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HomeMy WebLinkAboutHAMPTON HILLS #1 BLK 2 LT 11 Municipality of Anchorage On-Site Water and Wastewater Program • (907)343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181124 PID Number: 015 134 59 Dwelling: ❑■ Single Family (SF) ❑ Duplex(D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: TOM BRADY ABSORPTION FIELD Address ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 7760 MCLURE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 250-5608 4 -- GPD/SF -- Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot -- Ft.-- Ft. HAMPTON HILLS#1 2 11 Fill added above original grade Gravel length Township Range Section -- Ft. -- Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES -- Ft. -- -- Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches Tank Field Lift Station -- Tank Line From Ft` -- -- Ft. TANK ®Septic ❑S.T.E.P. 0 Holding 0 Other Well +1 QQ -- -- -- -- Manufacturer Capacity Surface water +100 -- -- -- ANCHORAGE 1250 Gal. Material Number of compartments Lot Line +5 -- -- NA STEEL 2 Foundation +5 -- -- -- LIFT STATION Manufacturer Capacity Curtain Drain -- -- -- -- -- -- Gal. Remarks OLD TANK DISPOSED OF PER MOA Pump on level at Pump off level at High water alarm at REQUIREMENTS -- in. -- in. -- in. TANK REPLACEMENT ONLY Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 to 3034 Installer drainfield GUARANTEED SERVICES Drainfield UNK CO/MTUNK Inspector CHARLES BALZARINI BENCH MARK (Assumed elevation) 100 ft Inspeectio: 1" 7/11/18 2�� Location and description 3,a 4N TOP OF CONC PAD COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date NVQ,..•' S,� ' ( 9I * :v*&/I // CHARLES G BALZARINI ,g, ;••. CE-13854 •;<� // • Approved L v"� a, k(—(4 0,`...,0; . ,,....:,::?:-'=:. Date ‘iF`a;,0,; ,.iO � Inspection Report_9-1-12.doc OFq��S1 i -/ =41- � q l *: TH * ••* / 4 • // r-• \ ,Ir• • HARLES G BALZARII j • t F CE-13854 •••`4,/ SWING TIES 1l1`\ PROFESSIONai+ I D A B `\\\\\��* FCO 38.9 11.7 T1 37.7 15 B T2 38.8 21.1 NEW 1250 GAL TANK. Cl 37.5 25.9CO OLD TANK DEMOLISHED C2 37 27.1 o PER MOA REQUIREMENTS MT1 17.6 54 4 BR HOMEllit` 2 NEW AFTER C1 ►•f� TANK CLEANOUTS arir • C I I AI • • �, I EXISTING . y o FIELD A . .A'• '..:. • A . • A .` • M 1 r-' DaIVEFAY •••• > ' m PROSPECT HEIGHTS #5 �_•••'dam. . ..• . . : •, ` m BLOCK 1 LOT 1 t:.* — BM, CONC Hz PAD • , . ,. A.. 100' WELL RADIUS \ \ PLAN-SCALE: 1"=I20' FOUDATION CLEANOUT CLNEANOUT MONITOR TUBE 1024 SBM•100.0' FiNISII[ CONC FAD GRA-JR !i':-,:i`iEF 111 96 99 9:16 NEN/125• CAL TA\K SCHEMATIC ELEVATION-SCALE:NTS LEGAL DESCRIPTION:HAMPTON HILLS#1 BLOCK 2 LOT 11 C&M ENGINEERING SERVICES OWNER:TOM BRADY DATE:9/05/18 I REV:O DRAWN:CBI REF: 907-854-5558 SITE PLAN AL",. MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program \0 5'� PO Box 196650 4700 Elmore Road A ,P ir Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 r, :- http://www.muni.org/onsite N. 1.51111' I) I,arini nt 4N'CH UNPGB On-Site Wastewater Disposal System Permit Mt//8 Permit Number: OSP181124 Effective Date: 6/29/2018 Work Type: SepticTank Upgrade Expiration Date: 6/29/2019 Tax Code Number: 01513459000 Site Legal Address: HAMPTON HILLS #1 BLK 2 LT 11 G:2540 Site Mailing Address: 7760 MC LURE CIR, Anchorage Owner: BRADY THOMAS P SR Lot Size in Sq Ft: 51032 Design Engineer: C & M Engineering Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: �--.i Date: ‘7/- (//1 Issued By: l /� �i(-)Orr �.�„4—i Date: 0 t-� 0 "'' MUNICIPALITY OF ANCHORAGE mens On-Site Water&Wastewater Program �o S�"� l .lug PO Box 196650 4700 Elmore Road _ Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 "` http://www.muni.org/onsite Clint■ l)t•I ;11'I Illt'I1I 9NCHOHPG6 On-Site Wastewater Disposal System Permit Permit Number: OSP181124 Effective Date: 6/29/2018 Work Type: SepticTank Upgrade Expiration Date: 6/29/2019 Tax Code Number: 01513459000 Site Legal Address: HAMPTON HILLS #1 BLK 2 LT 11 G:2540 Site Mailing Address: 7760 MC LURE CIR, Anchorage Owner: BRADY THOMAS P SR Lot Size in Sq Ft: 51032 Design Engineer: C & M Engineering Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field El Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: 4;2- Date: -� Issued By: � (/�/� C�"� � � Date: 4, MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section F.\•„,•.• 4 o 97 (N:b pOtip z ON-SITE SEPTIC/WELL PERMIT APPLICATION ��'N 4 2 .i Parcel I.D. Cil5 —1�1 _ 6/ !!�� 6 8 L95” Property owner(s) Ovv\ PDR4 t Day phone Mailing address 77Go M(_ Lv i2-t. Site address 771 ' rN((,w Legal description (Sub'd., Block & Lot) H iv 'P ' 1/12?-)--5 $ Legal description (Township, Range & Section) Lot Size S i 00c, Sq. Ft. Number of Bedrooms (,t APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field 74 Initial ❑ Single Family (SF) I Septic Tank Upgrade (w/wo ADU) Holding Tank ❑ Renewal Duplex (D) ❑ ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: 41(9/t/ Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Si. .. ure of property owner or authorized agent) Permit/Rush Fees: 4215 .'' Waiver Fees: Date of Payment: Of4/16 Date of Payment: Receipt Number: c�n,O(0343b Receipt Number: Permit No. OSP l$0-2-4 Waiver No. G:1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water&Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 6/26/2018 RE: Proposed Septic System Modification for Hampton Hills#1 Block 2 Lot 11 Dear Reviewer, The above referenced property is currently served by a 4 bedroom septic system installed in 1981. The 1250 gallon tank has failed and is in need of immediate replacement. We are proposing that the existing tank be replaced with a new 1250 gallon tank constructed and installed in accordance with MOA requirements. As noted on the plan, the top of the tank will be installed no lower than the bottom of the footing since it will be installed between 5'-10' of the foundation. This will keep the tank out of the foundations bearing prism. The tank shall be covered with a minimum of 2" moa approved insulation and 3' of cover. The repair shall be performed by a moa certified installer in accordance with MOA requirements. The engineer will inspect the tank before backfilling. Repair of the proposed system will not negatively impact adjacent lots. Upon completion of the installation, a record drawing will be submitted showing the location of the new tank, leachfield, well, and other applicable features. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email ccbalzariniftsimail.com with any questions or concerns. Sincerely, Charles Balzarini, PE fv� / HAMPTON HILLS#1q��l� if \ — — ` BLOCK 2 LOT 13 ANY Allg K 11 A . j*.• 49TM r� .*T Ne, ,�'' CHARLES G BALZARIN j �O f<`.• CE-13854 • NOTE: T . 6/26/18 .• . il�lN.. P •NP Piss- IF THE TANK IS INSTALLED BETWEEN 5'AND 10'OF THE FOUNDATION, ROFESS\� �•�' THE TOP OF THE TANK MAY BE NO LOWER THAN THE BOTTOM ��,"`t� OF THE FOOTING AND MUST STILL HAVE SUFFICIENT DROP TO THE TANK SURVEY LOT LINE AND UTILITY EASEMENT PRIOR TO INSTALLING TANK. INSTALL NEW FOUNDATION CLEANOUT WITHIN 5'OF HOUSE IF NECESSARY. 100'NEIGHBORING REPLACE EXIST TANK WELL RADIUS(APPROX) WITH NEW 1250 GAL TANK.DEMOLISH OLD TANK PER MOA 4 BR REQUIREMENTS HOME NEW AFTER TANK CLEANOUTS u I I \ +••, � I EXISTING .•: I FIELD TO I .: ..•�.••�y��A; I C REMAIN J. ` v • -1 _ +•D: • '.1.1'ti1 is• I n rn mPROSPECT HEIGHTS#5 •.,.:";...t!� • ,•.. , m BLOCK 1 LOT 1 HAMPTON HILLS#1 x r ,._• :.•••••• BLOCK 2 LOT 12 is•''- A- \ { \ c* \ .''A ''f. 'i PROSPECT HEIGHTS#5 +� HAMPTON HILLS#1 BLOCK 1 LOT 5 ~ BLOCK 2 LOT 11 ji. '• tea, I / I \ NOTES: LEGEND / 1.THE PROPOSED SEPTIC SYSTEM IS GREATER THAN: O CLEANOUT 100'FROM ANY PRIVATE WELLS • MONITOR TUBE / 200'FROM ANY PUBLIC WELLS 100'FROM ANY SURFACE WATER ® TEST HOLE 10'TO ANY PROPERTY LINE OR FOUNDATION 5'TO ANY TEST HOLES 0,5% SLOPE INDICATOR / ,4-,1,SCALE: 1"=40' LEGAL DESCRIPTION: HAMPTON HILLS(8LOCK 2 LOT 11 C&M ENGINEERING SERVICES OWNER:TOM BRADY I DATE:6/18/18 I REV:0 I DRAWN:CBI REF: 907-854-5558 SITE PLAN NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVlRONMENI'AL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 2.64-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AN~N~DL~-FIINSfPLq~I~bN REPORT ............... p~C~NE i ~] NEW MAI LING ADDRESS LEGAL DESCRIPTION LOCATION DISTANCE TO: I '1~ Manu~cttJ_rer ~ ~ - ,- Liq. capac~ in gallons I DISTANCE TO: Iwell' Manufacturer DISTANCE TO: I -~ No. of lines, I Length ~f each line ~ ['-opoftile~finishgrJde RECEIVED Length :ry~ f crib DISTANCE TO: .~ JCless DISTANCE TO: NO. OF BEDROOMS Absorption area Dwellina PERMIT NO. Material , No. of c?rnpartments Inside length Width Liquid depth Dwelling PERMIT NO. Material Liquid capacity in gallons Foundation. ~) Nearest lot line. ~-" PERM,~i~i~ ~ /~) $ ?~ Total length of lines Trench width Distance between lines ~ ~ ~ inches Material beneath tile Total effoctive absorption area Width Depth PERMIT NO. Crib diameter Crib depth Well Building foundation Depth /¢5~ Building foun~tion Sewer line ~/4o OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS 3,~4.,,.11~-c DATE LEGAL APPROVED Total effective absorption Nearest lot line Distance to lot line Septic tank area PERMITNO. 2/O~}~ Absorption area{si .k /40 72-013 (Rev. 3/78) January 4, 1982 Anderson Bros. P.O. Box ]_29 Eagle River, AK 99 57 '7 Permit ~ 810836 Subject: Lll B2 Hampton Hills A permit issued by this department for a well and/or sewer system has expired as of December 31, 1981. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation dahe. If an engineer inspected the installation of the on-si-he sewer system, please have them send us the as-builts for our files. If there are any further questions, pi_ease call. this office at 264-4720. Sincerely, Sewer and Water Program Enclosure: Copy of Permit F:I F' ? l... ]i C !q N T I... C! E:F:!'I" i[ q h I L.EGI:'t! T"¢F'E CIF: ::~;O ;[ l.. F1E:'_:.~;OF;:F'T }; C!N ~ '¢:~}.:;, F'F:H ]; ~; · T'HE I:'.;:E%!U ); I:;i:E'C, !~; .[ ;.~'.E OF THE '::];O ][!. RE '.i'~ ;.~ B:F"!" ]] ON !5"?-:-";'T'!Z!'! :[ :ii; ' THE I....E{NF.:i!'H J:;:, :[ i"!Ei:N!~; T r'ff.,I :[ :~i; 'r'l...tF:; ~..F'I'.,IG'~rhl ,:; ]; l',J I::"EE;T ;:, OF "FHIFZ TF;.L'~;htC H OF;: i)F:!::~ ]; NF' Z EL.E:,. '1"l.1.:~ [;'~:.ff:"r'H (TF:'.l:::l. .... ,..:,¢:'~.i-'.p. ....... Eft;;: F:']:T Tq THE: B,Z:STf:iNCE [ii~E:I"H,~EEN T'HE .': C.~F:O....ti'.,,D Rh,![;:, THE !E('FI"TCIH OF:' THE E;?,;ZFI',,,'RT:i: ~" n::'F:,~.:' ];:~i; ~.,lr-i '.~!;[;~7i" I,i;[E:,"f'H FI)F;: THE GI';;:F:I'v'EL. [::,EP'T'H :(~{; "t'HE !"t ]; h,! ;[ HLU"! BEF'T~-''~ F!l",![) THE E:Eq"TOPi ')I::: THE E:?:?:;:F::&,'FtT ;i ;;' .'q ,:; ]' H F'EE;T F'ERH :[ T FIF:'F:'L. ;[ I;:;:F:INT Hf::l!:~; T'H[:.; f~:E':~ F' Z J"!!~ ]~ E: .[ L :[ '!";.' "FEi ;( I".F' ;i rq:)',i 'TI-I .I,; Ei; C E.r::'F. 6?"FI,'.F:I'-rT [::,1...!1:,i: :[ NEi THIE :[ I'..:!;TF: ...... FF'F )' E !",1 Z !'.4!.~;F'ECT :[ !3J'.,!'!; (" I-:: F!I'.,W I,.fEI..L:E; ¢i[).)'I::'t(]:E{:I'.!'T' i"1.) TH ~; :!5 F'F: ]"ff.::'l:~:{~'T'.r' FIN[) THE HI II"I£~E:tq: OF:' F:E'J:~;:[[::,!i;i",!CE!;~!; 'T'HFFT 'T'HtZ HE:L.L bi];L.L. E:!:::ICI.:::F::[L.L_:EF41:~ OF' FII'.,I'?' ?.:.;"r'E;'TI. EH H]:THOi...IT F:::Ilh,!FU. .',.'i',I:i!;F'ECT':['.)i",I !:::lt"J.!:::' FiF'F:'F;t::',/F:IL. E:"r' IDE:'PF:!F?THI~Vi",rl" !'! ]: LJ.... 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F:I","F:i :[ L.!:::IE',L.E '1"O :( f.,I:E;UI:;~:E I:::'F~:OF'EF;: ]: N:E;"~¢~4[...I...FIT ]: !: C:Ei:;i:T :1: f:"¢ THFi'I" :1.' ]Z F!I'"I F'I:::IH:[L.]:FIF: H]:-i"H THE F~:E: :! _. :[ F:EHENT'.F_; F'OF: ':N.....::::):'I"E :E!:ZI,I[::JE: FINI:::, .!:~:Ll_2 ::.~ ~:qti:J E:;ET I::'" t;"1"I..4 j':"~ THE: HUN :( C: ]: F'I:::IL.. 2' :[ HZt...L ]:N:E;T'F:ILL.. THE :~:' :[ U!'.,![::,EI:;~:~;TFIh,!D THF~T' THE ON.-...:Si[TE ::SEHEF: :f~;h.'t~;!"EH I'"ll::!',.' i~:I:Z ;! .. :[ F'.FJ' fZ!'.,!L..F:ff~:EiEH[~iHT l[ f::' TFIIZ F:E'J~; ]1 DE:NC:E: '[ :~;:; ~:EhlO!::,E:L .E[:) ~qZ:'f:'i.. :!:~c:,:!.".-" :I~' [' E'[?':: C N ~: I:::' '" '::; r PERFORMED FOR: LEGAL DESCRIPTION: MUNICIPALITY OF ANCHORAGE [] PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SLOPE SITE PLAN 1 2 3 4 ~5 6 7 8 9 10 11 ~_13 14 15 16 17 18 19 20 COMMENTS NO, 1732-E Juno 22, 1968 L ENCOUNTERED7 O P E iF YES, AT WHAT DEPTH? .] I Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE {minutes/inch) TEST RUN BETWEEN ~ FT AND - FT PERFORMED BY: 72-008 (6/79) Well Log Location, [~ I1 ~.. ~ .. .~. ............... ~.. ....................................................... Date co~ple~ed ....... ~ ......... ~': ............................................ ~uN~a~u~ O~ ~c~O~ ................ $~yf.' ~' t~U~z~u '~' .... ~NVIRON~wffNfAL ~[~OT~C'[' ON Depth of well, Size of casin~ ................................................................................ Distance to Water. .............. ;~ ........... [ ....................................................................... Dist~ce to water while pumping. 't_?~ t ...at rate of. a . o .... gallons per hour. ..... : Formatmn from ...... :-to I I Driller DELTA DRILLING COMPANY SRA BOX 39/~ B ANCHORAGE. ALASKA 99~07 • • QTG U V/ Municipality of Anchorage °` On-Site Water and Wastewater Program (907) 343-7904 SAT CTY Certificate of On-Site Systems Approval Parcel I.D. 015 134 59 Expiration Date: ica.-- q--t7 1. GENERAL INFORMATION Complete legal description HAMPTON HILLS #1 BLOCK 2 LOT 11 Location (site address) 7760 MCLURE Current Property owner(s) TOM BRADY Day phone 2505608 Mailing address 7760 MCLURE Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: • TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well Cl Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Aele_A t7Date: r,-' COSA to be released t the engineer,un ss othe rrvd by the engineer. COSA Fee $ 52 Waiver Fee $ Date of Payment q,jl LI//'Y Date of Payment Receipt Number Q WO b Receipt Number COSA# 0 5Q $/qF(4 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address 20182 TULWAR C&M ENGINEERING Phone 907-854-5558 Engineer's Printed Name CHARLES BALZARINI Date 9/5118 pstko • '� i, ;� 6. DSD SIGNATURE :4 9 j'� '7 =*YA YSystem#1 Approved for l bedrooms VPd System#2 Approved �� Y for bedrooms r CHARLES : • w • - .i ,� Disapproved ���•l•a.CE-13854 ,-���� Conditional approval • F9FDpROFE$S10NA��?� for bedrooms, with the follbwin �st t -'� • O • \QP\\\`( FA/Vc = �V ON-SITE m WATER AND 0 WASTEWATER o = PROGRAM cam= ' .. F,ASER,,\RAJ B ' \ v\'`-a, tiC----- Original Certificate Date: q-c)-- --C 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 COSA blue sheet J '- _ c If more than 1 septic system is on the lot: COSA Checklist# 1 of1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: HAMPTON HILLS#1 BLOCK 2 LOT 11 Parcel ID:015 134 59 A. WELL DATA Well type PRIVATE If A, 8, or C provide PWSID# -- Well Log (YIN) YES Date completed 9/23/81 Sanitary seal (YIN) YES Wires properly protected (Y/N)YES Total depth 145 ft. Cased to +40 ft. Casing height(above ground) +12 in. FROM WELL LOG AT INSPECTION Date of test 9/23/81 7/31/18 Static water level 28 ft. 20.5 ft. Well production 5 g.p.m. +4.2 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 5.86 mg/L Arsenic ND ug/L Date of sample: 8/30/18 Collected by: C&M ENGINEERING B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC / STEEL Date installed 7/11/18 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) VeS Foundation cleanout (Y/N) yes Depression over tank (Y/N) no High water alarm (Y/N) yes Date of pumping NA Pumper NA C. ABSORPTION FIELD DATA Date installed 8/29/81 Soil rating (Tp7 -/#z or ft2/bdrm) 85 System typeTRENCH Length 26 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth 12 ft. Eff. absorption area 364 ft2 Monitoring tube yes Depression over field no Date of adequacy test 7/31/18 Results (Pass/Fail)pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 0 in. Elapsed Time: 10 min. Final fluid depth 0 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) none known If yes, give date na D. LIFT STATION Date installed -- Size in gallons -- Manhole/Access (YIN) -- "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 -- On adjacent lots -- Absorption field on lot -- On adjacent lots -- Public sewer main-- Public sewer manhole/cleanout -- Sewer/septic service line -- Holding tank -- Animal containment areas -- Manure/animal excrete storage areas -- SEPTIC/HOLDING TANK ON LOT TO: Building foundation 6 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 +5 Curtain drain +50 Wells on adjacent lots +100 F. COMMENTS DRAINFIELD PIPE EXTENDED, WELL CAP REPLACED. v3F -„CokkG. ENGINEER S CERTIFICATION .sc.. ° ° ° ° . ,q I certify that I have determined through field inspections and '.' ''.7;< * ° . . review of Municipal records that the above systems are in ,/'lam •° �7 conformance with MOA COSA guidelines in effect on this date. °4 Q: . Engineer's Printed Name Charles Balzarini ° ° ° ° °� ° ` '= Date 09/05/2018 I'6 CHARLES G BALZARINI GE-13854 •••6( COSA canary sheet_2-6-15.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT i • � "° 907-343-7904 On-Site Water and Wastewater Section " Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On-Site Systems Approval # 0SC181486 Subdivision: Hamption Hills #1 , Block: 2, Lot: 11 A water sample revealed a nitrate concentration of 5.86 milligrams per liter (mg/L). 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. Mailing Address: P.0. Box 196650 *Anchorage,Alaska 99519-6650 *www.muni.org Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen,which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org Frontier Surveys,LLC Project No: 18-318 Date:08/10/2018 Ordered By: Tom Brady Plat:76-141 Grid: N/A \ \ \LOT 13A Sca'e 1"=50' \ fp. 'tt,\, 70-). • \ -. 6r• \ SMT 6 cri .. 3 N, h LOT 12 ,- I--.' 2ND OJ STORY ES 34.7 DECK 2,5 8.1 4 2.5 o I'♦ '1 . PAVERS ,,, .�/ 5 ry iij .. 26.9 •O h;-/ 7.01 LOT 15 i 2,3 s' rn I RETAINING i."---I. F.I PAVERS ti WALL ' e P.4� I C7 / / ,t• \ a PAA'kNG W �,� I i / ,31 . \ 70.4 o / oo • 8.8 a 0 bh 0 CI SHED H CC apt n D. v��\,� \ a EDGE OF GRAVEL', 4.$' l c' �I,'tIl . GQ- O l OROV� 100'WELL RA01t1S 01 jc.,- 50.0 w " 50. I ``I J5 0 . or, / OL= R=5000 ES/147: / -- _ _82°32'10UW,/ \ t0TCTr _ 2. / 263.29/ J � Legend: Xy Electric Meter/Outside Power `O_, Telephone Pole c.S Tel.Ped. LOT 10 I X Gas Meter Deck -o- Fence dit Sat.Dish , Ce---S(S) Septic (W)Water Well Kr Mailbox —s'—Over Harging Power General Notes: 0 25 50 100 1.This document is created for the purpose of a single property transaction and is Subject to Federal Copyright Laws. sas•eri 2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey. Scale in Feet 3.All measurements/setbacks are to the visual/apparent building footprint. 4.All dimensions to property lines are pluslminus 0.1ft. This survey complies with the ASPLS Mortgage Location Standards.The survey represents visible improvements and ,� 0 F conditions at the time of the survey.This document does not constitute a boundary survey and is subject to any ,� 'S-y..++�.Q,q inaccuracies that a subsequent boundary survey may reveal.It is the responsibility of the Owner to determine the `.j�!'c Tom.+' +s•I if existence of any easements.covenants.or restriction which do no appear on the record plat.Under no circumstances o 47„ `I X49 j should this document be used for construction or for establishing a boundary or fence line. • 2.*.+.49TH 1� *4* As-Built Survey of: • Lot 11, Block 2 Hampton Hills Subdivision Unit No. 1 �+ rr.a«Icw. tierI,Frederic Wagner,herebycertifythat this Mortgage Ins Inspection Surveywasperformed byme,or ,'V-"... no.1.3..9946 ,� 8P 4.�''�� 1 under my direct supervision on August 9th,2018. 8/13/2018 PROFESSIONAv_\,'.0 Frontier Surveys,LLC FRI f:v ...,ZSTITElt 1144444i„004.. 650 W.58th Ave.Suite E Anchorage,Alaska 99518 907.460.1686-info@frontiersurveys.com PROFESSIONAL SEAL www.frontiersurveys.com 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. # /_)/._'5''-/''3'~'/~,:.-A-¢' HAA# (~(~_ ('"')~"27;;~ ("~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Location (address or directions) (b) Property owner T?,4L,"tz Mailing Address (c) Lending Institution ~[//~- Telephone: (home) ,"~(,;- ~ i&C""Business Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here [~. if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family"~ Number of bedrooms 4- 3. WATER SUPPLY Individual Well~' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site (~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 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 verify that my investigation of this 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 flies 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, Telephone ~_77 -/.~i / Engineer's Seal 6. DHHS APPROVAL Approved for/z~',/%_//?bedrooms by Approved ~ Disapproved Terms of Conditional Approval Conditional The MunicipalityofAnchorage Department of Health and Human Services(DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph S 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 DHHSdo not conduct inspections or analyze data before a certificate is issued. The MunicipalityofAnchorageisnot responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88)Back Page 2 of 2 SEP ,t 2 lgBB RECE V -D A. WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: 1-c'~ If A, B, C, D.E.C. Approved (Y/N) ~ ~ Depth of Grouting Total Depth-/~.5-' Cased to ~O' Static Water Level ~/~. ' Casing Height Above Ground ~ Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Pump Set At U/~ Sanitary Seal on Casing (Y/N) / Depression Around Wellhead (Y/N) __; On Adjoining Lots ; On Adjoining Lots _ /00 To Nearest Public Sewer Line ~ ,/'~& To Nearest Sewer Service Line on Lot Water Sample Collected by JEF?,x,/ Water Sample Test Results ,-~,2('FI-~/¢~dc To Nearest Public Sewer Cleanout/Manhole ;Date %/11~/~, Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~)/~/- __Size j, Zs~O~,,~ I Standpipes (Y/N) ~/ _Air-tight Caps (Y/N) _ ~// Depression over Tank (Y/N) _ Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) _/~//~- SEPARATION DISTANCFS FFIOM SEPTIC/HOLDING TANK: To Water-Supply Well /Cd~('? ~ To Building Foundation To Property Line _ / ~¢ ' ~ To Disposal Field -['o Water Main/Service Line _~0' 4- To Stream, Pond, Lake or Major Drainage Course /~//,L4~ No. of Compartments Foundation Last Pumped ~ "~-~6¢~ Date - ;for ~//~ .Temporary Holding Tank Permit (Y/N) Comments 72-026 (Rev. 7/88) Front Page 1 of 2 ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed _ ,~/~.~ Width of Field ~'(-~" Square Feet of Absortion Area _,~¢,L~_ .~. ,.t~,'_t Type of System Design '.T?~.t~./q' Length of Field Depth of Field _/4¢ Gravel Bed Thickness Statndpipes Present (Y/N) _ Depression over Field (Y/N) A~ Date of Last Adequacy Test ~h/~ Results of Last Adequacy Test ,~'~/q-'TT~; ~'~1~"T¢~' ¢ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ,/.%-~6) ~ To Building Foundation ~/O~ Lot To Water Main/Service Line ,:¢©' + To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course ~ To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line ~ To Existing or Abandoned System on ; On Adjoining Lots ~-~o' D. LIFT STATION Date Installed _~ Size in Gallons _~ "Pump On" Level at ~, High Water Alarm Level'~ Tested for __ '~ cMoeerntSm eMnOtsA Elect rical C°d es '(~N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. eck Permllted Bedroom~ating Against HAA Request** I certify tha't?¢~ave checkecj¢, vebif ed, or conformed to all MOA and HAA Signed ~?//~('/. '~ Z_ " Z MOANo ~-~ ~1% qes in effect on the date of this Engineer's Seal Receipt No. _~J~-~,5 Date of Payment_ Amount: $ __/~ 72-026 (Rev. 7/88) Back Receipt No. _ Waiver Fee: $ Date of Payment __ Page 2 of 2 LOT 35 , BLOCK 2 : 89'5705-E 54.°b . • 40,875 S.F. • --`' ��STI(. f 734.03, • ESMT • SEPTIC SYSTEM `` 3 • • �� % 11111 In ai 03 12.0' EXISTING BUILDING w b I b 0 a zb O 9.3' b O Z _J GRAVEL DR. N Pi er ai 2r. WELL 0 o o. t. o4,. o0F' 67.57. ��� 00 N 81.27,54,.E GAP +'h 1 "= 40 ) SHARED DRIVEWAY WITH LOT 34, BLOCK 2, WILLIAMSON SUBDIVISION NO. 0 1.100 06 AS - BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE ``; ��� PROPERTY DEPICTED ABOVE AND THAT NO 65152 ,9E GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. ‘..0" 6252 ����,•A�,,�4 SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO .••, �•••.,•••.•.S,i�1� JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, ,,Q.•• .••• 1� 2000 E. DOWLING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. C-0011 5 '\ *' 49 TH •' * : PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA 0 ) 0 • GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR \^ "\o 0 73 : Jeff er A. Gostald�o` I ESTABLISHING BOUNDARY OR FENCE LINES. . ,� • I..* LSA-6091 SW2737 9/3/2013 3p 0. f�,;-•% •:Sc/ • ANCHORAGE RECORDING DISTRICT, ALASKA �Z U, •v. roressiono1�:.�• F B 13-03 JOB WS352 NOTE: NO CORNERS SET THIS DATE. & GEOLOGICAL LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92-0040440 ,Ull. I,Y~jf3 ~?0P,'£ lCf 2AI4PIJE fe,.r I'lork 0~d~: ~ 9019 Dato lepozt Pz"Jnted: f;gP 9 gO ~ 10:20 M~alysis Co30ietod :,qEP 7 88 Send Reports Iteloased By : ~,.&?,, .... (L ,,?,t ,., ' 2) ./ (;hoi,il~b Rof ~: 2,!94 I~ab SIO1 Il): !. llat~:~x: Mlowabi~ ltolr:,ak~:: $1d.tPL~, ¢0LLI'K'TgD f ¥ .3. ~tI'¢$2. APPLIC NT FILLS OUT UPPER HA[ ONLY Property Owner (~-~ 0 ~.~/'l (~ ./~ '~ i ~' ~ ~- /"' '"t ~ ~''' ~'' ~-'v'c ~ Phone Buyer /~'~ "" "1 F ~ /, o { t:-: Address Zip Code Lending Institution ~:; ~ ~[ .~ ~< ~ ".d .... q: : / ~' o,.-',.~ ~ ~ ~ Q Phone · ~ h: Zip Code Address /,,/ ,. ,; / ..~ .~/< ~ ,, C ~:/ ~ /-/ ~, ~..20, 0 Realty Co. & A~nt j~/ Address Street Locali~ Type of Residence .~.Single Family ~ Multiple Family No. of Bedroo~ ~' ~ Other Waler Supply .~:lndividual ~ ~ ]D~,~~ A~ACH WELL LOG. A well log is required for all wells drilled since June 1975. ~ Community ~4~ ~ Z5~ ~.~/~ ~ For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspeclor Inspector Inspector Field Notes: ~ ~) MUNICIPALITY OF ANCHORAGE DFPT 0r PF'LT~f ,~, ENVIROI4I,~:~;~ A_ ; .,~. ECTION CCT 8 1982 RECEIVED (~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) CONDITIONAL APPROVAL' DATE I 0 '~ ~ Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received ~ '~ ~ { WelltoTank SeplicT~kSize