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BEAR VALLEY BLK 3 LT 3
Bear Valley Block Lot 3 3 #020-431-04 \ Municipality of Anchorage .� Development Services Department - Building Safety Division; On -Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 Onsite Wastewater Disposal System and/or Well Inspection Report Permit Number. $W020428 PID Number. 020-431-04 Name:CONNIE NELSON Wastewater System: ■ New ❑ Upgrade Address: 205 E DIMOND BLVD #135 ' ANCHORAGE, AK 99515 ABSORPTION FIELD Phone: No. of eedrooms: (907) 345-1695 3 ODesp Trench ■Shollow Trench OBed OMound OOther LEGAL DESCRIPTION Sol ": 0.8 GM/sq. n Tobi DW h earn 019N qn.a.: I SEE DWG. n Block: Lot: Subdivision: DW h to pIq koe.m f— eAynd ale&: Ga..l d.Pth Ewald PIPC 0.5 3 3 BEAR VALLEY SEE DWG. R 1 rt Township: Range: Section: — — — r• edd.d .b••• sdgN qn.d.: DWG. Gww rgln' I 2 ® 57' (114' TOTAL)R SEE rt. Gra.el wilt: N,.eEw aanr• oc.t.na. bwtv..n la..: 15+ WELL: ❑ New El Upgrade 5 n. 2 In. CI..wlkation Prhvb. A&C . Total C...d Tc T.W fib„ onm 570 P" nuftedol: I D 3034/ F-810 R R so. rL 1 Drel.r. Dab DrWd: sloth water tvw: kwtol.r: AKWWC Dob kwtol.t 10/23—,26/2002 i< Yl.ld:P wnp Set At cowq Nsklm Ako w rwwwie: TANK c„ R FL SEPARATION DISTANCES ■septic 0Holding 0S.T.E.P. I ODther Td Septic Absorption Uft Holding bk/Mmt. YO MdOCW. ANCHORAGE TANK t.P.ay ~9•e•»1 1000 Fnm Tank Field Station Tank seww Un.. Well 100'+ 100'+ — — 25'+ tlol.rld: STEEL N..,I,r N .ampv4n.nlc 2 Surface water 100'+ 100'+ — — — LIFT STATION Lot Una 5'+ e3'+ — — — su. M t� uan.rm4w.r: an Inwl ab ump en at tkae water olerm at: Foundation 5'+ 10'+ — — — 1harlo u.l. e.mteel p.nerwwe ar Curtain Drain NONE KNOW BENCH MARK Remarks: l.a.tbn and Dow,* io.: —EXISTING SEPTIC SYSTEM COMPLETELY ABANDONED BOTTOM OF SEPTIC TANK = 88.39, e3' LOT UNE WAVER REQUESTED = =TOP BOTTOM KEYSTONE STEP IN REAR OF HOUSE `ted E�� 1 100.00 n ENGINEERS SEAL o06O0 �0�0 Dates: 1st 10/23/2002 �:.4 Inspections performed by: AKWWC, INC. 2nd to/2a/2oo2 3rd 10/25/2002 4th 10/26/2002 eff e G as Development Services Department Approval p� r 7953Q�Fov ��Op� Reviewed and approved by: Date: IZ r ealonO �� 4p �� (o«. tI/ol) PMMMNUMBER: AS -BUILT DRAWING P2113NUMBER: SW0 00 SW020428 020-431-04 I Uri _ 15_� \ NEW 1000 GALLON SEPTIC TANK \ NEW DR INFIELDS TH/1/ S' HIGH RETAINING WALL `s + I I J• \ DB O � i� •L ,ice DBL 4 iii �1 � •?:":,. STI 68.63 65.25 ST2 69.82 70.35 DELI 70.10 71.40 DBL2 70.32 72.05 FS 90.71 114.34 C01 76.17 90.67 MT1 74.86 89.47 CO2 103.28 135.02 MT2 100.50 132.53 CO3 93.81 108.27 MT3 96.15 1110.77 C04 119.85 149.89 MT4 119.72 149.18 NSTALLED FLOW SPUTTER I\ \ -APPROXIMATE LOCATION AND DIMENSIONS OF CONCRETE PAD. AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 10/29/2002 �,..... ,. (14� DRAWN BY: •: ALASKA «'ATTR & WASTL'NATTR SCALE;C.J.G. CONSULTANTS,INC. 1^ 0 40' •••• ......•... 6001 DFRAPP POAO. SUITF n . ANGNOPAGF. AR OOSO4 • PNONF (00f)INI 6170 • FAX (001)S%A.3A6 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CONNIE NELSON (907) 345-1695 2 OF 3 QQ .1 Tr Garness: D� 953 .•' `Fo 0n�,_' • .. ...... LEGAL DESCRIPTION:QO BEAR VALLEY SUBDIVISION; LOT 3, BLOCK 3, AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE PERMIT NUMBER: SW020428 AS -BUILT DRAWING PARCEL. ID NUMBER: 020-431-04 INSULATION FINAL GRADE . 9526♦ TOP OF TANK A TOP OF TANK AT INLET - 9126 OUT ET - 93.26 NEW GALLON SEPTIC IYERT OF BUNG) SEPTIC TANK JNyERT OF BUNG AT AT INLET . 92.69 OUTLET - 92.48 1 ILIAL GRADE - 21 94.64-94.66 FINAL GRADE - ORIGINAL RL GRADE - - 9275-9279 FILTER FABRIC 9231-9337 INSWTION FUER FABRIC ORIGINAL FILL 9r5ULAnm 59.44-90.]5 IGNAL (NATURAL) GRADE . 59.55-9o.1e �/- ORIGw4L, (NATURAL) GRADE . 67.42-e6.39 i/- � i-2' Or M.OAq= " ( `- •,��if.; 'w+�o n}�TE..R ::L 9NERr Or PIPE 91.56 (A`AJ •APPROVm ��<>• 9NERT OF PIPE TOP OF SAND. a%.-r;;w+o.>9�,".-''-'• . 59.89 (AVG.) . 91.16 (AVG.)—/5' . :fv,..��=vr::i4 IOP SAND NCH B0: ee. . 69 39 (AM) 5� 3-ama 0' BOTTOM OF TRENCH . 50.42-07.39 RELATIVE ELEVATION OF GROUNDWATER SEASONAL HIGH - 85.38 EXCAVATION LIMITED TO THE REMOVAL OF THE NATURAL ORGANICS TIVE ELEVATION OF GROUNDWATER SEASONAL HIGH - 83.59 ELEVATION OF BOTTOM ESTHOLE - 80.89 1 ALASKA «'ATER & NVASTEAVATER SCALE: CONSULTANTS, INC. 1 ^ = 40' 6001 DFAARR ROAD. SVTF M • ANC.MAGF. AK 00504 • FNONF (007)MV 170 • FAX (007)MR. M6 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: CONNIE NELSON (907) 345-1695 3 OF 3 LEGAL DESCRIPTION: BEAR VALLEY SUBDIVISION; LOT 3, BLOCK 3. TYPE OF WORK: PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE RELATIVE ELEVATION OF TESTHOLE - W/." .. . . . .. ........ '•.Je re' e ne6S.-- 953 �� '•, C� ALASKA WATER & WASTEWATER CONSULTANTS, INC. , October 29, 2002 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Lot Line Waiver for Lot 3, Block 3; Bear Valley Subdivision. To whom it may concern: We request that your department issue a 3 foot lot line waiver from the southwest property line to the new drainfield.,ham unaware of any adverse impacts this waiver would have on adjacent wells or septic systems If you have any questions, please contact us at 337-6179. Thank you for M.S. 6901 Debarr Road, Suite 2B 0 Anchorage, AK 99504 Ph: (907) 337-6179 0 Fax: (907) 338-3246' Website: akwwc.com liTT)) Municipality ofAnchorage ; Building Stifeh• Divisimi Georye It 11 uercA. Mayor 12/20/2002 Jeff Garness Alaska Water and Waste Water Subject: Waiver Request for 5' Lot line Waiver Waiver Request #WR020096 Parcel ID 4020-431-04 Dear Mr Garness: Anchorage All -America City I I 1161 2002 Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 5.0 feet. n In tn_� al f -o This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. 1 Sincerely, oodall i Engineer n -Site Water & Wastewater Program P.O. Ik)x 1tX;G5O • Anchorage, Alaska W519-6650 • Telephone: (19)7) 343.8.`101 • Ptet: (907) 543-83(x1 4700 South I1ragaw Street • Anchonge, Alaska 99.507 h It p://a�t�c.ci.nnchorai;r.nk.us Municipality of Anchorage Development Services Department • building Safety Division On -Site Water and Wastewater Program 4700 Dragaw Street P.O. Dox 1%650 Anchorage, AK 99519.6650 www.ci.anchoragc.ak.us (907)343-7904 WR#: wr020096 Date Received: 12/20/02 Waiver Review Worksheet PID#:020-431-04 HA#: Legal Description: Bear Valley Block 3 Lot 3 Q=27MWLTiiL a -.- Waiver Requested: $' Lot Line Waiver Q Dv►GYL fo 3 Criteria: Geology A. Water Table B. Sal Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: Waiver is Granted: t� Waiver is not Granted: List Conditions or Reasons for above: /2.Zo41Z Date: By: e of Reviewer ................................wase... s e •some ..... . w.swea...eeeeeeaee....w Rec#: 29273 Amount: $12/19/02 Date Paid: MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW020428 Legal Description: BEAR VALLEY BLK 3 LT 3 Design Engineer: 0041 AK Water & Wastewater Consultan, i /aOy 3'3a YP41 Date Issued: Oct 22, 2002 Expiration Date: Oct 22, 2003 Parcel ID: 020-431.04 Site Address: Owner Name: Lisa Andrews Lot Size: 48629 SO. FT. Owner Address: 4673 Beaver Loop Rd. Total Bedrooms: 3 Permit Bedrooms: 3 Kenai , AK 99611 - This permit Is for the construction of: [I Disposal Field ❑/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: �LdI�A�'1��'SICC 1I1� Date: i� 2.2 O� (� Date: 4 2 2 d Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-431-04 Permit Number Property owner(s) LISA ANDREWS Day phone 301-0592 Mailing address (1) 4673 BEAVER LOOP RD K NAI AK Mailing address (2) Zip Code 99611 Legal description (Lot, Block & Sub'd.) BEAR VALLEY S/D• LOT 3 BLOCK 3• Legal description (Section, Township & Range) N/A Lot Size Il q 6;2 2 Acre Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. -¢ oo `� Permit Fees: �f'�27061 r/1'An D Date of Payment: J Receipt Number: �G.I 0 b Waiver Fees, Date of Payment: Receipt Number: ALASKA WATER & WASTEWATER CONSULTANTS, INC. , October 14, 2002 Municipality of Anchorage Department of Health &: Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade Design for Lot 3, Block 3, Bear Valley Subdivision To whom it may concern: The proposed 3 bedroom house is served by a private well and septic system. The existing septic system consists of a 1000 gallon septic tank and a trench type drainfield that is failed and needs to be upgraded. Two test holes were excavated on the property. We are proposing to install a new 1000 gallon septic tank and a new drainfield. Comment regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil profile, and the percolation test results. In test hole #1, the soils below the organic and fill layers are a ML material (with light gravel) to a depth of 10.5 feet (bottom of test hole). In test hole #2, the soils below the organic and fill layers are a GM/ML material to a depth of 13 feet (bottom of test hole). No groundwater was encountered during the excavation of the test holes except a seep at 7.5 feet in test hole #1. Groundwater levels were checked on 5/14/99 and found to be at 9 feet in TH#1 and at 8.25 feet in TH#2. A percolation test for TH#2 was performed between the depth of 5.0 feet to 5.5 feet and the rate was 10 minute/inch. 2. TRENCH DESIGN: a. Percolation Rate: 10 minutes/inch x b. Allowable Application Rate: 0.8 gallons/day/ft c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day 2 e. Minimum Absorption Area: 563 ft f. Total Depth: 4 to 5.5 feet (Excavate to bottom of organics) g. Effective Depth: 0.5 feet h. Width: 5 feet i. Reduction Factor: N/A i. Minimum Length: 2 @ 57 feet long each (114 feet total length) 2 j Effective absorption area = 570 ft 6901 Debarr Road, Suite 2B • Anchorage, AK 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPIIY: The average topography of this property is a 15 percent running from approximately southeast to northwest; in short, there are no slope concerns. The trench is to be installed parallel to slope contours. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you M.S. NOTE: Attached is a site plan drawing, a design drawing, a detail drawing, two soils logs, a topography site plan, and a 7 page construction specification letter which are all pari of the design package for this septic system. 6901 Debarr Road, Suite 2D • Anchorage, AK 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com I I II Jr --- II I I II II II II II I II I II 1 II LOT B. BLOCK 3 I BEAR VALLEY S/D I -41 I II �/ LOT 2. BLOCK 4 BEAR VALLEY S/D 1 1 1 1 1 1 LOT S. BLOCK 3 ; I BEAR VALLEY S/D WW1 % 1/ / DO- WELL RADIUS j 1 / / LOT 3. BLCCK 4 1 / BEAR VALLEY S/D / / / I LOT 4. BLOCK 3 BEAR VALLEY S/D -PROPOSED SEPTIC SYSTE (SEE DESIGN. PACE 2 OF 3 EXISTING SEPTIC LOT 2. BLOCK 3 BEAR VALLEY S/D 1 SYSTEM 1 \ / 100WELL RADIUS 0 I oil \ \ `\I APPROX. X. LOCATION ♦\ i I III I LOT 1. BLOCK 3 I BEAR VALLEY S/D \ �� I / r / \\ LOT 4. BLOCK 2 BEAR VALLEY S/D II I �yOlv, 1 1 1 IS. BLOCK 2 r BEAR VALLEY S/D LOT 3. BLOCK BEAR VALLEY S ......... __ _,...... �.._.. _. _ Z.T.G. �= ti ALASKA WAI LR & WASTE ATER CONSULTANTS, INC.' 4 6005 DFAA49 ROAn. SUITF M • ANCNOFAGF. AK 9950L • FNDNF (00])33).6179 • FAX (907)334-3?66 1 100' i REPARED FOR PHONE NUMBER: PAGE NUMBER . . . ...... . ..... CONNIE NELSON 345-1695 1 OF 3 r%—' f e n ss: LEGAL DESCRIPTION: BEAR VALLEY SUBDIVISION; LOT 3, BLOCK 3 PROPOSED SEPTIC SYSTEM UPGRADE INSTALL FLOW SPUTTER S' HIGH RETAINING EXISTING TRENCH TO BE ABANDONED COMPLETELYNPAD. APPROXIMATE LOCATI DIMENSIONS OF CONCR EXISTING FOUNDATION ' •� c' • dp• ��0� AT TIME OF CONSTRUCTION. ALASKA WATER & WASTEWATER 10/15/02 0G� NN BY: P`v B.S.G. E: o -:0 qf�... PREPARED FOR: PHONE NUMBER: PALL NUMOLK: CONNIE NELSON 345-1695 1 2 OF 3 BEAR VALLEY SUBDIVISION; LOT 3, BLOCK 3 : OF WORK: PROPOSED SEPTIC SYSTEM UPGRADE ®i eO 1 NOTE: THE CONTRACTOR SHALL HAVE THE WEST PROPERTY LINE AND THE 1 PROPOSED DRAINFIELDS UPGRADE. NORTH UTILITY EASEMENT FLAGGED BY EXCAVATE TO TRENCHES THAT ARE A REGISTERED LAND SURVEYOR PRIOR \ 4 TO 5.5 FEET DEEP (REMOVE ONLY TO ANY CONSTRUCTION. ORGANIC SOILS) BY S FEET WIDE BY 1 57 FEET LONG EA.(114' FEEF TOTAL). I ADD 2 FEET OF M.OA APPROVED 1 J SAND FILTER AND THAN 0.5 FEET \ OF CLEAN. WASHED DRAINROCK. -� INSTALL TRENCHES PARALLEL TO ALL SLOPE CONTOURS. r i (SEE DETAIL. PACE 3 OF 3) 1 -- CEMENT r r X r 11 EXISTING SEPTIC TANK TO Be PUMPED, CRUSHED AND BURIED. � \ \/ INSTALL DOUBLE h CLEAN—OUT / r PROPOSED 1000 GALLON SEPTIC TANK \ THI I MTO / CO f MT I / Gov/ INSTALL FLOW SPUTTER S' HIGH RETAINING EXISTING TRENCH TO BE ABANDONED COMPLETELYNPAD. APPROXIMATE LOCATI DIMENSIONS OF CONCR EXISTING FOUNDATION ' •� c' • dp• ��0� AT TIME OF CONSTRUCTION. ALASKA WATER & WASTEWATER 10/15/02 0G� NN BY: P`v B.S.G. E: o -:0 qf�... PREPARED FOR: PHONE NUMBER: PALL NUMOLK: CONNIE NELSON 345-1695 1 2 OF 3 BEAR VALLEY SUBDIVISION; LOT 3, BLOCK 3 : OF WORK: PROPOSED SEPTIC SYSTEM UPGRADE ®i eO ---------� -�— r —0 — — — — — —— — — — it co col o J L----------- --------- Mf wsrni-L FLow5MrclER 0 Mf---------- o--------- co �C01r ---------------- f L----- M1 I PLAN VIEW Mf K c0 CV fMCr.AX Mf c0 ��'�„ � u�w-nnoN OWWL" r fLltRfFim WSU.AfION FLIER MM 7 '\� 2 FEEf OF 6uJCtES SMDFLIER�};;F` EfFEcin . ? 4f05.5I'M 2 FEET OFT 54V 9 r �-- 0' MN. 0 PROFILE VIEW DATE: 10/15/02 ALASKA NVATER & WASTE WATER CON$ULTANTS. INC. ?01 DFSARB f AD SkpTF 7!1 ANCNOf+AOF. AR OOSOL fMfWF (00))311-0AO iAM f001113s-1RA .,.ems.. rno. PNONE NUMBER: CONNIE NELSON 345-1695 BEAR VALLEY SUBDIVISION: LOT 3, BLOCK 3 OF WORK: DETAIL DRAWING OF DRAINFIELDS LE: G -f 30E NUMBER: 3 OF 3 ALASKA WATER & WASTEWA TANTS. INC. I SOIL LOG - PERCOLATION TEST I LEGAL DESCRIPTION: BEAR VALLEY SUBDIVISION, LOT 3, BLOCK 3 PERFORMED FOR: CONNIE NELSON DATE PERFORMED: 4/22/99 (feet, =__ ORGANICS ITEST HOLE #1 1 2 FILL SOIL CLASSIFICATIONS GW ORG Gp 11 1 ML -- I GM CL GC I OL =_ ORGANICS SW 1 MH 5 -_ SP CH "4 f4SM SOH 6 ( III ✓. _J Sc 7 ML 6 WITH LIGHT GRAVEL 9- 10- 11— 1011 B.O.H. 12- 13- 14- 15- 16- 17- 18- 19- 20— COMMENTS: 21314151617181920COMMENTS: DEPTH TO GROUNDWATER DATE SEEP O 7.5' 4/22/99 10' 4/29/99 9' 5/14/99 •.. u.. .... ........... +TM1t TH/2 LOT 2.BLOCK 3 \ S EOLR VALLEY S/D S30' wEu aAoius APPROK. LOCAnU PERCOLATION RATE N/A (MIN./INCH) PERC. HOLE DIA. 'N/A (INCHES) TEST RUN BETWEEN N/A FT. AND / FT. t- ' B6Low. 0.4n. //, /7 PERFOMED BY ALASKA WATER do WASTEWATER I, THIS WAS PERFOR D ACCORDANCE WITH DATE. DATE: /`Z 4'i 1121 I CERTIFY THAT ,CT ON THIS I CLOCK I TIME NET TIME (MINUTES) WATER LEVELII READING I NET DROP (INCHES) I I I I I rDATEREADING NO PERCOLATION �R('oS� TEST PERFORMED ars '♦:b I OL I I I PERCOLATION RATE N/A (MIN./INCH) PERC. HOLE DIA. 'N/A (INCHES) TEST RUN BETWEEN N/A FT. AND / FT. t- ' B6Low. 0.4n. //, /7 PERFOMED BY ALASKA WATER do WASTEWATER I, THIS WAS PERFOR D ACCORDANCE WITH DATE. DATE: /`Z 4'i 1121 I CERTIFY THAT ,CT ON THIS I & WASTEWA' T. SOIL LOG — PERCOLATIONTEST 0/ xLEGAL DESCRIPTION: BEAR VALLEY SUBOMSION, LOT 3, BLOCK 3 ""' ' ' " "' PERFORMED FOR: CONNIE NELSON 0 ; Q A.I Garness; DATE PERFORMED: 4/22/89 QQ s –7953 (feet c= ORGANICS TEST HOLE #2 e,lb fes'gloo;�Eo� tLrm�ro 0 O0000��o 3 E]:=1 IORGAN ICS 4 mC'l""l� 9 10 11 12 13 16- 17- 18- 19 6171819 20 COMMENTS: SOIL CLASSIFICATIONS DRY 4/22/99 WATER LEVEL! READING I GIN GPI GMCL GC SW SP SM SC = �- ORG ML OL JIMMH CH ' ' % OH :,.v"o !io+•t il I SOAKED 4+ o •`• °• :; '• 4 DEPTH TO_ GROUNDWATR DATE DRY 4/22/99 WATER LEVEL! READING I 4/29/99 B'-3' 5/14/99 WAS PR SOAKED 4+ t /�—` LAT 2. BLOCK 3 BEAR VALLEY S/D 1100' WELL RADIUS \ APPROX. LOCATIO DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL! READING I NET DROP (INCHES) 4/23/99 — PERC CAVITY WAS PR SOAKED 4+ OURS PRIOR TOTE STING I 1 4:44 — 6- I — 2 5:14 30 3' 1 3' 3 5:16 — 6' I — 4 5:46 30 3" I 3- 5 5:47 — 6- i — 6 6::17 30 2 3/4' 1 3 1/4' I I I I PERCOLATION RATE 10 (MIN./INCH) TEST RUN BETWEEN 5.0 FT. AND Z; �- A° I.etoL.W.0•G.,, PERFOMED BY ALASKA WATER & WASTEWATER I, THIS WAS PERFORMP IV ACCORDANCE WITH ALL DATE. DATE: <// 8 t -- � A/ATx2J► C. PERC. HOLE DIA. 16 (INCHES) ICERTIFY THAT DELINES IN EFFECT ON THIS Uv d i 9 1 •j Municipality of Anchors j On -Site Water and Wastewater Progra (907)343-7904 Parcel I.D. 020-431-04 Certificate of On -Site Systems R SMIN MAR 2 3 2016 Expiration Date: lU _,-,q l "1 )o 1, GENERAL INFORMATION Complete legal description Bear Valley; Block 3, Lot 3 Location (site address) 16140 Black Bear Drive 'Anchorage Current Property owner(s) Tom Fouts Day phone Mailing address Real Estate Agent Nate Bear Day phone 727-1130 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 ® Y 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: v� Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNarence request for: N/A j Distance: N/A Received by: Date: COSA to be relea to the engine r, nless otherwise requested by the engineer. COSA Fee $ J�(o fi31(J_•(DL� Date of Payment C-91 L(�(�_ Receipt Number COSA# (')5rIto( 04d Waiver Fee $ _ Date of Payment Receipt Number, Waiver # lS Wal 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 Gayness Engineering Group, Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road, Suite 101 Anchorage AK, 99507-1259 I J) Engineer's Printed Name Jeffrey A. Gayness Date/fbli6 In conducting this evaluation„GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices- The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend 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 system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person/party 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 System #1 Approved for 2 bedrooms System #2 Approved for Disapproved Conditional approval for A bedrooms bedrooms, with the following �QP���Y OF/X, ON-SITE �vm. WATER AND :tiPu *AWEWATER o PROGRAM Original Certificate Date: 3 -1 --kV i 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. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet 9-1d2.doc Nitrate Advisory Arsenic Advisory Other If more than 1 septic system Is on the tot: COSA Checklist # _of_ Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: BEAR VALLEY; BLOCK 3, LOT 3 Parcel ID: 020-431-04 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 5/1983 Sanitary seal (17N) YES Total depth 150 ft. Cased to 51.25 ft, FROM WELL LOG Date of test 5/83 Static water level UNK ft, Weli,production ? g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: i jJ ug./L. B. SEPTICIHOLDING TANK DATA Nitrate-• - tg./L. Well Log (YIN) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 3/4/16 42.4 ft. 1.6+ g.p.m. Date of sample: 3/4/16 Tank Type/Material SEPTIC/STEEL Tank size 1000 gal. Number of Compartments E Collected by: GEG. Ltd. Date installed 10/23-26/02 Cleanouts (Y/N) YES' Foundation cleeneut,('ON), YES Depression over tank (Y/N)N_O High water alarm (Y/N) N/A ppa GFS Date of pumping t Pumper. NORTH TRENCH C. ABSORPTION FIELD DATA PBELOW EXISnNG GRADEJ ISOUTH TRENCH Date installed 10/2,3-26/02 Soil rating (g.p.dJftzo /bd 0_8 System type DUAL TRENCH 5 0.5 Length 57+57=114 ft. Width 5 ft. Gravel below pipe 0.5 ft. Total depth *3:1 + ft. Eff. absorption area 570 ftZ Monitoring tube YES Depression over field NO Date of adequacy test 3/4/16 Results (Pass/Fail) PASS For E bedrooms 0 419 Fluid depth in absorptjon'�field before test E in. Water added300+gal. Newdepth-0 in. Elapsed Time: E min. Final fluid depth E in. Absorption rate >*, 450+ g.p,d. Any rejuvenation treatment (past 12 mo,) (Y/N & type) NONE If yes, give date FLOW SPLIT BETWEEN NORTH AND SOUTH TRENCH; BOTH TRENCHES REMAINED DRY THROUGHOUT TEST D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump air leve al.===Wah water alarm level at 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,+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manholetcleanout 100'+ Sewer /septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING 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 *3' Building foundation 10'+ Water main 10'+ Water service line 10'+ Surfacewater 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN 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 JEFFREY A. GARNESS tDate 311b11b (Rev. 11/05) - or 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.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 64,0 - 1. GENERAL INFORMATION Expiration Date: I H C)- 0 a Complete legal description BEAR VALLEY S/D: LOT 3, BLOCK 3 i Location (site address) 16140 BLACK BEAR DRIVE • ANCHORAGE, AK 99516 Current Property owner(s) RUTH ANDREWS Day phone C/O AGENT Mailing address 16140 BLACK BEAR DRrVE ► ANCHORAGE, AK 99516 Lending agency Day phone Mailing address ' I Real Estate Agent CORA CARLESON w/COLDWELL BANKER Day phone 376-5700 Mailing address 2525 "C' STREET + ANCHORAGE. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site N Individual Water Storage ❑ Individual Holding tank Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The -Municipality of- Anchorage Development Bervices-Department {DSD) Issues Certificates of Onsite Systems- Approvat (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of On -Site 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 samples. (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 axed 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 CROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidohnes & 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, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden dofects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continuo to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will It confer any legal right whatsoever. . 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 337-6179 Date S//6/04 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: � COSA Checklist Arsg,lr 1G_Bdyim y Septic System Advisory Maintenance Agreements Well Flow Advisory Nitrate Advisory Supplemental Engineer's Reort Other WATERAND AD m P MAER; By: Lv �� Original Certificate Date: /R.• HIISI - i Municipality of Anchorage Development Services Department Building Safety Division ' On.41te Water & Wastewater Program A "' 47W Bragew, Street P.O. Baa 196650 Anchorage. AK 99519-6650 www.muni.orglonaite (907) 343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: BEAR VALLEY S/D: LOT 3. BLOCK 3 Parcel ID: 0L 0 - 31 - O1 - A. WELL DATA Web type PRIVATE If A, B, or C provide PWSID# N A Well Log (YM) YES Data completed 6/25/1983 Sanitary seal (YM) YES Wires properly protected (YM) YES Total depth 150 ft. Cased to 51.5 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Data of test 6/25/1983 8/11/2006 I Static water level 31 ft. 38 ft. Well production 3.0+ g,p.m. 2.63 g.p.m i WATER SAMPLE RESULTS: Coliform _0 ooloniesl100 ml. Nitrate 153-mgJL. Other bacteria 0cdonies/100 ml. I Arsenic: -htQ-ugJL. Data of sample: 8/11/2006 Colley by: GEG Ltd. B. SEPTICIHOLDING TANK DATA Tank Type/Matertal SEPTIC/STEEL Date Installed 10/26/2002 Tank size 1000 gal. Number of Compartments 3 Cleanouts (YM) "YES Foundation cleanout (YM) YES Depression over tank (YM) NO High water alarm (YM) N/A Date of pumping 8/12/2006 Pumper McDONALDS PUMPING C. ABSORPTION FIELD DATA Date installed 10/26/2002 Soil rating .p.d ft')bdnn) 0.88 System" SHALLOW TRENCH I Length 2 O 57 ft. Width 5 ft. Gravel below pipe 1 0.5 ft. Total depth 3# 0+/ ft. Eft. absorption area 570 ft' Monitoring tube YES Depression over field NO Date of adequacy test 8/12/2006 Results (Pass/Fail) PASS For !3 bedrooms 0/ 534/ I 0/ Fluid depth In absorption field before test 3 In.0/ Water added 510 gal. New depth Qin. Elapsed Time: = min. Final fluid depth _0 _ in. Absorption rate >= 450+ g,p.d. I Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date 1000 GALLON PRE-SOAK PERFORMED ON 8/11/2006 D. LIFT STATION Date installed "Pump on" level at _kr. E. SEPARATION DISTANCES SRe In gallons Manhole/Access (Y/N) "Pump Orr le ig water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAfit station on lot 100,+ On adjacent lots 100'+ Absorption held on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Public sewer manhole/deanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 100+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '3. Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkinglveWde storage 10'+ Curtain drain NONE KNOWN Welts on adjacent lots 1003+ F. COMMENTS G. ENGINEER'S CERTIFICATION I codify that 1 have determined through field inspecdons and review of Munldpal records that the above systems are M conformance with MaA COSA guidelines in effect on thls date. r y A....... 923 :... Engineer's Printed Name JEFFREY A. GARNESS 4�. —7953, Date°pI- f/F„AMY/d COSA Fee S 1 Date of Payment g z—q Receipt Number 8571 _J (Rev. 1I=) Waiver Fee E Date of Payment Receipt Number SGS ReEM 1064622001 Client Name Gamcss Engineering Group. Ltd. Project Name/p Lt 3 BIO Dear Valley Client Sample ID 16140 Black Dear Matrix Drinking Water Sample Remarks: All Dates/Times are Alaska Standard Time PrintedDate/rime 08/21/2006 16:57 Collected Date/Time 08/11/2006 9:53 Received Date/Time 08/11/2006 11:45 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results POL Units Method Container ID Limits Date Date [nit Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 08/15/06 08/17/06 MII Waters Department Nitrate -N 1.57 0.100 Microbiology Laboratory Total Coliform 0 mg/L EPA 300.0 D (<I0) col/IOOmL SN1209222B A (<I) 08/11/06 08/11/06 DSII 08/11106 TLF Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519650 www.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-431-04 1. GENERAL INFORMATION HAAif Expiration Date: -?Ile/ Complete legal description BEAR VALLEY SUBDIVISION: LOT 3, BLOCK 3. 1 1 Location (site address or directions) 16140 BLACK BEAR DRIVE " ANCHORAGE. AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address CONNIE NELSON Dayphone 345-1695 205 E DIMOND BLVD #135 ' ANCHORAGE, AK 99515 Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well I10 Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site Public Water System ❑ Public Sewer ❑ 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 samples. (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 engineers work. r ��✓ I Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior to closing for the engineering services provided. 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. 1 further verify that based on the information obtained from the Municipality of Anchorage riles 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 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD 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, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 Disapproved. Conditional approval for bedrooms. bedrooms, with the filowing Phone 337-6179 Date L la v} f!1 t it �!''tlr. ,\%y 0F,c, r, 7r .. •�r 5:' ON-SITE Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other By: j Original Certificate Date: 1 Z '1 c Z— (R". 12101( Municipality of Anchorage ` Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 198550 Anchorage, AK 99519-66W www.ciAnchorsge.ak.us sge.ak.us (907) 9437904 HEALTH AUTHORITY APPROVAL CHECKLIST I Legal Description: BEAR VALLEY SUBDIVISION: LOT 3. BLOCK 3. Parcel ID: 020-431-04 A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Date completed 5/83 Sanitary seal (Y/N) YES Total depth 150 ft. Cased to 51 A ft. FROM WELL LOG Date of test 5/83 Static water level 31 ft. Well production 3.0+ — g -p.m - WATER SAMPLE RESULTS Coliform 0 colonies/100 ml. Arsenic: N/A mgJL. S. SEPTIGHOLDING TANK DATA Nitrate 2.64 mg./L. Well Log (Y/N) ' YES Wires properly protected (Y/N) YES i Casing height (above ground) 24+ in. AT INSPECTION 12/5/02 33 ft. 3.2+ g.p.m Other bacteria 0 colonies/100 ml. Date of sample: 12/5/02 Collected by: AKWWC. INC. Tank Type/Materiat STEEL Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping NEW Pumper C. ABSORPTION FIELD DATA Date installed 10/23-2812002 Soil rating .p.d. ft%bdrm) 0`8 Length 2 O 57 ft. se.33—SA/ Total depth 1.09-6.98 ft. Width 5 ft. Eft. absorption area 570 to Date of adequacy test NEW Date installed 10/23 , 26/2002 Cleanouts (Y/N) (Ya High water alarm (Y/N) N/A t — I I I System type SHALLOW TRENCH Gravel below pipe I 0.5 ft. I Monitoring tube YES Depression over field NO Results (Pass/Fall) — For !3 bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = in. Any rejuvenation treatment (past 12 moa (Y/N 8 type) Absorption rate >= + g.p.d. I If yes, give date — i 0. UFT STATION Data installed 'Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at in. Cycles tested Meets alarm 8 circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/1111 station on lot 100'+ Absorption Held on lot 1009+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 1 Public sewer manhole/deanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line •3'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS * V I M 1 G. ENGINEER'S CERTIFICATION I oeMly that I have determined through field inspections and T �* review of Municipal records that the above systems are in """' "' "' conformance with MOA HAA guidelines in effect on this date. ... . aY . :. Go ., ... Engineer's Printed N me JEFFREY A. GARNESS 7953.` 4 Data 1 L119 1' fe�eFPr-•---d�c �A ��- I/Fees J 375 150 '� a Date of Payment 12—I g— Qg- 1 Receipt Number 022 3 (Rev. 12M) '1 _a)Jer Fee $ % o Date of Payment �� �I& OX O Receipt Number � [ r /. 3 12-10-02 15:30 FR%KT&E ENVIRONKNTAL SRV AAL.CUE Environmental Services Inc. r"" .........r�� CT&E Ref.N 1028273001 Client Name AK Water & Wastewater Consultants Inc. Project NamelN Bear Valley l3, B3 Client Sample ID Bear Valley I3, B3 blatria Drinking Water PWSID 0 Sample Remarks: i 9075615301 T-089 P.02/03 IF -819 All Dates/Tim" are Alaska Standard Time Printed DateMme 12/09/2002 16:43 collected Datemme 12/05/2002 17:00 Received DateMme 12/06/2002 11:10 Technical Director , Stepherpt%file Released By Allowable Prep I Analysis P��Q Results PQL Units Method Limits Date DMC Init Waters Department Nitrate -N Microbiology Laboratory Total Coliform 2.64 0.200 mg1L EPA 300.0 0 col/I00m1. SM189222E (<-10) (<=1) 12/06/02 JS 12/06/02 KAP 12-10-02 15:31 Ade L. FROM -CUE ENVIRONIENTAL SRV 9075515301 T-089 P.03/03 I F-819 ME Environmental Services Inc. Laboratory Division cv�dv,Yersre•;.7.rr�,,ny�,,.,a...�„ Drinking Water Analysis Reportfor Total Coliform Bacteria READ INSTRUCTIONS ON REVERSESIDE REFMW COLLECTINO SAMPLE D PUBLIC WATER SYSTEM I.D. N O PRIVATE WATER SYSTEM e Send Rernhs O Sent lnroke AK wly11-1 3 37-Hf'79 33fs 3a'y� t�/CJl . L�dnr� ia:�p tab .�YRL Q Send Reratrr 13 Seadlnwlre aaw.n.. m.0 ue SAMPLE DATE: 7PLE TYPE: Routine D Repeat Sample (for routine sample with lab ref. no. ) CI Special Purpose SAMPLE LOCATION . R,, r lily 13 8 3 Comments: 1731 F 01 OT�l Day Year O •Treated Water tr Untreated Water Time Collected Collected By 00, rnr Pkw hur 200 W. Potter Drive Anchorage, AK 99618.1606 Tel:(9071662.29d3 Analysis shows this. Water SAMPLE to be: 'r``/S' Satisfactory O Unsatisfactory O Sample over 30 hours old, results may be unreliable 13 Sample too long in transit; I ple should not be uver31tfl11ours old at examination to indicnia reliable results. Please send new sangrle via special delivery mail. Date Rerelved -12- G- TimeReceived 1110 AnalyslsBegan - W1 C) Analytical Mithod:Memb I ne Filter fMMO-MUD • hbrmhern(eolonies/IOOml. 1 r3 r— Result* Analyst 1 V/I .+•.. ,. ,..-�._. .__:h Fbks Jun ❑ Faced Date: Time: Client notified of unsatisfactory results: Phoned Spukewilh Fazed Date: T)me: BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-h1UG Result: Total Coliform E Coli Membrane Filter. Direct Count Coloole2Aoom1 Verification: LTB BCH COLIFIRM Fecal Collform Confirmation Final Membrane Filter Results Cullform/100 ml Reported By Date -LAL7U'- Time -7,L1_ hrs Tnrc-TNNM..mrf re C.. os -ow.a. VEMI .a Member of the SGS Group ISoei6td G6ndraie ae Surveillance) ENVIRONMENTAL FACILITIES IN ALASKA, CAUFORNO, FLORID& ILLINOIS, MARYLAND. MICHIGAN, MISSOURI. NEW JERSEY. OHIO. WM vmrlmla 12-18-202 8+25AM FROM MARY TUTTEROW 9072617551 N 1 1 1 w r 40. 1 0 Y w 1 G N J O y, l ' • 1 o `ti' I ! i 1 • P. 2 MUNICIPALITY OF ANCHORAGE t — DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street. Anchorage, Alaska 99501 Telephone 264.4720 REPORT ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION NAME FHUN ?VRAMil)EXE A0AT1NG— M NEW OUPGRADE MAILIN ADDRESS 10.9 W h fW11A z;n A7 oy•f 5cae o3 LEGAL DESCRIPTION I 6-f3 3(-OCK 3 NEARV LOCATION �q / b;4C�tl; /� NO. OF BEDROOMS Well / Absorption Dwelling wO i �j! PEH DISTANCE TO: 0 D Mater No, of compartygnt3 WY < Manufacturer veep Q-0 L 01— Liq. capacity in gallons IF HOMEMADE: I^side leng[h A, ,✓ Width A�//f Liquid depth /V 6Y DISTANCE T0: Wall Dwelling PERMIT NO. i —10 2=F Manufacturer tv JrT Material Liquid capacity in gallons p W= DISTANCE TO: Well // / Foundation 93 / 7 Nearest lot line i PER O [-f) V � 03,s � M = f = W No. of lines Z Le 14 a ch j t,;/ ' Total len ngs Trench wi inches Distance betvuee in s Fes- Top of tile to finish grade op MaIei 1 beVpath the f / Total effecti b orption ea ✓ inches Length Width Depth PERMIT NO. W C F Type of crib Crib diameter Crib depth Total effective absorption area o. S W W m Well Building foundatiorf vr Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) � OTHER I � PIPE MATERIALS It 4 �i��i73 H 32� SOIL TEST RATINv�G e 65'1 'o( F Z SE t t="3= re A 50 zN INS ALLER yramx 0.*T1Ne, R s t REM KS /.o' ll fo o actoleel 15 fe a �fe✓ er L -he 5-�- _ I I NN Ar co i •b 1,, - I x.00 A OVED DATE LEGAL //I C. r '4-dl3 (Rev. 3178) L n MUNICIPALITY OF ANCHORAGE n � ' DEPARTMENT OF �' HEALTH & ENVIRONMENTAL PROTECTION III ENVIRONMENTAL ENGINEERING DIVISION \\ 825 L Street -Anchorage, Alaska 99501 Telephone 2644720 \ ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NA E>c� �/� LiA (bMAI PHONE $�jr �2 NEW []UPGRADE LINti ADDRESS D W. 2 ER 10/JA 2 o LEGAL DESCRIPTION Zo f" 3 LOG 3 ,/ ! n lle C r VR - u �f"( on LOCATIO 6�� / NO. Of BEDROOMS 041 DISTANCE TO: Well #01 01 Absorption area;r O, Dwelling 40i PEH T O Ole E < ManWacturer1 Material / No. of compartments wF CT rip Q Liq. capacity in gallons IF HOMEMADE: Inside length ,t /,4 V / Width A/A Liquid depth 1V . / b Y DISTANCE TO: Well w.11ing PERMIT NO. I J LIZ = Z YQ- Liquid capacity in gallons Manufacturer Material D m= DISTANCE TO: Well ��43 Foundation i Nearest lot line i 35 PERMI 1w Z No. of lines Len o .ach li7e Total lengt o inns Trench ih Distance between lines F ? w ( inches A H Top rile to finish Mater' I bpeath lite Total ¢ of grade i7 effective absorption area p —v inches I Length Width Depth PERMIT NO. W i ~ W a Type of crib Crib diameter Crib depth Total effective absorption area I DISTANCE TO: Well Building foundatto Nearest lot line J Class Depth DrillerDistance to lot line PERMIT NO. J � W DISTANCE TO: Building foundation Sewer line Septic tank Absorption areas) I OTHER y PIP MATERIALS fry F OA/MD303 M 3Z SOIL TEST RATING 5-6 T' 21 r3 INSTALLER EwZCAVATICT fl A REMA KS 9. 6'14 $ L� !+ u� ~yF I s: X W L SIVAN N J AUSCALE I APPROVED DATE LEGAL s/b s� 5 :.0 e.rs Inc. '17413 (Rev. 3/78) r� & ENGINEERS, INC. S 7W7 7125 OLD SEWARD HIGHWAY • ANCHORAGE, ALASKA 99502 November 7, 1983 Municipality of Anchorage Attn: Mr. Cory Willis MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection rE.* . GF r.-i:r:t t P'; ENVIRO�'.t:NTAL PdJTE..TION Pouch 6-650 Anchorage, AK 99502 NOV U Re: Revisions to Septic System Inspections do Perc Tests R E C E I V L. D Gentlemen: 1. LeVar Subdivision, Lot 7: Your letter, of November 1, 1983, refers to our inspection report which states that the septic system was installed to a depth of 11.0', while the permit was for a 10.0' deep Installation. The system was installed level on a 2-3% natural slope, which has resulted in the system being Installed slightly deeper than allowed at the southern end. No groundwater is present at this site which is located on an Isolated hili of glacial origins. The hill Is composed of free -draining sandy gravel and Is used in part as a gravel pit. We feel that this is a minor discrepency and ask that this system be approved since only a small part of the system Is affected and since soil conditions are favorable. 2. Bear Valley Subdivision, Lot 3, Block 3: Your letter of November 1, 1983 refers to our Inspection report which shows that the system was installed one foot too deep. Surface grading was done at this site between the time of the percolation test and the final inspection. The' gradingPCW CW resulted in the addition of approximately one foot of fill being placed at the location S of the system. This information was inadvertantly left off of the inspection report. it A revised report is attached. 3. Huffman I11 Subdivision, Lot 2, Block 3 The percolation test and Inspection report were originally submitted with the wrong subdivision name (Huffman Hills). Revised reports are attached. i WASILLA ANCHORAGE SOLDOTNA (907) 3763770 (907) 349.6561 (907) 2629534 Z Ste- S10-7 r-� r Nom• pp -� S _ 94 I 0 SEPTIC- vrz"'r5 n � - ti PLOT PLAN: �3. AS -BUILT: x GRID: �9 DRAWN BY: Pt:, CHECKED BY: S & S ENGINEERS, 1pc 1 1 s� o ro Z ,Pqt�� > 6� L JOB NO.: ZONED; 1 SCALE: I%-=-jp' PLOT PLAN: AS -BUILT: x GRID: DRAWN BY: Pt:, CHECKED BY: S & S ENGINEERS, I N ( V 7125 OLD SEWARD H. ANCHORAGE. ALASKAW69502 I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY, LOT 2 , BLK. 5. r AEA,14L vAt.L� 51jBpANCHORAGE RECORDING DISTRICT, AK., AND THAT THE IMPROVEMENTS SITUAT 0 THEREON ARE WITHIN THE PROPERTY LINES AND 00 NOT ENCROACH ON THE PROPERTY LYING ADJACENT THERETO. THAT NO IMPROVEMENTS ON 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 THIS 17 DAY OFJIJAJE , 1983. ANCHORAGE. ALASKA. IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISH GRADE AND UTILITY CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. Ar S* 49n7 0• I • '� �• •JOHN L. 51vANSON f� ^ ••. LS - 3152 oe;e4'4`���Y`Mbow i IIUt4I C I F`1 L_ I TY ID F= nt4C::" HCGFEE ` DEPARTMENT 01 HEALTH AND ENVIRONMENTAL h.,JTECTION 825 'L' STREET, ANCHORAGE, AY,. 99501 264-4720 W ELL hit-JIJ Ot+I-SITE SE44EFR PERM I T PERMIT NO. ( 810350 ) APPLICANT HORIZON HOMES 2402 MCRAE 243-6636 LOCATION LEGAL LOT 3 BLP: 3 BEAR, VALLEY SUB LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSO FT/SR)= 217! i THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: j DEPTH= :D L.Et•IGTH= 32 GF[t� •EL DEPTH= 4 t THE LENGTH DIPIENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEE14 THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). REt�t_i I FEC• SEPTIC TA1VF. S I �E= 1J�� GF=1LLQt-4S i PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE _. ..—tea ��rw�� rrurr rf1L WGLL WILL 7CKVt. --- TW4 C 2 I t1SPECT I DAIS 1=1F2E FzLEGaU I PED• --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE I -JELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER, LIFJE IS 25 FEET AND TO A COMMUNITY SEWER LIFJE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE 4JELL COMPLETION. I OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PEF�M I T E}sP I RES E>ECEME3EFs 31r 15 c I CERTIFY THAT 1: I AJ1 FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. i 2: I WILL INSTALL THE SYSTEM IPJ ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED:------ -------------------------------- APPLI JT HORIZON HOMES ISSUED 6 -- - -- —---DATE_—£�S�?_ V4.0 A a MtjrJ x I FaL_ I ry +Trlp AP+.. HL�Rt�C`aE ` ' DEPARTMENT OF HEALTH AND ENVIRONPtENTAL PROTECTION 825 -L' STREET. ANCHORAM AK. 99501 264-4720 WEL_l_ t=vNL-.v t7N--SITE SEWER P•EiM I.r PERMIT NO. t 530350 ) APPLrcnNT HORIZON HOMES LOCATION 2402 MCRAE 243-5636' LEGAL LOT 3 BU: 3 -PEAR VALLEY SUB LOT SIZE 999999 SOVARE PES' TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH tlf1XIMUM t1UMeER OF BEDROOMS 3 SOIL RATING CSO FT/SR)t 217 THE REQUIRED SIZE QF THE SOIL ABSORPTION •SYSTEH IS: OEs✓TH� a3 L_Et•Jt3TN= 32 uFtfi'��EL 4'+JrFTH= 4 THE LENGTH DIMENSION IS THE LENGTH LIN FEET) OF THE TRENCH OR DRAINFIELD.,� THE osam OF A TRENCH OR PIT IS THE DISTANCE 6ETWCEN THE SURFA#X OF THE GROUND ANO THE BOTTOM OF THE EXCAVATION SIN FCET). THERE iS NO SET WIDTH FOR TRENCHES. THC GRAVEL DEPTH IS THE MINIWUM DEPTH OF GRAVEL SEnICEN THE OUTFALL PIPE; Ano THE BOTTOM OF THE EXCAVATION CIN FEET). ir,E►-rl.J'L'[fEi?IZt .L%a 0r CtFi[.-t_+3AJ''4 PERMIT APPLICANT HAS THE RESPON•SI8[LITY TO INFORM THIS DEPARTNeq DURING THEA INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE • .....rwuw..�.i rwrr rfh ►vCL1.. !•u Ll �tKYt„ � ' INS1=bE1=710t4tE; l-ilcE t-t•EWUIZREC)' --: BnCI:FILLING OF ANY :-a'r'STEP1 WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT [JILL BE SU3JECT TO PROSECUTION. minimim DISTANCE BETWEEN Ft WELL AND ANY ON-SITE SEWA�3E DISPOSAL SYSTEM 15 100 FEET FOR A PRIVATE HELL OR 150 TO 203 FEET FROM A PURI.[. WELL OEPENDIPIG .UPOt. THE TYPE OF PUBLIC HELL I ' 't-1INIMUM DISTANCE FRO14 A PRIVATE WELL TO A PRIVATE SE14ER LINE i5 25 FEET AND -TO A COI-11-JUNITY SEWER LINE tS 7S FEET. Lt£LL l.0135 ARE REQUIRED ANO MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DA'r5.1 at; THE WELL COMPLETION. I ;+ .-OTHER REQUIREMENTS MAY APPLY. SPECIFICATIOt15 AND CONSTRUr3TION DIAGRAMS ARE AVAILABLE TO INSURE PROPER. INSTALLATION. - pERt•7 I r E:-�P I>Z>=� (?ECEt•1�EF2 31� ��r3.s ' I CERTIFY THAT 3.: t A11 FAMILIAR WITH THE RO3UIREMEIITS FOR ON-SITE SE14ERS AND WELLS AS SET FORTH BY THE'NUNICIPALITY OF ANCHORAfM 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH T14& CODE5. 3: I UNDERSTAND THAT T14E ON-SItE SEWER SYSTEI4 MAY REQUIRE ENLARaErtENT tF rHc �.= RESIDENCE IS REMODELED TO INCLuce 1U)RE THAN 3 BEDROOPIS I j PL t�`17 HORIZON HOMES kV v ISSUED 8 ----_-DATE_ i . •:_ V4. F • i i i RETURN -TO: DivisionofGeological and Ge^sical Surveys (DGGS) 3001 Porcupine Driv59501Telep'•-•.e: 2176615) '•trchorage, es a•, W A T ( R W E L L AEC O R O Drilling Company Name TT rn 1 FT T)rl 11 l 11 4; Z, mit 'O C.,.� i n e... eomolete either la. Ib. or Ic. n U.S.G.S. Local No. Drilling Permit No. A.D.L. No. STATE OF ALASKA DEPARTMENT OF. NATURAL RESOURCES le Borough �__- Anch Subd lv Ilion Lot 3 Block 3 Ib. Fraction / / / Section No. I Township I N/S Range E/W Meridiani It. Distance and Direction from Road Intersections Bear Valley Street Address and Area of Well Location J. OWNER OF WELL: i Horizon Homes Addfess; Peel McGinnis 1 Z. WELL LOG Feet Beld Surface Material Type Top Bottum A. WELL DEPTH: (completed) �/� 150 /t• Surface El evetioTci i of 1 n ;rave y tiii 0 1 25 S. ❑Cable tool )M Rotary ❑Driven E] Dug ❑Auger ❑Jetted ❑Bored' ❑Other: ;rave.Ly YJ oU Qers 25 42 jouruck gray brn 6. USE:xQDomestic :t ;Public Supply [3IndustrY ❑Irrigation ❑Recharge i ❑connarcial Well C] Other: ray ae yr rrni e c re s seePag0[]Test 7. CASING: C] Threaded Welded 6 In. to 5 1 1 4-!' Depth Weight lbs/ft. 1 In. to ft. Depth I 9p� B. FINISH OF WELL: Type: Diameter• Slot/Mash Size: Length:' Set between ft. and ft. Flttings: N F ANCHOR A�, 9• STATIC WATER LEVEL: ft. ❑Above ❑Below land surface Type of Measurement: EPT. OF `.l.L,ri ENVIRON.-M-Ni'tL s •, 10. PUMPING LEVEL below land surface /t. after Mrs. pumping g.p.A. ft. alter Mrs. pumping 9 -P.M. 11. WELL HERO COMPLETION: ❑ In Approved Pit fl:Pltless Adapter Inches above grade 12. GROUTING: Well Grouted: ❑ Yes I ❑No Material: ❑ Meat Cement ❑ Other: 13. PUMP: (If available) MP Length of Drop Pipe ft. Capacity 9•P• I Type: ❑ Submersible ❑Reciprocating ❑ Jet ❑ Other:' IA. REMARKS: Water Temperature- em erature-IS. IS.WATER WELL CONTRACTOR'S CERTIFICATION: This well mas drilled under my Jurisdiction and this reoort Is true to the best Of MY knowledge and belle!: laska 11ow-17ell-Vern's Diilling & Ent AA3320 Registered Contract N..., Adore,,: SRA Box 1560 Anch. Alaska 99507 Signed: Date: Authorized Representative Form 02-WWR Copy Distribution: WHITE - State DGGS• PINK - Driller, CANARY - Customer i PERFORMEDI LEGAL DESCI P: h 2 3 4- 5-, 6 I' 7 7 8 9 W SOILS LOG MUNICIPALITY OF ANCHORAGE PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Stmt, Anchon98, AINks 89501 26"720 SOILS LOG - PERCOLATION TEST y: l--c.t Ft,c>:7r S SITE 72.008 (6/79) MUNICIPALITY OF ANCHORAGE Department of Health & Human Services e . 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. It 07. o `{ 3 / — O�— HAA # /�� 9 O O i 7/ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3; Bt'.ock 3; Bean Vattey Subdivi6ion Location (address or directions) 16140•Black Beaa D4ive, Anchorage (b) Property owner Robe�ct Dryden Telephone: (home) 561-0338 gusin Iss 349-6653 Mailing Address P•O.Box 111043 Anchorage, Afa6ka 99511 (c) Lending Institution- Telephone Mailing Address (d) Real Estate Company and Agent Address ` Telephone (e) Mail the HAA to the following address: (or check hereXX-If hold for pick up.) List contact person and day phone number below: ! S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 ' 2. TYPE OF RESIDENCE Single -Family ax Number of bedrooms 3 3. WATER SUPPLY Individual Well $k. _Community 0.-, . Public ❑ 1 Note: If community,wellysystem, -must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status 4 SEWAGE DISPOSAL ' On-site la - Public ❑ i . Community ❑ r Holding Tank ❑ .r Note: If community: well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status ',R. -' .. 72MS(R«. T/ 881 _ Page 1 of 2 Z 10 Z 06ed 1318 maid'MMI SMEL *Tom saaau!6ua leuo!ssalad eyl ul suo!ss!wojosjojiajol alq!suodsai lou si a6eio4ouVloApled!o!unjq ayl,panssl s! aleolpliaoe ajolagelep azAleuejo suo!loadsul lonpuoo lou OP SHHO 10 SO Aoldw3 •sluawai!nbai alels pue lejapal u!eljao Alslles of iapio u! suopnl!jsul 6u!pual i!ayl pue sawoy to siaseyand of Asalinoo a se s!yl scop SHHO ay1 •e�ISeIV to alelS ayl u1 paialsl6al jaau!6ua leuo!ssalwd luapuadapu! ue Aq anoge g gdei6eied u1 u9n16 suolleluasajdaj ayl uodn Aluo paseq paleollpao IenwddV AluoylnV ylleaH sanss! (SHHO) saolmos uewnH pue ylleaH to luawlieda0 96ejoyouV to AI!led!o!unjq ay1 iI IenaddV leuo!j!puo0lo swia1 IEUOII!puo'J panoaddes!p �.,� panwddV eje0 Aq swoojpaq JOl panaddV ao G IVAOHddV SHHO '9 I . LL566 oIs-IV '—IG -1--0 . .#.0 - :.... bOVON peon d061 JDAIa e16e3 bEOLI . ssa� ,. ,.. ..:-: , :;_ ... .... .... ... PPV.... ' euoydalal uind to OWUN I , uo!loodsul s!yl to alep oyl uo loalle ul sumpIn6ai pue 'saoueulpio 'sapoo aletS - pue led!o!unyq Ile yl!m eoue!Idwoo u.1 Si walsAs Iesods!p jalemalsLm io/pue Alddns,jait M, qps-uo eyl'uolloadsu! PUL UO!le6!is9nul Aw way pue saIg e6ejoyouV to AUledlo!unyq eyl wOJI poulelgo uo!IBWJojuI ayl Uo peseq .leyl A!!IaA JaylJnl I •u!aiay palso!pul einjonjis to adAj pue swoojpaq to jagwnu eyl jol elsnbape pue Ieuo!lounl ,'eps SI walSAs I sokp.JaleMa33Lm Jo/pue � iddns JaleM ails-uo atyj. Ieyl.sMogs`jEAOJddV AlUoyjn,/ yllea!-I sly)IOUOIIs61ISaAUTAWIeylAjuaAl'MolaquMOySajePUOIIUPIlenayljOSEPUeolaJayPDXljleleasAWAgpallluaosy ' NOIIVWHOdNI ONV V1V0'HOU'V3S 3IId'S1S31'SNO1103dSNl JNIOIAOHd WHid ONIH33NION3'9 ' aPJE \S`ONIUNICIPALITY OF ANCHORAGE (MOA) OF • Health Authority Approval (HAA) CHECKLIST 3FEBRUARY 1984 43.4744 �c ref A. WELL DATA R Well Classification 6; N rP FA'i 114 If A. B, C, D.E.C. Approved ( I Y/N) Well Log Present (Y/N) —t— Date Completed 5 - 3 Yield Total Depth lSOCased to -� Depth of Grouting =.2 Static Water Level 3 Pump Set Aty I I Casing Height Above Ground ) f Sanitary Seal on Casing (Y/N) u I Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot Ito, ; On Adjoining Lots / 00 � I . To Nearest Edge of Absorption Field on Lot it 3 ; On Adjoining Lots / 00 t To Nearest Public Sewer Line N(— To Nearest Public Sewer Cleanout/Manhole I M A To Nearest Sewer Service Line on Lot 26'-1 Water 5' - Water Sample Collected by 4%`j �S e n 1 r a e -e f i �1a ; Date r, - Water Sample Test Results S A 1 r <e& c fo ru - 6 R c tc r;A *A A :f'P s Comments B. SEPTIC/HOLDING TANK DATA Date Installed S- Ib - Q3 Size 1600181 No. of Compartments Z I Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanout (Y/N) —.Il - Depression over Tank (Y/N) I` l Date Last Pumped I Pumping/Maintenance Contact on File (Y/N) &) AA —;for— rJ 1/1 Holding Tank High -Water Alarm (Y/N) _AIM Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: Tc Water -Supply Well Ito r To Building Foundation 4 l it To Property Line To Disposal Field To Water Main/Service Line % -f To Stream; Pond, Lake or Major Drainage Course (' DO Comments Sdp& PyMpej 6N at NoMe Ser -Vise -S I 72-M (R". WN)F m Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 2 f �/_ r? Type of System Design j /' e or Date Installed5 - f b — 6 _+ Length of Field (e Width of Field 3 (� " Depth of Field 9 r .r Gravel Bed Thickness 0 Square Feet of Absortion Area _ (.0 01 D Statndpipes Present (Y/N) u Depression over Field (Y/N) 80 Date of Last Adequacy Test (o — Z — y O Results of Last Adequacy Test _'Sntsfiictra — 3 AeC(rooM SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well % 13� To Property Line 35 To Building Foundation 14 To Existing or Abandoned System on Lot JA ; On Adjoining Lots l oD �t To Water Main/Service Line h rs To Cutback (if present) �1[ To Stream, Pond, Lake, or Major Drainage Course / oo r4 To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size In Gallons "Pump On" Levet at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent(Y/N) I certify that I have checked, verified, or conformed to all MOA and HAA Inspection. 5 & S ENGINEERING Signed oop Road No '104 yerCompany Eapla3ver Alaska99577 Date 7 57- t MOA No. — `O --CO3 Receipt No. "?A Date of Payment Amount: $ 77-0261Re.. 7/861 Bxk Receipt No. _ Waiver Fee: $ Date of Payment Page 2 of 2 Pumping Cycles during Adequacy Test. ''Dobe, A. Shv&,,• No. 1437.E of this U d ao.n*o.*i CHEMICAL & GEOLOGICAL LABORATORIES OFALASKA, INC.Z AN 5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343 FEDERAL TAX I.D. 1192-0040440 ANALYSIS REPORT BY SWLE for York Order 1 25054 Date Report Printed: JUL 2 90 9 11:46 Client Sample ID:L3 B3 BEAR VALLEY SiD PVSID :UA Collected JUN 26 90 9 15:30 hrs. Received JUN 27 90 9 16:35 hrs. Preserved with :AS REOUIRED Analysis Completed :JUN 29 90 Laboratory Supervisor :STEPHEN C. EDE Released By : V�G 0 ---- Special Instruct: Chemlab Ref 1: 902115 Lab Sapl ID: 1 Matrix: WATER Parameter Tested NITRATE -N Sample ROUTINE SAMPLE. Remarks: SAMPLE COLLECTED BY RDJ. Cl lent Name : S L S ENGINEERING i Client Acct : SNSENGP P.0.1 NONE RECEIVED Reg 1 Ordered By : R. SHAPER Send Reports to: DS 6 S ENGINEERING 2> Result Units Method 2.4 mg/I EPA 353.2 W� 1 Tests Performed�Y See Special Instructions Above UA --Unavailable ND= None Detected xx See Sample Remarks Above NA= Not Analyzed LT=Less Than, Gr --Greater Than Allowable Limits 10 CHEMICAL & GEOLOGICAL LABORATORIES OF #LASKA, INC. teal TELEPHONE (907) 882-2343 5833 8 Street Anchorage, Alaska $9518 Drinking ter Analysis Report for Total Coliform Bacteria TO BE COMPLETEAY WATER SUPPLIER TO BE COMPLETED BY LABORATORY ❑ PUBLIC WATER SYSTEM I.D./ Ana)ysis shows this Water SAMPLE to be: PRIVATE WATER SYSTEM ��j/ Satisfactory Name Phone No. ❑ Unsatisfactory S t 5 ENGINEERINQ ❑ Sam ple too long In transit; sample should Malting Address No. 201 not be over 30 hours old at examination Eagle Biwa Auskam to Indicate reliable results. Please send new sample via special delivery mail. City State Zip Code l Date Received SAMPLE DATE: Mo. Day Year Time Received Ila 3S SAMPLE TYPE: Analytical Method: Membrane Filter X Routine ❑ Check Sample (for routine sample with lab ret. no. I ❑ Treated Water No. of colonles/100 ml. ❑ Special Purpose ❑ Untreated Water SAMPLE Time collected Lab Ret. No. "vault • Analyst NO. LOCATION Collected Bg 1 4•t�i6i,f!�tgi-art/al�. � � I J'�'3o _L�L�a\�.— 90s115 � ' 2 I I _ m, 3 L I L-! m' 4 L -X, BACTERIOLOGICAL WATER ANALYSIS RECORD i)G i 4 —a -g —`�a READ INSTRUCTIONS Membrane Reser: Direct Count O Cotiformnoo ml BEFORE r Vaditcatten: LTO Bce COLLECTING SAMPLE • Finial Membrane Flitw fteeulM Collformnoo mt - . - . Regaled By Date l+ ?r7^n') Time: I �G a.m. l p.m. rn><r am of Two MMAIN)M TNTC = Too Numberous To Count OB = Other Bacteria APPLIC" AT FILLS OUT UPPER HAL^ONLY Time Property 0`�r . NU e r ZUA1 �tLr ryP$ Date t;Z (-�Ci✓ta•� )Phone Mailing Address 9_ Z- . Date A tr Zip Code C� �c; f; 7 ZU 3 Buyer Inspector Ins for Address MUNICIPALITY OF ANCHORAGE CEPT, CF H-t.LTII T. ENVIRO-\LtCNTAL PRJTECIION OCT 7 IJ03 % Zip Code Lending Institution7 Pit S� SA) F�S1;1Je (3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL Phone ( ) CONDITIONAL APPROVAL' DATE � BY: h a Address rP V+ Zip Code Well To Absorption Area Realty Co. d Agent Septic Tank Size Phone Address Zip Code Legal Description L� 3_ �!K '$�, r -t Vil Ire/ 1, J. v.;.0X') Street Location Type of Residence ' Single Family O Multiple Family No. of Bedroom_ ❑ Other Water Supply Individual ATTACH WELL LOG. A well lop Is required for all wells drifted since June 1975. Community For wells drilled prior to that date, give well depth (attach fog if available). ❑ Public Utility Sewer Disposal R Individual , Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 6'T Time Time Time Time Date Date Date Date Inspector Inspector Inspector Ins for Field Notes: !' .� - -•( MUNICIPALITY OF ANCHORAGE CEPT, CF H-t.LTII T. ENVIRO-\LtCNTAL PRJTECIION OCT 7 IJ03 ' RECEIVED. (3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE BY: h Solis Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank uca UMI TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY • I Analysis shows this Water SAMPLE to be: WATER SYSTEM: LD.NO. / I Satisfactory 7-d-II 4.4ir7 S ❑ Unsatisfactory C1Sample too long in transit: sample should Water System Name Phone No. not be over 48 hours old at examination ,y:_to,indicate.reliable•results:••Pleasti send --' - Mailing Addrea 1 _ �i- .: r' . ,i,.,,, l-�..%-'r..:...,i._«..... _. {...�-.:._. -_'}�......[ new sample. i . _.... _ City . ....... ... . -. - 9teM - ., Zip Code, .... © F/TZ, Date Received SAMPLE DATE: Mo. Day ,, rev it<: .Time Re calved SAMPLE TYPE: Analytical Method: IdRoutine . ' K '" ❑ ermentatlon Tube ❑ Check Sample (for routine sample with lab rot. no. t [ITreated Water`Membrane Filter [I Special Purpose ❑Untreated Water,: I ` SAMPLE NO. LOCATION � 'Time'.-CoaDcted ,� ' Collected 9y Lab Ret No. R, t* Analyst I z wu-- 3 , 1 l � f €' g. - ,1 « � r 1 t ' ' • ♦No ,N cdo.`p/ 100 m a No i 1 eou1M penene .. 7. . I '- • - oeaEto ref - 6ACTERN)LOOICAL WATER ANALYSIS RECORD • ' ^ Rev. 197e 1 note Collected Sour" READ INSTRUCTIONS BEFORE COLLECTING SAMPLE EMs Drove 2411OYrr, Broth 4e noun, MWtlple Tube Reportt N 10ml Tub" POeitlre/TOtal I*Ml POrtlorle Marne"" Fater. Direct Count coliform/100"'1 Verification, LTD enD Final Membrane Fa ler,Cdlform/10On1 Reported Data p.m. Y October 19, 1933 11orizon ilomes 2402 McRae Road Anchorage, AY. 99503 Subject: Lot 3, Block 3, Bear Valley Subdivision I 1 /Q'1 1QQ 'cs 1 • �5.� nils c�2 6r� r1 Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: ° The depression or pit around the well casing needs to be 611 filled with impervious type soil so that it slopes away from the well casing. 0 /L° The standpipe to the sewer system need caps on then. ° The engineer's as-builts, which have been submitted to this office, are not within the parameters of the on-site installation pernit issued by this di:partrlent. The discrepancies will need to be corrected before this deparXment can accept the submitted engineer as-builts. (J 'Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Jin Roberts Associate Environmental Specialist JR53/cj/E2