HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 8 LT 17- "'Municipality of Anchorage Page / of /.. 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:L~//~/~2~/g~. PID Number: N~¢ ~ ~ ~ ~j~/~~ Wastewater System: ~ New ~Upgrade ~,~,: ABSORPTION FIELD Phone~;~_ ~7~ No. of B~oms: ~Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other Total Depth fro~original grade: LEGAL DESCRIPTION Soil Rating:o, ~ GPD/Sq. Ft. Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe I I Fill added above odgina, grade: ?~Dh: ~ ~ Ft. WELL: ~A D New D Upgrade Gr~ve, wiah: ~ Ft. / Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total a~o~ Pipe~e¢~ Ft. Ft. SQ. Ft. Ft. Yield: ~ Pump Set at: [ Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. TO Septic Absorption Lift Holding 3ublic/Private Manufacturer: ~ CapTty~g~b From Tank Field Station Tank Sewer Lines Water Line Foundation ~ ~ / / / "Pump on" level at: , "Pump off" level at: I High water alarm at: BENCH MARK Remarks: Location end Description: ENGI~AL Inspections performed by: Dates: 1st " ........ Department of He ~ ic Reviewed and approved .... Date: %/~..~,~,.~¢' __ // 7¢-nlR fray. 9/911 MOA 25 ~§/~/g :3ivo 3Iris Oi iON :3]VOS lO]d 8S¥~10~6:331J 600~§ :~ 80r :'ON aid z o ,gg I~ SJ. N3~a~Insv:I~ :ILL ONIMS · pqnS sa),ols] ~JOd '~1 'g ~tgOl0 'ZL lo-i uoNdugs~o IO§~1 Wright-Alaska Engineering Service~ · 6004 Glcnkerry Dr. · Anchorage, AK 99504 July 12, 1994 W.O. 94OO9 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Division P.O. Box 196650 Anchorage, AK 99519-6650 RECEIVED ;JUL ? q 1994 ,,~[n & IffumsR Services Re: On-site Septic System Record Drawings Lot 17 Block 8, iVit. Park Estates Subd. Dear Sirs, Enclosed with this cover letter are three drawings of the original 7 sheet design drawing set, showing Record Drawing information on the installed system. I have made three inspection visits to the site to verify that the system has been installed in accordance with the submitted plans, and all applicable Municipal requirements. The quality of the installation of this system, by Acreage Systems, was excellent. The only modification from the design drawings was the placement of the trench cleanouts at the distal ends of the pipes, and the use of 90° Bends at the tank end to facilitate ease of cleaning. The existing septic system was not located during construction. No signs of seepage in the new trench walls was observed, indicating that the old trenches are not in close proximity to the new trenches. Mr. Ed Sanderson of Acreage Systems dug 10 ft. to the west of the new trenches, to locate the old system. No system was found, indicating that the old system is more than the minimum distance from the new system. With the submittal of these Record Drawings, the system for this lot is complete. Should you have any questions or require additional information, please feel free to call or fax me at the numbers indicated below. Sincerely, //~/¢ht-Ala ska Engineeri~ng~ervices Robert W. Wright, P,E. Telephone (907) 338-6230 · Fax (907) 337-.Sl 112 ~Vright-Ala~ka Engincering Services · 6004 Gle]~ke,'ry Dr. · Anclaorage, AK 99504 August 2, 1994 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Division P.O. Box 196650 Anchorage, AK 99519-6650 Attn: Mr. Robbie Robinson Re: On-site Septic System Record Drawings Lot 17, Block 8, Mt. Park Estates Subd. Dear Mr. Robinson, This submittal is in response to your 7/25/94 "Pink Slip" for the Record Drawings of the above noted system. Attached please find a revised Record Drawing sheet, condensing the previous three sheets into a single sheet. Each of the questions you raised in your note have been answered or corrected in this submittal. Was the old septic tank abandoned? If so, how? The old septic tank was found to be structurally unsound. The contractor abandoned the tank in accordance with Municipal Regulations by pumping and filling with soil. Page 3 of 7 shows... The existing septic tank was abandoned in place, and a new 1250 gal. Anchorage Tank septic tank was installed. The inlet invert elevation... The attached Record Drawing sheet shows actual inlet and outlet elevations per contractors red-lined drawings. All invert elevations... The attached Record Drawing sheet shows invert elevations of beginning and end of both runs of perforated trench pipe. Tie-ins are not shown... Swing-tie dimensions to one tank cleanout and one drainfield monitoring tube have been shown on the Record Drawing sheet. Page 1 of 7 shows... Page 1 of 7 has been changed to reflect the fact that the system contains 100 I.f. of gravel total. The original cover letter explaining the that the contractor did not encounter the Leach Tanks as assumed during design is enclosed. Telephone (907) 336-6230 · Fax (907) 337-5182 Mr. Robbie Robinson August 2, 1994 Page 2 Should you have any questions or require additional information, please feel free to call or fax me at the numbers indicated below. Sincerely, ht-Alaska Engineering Services RobertW. rig , . . Telephone (907) 330-6230 · Fax (907) 337-5182. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940192 DESIGN ENGINEER:ROBERT W. WRIGHT, P.E. OWNER NAME:VON GEMMINGEN H & DELORIES OWNER ADDRESS:13037 RIDGEVIEW DR ANCHORAGE, AK 99516 PAGE 1 OF 1 DATE ISSUED: 6/23/94 EXPIRATION DATE: 6/23/95 PARCEL ID:01739125 LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES BLK LT 17 LOT SIZE: 32400 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 (18AAC?2) 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) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ~~/~/~ DATE :d~/~~ ~~ DATE: Wright-Alaska Engh~eering Services · 6004 Glenkerry Dr. · Anchorage, AK 99504 June 16, 1994 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Division P.O. Box 196650 Anchorage, AK 99519-6650 Re: On-Site Septic System Permit Lot 17 Block 8, Mt. Park Estates Subd. Dear Sirs, With the submittal of the attached design package and Permit Fees check in the amount of $320.00, the owners of the above noted lot, Mr. & Mrs. H. Von Gemmingen request the granting of a Septic permit for a four bedroom house. The existing system is now operating in a failed condition. We urgently request that this design be reviewed and approved immediately. The owner reports that sewage is backing up into the home during high flow periods. Acreage Systems, contractor secured by the owner is standing by to install this system at this time. Anything that can be done to expedite this review would be greatly appreciated. Should you have any questions or require additional information, please feel free to call or fax me at the numbers indicated below. Sincerely, ka E n g~ n/g//S/~v i c ~ Robert W. Wright, P.E. Telephone (907) 338-6230 · Fax (907) 337-5162 Wright-Alaska Engincering Service.~ · 6004 Glc]lke,.ry Dr. · Anchorage, AK 99504 June 16, 1994 W.O. 94009 Site Narratiw The following site narrative describes the probable impacts of a proposed on-site wastewater disposal system upgrade for Lot 17, Block 8. ~t. Park Estate Subd. T12N, R3W, Sec. 26. The subject lot is located at 13037 Ridge View Dr. in Grid 2838. Access is gained directly from Ridge View Dr. The lot has been extensively developed. The lower 2/3 of the lot have been cleared for the house, and landscaped. The lot slope and drainage pattern are from the high side on the northeast to the lower end at the southwest. The lower 2/3 of the lot is mostly lawn, and slopes toward Ridge View Dr. at between 2% and 5%. The upper 1/3 of the lot is in natural vegetation, which appears to be less than 20 years old. The vegetation consists of small Birch, Aider and Willow. Undergrowth is minimal. The upper 2/3 of the lot slope downward to the southwest at approximately 20%. No changes in lot slope, contours or drainage patterns are forseen as a result of this upgrade. Figure 1 of the design package shows all wells in the immediate vicinity of Lot 17. The wells shown have been field verified, and are well out of the 100' protective radius from the proposed system. Wells on Lots 8 & 9 of Block 8 were not located. The western portions of both these lots were investigated, and no sign of wells was noted. As the system is 95-~ ft. from the east property line, we feel that there is no danger of encroachment. No adjacent septic systems are within the 100 ft. protective well radius of Lot 17. Reserve space for a future system is still available on this lot, but any future system would most likely have to be a pressure system, located above the existing system on the eastern side of the lot. Impacts from the Septic System upgrade as designed for Lot 17 are minimal for all adjacent lots. No adverse effects are forseen. Tclephone (907) 338-6230 · Fax (907) 337-5182 Wright-Alaska Engineering Services 6004 Glenkerry Dr. · Anchorage. AK 99504 · Telephone: (907) aa8-62:]0 Fax: (907) 387-5182 Percolation Log Report/ Soils Log Performed for'. Dee Van Gemmingen Hole No:l Date: 6/3/94 Legal Description' Lot 17 Block 8 Tract NA Subdivision' Mt. Air Estates Township, Renqe, Section: T12N R3W Sec. 26 Groundwater Gross Net Depth ~o Net Adiusted Encountered? NO Reading Date Time Time (min.) Water in.) Drop (in.) Ra{e (min./in.; At what depth?NA I 6/3/94 1018 10 I 6.875 JO~O 240 4 HOUR P tESOAK WaLer level after 1 6/3/g4 1432 30 ~ 2,2~ 20.8 ~ .. 6/3/94 1503 30 5 ~,438 19.2 Monitoring? None 3 6/3/9~ 1534 30 ~ ~,~0 18.7 Date: 6/11/94 4 6/3/94 1605 3g 5 2.50 18.7 Percolation Rate 18,7 rain/in. Comments: Performed by: Bob Wright I, Certify that this test was perf~~ccordonce with ~11 State & Municipal guidelines in effect on this dote. D~te: ~/~ ~ 0-2 Lawn & Topsoil, Dry r--~---~---r--n 1 EOL~ ~--~---'--*-~ ; 2-5 Black Well consolidated ~--~---~---r--n ~ Organics, Dry I~ II II II II k__q __ --d-- __p--Iff 4 ~ 3.5-6 Grey to Ton Silt, Dry  smears easily, LitUe or no ' ' ' ' 5 Li Sand or Grovel. , ~ ~, t ~ ~--~-~,-,, ~N~-~---~-~--?-~' '' ~''' ~---h-;-~- -.:* ' ' ":' 0~ -"" 6-18 D°rk Grey S°nd w/Silt ' ' ' ' I ~:~t:~::~:;~:;~::~ 7 ": '. and GraveL. Dry. r- ~---i---r--q t--q- -F--T-- q ~9.,".. Caves below Silt layer ~ ~ ~ i i i I i i i f i i i i I 8 '.".~ '~ E~t. So~d= ~0~ ', ', ', I ', ' ' ' ' ' ' ' ' ' ' ' ' -- · .... :' GraveL= ~0~ L__A___I__--L---J '----'------'----'---'-----'----'---'------'----'--'----'--- ~ Silt= ~0~ Slope Site Plan ,--,---,--,--,---,--,--,---,--, ..... r-- .. ., Cobbles to ,__,___,__.__,___,__.__, L__J 10 e, 'o.' . I , , , ,2,~ ', ~' t~, Ii '1 II - "' "' Level Parc'd= 6.5 to 7 o, , , , , , , , , , , , 11 ," SW, 12 _ .... _:" ... ~..- . ..~ 13 ..4: '.', 1 4 ,.o '- / "';" -- " · . ' · ...... " '" 18'..':.3':~' 18 End Hole ~ot~: Wright-Alaska Engineering Services 6004 Glenkerry Dr. , Anchorage, AK 99504 , Telephone: (907) 33fl-6230 Fax: (907) 337-5182 Percolation Log Report/ Soils Log Performed for' Dee Van Oemmingen Hole No:2 Date'. 6/3/94 Legal Description' Lot 17 Block 8 Tract NA Subdivision' Mt. Air Estates Township, Ranqe, Section: T12N R3W Sec. 26 Groundwater Gross Net Depth ,to , i Net Adjusted Encountered? No Reading Dote Time Time (min.) Water ~in.21 Drop (in.) Rote (min./in., At what depth?NA Water level after Monitoring? NA Date: NA Percolation Rate ~one mln/In. Comments: ~ /~/ /~/ Performed by: Bob WrJgh~ I, (/~~ ~ Certify that this test was per~r~~ccordance with all State & Municipal guidelines in effect on ~his date. Date: ~/~/ ~ 1,5-11 Ton Silt w/Gravel, Dry, r--7--n--r--n r--n---r--T- ~--n- -r--~ I Very Tight , ' ' ' ~__~_x '' ~5~~+~-~--~. ' 9 SIo )e Site Plan 10 o, , , ,2~ , , ~', I ', , , 11 Nolo: Holo nol Porc'd p,~--~---~-~-~---~-*-~---~--*-~---~--~, , , , , , , , , , , , 6-18 Dark Grey Sand w/Grovel 1 2 Dry, Est Sand= 65% ~%~.OFAL-% '¢.~ [ROBERT W. WRIGHT~ Percolation Test Rate Adjustment All percolation tests conducted for this project have been completed using a 4" diameter tube in a 6" diameter hole. The annular space between the tube and the hole walls is filled with 3/8" pea gravel. The following adjustment has been made to all readings to account for the volume occupied by the annular gravel pack. h: 8 d :: 5.25 h d - 0.344 h P: 0.344 The porosity of the gravel has been determined using two identical 64 oz. containers. One filled with water, the other with gravel. The depth of water (h) was measured. Water was poured into the gravel container. The depth of the remaining water was measured. P= (h-d)/h. The correction factor 'R' was calculated using the formula from page 76 of Dr. O. Benjamin Kaplan's book "Septic Systems Handbook": r1 :=2 r2 :=3 1 r2. rl = 1.5 radius of 4" diameter perc tube radius of 6" diameter perc hole C: 1.5 1-,-P.~C2- 1'~ = 0.636 C2 R: 0.64 R= V1N2 gravel. Example: where Vl is the total water vol. in the hole, and V2 is water volume with no 6" water drop in 2:13 min. 2.22 - 0.37 6 0.37 min/in with gravel pack. 0.37 - 0.578 0.64 0.57 min/in without gravel pack in 6" hole. June 16, 1994 W.O. 94009 Lot 17, Block 8, Mt. Park Estates Subd. Absorption Area Calculations: Soil percolation rate is 18.7 min./in., see percolation logs. Application rate for design purposes= 0.6 GPD/s.f. Number of bedrooms= 4 Gallons of septic effluent/bedroom/day= 150 4. 150 = 600 gals/day 600 - 1000 s.f. required absorption area 0.6 Assume a deep trench where depth= 5ft. 1000 - 100 I.f. 5.2 Therefore, assuming side absorption only, trench= 100 I.f Use two trenches each 50 I.f long, with 10 ft. separation. 94002CAL.MCD Permit No. Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: On-Site Wastewater Disposal System and/or Well Inspection Page 1 of ? 545-4744 Report Lecal Description: Lot 17, Block 8, Mt. Park Estates Subd. PID No,: "x T~ ..... ~. o/'{'%.%'t,,,,~ · /~ "~* : O3 Permit No. Page 2 or 7 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 34-5-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Lot 17, Block 8, Mt. Park estates Subd, PID No.: Hbuse Lot 17 Block 8 posed French ~y~tem (See sySTEM PLAN Scale: 1"= 40' : Sht ~. ROBERT W. WRIGHT CE 8156 JOB ~: 94009 FILE:94009SIT PLOT SCALE:l"= 40' DATE: Permit No. Page 3 of 7 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 Syst.em and/or Well inspection Report. Legal Description: Lot 17, Block 8, Mt, Park Estates Subd. ' ' O ~ '-~ o ~' O ' o *6 3.© CLO 0 Remove existing 8' leeching tank to 10' from new trench JOB ~: 94009 FlLE:94009SYS 10.0' Mirh PLOT SCALE:I"=IO' 0 ~ O-- 10,00' Q PID No.: © O O .02 ,~,0~,0,' ~Prc~.t ect ive Well Radius ~o~. ROBERT W, WRIGHT CE 8156 DATE: 6/15/94 Permit No. Page 4 of 7 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, A aska 99519-.6650 Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well nspection Report Legal Description: Lot 17, Block 8, Mt, Park Estates Subd, PID No.: JOB ~: 94009 FILE:g4009TNK PLOT SCALE:I"= 3' Permit No, Page 5 of 7 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 3¢3-4744 On-Site Wostewater Disposal System and/or Well Inspection Report Legal Description: Lot 17, Block 8, Mt. Park Estates Subd. PID No,: l .xo ddv t.. .... :,O0'g .... ' 0 o ' 00o o° o o 8:~°° c II '~, :~ 'C Q) : O~ ,Ch: JOB #: 94009 FILE:g,~oOgTRN PLOT SCALE:l"= 4' Permif No. Legal Description: Lot 17, Block 8, Idf. Park Esfafes Sub. Page 6 of 7 W.O. 94009 Oa , B/ /g4 GENERAL NOTES ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER OISPOSAL REGULATIONS OF THE MUNICIPAL COOE AS CURRENTLY AMENDED. IF REQUIRED, INSTALL NEW 1250 GAL SEPTIC TANK AS SHOWN ON THE DRAWINGS. RECORD INLET AND OUTLET ELEVATIONS OF THE TANK. TANK BOTTOM SHALL BE PLACED LEVEL ON UNDISTURBED NATIVE SOIL. EXISTING STRUCTURES, WELLS, SEPTIC SYSTEMS OBSERVED ARE SHOWN ON DESIGN DRAWINGS. ANY OEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION INTO THE SYSTEM. CONTRACTOR TO LOCATE ALL UNDERGROUND UTILITIES, PROPERTY LINES, EXISTING WELLS, WATERWAYS, SURFACE AND SUBSURFACE DRAINAGE FACILITIES, LAKES, PONDS, AND OTHER FACILITIES REQUIRING SEPARATION DISTANCES FROM THE PROPOSED SEPTIC SYSTEM, CONTRACTOR TO STAKE PROPOSED SYSTEM PRIOR TO CONSTRUCTION. NOTIFY THE ENGINEER OF ANY OBSERVED CONFLICTS PRIOR TO CONSTRUCTION. 6 CONTRACTOR TO NOTIFY THE ENGINEER AND DHHS 24- HOURS PRIOR TO COMMENCING WITH CONSTRUCTION. A MINIMUM OF THREE INSPECTIONS ARE REQUIRED. THE FIRST INSPECTION SHALL BE OF THE SUBGRABE PRIOR TO PLACING THE SEWER ROCK. THE SECOND INSPECTION SHALL BE AFTER THE PLACEMENT OF GRAVEL, DISTRIBUTION PIPING, SI'ANOPIPES, TANK, AND OTHER COMPONENTS AS SPECIFIED. THE THIRD INSPECTION SHALL BE AFTER THE WORK IS COMPLETED. 7 CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED-LINED, AS-BUILT DRAWINGS SHOWING ALL DATA AS SPECIFIED IN SEC. 15.65.F.2, 3, 4-, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL REGULATIONS WITHIN FIVE DAYS OF THE FINAL INSPECTION. INVERTS SHALL BE MEASURED TO THE NEAREST HUNDREDTH OF A FOOT. SWING TIE LOCATES SHALL BE MEASURED TO THE NEAREST TENTH OF A FOOT. THESE AS-BUILTS SHALL BE USED BY THE ENGINEER TO PREPARE AND SUBMIT RECORD DRAWINGS TO DHHS. 8 ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN. 9 EXCAVATE THE ABSORPTION TRENCH. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE, AND END OF TRENCH BOTTOM, CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED ANO REPLACED WITH UNCOMPACTEO MATERIAL. 10 PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS, DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOIL FROM EXCAVATION, LEVEL ROCK SURFACE TO ::b 1" PRIOR TO INSTALLING THE PERFORATED PIPE. 11 ALL PIPE SHALL BE PVC CONFORMING TO ASTM 05034 OR ENGINEER-APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 5 FEET OVER THE PIPE AND 4 FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER. (SEE NOTE 12) 12 ALL INSULATION BOARD SHALL BE 2" THICK DOW HI-55 INSULBOARD OR ENGINEER-APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER SEPTIC TANK, EXTEND BOARD 4' BEYOND LIMITS OF TANK IN ALL DIRECTIONS. 13 GEOTEXTILE SHALL BE MIRAFI 140S OR ENGINEER-APPROVED EQUAL. LAP ALL JOINTS 2' MIN. 14 COVER THE DISTRIBUTION PIPE WITH A MIN. OF 2" OF SEWER ROCK, ANO COVER WITH GEOTEXTILE BEFORE PLACING INSULATION AND BACKFILL. 15 MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS. 16 SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MIN. SLOPE, AND 5:1 MAX SLOPE, AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN O.G. TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MUNICIPAL SPECS. 17 RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE, AND END OF SYSTEM. l& 19. 20, 21. Permlt No. Legal Description: Lot 17, Block 8, Mt. Park £stafes Sub. Page 7 of 7 W.O. 9400g Date 6/15/94 GENERAL NOTES (CONT.) CONTRACTOR SHALL VERIFY LOCATrON OF EXISTING FAILED SEPTIC SYSTEM PRIOR TO BEGINNING rNSTALLATION OF NEW TRENCH SYSTEM, REMOVE PORTION OF 8' LEACHING TANK AS SHOWN ON SHEET 5. DISPOSE OF TANK AND CONTENTS IN ACCORDANCE WITH ALL STATE AND MUNICIPAL LAWS AND REGULATIONS. IF EXISTING SEPTIC SYSTEM IS WITHIN 10' OF EDGE OF NEW TRENCH SYSTEM, ABANDON EXISTING SYSTEM IN ACCORDANCE WITH ALL STATE AND MUNICIPAL REGULATIONS AND LAWS, EXCAVATE THE ENTIRE PERIMETER OF THE EXISTING SEPTIC TANK TO BELOW THE WATER LEVEL TO ENABLE VERIFICATION OF THE STRUCTURAL INTEGRITY OF THE TANK. REPLACE EXISTING TANK WITH NEW 1250 GAL, TWO COMPARTMENT TANK IF EXISTING TANK IS STRUCTURALLY UNSOUND. GRE R ANCHORAGE AREA BOk Department of Environment Quality 3500 1-udor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ]~/),¢E~'~-],~ >~'?/ZJ~/ __ MAILING ADDRESS //~/'A/ ///'-.-/~.-~;"//~¢/'/',~S~. PHONE / · LOCATION g¢/rc/t:'z¢~'/?~ /¢/~¢'/:/¢',427,,~¢?/f/' LEGAL DESCRIPTION ,~/~--' -//'~ .r~'~ / /~->~2: ,/"/,~?,,<¢-~/'~< SEPTIC TANK: DISTANCE / NUMBER OF FROM WELL //~¢ MANUFAC-FURER ~/~,¢;¢z¢~ ~:~;~ATERIAL ~(' COMPARTMENTS INSIDE LENGTH__ INSIDE WIDTH LIQUID DEPTH LI QUID CAPAC ITY//~ -~ E;DALL. ONS. TILE DRAIN FIELD: DISTANCE FROM WELL //cC /- FOUNDATION /~' //'.NEAREST LOT LINE "~-'~ TOTALoF LINEsLENGTH//~X'' NUMBER OF LINES ,,'~'~ _ DISTANCE BETWEEN LINES /~/~.'? TRENCH WIDTH¢/.. $N~.,~ TOTAL EFFECTIVE ABSORPTION AREA "~'-~7 / SQ. FT. LENGTH OF EACH LINE /i DEPTH OF FILTER ~//, DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH -FILE IN. ABOVE TILE ,~ /y IN. WELL: TYPE BUILDING FOUNDATION _ CONSTRUCT ION NEAREST ~ / NEAREST LOT LINE ';~'~' SEWER LINE~/- CESSPOOL OTFIER SOU RCES APPROVED / DISAPPROVED DEPTP/ ~ ~ 22'~ ~DISTANCE FROM: SEPTIC / SEEPAGE TANK /~/~¢ , SYSTEM_ / /¢~ /-- REMARKS DISTANCES: INSTALLED BY: 'g['~ ~'~'6L,~/--c--''''E~''' SEWER LINE DEPTH: ¢>// PIPE MATERIAL: ~-~-.. LOT SLOPE: ¢7~ ';/,~ /~='~'2~- REMARKS: DIAGRAM OF SYSTEM G.A.A.B. Form PW-027 · it./.¥,..: i//I/'::~ ':":'~'"~ : .... u,.,,,L ,-,u,,~.rr',, 2192 ............... TYPE ::.¢,'~:-L' '""~' i ?' t: ' / ~ ~ ,'- / ~. Date ?effort, md Y'-',"~" ' Depth ~n¢~ ~araczer~sz~cs' ' Loca~ior, ~,, ~ ,~ ~ <, ~'-:, , % ~ {I~~' ~,~ . '~,"- ....... s a-?~- C.,.-~ ~,'!as Ground ¥!aze~, Enco'~n~ered?~_,~/.,~, if Yes, A~ Wha~ Depth ~ bReadin~ Gross Time Nez Ti::,e i Depth To ;420 f, Certified By: ........ _ ._ Da%e: ',. _ ....................... PI1OPOSV~D DV?L(I.v..INO LGC, A2"~ON .~t is the con2aeto,as responsibility to check Top of Foundation in relationship to Finish Grado, Top of Foundatfon as indicated is one c, our~o of btoek abovo Finish Grade.. hereby certify that I have smweyed thc following described property: ,~',,,v~ /~,~ ~',d,~,~_~,,4-'OrD Anchorage ~ccording Precinct, /'alaska, and that the in~provements situated thereon are witim~ the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on prop- erty lying adjacent thereto encroach on the premises 2ucstion and that there are no roadways, transmission hca or other viMble ea~emen~ on ~aid property except as indicah:d hereon. Dated at Anchorage, Alaska ~hi~ ·. day m' ,. ~ED WALA%~A & En~ineera and Surveyo~ V • �� Municipality of Anchorage 8:°.9 ,U p `° ts. On-Site Water and Wastewater Program (907) 343-7904 n JI APR 18 2017 Certificate of On-Site Systems Approval Parcel I.D. 017-391-25 Expiration Date: s'‘< 1J 11 1. GENERAL INFORMATION Complete legal description MOUNTAIN PARK ESTATES B8 L17 Location (site address) 13037 RIDGEVIEW DRIVE Current Property owner(s) DELORIES VON GEMMINGEN Day phone Mailing address 637 W 3RD AVE Real Estate Agent Day phone 2. TYPE OF DWELLING: El 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 Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received 47---707/I1C7( C( Date: //a/c20/?- COSA to be released to the engineer, unless otherwise requeste• • r engineer. COSA Fee $ 5240 Waiver Fee $ Date of Payment q 1 i J t Date of Payment Receipt Number 0 CAN 5`4 Receipt Number COSA# (y%t VICO 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 o�'iiostallation:. -.n, In conductlir est,I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations: he 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 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 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 Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 4/18/2017 Air OF Aqg kk , *: 4911-I I1 • yt 6. DSD SIGNATURE + t � System #1 Approved for Li bedrooms r % n H. Pannone System #2 Approved for bedrooms # (3,. CE-8149P �� Disapproved �l1 , OFESS� '� Conditional approval for bedrooms, with the following stipulations: . 1 1.VM3 LSd/u1 ONV ed1VNA - X115-fun r�.. „l,y -in Byrom �'RT Original Certificate Date: 11- 2.c.)-1 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 7 Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet - 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 B8 L17 Parcel ID 017-391-25 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (YIN) Y Date completed 06'18/04 San ry seat{af7f Y Wires properly protected (YIN) Y Total depth 184 ft aced to ) &p7 ft. �c Casing height (above ground) 24 in. - • FROM WEU - i ' AT INSPECTION Date of test 06/18/04 03/28/17 Static water level 171 ft170.5 ft. Well production 15 g.p.m. 4,6 g.p m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 7'04 mg/L_ Arsenic ND ug/L Date of sample 03/28/17 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date installed 06/28/94 Tank size 1 ,250 gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) NA Date of pumping 04/03/17 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA Date installed 06/28/94 Soil rating (g p.d./ft' or ft`/bdrm) 0.6 GPD/SF System type Deep Trench Length 100 ft. Width 2.5 ft. Gravel below pipe 5A ft. Total depth 1 0.9 'ft. Eff. absorption area 1080 ft` Monitoring tube Y Depression over field N Date of adequacy test 03/28/17 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0/0 in. Water added 460 gal. New depth 12/24 in. Elapsed Time. 1440 min. Final fluid depth 0/0 in. Absorption rate >= 450+ g.p.d. NO Any rejuvenation treatment (past 12 mo.) (Y/N & type) 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 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 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. C• 11� bg,S, k-- Pt V-e ' t 0-11 s , pei. P2---) G. ENGINEER'S CERTIFICATION ;+4`�"`�` I certify that I have determined through field inspections and rr 4,— review of Municipal records that the above systems are in .* _ % *��� conformance with MOA COSA guidelines in effect on this date. 0 •• • 2..4.:.A:::; • 0 Steven Pannone —Engineer's Printed Name i• : _lever' ii.•I�onnone Date 4/18/2017 9yy�•• CE-8149• _r k‘‘Xtt4'%.t. COSA canary sheet_2-6-15 doc • • Municipality of Anchorage f - i Development Services Department -46 Building Safety Division ''''''''''''''''E, . On-Site Water and Wastewater Program 4700 Elmore Street F.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # OSC 171140 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 17 of Mountain Park Estates subdivision. This inspection revealed a nitrate concentration of 7.04 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. 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. \ � � , \ \\\ \V,r, 5' SIDEWALK ," '/�\ 10' UTILITY EASEMENTS 4, N EASEMENTS ` Z " , \ \ Lot 9 .•.'.,--... A\ Lot 18 1�7 \ \ y4ai i \ \ \ kll \ --Y i / \ Z Lot 17 '< \ /' \ \ . \ a. \ \ 7 7 0, \ SEPTIC / P. PIPES \ s�O\ \ / P\ \ \ (* r 0111 Lot 10 ,moo . CT r73 n . 12.2'x16.0' DECK \ \ 64'x63' CANT AI \ \ i0i0. A I NI ;) re,j 4 n RETAINING WALL <� ASPHALT o I r^ 2.3'x4.6 CANT \ \ �� DRIVEWAY sem-:. 34.5' _ 00 PRCTECSNE RADIUS WELL \ --- \ \ et J AP 0 R 11 N12.4'x 10.4' \ o. SHED \ O o ' \ Lot 11 13 O. \ "W 18 4 94 1 \ 1. c`, ` 5 ,3 56'43 1 \1 �0 \ Lot 1 s I \ // i E 1 N. / / 011" \ 1 I PLOT PLAN AS BUILT X SCALE 1" = 40' GRID SW 2838 Project No. 17-074/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates , inc . (907) 522-6476 Phone ooppp‘D4 (907) 522-4625 Fax a'0 F A Z oN Professional Land Surveyors kenOlangsurvey.com �p.`�C.. ' 9s�0 jonathanOlangsurvey.com ,`Q'• ' i, ..'x-00 I hereby certify that I have surveyed the following described property: 49� i\ .7 0a LOT 17, BLOCK 8, MOUNTAIN PARK ESTATES SUBDIVISION (PLAT P-501) D Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that VA no Improvements on the property lying adjacent thereto encroach on the surveyed 0 3 KENNETH . : premises and that there are no roadways, transmission lines or other visible O �, 4111,r L7easements on said property except as indicated hereon. (fl 41 1�, (k)„9' '••. 5-520 J Dated this the ' Y' Day of %' , , , at Anchorage, Alaska 4 AR�'"•.• Z..e+oo. 0, 'SSIONA,aa� it is the responsibility of the owner to determine the existence of any easements, Oppppoo covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 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 Parcel I.D. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~)\'-') ~ ~%,.0~ / -..Z4~-z NAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) '/~)4~).~ '') /~/ ~,~-'~ ~/~'~¢-~¢ Property owner ~//~' ~ /~'/"~' Vo~----~-'/'~//2/7/']?~-7---/~ Day phone MaiLing address ~O¢'~ ~~q¢~ ~¢ '~ Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: '~ ~ 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. 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(Re¥.1t91) Fronl MOA,21 o 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/orwastewater 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 d' ,~,'¢'/~ ~/'-~,~.z./"/¢~,'2/~4¢ /¢'~-*,~(~Phone ~ <~z',~._//~ .,~ ~ Address ~-'¢~-/~--~ ~ D(-/~"-//'~-(Z~/'-~/~/?~-~.' Z~/'~'3~ J,,/~.. Engineer's sig nat u ~/., ,~,'~/_/~ ~-~~ Date bedrooms. DHNS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 #21  Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: / - / 7/~ '/~'¢*/~/¢~/'/' ~A~-'°~-~'-.;,d:~arcel I.D. g,l / 7 A. WELL DATA Well type F/'~! //"~/~-~lf A, B, or C, attach ADEC letter. ADEC water system number Log present (YN~. ~,Y-/Tot I depth ~ary se~_(,Y¢4) Date of test Static water level Well flow Pump level Date completed / ~/'7 '~__._ Driller Casedto /'~('// ~"~(~/¢~/~ Casing height Wires properly protected FROM WELL LOG g.p.m. AT INSPECTION g.p.m. SEPARATION DISTANCES FROM WELL Tz~.;~ , Septic/holding tank on lot _ Absorption field on lot Public sewer main ./~../ //__,~ Public sewer service line ,/~,½ /;/~ ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Date of sample: '~--~' '~ / Nitrate ~"~ ~- Og% '-- /~' .~..~ Collected by: Other bacteria SEPTIC/HOLDING TANK DA~A> Date installed j c.~ ~.__. Tank size // Cleanouts (Y/N) V Foundation cleanout (Y/N) High water alarm (Y/N) -/X/. Date of pumping "~ f)'(~ Compartments Depression (Y,~ Alarm tested (Y/N) SEPARATION DISTANCES:~OM SEPTIC/HO/.DING TANK TO: Well(s) on lot /~ .,,._ _ _On adjacent lots x;.>. Foundation Surface water/drainage /~ LD/~, 72-028 (Rev. 3t91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm'~ "Pump on" level atj Manufacturer ~- M an h ole/Ac'b~s (Y/N) "Pump off" level at Cycles tested Meets MOA electrical co~de~ ..................... ~._ SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D, ABSORPTION FIELD DATA Date installed ~ ~--~ 7 ~ Length ' 'qL ~th Total absorption area ~"~ Depression over field (Y/N) Results (pass/fail) Soil rating ~. o o System type ~) Gravel thickness Total depth Cleanouts present~,l) Date of adequacy test for ~ If yes, give (]ate Peroxide treatment (past 12 months) (Y/N) bedrooms SEPARATION DISTAN E Well on lot / /',,~/ ~ FROM ABSORPTION FIELD TO: On adjacent lots I~°o/ ~'7~ .) Property line To building foundation ~'¢~-~ ~ /' To existing or abandoned system on lot On adjacent lots ~' Cutbank /~'('~)/¢ ~ Water main/service line Surface water /~CO'/'~L/~ Driveway, parking/vehicle storage area Curtaindrain J~/dP/~ ~'~ J~'/~L~ /// ~¢~ ~ ~::~ ~'~ :'~" E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on th'e dat,e of this inspection. .:::,;: ,:;: ,! ~;, Signature (~-~/¢~ .~~~~ ate %.-- :-- HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number APPLI'- NT FILLS OUT UPPER HA~ ONLY Buyer q2__ Address ~~ ~ Zip Code Phone Realty Co, & Agent ~ /~ Address Zip Code Type of Residence ' ' :E&~ ~ Single Family ~ Multiple Family No. of Bedrooms %~)_ ~ Other Water Supply ~ Individual A~ACH WELL LOG. A w¢l log is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal [ (~ ~ Individual Year Individual Installed: "{ '~ ~ Public Utility When Connected to Public Utility: ~] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Date Date Date Date Insp~to, Inspirer insp~t%~d,,q-'~J ~ . Insp~tor0~, ~' ' ~ '~ ENVIRDN~, :l, ,' . .~.E~TION RECEIVED ~ > APPROVED ~D~OOMS 'CONnmO~S o~ *~OVAU ~ ~ mS*PP~OVED ( ) OONDmONAL APPROVAL' Soils Rating Date ~wer In~talled MIJNICIPALITY OF ANCHORAGF DEPARTM[ OF ttEAI,..Ttl AND ENVtRONMEN PROTECTION 279-~25].], OXt, 224 or 225 _ <' Date Reo~ve8: dune ~0. ] 977 /' '.. / · . /-- FOR APPROVAL OF INDIVIDUAL ~.E,W.[.R AND WATER FACILIT.IES ] o ]SerMinc_] Institution Request: Lomas and Nettleton Company Mailing Address: 4449 Business Park Boulevard Phone: 274-7661 2. Property Owner: ~]](~( Walter White Phone: Ma:ilJng Address: % Clo.yd Moser 274-3556 Lo. ga] Descrip't. ion: Lot 17 Block 8 I]ountain Park Estates Subdivision _ . Fam]. (X) Single '- 'ly Reside:nee: Number of Bedrooms: Unknown Mu].hip!e Family Residence: ( ) Number of Bedrooms: Well Sysgem: ]individual Well (X) Community/Pub]_ie Sysi'em ( ) Permit: ~[ Depth of Well Well Log on File ( ) Con,si:,]:ucl:ion Bacterial Analys:i.s (3. Sewage Disposal ~ ...... ~ .~}il · oys,..e.m: On-site System (X) Public ity ( ) Permit ti ........................... Instal'Led ~:_~ ...... install.er AbsOrp hion Area DJ stances: Well. to Septic l.=nk .... /~ ]{} to Absorption Area te Sew(;r LLne Near. esE Lot: line Absorption Area ['o NearesL Lot l,ine FDepaz'tmc'~l~t: oil [.IcaJi:h all('t Envi]:on[~lenLa]. P~otcctior~ Reques[: for Approva:L oJZ ]:nd:ivi. dual Sewer and l,ega]. Descripiiion: Lot 17 Block 8 MoUntain Park Estates Subdivision A~.fa lav] h Attached: ( ) Lek-her At::-tached: ( ) nj sapproved: Date: l)e}.)ar'kil/(;~li; Wor],'..sheei]: ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT O~: HEALTH AND ENVIRONMENTAL PROTECTION 825 .L Stree[:, Ancho]:acje, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPFIOVAL OF INDIVIDUAl_ SEWER and WATER FACILITIES 1. Type of Inspection: 2. Property Owner: ..... 4. Name of Lending Institution:__ '}'~ 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: 7. Type of Facility to be Inspected:__ 8. Water Supply Type of Supply: No. Bdrms. Public Utility~ Individual If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: If Individual, date of installation Public Utility. Individual (on-site) 72 003(3/76) 4446 Bu:~ine,qs Park ~:~ubj~3ct: t~,~t 17 Block f~ ~ountain Park Estatou S%~bdivision for sewe-~: and water approval can not be approve:d approval ~ty be granted~ the following must be (1) A pe~:colatlon test must be run (see enclosed handout). (2) 'i'he loaation of the well must be known~ SO that w¢~ can inspect it~ (3) we~e, not fou'nd~ If they have be~nr~emovedt they will need (w~ be insltalled, If there azw; mW furthor questions, please contact this office at 279-,~2511~ ext~mslon 224 or 225° j h July 7, 1977 R&M No. 751518 Cloyd Moser 4446 Business Park Anchorage, Alaska 99503 Re: Flow Test on Existing Septic System Lot 17, Block 8, Mountain Park Estates, Anchorage, Alaska Dear Mr. Moser: On July 5, at your request, we conducted a test of the septic system on the above described lot. The following table represents the level of the liquid in the leaching tank. All measurements were taken from the top of the standpipe. SUMMARY OF MEASUREMENTS Time Level of Liquid Meter Reading in Septic Tank in Gallons 0:00 6.6' 5591.4 (Initial) 0:08 6.5' 5616.6 0:15 5.9' 5641.2 0:50 6.4' 5641.2 1:10 6.4' 5641.2 1:18 5.5' 5666.4 1:50 6.4' 5666.4 The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R & M Consultants, Inc. Since the house on the lot concerned was occupied, it can be assumed that the leach field was at its normal degree of saturation. If it is assumed that the existing four bedroom residence will house 8 people, the average load on the disposal system can be expected to be 600 gallons per day or 0.42 gallons per minute. Since the existing leach field accepted 25 gallons in 32 minutes, or 0.78 gallons per minute, we conclude that the leach field is performing in an acceptable manner for a four-bedroom residence. July 7, 1977 Mr. Moser: Page -2- If you should have any questions concerning this test or this letter, please do not hesitate to call. Very truly yours, R & M CONSULTANTS, INC. Stephanie Hoag Staff Geologist Jim McCaslin Brown, Ph.D. Head, Earth Science Department SH:JMB/sl GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received ~ Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 2. Property Owner: .~;e~8~~~ ~ Phone:~ Mailing Address: a. 7- S. 4. Location: ~~~~ ~ 5. Type of facility to be inspected No. of bedrooms 6. Well Data: ."~ ~ ' ' ~ ,l / C. Construction: '/P)::~D--:L' D. Bacterial Analysis 7. Sewage Disposal SY'st~am: :.-~? .... A. Installed~?/~7~ B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: E. Disposal Field: 1. Absorption Area Total length of lines 2. Material 8. Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank , Absorption area ., Other contamination , Absorption area .., Sewer Lines , C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Re~ st for Approval of Individual ', .~r & Water Facilities Legal Description ~_m~--/'? ~ ~ ~ ~ f~/x ~ ~/x~ Comments Approved?~eJ~_~~//o- ~ -~ Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and wa~er facilities and these facilities are operat~s~tisfactorily. EQ-034 (1/74) GREATER ANCHORAGE AR[.,, BOROUGtl D~pat ~menc of F-nvi¥'orll~len'~al Quality 3330 "C" St~ Anchorage, Alaska 99503 274-4561 o REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES Type of Inspection: CIviRO Mailing Ada .ess: Mailing Address: Name Of I. ending Znstituti~,~: '~ Mailing Address ? 7, Type of Facility to be insl)ected: 8, Water Supply Type of Supply: Public Ui;ili"cy No, Bdrms. Indi vi dual ~ I'F Individual~ number of dwellings present'iy served Sewage Disposal System Type o/ S,ystem: Public Ui:ility If Ind'ividua'l~ date of insi:allation Individual (on-site)