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T15N R1W SEC 18 LT 59
T15N RIW Section 18 Block Lot 59 #051-171-26 Municipality of Anchorage Page I of y 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: St�g70348 PID Number: 051 -171 - �6 Name: FAT PRO Wastewater System: ❑ New Upgrade it I cK u Ir "P.O. g.x (07 47Z Q '1956-7 ABSORPTION FIELD Phone: 258 — 8(=00 No. of Bedrooms: 5 D Deep Trench ;Sti Shallow Trench ❑ Bed ❑ Mound O Other LEGAL DESCRIPTION Soil Rating: O n Total Depth aroma original grade: GOD Ft Lot: Block: Subdivision: Depth to pipe bottom tmmm original grade: Gravel depth beneath pipe $q — 1+ Ft Ft. Township: Range: Section: Fill added above original grade: 1 Gra"I length: 59 SIJ I lA1 1 e) O' — li Ft WELLC., D New ❑Upgrade Gravel width: 51 Number of lines: Dis7nce Dellen lines: Lhl$.r)1,i Ft. Ft. Classification (Pante, A.B.CI: Togl Depth: d To: Total absorption area: Pipe material: .P Ft. Ft. *O SO. Ft. Q TPI 0- o3N F-810 Onlierate Drilled: Static water Level: installer.Date G.eti'fcvcn installed: lo-Io-9-i Ft. WALKe'f, yield: Pump Set at: I Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES Septic 0Holding ❑S.T.E.P. To Septic Aasorptice Lift Holding ubii,_ r ate Manufacturer. Capacity in gallons: From Tank Field station Tank Sear tines AAc.146tAl.nE -rMK 1.500 Weft l+ "" Material: 5_reE1- Number of Compartments: loo+ too ZSI+ urfaceool+ I --' — LIFT STATION Water 1 LotSize — _ in gallons: Manufacturer. Line /01+ tol+ Foundation �'- �� -Pump on- level at: 'Pu level at: High water alarm at: 5',f 1011 Curtain PlofdE n oo 4 f7777f=Pump Mak Electrical Inspections performed by: Drain Remarks: LXss71dvG T2tNcN ANS BENCHMARK Strjr-C TArvK C-ompkptrEL Location and Dwriptipn: Sao4 6e f TV v Aa/7v oc/E0 P .1r " A`k Assumed Elevation: I00 1 EN tl[rbBi,SAL 3 3 S ENGINEERING 10 -1-9-1 Inspections performed by —Dates: ; .-...t "r.r �q,..— ; 17034 Eagle River loop Road, No. 2042nd 10-10-47 :; ...A 1 ? ROBERT C. COWAN I i Eagle River, Alaska 99577 1 —1 - e-, CE -8801 ' 4+����Fo Department of Health and Hyman Services approval ��= 1L -98 ; lt�:p�aiius—F`� Reviewed and approved by: Dater 72413 (Rev. alai) MOA 25 PERMIT NO.SW970348 PACE 2 OF 2 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Tele hone, 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAL LOT 59, SEC. 18, T15N, R1W P.I.D. No. 051-171-26 oau ' NEW 1500 GAL. A B Sa SEPTIC TANK 43.0 STI S 61.6 68.6 �i Nr�� /m' DBLf 67.0 DBL2 1 1 rto FD b 55— NEW TRENCH ;4M NEW co 60.6 �l $ SD MT1 9.0 2.b HOUSE MT2 98.0 83.6 111 I o i � SHED 11 I 1 11 I #'"i' RADIUS W � 1p0• WE1-L �r» d G ----------------------------- ----------- 9� --- --------- 33' PATENT ROW RESERVE STI ST2 HT1 COI Col 97.9' SCALE V . 40' . 99.5 RNAL GRADE MT2 CO2 CO2 - 100.7 ? 1t SOLATION /l 98.6• 98.3 .•.-.••. 1500 CAL . S.T. SR 01 93.8' .. MTI - CO2 89.9' 94.0' ll01IRT C. COWAN • •! ��+� j xrs MT2 89.9A84' �t %l1 CE -8801 WATER POUND 81.9' B.O.H. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST ROBERT C. COWAN --m—p—sm— PERFORMED FOR: r�}'C `ROo'C DATE PERFORME�1 (r LEGAL DESCRIPTION: Lo -r Sq Township. Range, Section: "'r 151 . { SLOPE SITE PLAN ORGAdtcS 3 � ' 4- 5- 7 5 8 8 9 10 12 / pp Y. 13- 14 3 14 Y X/ 15 •. e. 16- 17- 18- 19- 2o4 s17181920 COMMENTS GM TI1*z S WAS GROUND WATER �1 O ENCOUNTERED? 1� IF YES, AT WHAT DEPTH7 Depth to Wrier Atter Monitoring? -- Date: m PERCOLATION RATE tminutevmcn) PERC HOLE DIAMETER TEST RUN BETWEEN FTAND � FT v o a u.vu�ccnuw PERFORMED BY: I Wk. 4Ff✓x— CERTIFY THAT THIS TEST WAS PERFORMED IN G• ACCORDANCE WI4A1a j!IW* AtW GUIDELINES IN EFFECT ON THIS DATE. DATE. /U '13 / h Vil(t 72-008 (Rev. 4,851 Most Copy of vcx r� PAGE 1 OF 1 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 (UPGRADE) PERMIT PERMIT NUMBER:SW970348 DESIGN ENGINEER: $ 1,S tfV"L_fN2s (Znnb OWNER NAME:PROUT, PAT OWNER ADDRESS: on L,x ^SCR, ALASKA 99567 PARCEL ID:05117126 LEGAL DESCRIPTION: T15N R1W SEC 18 LT 59 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED:10/03/97 EXPIRATION DATE:10/03/98 lo—1 �41� 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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 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: RECEIVED BY: i�9/h.�% ✓� DATE: 9,-7 ISSUED BY: K, %��• L/ a' cl`1� DATE: IfALTMAUTHDRITY APPROVALS SEWER 8 WATER WNET(TENSIONS SEWER 6 WATER INSPECTION ENGINEERING STUDIES ANOREPORTS WELLI SPECRON AF(.OWTEST 617E PLANS ROADDESIGN SOIL. TEST PERCOLATION TEST STRUCTURAL& MECHANICAL rSPEcnoNs ONSITE WASTEWATER DISPOSALSYSTEM DESIGN August 21, 1997 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 59, Sec. 18, TI 5N, R1W ROBERT C. COWAN, P.E. CMLENGINEERS (907)694-2979 FAX(907)694.1211 Request you issue a permit to upgrade the septic system for the proposed five bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. The monitoring tube within thetest hole has been checked and found to be dry. CN4c.*0-9r'#„v oN 411i$-1917 A.4 LvAITtt 074 ,✓J 47- la Ya. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system If you require additional information, please contact us. Sincerely, -/&Z 4, C -- Robert C. Cowan, P.E. RCCImb, Enclosure 0NICIPAt, flVy,R� U ENr� aRV tj CCH0k4GE G 2 6199Es DIVISION 1 RECE� QED 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 111 SCALE SITE -PLAN DESIGN lE 0TOo c -F R1 ,mo < A A>y S t s� ^moo otl� t' M. r'^ 2ND O m M. p N y O nl•1 > !Nn o"L yCy r' _ITT Z O ? D j p I ,o4'kf .D Z r.• iH E(y i 0 7 V N N d ' m S— Ln O 1 fa A� i Z O E Z > O r 0 C/] O cF OD 11 r- ARCA 'D CRADEO BE n II O 1 i LESS I iD Azmq�25,-tocoN �r1 Ln Cn 0 0 c O O\C 1 � 0NIN 1 C% NO WELLS/SEPTIC N N O —W�TNiN 100'i Of j �' ..1� 1 > P PROPOSED SEPTIC 1 ^O � I 1 m 1 •• (J ! O O m. a 1° x ' > m s ; gn TCn eon 0 1 A W 1 y i CM ]^rO s i m ' cA 7t�y`DE O o C7 i ZE N -i= m N mi y .'Anda K ' o M m LO Ln A too b m l -1� C •� �m O D i DO nr0•'Tm ro m 8 z Z� pZm0 I�n 1 1 > 0 Z e < Cs1 00 i C r -n rn d 1 n r i j C O O M ?`L (f W 1 1 o2o� ;T4 O VIE Z n yl � fl O^'In�mOv I y N K C Z E orinSn 210 2 �2� �3 nY KDOa= ~Ty 0 Rn mz>p 4r mn f pYFR Rn�+ Nci;m mi ��i n . o+ 1 � 7AyE IOA § AAy OX �4+��+ 1`� �_ z PERFORMED LEGAL t ` 2- 3- 4- - 3 4 5- 6- 7 6 7 8- 9- 10 910 a /. 11 Q 12- 13- 14- 15- 16 2 131415 16 17 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST is P4 19- 20- COMMENTS s 20 COMMENTS DATEPERFORM Township, Range, Section: �Sr� WAS GROUND WATER \n ENCOUNTERED? 1 �! S IF YES. AT WHAT L DEPTH? p Depth to Water J1Ru-,. _ , q MMonitoring??1_._.�4-`i,AD�lt: AL— n ROBERT G COWAN c3••,�CE 8801 PLAN ==mmm�I PERCOLATION RATE ,!Z tminutewoncnl PERC HOLE DIAMETER TESTRUNBETWEEN `COFTAND L r�FT 5 6 5 tNViNCCRImw PERFORMED BY: pF17,�0,,t�14ppEtt RgiReeitlriii��fSgqagqLgiR�,&A Rte_ 4DA 1. - - � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITFfl tMVff1E���v' 1AW1CfPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: g / a 1`17 72-M (Rev. 4/85) PERCOLATION RATE ,!Z tminutewoncnl PERC HOLE DIAMETER TESTRUNBETWEEN `COFTAND L r�FT 5 6 5 tNViNCCRImw PERFORMED BY: pF17,�0,,t�14ppEtt RgiReeitlriii��fSgqagqLgiR�,&A Rte_ 4DA 1. - - � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITFfl tMVff1E���v' 1AW1CfPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: g / a 1`17 72-M (Rev. 4/85) 5 Municipality of Anchorage • Development Services Department Building Safety Division _.� On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL { FOR A SINGLE FAMILY DWELLING Parcel I.D. n5 i -o2r COSA # U 9wfa Expiration Date: j f — g1— 0 9 1. GENERAL INFORMATION Complete legal description Lot 59; Section 18; T15N; R1 W Location (site address) 19425 Becky Lane Chugiak, AK 99567 Current Property owner(s) Patrick b Pamela Prout Day phone 872419-8419 Mailing address Lending agency Day phone Mailing address Real Estate Agent James Tatum / Frontier Properties Day phone 440.0801 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site❑ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of 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 sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of 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 -she water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S engineering Phone 6942979 Address 15861 S. Birchwood Loop Rd. Chugiak, AK 99567 Engineer's Printed Name Robert A. Shafer Date 1% 16 e . • . e.'• "i . 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulation:' Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report Other ey:r� Original Certificate Date: '" (Rev IIft) Municipality of Anchorage •�, Development Services Department Building Safety Division s. ... On -Site Water 3 Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE cOF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: L� 5?4 r 9i /; F -It Parcel ID: - 71 �a A. WELL�ATJe 06CC CAVIL* Well type7t'-/t� If A, B, or C provide PWSID #= Well Log (Y& D yE�aFt noN t Date completed Sanitary seal(ON) � Wires properly protectec[j]ctrv)_�'r I It Total depth aff it ft. Cased to W-rft. Casing height (above ground) I -t in. FROM WELL LOG AT INSPECTION Date of test1,2 109,1 I Static water level ft. 69 ft. Well production g.p.m. 6' g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate _4mg/L Other bacteria C---> colonies/100 mL Arsenic: �ug/L date of sample: 1005 Collected by: S$5 Ek741Mr6P-W& B. SEPTIC/HOLDING TANK DATA Tank Type/Material SErIlG Sr ;5c _ Date installed 10111-1!7 Tank size 11-40 gal. Number of Compartments Cleanout4jY N) 1f') Foundation cleanout&'(( )) _)b Depression over tank CO kh High water alarm (ye �)10_ Date of pumping _ I '1 Pumper P -j�>(�iJ1!�li(Xu , C. ABSORPTION FIELD DATA Date installed T3 Soil rati Length_ ft. ng (g.p.d.e or ftzlbdrm) 0112) Width E71 ft. System type ` I Rt(0tJ (t° -f&" I Gravel below pipe �_ ft. I Total depth 6jr ft. Eff. absorption area ft' Monitonn tube `' Date of adequacy lest Results Pass/Fail I Fluid depth in absorption field before test 2L in. ���u Final fluid depth �rr In. Elapsed Time: gzmin. Water added gal. Depression over field A 'o For bedrooms If New depth in. Absorption rate >= :ZW+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y& type) U If yes, give date = D. LIFT STATION 10// 1 Date installed Size in gallons Mme/Accd 'Pump on' level at _ in. 'Pump off l Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic tank/lift station on lot IOD 4- Absorption field on lot /00 I -L Public sewer main A)/h Sewer /septic service line C2S i— Animal containment areas SO Lf High water alarm level at Meets alar & circuit requirements? On adjacent lots 100-4- r On adjacent lots /00 �' Public sewer manhole/cleanout Holding tank 0/ Manure/animal excrete storage areas /0Y9 04 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r Building foundation S f Property line S * Absorption field 5 14- f} I � Water main l) Water service line /D Surface water A""4t- Wells on adjacent lots /4!�) 4 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line -f- Building foundation /D + Water main A / / r Water Service line 09 t Surface water /06 Driveway, parking/vehicle storage rJ r Curtain drain /GGbu'' ells on adjacent lots /OD + F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined review of Municipal records th conformance with MOA COSA t Engineer's Printed Name Date / /6 /d COSA Fee $ 410— Date VDate of Payment IO Receipt Number ©a (Rev. 11105) h field inspections and above systems are in Waiver Fee $ Date of Payment Receipt Number e� ' A o. U1 l09 N7 .1 �H .`�'.. w<_r c � " y 1 1 f 0 t l% fr.t.. r Fscicti L. /a; i�.•T.•M .f .«u.e«oiF AS -BUILT 1 hereby certify that 1 have surveyed the following described property_ Anchorage Recording precinct, Alaska, and that the improve. ments situated thereon are within the Property lines and do not overlap or 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. /t 4C �^ StLy, ke•{(e.. t l% fr.t.. r Fscicti L. /a; i�.•T.•M .f .«u.e«oiF AS -BUILT 1 hereby certify that 1 have surveyed the following described property_ Anchorage Recording precinct, Alaska, and that the improve. ments situated thereon are within the Property lines and do not overlap or 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. Jan 02 09 12:19p F&M 907-622-1344 p•1 3.•i .i�i.VraaM�/r%w.w M/,..�.1 �. F I�if . ... • ..� 'L7d ♦ • :•. ; NO. `:33.55 t,Lat� �•.. j�Y .rye:,t+•.'Y AS -BUILT I nereoy " that l ltave surveyed the following destdbed property. J C r r �f .Al, Anchorage Recording Precinct, Alaska, and that the Improve- arcnts sitnaI'd thereon are within the property tines and do not overlap or encroach on the property lying adjacent thereto, that . no improvemems on property tying ad cent thereto encroach . an the premises in gaestron and that dare are no roadways, trmcmiaion lines or other visible easements on said property accept as indicated hereon. Dated at Eagle River, Alaska @ris —�'r day of ROBERT C. JOHNSON ;c• :1 SCAM Registered Land Srcveyor No. 06(6 LS Y'. .5-C Fox 77-045/,.Fagle River, Aiagka 99.W