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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES #2 BLK 5 LT 7Onsite File f � k c Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201269 PID Number: 017-023-31 Dwelling: © Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade Name KEN THOMAS ABSORPTION FIELD ❑ Deep Trench ❑■ Wide Trench ❑ Bed ❑ Mound Site Address 13000 LUPINE RD, ANCH AK ❑ other Phone Number of Bedrooms Soil Rating depth from original grade 3 0.8 GPD/SF JTotal 1.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1'0 Ft. Gravel depth beneath pipe 0 1 t. Subdivision Block MOUNTAIN PARK EST BLK 5, LOT 7 Lot Fill added above original grade 21+ Gravav el length Township flange Section Ft. 3 X 38' Ft. idth Ft. Beds: Number of Lines Distance between lines SEPARATION DISTANCES Septic Absorption Lift Station Holding Sew17Gravel orption area Number of trenches FtTo Dist. between trenches From Tank Field Tank Line 563FtZ 3 6.0 Ft. Well'� 00'+ 100'+ 50++ TANK ElSeptic © S.T.E.P. [] Holding ❑Other Manufacturer Capacity Surface Water 100'+ 100'+ GREER 11250 Gal. Material Number of compartments Lot Line 10'+ 10'+ NA PLASTIC 2 Foundation I 101+ 10++ LIFT STATION Manufacturer Capacity Remarks GREER TANK 1250 Gal. Alarm location GARAGE Electrical installed by RISING SUN Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield MIKE N ANDERSON, P.E. Drainfield 3034 CO/MT3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 103 ft Inspectiond10 7/22/21 2� 7/22/21 Location and description 31tl 4m TOP OF TANK MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL NP OF xj ��t Conditional Approval: DateOW ,`ry`��•• *:49LH �.fl • MICHAEL N. Af:DERSCN: r^ .;.�� �?`°�� Septic S rs rf� _ Approved So� Date ..% ii,` Note: this approval does not include well permit requirements. �� FSS1��� 1P." (1F lri'M Q1 Permit No. OSP201269 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: LOT 7, BILK 5 MOUNTAIN PART EST. S/D PID No.: 017-023-31 0�O' MUNICIPALITY OF ANCHORAGEnAcnrOn-Site Water & Wastewater ProgramPO Box 196650 4700 Elmore RoadAnchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997w http://.muni.org/onsiteDepai tmenr On -Site Wastewater Disposal System Permit Permit Number: OSP211269 Effective Date: 7/15/2021 Work Type: Septic Upgrade Expiration Date: 7/15/2022 Tax Code Number: 01702331000 Site Legal Address: MOUNTAIN PARK ESTATES #2 BILK 5 LT 7 G:2839 Site Mailing Address: 13000 LUPINE RD, Anchorage Owner: THOMAS KENNETH M Lot Size in Sq Ft: 20130 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 3 This permit is for the construction of: 10 Disposal Field 21 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: eA i IPA -,a, Date: 7 U Issued By: Date: 7% 5 -20.2 1 Development Services Department On -Site Water & Wastewater Section Parcel I.D. 017-023-31 ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) KEN THOMAS Mailing address PO BOX 231629, ANCH AK Site address 13000 LUPINE RD ANCH AK 99516 Day phone Phone: 907-343-7904 Fax. 907-343-7997 Legal description (Sub'd., Block & Lot) MOUNTAIN PARK ESTATES #2 BLK 5 LT 7 Legal description (Township, Range & Section) Lot Size 20,130 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Fx_1 Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank El Upgrade Q (D) ❑ Holding Tank ❑ Renewal ElDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: t 5 95 Waiver Fees: Date of Payment: 71012— l Receipt Number: 000700 Permit No. OS e /� 1 ) ) ('I Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc July 15, 2021 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New septic permit & 2’ lot line waiver Legal: MOUNTAIN PARK ESTATES #2 BLK 5 LT 7 To Whom it may concern: This is a request for a septic permit on the above referenced lot. A test hole was excavated and found silty gravel (GM) for the entire depth and water at nine feet. After the seven day monitoring period the water raised to seven feet. The perc rate was measured at 6 minutes per inch. A new 5-wide system has been designed which is 5.5 feet above this water elevation (4' plus 1.5' for July). Justification is the reading was taken only 2 days into the month (July 2) therefore we are over 94% compliant. A new STEP plastic tank will also be installed for the new 5-wide system. This septic replacement will not impact any of the neighbors or encroach on any wells, septic or open water issues. The slope across the site is less than 10 percent. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211269, Rebecca Carroll, 07/15/21 DESIGN CRITERIA: 1"=100' PROPERTY LINE EXISTING HOUSE LUPINE RDEXISTING SYSTEM TO BE ABANDONED SCALE: DJRDRAWN: DATE: MOUNTAIN PARK ESTATES #2 BLK 5 LT 7 Anchorage, Alaska KEN THOMAS 6/10/2021 0.5' EFFECTIVE 3 BDRM X 150 = 450 GPD SOILS = 450/0.8 = 563 GPD 563 GA/5/2 = 112 5.0' WIDE (3) 38' LONG (3) 5-WIDES TRENCHES 1.5' DEEP TEST HOLE RADIUSWELL WELL WELL WELL SEPTIC SEPTIC FIELD SECTION1.5'5.0' -1.5 -1.0 MOUND OVER FILTER FABRIC SEWER ROCK ‘3,3( GRADE & INSULATION 11 (TH#1) 1.5 GM ORG WATER @ 7' JULY 2021 0.25" HOLES @ 48" Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211269, Rebecca Carroll, 07/15/21 NEW 1250 GALLON PLASTIC STEP TANK WITH (2) 20" RISERS, OLD TANK TO BE REMOVED PER THE UPC 1"=50' FCO PROPERTY LINE DRIV E W A Y OLD SYSTEM TO BE ABANDONED IN PLACE SCALE: DJRDRAWN: DATE: MOUNTAIN PARK ESTATES #2 BLK 5 LT 7 Anchorage, Alaska KEN THOMAS 6/10/2021 WELL DCO NO SLOPES OR CUTS BANKS >25% WITHIN 50' OF THE SITE MT MT MTMT WELL WELL WELL SLOPE 6-7% NEIGHBORING LOT SERVICED BY COMM. WATER SEPTIC WELL 10' FROM PROPERTY LINE, NO WAIVER REQ. 10' UTILITY EASEMENT MT MT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211269, Rebecca Carroll, 07/15/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211269, Rebecca Carroll, 07/15/21 ++iF`— - _---�'' t�.Lit�C;b:'a� ��'4•'-`'�i �vz�.�t�;3 .,:� t�. _+�� ''�_�i:�v3ib 5J S%Q•Su' L: '4J tn.5.r',•�:•,1 L?_vi' .''e .ted ti+i'7i9 � �! 4/00 Clliiora,Zood W P.O. Se„ 19660 Anchorage, A"' 99507 Mark Begich s ` " 1:v,.m Ma �=u;s ;i.or^/oi; Mayor e Y (9 07) 343-790=- WeH Log Permit Number: OSP9Z Date of Issue: 7/16/19 Date Started: 8-27-19 Date Completed: 8-28-19 Is well located at approved pen-nit location? U Yes U No Legal Description: Mountain Park Est.#2 blk5 lot? G:2839 Property Owner Name & Address: Thomas Kenneth M Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To stickup 0 2 overburden 2 4 silt & gravel 4 17 moist silt & gravel 17 30 silt & gravel 30 135 rock shelf 135 140 wet silt & gravel 140 142 silt & gravel 142 152 hard pan 152 190 wet gravel 190 195 gravel w/ H2O 195 200 Water Sample Results: Arsenic: 0.21 > ug/L rt I3ol I`i Nitrates: lk 33 mg/L Total Coliform Bacteria: fts colonies/100mL v8T33L- Method of Drilling U air rotary U cable tool Casing type: steel Wall Thickness: .250 inches Diameter: 6 inches Depth: 152 feet Liner "type: PVC Diameter: 4.5 inches Depth: 140' to 200' Casing stickup above ground: 2 feet Static water level (from ;round level): Mfect Pumping level: feet after hours pumping gpm Recovery Rate: 3 gpm Method of Testing: airlift Open End R Open Holc ❑ Screened Start feet Stopped feet n Perforations Start feet Stopped feet 20' Start 0 feet Stopped 20 feet Pump: intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? [] Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller- Hefty Drilling, Inc. 3540 Akula Dr. Anchorage, AK 99516 ,attention: The well driller shall provide a well tog to DSD within 30 days of completion. MUNICIPALITY OF ANCHORAGE Phone, 90,7�Zkl `3 0 rl�vulopmerll Sr--i'Ac. Dapa '7 43 Fav -4 4997 Vi i; Water & Was belw0liff Pump Installation Log Dilto of lssft,� j i)ailrbag Permit Nis whefr f flz—NP-A &I Ad-drl�,M- Wack L414, FropeKy ()wrier Na.mespa a� �Z Pulnp Inq'allation [),ate. , VLH v g- pqjmP Namv: 'N rulap INIO&L Pump 1" hil I'l dee Adaplell' Bit ri A] DUP OU Ii Pilless Adaptcr Nlunuftacti tvir�si Naflw* llfle,8s WeR, rhmilfemited 11pall Camp 1,01, wt?l dYe6 13 N�� Method of Disin fettioll': Pain,p 1si-i'taller Name - X Cmup"IM cl ly Z, AfteAkdriii. 'Ille 7Wlp insta!Llf diaLl provida 14 kkg, - s to 0*-,itc -w[fhiji Yl day ARS Sample Delivery Group: ARSS-19-00794 Client Sample ID: 13000 Lupine Rd Anc. Sample Collection Date: 09/29/19 18:00 Sample Matrix: Drinking Water Percent Solids: N/A Inorganics Analysis Description Nitrate/Nitrite as N iIr t • a, A 3710 Woodland Dr. Suite 900 . Anchorage, AK 99517 907-258-2155 . FAX 907-258-6634 Request or PO Number: N/A ARS Sample ID: ARSS-19-00794-001 Date Received: 09/30/19 Report Date: 10/21/19 Analysis r Analysis Description MDL Results LOQ Dilution MCL Analysis Units Qua' Method Analysis Analysis ...... Factor Date/Time Technician E. Coli Absent N/A N/A 1.00 1 __. Present/Absent SM92236 09/30/19 17.19 EHENDERSON Total Coliform Absent N/A N/A 1.00 1 _.. _....._,,..... ...._., Present/Absent ; SM92236 .....0 09/30/19 17:19 EH ENDERSON ARS5-19-00794 Page 8 of 31 ARS Sample Delivery Group: ARS1-19-02698 Client Sample ID: ARS5-19-00794-001 Sample Collection Date: 09/29/19 18:00 Sample Matrix: Drinking Water Percent Solids: N/A 2609 North River Road . Port Allen, Louisiana 70767 1(800) 401-4277 . FAX (225)381-2996 Preparation Method: ARS-154/EPA 200.8 CAS# Analyte Analysis MDL - PQL MCL < Dilution Qual 'Analysis Result Factor Units 7440-38-2 Arsenic 0.273 0.109 1.00 10.0 1 1 ug/L ARS5-19-00898 Page 8a)6fl91 Request or PO Number: 13423 ARS Sample ID: ARS1-19-02698-001 Date Received: 10/02/19 Report Date: 10/14/19 Analysis Method: ARS-155/EPA 200.8 Analysis Analysis Technician Date/Time 10/08/19 16:16 KCROCHET MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196654 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone. (907) 343-7904 Fax: (907) 343-7997 httpJ/www.rnuN.org1onsite On -Site Water System Permit Permit Number: OSP191292 Work Type: Well Upgrade Effective Date: Expiration Date Tax Code Number: 01702331000 Site Legal Address: MOUNTAIN PARK ESTATES #2 BLK 5 LT 7 G:2839 Site Mailing Address: 13000 LUPINE RD, Anchorage Owner: THOMAS KENNETH M Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy 7116/2019 711512020 Lot Size in Sq Ft: 20130 Total Bedrooms: 3 El Private Well ❑ Water Storage All construction shall be in accordance with - 1 . ith: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 (2417). 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 r Special Provisions: 1 1. Old well shall remain in service or be decommissioned in accordance with AMC 15.55. 2. To close out this permit, please submit the following: i a) Well log I b) Pump install log c) Water sample results for total coliform, nitrates and arsenic d) Decommissioning log for old well, if not remaining in service. Received By: 1 Date: Issued By: / Date: MUNIC'IPALITY OF j U z, t Development Services Department a On -Site Water & Wastewater Section Parcel I.D. 017-023-31 ON-SITE SEPTICIWELL PERMIT APPLICATION Property owner(s) Kenneth Thomas Day phone Mailing address 13000 Lupine Road, Anchorage, AK 99516 Site address 13000 Lupine Road, Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Mountain Park Estates #2 B5 L7 Legal description (Township, Range & Section) Lot Size 20,130 Sq. Ft. Number of Bedrooms 3 Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (E all that apply) Absorption Field ❑ Initial 0 Single Family (SF) (w/wo AD U) Septic Tank ElUpgrade ElDuplex (D) ❑ Holding Tank ElRenewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 0 Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: /d D J Waiver Fees: Date of Payment: I I a 1 Date of Payment: Receipt Number: Receipt Number: Permit No. OS P 191 a 9 2 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc &knz Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COIVPUAN( OSP191292, Rebecca Carroll, 07/16 Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345-3377!EP ll- Fax345-1391 July 12, 2019 Municipalities of Anchorage On -Site Water & Wastewater Pro47ram 4700 Elmore Road 4 Anchorage,AK 99507 Re: New Well Permit Y� Legal: MOUNTAIN PARK ESTATES #2 BLOCKr, LO TX The owner has requested we proceed forward to obtain a well. permit to upgrade the lower producing well on the subject lot.The proposed well will serve the existing 3 -bedroom house. The lot and area is served by private water and wastewater systems and the proposed well will not impact any of the neighboring properties due to the lot layout.Please contact Brent M. Western or me if you have any questions. Sincerely, Michael N. Anderson, P.E. Support Services Brent M. Western 907-440-4601 DESIGN CRITERIA: DRILL NEW WELL & CONNECT TO EXISTING WATER SYSTEM MAINTAIN 100'+ FROM ALL SEPTIC TANKS AND FIELDS, STAKE ANY SEPTIC TANKS OR FIELDS W/IN 150' OF PROPOSED WELL PRIOR TO DRILLING, U) 0 O 0 Ln m I LOT 6 0 N 89*56'06" AN 183.00' 37.0' PROPOSED WELL STATAKE ANY SEPTIC NKS OR FIELDS nl W/IN 125' EXISTING WELL Z: �EBD X—X— GRAVEL D/W LOT 8 0 PREPARED FOR: KENNETH M. THOMAS MOUNTAIN PARK ESTATES #2 BLOCK 5, LOT 7 13000 LUPINE RD., ANCHORAGE, AK 99516 Michael N. Anderson, P.E. DATE: 4661 Natrona Ave. DRAWN: Anchorage, Alaska 99516 (907)727 8864/FAX: (907)345 1391 SCALE: �XiSTING HOUSE E 30, t" I SUPPORT SERVICES: OF AZ,4 a - E 5 41�cW� ,or 9 LH-* 0 7/17/2019 MICHAEL N ANDERSON N.. Ci 9469 AO FWCS 7/17/19 1 40' LOT 7 BLK 5 _X_X_X_X_X_X_x SEPTIC fS 42.5' SEPTIC VENT 0 GARAGE/ (typ) C5 STORAGE 89'56'06" E �EBD X—X— GRAVEL D/W LOT 8 0 PREPARED FOR: KENNETH M. THOMAS MOUNTAIN PARK ESTATES #2 BLOCK 5, LOT 7 13000 LUPINE RD., ANCHORAGE, AK 99516 Michael N. Anderson, P.E. DATE: 4661 Natrona Ave. DRAWN: Anchorage, Alaska 99516 (907)727 8864/FAX: (907)345 1391 SCALE: �XiSTING HOUSE E 30, t" I SUPPORT SERVICES: OF AZ,4 a - E 5 41�cW� ,or 9 LH-* 0 7/17/2019 MICHAEL N ANDERSON N.. Ci 9469 AO FWCS 7/17/19 1 40' LOT 6 0 N 89*56'06" W 183.00' 37.0' C� WELL z C0 0 36,0' LOT 7 GAZEBO BLK 5 EXISTING HOUSE C)i -X—X—X—X—X—X—X--X—X—X—x—x 7� 36.0' o > 0 Cj O 0 GRAVEL D/W '2 �5' GARAGE! ST07 A. 6 0, SEPTIC 42�5' VENT 0 GARAGE/ STORAGE FS891-5606"o E N 18.00' x- X 30' LOT 8 ANCHORAGE RECORDING DISTRICT, ALASICA AS-BUILT OF: MOUNTAIN PARK ESTATES SUBD NO.2 iJ = FND 5/8" REBAR LOT 7 BL K 5 PLAT P-561 - � N"NN, SURVEY CERTIFICATE: 1, John L Schuller, Have conducted a LAND physical survey of this property as shovvm on this drawing and that the improvements situated hereon are within the property lines and no ,go enchroachments exist other than noted. Under no circumstance should TH information on this drawing be used for construction of fences, , 49 structures, improvements, or for establishing boundary lines. .......... JAI EXCLUSION NOTES: It is the owners responsibility to determine ?I ....... the existence of any easements, covenants, or restrictions which •jbHN L. SCHULLER,* do not appear on the recorded subdivision plat. LS-10408 •5 DAM- 1831 Talkeetna Street ER NUMBER: SCAM E-MAL- WORK ORD . 1 -7, Anchorage, Alaska 99508 JULY 17, 2019 1"=30' 0' MAM J3',' 10JEOM Syl MM ?JU�JBM- 9 1 I 19 - 0 6 2 k�' essiono\ (907) 227-1455 office JLS SW283 194126 (907) 274-4992 fax  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION · ~ ENVIRONMENTAL ENGINEERING DtVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEG~AL DESCRIPTTON . . C Well Absorption area Dwelling P E R ~/~. ~ ~ Manufacturer ~ ~ Ma~[~ . No, of c~tments ~ ~ Liq. c:~9~p it i~llons { Inside length Width Liquid depth /.~.~,_~ IF HOME.DE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons ~ ~21(1~ ~ Foundation ~earostlotl~no ~o. o~es ch inches N~ T°P°~'i'~°finishgrade'(~/ ~ ~ 7, , ' Material Seneath tile ~ inches Total effectiv ~abs rpti n area Length ~dth Depth PERMIT NO. ~ N Type of crib Crib d~ameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Dlass Depth ~ Driller Distance to lot line PERMIT NO, ~ Building foundation Sewer line : Septic tank Absorption area(s) ~ DISTANCE TO: O~HER PIPE MATERIALS SOIL TEST RATING,~ ~ ~ INSTALL~ ~/~~ REMARK~ ~ )::::. ,:* .,,, ,, A~ / . DATE .~/~EGAL 72-013 (Rev. 3/78) F_F:.III T NCL DEPRRTHENT ~ HERLTH laND EN',,,'IRONMENTRL ,:,:OTEC:TION 825 '"L'" STREET., RI'.4CHORlaGE., HF F [_ I L 3CFIT I ON LEGRL. ( E::t Et~_75 ', C. L- E I_ C k: L LIF' I N E F.:[:,. LOT 7 BLK 5 MT F'RF.:K EST. T'¢F'E OF sr:IL FIE':.;t]F:'F'TION =,~,='f_i'l IS: flH,-.,IM_M NUMBER OF BEDROOMS = 4 TP.E F.:EL.]UiRE[:, SIZE OF THE SF~IL RBSORF'TION _-,~_-,TEM IS: [:, E F"-f'14 == J¢¢ L E lh~,3 T H-:= -fll¢~ ~.3 F=: IFI '-,-' E: IL [:,E: F' T'~ == ¢ THE LENGTH E:, Z MENS Z ON ZS THE LENGTH ,::IN FEET) OF THE TRENCH L~ B, RRZNFZEL[:,.' THE DEF'TH OF R TRENCH OR PIT ZS THE DZSTRNCE BETWEEN THE SJRFRC:E OF THE GROUND RND THE BOTTOM OF THE EXCWCRTZON (IN FEET::,. ~ RENUHE=,. THERE ZS NO SET WIDTH FOR '" ~ ¢ THE 2RRVEL DEPTH ZS THE MZNZMLIM DEPTH OF GRR',,,'EL BETWEEN THE OUTFRLL F'ZPE laND THE BOTTC~M OF THE E:~.,',CRVFCFZON (IN FEET.'.',. F'ERMIT RF'F'LIC:RNT HRS THE RESPOIqSIBILIT'¢ TO INFORM THIS [:,EPRF.:'FMENT [:,LIRIIqG THE INSTlaLL. FITION ItqSPECTIONS OF F1.N'¢ WEL.LL:; R[:,JFICENT TO THIS F'ROF'ERT¥ FIND THE tqUMBER OF RESIDENCES THFIT THE 14ELL WILL SERVE. I'H..L,T FINRL IN:SF'Er:TI]N RND RF'F'RO',,,'RL B'¢ THIS BFIE':KFILLING OF FtN¥ S'~'STEM WI ~ ' E:,EF'laRTMENT WILL BE SUBJECT TO PRCSE]UTION. MINIMUM DISTRNCE BETI4EEN R WELL taN['., RN'¢ ON-SITE SEWRGE DISF'OSRL S'¢S'TEM ]:S :1.0C~ FEET FOR R PRIVRTE WELL OR Z50 TO 2E~C~ FEET FROM R PUBLIC WELL [.',EPENDING UPON THE T'T'PE OF PUBLIC WELL MINIMUM DIS]'RNCE FROM R F'RIVF1TE WELL TO R PRIVR]"E SEWER LINE IS 25 FEET FIN[.', TO R COMMUNIT'¢ SEWER. LINE IS 75 FEET. OTHER RE(.:.!UIREMENT'--; MR"? RPPL9. SF'ECIFICRTIONS laND CONSTRUCTION DIFIGRlaMS RRE la',/RILRBL. E TO INSURE F'ROPER INSTFtLLRTION. F"E]F:IPl % T ~--':Z:;:-::F' :[ _ -.E:. [... EL.,Ei-IE. EF~' 2,'.,::1 .... I C:ERTIF'¢ THRT :L: I FtM FRMILIRR WITH THE REQUIREMENTS FOR ON-SiTE SEWERS FINE:, WEL..L.S RS SET FORTH B'¢ THE MLINICIPRLIT'¢ OF' RNCHORFiGE. 2: I 1.4IL.L INSTRLL THE SYSTEM IN RCCORDRNCE I.,.IITH THE CO[:,ES. 3:: I UNDERSTFIN[:, THFIT THE ON-SITE SEWER S'T'S]"EM MFI~' REL.]UIRE ENL. RRGEMENT IF THE RESIDENCE IS REMOE:,ELED TO INCLUDE MORE THFIN 4 BEDROOMS. DEPTH= 8 : LEt"II-~TH~ ,~I-L~ ~_J-:I'~.'EL [;,EPTH~-~ -~;I- ' :: Location... coz 7 ~aK 5 >fr/~{. FZn.~ :c~.: ........................ Depth of well.. ~2 ~ Size of casing ........... ~ ................................................................. Distance to water. ~ 7 ~ - Dist~ee to water while pumping .......... ~ ..at rate of .................... ~.~ ................... gallons per hour. Formation from to Driller DELTA DRILLING COMPANY SRA BOX 394 B ANCHORAGE. ALASKA 99507 D A ~'"E RECEIVED · . ,_? INSPECTION APPOINTMENTS TIME TIME ~.j~',, / TIME INSPECTOR INSPECTOR I NSPECTO~  825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTIO~ ENVIRONMENTAL SANITATION DIVISION JUL ~ Y I981 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be preceded, Please allow ten (10) days for processing, MAI LING ADDRESS P~OPE~TY ~ESIDENT (If different from above) PHONE 2. BUYE~ PNONE MAILING ADDRESS MAILING ADDRESS 4. REALTOR/AGENT ~I ~/~./ [ PHONE UA~UNG ADDR,SS 5. LEGAL DESCRIPTION STR LET LOCATI ON 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four ,,l~'- SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other 7. WATER SUPPLY ~ INDIVIDUAL* * ATTACH WELL LOG. Awell log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** /~'~*/ YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE IViUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ~-o~o (.~. ~ .~,.~ ~ r,~) ~,~ , THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []iNDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [:]Septic Tank or []Holding Tank Size: /~).~_%'-O If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS I~],,,/APP ROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED//2//' DATE BY ~ , 72-010 (Rev. 6/79} 826 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 ~1-,.~ GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF /tEALTH AND ENVIRONMENTAL PROTECTION July 23, 1981 John Bashaw 1577 C Street, Suite 101 Anchorage, Alaska 99501 Subject: Lo% 7 Block 5 Mountain Park Estates Subdivision ~2 Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (2) The water facilities were not turned on at the time of the scheduled inspection. Please call this office to make another appointment. Exposed electrical wires to the well head are in (~/,.~, violation of the Municipality of Anchorage codes and _ must be encased in conduit. Please notify this office for a reinspection when the noted descrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Alaska Mutual Savings Bank Post Office Box 1120 99510 q Development Services Department On -Site Water & Wastewater Section Certificate of On -Site Systems Approval Parcel I.D. 017-023-31 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: , J2 —29—ol — Complete legal description MOUNTAIN PARK ESTATES #2 BLK 5 LT 7 Location (site address) 13000 LUPINE RD ANCH AK 99516, ANCH AK Current property owner(s) Mailing address Real estate agent KEN THOMAS Day phone PO BOX 231629, ANCH AK 2. TYPE OF DWELLING: � Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Fx] Private Septic El Water Storage El Holding Tank ❑ Community Well El Community ❑ Public Water System n Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee 9_; ), ?D . Waiver Fee $ Date of Payment Date of Payment Receipt Number 01 g, Receipt Number ()5c) 11 �q COSA # 5Waiver # 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. 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 9-15-21 O `i k •49TH •:Kr 6. DSD SIGNATURE • • •_• • • • • ....... r /.... t System #1 Approved for 3 bedrooms l :"'" ' • • • • • • • • • • • • � •• MICHAEL N. ANDERSON .%�' / System #2 Approved for bedrooms CE 9469 Disapproved Conditional approval for bedrooms, with the following stipulatior��.o.�� WATER AND G AST'_= V''ATER z P c� SER\KG By: - Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory A Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: MOUNTAIN PARK EST. BLK 5 LT 7 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 8/26/19 Total depth 2Q0 ft Cased to 152 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 2'0 in. Date of flow test for COSA 6/15121 Static water level at beginning of test 171 ft. Comments S. TANK DATA Age of tank(s) new years �D Tank type/material .- � �1 Measured operating fluid level in septic tank neve On Standpipes/foundation cleanout per record drawing Date of pumping new D. ABSORPTION FIELD DATA Which system tested (date installed) 7122121 ❑ ALL standpipes present per record drawing Total measured depth from grade 4 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 Parcel ID: 017-023-31 Structure served by this system Well production at time of test 3+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 5.14 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 8/3/29 C. LIFT STATION -` ❑ Required maintenance completed Age of lift station NEW years Lift station material PLASTIC Comments: Adequacy test date NEW Results M Pass For 3 bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min ❑ Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) 0 If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet 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' El Yes if No ft M Yes if No fl Neighboring Tank > 100' Q✓ Yes if No ft Private Sewer/Septic Line > 25' Yes if No R Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' 0✓ Yes if No ft Water Main > 10'Q Animal Containment > 50' Yes if No ft 0 Yes if No ft 0 Yes if No ft Water Service Line > 10' (7✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' 0 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' Q Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ED Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' if No Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Main > 10'Q ft Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' (7✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on L/ot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 1 ' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Lin > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water > 100' ✓❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / 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. COSA Checklist yellow sheet 0 F A1,4 \ MICHAEL N. ANDERSON ; P P CE -94 ` �`o �,•, Nitrate Advisory Certificate of On -Site Systems Approval # OSC 211574 Subdivision: Mountain Park Est.#2 Block 5 Lot 7 A water sample revealed a nitrate concentration of 5.14 milligrams per liter (mg/Q. 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. 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. dress P `O Box 96650 *Anchorage, Alaska 99519 6650 *www muni org LOT 6 S89°59'34"W 182.74' (N89°56'06"W 183.00' R) 37.0' X SEPTIC • VENT (typ) M i M WELL x ry co 0 0 0 ® d 36.0' 18 GAZE80 ' ® MMH _ EXISTING a L6 U ul N HOUSE N 0 x—X--x-X--x-X-x--X 36.0' .. LOT 7 BLK 5 d GARAGE/ CN STORAGE GRAVEL D/W X S89°58 00 E 182.88 (S89°56'06"E 183.00' R) LOT 8 T i ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: MOUNTAIN PARK ESTATES SUED NO.2 LOT 7 BLK 5 PLAT P-561 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundan, lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE: E-►tvL• SEPT 27, 2021 1"--30' 21-114-2 DRAWN BN CHECKED BY GRID NUMBER: —i BOOK/PACE JLS SW2839 210251 O = FND 5/8" REBAR 0, F 49TH io J©HN L. SCIiULLER: o LS -10408 io, �CO �lJ{A°a`' . r CP . O O CD 0 z LLJ M L1_ t` O d to P Q O ITO 0 z 30' %> ASDL NlyWv�� 1831 Talkeetne. Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax x-4x—x—x- LL J M in O O r7 w 0 P 00 z 0 z 1= I J 3 O ® d 36.0' 18 GAZE80 ' ® MMH _ EXISTING a L6 U ul N HOUSE N 0 x—X--x-X--x-X-x--X 36.0' .. LOT 7 BLK 5 d GARAGE/ CN STORAGE GRAVEL D/W X S89°58 00 E 182.88 (S89°56'06"E 183.00' R) LOT 8 T i ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: MOUNTAIN PARK ESTATES SUED NO.2 LOT 7 BLK 5 PLAT P-561 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundan, lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE: E-►tvL• SEPT 27, 2021 1"--30' 21-114-2 DRAWN BN CHECKED BY GRID NUMBER: —i BOOK/PACE JLS SW2839 210251 O = FND 5/8" REBAR 0, F 49TH io J©HN L. SCIiULLER: o LS -10408 io, �CO �lJ{A°a`' . r CP . O O CD 0 z LLJ M L1_ t` O d to P Q O ITO 0 z 30' %> ASDL NlyWv�� 1831 Talkeetne. Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax