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HomeMy WebLinkAboutPETERS GATE BLK 2 LT 4Peter's Gate Block Lot 4 #051-541-12 • ` Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151387 PID Number: 051-541-12 ❑ New ■Upgrade Name: TROY LOWDERMILK ABSORPTION FIELD ❑ Deep Trench ■ Shallow Trench ❑ Bed ❑ Mound Address: 24947 MALCOME DRIVE *CHUGIAK, AK 99567 ❑ Other Phone: No. of Bedrooms: Soil Rating: Total Depth from original grade: (907) 748-0156 3 1.2 GPD/Sq. Ft. 6 Ft. LEGAL DESCRIPTION Depth to pipe imart from original grade: Gravel depth beneath pipe: SEE DWG. Ft. 2 Ft. Subdivision: Block: Lot: FlII added above original grade: Gravel length: PETERS GATE 2 4 SEE DWG. 30 Ft. Fl. Owns ip: anger — — ec ton: — Gravel width: Beds Number of lines: Distance between lines: 5 Ft. — it. SEPARATION DISTANCES Total absorption area, 214 amber of trenches: 1 Dist. between trenches: — To Septic Absorption Lift Holding Public/Private From Tank Field Station Tank Sewer Lines Sq. Ft Ft. Well 100'+ 100'+ — — 25'+ TANK ■Septic ❑S.T.E.P. ❑Holdin ❑Other Manufacturer. capacity: Surface Water 100'+ 1DO,+ — — ANCHORAGE TANK 1000 cal. Lot Line 5'+ ,o'+ - - N/A Material: Number of compartments: STEEL 2 LIFT STATION Foundation 5'+ 10'+ — — Curtain Drain NONE KNOWN Manufacturer Iy: cal. 'Pump on' level at: 'pump off I High water alarm at: Remarks: *SEE PERMIT REGARDING SEPARATION TO GLACIATION. THIS IS A 1.5 BEDROOM UPGRADE TO CONVERT TO A 3Pump Make & Electrical inspections performed by: BEDROOM SYSTEM. PIPE MATERIAL OLD TANK DECOMMISSIONED PER UPC House to tank EXISTING Tank to D3034 drainfield Installer ARM SERVICES, LLC Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 n, Inspection Location and Dewrlption: Dates: 1st 12/11/2015 2nd 1/22/2016 3rd 1/22/2016 4th BOTTOM OF TRIM AT FCO ENGINEER'S SE Community Development Department Approval oo�o 0 4 o OF 4p Conditional approval: Date: ........ . .................. A. rn ss. - s:E-79 E— 79�Q � s ,ce0 « Approve i rn.� lr Date: `�� ' e''•i.�.2�x EoAo 0� aprafessla�°o Inspection Report _1-1-12.dac PERMIT NUMBER: PARCEL ID NUMBER: OSPI51387 L RECORD DRAWING / 051-541-12 Zab4� �� tvcfi�f tnSfa e / TK-Ltt 1v SPlli r C,�5J �t�Wa4.f� �12�51 1'%O is a 11nS kgt Iz A B �+ m DRCHUNE WITH / SURFACE WATER / DOUBLE EXISTING CLEWOUTS 2 BEDROOM DRAINFlELD � I EXISTING CULVERT NEW 1000 GALLON SEPTIC TANK PATH IF GLACIATION INTINUES VE 140 — — GARNESS ENGINEERING GROUP, Ltd - CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TUDOR ROA. SURE 101 • ANCHORAGE, AK 99507 • PHONE (907) 337-6179 • FAX (907) 33B-3846 • WEBSITE: wxw.gameven9lnaedng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TROY LOWDERMILK 748-0156 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: PETERS GATE; BLOCK 2, LOT 4 J.L.M./L.K.B. TYPE OF WORK: DATE: �- RECORD DRAWING 1/25/2016 u \ GARNESS ENGINEERING GROUP, Ltd - CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TUDOR ROA. SURE 101 • ANCHORAGE, AK 99507 • PHONE (907) 337-6179 • FAX (907) 33B-3846 • WEBSITE: wxw.gameven9lnaedng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TROY LOWDERMILK 748-0156 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: PETERS GATE; BLOCK 2, LOT 4 J.L.M./L.K.B. TYPE OF WORK: DATE: �- RECORD DRAWING 1/25/2016 u PERMIT NUMBER: PARCEL ID NUMBER: OSP151387 RECORD DRAWING 051-541-12 TOP OF TANK - AT INLET = 94.36 INVERT OF BUNG AT INLET = 93.72 INSULATION 2" THICK PER CONTRACTOR FINAL GRADE = 98.1-98.64 ST2 TOP OF TANK AT OUTLET = 94.46 NEW 1000 GALLON II SEPTIC TANK INVERT OF BUNG AT OUTLET = 93.68 TH#1 ORIGINAL GRADE AT HIGHEST POINT = 92.10 BOTTOM OF TRENCH = 86.1 MT CO FINAL GRADE _ 92.28-93.42 rFILTER FABRIC RELATIVE ELEVATION OF BOTTOM OF TH#1 = 80.10 DRY ON 1/12/2016 GARNESS ENGINEERING GROUP, Ltd M = CIVIL & ENVIRONMENTAL ENGINEERS 3701 E TUDOR ROOD, SUITE 101 a MCHORODE M 995M a PHONE (9077) 337-6179 a FM (907) SSB -3246 a WEB . w .gamomeWlnaMng.aam PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TROY LOWDERMILK 748-0156 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: PETERS GATE; BLOCK 2, LOT 4 L.K.B. TYPE OF WORK: DATE: �, RECORD DRAWING 1/25/2016 On -Site Water and/or Wastewater System Permit 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 Permit Number: OSP151387 1'2,15 /Z1po Tax Code Number: 05154112000 Work Type: SepticTank Upgrade Permit Effective Dates: December 09, 2015 to December 08, 2016 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: PETERS GATE Site Legal Address: PETERS GATE BLK 2 LT 4 G:1262 Owner/Address: LOWDERMILK TROY EDWARD 24947 MALCOM DR CHUGIAK AK 995670000 Site Mailing Address: 24947 MALCOLM DR, Chugiak Lot Size in Sq Ft: 54014 Total Bedrooms: -9-3 This permit is for the construction of: '(-N- Disposal Field Y 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. Received Issued By Cat rye v ->es 4o btz ewtvt s. By Date: Date: d f MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcell.D. Ci�t-S4t -I * Property owner(s) I Vw A'-JCAfd %tt Mailingaddress :�Lla YAcdcolw1 Ott-, Lyi Site address S c.✓„ -'L Legal description (Sub'd, Block & Lot) I -Pn Legal description (Township, Section & Range) Lot Size Sq.Ft. Day L Number of Bedrooms _iFF-3 APPLICATION IS FOR: APPLICATION IS AN: (sithatapply)rption Initial ❑ Field Absorption Field nLr�J,/ Upgrade IBJ/ Septic Tank Renewal ❑ ❑ Holding Tank Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: I certify that the above information is correct. I further certify applicable Municipal codes. (Signature of property owner or authorized agent) Permit/Rush Fees: -oll-0 Date of Payment: Ic' I/S— Receipt Number: 07 LdLl Permit No. O -CRI s1.3 S zL '� L't'd ` TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) Distance: — is in accordance with b°360acti Fees: Date of Payment: /41 Receipt Number: 7 rgj �--- Ne— (Rev. 01/11) col GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS January 12, 2016 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Attention: Jay Crewdson, P.E. Ref: Proposed Drainfield Upgrade for Peters Gate S/D; Block 2, Lot 4 Mr. Crewdson: The existing house is served by a private well and septic system. The septic tank was recently upgraded with a 1000 gallon septic tank and paperwork was submitted for a COSA for a 2 bedroom house. A recent appraisal of the house showed that the house is actually a 3 bedroom residence. Based upon the documentation of the septic system, the new septic tank meets the size requirement for 3 bedrooms, but the drainfield does not meet this sizing requirement. We are proposing that a 1-1/2 bedroom sized drainfield be installed to meet the sizing requirement. We are proposing that after the double cleanouts (after the new septic tank), a new flow splitter be installed so it evenly splits the flow between the existing drainfield and the new drainfiled. Comments regarding the design are summarized as follows: 1. SOILS: See the attached soils log which show the soil classifications, groundwater monitoring, and the percolation test results. The new drainfield will be installed within the 30 foot radius of this test hole. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: During our site visits to the property in October, there was no surface waters within 100 feet of the existing septic system and there was no visible standing water found on property. While excavating the test hole, we found glaciating water coming from the ditchline to the west flowing on to the property. Per our conversations with you, this glaciated water is not deemed to be a surface water. It was your recommendation that a berm or Swale be installed between the new drainfield and the glaciation so that in the event of a drainfield failure, daylighting effluent would have to travel 100 feet (or more) before reaching the glaciated area. As can be seen on the design drawing, we have shown a Swale with a note addressing this issue. Based on our conversation with you, a surface water waiver is not required. We are also recommending that the homeowner contact the MOA Right -of -Way Department to 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.00m CO1 Page 2 of 2 address the need for the ditchline to be cleaned -out. It is our opinion that if the ditchline were cleaned out of debris and regraded, with possibly a dirt block at the property line, glaciation would most likely not occur on property in the future. 4. TOPOGRAPHY: As can be seen on the attached design drawing, the average topography around the proposed drainfield is 15-20%. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assiAtance. .E., M.S. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338.3246 * Website: www. garnessengineering.com GARNESS ENGINEERING GROUP, Ltd Ad---dr—`5Y-`- WEENOM CIVIL &ENVIRONMENTAL ENGINEERSommo December 9. 2015 6'51-`Vl-12 Municipality of Anchorage 2l S— 12�q 15 Development Service Departmentu/ 6-7ya�{ On -Site Water & Wastewater Program 17. 4700 Elmore Road ► OSP lS j3�� Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Peters Gate S/D; Block 2, Lot 4 To whom it may concern: The existing 2 bedroom house is served by a private well and septic system. The septic system consists of a 1,000 gallon septic tank and deep trench type drainfield. We recently tested the drainfield and it passed an adequacy test; however, we found that the tank had leaks in it and is not retaining a normal liquid depth. We are proposing to decommission the old 1,000 gallon septic tank and install a new 1,000 gallon septic tank. We request a permit be issued to replace the tank. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com I LOT 8, BLOCK 1; I PETERS GATE S/D AlI I N I i SCALE: `, / I I LOT 7, BLOCK 1; PETERS GATE SID ------------ DITCHLINE WITH I SURFACE WATER -G' •\ I DITCHL WITH I LOT S, BLOCK yRFACE TER PETERS GATE SID ---------- I ♦ I ♦J ♦ I ♦ I I I LOT 2, BLOCK 2; PETERS GATE SM I I II--------------- NEW-------------- LOT 3, BLOCK 2; 1 PETERS GATE S/D , NEW 1000 GALLON EXISTING DRAINFIELD PROPOSED GLACIATION I 1 LOT 7, BLOCK 2; PETERS GATE SID I I I I I — — — — — — — — — — — — — — I 1 I LOT B, BLOCK 2; 4100'yyE PETERS GATE SID -EXISTING 100P,/ 3 BEDROOM I IONS HOUSE 1 I 1 I LOT5,B1LOCK2; `♦ PETERS GATE S/D I ♦ I 1 � I DITCHLINE _ CULVERr—MALCOM DRIVE_'_--- ----- — — —z-=== -------------- I I I LOT 3, BLOCK 3; ` � I " PETERS GATE S/D ``♦ U i / I ♦ ♦Iltw r I � '---•--------- — — — — / LOT 4A, BLOCK 3; ♦11 PETERS GATE SID YI LOT8, BLOCK 3; APPROX. LOCAnM r 1M. N,F II PETERS GATE SID 1 it GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS DREPARED FOR: TROY LOWDERMILK C!O BROOK STILTNER PHONE NUMBER: 244-6742 PAGE NUMBER: 1 OF 2 _EGAL DESCRIPTION: DRAWN BY: PETERS GATE SID; BLOCK 2, LOT 4 J.L.M. TYPE OF WORK: DATE: I SITE PLAN FOR PROPOSED DRAINFIELD UPGRADE 1/12/2015 13 e7 A' I N I SCALE: 1"=40' I RECOMMEND THAT THE MOA ROAD MAINTENANCE OUT DEBRIS DEPARTMENT THE ITCH 50 THATRESTRICTED. I I J U I I Q I Q Ul (n i i i ------- ---- -DITCHUNE WITH SURFACE WATER EXISTING 2BEDROOM GRAINFIELD 100'SETBACK PROPOSED 1.5 BEDROOM RECOMMENDTHAT ORAINFIELD- MOA ROAD MAINTENANCE INSTALL A DIRT BLOCK AT PROPERTY (SEE NOTE). GLACIATION (NO VISIBLE 10128/2015) NOTE: THE CONTRACTOR SHALL HAVE N L EST LOT LINE AND THE 100 FOOT CK TO THE DITCHLINE ALONG THE PROPERTY LINE FLAGGED BY A TERED LAND SURVEYOR PRIOR Y CONSTRUCTION. / r coi NOTE: WE ARE RECOMMENDING THE f- /1 NEW 1000 GALLON / SEPTIC TANK / DOUBLE / CLEANOUTS I INSTALL FLOW I SPLITTER–, I, 9A • i".': '.ate__... :R OF BEDROOMS: 112 OF 3 (UPGRADE) NS PER DAY (GPD): 225 ILATION RATES: 1.08 GPD/SQ.FT. )SED APPLICATION RATE: 1.2 GPD/SQ.FT. 1M DRAINFIELD SQ.FT.: 187.5 SQ.FT. NFIELD DESIGN: UM DEPTH: 8 FEET (@ DEEPEST POINT) 5 FEET H. 30 FEET APPROVED SAND FILTER: WA TIVE: 2 FEET :TION FACTOR: 0.7 .L SQ.FT.: 214 -- i 0 1 • . y��r - ��� EXISTING •' "a. WELL– \ --CONTRACTOR SHALL ELL– CONTRACTOR.SHALL INSTALL 1 SWALE SO THAT THERE IS A 1001 1 TRAVEL DISTANCE FROM ANY PORTION OF THE GRAINFIELD TO ANY VISIBLE GLACIATION. HOMEOWNER CONTACT THE MOA TO PHONE NUMBER: APPROXIMATE PATH IF C/O BROOK STILTNER GEG, Ltd. HAS A 8 PAGE SPECIFICATION RESOLVE THE ISSUE OF GLACIATION ON 2 OF 2 1 L EGAL DESCRIPTION: GLACIATION CONTINUES DRAWN BY: LETTER THAT PERTAINS TO THIS DESIGN. TO THEIR PROPERTY DURING J.L.M. TYPE OF WORK: DATE: COPYESDI THE LETTER CONTACT OG. WINTERTREEZING CONDITIONS. – – _ 1/12/2016 – – – – — – _ – BY P GEG. BY PROCEEDING FORWARD WITH THIS MALCOM DRIVE INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE EXISTING CULVERT SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. — — — — — — — — — GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS PREPARED FOR: TROY LOWDERMILK PHONE NUMBER: PAGE NUMBER: C/O BROOK STILTNER 244-6742 2 OF 2 1 L EGAL DESCRIPTION: DRAWN BY: PETERS GATE SID; BLOCK 2, LOT 4 J.L.M. TYPE OF WORK: DATE: a DESIGN OF DRAINFIELD UPGRADE 1/12/2016 0 CD GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701E. TUDOR ROAD,$UTE 101'AWHORAGE. AK 8950]' PMW(MI 337E170 -F (M) 3383246'NMTE. W gem—nolnemmp.com SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: PETERS GATE S/D; BLOCK 2, LOT 4 PERFORMED FOR: TROYLOWDERMILK DATE: 1/5/2016 DEPTHORGANICS (feet) _ _ TEST HOLE #1 1 } ¢l, SM (LOAM) 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 GP TO SP WITH SOME SILT BEDROCK SOIL CLASSIFICATIONS DATE os GW _ J ORG ° r .GP 1/12/2016 2 6.5 ML 6" GM CL GC 6.5 OL 6" 5 MH .... . •,• •.• SP 6.5 CH 6" SM < <<,' OH 8 6.5 0" q SC DEPTH TO GROUNDWATER DATE DRY 1/5/2016 DRY 1/7/2016 DRY 1/12/2016 2 6.5 DATE READING CLOCK NET TIME TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 1/5/2016 1 6" " 2 6.5 0" 6" 3 6" 4 6.5 0" 6" 5 6" " 6 6.5 0" 6" 7 6" 8 6.5 0" 6" 9 6" 10 6.5 0" 6" 11 6" 12 6.5 19 PERCOLATION RATE 1.08 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5.5 FT. AND 6.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO SOILS LOGGED BY: JODYMAUS PERCOLATION TEST PERFORMED BY: JODYMAUS COMMENTS: PERCOLATION READINGS ARE WITHIN 1116 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASP RFO MED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: I f la iL \\ r MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE EW �S T �i'L575 ❑UPGRADE MAILING ADDwL--=.-T, 167LEGAL DESCR LOCATION �2 NO. OF BEDROOMS L, O Y DISTANCE TO: Well / sorpuon ar 6y Dwelling PERMIT Olo to Z w Manufacturer A^/ �/r-C'�7y M vial �— No. of compartments Z ci gallloons Liq. /p a IF HOMEMADE: Inside length Width Liquid depth d V Z DISTANCE TO: Wall D el ng PERMIT NO. S? 4 Manufacturer TT Material Liquid capacity in gallons = DISTANCE TO: Wall ountlatior)� Nearest to n PEf3pa{T On C7 _, 2 w No. of lines Length of ch line' Total len n f nes Trench wi h M Distance between lines f H Top of the to finish grade 4. inches Material beneath the ,�/ Total effective absorption e inches W Length Width th PERMIT NO. Qv F W Q. W Type of crib Crib diameter r' depth Total effective absorption area w DISTANCE TO: Well wilding foundation Nearest lot line W Class Dep Dril er Distance to lot line PERMIT NO. 3 DISTANCE TO: Building foundation Sewer li Septic tank Absorption area(s) OTHER s PIPE MATERIALS v� SOIL TEST RATING �7 I L-.� IL _ INSTALLER �� QG[lLOF_ REMARKS S[. STt7r7 DrtiL1. itDE(1[IA7;E�7 2 Bor.ya: y F Al� s��P •ti$- ri« •� 9 t r�i Me«+ A. Mels V.. . Nei �F • APPROVED S` „E. I E= 1 i DATE LEGAL SRD I= Y.ruLE RIVERLAS'4% i:-)N / 11ll;�g1 a T n /7 MtJN I C I PAL I rrN' OF ANCHC]i-:zACGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK, 99501 264-4720 C3N— S I T E E3EWE R ,BSc W ELL PERM I T PERMIT NO: 840696 DATE ISSUED: 08/15/84 APPLICANT: MYERS CONSTRUCTIOIN ADDRESS: % S&S ENGINEERING EAGLE RIVERE, AK. 99577 CONTACT PHONE: 694-2979 LEGAL DESCRIP: SUBDIVISION: PETERGATE LOT r� BLOCK: 2 SECTION: 11 TOWNSHIP: 15N FLANGE: 114 LOT SIZE: 1.42A (SO.FT. OR ACRES) MAX BEDROOMS: 03 Listed below'are the options available to you in designing your septic system. Choose the.option that best fits - - - - - - - - - - - - - - - - - - - - - your site. - TRENCH - - - - - - - - L EE: ID - - - - - - - - - - W _ DRink I N DEPTH TO PIPE BOTTOM (FT.). 4.0. 4.0 4.0 GRAVEL DEPTH (FT.) 6.0 0.5 3.5 TOTAL DEPTH (FT.) 10.0 4.5 7.5 GRAVEL WIDTH (FT.) 2.5 17.0 .5.0 GRAVEL LENGTH (FT.) 32.0 34.0 41.0 GRAVEL VOLUME (CU.YDS.) 19.2 21.4 30.3 TANK SIZE (GALS) 1,000.0 ** 1,000.0 ** 1,000.0 ** SOIL RATING (S(I.FT./BR) 125 125 1125 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality,of Anchorage (MOA) and the State of Alaska. 2. I 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 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 ;s valid for a maximum of 3 bedrooms and any enlargement will require an additional permit. IF AI[IFT•STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK. MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED APPLICANT ISSUED B Y DATE: : MYERS RUCTI N DATE- - --- - ---=------- ' SOILS LOG MUNICIPALITY OF ANCHORAGE 1 • �+l DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR: pc-�LS DATE PERFORMED: e3 13 LEGAL DESCRIPTION: LOT B �- Ae. Z S E S/o r7ys SLOPE SITE PLAN E1{1 0P_67t wl \ L 1 i( ;• 2 ��% RefstQ1SN Sta.�n�'j sk"r — 0 �1 Date Gross Time Net Time 4- Net Drop 5 5- 6- 6 7- 7 c6b 8- 9 9- 10- 1011 11- 12- 12 13 13-, ' rC.1 s 14 15 µvt 16 t 17 ; *qPt.• .qa 18 a 19- all 20 S• fio. 14371 r WAS GROUND WATER ENCOUNTERED? NJ O IF YES, AT WHAT DEPTH? '11 Reading Date Gross Time Net Time Depth to Water Net Drop i F• .-bfev t��f0~•••••••ie•••• Ea PERCOLATION RATE 40FESStaK (minutes/inch) hp•► TEST RUN BETWEEN FT A)IIB•t FT PERFORMED s'8 � i "GINMRIHi ��%+'' CERTI F I E DATE�p RIVER. ALASKA 29577 PH. 634-2970 72-008 (6/79) -- . f WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geologicat a GeoP1hysical Surveys Drilling Permit No. LOCATION OF WELL (Ploa.e complete gime$ is, 1a or it.) A.D.L. No. to Borough Subd:rioloa Lot Block lb. 'A4t r e. E.atI.R No. Townohl 111 11, Range E� Meridian —ef�ef_ef� S� Is ic.11 DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS S. OWNER OF WELL: Mr. Paul Myers Address: P.O. Box 351 Street Address and Ano Of well Location Chugiak, Ake 2. WELL LOG FeetBelo. So, face Malarial 0. WELL DEPTH: D. OA9TE OFCOMPLETION .O N84 Typo Top Bottom ft(flnol) os, I d ers san ,grave , IS "— G. ❑Coble feet oterr ❑ Driven greens one ❑Dug Grey rock ❑ Awg"r QJotNd [:3 Barad ❑ other T. USE: Do..otle (3 publicSupply❑ Induolr y Brown rock water 60 64 ❑ Irrigation ❑ Recharge ❑ Cemmerlcol I Greenstone qu ❑ Test WNI ❑ other; B. CASING. ❑ Tbreed.d n(w.lded dia., 6 '-. 1 -2 -9 --ft. Depth III �_ lee./lt. ado.. In. tom ft. Depth Stickup ft. I. FINISH OF WELL: Type' OlcI SICtlM.ek Slce: Length: F P 13` set be+.e.o 11. and 11. \�Q OF 0.0ZE Boe Yfllting Brerel pock t 10. STATIC WATER LEVEL: ft. ❑ ADore at ❑ Belo. Iona Dot rorfau r Equipment woad:, a 16. WATER WELL CONTRACTORS CERTIFICATION: II. PUMPING LEVEL below Iand surface and TIELD It. offer —bre. ►a.aing g.P... it. ellerhre. pumping—O.P.n, 12.GROUTING wall Oroul.d: Q Too ❑ No Material: ❑ Neat Cement ❑ Other: IS. pulePt (it available) HP C a Length of DLP Pip, It. tapodily 9p•., a r Subs,. ❑ ds, ❑ Contriflcol ❑ other Id.REMA S: _ "Production of 1/2 GPM IS. Water Tomporann -- Thin .all was orilbd under my Jurisdiction and this report la it., to the bast of my hn..l.dg. wed belief; i -Magnuson_Dri22jmg AA 5385 Registered Busmen No., 00"577 License Numbs, Addra"ePnO• Box 770504 Eagle River, Ak. Signed: I • pars, 02• W WR (11/01) R" Distribution: WHITE•St.r. oat,: Sept, F Uc Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 K a r f v fi i CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-541-12 Expiration Date: f 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: PETERS GATE S/D; BLOCK 2 LOT 4 24947 MALCOLM DRIVE *CHUGIAK, AK 99567 TROY LOWDERMILK Day phone 24947 MALCOLM DRIVE *CHUGIAK, AK 99567 BROOK STILTNER Day phone 748-0156 ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: NSA - Distance: Received by:v y Date: COSA to be released the engineer, unless olheMW requested by the engineer. COSA Fee $ �—zb , 3 t (Y , • o Date of Payment �� (2' 1 J Receipt Number CJ 2 G COSA # © SC- i S i 2-2? Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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. Address 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK, 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting (his evaluation, GEG provided an engineering evaluation of the wall and/or septic system in accordance wifh the guidelines and regulations established by the Municipality ofAnchorage and industry practices. The reported results describe the condition of the systems on The date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist That were not identified during the evalualion.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 ulifiang the systeMs. These conditions can vary, and are outside the control of GEG. Satisfactory fast 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 alternative wall or septic system can be installed an the property in the event either of the current systems fail. The content of this report is for the sole benefit of the persor✓p my who retained GEG. Reliance upon the information provided in this repon by any olherperson or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duly to anyone other than the persoNparly who paid for this report. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-5179 Date ®bf9FESS� �e s bedrooms, with the following stipulations: ON-SITE r� m. ?-s WASTEWATER mac, Original Certificate Date: ( 2 1. "-1!o The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist_ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 10112/12) If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: PETERS GATE; BLOCK 2, LOT 4 Parcel ID: 051-541-12 A. WELL DATA ISTORAGE TANK WAS BY—PASSED FOR WELL TEST Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 9/$/1984 Sanitary seal (YIN) YES Wires properly protected (YIN) YES Total depth 90 ft. Cased to 29 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 9/8/1984 10/28/2015 Static water level UNK ft, Well production, 0.5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate '1.63 mg./L. Arsenic: ND ug./L. Date of sample: 10/27/15 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1000 gal. Number of Compartments ? 9— p.m- Collected by: GEG. Ltd. Date installed 12/11/2015 Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping NEW Pumper — C. ABSORPTION FIELD DATA *BELOW nNAL GRADE NORTH SOUTH g/1984 DEEP TRENCH Date installed 1/22/2016 Soil rating .p.d./ rftl/bdrm) 1_2 System type SHALLOW—TRENCH Length 21/30 ft. Width 2.5/5 ft. Gravel below pipe 6/2 ft. Total depth 10.3 *6.2 ft., Eff. absorption area252 214ft2 Monitoring tube YES Depression over field NO Date of adequacy test 10/28/2015 Results (Pass/Fail) PASS For **3 bedrooms Fluid depth in absorption field before test 42.5 in. Water added 343 gal. New depthy5_25 in. Elapsed Time: 190 min. Final fluid depth 58.5 in. Absorption rate ?_.: ' **300+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — **TESTED 1984 TRENCH ON 10/28/2015 FOR 2 BEDROOMS. ADDED ADDITIONAL TRENCH 2/2016 TO MAKE 3 BEDROOM SYSTEM t D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level High water alarm level at in. 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 lot: Absorption field on lot 100'+ On adjacent lots Public sewer main 75'+ - Sewer/septic service line, 25'+ Public sewer manhole/cleanout 100'+ Holding tank Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water *103' Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *SEE 2016 PERMITTED DESIGN COMMENTS REGARDING GLACIATION. 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 Pri ted Name JEFFREY A. GARNESS Date 1 74/1& (Rev. 11/05) csflda of m 49N "r-oJ S� A*VU,LI SEWARD & ASSOCIATES LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT i HAVE SURVEYED THE SCALE' -"! FOLLOWING DESCRIBED PROPERTY- / J 3d t OF At 04 AND THAT NO E466ACHMErNTS EXIST EXCEPT AS �3o%f .v /v•' 54 INDICATED. IT IS THE RESPONSIBILITY OF THE i $ OWNER TO DETERMINE THE OCISTENCE OF ANY GRID= .........••••• 6 EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- 4y o.... VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FS:4 t , s ANY DATA HEREON BE USED FOR CONSTRUCTION /`387 ;t OF FENCE LINES, OR FOR ESTABLISHING BOUND- ..+" ARY LINES. DRAWNS z ydg+� n, \D o csflda of m 49N "r-oJ S� A*VU,LI SEWARD & ASSOCIATES LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT i HAVE SURVEYED THE SCALE' -"! FOLLOWING DESCRIBED PROPERTY- / J 3d t OF At 04 AND THAT NO E466ACHMErNTS EXIST EXCEPT AS �3o%f .v /v•' 54 INDICATED. IT IS THE RESPONSIBILITY OF THE i $ OWNER TO DETERMINE THE OCISTENCE OF ANY GRID= .........••••• 6 EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- 4y o.... VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FS:4 t , s ANY DATA HEREON BE USED FOR CONSTRUCTION /`387 ;t OF FENCE LINES, OR FOR ESTABLISHING BOUND- ..+" ARY LINES. DRAWNS z ydg+� Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 4107 a y f 3u[f: CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ()5/ -145 — /a COSA # bu l � l Expiration Date: q — /P-- O 7 1. GENERAL INFORMATION Complete legal description P E L45k S GAM 81- A CFC 2 j Z -07 - oTLocation(siteaddress) Location (site address) /19ALCoLr✓l Rr✓E CNft"i.4K Current Propertyowner(s) Dayphone 24./9y Mailing address Lending agency Mailing address 2G�9t.�7 �jLGdGrrt !�/Ti✓l Cffd�Y.¢k Day phone Real Estate Agent �i/� ! /G row/ Day phone %%l OZy4/ Mailing Address 6:4rce Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Z 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Weil ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 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 Onsite 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, 1 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-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 Address Engineer's Printed Name Phone 702-e Date e14 �... ............. 5. DSD SIGNATURE�' . 51e.aR W. Egg 2 to �.,�•,• PE 6:36 : v� Approved for bedrooms. �d�Fo�nrcssr�;.����<�-� Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: ,,/ 14 '29�e-c_;?� Original Certificate Date: (4 — /a — 0-7 (Rev. 11105) 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: ?Er15'e S 047-e 14 8L 0 e k a. ZarV Parcel ID: 05/--17-4 1-12 A. WELL DATA Well type _r_ If A, B, or C provide PWSID # _ Well Log (Y/N) —Y Date completed I2106y Sanitary seal (Y/N) 4— Wires properly protected (Y/N) Total depth 10 ft. Cased to 2 7 ft. Casing height (above ground)in. FROM WELL LOG AT INSPECTION TT Date of test Static water level ft. Well production Q.5 g.p.m. WATER SAMPLE RESULTS: Coliform —.6—colonies/100 mL Nitrate /. , mg/L Arsenic: 6,37? ug/L dale of sample:�S 7 B. SEPTIC/HOLDING TANK DATA 7 ft. + g.p.m. Other bacteria _Q colonies/100 mL Collected by lc .ri Lzr . Tank Type/Material-GZE'E& /STEEL Date installed 9�y Tank size — gal. Number of Compartments Z Cleanouts (Y/N) Foundation cleanout (Y/N)4 V Depression over tank (Y//NN) High water alarm (Y/N) Al Date of pumping I:y /Q 7 Pumper �. %e IT C. ABSORPTION FIELD DATA Date installed Soil rating (94444te or ft2/bdrm) /1 S System type TTIE.r/G' f/ Length .21 ft. Width Z. 5 ft. Gravel below pipe 4- ft. Total depth Zo ft. Eff. absorption area2-572ft2 Monitoring tube 4__ Depression over field .L s Results (Pass/Fail) Jr For 2 bedrooms Date of adequacy test -&1 Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time:/20 min. Final fluid depth in. Absorption rate >= 300 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type)yxtk If yes, give date D. LIFT STATION /J/I Date installed "Pump on' level at in. Datum E. SEPARATION DISTANCES Size in gallons- Manhole/Access (YIN) 'Pump off' levet at in. High water alarm level at in. Cycles tested Meets alarm & circuit requ' ments? SEPARATION DISTANCES FROM WELL ON LOT TO: i Septic tank/lift station on lot /0Q 4' Absorption field on lot /do 'f Public sewer main r Sewer /septic service line /Gtr? Animal containment areas 0 rt r On adjacent lots /0Q t On adjacent lots /Q0 it Public sewer manhole/cleanout Holding tank (� Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r,F Building foundation S4' Property line !SO Absorption field /Q Water main Water service line 2514 Surface water /00 f Weiss on adjacent lots/00 �'f' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line SQ '� Building foundation/Q Water main / it Water Service line 75 r Surface water /00 r Driveway, parking/vehicle storage z0 i Curtain drain Wells on adjacent lots ZQQ fi F. COMMENTS (E.•ur•"�k%I G. ENGINEER'S CERTIFICATION ;yAP •.•�f9?' I certify that I have determined through field inspections and jo :491U '•. � review of Municipal records that the above systems are in 110 •"' """"• conformance with MOA COSA guidelines in effect on this date. •; 't ....... Slwjjn W.Eng W Engineers Printed /Q r7Name C Tgo- Ey( En/G ��� s, PE 6256 ••F Date 6/6 ^F •.......... COSA Fee $ Date of Payment II'tt,,D Receipt Number (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number II IV UTILITY EASEMENTS I I LOT 3 - POWER POLE WOODEN 1 J U 2 SEPTIC cLEAN0UT5—L\,',"' 8.1' X 16.2' SHED ,3ao Q LLJU� o 41 � fes' ' W in LOT 4 1.24 Acres Y 30.00' l ;K. I*'�z STORY FRAME S� 6 WqL. B P Cly,4y_. N 89'57 4NZ 110.08—. MALCOLM DRIVE LOT 6 i --- Q. 3 i LOT 5 PLOT PLAN _ AS BUILT X SCALE 1' - 40' GRID NW 1262 Project No. --_97-066 Lang & Associates, Inc. 11500 Dory! Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax kglanglsOalaska.net / jclanglsOaloska.net � OF ,.•••••A. ,9sp`l�J� 1 hereby certify that 1 have surveyed the following described property. P' LOT 4, BLOCK 2, PETERS GATE SUBDIVISION (PLAT No. 74-146) o;�: 49� *`jQ/ Mahoroge Recording District, Alaska, and that the Improvements situated thereon an :... ........... within the properly lines and do not encroach onto the properly adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed -b' ...• .•• _.. ..•. promises and that then are no roadways, transmission lines or other, vielbl* KENNETH .UNG easements on said property except as Indicated hereon. Dated this the 3R= D of �? ZOp Q LS -5202 �— aY MLA _Z—. at Anchorage. Alaska �4 �Rp•151 L7f�j,• It Is the rosponsibtilty of the owner to determine the exlsfence of any easements, ""0N covenants, or restrictions which do not appear on the recorded subdivision plat. Analytica International, Inc. 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 Northrim Eng Report Date: 5/22/2007 Attn: Steve Eng Receipt Date. 5/8/2007 17237 Bear Paw Circle Sample Date: 5/8/2007 Eagle River, AK 99577 Sample Time: 9:00:OOAM 907-694-7028 Collected By: SA Fax: 907-694-7026 Client Sample ID: Peters Gate B2 14 Sampling Location: Parameter Result Units Flags s ISiRL Client Project: Northrim Eng Sample Matrix: Aqueous COC #: 59379 PWS#: Total Coliform <MRL CFU/IOOmL 1.0 Residual Chlorine: 5/8/2007 SG Comments: Lab#: A0705098 -01A Flae Definitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B = Present also in Method Blank 11= Exceeds Regulatory Limit M = Matrix Interference J = Estimated Value D = Lost to Dilution •• = RL higher than MCL; target not detected TNC = Too Numerous to Count - result rejected CF = Confluent Growth - result rejected TCNG = Turbid Culture No Growth - rejected Analysis Methal Prep s MRL MCL Method Prep Analysis Parameter Result Units Flags Date Date Analyst 4500-NO3E (Aqueous) - Nitrate Test was conducted by: Analytica - Anchorage Nitrate asN 1.87 mg/L 0.50 /0 5/8/2007 5/8/2007 AJ Lab#: A0705098-OIB Analysis Method Prep s MRL MCL Method Prep Analysis Parameter Result Units Flags Date Date Analyst 200.8200.8 (Aqueous) - Family Well Water I Test was conducted by: Analytica - Thornton Arsenic 0.379 ug/L 0.15 /0 200.8 5/1812007 5/18/2007 KB Lab#: A0705098 -OIC Analysis Method Pre Prep Analysis Parameter Result Units Flags s ISiRL 51CL Method Date Date Analyst 92228 (Aqueous) - Membrane Filtration MF Test was conducted by: Analytica - Anchorage Bacteria, Other <MRL CFU/IOOmL 1.0 5/8/2007 5/812007 SG Total Coliform <MRL CFU/IOOmL 1.0 / 5/812007 5/8/2007 SG Reported by: Claire Toon, Laboratory Project Manager Page 1 of 2 �s Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program . A I 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D._O151— Jbil— /'L HAA# Expiration Date: 1. GENERAL INFORMATION t Complete legal description 1 o I H T3 (L 2 Location (site address or directions) yr9Y7 HAL pa - Current Property owner(s) co rg 4 t i si�., N �w ..rT ^ay phone Mailing address, ;'-.:.-. Lending agency Mailing address Real Estate Agent Mailing Address Day phone t olte13o.t t/,tr, „0 P L101 Day phone Unless otherwise requested, HAA 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 7 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. TYPE OF WASTEWATER DISPOSAL: Individual On-site 211 ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ 7 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 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 Health Authority 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 f y4k.C&, T- 1 Address 7�0 3 t t'i 1 ✓ �-�t Zvi Engineer's Printed Name 1 o wy-c S' ... V Ia Kd 5. DSD SIGNATURE __IZ Approved for _ 1 bedrooms. Disapproved. Phone Q4 — 3j a Conditional approval for bedrooms, with the following stipulations: Additional Comments Note: The well for this property meets existing State and Municipal Codes. There are nitrates present. It is suggested that periodic testing be per- formed to insure the wells continued suitability. Current nitrate concentration is 7.55 me/1 EPA maximum concentration is 10.0 mg/1. More information on nitrates is available from the On -Site Services Program, at 343-7904. Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory X_ Other By: I y ��., / /!� Original Certificate Date: �4 -03 (Rev. 0103) Municipality of Anchorage ' Development Services Department Building Safety Division On -Sita Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 995196650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L -a+ N aK 9- '�' (Zk 12 5 C Xr k Parcel ID: 061- ,5Y 1- 11- A. WELL DATA Well type -4L If A, B, or C provide PWSID #N/A Date completed iwlpy Sanitary seal (Y/N) Total depth -Ia_ft. Cased to A-CLft. FROM WELL LOG Date of test Static water Level 0" it a ft&*A ft. Well production to. -S g.p.m. WATER SAMPLE RESULTS: Well Log (Y/N) Y Wires properly protected (Y/N) Casing height (above ground) IZ in. AT INSPECTION u / AP -6(0 ft. 0-63 g.p.m. Coliform _��colonies/100 ml. Nitratemg./l. Other bacteria N t� colonies/100 ml. Arsenic: V/ mg./l. Date of sample: b ( 03 Collected by: B. SEPTICIHOLDING TANK DATA / Tank Type/Material L—e-. Stt1AAJ Date installed 4 { g Y Tank size I&0Q gal. Number of Compartments %L Cleanouts (Y/N) x Foundation cleanout (YIN) t Depression over tank (YIN) -L!- High water alarm (Y/N) Date of pumping y 16 -0 3 Pumper . IZ C. ABSORPTION FIELD DATA Date installed Q : Soil rating (g.p er ft'lbdrm) - System type YAtt&& � Length ft Width .2_ �� fl. Gravel below pipe 4P ft. Total depth 1,(2_ ft. Eft. absorption area 2,6_Z-ftr Monitoring tube -�L- Depression over field N Date of adequacy test y iy-v 3 Results (Pass/Fail) _" For a bedrooms Fluid depth in absorption field before test pin. Water added 3ev gal. New depth LZ in. Elapsed Time: 1A0 min. Final fluid depth _JL in. Absorption rate >= 300 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N 0 If yes, give date f/ D. UFT STATION Date installed 'Pump on" level at_ in. Datum E. SEPARATION DISTANCES gallons off" level at _ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /;up t Absorption field on lot Public sewer main "A Sewer /septic service line I" t (Y/N) water alarm level at Meets alarm & circuit requirements? On adjacent lots i,> 1 ao On adjacent lots 'loo f Public sewer manhole/cieanout N%A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line 6 t Absorption field 15 Water main N �A Water service line a 5 t Surface water I O -C) + Wells on adjacent lots 100 -� in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10.0 Building foundation 3 O Water main %A Water Service line A ±5- 4 Surface water 12!0— Driveway, parking/vehide storage 7-y 0 Curtain drain N l b Wells on adjacent lots �}/2/.o F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certffy that I have determined through field Inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name I a l,%e N �� r I�Lw ►a . 1 Date -00 HAA Fee $ 06 Date of Payment 10/134 3 Receipt Number ITIS -1 L, (Rev. 12/07) Waiver Fee $ Date of Payment Receipt Number nge,Ess'. -- r Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Health Authority Approval # 030276 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 2, Lot 4 of Peters Gate subdivision, the well's productivity was determined to be 0.33 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 2 -bedroom residence is 0.2 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. f 86-23-03 MOM FROIhCTLF EM71RMLINTAL SRV BOTSCIS301 T -14E P.C2/C5 F-443 SGS SGS Re.t.# 1033588001 Client Tame Tobben Spurklard P.E. Project NameAt Various Client Sample ID Lot 4, Blk 2 Peters Gate Mstris Drinking Water Sumple Renvrks. All Date6MMes are Alaska Standard Tlme Printed Date/rime 06/2312003 15:22 Collected DatwTlme 06/18.2003 11:00 Recelved DateMme 0611 003 15:32 Tecbnical nla*cto � Ste a C. Ede Par4nwer Resin PQL Units Method Conuiner ID Allowebie Rep Arwlpia Le9i•s Dete Dale Ind Haters Department Kitnte•N 7.55 0.100 mg1L EPA 300.0 B ("10) 06118'03 JS VACroblology Laboratory Taal Coliform 0 calilMmL 3%11892220 A (<-I) 061I1L'03 KAP :;• a . Z L - .I YO /i T'i `Vnr i ct . Cr,J AS -BUILT 1 hereby certify that 1 have surveyed the follu,ving desmhec pr[mpeny:�L 7 /GG1 7 LJ. •i' -a Fr fir/- ��� 5 Anchorage Recording Preankt. Alaska, and that the impruve• menti situated thereon are within the proper,%. lines and du not overlap or encroach on the property lying adlacrnt thereto, that no improvements on property lyintl adjacent thereto encroach On the pno roadwavi. transmoiiiuntses li es or wher visible in qut-stitin and tcasementsat thereare on said propeits trtcept as indicated hereon. Oared at EaSle Rls•er. Alaska , •.'- T chs- 1C day of i9 �4 . f,1 t' KALE ROBERT C, JOHNSON p ` Re ERT Sunc or N• ,':. " •'•'� &,t :,•C•i5,i, Eay!e River. Alaska 995, •`4..,... .Mn ,... .•.. MUNICIPALITY OF ANCHORAGE DIVISION OF Eh'VIROK4ENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Informatio Application Date Z/1/p 1x Cf (a) Legal Des i t on (include lot, block, subdivision, section, township, range) L' `c Location (address or directions) / N 4tl S1iZP7 (b) Applicants Name! R'141Q_rf Cd Is'T / Telephone - Home Business Applicants Address SS 004q /7i6e >z.P (c) Applicant is (check one) Lending Institution ; Owner/builder Buyer [::::[ ; Other = (explain); (d) Lending Institution -'l% 0-'�..i Telephone Address (e) Real Estate Co. b Agent iU v oa Address Telephone 1- ZID (f) the HAA to the following address: £ G.`101 N[ c"iiU\C� rcr !i::UF��x 2. Type of Residence Single -Family Multi -Family Number of Bedrooms 2 3. Water Supply Individual Well D�T Community Other (describe) Public = Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite r5;�'T Public M Community M Holding Tank Q Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] Engineering Firm Providing Inspections Tests File Search Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm Telephone SRO 106)c IN(s Address VFa AIAo". �".!'%Vku. Date— . i i�r: • ' . •/. moi,• � •t� ,•� (ENGINEER SEAL) No. 1437-E •.'•.• 6. DHEP Approval f��ic'•,,• •'�-,R Approved for bedrooms By Date Approved Disapproved Conditional Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE PWQUIRE- MENTS. EMPLOYEES OF DUEP 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 21 7-19-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEAM AUTHORITY APPROVAL (HIAA) CHECKLIST - FEBRUARY 1984 Legal MUNICIPAL17Y OF ANCHO?.ACZ DEPT. OF HEALTH & E.WrON:AF-14 AL PR- Ci:TICi! Nov 2 ��CEIVED Well Classificati U!d K If A, B, or C, D.E.C. Approved(Y/N) Well Log Present f) Date Completed _ (7/8 174 Yiel Cd� Total Depth 0 Cased to Z9 '&(e Depth of Grouting Static Water Level Zr% Pump Set At CAL (.( Casing Height Above Ground Sanitary Seal on Casing ( ) Electrical Wiring in Cmduit((Y D Depression Around Wellhead (� ) Separation Distances from Wall: To Septic/Holding Tank o1 Lot /� f On Adjoining Lots /OD To Nearest Edge of Absorption Field on Lot / 4- On Adjoining Lots 1677 < To Nearest Public Sewer Line '4J M To Nearest Public Sewer Cleanout/Manhole N 114 To Nearest Sewer Service Line on Lot Water Sample Collected By 5 , 5 t, xic i Date Water Sample Test Results C Comments ' B. SEPTIC/HOLDING TANK DATA Date Installed B Size /0490 No. of Caq=tments z Standpips (Y L) Air -tight Caps am) Foundation Cleanout (Y ) Depression over Tank Date Las Pumped x J e W Pumping/Maintenance Contract cn File Y ; for Holding Tank High -Water Alarm (Y Temporary Holding Tank Permit Y Separation Distances from Septics Tank: To Water -Supply Wall /DU '�c To Building Foundation. To Property Line d To Disposal Field To Water Maiwtervice Line 30 To Stream, Pond, Lake, or Major Drainage Course '0UL7 a.Je= Comments /(ID n/e Receipt $ Date Paid: 11-at-Fc+l Amount:-WCS;:_ [Page 1 of 21 2-15-84 C. ABSORPTION FIELD MTA ^ Soils Rating in Abs tion Strata IZSAType of System Design ( Date Installed B 44' Length of Field Z Width of Field 30 a Depth of Field /D Gravel Bed Thickness Z �� Square Feet of Absorption ea Z S 2 Standpipes Present Y �) Depression over Field ( ) Date of Last Adequacy Test /V a �✓ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Wall /M �-� To Property Line To Building Foundation 30 To Existing or Abandoned System on Lot iCJ O AJ E f On Adjoining Lots 30 To Water afaisr/Service Line � �f To Cutbank(if present) -oU o k J f To Stream/Pond/Lake% Major Drainage Carse AJO n/ Agr To Driveway, Parking Area, or Vehicle Storage Area jz /f Ccrents 4uv Aajer D. LIFT STATION Date Installed Dimensions Size in Gallons /Access (Y/N) "Pump Qtr Level at Off" Level at High Water Alarm Level at I — nt (Y/N) Tested for Pumping Cycies during Adequacy Test. Meets MDA Electrical Codes(Y/N) Cc auents ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MDA HAA Guidelines in effect on the date of tris inspection. Signed S a18 "Itfewr bats Calpany ;dLE P105k�� MDA No. M/d5/s [Page 2 of 21 fe;4" rq,,,:... 'r aryl A. 4+441 ;= N.C. 1467 E 2-15-84