TIME NEI' TIME (MINUTES) UW UNU NET DROP (INCHES) 12/1/98 3- 1:25 1:55 1:55 2:25 GP 1 i 7, ML 2 3 4 5 6 30 30 30 7/8" GM CL 2:55 4— 14 GC OL SW MH 5— SIP CH It il VAR SIM OH SEE PAGE 1 OF 2 6— 0 SC 7— DEPTH TO DATE GROUNDWATER < SEE PAGE 1 OF 2 n 9 LLJ I D 13 14 Is 16 17— is— DATE READING CLOCK TIME NEI' TIME (MINUTES) WATER LEVEL RC4DING NET DROP (INCHES) 12/1/98 1 1:25 1:55 1:55 2:25 6 5" 6" 5 1/8.. 6" 5 1/8" 2 3 4 5 6 30 30 30 7/8" 2:25 2:55 7/8" 19— PERCOLATION RATE 34.3 —(MIN./INCH) 20--- TEST RUN BETWEEN 2.0 FT. AND COMMENTS: PERC. HOLE WAS PRESOAKED 4+ HOURS/�RRIO� Nq, FOR UPPER BENCH PERC. HOLE ONLY. PERFOMED BY ALASKA WATER & WASTEWATER 1, STAT THIS WAS PERFORYED 1p ACCORDANCE WITH ALL Et DATE. DATE: z "i HOLE DIA. 6 -(INCHES) I DATA ON THIS PAGE —, CERTIFY THAT IN EFFECT ON THIS 5678g '• V •a!'- 5 •O7, a£O 8 !it-Z7 tt-_7 Municipality of Anchora �� On-Site Water and Wastewater Program R 0 5 2018 . (907) 343-7904 Q ��• A F E T Y N' o Certificate of On-Site Systems Approv. 6 8 L9 S" Parcel I.D. 019-141-12 Expiration Date: 11^7 1. GENERAL INFORMATION: Complete legal description SKYWAY PARK ESTATES; BLOCK 3, LOT 2 Location (site address) 11801 Puma Street*Anchorage 99515 Current Property owner(s) Jeff Waltz Day phone 229-0189 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Distance: Received by: ��^ Date: �+I 19 COSA to be released to the-e4neer, unless otherwise requested by the engineer. COSA Fee $ (52- �,, Waiver Fee $ Date of Payment y— ' Date of Payment Receipt Number OCI�S I Receipt Number COSA# dS�1 l� J D 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: Q000Op.,, In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o O F 4 in accordance with the guidelines and regulations established by the Municipality of Anchorage and • 4 4 industry practices. The reported results describe the condition of the system/s on the date/s of the i .• V n n evaluation. Separation distances were measured to readily identifiable features. Hidden defects or ' T V encroachments may exist that were not identified during the evaluation. The operational life of all wells T' 4 i .'\ v and septic systems depend upon a variety of variables, including but not limited to, soil conditions, VA groundwater levels (that may fluctuate during the year), quality of construction (materials and Q workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and .. .I.. are outside the control of GEG. Satisfactory test results do not guarantee future performance of the / • of,r: • 'mess.: system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of /)9 • E— the well or septic system. GEG makes no representation whether an alternative well or septic system Q .mac p can be installed on the property in the event either of the current systems fail to perform adequately in %/e ••4/'S �.�ccA� the future. The content of this report is for the sole benefit of the person/party that retained GEG to % aProfessic00o� perform the evaluation. Reliance upon the information provided in this report by any other person or ��\00o party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms DisapprovedQ\- OFANc, Conditional approval for bedrooms, with the following sti ations: O� ON-SITE c . WATER AND om WASTEWATER oz PROGRAM nr, cr'C� cK- By: �.- �� A - Original Certificate Date: _ 9 -10 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 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: SKYWAY PARK ESTATES; BLOCK 3, LOT 2 Parcel ID: 019-141-12 A. WELL DATA PUBLIC Well type If A, B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N Total depth ft. Cased to ft. Casing height (abo - .round) in. FROM WELL LOG AT I .` CTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RES - : Coliform colonies/100 ml. Nitrate mg./L. Collected by: enic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 4/16-5/24/99 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (YIN) YES Depression over tank(Y/N) NO High water alarm (Y/N) N/A Date of pumping 06/7/17 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE AT MONITORING TUBE Date installed 4/16-5/24/99 Soil rating (g.p.d./ft2or ft2/bdrm) 0.8 System type SHALLOW TRENCH Length 66 ft. Width 5 ft. Gravel below pipe 3.0 ft. Total depth *7.8+ ft. Eff. absorption area 569 ft2 Monitoring tube YES .Depression over field NO Date of adequacy test 3/23/18 Results(Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 12 in. Water added 468 gal. New depth 22 in. Elapsed Time: 120 min. Final fluid depth 17 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 off' level at '• a er alarm level at in. .- Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES PUBLIC SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main '•• ' sewer manhole/cleanout Sewer/septic service line Holding tank - - containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ Property line 5'+ Absorption field 5'+ Building foundation p y Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation *10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *IMMEDIATELY ADJACENT TO SMALL SHED (NO CONCERNS) oo600pp,. G. ENGINEER'S CERTIFICATION �,c..P ••A `14 I certify that I have determined through field inspections and vo 0* 9 d , * review of Municipal records that the above systems are invA conformance with MOA COSA guidelines in effect on this / 1/ date. I J!f of A. Games.: Engineer's Printed Name JEFFREY A. GARNESS vO,Op 1 */. E A-d 7• 3�. .�co0Q •,. v 47 Date /� / (40 professioCOv� �Dp000�� #AECC884 (Rev. 11/05) • _ _ _OL_D KLAN T' ROAD _ _ K(A b (WEST +•ATTT ROAD — NI,' H Vo. LU LLI 16.20' : a as S85"27'34:rE 250.84' Cl)I t: - — -— _ 10' UTILITY EAS 9.0.Q n -- — - — `-- — — CP EXISTING 1 _ o. 20'UTILITY EASEMENT(SCALED FROM P-632) r d HOUSE 'O' 50' 0 GAZEBO .. — — No. RIVER ROCK �' `Bp • GARDEN `1 ,'; LOT 2 I a ry'. d LIGHT POLE g NO W 7.t 2 SHED i q N BUILDING DETAIL SCALE 1"=30' CC W : _.. • /'- >>co W � LOT1 C , 5CO J el BRICKIltS 000�0.pp� RETAINING �� _ 8 g ,oQ OFA OQ o WALL EXISTING o b o 0 oLL PF......... AAA. .gsp O 152.8'- ��.,,, HOUSE 0 O Qa'\. • •.'00 Z .11 I� 2 CO DO* 4 TH y*QQ 'i Q BRICK . b --TO - �A •.STEVEN CALLA AN: 0 RETANVMIG x °cR 0'� LS—C2 34 . ,..- D I FOUND 3/4'IRON PIPE WALL I i FOUND 3/t'IRON PIPE 04^^00•':17/206%°iJ4� 50' 0 N90"00'00"W 299.801 (R) 6 44p�0000° �� N89°54'47"W 299.93(M) LOT 4 LOT 3 SCALE 1"=50' NOTE: THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN LEGAL WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH. 250 H Street DESCRIPTION: ADDRESS: 11801 PUMA ST. PARCEL NO:019-141-12-000 Anchorage,Alaska 99501 LOT 2, BLOCK 3, AS-BUILT (-'- �I��r� SURVEY CERTIFICATION:LOG LANTECH.INC HAS CONDUCTED A PHYSICAL SURVEY OF 1 .= iV•1>>\J THE PROPERTY A4 SHOWN ON THIS DRAWING AND CERTIFIES THAT TINE Survey Department SKYWAY PARK ESTATES ` Phone 562-5291IMPROVEMENTS EMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO Mainline LEGEND- CLEAN UT ENCROACHMENTS EXIST OTHER THAN NOTED. antlaEr. Inc Phone 243-8985 - -DRAWN DATE: 3/29/18 WORK ORDER 18022I ---• Asphalt a4thilethete• en9N�a+9•a ^g DRAWN BY: AP PLAT: P-632 Gravel.. ,-. EXCLUSIONARY NOTE IT I.THE OWNERS'ENA RESPONSIBILITY TO OR RIGHT-OF-WAY TIE — — EXISTENCE OF ANY EASEMENTS.COVENANTS.RESTRICTIONS OR RIGH-OF-WAY CHECKED BY: SC GRID: SW2729 -...r..' - o q...._.-;iii. CIR STANCE S NOT APPEAR A THE ON ED USED FOR ISIONCONS PLAT.UNDER NO ORDERED BY: KIM MITTNESS FENCE —x—x— =WOOd D dRCUMSTANCEB SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION.FOR SCALE: AS SHOWN FB/PG:808/44 REF:16018 ESTABLISHING PROPERTY LINES.OR FOR PLOT-PLAN PURPOSES. Parcel I.D. 019-141-12 F1 E: Municipality of Anchor* MAY i On -Site Water and Wastewater Prograrp (907)343-7904 \�Z\ Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: V-1 (7-1 (�- Complete legal description SKYWAY PARK ESTATES; LOT 2, BLOCK 3 Location (site address) 11801 Puma Street *Anchorage AK 99515 Current Property owner(s) Chris & Marie Curry — Day phone 868-7578 Mailing address Same Real Estate Agent Brett Hull 2. TYPE OF DWELLING: Single Family (w/wo ADU) Duplex F� Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Individual Well R Individual Water Storage El Community Class — Well El Public Water System El WaiverNariance request for: NIA Received by: Day phone 351-8047 TYPE OF WASTEWATER DISPOSAL: Individual y Holding Tank F-1 Community F-1 Public Sewer F COSA to be released to the engineer, unless otherwse requested by the engineer. COSA Fee $ �2 a Date of Payment 4,5 1/ (J14, Receipt Number Date: Waiver Fee $ Date of Payment Receipt Number COSA # Waiver# N/A S. 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 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259 Engineer's Printed Name Jeffrey A. Garness — Date �3 1 )t3 & In conducting this evaluation, GEG provided an engineering evaluation of the well andlor 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 systemls on the datels 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 on 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 systemls. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systemls; 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. The content of this report is for the sole benefit of the personfoarty who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the personlparly who paid for this report. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms OFq� Disapproved Conditional approval for bedrooms, with the following sti- atiorON-SITE WATER AND By: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of Ori -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 >C Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA bi.e sheet 9-1-12.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: SKYWAY PARK ESTATES; BLOCK 3, LOT 2 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 4/7/99 Sanitary seal (Y/N) YES Total depth 44 ft Casedto 43.6 ft. FROM WELL LOG Date of test 4Z7/99 Static water level 16 –ft. Well production 20 9 -P.M. WATER SAMPLE RESULTS: Collform 0 colonles/1 00 mi. Nitrate NO Mg./L. Parcel ID:- 019-141-12 Well Log (YIN) YES Wires properly protected (Y/N) YES Casing height (above ground) 18+ in. AT INSPECTION 4/27/16 3.4+ —g -P -M - Collected by: GEG, Ltd. Arsenic: 22.8 ugA. Delp- of sample: 4 /27 /16 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 4/16-5/24/99 Tanksize 1000 gal. Number of Compartments 2 '. Cleanouts (Y/N) YES Foundation deanout(Y/N) YES Depression over tank (Y/N)' NO High water alarm (Y/N) N/A Date of pumping 8/11/15 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA �BELQW EXISTING GRAD—El Date installed 4/16-5/24/99 — Sol[ rating 'Qki-1401-W, 0.8 Syetarritypg SHALLOW TRENCH_ Length 66 ft. Width 5 -ft. Gravel below pipe 3.0 ft. Total depth *7.4+ ft. Eff. absorption area 569 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 4/27/16 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 26 In. Water added 516 gal. Newdepth 29 in. ElapsedTime: 120 min. Finalflulddepth 27 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE — If yes, give date D. LIFT STATION Dateinstalled— Sizeingallons— Manhole/Access(Y/N) "Pump on" level at—in. "Pump off`12ygLat--------ffr� --- Tilig;�h �wateralarm level at Cycles tested— Meets alarm & circuit requirements? - E. SEPARATION oisTANCES SEPARATION DWTAN-CES 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 Public sewer manholetcleanout 100,+ Sewer /septic service line 25'+ Holding tank Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ PrDperty line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100,+ Wells on adjacent lots 100,+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parkingivehicle storage 10'+ Curtaindrain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEERS / cerffly 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 N me JEFFREY A. GARNESS Date T/V (Rev. 11/05) Municipality of Anchorage Development Services Department 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 # OSC161171 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 2 of Skyway Park Estates Subdivision. This inspection revealed an arsenic concentration of 22.8 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/onsitg) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. PUMA 4 STREET (JUNIPER STREET) Kinno n4—in-c 47& �A I so, I 10 ::� lr— m cn 0 i A X ffin in Ce m Fgmo z 0 tR LL T Too PUMA 4 STREET (JUNIPER STREET) Kinno n4—in-c 47& �A I so, I 10 ::� lr— m cn 0 i A X MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEA[.TH & HUMAN SERVICES C40 Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 a P/1 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 2)b Parcel I.D. # 019-141 12 HAA # ANA93041� 1. GENERAL INFORMATION Complete legal description - Lot 2; Block 3; Skyway Park Estates Location (site address or directions) Juniper & West Klatt Rd. J. Anchoraqe, AK 440-5363 Prope;rty owner _Russ Keller Day phone Mal - lingaddress P.O. Box 91871 Anchorage, AK 99509 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 — 3. TYPE OF WATER SUPPLY: XX Individual well Community well Public water NOTE: If community wellsystem, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL, Individual on-site XX Holding tank Communi.ty on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-026 (Re�. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER Ascertified bymysealaffixed heretoanclasof the validation date shown below, I verifythatmy 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 Alaska Watq Name of Firm A I I '_ /__� x -, Address Engineer's signature 6. Dli SIGNATURE 0 Approved for THIRF bedrooms. Disapproved. Conditional approval for Additional Comments 1� &_'. 111TIC, is inspection. Phone _-3�7-60'�l Date I bedrooms, with the following stipulations: Date 0/- /3 -CM 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 theStateof Alaska.The DHHSdoesthisasa I courtesyto purchasersof homes and theirlending institutions in order to satisfy certain federaland state requirements. Employeesof DHHSdo 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. 7M25(Rft.1/91) aack MOA�i RECEIVED Municipality of Anchorage SIEP 10 1"9. 1 DEPARTMENT OF HEALTH & HUMAN SERVICES 0&) Environmental Services Divis,ion MWANQUAWY Of- ANCHO 825 L Street, Room 502 9 Anchorage, Alaska 99501 e (9"" �A ehigliviclis'Di Health Authority Approval Checklist Legal Description: - SKYWAY PARK EST.; LOT 2, BLOCK 3 Parcel LID.:— 019-141-12 A. WELL DATA Well type PRNA-TE — If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N).— YES -- Date completed 4/7/99 Total depth 43.6 Cased to 43.6 Casing height (above ground) Sanitary seal (Y/N) -- YES — Wires properly protected (Y/N) YES FROM WELL LOG AT INSPECTION Date of test 4.171139 Static water level 16' Well production 20 —9 -P.M. WATER SAMPLE RESULTS: Colifo rm Nitrate Other bacteria -6— Date of sample: Collected by: A.W.W.C., INC. B. SEPTIC/IHOLDING TANK DATA Date installed 4/1 6L99 - 4/19/29rank size _ 1000 Number of Compartments 2 — Cleanouts (Y/N)- YES Foundation cleanout (Y/N) YES Depression (Y/N) NO High water alarm (Y/N) NO Date of Pumping_ NEW Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft' or ft2/bclrm) . 0.8 - System type — TRENCH - Length -- 66'- -Width 5' Gravel thickness below pipe.— 3' 7,5' - 8.0' --Total depth -- Effective absorption area 569 SQ F1 Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO Date of adequacy test__ NEW — Results (Pass/Fail) -� Fluid depth in absorption field before test (in.); Inuued after gal. water added (in.): Fluid depth --- (ins) 9[m a on. -- Absorption rate =----g-p-d- (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm E. SEPARATION DISTANCES Size level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: "Pump off" level at* Septic/holding tank on lot too'+ On adjacent lots Absorption field on lot 100 + On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line 25'+ Lift station 100,+ 100,+ N/A N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5,+ Property line — 5'+ Absorption field 5'+ Water main/service line Surface water/drainage 100'+ Wells on adjacent lots . too'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 10,+ Property line 10,+ Building foundation lo,+ Water main/service line — Surface water 100,+ Driveway, parking/vehicle storage area Curtain drain NONE KNOWN Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that in conforma Signature � Engineer's l' Date inspections and review of Municipal is in effect on this date. JEFFREY A. GARNESS &.0 HAA Fee $ Waiver Fee $ Date of Payment 0 --CTq Date of Payment Receipt Number :!52 1,Q(,2 C Q Receipt Number 72-026 (Rev. 3196)* 40'+ too'+ Nms are P6