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ALPINE TERRACE BLK 2 LT 6
Alpine Terrace Lot 6 Block 2 #015-243-02 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201038 PID Number: 015-243-02 Dwelling: R Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0_1 Upgrade Name Wolford & Chesla Mogan ABSORPTION FIELD Deep ❑Wide Trench ❑ Dee Trench ❑ Bed ❑ Mound Site Address 7441 Alatna Avenue E] Other Phone Number of Bedrooms Soil Rating Total depth from original grade GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Alpine Terrace 2 6 Ft, Ft. Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well 109.9 Existing n/a n/a 25'+ TANK ❑ septic 90 S.T.E.P. ❑ Holding ❑ Other Manufacturer Infiltrator Capacity 1500 Gal. Surface water 100+ Existing n/a n/a Material Number of compartments Lot Line 50.3 Existing n/a n/a NA Plastic 2 Foundation 13.5 Existing I n/a n/a LIFT STATION Manufacturer Capacity Remarks Simteck PE 51-M 250 Gal. Alarm location Electrical installed by Rising Sun Electric Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Arm Services Drainfield CO/MT Inspector Pannone Engineering BENCH MARK (Assumed elevation) 100 ft Inspection ection 15' 4/2/2020 4/3/2020 Location and description 2nd 3m 4th Back Door Threshold ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date OF A� co 4Ld. ........... Fon�ione Septic System ApprovedA rajux,Date y a06��'�� CE 81,10 �. Note: this approval does not include well permit requirements. Gt c®�gj k.— VJ/—,.1 z j O O q SCALE: N.U. 1 � �i WELL E / WELL (E) I SEPTIC AREA (E) I � � i� INSTALL I� —w w WATER LINE / ABBREVIATIONS WELL RADIUS TH TEST HOLE NEW SEPTIC (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. DCO DOUBLE CLEAN OUT FC FOUNDATION CLEANOUT FS FLOW SPLITTER MT MONITOR TUBE NO. TYP TYPICAL DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4(600 gpd) TANK SIZE: 1500g S.T.E.P. \J M NORTH „„ CALE I" 7 6 WELL(E) � J � -W 1500g S.T.E.P TANK INSTALLED DV IN LIFT STATION MH / A4 / 50.3 SEPTIC TANK TO MEET ALL REQUIRED / —�= W ABANDONED 1500 S.T. E.P. TANK +SEPARATION DISTANCES STATED IN AMC15.65 PER MOA CODE T 5 �/ \' A �i 54.9 ' ml I I LOT 6 4BRHO B M j WELL \ E) ,� d M Q ( 109.9 s / SEPTIC AREA (E) / TL W /I DRIVEWAY l 3- 10' M '` 10' UTILITY_ EASEEi1ENT WELL (E) _ 130.9— _ / \N 'ALATNAAVENUE PWSID:216839 % DEC SEPARATION WAIVER - -_—f _ =GRANTED FEBRUARY 1991— Tl 32.5 0 LS 39.5 30.0 NOTES: PANNONE ENG SVC LLC (C.l. 1088) REVISIONS DATE RECORD DRAWING P.O. BOX 1807 PALMER, AK 99645 r ��OF!4[q�>ty 04/03/2020 PHONE (907) 745-8200 FAX (907) 745-8201 'e�,�P• ' �9 �t SCALE j,q: fP 1" = 60' ALPINE TERRACE 132 LC "" "" "" P.I.D. NO DRAWN DRM WOLFORD & CHELSEA MORGAN " 'teven nri0. 015-243-02 7441 ALATNA AVE �t1'+�i CE 8149 � PERMIT OSP201038 SITE PLAN ANCHORAGE, AK ��1��\\> . SHE OF 2 rK 0 0 00 0 01 00 A .00'OOZ M,.00.ZOoOO N X ® 0 1 % I� W W w I w �o I < I �\ X*6 OJ� 1 ui co O � � I I ' I 1 I � � I 3 I W V 1 — — — — — — — — — — — — — — — — — — — — — — — — — — — — —I UNS3 XB"lLLn .0l 11I11JLILlr ejynllol'C4onfilmC CD D 14 14 a loc z w' D z w F- Q WE 090 M ix 30 ee{{ z 0 w Z UJ vi a 1-z�29� zz O S2 5 Q �j S w min te z wjW�tnVltll� W V Z W —O�OWO 12�Oj0 Z N IX W Z Z w 0 W O wvaO� x v W. F- � ca cwa z Z L) O w Z w4 z EZ= = w a-wiwc) V ow zaw)M -a.Co*=.. au r, wO N . 9 w I 2 z l z9 N CO t/� Z 1— 4 o m N O= CL woU iJ? O Q 0 (.g m a 4,Iz/�2a2o MUNICIPAUTY OF ANCHORAGE On -Site Water & Wastewater Program ".1 PO Box 196650 4700 Elmore Road i Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 � :f http://vAw/.muni.org/onsite � llcpartmcnt` 9t'<H O R�G� On -Site Wastewater Disposal System hermit Permit Number: OSP20-1038 Effective Date: 3/9/2020 Work Type: SepticTank Upgrade Expiration Date: 3/9/2021 Tax Code Number: 01524302000 Site Legal Address: ALPINE TERRACE BLK 2 LT 6 G:2740 Site Mailing Address: 7441 ALATNA AVE, Anchorage Owner: LOEWE MATTHEW F Lot Size in Sq Ft: 40000 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: a This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: v Date:�j l �/20 Date: 7D l MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program t ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-243;002Property owner(s) Woldford & Chelsea Morgan Day phone Mailing address 7441 Alatna Ave Anchorage, AK Site address Same Legal description (Sub'd., Block & Lot) Alpine Terrace 132 L6 Legal description (Township, Range & Section) Lot Size 40,000 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank ❑X Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) ❑X (w/wo ADU) Upgrade 0 Duplex (D) ❑ Renewal ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: 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: -:2 o2 6 - Date of Payment: ,y"2U Receipt Number: O 24 15(da Permit No. Q 5P a 0103 Permit App_.;-::' .. c Waiver Fees: Date of Payment: Receipt Number: Waiver No. I Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201038, Deb Wockenfuss, 03/09/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201038, Deb Wockenfuss, 03/09/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201038, Deb Wockenfuss, 03/09/20 inspecnon nepon_i-i-tz.aoc Municipality of Anchorage Community Development Department Page 1 of 4 On-Site Water and Wastewater Program 4700 Elmore St. - P.O. Bax 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161032 PID Number: 015-243-02 ❑ New D Upgrade Name: - Perry & Catherine Duffy - -- ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑✓ Bed ❑✓ .Mound Address 7441 Alatna Ave. Anchorage, AK 99507 ❑ Other Phone - Number of Bedrooms Soil Rating Total depth from original grade 4 0.5GPDISF 0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +0.5 Ft. Gravel depth beneath pipe " 0-5Ft. Subdivision Alpine Terrace Block Lot 2 6 Fill added above original grade 3 Ft. Gravel length 1 60 Ft. Township. Range Section Gravel width 20FL Beds: Number of Lines 4 . Distance between lines 5Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area 1,200 z Ft Number of trenches N/A Dist. between trenches N/A Ft. Well N/A 129.1 N/A N/A 95.0 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water N/A 100+ N/A N/A Gal. Material Number of compartments Lot Line N/A 10.2 NIA N/A NA Foundation N/A 26.8 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain N/A 50+ N/A N/A Gal - Remarks - Pump on level at in. Pump off level at in. I High water alarm at in. - Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL Housetotank 3034 Tank to drainfield 3034 Isaacs Excavating Drainfield 3034 CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 100n Inspection � 4/1.9/2016 dates: � 3" 4/25/2016 � 2 4/21/2016 4'" Location and description - Back Door Threshold COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineers Stamp Conditional Approval: Date or 1k �sg'�P . - •.9 $�even 'E : 'I onnome' F 1 Approved /(/ Date 5 20 inspecnon nepon_i-i-tz.aoc j / f / / L/ 7i z / WELL QE / SEPTIC AREA (E) -14 -14M REMOt A B ml459 37.3 51.7 M249.2 64.3 M352.2 80.3 M4.9 87.8 .D EXISTING MONITOR TUBE - / 1500g S.T.E.P. TANK (E) SHED M4 \INSTALLED DIVERTER VALVE NEW DRAIN FIELD / UNDER ACCESS LID �� M3 20.0'W x 60.0'L x 0.5'ED x 0.O'TD 1 \ .INSTALLED MONITOR TUBES TH-1987 `O o 4BR + LEROY REID� - �I -� HOUSE \ Z \ (E) A w 10.2 1 w l� 47 WELL WELL I,1 I NOTES: DRAWING DRAWN BY: NJC PLAN /I / 1 D' WAN ALATNA AVENUE 13. SEPTIC AREA (E) / M2 / I TH-1990 ROBERT SCHAFER / 0 Y i N/ DRAIN FIELD (E) RE–USE AS RESERVE / 1'30.-9-- — PWSID: 216839 / DEC SEPARATION WAIVER -GRftNTELLEEBRUARY 1991 i 3; CLASS 'C i�M _ 3 / / WELLY) /M/ 41 i PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ALPINE TERRACE, BLOCK 2, LOT 6 PERRY & CATHERINE DUFFY 7441 ALATNA AVENUE ANCHORAGE, AK 99507 5/20/2016, Scale P.I.D. NO StevenR.'PannonW; PERMIT N0. A'. CE 8149 •. �2-� OSPI61032 ci r Sheet 2 OF -1.0 -10.0 DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. (E) PERC RATE: 3 MPI SOIL RATING: 9.5 GPD/SF AREA ROD: 1,200 SF SYS. TYPE: BED 20'W MIN LENGTH: 60 LF USED: 60.OLFx2O'WxO.5' E.D., 0.0' TD WITH 1' OF SAND TOTAL AREA: 1,200 SF NOTES: RECORD DRAWING DRAWN BY: NJC DESIGN DETAILS 2.5 I-5.0-1-5.05.0—{ 25 t-ORAIN ROCK REMOVED ALL ORGANICS, INCLUDING ANY FOUND TO BE MIXED INTO SOIL ABOVE OLD FIELD PLACED V SAND ABANDONED LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ALPINE TERRACE, BLOCK 2, LOT 6 PERRY & CATHERINE DUFFY 7441 ALATNA AVENUE ANCHORAGE, AK 99507 ABBREVIATIONS TH RIGID INSULATION m FILTER FABRIC FCO 1.25" m PERF PIPE W/ - T# HOLES DRILLED 78" O.C. 0 0 w DRAIN ROCK 2" ABOVE TOP OF PIPE M# MONITOR TUBE NO. 3 MAX 103.0 F 3 MAX —� 2.5 1 TH-1 0 .5 -DIVERTER VALVE -1.0 -10.0 DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. (E) PERC RATE: 3 MPI SOIL RATING: 9.5 GPD/SF AREA ROD: 1,200 SF SYS. TYPE: BED 20'W MIN LENGTH: 60 LF USED: 60.OLFx2O'WxO.5' E.D., 0.0' TD WITH 1' OF SAND TOTAL AREA: 1,200 SF NOTES: RECORD DRAWING DRAWN BY: NJC DESIGN DETAILS 2.5 I-5.0-1-5.05.0—{ 25 t-ORAIN ROCK REMOVED ALL ORGANICS, INCLUDING ANY FOUND TO BE MIXED INTO SOIL ABOVE OLD FIELD PLACED V SAND ABANDONED LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ALPINE TERRACE, BLOCK 2, LOT 6 PERRY & CATHERINE DUFFY 7441 ALATNA AVENUE ANCHORAGE, AK 99507 ABBREVIATIONS TH TEST HOLE EA EACH FCO FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION - DCO DOUBLE CLEAN OUT DV -DIVERTER VALVE FS FLOW SPLITTER (E) EXISTING (P) PROPOSED TYR TYPICAL 0 TH *(/ NTS P.I.D. NO --r< Ole 243-02 Steven •R�Pannone PERMIT NO. ?�•. CE 8149 .'ci�� OSP161032 +{�kkF�H?OFESSIONP�\� Sheet �� `_� 3 O 4 1 SPECIAL PROVISIONS 70 SPECIFICATIONS 1. ALL CONSTRUCTION SHALL WAS INSTALLED AS SPECIFIED fN THE MOST CURRENT EDITION Of THE 4dUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIDNS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15,55. ?. SCOPE OF WORK: INSTALLED NEW SOIL ABSORPTION SYSTEM AND DIVERTER VALVE, 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 10 FEET BELOW EXISTING GRADE AS EVIDENCED, BY THE SOIL TEST HOLE. NO APPARENT WATER TABLE WAS OBSERVED IN ANY OF THE EBCA'✓ATJONS LESS THAN 6 FEET BELOW EXISTING GRADE. 4, THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) HAD THE WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS'SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 5.: THE CONTRACTOR IS REBPGNSIQLE FDR ALL R.Q.W. AND OTHER P.EOUIREO PERMITS, OTHER THAN THE ATTACHED. 6, THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 7, THE CONTRACTOR SHALL PROVIDE 24 HOUR' NOTICE TO THE ENGINEER PRIOR TO START OF WORK, ALL SURVEYING ,AND LOCATES WERE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. _ B, THE CONTRACTOR NOTIFIED THE ENG WEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 9 TAT THE coPLEION OTHE HE RED-LINESYSHALLL INCLUDE RPIPE LENGTHS, ORIGINAL GK THE CONTRACTOR ROUND ITFD EELEV.ATIONS, PIPE DRAWINGSD-LINE AS-BUILI EVATIONS, 'APD TANKIIJEER. ELEVATIONS. 10 THE OF PIPE WITH H CLEAN -OUTS ANDOMONIITOR TUBES INSTALLED. GRAPHS OF THE SYSTEM INSTALLATION II INSTALLED TANK A NK INCLUDE GRADING.BOTTOM EXCAVATION, TOP ll. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE . ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 12. THE CONTRACTOR SHALL SIGN THE FOLLOVONG; I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS -BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED._ Senr��5 LLL CONTRACTOR: -U•'-" `~"� `�-C"���1� BY TITLE: 0WV1 DAT?:�� PAMONE ENG SVC, LLC P,O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211, ALPINE TERRACE, BLOCK 2, LOT PERRY & CATHERINE DUFFY 7441 ALATN.A AVENUE ' ^`AGE, AK 99507 Received Tirne;Way. 9.L2016 2:05PM No. 1257` Do �EoF.A ,, ltd 44/28/201F �/�`?; ','(•4�� Scale �, NTS *; 49TH ..... •• .• I F.I.D. NO 015-241-02 Steven �Z- Panno'Re / PERMIT NO i��4, CE 8149 ,` �,� OSPI61032 4s •. 1 elf,", `Fo Sheet l`t\.OFTT51 4 OF 4 DEPT. OF ENVIRONMENTAL CONSERVATION C-iORA'" 'InSTBR' DISTRICT OFF!''CE 3501, .. STREET, Sf3ITI, '12 AMMT17 ^9503 WALTER J. NICKEL, GOVERNOR I 563-5775 I RECEIVED February 1, 1491 Mr. Tobben Spurkland, F�� 6 79u1 Consulting EngineerLy<st,�rtcroragp 5751 ?''. Di:acnu .lva_ . i1=p .1-eajtlh u Human $ervices Anchorage, Alas;;a 99502-3904 ::.':: T,Ot 2, *]111.sid (?vieF7 subdivision, Class C Public '-',at r ant `TasteWatar Disposal SySt-Ms (Bed and 3reakfast), ,DEC-?roject ,umber 91.21-27%-02.3s Rw,aar Spurkland. This is in response to your Sub: ittal., re 0ivvd in this o2fice On December 17, 1990, in which you address the ita-;s noted in my -Toveiiib-r 30, 1990 letter regarding the -?Ub]ic Water ani wast -?Water disposal te' h„ facility or. above- _fazenced lot. S sys .rs -serving tl :' have r..'vi'ewed the sub littoal information, the ofli,^2's ii1L On tni.`.: facility, and di=cunSed tfle project With }e a?'ti:entel staff and :lavL the r01:.O,9 ing CO�il3£nI - 3a5ed on the information Submaittec' to tni3 Office, it appears that the e:cist ii:g i.%U:^.7 iC ;7ater sys teal ;alis installed in com-lliailCe S71t:7 _ oa tim3 tallation. In the ai7��ll..ae]-Q state egu_ations at �:,� �_ of ins add it ion, t- ce:J:,)^carS that current regulations ani: lu idel isles could be i:7eeet wi.t:h the e:,ce'ption of the separation distance between the et.i^ting source Well and the soil ahsor,tion s,stem .located on a naar-by lot. Therefore, the 0"i0ti-ng Class r Public ,Tater uyste:i serving='the five ballroom Be' and Breakfast located on tha aUove- reference) "oropei'ty. is approved for the. concerns of this Depart. "ant. A final Operation Oertiii.cat.^., constituting this a_O%roval, is enclosed for t:le existing Cl.a :i O Public'Tater System. -n your DeCa.m.bcr 17, 1900 subu-'ittal, a separation 3-istante Waiver was requa te'3 for the 130 reef bet-Wecc ii t:h.'. on -lot ° ublic water S,',,st�:l7 source wool ;:nd a sell absorption sy Ste.m on. Lot J, B1.QC'., 2, Alpine Torrace.." -As a ;:exult of my rev, ,. 6i true infer.nation submitted, the De_�artment has `ound.the information rravifell to be satisfactory for a1lo",'7inS the re%uestel Waiver, in acc OrJanC'e with 1' eaA'•^ 72.035 ani 1 n AA^ 00.02.0 (a) of the state dastewater Disposal ane'. Drinking Vater P.egulations, respectively. The 3 eparation distance-bet9leen t:7c el i.stiny ::ia:i£ .% ?ub1,C ^:'stet System Source :'Tell anhJ t:le Soil nb:or7tion System on Lot J, BIOck r Alpine `�'ertace -:las been waived i rout 15^ feet iso 130 rvet. This waiver 'Alll re::lain vali:l as long as semi-annual anallti.cal 'results - or nitrate (as nitrogen,) ,'and Tota'_ aCt-4rla are _Subilitte2 to t1l.is Dapar-tmient.. I reCom-Mand that water Sa?ff Iles be C01110-C-4C01110-CC01110-C-41-23during :a; and October of each year. in a&dition, once nitrate levels start to ret:lain Over % 11v for.mor-a thant.vo consecutive samples, engineering 'plans will reed to be submitted'to this office -for installation- of a nitrate. ri-moval pac%aye. �x wimndonrec,clad3noz; by G' -2- 2-ased on the results of the adequacy test and the statement that the existing wastewater disposal system meets all coda requirements of this Department; submitted under your as a Professional Engineer, it appears that the existing wastewater isposal system is adequate to handle the volume of wastewater from a five bedroom Bad & Breakfast. Thus, in accordance with the provisions of 18 AAC 72, dastewater Disposal regulations, the ;wastewater disposal systelr. serving the facility on Lot 2 Hillside View Subdivision is approved for operation. Thislatter_constitutes final approval for the existing wastewater disposal system. Due to the monitoring requirements of the waiver, the following Public ". 7atar system Idenof kation (Pt-7SID) NumbYJassigned to this public water system, 215839. By copy of 'this letter, I am informing your clients that the PSwSID `Sumber assigned to their public water system will need to be on all analytical data subl,titted to this Department so that the waiver will relaain valid. In closing, I wish to recomuend that additional steps be taken to abandon the 15 inch diameter, 14 foot deep irrigation well. The abandonment procedures recommended by the Department Can be found in the departmental publication entitled " Suggested; Practice for Small Slater Systems". I have enclosed a Copy the well abandonment procedures for your uae. Than% you for your cooperation Swith this Department. -T_f you have any questions, please do not hesitate to contact Isle. Sincerely .even '_:lawcno Environmental Engineer L'nclosures: As Staged / CC: john Smith, D:3.TS, w/o -.nc.✓ Tom Gittins, Owner, w/ Enc. Permit Number: Tax Code Number: On -Site Wastewater Disposal System Permit OSP161032 01524302000 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Work Type: Septic Upgrade Permit Effective Dates: March 09, 2016 to March 09, 2017 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: ALPINE TERRACE Site Legal Address: ALPINE TERRACE BILK 2 LT 6 G:2740 Owner/Address: DUFFY PERRY M & CATHERINE F 7441 ALATNA AVENUE ANCHORAGE AK 995078035 Site Mailing Address: 7441 ALATNA AVE, Anchorage This permit is for the construction of: Lot Size in Sq Ft: 40000 Total Bedrooms: 4 Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Receiv+ Issued MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION SUBIMIJITTAI FEB 2 5 9018 Parcel I.D. 015-243-02 Gretchen Stuller Property owner(s) Perry & Catherine Duffy Day phone Mailing address 7441 Alatna Avenue, Anchorage, AK 99507 Site address 7447 Alatna Avenue Legal description (Sub'd., Block & Lot) Alpine Terrace, Block 2, Lot 6 Legal description (Township, Range & Section) Lot Size 40,000 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑x Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑ Upgrade 0 Duplex Duplex El (D) Tank El Renewal F-1 Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Bed Width of 20 feet / Separation to Existing field to 4 vertical feet. Distance: certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or Permit/Rush Fees: JraS Date of Payment: 4q IA5 ((0 Receipt Number: d /— O "7 Permit No. (16P11410,342 Permit App_:;-: Waiver Fees:— X15 Date of Payment: Receipt Number: opl7 Waiver No. VAP loiq Its Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panen¢ak.com February 23, 2016 Subject: Alpine Terrace, Block 2, Lot 6 Septic System Upgrade Permit Request Design Narrative This is a design narrative for a permit to upgrade a septic system to be issued for this property. The proposed systems will serve an existing four bedroom (4) bedroom house. Currently the lot is developed. The existing field is in failure and will be re -used as a reserve. The surrounding developed lots are served by private wells, with a Class 'C' well to the south. There are no wells within 100' of the proposed septic system. The Class 'C' well is located approximately 130.9 feet from the existing field and a waiver is on file at the Municipality. 1. Soils. One test hole was performed on this lot by PES in February of 2016, and groundwater was monitored for at least seven days. Ground water was not observed to a depth of 10.0' below the surface in the test hole monitor tube in February of 2016. Bedrock was not encountered in the test hole. Based on the results of the percolation test and overall soils appearance; an application rate of 0.5 gallons/day/square feet was used for a conventional septic system in the area of the test hole. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100' of the proposed drainfield. 4. Topography: The existing topography generally slopes from the east to the west in the area surrounding the septic system at approximately 2%. There are no steep slopes within 50' of the proposed drain field. The proposed drain field will maintain 50' separation all steep slopes. S. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@oanenaak.com 23 February 2016 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P O Box 196650 Anchorage, Alaska 99519-6650 Subject: Alpine Terrace, Block 2, Lot 6 Separation to Existing Field Waiver Request Bed Width Waiver Request Ladies and Gentlemen: 1. Separation Distance to Existing Field: We request a separation distance waiver for the absorption field to an abandoned absorption field. During the excavation of a test hole on this lot PES found the existing abandoned absorption field located on this lot to be located in the only reasonably usable area for a new drain field. The field is located between 4.5' and 5.5' deep and has no insulation or biomat. The soil above the field is native material that was excavated and replaced during the installation of the existing field in 1987. There appears to be very little if any organics mixed in to the previously disturbed soil, and over the course of nearly 30 years that soil has settled back into a well compacted state. It would be prohibitively expensive to remove this old field and replace it with sand so we are requesting a separation waiver from the proposed field to this previously abandoned field to a distance of 0 feet horizontally and 4.0 feet vertically. Any organics found to be mixed into the soil layer above the old field will be removed and replaced with sand. Granting this waiver will pose no threat to the operation of the proposed field, or the health and safety of this lot. 2. Bed Width: We request a waiver to the maximum width of a bed from 15' to 20'. The area available cannot readily accommodate a bed with a length necessary to use a 15' wide design.' The system will be pressurized with the manifold in the center of the field to ensure even distribution of effluent to the field. Granting this waiver will pose no threat to the operation of the proposed field, or the health and safety of this lot. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 If you have any questions or concerns, please contact me at 907.272.8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 / ZWELL �E l J SEPTIC AREA (E) .Ir� AA I SOOg S.T.E.P. TANK (E) SHED % 'INSTALL DIVERTER VALVE wow 4BR + °I � HOUSE (E) TH-1 111. w r \ DRIVEWAY I WELL (E 10' UTILIi�EASEMENT 1L (E) �. - v-� WAN ALATNA AVENUE I NOTES: CONSTRUCTION PLAN REMOVE EXISTING MONITOR TUBE DRAIN FIELD (P) - /-20.0'W x 60.01 x 0.5'ED x 0.O'TD ) INSTALL MT AT EACH CORNER ' -TH-1987 ! \LEROYREIDA� SEPTIC AREA (E) t30.�g- — PWSID: 216839 DEC SEPARATION WAIVERI GRA14TED-EEBRUARY 19911 CLASS ',C % WELL -,(E) i PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ALPINE TERRACE, BLOCK 2, LOT 6 PERRY & CATHERINE DUFFY 7441 ALATNA AVENUE ANCHORAGE, AK 99507 Ij H�,q.0 II I 3/8/16 *f/.1 1"=50' / 015-243-02 n R. an , PERMIT N0. CE 8149 .. ��A OSP161032 pROfESS10NP�"��r Sheet o TH-1990 i ROBERT SCRAPER i I e DRAIN FIELD (E) - RE -USE A� RESERVE t30.�g- — PWSID: 216839 DEC SEPARATION WAIVERI GRA14TED-EEBRUARY 19911 CLASS ',C % WELL -,(E) i PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ALPINE TERRACE, BLOCK 2, LOT 6 PERRY & CATHERINE DUFFY 7441 ALATNA AVENUE ANCHORAGE, AK 99507 Ij H�,q.0 II I 3/8/16 *f/.1 1"=50' / 015-243-02 n R. an , PERMIT N0. CE 8149 .. ��A OSP161032 pROfESS10NP�"��r Sheet 3 MAX F— TH-1/0 GM/ SM -10.0 - w RIGID INSULATION - wz DESIGN PARAMETERS m FILTER FABRIC U L 2n" 0 PERF PIPE W/ LEGEND HOLES DRILLED 18" O.C. EACH N0. BEDROOM: 4 (600 gpd) oz F �a DRAIN ROCK 2" ABOVE TOP OF PIPE DRAIN ROCK 2.5 �.0 5.0 5.0 2.5 REMOVE ALL ORGANICS, INCLUDING ANY FOUND TO BE MIXED INTO SOIL ABOVE OLD FIELD PLACE 1't SAND PREVIOUSLY ABANDONED BED NOTES: FOR CONSTRUCTION DESIGN DETAILS PANNONE ENG SVC, LLC —'oF:; P.O. BOX 100217 ANCHORAGE, AK 99510 � ... • PHONE (907) 272-8218 FAX (907) 272-8211 -If ALPINE TERRACE, BLOCK 2, LOT 6 PERRY & CATHERINE DUFFY 7441 ALATNA AVENUE ANCHORAGE, AK 99507 Steven R. 'rdnn'N �F,•. CE 8149 ,moi +t>1�F�H2OFESS101�P�'�.� 3/8/16 Scale NTS P.I.D. NO 015-243-02 'ERMIT NO. OSP161032 2 O 4 ABBREVIATIONS DESIGN PARAMETERS TH TEST HOLE PRIMARY SEPTIC SYSTEM LEGEND EA EACH N0. BEDROOM: 4 (600 gpd) FCO FOUNDATION CLEAlN. Q - TANK SIZE: 1500g S.T._E.P. (E) W - WATER LINE/ - T# -14T TANK CLEAN OUT NO-. PERC RATE: 3 MPI WELL RADIUS C# CLEAN OUT NO. SOIL RATING: 0.5 GPD/SF M# MONITOR TUBE NO. AREA ROD: 1,200 SF SS NEW SEPTIC R.I. RIGID INSULATION SYS. TYPE: BED 20'W MIN LENGTH: 60 LF - DCO DOUBLE CLEAN OUT - - DV DIVERTER VALVE USE: - FS FLOW SPLITTER - 60.OLFx2O'WxO.5' E.O., 0.0' TD - - (E) EXISTING WITH ±1' OF SAND " - (P) PROPOSED -TOTAL AREA: 1,200 SF TYP TYPICAL NOTES: FOR CONSTRUCTION DESIGN DETAILS PANNONE ENG SVC, LLC —'oF:; P.O. BOX 100217 ANCHORAGE, AK 99510 � ... • PHONE (907) 272-8218 FAX (907) 272-8211 -If ALPINE TERRACE, BLOCK 2, LOT 6 PERRY & CATHERINE DUFFY 7441 ALATNA AVENUE ANCHORAGE, AK 99507 Steven R. 'rdnn'N �F,•. CE 8149 ,moi +t>1�F�H2OFESS101�P�'�.� 3/8/16 Scale NTS P.I.D. NO 015-243-02 'ERMIT NO. OSP161032 2 O 4 SPECIAL PROVISIONS TO SPECIFICATIONS 1 . ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 2. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM AND DIVERTER VALVE. - 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 10 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 6 FEET - BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES, 7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO. NOTIFYING THE ENGINEER. 8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. 12. THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. - CONTRACTOR: BY: TITLE: DATE: NOTES: PANNONE ENG SVCLLC — oF. aG ill 0 [ , /8/16 FOR CONSTRUCTION P.O, BOX 100217 ANCHORAGE, AK 9951.0""qd' 3ll PHONE (907) 272-8218 FAX (907) 272-8211 /%cp�P �y�t Scale NTS ...... .. .. .... J P.I.D. NO ALPINE TERRACE, BLOCK 2, LOT 6 .. .. / 015-243-02 PERRY & CATHERINE DUFFY S'te'ven R, enno / PERMIT NO. PS CE 8149 OSPI61032 7441 ALATNA AVENUE f . DESIGN DETAILS ANCHORAGE, AK 99507�FPFDPmo...... ' Sheet `�V%1 �-v�`. 3 OF 4 1 — 2 — 3 4 — 5- 6- 7- 6- 9- 10 — 11 — 12 13 14 — 15 — 16 — 17 — 16 — TEST HOLE i OR GM/ SILTY GRAVEL SM AND SILT DRAIN ROCK` DATE PERFORMED: 02/1612016 SOILS LOG - PERCOLATION TEST SLOPE X TH O \ y 4BR HOUSE (E) /D�RJVEWAY i WAS GROUND WATER ENCOUNTERED? -N IF YES, AT WHAT DEPTH? DEPTH TO WATER AFTER MONITORING? -DRY- DATE: 02/23/2016 ' EDGE OF DRAIN ROCK ENCOUNTERED AT END OF TEST HOLE BETWEEN 4.5 AND 5.5'. DRAIN ROCK WAS FREE OF BIOMAT WITH NO INSULATION PRESENT. PERC TEST RUN IN UNDISTURBED NATURAL MATERIAL. TH-1987 ILER(IOY REID� `TH-1. N III/ /I TH 1990 ROBERT SCHAFER 41 SLOPE TH X READING DATE CLOCK NETTIME WATERTIME LEVEL READING NET DROP 1 2/15/2016 12:25 --- 4.64 --- 2 12:35 10 MIN - 8.37 3.73 3 12:35 --- 4.64 - --- 4 12:45 10 MIN 8.04 3.40 5 12:45 --- 4.64 --- 6 12:55 10 MIN 8.02 3.38 SOIL TEST RESULTS/ANALYSIS • PERCOLATION RATE 3 (minlinch) • PERC HOLE DIAMETER 6" • TEST RUN BETWEEN 3 FT AND 4 FT. • TEST RUN FOR OVER AN HOUR, LAST THREE READINGS PROVIDED. COMMENTS: Test hole excavated by POMRANING EXCAVATING. Test Hole was presoaked before Perc test. PERFORMED BY: Joseph Lawendowski. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE FOR VIUNILIPAL GUIUUNtS IN tFhtL.I UN IHt UAIt Uh IHU Itb1. NOTES RkNNOl oNE4 EN SVGE,C, 9910 PHONE (907) 272-8218 FAX (907) 272-8211 ���� �\ ,� ,(�i OF A`.sl�i /CD _ • F9�+ j *; q9 1 ....... .. . ... % / Steven R.•Panno.ne / +Pc, CE 8149g ���;`\\ aFES"�� � Date 3/8/76 JSTRUCTION Scale NTS - ALPINE TERRACE, BLOCK 21 LOT 6 PERRY & CATHERINE DUFFY 7441 ALATNA AVENUE ANCHORAGE, AK 99507 P.I.D. NO 015-243-02 P RMLT No. OSP 161032 SOILS LOG Sh4eet 4 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name , JG` DISTANCES SEPTIC ABSORPTION WELL • Address FROM TANK FIELD Phone(s) Permit No. No. of Bedrooms WELL 17 LOT LINE c> e4cZ�fl Iib I LEGAL DESCRIPTION Lot Block Su ivision I FOUNDATION 1 I -- Township, Rangon T �' !� T AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, ••/ V • driveway, water bodies, etc.) TANIkS ,SEPTIC L,1 r—r ❑ HOLDING I MC.42 2 I Z Man t;tr Capacity in ga11MM CA—, 2 eltr Materia No. of compartments Aa TYPE OF SYSTEM ❑ TRENCH �ED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth feroom inginal grade original grade -O 95 w -4-FT b FT Fill added above o�X�al grade -I%'Z— Gravel depth beneath pipe FT E7d5_ FT 4 00, A A Gravel length 4-_5 Gravel width FT FT Total absorption area Distance between lines �. OSQ FT �P FT Number of lines Soil rating2 Pipe material ZI J SQ FT yi 5%r_> . Insta Q) I Date instalad, , t.i WELLS �RIVATE El OTHER (Identifv) Classification (A,B,C) Total Depth Cased to �1 FTJ FT ` ' All " 14r. - Installer Date Installed: REMARKS: ,n Uoc. n• 1 tlx . .aw N E 3 t'sE `. 4 e e Cr' inspections Performed AW,��� °n rd Date: —7 ..sj-25, 41 c> ��.i.T I OYN �" ••Utl tlutl"itl"Y. ri17b'. ukM1 ��• A f ry AD . tl tl �" tl 17034 Eagle River Loop Road No, 204 irArt A. Sh«fer I certify at this inspe 'on was performed according to all r ' Ne. 1457-E. Eagle River, Alaska r.o " Municipal and State uidelines in effect is date: ZF °�.+... ,.�'° �. P 9 Health Department Approval: Date: 72-013 (3/85) I CERTIFY THAT: l. 2 am �amiliar with the requirements for site sewers and wells as set {orth by the Municipality of Anchorage (MOA> and the State o[ Alaska. 2. % will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances [rom any existing wel]�, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for. a maximum o{ 4 bedrooms. l also understand that the capacity o[ the total system is 4 bedrooms and any enlargement will require an additional permit. Signed: - DATE: ?��/_�___O�� Issued By DAYE: �� MUNICIPALITY OF ANCHORAGE Department oH' Health & Human Services 825 L Street, Anchorage, Alaska 99501 343-4720 ON - SITE SEWER PERMIT Permit Number: 9001B8 Upgrade Q� Date Issued: 07/05/90 Engineer Designed Owner Name: Al A!-') U8A FED CR UN Day Phonex Owner Address: BOX 196613 786-2709 ANCH, AK 99519-6613 � 4� �arce� Id: 015 02 Lot Legal: Subdivision: ALPINE TERRACE Lot: 6 8lock: 2 Section: 24 Township: 121q Range: 3W Lot Size 40008 (sq.{t_ op acres) Max Bedrooms: This �ermit: 4 Total Capacity: 4 SEPlIC TANK: Minimum total septic tank capacity: 1,250 gallons. �ach septic tank musthave atleast 2 compartments. Depth to top o[ septic tank(s> < 4.0 Feet reguires insulation over tank(s). THE EXISTING DISPOSAL FIELD MUST BE PROPERLY ABANDONED. THE L|PGRADE SYSTEM MUST BE INSTALLED IN ACCORDANCE WITH THE ENGIN�ER DES18N DATER 6/30/90. NOT�IFY DHHS PRIOR TO ALL INSPECTIONS. THIS PERMIT IG FOR A 4 BEDROOM GINGLE FAMILY RESI�ENCE ONLY, AND EX�IRES ON 12/31/90. I CERTIFY THAT: l. 2 am �amiliar with the requirements for site sewers and wells as set {orth by the Municipality of Anchorage (MOA> and the State o[ Alaska. 2. % will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances [rom any existing wel]�, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for. a maximum o{ 4 bedrooms. l also understand that the capacity o[ the total system is 4 bedrooms and any enlargement will require an additional permit. Signed: - DATE: ?��/_�___O�� Issued By DAYE: �� PERFORMED FOR: A14, U! IA r—G'c4 DATE PERFO M.��'2.- /S r 11'0 r4s rr 3s�—� g 1A% .�+ Township,Range, Section: (""�"�" LEGAL DESCRIPTION: L BZFf %�/��i I g DEPTV SLOPE SITE PLAN Date Gross Time Net Time rr OF 4 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES "L" 825 Street, Anchorage, Alaska 99502-0650 2- SOILS LOG — PERCOLATION TEST 3 3- O•o9.w... �Y yrs •a Y4y a P PERFORMED FOR: A14, U! IA r—G'c4 DATE PERFO M.��'2.- /S r 11'0 r4s rr 3s�—� g 1A% .�+ Township,Range, Section: (""�"�" LEGAL DESCRIPTION: L BZFf %�/��i I g DEPTV SLOPE SITE PLAN WAS GROUND WATER 10 �j AENCOUNTERED? ri �• S 11 © ► Oji DEPTH?IF YES, WHAT L s P 12 E Depth to Water After 13 Monitoring? Date: '�00'o� 14 15 16 17 18 19 Reading Date Gross Time Net Time Depth to Water Net Drop 2- 3 3- 4 4 y 5 "=i 4 6 L rrj p 7 Qs 1 to 8 9 WAS GROUND WATER 10 �j AENCOUNTERED? ri �• S 11 © ► Oji DEPTH?IF YES, WHAT L s P 12 E Depth to Water After 13 Monitoring? Date: '�00'o� 14 15 16 17 18 19 Reading Date Gross Time Net Time Depth to Water Net Drop fv (-C4 "=i 4 L rrj p o `.1 Qs 1 to 20 •, PERCOLATION RATE �� (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS Jar 1 S & S ENGINEERING PERFORMED BY:17094 E01111Rluar LORR ROa[Ne_ — I VIAi4ppNU�ACCORDANCEgiDMNCIPAL GUIDIN IN 72-008 (Rev. 4/85) ¢� v RTIFY THAT THIS TEST WAGPPEE�R�FORMED IN ON THIS DATE. DATE: (4/ r f• A ROBERT SHAFER, P.E. ROGER SHAFER CIVIL ENGINEERS f (907) 694.2979 x May 29, 1990 FAX 694-1211 HEALTH AUTHORITY APPROVALS Mn. Jim Levna ALASKA USA FEDERAL CREDIT UNION COPY P. 0. BOX 196613 SEWER &WATER Anchorage, AtaAka 99517-6613 MAIN EXTENSIONS REFERENCE: Lot 6; Btock 2; A.epine Terrace SubdiviA ion; 7441 Atatna Dean Mn. Levna, SEWER &WATER INSPECTION At your %equeat we have in,6pected the negeAenced pnopen#y bon purpodea o6 obtaining a Heat th Authotit y Appro vat. ( HAA) on the weet and 6 epx is 6 y6zem6 .ENGC ANDINEERING REPOR REPORTS Du,%ing our site vi6it on May 25, 1990 we bound the 6eptii.c 6y6tem .eeachb.ietd to be 6atura#ed with groundwater. The teachb.ieed monitoring tube had a t i.qu.id .eevet above .the normae openafii.ng .eeve 4 and water wa6 b.eow.ing back bnom the teach6ieid through a weep ho.ee into the e66tuent WELL INSPECTION ti -6t 6tation. & FLOW TEST Prion .to obtaining a Health Cert.ib.icate on the property, the 6epti.c 6 y6tem Witt need to be upgraded either by etevating the ex.i6ti,ng teach6.ieed on by utocating the teachb.te•ed. SITE PLANS The upgrade proce66 beg.in6 with a 6o.i z tat, daign, and Munici-pae permit. ROAD DESIGN zb you have any quutiou, on w.i6h u6 to proceed with obtaining the pe"it nequined to upgrade the 6eptic 6y6tem, ptea6e contact us. Sine y SOIL TEST . SHAFER, P.E. PERCOLATIONJ4RJgm TEST Ix STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE a 3 ur DE, ITMENT OF HEALTH AND HUMAN SER\ S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name 4 as -4 DISTANCES AddressFROM TO SEPTIC ABSORPTION WELL l 2 vo U3 7- 1 44- 7fs-O-7 TANK FIELD Phone(s) (� Permit No. No. of Bedrooms WELL 106, /2-/ LEGAL DESCRIPTION LOT LINE Lot Block Subdiv son r — -1-9 /C//� ! n /f' �z�C' FOUNDATION r Z c - Township, Range, Section AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway, water bodies, etc.) TANKS ® SEPTIC ❑ HOLDING Manufacture//r Capacity in gallons Material No. of Compartments Ibl Cb TYPE OF SYSTEM ❑ TRENCH BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth from original grade original grade / if 2,'3 FT 17__ Fill added above original grade Gravel depth beneath pipe L FT Gravetlength Gravel width .5-6 FT �$ Total absorption area Distance between lines 10 0 SQ FT Number of lines Soil rating Pipe material :3 165- SQ FT /= $/ D Installer Date Installed FT FTN I I I I I I INI FT FT WELLS ❑ PRIVATE ❑ OTHER Q Classification (A,B,C) Total De Cased to FT FT Installei Date Installed: REMARKS: l�'sul2riEQ �fr S7tijr2�•— ��(2Ss' SP�hc n F C''D Mo T$ s e,,,i/ - T`! A' . Scale: / o � Inspections Performed by: Re,d�w��:, Date -7 I certify that this inspection was performed according to all Municipal and State guidelines in effect on this date: Health Department Approval: Date. 72-013 (3/85) ENGINEER'S SEAL �r r, err.,..,-y�... .,.w. .,�..,._,,...,,. .., >.. _ .� .....�.. ._.:..,:r ,.. _ wl�x.e+u..-vw-,.rc� .cr-->.,�•:, �. ..,,�.,-;t .wvsu:^•.. - .r x�.., .. Y�. INSPECTION REPORT MUNICIPALITY OF ANCHORAtAE, BUILDING SAFETY DIVISION 3500 EAST TUDOR ROAD INSPECTIONS (907) 563-3464 !' ADMINISTRATION (907) 786-8301 NAME �' - STREET ADDRESS LOT / BLOCK / T' SUBDIV.' {- / PERMIT NO. / PHONE / DATE a; , FOOTING FOUNDATION BOND BEAM FRAMING INSULATION SHEETROCK STRU T. FINAL OT R ❑ ELEC. TEMP. ✓ ❑ PLBG. UNDGR. ❑ ELEC. SERVIC ❑ PLBG. ROUGH ❑ ELEC. ROUG ❑ GAS TEMP. ❑ ELEC. FINAL ❑ GAS ❑ OTHER 5L War ,l7 MECHANICAL ❑ {�'j '; j 4-7, MECH. FINAL 1:1 FIRE FINAL LJ PLBG. FINAL ❑ ZONING ❑ OTHER ❑ ❑ ❑ ❑ ❑ ❑ El ❑ NO NONCOMPLIANCE OBSERVED ❑ WILL REEXAMINE AT NEXT INSPECTION CORRECTIONS ESSENTIAL AS EXPLAINED BELOW ❑ DO NOT CONCEAL UNTIL REINSPECTED COMMENTS INSPECTOR ATE WHEN, CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION DO NOT REMOVE THIS NOTICE 84-002 (Rev 10/861 v IL PERMIT NO: DATE ISSUED: 870O50 Ath 04/10/87 APPLICANT: ALASKA USA C.U. / AK. ENVIRONMENTAL ADDRESS: 1200 W 33 AVE. SUITE B ANCHORAGE, AK 99583 CONTACT PHONE: 561-5040 LEGAL DESCRIP: SUBDlVISION: ALPINE TERRACE LOT: 6 SECTION: 24 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 40000 (SQ.FT. OR ACRES) MAX BEDROOMS: 4 Listed below are the options available to system. Choose the option that best [its DEPTH TO PIPE BOTTOM F:, 6.0 GRAL VEDEPTH TOTAFT.) 6.5 GRAVEL WIDTH GRAVEL LENGTH BRAVEL VOLUME LI 1") 37.5 TANK SIZE (GALS) SOIL RAT]NG (SQ.FT./BR) 165 you in designing your septic your site. 6.0 2.0 8.0 5.0 43.1 165 ** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) ** TANK MUST HAVE I—) LEAST TWO COMPARTMENTS _..... ..... ______..... ___________.... ... ..... _____..... ..... __ I certi/y that: familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA> and the State o{ Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria o[ this permit. 3. I wil1 adhere to all MOA and State o{ Alaska requirements {or the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid [or a maximum o[ 4 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA CUVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICALPERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WlLL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE I YENSED ELECTRICIAN. SlGNED DATE: _..... ..... ..... __ APPLICANT: A1 1IRONMENTAL y ^^ ISSUED BY DAlE: � ����������������� ���^� ~- ~ °x^ � -^ DEPARTME H AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, 264-472O AK 99501 870O50 Ath 04/10/87 APPLICANT: ALASKA USA C.U. / AK. ENVIRONMENTAL ADDRESS: 1200 W 33 AVE. SUITE B ANCHORAGE, AK 99583 CONTACT PHONE: 561-5040 LEGAL DESCRIP: SUBDlVISION: ALPINE TERRACE LOT: 6 SECTION: 24 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 40000 (SQ.FT. OR ACRES) MAX BEDROOMS: 4 Listed below are the options available to system. Choose the option that best [its DEPTH TO PIPE BOTTOM F:, 6.0 GRAL VEDEPTH TOTAFT.) 6.5 GRAVEL WIDTH GRAVEL LENGTH BRAVEL VOLUME LI 1") 37.5 TANK SIZE (GALS) SOIL RAT]NG (SQ.FT./BR) 165 you in designing your septic your site. 6.0 2.0 8.0 5.0 43.1 165 ** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) ** TANK MUST HAVE I—) LEAST TWO COMPARTMENTS _..... ..... ______..... ___________.... ... ..... _____..... ..... __ I certi/y that: familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA> and the State o{ Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria o[ this permit. 3. I wil1 adhere to all MOA and State o{ Alaska requirements {or the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid [or a maximum o[ 4 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA CUVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICALPERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WlLL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE I YENSED ELECTRICIAN. SlGNED DATE: _..... ..... ..... __ APPLICANT: A1 1IRONMENTAL y ^^ ISSUED BY DAlE: � ����������������� ���^� ~- ~ °x^ � -^ .::_.... :.....0_� 7 74/ 49 oor. ..fees ...:... ; . 0 •% E - 2251 :Ar .. ... .._ : 1 _. . - / .• ' �� •••.•Y+Y-gyp AV (t Ar pro /01 l�ecerfl><;ra(4 14vC(/.;- - A__rtJ k AS -BUILT NO CO,,;•, -..,S SET THIS DATE - - - �,M��Odwti I hereby e,::- ify that I have performed a Mort;;39ee's' %OF A; �y inspecting fnllowing described property: •� _ ✓ . /%`��f"` ;'.•: .... •� Anchorage ltccordin Alaska, and that the I improvements situac.rc. .. a within the property + Q Fid �va4sa ,,'r lines and do not ovr:.. s: roach on the property ?1" X2535 t w,, lying adjacent therei i-....mprovements on prop- : $ . ' �n� erty lying adjacent ti:c.e.o ei,c.oach on the premises in �� `�i •..,,,,��..•+ 4W question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska : this 2�T=' day of .J Lr r 1 197 -7 EASEMENTS OF RECORD, OTHER THAN FRED WALATKA & ASSOCIATES THOSE SHOWN ON THE RECORDED PLAT, F8.77-4 PU 47 . Rnrinoorc Ani: C+,rvvvnre 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 9 4?17 /m -u -d r.9r.1,.e./ 2„ (G M) WAS GROUND WATER ENCOUNTERED? CS S IF YES, AT WHAT L O —t DEPTH? I� P E Depth to Water.% ---N Monitoring?/ _ Date: Reading Date Gross Time Net Time Depth to Water Net Drop Ila c. ie r (0 N R'S SEAL) 0.6 9 ,�� •••••••' • Municipality of Anchorage ,o * 4 T 0 .Yr DEPARTMENT OF HEALTH & HUMAN SERVICES �•••••• •• ••••• •�••• 825 "L" Street, Anchorage, Alaska 99502-0650 / SOILS LOG — PERCOLATION TEST �• # ••••• ••�• • I 40 ••••••• a OY . REID, JR. #- - 2251 .� �� /j �� � +��•r••.•...••• • PERFORMED FOR: L. 2 � C- a 0 2 ��'r DATE PPI<f / LEGAL DESCRIPTION: X l e, .ie Te r re ce G Ig z Township, Range, Section: SXI, T/ z/U P_ .?A j s y DEPTH o SLOPE SITE PLAN 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 9 4?17 /m -u -d r.9r.1,.e./ 2„ (G M) WAS GROUND WATER ENCOUNTERED? CS S IF YES, AT WHAT L O —t DEPTH? I� P E Depth to Water.% ---N Monitoring?/ _ Date: Reading Date Gross Time Net Time Depth to Water Net Drop Ila c. ie r (0 0 0.6 9 0 //01 0 .Yr D . /1 ' / 20 , 2D / / 3 b o p / 20Ste? t7 �j©t2, b O PERCOLATION RATE ,,� rz�(iinUtes/inch) PERC HOLE DIAME7 / f TEST RUN BETWEEN __ FT AND Ald FT COMMENTS !rte /'� – /�Gt�.+�t..� e.. Jed e-4 / rY-,' ,Sa)a%t)e .?.S/rneL PERFORMED BY: L ' 12'2 i9 I CERTIFY THAT %THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �/ L/Q 2 72-008 (Rev. 4/85) (Eq0, GRE„ I'ER ANCHORAGE AREA BOK jUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ��'9a ��hBDh MAILING ADDRESS { ��g � Ck�et,.1 PHONE Sq3. L11`FPr I LOCATIONNlldl�ple LEGAL DESCRIPTION_ L C0 'Z:b Mgt' ne 1'tMA-C.e__ SEPTIC TANK: C' DISTANCE I NUMBER OF FROM WELL MANUFACTURER h MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY (Z�SO GALLONS. �hM►llow �tta�:, F I E L D: t ! TOTAL LENGTH DISTANCE FROM WELL n L -)I FOUNDATION W NEAREST LOT LINE OF LINES 160 NUMBER OF LINES DISTANCE BETWEEN LINES RENCH WIDTHIN. TOTAL EFFECTIVE 69 Lkzf ABSORPTION AREA SS a T ac, SQ. FT. LENGTH OF EACH LINE I h o r ��jj%p DEPTH OF FILTER r r DEPTH: TOP OF TILE TO FINISH GRADE _MATERIAL BENEATH TILE -IN. IN. ABOVE TILE `'h 56 IN. WELL: TYPE_ `1 �� CONSTRUCTION C_ �-AC�'�J U. (' Cwl S ' DEPTH DISTANCE FROM: BUILDING C1 /r� NEAREST ( NEAREST ,/ SEPTIC SEEPAGE I FOUNDATION I , LOT LINE �, SEWER LINE , TANK ! 0 14 0� SYSTEMy CESSPOOL l`- OTHER SOURCES APPROVED _ DISAPPROVED DISTANCES, INSTALLED BY: - k!r'I CA"t' � j e`% SEWER LINE DEPTH: o I l W L i G 2 0,�k PIPE MATERIAL: L,`3 L�t ©lLJ��ora�C` LOT SLOPE: REMARKS: S sLwse Jo Form EQ -032 REMARKS Nth +VLkK+^ti6e-J 0_�' DIAGRAM OF SYSTEM tN "� G Ib'CT Lk gawp. t�o�.s�.• DATE `J } APPROVEDmom G.A.A. B. W � �A F=' F-1 r -j C:'-[ -'IF--* � - DEPHRTMENT JF HEAL TH AND ENVIRONMEN 825 'L' STREET, ANCHORAGE, HK 279-2511 L4 EF L_L_FIPAE> KAPA--o-FEE: 00A py,E EQftwl :11 PERMIT NO. ( 77145 ) \ v(� APPLICANT GEORGE BENSON 9301 BLACKBERRY ]'~ LOCATION HLPI '' ^� LEGAL L6 B2 ALPINE TERRACE LOT SIZE 40000 SQUARE FEET TYPE OF SOIL HBSORBTIONSYST' IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 138 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: -�L&2-1 -4-7�' �3F?F-i%-"F-_lL_ �F�����= � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). �F::- F:> -F I IZ:' ���� Ir A- -z:. r--; ������� ����-r T_ co r -i ����� � ���� ��� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. '^ MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. - ��F;�rl I "r ���I E�-v F-CAFN ClrJEEE 1 iL..j F--., I CERTIFY THAT ' 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES ]: I UNDERSTAND,;r � RESIDE MAY REQUIRE ENLARGEMENT IF THE MORE THAN 4 BEDROOMS. SIGNED:- HPPL cAm|IORGE BENSON ISSUED BY-- �^/�, ` ����-��~ ,'V/ /'u� �M/ »r '�' - �� conittuetion Srad -fat "One test is worth a thousand opinions" 2204 Cleveland Anchorage, Alaska 99503 Performed For G eor �� Date Performed 4 7 Leaal Oescrintion: L t Bloc: Z Subdivision�,9e. e - rIACC This Form Renorts Soils Loq e -s Percolation Test nenth Feet Soil Characteristics 2 6- 8— — 8— '-w r1�zCO-, tU r'5 s - I 12 14 16— iw-� 20— Was Ground Water Encountered? ,?//47 If Yes, At what Denth? W ,lI �p��� Percolation Rate Plinute Proposed Installation: Seenaoe Pit Drain Field _ Deoth of Inlet Depth To Bottom 0 Pit Or Trench Cr)mMENTS: 77?�%?G(s z _1 -pe /V_5 Sq, -f- t - , 1cc�rar�-A" Test Performed By Data Certified By: Date: L c -')L ► ll� �� w �f KJ (� lit l�2 f _ f G r _epi l. leo `'�-''- 1 I f � 11 0 C `a Z- scv —f,4"12 3 �' tol JA h� k ^�4 5rzW`Mp CN�I•..K�tU 7 71 s - �Cy �� Well Log For........................................................................ Location,(....,........ Datecompleted. ................................................................ Depthof well..... ........................ ...................................................................... Size of casing....... ... .......... ......... . ............ ... ....... Distanceto water ...... 6. Y./ ..................................................................................... Distance to water while pumping ......... P10.11 ....... I ....................... I ...... at rate of ......V ................................... gallons. per hour. Formation from to Driller DELTA DRILLING COMPANY SRA BOX 394 B ANCHORAGE, ALASKA 99507 Certificate of On -Site Systems Approval Expiration Dat , e: J A4 11)020 5. GENERAL INFORMATION Complete legal description Alpine Terrace B2 LIP Location (site address) 7441 Alatna, Ave Current property owner(s)' Wolford & Chelsea Morgan Mailing address Same Real estate agent 2. TYPE OF DWELLING: M Single Family (w/wo ADU) n Duplex 171 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: Private Well Water Storage Community Well Public Water System Waiver request for: Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Received by: COSA to be released to the rfgVeer, unless otherwise requested by the engineer. COSA Fee $ MigrA&M --7- Date of Payment Wylo-ViO16 Receipt Number (130111 Lo —IW6 COSA# D ej I/ YL Date: Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: Private Septic Fxl ❑ Holding Tank', ❑ FJ Community 1' ❑ ❑ Public Sewer ❑ Received by: COSA to be released to the rfgVeer, unless otherwise requested by the engineer. COSA Fee $ MigrA&M --7- Date of Payment Wylo-ViO16 Receipt Number (130111 Lo —IW6 COSA# D ej I/ YL Date: Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date ZOO KD � 0. AL, 1 19 TH DSD SIGNATURE 4- V System #1 Approved for bedrooms r Ste've'n• ' Pannol-)e� CE 8149 r System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: OF ANCh,����c \,Njr VN_ ./�,1`j� NT SER �����, By: C;i Original Certificate Date: `I Ian �� 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory Arsenic Advisory. Other Legal Description: Alpine Terrace B2 L6 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1977 Total depth 113 ft Cased to 40'+* ft ❑ Sanitary seal is functioning correctly no Wires are properly protected Casing height (above ground) 12 in. Date of flow test for COSA 2/21/20 Static water level at beginning of test 34.5 Comments B. TANK DATA Age of tank(S) 4/3120 years Tank type/material STEP; -b. ft. Measured operating fluid level in septic tank n/a ❑ Standpipes/foundation cleanout per record drawing Date of pumping n/a D. ABSORPTION FIELD DATA Bed Which system tested (date installed) 2016 ❑ ALL standpipes present per record drawing Total measured depth from grade 3.0* ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 015-243-02 Structure served by this system 1 Well production at time of test 3.98 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑✓ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 4/3/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station ® years Lift station material 'S rz r Comments: $4eAA-7 Adequacy test date 2/21120 Results IDPass For 4 Fluid depth prior to test 0 Water added 624 gal New depth 0 in Elapsed time 140 min On Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate '600 gpd bedrooms H (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: ' system is insulated 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' 0 Yes Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft Q Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' F_/� Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Yes if No ft 0 Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft Q Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots.- ots:Absorption AbsorptionField > 5' [✓ Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200'✓0 Yes if No ft Water Service Line > 10' 0 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' E✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ✓� Yes if No ft Wells on Adjacent Lots.- ots:Water WaterMain > 10' 0 Yes if No ft Private Wells > 100' 0✓ Yes if No Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' 0✓ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION � of ALqk���� 1 certify that I have determined through field inspections and reviewC1. Aw—F N of Municipal records that the above systems are in conformance with MOA COSA in this date. guidelines effect on Stever 7. Pannone CE 8149 COSA Checklist yellow sheet ft ft Parcel I.D. ��t���� u �% IV RUM , M �v y 17 '7 ;ZiDfl:i; ozs� I I -x 6 Municipality of Anchorage = On -Site Water and Wastewater Program (� �" s (907) 343-7904 b 8 L 9' fl Certificate of On -Site Systems Approval 015-243-02 1. GENERAL INFORMATION Expiration Date: Complete legal description Alpine Terrace, Block 2; Lot 6 1_ocatinn (site addressl 7441 Alatna Ave Current Property owner(s) Perry and Catherine Duffy Day phone Mailing address 7441 Alatna Avenue, Anchorage, AK Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual n Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: ;� COSA to be released to the engineer, unless COSAFee $ �Co��� lbi.ib� 1;1 DateofPayment sttg�lb Receipt Number COSA # f7SC-t 1 I1 t Date: by the engineer. Waiver Fee $ Date of Payment Receipt Number Waiver # I (? 5. STATEMENT OF INSPECTI-ON• 3Y ENGINEER As certified by my seal affixed hereto and as of the vat dation 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, ordinance§, and regulations in effect at the time of installation. :1 1 In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in acc4dance with Iv10A COSTA guidelines and regulations. The reported results describe the performance of the system under the conditions encoun(ered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic sysieriis-aepend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory testa results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot -provide gny warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineers Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907)272-8218 l�2_ Date 050!2016 Wv;�nnritirie ate. CE -8149 Conditional approval for bedrooms, with the following stipulations: BY \ Original Certificate Date: d ! 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 forerrom or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAblue sheen c * YD If more than 1 septic system is on the lot: COSA Checklist # _L_of + Structure served by this system Certificate of On -Site Systema Approval Checklist Legal Description: Alpine Terrace Block 2, Lot 6 Parcel ID: 015-243-02 A. WELL DATA Well type Private If B, or C provide PWSID # Well Log (Y/N) Y Date completed 6/4/1977 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y Total depth 113 ft. Cased to 40+ . ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of -test 6/4/1977 04/26/201.6 Static water level 64 ft 52 ft. Well production 5g•p•m• 2'21 g,p•m. WATER SAMPLE RESULTS: `. Coliform Neg colonies/100 mL Nitrate: ND mg/L Arsenic ND ug/L Date of sample: 04/26/2016 Collected by: PES B. SEPTICIHOLDINGTANK DATA Tank Type/Material S.T.E.P./Steel Date installed 5/19/1987 Tank size 1500 gal Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) 3 High water alarm (YIN) Y Date of pumping 08/12/2015 Pumper Isaacs Pumping Services C. ABSORPTION FIELD DATA Date installed 04/19/2096 Soil ratingd./fe or fe/bdrm 0.5 GPD/SF System Bed f9•P• ) Y tYP? Length60 ft. Width 20 ft. Gravel below pipe 0.5 ft Total depth 3 ft. Eff. absorption area 1,200 fe Monitoring tube Y_ Depression over field N Date of adequacy test NeV Results (Pass/Fail) Pa$S For,4 bedrooms Fluid depth in absorption field before test New in. Water added NeW gal. New depthNew in. _ Elapsed Time: New min.; Final fluid idepth New in. Absorption rate >= 600+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed 5/19/1987 Size in gallons 1,500 ManholelAccess (YIN) Y "Pump level 43 in. "Pump level at 40 alarm 45 on" at in. High water level -at in. _off' Datum Bottom Of Tank Cycles tested 4 Meets alarm & circuit requirements? Yes E. SEPARATION DISTANCES WELL ON LOT TO: Septic tankllift 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 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTICIHOLDING TANK ON LOT TO: Building foundation 5+ -Property line 5+ Absorption.field 5+ Water main 10+ WateFservice line 1-0+-- surface water 40.0+ - — — 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 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F—COMMENTS G. ENGINEER'S CERTIFICATION I certify that: I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA ,guidelines in effect on this date. Engineer's Printed Name Steven Pannone Date '5/19/2016 COSA canary sheet_2-6-15.doc Lot. 2 / 75086 N89058'00"W 200.00 Lot 4 I Chain link fence (7C.O. Septic v nts�9 o �S3 eptic tanks o b 2 O 2.0 OH O I 4 '�S Sfo2T 2 00 I 2.00 A O O I O°�. 26+3, rye• .+ti 0 E I Well O Lot 5 N O O — ,, •}Fly. Z nti'= Yti ,m I ,{ CQ I 06 e"r: LOT 6 rk N L---- '`'-------- - ------ ..rte ;= 10' Utility Easement ' N89058'00"W 200.00 O M ALATNA AVENUE 49th •� /...... �• 00 00 I, '.Fred Walatka. ff/ sr 3255 - S , •fie- � ft SCALE: 1"=40' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB 77-4, pg 47 O O O O CV O O N O O O Z fence Lot 1 0 M REVISED SEPTIC PIPES 5-20-20161te RECERTIFIED 5.18-2016 AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: LpT 6. BLOCK 2. ALPINE TERRACE SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property tying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 29th day of JUNE 1977 FRED WALATKA & ASSOCIATES BEEngineers and Surveyors (907-248-1666) Municipality of Anchorage • -� Development Services Department •'`� Building Safety Division , +•�. :. . Onsite Water and Wastewater Program ' 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 015.245-02 1. GENERAL INFORMATION Complete legal description opine Terrace Block 2 Lot 6 COSA #— 09018 4 Expiration Date: f " % 9 — Q Q Location (site address) 7441 Alatna Avenue Anchorage 99507 Current Property owner(s) William & Heather Rosborough Day phone Mailing address 7441 Alamo Avenue Anchorage 99507 Lending agency Mailing address Real Estate Agent Carol Bennett / Dynamic Properties Mailing Address 3111 C street suite 100, Anchorage, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well ✓❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone 227.8070 TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑r Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Onsite Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of Onsite 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 -she 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 Finn Watkins Engineering, Inc. Phone (907) 349-1851 Address 2520 Laird Circle Anchorage, AK 99516 Engineer's Printed Name Cindy W. Ellis Date 6n3= 6. DSD SIGNATURE _LL__Approved for __q__ bedrooms. Disapproved. Conditional approval for bedrooms, with the following iffy W. Ellis CE. tos77 Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: [ `� (R",1,M) Municipality of Anchorage Development Services Department \_ Building Safety Division ` On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Alpine Terrace Block 2 Lot 6 Parcel ID: 015-243-02 i A. WELL DATA Well type Private Date completed 6/4/77 Total depth 113 ft. Date of test Static water level Well production If A, B. or C provide PWSID # _ Sanitary seal (Y/N) Yes Cased to 40'+ ft. FROM WELL LOG 6/4/1977 64' ft. 5 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Arsenic: 0 mg/I g.p.m. Nitrate 0 mg/L Date of sample: 04/22/08 Well Log (Y/N) Yes Wires properly protected (Y/N) Yes Casing height (above ground) 13 in. AT INSPECTION 4-11-08 45 ft. 3.8 g.p.m. Other bacteria 0 colonies/100 mL Collected by: Rocky Trainor/Watkins Engr B. SEPTIC/HOLDING TANK DATA Tank Type/Material steel STEP tank Date installed 5/19/87 Tank size 1500 gal Number of Compartments 2 Cleanouts (YM) yes Foundation cleanout (YM), yes Date of pumping 4/11/08 C. ABSORPTION FIELD DATA Depression over tank (Y/N) no High water alarm (Y/N) yes Pumper Isaac's Pumping Service Date installed 7-23-90 Soil rating (g.p.d.t t2 or ft2/bdrn) 213 type System BED Y Length 43' ft. Width 30' ft. Gravel below pipe 0.5 ft. Total depth 2.8 ft. Eff. absorption area 1290 ' rP _ft Monitoring tube Yes Depression over field No Date of adequacy test 4-11-08 Results (Pass/Fail) Pass For 4 1 _bedrooms Fluid depth in absorption field before test 3.5 in. Water added613.5 gal. New depth k.6 -in. Elapsed Time: 300 min. Final fluid depth 3.5 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None known If yes, give date D. LIFT STATION Date installed 5/19/67 ! Size in gallons 1500 Manhole/Access (Y/N) Yes 'Pump on' level at 39 in. 'Pump off level at 31 in. High water alar level at 46' in. Datum Bottom of Tank Cycles tested 10+ Meets alarm & circuit requirements? yes E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 100'+ Sewer /septic service line 25'+ Animal containment areas 100'+ On adjacent lots 100'+ On adjacent lots100'+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'± Absorption field 10+ Water main 100'+ Water service line 25'+ Surface water 100'+ Wells on adjacent lots 1001+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 100'+ Water Service line 10'+ Surface water 100'+ Driveway, parkingNehicle storage 10'+ Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS: Northeast MT Is too shallow, Southwest MT Is too deep by 3 Inches. Reported levels are adjusted to 6 inches effective depth. Field was filled to capacity on test. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Cindy EAis Date 6/13/08 COSA Fee $ ' '�D Date of Payment Receipt Number _ i o 9 3 3 q (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 49TH MY W. Ellis CE -town ., wof SOS RcE# 1081608001 Client Name Watkins Engineering ProjectNamt/N Alpine Terrace Blk2Lot6 Client Sample ID Alpine Terrace Blk2 Lot6 Matrix Drinking Water PWSID 0 Sample Remarks All Dates/fimes are Alaska Standard Time Printed Datelfime 05/012008 10:11 Collected DateMme 04/222008 13:27 Received DateMme 04222008 15:40 Technical Director Stephen C. Ede Allowable Prep Analysis Panmicter Results POL Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 0428/08 04/30/08 NRB Waters Department Total Nitmte/Nitritc-N Microbiology Laboratory Colony Count Total Coliform Fecal Coliform ND 0 0 0 0.100 mg/L SM20450ONO3-F B (<10) coU100mL SM209222B coUl00mL SM209222B coUI00mL S1020922211 A (<200) A (<I) A (<I) 0428/08 LCP 0422/08 DLC 0422/08 DLC 0422/08 DLC aAr ISI Nsa.e •.n.e �� aAx t.a.«a> '"•" e+e•10 �1•^a N 89.5e'00' w 200.00' T.II •uvea x1eAa •i YO C. I UFT p Q ?S), STATION o CS ' ya N ! g EXISTING 57.0' f o ne HOUSE rn 5 .. C. 7 WELL 8 i I � I QV V OI L--- =-------- ------ 10' UTR ESMT ------------ S 8938'00' E 200.00' ALATNA AVENUE o --------------------------- SURREY COMMAIM ASAM%%%%, Prepored by PLOT PIAN �.•P-�E...,,,. Robert E. Johns, Jr. & Assoc. 1`�""°je«"'« :1 •. M 1� M 4N« "'� «....�.rN •�' 1" •'e., :��; •' ��. Professional Land Surveyors «�«. ••IN N• Ye. e�«M M«Ny. •.•r+..w er, 1700 BRINK DR. ANCHOIiACi, AlA$KA 119504 �+•.� �� e�N AV FOUNDA11ON AS -BUILT SCOW lR - 40! Ret. Lot S.F. Roo. Plot Flo No, t erM c ++.� e, ••+r �wr er 1 .........N ..... «.. :.. Gale SUrve a r 5-27-08 Oraven Dy. i2FiT C11ackaa Dy JMEC Yr w. N NAY .YI SYN o` / 21-5 Oale Oram: Grid: 2740 W.O. 896 FINAL smucn,RE As BULr �r...A..r - , �.�� ��♦ ••'•...... _ _ A+ i'•r~+I Nary e.. I ...... N w.......: '..: ti s ... •• •,/ Ueeaiptim: wry r wr..a., N ,I.N e�.N A,01,68 d Laa��♦ Loot 6 Block 2 r w�i.� �.wr erl w. /1 j \\\\\\�• Alpine Terrace LOT SURWY SURVEY TYPE FalA1DATKN A9-8MT VMS= TRIAL SINUCIUAC AS_q%y LEE PLOT PUN a • SET PLUM � y� DRAINAGE .........: r..—.D ASPHALT ... AST. ... �.Na COIb.Oes 4i DY er•e�ne..•...... .. ..... ..� ��.___ ___ REBAR �7f1 .c.•....�.. ..-. WOOD FENCE CONCRETEFOUN C IS THE RESPONSIBILITY OF THE BUILDER OR OWNER. PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL ee CONSTRUCTION, TV VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, 91DEwAUt3, E VALL BE TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW TMI12m nn HE EXISTENCE _A ANY EASEMENTS, COVENANTS OR RESTRICTDN3 MAY PREVLNT 30ME IMPROVEMENTS FROM BEING SEEN AND LOCATED. PP CORDED SURDIMSION -- A66 DISTANCES UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRJCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. Municipality of Anchorage Development Services Department Building Safety Division _ Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Cindy Ellis Legal description: Alpine Terrace Block 2 Lot 6 []Permit ®C.O.S.A. ❑Inspection Report ZD The attached paperwork has been reviewed and is being returned for the following reasons: 1. Uft station lid needs lock and gasket 2. Old septic bed must be decommissioned. Name of reviewer: Jeff Date: June 17, 2008 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services e On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907)343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILL,, /Y DWELLING Parcel I.D. # 015-243-02 HAA# 1. GENERAL INFORMATION Complete legal description ALPINE TERRACE LOT 6 BLOCK 2 Location (site address or directions) 7441 ALATNA AVENUE ANCHORAGE AK 99516 Property owner BRANT REEVES Day phone X927) 345-1548 Mailing address 7441 ALATNA AVENUE ANCHORAGE AK 99516 Lending agency Mailing address Day phone Agent MATT DIMMICK W/PR D NTIAL Day phone _(97) 773-7733 Address 4241 "B" STREET ANCHORAGE AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 4 XXX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC ing to the legality and status of system. 72-025 (Rev. 1191) Front MOA #21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1,110.00 at, or prior to, closinq for the enqineerinq services provided. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspe tion, the on-site water supply and/or wastewater disposal system is in compliance with all Municipa hd State codes, ordinances, and regulations in effect on the date of this inspection. A SII Name of Firm Phone --(Q07) 337-61.79 Address 6901 DEBARR ROAD, $ I B) fi1CH RAGE ALASKA 99504 Engineer's Signature _ Date In conducting this evaluation, AWWC, Inc. latt�'mp�d to proWd6 a thorough, conscientious engineering analysis of the system in accordance with ADEC and M A DHH Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, ground water levels that may fluctuate during the year, and the water oo�opp usage of the family being served by the system. These conditions are outside the control of o the evaluator of the system. Satisfactory test results do not guarantee future performance o 0 e.FA of the system, nor do they guarantee that there are no hidden defects or encroachments. Q AWWC, Inc. can therefore not provide any warranty for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. , , , . The content of this report is for the sole benefit of the owner listed above. Any 0 reliance upon or use of this report by any other person or party is not authorized, 0..... . . nor will it confer any legal right whatsoever. fr A. (�nfss 6. DHHS SIGNATURE Approved for bedrooms Disapproved Conditional approval for Additional Comments BE c bedrooms, with the following stipulations: Dated 1 s Yif {i.r-�"!`Ubiri'r1t �u�.«twsewez.r�.u-,ae�,s-z,�. } S The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 72-025 (Rev. 1191) Back MOA#21 Computer Version RECEIVE® Municipality of Anchorage OCT 2 4 2000 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIPALITYOFANCHORAG 825 "L" Street, Rm 502 Anchorage, Alaska 99501HWAbMNfi*SERVICES DIVI Health Authority Approval Checklist Legal Description: ALPINE TERRACE; LOT 6, BLOCK 2 Parcel I.D.: 015-243-02 A. WELL DATA *PER PREVIOUS HAA Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A Log present (Y/N) YES Date completed 6/4/1977 Total depth 113, Cased to 40'+* Casing height (above ground) 16" Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 6/4/1977 AT INSPECTION 10/13/2000 Nitrate o. 6 noaL Other bacteria C2 Date of sample: 10/17/00 Collected by: A.W.W.C., INC. B. SEPTIC/HOLDING TANK DATA Date installed 7/23/90 Tank size *1500 Number of Compartments 2 Cleanouts (Y/N) YES v.d Foundation cleanout (Y/N) YES Depression (Y/N) NO High water alarm (YIN) Aibr YES Date of Pumping 10/13/00 Pumper ISAACS PUMPING **BELOW ORIGINAL GRADE C. ABSORPTION FIELD DATA NOTE: ONLY ONE MT FUNCTIONAL WITH TWO CLEANOUTS. INVERTS ARE 7" AND 7.7" ABOVE BOTTOM OF MT. Date installed 7/23/90 Soil rating (g.p.d./ft2 or ft2Jbdrm) 213 System type BED Length 43' Width 30' Gravel thickness below pipe .5' Total depth **2' +2' SAND Effective absorption area 1290 SQ FT Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO Date of adequacy test 10/13/00 Results (Pass/Fail) PASSED For 4 Bedrooms Fluid depth in absorption field before test (in.); 6 Immediately after 1107 gal. water added (in.): 9.25 Fluid depth 6 (ins) Minutes later: 1183 Absorption rate = 600+ Peroxide treatment (past 12 months) (Y/N) NONE KNOWN If yes, give date ----- 72-026 (Rev. 3/96)• Computer Version D. LIFT STATION Date installed 7/23/90 Size in gallons 1500 Manhole/Access (Y/N) YES "Pump on" level at* 42" —"Pump off' level at* 42" High water alarm level at* 46" *Datum BOTTOM OF TANK Cycles tested E. SEPARATION DISTANCES 3 SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100' Public sewer manhole/cleanout N/A Sewer/septic service line 25'+ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field 5'1 - Water main/service main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots _100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ _Water main/service line -1()'+ Surface water 100'+ Driveway, parking/vehicle storage area 10'4_ Curtain drain NONE KNOWN Wells on adjacent lots 100'-1- F. ENGINEER'S l certify that 1, of Municipal n with MOA HA Signature I Engineer's Id inspections and review stems are in conformance this date. HAA Fee $ a 0-2 ' " Date of Payment ,I D Lzal" Receipt Number uo 0 1 4lcn 72-026 (Rev. 3/98)' computer Veralon Waiver Fee $ Date of Payment Receipt Number ->v... e re A. Vness;' P —7953 Of"•ea �Eo°jv 0 ,\aPro f e s sleloo 10-24-00 08:42 FROM -CTE ENVIRONMENTAL AL.CT&E Environmental Services Inc. rwii—riiii-- r��"i CT&E Ref.# 1006479001 Client Name AK Water & Wastewater Consultants Inc. Project Name/# Alpine Terrace Lot 6 Blk 2 Client Sample ID Alpine Terrace Lot 6 Blk 2 Matrix Drinking Water Ordered By PWSID 0 Sample Remarks: 5615301 T-830 P.02/03 F -90T Client][100 Printed Date/Time Collected Date/Time Received Date/Time Technical Director Released By "A 10/20/2000 14:22 10/17/2000 11:45 10/17/2000 12:07 Stephen C. Ede n -- Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date Init Waters Department Nitrate•N 0.500 U 0.500 mg/L EPA 300.0 Microbiology Laboratory Total Coliform 0 col/IOOmL SM18 92228 10 max 10/17/00 SCL 10/17/00 KAP LY' (3lack ZAC Location (site address or directions )' ?yyl '` �4 Ict%7a`' /`}molnar ' < .; xr Property owner�� Day phone ��3 YS - 11 6Y Mailing address, Y 2l' ,4nchyru�r�pk 99S z y LendingLagency . PµN,. l" (vim' 9cu9� Serer%epi bay phone'&00j Mailingaddress 6aU hfrtu»�"°u�Gv. Hf L ae4rel, l <! D7 r Agent GeGCF_ rne l`Killet- DXnur►�« Pronenfi.�; bay 2G'% 7669 =t phone ., Address 3111 C" Sf 'Su.Fe- «. Ane_A)ar-zzoe 99So3 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: ` � y 3. TYPE' OF WATER SUPPLY: ; Individual well Community well s . Public water NOTE'. if community well system, "provide written confirmation from State ADEC attest " ing`to the legality and status of system.` r sj 4. TYPE OF WASTEWATER DISPOSAL _ x `t Individual on-site Holding tank'; Community on-site-��r_< Pubii6sewer NOTE:' if community wastewater system, provide written confirmation from State ADEC" a` attesting to the legality and status of system: 72-025 (Rev.1/91) Front MOA #21 The MUM cipajity of Anc Approval Certificates aF ms or rocs or --i Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES . ,,iRONMENTAL A Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-47441AN 20 1998 Health Authority Approval Checklist RECEIVED Legal Description: 6_oot 43/oc4r Z# A /g, ne I c-11'Gc a Parcel I.D.: O /S z 1930 P- A. A. WELL DATA Well type Fv f If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Yes Date completed 6/ 3 / 7 7 Total depth 113, Cased to Y8' Casing height (above ground) /6'' Sanitary seal (Y/N) Wires properly protected (Y/N) Y FROM WELL LOG AT INSPECTION Date of test 6 / 3 / 77 / o / 2 y / 97 Static water level (� y ' 36 Well production S g.p.m. y / 9 - p.m -WATER SAMPLE RESULTS: Coliform O col / 100 m t Nitrate Other bacteria nos a r4oa� c.( Date of sample: 1 /8 19e Collected by: /-"tc cch Svc. B. SEPTIC/HOLDING TANK DATA Date installed S/ 19 /,9 7 Tank size a of Number of Compartments Cleanouts (Y/N) Y ST r Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) Y Date of Pumping 10/27/97 Pumper A + C. ABSORPTION FIELD DATA Date installed 7/ 2 y/ q0 Soil rating (g.p.d./ft2 or ft2/bdrm) 213 a' System type Bea 01>13 $'7 Length YY Width 30' Gravel thickness below pipe D.S' Total depth 2' w. 2' -Cwp� Effective absorption area 1290 0' Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test I c / 2 y / 9 7 Results (Pass/Fail) Pc xt For `/ bedrooms Fluid depth in absorption field before test (in.); h Immediately afters gal. water added (in.): o Fluid depth (L_ (ins) Minutes later: Ga Absorption rate. = > 60U g.p.d. Peroxide treatment (past 12 months) (Y/N) NoAt known If yes, give date Al- A. 72-026 (Rev. 3/96)* D. LIFT STATION Date installed 5-119167 Manhole/Access (Y/N) Y Size in gallons )S-00 qcr I S i 011 "Pump on" level at* `/v "Pump off" level at* 3914.J, High water alarm level at* ''/s *Datum 3,,f -/VV" oic vault Cycles tested ?0 * E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot 10s On adjacent lots 106, Absorption field on lot lis" On adjacent lots > /00' Public sewer main N • A. Public sewer manhole/cleanout 1v A. Sewer /septic service line 2S' Lift station 147s, SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 10' Property line SB' Absorption field SG' Water main/service line > to' Surface water/drainage > too' Wells on adjacent lots > /00' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10' +- Building foundation 30' Water main/service line Surface water > too, Driveway, parking/vehicle storage area _ io Curtain drain None Seen Wells on adjacent lots > I ua' F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records tib# fhe abpv systems are HAA Fee $ 30a Date of Payment I l 20'J� Receipt Number 03�-l2- (l9Ygj-� 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number ��IL CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 980103001 Flattop Technical Srv. L6, Blk 2, Alpine Terrace L6, Blk 2, Alpine Terrace Drinking Water Client PO# Printed Date/Time 01/13/98 15:01 Collected Date/Time 01/08/98 13:50 Received Date/Time 01/08/98 14:15 Technical Director: Stephen C. Ede Released By Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date Init Nitrate -N 0.100 U Waters Department Analyses 0.100 mg/L EPA 300.0 10 max 01/08/98 GCP Total Coliform 0 col/100mL SM18 9222B 01/08/98 TMW MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # 'a HAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 6; BQock 2; Atp.i.ne Teanaee. Subdivi,6ion; Location (address or directions) 7441 Atatna (b) Property owner A. ,6ka USA' F.C.U. Telephone: (home) Business 786-2709 Attn: Lim Levna Mailing Address P U Bax 196613 Anchonac a Ah 99518-6613 (c) Lending Institution Mailing Address _ (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the following address: (or check herea if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eek River Loop RoaCl Nam Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family., Number of bedrooms 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site 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. 72-025 (Rev. 7/88) Page 1 of 2 Z jo Z abed MC)UG (99/, 'ABU) SZO-ZL .Njom s,aaaul6ua leuolsseloid eqj ul suoiss(wo ao sioiie aoj alglsuodsaa;ou si a6eaoyouy jo A1lledlolunW ayl'panssi s1 eleolIl}J90 g aaolaq elep ezAleu>; ao suol�oadsul;onpuoo fou op SHH4 �o saa�(oldui3 -sivaweimbaj alels pug leaapa} umpoo � (suss of aapio ul suollnlllsul 6ulpu9l a1ayl pug sawoy jo sieseyoand of Aselinoo u se slyl S90p SHHa 9141 'e�lSelt/ }o a}egg aye ul paaa}sl6aa aaaul6ua Ieuolssa}oad �uapuadapul ug �(q anoge g ydoiBeied u1 U9A16 suollgl,uesaidaa ayj uodn �(luo paseq pel.eol jlaao lenoiddl!joglny y;IgaH sanss! (SHHa) sao!AaaS uewnH pue g4lgaH }o luawlaedaa a6eaoyouy Io �(lIledlolun y �IN aye. lenoiddy leuolilpuoo 10 swaal iguoljlpuoO panoaddesla panoiddy ��- aIep Aq swooapaq ao} penoiddy L z '1VAOaddV SHHa '9 p�SSi3�0yd�i� 3'LSf! 'oto � ti• � • LLS66 ='•IT area tog •04, aeob dool aan7111 e15e3 VEOZL 6N1?133 ssaaPPy euoydele 1 wall 10 aweN ..._ 04 uol�oadsul sly} jo algp ay} uo 10911a ,ul suollelnbej pug 'saougulpao `sapoo a�elg pug ledlolunW ile q- aoue11dwoo ui s1 wels�(s Iesodslp ial.gmel,sM ao/pug �(lddns aalenn ails-uo ayl `uoll,oadsul Pug uo1le611sanul �(w woal pug sa111 a6eaoyouy jo �(;Ilgdlolunw ay; woal paulglgo uo1}ewaojul aye uo paseq Igy} � jjj9A i.9gipnj i 'ula.iay paleolpul ainlonjis }o edAl pug swooapaq }o aagwnu eqj aol algnbape pug Ieuoljounj `91gs s1-welsAs Iesodsip jlajgnnal.sBm ao/pue Ajddns jejam. -alis-90 ay}.,Iey}-snnoys Ienoiddy Allaoglny ylleaH siyl �o uo1}g6l�sanul �(w 1g41 A�laan i 'nnolaq uMoys el,ep uolIgplleA ayl io se pug olaaay pax j)e leas Aw Aq paljl3aao sy JN3 'S NOIIVWtIOdNI aNV V1Va'HOaV3S 3�Id'S1S31'SN01103dSNl ONIalAOad Wdid ONIU33NI MUNICIPALITY OF ANCHORAGE (MOA) *PALITY Health Authority Approval (HAA) OF AQ§§IST - FEBRUARY 1984 ENVIRONMENTAL SERVICES DIVIS10043-4744 Legal Description: J U L 2 5 1990 A. WELL DATA E E Well Classification If A, B, C, D.E.C. Approved (Y/N) Well Log Present/N) Date Completed ' '' 7 Yield rD 49 V— Total Depths Cased to Depth of Grouting 14 JA,- D o i Static Water Level Pump Set At An�C Casing Height Above Ground 12 Sanitary Seal on Casing &/N) Electrical Wiring in Conduit/N) Y Depression Around Wellhead (Y/110 1� SEPARATION DISTANCES FROM WELL: To Septic/HQW*g Tank on Lot ���' ; On Adjoining Lots ��fp " 1 To Nearest Edge of Absorption Field on Lot I ; On Adjoining Lots \ C "4 To Nearest Public Sewer Line 7A To Nearest Public Sewer Cleanout/Manhole 1 To Nearest Sewer Service Line on Lot 2•`✓ Water Sample Collected by ;�. S—� ��'�� ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA u��� Date Installed ''��Size 1570 n No. of Compartments 2 Standpipes ON) Air -tight Caps MN) Foundation CleanoutN) Depression over Tank (Y/Oe Last Pumped :7-1-1-10 Pumping/Maintenance Contact on File (Y/N) ; for A Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: / r To Water -Supply Well o s To Building Foundation d f To Property Line b '4-- To Disposal Field To Water Main/Service Line /b ' t' To Stream, Pond, Lake or Major Drainage Course Comments A et�,L15 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �24 3 fd� Type of System Design ��1fl Date Installed x%"23 -'at Length of Field Width of Field 7a� Depth of Field f C t Gravel Bed Thickness Cis Square Feet of Absortion Area �2-� ©� Statndpipes Present4VN) Depression over Field (Y/Q Dat of Last Adequacy Test _ Results of Last Adequacy Test �J� vlQCfL�9� SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well ,bG f To Property Line To Building Foundation 3 1 To Existing or Abandoned System on c .�� Lot 3c� -�'' ; On Adjoining Lots 4- To Water Main/Service Line % C> 14, To Cutback (if present) t To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area / S Comments D. LIFT STATION Date Installed 5_—J-1,67 Dimensions I 6A<L_ S►%� �� Sym Size in Gallons � A Manhole/Accessd%) t� "Pump On" Level at � N "Pump Off" Level at 3Z High Water Alarrn Level at Z'jo Vent IPJ) Tested for _)Ik_ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes O?N) Comments /-Vie )- —inw— /N�G� �cJM1° GAG[.-in3,5; **Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and inspection. Signed S & S ENGINEERING Company 17034 Eagle River Loop Road No. 204 age Kilvarl Date Z a MOA No. Receipt No. as�2JI asl� Date of Payment 7) Amount: $ 1`1 O7 c -D Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET • ANCHORAGE, ALASKA 99518 " TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order # 25299 Date Report Printed: JUL 16 90 @ 20:11 Client Sample ID:L6 B2 ALPINE TERRACE S/D Client Name S & S ENGINEERING PWSID :UA Client Acct SNSENGP Collected JUL 10 90 @ 15:30 hrs. P.O.@ NONE RECEIVED Received JUL 11 90 @ 16:00 bra. Req # Preserved with :AS REQUIRED Ordered By : R. SHAFER Analysis Completed :JUL 13 90 Send Reports to: Laboratory Supervisor :STEPHEN C. EDE 1)S & S ENGINEERING Released By G 2) Special Instruct: Chemlab Ref #: 902385 Lab Smpl ID: 1 Matrix: WATER Parameter Tested NITRATE -N Sample ROUTINE SAMPLE. Remarks: SAMPLE COLLECTED BY RR. Result Units Method ND(0.10) mg/l EPA 353.2 Allowable Limits ------------- 10 .............................................................................................................. I Tests Performed See Special Instructions Above UA -Unavailable ND- None Detected "' See Sample Remarks Above NA- Not Analyzed LT -Leas Than, GT -Greater Than °F.�NDECENpF HJ. G DATE RECEIVED �- 6. LEGAL DESCRIPTION INSPECTION APPOINTMENTS r3 �P�•v STREET LOCATION T. TIME_ TIME NUMBER'OF,BEDROOM DATE DATE DATE ] W� / (Y� 7�l� u v INSPECTOR _ _. INSPECTOR INSPECT P/L&UXUTY n;: A �S,,UUP L� INDIVIDUAL* DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PR©TECTI ot DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION depth tach, log if available.) 826 L Street - Anchorage, Alaska 99501 • JUL 81980 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 E'C E ,/ (1 Il REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEINER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER Ge. PHONE 7- 2 - -PR i .3Z.4s#4 01? MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE �J/ Ih ,4. .wa, . 2. BUYER PH NE MAILING ADDRESS SrQ X613 3. LENDING INSTITUTION PHONE MAILING ADDRESS / o3 W - 3tsr d. 4. REALTOR/AGENT PHONE i MAILING ADDRESS DATE RECEIVED �- 6. LEGAL DESCRIPTION L dor # G ;3/ Z. r3 �P�•v STREET LOCATION - dnl '4401;io r0.Ff_ �/•//.t•PE O�Q 6. TYPE OFF RESIDENCE NUMBER'OF,BEDROOM ❑ OneFour ❑ Other CIS" SINGLE FAMILY ❑ Two ❑ Five MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER LY �S,,UUP L� INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY sinc June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth tach, log if available.) a. SEWAGE DISPOSAL SYSTEM e INDIVIDUAL/ON-SITE** q7? YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY S E T ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. NOTE: -THE INSPECTION FE MUS ACC. MP 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: r 1- If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES . WELL TO: Septic/Holding Tank Absorption Area Sewer Line .. Nearest Lot Line Absorption Area to nearest Lot Line " 5. COMMENTS L"APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE B 72-010 (Rev. 6/79)