HomeMy WebLinkAboutNORTH WOODS PHASE 2 BLK 4 LT 5 ' ~ Municipality of Anchorage Page { of ~''~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage. Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: '~X/~ ¢1(00 iT,dc. PID Number: N~: ~0 ~ ~ ~~~ ~ Wastewater System: D New ~Upgrade Address: ~¢0~'~%' ~'~n~5~7 .'ABSORPTION FIELD JNo. of Bedrooms ~ Deep Trench ~ Shallow Trench LEGAL DESCRIPTION Soil Rating: ~'~'GPD/Sq. Ft. Lot: ~ BIo~ Subdivision: Depth to pipe bottom from origi~ grade: Gravel depth beneath pipe Range: Fill added ~bove or~i~l grade: Gravel length: Township: Sectio ~~ New ~ UPa,adc ¢ Gravelwidth: ~ ' Ft,' Nu~berofllnes: IDista.cebetweenlines: :~ Classificalion ~~: Total ~Depth: ~d To: Ft, Total absorption~area: SQ. Ft. Pipe Driller: ~ ~Drilled: Static Water Level: Installer: Date ins.led:/ P.mpSet at: ~Height*~ov~ 0,o,,.~: TAN K SEPARATION DISTANCES ~ Septic D Holding ~.T.E,P. TO Septic Absorpbon L fl Holding Public/P(ivate Manufacturer: Capacity in gallons: From Tank Field Stat,on Tank S .... L .... ~¢~, '~ / i Material: Number of Compartments: Su~a~ ~, ~0~ ~/' ~/4 Wat~ ~I~T ~TIO~ Size in gallon~: Man~ Line : ' Drain ........................ ~0 ~ ~ Remarks: ,.~~2~ ~/~ FI~ BI'CH A~sumed Elevation: Inspections performed by: ~~ ~'~¢~' Dates: let Department of Healtl~ and H~ i~ ~ 5,~'vices apprqval Reviewed and approved by ..... ,k,~ju~ate: 0~, ,.- 72-013 (Rev 9/91) MOA 25 w 5 FOOT FROM PROPERTY LINE TD EDOE DF TRENOHE~. SEE NOTE ON ~DTTDM DF THIS DRAWINg. NORTH PROPERTY LINE ~' ~ _ APPROXIMATE LOCATION / DF WATER LINE. 10 FEET TD NEW TRENCHES ~ TRENCH PER CONTRACTOR 37,5' LONG EA. ~- LOCATES SEE NOTE DN lO FEET+ BETWEEN BDTTDM DF THIS DUO, EDGE TO EDGE. BENCHMARK IS THE M.T. ~ CONCRETE SLA~  UNDER ~INDOW, ~ BELOW DECK. ELEV. .. ~ 15 FOOT UTILITY EASEMENT . . '~. DRIV/~WAY I ~ OARAOE TH,~4 \\ r/~---Z~ / J ~----1/8 INCH DIA, PVC AIR LINE /~___.~--~--~ J FROM]COMPRESSOR IN. OARAOE / ~C~ ~ (THOMAS INDUSTRIES, MODEL 5070) / kt----~"~___'~--"F~// ID TRENCHES. FROM ~ARA~E TO / ~ TREN6HES, PIPE IS INSULATED 15 INCH PVC / ] ~- ' ~ ~ITH i/~ INCH FOAM PIPE ~RAP FEET~ 1500 GAL. STEP TANK, ANCHORAGE TANK, EQUIP WITH DUAL OUTLETS, AND PRU- GR^MMA~LE TIMER DOSING,FOR INTERMITTENT '/ ~--1,85 INCH PRESSURE ~- ~ "-'~ LINE, \ · '~ ~-~TOP ]F OUTRANK APPROXIMATELY AD = 355 BD = 50,6 AE : 88,5 BE = 38,9 9F = 17 CF = 62 ,~SEPARATION-~IBTANCE$:TD THE LOT LINE ANDTHE WATER LINE, AREBASEDUPQN,. 'LOCATIDN~DFPRBPER~Y~L'INE,,~AND'~TER LINE,,,AS, MARK~D,B¥ CDNTRACgCDR~x! ALASKA WATER & ~ASTEWATER ASSUMES NO RESPONSibILITY FDRACCURACY o~'TH~'LDCATES~ ' SEPTIC AS-BUILT, PREPARED FOR, PREPARED BY, DATE' LOT 5, BK 4, NORTH ~BODS . PHASE II JOHN AND MARGARET _DE~ ALASKA ~ATER & ~ASTE~ATER SERVICES DRAWN~ GARNESS SCALEI 1' = 30' CE-7953 A -BUILT DRA ING GROUND ELEV, AT TANK = 99.1 COVER = 2,7 FEET (APPROX,) INSULATED OVER TANK, NE~ 1500 GALLON STEP TANK, INCH PRESSURE LINE T0 ~ ~NCHDRAOE T~NK, INLET INV, NE~ TRENCHE~, 1,~5 INCH ~ : 95,88 PRE~$URE LINE TO OL~ BED, T~NK SET LEVEL ~ITHIN ,0~ FE~T, 4 INCH DIA, PVC LINE FROM HOUSE, -INVERT AT HOUSE = 97.B5. 'DROP FROM HOUSE TO TANK = 1,97 FT, GROUND ELEVATION OVER ~OUTH TRENCH = I01,3+, MINIMUM COVER = 2,3 FEET. ORDIJND ELEVATION OVER NORTH TRENCH = 103+, MINIMUM COVER TM ~ FEET LOCATION OF 4.T's SEE PLAN DRA~/ING INCH PVC, ~/ITH 3/16 IN£H DIA, HOLES EVERY 3,75 FEET, AND AT EACH ENO, ALL HOLES FILTER FABRIC OVER DRAINROCK AND ~ INCHES OF INSULATION, NOTEI AIR COMPRESSOR OPERATING AT 2,5 TO 3 A, BOTTOM DF TRENCH = 98,3 NORTH TRENCH = 96,2 SOUTH TRENCH C, TOP SAND = 100.3 NORTH TRENCH = ga. E5 SOUTH TRENCH A, INVERT OF DRAINPIPE = 1DO,B ¢+) NORTH TRENCH = 98,75 (+) SOUTH TRENCH D, TRENCH LENGTH = 75 FEET E, TOTAL ABSORPTION AREA = 375 S~, FT, F, 2 INCHES DF INSULATION OVER THE ENTIRE TRENCH LENGTH, DENCHMARK I~ TOP DF 9ECKSDNA TU~E AT THE SOUTHVEST CORNER OF DECK. ASSUME9 ELEVATION = 99,95 1/8 INCH AIR SUPPLY LINE, CHANGED ORIGINAL USED 8 AIR LINES IN EACH TRENCH, 3%3 EACH LONG, lO0 L,F TOTAL FOR ~DTH TRENCHES, SEPTIC AS-BUILT~ LOT 5, ?K 4, NORTHWDODS. PHASE II PREPARED FOR~ JOHN & MARGARET LOEW ALASKA ~ATER & ~ASTE~ATER DATE~ 7/22/96 D~N: GARNESS SCALE~ NTS CE-7953 Cook Inlet Electric Inc. - Chugiak ~ (907) 688-1540 2z3J7/22/96 ~',) 6:55 PM Li: 1~ Cook Inlet Electric, Inc. P.O. Box 670375 Chugiak, z-~d( ~)9567 907-088-.5202 fax 688-1540 FaxjM e_e~age To: Alaska Water and W as te wa tei' Attention: Jeff Fax Number: 338-3246 From: Marty Date: July 22; 1996 NUmber of pages ( including this one) 1 · garet Loew, 23214 Northwoods Dr,, Chuglak, AK 99567 Jeff, I reinstalled the link between terminals 3 & 4 and retes'r~:d the system. Whei~ panel goes into alarm and the pump runs. the pump ran for approx, two minutes and 'the control panel Been'a pleasure Working ~ith you Cook Inlet Electric, Inc. P,O, Box 670375 C, hugiak, Ali 99567 907-688-3202 fax 688-1540 To: Alaska Water and Wastewater Attention: Jeff Fax Number: 338-3246 From: Marry .Date: ,July 17, 1996 Number of Pages ( including this one) 1 In regard to: John and Margaret Loew, 23214 Northwo0ds Dr., Chugiak, AK 99567 This is to certify that the on site sewer lift station at tile above address has been wired in accordance with the 1996 NEC and manufacturers specs. ;a~~ ~heCi{~and performed as specified in tile system manual. Martin Lovejoy Electrician Journeyman License # 108634 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 PAGE 1 OF PERMIT NUMBER:SW960154 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES OWNER NAME:LOEW JOHN A & MARGARET R OWNER ADDRESS:23214 NORTHWOODS DR EAGLE RIVER, ALASKA 99577 PARCEL ID:05182102 DATE ISSUED: 6/26/96 EXPIRATION DATE: 6/26/97 LEGAL DESCRIPTION: NORTH WOODS PHASE II BLK 4 LT 5 LOT SIZE: 40661 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (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 PROV//I~IONS. SPECIAL PROVISIO "~ ? ~)~ R c .iV D BY: DATE: Rick Mystrom. Mayor Mttmcipality of Anchorage Department of Health and Human Services 825 "L" Street P,O. Box 196650 Anchorage, Alaska 99519-6650 June 27,1996 JeffGarness, P.E. Alaska W~er &WastewaterServices 8471Brookridge Drive Anchorage, Alaska 99504 Subject: Waiver Request for Lot 5 Block 4 North Woods Phase II Waiver Request # WR96025, PID #051-821-02, SW960154 Dear Mr. Garness: Your request for a waiver of the required 10 foot separation between a on-site wastewater disposal system and a lot line has been approved. The waived distance is 5 feet from the leach_fields and the west property line. This approval applies to the existing on-site wastewater system (leachfields) lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. If there are questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljm:Loew MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR%~I~FY~ PID% 051-821-02 HA% Date Received: June 11, 1996 Legal Description: Lot 5 Block 4 North Woods Engineer: Permit # Jeff Garness, P.E., Alaska Water & Wastewater Services 8471 Brookridge Drive, Anchorage, Alaska '99504 Applicant: John & Margaret Loew '.~ Waiver Requested: Lot line waiver of 5 feet from trenches to west property line. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: Date: Rec ~: %01941/9550 By: Amount: $ 115.00 Name of Reviewer Date Paid: 6-11-96 I · FAX COVER SHEET Alaska Water & Wastewater Consulting Engineers 8471 Brookfige Drive Anchorage, Alaska 99504 Country (907) 337-6179 (9O7) 338-3246 SEND TO Company name A~tention Office location Fax number []Urgent [] Reply ASAP From Jeffrey A. Garness, P.E., M.S. Date Off'~-'e location Anchorage, Alaska Phone number Pa~er: 1-800-481-1162 Cellular: 244-9612 [] PIease comment [] PIease review [] For your information Total pages, including cover: COMMENTS 8471 Brookridge Drive ~ Anchorage - Alaska 99504' (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers June 9, 1996 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref' Sewer Upgrade for Lot 5, Bk 4, Northwoods S/D II. To whom it may concern: The existing 4 bedroom house is served by an onsite septic system, and community water. The drainfield will not pass an adequacy test (surcharged) at this time, and must be upgraded prior to the sale of the house. Comments regarding the proposed upgrade are summarized as follows: 1, GENERAL: There are a number of site restrictions which limit the available spots to put the septic upgrade. * South of the existing drainfield, the slopes are approximately 25% to 35%. · Immediately to the west of the existing bed (TH #2 & TH #4) the soil perked at 120 min/ineh. · To the east of the house, there is a foundation drain 8-10 feet deep, which drains to a drywell somewhere east of the existing bed. · The utility service lines run from the northeast property corner to the east side of the garage. * There is a 15 foot utility easement, the driveway, and the water service line, on the north side of the house, which limits the available space for a new drainfield. Given these restrictions, I have opted to put the septic upgrade west of the house. Furthermore, because of the space constraints, I am proposing to install a Bottomless Sand Filter (BSF). 2. SOILS: At the proposed site the soils were a mix of SP-SM to SM. The percolation rate in TH #1, at a depth of 4 to 4.5 feet was 9.2 rain/inch, and groundwater was encountered at a depth of 5.9 feet below grade. In TH #3 the percolation rate was 1.5 min/inch, at a depth of 2.5 to 3.0 feet. Water monitoring was not done in TH #3. 3. TRENCH DESIGN: Bottomless Sand Filter (BSF) a. Pereolation Rate: 9.2 minutes/inch b. Allowable Application Rate for BSF: 2 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 300 fi2 £ Effective Depth: .5 feet g. Width: 5 feet minimum h. Length: 75 feet. i. Effective absorption area = 375 ft2 (>300 ft2 OK) j. Air Supply: Thompson Industries, Model 5070, Supplied by Anchorage Tank. k. Air Supply Line: '~qqasteflow" emitterline, 1/2 inch I.D, Supplied by Anchorage Tank. Same type used in intermittent sand filters. 1. Sand Material: Central Paving Products "Winter Road Sand" We are proposing to excavate down to a depth of 3.5 feet, place the air supply line, and cover it with 2 feet of sand. On top of the sand, we will place a conventional five foot wide trench, using pressure distribution. The bottom of the dralnrock will be 4.4 feet above the groundwater elevation encountered on 5/22/96. We are proposing to use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the trenches. 4. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 5. TOPOGRAPHY: See the 1" = 30' site plan for topography information. There are no slopes in excess of 25% within 50 feet of the proposed trenches. 6. ALTERNATOR VALVE: The lift station shall be furnished with two outlets, and a valve configuration, so that flow can be diverted periodically to the old bed system, allowing the BSF time to completely recover. This should make the proposed design fairly conservative. 7. LOT LINE WAIVER.' In order to create a drainage path between the house, and the east end of the trenches, I would like to maximize the separation distance between the two. In order to accomplish this, I am proposing to place the new trenches only 5 feet from the west property line. There are no wells, or septic systems which would be affected by this encroachment. CLOSING: Given the site restriction, and the soil/groundwater conditions, I think the BSF is the most viable option for this lot. I am open to any suggestions from your department, which would be an improvement to the proposed design. I am unaware of any adverse impacts this installation would have on adjacent wells (there are none within 200 feet) or septic systems. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Thank you for your assistance. Sincerely, Owher?Co~ultant John and Margaret Loew MOA Package.wps ,I J I PHASE II. COMMUNITY WATER SYSTEM, AND PRIVATE SEPTIC SYTSTEN, 17DO SQUARE FDDT BED~ INSTALLED IN 1982. GROUNBWATER AT 8 FEET, 9/17/82, .................. N RT.WOODZ?I E SEPTIC AREA LOT 4, ~K 4, NORTH WOODS S/D, PHASE It, COMMUNITY WATER & PVT, SEPTIC SYSTEM, 1108 SQUARE FOOT BED, INSTALLED IN 1982, GROUNDWATER ENCOUNTERED AT 8 FEET DN 8/4/82, LOT 1, BK 3, NORTH WOODS S/D PHASE II, COMMUNITY WATER, & PVT. SEPTIC SYSTEM, 1000 SQUARE FT. BED INSTALLED IN 1988, GROUNDWATER AT 7 FEET ON 8/7/88. 15 FOOT UTILITY EASEMENT LOT 7, BK 4, NORTH WOODS S/D, PHASE II. COMMUNITY WATER AND PRIVATE SEPTIC SYSTEM, 8400 SQUARE FOOT BED INSTALLED IN 1984, iGRDUNOWATER AT 11 FEET !ON 3/80/83. LOT 6, BK 4, NORTH WOODS S/D, PHASE II, COMMUNITY WATER ~ PVT. SEPTIC, 975 SQUARE FOOT BED INSTALLED IN 1983. GROUNDWATER AT 12 FEET ON 3/20/83, SEPTIC IS LOCATED ON THE EAST SIDE OF THE LOT. lO0 FQBT GREENBELT AND DRAINAGE EASEMENT i I I 5 FOOT FROM PROPERTY LINE TO EDGE OF TRENCHES, L5 INCH PVC PRESSURE LINE TD TRENDHES,--'~ 500 GAL, LIFT ANCHORAGE TANK. EQUIP WITH DUAL OUTLETS, AND PRO- GRAMMABLE TIMER FOR INTERMITTENT ~ DOSING, 1,5 INCH PVC / PRESS. LINE. TO BED,' NORTH PROPERTY LINE 15 FOOT UTILITY EASEMENT x. ~ ~. APPROXIMATE LOCATION 'DRIVEWAY ' T-~-"-HESI.~LN~ ~ GROUND = I0~,38 ' . .. 18 FEET 9ET~EEN '~ BENCHMARK IS THE '. · ~EDGE TO ED6~ ~% C~CRETE SLAB · . : ' ' ~GROUND ELEV. = 104 ~ ~ ~ UNDE~ WINDOW, & ' ' ". ' / ~ ~ ~ELO~ ~EGK, ELEV. ~ / FOUNDATION DRAIN, 8-10 FEET ~ x~ i00,00~ ~ ' DEEP ALDNG THE EAST SIDE DF · M,T ~ ~ ~ ' GARAGE. FOUNDATION DRAIN ALSO [Y~ ~ " ~ ~ -- F / 6ARAGE ALONG SOUTH SIDE OF '-~ ~- mm t / ~ ~ GOES TO DRY WELL EAST DF H ~ / HOUSE ~FOUNDATIDN ~ THE EXISTING 9ED, C/D. GROUND .. M.T., ,,, ~ ~ / ~ELEV. = 99.5~ ~ELEV. = 103.5 98,9 EXI~ITING ~/ ~ [ [ TANK - ' ~ .... 3/4 INCH DIA, HOPE AIR LINE ~ ~ ..................... ~ ~-," (THDMA~ INDUSTRIES~ MODEL 5070 AVAILADLE THROUGH ANCH, TANK~ 1 , TO TRENCHES, FROM GARAGE TO TRENCHES PIPE SHALL BE INSUL- I I ATED WITH 1 INCH FOAM~ AND INSIDE PVC JACKET, PIPE SHALL 120 MIN~INCH'~ ~-~ L---EXISTING BED M.T. ~ AT DEPTH = 5.0 ~ .J--" ~ GROUND = 98,16 ~ TO 5,5 .-- ~-'-EXISTING DED M,T. I ~ ' .... ' \ GROUND = ~--TDP OF CUTBANK J j APPROXIMATELY NOTE, CONTRACTOR SHALL HAVE THE WEST PROPERTY LINE, IN THE VICINITY DF THE SEPTIC SYSTEM UPGRADES, FLAGGED ~Y A REGISTERED SURVEYOR, THE PROPERTY OWNER SHALL BE RESPONSIBLE FOR IDENTIFYING ANY EASEMENTS WHIGH ARE NOT SHOWN ON THE AS-BUILT SURVEY, CONTRACTOR SHALL HAVE THE WATER LINE FROM THE HOUSE TD THE KEY ~DX LOCATED TD VERIFY THAT THE NEW SEPTIC SYSTEM IS AT LEAST lO FEET FROM THE WATER LINE, SEPTIC UPGRADE, PREPARED FOR, PREPARED BY, DATE' 8/6/98 LOT 5, BK 4, NORTH WOODS , PHASE II JOHN AND MARGARET LOEW ALASKA WATER ~ WASTEWATER SERVICES DRAWN~ GARNESS SCALE~ 1' = 30' ,i I I THE TRENCH SHALL HAVE A MINIMUM LENGTH OF 75 FEE~ AND A TOTAL EFFECTIVE ABSORPTION AREA OF 375 SQUARE FEET, MONITORING TUBE CTYPJ PERFORATED IN DRAINROCK. NOTEI BOTTOM DF TRENCH, EXCAVATION, AND TOP OF SAND SMALL BE LEVEL, MAXIMUM VARIATION OF ~ INCHES BETWEEN HIGH & LOW SPOTS, WITH NATIVE SOIL AND MBLIND. TOPSOIL & RESEEDING SHALL BE RESPONSIBILITY DF HONEOWNER, IF HOUSE IS BEING SOLD, SELLER SHALL COORDINATE VITH BUYER, --PROVIDE L~ INCHES DF BOARD INSULATION. INSULATION SHALL COVER THE ENTIRE ~VIDTH OF THE TRENCH. FABRIC SILT BARRIER DRAtNROCK SHALL BE SCREENED PER ~A SPECIFICATIONS. -- ,® ® SAND FI£TER ~,' · ',' ' ' NOTE, 1. TRENCH SHALL RUN PARALLEL TD THE SLOPE CONTOURS, 2, FOR LOCATION OF CLEAN-OUTS AND HEINITORY_NG TUBES SEE THE SITE PLAN, CONSTUCTIDN PRACTICES, AND MATERIAL SPECIFICATIONS SHALL CONPL Y WITH ANCHORAGE MUNICIPAL CODE 'WASTEtdATER DISPOSAL REGULATIONS'. 4, INSTALLATION SHALL COHPLY WITH SPECIAL PROVISIONS NOTED ON THE SEWER PERMIT. INCH DIA, PVC. 3/16 INCH DIA, HOLES AT 3,75 FEET CiC, 22 HOLES TOTAL FOR BOTH TRENCHES, PLACE ONE HOLE AT EACH END. ALL HDLE~ SHALL FACE DD~N. 1/8 INCH AIR SUPPLY LINE. ~ASTEFLDW" PROVIDED BY ANCH. TANK. SAME AS FOR INTERMITTENT SAND FILTERS. PLACE 6 INCHES ABOVE BOTTOM DF SAND, OR AS STATED UNDER SPECIAL PROVISIONS SECTION DF SEWER PERMIT, SPLICE TO TD HOPE SUPPLY LINE ~ITH STAINLESS STEEL BAR~ED FITTINGS~ AND S,S HOSE CLAMPS. 5. SMEARED BOTTOM AND SIDEWALLS SHALL BE RAKED. 6, SAND FILTER MATERIAL SHALL MEET LATEST GUIBANCE BY THE DETAIL FOR 5 FDDT PREPARED FOR: ALASKA 6,lA TEl? DA TE; 6/9/96 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DE$CRI 'ION: 11 12 13 14 15 16 17 18 19 20 Township, Range, Section: SLOPE 81TE PLAN WAS GROUND w^'rE~ ENCOUNTERED? YES. AT WHAT E Depth to Water Aibr~/ /Or/z. Date: .r'4onilering? '-~ - Gross Net DePth to Net Reading Date Time Time Water Drop PERCOLATION RATE I~, ~. [m,nutes/mcn) PERC HOLE DIAMETER 72-008 (Rev, 4/85) Municlpalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS_ I~'~,.-~~LOG -- PERCOLATIONi_.o~.,jj TEST ~'~ ~ PERFORMED FORt ~...~(~,~ ~ DATE PERFORMED~ 't.-c~"'F ~., ~F-.. a~.. Township, Range, Section: LEGAL DESCRIPTION: }.~'o r~'T3,~ L,,.,.~::~(:) ~ SLOPE SITE PLAN 1 E~COUNT~REO~ S 11 L tF YES, AT WHAT 12 E 1 3 Boniloring? ......... ..~___ DAP.: Gross Net Depth to Net Reading Dazo Time Time Water Drop 14 15 16 17, 18- 19- 20- PERCOLATION RATE I "~-.O. m~nutes/mcn, PERC HOLE DIAMETER .'~ // TEST RUN BETWEEN ,,-~-~-~-~-~-~-~-~-~' FTAND ~"'~ Fl; PERFORMED BY'. ~ ~ i~ ~~ CERTIFY THAT THI~ 'EF WAS p~RFORMED IN ACCORDANCE WITH ALL STATE ANDMUNC A G ' ' '~ ; ', : -'~ -- 72-008 (Rev, 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13- 14 15 16 17 18 19 20 Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTEREO? IF YES, AT WI-IA'[ /~ DEPTH? _ I'~ . pO E Depth to Wal~r Aller I,,.)I/;N~ . Monil0rln~/ Dale: SITE PLAN Grose Net Depth to Net Reading Date Time ~ Time Wate¢ Drop PERCOLATION RA'fE /o ~ ¢~mules/mcnj PERC HOLE DIAMETER TEST RUN BETWEEN "~°~'.FTAND -,~' ~,F~ C~OMMENTS ~...~. ~__~ ~. ~,,~ ~,~.,.. ~,..~ · ~,~ ~ ~l ~ ~ ~ ~t~ PERFORMED BY: ~ ~ . ~ ~~ CERTWY THAT THIS TE$'T WAS PERFORMED IN 72-008 (Rev, 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 %" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 t4- 15- 16- 17- 19- 20- DATE PERFORMED: Township, Range, Section: SLOPE I SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT J,~ l/G,. 0 DEPTH? P E Monitoring? Date: Gross N~t Depth to Net Beading Date Time Time Wete¢ Drop PERCO,.ATION hA-rE .¥"~O iminutes/mcn) PERC HOLE DIAMETER TEST RUN BETWEEN ~' ~' FT AND ~' 0 Fl: AOCORDANOE ;ITH ALL STATE AND MUNICIPAL GUlDELI'ES IN EFFEOTONT~ISOATE. ~ATE: , ~/~/*;: 72-008 (Rev. 4185)  MUNICIPALITY OF ANCHORAGE ' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 'E~ ~ / PHONE _ LEGAL DESCRIPTION LOCATION ' J We, l , Absorption ,~ ,Dwelling~ , E R~O~.~ ¢ D~STANCETO= I~d~¢l ~ ~ ~ Manufacturer__ . J __ Ma~ No. of compartment~ q/q~ Inside length Width Liquid depth Li aliens IF HOME.DE: ~ ~ Y DISTANCE TO: Well O ~ ~ ~anufacturer · --~ Mater~al Liquid capacity in gallons ~ WeN Foun~tion Nearest Jot line PERmiT ~ DISTANCE TO: . / / ; ~ ~ NO. of lines Length of each line '~ngth of lines Trench width Distance between lines Top of tile to finish grade Material beneath tile Total effective absorption area ~ inches ~ ~ Type o¢ ~i6 Crib diamet~ Crib depth ' Total effective ~ Well Buildi~tion Nearest lot line ~ ~¢ DISTANCE TO: / ~ ~ D~pth Driller Distance to lot line PERMIT NO. ~ DIS--~CE TO: nk Absorption area(s) OTHER SOIL TEST R~TING ~ iNSTA~ER ¢ REMARKS ~' 72-013 (Rev; 3/7~ MUNICIPAB I'FY OF . .N.C..QRASE DEPARTMENT OF HEALTH. AND ENVIRONMENTAL PROTECTION 825 L STREET~ ANCHORASE~ AK 99501 264-4720 PERMIT NO: DATE ISSUED~ APPLICANT: ADDRESS: CONTAC]' PHONE: LEGAL DESCRIP: LOT SIZE: MAX BEDROOMS: ON--S ~ T'E~ 840302 05/07/84 DON WALKER %S&$ ENGINEERING EAGLE RIVER~ AK 69-2979 99577 SUBDIVISION: NORTHWOODS ~2 SECTION: 4 TOWNSHIP: 40660 (SQ. FT. OR ACRES) 15N LOT: 5 BLOCK: RANGE: 1W Listbd below are the options avai.lable to you in designing youn septic. system. Choose the option that best £its your site. ]FRENCh{ BED W.DRAIN DEPTH TO PIPE BOq'TOM (FT.) 4.0 4.0 4.0 GRAVEL DEPTH (FT.) 4.0 0.5 5.5 TOTAL DEPTH (FT.) 8.0 4,,5 7.5 GRAVEL WIDTH (FY.) 2.5 ~1.0 5.0 GRAVEL LENGTH (FT.) 75.0 42.0 GRAVEL. VOLUME (CU. YDS.> 50.4 5~.6 46.6 9ANI< SIZE (GALS) 1~000.0 ** 1~000.0 *~ I~000.0 **. SOIL RATING (SQ.FT./BR) 194 195 - 194 TANK MUST HAVE AT LEAST TWO COMPARTMENTS I c:erti£y that: 1. I am familiar with the. requirements fop on-site sewers' and,wells as set ~orth by the Municipality o£ Anchorage (MOA) and the State o~ Alaska. 2. I will instal] the system in accordance with all MOA ~odes, and regulations'.. and in compliance with the design criteria o~ this per'mit. 5. I will adhere to all MOA and State o.£ Alaska requirements for th'm set back~ distances £rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent'or nearb~ lot. 4. I understand that this permit is valid for a maximum o~~ 3 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~ ]'HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILT8 WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (5) THE E -LECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.. SIGNED APPLICANT: DON WALKER DATE: ISSUED BY DATE: MUNICIPALITY OF ANCHORAGE DEP~RTMENT OF HEALTH 8ND ENVIRONMENTAL PROTECTION 825 L STREET~ ANCHORAGE~ AK 99501 264-4720 ~ERMITNO: DATE ISSUED: Ot~ ......$I TF SFI~iFR PFRt~ IT 840502 APPLICANT: DON WALKER ADDRESS: ~$&S ENGINEERING EAGLE RIVER, AK CONTROTPHONE:~-2~?~ ~577 LEGALDESCRIP:' ~J~BD~VISION: NORTHWOOD~PH#~ ' ~ SECTION:'4 ' TOWNSHIP: 15N ~OT-5I~E: 40660 <~O.'FT.'OR ACRES> MA~BEDROOMS': ~ LOT: 5 BLOCK: 4 RANGE: iW LIS~ED'~BELOW ARE THE OPTIONS A~A:ILABLE'TO VOU IN DESIGNING YOUR SEPTIC ~'~!~TEHF :' CHOOSE 'THE' OPTION · TH~IT BEST FI TS .YOUR SI TE. ..... TREN,C'H BED N. 'DRi=I 1' N DE~TH' ~O"P~PE BOTTOM ~(FTi > 4. 0 4. 0 4. 0 t:.,~RRV. EL, DEPTH (FT, > ~. 8 0:5 ~. e GRAVEL' rW{DTH-(FT. > '~ 2. 5 i4. 0 5. 0 GRAIL LEITH (FT.) 42:0 27. 0 ~8, 0 ~L ':~LI~E '(CU. 'YDS. ) ~.6 i4. 8 t~. 4 T~K ~'I~E~ (GRLS> ~000.0 ~ i, 000. 0 ~ 1,000. 0 ~ SQIE. RS~.ING (SQ. FTi/BR) - ' 8~ 8~' 8~ ""~ TANK MUST HRYERT LEASTTWO COMPARTMENTS I CER~.IF~' THAT: I2~':1 'AM FF~ILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS 8ND WELLS RS SET FORTH B¥'~HE ML~ICIPALITV OF ANCHORAGE (MOA> AND THE STATE OF 2, WILL~ INSTALL THE SYSTEM IN 8CI~ORDRNCE WITH 8LL MOA CODES AND REGULRTIONS.~ RNDIN COMPLIANCE WITH-~HE DESIGN CRITERIA OF THIS ~RMIT. ~;"~I~'WI~L'RDHERE TO ALL MOA AND 5T8TE OF RLRSK8 REQUIREMENTS FOR THE SET' B~CK u~I'STR~ES FROM ~V EXISTING ~LL~ WR~TE~TER DISPOSAL SYSTEM OR PUBLIC ~::. ~_.SEWERRGE 5~STEM ON THIS OR ANY ADJACENT OR NEARBY LOT. ?:i'4. ~'.I UNDERSTAND THAT THIS PERMIT IS VALID FOR ~ MAXIMUM OF ~ /::-:'8N~ ENLARGEMENT WILL ~QUIRE RN 8DDI~IONR~ PERMIT. I~F R ,,~IFT STATION IS INSTALLED IN 8N 8REA COVERED BY MOA BUILDING CODES~ ~ (lY 8N ELECTRICAL PERMIT AND INSPECTI~ MUST BE OBTAINED~ (2> RS-BUILdS WILL NOT BE APPROVED WITHOUT~RN ELECTRIC8L INSPECTION REPGRT.: AND <~> THE ~LECTRIC~ WO~" MUST BE DONE BY '~ LICENSED ELECTRICIRN. ~I~; ~ RTE' : DON *~- -'---. [~ SOILS LOG PERFORMED FOR: LEGAL DESCRiPTiON: ~ ~)7-- :~"' 8 9 10- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~ PERCOLATION TEST 825 Lo Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SLOPE SITE ~LAN 12 13 14 19 2O WAS GROUND WATER q~.~ ~ ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? I/ ~---~ Reading Date Gross Net Depth to Net Time Time Water Drop TES~RUN BETWEEN ~'~ FT ~O ~ FT PERFORMED B~ ~ ~,~ CERTIFIED BY: 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVl RONMENTAL PROTECTION 825 L. Street, Anchorage, A!ask~t 99501 264-4720 SOILSLOG- PERCOLATION TEST [] SOILS LOG [~PERCO LATION TEST 1 2 3 4 5- 6- 7- 8 SLOPE DATE PERFORMED: '~ SITE PLAN i []- 1 10 11 12 13 14 15 16 17 18 19 20 COMMENTS ~--~ ~Y~/~/~ '~"~'~'~ ENCOUNTERED? ¢/~ 0 WAS GROUND WATER SL P E DEPTH? '//~ /~--~-~S~-' 72-008 (6/79) Gross Net Depth to Net .Reading Date Time Time Water Drop . Reading PERCOLATION T RAft .... ~, ~ = ~ -~' -~.~/ ©$ ~ 825 _ Street, Anchorage, AK. _~501 264-4720 Permit ~ ~ ~ ***HANDWRITTEN PERMIT*** Applicant:~~/~ Mailing Address: Location: ~~mber: Legal Description: X07~.~ ~/~? Lot Size: Type of Soil~sorption System Is: Trench: ~ Drainfield: Maximum Number of Bedrooms: MUNICIPALITY OF ANCHORAGE Department~-~ Health and Environmenta3~rotection Seepage Bed: Holding Tank: Soil Rating(sq.ft/br) ~, ~ The Required Size of the Soil Absorption System Is: ~ DEPTH 7 LENGTH .?~<-'-- GRAVEL DEPTH ,'~ 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 = /~-'"~90 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 31j 1 9 8 3 * * * I certify that: (!) 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 require enlargement if the residence is remodeled to include more thg~ 3.~edroo~s//~ A'pp lic a~t , ~ 6- ~ SWP/024 (1/81) - ,_..El 141,:. I'NE.I'IT JIF HEl',u.,, 1 FIN[::, EN'v'ZF:L-INHENTI=IL F'ROTECTIOiq "- ':":'.=; "L." ff, TF:EET., i=INF:,HFIRFtGE., FIK 995Et1. · -, -. ~ -'. "" -~ FiI'.~F:HF~RFIGE a';'::~4.-;:':2_-'-':± : EFIGLE R I ',,,'ER ,== :,'4 *T ~' ,mi'-'.' : -- -- -- -- '-- ,.7.~ if'..,l ........ dZ.-;, % T' E: n.--, E ll..ql E-- # .. F" EZ Ea: ~'*1% F'ERH IT l',ll"t' O'=>-" FIF'F'LICRNT: :' E,Et'I L : r- - ~, ::',=,': t" L ~:, - ,'", .... [...~. .: ; -'-t r'l]"" -' t t'-' I Ftt<:], t::It';;: ' "=' :~ q _. , _.:, - - -¢ -, ,:! ,p[.,'r, 'T*='TI-¢'..I ' I',ICI~'.THI.,JOO[:.' 92 BLLL. k: 4- LOT: Enl',f_. C,E'5~ :I:,:'IF'T.~ _,N ........ ',' ..OT ff, tZIE O %6!. IrT. TOI.,.IN:~;HIP: F.:FINGE: .... E;ECTION: ..... 1,:,,:, ," '=;F., ,."BR ) 1t,,.., ......... 4.J IEILR OF E,'ED, I::OOM2'; = :,~ Il.. i;i:t::fTINI3 = :I.:~:E.: i:.E::E: .... ' FT. [.:,[.:. ........ , t::II;:[ THE,- .,. _, f'45 t::t',,,'!:t I L. FIDLE TO '¢O1_! I N /:.:,ES I Gi",I I NG "¢OUR ff, EF'T I C _tST[:[:' '~- ~" 'TII EE_.T FITS '.r'F' F.' 2;TTE. ............. ": :: TI'ti C:F"T' ~ _,,',, - - ,.IZDTH = 2.....,~:'FT. ~ FT. TI:REI'-,ICHEE; EhEiTH = 94-. ~::q F"T. i ~i-"rm ..... '"'?'B '~'Ef~I IRES TI-,.IO '-', '~ '~ F'T. FOTFtL [.,EF TH '':= ,' .:tF-'.ll, E~.. I:>IZF'Ttl = ]'.'= ''" FT. - ~-.r::' ::= '-'-'C:: 4. [:U. %%".~. :'iE:FI',/E t ........ -'" '~ ': ,:;TklO COI'"It:::'FIF.".TI'dENT TF1NI:::;:' FI:INK ff, IZ[Z = :2., '~P'f:~ 13 L~hLL._,,,L, '-'"' ~:_"~ FT. ,.l'I L)TI"I _EIqGTH = 4;2. ';3 F-'F. TOTI=tL ,_ I=.F , 1.1 := ._,=. ,:.,":' FT.., -. - ~- ..,-,..r~ "~ !5 F'T. .. F. .... L. E..,=.F ,,-I = ]F.".F¢,/EL, ,-.,,~'~" .Ih'm:',,... =: =.,::.."~'"" 6 L]:U. TFI;..tI< ff, I2:E: = T., ¢]lCj!tt;]1. I.Zi GF:IL. LC;,I:5 ,:;TP!FI COHF'Fhr"i:THEI'4T TI::tNI<', ...ItDTI'I = 5. 8 , r:.I, ,-..r ..~ (E;l:;; ~.-'-~ F-T'. TO'TFtL [:,EF'TI.I ...... -'. ',3 FrT. GRRVEL [:,EF'TH = 3. I.ZI FI'. .aF. t i, E.- .,. _1.__~1~.. 4;:2. ," [;U. TI:INK :31 ZE = I, GG8. (~ ..~ L.I ..... t ..... ' TFIO E:CIHI:?I:::tF~:THEI",tT TFIi",tK > .T. - :'}>TIF"r' TI'"Ii::I"I": "" . ..... =,E. HER: FIND' I.,.IELL2; FrE, SET :L. I FIH F'FiHILIFIF: HITH 'T'HE: pE::,I'[F.'Ef"E'",T5 FOF.: [iI'.,[..-.%ITE ..... '"" F 0 F.". T H r: . L, THE ML.Ii'4 .I C I Fl:IL. i T'T' ':il:" FII',ICHOF:F:IGE i::.iI'.,ID THE ff, TFITE ElF: HLI i:,l'...I I. L..LE.'E.:, RND Hf:I',,,'E F.'E::ET'v'ED ~. Z !.,.tILL ZN?I"Fti...L THE .:, :,lLfl IN RCC:CI'F.:[.:,I=II"4C:E-1.4ITH THE .... r,:' T HI _, FI CL"'P"¢ uF THE ::f']F:'E' '51Jf'IHIRF~'."? FIN[) C, IFIGRFtM FITTFtCHHE:I",IT::7., t.4HICH Z:'~ F'FIF.:T OF" '': F'ERHIT. ,I',~. "'I'I"'=;I. TE '_=,Et.4EF: ::, :qEI1 HRV I;.:E6!LIIF:E ENLFII;d3EMENT 'rF THE _-.::. t UNDEF.'.STFtNE:' T~JF:IT ,.. ~r= _. - ..... ' F.:E:E;IDE:NC:E I% F.':EMODELE£:' TO ZN':I.._F'E MORE THFIN ]: BEC"F-'.OOHff'. t t:.,..f., RPPL. IC:FINT I'IFI5 THE F.:E~;F'OhlE, IE:II Z"l""r' TO INFOF.:H F:'E'F.::5ONNEL. DURING · ,=.~-: ~,--,--~-~'. ~'~--~:,r:'-.T,'-~,,-- OF t::1t",1¥ I.,.IELLL5 FIE:',.TFICEHT TI] TH.I:5 PF.':OF"EF-'.T¥ FIND THE: IN:,,,I ....... -I ~_,4 ..... :,*'l= .... .~.,,: THE I'4,..t1_E'F.;. OF I,;.~.:,.,DI=I,,..., ...... ,1"11'-,, THE I,.IE:L.L ZLL. .:,EF.,E. IF i'::t L'rr:''r., ," , ff, TFtTI[;N Z2; .,.t',l.:, l",a.L~..[.. FIN ~L*..._-,F .... HL PEF.:HIT Ri",ID ZI",tLSPECTZOI",I HUST E:E ODTI::t.,t',*~,...'. FY.E;'""E .. '[LT'Z;~, .... ,," ",r"'"'~_,~ E:E FfF'F'tq'"",,,'EE:, LqITI-IFI!IT__ FIN ELECTRIF:FIL IIqSF'ECTIOI",I. ,, , - ..... r- -. ".F,.' ~ '-' ~ l ,...~ _1,]-T r. - ~ _ F. EF _ ~: ~ "FH[:7 £,...,_u't .......... LIC~Ri.::: E:E ~. _, ~E fl L Z CEN:SE[> ELECTF.': :[ C I FIN. I F F L., _." N, . .:,, ~:, EN '];}:::FtG(S:E; [:,RTE: • • 1vn.' 4 E B L PP !_d Municipality of Anchorage • On-Site Water and Wastewater Program I:0112.. (907) 3434904 d. SAFETY Certificate of On-Site Systems Approval - Parcel I.D. 051-821-02 Expiration Date: 2 - 13 1. GENERAL INFORMATION: Complete legal description NORTHWOODS PHASE 2; BLOCK 4, LOT 5 Location (site address) 23214 Northwoods Drive*Chugiak 99567 Current Property owner(s) John & Deborah Hageter Day phone 602-8817 Mailing address Sccrne Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: 6,724 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ + I ?if 1 C'() Waiver Fee $ Date of Payment (pi 26111 Date of Payment Receipt Number 03 4c13.6, Receipt Number COSA# O JCA ! l 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. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 , Engineer's Printed Name: Jeffrey A. Garness Date: �d 23/' ao�oop��0 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system oQOF A in accordance with the guidelines and regulations established by the Municipality of Anchorage and . 4 industry practices. The reported results describe the condition of the system/s on the date/s of the , P.•• t Q'1 evaluation. Separation distances were measured to readily identifiable features. Hidden defects or , �' •. U encroachments may exist that were not identified during the evaluation. The operational life of all wells • 9 I i . \ V9 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and 4 VA workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the Q •••J f r- •rness• • system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of V0 o • �E_ • the well or septic system. GEG makes no representation whether an alternative well or septic system 9 c0 can be installed on the property in the event either of the current systems fail to perform adequately in �``P ••e' z:3 1 f��°� the future. The content of this report is for the sole benefit of the person/party that retained GEG to ��pro f e s s\oc\c' perform the evaluation. Reliance upon the information provided in this report by any other person or D�O�000a party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for 4if bedrooms System #2 Approved for bedrooms •, O•y-; /4. ; Disapproved Conditional approval for bedrooms, with the followir stip�ilaii i NU IpTE �r�,I�STC�Ip,TER p PROGRI\til 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: NORTHWOODS PHASE 2, BLOCK 4. LOT 5 Parcel ID 051-821-02 A. WELL DATA AWWU Well type If A, B. or C provide PWSID# Well Log (YIN) Date completed Sanitary seal (YIN) Wires properly protected (YIN) Total depth ft. Cased to ft. Casing height (abo - 'round) in FROM WELL LOG AT I ' CTION Date of test Static water level ft. ft Well production g.p m. g.p.m. WATER SAMPLE RES Coliform colonies/100 ml. Nitrate mg./L. Collected by: enic ug.IL Date of sample: B. SEPTIC/HOLDING TANK DATA 21 YEAR OLD STEEL STEP TANK IS LIKELY APPROACHING THE END OF ITS USEFUL LIFE Tank Type/Material STEP/STEEL Date installed 7/12-16/96 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) YES Date of pumping 3/13/17 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE @ MT NORTH/SOUTH BOTTOMLESS SAND FILTER Date installed 7/12-16/96 Soil rating (p.d./)7or ft'lbdrm) 2.0 System type DUAL SHALLOW TRENCHES Length 37.5/37.5 ft. Width 5/5 ft. Gravel below pipe 0 5 ft. Total depth *3.751*3 ft. Eff. absorption area 375 ft2 Monitoring tube YES Depression over field NO Date of adequacy test '*5/19/17 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0/0 in Water added 617 gal. New depth 0/0 in. Elapsed Time: 0/0 min. Final fluid depth 0/0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date - -INFORMATION ON 1984 BED IS IN MOA RECORDS. —1984 BED WAS SURCHARGED ON 5/19/17 *PER OWNER.THE DRAINFIELD WAS SWITCHED FROM THE 1984 BED TO THE 1996 DUAL TRENCHES A DAY PRIOR TO OUR INSPECTION. WE PRE-SOAKED THE DRAINFIELDS WITH 2.008 GALLONS ON 5/17/17 AND IT REMAINED DRY THE TEST WAS RAN ON THE SAME DAY AS THE PRE-SOAK. ALL WATER WAS INTRODUCED THROUGH THF I IFT STATION 'SECOND COMPARTMENT OF 1500 GALLON TANK D. LIFT STATION **PER COOK INLET ELECTRICAL-SEE 1996 INSPECTION REPORT SEE ATTACHED ARM SERVICES INSPECTION REPORT Date installed 7/12-16/96 Size in gallons •500 Manhole/Access (Y/N) _YES "Pump on" level at '"' in. "Pump off'level at_•'• In. High water alarm level at_ "' in. Datum BOTTOM OF MANHOLE Cycles tested "' Meets alarm &circuit requirements? '"YES E. SEPARATION DISTANCES AVVWU SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main r-PubtiCsewer manhole/cleanout Sewer/septic service line Holding tank • • - •ntainment 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 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 10(Y+ PRIVATE 1200'+PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '5' Building foundation 10'+ Water main 10'+ Water service line "101+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+PRIVATE/200'+PUBLIC F. COMMENTS 'WR96025 PER BOB DEAN LOCATES FOR 1996 INSTALLATION � _ 717 ej1.`.rl l C-1 .••viss>a G. ENGINEER'S CERTIFICATION • " f •. f� certify that/have determined through field inspections and , , I • review of Municipal records that the above systems are in (• • ' • conformance with MOA COSH guidelines in effect on this , • date. I r^ : eu A. Garness; Engineer's Printed Name JEFFREY A. GARNESS '• t-PA . A. 3 Date e. PROFESS\ \•� LICENSE II%toms* #AECC884 (Rev. 10/12/12) _ Frontier Surveys,LLC Project No:17-083 Date:May 24th,2017 NORTH Ordered By: Sourivong Erica Plat:82-167 Grid:N/A Scale 1",-'40' --------------4- nrammoDsDRn&----_____- --------- -- ��. +� ��wy: rEDGE OF PAVEMENT :wd .f�ls�.., ORAENA6EOITCH'_- +a, �. DJat,`x,t.vc --,.,.., . r9i6 -..-g l-up-3^ I. oL','jg M90.04'00"E l 150.00' 1Ha] 1S'T&E EASEMENT 1 1 L. j_1- i I \a+ I - I MAMEprwvtWAY ` 1 S 1 S, 1 58.• 66.2' I ,j I i N p 4 ' 1 28.0' ' 38 2 1 oio, ..__. a 1'.8--- m LIED (J 111 Y.. r 5 m LOT 4 ^ g g ^ LOT 6 N �2 N Northwoods Ph.2 Subdivison Z Lot 5 of Block 4 40,660.59 sq.ft. 23214 NorthwoodsOr.ve m 2 Story Wood Framed House w/Attached 1 Car Garage 589'55'23"E 150.00' Legend: :`j Electric Meter/Outside Power Gas Meter El Deck 0 Concrete 020 40 80 WV 'S Septic [X Water Valve momimmai Feet General Notes: 1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law. 2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey. 3.All measurements/setbacks are to the visual/apparent building footprint. 4.Dimensions to property lines are plus/minus O.lft. +..,110101k ii ik This survey complies with ASPLS Mortgage Location Standards.The survey represents visible improvements and f O F .4 1'� conditions at the time of the survey.This document does not constitute a boundary survey and is subject to any [r a...: inaccuracies that a subsequent boundary survey may reveal.It is the responsibility of the Owner to determine .'4•' '.�_H�` the existence of any easements,covenants,or restrictions which do not appear on the record plat.Under no M C.1 •.��1. circumstances should this document be used for construction or for establishing a boundary or fence line. :. •.•• 49T11 A` As-Built Survey of: 0 ...••.....:.:r•* i• a:. -r M Lot 5, Block 4 of Northwoods Ph. 2 Subdivision 0 ,./ FREDERrc W.WAGNER: r I,Frederic Wagner,hereby certify that I have performed a Mortgage Inspection Survey on the #ir•••11.3 LS-9946 i j subject property as described above on May 24th,2017 4 ••—t-st,5 ,, 10x+ Frontier Surveys, LLC FROjTjER• 1.1 t,. �� 650 W.58th Ave.Suite E Anchorage,Alaska 99518 S 907.460.1686•info@lfrontiersurveys.com . PROFESSIONAL SEAL www.trontiersurveys.com ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Day of ofle `le of 20(l,by and between N 'oe; , herein the "OWNER,"and the Municipality of Anchorage,herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein,the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as To 5 located at(legal description). Northwoods Ph2 L5 B4 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code(hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS,the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense,to pay for any and all: (1) repair(s), (2) maintenance,(3) adjustment(s), (4) replacement costs, and(5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaivcr. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: a. Owner: b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify,or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9, Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: xi.,L • (signature) Date: (C 1 ( ! auium ( (print name) STATE OF ALASKA ) )ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 1 if day of J u h C , 20 11, by r irx m 0)0(44 u.)-k I I A2mt,Q - STATE OF ALASKA NOTARY PUBLIC FORA A NOTARY PUBLIC My Commission expires: ALASKA Uot Kristina L. Palmer � • My Commission Expires:April 1,2021 MUNICIPALITY: e-------(16,1(signature) r B . ( �— C1� (signature) Date: (print name) Title: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O/Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone r'v'/~ Day phone /'V//4 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER. o As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verifythat 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 corn )liance with all Municipal and State codes, ordinances, and regulations in effect on the date of th Name of Firm Address Engineer's signature DHHS SIGNATURE · S ^ rowo,or Disapproved. Conditional approval for bedrooms. s inspection. Phone Date bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA fYZ1 A. WELL DATA Well type C-c~/-4b-4. Total depth Sanitary seal Date of test Cased to Parcel I.D.: ~ADE~ water system' ¸Al' Static water level Well production. WATER SAMPLt Coliform ~ Nitrate D ~le~samp" ~' ' ' B. SEPTIC/HOLDING TANK DATA Tank size !I~-00 N~ Foundation cleanout (Y/N) ' y ~Depressi0n (Y/N) ;.../~] , High water alarm Dat~ of pumping ~ Pumper ~ ~ C. ABSORPTION FIELD DATA Dateinstailed '7/~ , Soilr~iing (g.p.d.lft2orffi/bdrm) · ' r ' t i~ ~ . ' - t : Length ~7~' Width' : ~-' ( .Gmvelthicknesgibelowpipe., ~'' Total'depth Effective absorption area ~'7 ~ Mt~ttring Tube pr~s~t(Y/N) Y Depre~sion0ver field (Y/N) Date of adequacy test tO/~ Results (Pass/Fail) ~ ~ For ~-~ Fluid depth (ins' Peroxide Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested Size in gallons ! ~ CD "Pump on' level at* ~I~ "Pump off" level at* *Datum '~ P~'J~-' ~17-.~=~ E. SEPARATION DISTANCES Septic/holding tank on lot Absorption field on lot Public sewer main SEPARATION DISTANCES FROM WELL ON LOT TO: ~/ /~r' ; On adjacent lots fJ//t~- ; On adjacent lots f4' (~k Public sewer manhole/cleanout Sewer/septic service line /xJ ~.- Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation J ~ t ~ Property line ~ ~ Water main/service line I.~3/* Surface water/drainage ~'l Wells on adjacent lots ~' 2-00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ! Water main/service line I ~ l:>~-$z't.o~~41''-'~-~ ~"~'~ Building foundation Surface water Curtain drain Driveway, parking/vehicle storage area t..t~q- Wells on adjacent lots ~' ~'DO ! Prope~ line ENG~ER'S CERTI~CATION - ~ ' s.a ur ( 7 ' ~ re. E ngineersName ~~ ~' ~~ Date v t ~ ~ 7 ~ '~ 5~%.,. ..... . '~__ HAA Fee $ Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (incldde 10t, block, subdivision, section, township, range) CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Telephone:(home) 4~obn~ga; Ab. 99503 Telephone Lot 5; BZock 4... ~o~k Woods #2 Location (address or directions 23214 (b) Property owner AHFC~61290 Mailing Address ~gfl'Ea~ 34~ Auo~ua; (c) Lending Institution Mailing Address Business (d) Real Estate Company and Agent '~F.I~/~( P~,n??~_ex_,~[ne_ /~tt,' ILnda ~fa~¢-¢ (e) Address Telephone 2'76- 2761 Mail the HAA to the following address: (or check herex[j~, if hold for pick up.) List contact person and day phone number below: $ & ~, ENGiNEERiNG 17034 Eagle River Loop Road No_. 204 Eagie River, Aiasica 9~5/-'7 2. TYPE OF RESIDENCE Single-Family r~X Number of bedrooms 3. WATER SUPPLY Individual Well [] Community ~( Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ~X Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA 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 end 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 Telephone 17034 Eagle River Address Date Approved ,o r '~'I Terms of Conditional Approval Date The Municipality of Anchorage Department of Health and Human Services(DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 . ~' '" ,~,O~'~,;~: MUNICIPALITY OF ANCHORAGE (MOA) ~.~C, ~.~(~.,F.~,~ Health Authority Approval (BAA) ~~ ~ CHECKLIST-FEBRUARY 1984 ~~,~~~ . 343-4744 -' A. WELL DATA ~v ~, Well ClaSsificationS- ~ If A, B, C, D.E.C. Approved~) Well Log Present (Y/N) Total Depth Cased to __ Static,Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Date Completed Depth of Grouting SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) .; ~ing Lots ""~ 1 1c ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date B' SE"T'C/"OLD'"G TAI"5ZATA Date Installed ~'-'~c~- 6~'"" ' Size I '7-'~- . of Compartments Standpipes (~N) ~'./ Air-tight Caps./N) Depression over Tank (Y/:~;~ Pumping/Maintenance Contact on File (y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/H~--'DING TANK: To Water-Supply Well ~_p t' To Building Foundation To Property Line / o ~4- /'" T.~ Disposal Field To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course \ ,-~c:? --~ Comments '--~'-~'~ ~--~-~'~ ~',.~--..~L~ '-/' Foundation Cleanout ([~/N) te Last Pumped ~- ~//~/~ ; for ~ - Temporary Holding Tank Permit (Y/N) 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ! Width of Field ~ ~'~¢/¢¢--'~ Type of System Design ~ f Length of Field (,,,,~ i ~'~'-' Depth of Field '~, 5-~ Gravel Bed Thickness ~, ~- Square Feet of Absortion Area / ~- ~ ~=~ Statndpipes Present (~/N) Depression over Field (Y~) /'J Date of Last Adequacy Test Results of Last Adequacy Test '~,/~.T~ $ ~ ~ _ ,~, ~:z~/2_.._ SEPARATION DISTANCE FROM ABSORPTION F~_I_D: To Water-Supply Well ~ L.p ~' To Property Line ! ~ To Bui,ding Founda n/ ,To Existing or Abandoned System on Lot ; On Adjoining Lots % ~4-- To Water Main/Service Line /.~p, ~./r'~ TO Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course //C~ /4. To Driveway, Parking Area, or Vehicle Storage Area ~,C, ~ Comments / D. LIFT STATION Datq~lled Size in GallOns-. "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments _ Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) es during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. $ & $ EN61NEERIN5 17034 Eagle River Loop Road No. 204 Signed ........ ,,I.~ 99~77 Company Date ~/~ MOANo./'~ ~¢~O ~ Receipt No. Date of Payment Amount: $ ~-/¢:-')'-'/~ (~ (7~-~?~ ReceiptNo. 72-026 (Rev. 7/88) Back Waiver Fee: $ Date of Payment Page 2 of 2 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORGE WESTERN DISTRICT OFFICE / 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-6775 DATE: ~n~ 2R, 1989 PWSID: 213.00,1 TO Whom It May Concern: According to the records on file in this office, the Chugiak utilitigs/Northwgo, ds Deer Horn ~ater System is in compliance with the state'of Alaska Drinking Water Regulations. VEC: gd Sincerely, Environmental Field Officer