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HomeMy WebLinkAboutKINCAID ACRES LT 1C-1Kincaid Acres Lot 1¢-! #011-125-01 Municipality of Anchorage Pageofa 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: 5W 9;>OP, 34 PID Number: 0!! -I a 1 —9> Name: 7?elaca �0 Wastewater System: ❑ New pgrade I L N('�h t �qn L Address: ABSORPTION FIELD Pd '�41y Sex 84 Phone: No. of Bedrooms: 3 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other 562 �oo6a LEGAL DESCRIPTION Soil Rating: �� S Total Depth from original grade: GPD/Sq. Ft. Lot: Block: Subdivision: " C k n t r /t i re .0 Depth to pipe bottom from original grade: 91 S Ft. Gravel depth beneath pipe "211 1 Ft. Township: Range: Section: Fill added above original grade: Gravel length: (RADE Ri-i& o2 Ft. Ft. �'X� i�� ❑ Upgrade WELL: ❑ New Gravel width: 3 Number of lines: ) Distance between lines: M.4 Ft. .1`' Ft. Classifica i A,B,C): Total Depth: Cased To: Total absorption area: TRFfWA( 4�e4So. Ft. Pipe material: ?VC 3c 3 4 Ft. Ft. ENT IRE Driller: DAte4arQed: Static Water level: Installer: _/ �Ar� S Date installed: -14-9 Ft. ,c[AVe JIt`l Yield:Heig Pump Se[ at: Casing ht Above -Ground TANK GPM Ft. Ft. SEPARATION DISTANCES CB(Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: AAk. Tq Capacity in gallons: - 1006) From Tank Field Station Tank Sewer Lines t NA r tSU Material: Number of C mpartments: Well J thio' Nf1 S-ioP I Surf ac +)U01 a 100 1 t!w' LIFT STATION Water e Sot i } f i Size in gallons: Manufacturer: Line 3 5j ' 7 r B, v NA "Pump on" level at: "P off" level at: High water alarm at: Foundation Curtain NA- Pump Mak odel Electrical Inspections performed by: Drain Remarks: IS' o -C ��� le ci,��ei BENCH MARK c�2ci o Q` f f . bud ped ,A 4 Location and Description: .n lu 6. r of Ern 't @} r� P_ �tr ll2 wr � Assumed Elevation: Lo4r,e d, 4-e0- Jcle fu 0 - c ENGINE ik4EA�L `� "+va• �,g �`�, ®P. e a a s s�a `Y 3A_ �4� ",t : a .. vie `• 4T H CQES Dates: 1st �-ty -5j �•..s4aeaa c ......s .:> Inspections performed by: 2nd tfi : Louis A. $u19t6 L .• CE �iub� Department of Health and Human Services approval ##Z;,a�.,„„...d«'hr�s�" c% a�_� i�'�"tl► Reviewed and approved by: i?4.�ef arum Date: 72-013 (Rev. 9/91) MOA 25 f Permit No. SW970238 Page 2 of 2 i 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: KINCAID LOT 1C PID No.: -- S 89.57'06' E Amh 315.45 15' OF EXI5TINQ D FIELD ABANDONO'ED 15' OF TRENCH WITH EFFECTIVE DEPTH o Iv 7.5' INSTALLED AS SHOWN om m N a NEW 1000 CAL SEPTIC TANK M A ALL CAST IRON PIPING REMOVED AND REPLACED WITH PVC 3034 g.P O+ HOUSE SWING TIES Q P A -C = 46.2' B -C = 56.8' A -D = 92.5' B B -D = 101.2' 5CALE 1" =30' • - MONITOR TUBE 0 - SEWER CLEANOUT ¢ - WELL PROPOSED LEACHFIELD - EXISTING LEACHFIELD - EASEMENT ELEVATILINS GGNC SLA2SLA2 GARAGE 8/20/97 (NOT TO SCALE) ASSUMED EBLEV = I00.00 ENGINEER'S SEAL Qoo�4p04 ORIGINAL o of A� LEVEL GROUND AT: o ......... 96,44 DED �HFl�D P 4 9 TH D� +6 Q....:.... .�.�. .........:....D 0� D - �.`..; -..� .............. ..... D 94,0 TANK 3.7 92.4 92.4 �Q �% LOUIS A. BUTERA Q S CE -6736 ? O -\84.7 o4a0�F� pROf ESS10NPo���o 4��OO000�� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 0� PAGE 1 OF 1 acoem t t-1-21 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970238 DATE ISSUED: 8/05/97 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE: 8/05/98 OWNER NAME:NORTHRIM BANK OWNER ADDRESS:P.O. BOX 241489 ANCHORAGE, AK 99524 PARCEL ID:01112187 LEGAL DESCRIPTION: KINCAID ACRES LT 1C LOT SIZE: 89888 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 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: .`% G RECEIVED BY: ��� DATE -;2 �� 7 ISSUED BY: �CI�W'�+��� DATE: Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax July 28, 1997 Jim Cross, P.E. RECEIVED Manager, On -Site Services Municipality of Anchorage J U L 28 1997 P.O. Box 196650 Municipality of Anchorage Anchorage, AK 99519 Dept. Health & Human Services Re: Narrative & Permit Application for Lot 1C Kincaid Acres Dear Mr. Cross: We are requesting an addendum to our previous permit application to replace the septic tank on the above referenced lot to include a relocation of a portion of the leachfield. An asbuilt survey recently performed by our firm has revealed that the present leachfield, installed in 1985, is located within the Public right of way and also crosses a utility easement. The proposed relocation will utilize the existing system design simply shortening the trench and then continuing it at a right angle along the property line adding a similar sized leachfield in the location as shown on the attached site plan. The original soil log should be sufficient as it was performed as a percolation test. The proposed leachfield upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are very large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity and lot size. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \ 1997\97-029B-NAR.DOT Appro well Locdf <•I �.i �.I r'I IT PIPF ALL WELLS +100' DISTANT NO SURFACE WATER NO KNOWN CURTAIN DRAINS Leachffelcl Relocation Plan LEGAL: Kincaid Acres Lot 1 C CLIENTS: Northrim Bank CONTRACTOR: Carl's Excavating JOB# 97-029A I DATE: 7/28/97 SCALE 1" = 60 EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5995 FAX: (907) 694-3297 — NEW TRENCH «�xr — EXISTING TRENCH — MONITOR TUBE a — SEWER CLEANOUT ¢ — WELL — — — EASEMENT Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR LEACHFIELD RELOCATION LEGAL: Kincaid Acres Lot 1-C 7/28/97 A. GENERAL 1. The septic plan is for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. B. SEPTIC TANK 1. Septic tank shall be a minimum of 1000 gallons, and of MOA approved design.. C. TRENCH 1. The trench is to be located as shown on the site plan and tied into the existing leachfield piping. 2. The bottom of the trench shall be level, plus or minus 1.5". 3. The total depth of the trench excavation is match that of the existing trench. 4. .The effluent line within the trench shall be laid level within 0.03'. 5. The trench gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 7. The area over the trench is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH= ±12.5' GRAVEL DEPTH = 7.5' under pipe, 2" over pipe TRENCH LENGTH = 44'(total inc. existing) TRENCH WIDTH = 3' SOIL RATING = 225 sUbr. BEDROOM CAPACITY = 3 SEPTIC TANK = 1000 gallons Twenty-four (24) hours notice required for all inspections. \1997\97-003-spc Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION July 17, 1997 JUL 21 1997 Jim Cross, P.E. RECEIVED Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Narrative & Permit Application for Lot 1 C Kincaid Acres Dear Mr. Cross: We are requesting a permit to replace the septic tank on the above referenced lot. An adequacy test was performed on the leachfield by our firm on 6/26/97 that showed there to be a blockage between the tank and the leachfield. In the process of excavating to clear the blockage it was discovered that the tank had some pinholes in it indicating replacement. While this is a separate issue, the leachfield on lot 1C is located at 92' from the well serving adjacent lot IA. There is some correspondence in your files concerning this and the problem was noted on a previous Health approval application in 1992 that was approved by the city. We were planning to test the system and then apply for a Health Approval using the distances as previously approved in 1992. The proposed septic tank upgrade will have very limited impact on adjacent properties for the following reasons: The surrounding lots are very large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity and lot size. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \1997\97 -029 -NAR Eagle River Engineering services ' Louis Butera, P.P. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR SEPTIC TANK REPLACEMENT LEGAL: Kincaid Acres Lot 1-C 7/21/97 A. GENERAL 1. The drawings shall be a part of this specification. 2. All materials and workmanship shall meet the requirements of Anchorage Department of Health and Environmental Protection Permit. B. THE SEPTIC TANK 1. Septic tank construction shall be a 1000 gallon steel two compartment tank approved by the Municipality of Anchorage. 2. Septic tank is to be installed level on compacted base material. 3. All connections are to be made with caulder couplings. 4. The existing tank is to be pumped, removed and disposed of properly. 5. New tank to be provided with 2 cleanouts after tank. 11997\97-029-spc.doc — - K-Am(c�.�,>ia IFS.®�,cc11. --------------- - — 75' ROW S 89"57'6' E 315.45 (ptic SeM5TING 5EPT1C TANK Septic / AreaREMOVED AND REPLACED ` V 0 Approx o well R Location / NE1vgY HSE rnti �. CO \ (No N o N %13 Q; ori C:) � / 1i ImN ¢// l CD IIV m Portable Storage Buildings -----------J 315.2-3- - 10-' Utit -1i -Ease-em -nt N 89056'23' W This site plan prepared from Asbuift supplied by Northrim Bank dated 12-8-89. All distances and locations are based upon the measurements from that asbuiff• o - SEWER CLEANOUT ALL WELLS +100' DISTANT - WELL NO SURFACE WATER — — — EASEMENT NO KNOWN CURTAIN DRAINS Septic Tonk Site PlanOF���A� it �� LEGAL: Kincaid Acres Lot 1 —C �E •,•, CLIENTS: Northrim Bank i ��P•.•' ••.�5�/�,, CONTRACTOR: Carl s Excavating *0049TH ............ JOB 97-029A DATE: 7/21/97 SCALE 1"= 60 . �— °......x:...00 EAGLE RIVER ENGINEERING SERVICES �j LOUIS A. BUTERA AP.O. Box 773294 I��s� •..•ce-6736 .• �,! EAGLE RIVER, AK. 99577 �#�eo AW4,0 (907) 694-5195 FAX.• (907) 694-3297 ,�%%% ��:�'� MUNICIPALITY OF ANCHORAGE 9 DFPARTMFNT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑ NEW DAVID HaV-D- 'f)ev UPGRADE MAI LING ADDRESS LEGAL DESCRIPTION 6-' LOCATION NO. OF BEDROOMS D _ ,9 Well Absorption area Dwelling PERMIT NO. DISTANCE TO: F- Z Manufacturer( , _ /r M rial fi No. of compartments ti Liqc p cyty in gallons U IF HOMADE: Inside length Wi h Liquid depth ❑ �' DISTANCE TO: Well Dwelling PERMIT NO. J Z ❑ ZQ 2—F Manufacturer Material Liquid capacity in gallons ❑Well -j= w DISTANCETO: �� _ Found 'o Nearest lot lin PERMIT NO. J W Z No. of lines Length of each I'ne Total length f I'n s Trench width Distance between lines H Z w inches - F Top of tile to finish Material beneath grade rile p -c Total effective absorption ar ❑ J5 6 inches Length Width Depth PERMIT NO. w 0 a Type of crib Crib diameter Crib depth Total effective absorption area w a~. LU DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption areals) OTHER jJJ� K+� C PIPE MATERIALS !/ ao 3'7 SOIL TEST RATING INSTALLER W a i$ 5 s a � REMARKS .� OF .� on T H• � rr1a• ••• oeencara so ao • "aly'V e •w •• a �• N 2225-E A ; ��••• J K 25e 1971. ,i sl rarrnvv cu URIC LtUAL f 6{ / 3 '19n1Q fp­ Q1V01 ' �� l- '~�� C3 FR 6N U- E: ^ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGEv AK 99501 264-4*720 C3 E`F;�F="E: FTC M 1 7" ~ PERMIT NO: 850423 DATE ISSUED- 07/19/85 {_}VC� APPLICANT: % T. SPURKLAND DAVID MER8 ADDRESS: 203 W"15� / � ANCHORAGE, AK 99501 ��\{�~A�-O'�\ LEGAL DESCRIP: SUBDIVISION: KINCAID ACRES LOT., 1C BLOCK: N/A SECTION: 9 TOWNSHIP: 12N RANGE: 4W LOT SIZE: 2.50A (SQ.FT. OR ACRES) MAX BEDROOMS: 3 Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. ��F� E:: M CZ� EC e: ID n0 -R P�][rNA DEPTH TQ PIPE BOTTOM (FT.) 6"0 4"0 4"0 GRAVEL DEPTH (FT.) 3 ^ 7.0 0.5 TOTAL DEPTH (FT.) 1 /+5 , "o 7 3 0 � "5 GRAVEL " WIDTH (�T ) ^�� 2"5 22"0 5 0 GRAVEL LENGTH (FT.) 49"0 44"0 73"0 GRAVEL VOLUME (CU. YDS. ) 34.1 35"9 / 54^ 1 TANK SIZE (GALS) 1,000"0 **' 15000°0 ** 1 0O0^0 ** SOIL RATING- (SQ"FT. /BR) 225 213 ' " 225 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS ' I certify that..- J.- hat:1. I am familiar with the requirements for on-site forth by the Municipality of Anchorage (MOA).and and wells as �e� 2^ I will install the system in accordance g �n the State of' Ala��a" and in compliance with the design with all MOA codes and regulations, zgn criteria of this permit 3. I will adhere to all MOA and State of Alaska requirements"�or the �et.b k distances from any existing wellr wastewater disposal s � ac sewerage system on this or any adjacent or nearby lot.ysz�� or public 4" I understand that this permit is valid f�- any enlargement will require an additionalor a ma»imum o� 3 bedrooms and permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES' THEN (1) AN WILL NOT ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED, (2) AS B'aILTS BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND 'v (3)�T�E ELECTRICAL. WORK MUST BE DONE B ELECTRICIAN. SIGNED DAT�: ' a��� �� � APPLICANT: % T. SR���KLAND l�AV^`8 MERO -_~-_� __�����,_�� " � -~~ ISSUED BY DATE: SOILS LOG MUNICIPALITY OF ANCHORAGE �e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST 1. 7 / PERFORMED FOR: DAVID ER0 DATE PERFORMED: � W81frrz LEGAL DESCRIPTION: Lo"r I L 14IIVCA,1 b &&,.Le.r.S SEC. l 11m i .!V rrn SLOPE SITE PLAN 1 2 3 4 5 6�.__,) 7 8 9 10- 11 12 --13- -14- 17 -13-1Q17 i3e v►a V-•........ s 9 19 * e 9TH �f• eenoo ee •e 20 •e r 0. 2225-E �,•• JUNE 25, .1971 •'k 40� R. COMMENTS Q�.ran_'•.,_ _.e •�l��^°= PERFORMED BY: 72-008 (6/79) F WAS GROUND WATER , 1 D L ENCOUNTERED? 1� O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop // r o Z - 14-4 9- v — —e — 5 vC/ 170 J10 10 10 (p — 31fe 12.,0 112 10 -3s/6 11:10 ZO I b 3 3l /2:20 300 l0 3 7% Z /1: 30 w a 10 3(/8 1 !�Z' PERCOLATION RATE P/w✓ / minutes/inch) TEST RUN BETWEEN FT AND Z FT CERTIFIED BY: DATE: 7/f&[ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS C&�' L b 1 /fzc_j I Liqpcit_y in gallons EEJJCCJJ IF HOMEMADE: LEGAL DESCRIPTION C07-10- 0i-I vrr C�� Width LOCATION LOCATION 0 J C7z NO. OF BEDROOMS Wel U X DISTANCE TO: Absorption�rea Dwelling • %� PERMIT NO. H Z Manufacturer ^ a R I n 2t��c; �J? Materia♦\, r l No. of compartments men s UPGRADE y• Liqpcit_y in gallons EEJJCCJJ IF HOMEMADE: Inside length vrr C�� Width �L• Liquid q depth 0 J C7z DISTANCE TO: Wel Dwelling PERMIT NO. 2 Z F Manufacturer Material Liquid capacity in gallons 0 = W DISTANCE TO: Well Foundation / Nearest lot line ! 40 PERMIT N C� G Lu LL Z 2 W ~ Z( Fcc O No. of lines Lengtb of each line / r Top of the to finish grade / Total len th fines 77qq Material beneath the Tren id h (, inches inchesf��� Distance betw�n}fines iyq sorption area P=RMIT W CD Length Width Depth . a F- w& Type of crib Crib diameter Crib depth Total effective absorption area rn DISTANCE TO: Well Building foundation Nearest lot line J J W Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER E MATERIA S 1 J�/f' I 0 ' SOIL TEST RATING INSTALLER _6(' REMARKS (MU, 13 6 CSO - PR VE DATE LEGAL 72- 3 (Rev. 3/78) � ������_ ��� �� ������ ��If��� DEPHRTMENT EHLTH HND ENVIRONMENTHL F1.jT�CTI[.� STREET/ HMCHORHGE, HK99501 ~ ' " 264`4720 Ff��� �� PERMIT NO ( 790269 ) HPPLICHNT GLEN ROBERTS 2284 HRCADIH LOCHTlON KINCHID LEGHL L1C KINCHID HCRES LOT SIZE 55000 SQUHRE FEET TYPE OF SOIL HBSORBTION SYSTEM IS� TRENCH MHXlMUM NUMBER OF BEDROOMS � ] SOIL RHTING (SQ FT/BR)= �90 « THE REQUIRED E. OF THE SOlL HBSORPTION SYSTEM IS� 11 Ff q����� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHlNFIELD THE DEPTH OF R TRENCH OR PIT IS THE DISTHNCE BETNEEN THE SURFRCE OF THE GROUND HND THE BOTTOM OF THE EXCHVHT]QN (IN FEET) THERE IS NO SET III lDTH FOR TRENCHES. THE GRHYEL DEPTH IS THE MINIMUM DEPTH OF ETE GRHVEL BWEN THE OUTFHLL PIPE HND THE BOTTOM OF THE EXCHVHTION (IN FEET) ������ ������ ������ ������ ���� �����_��� PERMIT HPPLICHNT HRS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DRIG UNTHE INSTRLLHTION INSPECTIONS OF HNY NELLS HDJHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE �I ...... ��� ��������������� ���� ���� �� BHCKFILLING OF RNY SYSTEM WITHOUT FINHL INSPECTION RNPPROVHL BY THIS DEPHRTMENT WILL BE SUBJECT TO PRUSECUTION MINIMUM DISTRNCE BETWEEN H WELL HND HNY ':D 7' SENHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIYRTE WELL/ OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL WELL LOGS HRE REQIII lRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION OTHER REQUIREMENTS MHY HPPL\! SPECIFICHTIONS HK0 CONSTRUCTIQN DIHGRHMS HRE HV8ILHBLE TO INSURE PROPER INSTHLL8TION Y.-=- if _111 3- ��riz.. v ������ ��� ���� � I CERTIFY THHT HM FHMlLIHR WITH THE REQUIREMENTS FOR OV. 1~SITE SEWERS RND WELLS HS SET � / FORTH BY THE MUNICIPHLIFill OF HNCHORHGE. �2� I WILL lNSTHLL THE SYSTEM IN RCCORDHNCE WITH THE CODE�� ] I UNDERSTHND THHT THE ON SITE SEW IF THE ISSUED BYGES I �HTE__-�l/ � R K 23 P&M CONSIJLTANTS. I NC, 1,02� <:o W(Iv+ rl�• a u. ,... a1 ..L. .1; !:q - LH n1:9y • TL_.e. 99p.25,40 ENIi�NEl: f]!'� Ci E..1 CI Ci 11 TS -.\NNk: flv May 8, 1979 RO No. 951022 St. John/Kambac6, Joint Venture 5950 Kincaid Road Anchorage, Alaska 99502 Subject: Soil Investigation. for Sanitary Sewer System, Lot 1C Wg, NEI, NQ Section 9, T12N, R4W, Kincaid Acres, Anchorage, Alaska Gentlemen: At your request of May 7, 1979, we conducted a subsurface soils investigation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage Department of health and Environmental Protection. This This investigation, which was accomplished on May 8, 1979, consisted of: a Lest hole drilled to a depth of 20 feet below the existing ground surface. The test hole was sited according to your instructions and its location is shown in attached Drawing A-01. Drilling was accomplished with a rotary drill rig using continuous flight solid -stem auger with an outside diameter of 6 inches and all material brought to the surface by the augers was con- tinuously monitored by an experienced engineering geologist. The topography at the drilling site is generally horizontal. The Lop of the test hole was located at original ground surface. The soils encountered in the bore hole are shown in the test hole log in Drawing A-01. This log displays specific conditions encountered at the test location. However, subsurface conditions may vary in other parts of the lot without any apparent surf.icial evidence of the change. Groundwater was not encountered .in the test hole and bedrock was not encountered. At the Lima the hole was drilled seasonal frost was not present and permafrost was not. encountered. A percolation test was performed within the bore hole at the depth shown in the attached Table 1. A1.1 depLhs,were measured from the top of the hole. The data in Table 1 show average infiltration from the depths indicated to the boLtom of the hole. The measured percolaLion rate_ was 2.66 minutes per inch. Page -2- We appreciated this opportunity to be. of service to you. Pl.ease contact us if you have any questions concerning thus letter or if we can be of addi- tional service.. Very truly yours, R&M CONSUL'T'ANTS, INC. Ernest R. Rahaim Staff Geologist ERR:GS/rm/AT&SI-K Gary )ith Proj.ct Manager �_ ..2�Y`j:. C'1• ..— �—_._._ .v:Y tl'+ F-r.t.� w`�'?'..^.";`,fin, �>ai``:' 'BORING NUMBER 1 Date Completed: 5-8-79 �o SOIL DESCRIPTION NU' :. ORGANIC MATERIAL, OL 5' LOCATION SKETCH No Scale n a 0 0 C-1 HAVE HO05. OWN. E.R.R. FDWG.NO �/� Lot IC of Lot 1 W 1/2, CKD. R6M CONSULTANTS INC. NE 1/4 NW 1/4, Sec. 9, i�wvc.ous T12N, �4W DATE.5-8-79 Kincaid Acres O 95102 SOILS LOGscA�E Anchorage, Alaska A-01 PERCOLATION TEST TABLE 1 R&M NO. 951022 ELAPSED WATER TIME LEVEL TIME (MINUTES) (INCHES) INCREMENTAL DROP (INCHES) 9:15 0 18.25. 0 9:16 1 20.0 1.75 9:18 3 22.25 2.25 9:20 5 24.50 2.25 9:25 10 29.75 5.25 9:35 20 37.50 7.75 9:45 30 44 6.5 9:55 40, 49.25 5.25 10:05 50 53.00_ 3.75 10:15 60 55.25 _ 2.25 11.25 Inches 2.66 Minutes Per Inch i 64?I I I I i I I 9Pol I � H i J f� �� — -- EvEHSOM- CT 5103 FYI LO v 8500 W J r Vic. s 13 W J I f -` LJ \ 6533 8700 L I Y707 L6W i Point Campbell Area Reference Map -P9 -Q®� 140 R&M CONSULTANTS, INC. 5824 CORDOVA ■ BOX 6087 0 ENGINEERS GEOLOGISTS PLANNERS SURVEYORS June 14, 1979 St. John/Kamback, Joint Venture 5950 Kincaid Road Anchorage, Alaska 99502 DEPT. Ci" I '.".:7 f & ENVIRONVENTAL i .cJIECTION liV1 _9 RECEIVED 90]-2]9-0483 111 TLX. 090-25360 R&M No. 951022 Subject: Soil Investigation for Sanitary Sewer System, Lot 1C, W-' NE -4 NW-� Section 9, T12N, R4W, Kincaid Acres, Anchorage, Alaska. Gentlemen: This letter is a supplement to the original letter dated May 8, 1979. The soil which was encountered during the installation of the system was not consistent with the original borehole log and perc rate, therefore on June 14, 1979, another perc test was performed. A test pit was excavated with a backhoe to a depth of 6.5 feet next to the newly installed leach field. The perc test was conducted in a 2 -foot deep hole in the bottom of the pit. The data in Table 1 show average infiltra- tion from the depths indicated to the bottom of the hole. The measured percolation rate was 15 minutes per inch. The 24-hour soaking period was waved for this test since it was determined that the soils encountered did not contain clays that would be susceptable to swelling. This modification in procedure should have no effect on the test results. We appreciated this opportunity to be of service to you, Please contact us if you have any questions concerning this letter or if we can be of additional service. Very truly yours, R&M CONSULTANTS, INC. Ernest R. Rahaim Staff Geologist ERR:GAS/rm I Gary . Smith Proj t Manager ANCHORAGE FAIRBANKS JUNEAU VALOEZ WASILLA i PERCOLATION TEST Table 1 R&M No. 951022 ELAPSED WATER TIME PERCOLATION TEST Table 1 R&M No. 951022 ELAPSED WATER TIME LEVEL INCREMENTAL DROP TIME (MINUTES) (INCHES) (INCHES) 12:10 0 6'6" 0 12:11 1 6'6.75" .75" 12"13 3 6'7.0" .25" 12:15 5 6'7.25" .5" 12:20 10 6'7.75" .5" 12:30 20 6'8.5" .75" 12:40 30 6'9.5" 1" 12:50 40 6.'10.0" .5" 1:00 50 6'10.75" .75" 1:10 60 6'11.5" .75" 2 inches 15 minutes per inch DRILLING, Inc. P. O. Box 4-1224 • 1310C International Airport Road DEPT. C (907) 274-4611 Fiv✓'2 .. T:O"d ANCHORAGE, ALASKA 99509 r -z0 n _� DRILLING LOG Well Owner_ -Fritz_. Kalmbach____ _-- _ ___ _ ksDom. - Location (address of: Township, Range, Section, if known; or distance main Lot 1 Kincaid Acres Size of casing—._- p 6 De th of Hole -306 30 Hole-30-6—feet Cased to -6.3 feet Static water level 125 ft. (ab&6e) (below) land surface. Finish of well (check one) open end ( XX ) Screen ( ); Perforated ( ). Describe screen or perforation IIIA — Well pumping test at 7 2 gallons perX(lr) (minute) for_ 1 hours with 100Q/o of drawdown from static level. Date of completion 8/23/79 WELL LOG Depth in feet from around surface Give details of formations penetrated, size of material, color and hardness 0 -To 5 5 rn 20 20_TO 90 _250 TO 90 TO 120 __300 TO 120 TO 160 _I6-0 TO 170 __170 TO 200 2Q _TO 210 __ _2 L0_TO__2_3_5_ ____23_5�_TO 240 _24G -TO 250 _250 TO 300 __300 TO 303 303 TO 306 TO Peat Clav: cobbl Sandy clayey gravel Red clsancly gravelly silty _sand clay C Clay: sandy -.-silty Sandy silt ilPt sand —gravel cehhly Sand: gravelly, clayey Heaving silt: clayey, wet Silty water sand San water gravel 1 —CUSTOMER • Municipality of Anchorage On -Site Water and Wastewater Program (907).343-7904 Parcel I.D. 011-125=101 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Expiration Date: I (_ 19' f do Kincaid Acres, Lot 1 C-1 Location (site address) 6530 Kincaid Rd :Current Property owner(s) David DUCIOS Day phone M , .,- :addri ! PO Box 92710 Anchorage, AK 99509 Real Estate Agent Day phone 2. TYPE OF DWELLING: R Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER, OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: IndiVival Water Storage Commianity,Class Well ':Public Water System B Holding Tank Community Public Sewer IN Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 Waiver Fee $ CoDate of Payment �' g tDate of Payment Receipt Number b cit (9 Z 6 Receipt Number COSA # ©Sc_ 1 Irc o Ll" f Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 installaflon. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The report ad results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any watranly, for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for--Z—bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Date 8/1212016 bedrooms, with the following stipulations: By: �� v� n ��fiG--P Original Certificate Date: 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. 7. ATTACHMENTS- COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAbluesheet ° 1., c y61 8 9 10 u 1 JAq. If . a AUG Q 5 2016 g 7 than 1 septic system is oh the lot: I COSA Checklist # _of cture served by this system Certificate of On -Site a�w proval Checklist Legal Description: Kincaid Acres Lot 1C-1 pa��11D:011=125-01 A. WELL DATA Well type Private If A, B, or C provide PINSID # Well Log (YIN) Y Date completed 08/23/79 Sanitary seal (YM) Y. Wires properly protected (YIN') Y 306 306.3 18+ " Total depth ft. Cased to ft. Casing Height (above ground) in. FROM WELL LOG AT INSPECTION Data of test 08/23/1979 04/02/15 _ Static water level 125' " 177 ft. Well production 7.5 g.p.m. 4.0+ 9 - p.m -WATER SAMPLE RESULTS: Coliform 7-3. colonies/100 mL Nitrate A) mg/L Arsenic 01v V ug/L Date of sample: 10 14 Collected by: f /� 5 _ B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 08/14/1997 Tank size 1000gal. ,~ Number of Compartments Cleanouts (YIN) Y Foundation cleanout (Y/l¢y Y _ - Depression over tank (Y��/N))) N High water alarm (Y(N) N Date.of pumping � t G Pumper At fYOw e S2l✓i,&4 S 1 t;. ABSORPTION FIELD DATA Date installed 08/6/19851 Soil rating (g.p.d./fe or ft2/bdrm) 225 g.p.d/sq System type Deep Trench Length. -44 ft. Gravel below pipe ft. Total depth 1�7.1� ft.-- Eff, absorption area '660 ; flz Monitoring tube Y • . Depression over'field N Date of ad6ki' acy test 04/ 2-12615 Results (Pass/Fail) PASS For S_ bedrooms Fluid depth in absorption field befsir`> test 33 in. Water added 486 gal. New depth 35 in. Elapsed Time: 139 -min. Final fluid depth 33 in.. Absorption rate r_ .450+ g.p.d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. 'Pump,off" level at in. High water alarm level at in. Datum Cycles tested. Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 10.0+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ 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+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS Survey on file. G. ENGINEER'S CERTIFICATION 1 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 Steven R. Pannone Date 8/3/2016 COSA canary sheet_2.6-15.doc t ■ Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 Certificate of On-Site Systems Approval Parcel I.D. 011-125-01 Expiration Date: ~ retc'heA~tuJ~er GENERAL INFORMATION Complete legal description Kincaid Acres, Lot 1 C-1 Location (site a.d_¢ress) 6530 Kincaid Rd current Property owner(s) Lisa Evanoff Mailing address Day phone 6530 Kincaid Rd Anchorage AK 99509 Real Estate Agent Day phone 2. TYPE OF DWELLING: [] Single Family (w/wo ADU) [] Duplex [] Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class __ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual [] Holding Tank [] Community [] Public Sewer [] WaiverNariance request for: Received by: ~~~ COSA to be released t~ the engineer, unless otherwise requested by the engineer. Distance: Date: ~Zg~/ COSA Fee $. Date of Payment Receipt N umber COSA # 05¢15'/tqo Waiver Fee $. Date of Payment Receipt N umber Waiver # 5, STATEMENT OF INSPECTION BY ENGINEER AS certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Ceffificate of On-Site Systems Approval Guidelines fer 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 ve~-if~ that based on the information obtained from the Municipa[gy 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. In conducting an adequacy test, I aItampt to provide a thorough, conscientious engtaeedng analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 wefis and septic systems depend on the local soil condition, ground water levels that may fluctuate during t~ year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventuafiy fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone bedrooms bedrooms DSD SIGNATURE System #1 Approved for __ System #2 Approved for __ Disapproved Conditional approval for Phone (907) 272-8218 Date '04/8¢15 g.*..:--.¢. -..% bedrooms, with the following stipulations: ON-SITE WATER AND V V,~"~O I ~-,- v v r PROGRAM By: TheC~nici~it of~Jhorage Bevelopmen, Servtae, Divisiorl (DSD) issues Oerfificates of On-Site Systems Approval (CASA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Ataska. The blgnicipafity of Anchorage is not responsible for errers or omissions in the professional eegineer's work. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory X Nitrate Advisory ' Arsenic Advisory .,~ Other 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: Kincaid Acres Lot 1C-1 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 08/23/79 Total depth 306 f. Parcel ID: 011-125-01 Sanitary seal (Y/N) Y Cased to 306'3 ft. Well Leg (Y/N) ¥ Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. Date of test Static water level Well production WATER SAMPLE RESUETS: Coliform f~) ~ colonies/100 mL Arsenic #O, ~ ug/L FROM WELL LOG 08/23/1979 125 f. 7.5 g.p.m. N~rate /U~ mg/L Date of sample:- ~/A,/~0 ! S AT INSPECTION 04/02/15 177 4.0+ Collected by: P ~ ~ B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tanksize 1000 gal. Number of Comeartments 2 Foundation cleanout t'¥/N) Y Depression over tank (Y/N) N Date of pumping ?/~}/~"]~--~ Pumper 4''1' Date installed 08/14/1997 Cleanouts (Y/N) Y High water aiarm (Y/NI N C. ABSORPTION FIELD DATA Date installed 08/6/1985 Soil rating (g.p.d.,~. or ~/bdrm) 225 g.p.d/sq System type Deep Trench Length 44 ff. Width 2.5 ff. Gravel below pipe 7.5 mota~depth 17;1 ft, Eff. absorpii~n-am'a"660 ~ UonitoringtubeY ' Dep~:eSSibn over field N Date of adeouacy test 04/02/2015 Results IPasslFail) .Pass For 3 bedrooms Fluid depth in absorption field before test 33 in. Water added 480 gal. New depth 35 in. Elapsed Time: 130 min. Final fluid depth 33 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO _If yes, give date UFT STATION Date installed "Pump on" level at __ Datum Size in gallons "Pump off' level at in. Cycles tested Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit reauirements? in. E. SEPARATION DIST.~NCES WELL ON LOT TO: Septic tank/liftStation on lot 100+ Absorption tield on lot 100+ Public sewer main 75+ Sewer/septic service line 25+ Animal containment areas 50+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Water main 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: On adjacent lots 100+ On adjacent lots 100+ Public sewer manholetcleanout 100+ Holding tank 100+ Manure/animal excrete storage areas '~ 00+ Property line 5+ Water service line 10+ Property line 1 O+ Building foundation 1.0+ Water Service line 10+ surface water 100+ curtain drain.50+ Wells on adjacent lots 100+ Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vetiicle storage 1 O+ 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 Steven R. Pannone Date 4/3/2015 COSA canary sheet_2.6-15.doc Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmor¢ Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On-Site Systems Approval # 151140 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot lC-1 of Kinard Acres Subdivision. This inspection revealed an arsenic concentration of 10.9 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. �31atFt,r� =z Municipality of Anchorage -e Development Services Department Building Safety Division _ On -Site Water and Wastewater Program „ ;.. 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING t Parcel I.D. 011-121-87 COSA # Oq: � V 14!4 Expiration Date: 8—/? -0 % 1. GENERAL INFORMATION Complete legal description Lot 1C 'Kincaid _`A C, IAF S Location (site address) 6530 Kincaid Road Anchorage. AS Current Property owner(s) ElizabethWeekly Day phone 222-8842 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 92087 Anchorage AK 99509 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 19 Individual Water Storage Cl Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of 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-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 Pannone Engineering Services. LLC Phone 272-8218 Address _P.O. Box 102954, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 4-26-07 Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. ••„a The operational life of all wells and septic systems depend on the local soil condition, ground water �.•�• OF 41444 levels that may fluctuate during the year, and the water usage of the family being served by the system. .•1p��••"""'^ �1� These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that IT. there are no hidden defects or encroachments. PES can therefore not provide any warranty for future 0— �-00 performance nor give any estimate of how long the system will continue to meet the operational 0�'` requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed i (n Steven R onnonel o above. Any reliance upon or use of this report by any other person or party is not authorized nor will it sic No CE 81 a �f confer any legal right whatsoever. 5. DSD SIGNATURE �h._AdrT"cc a��••• Approved for _ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: %^ O (Rev. 11105) Municipality of Anchorage ' Development Services Department Building Safety Division Ort -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsBe (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description; + e I vlCd e j A CY c Parcel ID: 011-121$7 A. WELL DATA Well type Private If A. B, or C provide PWSID fI _ Well Log (Y/N) YC2 Date completed 8/23/1979 Sanitary seal (YIN) Yz Wires properly protected (Y/N) Yes Total depth 306 ft. Cased to 306.3 ft. Casing height (above ground) 24 in. FROM WELL LOO AT INSPECTION Date of test 8/23/1979 4/6/2007 Static water level 125 ft. 130 ft. Well production 7.5 g.p.m. 3S+ g.p.m. WATER SAMPLE RESULTS: Coliform _I—colonies/100 mL Nitrate _ND mg/L Other bacteria 0 colonies/100 mL Arsenic: 14,_7 ugA Date of sample: 4/19/2007 Collected by ISP B. SEP'TICIHOLDINO TANK DATA Tank Type/Material Septic/Steel Date installed 8/1411997 Tank size _1000 gal. Number of Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (YM) Yes Depression over tank (YIN) N2 High water alarm (Y/N) N/A Date of pumping _i- 3 % U :�L Pumper A 2 Aci M _s ? y 1 c as — C. ABSORPTION FIELD DATA Date Installed 7/1/1985 Sop rating (g.p.d.4i or ft+/bdnn) 22s System type Deep Trench Length 43 ft. Width 3 ft. Gravel below pipe 7.5 ft. Total depth 12 ft. Eff. absorption area jafe Monitoring tube Ygft Depression over field N3 Date of adequacy test 4/2/2007 Results (Pass/Feil) Pass For I bedrooms Fluid depth in absorption Heid before test On In. Water added*Q gal. New depth! in. Elapsed Time: 10 min. Final fluid depth Ra in. Absorption rate >= 450+ g.p.d. Arty rejuvenation treatment (past 12 mo.) (YM & type) No If yes, give date D. LIFT STATION Date installed Size In gallons N/A Manhole/Access (y/N) _ "Pump on" level at _ in. `Pump off" level at _ in. High water alarm level at Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/Nit station on lot 100+ Absorption field on lot 100+ Public sewer main N/A Sewer /septic service line 75 Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots _190+ Public sewer manhole/cleanout N/A Holding tank 100+ Animal containment areas 100+ Manure/animal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/MOLDING TANK ON LOT TO: Building foundation _ 40 Property line _4Z Absorption field 15 Water main N/A Water service line 50+ Surface water. 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 11 Building foundation 80 Water main N/A Water Service line 100+ Surface water 100+ Driveway, parking/vehicle storage 15 Curtain drain 75+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION .��� �M: •e�hs I certify that I have determined through field inspections and : `' i •t review of Municipal records that the above systems are in • ` conformance with MOA COSA guidelines in effect on this date. • r Engineer's Printed Name Steven R Pannone P E 0, 0', ;iE �^ • �p Nn CE 5149 Date 4/2612007 ++j .... .'i. ...... :. COSA Fee $_3 C� Date of Payment Receipt Number 3 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number in. Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsitc (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # 070144 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1 c of Kincaid Subdivision. This inspection revealed an arsenic concentration of 14. micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.orWonsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. LOl 1 11= 79-24B KINCAID ACRES SUBDIVISION LOT 1 C 89,888 S.F. KINCAID ROAD in AS -BU I LT GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 4726 WEST 88TH AVENUE ANCHORAGE, ALASKA 99502 PHONE 248-5454 GRIDDATE 2222 5/10/2007 F.B. JOB NO. 07-01 1 KA1C I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE BUILDING DETAIL BUILDING DETAIL MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # G!/ -/2-/ HAA # 1. GENERAL INFORMATION Complete legal description K ���" �z`cs LST 7 - L Location (site address or directions) 3 /YNL GI L°✓G � �t\ _ I Property owner iG, /� .� l��Yr k Day phone �" Mailing address 14s- z y Lending agency A' Day phone Mailing address Agent ' ` ' 7 Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: if community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA x21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm C el<x k k,'vc/ Phone E `7 Address 4,1 % „c, /ljc yvs-? j Engineer's signature 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 order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72 -CM (Rev. 1/91) Back MOA k21 ���`l"� grin• .'' f r�� � �y� niR j Mro 1f e 'i is e� ..�♦ a^ 1R °ihy �''� I �r' �t 2� •vl�'9ar' �t K�.sil�in'S�iit�r$},ra(re • r.n .sA Louis A.. %i,,r 6. DHHS SIGNATURE a 9 'rl. r••. a'r�r .i / Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: f 2 c a 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 order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72 -CM (Rev. 1/91) Back MOA k21 d. , r u1s. n n.....iy va " v'bL Q L, I v lJ 1�_;1V Municipality of Anchorage AVG 2 1 1997 DEPARTMENT OF HEALTH & HUMAN SERVICES � � C Environmental Services Division a €� ;,; V E U* 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist l� Legal Description: l 'h t'+ 1 iNct ✓ es T %C Parcel I.D.: /Jt/ Z j — A. WELL DATA Well type 'r°'vo Tr If A, B, or C, attach ADEC letter. ADEC water system number 9 -a3 -7y Log present4N) p_55 Date completed Total depth 306- Cased to 3d 6 Casing height (above ground) 3 ;Z Sanitary seal Date of test Static water level Well production FROM WELL LOG T -z3- 29 WATER SAMPLE RESULTS: Coliform d Nitrate Date of sample: G - 2 s --q B. SEPTICJHOLDING TANK DATA Wires properly protectel AT INSPECTION 2 g.p.m. 5 l/ 0400 Collected by: Other bacteria l• 13<.Ter4 Yes Date installed X_l q ?' Tank size Number of Compartments 2— Cleanouts6(�)N 2 Foundation cleanout LM IV _ Depression (YO /1� High water alarm (Y/1) /L/4 Date of Pumping IVCWI Pumper IVA C. ABSORPTION FIELD DATA P Date installed ��-�/=`? Soil rating (g.p.d./ft2 or ft2/bdrm) 2 S System type 2LV_� y Length Ll Y ( Width 3 a " Gravel thickness below pipe S / Total depth __Lf Effective absorption area G 6O r% 2Monitoring Tube presemeW Y Depression over field (YO /`) Date of adequacy test K " 2 6 j Results (Pass/Fail) i � s s For 3 bedrooms Fluid depth in absorption field before test (in.); ®� Immediately after 315 gal, water added (in.): Fluid depth U " (ins.) Minutes later: 0 Absorption rate = -t-, q S^ d g•p•d• Peroxide treatment (past 12 months) (Y/P /V� If yes, give date "1-1-4 D. LIFT STATION Date installed Size in ffalle Manhole/Access (Y/N) " p on" level at* "Pump off' level at* IV4 High water al evel at* *Datum Gy ested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot (( 0/ ; On adjacent lots �- 100 Absorption field on lot - r �f / yo ` ; On adjacent lots ( 00 11 Public sewer main AM Public sewer manhole/cleanout IVA Sewer /septic, service line 67 e" f Lift station /VA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Buildingfoundation j S ` Property line 5�6> Absorption field zl S� Water main/service line fi 5�O Surface water/drainage /144 Wells on adjacent lots l Oe9 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: i Building foundation r Property Line // Water main/service line —f- 3- d Surface water / 0a ' Driveway, parking/vehicle storage area 1,4 Curtain drain IvA Wells on adjacent lot F. ENGINEER'S CERTIFICATION I certify that I have determined thru geld inspections and review o Munici al recur .a„. i P % P ,tt� �h•(b,ab4ti °s s�are in conformance with�MMOOArHHAA guidelines in effect on this date. , 4� 1 «ec:Y Fug H� L r /A1Neat',V Signature a r� e.,: aa. a..i. y Engineer's Namey y,� �� A- mac,� n � �Qeal'HePe""'" g rie(,�,�� Sui, .o t der Date CF•b?'•g Zi Pit HAA Fee $ j fL) ` Waiver Fee $ Date of Payment �-� r 7 Date of Payment Receipt Number O 7 `� (%-vo y) Receipt Number _ Rev. 8/95 OSS: haa.wk.doc M_____ Ipality of Ancl rage K Department of Health and Human Services d1 -1r15 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 21, 1993 Tobben Spurkland, P.E. 203 West 15th Avenue #206 Anchorage, Alaska 99501 Subject: Waiver Request for Lot lA Kincaid Acres Subdivision Waiver Request #WR930037, PID #011-121-85,HA930362, SW930233 Dear Mr. Spurkland: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance(s) are a private well on Lot 1A to the drainfield on Lot 1C of 93 feet. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services ljm:#6 Concur: rJI V w Jhn Smi gram On-site Services MUNICIPALITY OF ANCHORAGE M E M O R A N D U M DATE: May 28, 1992 TO: Tina Crary, Scott Wentzel Services, Inc. 3000 C Street, Suite 110 Anchorage, Alaska 99503-3914 FROM: Robert W. Robinson, Civil Engineer On-site Services, DHHSi� SUBJECT: Lot lA Kincaid Acres Subdivision Claim #22235 - David Bredin Reference herein is to the letter from Mr. David W. Bredin dated May 11, 1992 which was attached to and the basis for the captioned claim. The historical data and information pertinent to this claim is as follows: 1. Apparently the well on Lot lA Kincaid Acres Subdivision is located less than the required 100 foot setback from the septic system on Lot 1C Kincaid Acres Subdivision. 2. The well on Lot lA was completed on October 23, 1982 under permit #810656 dated On June 8, 1981. 3. The as -built drawing for Lot 1A, which was approved by this office on June 8, 1981 clearly noted that the well was not yet drilled. 4. On the above referenced permit, there is the following proviso: "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 well." 5. The septic system on Lot 1C was completed in June 1979, and the as -built drawing was approved by this office on June 19, 1979. This completion date precedes the completion of the well on Lot 1A by approximately 2.4 years. A Health Authority Approval was issued by this office for Lot 1C on March 22, 1990. The issuance of this approval was based on data and information provided by a registered Professional Engineer. (Mark Pearson, Mountain Engineering). Mr. Pearson 's signature and seal supposedly provides assurance that all requirements of the Municipal Codes (including setback distances from all on-site or nearby wells) are in compliance. It is the responsibility of the property owner and driller to assure that a well is sited outside of the mandatory setback distance from any on-site septic systems. For these reasons, it is our opinion and recommendation that Claim #22235 - Bredin be denied. RWR/ljm:424 V T MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES p e Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# �t1� la\-�S'-1 HAA# 1�Q�1�f�?�3C7_ 1. GENERAL INFORMATION Complete legal description Kincaid Acres, Lot 1C Location (site address or directions) 6530 Kincaid Road Anchorage, Alaska Property owner Jim Macarillo Day phone ( 303) 292-7154 Mailing address c/o: Us Relocation Services (Gail Roybal ) 1801CCalifornia St.- Suite 2740 L)enver, co 80202 Lending agency Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. Please hold for pickup by Mountain Engineering., 2. NUMBER OF BEDROOMS: 3 v 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer X NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-925 (Rev. 1/91) Front MOA M I w 5. STATEMENT OF INSPECTION BY ENGINEER As certified by. my seal affixed hereto and as of the validation date shown below, ►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 furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of .this inspection. Name of Firm Mountain Engineering Phone 562-1500 Address 3868 Shannon _Wcie Anchorage, AK 99508 Engineer's signature Euc. a -k-- Date x1216192 Ai •"y b v,� ` MARK W. PEARSON Q TF �0ayC0 PROFESS��>�� 6. ' DHHS SIGNATURE - x 3 Approved for bedrooms. Disapproved. Conditional approval for ' bedrooms, with the following stipulations: Additional Comments By: �/ Date 1uric The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA 021 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST 44 Legal Description: Kincaid Acres, Lot 1C Parcel LD A. WELL DATA Well type Res identia]lfA, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Y Date completed 8/23/79 Driller M -W Dri11i Total depth 306' Casedto 306.3' Casing height 20" Sanitary seal (Y/N)y Wires properly protected (Y/N) Y Date of test Static water level Well flow Pump level FROM WELL LOG 8/23/79 125' 7.5 n/a Inc. AT INSPECTION i� 4/20/92 r 1731 1'T7 na 8 , g.p.m. g.p.m. n/a SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 102, ; On adjacent lots G . T Absorption field on lot 108' ; On adjacent lots G. T. Public sewer main n/a Public sewer manhole/cleanout — Public sewer service line n/a Petroleum tank n/a WATER SAMPLE RESULTS: Coliform Passed Date of sample:44%200/9% B. SEPTIC/HOLDING TANK DATA I M a Nitrate Passed Other bacteria Passed Collected by: Brent Eaton Date installed 3/19/79 Tank size 1,000 gal . Compartments 2 Cleanouts (Y/N) v Foundation cleanout (Y/N) N Depression (Y/N) High water alarm (Y/N) N Alarm tested (Y/N) n/a Date of pumping 5/*/92 IU SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s)onlot 102' Onadjacentlots RN' 115' Foundation 30' To property line r- - T_ 101 Absorption field 10' Water main/service line G.T. 25' Surface water/drainage n/a 72-026 (Rev. 3/91)Front MOA 21 CONTINUED ON BACK PAGE U< O r 4 C. LIFT STATION Date installed Size in gallons Vent (Y/N) — High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" level at SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Cycles tested Surface water Date installed 6/19/79 & 8/6/85 Soil rating 190 & 225 System type Trench Length 44+51=95' Width 36"&30" Gravel thickness -71 Total depth 13' Total absorption area 570+660=1230 sf Cleanouts present (Y/N) Y Depression over field (Y/N) Results (pass/fail) Passed Peroxide treatment (past 12 months) (Y/N) N — Date of adequacy test _ for 4 SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 1081 On adjacent lots 92 If yes, give date 4/20/92 bedrooms Property line G.T. 10 ' To building foundation 40 To existing or abandoned system on lot none Onadjacentlots none Cutbank none Water main/service line 35' Surface water n/a Driveway, parking/vehicle storage area G.T. 10' Curtain drain none E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on thntda of this inspection. Signature 1 Engineer's Name Mark Pearson Date (� `615 MARK W. KARI50N A1 HAA Fee $ — / 70 °� Waiver Fee: $ Date of Payment / \ Date of Payment Receipt Number o2 3 7 3!1� C 2 3 �i ) Receipt Number 72-026 (Bev. 3/91) Back MOA 21 MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services 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. # — I� 1 -S'c1 _ HAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) _ ._ Kincaid Acres, Lot 1C Location (address or directions) 6530 Kincaid Road, Anchorage (b) Property owner David Mero Telephone.: (home) 248-0004 Business 522-1291 Mailing Address (c) Lending Institution Mailing Address 6530 Kincaid Road, Anchorage; AK 99502 (d) Real Estate Company and Agent Ref inanci Address Telephone Telephone (e) Mail the HAA to the following address: (or check here t, if hold for pick up.) List contact person and day phone number below: Contact Mountain Enqineerinq at 696-1700 2. TYPE OF RESIDENCE Single -Family ff Number of bedrooms 3 -= 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verifythat my investigation of this u -:Health Authority Approval.;shows-that the on-site water _supply and/or wastewater'„disposal system is safe,,. functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that "based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the. on-site water supply and/or wastewater disposal system is incompliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm. Mountain Engineering Telephone 696-1'/uu Address 10251 Crestview East Eagle River, AK '99577 Date 3/20/90 �rEOF.... t,...•........ _ _ __ � .• .•..� eye 9th i �A 0' Engineer's Seal 44 pMA CE - 776RSON k%'% PROFESSO 6. DHHS APPROVAL - Approved for-edrooms by Date = a 70 ApprovedDisapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. ziae) Back Page 2 of 2 ENVIRONMENTAL SERVICES DIVISION * MAPS 2 0 1990 RECHVED A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: Kincaid Acres, Lot 1C Well Classification Residential If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Y Date Completed 8/23/79 Yield 7 • 5 GPM Total Depth 306' Cased to 306' Depth of Grouting Static Water Level 176' Casing Height Above Ground 20't Electrical Wiring in Conduit (Y/N) Y SEPARATION DISTANCES FROM WELL: Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot 102' ; On Adjoining Lots >200' To Nearest Edge of Absorption Field on Lot 108' ; On Adjoining Lots >200 To Nearest Public Sewer Line NA To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot 401 Water Sample Collected by Mountain Engineering ; Date 3/15/90 Water Sample Test Results Passed Coliform & Nitrate Comments Well test pumped 3/3/90 (see attached letter dated 3/5/90) B. SEPTIC/HOLDING TANK DATA Date Installed 3/19/79Size 1,000 No. of Compartments 2 Standpipes (Y/N) Y Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) N Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Date Last Pumped 3/20/90 ;for Holding Tank High -Water Alarm (Y/N) NA Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 102' To Building Foundation 30 To Property Line > 10' To Disposal Field 10' To Water Main/Service Line >25' To Stream, Pond, Lake or Major Drainage Course NA Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA h„t i 5k Soils Rating in Absorption Strata 190 & 225 Type of System Design Trench Date Installed 6/19/79 & 8/6/85 Length of Field 44' + 51'= 95' Width of Field 36" & 3011 Depth of Field 13' Gravel Bed Thickness 7 11.5 Square Feet of Absortion Area 570+660=1230 Statndpipes Present (Y/N) Y Depression over Field (Y/N) N Date of Last Adequacy Test 3/3/90 Results of Last Adequacy Test PASSED - 4 Bedroom SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well 108' To Property Line >10' To Building Foundation 40 To Existing or Abandoned System on Lot NA ; On Adjoining Lots none To Water Main/Service Line 35' To Cutback (if present) none To Stream, Pond, Lake, or Major Drainage Course none To Driveway, Parking Area, or Vehicle Storage Area >10 ' Comments Initial system was installed 6/19/79, upgraded on 8/6/85. Adequacy test performed on septic system 3/3/90. See 3/5/90 letter from Mountain Enaineerina D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments — Dimensions Manhole/Access (Y/N) "Pump Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. *'Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA g inspection. ®ems pF Signed Mark Pearson ��(Q`,.• " Com an Mountain Engineering®.;` •• p Y hnLL Date I'L� CE89-007 MOA No. on the date of this �I $ MARK W. PEARSON a �2 :ti CE -7760 ::\�, Ile .1 .7 / 0� Receipt No. rJ / / Receipt No. Date of Payment 1_42 VO - 7 e�) Waiver Fee: $ Amount: $ Z 2 00 Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 Engineer's Seal MOUNTAIN ENGINEERING 10251 Crestview East • Eagle River, Alaska 99577 Anchorage 907-696-1700 Outside Anchorage 800-478-0101 Dave Mero 6530 Kincaid Road Anchorage, AK March 12, 1990 Dear Mr. Mero: The purpose of this letter is to document the testing of the well and septic systems on Lot 1C, Kincaid Acres. Mountain Engineering conducted the testing on March 3, 1990. SUMMARY: The well was pumped at a constant rate in excess of 7 gallons per minute (GPM) for 4 hours. Original static water level was 176 FT, and during the sustained 7 GPM flow, the maximum drawdown achieved was 182 FT. The well has a total depth of 306 FT. When the pump was turned off, the well recovered to the undisturbed static water level within 1 minute. Over 600 gallons of water was added to the septic system via the stand pipe at the end of the drainfield. After the water was added, there was no detectable rise in the fluid level in the stand pipe. CONCLUSION: The well and septic systems on the above referenced lot exceed the requirements of the municipality and FHA. Please contact me if you will need any additional information. Additionally, if the FHA needs any further information, they can contact me at 696-1700. Sincerely,