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HomeMy WebLinkAboutRAVEN WOODS BLK 2 LT 3Raven Woods Block 2 Lot 3 #015-232-17 b 4�3 Municipality of Anchorage Page of l DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -S1J ''i?jOZZd PID Number: 015 Z 32 --J--Z- - 17Name: Name: Wastewater System: New 11Upgrade Lj_oyD F. A,.! Address: �- 12 t T 1 d ABSORPTION FIELD Phone: No. of Bedroo s: iL El Deep Trench El Shallow Trench Bed 11 Mound ❑Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 5 • GPD/Sq. . Ft, Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe , 3 ,4 ✓eA, Ft. 115 Ft. Township: Range: Section: Fill added above original grade: Gra el el length: f- Z Ft. Y C I e 6 0- t Ft. WELL: New ❑Upgrade Gravel width: ' Number of lines: Distance between lines: 3 UA i. i' Z0 FL Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorptionarea: } Pipe material: it Ft. Ft. I. OZ SQ. Ft. !' u " 6p, Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. Z Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft Ft. SEPARATION DISTANCES "S ptic 13 Holding ❑ S.T.E.P. To Septic Absorption Lin Holding Public/Private Mufactu er: Capacity in gallons: From Tank Field Station Tank Sewer Lines Well Material: Number of Compartments: 100 160— Surface f_ _ io afi LIFT STATION Water p 00+ Lot "' ,+- 3a Size in gallons: Manufacturer: Line )O j b Foundation Q-{— Q+ ) f r "Pump on" level at: "Pu level at: High water alarm at: Curtain ,+ -f-- „� Pump Mak del Electrical Inspections performed by: Drain Remarks: BENCH MARK Location and Description: _ T3 1-1 AI r. Assumed Elevation: ENkiIEER SEAL /Z.9 )�� �0 b6T 6UC66N e;, 4+Ot Inspections performed by: Dates: 1 st 7 Z� ` � Inspections . } 2nd'm ammPo m a oa Department of Health and Human approval ,S_er�vices ' 2 �11--`i>' Reviewed and approved by:Date: , l ,�_%, �Ess',�- �'��������'� 72-013 (Rev. 9/91) MOA 25 Permit No. SW 930220 1 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. T.M. MORTO ON C[NCRK LOCALON a C[IM$TRUCIpM iNIIC p � bASTIb SCRTO ARCA M. PID No: 015-232-171 LOT 4 Wki O LOT 3�, BLK 2 "c 0 M� P� �4z- Q G LOT 2 ASBUILT SITE MAP 1 =1„ oo' OWNER/CONTRACTOR TO SET FINISH FLOOR ELEVATION TO ASSURE MIN. GRADE TO SEPTIC TANK. BMAMA BM B M B SEE CONTROL DIAGRAM BENCH MARK A IS 170' SOUTH OF NE PROPERTY CORNER ON PROPERTY LINE (02.6' DIA. BIRCH) BM 8 DESTROYED. SEE NEW TIES TO BLDG. FOUNDATION. OF q�g11�1��I 9th 11iiY......... Meyer /(• .'� PE 35 Permit No. SW 930220 Municipality of Anchorage Page 2 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. PID No: 015-232-17 LOT 3, BLK 2 RAVENWOOD �1 T.H. PRIOR TO CONSTRUCTION GENERAL LOCATION OF C _ EXISTING SEPTIC AREA 30' 3-C.O. 26' 48' 18' M. T. 45' M.T. ANK C.O. 4 BEDROOM HOME 50IC SYSTEM PLAN VIEW 1 =50' NOTES 1. CONTRACTOR TO VERIFY MIN. SO. FOOTAGE PRIOR TO PLACING TOPSOIL. 2. CAUTION SHALL BE TAKEN TO MINIMIZE REMOVAL OF EXISTING VEGETATION OUTSIDE OF SEPTIC MEAS. 3. DISTURBED AREA SHALL BE SEEDED TO PREVENT EROSION. 4. NO WELLS. SURFACE WATER. OR CURTAIN DRAINS WITHIN 100 FT OF NEW ABSORPTION SYSTEM. 5. SYSTEM TO BE INSTALLED A MINIMUM OF 10 FEET FROM PROPERTY UNE. 6. ALL CONSTRUCTION SHALL CONFORM TO M.O.A. @ D.H.H.S. STANDARD SPECIFICATIONS. 7. CONTRACTOR TO VERIFY 100' MIN. SEPARATION FROM ADJOINING WELLS PRIOR TO EXCAVATION OF SYSTEM. 6. BUILDER TO VERIFY FINISH FLOOR ELEV. IS SET SO PROPER SLOPE IS ASSURED TO SEPTIC TANK. O WELL ASBUILT BM A BA1 B BLDG. CORNER FND. USED TO TIE C.O. do M.T. 49th 1 •i A : Core Meyer C 63;3zr It 11 14i l alop v V Permit No. SW 930220 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N. R. 3 W, SEC 23 SM AK. PID No: 015-232-17 MONITORING TUBE C.O. SURFACE C.O. s 4" rD PVC PERFORATED PIPE 1Y •: _ ... SPIICROC[ RL1ER f s6 sP 4P110 ROC[ LICK DOW j . _ :.. 7.0' WCS IT -N' SEPTIC SYSTEM PLAN VIEW HORIZ 1"=40' VERTICAL 1"=4' ASBUILT CLEANOUTS CLFANOUTS J C\ 3 ASSUME EL 100 M BEORING PROPOSED O.C. MONITORING NWNTAIN GRADE EL. 97 4' MIN. COVERAGE pt� CAL0TANK.•9 M!N (OP S ?OOxE R.O.P.91. APPROX. REV. O.C. 51 92 91 VARIES .N`��.���������� OF ,; .till .. IF i 1 9th i ... L LOCATION OF NEW 1250 GALLON Care MeyerU : S '. C - 3591134q SEPTIC TO BE FIELD DETERMINED IN i _ �' s NvERiCAL^1" Ho PRDOFI 11 4i<<<?QFESSICK •'r- zORP2Io 0 ARCTIC SLOPE CONSULTING GROUP. INC. Engineers • Architects • Scientists • Surveyors 3m tlsnr i.... h +�ana+ .w.,e ass+a-mss r4hpl�w: (am) 3411-5+b Pou (am) 3w-4213 SOILS LOG — PERCOLATION TEST 179. s • s a COMMENTS DEPTH (FEEL) 1- 2 'f ``I' h ` • $and-� t1 KI1 x+ores 4_ 6- j 7 7- , S- P. 'A 9. A. to- 0-l2-13- G' 12- 13- 14- 14- 15- 15- 16- 16-1?-1s- 17- Is- 19- 19- 20- 20- COMMENTS SLOPE DATE PREFORMED: —7 Z I C1TF PLAN WAS GROUND WATER S I• ENCOUNTERED? 0 IF YES, AT WHAT DEPTH? P Depth to Water After E Monitoring? hate 0 Data PERCOLATION RATE TFSTRUN BETWEEN Gross Tum Net T= Depth toI Net Wstee . Drol (mieoteslinch) PERC HOLE DIAMETER FT AND 7 FT CERTIFY THAT THIS TEST WAS PERFOttmtu PERFORMED BY. 1 ' g ,�,CCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON T141S DATE. DATE: I izio5�o3 TEL: 15:03 09075033734 tACdT10N OF WEU, �� stwt>hrtatoa r. LOT . I "OK oL Dec 08.93' -'9:39'No'002'P.M 'NA110R AX,DRILL STATIC CW A1AiltA t &ARYMMT AI NATUPAL ORBOURCU MUM Of WATER WATER WILL RMRD MtA1YfiM OTt1 MictloW T01MNeM1► KaMOE maw" ON DE DS ow WELL owelt�t: I" MorouM surface WELL D. . of hcde: itDATE OF COWL>r<7'IDN Depth Dboot'Oftthh of glinp: • 11 i r�...�. sw From To D r STATIC WATER UEVJ;ta h blow )c top.of votov D Mur►d Morita • deur ,�..i O / J.l� MCMDO OF 1DR LUNO: Sffiaar toury D table teal C) ether' tftt OF w au domestic D Itripetton . D n WOW C7 ptlblb owply 0 aft �•...... cAanlG sTICK•ur►: tt. Diem: fQ.I to,,,;,.tt Cseuto_type: - /.. In, to .a3/ tt WELL INTAKE DORM N0 TYPlt open and D sarsened Cl perltuswd (111 apen hole Depths of apsrrirtps: to It sCRM Type Dlem:in. Slotimesh Glee: QRAVM PACK YM - Volume used: Depth 10 topr OROUT TYPE: Volume: Deoth: Iron _ It to it DEMOPAItf2NT ML'THOD: PUMPtNO LEVET. AND Y!EWt 1.6 41 tt o ter hra povft 7 1 V PUMP INTAKE DEPTH: , Q_ it Horaepowlh- lx_ WRI DISINnwo YES Q NO CONTIIACTOR INFORM TION; , • RIDV►ARK;; r-• ' �. DEC 71993 uQt r d mess NameQi Anchorage _. 7 •'ttr7,�� 9 PLEASfoftM' j lf: jpFjFda0G TO: 1. :fis�r+�tvre or winn ries re.proprnMwe �ia PO ROX 772116 ...Tffpt 4 EAGLE RIVEN AK 99077.2110 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930220 DESIGN ENGINEER:ARCTIC SLOPE CONSULTING GROUP OWNER NAME:ANDREWS LLOYD E OWNER ADDRESS:6121 TRAPPERS TRAIL RD ANCHORAGE AK 99516-2326 PARCEL ID:01523217 LEGAL DESCRIPTION: RAVEN WOODS BLK 2 LT 3 LOT SIZE: 101495 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 7/15/93 EXPIRATION DATE: 7/15/94 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER MUST CONDUCT ANOTHER SOIL TEST NEAR THE NE PORTION OF THE PROPOSED BED DEPTH MUST BE AT LEAST 12 FEET AND RECEI VING SOILS MUST BE PERCED. RECEIVED BY: DATE: _ /� ISSUED BY: NIOHN 5ZMlT74- DATE: 7�I6&3 ASCG Calculations System Calculations for LOT 3, BLK 2 RAVENWOODS 10 -Jun -93 Paae 1 of 1 Tank Size 1250 GALLON TANK REQUIRED Absorption Field Sizing Using an acceptance rate of 0.4 gal/SF/day and a daily load for 4 bedrooms of 600 gal/day. Req'd Absorption Area = 600 gpd / 0.4 gpd per SF = 1500 SF System Dimensions 64.0'X 24.0' = 1536.0 SF The laterals are to be spaced 6.0' apart and 3.0' from edge of the bed.gir or C • e S. Mey 4 ��% 6353 i April 5, 1993 Mr. Dan Roth Municipality of Anchorage Dept. of Health and Human Services 825 L Street Anchorage, Alaska 99501 Re: Septic System and Well Approval Lot 3, Block 2, Ravenwoods Dear Mr. Roth: Attach is the permit application for installing a septic system on the above referenced lot. Below is a narrative of probable impacts to adjacent properties. 1. Adjacent Wells - There are no existing wells within 100 feet of the proposed new septic system. The well for the lot will be drilled on the southeast portion, approximately 125' from the proposed septic area. 2. Adjacent Wastewater System - The proposed bed absorption system is the first system on the lot. The proposed system will not adversely effect the future sites on the surrounding lots. 3. Reserved Space - The soil conditions on the lot meet EPA standards. There is enough room for a future system to the northwest of the proposed system. 4. Drainage - Positive drainage away for the field will be maintained. No concentrated surface water will be directed toward the field and no existing streams are within 100 feet of the proposed field. The installation of this on-site system will have no probable impacts to adjacent well or septic systems. The proposed system's separation distance radius will include parts of adjacent lots, but will not interfere with the on-site systems on these lots. truly yours, Sr. .E. CSM : EG : MLT:1110-0026.055 Permit No. 1 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. i0Y J9 W N mrznY. LorwnM a EYSnW R?M AREA Nt� ,! M Y �9ifc� 9� BLK 2 e �p _O• ��?� 2C AN A �4i9�p 4p ( rR000sco .BEY 0W Jy�0 twit m rnasusm O 41 TH-3 5� FF�•0 CONTROL DIAGRAM LOT 2 SITE MAP I"- 00' OWNER/CONTRACTOR TO SET FINISH FLOOR ELEVATION TO ASSURE MIN. GRADE TO SEPTIC TANK. .CMA BM MT 1124' 1 70' MT 2 76' 42.5' SEE CONTROL DIAGRAM BENCH MARK A IS 170' SOUTH OF NE PROPERTY CORNER ON PROPERTY LINE (02.6' DIA. BIRCH) PID No: 015-232-171 LOT 4 Ku O OF• q�q 114 9th! ... ......... i p Co S. Me r '• qq Nr 111 '&OFESSICKA V Permit No. Page 2 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. PID No: 015-232-17I LOT 3, BLK 2 RAVENWOOD Alternate Field ~` TH-2 PROPOSED 4 BED HOME PROPOSED WELL O KPTIC SYSTEM PAN VIEW 50' NOTES 1. CONTRACTOR TO VERIFY MIN. SO. FOOTAGE PRIOR TO PLACING TOPSOIL 2. CAUTION SHALL BE TAKEN TO MINIMIZE REMOVAL OF EXISTING VEGETATION OUTSIDE OF SEPTIC AREAS. 3. DISTURBED AREA SHALL BE SEEDED TO PREVENT EROSION. 4. NO WELLS. SURFACE WATER. OR CURTAIN DRAINS WITHIN 100 FT OF NEW ABSORPTION SYSTEM. 5. SYSTEM TO BE INSTALLED A MINIMUM OF 10 FEET FROM PROPERTY UNE. 6. All. CONSTRUCTION SHALL CONFORM TO M.O.A. k D.H.H.S. STANDARD SPECIFICATIONS. 7. CONTRACTOR TO VERIFY 100' MIN. SEPARATION FROM ADJOINING WELLS PRIOR TO EXCAVATION OF SYSTEM. 6. BUILDER TO VERIFY FINISH FLOOR ELEV. 15 SET SO PROPER SLOPE IS ASSURED TO SEPTIC TANK. V BM A BM B D-1 1 35' D-2 6.8' D-31 150.2- D-4 DESCRIPTION 8M AM A TREE SMB M 8_ TREE OF S 49th i .. .... ........./ I i i Cor S. Mey !,f C-, . E 6353 Permit No. Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone:343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description T. 12 N, R. 3 W, SEC 23 SM AK. PID No: 015-232-17 LOT 3, BLK 2 RAVENWOOD MONITORING TUBE C.O. \ SURFACE C.O. C.O. 5. 4" 0 PVC PERFORATED PIPE--\ 3& 24' SEPTIC SYSTEM HORIZ 1"=40' PLAN VIEW VERTICAL 1"=4' CLEANOUTS CLCANOLTS PROPOSED SO14TO ASSURE POSITDRAINAGE r ASSUME EL 100 lAONrrORING TUBE MAINTAIN GRADE EL 97 4' MIN. COVERAGE NEW 1250 GAL TANK NIN L P "topc .00-- 92 91 64' 0 fill 49th ..... .......... 1� ........... ........ ....... c 11 S. M�e Y ;Y LOCATION OF NEW 1250 GALLON '3r r ':S C" 6 53 SEPTIC TO BE DETERMINED IN X FIELD "(fill ..... - ABSORPTION �01A 0 HORIZ 1"=20' 1..�RPEILE v 10 PERFOP LEGAL I- 3- S ENCOUNTERED? L IF YES, AT WHAT DEPTH? ' O P 4- - Monitoring? 4 Due r S- �. 6- --12-13- 7- -12- 13- 14-0 14- 0 IS - }� 0 16- 17- is- 19 - 20 - Y S� 1-1- w' Crau-e-1 SLOPE WAS GROUND WATER S ENCOUNTERED? L IF YES, AT WHAT DEPTH? ' O P Depth to Water After E Monitoring? 4 Due r SITE PLAN /�y^/ .�, / , �+ PERCOLATION RATE n (minute�nch) FERC HOLE DIAMETER TEST UN BETWEEN COMMENTS ! I `'--! -- �1 S eT7 ! sR 4l1 I� I , Bif%f��r PERFORMED BY: CERTIFY THAT THIS WAS PERFORMED 1: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 3�Zg�"� C PERFOF LEGAL DEPTH (FEET) 1 - 2- 3- 4- 5- 7- 9- 12- 13- 14- is- 16- 17- is- 19- 20- ,r14 - 3- 4- S- 7- 9- 12- 13- 14- is- 16- 17- 1s- 19-20 - 14 - 1 over b vette n Sandy 5,14105M) WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH7 Depth to Water After Monitoring? Date SLOPE �d Alp L 0 P E SITE PLAN Reading Date Gros Time Net Time Depth to Water Net Drop 2 V l 'D5 '• / / O /p � rt�� �' I�. :'78 I PERCOLATION RATE (minutetrnch) PERC HOLE DIAMETER �% / TEST RUN /BETWEEN /_ O FT AND It FI' COMMENTS pi10 S K OQiC. 4 h ✓� • �-/ Cl 6c / ST' PERFORMED BY: J�wmy CERTIFY THAT THIS TEST WAS PERFORATED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: SI Z 9. I cj ARCTIC SLOPE CONSULTING GROUP. INC. Engineers • Architects • Scientists • Surveyors 301 naw A.w- M.h . N..Y "M-3615 x41.91 (9M 349-514a r.c (907) 349-4213 • SOIIS LOG — PERCOLATION TEST PERFORMED LEGAL DESC DEPTH (FEED 2- 3- \ 1 4- ' 1 5- • 6- 7- g- 9- lo- ll - 0-11- 12- 13- 14- Is- 16 - s -16- 17- is- 19- 20- pve r Lorc(en Sanj. 5r1---6Gm I�o�ke-f'S o•� �J-un�. SLOPE OY a +`• '••(ENGrINEiR,��`E9J�� c�OL s4 ;icd. ra. .� .......... ....'00 a s t'... .... ....� �iil^ Care Moyet Pfd' '.••. S3 <�'�r 4%%'10FES50' .6 " �`to3`tti�'°' DAT �E7PPREFO,RMED: f-.2 C? -.2C%i lion: / o /V SITE PLAN WAS GROUND WATER S ENCOUNTERED?�[>� L IF YES, AT WHAT DEPTH? O P Depth to Water After E Monitorings Date Reading Date Gross Time Net Time Depth to Water Net Drop //• 2 0 -- 5-0" 1 Sq 3 / " r7 ' z- 1 6 i9 so / %a'' I ` 0 d � ,71 o sr5ij „ y Y Zv IZo /D S -S" 2 S •�' /vD I o PERCOLATION RATE 3 - % (minutesrnch) PERC HOLE DLIMETER (P TEST RUN BETWEEN ,S ° FT AND -� B FT COh41ENTS UA12 b CV,, )Le �t rLA-0 It I UI � PERFORMED BY: CERTIFY TH?T Til TEST WAS PERFORNiEn IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES W EFFECT ON THIS DATE. DATE: ARCTIC SLOPE CONSULTING GROUP, INC. Ui Engineers - Architects - Scientists - Surveyors 301 0---r h...,. Mer..9,. N -4r 015I0-3015 .. ._ TO"n (907) 319-514a ►he (907) 349d213 • SOIIS LOG - PERCOLATION TEST Mr: PERFORMED FOR: C ree—La e-/J� �j/S 111e{ Y1 Gross Time DATE PREFORMED: LEGAL DESCRIPTION: A(.w fl Gtr 6 6a' LO -f 3, Elk L k :2- Township, Ranee, Section: 1A A1, 1340 Z77) DEPTH (FES I- o V e r- b j re -(.o ry 2- 3- - Sni1a� sli� 4- s- 7- E- Date Gross Time 9- Depth to Water Net Drop WAS GROUND WATER 10- ENCOUNTERED? IF YES, AT WHAT DEPTH? 11 - a . Depth to Water After 12- Monitoringl 13- 14- 16- 17- Is- 19- 20- COMMENTS 3- 14- 16- 17- Is- 19- 20- COMMENTS SLOPE S L O P E Date SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop a . o o a '/ I J eq d SST / 7 I / o If-6%r.I, 7 / ' / PERCOLATION RATE b (minutesfinch) PERC HOLE DIAMETER 62 r _ '.T -ST RUN BETWEENC� , b H FT AND ' FT v) PERFORMED CERTIFY THAT Tli TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES W EFFECT ON THIS DATE. DATE:_ _ Parcel I.D. 015-232-17 a Municipality of Anc On -Site Water and Wastewater (907)343-7904 r�r DEC I 0 2015 )3> Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Raven Woods; Block 2, Lot 3 Expiration Date: Location (site address) 6121 Trappers Trail Road 'Anchorage 99516 -Current Property-owner(s) Lloyd -Andrews__ __ __ ______ - ____-- Day phone 601_508-0377_...____ Mailing address Real Estate Agent Darrel Ferris Day phone 240-9225 i-YPE:.)F '4ELLING: Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) NUMBER OF BEDROOMS: 4 4. TYPE OF VdIATER' SUPPLY: Individual We!:. Q Individual Water Storage ❑ Community Class _ Well ❑ Public Water System ❑ WaiverNariance request for: NIA Received by: COSA to be relea TYPE OF WASTEVIATEr, DISI`{;:SAL Individual Q Iiolding Tank ❑ Community ❑ Public Sewer ❑ otherwise requested by the engineer. COSA Fee $ 69-4p Date of Payment I A 1 g I l l - Receipt Number o ao6 COSA # ©S US I "P o S Date: Waiver Fee $ Date of Payment Receipt Number Waiver # T 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation -and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Garness Engineering Group, Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259 Engineer's Printed Name Jeffrey A. Garness Date 12 > I �_ In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the systems on the dates of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternativo'well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person1party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the personlparty who paid for this report. 6. DSD SIGNATURE M '� System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved WA7'ER'AND WASTEWAT-E por __R Conditional approval for bedrooms, with the following stipulations: Original Certificate 116 The Municipality of Anchoragevoevelopment Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist x Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA bale sheet 9.1-12doc If more than 1 septic system is on the lot: COSA Checklist # of Struuture served by this system Certificate of On -Site Systems Approval Checklist Legal Description: RAVEN WOODS; BLOCK 2, LOT 3 Parcel ID: 015-232-17 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 9/21/1993 Sanitary seal (Y/N) YES Total depth 428 ft. Cased to 231 ft. FROM WELL LOG Date of test 9Z21/1993 Static water level 184 ft, Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 9/29/2015 187.5 ft: Well production 4.8 9.p -m. 2.4+ — 9 -p.m -WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate NO mg./L. Collected by:. QEG Ltd Arsenic: 15.5 ug./L. Date of sample: 9/99 01 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/29/1993 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 9/30/15 Pumper MCDONALDS PUMPING SERVICE C. ABSORPTION FIELD DATA eELow EXISTING GRAD Date installed 7/29/1993 Soil rating (.p.d./ft r ftlbdrm 0.4 )— System type BED Length 20-60 ft, Width 20+ ft. Gravel below pipe 0.5 ft. Total depth *3.75 ft. Eff. absorption area 1600+ft' Monitoring tube- YES -.Depression over field NO Date of adequacy test 9/29/2015 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 730 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600+ g,p.d, ukh%Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date AST MT DOES NOT EXTEND INTO THE EFFECTIVE DEPTH. W9T teeffEB. TEST WAS PERFORMED BY INTRODUCING H2O INTO A C/O ON THE NORTH SIDE OF THE BED. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level at_---; . High water alarm level Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 75'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line 5'+ Absorption field UNK Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'.+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacentlots 100'+ F. COMMENTS G. ENGINEER'S 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 JEFFREY A. GARNESS Date (213�f,r (Rev. 11W) Municipality of Anchorage PPGE Development Services Department a, Building Safety Division ` $P ETY On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC151665 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 3 of Raven Woods Subdivision. This inspection revealed an arsenic concentration of 15.5 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (=.muni.org/onsitc) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. N89'59'00"E _175_00 _10=UUtility Easement N I LOT 3 0°° BLOCK 2 SCALE: 1"=40' O o' 26' 40' 80' s u' z Riser Pipes 9j Ao C14 (Typ) O rp. F LOT 4 O 2—Level Wood Frame Residence (See Detail Below) Asphalt. Pad �l well ori X27 ). 4h om f / 4D wry. rO� 3 Ns0 305 LOT 2 00 yy Bay Window Covered Wood Porch ood Landing w Wood Stairs Q� ,*a00 Bay Window Sn J eco u+o u. 30• 1.0' x 5.0' NO1 2� 5 Cantilever i, o DETAIL Scale: 1"=20' PREPARED FOR: NOTE: Dimensions are measured to the wood trim. LLOYD ANDREWS I hereby certify that an accurate survey of the following described _'`t\,i property: AS -BUILT g4bOF q ++ RAVEN WOODS SUBDIVISION (P-583) �Q.E.......... qJ�0 LOT 3, BLOCK 2 AV C- 9�1 was made on February 11, 2016 r *•49TH *I and that the improvements DWN. DATE GRID ,•,,; — •• ••' I situated thereon are within the property lines and do not overlap or i' •••••••••••••••••••••.•••I P P Y P JSP 2/11/2016 SW 2738 encroach on the property lying adjacent thereto, that no .F. Lee Knrnbelnikoff: %improvements on the property lying adjacent thereto encroach on FILE NO. F.B. 2015 JOB N0. %11 the premises in question and that there are no roadways, 1564 PG. 55 1603 No. 3143-5�•,•� transmission lines or other visible easements on said. property except t"`�� idhereon. �onthisd as tshef whng those shown on the ecordplat may not appear KARABELNIKOFF Anchorage Alaska, this 11th day of February 2016. SURVEYING (9o7) mm7—same r 12 r� 14 -4G MUNICIPALITY OF ANCHORAGE • 'Y DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# 01`x— 7-37-- 17 HAA# GkR4S1b )H 1 1. GENERAL INFORMATION Complete legal description 1_07-' 3, a 1'0 GL. Z , f24` Crj W oO os Location (site address or directions) (;11 Z I -T—a" P ca 5 T>�I L Ro" Property owner L. L_oyb t_' '4'`' U a4ni s Day phone 3 Lj5'- Z/ Z.'L Mailing address Lending agency Day phone Mailing address Agent _ Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rw.1/91) Front MOA921 5. STATEMENT OF INSPECTION BY ENGINEER 6. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 4ritc—asoAI LA16/d45ZlL4AIG- Phone SSV-4SSI Address ISD 3nx 2-LID773 4NfoorL4z, g9Sx-y Engineer's signature Date /Z-/71473 DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments bedrooms. WTIr L�C-�. '•�' a all 9 �G '% C i .• tQ jy r� .rx�. *w a A nwz o scy�•101• YL. •.YYv. IAichai.l E. Anderson F a 4381.E .. r `;1 Ccs+..o••••`a �\^±,• 1t �P /�f1:11 �.ail�':,• rid• n F bedrooms, with the following stipulations: Date/ 2 —17- /-3 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 engineer's work. 72-M (Rw.1191) Back MOA #21 1 Municipality of Anchorage Department of Health and Human Services an HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo-"; 13wc.L-2- 2A l)crJ WOO1S Parcel I.D. 0/5— Z37-- 17 A. Well Data Well type n2% V4 - If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y pate completed L717 -11q-3 Driller A aMJt': Total depth Cased to Z 31 Casing height Z / Y Sanitary seal (Y/N) Wires properly protected (YM) FROM WELL LOG AT INSPECTION m 3i3 �Z / 55 a0 Date of test^ r /9 3 �, Static water level g'7F M -o z Well flow q.g.p.m. 9 -P.M. rT1 –t o Pump levell w r'r7 SEPARATION DISTANCES FROM WELL TO: "' m Septic/holding tank on lot v >/00 � ; On adjacent lots >/00 Z Absorption field on lot > /00 ; On adjacent lots Public sewer main /,1/A Public sewer manhole/cleanout N�A Sewer service line 80 ) Petroleum tank _ - J / WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: /7–A &? Collected by. M 0A B. SEPTICIHOLDING TANK DATA Date Installed 71zq 1q3 Tank size /Z� G4 L Compartments �a Cleanouts (Y/N) Foundation cleanout (Y/N) Y Depression (Y/N) High water alarm (Y/N) // Alarm tested (Y/N) /1 evlA Date of pumping A10,J - t,/r+ o'Q5—, nQ C 7t]'h1 Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: r Well(s) on lot 7100 On adjacent lots >/O0 / Foundation /0 To property line Absorption field S� Water main/service line >SOr Surface water/drainage A10465 72.026(3/93)• From - CONTINUED ON BACK PAGE C. LIFT STATION /v 1A Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent(Y/N) High water alarm level "Pump on" levet at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: "Pump off" Level at Cycles tested Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed 71461 19.3 Soil rating (GPD/Ftz) V / System type B in Length U'-ry b D' Width Vmu cs Gravel thickness 16 1 51 Total depth S .4 ' Total absorption area A00 Fr-" Cleanout present (YIN) Y Depression over field (YIN) /J Date of adequacy test A/elJ CoN S-" Results (pass/fail) nA5 S for Bedrooms Water level in absorption field before test /J o ^f E After test /� 1 o O C Peroxide treatment (past 12 months) (YIN) d /A If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot r On adjacent lots >/00 / Property line 10 To building foundation >E0 r To existing or abandoned system on lot 14A �I i On adjacent lots >/00 r Cutbank NO NG Water main/service line '> Surface water A10 a76 Driveway, parking/vehicle storage area Curtain drain A/o/JC- E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in of this inspection. i .00 . 1 e •. t Signature ,/ ,, F � e°w sD mc6M+.e •+v ea °ujp° W� Engineer's Name �1 0a" -A cn— AIAoZi0 E;`T'�/t•�G '. ', °.•; ndacson • b �: fhE. A '.icac Zl / 4:, , .E Date /7/ 7� •. �`♦^j� re°' £1 HAA Fee $ N?,b d e rio Date of Payment /oZ _ %L n7� Receipt Number. aa(.5-447// � ( loll 72-026 (3193)+ Back Waiver Fee S Date of Payment Receipt Number Chemlab 8efJ Client Sample Matrix 12,109193 14150 S 907 344 2130 ROCKFORD CORP 02 u 1 l= l L U EW I RON EWAL LAB SERUi CE3 '+ 907 344'-213 ''41, � 10.99a woe: COMM!lRCIAL TESTING & ENGINEERING CO. INVIRCHURNTAL LAMORATOMY ORRVICEti rMXMr of ANALYSIS 4 111111190 :93.6530-1 ANCNOWIL Ax Mia IO :LOT 3, BLACK 2 RAVEN FLOODS TEL. Pon 5M.M0 t RATER PAX. porl 5e1•aw1 Client Name 1AMMIRSON ENGINEERING WORK Order :73878 Ordered By :ALAN Report Completed x17/09/93 Project Now s Collected :12/06/93. 1 hr Project! t Received :12/06/93 6 14:45 hr F'R6ID :i7A Technical DirectorsCo f Released By : sample Reumrks: SAME COE Z CMD Us IWA. —� 0C Allowable Ext. Anel Paraaeter Reeulte Qual units Method Limits Date Date Inii Nitrate -N 0.10 U mp/L CPA 353.2/300.0 10 12/08 LU a ssssaalYaaaars111q�aaa.aa� sae n a arsa/Mraa rsrs 3FsaaaalM�lanaa�lasossa.taKY�aastaaass.7�a�slrw#afrzars • See Special Instructions Above UA a unavailable •* see eampla Remarks Above NA as Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT = Lase Van D . Seetxdary dilution. 0'T ■ Greater Than *IN= M*MbW of 00 Las OrOW (010011d:d1MrNe de fSurvNllams) ENVINoNmmTAL WAVIC90 W ALASKA, OOLOMDO, VTAN, ILLIN(M OHIO, MMYLANO, WEST VIR01111k NEW JERSEY, SOUTH CAROLINA