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HomeMy WebLinkAboutNORTH WOODS BLK 4 LT 3Northwoods Block 4 Lot 3 #051-731-08 Municipality of Anchorage Page of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report / �0.2oz/05? - 73 / - 0!9 Permit Number: -50 PID Number: Name: Wastewater System: R<ew ❑ Upgrade Address: ,b 3e>X 719`3 646mK r%��' �� ABSORPTION FIELD Phone: No. of Bedrooms: ❑ Deep Trench ❑Shallow Trench 2 -Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: 0.3 Total Depth from original grade: d+ I Av3wlt GRgd GPD/Sq. . Ft Lot: 2 Block: 9 subdivision: 3 wozi '/-I 0&57 Depth to pi /e bottom from original grade: 0.46 6X 4PA�_ Ft. Gravel depth beneath in> ©• � Ft. Township: Range: Section: Fill added above original�.{ade: Gravel length: .y 670 0 9�. • d Ft. Ft. WELL: ❑New El Upgrade Gravel width: s/ ^ Numberrof lines: Distance between lines: Classification (Private, A,B,C): Total) D/pth: Cased T / Total absorption/area: Pipe material: N �/ Ft. /lam Ft. SQ. Ft. Driller: Date Drilled: Static ater Level: Installer;/' Date installed: Yield: Pump Set at: Casing Height Above Ground: TANK QPM Ft. Ft: SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P To Septic Absorption Lift Holding Public/Private Manufacturer:In gallons: From Tank Field Station Tank Sewer Lines Material: - Number of Compartments: Welh Surface 70� r r LIFT STATION Lotr /o E /®/ / 0 Size in gallons: .15,60 Manufacturer: /a G7y1CzE Line Foundation D F �L� / — �– "Pump on" level at: .7 +r "Pump off' level at: .],5'+ High water alarm at: Sj�' + Curtain Make & Model Electrical Insp I tions performed y:Z �Gi s Drain BENCH MARK Remarks: ioG�yc�E �,,Ie� xlS%AcLc'� Location and Description: �� n toe a% JlodvCLF aA11 1.1 OF 514N0 'f m QJAL•rY 5+4elO Assumed Elevation: APnnlJ fUt,0w Siwf,e P -o occ . , ENGINEER'S SEAL OF i c S & S ENGINEERING Inspections performed bj- .90pKOM o Qates:1st Eagle River, Alaska 99377 2nd '� g 9-049, ."»; "........ ....................i �e ROBERT C. COWAN 011 Department of Health and Human Services approval w• / Date: F'R6FE Reviewed and approved by: 72-013 (Rev. 9/91) MOA 25 PERMIT NO, SW980204 PAGE 2 OF 2 MunicipaUt of Anchora e DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.11, Box 196650 *Anchorage, Ataska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 3, BLOCK 4, NORTH WOODS S/D P.I.D. NO. 051-731-08 N®RT ®N COURT— 15' UTILITY]H40USE -------- LOT 4 LOT 2 A B FCO ALT. SITE NEW IT0 N BIOCYCLE _0_ ------ 1 I ------ 7 1 I NEW DRAINFIELD L ------ ------J N ------------I-- A B I I o f FCO 5A 19.5' -------------J ---- MTI — SCALE 1" 40' BC 21.0' 29.5' ATH MT1 V 75.0' 87.5'F�P 66.0' 58.0' ,t� car q\t + MTl 102.6' MT2 103.2' • .».:». ...l...•. 2- IMUMN WATER AT 95.4' B.O.H. 87.3' ye ROBERT C. SZM ROCK 99.4' I 99.4' ,1y0pR4M _ �E$S10ttp�. sap -2!Z -9e WED 9 2 7 P.01 CAI'tCEL LLECTRIC INC. 10410 FINLEY CIR. • ANCHORAGE, AK. 99518 907.348.4030 • 907.340-4032 fa% X25 (Engineering 1'7"034 H. Eagle River Coop Rd. Eagle River; Ate. Mr. Robert Perry; Sept. 23, 19981 Our company Carcel Electric Inc. wired the Biucyc.le septic system located at Lot 3 Block d North Xooda Sub;dlv_i.s.3.on..._ Carcel wired this system per the National 1Electr- ,cal',.Gvdi�. T , you have any questions please give me a call. Thank iYou oteve Cloud General Manager /�10l4- 4 apY J- -E1 g i�', f J- 1,c» 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 PERMIT PERMIT NUMBER:SW980204 DESIGN ENGINEERS & S ENGINEERING OWNER NAME:NORTHWOODS INC OWNER ADDRESS:3111 C STREET ANCHORAGE, ALASKA 99503 PARCEL ID:05173108 LEGAL DESCRIPTION: NORTH WOODS BLK 4 LT 3 LOT SIZE: 20166 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 6/25/98 EXPIRATION DATE: 6/25/99 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 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 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:' PROPOSED MOUND SYSTEM SHALL BE:?CONSTRUCTED'A'MINIMUM,OF 1 FEET ABOVE GROUND SURFACE TO MAINTAIN A; MINIMUM OF'A?FOUR. FEET SEPARATION FROM THN SEASONAL HIGH GROUND 'WATER THAT WAS MONITORED AT 1.9 'FEETT 7RROM�GROUND+ SURFACE . RECEIVED BY'�� �s�)(// `�� L�Z ✓r`�. DATE : �% �'` Q ISSUED BY: 4 G�l/�"wJ DATE:4 —2 -70 s&s� pneeking ROBERT C. COWAN, P.E. IAO CIVILENGINEERS RK (907) 694-2979 Z5_> June 2, 1998 FAX (907) 694-1211 HEALTHAUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 SEWER&WATER MAIN EXTENSIONS Anchorage, AK. 99519 REFERENCE: Lot 3, Block 4, North Woods Subdivision SEWER&WATER INSPECTION Request you issue a permit to install an innovative (BioCycle) system to serve the proposed four bedroom house on the referenced property. ENGINEERING STUDIES AND REPORTS One test hole was excavated and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation, ground water was encountered in the test hole at 8 ft. After WELL INSPECTION &FLOWTEST seven day groundwater monitoring, the monitoring tube was checked and the ground water level was found to be at 3.9 feet. SITE PLANS We do not anticipateany adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on adjacent properties. ROAD DESIGN This subdivision is serviced by a Class "A" water system. If you require additional information, please contact us. SOILTEST Sincerely, PERCOLATION TEST Ito_h Robert C. Cowan, P.E. RCC/ j lm STRUCTURAL& MECHANICAL INSPECTIONS Enclosure ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 z ��P„ .••Y ..�./��/�� �� W to O \ Lowy ac��o to lz,m %V •Q� �O Tp i � F' \ wzzo o s an Q ��w�z ©1 ( F Q Lu fy 0PU w�3wzoo �Q� O oo Z ,------ ZZ r oLd pN OwF Fif L- Cf En �UNd r O Z :3 W 0 (A I 11 W W Q x W W I QQ } N W O J I I w oZmoa C-4 O 0 W ?- 1 1 1 J V1 y Z�QO J� W 11� �/ O G w W W-�00NIL _ W nOZNza e ® rn �a (n L') U a— V) Z o Ld V^ w i o z Pa. 0.wi O O L� = W W HZH HLJd'I M I \I U OC W Zh-—i 3W >�O U zLLI ON O �I O�— NNxQ U Fooi:�uWO V) III IIIx'-1lI II O I I I O !L Om= I I J CL It= CY a[CO�FOI� -•�%i�-e11 oim3ociUi N�j WQ~��W�7yLar 0WC7 OfW�-I, NM0HO!n ' (�UO�A r"`FQ-J-J//)^l1j1 j1i CJ7 0 N II iI11k-VM3nNa 'Jd' r H OI AVM3Na0 U1O 11 I 035d00dL)YW y1 1 I(IW I OO I �2y1/,OH0)0— s Om> O FOOE L JL _J O O O 00 ct W W a`U-0 ZN f3fO J 0 W O m O W 00� 'n In I1I Sp � C' W— rdi O t V)toQ to rr,E- E- �O L 00 >--op ozO p (13S ONO dawd J J zF� 0�.1• 0ANN UJ•1 i•I J v l I —il I I 0v cr a oa i 1 i Q3U MQa Ow JjV✓J _ NJISM NV'ld 3115 ,09 = „l, ,M AM \i n a z tn oz M3 Q�o = 0 K w N Q� Zd0 OWE O Wa �L)Na w N W LLJ Q H Z Q } N w Ozm 00 W} N�zo XX - � (L w zQo�v a ww�JmF 0 win�aNww N �ZZ a QN<Odwm 00 w Ma CL U) z N 0 Q� W O � W Z w w} N V �. = O w = � U = I- F F- F K j�W N; in r \l n IIb'134 1 (138 1 'STN f— z io j)f0N Ld J 0 � LLJ ,SII O .. 0 } OI— `may 4?VU�,3 vZ O p I L/) p � W— U J O LJ �rpr)~JNLJa I� w0�J� N� E-4 W �V) LLI Ja~ ao JO W QNwQ N o O N II W JJ0�Q 20 F+ti E—L CL<02:^ \p Z �J2 d � U co J I I IIb'134 1 (138 1 'STN .K t i Q• m o n �� LLL. _ �o,11 � M :d w� Q LL, a rc p M ow 9=1 �< s�l✓�f1 a•.eai .aoa••�`� "" 61 z xF Dw 00 M C7 E -g 3 � G yy R :2z III—I� Ln I- w—I III o IIIIIII: � saw N I—I III I I co 3 0 1=1 III— I E cn IIIIIII: N CO $ W. x—I 0 W I MLd o s Q IIIIIII FQ w w E-+ III— , IIIIIII � � � � mFq Z� al x U] zJ VU 7® 0.Ya I—II E a \.J Y Z — o —I I u III— � ` 1=1I III - 111— =I o a � z III -11 illlllll� w 0 CP }U a onm �m I� rye/ h+ pgNN F W C 2 � or o a�»k J�ZX pU ZW wJQ a o<d4 Q Mo ^w 3�yos 1IViH 3Tjodd 'STN r� • ,t �, Z .ti rt �� 0 ILOL i u o 0 i �joo a a oa 2 o ,! 0) E W E N 01 0 7r L 0 Ln o w 00E (pE r, EE U w wN�B o p,E �o W � z a (I °a X Was E O ao > za O rn N^ P rn Z a In I w Fa ao < > ° N� o W a° O (Ww00B) (wwOsB l) 9'Z 90' z =K Q �zz M.. nog �W�. �yOo ✓� U w W°aw z o N Wwo a > aV J W Fad w O i J v Q ]Qa W V O own z m wwz w �a m ow m L � p C� m O N app au z a ZU g�g 05 Y. O, onm a rcm�� OmNN �O<mv w •� �vYiao om o wgo� ax aa>_ 'ZX aA M Q D- ^W 31yps IIV130 31OA0018 S•1•N ' Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: DATE PERFORM LEGAL DESCRIPTION: DEPTH (FEET) tc �J C7 IQ 1 2c d t P 3 U ©wwiwwiwr�w�� SI2�4- 5- 5 �j 6 lCiiwwww�®�®. 7 8- 9 9 10- 0 11 11 L 13- 3141516171819 14- 15- 16- 17- 18- 191 20 COMMENTS D, Range, Section: SLOPE SITE PLAN I I I I I WAS GROUND WATER ENCOUNTERED? / 7 S IF YES, AT WHAT L O DEPTH? v P E Depthto Water After p Monitoring?' -Date.- �C7 u PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN / FT AND FT S & S ENGINEERING PERFORMED BY: 1M4 Eagle pp River loop Road AIVQI ��-- CERTIFY THAT THIS /TEST WAS PERFORMED IN IT ACCORDANCE WPAP S E RKL GUIDELINES IN EFFECT ON THIS DATE. DATE: / -7 / A 72-008 (Rev. 4/85) ©wwiwwiwr�w�� s��wwwwQa*wr�w■��� lCiiwwww�®�®. �C7 u PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN / FT AND FT S & S ENGINEERING PERFORMED BY: 1M4 Eagle pp River loop Road AIVQI ��-- CERTIFY THAT THIS /TEST WAS PERFORMED IN IT ACCORDANCE WPAP S E RKL GUIDELINES IN EFFECT ON THIS DATE. DATE: / -7 / A 72-008 (Rev. 4/85) HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN S&SN �inee u"G ROBERT C. COWAN, P.E. CIVIL ENGINEERS ON-SITE WASTEWATER DISPOSAL SYSTEM FAX(69a-29Ax (soy) 694-1211 CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 3, Block 4, North Woods Subdivision June 5, 1998 GENERAL: The scope of this project includes the installation of an "innovative" Biocycle Wastewater Treatment System and a drainfield bed to serve the four bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, M.O.A. certificate with any special provisions or conditions, and all applicable State Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be familiar with construction practices in this area and either certified by the Municipal Health Department or have been previously certified under the D.E.C. certification program. Owners installing their own systems must also receive prior approval from the M.O.A. PRESSURIZED MOUND SYSTEM INSTALLATION: 1. Any peat or organic matter must be removed from the elevated mound site. 2. The bottom of the basal bed area as well as the top of the sand filter is to be within two inches of level. 3. The distribution piping is to be of PVC (ASTM D3034 or equal). All joints are to be solvent cemented. 4. The side slopes of the top layer of the mound system must not be steeper than 33% (3:1). 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 3, Block 4, Northwoods Subdivision June 5, 1998 5. The top of the mound shall be covered with a minimum of 6 inches of topsoil and vegetated sufficiently to prevent erosion. 6. The distribution pipes are to be embedded in sewer rock. Care should be taken to back- fill in such a way as to prevent damage to the piping system. 7. Silt barrier material must be installed between the final gravel layer and the native soil back -fill. Ensure the silt barrier covers the entire gravel surface before placing back -fill. 8. Back -fill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the depth is less than thirty-six (36) inches above distribution pipe. ABSORPTION BED/DRAINFIELD INSTALLATION: 1. Excavate the proposed bed to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the side walls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil back- fill. Ensure the silt barrier covers the entire gravel surface before placing back -fill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Back -fill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfield depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Lot 3, Block 4, Northwoods Subdivision June 5, 1998 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pie Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable non-toxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil back -fill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its 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: Page Four Lot 3, Block 4, Northwoods Subdivision June 5, 1998 1. 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. 2. 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 back -fill. 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 least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER C PROPERTY OWNER AGREEMENT FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated o?*3VA/g 199B, is made between the Municipality of Anchorage Department of Health and Human Services (DHHS) and the property owner(s) of: �mT 3 ick y N�T,ywv�s Sid This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owners agree to the following: Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, and that any deficiencies have been repaired and that the system is functioning as designed. (Signature) (Printed Name) (Notarize Here) Subscribed and sworn to before me this day of 19 to Notary Pu rc My Commission Expires (Signature) (Printed Name) Municipality of Anchorage •• •��� Development Services Department ; '•c Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL �t FOR A SINGLE FAMILY DWELLING r Parcel LD. n51- 131-D$ CosA# Q._ -f L 1. GENERAL INFORMATION Expiration Date: to/ 4slg Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address NORTHWOODS SUBDIVISIONLOT 3 BLOCK 4 22506 NORTON CT. • CHUGIAK AK 99567 MICHAEL LAUER Day phone C/O AGENT 22618 MCMANUS DRNE ' CHUGAIK AK 99567 Day phone RANEY HARDMAN w/RAMAX PROPERTIES Day phone 440-7257 16600 CENTERFIELD DR. • EAGLE RIVER AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well Community On-site ❑ Public Water System ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of on -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. 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 (les and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date t I I Zi 07 - Engineer's Comments: In conducting this evaluation, GEG, Lt D. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the rime of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater 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 the system. Satisfactory lost results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benerit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory L/ bedrooms, with the ftlowing Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other w=w ' CS►_n.Qas By: ML_ Original Certificate Date: h ZE ° 7 (Rev. 11105) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196850 Anchorage, AK 99519-66W www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: NORTHWOODS SUBDIVISION, LOT 3. BLOCK 4 Parcel ID: A. WELL DATA COMMUNITY WATER Well type CLASS A If A. 8, or C provide PWS213001 Well Log (Y/N) Date completed Sanitary sea>ID# Wires properly p /N) Total depth ft. Cased toCasing he' above ground) in. FROM WELL LOGINSPECTION Date of test Static water level ft. Well production 9•P•m• g.p.m. WATER SAMPLE R TS: Coliform colonies/100 ml. Nitrate mg./L. Other becteria colonies/100 ml. enic: ug./L. Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA *LAST INSPECTION BY BIOCYCLE ON 11/3/2007. PUMPED AS RECOMMENDED BY BIOCYCLE Tank Type/Material BIOCYCLE Data installed 7/8/1998 Tank size 1500 gal. Number of Compartments 4 Cleanouts (YIN) YES Foundation cleanout (Y/N) NS Depression over tank (Y/N) NO High water alarm (YIN) N/A Date of pumping ' Pumper C. ABSORPTION FIELD DATA Date installed 7/8/1998 Soil rating (4�r ft'fbdrm) 0_3 System type BED Length 67 ft. Width 15 ft. Gravel below pipe 0.5 ft. Total depth *3 ft. Eff. absorption area 1005 fe Monitoring tube YES Depression over field NO Date of adequacy test 11/12/2007 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test DRY in. Water added 1090 gal. New depth 5 in. Elapsed Time: 360 min. Final fluid depth DRY in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date D. LIFT STATION Date installed "Pump on" level at —in, E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N "Pump ofr I Hlgh water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service COMMUNITY WATER On adjacent On adjacent lots sewer manhoie/deanout Holding tank areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 25'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 25'+ Water service line 10'+ Surface water 100'+ Driveway, parkingNehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and i review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS a Date 11 f 21 /o COSA Fee Waiver Fee $ Date of Payment / °2(a Date of Payment Receipt Number My-& Receipt Number (Rev. 11/05) �* ....... ....... y . Garn ss. 'E— \fie.'' NOU-26-2007 10:40 From: n 9076944214 To:9073383246 /yGyNJGN GOri/P% d7>.f;p' .Q6 j 7 ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 691 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE:' FOLLOWING DESCRIBED PROPERTY, r OF At DATE, . p S e AND THAT NO ENCROACHMENTS EXIST EXCEPT AS /��j�j �'� INDICATED. IT IS THE RESPONSIOILITY OF THE i s 4nTH Z' OWNER TO DETERMINE TH» EXISTENCE OF ANY GRID: r"' '•.. 1 EASEMENTS, COVENANTS, OR RESTRICTIONS NWil�f'i r EASEMENTS, I WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD F& �1�¢� ., LS -a918 a' ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- DI2AWNt AlRovr�+�' ARY LINES. oryf 0.�gw�t� BioCycle Alaska POB 202691 Anchorage, ATC 99520 563-1646 office/398-6574 ccll Email: biocyclealaskaraalaska.net Customer Mike Lauer 22506 Norton Court Chuaiak. AK 99567 MAINTENANCE DESCRIPTION I 0 Qtr -Maintenance Report 1st Ort 2007 PRIMARY CHAMBER SCUMLtVtL I UNI Mv. AERATION CHAMBER & AERATION SYSTE BLOWER SIZE 80 120 UMIN AERATION PRESSURE HIGH LOW NOISE LEVEL WOK GENERAL CONDITION POOR PIPING SYSTEM: AIR LEAKS LEAKS AIR DIFF'USERIAIRSUPPLY POOR MDCED LIQUOR COINMMON ODOri N YES CLARIFICATION CHAMBER ` SLUDGE ACCU�11NIi0PPER LOW HIGH CLARITY orErrLUENT CLE. FASB CLOUDY DISCHARGE CHAMBER DISCHARGE PUMP OPERATING I YES NO 4LARNiS CHECKED AND OPERATING AIR/POWER YES NO HIGH WATER NO I St QIt 2007 maintenance was erformed today BY: DATE: /D Ja'y► V L COMMENTS 3 u u BioCycle Alaska POB 202691 Anchorage, AK 99520 563-1646 officc/393-6574 cell Email: biocyclealaska`^aalaska.net Norton Court ik. AK 99567 MAINTENANCE DESCRIPTION 0 Qtr Maintenance Report AERATION CHAMBER& AER HON SYS -1 'M BLOWER SIZE 80 120 L/Mllr' AERATION PRP-WIRF HIGH LOW NOISE. LEVEL GON HIGH GENERAL CONDITIONPOOR PIPING SYSTEM: AIR LEAKS (55-10 LEAKS AIR DIFFUSER/AIRSUPPLY POOR I IUXED LIQUOR CONDITION OMR N YES CLARIFICATION CHAMBER SLUDGE ACCUM IN HOPPER CLARITY OF EFFLUENT DISCHARGE CHAMBER DISCHARGE PUMP OPERATING COW HIGH CI.F.Aj FAIR C1.0II0Y NO MS CHECKED AND OPERATING AIR/POWER ES NO HIGH WATER YES NO Id Qrt 1007 maintenance was performed today Y: ' DATE: 2ndQrt 2007 on coMM[NTS BioCycle'Alaska POB 202691 Anchorage, AK 99520 i 563-1646 office/398-6574 cell Email: biocyclealaskaCalaska.nct Norton Court ik. AK 99567 Qtr Maintenance Report 3 rd Qrtr 2007 MAINTENANCE DESCRIPTION COMMENTS PRIMARY CHAMBER SCUM LEVEL OK 1110H AERATION CHAIMBER & AERATION SYSTEN BLOWER SIZE 6 80 120 LININ AERATION PRESSURE O --I'mOH LOW NOISELEVEL OP_ HIGH GENERAL CO\'DITION OL'a POOR PIPING SYSTEM: NR LEAKS OI.�EAKS AIR DIFFUSERIAIR SUPPLY 0 POOR NOa YES miXED LIQUOR CONDITION ODOR , CLARIFICATION CHAMBER SLUDGE ACCL'bl N HOPPER L9S3�' THIGH CLOUDY CLARITY Of EFFLUENT CL$AR PAIR DISCHARGE CHAMBER NO DISCHARGE PUMP OPERATING YE�7 ALARMS CHECKED AND OPERATING Y A1R/POWEK YES` � NO YE?) NO HIGH WATER 3rd Ort 2007 maintenance was performed today BY: n� LZ cJtT� DATE: 3 Jv� U BioCycle Alaska POB 202691 Anchorage, AK 99520 563-1646 ufficd398-6574 cell Email: biocyclealaskagalaska.net Norton Court ik. AK 99567 Qtr Maintenance Report 4th Qrtr 2007 MAINTENANCE DESCRIPTION COMMENTS PRIMARY CHAMBER SCUM LEVEL O NIGH AERATION CHAMBER & AERATION SYSTEM60 BLOWER SIZE So Izo IJAtN AF.RATION PRESSURE n HIGH LOW NOISE LEVEL HIGH GENERAL CONDITION POOR PIPING SYSTEM: AIR LEAKS LEAKS AIR DIFFUSERIAIR SUPPLY O POOR MIXED LIQUOR CONDITION ODOR . O YES , CLARIFICATION CHAMBER SLUDGE ACCUM N HOPPER HIGH CLARITY OI' CrrLUC`1T (DCLVA FAIRCLOUDY DISCHARGE CHAMBER DISCHARGE PUMP OPERATING YES NO ALARMS CHECKED AND OPERATING AIRIPOWER ES NO HIGH WATER YES NO 4th Qrt 2007 mainteriancc was performed today BY: DATE: MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES WORM Division of Environmental Services CEM On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 051-731-08 HAA # 1. GENERAL INFORMATION Complete legal description Lot 3, Block 4, Northwoods S/D Location (site address or directions) NHN Norton Court Property owner Mike Lauer Day phone 694-2388/Target Mailing address Lending agency Day phone Mailing address Agent Dick Brown/Target Real Estate Day phone 694-2388 Address 17034 North Eagle River Loop Road, Eagle River, -AK 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 - 3. TYPE OF WATER SUPPLY: Individual well Community well XXX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOA521 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. s & S ENGINEERING Name of Firm 17924 Eagip River Loop Road No. 204 Phone 6'fy `-19-7Y Address Eagle River, Alaska 99577 Engineer's signature 6. DHHS SIGNATURE Approved for Q v bedrooms. Disapproved. Conditional approval for Additional Comments LM 4UTIC Date q(}3/ct;� ©F fid r� •• KVBtKI C. COWAN �'• .% CE - 8801 bedrooms, with the following stipulations: Date 'l - 2 5"- 9 2 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 I j r. Municipality of Anchorage SEP DEPARTMENT OF HEALTH & HUMAN "SERYV,1,q�1FA�IIr u1i AN.HvKA Environmental Services Division N �aoNI TAtSERVICESo1V1 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority A'proval Checklist j Legal Description: Zo% 38 !�c°ck -�� /N/097WIQD/;arcell.D.: 05-/' %CJI-'Qg A. WELL DATA Well type eZ 45 5 A If A, B, or C, attach ADEC fetter. ADEC water system number 3©�� Log present ( Date completed i Total depth Cased to Casing height (above ground) 1 Sanitary seal (Y/N) Wires properly protecte FROM WELL LOG`- AT INSPECTION I Date of test Static water level Well production g;p.m. g.p.m. WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: I r, �C/HOLDING TANK DATA Q 1 O C' � Ct- `4' Date installed %( X51 4- Lank size / S °'� Number of Compartments q Cleanouts (Y/N) -4 T �a t/ I Foundation cleanout (Y/N) yES Depression (Y/N) h water &/N)� % Date of Pumg`'a Pumper C. ABSOR►ffJN FIELD DATA Date installed' Soil rating (g.p.d./ftz or fta/bdrm) 0.System type Length 67 Width '""� Gravel thickness below pipe �• / Total depfh Effective, absorption area AO0��&41V!onitoring Tube present (Y/N) Depression over field (Y/N) A Date of adequacy tes _ Results (Pass/Fail) For bedrooms '- i Fluid depth in absorption field before test (in.); mediately after_ gal. water added (in.): { Fluid depth (ins) Minutes later: Absorption rate - g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* j i D. LIFT STATION (5/0cy014) Date installed 7 -9 -?9 Size in gallons /-,�0, 0 i Manhole/Access (Y/N) ILS "Pump on" level at*"Pump off' level at* 7-7-�- High water alarm level at*�z� *Datum v r ro Cycles tested 3 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: on lot Absorption field on lot Public sewer main Sewer /septic service line M/w _ On adjacent lots On adjacent lots Public Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation /S) Property line ® Absorption field -30 Water main/service line /O /+ Surface water/drainage IDO /+ Wells on adjacent lots /00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /O Building foundation .4 7 Water main/service line /0 Surface water /00 /-/- Driveway, parking/vehicle storage area Curtain drain n/E .f Ok)A//�� ��` Wells on adjacent lots /00/ 4- F. ENGINEER'S CERTIFICATION /0"+ I certify that l have determined thru field inspections and review of Municipal records Nys, ems are in conformance with MOA HAAgzds�n�_— Engineer's nes in effect on this date. •(k OW A4 ^�� [% 1A ........em , Signature �o �� �� Name Date h �a 3/q io, ROBERT C. COWAN J�Q ��•� CE -8801 HAA Fee $ 3 0-0 ' &-V Date of Payment � fq-3 L-8 Receipt Number 1,c Z b 2 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number