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Home My WebLink AboutGREENBROOK BLK 2 LT 8C...:, a P, r, & . I WL kf raPIN WA&h& w 0 10 --)-oar- s a Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161078 PID Number: 017-023-58 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: Dominique Van Nostrand ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Shallow Trench ® Bed ❑ Mound ❑ Other Address 12800 Von Scheben Drive, Anch., AK 99516 Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot GREENBROOK 2 8 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of LinesDistance __ between lines -- Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area Ftp Number of trenchesDist. __ between trenches __ Ft. Well 200+ -- 200'+ NA NA TANK ® Septic ® S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1 1500 Gal. Surface Water 100'+ -- 100'+ NA Material Steel Number of compartments 2 Lot Line 5'+ -- 51+ NA NA Foundation 5'+ -- 5'+ NA LIFT STATION Manufacturer Anchorage Tank Capacity 1500 Gal. Curtain Drain NA "50'+ NA NA Remarks "None known. Existing S.T. & L.S. Pump on level at 44 in. Pump off level at 42 in. High water alarm at 48 in. decommissioned per code. Pump make and model Franklin 2445040117 — 1/2HP Electrical Inspections performed by Installer A+ PIPEMATERIAL Housetotank3034 Tank to3034 drainfeld Drainfield 3034 COIMT 3034 Inspector ARCTERRA BENCHMARK (Assumed elevation) 100 It Inspeection ction 1" 4/26/16 2"° 5/6/16 Location and description 3r° a" Bottom of siding COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date Engin OF ALS or 4g r1)> Approved Date "r [CENIvE'PH M D - U tr / 711 RDFF15S101� ./ sees Stam Inspection Report_9-1-12.doc AS -BUILT SYSTEM DETAILS/SITE PLAN GREENBROOK BLOCK 2, LOT 8 S850 58' 22"W 329.60' NEW 1500 -GAL STEP TANK A -C=13.0' s B -C=28.0' A -D=21.0' u o B -D=33.5' 0 rc 9 1500 G w STEP e TANK i�:q,. OF. A j,4' I * 9TH *# o . KENNEii1-- g 00`CaE .4�% .6`iG .AWr. '•w'Kgglo'a AV i PREPARED FOR: EXIST. BED Permit OSP161078 PID# 017-023-58 cn FINAL GRADE EXISTING BED DOMINIQUE VAN NOSTRAND 12800 VON SCHEBEN DRIVE ANCHORAGE, AK 99516 FIELD BOOKS BOUNDARY. 80UNC SIMM STAKR ASBDILT RJ DMC. FlLE: ACA° "LF' FILE COUPUIED: DRANK: BMW CHECKED: KMD DAZE 05/06/ GRID' 2839 "Na: 16140 z f SCALE: V=30' T SCALE: NTS ew: On -Site Water and/or Wastewater System Permit Permit Number: OSP161078 Tax Code Number: 01702358000 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Work Type: SepticTank Upgrade Permit Effective Dates: April 25, 2016 to April 25, 2017 t 2 6 — f Desfgn Engineer: ARC TERRA CONSULTING INC Subdivision: GREENBROOK Site Legal Address: GREENBROOK BLK 2 LT 8 G:2839 Owner/Address: VAN NOSTRAND DOMINIQUE L & RUTH K 12800 VON SCHEBEN DR ANCHORAGE AK 995163206 Site Mailing Address: 12800 VON SCHEBEN DR, Anchorage Lot Size in Sq Ft: 51522 Total Bedrooms: 4 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 UNICIPALIW OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 00 — 423 — S$ Propertyowner(s)_ Z)vm7n;;We j14, //us4wi d Dayphone 351— 7032 Mailing address 17- -?,90 VDw 9,,k o D-. AK 91 S/(® Site address If If I, ,. Legal description (Sub'd., Block & Lot) A0-oug_ 32LS Legal description (Township, Range & Section) Lot Size 5/ 5 z Z Sq. Ft. APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank Single Family (SF) ❑ Holding Tank /❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms _/ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) ❑ Upgrade ❑ (w/wo ADU) Duplex (D) El❑ Renewal Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Permit/Rush Fees: d!. _ Waiver Fees: Date of Payment: T* It6? Date'of Payment - Receipt Receipt Number: 0 ? 3 Receipt Number: Permit No. Permit App_9-1-12.doc Waiver No. April 22, 2016 CONSULTING, INC 212E. 51" Ave, Anchorage, AK. 99503 Office (907) 868-3791, Fax (907) 868-3793 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RUS01, APR 252016 Subject: Emergency Septic Tank Upgrade Permit — Greenbrook B2, L8 The owner has requested we proceed forward to obtain a septic permit to upgrade the failed septic tank and lift station on the subject lot. The existing lift station is cracking and the manhole lid and flanges are totally corroded, nonfunctioning and not secure causing a severe safety issue. We propose to decommission the existing 1981 1250 -gallon septic tank and 1993 500 -gallon lift station and install one 1500 -gallon STEP tank to serve the existing 4 -bedroom house. For your information, attached is a copy of the MOA On -Site Inspection Report drawing of the existing system. The adjacent lots are served by public water. There is no surface water within 100' of the proposed tank. We do not expect there to be any adverse effect on adjacent lots by the development of this tank. If you have any questions, please contact me at 868-3791 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Bre . Western Owner's Representative Attachments: On -Site Sewer Application MOA On -Site Inspection Report Drawing - Copy 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 Permit No. Page Z of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 * Telephone: 343-4744 On -Site Wastewater DIsposal System and/or Well Inspection Report Description; dock Z, Lof $ 6ree.,brool. s/n PID No.: MINKINUMINE 571 k14vltr (FLAA1 VICV) LOT 6 Co= CIXAM.vr Sr. SeFM TANK MrT M -XTotlJJ6 T LS • lZrr SrArlod L So' �..- 1; ODRA Z DG�1. co 0 �s�' `�}lovstt afk 04 Sfailt•. cot <-- ----- Coe w �rt STI 0 aol f25o 11 �Ga slml5slcv� A15A15A ENCINEEI tK�shh [ ,S. S.T. zdj� `` Sri 25��• QC" Cp CIE', rr )NSiztf� toy'.zsLS 10' AC!/ 49T . CE. 72-011 AIR". Pgtt MOA 25 s I'S SEAL • Municipality of Anchorage Page of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: tit>��n%aLt�1 PIDNumber. Name: Al aV I%CC k f1128D0 Wastewater System: ❑ New �Q Upgrade Address VcA Sety" ,Dr. ABSORPTION FIELD Phone No of Bedrooms 3'15— 72 (a9 ❑Deep Trench O Shallow Trench ❑Bed ;(Mound ❑Other LEGAL DESCRIPTION Soil Rating /� �• Total Depth from original grade- F i GP01Sq FI Lot. Block' 21 Subdivision: 1 GiCenbr depth to pipe bottom Irom onginal grade — Gravel depth beneath pipe FI Ft Township, Range Section Fol added above original grade: Gravel length' FI Ff WELL: ❑ New ❑ Upgrade Gravel wldlh: �S Number of Ines: Ddunce between Imes FI Ft Class,l�i,�oon tPnvale Total Deptn: Cased To: Total absorption area Pipe material: mip=i.B.CI' FI Ft So FI PV G Onuer Date Drilled: SlaucWater LevF InW#/Tr�n5 �NDSCAP MIG` ailed. 86/93 lC Yield Pump Set at Casing Height Above Ground TANK GPM Ft Ft SEPARATION DISTANCES aseptic ❑Holding ❑S.T.E.P. To Septic Absorption Ld1 Honing 'ublm/Pnvate Manufactures Gr<a- Capacity in gallons: 17-50 �O From Tana Field Station Tank Sewar Lrras Well — Material: :54tC' Number or Compartments Surface _ — _ _ – LIFT STATION Water Lot1 Line /�f i�O LIQ — — Slee in allons ,Moo Manufacturer O%anCO Foundation ,0 1 NO Pump on'��evel at: "Pump off4 r� tat, High wate�lm at: Curtain — — — Pump Make&Model I Electrical Inspections performed by: Drain orarrid ZO OS 0smy Remarks: BENCH MARK Location and Description: Assumed Elevation: ENGINEER'S SEAL ♦,Ssp\\1171 OF At 14460e r ;9* AUt^lAAI '319%3J Inspections performed by: ep!1y,1) Dates: 1s *�?:�4gTH* �•(J,,�a/�•��a�.�'N�/..//�aN.... 2nd 8 %3 ,.��..• �`..J. ':«`..:..0..0a • 'AM V. A Department of Heal a Human Services pr al #4' 1% CF • 193 &m Qa+r�'•6 Reviewed and approved b "��--� Dat 3 �6_ 72-013 (Rev. 991) MOA 25 fid' Permit No. Page Z of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: B/o`k Z, zl 8, Cree�lrook S/D PID No.: ks,$uur (FLAN 1111".4 r- -- -- - - --- - ----� I � AI & �A Lo -r 8 T 52 co, C"AN.Vr 'v15 Sr. S[PT2c TANK MTl ~rTott" TU(tE • CS • C.IFr STA7YD.t� 2 v A s S,o L N BDRM 2 GI. Cs' Mous£ �— L sf.h►. Cot CID sn j1,s,yke4.,k A d ENGINEER'S SEAL T/ 1 n Sri z5. 1E' Cott C7' 22'Co Its 27 % OF R� ,• HL -S 2e' b' IF • 0, Ar • 49TH ;9* If twtir v. Ausnwe f1 CE.1393 •.v u w ,nw. ro.ro p .nvn.a Permit No Page 3 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report nl 1. e I L Q /•- L_ L e/n Legal Description: OJOCK VIL/ NO.: i flE�•=/00r'1 A z.S 5G1 TA,� LIN[ re 9%3r PRusuRE I.S. Rom Llff unrf To pro S,T• SfA�ION 1 SEcTIOw (PRoF1cE) pp. /1Z ve'f. r( 2 Z 1 1 0 0 0 0 / 1r • to r =N,JqF,j;i SEAL ote OF A4 :7 ,* t /4/9TN 0 •. ��N N •N.N� • 1 *31 NeC Y AIASMAi1 / • a % ..L - 1993 *1 O .06 Ar 2-013 A (Rev 9/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930249 DESIGN ENGINEER:POLARCONSULT OWNER NAME:PAVLICEK ALVIN A & OWNER ADDRESS:12800 VON SCHEBEN DR ANCHORAGE, AK 99516 PARCEL ID:01702358 LEGAL DESCRIPTION: GREENBROOK BLK 2 LT 6 LOT SIZE: 51522 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 714 tr�8-4-`!3 P:oo*, /it ttiscec DATE ISSUED: 7/23/93 EXPIRATION DATE: 7/23/94 8-6—y3 /2-3Olt. � .2 ltifsod, lT 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE-SAND-USE671N-THE FILTER-LAYER.MUST'CONFORM-TO ,.33 -CONCRETE -SAND. A.SIEVE'ANALYSIS'MUST-BE TAKEN "USED"IW THE FILTER LAYER WITH THE RESULTS OF -THE - PROVIDED RECEIVED ISSUED BY -ASTM-C- ON THE SAND ANALYSIS" DATE: -;713o%3 DATE: 7 Z3 polarconsult alaska, inc. ENGINEERS • SURVEYORS • ENERGY CONSULTANTS July 16, 1993 DHHS, Environmental Services, On-site Services P.O. Box 196650 Anchorage, Alaska 99519 Attn: Permit Review Officer Re: Design and Construction Approval for On-site Sewer System at Lot 8, Block 2, Greenbrook S/D. Dear Sir or Madam: Please accept the following design for review and permitting. The proposed system does not affect the current use of the adjacent properties and will have minimum future impact. The existing septic tank will be utilized depending on a favorable inspection. If you have any questions, please give me a call. Sinc ely, David Ausman, CE Attachments: On-site Sewer/Well Permit Application Site Plan, Sheet 1 of 5 System Design Calculations, Sheet 2 of 5 System Cross Section, Sheet 3 of 5 Percolation Test, Sheet 4 of 5 Percolation Test, Sheet 5 of 5 $200 Check for Permit Fee 1503 WEST 33RD AVENUE • SUITE 310 • ANCHORAGE, ALASKA 99503 PHONE (907) 258-2420 • TELEFAX (907) 258-2419 waan�i is.^sami n..n O.�_rw�. �r aui ra.�« wunrt immao polarconsult alaska, Inc. 1503 West 33rd Avenue * Suite 310 ANCHORAGE, ALASKA 99503 (907) 258.2420 Fax (907) 258-2419 I PERC. RA _"'yIN IIN D 5.—Vi I _Dl Wig' x 31 51 '008 gl-oCle 2. LV7- B. CrREZ1V8Ro0K SHEET NO. Of 3 CALCULATED ev MK DATE 7MI23 CHECKED BY DATE I . * , . 9 1 �l -SAM V.-AMAM — 0 qo_—m % CE -1999 .0 . jp 0 Ar aAt Af.4Ni1Aj,__7_PP 279 -?7/ nnaOA�n lsrta atm�0+.n®.� wr Vui rw..noarmxawc Municipality o1 Anchorage ~P DEPARTMENT OF HEALTH 8 HUMAN SERVICES v 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST 0 A /n/ Iy 0 : 1 PERFORMED FOR: .41 , '^V lite^ Q DATE PEER��FORME�✓� LEGAL DESCRIPTION: Ohck Z LD->< $ Township, Range, Section: GreCn6ree DEPTH O SLOPE SITE PLAN COMMENTS TNZ 9r ■■■■■■■■■■ IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? N/ PERCOLATION RATE 2 Y tminulew.nch) PERC HOLE DIAMETER. I TEST RUN BETWEEN 3 FT AND 19 FT PERFORMED BY. MA V1 10 MA AI 1 :4 4UIAX �RTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 72-008 (Rev. 4/85) 1 2 ': -; SM 3- 4 4 M "C 5-/ 6- 7 8- 91011 9- to - 11 12- 2131415161718 13- 14- is- 16- 17 - 18 19 20 COMMENTS TNZ 9r ■■■■■■■■■■ IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? N/ PERCOLATION RATE 2 Y tminulew.nch) PERC HOLE DIAMETER. I TEST RUN BETWEEN 3 FT AND 19 FT PERFORMED BY. MA V1 10 MA AI 1 :4 4UIAX �RTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 72-008 (Rev. 4/85) e . • Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage. Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: A/ (� I '�7VII ek DATE PERF( LEGAL DESCRIPTION: ✓�^' Z 8 Township, Range, Section: Green 6rpk 5/p SLOPE SITE PLAN DEPTH _ ._!1"/r{ jFEET 1 2 .' . 3- 4- S5 5- 6- 7 67 // 8- 10- 11 10 11 12 l 13- 14 15 16 17 18 19 WAS GROUND WATER ENCOUNTERED? O S L IF YES, AT WHAT O DEPTH? P E Depth to Water lllter,' /,,A ? Monitoring? N�Date: 7 93 ®®mmm sn�r,�asas 20 /a PERCOLATION RATE (minutevinch) PERC HOLE DIAMETER TEST RUN BETWEEN _J_ FT AND 5 FT COMMENTS PERFORMED BY: Air r L�I A, )41" fa" L 1 4- J, - CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �'• �� 4 72-008 (Rev. 4,85) MUNICIPALITY OF ANCHORAGE l DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION / 825 L Street • Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME a b / (_ /IAVjr) !i � PHONE S'—�� &NEW ❑UPGRADE MAILING ADDRESS aA? LEGAL DESCRIPTION 4 LOCATION 1 57, / On J/!f LPn• NO. OF BEDROOMS D DISTANCE TO: W I/ tr �� C✓sH�r Absorption area / Dwelling PERMI NO. _ - / 0 7-S-Y _Y n ZQ Manufacturer Matjri I No. of compartments W Liq. capacity in gallons �. IF HOMEMADE: Inside length Width Liquid depth 6O Z OI STANCE TO: Well Dwelling PERMIT NO. _? f Manufacturer Material Liquid capacity in gallons Cl w= DISTANCE TO: Well Al Foundatiorr� o Nearest lot b e PERMIT NO. W Z 2 w No. of lines Length of ePCh lin f_ Total length of lines Trench width J inches Distance between lines 4 s¢.. p Top of the to finish gratle Material beneath tile inches Total effective absorption area W Length *4th Depth PERMIT NO. Q H wa Type of Crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J Cla Depth Driller Distance to lo[ line PERMIT NO. DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER �L PIPE MATERIALS it X' SOILTEST RATING INSTALLER �? v C REMARKS/ i. •� �C�v.� J�3 ... /mss Sv%a Y�� r7 pf 1 L /y^ So • I3 P APPROVED DATE LEGAL /� / —21 $/ / � d' 7 c 7 rens L, V e 72013 (Rev. 3/78) mur4 I ez� I L_ I TY rnF nr49C"r •RFIGE DEPARTMENT l HEALTH AND ENVIRONMENTAL �73TECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 rnr.l— I TE SELJER PERM I T PERMIT NO. C 810754 ) APPLICANT DICK 14RIGHT SPA BOX 2531 ANCH. 345-0958 LOCATION VON SCHEBEBEN LEGAL LOT 8 ELF: 2 GREENEROOK SUB LOT SIZE 59220 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRAINFIELD MAXIMUM NUMBER. OF BEDROOMS = 4 SOIL RATING CSO FT/BP.>= 165 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= �� LEt-aGTH= �'y" GRAk�EL DEPTH= 2 THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DP,AINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEE THE TREt-IGH 141r> -r" I c FEE THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL EETG1EEFt-iHE-O+JfiFRLL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). REiG!�J I RECD 'SEPT I G TFir 7F� I �E= 125 GFiLL_(Dr4 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL 14ILL SERVE. --- TWfn C 2 > I "SPECT I ODNS nM1-= Ra:QU I REO --- 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 WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC b1ELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER.. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERMIT EXPIRES L'•ECEME?ER X11 1L I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE 011 -SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDEFJCE I5✓REjF10DELED TO INCLUDE MORE THAN 4 EEDROOMS,� SIGNED ISSUED -- ------------- ---------------- APPLICAF DICK. WP, T 6Y -------- ------------- ATE-��7-�` V4. 0 Alaska Testlab 4040 08" Street -Anchorage, Alar4a 99503 r1s. Phone (907) 278-ISSI (Telecopler (907) 273-5742 April 17, 1981 r W.O. AA19708 Second and Fourth Anchorage Limited Partnership 4611 Business Park Blvd.. Anchorage, Alaska 99503 Attention: Fir. Les Pace Re: Subsurface Investigation for Suitability of On -Site Sewage Disposal,'Lot 4, Block 1;'Lot 4, Block 2; Lot 3, Block 2; Lot 8, Block 2; Lot 9, Block 24 Lot 10, Block 2; Lot 17, Block 2; Lot 19, Block 2; Lot 26, Block 2; Lot 3, Block 4; Lot 41 Block 4; Lot 6, Block 4; Lot 12, Block 4; Lot 13, Block 4; Lot 14, Block 4, Greenbrook Subdivision Dear Mr. Pace: During March and April of 1981, we drilled a 15 foot boring on each of the above lots and placed a perforated, 3/4 inch PVC pipe in each hole so that the water table could be monitored over a period of time and a percolation test run in the hole. The holes were drilled using a Nodwell.mounted, Mobile.B50 drill rig owned and operated by Denali Drilling, Inc. The drilling was supervised and the test holes logged by Mr. Ted Krupka, senior technician, and Mr. O.M. Hatch, geologist with Alaska Testlab. After the holes were drilled, our technician returned on several occasions and checked the water level in each of the test holes. After a period of time the holes were saturated, left to stand overnight, saturated again and a percolation test run. The percolation test was run by monitoring the'drop in the water table elevation at 10 minute intervals for a minimum of one hour. The percolation rate listed in this report was computed using the slowest 20 minutes of that percolation test. Included with this report is hole location lotsketch for each lot and a log of the boring placed o The results of this exploration are described as follows: Lot 4, Block 1 The water table elevation measured in the test hole at this site remained fairly constant at about 12 feet. The percolation rate measured on April 15 was 6.0 minutes/inch. Because of the need to keep the system shallow and the high silt content, we recommend' a more conservative design percolation rate of 10.0 minutes/inch. r'1 Second and Fourth Anchorage Limited Partnership April 17, 1981 Page Two We recommend the sewage system be placed as high as possible, in the upper 4 to 8 feet, to avoid high water problems during the spring breakup. Lot 2, Block 2 The test hole was placed in the front of the lot, and this is where we would recommend the on-site sewage disposal system be placed. The lot slopes considerably to the back; where it appears there may be a high water table. The water table in the test hole was observed at 8.0 feet on March 18, during the peak of breakup then lowered to 10.5 feet by April 9. The percolation rate measured on April 15 was 4.0 minutes/inch. However, we recommend using a more conservative percolation rate of 10.0 minutes/inch, due to the silt content of the soils. We also recommend that the disposal system be kept as shallow as possible. It may require mounding to provide adequate insulation and yet maintain the necessary separation between the system and the ground water level during spring runoff. Lot 3, Block 2 The disposal system on this lot should also be located at the front of the lot, near the test hole, as this lot slopes downward to the back. The water level in the test hole was measured at 11.6 feet on April 18, but had measured at 8.1 feet on March 9. The water level was encountered at 11.4 feet on March 15, and the percolation rate on this date was 12.5 minutes/inch. We recommend a mounded sewage disposal system be used to maintain the necessary separation from the seasonal high water level, and adequate insulation of the system. Lot 8, Block 2 When drilling the test holef no water -was observed within the 16 foot depth hole at this site. The following day, April 9, water was observed at 7.6 feet. The water level in the test hole was 8.2 feet on April 15. This water is probably surface seepage from thawing conditions. The percolation rate was measured at 5.5 minutes/inch, however, we recommend a design rate of 10.0 minutes/inch because of the silt content. A mounded sewage disposal system due to the high spring water level, should be used. — No water was observed in the test hole while drilling, but was found at 7.8 feet the next day, April 9. The water is probably surface seepage from thawing conditions. The measured percolation A•[ 1, ALASKA TESRA s Second and Fourth Anchorage Limited Partnership April 17, 1981 Page Three - rate was 5.2 minutes/inch, however, we recommend a design rate of 10.0 minutes/inch. Since the seasonal.water level is quite high, we recommend a mounded disposal system so sufficient separation is achieved. Lot 10, Block 2 The test hole was located in the southwest corner of the lot, and we recommend that'the sewage disposal system be -placed in this area. The water level is quite near the surface towards the - front of the lot. The water level while drilling on April 8 was 9.0 feet, then was found at about 12 feet over the next few days. On April 14, the percolation rate was measured at 2.5 minutes/inch. - We recommend that a more conservative rate of 10.0 minutes/inch be used, due to the silty nature of the upper soils. The system should -be placed as high as possible, in the upper 8 to 10 feet, to avoid conflicts with the seasonal high water, mounding may be necessary for insulation. Lot 17, Block 2 No ground water was encountered while drilling on this lot on April 8, or when checked again April 9 and April 16. The measured percolation rate was 5.4 minutes/inch, however, we recommend a more conservative design rate of 10.0 minutes/inch because of the siltier nature of the soils. ti Lot 19, &ck 2 - No water table was observed in the 16 foot test hole while drilling on April 8, or on April 9. The percolation rate was measured at 8.9 minutes/inch, however, we recommend a more conservative design rate of 10.0 minutes/inch because of the silty nature -of the soils. The system should be placed as high as possible, as high seasonal water levels were found in the immediate area. Lot 26, Block 2 The test hole was drilled near the center of the lot April 8, and no water was observed. The test hole was also found dry April 9. The measured percolation rate was 6.2 minutes/inch. I Lot 3, Block 4 No water was observed in the test hole at this site while drilling on April 8, but was at 12.5 feet the following day. The measured percolation rate was 14.6 minutes/inch. -The disposal system should be kept as high as possible to avoid conflicts with the A'1 1,, AtAShn 11. S ILAH Second and Fourth Anchorage Limited Partnership April 17, 1981 Page Four 1, seasonal high water. Lot 4, Block 4 The measured water level in the test hole at this site remained fairly constant and high. Saturated conditions were encountered at 12 feet while drilling on March 14. The water table elevation was found at 6.8 feet on March 23, at 6.8 feet on April 9, and at 8.3 feet on March 16. The measured percolation rate was 40 minutes/inch. Because of the high groundwater, a shallow mounded disposal system should be used. Lot 6, Block 4 The high water level at this site necessitates a highly mounded system; or using insulation to provide frost protection while maintaining the necessary separation between the disposal system and the seasonal high water. While drilling, saturated conditions were encountered at 13 feet. On April 18, the water level was measured at 5.4 feet, then at 5.1 feet on April 23, the water level had lowered to seven feet by April 9, and then to 7.5 feet on April 15. However, much of this water is probably from surface water and melting seasonal frost. The measured percolation rate was 3.8 minutes/inch, however, we recommend a more conservative design value of 10:0 minutes/inch. Lot 12. Block 4 Again, the disposal system should be placed as high as possible at this site. The water level in the test hole remained fairly constant at eight feet. The water level was measured at 2.8 feet on March 8, but it appeared that this high level was caused by infiltration of surface water, and was not the true water level at the time. The measured percolation rate on March 17 was 3.4 minutes/inch, but it is recommended the more conservative value of 10.0 minutes/inch be used, because of the high silt content of the -upper soils. Lot 13, Block 4 The test hole was drilled near the center of the lot on April 7, and no water was observed. Again on April 9, no water was detected. On April 15, the measured percolation was 9.0 minutes/inch. We recommend the disposal system be placed between 5 and 11 feet, to avoid the surface silts. Lot 14, Block 4 No water was encountered while drilling, on April 7, or when. • cA'f 1.) ALASKA TESTLA6 r, Second and Fourth Anchorage Limited Partnership April 17, 1981 Page Five checked April 9. The measured percolation rate was 4.0 minutes/inch. We recommend a more conservative rate of 10.0 minutes/inch be used, since the upper soil is silt. If you have any questions regarding these tests, please feel free to call. Very truly yours, ALASKA TESTLAB Carl A. Bassler Geotechnical Engineer Approved.by: Melvin R. Nichols, P.E. Manager CAB/mg Attachments cc: Ralph Westover, Tryck, Nyman s Hayes ror CQ��•'•....,,�gs �+� ••. v • v�t49Th00 •' ;•pra r ......... 0 • •c'C Melvin R. N chol. F,y •.,, i all k�FF:i: ;." U • • A T I i AIASKA II SII Ali b r C S r • ...N `•e gw.2t_ w .60 ' vl�Jl •J Cr�I• lc �..JrO.fO` Op4�e i �0 •6,•ef/ N Oy " of;e Ooo Ot• �e Off' M _9G Ie6Z pp O • . '•lea - , ede e00 8 L•e69 Y t b Or Or N ' N e tN I Y = p P 18N Y //�'� Y "I O rn � .. vj 90 \ \ � \J • 1 1 •\ GO 01 ' U 6 Q O ,g O 1 c tpop o O � ' t 1 Y I 6 O O O O O O O I O • ...N `•e gw.2t_ w .60 ' vl�Jl •J Cr�I• lc �..JrO.fO` Op4�e i �0 •6,•ef/ N Oy " of;e Ooo Ot• �e Off' M _9G Ie6Z pp O • . '•lea - , ede e00 8 L•e69 Y t b Or Or N ' N e tN I Y = p P 18N Y //�'� Y "I O rn � .. vj 90 rN r�' Lot 4y Block 1 Table A WO IA19708 Date: 3/14/81 Logged by: T. Krupka Depth in Feet 41 From To Soil Description 0.0 0.5 Peat 0.5 7.0 F-3, Brown Silty Sand, SM, silt to 40 moist 7.0 15.0 F -2/F-3, Brown Silty Sand, SM, silt to 258, saturated below 12' Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. here Rate = 6.0 minutes/inch. Recommended Design Perc Rate = 10.0 minutes/inch Bottom of Test FIole: 15.0 Feet Frost Line: 1.0 Foot Free Water Level: 3/14/81 - 12.0 Feet 3/18/81 - 11.9 Feet 4/9/81 - 12.5 Feet 4/14/81 - 12.0 Feet nIY I • ♦�'/ 15 5 s�� a 5 e Nab°te'33"E N)6e°6'09••W 1 N )A°je•ej ( 339.30 ^ =°6.9e e • `.1 ti 30 ^ 30 16 ' 1 / 30 30 • w e NNTn •. •1.^N i • P ^ w g ..w e °'J NBlell'76^ W . • w 1p •o '�30 6 3 I • ♦�'/ 15 5 s�� a 5 e Nab°te'33"E N)6e°6'09••W 1 N )A°je•ej ( 339.30 ^ =°6.9e e • `.1 ti 30 ^ 30 16 ' 1 / 1• N,�7)ti,=y • w P ^ _ NBlell'76^ W . •o 1, 3 ae e eoo jo >ti ti e type 1'e♦O 1 ,08 Nyle Pa •10 "• / O '4 0D o �^ O ` - � O5.ppp•'� CA LCA Clr,:1AWA TEST. o o Z HOLE FJ 1 11 eJ I 14t a Q:: : Io I •: ( \ N.•• I . I I � 10•IP.1 1• N,�7)ti,=y rN r`, Lot 2, Block 2 Table B WO W9708 Date: 3/14/81 Logged by: T. Krupka Depth in Feet , From To Soil Description 0.0 0.5 Peat 0.5 15.0 F-3, Brown Silty Sand, SM, with 108 rounded gravel, well graded sand, 40% silt, plastic, moist, firm, occasional cobbles below 10', saturated at 15' Set 3/4" perforated PVC pipe to run pore test and to monitor water table elevation. .Perc Rate = 4.0 minutes/inch. Recommended Design Perc Rate = 10.0 minutes/inch Bottom of Test Hole: Frost Line: Free Water Level: 15.0 Feet 3.0 Feet 3/14/81 - 15.0 Feet 3/18/81 - 8.0 Feet 3/23/81 - 8.9 Feet 4/9/81 - 10.5 Feet 4/15/81 - 9.0 Feet Lot 3, Block 2 Table C Depth in Feet From To 0.0 0.5 0.5 12.0 12.0 15.0 Bottom of Test Hole: Frost Line: Free Water Level: n WO NA19708 Date: 3/14/81 Logged by: T. Krupka 'r Soil Description Peat F-3, Brown Silt Sand, SM, 108 rounded gravel to 3/4", silo 308, moist, firm F -2/F-3, grey Silty Sand, SDt, silt to 208, saturated, -firm Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Perc Rate = 12.5 minutes/inch 15.0 Feet 2.5 Feet 3/14/81 - None Observed 3/18/81 - 11.6 Feet 3/23/81 - 10.4 Feet 4/9/81 - 8.1 Feet 4/15/81 - 11.4 Feet i ,,... . .� /•1'•r 41•.1. b .\/I: •I• I'I: .,/ w 11)•111.1.1♦ 1. r �` '. /4 00 .Sk ' ^'8e p'e0 710 23 33 23.76 \ \ O ♦ U h 6se 2K!'7!"f 339.30 69e e9'17"F � � � •• 1 1/ . —313:.3 5 G '• I 00 • w h 16 20 w 6 P . I ry • 1 '•t I 1 I ' here /,,y w � 22sq, • ♦e el. 09 240.7325 d n TEST'•; ; `. Ye,oJ �� • F1Kf I 23 / O M 1\O ee � F•.. i e�00 /9 _ � •. " / /7 2 e �� e• ,1 ♦ V O w n O OO JO A- to 3o I't 1 111.1'1.1.1 • •11 1�• +I I\•..MI •1I 111 : ".1 • 1 Lot 17, Block 2 Table D WO AA19708 Date: 4/8/81 Logged by: 0. Hatch Depth in Feet From To Soil Description _ 0.0 1.0 Brown Peat, Pt 1.0 2.0 F-4, Brown Silt, ML, moist, stiff, NP 2.0 16.0 F-4, Brown Gravelly Sandy Silt, ML, moist, stiff, NP, 3" maximum Set 3/4"•perforated PVC pipe to run perc test and to monitor water table elevation. Percolation Rate 5.4 minutes/inch. Recommended Design Perc Rate = 10.0 minutes/inch. Bottom of Test.Hole: 16.0 Feet Frost Line: 1.0 Foot Free Water Level:.. 4/8/81 - None Observed 4/9/81 - None Observed 4/16/81 - None Observed Lot 191 Block 2 Table E Depth in Feet From To - 0.0 1.0 1.0 2.0 2.0 13.0 " 13.0 16.0 n WO iA19708 Date: 4/18/81 Logged by: O. Hatch Soil Description Brown Peat F-4, Brown Sandy Silt, DIL, moist, stiff, NP F-2, Brown Silty Gravelly Sand,.SM, moist, medium dense, 3" maximum F-4, Brown Gravelly Sandy Silt, ML, moist, stiff, 2" maximum, NP Set 3/4" perforated PVC pipe to run perc test .and to monitor water table elevation. Perc Rate = 8.9 minutes/inch. Recommended Design Perc Rate - 10.0 minutes/inch. Bottom of Test Hole: Frost Line: Free Water Level; 16.0 Feet 1.0 Foot 4/8/81 - None Observed 4/9/81 - None Observed Bottom of Test Hole: 15.0 Feet Frost Line: 1.5 Feet Free Water Level; 4/8/81 - 9.O Feet 4/9/81 - 12.0 Feet 4/14/81 - 11.7 Feet Lot 10, Block 2 Table It WO #A19708 Date: 4/8/81 Logged by: O. Hatch Depth in Feet , From To Soil Description _ 0.0 1.0 Brown Peat 1.0 2.0 F-4, Brown Silt, ML, stiff, moist, NP 2.0 12.0 F-4, Brown GravellySand Silt, ML,-moist to saturated, stiff, 3" maximum, NP - 12.0 15.0 F-2/F-4, Silty Sand, SM, saturated, stiff, NP _ Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Measured Pere Rate = 2.5 minutes/inch. Recommended Design Perc Rate = 10.0 minutes/inch. Bottom of Test Hole: 15.0 Feet Frost Line: 1.5 Feet Free Water Level; 4/8/81 - 9.O Feet 4/9/81 - 12.0 Feet 4/14/81 - 11.7 Feet i' Lot 26, Block 2 Table I WO 1A19708 Date: 4/8/81 Logged by: O. Batch Depth in Feet From To _ 0.0 1.0 1.0 8.0 8.0 11.0 11.0 16.0 Bottom of Test }tole: Frost Line: Free Water Level - Soil Description Brown Peat F -2/F-4, Brown GraveLIX Silty Sand, SM, occasional cobbles, moist, medium dense NFS/F-2, Brown Gravelly Sand, SP, trace silt, moist, medium dense, 3" maximum F-1, Brown Silty Sam Gravel, GM, occasional cobbles, moist, medium dense Set 3/4" perforated PVC pipe to'run perc test and to monitor water table elevation. Perc Rate - 6.2 minutes/inch. 16.0 Feet 1.5 Feet 4/8/81 - None Observed 4/9/81 — None Observed • n n . Lot 3, Block 4 Table J WO AA19708 Date: 4/8/81 Logged by: O. }latch Depth in Feet From To 0.0 1.0 1.0 2.0 _ 2.0 7.0 7.0 16.0 Bottom of Test Hole: Frost Line: Free Water Level: Soil Description Brown Peat F-4, Brown Sandy Silt, ML, moist, stiff, NP F-1, Brown Silty 'Sandy Gravel, GM, moist, medium dense, poorly graded, 3" maximum F-4, Brown Sandy Silt, ML, trace gravel, moist, stiff, NP Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Pere Rate = 14.6 minutes/inch. 16.0 Feet 1.5 Feet 4/8/81 - None Observed 4/9/81 - 12.5 Feet Lot 4, Block 4 r• Depth in Feet From To 0.0 0.5 0.5 6.0 6.0 15.0 Bottom of Test'Hole: Frost Line: Free Water Level: ' Table K WO AA19708 Date: 3/14/81 Logged by: T. Krupka �r Soil Description Peat F-4, Brown Silty Sand, SM, moist, firm F-3, CrAvelly Silty Sand, SM, occasional cobbles— ,est, firm, becomes saturated at 12' Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Perc Rate = 40 minutes/inch. 15.0 Feet 1.0 Foot 3/14/81 - 12.0 Feet 3/18/81 - 6.0 Feet 3/23/81 - 6.8 Feet. 4/9/81 - 7.0 Feet 4/16/81 - 8.3 Feet — Lot 6, Blbck 4 Table L WO #A19708' Date: 1 Logged by: T. Krupka Depth in Feet From To Soil Description 0.0 15.0 F-3, Brown Silty Gravell Sand, SM, well graded, particles rounded to 3 4", moist, firm, becomes saturated at 13' Set 3/4" perforated PVC pipe to run pert test and to monitor water table elevation. Perc Rate = 3.8 minutes/inch. Recommended Design Perc Rate = 10.0 minutes/inch. Bottom of Test Bole: 15.0 Feet Frost Line: 2.5 Feet Free Water Level: 3/16/81 - 13.0 Feet 3/18/81 - 5.4 Feet 3/23/61 - 5.1 Feet 4/9/81 - 7.0 Feet 4/15/81 - 7.5 Feet f Lot 12, Block 4 Table M WO #A19708 Date: 4/14/81 Logged by: T. Krupka Depth in Feet From To Soil Description 0.0 7.5 F-4, Brown Silty Sand, SM, silt to 406, firm, moist 7.5 15.0 F-3, Brown Gravelly Silty Sand, SM, occasional cobbles, firm, moi t, becomes saturated at 15' Set 3/4" perforated PVC•pipe to run perc test and to monitor water table elevation. _ Measured Perc Rate = 3.4 minutes/inch. Recommended Desing Perc RAte = 10.0 minutes/inch. Bottom of Test Hole: Frost Line: Free Water Level: • 15.0 Feet 1.0 Foot 3/14/81 - 15.0 Feet 3/18/81 - 2.8 Feet (Apparently from surface water intrusion) 3/23/81 7.8 Feet 4/09/81 - 7.8 Feet 4/16/81 - 8.5 Feet Lot 13, Block 4 Death in Feet From k,To _ 0.0 1.0 1.0 2.0 2.0 8.5 8.5 11.0 11.0 16.0 Ara n Table N WO AA19708 Date: 4/8/81 Logged by: 0. Hapch Soil Description Brown Peat F-4, Brown Silt, ML, moist, stiff, NP F-4, Brown Gravelly Sandy Silt, ML moist, stiff, 6" maximum, NP F-2, Brown Silty Gravelly Sand, SM, moist, medium dense, poorly graded, 2" maximum F-4, Brown Gravelly Sar ndy Clayey Silt, ML, moist, stiff, 2" maximum, PL- to NP Set 3/4" perforated PVC pipe to run perc test and to monitor water table elevation. Perc Rate = 9.0 minutes/inch. System should be placed between 5.0 Feet and 11.0 Feet. Bottom of Test Hole: Frost Line: Free Water Level: 16.0 Feet 1.5 Feet 4/7/81 - None Observed 4/9/81 - None Observed Lot 14, Block 4 r+ Depth in Feet From To 0.0 1.0 1.0 A1111.0 11.0 16.0 Bottom of Test hole: Frost Line: Free Water Level: Table O WO #A19708 - Date: 4/8/81 Logged by: 0. Hatch �r Soil Description Brown Peat F-4, Brown Gravelly Sandy Silt, ML,,moist, stiff, occasional cobbles, NP NFS/F-2, Brown Gravelly Sand, SP, trace silt, moist, medium dense, 2" maximum Set 3/4" perforated PVC pipe to run pare test and to monitor water table elevation. Measured Pere Rate = 4.0 minutes/inch. Recommended Design Perc Rate = 10.0 minutes/inch. 16.0 Feet 1.5 Feet 4/7/81' - None Observed 4/9/81 - None Observed • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS Parcel I.D. 017-023-58 Expiration Date: 1. GENERAL INFORMATION Complete legal description GREENBROOK BLOCK 2, LOT 8 Location (site address) 12800 VON SCHEBEN DRIVE ANCHORAGE AK 99516 Current Property owner(s) DOMINIQUE & RUTH VAN NOSTRAND Day phone Mailing address Real Estate Agent 12800 VON SCHEBEN DRIVE, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone U � 2616 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class A Well ® Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to 7 ineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number CD(A 516G%'�o COSA# ®5C1(0)k59 Waiver Fee $ Date of Payment Receipt Number Waiver * 5. STATEMENT OFINSPECTION BY ENGINEER As certified by m seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on, orooedes outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the bn=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 obtainedom the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply a torwgstewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances', aid regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS 5/6/2016 Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the. year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future _-%, occupants or can ArcTerra guarantee that no unseen j Or ALS, encroachments, deficiencies or discrepancies exist. ®* 49 TI I B, 6. DSD SIGNATURE ` ?�KF.YHHTH . I. DUB System #1 Approved for bedrooms. System #2 Approved for bedrooms. `roF8S310h� o Disapproved. Conditional approval for bedrooms, with the following stipulations: A Original Certificate Date: 5 l 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 Slate of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheel_10.1412.dw 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: GREENBROOK BLOCK 2, LOT 8 Parcel ID: 017.023.58 A. WELL DATA — CLASS A Well type A Date completed _ Total depth _ft. Date of test Static water level Well production If A, B, or C provide PWSID # 210346 Well Log (YIN) Sanitary seal (Y/N) Y Wires properly protected (Y/N) Cased to _ft. FROM WELL LOG WATER SAMPLE RESULTS: ft. 9— p.m- Coliform _colonies/100 mL Nitrate _mg/L Casing height (above ground) _in. AT INSPECTION Arsenic: _ ug/L Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA ft. 9•p -m - Tank Type/Material SEPTICISTEEL Date installed 4012016 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alar (Y/N) Y Date of pumping NA- NEW TANK Pumper C. ABSORPTION FIELD DATA Date installed 81611993 Soil rating (g.p.d.W or ft2/bdrm) 0.4 System type BED Length 35 ft. Width 45 ft. Gravel below pipe 1 ft. Total depth 3_7 ft. (Measured 4/15/16) Eff. absorption area 1500 fe Monitoring tube Y Depression over field N Date of adequacy test 4115/16 Results (Pass/Fail) PASS For g bedrooms Fluid depth in absorption.fteld before test 0I6 in. Water added 600 gal. New depth 316 in. Elapsed Time:;t0 min.. Final fluid depth 016in. Absorption rate >= 600+ gp.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed 4/26116 Size in gallons 1500 Manhole/Access (Y/N) Y "Pump on" level at 44 in. "Pump off" level at 42 in. High water alarm level at 48 in. Datum BOTTOM OF TANK Cycles tested E. SEPARATION DISTANCES - PUBLIC WATER WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas '142116 1614 •II�[e3fT�t:(e7�ftttiSil[i: Meets alarm & circuit requirements? Y On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas Building foundation 5'+ Property line 54 Absorption field 5'+ Water main 104 Water service line 104 Surface water 1004 Wells on adjacent lots 2004 ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 104 Water main Water Service line 10'+ Surface water 1001+ Driveway, parkingtvehicle storage 10'+ Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 2004 F. COMMENTS Total depth of of 1' effective death bed is 3.7' with 2.7' cover and MOA records show insulation. Absorption tied has adequate cover with insulation and has been in operation for 23 years with no known freezing / frost issues. 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 KENNETH M. DUFFUS Date 51612016 COSH canary shcet2-6-15.doc "`«mm WMACKf s sas° ss zzwv, ansa _ uj t cxaz�e:� 7 i IRiDER N0 tARWMSTARCES 'S.F1(N11(3 AN AS -MT,. LL56o FG[3 FA�1S'ffld? }TJdI.CM EOR FSTASClSdiR1G SOtIN6ARY OR TENCE ONES. THE SMVtY R TAKES RE&lON CITY FDR 7NE kRT1AL 7RANSACT[C1N CiNIY AND-_ ASSiNAES FlNANIiAf, LIA�tJTY Pesti' FOR THE COST OF THE SURYM {ISyEp I11STrW.OE$ PREYAI{,-OYBR SCALRKn REPRODIICTI04I MAY GA{7SE ERRORS IN wj4F• t4T *040 SURVEY, TNPE SYtrf MS F htkW 49-SWId a *'P RESAR° D"NACE *`.... ASPHALT - Alk m A9�aftf 6. Eg1Rp REEAR . PtdTReW .-.. A9-tlY4ti-.:.., ; <<.. iPppplAP€q - _ rWfIT fENfR1NG ASS�CAiEO E}.EY. if -9F -JF M�iAt FERY,£ D 4. R ds .. ND IT %x,14 0 RESP#15 sw.TY OF THE ER 9W O MEk PRIOR T4 ONLY THOSE IMQROW. MENTS. aZ"K G ROCIND AND V10SLE (MLL- BE C IANSTI UCiTAM, TO VERIFY PIRS!N'O BUILOING GRADE RELATIVE $1 9M, "OES. WELDS, SEW11C G'�..&ANCi1IiS'. �EYfALK% 6RtMEWAY$ _ TO FINf'STIG�[i GRADE Aft- UTILITY QONW.CrT1� AHiS tb' CSETESk{IN8 61'S'r.; ARE 5t+QYM IN THEIR APPC{Ff%WAV LOCATION, ONLY, S1it3W F1E Eau CC OP AW EASO"TS ,: COVENANTS 441 RE. MC,T ( S ltAk;PRBiERT SWC,, P WMEW FROM BE(NO SEEN AND UXATEO, TMU $i3 45T APPEAR oH'TIA l EA sumvTSION Pt<A'E. %1 L DISTANCES ARE RECOA0 LINKERS OTTtEFT ISE N , 5u�ukY t 1Fi AitflN � Prepered by f cb rt E Johns, Jr. & Assoc. Kar PLAN°•:NY••`�,.q ProfesSior dl Land Surveyors 'w °� ANaiwrA A 40664 rNa.49Ni f'j��iee-S.r• Ree. Pae EPe:. Nd f04RIDAUtlN A$-EC4LT . u n . ,:TNN =50" ,AatitL rw.. r. tAf,Y°;.kr"Mntes,.Sacc S+M t,ItaO-R,�N.3riRLE . AS.r.SBnairflMelTroayr «Ma`l,r f �f�>�hlk�l ,r �i2•iNi.NY.—N'!Ni5lS��S. �Nei`4Yy„�- N#i?YN1544CR g- .—y: dk 3 6y C$'edkd'4rtREJ V RMUM ROOM 0" .R SDmO5f03916 630 W,0' 16=143 T;d 0W11w. Lot 8 BLOCK 2. a GREENBROOK MUNICIPALANCHORAGE • -- DEPARTMENT OF HEALTH b HUMAN SERVICES Division of Environmental Services it On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 01_7r013'5-09 HAA # 114' 230 480 1. GENERAL INFORMATION Complete legal description Lor g i;6oG/e 2, G,4�i oar �S/o Location (site address or directions) I2Fio0 'V01,1 Sc N� C c.0 D/e. Property owneriGe K Day phone 3z/S-7-2G9 Mailirig address -:5,4M Lending agency Day phone Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone NOTE: If community well system, provide written confirmation from State ADEC attest - Ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025m«.1n1) Front MOA9I7 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto %nd as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and yregulations in effect on the date of this inspection. Name of Firm T Phone Address /51L3 b). '3q.fA- Engineer's signature 6. DHHS SIGNATURE X _ Approved for Disapproved. Conditional approval for Additional Comments bedrooms. Date wu v.•Ausw C£ -1393 1. RofBss� bedrooms, with the following stipulations: /EOOineN.K. F#L4_yAA1 i4c IMuST IAB AIIC D oux Tif *< UPr Smo" A46ts By: ,�oEh,l Sn',Ttt Date • The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions In orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. rzoa (P••• usi) e.a MOA021 Municipality of Anchorage Department of Health and Human Services Amm HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: 1—g, g,?y G/ vN/ a�/Win. Parcel I.D. A. Well Data Well type A If A. B, or C, attach ADEC letter. ADEC water system number 2/013 Vo Log present (Y/N) Date completed V Driller Total depth Cased to "~ Casing height = Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION SEPARATION DISTANCES FROM WELL TO: Septiclholding tank on tot On adjacent lots Absorption Held on lot `•' ; On adjacent lots Public sewer main -- Public sewer manhole/cleanout Sewer service tine —' Petroleum tank WATER SAMPLE RESULTS: Coliform — Nitrate Date of sample: — Collected by: B. SEPTICIHOLDING TANK DATA Other bacteria Date installed 7- — Zti — S 1 Tank size /2 Compartments 7 Cleanouts (YIN) Y Foundation cleanout (Y/N) _V Depression (Y/N) High water alarm (Y/N) —Alarm tested (Y/N) A%%4 Date of pumping �i� c1 3 Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots -11-200 Foundation /01 To property line > /O Absorption field i /O Water main/service line Surface water/drainage 'A114 +` /Oo sV 72-026 rM)•Frortt CONTINUED ON BACK PAGE C. LIFT STATION Date Installed Sit �-/ 9 .. —Manufacturer��E /�!G 0 Size In gallons '6-0 0 Manhole/Access (YM) Y Vent (Y/N) y "Pump on" level at 30 /r •Pump off* Level at Z!o r r High water alarm level 3 [.) 11 Cycles tested Meets MOA electrical codes (YM) Y SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot ly�114 On adjacent lots > /Oo e' Surface water. jt4ZA D. ABSORPTION FIELD DATA Date Installed (�� .� Soil rating (GPD/F1') Q. ee�' 6Pb/,4ystem type p�csr. Orsr. —73;J Length ��55 ! Width 3 ,5- Gravel thickness P Total depth / r Nowvr> Total absorption area Cleanout present (Y/N) Depression over field (YM) Date of adequacy test A1117 Results (pass/fall) ArA for 114r9 Bedrooms Water level In absorption field before test Al' Aftertest R/19 Peroxide treatment (past 12 months) (YM) eyw If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: A/0/-7 Well on lot A/fig On adjacent lots f X00 ` Property line To building foundation i /n r To existing or abandoned system on lot _ /O On adjacent lots > /,9 r Cutbank Water mairVservice line Surface water /V/A Driveway, parking/vehicle storage area 5-1 Curtain drain A,�/W E. ENGINEER'S CERTIFICATION I certify Drat I have checked, verified, or conformed to all MOA and HAA guidelines in effq is inspection. "DO goal* Signature,w, Engineer's Name _CFSaGF ✓. Av.TM�.v w ; Jr Date CE.189S o .• HAA Fee $ Waiver Fee $ Date of Payment Ell 3113 Date of Payment Receipt Number Z5_O3 d- (c75'4-/ Receipt Number 72-020 (=)' Back MUNICIPALITY OF ANCHORAGE (MOA) • Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: A. WELL DATA I Well Classification COr.imuni']Y If A, B, C, D.E.C. Approved (Y/N) — Well Log Present (Y/N) — Date Completed Total Depth - Cased to — Static Water Level Yield — r2 Depth of Grouting o Casing Height Above Ground Electrical Wiring iri Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot — To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot = Water Sample Collected by Water Sample Test Results Comments — Pump Set At Sanitary Seal on Casing (Y/N) rn Depression Around Wellhead (Y/N) "C =Z < a rn40 E w D 0 N On Adjoining Lots n, � n, On Adjoining Lots — z To Nearest Public Sewer Cleanout/Manhole _ ; Date = B. SEPTIC/HOLDING TANK DATA Date Installed ZS/ Size 12-,!50 No. of Compartments Z Standpipes (Y/N) Y Air -tight Caps (Y/N) Y Foundation CI ano t (Y/N) Depression over Tank (Y/N) N Date Last Pumped Pumping/Maintenance Contact on File (Y/N) N ; for �,t Holding Tank High -Water Alarm (Y/N) VIA Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HO LDING TANK: Bt To Water -Supply Well A11A `�� To Building Foundation To Property Line to To Disposal Field % A) To Water Main/Service Line Ala To Stream, Pond, Lake or Major Drainage Course NIA Comments 72-OM(R«.71N)Fwt Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Abso/`ptii n Strata n• y GPDIF-rZ Type of System Design PreStarc- OJsi- q,�1� . Date Installed —B/�/ %3 Length of Field 5 Width of Field 35 Depth of Field u1n+n`% 2 Gravel Bed Thickness Square Feet of Absortion Area 1500 e Statndpipes Present (Y/N) Depression over Field (Y/N) N Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well NIA J= To Property Line �D , To Building Foundation % To Existing or Abandoned System on Lot ''� / 0 ; On Adjoining Lots /yu To Water Main/Service Line To Cutback (if present) N//4 To Stream, Pond, Lake, or Major Drainage Course N4A To Driveway, Parking Area, or Vehicle Storage Area S� Comments D. LIFT STATION Pi9matK1, Date Installed 6103—Dimensions5�' _ x (9 ' Size in Gallons 500 Manhole/Access (Y/N) Y "Pump On" Level at "Pump Off' Level at 26 r� High Water Alarm Level at 3 L' Vent(Y/N) Y Tested for ly Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments "Check Permitted Bedroom Rating Against HAA Request" I certify that I �,a"ecked, veered, or conformed to all MOA and HAA guidelines in effect on the date of this Signed _ Company Date _ MOA No. KVW Y. AM MN CE -1593 .Cj} • Receipt No. 0, Date of Payment Amount: $ I -7 Receipt No. _ Waiver Fee: $ Date of Payment 72-M (A".7/88) Back Page 2 of 2 Seal r , APPLI"-gT FILLS OUT UPPER HA' -ONLY ..tperty Owner /' �Acj� �/Lc- •.t%I— Phone Mailing Address / � �y) Buyer /� A. "s N. (/ e2�- Ci.e-t.l.- �-C Address ZIP Code Lending institution Q Mone AddressZID Code Inspector Realty Co. & Agent Phone Address / ZIP Code ey Legal Description ,f� ��+-F/.. a /• / �,,,. LA G. (ktru(! �`�+�• Street Location ( ) CONDITIONAL APPROVAL' Type of Residence Single Family Multiple Family No. of Bedroom.�_ ❑ Other BY: Water Supply Date Sewer Installed ATTACH WELL LOG. A well tog Is required for all wells drilled since June 1975. ❑ Individual Q Community Septle Tank SISe �.� For wells trilled prior to that date• give well depth (attach tog If available). CJ Public Utility I Well to Tank Sewer Disposal Individual �a p Year Individual Installed: Public Utility When Connected to Public Utility: O Holding Tank - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time 0 ate Date Date Date Inspector Inspector Inspector Inspector Field Notes: ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL - ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' % � 8 DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septle Tank SISe �.� -7—f/ I Well to Tank 72o CM