HomeMy WebLinkAboutPOLLOCK HOMESTEAD BLK B LT 8Onsite File HomesTeaa C' Municipality of Anchorage Development Services Department " Building Safety Division �- On -Site Water and Wastewater Program. 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 0f-3' www.cl.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT L� Permit Number: �ti PID Number: e01/ 7'- //d _ / 0 Ham®:••!t J, , 00b kidw Wastewater System: EDNew (Upgrade Addrett' t 1 r; PERMIT No. SW040334 PACE 2 OF Municipalit of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 8, BLOCK B, POLLOCK HOMESTEAD P.I.D. NO. 017-112-40 GREENPOINT AVENUE 10' UTILITY EASEMENT I I I I- I o `Jy Qp� I C I I I LOT I�3 m LOT 7 I� IZ I -' CO2 Hp I I MT I 4 100' WELL RADIUS I NEW TRENCH I j _ MT1 I Q fqS�� om�os� 01 0 LI j BGG I \ •� O CO TOM STI EXISTING 1000 GALLON SEPTIC TANK VERIFIED r DELI&DBL2 sgALE; 1' - +o' H DV (DIVERTER VALVE) _.$iJt�l,�i f%Sytit,1 A i+tPENC CO f�C;��� ..... G �•' ,'/ �� MT LOT 9 �. O ROBERT C. COWAN ti �IT,P,, f tC° 8801 1��111�a►_.. PERMIT NO. SW040334 PACE 3 OF 3 Municipatit of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 •Anchorage, Atasko 99519-6650 • Tetephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 8, BLOCK 8, POLLOCK HOMESTEAD P.I.D. N0. 017-112-40 C01=97.6' CO2=95.6' FINAL GRADE- 001 RADE 2" INSULATION C01=93.1' SR CO2=93.3' N. T. S. MT1=86.8' MT2=87.0, r c \j., ..........lS,y WATER FOUND @ 82.8' 78.3 B.O.H. "„ ROBERT c COWAN CE -88 I A C FCO 19.5 — — ST1 19.5 — 17.0 ST2 21.5 — 21.5 DBL1 24.0 — 25.5 DBL2 25.0 — 27.5 DV 25.5 — 28.0 CO1 — 27.5 18.0 MT1 — 27.5 19.0 CO2 — 14.5 53.0 MT2 — 14.0 39.0 C01=97.6' CO2=95.6' FINAL GRADE- 001 RADE 2" INSULATION C01=93.1' SR CO2=93.3' N. T. S. MT1=86.8' MT2=87.0, r c \j., ..........lS,y WATER FOUND @ 82.8' 78.3 B.O.H. "„ ROBERT c COWAN CE -88 I Pannone Engineering ServiceS LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steveppanengak.com 14 July 2020 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. 0. Box 196650 Anchorage, Alaska 99519 Subject: Pollock Homestead BB L8 15310 Pollock Drive Well and Septic Permit Comments Permit Number: SW040334 Ladies and Gentlemen: On 02FEB2005 comments from the On -Site Water and Wastewater Program were issued in response to an On -Site Sewer/Well Submittal. The comments have been addressed as follows: 1. Field appears to be located less than 35 feet from a slope greater than 25% The drain field meets the current code perAMC 15.65.060, that the top of the drain field is lowerin elevation than the toe of slope" The drain field was installed 1 foot below original grade and 1.5 feet of fill was added over the field. See attached profile drawing. Please contact me if you have any comments or concerns. Sind Steven R. Pannone, P.E. Owner/Civil Engineer Anch-Porage Mailing: P.O. Box .100217, Anchorage, /AI<. {'?_ l0-02;. 7 Pain•Ier Mailing: P. -C). Box 1807, Palmier, A :. 990''5 i elephon,e: `9 J7) 77_,-8100 i A>;: %' 07 15_g2i?1. e D mO� (n a W N "' o d N v Q, Cil a W N "' M ! 1-- 3 = C\t x7 S rl ri o m II I N Z7 c c z 0 1. D --i m O rTl m co ID ro � 1 01l F r cn w Z_ ul oom mvz cm> 7D goy o� �( m� �o D Z n v i_ D M o r - M.6; <o� t Sao a% ozo z -n m S z�_ O m m o p m _ D o = r- � � O o �. D O M NOTES: PANNONE ENG SVC, LLC (C.1. 1088) P.O. 80X 1807 PALMER, AK 99645 REVISIONS DATE 7/12/2020 FOR MOA REVIEW ONLY PHONE (907) 745-8200 FAX (907) 745-8201 SCALE POLLOCK HOMESTEAD BB L8 ROBERT BUNDY 15310 POLLOCK DRIVE 1' = 5' P.I.D. NO 017-112-40 DRAWN MJL PERMIT NO. xxxxx SITE PLAN ANCHORAGE, AK 99516 �SHUE f 1 NOTES: PANNONE EPG SVC LLC C.I. 1088) P.O. 50X 1807 PALMER, AK 99646 ""`.,, :PSE OF, A(qS, ^_��.. f9 h, `-.s o none ' ce-87f9 �= %s, .. �= „ess; -I- DATE 8/12/2020 v u m m 8- E u N 3_ 1 SCALE P.I.D. NO 017-112-40 DRAWN ACP C3.1 PERMIT NO. OSPXXXXXX SHEET 2 OF 3 � Sys f a I Zo z i 2p�J o y� z F/ / O I O / z z O / O0 n m rn / i 111 j I / I I I I 1 ;1 ; 1 I 1 1 1 I l l i 1 1 1 1 1 1 I I I 1 1 1 1 1 1 I I 1 I 1 I I 1 ; 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 NOTES: PANNONE EPG SVC LLC C.I. 1088) P.O. 50X 1807 PALMER, AK 99646 ""`.,, :PSE OF, A(qS, ^_��.. f9 h, `-.s o none ' ce-87f9 �= %s, .. �= „ess; REVISIONS DATE 8/12/2020 FORMOA USE ONLY PHONE 907) 745-82.00 FAX (907) 8201 POLLOCK HOMESTEAD BB L8 ROBERT & JERRIAN BUNDY 15310 POLLOCK DRIVE"' ANCHORAGE, AK 99516^ SCALE P.I.D. NO 017-112-40 DRAWN ACP C3.1 PERMIT NO. OSPXXXXXX SHEET 2 OF 3 NOTES: PANNONE ENG SVC LLC (C.i. 1088) ++++ REVISIONS DATE FOR MOA USE ONLY P.O. BOX 1807 PALPIER, AK 99645 �E OF A(q'h, 8/12/2020 PHONE (907) 745-8200 FAX (907) 745-8201 _=��P ~•S�9', scnEE 30, POLLOCK HOMESTEAD BB L8 4.. .....; P.I.D. NO ......,a'_. 017-112-40 oRnwN _ ACP ROBERT & JERRIAN BUNDY .. St— a. P�.�,M : PERMIT NO. 15310 POLLOCK DRIVE /�. CE -8149 (p_ OSPXXXXXX C3.2 ANCHORAGE, AK 99516 ?_ SHEET 3 OF 3 MUNICIPALITY OF ANCHORAGE Development Services Department ��� Onsite Wafer d Wastewater Program 4700 South Bragaw Street \ P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Aug 11, 2004 Expiration Date: Aug 11, 2005 Permit Number: SW040334 Parcel ID: 017-112-40 Legal Description:CPOLLOCK HOMESTEAD BLK:_B LT.: 87 Design Engineer: 0003 S & S Engineering Site Address: 015310 POLLOCK DR Owner Name: JERRY & BOB BUNDY Lot Size: 26808 SQ. FT. Owner Address: 15310 POLLOCK DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516.4908 This permit is for the construction of: 0 Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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 DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. Issued -; �/4:� 4 Date: � /11/0 y Date: S 1, Municipality of Anchorage • '� Development Services Department Building Safety Division On -Site Water and Wastewater Program ' 4700 South Bragaw St. S. C" P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage. a k.us (907)343.7904 T, ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 / 7 — /1 a —'10 Permit Number SW Property owners) r TCA/Ly 4- 13o/3 6v N D y Day phone Mailing address (1) /sSa.;L vtl.oc#C DifryC (�Lk *taffinTaddress (2) la+l44Arne7+-6 4C 1550 0 4,le Zip Code _ 9/ 4/ S/ b Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size ^'r 1(SI gob Acre Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only El and Well 11 Water Storage ElSewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi El Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above Information is correct. I further certify that this application is being made for a Single Family Dwelling and Is in accordance with applicable Municipal Codes. 1A / S & S ENGINEERING 7. (Signature of property owner or authorized agent) Permit Fees: _ I q60. a o Waiver Fees: Date of Payment: 7 / 19 /of Date of Payment: Receipt Number: 05.5 4SL Receipt Number: (Rev. 12/oo) 17034 Eagle River Loop Road No. 204 S& July 16, 2004 ROBERT C. COWAN, P.E. CIVILENGINEERS (907)694-2979 FAX(907)694-1211 IHEALTNALITHORTn MUNICIPALITY OF ANC1fORAGE APPROVALS Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWER& WATER LIANDDEISIOLB REFERENCE: Lot 8, Block B, Pollock Subdivision SEWER&WATER It is requested that you issue a permit to install a septic system upgrade to serve the INSPECTION existing three bedroom dwelling on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of DOWERINGSTLUIES the test hole is located on the attached site plan. At the time of excavation 2/3/92, water ANOREPORTS was found at 14 feet. Atter monitoring, ground water was found at 11.5 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WELLNSPECTION areas br drainage patterns by the installation of the proposed septic system. The t FWW TEST construction of this system will not prevent any future development on any of the adjacent properties. SITEPUAS If you require additional information, please contact us. Sincerely, ROAD DESIGN Robert C. Cowan, P.E. SOI TEST RCC/bjj . Enclosure PERCOLATION TEST &TRUCTURAL& - ►IECNNaCAL INSPECTIONS ONSITE WASTEWATER DtS OSALSYSTEA1 DESIGN 17034 NGRTH EAGLE RNER LOOP • surrE 204 -EAGLE RIVER, ALASKA 99577 2 a J CL I W I -- TA LOT 8. BLOCK I3. POLLOCK S B.J.J. I R.C.C. 1 8-10-04 1 1 OF 2 Irring DESIGN CRITERIA: - 3 BDRM = 450 GPD SOILS = 0.8 GPD/SO.FT. 450/0.8 = 563 SO.FT. REO'D. 17034 EAGLE RIVER LOOP ROAD DRAINFIELD CRITERIA: 7.5' DEEP (SEE NOTE) 6.5' EFFECTIVE 3.0' WIDE 44' LONG LOT 7 NOTE: 7.5' DEPTH IS FROM ORIGINAL GRADE UNDER FILL Z _ 100' WELL RADIUS ED 10' UFIE; f jr �fq SE,M fNT ---- -- PoLLo 0 0 r� 11 LOT 4 ALL PORTIONS OF SYSTEM WITH LESS THAN 75' OF COVER REQUIRE INSULATION. CONTRACTOR IS REOUIRED TO OBTAIN UTILITY LOCATES PRIOR TO ANY EXCAVATION WORK. GREENPOINT AVENUE 10' UTILITY EASEMENT '-INSTALL DIVERTER VALVE LOT 9 A ROURT,CCCOWANu CEi88011 , LOT 3 rY (M1C+.Irf u.. WR.' M1r I..C. 'l✓v50M15 M1M1J 011G nw✓TH r0 Hn rq vf .ncrsv.... n <aarorz I I Jy I I� I c c: xi Im ID Im 04, I m M1QJ I1 f� Q �% 114 ` V 'r . I '-INSTALL DIVERTER VALVE LOT 9 A ROURT,CCCOWANu CEi88011 , LOT 3 rY (M1C+.Irf u.. WR.' M1r I..C. 'l✓v50M15 M1M1J 011G nw✓TH r0 Hn rq vf .ncrsv.... n <aarorz LOT 8, BLOCK 13. Y't.wN aw :NECKED W B.J.J. R.C.0 DESIGN CRITERIA: 3 BDRM = 450 GPD SOILS = 0.8 GPD/SQ.FT. 450/0.8 = 563 SQ.FT. REQ'D. 17034 EAGLE RIVER LOOP ROAD EAGLE RIVER. ALASKA 99577 PHONE/ (907)694-3979 FAX/ (907)694-1711 DRAINFIELD CRITERIA: 7.5' DEEP (SEE NOTE) 6.5' EFFECTIVE 3.0' WIDE 44' LONG 0 a z 0 FA w 0 N H a Z r 2' POLLOCK S D }..E 8-10-04 35' 2 OF 2 ii Y...__. .......... ROBERT C. COWAN CE -8801 r, 4 d J�J +:Tlginarring 17034 EAGLE RIVER LOOP ROAD EAGLE RIVER. ALASKA 99577 PHONE/ (907)694-2979 FAX/ (907)694-1211 DRAINFIELD LO'C 8, BLOCK I3, POLLOCK S D Hawn tlr. nLC.LU tl. JArL. S..f FI: B.J.J. R.C.C. 7-16-04 1 OF 1 T CONTRACTOR IS REQUIRED TO DESIGN CRITERIA. OBTAIN UTILITY LOCATES 3 BDRM = 450 GPD PRIOR TO ANY EXCAVATION SOILS = 0.8 GPD/SO.FT. WORK' 450/0.8 = 563 SOFT. REO'D./GREENPOINT AVENUE 10. UTILITY EASEMENT - — — — — — — — — — — — — — — — ------------ CRITERIA: ?�T OF ^f LI � r�l'�•••w•••�'•.�rl-� _ (� do lO6ERT G COWAN �E-8801,���; f"'c�....... ",t, 7.5' DEEP (SEE NOTE) to 6.5' EFFECTIVE J 3.0' WIDE a 44 LONG ayc v � N I D LOT 7 a� I m t �o. 0 oq s� I m IZ Of, NOTE: 7.5' DEPTH IS Io• MT t FROM ORIGINAL GRADE C UNDER FILL PROPOSED TR H I fHC 100' WELL RADIUS 11 H CO I Z N10' _ I LOT 3 " UTILITY ,� w� - x� LJ FASF� ya00 p fNl 1'0 LLo0 7 ---- -__ FCD \ o ` <^f DOUBLE \• CLEANOUT EXISTING 1000 GALLON SEPTIC TANK (TO BE VERIFIED AND REPLACED IF NECESSARY) I V 2 N CO O \ �c+tRE 2i INSTALL DIVERTER VALVE `T 11 Q MT, LOT 9 LOT 4 ALL PORTIONS OF SYSTEM ■IT11 LESS THAN 35' OF \ A O, Y £ I I rV Irurte .u. van .K pv' S•^`°'4i5 ""' xu" wr•.*s"� ao. •.cr.m o .KFr vrt COVER REQUIRE INSULATION N f I cxrwvn ,. Municipality of Anchorage DEPARTMENT OF HEALTH Q HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 1 /9'L � kL11 N� "e1r- DATE LEGAL 18 �� • Io"� �9Iti 20 ROGEN•J. COMMENTS is SLOPE WAS GROUND WATER ENCOUNTERED? l IF VES, AT WHAT 1�1. DEPTH? 1 1 1l.r7F rr-II Depth b Water After Monitoring? _1_Dale:7_Ic Section: Reading Data Time Time Water Depth Not Drop 1 a 2- v' ,57 3 3- .. 4 4 _ a,•.a� 5 �'It'1�(� 6 , 7 :J 8- 9 9- 10- 11 11 ,67.r 12- 2 13 13- 14- 1a 15 15- 16 16 18 �� • Io"� �9Iti 20 ROGEN•J. COMMENTS is SLOPE WAS GROUND WATER ENCOUNTERED? l IF VES, AT WHAT 1�1. DEPTH? 1 1 1l.r7F rr-II Depth b Water After Monitoring? _1_Dale:7_Ic Section: Reading Data Time Time Water Depth Not Drop �' -%. L&7! v' ,57 twc .. _ tk Z9 h PERCOLATION SATE -ELL (minutesnnch) PERC HOLE DIAMETER TEST RUN BETWEEN G FT AND -4—FT PERFORMED BY: Eagle River, Alaska 99i77 PERFORMED n nlil I I,RTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �� �1 C- /" N'e Iri .1 n5t ROBERT C. COWAN. P.E. CML ENGINEERS (907)694-2979 ON-SITE WASTEWATER DISPOSAL SYSTEM FAX (907)694-1211 CONSTRUCTION PRACTICES and HEALTMAN,TN�,r MATERIAL SPECIFICATIONS APPTN N S REFERENCE: Lot 8, Block B, Pollock Subdivision SEWERS WATER July 16, 2004 SWNEXTENSIONS GENERAL: SEWERSWATER 1. The scope of this project includes the verification of the existing 1000 gallon INSPECTION septic tank, replacement with a new 1000 gallon septic tank if required, and installation of a new trench to serve the existing three bedroom residence located on the referenced property. ENGIWERNGSTWIES ANOREP'ORTS 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. WELL INSPECTION FLOW TOT 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITE PLANS 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 certified by the ROAD DESIGN Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SCS TEST SEPTIC TANK INSTALLATION: TRTouraN I. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2• The septic tank shall be sufficiently bedded to prevent settling or shifting of STRI YLPAa MECRAPKA. INSPECTIONS the tank. ON SITE WASTEWATER DISPOMSISTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER ALASKA 99577 Page 2 Lot 8, Block B, Pollock Subdivision July 18, 2004 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCII/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls 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 backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 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. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 8, Block 0, Pollock Subdivision July 18, 2004 MINIMUM MATERIAL SPECIFICATIONS: I. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pine 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 nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 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, which ever requirement applies. 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 4 Lot 8, Block B, Pollock Subdivision July 16, 2004 The first inspection must be conducted atter 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 backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at 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 o { M Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: S&S ENGINEERING t� Legal description: POLLOCK BLOCK B LOT 8 The attached paperwork has been reviewed and Is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. _ ❑ Additional soils information needed. y❑ Water monitoring results inadequate. i ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. _ ti ❑ Incomplete; missing o ❑ Incomplete; missing V ❑ Additional adequacy test information needed. 3 ❑ Water sample unacceptable. ❑ Measured/proposed distances/dimensions missing. _ ❑ Locations of all soils, percolation and water monitoring tests not shown. �, ❑ Proposed system too deep for soils information submitted. ❑ Well log required. U- ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ �.El Other. SITE PLAN SHOWS PROPOSED TRENCH IS TOO CLOSE TO THE TOP OF CUT BANK. TRENCH NEEDS TO MAINTAIN 50 FOOT SETBACK FROM SLOPE GREATER THAN 25%. OR 35 FOOT HORIZONTAL SEPARATION USING INSTRUCTIONS ON ATTACHED MEMO DATED APRIL 7, 2004 Name of reviewer. JOE GOODALL Date: 7/26/2004 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK t c Y` - y , 1 �,,�1✓ `"�w:.4 ...�,�iy' 5��� '�7 1 u.00 s r L Y C 1:.{ Y n t i• O/ n� V d•b 3 \� Y:TCLL— q` apv'scAsr� a� ' ( G Addiii n i 7 a i ire. 1 1 r • � � ten. • � • .� r \ '� ago ♦ d°1A C r•w1 aqW\ 't, y tease teen 16000 u • loot ISOM C s 's•34 *120 � is," • u • O Okra, u +`. 1... 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Alaska 99519 68 50 TMs map m•y M onn.ts4 L,o nor ,s end his ane imwnam W ,,,ki on yo not r•ty on this August 28, 2004 notb.Ubl.TMMs,tsadsingfrrn*.saewia .W 23 rote•r.cie orfew losws uisintfrom•mors, Y,saauneMs a omissions ti the msp Anchorage Area Atlas reference number: 364 Municipality of Anchorage Page of S DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Pox 196650 • Anchorage, Alaska 99519-6650 e Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: c l ),I) l, 6 1 PID Number: _ n 1 7� 11 a.4© Name: Wastewater System: )<New ❑ Upgrade QLA IST Address: 99516 ABSORPTION FIELD i3 � Phone: �>`1I, No. of Bedrooms: Deep Trench 11 Shallow Trench ❑Bed O Mound ❑Other LEGAL DESCRIPTION Soil Rating: D r GPD/Sq. Ft. Total Depth from origin grade: _v Lot: Block: S division: 8 P:,> ID Depth to pipe bottom from o'ginal grade: Z,- Gravel depth beneath pipe Ft. _ �� Ft. _ Township: Range: v I Section: _ Fill added above original grader -AtS Gravel length: I — Ft. S Ft. _ WELL: ' "` El New El Upgrade Gravel WKH ^2� /I Ni of lines: 1 Distance bee/(ween lines: N/R �;�; •.10 # Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: / ✓ Pipe material: SOLLD - AS7M Ft. Ft. 0 SQ. Fl. PERE FBIO _ Driller: Date Drilled: Static Water Level: Installer: �XC(auwrlNG Date installed: -1i"9a Ft. n�A�'� Yield: _ Pump Set at: I Casing Height Above Ground: TANK GPM Ft. a SEPARATION DISTANCES i' Septic ❑ Holding ❑ S.T.E.P. TO Septic Absorption Lift Holding Public/Private Manufacturer: i Capacity in gallons: 000 From Tank Field Station Tank Sewer Lines ric-14, 1 pdV K Well/ N/A N/A AS `� Number of Compartments: SurfaceLIFT Water I00t+ 10014 N A STATION Lot r / Size in gallons: cturer: Line 10 Foundation r .'Pump on" level at: ..p oft, lev High water alarm at: Curtain oNE MoNr? Pump Ma odel I Electrical Inspections performed by: Drain t f ,}1�ZuL.F_D As oFgf2a�9z BENCH MARK Remarks: a7• _ Location and Description: ! iP OF GAR Ad OM A"it P (L fcdA s Assumed Elevation: ENC;I�S®AL r)� OF 44 00 S Inspections performed by: � ►Jrri mEELAIcDates: 1st z fle ^a9®eef irft a�a D � � 9G 96 D[ 2nd _Ib_ o �u®aoem®o env °oQ �o —2 f10t E'1 J. HAFER No 8.16 Department of Health and Human Services approval �NF�.fl .veeq�c� by: ��� h Date: ��— es000fl0 9��"ROPES Reviewed and approved ti _ i 72-013 (1/91) MOA 25 Permit No. �"" C) I � I Page C)" of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ® Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report QLK L� Legal Description: CST S n [�OLLUcIC SCca��, PID No.: d «l l X4'D _ Cl . I I . I / _T Gc STAND PIFEr, HSE CoRNF2S Vp A Q3 col 19, IT, coz al' ;w cos ass ass COLJ a5 has Cos, a65 y15 M"f 39 � 68 STSe kFFCH C06 72-013 A (2/81) MOA 25 Simi(_ As- i I>u 111,40 QRUR15cA WEL[_ �II I hal_l_ocl< SUa�. D �Vo m`ry I �� n0eae08a6 ®�0,0 'U HAH 15 / ) ngp80 % . tvauno Permit No. S�9Zal (.� 1 Page 5 —of 3 Municipality of Anchorage 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 BLL g A Legal Description: Lc:)7 8 EOL-LOGiL �fAJID' PID No.: 011 1.),4-0 Tv TRE -NCH ail � �� �IL'(ER FRORIC 72-013 A (2/01) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW920161 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HULTQUIST DAVE OWNER ADDRESS:11741 BARR RD. ANCHORAGE, AK 99516 PARCEL ID:01711240 :LEGAL DESCRIPTION: POLLOCK SLK B LT 8 .LOT SIZE: 26808 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 PAGE 1 OF 1 DATE ]ISSUED: 6/30/92 EXPIRATION DATE: 6/30/93 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / WELL 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: /-i// �c ��r�12�/ OGS/- �� S�i�� X67 RECEIVED BY: ISSUED BY: DATE: DATE: _. lid ecy00 June. 29, 1992 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVILENGINEERS (907)6942979 FAX 694-1211 HEALTH AUTHORITY APPROVALS p I 'j �j Munticc.patity o4 Anchmage. ,IUPJ 3 O IJ3P DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTN: Dan Botta Ibiunirjr, :i,;, ,i rlilc!I;fu�3 DOW. Hca ih 8, hh;mcii Services 825 LL Stke.e.t SEWER &WATER P.O. Box. 196650!_ MAIN EXTENSIONS Anchorage, Alaska 99519-6650 REFERENCE: Lot 8; B.-ock. B; Pottock Homestead Subdivision; SEWER & WATER INSPECTION Dean Dan, Pen ouh site visit and numerous telephone conveAzati.ona on .the ne4exenced pkopexty we have pm6mmed additional sow te.htGi.ng on the ENGINEERING STUDIES ne4eAenced pupehty. AND REPORTS Attached pteaae 4ind a tev,ised de,6ign Uon your 7Leview. The new design change,s the proposed wW location to the non.th oU the pnopen.ty allowing the. h,igheA ground and mohe peAmeable soils to be uti.Uzed on WELL INSPECTION the south o{) the pnope&ty. 8 FLOW TEST I{ you have any quations of 4equ.i.fLe addition, .in{onmation 4o& your n.ev.Cew ptease contact u3. SITE PLANS S.incenely, ROAD DESIGN ROGER J. SHAFER,'P.E. RJS/gm SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204. EAGLE RIVER, ALASKA 99577 SCALE V J I Ws -L -L 'F-.6n7L J S I A� L2 �I Pl &' 9 p A ���J� eg ��o o� � c m D 2 r V' K� 1� n n 7-- I N II a A� L2 �I Pl &' 9 p A ���J� eg ��o o� Municipality of Anchorage 4 DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR.'I ) VC-`�J�`� 1 DATE LEGAL DESCRIPTION: DEPTH 2 O(( 3 ✓j/� O 4 d 5 � ' 6 Or 7 '. 8 10 11 ip 12 p v 13 14 15 /jrjj�7 16 17 IE Me 0 4�4 -6,1f Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? s L O P E Depth to WaterAll Monitoring? .. Date: SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop q 5e � e �I S S 0 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN RRUppN BBE�ETTWEEN 11--F`TAND � FT COMMENTS !'�� ` ` 1 `� 't"'�✓``. W W GK�� ✓''�"• ' ' - 1-�1 - PERFORMED BY: S & S ENGINEERING I CERI IFY THAT THIS TEST WAS PERFORMED IN 17034 Sa le River Loo) Road No. 2� ACCORDANCE WITHrFtI-Li�S' � I q,4t,V� 1�Ih§�JGUIDELIN IN EFFECT O THIS DATE, DATE: 72-008(Rev.4/85) �_�J� Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOC — PERCOLATION TEST PERFORMED FORtVL-C��� DATE P LEGAL DESCRIPTION: L0-4 �1n rlFr]iQ� Range, Section: SLOPE SITE PLAN DEPTH (FEET 1 ^ r r r � 2 e SAn — 3 Ml. - C l A^t LA yEn 5 ::SM I L1 ML - 6 7 C>CNSF CoUaR , 9• 10 11 12 13 14- 15 4-15 / 16 I 17 18 19 20 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L 0 DEPTH? P E Depth to Water After GI Monitoring? 1 Dale: Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER n��"�J� 11 TEST RUN BETWEEN FT AND — FT COMMENTS I�— �t�47A SaPpW(., ({✓7U 7(-% 71bQ0UG(.L (U6"ZoV6 & Lo-7oAA oi' (-fwrz 6-C- FfZWA - -Iv -(,Kr aEw (nx. cn y 17i -",Sr MRR(rirJA'L(--y TN,pEl1mA4Lrz- , PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN S & S ENGINEERINUlo_2g—�y ACCORDANCE WITH EFFECT ON THIS DATE. DATE: ll 72-008 (Rev. 4/85) Eagle River, Alaska 99577 SCALE m y� m 9 T� 9 �l :u m D L) :E D z r 1 � n N r r O i o 0 0 �r O m x O \h n CIO, 0 oa 3� P CSE I(IVEH, PI PS HEALTH AUTHORITY APPROVALS May 14, 1992 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 1825L Street SEWER&WATER Anchorage, AK 995196650 MAIN EXTENSIONS ROBERT SHAFER, P.E ROGER SHAFER. P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 REFERENCE: Pollock Homestead Subdivision, Block B, Lot 8 SEWER & WATER INSPECTION We request you issue a permit to drill a well and install a septic system to serve the proposed 3 bedroom house on the referenced property. ENGINEERING STUDIES AND REPORTS A test hole was performed on the property on February 3, 1992. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the hole was checked on February 10, 1992 and water was at 141. The WELL INSPECTION monitoringtube was checked again on May 11 1992 and water 8 FLOW TEST g Y � � was at 11.51. This property has enough area for future septic upgrades, which can be seen on the attached site plan. We do not SITE PLANS anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information ROADDESIGN for your review, please contact us. Sincerely, so1LTEsr :er,.P.E. � Roger J. Sh f PERCOLATION TEST RJS/lsu STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 n = s0 - SCALE rn �k 2 i 0) Ncmm� rn f rq r Z c)� �m - 100' WELL RADIUS m(noa '"� zany g oily ao 00 � m — C / o r 100' WELL. RADIUS / ✓ �o n�AIN r9 C-% fl4 �/ vp v9P�gd940f `9$�Slr7 0 7J 33 z r- m O (c1) r, 4. n 4 O 03 °co 4 nnT c i - O O N n G) I o o m o Plo D O ul rTl O rTi rt,m ro C Cr) �n� Z y rC � o m C o u w � N r �O z n�AIN r9 C-% fl4 �/ vp v9P�gd940f `9$�Slr7 'lip Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 s ` SOILS LOG — PERCOLATION TEST1.0 PERFORMED FOR: _-����\� DATE PERFORNI1t'L�.,- LEGAL DESCRIPTION: � Ij EEPTH WE EATS- CCK" 1 18- 19- 20- COMMENTS 819 20COMMENTS _ eo,�saaa % J. 'MAI No, 8.15 ownship, Range, Section: SLOPE WAS GROUND WATER �, r ENCOUNTERED? t S IF YES, AT WHAT1(`, L DEPTH? ll P Deplh to Waler Aller I�QQ Moniloring9 Dale: SITE PLAN Reading PERCOLATION L ., Net Time 2 Net Drop 3 ' 4 t14 v 5 (2. 4 6-1 l,� "qo% r'e 6 7 ` 8 1 9 k - 4 - 714 - 11 12 13 !r t' 14 5 15- 16-- 16 17 17 c �e 18- 19- 20- COMMENTS 819 20COMMENTS _ eo,�saaa % J. 'MAI No, 8.15 ownship, Range, Section: SLOPE WAS GROUND WATER �, r ENCOUNTERED? t S IF YES, AT WHAT1(`, L DEPTH? ll P Deplh to Waler Aller I�QQ Moniloring9 Dale: SITE PLAN Reading PERCOLATION Date Gross Time Net Time Depth to Water Net Drop t14 v 1 4 l,� "qo% r'e 6 ` 1 k - 4 - 714 - PERCOLATION RATE � %' � (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 4—FT 17034 Eagle River Loop Road No�u Eagle River, Alaska 99577 PERFORMED \�/ PERFORMED BY: I /RTIFY THAT THUS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: �� 1 D 72-008 (Rev. 4/85) u = 30' SCALE 1 100' WELL .pUiO�'Ir �m°m Q Cn O II o O m 4z, v m Ci SO. H \n a� YO o�oo 0 y C3 00 m. / o =LL RADIUS �!OP ✓ d i latizirom tI i V r Orp (!) z r O 00 QD - (� II 91 O C I I o v Co m L O (10 C ��� rn O r moZ �� c� 00 Z NN O `e � O k S y y 71 co N SCALE r �m c I � I j � N CD n ° SCALE '6J , - -1 6r, 16 A//(/� NIMPAUTY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approva Parcel I.D. 017-112-40 1. GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: V—/I-Zr%Z_0 Pollock Homestead Block B Lot 8 15310 Pollock Drive Current property owner(s) Robert & Jerrian Bundy Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic E Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J1 a� 5 ��� 16 Waiver Fee $ W1 1 CJ(co V as- 1 Date of Payment �I y/,)— , Date of Payment o Receipt Number 0 L 7-3q6 Receipt Number C 2 3 g G COSA # 0 S C 0 ,, 4 dSS Waiver # 05 v a ©I v y 5 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MCA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date zF>CG` 6. DSD SIGNATURE 49 H System #1 Approved for bedrooms S'tev'en 'R. Pan ione'� CE 8149 System #2 Approved for bedrooms�cs; Disapproved t Q��, IOFESS 'k"'��� Conditional approval for bedrooms, with the following stipulations: rr ON-SITE --o W p m= 'qST=VIr OORA o Original Certificate Date:— 17 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory Arsenic A visory Other V r Legal Description: Pollock Homestead BB L8 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑® Well log is filed with Onsite (or attached) Date drilled Qf2°"f Total depth 205 ft Cased to 85 ft © Sanitary seal is functioning correctly A Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 6/25/20 Static water level at beginning of test 30.4 ft. Comments B. TANK DATA Age of tank(s) 28 years Tank type/material Measured operating fluid level in septic tank © Standpipes/foundation cleanout per record drawing Date of pumping 9/18/19 D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) /16192 0 ALL standpipes present per record drawing Total measured depth from grade 10.4 ft (max) Measured depth to pipe invert from grade 4.2 ft (min) ❑ N/A — pressurized field © Monitor tubes go to bottom of effective. If not, state depth into effective X Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 017-112-40 Structure served by this system 1 Well production at time of test 3.93 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑✓ No © Coliform bacteria is Negative Nitrate mg/L FEI Nitrate less than MRL (ND) Arsenic ug/L FE -91 Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 7/22/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 6/25/20 Results [D Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 466 gal New depth 10 in Elapsed time 30 min Final fluid depth 0 in Absorption rate '450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date No E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No 6 Community Sewer Manhole/Cleanout > 100' [✓ Yes if No ft 7 Yes if No fl Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' [D Yes if No f1 Absorption Field on Lot > 100' F71 Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Water Main > 10'✓0 if No Animal Containment > 50' ✓� Yes if No ft ✓❑ Yes if No ft Water Service Line > 10' ✓0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' (�✓ Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 6 ft . Surface Water > 100' Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' Absorption Field > 5' Yes Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10'✓0 if No Yes if No ft Community Wells > 200' [71 Yes if No ft Water Service Line > 10' ✓0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' F-1 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' F71 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 2F. --Jg _ COSA Checklist yellow sheet 49 ili Septic Wank Advisory Certificate of On -Site Systems Approval #OSC 201408 Subdivision: Pollock Homestead Block B lot 8 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 28 years old. Typical replacement costs range from $8,000 to $11,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 -year-old steel tank MAY look like. Ma�hng AddressP O Box 196650*Anchorage, Alaska 99519 6650 *www mum org . H.a� SCALE: 1 "= 40' Lot 7 Sd, � Drivewayencroaches�/� dec GREENPOINT AVENUE 7325A 0 N89050'45,E 710 53.74 Utility Easement Well I I I I I� Iv LOT 8 I w 2.0 OH \C� ninQ cj c9 \2S�e o B"' ­Septic vent (typ) � p F�ouse / r '0 °k 2 O `�0 so ° ° �c6p) 25 0 o Q I o ° *� N6°v Lot 9 �Ax�� of •��qs�Q G? 49th :7 �e 00 E Elizabeth L. Walatka . P s0 sTF • , 8036 - LS . • �e�� EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. UNLESS OTHERWISE NOTED FB 20-5, pg 16-17 BE 0 co 00 0 00 Lot 3A W 0 to 0 0 U) AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's Inspection in accordance with ASPLS Standards of the following described property: LOT 8, BLOCK B, POLLOCK HOMESTEAD SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 12th day of AUGUST ,2020. FRED WALATKA & ASSOCIATES, L.L.C. ^^^ Engineers and Surveyors I his drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the nrpnarar is limitr.ri in thr: mmni int of faac rnllortorl fnr coniirae in nranamfinn of ihie nrnrh-t MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES M}� Division of Environmental Services 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. # l / ����— ��� HAA # 1. GENERAL INFORMATION Complete legal description Lot 8; Block "B"; Pollock Homestead Location (site address or directions) 15310 Pollock Drive Property owner Day phone 345-3493 Mailing address 15225 Pollock Drive, Anchorage, Alaska 99516 Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well xx Community well Public water Day phone Day phone 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 XX 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 421 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 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 furtherverify 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 5 A g ENGINEERING Phone 17034 Eagle River Loop Road No. 204 Address '1,1 ; Engineer's signature 6. DHHS SIGNATURE Approved for ✓`' bedrooms. Disapproved. Conditional approval for Additional Comments UJITln Date I L � q2-� Gr '� d9sE � 'Fsovweaa0 edo.._`/l�i � e Y a siwewwua6n'A NOlOb 1vb ROGE`9 J. 4HAFER No. 32 5 •*saewago, Ny ?R0FES510�` bedrooms, with the following stipulations: Date l�/� 742 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 ti91) Back N10A 1121 Municipality of Anchorage1 Department of Health & Human Services] HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L a:1 8, W)(g�_Poc.C-n(,(r, SI/D Parcel I.D. e!� /7`ll/2` (6 A. WELL DATA Well type I K\U+7F If A, B, or C, attach ADEC letter. ADEC water system number Log present (SIN) Date completed /0-a&-92 Driller fZ ��Z)c �in1G Total depth Cased to Sr Casing height )a t r Sanitary seal &N) 11,C.5 Wires properly protected YON) %F_S FROM WELL LOG AT INSPECTION n� Date of test M – AiR_92 a, c 6C, ti' y Static water level Well flow 6.o g.p.m. VI a 9.p -m- o < Pump level �)C v < i r`d ;� Z n 0 SEPARATION DISTANCES FROM WELL TO: G� Septic/holding tank on lot d 'F ; On adjacent lots Absorption field on lot rS�� On adjacent lots �`� Public sewer main anhole/cleanout Public sewer manhole/cleanout— Sewer service line Sewer oZ5 Petroleum tank owfj WATER SAMPLE RESULTS: 4N 0 Coliform Nitrate Other bacteria Date of sample: 1 – 1 �__? L Collected by: k–NGuv�r-zlNG _ S. SEPTIC/"0L-DtNFG TANK DATA Date installed , -I(1',- 9 2-- Tank size IN 6,i� Compartments Cleanouts &N) TWO _ Foundation cleanout (&N) ES Depression (Y/® No High water alarm (Y/'6 Alarm tested (Y/'o W/ ` Date of pumping P -'A – �EW (ANK Pumper A) — I v�_::W 141,)k _ SEPARATION DISTANCES FROM SEPTIC/HOEiN-r, G TANK TO: Well(s) on lot�On adjacent lots Foundation 5 r r To property line ri Absorption field 13 Water main/service line Surface water/drainage _ /00 /t /4 � 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION,/ Date installed Size in gallons Vent (Y/N) "Pump o High water alarm level Meets MOA electrical codes (Y/N)) SEPARATION DIST Well on I Manufacturer Manhole/Act (Y/N) at "Pump off' level at Cycles tested FROM LIFT STATION TO: D. ABSORPTION FIELD DATA On adjacent lots Surface water Date installed 3 Cl2 Soil rating , GPp�SF System type i EP R5 -X I-+ Length SR Width 1Q C;, 37 9 Gravel thickness Tolt/al depth 1� Total absorption area 7 SF Cleanouts present ON) k n 1 Depression over field (Y/Q�J.}� no Date of adequacy test �� — / UEw •S,, Results (pass/fail) 1y�fE — N&W SyS. for bedrooms Peroxide treatment (Past 12 months) (Y/&1 t "O If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: N/A Well on lot /86 4- On adjacent lots 166,1- Property line /0 1 To building foundation r To existing or abandoned system on lot N`A- On adjacent lots aS Cutbank NZA 1, Water main/service line 2S r , Surface water �� � Driveway, parking/vehicle storage area S Curtain drain / NF_ E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & S ENGINEERING Signature 17034 Eagle River loop Roar! No. 204 Eagle River, Alaska 99577 Engineer's Name Date HAA Fee $ r �� 1 Lv- �Z Date of Payment Receipt Number c �r ? ���� I �� 'D J 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number OF 14 _"t !49 sq ' �'es96"0469e 66 a 095950 055 e50 05690 > qOGE J. HAFER a �, m0 m" C9 ell0Qe0p•oee666°e® %is AOFESSIO��v