HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 8 LT 14Mountain Park
Est.
Block 8
Lot 14
#017-391-28
Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water & Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number. OSP161266 PID Number. 017-391-28 ❑ New 0 Upgrade
Name:
JIM 8 KAREN EMMEL
ABSORPTION FIELD
■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address:
13121 RIDGEVIEW DRIVE'ANCHORAGE, AK
❑ Other
Phone: No. of Bedrooms:
Soil Red,
Total Depth from Frlglnalg2ae:
952-7657 3
0.6 GPDrsa. PL
10 (MAX') Ft.
LEGAL DESCRIPTION
Depth to pipe lnven from original grade
Gravel dapm beneath pipe:
SEE DWG. FL
4 PL
Subdivision: Block: Lot:
Fill added above onamal grade:
Gravel kmur:
MOUNTAIN PARK ESTATES 8 14
SEE DWG.
75
FL
Ft.
owns Ip:Flange: Section: _
Gravel Witco,
BealsNumaroffires.
Distance between linea:
5 FL
I -
- Ft.
SEPARATION DISTANCES
Total abswptbn arae:
750
umbermtranmea:
1
Dist. between trancbee:
-
T°
Septic
Absorption
Lift
Holding
Public/Private
Prom
Tank
Field
Station
Tank
Sewer Lines
SD, FL
FL
Well
100'+
100'+
_
25'+
TANK ■ Septic Cl S.T.E.P. ❑Holding Cl Other
ManuracWrer
Capacity:
Surface Water
100'+
1001+
-
-
GREER
1000
Gat
Lot Line
5'+
101+
-
-
N/A
Material:
Numterotcwnpa,tmanta:
STEEL
2
LIFT STATION
Foundation
5'+
1o'+
-
Curtain Drain
NONE KNOWN
Manufacturer
c
Gel.
Remarks: OLD SEPTIC TANK DECOMMISSIONED PER UPC.
-Pump on' level at:
'Pury,tlavela°
fHeh,ameralarmat
VOID OF EXISTING SEPTIC TANK WAS FILLED WITH SOIL.
Pump Make B Mcdel'
Electrical lnspecil perumal by
BOTTOM OF TRENCH INSPECTED BY MOA EMPLOYEE TIM
ECKLUND ON 10/26/2016
PIPE MATERIAL
House to tank D3034/EXISTING Tank to D3034
drainfeld
Installer
WILCO EXCAVATION, LLC
Drainfield D3034 CO/MT D3034
Inspector GEG, Ltd.
BENCH MARK (Assumed elevation)
100.00 Ft.
Inspection
Lowt"n and Daacripmn:
Dates: 1st 10/25/2016 2nd 10/26/2016
3rd 10/26/2016 4th -
GARAGE SLAB
ENGINEER'S SEAL
Community Development Department Approval
too
*
Conditional approval: Date:
�y ANGam ss .... r
(�C
-7953
`-
"! -�
.•'� :
�F...,fit 14 14411
PROFESS\�P:•�
Approved: w 1 Date:
�t
1��liviiiiskii
_•
unEcceeEa
Inepedun Reparl it.
PERMITNUMBER: RECORD DRAWING PARCEL ID NUMBER
OSPI:
OSP1612661266 017-391-28
1 BUL RUN VALVE
O 11
X1!1
r\1
BOTTOM OF TRENCH WAS
INSPECTED BY MOA EMPLOYEE
TIM ECKLUND ON 10/26/2016
OLD SEPTIC TANK WAS
)ECOMMISSIONED PER UPC PER
CONTRACTOR
ALL WELL RADAII WERE
PROFESSIONALLY SURVEYED IN
PRIOR TO CONSTRUCTION
1000 GALLON `+-
IPTK%TANK
.1&21 _EXISTING HOME
A
I B
C
ST1
54.4
62.5
88.81
ST2
61.4
70.1
95.5
DBL1
51.5
58.7
85.1
DBL2
51.9
59.4
85.9
DBL3
63.3
71.8
96.9
DBL4
63.9
71.7
96.3
C01
57.7
59.7
61.4
CO2
110.6
90.0
74.7
MT,
59.9
61.5
82.4
MT2
109.8
89.1
73.9
BRV
76.9
69.7
79.7
1 BUL RUN VALVE
O 11
X1!1
r\1
BOTTOM OF TRENCH WAS
INSPECTED BY MOA EMPLOYEE
TIM ECKLUND ON 10/26/2016
OLD SEPTIC TANK WAS
)ECOMMISSIONED PER UPC PER
CONTRACTOR
ALL WELL RADAII WERE
PROFESSIONALLY SURVEYED IN
PRIOR TO CONSTRUCTION
1000 GALLON `+-
IPTK%TANK
.1&21 _EXISTING HOME
FCO
GARNESS
ENGINEERING
1` '.:::. •:') ::' �. DECK
CIVIL & ENVIRONMENTAL ENGINEERS
3101 E IUDOR ROM, SlR1E 101 • ANC110RMaE. AK'gW • AIpE 1'1Q/)4lfilA • FA%(9�/) }i&�i18•Ng91Ew�p�p�.mn
PREPARED FOR:
PHONE NUMBER:
1 � DRIVEWAY '��
KAREN EMMEL
952-7657
2 OF 3
PROJECT/LEGAL DESCRIPTION:
T.H.#1
SHED
MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14
L.K.B./D.J.G.
TYPE OF WORK:
DATE:
� RECORD DRAWING
,tr
11/212016
CO2
<. .
FCO
GARNESS
ENGINEERING
GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3101 E IUDOR ROM, SlR1E 101 • ANC110RMaE. AK'gW • AIpE 1'1Q/)4lfilA • FA%(9�/) }i&�i18•Ng91Ew�p�p�.mn
PREPARED FOR:
PHONE NUMBER:
PAGE NUMBER:
KAREN EMMEL
952-7657
2 OF 3
PROJECT/LEGAL DESCRIPTION:
DRAWN BY:
MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14
L.K.B./D.J.G.
TYPE OF WORK:
DATE:
� RECORD DRAWING
11/212016
S....
LICENSE 11\VASIka* •
#AECC884
N
PERMIT NUMBER: RECORD DRAWING PARCEL ID NUMBER:
017-391-28
T.H.#1
TOP OF TANK
AT INLET = 93.21
INVERT OF BUNG
AT INLET = 92.77
ORIGINAL GRADE AT
HIGHEST POINT= 98.12
— RELATIVE ELEVATION OF
BOTTOM OF TESTHOLE = 82.12
T.H. DRV ON 10/15/1016
FINAL GRADE = 97.21-97.44
ST1 ST2
f TOP OF TANK
AT OUTLET = 93.21
NEW 1000 GALLON
SEPTIC TANK INVERT OF BUNG
AT OUTLET = 92.58
MT CO rFINAL GRADE = 97.43 - 98.52
FILTER FABRIC
INVERT OF PIPE = 92.12
�.•�E OF ,
GARNESS ENGINEERING GROUP, Ltd
CIVIL 8: ENVIRONMENTAL ENGINEERS
3701 E. NOOK ROAD. SUITE 101 • rWCHORAGE, rV(9950]' PIgNE (80])33]$1]9' FA%(90)133&3248'blEBSITE wwxAemmaergneeng.mn .•... 1 ........... .....
�.. /.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: I C� '. / Ge @S:
KAREN EMMEL 952-7657 3 OF 3 ���%�; C 7 3
PROJECTILEGAL DESCRIPTION: DRAWN BY: �♦ F •••.,•1 II L ••."
MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 L.K.B. 1*4 p/ . j.
TYPE Of WORK: DATE: ;"1 `SS\ •\
� RECORD DRAWING 11/2/2016 #AECNC864 1 •
e:
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP161266
Tax Code Number: 01739128000
Work Type: Septic Upgrade
Permit Effective Dates: October 24, 2016 to October 24, 2017
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: MOUNTAIN PARK ESTATES
Site Legal Address: MOUNTAIN PARK ESTATES BLK 8 LT 14 G:2838
Owner/Address: EMMEL JAMES N & KAREN S
REVOCABLE TRUST EMMEL J N & K S/TRUSTEES 12741 SHELBURNE ROAD ANCHORAGE AK 99516;
Site Mailing Address: 13121 RIDGEVIEW DR, Anchorage Lot Size in Sq Ft: 21900
Total Bedrooms: 3
This permit is for the construction of:
Y 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 By
Issued By:
IV ZK -L
10 Zy W16
Municipality of Anchorage
M=
P.O. Box 196650 • 4700 Elmore Road
Anchorage Alaska 99519-6650 • (907) 343-7904 Y Fax (907) 343-7997
http:/Iwww.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSV161124 COSA#: Permit#:OSP161266
PID#: 017-391-28
Legal Description: Mountain Park Estates Block 8 Lot 14
Engineer: Garness Engineering Group
Applicant: Karen Emmel
Your request for a waiver of the required 5 feet horizontal separation from the absorption field
to the test hole has been approved. The approved separation distance is 0.0 feet. See engineer's
letter for waiver request.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owners) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
..................... ........................................................
Waiver is Granted: X Waiver is not Granted:
Date: lf7 2Y .?bApproved by: %k� lx'U�
Name of Reviewer
...............................................................................
**** VARIANCE/WAIVER REVIEW ****
9
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 017-391-28
Property owner(s) KAREN EMMEL Day phone 952-7657
Mailing address 13121 RIDGEVIEW *ANCHORAGE, AK
Site address 13121 RIDGEVIEW *ANCHORAGE AK
Legal description (Sub'd, Block & Lot) MOUNTAIN PARK ESTATES; BLOCK 8 LOT 14
Legal description (Township, Section & Range)
Lot Size
Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DEWELLING:
( Pall that apply)
Initial ❑
Single Family (SF)
Absorption Field
®
®
(w/wo ADU)
Septic Tank
®
Upgrade
❑
Duplex (D)
❑
Holding Tank
❑
Renewal
Multiple Dwellings
❑
❑
(SF and/or D)
Privy
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES
A VARIANCE/ WAIVER REQUEST FOR:
tV _�e5\ \A0\e 4-o
° `�� e
Distance:
I certify that the above information
is correct. I further certify that this
is in accordance with
"
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 15 (A
Date of Payment:
Receipt Number: O 14 S2.Gt
Permit No. ISP! to 12(0'"
Waiver Fees:
Date of Payment: A o) a q 16
Receipt Number: Oq
Waiver No. 0 SV 1( 112
(Rev. 01/11)
WIN r -
pp
GARNESS ENGINEERING GROUP, Ltd
•.CIVIL &ENVIRONMENTAL ENGINEERS+
October 24, 2016
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic System Upgrade for Mountain Park Estates, Block 8, Lot 14
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. The drainfield is in a state of
failure and needs to be upgraded. We are proposing to install a new 1000 gallon septic tank and 5 -wide
type drainfield. One testhole was excavated on the property and the drainfield is designed within its 30
foot radius. Comments regarding the design are summarized as follows:
1. SOILS: See the attached 2016 logs which show the soil classifications, groundwater monitoring, and
the percolation test results. During the excavation of the testhole it was noted that the SP -SM layer was
encountered at 5 feet below existing grade. However, during the excavation of the perk bench, the GM
layer was encountered down to 7 feet. Due to this fact, a percolation test in the SP -SM material was not
performed. In short, we are proposing to use the percolation rate of the GM material for the entire trench.
Given the visual (see attached soil sample) percolation rate of the SP -SM material (less than 30 min/inch)
a 0.6 application rate throughout the trench should be conservative. We would also like to note that a
percolation test was performed in the GM material at 3 feet below grade but did not perk. We do not
believe this is an accurate representation of the GM material, however, it should be noted there are
pockets of impermeable ML (above the proposed septic system).
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY: As can be seen on the attached design drawing, the average topography around the
proposed drainfield is 0-5%.
5. WAIVER: We are requesting that your department issue a variance from the required separation
distance from T.H. to drainfield from 5 feet down to 0 feet. During the excavation of the trench any sluffing
that occurs near the T.H. will be excavated out and compacted as to ensure minimal impact on the
proposed drainfield. We are also requesting that your department allow for the drainfield to be installed
near the existing tank given that we are requiring the existing tank area to be filled with pit -run gravel.
We are unaware ofla0y adverse impacts this installation would have on adjacent wells or septic systems.
If you have any cues ions, please contact us at 337-6179. Thank you for your assistance.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
MOUNTAIN PARK EST
—�� BLOCK LOT
\ 1
� \ I
100' WELL RADIUS
11 Y -MOUNTAIN PARK MTATES; OO
1 1 BL05j�.5 LU `5 W
I \\ 100' WELL RADIUS _ I
1 \\ \ I
\ \ MOUNTAIN PARK E�TATES;
\ \\ \\ BLOCK L07 B
MOUNTAIN PARK ESTATES;
BLOCK LOT 161
I
1
I
\ p
A
CS—EPTIC ARE
/ I
MOUNTAIN PAR15/ESTATES
BLOCKS T 151
I, \
I/ \
A \
0
MOUNTAIN PARK ESTATES;
BLOCK 4 LOT 6
1 1
1 1
�\
1 \
1 1
1 I \
I I \
1 \
L 1
/�1 1 ioo•wELLIRAOI
/ \
i�-T ('MOUNTAIN PARK4`FATES; O
1 SOCK B LOT 1� /
\�-- —F TdO WE I. R I S
RAD
/
\ I /
OUNTAIN BLOCKAyyk ,BATES;
i gf
i
_MOUNTAIN PARK ESTATES;
BLOCK5LOT5
/ \
MOUNTAIN PARK ESTATES; \\ \ \ 11 \
BLOCy SLOT 413 \ \\ \\ \\ r1
I \\ I 160MLI RADIUS I\
I /
MOUNTAIN PARK ESTATES \ \
\ BLOCK51-OT 4A
UNTAIN PARK ESTATES; \
BLOCKS
_____________- I \II \\\\ \
GARNESS
ENGINEERING
GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 E. TUDOR ROAD. SUITE 161'
ANCHORAGE, AK 99597' PHONE (907) 337-6179' FAX (907) 336 31x6' WEBSITE. ww garnessengineerinq=m
PREPARED FOR.
PHONE NUMBER:
PAGE NUMBER:
KAREN EMMEL
952-7657
1 OF 2
PROJECT/LEGAL DESCRIPTION.
DRAWN BY:
MOUNTAIN PARK ESTATES,
BLOCK 8, LOT 14
D.J.G./L.K.B.
TYPE OF WORK:
DATE:
SITE PLAN
9/13/2016
LICENSE
#AECC884
--.1.4h^
PYOFESS�� o
U
DESIGN CRITERIA:
NUMBER OF BEDROOMS: 3
GALLONS PER DAY (GPD): 450
PERCOLATION RATE/S: 30 MIN/INCH
PROPOSED APPLICATION RATE: 0.6
MINIMUM DRAINFIELD SO.FT.: 750 FP
DRAINFIELD DESIGN:
MAXIMUM DEPTH: 10 FEET
WIDTH: 5 FEET
LENGTH: 75 FEET
EFFECTIVE:4 FEET
ACTUAL SOFT.: 750 FP
EXISTING TRENCH WITH 4 FEET OF
EFFECTIVE PER THE 1978 INSPECTION
REPORT. CONTRACTOR SHALL CONFIRM
EXISTING TRENCH LOCATION (BY A
PROFESSIONAL LOCATOR USING A
TRANSMITTER) PRIOR TO
CONSTRUCTING OF THE PROPOSED
DRAINFIELD TO ENSURE SEPARATION
DISTANCE BETWEEN DRAINFIELDS,
(. I
)
I
GES, Ltd. HAS A 8 PAGE SPECIFICATION
PHONE NUMBER:
952-7657
LETTER THAT PERTAINS TO THIS DESIGN. TO
NOTE: THE CONTRACTOR
OBTAIN A COPY OF THE LETTER CONTACT
SHALL HAVE THE NORTH LOT
GES. BY PROCEEDING FORWARD WITH THIS
LINE, AND ALL WELL RADII
INSTALLATION, THE ENGINEER, WELL DRILLER
FLAGGED BY A REGISTERED
CONTRACTOR AND PROPERTY OWNER AGREE
LAND SURVEYOR PRIOR TO
THAT THEY HAVE READ THESE
SPECIFICATIONS AND AGREE TO ACCEPT THE
CONSTRUCTION.
TERMS AND CONDITIONS OUTLINED.
0-5%
0-5 %
GARNESS ENGINEERING GROUP. Lid
PREPARED FOR:
KAREN EMMEL
PHONE NUMBER:
952-7657
PAGE NUMBER'.
2 OF 2
PROJECT/LEGAL DESCRIPTION:
7�
MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14
�� PROPOSED 1000 GALLON
',/ SEPTIC TANK, INSTALL DOUBLE
TYPE OF WORK:
-`
CLEANOUTS BEFORE AND
10/14/2016
// AFTER TANK
9
O/G
EXISTING TANK SHALL BE MOVED AND
PROPERLY DECOMMISSIONED. VOID
S
SHALL BE FILLED WITH PIT -RUN GRAVEN
EXISTING FCO
EXISTING HOME
O
_-_---
`
DECK
w
' a
5 10%
.- SHED
j
GARNESS ENGINEERING GROUP. Lid
PREPARED FOR:
KAREN EMMEL
PHONE NUMBER:
952-7657
PAGE NUMBER'.
2 OF 2
PROJECT/LEGAL DESCRIPTION:
DRAWN BY:
MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14
D.J.G./L.K.B.
TYPE OF WORK:
DATE'.
�, DESIGN
10/14/2016
= 40'
41
e
� "Vy A. e rness i W m
CE -795 =e
0
LICENSE O,°111mv&*
#AECC884
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 E. TUDOR ROAD. SHITE 101' ANCHORAGE, AK 89507' PHONE 1R071 3076179 - FAX S0713Y32AE - MBSNE; rxw.ymmeagmemp mn
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14
PERFORMED FOR:
DEPTH
(feet) ORG/LOAM
1
JIM EMMEL
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
GM
DATE: 9/1/2016
TEST HOLE #1 - LOWER BENCH
SOIL CLASSIFICATIONS
DEPTH TO
GROUNDWATER
DATE
DRY
9/1/2016
DRY
9/7/2016
IIIIIIIII
9/8/2016
II�III!11
U//�I
E1�
111111111
!1111111!
V.M
•
DEPTH TO
GROUNDWATER
DATE
DRY
9/1/2016
DRY
9/7/2016
DRY
9/8/2016
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
10/18/2016 1 3:20 - 6"
2 3:50 30 4.5" 1.5"
3 3:50 - 6"
4 420 30 4.5" 1.5"
5 4:20 - 6" -
6 4:50 30 4.5" 1.5"
DURING THE EXCAVATION OF THE T.H. TH LAYER WAS ENCOUNTERED AT 65 FEET.
HOWEVER, DURING THE EXCAVATION OF THE PERCOLATION BENCH, ONLY THE GM
MATERIAL WAS ENCOUNTERED DOWN TO 7 FEET. THEREFORE, A PERCOLATION TEST WAS
NOT PERFORMED ON THE SM MATERIAL AND ONLY THE GM MATERIAL WAS PERKED. SEE
DESIGN LETTER IN REGARDS TO THE *UPPER BENCH"
PERCOLATION RATE 20 (MIN./INCH)
TEST RUN BETWEEN 7 FT. AND 8
PERC. HOLE DIA. 6 (INCHES)
FT.
20 1 1 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO
SOILS LOGGED BY: DAVID GARNESS PERCOLATION TEST PERFORMED BY: LANDON BRUCE
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PER RM D IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 7to
4�_Pat E1)
4"UNICIPALITY OF ANCHORAGE
r 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
NAME \
�Lx1nrn1F_\
PHI�ONEA,,``
NEW
'J�Tn .
44-9446
❑UPGRADE
MAILING ADDRESS (1
N 0y `S -1
LEGAL DESCRIPTION .
90
l-- \4 �- 8 MT
LOCATION
NO. OF BEDROOMS
1 Un ij
3
U M
DISTANCE TO:
Well \ 1� t - Absorption area I
Dwelling �� I
PERMIT NO. p
—L 8C)-633
t G
Manufacturer ���
Material
%-ME L-
No. of compartments
LU F
^
w
Liq. capacity in gallons
�O
IF HOMEMADE:
Inside length
t
Width
A
Liquid depth
JA
G Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
JAZ
=Z F
Manufacturer
Material
Liquid capacity in gallons
w =
DISTANCE TO:
Well
Z
Foundation
Nearest lot line A
PERMIT NO.
j Y- 2
No. of lines
Length of each line t
Total length of Ii t
es
Trench width
Distance between lines . I M
F Z w(C)
b inches
�1 -A
F
Top of tile to finish
Material beneath the
grade r I.
L{ p It
Total effective aks tion area
inches
Length
idth
Depth
PERMIT NO.
UJ
(7
I
i F
Type of crib
ri ameter `
Crib depth
Total effective absorption area
wa
N
DISTANCE TO:
Well
Buildingfo d ion
Nearest lot line
lassA
Depth
Driller
Distance to lot line PERMIT NO.
r
SE
3
DISTANCE TO:
Building foundation
Sewer line
Septic tank Absorption area(s)
OTHER
W
PIPE MATERIALS
3O7S-A- YLMMO.
SOIL TEST RATI NG
^
INSTALLER
REMARKS
a
ti
Lh
A Ito(
c.
L.
3
L
G
L
A ED1DATE1 p LEGAL
n � t -
IS & 1\�
3
w
MU" 10 I Pf�IL- I TY OF=' Fi/ C3FiC}RF-iC'aE � t
DEPARTMENT RLTH AND ENVIRONMENTAL TION
825 'WREET, ANCHORAGE, AK. 9(.rj2���
264-4720 . , {(.ec, �- --'
�t+i— I TE SSEWER P r
PERMIT NO. [ 780333 ) C) : qq;� ra
1-r3-7k
RPPLIGANT JIM $MMEL SRR BOX 1592- 507 no
4-9446
LOCATION CRESTVIEW 1-ra ��
LEGAL L 14 B 8M PARK ESTATES LOT SIZE 20000 URRE FEET
TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT?BR)= 160 II��
THE REQUIRED SIZE OF THE SOIL RBSOON SYSTEM IS O vY.
E>EF"TH- E ILEh1C3-r"1 C3FZI,-4VEL E E:F�I-r"=
THE,LENOTH DIMENSION IS'THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE -IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
REGtU I REEFlT
E? n3'I IG TFI1'4K �5 I 2�E_ �Li10iO r. nL_L_C]F-as
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 WILL SERVE.
TW01 C 2 ? I t+i F'ECT I C]NS~ DIRE REGlU I F2EE? — —
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE'WELLS OR
150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F•ERM I T E>{F' I RE S E>ECaEME�ER 3:3r 1sA r�:B
I CERTIFY THAT 4
1: I RM 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 ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
SIGNED:- -e z-- ---------------
APPLICANT JIM EMMEL
ISSUED BYJ,� � �" . -DATE- g ---,,91- - ;�
V3. 2
r
GARY PLAYER VENTURES
CONSULTING GEOLOGIST
BOX 476-M, STAR ROUTE A • ANCHORAGE, ALASKA 99507 • PHONE 344-7071
SOILS LOG
Performed for
Location NOCK 14
i40' �3 -2-5' E 4�-evM
0
2
4
6
18
20
Soil Type Water Level
Date -3/4-hg
Remarks
Total Depth of Excavation ��l r Material at Total Depth
Groundwater Bedrock
( ) Not Reached �ot Reached
Depth, if Reached 12—
Classification
2Classification Method'
{/visual
✓( ) Sieve Analysis
�' �enrcv�vtw. fZp.�e = �11 eeAt\Aov-,,r
M
Depth, if Reached
Gary F. Player, Consulting Geologist
vw
vv
uv env a �) c vci G lit (G O {, '
C.
('�coluj�w
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Q�CN_I)'Vj1,j0\< eAZAV',
j 3.5 — 16. S c,, ccu: e1
S W
Total Depth of Excavation ��l r Material at Total Depth
Groundwater Bedrock
( ) Not Reached �ot Reached
Depth, if Reached 12—
Classification
2Classification Method'
{/visual
✓( ) Sieve Analysis
�' �enrcv�vtw. fZp.�e = �11 eeAt\Aov-,,r
M
Depth, if Reached
Gary F. Player, Consulting Geologist
60, kA9
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W0
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F: I:;:. T. . .Fl T
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1000 91,�Lf
N
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 017-391-28 Expiration Date:
1. GENERAL INFORMATION:
Complete legal description Mountain Park Estates: Block 8, Lot 14
Location (site address) 13121 Ridgeview Drive *Anchorage, AK 99516
(?�—tssLj4-OL-4-7-
2-7-/7
Current Property owner(s) Karen & James Emmel Day phone 952-7657
Mailing address
Real Estate Agent
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
W aiverNariance request for:
Received by _ Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5 Waiver Fee $
Date of Payment j 7'1 Date of Payment
Receipt Number 0 15-S DO (7 Receipt Number
COSA# (iSL 1 %t 730 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 installation.
Name of Firm: Garness Enaineering Group. Ltd (GEG) Phone: 907337-6179
Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date: cib I
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system
in accordance with the guidelines and regulations established by the Municipality of Anchorage and
industry practices. The reported results describe the condition of the system/s on the date/s of the
evaluation. Separation distances were measured to readily identifiable features. Hidden defects or
encroachments may exist that were not identified during the evaluation. The operational life of all wells
and septic systems depend upon a variety of variables, including but not limited to, soil conditions,
groundwater levels (that may fluctuate during the year), quality of construction (materials and
workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the
system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of
the well or septic system. GEG makes no representation whether an alternative well or septic system
can be installed on the property in the event either of the current systems fail to perform adequately in
the future. The content of this report is for the sole benefit of the person/party that retained GEG to
perform the evaluation. Reliance upon the information provided in this report by any other person or
parry (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
6. DSD SIGNATURE
System #1 Approved for -� bedrooms
System #2 Approved for bedrooms
#AECC884
Disapproved
Conditional approval for bedrooms, with the following stipulations: `Z,
03�-SiT� T,
WASTEWATER
=; PRO Iw
By: 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 —7a— Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA bWe sheet 10-10-1z.da
If more than 1 septic system is on the lot:
COSA Checklist If of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: Mountain Park Estates; Block 8, Lot 14 parcel ID: 017-391-28
A. WELL DATA J'Reasonable to believe cased to 40'+ based upon surrounding well logs)
Well type Priwte If A, B, or C provide PWSID# N/A Well Log (Y/N) Yes
Date completed 4/1978 Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes
Total depth 176 ft. Cased to`Unknown ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 4/1978 8/5/2016
Static water level 146 ft. 150.1 ft.
Well production 12 g.p.m. 2+ g.p.m.
WATER SAMPLE RESULTS: 1
Coliform n ,V colonies/100 ml. Nitrate '-T � � g./L. Collected by: GEG, Ltd.
Arsenic:/ " Qg./L. Date of sample: 8/16/2017
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 10/25-26/2016
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Yes
Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N) N/A
Date of pumping New Pumper -
C. ABSORPTION FIELD DATA �Bdow Flna1 Grade
Date installed 10/25-26/2016 Soil rating OiDvor ft /bdrm) 0_6 System type Deep Trench
Length 75 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth *9.3+ ft. Eff. absorption area 750 ft2 Monitoring tube Yes Depression over field No
Date of adequacy test New Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test = in. Water added =gal. New depth =in.
Elapsed Time: = min. Final fluid depth = in. Absorption rate >= 450+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (YM & type) None Known If yes, give date -
(Drainfield was dry upon inspection on 8/15/2017)
Information on the 1978 trench on record with MOA
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)_
'Pump on" level at in. "Pump off' level ata er alarm level at
Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main
Sewer /septic service line
Public sewer manhole/cleanout 100'+
Holding tank
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+
Property line 5'+
Absorption field
5'+
Water main 10'+
Water service line 10'+
Surface water
100'+
Wells on adjacent lots
:9
SEPARATION DISTANCE FROM 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 5'+
Curtain drain None Known Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION i OF.q�
i certify that I have determined through field inspections and y I Y
review of Municipal records that the above systems are in ...... "• ' ' '"' "' • • ..
conformance with MOA COSA guidelines in effect on this
date.
t7 f y A. uie s:
A. GARNESS �Q
Engineer's Printe Name JEFFREY CE— 9
Date q�%11� JGc FoG
#AECC884
(Rev. 11/05)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC 161530
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 8, Lot 14 of
Mountain Park Estates subdivision. This inspection revealed a nitrate
concentration of 7.96 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/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.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
Municipality of Anchorage
On -Site Water & Wastewater Program ^
(907)343-7904 >CU;O n
1
CERTIFICATE OF ON-SITE SYSTEMS
Parcel I.D. 017-391-28
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
Expiration Date: 2 -1 l0 -I I
MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14
13121 RIDGEVIEW DRIVE*ANCHORAGE
JIM & KAREN EMMEL Day phone 952-7657
13121 RIDGEVIEW DRIVE*ANCHORAGE
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual Well
i®
Individual On-site
E
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
WaWerfVananoe request for. _NIA Distance:
Received by� �Date:
COSA to be released o the engineer/unless otherwise requested by the engineer.
COSA Fee $ 5-:2 d Waiver Fee $
Date of Payment ��- Date of Payment
Receipt Number X538 Receipt Number
COSA # �Cl �r� a Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my
investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE, AK, 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date It tf 111.
Engineer's Comments:
In conducting lhisevaluaiion, GEGpovidedan engineering evaluab'an ofthe well andlorseptic system in accordance with the
guidelines andregulations established by the MunkipaldycfAnchorage andindushypractices. The reportedresults describe the
condition of the systems on the datek of the evaluation. Separation distances were measured to maddyidentfiable feature.
Hidden defects orencmachmenfs may lha(were idenfifod
1,
4V
exist not during the evaluafion.The operationalfile atoll wells and septic
41,
systems dependon a vanatyof vdriablesinGuding, but notlimrtedto, soilcondNons, gmundwaterlemis(that mayguctuale during
the yea4, quality of construction (materials and workmanship), and the water usage of the family utliving the systems. These
* ;� 4
conditions can vary, and am outside the cannot of SEG. Satisfactory test results do not guarantee future performance of the
■ .e:. .
.
systems; therefore, GEG makes no, warranty (express orimplieog regarding the future performance of the well or septic system.
.I
0
GEG makes no representation whether an aftemative well orseptic system can be installed on the property in the event either of the
/,,,,,1 •,'
current systems fail. The content of this report is for the sale benefit of the persoNparty who retained GEG. Reliance upon the
information in this report by including
t e t�� (ja eSs 4�i
pmvided any otherperson orparty, but not limited no subsequent properlypumhasers,isnot
♦61�:, 4rz
�� C 7953
authorized. In short, GEG disavows anylegal duty to anyone other than the person1party who paid forthis report.
rJ1T ,Y
6. DSD SIGNATURE
♦����FO ppp!,.�........!.�1P���1
System #1 Approved for bedrooms.
LICENSE' 1it"S"1�11•
#AECG884
System #2 Approved for bedrooms.
Disapproved.
'uu(i 1ttrf10F
`;
kl v6,
Conditional approval for bedrooms, with the fallowing
P�
stipulat p
��
ON SITE
^
71 V I I - -'
o STE\NATER c)
PROGRA
Original Certificate Date: I I- ( � — JC-)—
The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work.
7. ATTCHMENTS:
COSA Checklist - Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev. 10112n2)
Q='Ji -D
v ,1)1�11b
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: MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 Parcel ID: 017-391-28
A. WELL DATA *PER SURROUNDING WELL LOGS.
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 4/1978 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 176 ft. Cased to *40+ ft. Casing height (above ground) 1'2+ in.
FROM WELL LOG
Date of test 4/1978
Static water level 146 ft.
Well production 12 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml.
Arsenic: ND<5 ug./L.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material
Nitrate 7.98 mg./L.
AT INSPECTION
8/5/2016
150.1 ft,
2+ g.p.m.
Collected by: GEG. Ltd.
Date of sample: 8 /2 /2016
STEEL
Tank size 1000 gal. Number of Compartments 2
Foundation cleanout (Y/N) YES
Date of pumping NEW
Depression over tank (Y/N)NO
Pumper —
Date installed 10/25-26/2016
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A
C. ABSORPTION FIELD DATA *BELOW FINAL GRADE
Date installed 10/25-26/2016 Soil rating Cfp.d.r ft2/bdrm) 0_6 System type DEEP TRENCH
Length 75 ft., Width 5 ft. Gravel below pipe 4 ft.
Total depth *9.3+ ft. Eff. absorption area 750 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) PASS For E bedrooms
Fluid depth in absorption field before test NEW in. Water added NEW gal. New depth NEW in.
Elapsed Time: NEW min. • Final fluid depth NEW in. Absorption rate >= .450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N R type) NONE If yes, give date —
INFORMATION ON THE 1978 TRENCH IS IN MOA RECORDS
D. LIFT STATION
Date installed.
"Pump on" level at in
E. SEPARATION DISTANCES
Size in gallons Manhole/Access (Y/N
Pump off' level High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION.DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer /septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
Water main
Wells on adjacent lots
5'+
10'+
_ Property line 5'+ Absorption field 5'+
_ Water service line 10'+' Surface water *100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+
Water service line 10'+
Building foundation 10'+ Water main 10'+
Surface water *100,+ Driveway, parking/vehicle storage 5'+
Curtain drain. NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*SEE ATTACHED MOA WETLANDS MAP
G. ENGINEER'S CERTIFICATION
I certify that / have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date 111 /D lit,
(Rev. 11105)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC161530
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 8, Lot 14 of
Mountain Park Estates subdivision. This inspection revealed a nitrate
concentration of 7.98 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/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.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
I dot 15
I N82°15'01"E 189.91
30
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RECERTIFIED 11-316 'Y,f�/
AS -BUILT NO COR ERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
of the following described property: LOT 14. -BLOCK 8.
MOUNTAIN PARK ESTATES SUBDIVISION
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 11th tlay of August .2016
FRED WALATKA & ASSOCIATES
Engineers and Surveyors
(907-248-1666)
.OF , A`
•y
49th00
00
/•••••
#4 .Fred Wal atka. /
SCALE: 1"=30'
if 3255 — S Je��
l,�o'•.
oy�
EASEMENTS OF RECORD. OTHER THAN
THOSE SHOWN THE RECORDED
ON
PLAT ARE NOT SHOWN HEREON.
FB 16-10, pg 37 BE
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RECERTIFIED 11-316 'Y,f�/
AS -BUILT NO COR ERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
of the following described property: LOT 14. -BLOCK 8.
MOUNTAIN PARK ESTATES SUBDIVISION
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 11th tlay of August .2016
FRED WALATKA & ASSOCIATES
Engineers and Surveyors
(907-248-1666)
5. LEGAL DESCRIPTION
DEPT. OF ALT:- &
MUNICIPALITY OF ANCHORAGE
IOt
E
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI ONNVIRQNMENT _ -i ECTION
825 L Street - Anchorage, Alaska 99501
•
FEB 6 11-j-1-9
j
ENVIRONMENTAL ENGINEERING DIVISION
6. TYPE OF RESIDENCE
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
},�
PHONE
<ICstvL �
7. WATER SUPPLY
ry�
MAILING ADDRESS
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
PROPERTY RESIDENT Of different from above)
PHONE
2. BUYER
PHONE
MAILING ADDRESS
❑
3. LENDING INSTITUTION
PUBLIC UTILITY
PHONE
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
IOt
STREET LOCATION
j
V �f ui
6. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
Three ❑ Six
7. WATER SUPPLY
- 4 INDIVIDUAL*
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM
f ] INDIVIDUAL/ON-SITE**
**If individual/on-site, give installation date fU
❑
If system is over two (2) years old an adequacy t st is required
PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED ,
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
❑ SINGLEFAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON-SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
INSTALLER
S
❑Septic Tank or ❑ Holding Tank
Size: 1090 If Tank is homemade
give dimensions:
SOILS RATING
I (f O
TYPE OF TANK
MANUFACTURER /�i'u.✓•"�
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
M- APPROVED FOR �� BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
r
BY (Title)
LEGAL DESCRIPTION
72-010 (Rev. 3/781