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Home My WebLink AboutMOUNTAIN PARK ESTATES #2 BLK 4 LT 22Onsite File Mountain Park Estates #2 Block 4 Lot 22 #017-023-22 Municipality of Anchorage Page __L._J 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 Numb_.e.r: ~-,'1 ~ '~cl ~ ~ i(~ PI D Number: (~ [--~ - £'3,~L~ "~_'~k Name: ,, ~ [-'- ~ ~ ~= i'ne~ Wa.lewater System: m New ,,Sl~Upgrade ~ ~-~-~.n~-r ~,T~,~'=~' ~ ~ ABSORPTION FIELD LEGAL DESCRIPTION ~" ~'~: > ~:/~; . ~ ~= ~o,,, ~,%~ ~: BIo~: ~u~n: ~ ~ ~ ~om ~1 ~ ~ G~ depth ~e~n WELL: ~ New ' D Upgrade e=w~ ~i~: Nu~Wr O,,~:' C~i~ (~, A,~.C): T~I ~; C~ TO: T~I ~n ~: Pipe ~r~h ~illl~ ~ DHI~: ~W~r ~1: I~lllr: Dill ~ ~ ~., TANK SEPARATION DISTANCES a ~tic = Hoi~i.g ~S.T.E.P. ~1~ Numar of w.. :- LI~ STATION L~ · 2 ~1~ in ~1o~; ' I M~u~ ' ~u~ ~/ I~~ ~l_t; ' ~.g [~~k ~<~ "Pump on'* ~1 ~ ~ ~ ~ ~1 a~ I High ~r Cumin ~mirk.: BENCH MARK In~io~ ~Ho~ by: ~ ~ n~ Dat~: ls~ ~~., .,=. Depa~ment of Health and Human Sewice. approval "~;~:~.' c~.~ R~l~ and appmvK b~ ate:.~'//-~ ~ ~G WeLL LDT 88 STEP ~ev = 99¢,35 I Deck / ~ House ]]rive \ Lupine Ro~d / / So. nd FILter Plan View (Not To Scale) Well AS-BUiLT P'LAN STEP System':& Sand FILter ~ot 88, Block 4,, INountcln Perk SuBdivision 08 Sc~Le 1' = 40' AssuMed ELevation oF Concrete SL~b At Deck Stcirs = 1000,00 ?.0, ~o× 677S2 W~sllla. Alaska Kclle J, Cherrq, Civil and ~nvirenmerfcal ~nqineerinq Fhoce: (cXOT) Pax: ( Celluar: (c~07) 5Sd'-IId'l ~mal: July 29, 1998 Mr. Jerome Pape 206 Steward Street Anchorage, Alaska 99508 RE: Wastewater Disposal System Upgrade - Mountain Park Estates #2, Block 4, Lot 22 Dear Mr. Pape On July 29, 1998, I completed the series of inspections required by your Wastewater System Permit. The system was inspected during construction consistent with the plans and specifications submitted to the Municipality o£Anchorage for approval of the permit application. The system as installed is consistent with the plans and specifications and permit. I understand that the disturbed area will have topsoil applied and will be seeded in the very near future. Sincerely, Kyle J. Cherry, P.E. PAGE 1 OF 2 MUNICIPALITY OF DdqCHORAGE DEPARTMENT OF HEALTH ia_ND ~ SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUPIBER:SW980103 DESIGN ENGINEER:S & S ENGINEERING OWNER NiS/~E:PAPE JEROME & LORRAINE OWNER ADDRESS:206 STEWARD ST $2 ANCHORAGE, AK 99508 DATE ISSUED: 5/08/98 EXPIRATION DATE: 5/08/99 PARCEL ID:01702322 LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES $2 BLK 4 LT LOT SIZE: 20130 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL 22 CONSTRUCTION MUST BE IN ACCORDD. NCE WITH: THE ATTACHED APPROVED DESIGN. ALL REQUIRESIENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 D/qD 15.65 ~ THE STATE OF 15_LASKA WASTEWATER DISPOSAL REGULATIONS (183~J~C72) i~%TD DRINKING WATER REGULATIONS 18AAC80). THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM L1NDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED /~ND CLOSED ON THE S3~4E DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. sPEcID-L PROVISIONS: Sia~ND FILTER SHALL BE THREE FEET INSTEAD OF THE 2 FEET SHOWN IN THE S&S DESIGN DATED 10/28/93 THE Si~NMD USED IN THE FILTER LAYER MUST BE A CLED~N COia_RSE ~A~ WITM &%_OR LESS PASSING THE $100 SIEVE AiqD @% OR LESS ON THE SAND USED. RECEIVED BY: l~'--~ DATE: DATE: -5'f.- --'- ~ b!w ANu oA NH FILTER PROPOSED S T E.P. ~ .... -'~ ' ......"- , ~R,. SUBDiVISiON ¢2 LO, 2z,- r~r-~. BASIS OF DESIGN On May 23, 1998, two test holes were excavated on the subject propeAy. TH I was located 45 - ¢.~ ~-*.~. +k^ q~. :~, ~.-n~,~..-t,v iine and 70 feet from the East ~*~¢A" iin¢ Test ~n'~ ~ *'" excavated 2~ fee~from ',,¢ ' ,,'"' ~'~¢'~¢'" "~¢ ~ ' . ,,, .,,¢ ~ , propeAy line. Tbese two ~t~e~p~ to uellnu u le possible extent of a gravel laver in this area of test holes were excavated to ...... ' - '" - TH~ ..~,,¢ between 4 ,.. and 7 .............. ~o¢~tea between 3.2 ~..~d 7.1feet in TH2 and appeared to be dipping west toward TH1 in this location.. A water level monitoring pipe was ~ . ,,¢~ ... w~ er ~u Ru~ RiRvation in u3e monitoring H,sta ~.u in each test bole for future obse~¥ation. The ............ the installation is allowed. Th,s desi~n assumes this dr~ .~i -.~-af,,m fn be continuous b¢',.,¢¢" +~' ~,.. +^~. h*, . " ..,.~,~., .~.~ .......... . ........ :~e .wO ~.-;~f_ ,,u~e... If upon excovouon ~nis is nu~. ~..'i~ case me o¢~on wiii hove be adlusted or redesigned based on the actuai extent of the gravel stratum and any other soils encountered in the area of the proposed seepage bed A percolation test was run on a bench of undisturbed soil at 4 ft. in the gravelly sand. adjacent to TH1. Even ah.:er the percoIouofi ~es~. no~e w~s so~uru,~e, (ne pefco!aDo.q Fore was iess thon i.0 minutes/inch and the water level fell so rapidly it could not be measured accurately with a tape. .U .,,,nu,~/n .....d t .... ,--,-, ~ ~;^, n,~ desitin wiii .... ~,,,~'"~"-~ ...... a percoiafi~n rate of !ess than i. ~ m~ ¢~' ~H ~ 'h~ annqc~tion rate of i 0 ~ii~ ¢' ~ ,minim nan nv mar m me ~ranosed filter sand (MOA i5.65.40 lC) f3). PROPOSED DESIGN Based on the soii profile, the location of the water table, and the lot topography, it is proposed to - - ~ .~m.-%uri. ~u d,~., ........ n ~.~_~,,, a instail..~ i ~,_..u£n"' .,..,n"l u,.-n R I ~- P. ~wfem ..,-".d, .. ..... H i.+- h, ,fin *,totem. with sand filter. The i500 gaii~n S.T.E.P. System shaii be manufactured by a manufacturer approved by ti~e Municipaii~y ¢ Anchorage ~nd installed in accordance with Municipality ¢ Anchorage requirements. Aii pipin¢ and coupiings will confo~ to Municipaiity ¢ Anchorace requirements. The existin9 septic tank and seepage system wiii be obandoned in place. The four bedroom house wi!! produce 600 9pd ¢ was4ewater. At an application rate ¢ 1.0 ~ud/~u, this wiii require a see¢~age bed area of 600 ~2. A seepage bed 24 feet wide by 25 feet (~00 ~2) is proposed. The seepage bed wiii have four I ~" diameter laterals spaced at 6 feet installed with pedoration down a~ached to a i ~A" manifold. Based on the pump proposed to be :,nstaHed each Jaterai will receive 7.5 gallons per ~aAeral. This will require ~/elve 3/~6" holes ddlled on i.4' centers. The bed location wHi be excavated to the top surface of the gravel layer that as stated above is assumed to dip to the west. A m.nim,Jm of .~--~o ¢~et of acceptobie native, in place soil will be maintained between the bottom of the excavation and the water table. A minimum of three feet of. o,.. ..... innhes or' ~uwe,~ ..... shave,' wi!! he ninced below and two bches above fhe. distribut on system. hewer araveJ snail De U.O inch to 2.5,,,~nc'h ~qPrPOJl¢:~¢ .~ Ornw81...~. ¢ .... witi] less than 3% passing the ¢200.. sieve. Four monitoring tubes that extend to the bosom of the sand filter to two feet above the :. m_nimum of ~our feet of cover of native boc~i.i or will be insuiated to that level of ~rotect on and accu. ,u~a;.ien in --'he bed area. The system must be inspected at the following cnticai times: i. Cumpiutiun e? e.--.u~v;_~iun ~or th~- tank and fJi.~:; bed ~;~d prior .~n any backfiH~n~ or installation Z. After the installation of filter sand, distribution system, sewer gravel, filter fabdc, monitoring tubes, deanout~ und standu~nes, but b-Jnre anv h~,c~iH~n? has taken piace ,~,.Je to the in$~aiiers aoQuenc~nQ of Consmic~i~sF, m~Fe ~L~;~ ~-':,,e .e.~_~,~,..~ mlnlBium' inspect OhS n ay be required. Any work which is done without the engineer's prior approval will not be accepted. \/'= . ,,,,,'-~"~ ~,~ d' 6 o o ypica[ Sand FiLter Section Sand FiLter PLan View (No% To Scale) LOT B~ WeLL FCD 0 TH1 G~Lon S,T;E,P, Sys~en House ~rave!, Drive Lupine Road WeLL Proposed sTE~ SyS.'tem & Sand Filter'.CoP Lo~ 22/ BLoCk 4, , INountam Park Subdivision ScaLe 1' = 40' TH1 Soil Log Percolation Test Date Performed ILegal Mountain Park Estates Subdivision No. 2 Description Block 4, Lot 22 No. of Bedrooms 4 5/23/98 TH2 Slope [-T_¥i.,; s Site Plan Comments: Performed By: Reading Date Gross Net Depth To Net Time Time Water Drop Percolation Rate ~ J, ~) (minutes/inch) Test Run Between -- '~..d Ft and ".~'.4 Et ~[,~/~o~//~H t~ ~t~ ~~u~. / I :~ _-..' Rick Mystrom, Mayor Mmficipality of Anchorage Department of Health and Human Services 825 "L" Street P,O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 December 8, 199~ Jerome and Lorraine Pape 2(/6 Stewm't Street Anchorage, AK 99508-2420 Subject: Lot #22, Blk. 4 Mountain Park Estates #2 Permit #SW930484, Parcel ID #017-023-22 Dear Jerome and Lon'aine Pape: The subject permit, issued November 18, 1993 to the previous owner of this property by this office for a single family well and/or on-site wastewater system, has expired as of November 18, 1994. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If the well was ch'illed, a well log must be sent to this office for documentation of the installation and to close the permit. If the ou-site wastewater system has been completed and a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built iuspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit aud $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Program Manager On-Site Services JC/kb cc: Robert C. Cowan, P.E. U.S. Department of Housing and Urban Development Northwest/Alaska - Alaska Office University Plaza Building Office of Housing 949 ~ast 36th Avenue, Suite 401 Anchorage, AK 99508-4399 November 25, 1994 James Cross, P.E. Municipality of Anchorage, DHHS P.O. Box 196650 Anchorage, AK 99519-6650 Subject: 12841 Lupine Rd, Anchorage, AK L22 B4 Mountain Park Estates HUD Case number 111-036067 This letter is in response to your letter dated 11/19/94 in regards to a well/septic permit. HUD is no longer the owner of the property. HUD sold and closed the property 2/25/94. The buyer of the property was Jerome and Lorraine Pape. If you have any questions, please contact me at (907) 271-4330. Sincerely, Daniel Lee, Realty Specialist Housing Management Branch Enclosure (s) 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:SW930484 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SECRETARY OF HUD OWNER ADDRESS:949 E. 36TH AVE. ANCHORAGE, AK 99508-4135 DATE ISSUED:Il/18/93 EXPIRATION DATE:Il/18/94 PARCEL ID:01702322 LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES #2 BLK 4 LT 22 'S LOT SIZE: 19800 i Q. FT.) NUMBER OF BEDROOm]S: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS 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: INSTALL THREE FEET OF LAKE OTIS GRAVEL INSTEAD OS THE TWO FEET SHOWN IN THE S &S DESIGN CRiTERIADATED 10/28/93 RECEIVED BY: ~'~.~--'-J, ~ ISSUED BY: -- / DATE: DATE: ROBERT SHAFER, P.E. ROGER SHAFER, P.E. November 3, 1993 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAiN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEAL TH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99519-6650 REFERENCE: Mountain Park Estates Subdivision No. 2, Block 4, Lot 22 We request you issue a permit to upgrade the septic system serving the four bedroom house on the referenced property. An adequacy test performed on the existing system for Health Authority Approval purposes found the absorption capacity of the existing system to be inadequate. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. At the time of excavation water was encountered at 11 feet and after seven day water monitoring water was found at 9 feet. Attached it the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. Sincerely, ~r,-P.E. RAS/LSU/Isu 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 SCALE UPGRADE LUPINE ROAD ........... . --- i O~dTIL~-. ES~NT. -- - -- o Z~ 0~ SP ~z~ O~mm ~ ~ z oo~o Z~ m~ o ~ 0 o~o zo O~ Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL BESCRIPTION: /-.-,-0'2~.f ~2,1~//~l~O(.llt,,,"'[,l~llg ~/'~IC. Township, Range, Section: SLOPE WAS GROUND WATER V.~------¢ ENCOUNTERED? 1 2 "='3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17- 18- 19- 20- S IFYES, ATWHAT /j I 0L DEPTH? P E Depth t° Water Alter f ) !o/ Moniloriflg? ~' Date: I0. ~1 ,~, SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop . off ~ ,, -5,f~,, ,/~,, PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER ~'~ '~ · TEST RUN~_BET,~EEN ~.~_~'~T AND (~' FT PERFORME~4 Ea~l~ Riwt L~ Roa~ N~, ~ ~ / ~ _ CERTIFY ~HAY TH~S TEST WAS PERFORMED IN ~GGOfiDANG~ITH ALL STATE AND MUNIG~PAL ~UIDEL~F~T QN THt~ D~TE. D~TE: ON-SITE WASTEWA TER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MA TERIAL SPEClFICATIONS REFERENCE: Mountain Park Estates Subdivision No. 2, Block 4, Lot 22 GENERAL: 1. 3. The scope of this project includes the installation of a 1500 gallon septic tank effluent pumping (S. T.E.P.) system and an absorption bed to serve the four bedroom residence located on the referenced property. The existing leachfield, 1250 gallon septic tank, and lift station are to be abandoned in place. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shaft be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shaft be responsible for final grading areas subsequently depressed from soft settling. On all leachfield mound systems, the property owner shaft be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shaft be sufficiently bedded to prevent settling or shifting of the tank. Page Two Mountain Park Estates Subdivision No. 2, Block 4, Lot 22 November $, 1993 Aft standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shaft be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shaft be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shaft be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shaft be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shaft be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shaft be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. If a sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. 3. Sewer rock shaft be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shaft be a minimum of six (6) inches. Gravel depth above the perforated pipe shaft be a minimum of two (2) inches. The total gravel depth throughout the entire bed shaft be a minimum of twelve (12) inches. The perforated distribution pipes must be no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Page Three Mountain Park Estates Subdivision No. 2, Block 4, Lot 22 November 3, 1993 Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shaft be of four (4) inch diameter and installed at the locations shown on the design. The portion of the monitor tube extending through the gravel depth shaft be perforated six (6) inches below the bottom of the horizontal distribution lines. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. MINIMUM MA TERIAL SPEClFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes ASTM D3034 (PVC) Yes ASTM F810 (HDPE) Yes ASTM D2662 (ABS) Yes Yes Yes No Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shaft be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shaft be fitted with watertight couplings (Caulder, Femco, or equal). Page Four Mountain Park Estates Subdivision No. 2, Block 4, Lot 22 November 3, 1993 A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, it's gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. · Well Owner. · M-W'D~ILUHG, Inc..'. '" . .' i '~0'5-/ " P.O: Box 10~378 · 1030~ Old Seward Highway (907) 349-8535 ANCHO.RAGE, ALASKA 99511 i;Ai:01.2; 0STE~-UD DRILL. lNG LOG: il.'. "'.-.:.'). '"' -".'::...:'.-'.-:'...' WELL ' (t 2 ' ' U.~e of.Well Domestic Location (address of: Township, Range, Section, if known; or distance main road Lq, t.~"'~ ~loc~. 4 ~ountain Park ;;states Size of casing ('" Static water level Screen ( ); Perforated ( ). Describe screen or perforatio None Well pumping test at 1 gallons per >(hl~i~)r of drawdown from static level. Depth of Hole 362 Feet Casedto 116.2 feet ! 2 (. ft. (~i15~9~) (below) land surface. Finish of well (check one) open end ( xx (minute) for i hours with 100% Date of completion Octoker '? WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness ); ftt< 0 TO 2 2.5 TO 3.5 TO 16 16 .TO 21 21 .TO 28 28 .TO 34 34 .TO. 45 45 .TO. 82 82 .TO. g4 ~4 .TO 93 93'.ro 97 TO 112 112 TO. 2~0 200 TO Casing s tlic ku.p :;Top soil RECEIVED · -:'..'-'-- NOV 1 8 19'33 '?Sandy clay Gravelly clay ~layey gravel Municipality of Anchorage Dept. Health & Human San, ir, es 'Gravel - - Cravel,.cparse 6~nd Cr v l .... Hard sand Boulder $ondstone, hard Bedrock- s~ft Bedrock. varicolored. " water smazl seeps sporadic fractures ' 2cdrock. fractured, 2'~j 4.~ 2 ~ STATE -\ LOCAL NO. .... DRILLING LOG .. '.-.. · ' . - ~ '~ ':-.':"-" .... ~": ":.':~/ ' ......i "..':' · <:.-i~-' :'. ',~'......:-:. .... :../~.....-...."-..+~. ~ ~o ~O0' Use Of Well Dom, " Location (ad~ress of: Township,: Range,:.Se'etion, ff ~own.; or distance 'main road"~ "' .. Size of casing g,' Depth of Hole Static water level ft. (above) Screen ( ); Perforated (. 3Oq feet Casedto 'l.?n .., ~' feet (below) land surface. Finish of well (check'one) open end ( Describe screen or perforation Well' pumping test at t gallons per f~l]9~O of drawdown from static level. Date of completion .' :- <.'~ ',/~;'~ ~ ); (minute) for ]. hours with ].0m:' -- .... ;ftc WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness n .~0 '.') ' 2 TO 3 2 TO L.n TO 80 TO 89 82 TO 97 97 TO 105 10q TO 1____~__ ll5 TO ]90 170 TO 300 TO TO .TO .TO 0rganic~ RECEIVED ;~eeping hard pan NOV 1 8 199b n MunicipalJty of Anchorage ~ar4, pan ' _P, edrock: ~.,;ater seeps 2 -- STATE ~~~~ ~ ANCHORAGE, A~S~99511 ~' · -: . '..~'~" .-.,.. ~ .... -..-.~.'."~.~. ~ - .~. ':-~ ...... ~:'. ',.'-..~..r.... ,' .... .'....~, :;'~.)~n. ~UD:'-'. L'. '~~"- . :.'".:' ' ...... ;'g;~ofWeB ~e~eb2~c.' - Well Owner ............. ~ .... __~-. - · - . . Location.. (addrbss .of: .Tow~iship, Range,"Section, if lm0wn~ or.distance main road Size of casing " Depth of Hole400 feet Cased to 12'.,. o .feet Static water level ft. ~ve) (beiow)'i'and surface. Finish of Wbil·(check one') ope~i ~nd ( :.:; ); Screen ( ); Perforated ( ). Describe screen or perforation Well pumping test at 2.qq4- gallons per (ho~)',- (3~Ktr~t_e.) for hours with of drawdown from static level. "~ ~"~ Date of completion .... ' -- WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness · ' .TO TO__ .TO. .TO. .TO. TO .TO. .TO. TO. TO. TO_ .TO TO RECEIVED Municipality of Anchorage ~,~ ~1~ .~O DepL Health & Human Services .... ~14 & 2 -- STATE [::EF'FiRTMENT OF HEFILTH FINE:, EN',,,'II;'.ONMENTRL PROTECTION 825 '"L." STREET., FNEHORFIGE.; :pr- :,~:,:,:. SRFi E -;:':: ......'-'"~ FIN ZI--tOF'FiGE, FIE LEGRL DESCRiPTiON SUE:DiVISION: MTN PK EST ~2 BLOCK: 4 LOT: '-"-' LOT SiZE 0 '"Jb3. FT. TOHNSHIF': - RRNGE: - SECTION: -' i CERTIF'¥' THFIT: 1. I RM FRMILIRR HZ"I'H THEE REiCJIPEMENTS FOR ON-SITE SEPJERS FINE:' 'HELLS FtS SET FORTH EF'r' THE I"'tUNICIF'RLIT'¢ OF,,,c*~"-'L'n~R':'~,--, ,_,r~.~,a~ RND 'THE STFtTE OF FILFISI'(FI. 2. Z k!ZL.L l ....... LL THE :, :,]bi, Zf'4 FIEi::OF?[:'FiNfZ:E HiTH THE F:ODES RND FIFI',,,'E RECEZVED PFt~ OF TIlE ,-.mr,,= - ,..~- Ft _._-T , ............ ~ =,Ur'l,'F.'r FiND DiFiGRFIM RTTFtCHHENTS [,~I'~ZZI-I ZS PFIRT OF TI'-I~ F'ERM Z T. 2:. i UNDERSTAND THRT THE ON-SZTE SEHER .:, =,lEt, h'li:rCT' REQ liRE ENLi. RaEHENT ZF THE RESZDENCE iS REHODEL.ED TO Z,'tCLU['E MORE THFIN O BEDROOMS. PERI"IZT 9~'~'~_ZZ;'=~J~ HI:tS THE RESF'OI'-4SZE:ZLZT'T' TO iNFORM PERSONNEL DIJRZhlG THE ~,,,..,~"=~qi ~ c'=~ON,, ._~., , , .~ ][[4:,I El .... ~,...,[~;;, OF I:t['~"r' HELLS t:t[:'.3FICE['~T TO THIS P~'.OPER]"~¢ t~N[:' THE NUMBER OF RESiE,EN3ES THFIT THE P4EL[ ..... I .... SERVE. IF F! LIFT STRTIOI'-4 IS INSTI:tLLED., RN ELECTRICRL F'ERMIT FIND INSF'ECTION MUST .... ~!~1._] E:E FIPPROVED k~iTHOUT Rt'4 ELECTRICRL INSPECTION 13E OBTR I NEE:,. RS-E',U t LTS .--c, - REF'ORT. THE ~.~c. -.~-c, ~. -.,:,, - F" _ _ c: ~ E:"r' .......... · .............. I.. I"tl I'::;T ~E [:,Ot",IE FI LICENSED ELEC'TRICIRN. '..T, I ]NE[,: FtF'F'LIE:FII'-4T: JERt'.,INIE L 3STERLI[:, I':':;__ E[,. E',', . [:,FITE: iO;gI MUNICIPALITY OF ANCHORAGE Department/~. Health and Environmenta?-protection .... 825 ~ Street, Anchorage, AK. _9501 264-4720 Permit ~ ~0~ * * * HANDWRITTEN PERMIT * * * WELL ~, ~,~-,=--~ ....... PERMIT Location:~ Phone Number: Legal Description: ~ff~ ~ ~ ~ ~~BO~ Type:: of Soil ~sorption Sys~em Is: Trench: Drainfield: Seepage Bed: Holding Tank Maxim~ N~ber of Bedrooms: ~.._ Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: ' DEPTH ~ LENGTH'-~ GRAVEL DEPTH (~,'2 WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth~of a trench or pit is the distance between the surface of the ground and the bOttom of the excavation(in feet). There is no set width for trenches. The. gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~///~ GALLONS Permit:applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may re~ire enlargement if the residence is remodeled to include more that ~ 5edrooms. /~ Date: ~ Y~//~-~. ' / / SWP/024(1/81) ,. ..~. '~.,~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENW RONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~- PRONE t'~ NEW MAILING ADDRESS LEGAL DESCRIPTION LOCATION ~ DISTAN ~ ~ ~ Manufacturer ~¢ Mater' ~{ I ( No. of %partments ' iLiq. capacity in gallons ~ / Width Liquid depth ~ %~ IF HOME~D-, L~ Inside length ~O'~ DISTANCE TO: We~ (~ Dwelling PERMITNO, O ~ Manufacturer Material Liquid capacity in gallons Nearest lot line PERMIT NO,~ O We]~~ Fo.ndation ; ~ w~¢ ~ Distanc,. ~ DISTANCE TO: ~~ :No. oflines ~ Len line~ Total lengthof~e~ Trench -- ~/ ~ inches Total effective~s~n area ~ ~ Top of tile to finish grade Materiel beneath tile 0 ~' / ~ inches Length Width~ / ~ ,epth PERMIT NO. ~/ ~ P Type of crib Crib di~~ ~depth Total effective absorption area ~ Well f Building foundation Nearest lot line ~ DISTANCE TO: ~ Class~ ~ Depth Driller Distance to lot line PERMIT N~O ~?. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS,~ ~) SOIL TEST RATING ' iNSTAELER REMARKS AP~ROV~ ~ DATE LEGAL 72-013 (Rev. 3~ DRILLING, INC. DRILLING LOG Well Owner Dick. Wright ~, Use of Well Location (address of: Township, Range, Section, if known; or distance main road Lot 22 Block 4 Mountain Park Estates, Anchorage Dom. Size of casing 6" Depth of Hole Static water level ft. (above) Screen ( ); Perforated ( 300 feet Cased to 120.8 ~feet (below) land surface. Finish of well (check one) open end ( ). Describe screen or perforation Well pumping test a~ 1 gallons per of drawdown from static level. (minute) for 1 hours with 100% Date of completion 12 / 2 0 / 7 8 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness ); 0 3 4~ 80 82 97 105 115 TO 120 _TO _TO TO _TQ .TO ~TO. TO_ 2 Casing s-tickup TO 3 Organics TO 40 Sandy graYell~ hard pan TO 8~ S±ltM hard pan TO 82 l~eeplng hard pan TO 97 Hard pan TO__~10-5~ Loose gravel TO 115 Hard pan 120 30O Soft bedr'ock Bedrock: waker seeps ~n sporadic fractures throughout /7 ' ""7'''~ ~'' ~ - ' '" ' / CUSTOMER F'ERMIT NO. DEPAF,:TMENT OF HEALTH AND ENVIRONMENTAL FF_~TEL, TICIN 8":-.-'5 '"L'" STREET., ANCHORAGE., AK. APF'LI E:RNT ~ LOCATION MT. F'ARR~EST 2 LEGAL L,:.~ E:~ MT F'K EST. 2 qRA B0,'-.:: ::L.:,_,..Ft LOT SIZE _'.'.4 4 - 4,-:.14 '.T-' .... Yl ~:~OL4tz SQUARE FEET T'T'F'E OF =,UIL RE:qF'RE:TION _,Y=,TEH I=']: DRRINFIELD MRXIMIJM NJrlE, EF,. ElF BEDRFII-M~ = 4 ,- ] , F' SQ ' '"" =,L IL RRTINa ( FT,-'BF .... ' THE REQLIIRED SIZE OF THE SOIL HB::,ORFTION _V_TE[1 I=,. [:,E F" T'Ft= 4- L E I'-.! m.3 T H = E::~.: 6 I~: R"-,-' E L [:, E F'-~' 14 = :~L THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF A TRENCH OF,: PIT IS THE DISTANCE E:ETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE E>,:CRVRTION (IN FEET:). THE 'T'REI"-.i,-:H I~--~ I [:,TH I 5 5. 0~.~"~3-~ FEFT THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFFILL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT AF'PLIIZ:RNT HRS THE RE_.FUN_.IE, ILITV TO INFORM THIS DEF'RR'FMEN'r [, RIN] THE INS"rFILLRTION IN=,PEL. TION_, OF ANY WELLS HDJRL. ENT TO THIS F'ROPERTY RND THE NUMBEF,: OF RE:,IE. ENCE=, THFIT THE WELL WILL "=;ERVE. 'f' I-4 mi, ,:'.,'~..".~, I ~"-.~ __~-; F' E ,:_: T I C, [-~ S Et F-: E F.: E ~.7-~ IJ I r-:: E [.'.:, BHL:K. FILLIN[~ OF ANY =,¢:,TEM WITHOUT FINAL INSPECTION RN[) APF'ROVAL BY THIS [:,EF'RRTMENT WILL BE '- ' r' . .... =.UBJE_.T TEl PF.'F'~E' tTION. MINIMUM DISTANCE BETWEEN A WELL RND ANY ON-SITE SEWAGE DISPOSAL. SYSTEM IS i00 FEET FOR A PRIVATE WELb OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEP~RTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET' FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE HITH '[HE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT tF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch ~-650, Anchorage, Alaska 99502 276-2221J SOILS LOG -- PERCOLATION TEST PEREORME~; EOR= ~ I C- ~L U~ ~ ~ ¢~ t4-T DATE PERFORMED: [~SO ILS LOG [] PERCOLATION TEST § 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS ;LOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? DEPTH?IF YES, AT WHAT Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) PERFORMED BY: TEST RUN BETWEEN FT AND I FT DATE: 72-008 (7/76) RMUMCPAUTY OF ANCHORAGE Development Services Department Phone. 907-343-7904 On -Site Water & Wastewater Section ��-� Fax: 907-343-7997 Certificate of On -Site Systems Approval P_ar_ce.l_l-D 01702322 Expiration -Date: 1. GENERAL INFORMATION Complete legal description Mountain Park Est #2 134 L22 Location (site address) 12841 Lupine Current property owner(s) Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: Ej 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: Private Well El Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 5D Waiver Fee $ Date of Payment /1/3D/Z1 Date of Payment I Receipt Number Ogg Q 6 t Receipt Number COSA # 0 5 c 9111 (18 a 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA COSA guidelines and regulations. The 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-th e- owne r- listed -above.-Reliance-on-this-report-by-another-person -is at -their own risk -Pannone Ehgineering Services ELC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE Phone (907) 745-8200 Date —'vf ((2 OF A�qs�� System #1 Approved for bedrooms P,. Pannone even CE 81 9 System #2 Approved for bedrooms Y pp VSF Disapproved V� �'OFE�Siv� Conditional approval for bedrooms, with the following stipulations: wp,TER\t TER zo^ -- MA ROGk, By: Original Certificate Date:�a 3 a?a�/ 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 Septic System Advisory Well Flow Advisory x COSA Checklist blue sheet Nitrate Advisory X Arsenic Advisory Other T0.,vy�r� C.Q¢ Qu,isorv� k Legal Description: Mountain Park Est #2 134 L22 Parcel ID: 01702322 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 106'3/k3 Total depth 34a ft Cased to /A -Aft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 710121 Static water level at beginning of test 237 ft. Comments B. TANK DATA Age of tank(s) 8f98.... years / Tank type/material Measured operating fluid level in septic tank 0„ ❑ Standpipes/foundation cleanout per record drawing Date of pumping 11/23/21 D. ABSORPTION FIELD DATA Mound Which system tested (date installed) 8/98 ❑ ALL standpipes present per record drawing Total measured depth from grade 8.9 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective f-011) ( Well production at time of test .8nnm Water storage tank volume na gallons Well disinfected for coliform test? ❑ Yes No ❑ Coliform bacteria is Negative Nitrate 8.79 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by PES Date of Sample p® /11/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station 89"”" years Lift station material steel Comments: Adequacy test date 11/10/21 Results D Pass For 4 bedrooms Fluid depth prior to test 0" in Water added 600 gal New depth 1 in Elapsed time 60 min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) _ date of test) Gallons introduced 1800 gallons If yes, enter date Comments/Deficiencies: field flooded at 1800 gallons, added 600 gallons for test COSA Checklist yellow sheet From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' r7l Yes Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ❑✓ Yes if No Neighboring Tank > 100' F- Yes if No ft Private Sewer/Septic Line > 25' Yes if No Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' Yes if No Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' Yes if No 0✓ Yes if No ft 0 Yes if No ft Water Service Line > 10' ft ft ft ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' M✓ Yes if No ft 0 Yes if No ft From Septic/holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' r7l Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' ✓v Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' F71 Yes if No ft Private Wells > 100'✓l Yes if No ft Water Main > 10' ft Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' 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' ✓l Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' U Yes if No ft Water Service Line > 10' R� Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water > 100' FV1 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that l 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. t COSA Checklist yellow sheet C F k, r C-) Steven-'.*"•Pcannorie• �,•. CE 819 •�� MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Septic Tank Advisory Certificate of On‐Site Systems Approval # OSC211688 Subdivision: Mountain Park Estates #2 Block:4, Lot: 22 The septic tank for this property is 23 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Nitrate Advisory Certificate of On‐Site Systems Approval # OSC211688 Subdivision: Mountain Park Estates #2, Block: 4, Lot: 22 A water sample revealed a nitrate concentration of 8.79 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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached “Nitrate Fact Sheet” for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Well Water Advisory Certificate of On‐Site Systems Approval # OSC211688 Subdivision: Mountain Park Estates #2, Block: 4, Lot: 22 This well’s productivity was determined to be 0.8 gallons per m inute. The minimum well productivity required under (AMC 15.55) for a 4‐bedroom residence is 0.42 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate and may be insufficient to meet your needs. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. Station/Pump Vault Maintenance Log ..ate'. gal *Sludge 1pwel .5' lis-Fliurnpi g,, required y z, �.�y 4, Umprn;c rr" Pl e -Control ffoats e {;�,�_., v -Propey float s gigs monr i -Operation s1mct!3 — an Swam. @p' yt�{. ##y��.��✓✓��.. $ q�y j �t ,yam y�' y j %. +�, ala-, �y g{�y. �y v�3e, y'k �+ a $+ tti %,✓.a3.2 �'L�i �.S 3 3 +La. arm Lir .3 3.. r - i ka'.^ C.�, d �L�S•��`* tua' :d.la-, , ins,;,,de dvveIU 5' r' y '.�."�^'. .«i 64�:". •Alarms system in er t} , nhp Rifagr~ -Ground water iritruit i at riser ' tank .meq -Grourld eater #n"a€.k:`sic 1 arcund, ,`'"sips' penetrations E -�.._-W*l n h __ 4JrK:IiO pFnn -Mlanhole iii:uncfs nal _.: !; sults ed roper Secured a -AU manufacturer r u red inspections ares rncrm n_r:s� cmplet ij, f chaa,ri .�' `, lee � iia si ian , Municipality of Anchorage ENCROACSMENT PERMIT THIS AGREEMENT is made this 3 3) day of r' , 19 by and between Jerome A. Pape and Lorraine J. Pape, and their heirs, administrators and assigns, hereinafter called the "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called tate "PERWIW WITNESSETH: WHEREAS, "PERMITTEE" is the owner and/or administrator of the following described real property: LOT 22, BLOCK 4, MOUNTAIN PARK ESTATES SUBDIVISION, ADDITION NO. 2, according to the official plat thereof, on file in the office of the District Recorder, Seward Meridian, Alaska, and; I' -- WHEREAS, "PERMITTER" owns and/or maintains the real property more particularly described as follows: THE SIXTY FOOT (60) RIGHT OF WAY OF LUPINE ROAD immediately to the West of the "PERMITTEE'S" property, and THE TEN FOOT (10) UTILITY EASEMENT comprising the East ten feet of the "PERMI r=S" property, and; WHEREAS, "PERMITTEE" has caused to be placed a lamp pole and a well which encroach upon the "PERMITTER'S" Lupine Road Right of Way, and a chain link fence which encroaches upon the "PERMITTER'S" ten foot utility easement; NOW, THEREFORE, it is mutually agreed between the parties hereto that: i . The "PERMITTER", acting through the Director of Public Works, hereby grants to the "PERMITTEE" the privilege of allowing their presently placed lamp pole and well to encroach upon the "PERMITTER'S Lupine Road Right of Way distances of two and seven -tenths feet (2.7') and one and two-tenths feet (1.29 Wdmpanw 1 31 March 1994 ' Way distances of two and seven -tenths feet (2.7) and one and two-tenths feet (1.2) respectively; and for their presently placed chain link fence to encroach upon the ,,p 'S" ten foot utility easement a distance of six and eight -tenths feet (6.8) for its length, as shown on Attachment "A", included herein. 2. The "PERMITTEE" agrees forever to indemnify, defend, save and hold harmless, the Municipality of Anchorage, its officers and employees, from any i and all lawuits, claims or actions brought by any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal, rwwfitructl0n, operation, use or removal of the encroaching lamp pole and/or well as situated upon the " MMrIER'S" Lupine Road Right of Way, and/or the encroaclmW chain link fence as situated upon the "PERMITTER'S" ten foot utility easement as described ribe d herein. 3. The "PERMITTEE" shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Public Works. 4. This agreement and permit grants the "PERMMEE" no interest in the "PERI IT R'S" real property whatsoever, except only the encroachment rights described herein. 5. The "PERMITTER" reserves the right to revoke this permit upon twenty (20) days written notice to the "PERNUTTEE". The "PERMITTEE" agrees upon said notice of revocation to move immediately any or all said encroachments from the Lupine Road Right of Way and/or ten foot utility easement in which the "PERMITTEES" lamp pole, well, and chain link hence are placed. Should the "PERMITTEE" refuse or fail to comply with said written notice, the "PERNuriw may, without fiuther notice to the "PERMITTEE", remove, or cause to be removed, the encroachment, and the "PERMITTEE" hereby agrees to reimburse the "PERM=R" for any and all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the "PERMITTEE" hereby promises to pay the "PERMITTER" a one-time permit fee of one hundred dollars ($100.00). IN WITNESS THEREOF, the parties hereto have hereunto set their hands and seals the day and year first above written. hum 2- 25 Febnu y 19% Grant Grantor: Municipality of Anchorage Right of Way Enforcement Supervisor �i STATE OF ALASKA ) THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this 3/a� day of �% r -C_ , 191- before me, the undersigned, a Notary Public in and for the State of Alaska, duly commisioned and sworn as such, personally appeared t i n �• #a, l l &r- , known to me to be the Right -of -Way Enforcement Supervisor for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and helshe/they acknowledged to me that helshelthey executed the foregoing instrument as a free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he/she/they was authorized to execute said instrument. WITNESS my hand and seal on the day and year first above written. A�PBLIC �inand or Alaska My commission expires: W 4, STATE OF ALASKA )ss. THIRD JUDICIAL DISTRICT 3, 25 FeWUWY 1994 a THIS IS TO CERTIFY that on this _jj- day of jj 19 9 Lf. before me, the undersigned, a Notary Public, in and for the State of Alaska, duly commissioned and sworn as such, personally appeared 3C rnm e . e T. &. known to me to be the individual named herein who executed the foregoing ffistrument, and helshelthey acknowledged that he/"they did so freely and voluntarily for the uses and purposes therein mentioned, and on oath stated that helshelthey was authorized to execute said instrument. WITNESS my hand and official seal the day and year first above written. 4UBUC in and or Alaska, my commission wires: wawa"= 0 hu&Wmm 4 25 February 1994 MUNICIPALITY OF ANCHORAGE ' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date (-¢ ~' ~ ~' GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ¢¢~F~:>~¢~, ~:~-~I-¢~¢-d[~ Telephone: Home ¢-~-~'~- ~'~¢[ Business Applicant Address /'Z~-~L~ ~---OF~r'-~' ) ~d~-.J~---'I ~ ct¢:~t~\~ (c) Applicant is (check one): Lending Institution []; Owner/builder'S; Buyer []; Other [] (explain); (d) Lending Institution ~Dt..4~. ~1~/1~ ~ ~o/,-.~ Telephone Address ~,-'C'¢'1...[ ~ I ~o~ ~ ~ ~ ~ (e) Real Estate Company and Agent ~~ Address Telephone. ' (f) ,.Jj~eiCthe HAA to the following address: S & S ENGINEERING SR B 196X EAGLE RIVER, AK 99577 TYPE OF RESIDENCE Single-Family/~ Multi-Family [] Number of ~edrooms /~ Other WATER SUPPLY Well'~/ Community [] Public [] Individual Note: If community Well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsitej~ Public [] .Community [] Holding Tank [] Note: If corn munity well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) ENGINEERING FIRM PROVIDIN~ INSPECTIONS, TESTS, FILE SEARCH, DA ix4'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 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 S & S ENGINEERING Telephone SR B 196X Address EAGLE RIVER, AK 99577 JUN I 0 1986 Date Approved for _FOIl-P,, Approved ~ Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) WELL DATA MUNICIPALITY OF ANCHORAGE (MO~,l HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 MUNICIPALITY OF ANCHORAG;: DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Cased to ~'~-~:), Well Classification Well Log Present/N) Total Depth '~t¢'t~~ Static Water Level Casing Height Above Ground Electrical Wiring in Conduit ~)N) Separation Distances from Well: To Septic/.j;~tfl~Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line 1986 Legal D,es~ription: ~<..~'7~' '~C~ ! V rc D If A, B, C, D.E.C. Approved (Y/N) Date Completed ~"~"~'Z-~-"~ ~ Yield Depth of Grouting '"'"- "' Pump Set At 0~ J/"~ Sanitary Seal on Casing4:~9'N) Depression Around Wellhead ('~;) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by ~ ~ ~ ~N~ t~d~r~ ; Date Water Sample Test Results -~'~~---"~'~---~'~n--~1' Comments ~ 'X/~d;~4~ ,--Jl ~ ~ ~\~-- To Nearest Sewer Service Line on Lot B. SEPTIC~I:E~L~--N~TAN, K DATA Date Installed ~;~-~-~ ~ Size 1''~'~ No. ct Compartments Standpipes~/N) Air-tight CapstaN) Foundation Cleanout To Property Line To Water Main/Service Line Course Depression over Tank (Y~ Pumping/Maintenance Contract on File (Y/.~ Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic,4Net~ Tank: TO Water-Supply Well I C'~ ~ Jr' Date Last Pumped (.¢ ~r~ ...-~,¢ i tot Temporary Holding Tank Permit (Y/N) To Building Foundation ~"~ / To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) Square Feet of Absorption Area Depression over Field (Y~¢~:)_ Results of Last Adequacy Test ABSORPTION FIELD DATA Soils Rating in Absorption Strata /''¢'4~ 4Fa/1"~rv"' Type of System Design Date Installed ~_~-- ~ '~ ~7 ~ Length of Field Width of Field ~E) ¢ Depth of Field Gravel Bed Thickness '~--~"~¢~"¢~ Standpipes Present (~N) Date of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building FoundatEon Lot l-A To Water Main/Service Line 't_~ I Jr To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Properly Line 1O1 To Existing or Abandoned System on ; On Adjoining Lots "~:::~ ~"JIE Ck To Cutl~ank (if present) Comments D. LIFT STATION Date Installed ~¢ ~ ¢ ~ Dimensions DC~ Size in Gallons /¢'~z:) ~.4-'~..., Manhole/Access ~/N) "Pump On" Level at ~ ~O ~ ~o, "Pump Off" Level at High Water Alarm Level at q ~t ~ ~O. I~/~ Vent~) Tested for ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes ~N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify th~ I~a~:~dl~l~'j~~ or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed $.D.~ ~,zv Date JUN I0 1986 Company[::~, l"~l I:: Receipt No. Date of Payment Amount: $ ~ Page 2 of 2 72-o26 (11/84) ~" MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT~NT. 825 L Street - Anchorage. Alaska 99501 ENVIRONMENTAL ~'~ ENVIRONMENTAL ENGINEERING DIVISlO~N 'OEO 2 61978 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SJ~t/~ E/JcVIL~'~S DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PP~I)PERTYOWNER J PHONE M R PROPERTY RESIDENT If different from above) PHONE MAILING ADDRESS 3, ~J~NDING INSTITUTION PHONE MAILING ADDR E~5~ ' LEGAl_ DESCRIPTION STRE~jT LOCATION ' J 6. TYPEj~J'F RESIDENCE ~ NUMBER OF BEDROOMS ~ SINGLE FAMILY [] One ~"~Four [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six , [] Other 7. WATER SUPPLY ~ INDIVIDUAL~ [] COMMUNITY [] PUBLIC UTILITY ' ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) /--~-~--~.i /~2~ 8. SEWAGE DISPOSAL SYSTEM ~ iNDiViDUAL/ON.SiTE*~ **If individual/on-site, give installation date (/~.~.-~. ' ~d~' . If system is over two (2) years old an adequacy ~st is required [] PUBLIC UTI LITY by this Department. /v,iUj,,iIciPA~.iT,' ., DEpi: ~r._ O~F,. ANcH( NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING ~J~/~._~,~IA,3~E,J~, ~UNICIPALITY OF ANCHQp4~.~ '- ,,AL DEPT. L~F I ~F,4, LT~ THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR 1NSPECTOR INSPECTOR DIRECTIONS: i. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~;~'~'SI N G LE FAMILY [] ONE [] THREE [] FiVE [~] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER - 2, WATER SUPPLY [~*"~NDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER I~NDIVIDUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER I~]Septic Tank or [] Holding Tank ~'~~ Size: ~-~,~'¢~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line [ Nearest Lot Line WELL TO: I Absorption Area to nearest Lot Line 5. COMMENTS ~PPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE ? BY {Tit~ LEGAL DESCRIPTION 72-010 (Rev. 3/78)