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MULBERRY TR A2
Onsite File Mulberry Tract A2 #018-232-28 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181403 I PID Number: 018-232-28 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name BOB CARLE ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 4701 EAST 135TH EJ Other Phone of Bedrooms Soil Rating depth from original grade [Number 1.0 GPD/SF JTotal 11.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.4 Ft. Gravel depth beneath pipe 9.0 Ft. Subdivision Block Lot MULBERRY TR A2 Fill added above original grade 1-2+ Ft. Gravel length 1 1 1 Ft. Township Range Section Gravel width 2.0 Ft. Beds: Number of Lines 0 Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Litt Station Tank Line 1998 Ft2 1 Ft. Well 1001+ 100,+ 5 01 + TANK 0 Septic © S.T.E.P. ❑ Holding ❑ Other Manufacturer TANK Capacity 2500 Gat. Surface waterANCH 100+� 00'+ Material STEEL Number of compartments 2 Lot Line 01+ i 10,+ i NA Foundationi *14+ LIFT STATION Manufacturer ANCH TANK Capacity 2500 Gal. Remarks *TANK MORE THAN 10' FROM FOUNDATION Alarm location Electrical installed by NORTH WALL OF GARAGE RISING SUN ELEC. PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer MIKE N ANDERSON, P.E. Drainfield 3034 COrMT3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 85.1 ft Inspection Is: 5-15-19 5-15-19 Location and description ection ZM GARAGE SLAB 3`d 4th ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date y J. „ o o c • a ' o u . • . .. 't �. Septic SystemD� Y- , cE - y;:.; Approved �7A l.� Date i o?dd t' i'•.'�'" _�.1 .l Note: this approval does not include well permit requirements. ....1...�. r'';,, `!r -.`y. `,ti •:. ,,; (Rev 05/02/18) -ate - - Permit No. OSP181403 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: MULBERRY SUBDIVISION, TRACT A-2 PID No.: 018-232-28 e— TCO2 23 28 — MT2 192 210 TC01 16 20 ,4T' _ — — I\ • OLD SYSTEM DECOMMISSIONED = _ _ _ �— _ — 14_ TI�t—�� RESERVE AREA 2500 GALLON STEEL STEP TANK, 10 GAGE TCO2 L TC B BENC — — If I I � i 1 I� DRIVEWAY /EXISTING 1 WELL / ASBUILT SCALE: 1"=% C01 TC01 TCO2 MH G11.11. MT2 100 F /� • 3.4 2 GRAOE �.�P�................ S �. .• ,�— . I � �.• �•� I��J ♦ .0 ORG —FILTER FABRIC — & INSULATION G 2' OF COVER i i i 49TH 0 2,500 GAL LON 84.9 STEEL STEP TANK [rs x�cK 98 sn 98Zv SP/GP ... / Z_ 80.9 80.9 ���?•MICHAEL N. ANDERSON;- No. CE 9469 .Ar •♦ ••••., 11/12/20 .•'i ♦♦�♦ ••••* ........... �• SEPTIC SECTION N.T.S. 83 X111 SS DRY, MAY 12, 2019 ..�• Municipality of Anchorage Development Services Department On -Site Water and Wastewater Section 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99519-6650 WWw.muni.org/onsite (907) 343-7904 Soils Log - Percolation Test Performed For: D Lj co Y (C I / Date Performed: Lea tion: IN11N I eW',n 1 t(J T Z Township, Range, Section: T N At ( Slope I II z- 4- 0 9_I I WAS GROUND WATER ENCOUNTERED? 4 0 15- 16- i�lo A r1 r COMMENTS IF YES, AT WHAT DEPTH? L Depth to Water After.�'y////^1���� O Monitoring? � a E Date: zO LD Reading Date Gross Time Net Time ;,.V�_GINEEfl2' 5e At /D ........ 'a • MICHAEL N. ANGCRSCN CE -94f9 It a^�•d Performed For: D Lj co Y (C I / Date Performed: Lea tion: IN11N I eW',n 1 t(J T Z Township, Range, Section: T N At ( Slope I II z- 4- 0 9_I I WAS GROUND WATER ENCOUNTERED? 4 0 15- 16- i�lo A r1 r COMMENTS IF YES, AT WHAT DEPTH? L Depth to Water After.�'y////^1���� O Monitoring? � a E Date: zO LD Reading Date Gross Time Net Time Depth to Water Net Drop /D 5 ULA I ION RATE Z/ (minuteshnch) PERC HOLE DIAMETER LP RUN BETWEEN _�_FT AND 4f FT - t/_ /I PERFORMED BY: /mNA, I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: r/// 7p Municipality of Anchorage Development Services Department On -Site Water and Wastewater Section 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Soils Log - Percolation Test Performed For: &) � Net Time Date Performed: Legal D n tion: M U I �j-ry,y,H j� 'L Township, Range, Section: Date: _477 7D voq . 1 2- 3- y P/C" P 1 V.0 90 10, 18- 19 - WAS GROUND WATER Date ENCOUNTERED? Net Time Depth to Water S IF YES, AT WHAT DEPTH? t Depth to Water Atter Monitoring? O y n � P N PE Date: _477 7D (EN13INEEKS SEALr "t ;fes rian 0 Reading Date Gross Time Net Time Depth to Water Net Drop tr Sir S/t 6P S " PERCOLATION RATE Zi (Mnuteslinc) PERC HOLE DIAMETER �( n(� TEST RUN BETWEEN Z FT AND�C- _FT COMMENTS �i I YL r0. �ryre I a 1// V" PERFORMED —f -- PERFORMED BY: bI n(A I CERTIFY THAT THIS TEST AS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: r/ i L tv N 89'55'47" E 33':.30') 10' UTIUFY . . . . ...... is law% A LEGEND X O� 0 2,0 A L$ o OPP, ' 50' FRaNT SEIMA CK 11..1"E (N 89*55`47" S 89'5426" W 330,22') SITE SURVEY MULBERRY SUBDIVISION TRACT A-2 EAS- 735TH AVENUE NOTES imiik ,oct'_"Li.TYOR MUNICIPALITY OF ANCHORAGE ,Aft° ,,.cnr 7-- �\ On-Site Water&Wastewater Program I , PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 �' http://www.muni.orglonsiteli„ I)� luirtnt(nt 444 HORPGE On-Site Wastewater Disposal System Permit Permit Number: OSP181403 Effective Date: 11/9/2018 Work Type: Septic Upgrade Expiration Date: 11/9/2019 Tax Code Number: 01823228000 Site Legal Address: MULBERRY TR A2 G:2936 Site Mailing Address: 4701 E 135TH AVE, Anchorage Owner: CARLE ROBERT & KAREN LIV TRUST Lot Size in Sq Ft: 98881 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 8 This permit is for the construction of: 0 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 Special Provisions: Two percolation tests shall be completed prior to construction of the drainfield, in locations shown on site plan, to confirm application rate. If results require a design change, construction shall stop pending Onsite review and approval of a change order. Please submit complete soils logs with inspection report. /4- Received By: Date: I1(9 Issued By: ghee64 6110668Date: I i 1 07 °70/6 . i MUNICIPALITY OF ANCHORAGE (1-91.c2) Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 018-232-28 Property owner(s) BOB CARLE Day phone Mailing address Site address 4701 E 135TH AVE Legal description (Sub'd., Block & Lot) MULBERRY TR A2 Legal description (Township, Range & Section) Lot Size 98,881 Sq. Ft. Number of Bedrooms 8 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field 0 Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank El Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF andlQW 5 Private Well CI ,)u 678870 Water Storage ❑ RUSH • THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: NOV 0 6 2018 a i ci •` Distance: ti �, hs. I certify that the above information is correct. I further certify that this is in a ►•. - , ith applicable Municipal Codes. Wk74-- (Signature of property owner or authorized agent) Permit/Rush Fees: q(0.4d Waiver Fees: Date of Payment: I t t t l(8 Date of Payment: Receipt Number: ej(, # I O1'Z3 Receipt Number: Permit No. 06 Pt $l'-1O3 Waiver No. G:1Development Services\Building SafetylOn Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Nov.2,2018 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage,Alaska 99519-6650 Fax 249-7847 Re: New Septic Permit Legal: MULBERRY TR A2 To Whom it may concern: This is a request for a septic permit on the above referenced lot. Two test hole will be excavated prior to the installation and found poorly sands and graded gravels for the entire 17 foot depth with no water during excavation or after the 7day monitoring period. Both of the test holes were done by another engineer with myself doing the excavation. The test hole data has been lost therefore a new perc test will be done during the installation period to verify the rate, but the soils were very good sandy gravels. The monitoring tubes are still present and have been checked for any water,both dry. The existing system will be abandoned due to the owner planning on expanding the house in the spring of 2019. This system will not impact any of the neighboring properties due to the lot layout. Please call me if you have any questions. Sincerely`pi ,[L Michael N. Anderson, P.E. 4661 Natrona Anch,Ak 99516 Ph 727-8864 DESIGN CRITERIA: MOUND OVER (TH#1) (TH#2) En GRADE 8 BDRM X 150 = 1200 GPD ORG ORG SOILS = 1200/0.6 = 2000 GPD 1.0 1.0 FILTER FABRIC 2000 GA/18 = 111' ,—r'T=–.--1.25'0 PIPE SP/GP SP/GP -2.0 `SEWER ROCK (1) TRENCH 11.0' DEEP 9.0' EFFECTIVE -11.0 2.0'WIDE 11 111' LONG _17 _ —17 2.0' SEPTIC FIELD SECTION \ \ II ' \–: \\ ,) ---, \\ �� i \ ..ii I \ \\ ----' \\ \ \\ l \ I V Nil — — l / l / — — — — — — — — — — �— r- — � _1r ) ' - - — `\�– _-r I PROPOSED t \ '' �' 1 DRAINAGE FIELD 1 I L , I I EXISTING HOUSE /1 i \\l •� \\ 1 ��EXISTING WELL _ I I I• o 1 / 100'RADIUS t� / 1 I PROPERTY LINE \ / / I 'E-435IF.L�(V E- `, Q / _ - - – - _ --- r 'ILI w THIS PROPERTY HAS NO WELL WITHIN 100' I- 0) 0) Ii Ql 9 Jl I — - I _ _1 I_ - _ 1 I Septic Design Prepared for ..:0611Slivi1111 ROBERT & KAREN CARLE •��P\� OF q�� 4• 4.MULBERRY, TRACT A2 G: �� �i Anchorage, Alaska % �`:� 49TH /\ '� �0, Michael N. Anderson, P.E. DATE: 11/5/2018 • ..MICHAEL N. ANDERSON;: ° C ' No. 46 C� 4601 NATRONA AVE DRAWN: DJR 4j ANCHORAGE,ALASKA 99516 - �j4 ''/,/..t ( `�'"i (907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=200' 1111 ESS\ 4.4 \ I \ ` \ \1 KNIK HEIGHTS 1 \ \_. • • • \ BLOCK I,LOT 14`� • \ \ \ �_ ` EXISTING ' \ • • 1\ SEPTIC / - — — PROPERTY LINE �--�� -- Ii, 10'UTILITY EASEMENT —`' N 10'UTILITY EASEMENT___ — ____ — ____ -- — — — �— — i NN % MT \ / PRIM'I�Y •\ , I 11 1 •• �I • I 1\ \• \ I _ \v c j SECONDARY CC F \ \ \\ •-•41411'� / \�i'tl .,' \\ m 4a \\ \ 1- • \\ 2500 GALLON 2 NSTEP TANK Q i N I \ EXISTING TO-_ TCO \ y \ \ `� j BE DECOMMISSIONED c• �\ PER UPC _-=-____ j i .\♦ - \(' .... . EXISTING w // �rJ HOUSE \\ f-2'CONTOURS o 1- / �1 z° / 1 \\Ak,;(,\ \ \\ \ \\ -J 1- 1 • 1 1 \ x \ \ .., .......„. , . ......,,,,..., \\\ \ �� I EXISTING WELL \ rte-100'RADIUS I wWELL \ \ \ �\ N1 \NI, \\\ \, \ \ \ \\ N\NN\N \ \•� \ ‘)NS.i \\\ \ \ \� \ \ `\ N \ \\\ /N\r\\\ C` \ \ \\�PROPERTY LINE ,\\ \ \ c • • OHe', 0)1-1E \ -E 135TH AVE- \'�--- // \ \ \\-\\"\ \ \\\ �\N � i Septic Design Prepared for ROBERT & KAREN CARLE ••�P�� OF 4444.4. ..:4,36„4.� 1, ••. .i MULBERRY, TRACT A2 1 ,� 70 Anchorage, Alaska • % ; 49TH /\ • Michael N. Anderson, P.E. DATE: 11/5/2018 0 •'•MICHAEL N. ANDERSON; a 4601 NATRONA AVE DRAWN: DJR �t1 �•• No. C 9 69 z ANCHORAGE,ALASKA 99516 �# • ..I) .... •:.•� SCALE: 1"=50' 1 .• (907) 727-8864/FAX: (907) 345-1391 4.��•�� N (N 8955'47' E 331.301 N 8955'43" E 331.00' O O S.................., wUTeltt EASUEIIT 3,_________j - -1 LH _........, A .., ,.. ..- „,1i ‘26.\---\ O /,b 10 0 t5 w — It\ ago m Cy f0 n ( RT FIST ) go;Si x 1 inch = 30 r: N N i N N �Alt4� {S9 `, __ i Ilir Vo. +YG4tr 'a LEGEND 3q��` `a1 b WwN N y� <0 o, o O FOUND REBAR g* IN r VQas �v( Ilika 9l o 0 TEST HOLE g Q4 at. \ o Z i7 N v x SEPTIC SYSTEM VENT .40 . \ '4 \ Y WATER WELL P"" ' 4?i \ nuc CABLE TV PEDESTAL /4,� •vr. POWER POLE I 's OVERHEAD UTILITY UNE ne --------120— CONTOUR UNE rrt rl 7e (N 8955'47' E) RECORD DATA PER PLAT 75-82 \ TT, T4 i• \ IN 'O, SITE SURVEY O S 8955'13' WX30.22' .78' \ (s 89'54'26' w MULBERRY SUBDIVISION \ R TRACT A-2 \ - - EAST 135TH AVENUE NOTES 1.EASEMENTS OF RECORD.IF ANY EXIST,OTHER THAN LOUNSBURY & ASSOCIATES, INC. THOSE 910NN CN PLAT 75-82 A.R.D.ARE NOT SHOMN HEREON. SURVEYORS-PLANNERS-ENGINEERS 2.PARCEL CCNTANS 98982 S.F. 723 W. 6th AVE. ANCHORAGE. ALASKA 99501 3.VERTICAL DATA IS ASSUMED. (907) 272-5451 4.CONTOUR INTERVAL IS TWO FEET. r DATE OCTOBER 2003 SCALE 1• . 30' DRAWN BJR GRID 2936 CHECKED 0J8 F.B. NO. 98-041/03-062 DWG NAME 03-0620S SHEET 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTFCTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ,~.~)~ APPLICAN.~ NAME: M~RY ~NN GIBSON 7125 Old Seward ~'~hway NEw LEGAL DESCRIPTION LOCATION ~mO~ -- ~1 ~' -- O~ ~"[ [~S'~ ~O. OF r Absorption area Dwellin~ ~ PERMIT NO, _ u DISTANCETO: jm,, 132 0 o'' ~¢E ~ Manufacturer ~aterial~L No. of compartments Liq. capacityingarJons/.~ ~¢ IF HOMEMADE: Insidelengt~ ~ Width ~ ~ Liquiddepth¢~ ~ ~ DISTANCE TO: Well ~ / ~welling PERMIT NO. 0 Z ~ Manufacturer/V~ ~ - ~ Material Liquid capacity in gallons ~ Well . Nearest lot line ~ DISTANCE TO: 142,o I F°undoti°n-- , [PER~ITNO.~ ~OC ~ No. of lines~ 4 Le,~th,of each ,ne Total ,e,~4q:e~ Trench %:~ O Distal, ce betweenji~s ~ ~ ~ Top of tile to finish gra~ e ~ M~erial~e~ath tile t Total effecdge absorption u~ Length Width Depth ~ . PERMIT NO. / ~:4b~ Typeofcrib Cribdiameter/~/~...__ Cribdepth Total effective absorption area ~u~ DISTANCE TO: Well ~ ~ ¢ ~ Building foundation Nearest lot line ~ Class Depth / ~riller Distance to lot line pERMIT NO. ~ DISTANCE TO: Building foundati¢ V / ~ewer line Septic tank Absorption area(si OTHER PIPE MATERIALS ~3f,[ SOIL TEST RATING ~ / % % JOHN E. SWANSON~ ~ ~ ~ ;.~2-013 (Rev. LEGEtL Plf:I~'.'T' EtI'.,tN GI. EISON TF.:FIL':T 1712 Il. L E,E I:~ ~ :.:.;l_lB ,..:L,.,_'... OLD SE:I4EtI:;.:D HI.,.I'¢ L O T S I Z E 'I"¥F'E: OF SOIl_. R[~SOFd:'TION S"r'STEH :1'':5' TF,:E?',h"H I IH,,iHI_iH I,I. t lE,t:F.. OF E',EDP;:OEFl"t'-_x; ':T.';O]:L. RETTING (SE.! F'F,.-"E:Fi:)= '-'""'"' THE F'~:E1...:!UII;:E[::, SIZE OF TFIE: ::-:;Oil... FIE::~OF::F'TION "-'=,'T'STEH IS' THE LENG"i'H [:' I HENS I ON IS THE LENGTH ,:;:1,1",1 FEET) 1.:)F THE TRENCH OF-: DRI:rtiNFIELD. THE [:'EF'TH OF' El 'FRENCFI OR F'IT IS THE [:'ISTFINCE BET!4EEN THE SURFI::tCE OF (]:iI:~OUNE:, FIN[) THE: I~i',O'FTOH OF THE E?-';CFF,,¥q]'];ON ':.'IN FLEET::,. THEF.~E ];':5 NO SET I.'.II[:,TH F'OR "1.'F.'.ENCHE~. THE GRFI',,,'E:L. I)EF'TH IS THE HINIHLIH [:'EF'TH OF GI~II:¥,,,'EL BE:TI4EEN THE OLITFEtLL. F'IF'E EIN[:, THE E',OTTEd"I OF' THE EXCt"t',,,'I'3'f'I ON ( I N FEET). F'EF:I'"I ]: T F'IF'F'L. I CFtN'F HI::IS 'l-HE IE:ESF'OI'.,I':".~ Z E', ]:. L l T"r' "f'O I I",IFOFi:H ..... 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P.IEI....I._ I..OE~S r':~RE~' I';:'.E6!LIZF'.ED FIND HLISq" BEZ F...'ETLtI:;;:NED TO THE DEF'FIF..'.Tt','IENT t.4ITHII'.,I Z~....E~ I:::'EI"r'S OF THE I.,.IEL. L. COHF'LETZOI'.,t. Oq"HEF.'. F:EO.U :1. F.'.EHEI",IT:':E; I'tFW F~I::'F'L.¥. :E.;F'EC .~ F I CRT I ONE; FIN[:, (:::Oi",I:!STIE:UCT :1:O1",1 B' :1' F~Gt'E.:FIt'IS FIRE Fl'v'FI :i: L.FIBL. E TO ]: IqSUF::E F:"I;?.OF'ER I 1"4S TFiM..J::IT :[ Oi",1. I CEF~:TI'F'-'~" THEI'i" ::L; :1; I:'fl'"t FFIHII_tEIF.: 14];TH THE f~:E6!1.J:[F,:EHEI",ITS FOR EFF',t'~'SITE iE;EI.,.IEI;-':S Fllql) I.,,IEIJ:_:, Fl:,:.i; SE:T FO'F.'~TI-~ E'?¢ THE HUN.~ C I F'FtL I. T'T' OF FII",ICHEIE;:FIGE. ~'~: I t.,.IILL. ,T.i",ISTFIL.L THE; 'Z-;'¢:~;TE:H IN RCE:Of~:DFIi"~!CE I.,.IITH THE COl)ES. ];: I. UNE:,E:F.'.STFINE:, THFIT THE ON--.S]:TE SEt4EF~: S"r'::.-.';TEH I'"tFI'T' F::EEQI..I:I:~;i:E E't"4LFtF-:GEHENT ]:F THE REE% I. [:,ENCE ]: S F. tEHO[.':,EL. ED TO :1. NCLU[:,E F'IOF;;:E TI4F~I'.,I ':1. BE[:,ROOHE:;. FIF'F:'L. I 6:FINT i'"IFIF'."r' FINN iS I E:S.,ON I S'L:. El' E ~ .......................... ~-..~....-._[.'1 t1 E _ ","4. E~ ~.. SOILS LOG 7125 Old Seward Hwy. Anchorage, Alosko 99502 549- 6561 SOILS LOG - PERCOLATION TEST PERCOLA1 ION TEST 1 3 ~'--... 4d 5 6 7 17 2O SI OPE SIYE PLAN ',' ! I' i ..... ~ --~ ......... :, ~ -- , ._ ~ _- .... t.3%_~ ~¢¢-~u~ ....... [ ' I ~ , , o/ , L_ 1_ : j _ { _.~ . ~ J_ ~ . L...J PERCOLATION RA~ E COMMENTS MUNICIPALITY OF ANCHORAGE Development Services Department �/1 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I .D. 018-232-28 1. GENERAL INFORMATION Complete legal description MULBERRY TR A2 Expiration Date: 2_ Z o —2—(2q Location (site address) 4701 E 135TH AVE, ANCH AK Current property owner(s) Mailing address Real estate agent ROBERT & KAREN CARLE F.Lim 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 8 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic 7 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer F1 Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer, COSA Fee $33 �o �,lhtt ( Waiver Fee $ Date of Payment ((� Ct 12 !i Z Date of Payment Receipt Number (91q © iI Receipt Number COSA # 0 SC 2D I a q?_ Waiver # S. 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 11-15-20 6. DSD SIGNATURE0 49TH. , . r o• e. e e .. r. s System #1 Approved for 8 bedrooms � System #2 Approved for bedrooms A,!CHAH N. Disapproved ¢a s ` C_ Conditional approval for bedrooms, with the following stipulatioh 4 OF A*,((r,i cITP WATER AND WAST!-_- V AM Eno 1 Y �^' Original Certificate Date: /(-20-20 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 Checklist blue sheet Legal Description: MULBERRY TR A2 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UK Total depth UK ft Cased to *40'+ ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12"+ in. Date of flow test for COSA 9/30/20 Static water level at beginning of test 194 ft_ Comments * verified by Sullian Well Drilling B. TANK DATA Age of tank(s) 2019 years Tank type/material Measured operating fluid level in septic tank 48 ❑ Standpipes/foundation cleanout per record drawing Date of pumping * STEEL SEPTIC STEP TANK D. ABSORPTION FIELD DATA NEW IN 2019 Which system tested (date installed) 5115/19 ❑ ALL standpipes present per record drawing Total measured depth from grade 12 ft (max) Measured depth to pipe invert from grade NA ft (min) ❑ NIA — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 018-232-28 of Structure served by this system Well production at time of test 4+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ Nc All Coliform bacteria is Negative Nitrate 2.32 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 9/30120 C. LIFT STATION ❑ Required maintenance completed Age of lift station NEW years Lift station material STEEL Comments: Adequacy test date NEW Results Q Pass For 8 bedrooms Fluid depth prior to test NEW in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ✓Q Yes Community Sewer Manhole/Cleanout > 100' Q✓ Yes if No ft M Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' E] Yes if No Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Q Yes if No M Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q✓ Yes if No ft Z Yes if No ft ft ft ft ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F/ Yes if No ft . Surface Water > 100' Yes if No ft Property Line > 5' ✓Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100'[]✓ Yes if No ft Water Main > 10' El Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' [j✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ft ft Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100'[]✓ Yes if No Water Service Line > 10' ❑Q Yes if No ft Community Wells > 200' Q Yes if No Surface Water > 100' Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ft ft 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 1. GENERAL INFORMATION Complete legal description Trac,~; A-2 Mulberry Subdivision Location (site address or directions) 4701 E. 135t~t Ave.nue Property owner Mailing address · ' Av~chorag¢, AK Mar~! Ann Gibson c. 135th Avenue nnc~oraqe, Day phone 345-6715 AK 99516 Lending agency Mailing address Day phone Agent Beth S'~¢son/ S~pson Co. Day phone 345-1020 Add ress f Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 ~ 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-O25{Rev. 1/91) Front MOA#21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature ENGINEERING Phone Date '7/~~/~¢ DHHS SIGNATURE Approved for 'O"- Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: / , Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does th is 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 (Re~. 1/91) ~c~ MOA MUNiCIPALiTY OF ANCHOP, AGE ENVIRONMENTAl- SERVICES Dh/ISlON Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES'JUL 05 Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907 Health Authority Approval Checklist A. WELL DATA Log present (Y~.~ /'U/CO Total depth 6-¢//~' Sanitary seal (Y~/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to Date of test Static water level C~/'~"' Well production WATER SAMPLE RESULTS: Coliform C:) Nitrate Date of sample: B, TA.K DATA Date installed o¢'-Z ~-~) ~' Tank size Foundation cleanout(~C/N) Date of Pumpihg ¢¢~"2 ~'- ~ ~ c. ABSORPTION FIELD DATA, Date installed ~'~Z.~;' ~ ~.¢ :, FROM WELL LOG g.p.m. Casing height (above ground) / /'/- Wires properly protected ~-'¢~kl) AT INSPECTION g.p.m. J' ] ")- Other bacteria O Co,ected bY: Number of Compartments ~ Cleanouts Depression (Y/~ /b¢¢ High water alarm (Y/N) Pumper ,4 ,'¢c ,~¢o,e/4¢; _,=-- Soil rating (g.p.d./fF orf~/.~_,.~ ,~ ~ ~' Length ~/'('z,,z;4z.) Width 2..~ ~ Gravel thickness below pipe /cO Total depth .c]. 5- / Effective absorption area/7.2 ~ ~ Monitoring Tube present (l~N) Y-/~'- .~ Depression over field (Y/~ .4./0 Date of adequacy test 7'- ¢ '" ') ~' Results (a('a~r~Fail) //¢' .('..~' For Y bedrooms Fluid depth in absorption field before test (in.); 2 / *' Immediately after¢/? gal, water added (in.): ~"~ *~ Fluid depth ¢7 :* ~ (ins) Minutes later: ~ O Absorption rate = ~ Z ~¢ g.p.d. Peroxide treatment (past 12 months) (Y~ ~ If yes, give date ~/~ 72-026 (Rev. 3/96)* Manhole/Access (Y/N) ...~Pd~p o~*ieveL.a_.~* "Pump off level at* High water alarm level * -~"~-'~ *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: e~'-~olding tank on lot Absorption field on lot Public sewer main Sewer/septic service line Lift station On adjacent lots On adjacent lots Public sewer manhole/cleanout SEPARATION DISTANCES FRO~/HOLDING TANK ON LOT TO: Foundation /O '~ Property line /~ ':/' Absorption field Water main/service line /~ (/'' Surface water/drainage /0o /~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /O //' Building foundation ~O '-~ Water main/service line Surface water ./~:7(~ //-- Driveway, parking/vehicle storage area Curtain drain /"'~:~4¢' /'/' Wells on adjacent lots //~-)~2 ENGINEER'S CERTIFICATION I certify that, have determined thru field inspections and review of Municipal'records th~a~l~..,~, ~d~,are in conformance with MOA HAA guidel~s in effect on this date. Signature ..... Date '? / 5-/9 g HAA Fee $. Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number APPLIC FILLS OUT UPPER HAL ONLY ~": ' > " Zip Code Buyer Address Zip Code Phone Address d' 7/ c' ~) ~ ;~ Realty Co, & Agent Address Zip Code Zip Codo Phone Phone Legal Description Type of Residence ~'i'~ g le Family ~ Multiple Family No. of Bedrooms ~ Other Water Supply %]. Individual (_..~.~ ~.L~-~ ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. ~ Community For wells drilled prior to that date, give well depth (attach Icg if available). ~ Public Utility Sewer Disposal ~¢lndividual Year Individual Installed: / '~ Public Utility When Connected to Public Utility: '~ Holding Tank NOTE: THE INSPECTION FlEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Inspector Date Inspector Fime inspector Time Date Field Notes: MUNICIPALITY OF ANCHORAGB DEPT. OF t:-/,L[II & ENVIP, Oh;M~_NTAI. Pi4OYE,CI ION ( ) APPROVED BEDROOMS ¢,~,..-',.~ ..,,~.,~-.- . . *CONDITIONS OF APPROVAL Soils Rating 72-023 (3182} I' Date Sewer Installed Well To Absorption Area Well to Tank / ~.¢ ~ Well Log Received Septic Ta~k Size ~ ~-~ ~, .....