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HomeMy WebLinkAboutPROSPECT HEIGHTS #1 BLK 6 LT 4Prospect Heights #1 Block 6 Lot 4 #015-092-27 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page / of� www d.anchorage ak.us (90T)343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO80130 PID Number. 015-092.27 Name LASSIE SMITH Wastewater System: ❑ New ✓❑ Upgrade Assess 7945 PORT ORFORD ANCHORAGE, AK 99507 ABSORPTION FIELD p Nw ibr d Baboaha 770-2688 6 D Dara 7raraYt 0 Slriw. Trento O Baa Cl Mann ❑ Opter Snl Rama Taal Depen Iron spam grace LEGAL DESCRIPTION 1.2 Gpo,,e 7 Ft. alr Lao Depn to p" oonom nom rparl lyssa Gm deph barram papa PROSPECT HEIGHTS Mt 3 Ft. 4 Ft Townahp Rerge saagn Fe eased sows ongn 1pane Gruel Lapin 1-2 Fl. 41+40=81 TOTAL Ft. Well: ❑ New [I Upgrade Gruel wCm, N✓ lxx d InesDurance 2 pa+aen Yrs 15 5 F. Ft CYsututrn (Prnra, A 6. C) Total DWh CaW r ToMI nbsorptxn ane Ppe mwe ai EXISTING PRIVATE FL 810 Ft" ASTM D3034IF810 poly .xr SrrC W" LSNt npaaa Ow F'ataira FL PAUL INGRAM 8129/2008 Yr l Prop Sra c..naHa �,..tiwr TANK GPM Ft. t SEPARATION DISTANCES El Septic ❑ Holding ❑ S.T.E.P. 0Other: To Septic Absorption LAI Holding ublrJPnvate itlaw y From Tank Field Station Tank Sewer Line PREMIER PLASTICS 1300at00DGai Mann Nu w Of Canpawtwas was 144' 167 25't HDPE 2 EACH Sutr.wata 100'• 100'. LIFT STATION ae suww La Loa 111' 75' Gal 'Prop ori Hpnwata awm at Fanaatxn 9' 48' �.xr in n. PuneM E reonai InWemma pW1 r by CwnOran NONE KNOWN R°"' 'BENCH MARK EXISTING SEPTIC SYTEM WAS ABANDONED COMPLETELY. , Lmiti arr Dee V— ":;. AT — TOP OF GARAGE SLAB @ POINT'S' _ h mea Ewramn +oa. v - FL SSS Engineedng = > End aea;se Inspections performed by: 15861 S. Birchwood to RA. Dates: 1" 812912008 Chuglak, Alaska 99567 2nd a29n008 saFb4 ,� �,= •° t.ti. ''> Development Services Department Approval ` = -- • ' `:' •' Conditional Approval Date: y •� Reviewed and approvedbY. 1 'l�'t�1 Date: fie. Z—V PERMIT w0. SW080130 PACE _2._ OF 4 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET PhOnE ONBSITEERDISPOSAL SYSTEM 6WASTEWATIaska 6650 0 pAND/OR)WELL904 INSPECTION REPORT LEGAL LOT 4 BLOCK 6 PROSPECT HEIGHTS #1 P.ID. NO. 015-092-27 NEW 1000 GALLON HDPE SEPTIC TANK DBL1 OBL& & ADBL 2 TBM DBL4 EW 1300 SEPTIC TNKK'^ 2q� r m1 CO3 ST4 �• y_ T3 ♦ I J5T f 0 TH#31�om. �n!^A0 � TMT I m. i 10' MIN.Ji— C 2MT2 / \, ♦THd2 4� C0�4 �+eQO y4. b � -------------------- __________ L —--------- - — — — — — — ��\— — — — — — — — — 10' UTILITY EASEMENT /T ?PLAYHOUSE LOT 5A Z- PERMIT no. SWO80130 PAGE 3 OF 4 Municipality of Anchoraqe DEVELOPMENT SERVICES DEPTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET 196650 0 Anchor-09e, )DINSPECTION R4 0 E SITEWASTEWAERDISPOSAL SYSTEAND/ORWELLPORT LEGAL LOT 4, BLOCK 6 PROSPECT HEIGHTS #1 P.I.D. NO. 015-092-27 PORT ORFORD DRIVE I I I I I � w iw iNEN 1000 GALLON NDPC SEPnC 'ANN DOLT ! OIL: DOLS Y D`IN TO ! Q4 wNF MOIL C`SL�CAI.MN� C01 it T3 fO'C6C'y TN[NCNCS I VN/1 r -w1 03 I Ta i3 r �j TN/31yo1 i 1 I f 0 TMTJ O IYL.oI I I I Yii to WN G• i / 11-Y t5A p•DIUS 1- ---------------- 1o' unuT EASEME\CI;:CER STAMP wd sac, .r +rte.. •._ C:� v LOT :YY•:`` '•N;�:^"/ • % `C i asp: A. PERMIT NOSW080130 PAGE 4 OF 4 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT - BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM, 4700 BRAGAW STREET PONBSITE6WASTEWATER IDISPOSAL 6SYSTEM PAND/OR �904 9 E WELL INSPECTION REPORT LEGAL LOT 4 BLOCK 6 PROSPECT HEIGHTS #1 P.I.D. NO. 015-092-27 FINAL GRADE 1 ST2 ,-99.1' 2" INSULATION =95.6' NEW — 94.5' 1000 GALLON POLYETHYLENE 94.2' SEPTIC TANK CO1 CO3 h1T1 CO2 MT2 SAL 1=94.8' hM C04 F2=94.0' GRADE- GRADE--- Ili:: 11� 51 CO3=94.3" C04=93.9' 92.9' CO3=90.3' C04=90.2' C04 =90.2' �--h172=86.1' �� MT3=86.0' h1T4=85.9' h1T1=86.2' A 15' NATER FOUND © 79.4' � 77.9' B.O.H. ST3 ST4 FINAL GRADE NEW 94.5' 1300 GALLON POLYETHYLENE SEPTIC TANK 99.1' 2" INSULATION '-95.6' 94.2' MUNICIPALITY OF ANCHORAGE Development Services Department On -Silo Water 8 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: Jul 21, 2008 Expiration Date: Jul 21, 2009 Permit Number: SW080130 Parcel ID: 015-092-27 Legal Description: PROSPECT HEIGHTS #1 SUBDIVISION BLOCK 6 LOT 4 Design Engineer: 0003 S & S ENGINEERING Site Address: 7945 PORT ORFORD Owner Name: CASSIE SMITH Lot Size: 98825 SO. FT. Owner Address: 7945 PORT ORFORD Total Bedrooms: 6 Permit Bedrooms: 6 ANCHORAGE. AK 99507 - This permit is for the construction of: Q 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 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 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: Date: —7 ZZ ( Issued By: �' y m4,(; Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519.6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 6t'5-oqa-a7 Property owner(s) e S r, , A� Day phone i -7 6 -:2V3 8 Mailing address \\ Zip Code Site address , R q �, r r Zo r d Zip Code Legal description (Sub'd., Block & Lot) _ L Li ', Io (Pro50e d ti>` 5 dl Legal description (Township, Range & Section) Lot Size 99, 9A5� Sq. Ft. THIS APPLICATION IS FOR (® all that apply : Absorption Field Septic Tank Holding Tank Privy ❑ Private Well ❑ Water Storage ❑ I certify that the above Single Family Dwelling (Signature of property owner or authorized Number of Bedrooms THIS APPLICATION IS AN: Initial Upgrade ❑ Renewal ❑ I further certify that this application is being made for a rith-applicable Municipal Codes. Receipt Number. (Rev. 11/05) P, s. 1 oke oYSSoD Receipt Number. / 1 ) pe -c l9 e? l e-te /- 74%1? 1-grol e c Ta ane d P? ee?re P ezrl-u.Jfelh1P.,/- S&I �t?I<IriG ROBERT C. COWAN, CE. R013ERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX(907)694.1211 ✓V Enclosure CNGTE I W ZTEWATER CrXOSALSVSIEM DES;G9 15861 S. Birchwood loop Road — ChuAiak, Alaska 99567 July 14, 2008 Iu:nLnlnurNGTaTr OVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEWER& WATER M-NE%TEW," NS Anchorage, AK 99519 REFERENCE: Lot 4, Block 6, Prospect Heights #1 S/D SMER S WATER V.S ECLON It is requested that you issue a permit to install a new septic system to serve the existing four bedroom dwelling and existing barn that is being converted to a two bedroom family care dwelling on the referenced property. ENc•NeERNcsrwIE, u:o REroars Three test holes were excavated and percolation tests performed. The approximate locations of the test holes are located on the attached site plan. At the time of excavation (6/30/08) water was found at 14 feet on test hole #I other two test holes were found to be WCLL �,P CCTION &ROMTEST dry. After seven days of monitoring, test holes 42 & 43 had no ground water, test hole #I had water found at 13.5'. We are installing a 1300 gallon HDPE tank for the existing four bedroom dwelling, and a &TEIII AIZ separate 1000 gallon HDPE for the two bedroom family care dwelling. Both will be tied into the proposed septic field. Tku.D DESIGN We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent SULTEST properties. If you require a al information, please contact us. rEROOInTION Sincere TEST STWCT=& N CNM:ICAL I an, P.E. P:.oECT*NS C/I ,. ✓V Enclosure CNGTE I W ZTEWATER CrXOSALSVSIEM DES;G9 15861 S. Birchwood loop Road — ChuAiak, Alaska 99567 SITE -PLAN DESIGN m C O X 1" - Dc N oxmZ D � O 0'0 I M>rD AO t7 Z M Z ooA I I I I l i ts° l7• n anig oe r I O ►o° wo 0 I O! n O -i I h O y ° D—mom m W OOCO m O Z 1 O m Z m EO vvom 9 z D O Z xr g (A l? 7 ~ Z ST m d _" m C O X H Dc N oxmZ D � O 0'0 eI Q� T� M>rD AO t7 Z M Z ooA O O Orm CT] m d _" l 03 v +tmo � rTim .r O i Ua O O Orm CT] zm f. l7• n anig r 03 v � I- to N O) i Ua O O Orm CT] z a f. ISITE—PLAN I DESIGN I 11' = 60' CONIFER STREET I I I I I I I I I j Ferri y j j n L o p o # GG' nday o in ° 1 mi * Via° Spd . ° ClNh V �o V I I 4t eg I I Roo' f eu w 4 co 0 a^o I g^ I w I 1 O 73 .001 '. , 1 w I 0 = 0 vN O 00 N o m � D N / ri m o f a y� COo_ Of T 2 In m i 4S_ Municipality of Anchorage Development Services Department Building Sarely Division On -Site Water and Wastewater Program /700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995196650 www.munl.org/enslte (907)340.7904 SoilsLog- Percolation Test (_ Performed For: SIS/ &)i ) 1 Date performed: Legal Description: ' ��' Township, Range, SecOore_ COMMENTS 1AticS) e sats A. Mdar tNw 111074 Site Plan C5 WAS GR01"WATER `' ENCOl1NTEfERED7 jCS t s IF YES.At Va IAt DEP to Tt17 _ L /� 3r57 E mpthWall, n" 1 Dale '706 Reading Dale Gross Time Not Tone Depth Io Water Net Drop ,2 30 30 /OrL 8-S 30 6003/ 6 1/ ,. 2" 30 90 Yl' v 2'T 30 (zo ro'/0, Reading Dale Gross Time Not Tone Depth Io Water Net Drop ,2 30 30 /OrL 8-S 30 6003/ 6 1/ ,. 2" 30 90 Yl' v 2'T 30 (zo ro'/0, ae Iso �1,, Olt PERCOLATIONRATE iew%lie d) r PF.RCNOLEDIAMETER _ TEST RUN BETWEEN 61 FT AND 7 FT PERFORMED BY: PERFORMED IN ACCORDANCE WIT N ALL SIATE AND MUN �.�CERTIFY TIIAT TMS TEST WAS IN EFFECT ON NITS DATE. DATE: 7M#a Municipality of Anchorage Development Services Department Building Safely Division OwSite Water and Wastewater Program 4700 South Bregaw St. P.O. Box 196650 Anchorage, Aft 99519.6650 www.munl.org/onsite (907)343-7904 ///�1_ �� Soils Log - Percolation Test Performed For: CSI r- oom r IJ Date Legal Description:I_Qrl V1O rI 'P¢-DSj'r I tF> 41 Township, Range, Section: Depth Dale Y5t —oeGgftltc,S .esti: No Drop 2- i.:.r. ...• ; 'J745 oS —(0M 10- D Dale Gross Time Not Time .esti: No Drop efseWU 'J745 oS JAMS 13 y. 30 14- ��n• rL tt 30 1s- 18- -30 17- 1��' 9y 18- 30 19- 1 t' 9Y 2D_ COMMENTS 1 ISO � PERFORM[D BY: PERrORMED IN ACCORDAN( WAS GROUND WATER 1 — ENCOUNTERED? e IF YES. AT Wt UT DEPTH? Depth to Wtlo AMro r p Moaitoringl ..��0 E _ Dole Reading Dale Gross Time Not Time Depth to Water No Drop efseWU 'J745 oS JAMS ar' 30 36 -1i rL tt 30 tob air -30 0 1��' 9y " 30 1 120 1 t' 9Y err' 30 1 ISO � _ i' all 30 1 i80 1 n qH PERCOLATION RATE 3,15(�~) TEST RUN BETWEEN ,r FT AND WIIH ALLSTATE AND T PERC HOLE DIAMETER �j•• FT CERTIFY TI IAT THIS TEST WAS ONTHISDATE. DATE: --Fo 4- 3 Municipality of Anchorage or Development Services Department Nei Time Building Safely Division r On -Site Water and Wastewater Program •� 4700 Swill Bragaw S1. P.O. Box 196650 Anchorage, AK 995190650 vrww.m Inl.orgronaile (907) 343.7904 SoilsLog- Percolation Test feS 9 ri Performed For: lIir Q✓nt r r 1 Dale Performed: / GO Legal [Msaiplion: p township, Range, Socllon[ _ c1„ 30 D pth B.: 2. 3• :•-G 4- �s. 5 '•:. V 7- It - 12. 13- 14- 15- 16- 17- 18- 19 - COMMENTS —0e6wlCa _&q son oy .gt�7�/1 WAS GROUND WATER k •� ENCOUNTERED? ��JC/ 6 IF YES. AT W7IAT DEPTN7 L D.plh to W,l.r An.r U — — P Moniloring7 E — Dal. reek PERFORMEDBY: L PERFORMEDINACCORDANCE Reading Dale Gross Time Nei Time Depth to Waler Nel Drop IRA 0 GO 3 N ;z 30 CID :3 2" 30 1 z0 3 12 Ya l , PERCOLATION RATEr�(�~) PERC HOLE DIAMETER �•• TEST RUtf BETWEEN S FT ANDFT ,l ` i / I CERTIFY TI IAT TNIS TEST WAS ALL STAV AND MUNICIP IN -FFECT ON THIS DATE. DATE: GREATER ANCHORAGE AREA BORUUGH Department of Environmental Quality ��1 IIII tl 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME KSft4 MAILING ADDRESS 2 I � 1 � 6 PHONE 1 LOCATION LEGAL DESCRIPTIONNoS7cC,%'�v �Ic �✓ t V l SEPTIC TANK: DISTANCE FROM WELL i 05 ( MANUFACTURER INSIDE LENGTH INSIDE WIDTH SEEPAGE PIT: / NUMBER OF MATERIAL COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY /2-J•'0 GALLONS. NUMBER OF PITS—. DIAMETER OR WIDTH =r,1 LENGTH2�-f DEPTH 17' A. V ! + Cry bj LINING MATERIAL � CRIB SIZE: DIAMETER=DEPTH L� DISTANCE FROM: WELL Lie TOTAL EFFECTIVE BUILDING FOUNDATION NEAREST LOT LINE 2 % ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL TYPE ��' ����' �` CONSTRUCTION CJ, ppo0 V 6' CA DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION , LOT LINE , SEWER LINE , TANK ' SYSTEM I cif CESSPOOL OTHERSOURCES APPROVED DISAPPROVED REMARKS DISTANCES INSTALLED BY: EftA -Hnop I PIPE MATERIAL: (°C1> I1 I �_"_ti`tA LOT SLOPE: / � J_Vwy 'i,' REMARKS: Wei( J DIAGRAM OF SYSTEM (v( r i ex�a�kh� I\ L& AA ry f � a' I cri h f til We GRE.. y .R ANCHORAGE AREA B01 JG �hL DEPARTMENT OF ENVIRONMENTAL QUALITY f 3330 "C" STREET ANCHORAGE, ALASKA 99503 e TELEPHONE 274-4561 G SEWAGE DISPOSAL SYSTEM - APPLICATION AN[ I/ �47RMIT NO. cle NAME OF APPLICANT MAILING ADDRESS- PHONE INSTALLATION LOCATION -- LEGAL DESCRIPTION - - - - INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD OTHER , TYPE AND SIZE OF FACILITY TO BE SERVED - FINANCED THROUGH TO BE INSTALLED BY " -SOIL TEST RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED - - FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. - SEPTIC TANK SIZE - TYPE - SEE AGE. AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS ( / � • rpm �.(��'J l 170l%"'�- DIAGRAM- OF SYSTEM ��q C - - �� J FOUNDATION TO SEPTIC TANK r Wim` FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL - SEPTIC TANK - , SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT , DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT , DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.S. OR LICENSED DESIGNER 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE FORM NO. EQ -016 1 � --I I I 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE FORM NO. EQ -016 Conitptaction gest -'tab "One test is worth a thousand opinions" 0820 TUDOR ROAD, ANCHORAGE, ALASKA 89507 0 T[L[rNON[ 333-8472 l Performed Ford �`�! Date _terformed / 7 7 Legal Descrintion: Loth ock._ Subdivision�L,? e•Z �5 This Form Renorts Soils LogPercola"ion Test_ Oenth Feet Soil Characteristics pi V -114 10— Was Ground Water Encountered? --di If Yes, At what Depth? Readinq I Date I Gross Time Percolation Rate Minute Proposed Installation: Seenaoe Deoth of Inlet CnMtAENTS Net Time i Depth to H2O Pit �y�.5 Drain Field Net Dron Test Performed By F// _ Data Certified By: narn. -411141 7-2Z— f, M -W DRILLING, Inc. / 1 e. U. Box 4-1224 • 1310C International Airport Road a n (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner Ken I,vthgoe Location (address of: Township, Range, Section, if known; or distance main L.49 B6, Prospect Hts. Sub of Well Dom Size of casing 6 Depth of Hole 301_ feet Cased to 21-0 feet Static water level 255 ft. (aVotfoX (below) land surface. Finish of well (check one) open end ( X ) ; ._-Screen ( ); Perforated Describe screen or perforation N ne Well pumping test at 7. per (h` ur4x (minute) for 1- hours with 1_n lc ft. of drawdown from static level. Date of completion 1 5 Mar 75 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0TO 3 Organics &nFill 3 25 Silty Gravel TO 25 30 Gravel TO 30 100 S„ndy Gravel TO 1.00TO 1.1.0 Sand 1.10 TO— 126 Small Gravel 1 26TO 1.30 Siltv Gravel 1.30,.3 TO 7 Sand 137 �O 1.68 Sandy Gravel: small. 168 TO 200 Siltv Gravel 200 TO 208 Sm,ll Gravel: clean, wet 208 TO 300 Bedrock: arae to blue, soft 300TO ?01 fracture lone with food wp.ter seap. TO - TO 4' NVVIVA Cert: ied CC'itraciOr 1—CUSTOMER Ccraficzt;; N --'t;. 811 & T13 l Municipality of Anchorage e On -Site Water & Wastewater Program ` (907) 343-7904 I Ar CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-092-27 Expiration Date: 0 -23-12. 1. GENERAL INFORMATION Complete legal description PROSPECT HEIGHTS SUBDIVISION #1: LOT 4. BLOCK 6. Location (site address) 7945 PORT ORFORD DRIVE * ANCHORAGE. AK. 99507 Current Property owner(s) COLBY SMITH Day phone (907) 764-1970 Mailing address 7945 PORT ORFORD DRIVE * ANCHORAGE. AK. 99507 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: 6 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class - Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 'I 9 0 Date of Payment -5,2-12 Receipt Number COSA # D 5 G 121 157 Date: Waiver Fee $ Date of Payment Receipt Number, Waiver# 6. 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. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the 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 soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other parson or party is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for _iZ bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for 337-6179 bedrooms, with the following stipulations: ON-SITE WATER AND WASTEWATER PROGRAM The Municipality or Anchorage Develop,emt 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 engineers work. 7. ATTCHMENTS: COSA Checklist ✓ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other. Original Certificate Date: .5- 23-1'Z- (Rev. 3-12 (Rev. 11M) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: PROSPECT HEIGHTS #1 LOT 4 BLOCK 6 Parcel ID: 015-092-27 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Date completed 3/15/1975 Sanitary seal (Y/N) YES Total depth 301 ft. Cased to 210 ft. FROM WELL LOG Date of test 3/15/1975 Static water level 255 ft. Well production 7.5 g.p.m. WATER SAMPLE RESULTS Coliform 0 colonies/100 ml. Nitrate ND mg./L. Arsenic: mug./L. Date of sample: 4/16/12 B. SEPTIC/HOLDING TANK DATA IN GARAGE FLOOR Tank Type/Material HDPE/SEPTIC Tank size1300&1000gal. Number of Compartments 2&2 Well Log (YIN) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 4/16/12 5.53 g.p.m. Collected by: GEG, Ltd. Date installed 8/29/08 Cleanouts (Y/N) YES Foundation cleanout (YIN) *Y/Y Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping 8/3/2011 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA Date installed 8/29/08 Soil rating (g.p.d./ft`or Ibdrm 1.2 System type DUAL TRENCHES Length 41/40 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth *9/8.25 ft. Eff. absorption area8� 00 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **4/16/12 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 2_5 in. Water added 1290gal. New depth 20.5 in. Elapsed Time: 120 min. Final fluid depth 1 �.5 in. Absorption rate >= 900+ g.p.d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date **EAST TRENCH TESTED ONLY. WEST TRENCH HAD 9 INCHES OF LIQUID IN IT. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump ofr level h water alarm level at Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/I'dt station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *LOCATION OF WATER LINE FOR MOTHER—IN—LAW UNIT IS UNKNOWN G. ENGINEER'S CERTIFICATION o v I certify that I have determined through field inspections and review of Municipal records that the above systems are in """ ' """""""' conformance with MOA COSH guidelines in effect on this date. Q r y A. tress; Engineers Printed Name JEFFREY A. GARNESS �Qo9 C —79 3 DateSzz�y 0 COSA Fee S qL," C) y Waiver Fee $ _ Date of Payment — 1:2 / 2 _ Date of Paymeni Receipt Number Receipt Number (Rev. 11roe) pLi: .g7H at�/Ip t O'Iy •�•.YDtIRIG11; p tl P LS— , re991"aGt x PLAT NOTE #2 STATES THAT ALL EASEMENTS ARE AVAILABLE W FOR HORESEBACK RIDING HIKING, AND CROSS COUNTRY SKIING. C Port Orford drive W w 0 0 30' S 89'53'55" W 330.0 j 1 LOT 4 1 N CG D i awed A 1" 10' Utility Easement / S 89`53'55' W 33( NOTES: 30, 1) THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LANTECH. 2) SNOW AND ICE MAY CONCEAL MINOR SURFACE FEATURES. `�01 Lo 14 I m 7 0 W wdl 0 Lot 5A LegalDescription: AJ—GB i l oys,r sy Colby Smith Legmtl: �z co9 Lot 4, Block 6, °h Prospect Heights Subdivision Sept- St.ndplpe® water ell © EM= O """—X—X— RP�saD k SURVEY CERH19CATION: LAN'IECN hos .ondu.fed oph,se.1 survey of the property as she - drawing awing end certitlee thol the improvemenis LxwZmltPmmCmh ]961 N0 2�C09 EXCLUSIONARY NOTE: R is the owners' responelbillty to datermine the LAND & CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS exi te.Cs of any easements, .ovrenonte. resm.nons .r right—of—..y 440 West Benson Bouleyord, Suite 200 Phone: 562-5291 Hkleyp whIeh oo not .,poen .e the recorded xubdw l- let. under 'rcumataova. should y date hereon be d for t,u.Uon, 5 for warty Irc, or r., dot—plan purposes. mm: 67-23 Grim 2440oma: May 15. 2012 Drown 8, PL wax order: 26i 2—L-442 Pb/Pg: >]9/37 ReF. 2DD5—L-761 Scae: 1"=50' CM1ecked 8y. TAE 2 Coe 2 D 10' Utility Easement / S 89`53'55' W 33( NOTES: 30, 1) THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LANTECH. 2) SNOW AND ICE MAY CONCEAL MINOR SURFACE FEATURES. `�01 Lo 14 I m 7 0 W wdl 0 Lot 5A LegalDescription: AJ—GB i l oys,r sy Colby Smith Legmtl: Lot 4, Block 6, °h Prospect Heights Subdivision Sept- St.ndplpe® water ell Addition No 1 EM= O """—X—X— RP�saD k SURVEY CERH19CATION: LAN'IECN hos .ondu.fed oph,se.1 survey of the property as she - drawing awing end certitlee thol the improvemenis LxwZmltPmmCmh sit .ted there- ora within the property Imes ontl no encroachments exUt other then noted. EXCLUSIONARY NOTE: R is the owners' responelbillty to datermine the LAND & CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS exi te.Cs of any easements, .ovrenonte. resm.nons .r right—of—..y 440 West Benson Bouleyord, Suite 200 Phone: 562-5291 Hkleyp whIeh oo not .,poen .e the recorded xubdw l- let. under 'rcumataova. should y date hereon be d for t,u.Uon, Anchoroge, Alaska 99503 Fax: 561-6626 for warty Irc, or r., dot—plan purposes. mm: 67-23 Grim 2440oma: May 15. 2012 Drown 8, PL wax order: 26i 2—L-442 Pb/Pg: >]9/37 ReF. 2DD5—L-761 Scae: 1"=50' CM1ecked 8y. TAE Municipality of Anchorage .. .. Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 � www907) 343-79e.ak.us 409'A*, ✓/ (907) 343-7904 C /^ C� CERTIFICATE OF HEALTH AUTHORITY APPROVAL J / FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-092-27 HAA# 05 034 1 1. GENERAL INFORMATION Expiration Date: /041105- I Complete legal description PROSPECT HEIGHTS SUBDMSION f1: LOT 4. BLOCK 6. Location (site address or directions) 7945 PORT ORFORD DRIVE + ANCHORAGE. AK. 99507 Current Property owner(s) MERIDETH SELMER ' Day phone (907) 346-3435 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 7945 PORT ORFORD DRIVE • ANCHORAGE. AK. 99507 Unless otherwise requested, HAA will he held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 Day phone Day phone 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Weil ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below,/ verity that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the onsite 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 Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines 6 Regulations. The reported results described 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 soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owrier listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE A.� Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following Attachments: ✓ HAA Checklist Septic System Advisory Well Flow Advisory Phone 337-6179 Date 6 ZZ/oS / Z�\�Y OF Pgiy�yo� tis: ON-SITE : c WATER ANO : m: ..�eTGWATER Maintenance Agreements Supplemental Engineer's Report Other Joy— By:d Original Certificate Date: '71-1-1 (Rev. 12.01) Municipality of Anchorage Development Services Department Building Safety Division OnSke Water b Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995196850 www cl.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: PROSPECT HEIGHTS S/D /1: LOT 4. BLOCK 6. Parcel ID: 015-092-27 A. WELL DATA Well type PWATE If A, B, or C provide PWSID# N/A Date completed 3/15/1975 Sanitary, seal (YIN) YES Total depth 301 ft, Cased to 210 ft. FROM WELL LOG Date of test 3/15/1975 Static water level 255 ft. Well production 7.6 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0.133 mg,/L, Well Log (YM) YES Wires property protected (Y/N) YES Casing height (above ground) 12+ In. AT INSPECTION 8/7/21)05 167 ft. 4.88 9— p.m- Other bacteria 0 colontes/100 ml. Arsenic: N/A mgA. Date of sample: 6/7/2005 Collected by: GEG. UD. B. SEPTIC/HOLDINGTANK DATA *IN GARAGE FLOOR Tank Type/Material STEEL / SEPTIC Date installed 7/21/1975 Tank size 1250 gal. Number of Compartments 1 Cleanouts (Y/N) YES Foundation cleanout (Y/N) OYES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping 6/20/2005 Pumper DENALI SEWER AND DRAIN EXCAVATING C. ABSORPTION FIELD DATA Date inatalled 7/21/1a75 Soli rating ttj.p.d ft%drrn) 167 AVG. System type CRIB Length 22 ft. Width 14 ft. Gravel below pipe 9.0 ft. Tobe depth •14 fL ER. absorption area 648 ft' Monitoring tube`1ES Depression over field NO Date of adequacy test 6/7/2005 Results (Paas/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 46 in. Water added 700 gal. New depth*55.5 in. Elapsed Time:51 min. Final fluid depth 52_25 In. Absorption rate >- 600'+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YM 6 type) NONE KNOWN If yes, give date *LAST 120 GALLONS ADDED ONLY CAUSED A RISE OF 3 INCHES. D. LIFT STATION Date Installed Size in gallons "Pump on" level at _in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic lankiliR station on lot 100'+ Absorption Heid on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 0. ENGINEER'S CERTIFICATION JgG _ %.: I certdy that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. ess.� Engineer's Printed ame JEFFREY A GARNESS Date �,�22 OS 4• j2 0` --f— t••slor`d HAA Fee $ L4W r ?1? KwSji Date of Payment % - Z' Receipt Number V7 (Rev. 1201) Waiver Fee $ Date of Payment Receipt Number JLL-20-2005 10:38 PRUDENTIAL VISTA REAL EST 907 562 5485 P.02 PORT 30' ,v-Q,.,-.� . •�.-gyp 1•D D : Michool L. Jokela .- o 0, '-, LS -7839 pp�d •�.�B:.4S' ayd Of, 10 1 0 ORFORD DRIVE CA 0 S 89.53'55" W LOT 4 /i 330.00' +L O 0 O ® MALL Z z O O ® TI ® O ............ , rn 22.1 o f ; {0 0Iw rri v TLn N m W o 30' ,v-Q,.,-.� . •�.-gyp 1•D D : Michool L. Jokela .- o 0, '-, LS -7839 pp�d •�.�B:.4S' ayd Of, 10 1 0 ORFORD DRIVE CA 0 S 89.53'55" W LOT 4 /i 330.00' +L O 0 10' UTILITY EASEMENT . S 89'53'55" W 330.00' LOT 5A 1 01 e7 AInTC Al eT.Tre Tu.T ... ...- .-.- `•' I ® MALL %v 0 o ® ® q ............ , 22.1 f XWY HOUSE 10' UTILITY EASEMENT . S 89'53'55" W 330.00' LOT 5A 1 01 e7 AInTC Al eT.Tre Tu.T ... ...- .-.- `•' I TOTAL P.02 06-22-05;15:42 ; SCS Rcf.# Client Name Project NameN Client Samplo M Matrix Sample Remarks: 1053217001 Gamess Engineering Group, Ltd. Lot 4 Bk 6 Prosocet Heiehts 01 7945 Port Oxford Drinking Water :907 561 5301 # 2/ 4 AU Dstcs/fimcs are Alaska Standard Time Printed DateMme 06/102005 18:10 CoUccted DateMme 06/072005 9:45 Received Datc/Time 06/072005 13:49 Technical Director Strohm C. Ede Allombic Prep Analysis Parameter Results PQL Units Metbod CoatainerID Limits Dote Date Init Waters Department Nitmte-N 0.133 0.100 Microbiology Laboratory Total Coliform 0 mgt EPA 300.0 B (410) 06/08/05 JIB eol/100mL SVL'092258 A (<-I) 06/07/05 TLF