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HomeMy WebLinkAboutPROSPECT HEIGHTS #1 BLK 6 LT 5AProspect Heights #1 Block 6 Lot 5A #015-092-26 Inspection Report _1-1-T2.doc (/ / /I Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151083 PID Number: 015-092-26 ❑ New Q Upgrade Name: Jairo & Eugenia Buitrago ABSORPTION FIELD ❑r Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 7801 Sitzmark Circle ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade Not Available 5 1.2GPD/SF 13.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 6.0 Ft. Gravel depth beneath pipe 7.0Ft. Subdivision Block Lot Prospect Heights #1 6 5A Fill added above original grade 0 Ft. Gravel length - 50.0 Ft, Township Range Section Gravel width 3.OFt. Beds: Number of Lines N/A Distance between lines - I N/A Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 700 Fe 1 N/A Ft. Well 108.6 133.8 N/A N/A 98,7 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 150OGal. Surface water 100+ 100+ N/A NIA Material Number of compartments Lot Line 51.3 16.0 N/A NIA Steel 2 NA Foundation 11.1 40.0 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ 50+ N/A N/A Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model 7_7�1 Inspections performed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfeld A+ Home Services Drainfield 3034 CO/MT 3034 Inspector Steven R. Pannone BENCHMARK (Assumed elevation) 100ft Inspection, 1' 4/22/15 4/23/15 Location and description dates: 3rd 4124/15 2"" 4'" Top of Driveway Curb by Garage COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date 1� Kt!40. *• hi -* eveii : onrione' i ll'Zq- ##++ CE X�8'77149 low Approved Gt1 Date Inspection Report _1-1-T2.doc (/ / /I NOTES: DRAWING PLAN '7 PANNONE ENG SVC, LLC Date P.O. BOX 100217 ANCHORAGE, AK 99510 ...... 1,,J'qkk� 4/24/2015 PHONE (907) 272-8218 FAX (907) 272-8211 Scale ..... . ... P.I.D.NO PROSPECT HEIGHTS #1, BLOCK 6, LOT 5A.. . . 015-092-26 Steven.R.PonnopeJAIRO & EUGEINIA BUITRAGO PERMIT NO 7001 SITZMARK CIRCLE CE 8149 OSP151083 ANCHORAGE, AK 99507 D . ....... Sheet s 2 OF 3 U Of V) O� 5A0 WELL (E) 5DP 1500g SEPTIC TANK HOUSE DECOMMISSIONED PER CODE (E) INSTALLED NEW 1500g SEPTIC TANK INSTALLED DCO AND DV 108.6 A DRAIN FIELD (E) IN FAILURE Zc lvim NN —REUSE AS RESERVE T1 T2 THI D-0 DV rn C11 NEW D RAIN FIELD (EW 5OLF x 3.0'W x 7.0'ED x 13.0'TD ........ . .. . SITZMARK CIRCLE NOTES: DRAWING PLAN '7 PANNONE ENG SVC, LLC Date P.O. BOX 100217 ANCHORAGE, AK 99510 ...... 1,,J'qkk� 4/24/2015 PHONE (907) 272-8218 FAX (907) 272-8211 Scale ..... . ... P.I.D.NO PROSPECT HEIGHTS #1, BLOCK 6, LOT 5A.. . . 015-092-26 Steven.R.PonnopeJAIRO & EUGEINIA BUITRAGO PERMIT NO 7001 SITZMARK CIRCLE CE 8149 OSP151083 ANCHORAGE, AK 99507 D . ....... Sheet s 2 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: DECOMMISSIONED EXISTING 1500g SEPTIC TANK PER CODE AND REPLACED WITH NEW 1500g SEPTIC TANK. INSTALLED DCO AND DV, AND ABSORPTION FIELD. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 19.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 19.0 FEET BELOW EXISTING GRADE. - /r FILTER FABRIC TH-1 / , 1.25" 0 PERF PIPE W/ 1.25' HOLES DRILLED I8" O.C. -ID DECOMISSIONED EXISTING 1500, SEPTIC TANK PER CODE AND REPLACED WITH NEW 1500, SEPTIC TANK DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 5 (750 gpd) TANK SIZE: 15009 . PERC RATE = 1 -5 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 625 SF SYS, TYPE: DEEP TRENCH 7.0'ED MIN LENGTH: 45.0 LF USED: 50 LF X 3.0' WIDE, 7.0' E.D., 13.0' TD TOTAL AREA: 700.0 SF PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC 97.2 ABBREVIATIONS CU OR Ivy. DRAIN ROCK 6" ABOVE PIPE INV TH TEST HOLE GN/SM 6'0 T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT —97.2 DIVERTER VALVE FS FLOW SPLITTER 7..0 BELOW FINISH GRADE OG ORIGINAL.GRADE SW/GW L 3 GB GRADE BREAK -90.2 6.0 SECTION -19.0 84.2 J m QO O O w0 w O Q Z r Q O Q w G Z F sV .] U w U DECOMISSIONED EXISTING 1500, SEPTIC TANK PER CODE AND REPLACED WITH NEW 1500, SEPTIC TANK DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 5 (750 gpd) TANK SIZE: 15009 . PERC RATE = 1 -5 MPI SOIL RATING: 1.2 GPD/SF AREA ROD: 625 SF SYS, TYPE: DEEP TRENCH 7.0'ED MIN LENGTH: 45.0 LF USED: 50 LF X 3.0' WIDE, 7.0' E.D., 13.0' TD TOTAL AREA: 700.0 SF PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC 97.2 ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG - BELOW FINISH GRADE OG ORIGINAL.GRADE FG FINISH GRADE GB GRADE BREAK NOTES: PANNONE ENG SVC, LLC ��oF q ��� Date RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 '(�•" " �. 11 °/Z4/2o15 PHONE (907) 272-8218 FAX (907) 272-8211 '-wc�- .--V 0 Scale P.I.D. NO PROSPECT HEIGHTS #1, BLOCK 6, LOT 5A J, 015-092-26 JAIRO & EUGEINIA BUITRAGO Steven 'Be PERMIT N 7001 SfTZMARK- CIRCLE 0. �.', CE 8149 .'� j OSP151083 +t cs DESIGN DETAILS ANCHORAGE, AK 99507 'it�RFD......1... ,` r sheet 3 OF 3 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151083 Tax Code Number: 01509226000 Work Type: Septic Upgrade Permit Effective Dates: April 18, 2015 to April 17, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: PROSPECT HEIGHTS #1 Site Legal Address: PROSPECT HEIGHTS #1 BILK 6 LT 5A G:2440 Owner/Address: BUITRAGO JAIRO A & EUGENIA 7801 SITZMARK CIRCLE ANCHORAGE AK 995076028 Site Mailing Address: 7801 SITZMARK CIR, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 123275 Total Bedrooms: 5 N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received ZOr 26(s it t"' 1% :i° MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 015-092- ,g( Property owner(s) Jairo & Eugeinia Buitrago Day phone 727- 650 y Mailing address 7001 Sitzmark Circle, Anchorage, AK 99507 Site address M01 Sitzmark Circle Legal description (Sub'd., Block & Lot) Prospect Heights #1, Block 6, Lot 5A Legal description (Township, Range & Section) Lot Size 123,275 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X Septic Tank ❑X Upgrade (w/wo ADU) Duplex (D) ❑ Holding Tank ElRenewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 9/O, K6 Date of Payment: As /15 Receipt Number: Q al q 5ko Ei Permit No. Js � is! o 93 Permit App_ :-I(.._c- Waiver Fees: Date of Payment: Receipt Number: _ Waiver No. Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steveftanengak.com April 15, 2015 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Rd. P. O. Box 196650 Anchorage, Alaska 99519 Subject: Prospect Heights #1, Block 6, Lot 5A Septic System Upgrade Permit Request Ladies and Gentlemen: I am writing request a permit to construct an upgrade five (5) bedroom septic system on this property. Currently the lot is developed. The existing drain field is in failure and will be re -used as a reserve. An upgrade drain field will be constructed. The existing 1500g septic tank will be verified and if it is found to be leaking a new 15008 septic tank will be installed. This lot and the surrounding lots are served by private wells. There are no wells within 100' of this system. Soils. P.E.S. performed one test hole in the vicinity of the drain field in April of 2015, and groundwater was monitored for seven days. Ground water was not observed to a depth of 19.0 feet below the ground elevation in the test hole monitor tube after the seven day monitoring period. It is my opinion, based on the results of the soils tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used fora conventional Wastewater system. 1. Soil Absorption System Design. a. See Sheet 2 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The existing topography is characterized by a small knoll that the house and drain field are on the top of. The top of the knoll is flat and slopes away in every direction. There is a small cut slope for the road to the south of the system, but the top of the drain field is lower than the toe of the slope. The higher slope to the north and west of the system are over 50' away. There are no steep slopes within 50' of the proposed drain field location. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 4. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no surrounding wells within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 \ '|/ .".-�` 3: \ DRAIN FIELD (P) 8OL[xJ0�wx70'L8x�J0`TD ' � ��- �� ��� ---' —' - | -' -� SKZw^xxC|RCL[ NOTES: FOR CONSTRUCTION PLAN � PANNONE ENG SVC, LLC Dote 4/16/2015 P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ..-v Scale PROSPECT HEIGHTS #1. BLOCK 8, LOT 5A JA|R0 & EUCE|N|A HU|TRAG0 7001 SUZMARK CIRCLE ANCHORAGE, AK 99507 � 015-092-26 PERMIT No. Sheet 41 1500g SEPTIC TANK (E) HOUSE VERIFY INTEGRITY AND REPLACE WITH (E) 1 bOOg SEPTIC TANK (P) IF FOUND TO BE LEAKING INSTALL EGO AND Dv DRAIN FIELD (E) IN FAILURE vv REUSE AS RESERVE 0 \ '|/ .".-�` 3: \ DRAIN FIELD (P) 8OL[xJ0�wx70'L8x�J0`TD ' � ��- �� ��� ---' —' - | -' -� SKZw^xxC|RCL[ NOTES: FOR CONSTRUCTION PLAN � PANNONE ENG SVC, LLC Dote 4/16/2015 P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ..-v Scale PROSPECT HEIGHTS #1. BLOCK 8, LOT 5A JA|R0 & EUCE|N|A HU|TRAG0 7001 SUZMARK CIRCLE ANCHORAGE, AK 99507 � 015-092-26 PERMIT No. Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. SCOPE OF WORK: VERIFY CONDITION OF EXISTING 1500g SEPTIC TANK AND REPLACE WITH NEW 1500g SEPTIC TANK IF FOUND TO BE LEAKING INSTALL DCO AND DV, AND ABSORPTION FIELD. 3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 19.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 19.0 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 0 TH-1 -ID OR cn+/su 6 -19.0 7.0 µ 6.0 'o wo w ' s ow > FILTER FABRIC 1.25' 0 PERE PIPE W/ 1.2Y HOLES DRILLED 18' O.C. ROCK 6" .ABOVE PIPE INV SECTION m r 0 z o 0 0 0 0 ABBREVIATIONS DESIGN PARAMETERS CU COPPER DIP DUCTILE IRON PIPE PRIMARY SEPTIC SYSTEM TH TEST HOLE BEDROOM: 5 (750 gpd) LEGEND FC FOUNDATION CLEAN OUT TA TANK SIZE: 15005. SERC RATE = 1MPI W WATER LINE/ T# TANK CLEAN OUT NO. SOIL RATING: 1.22 GPD/SF WELL RADIUS C# CLEAN OUT NO. AREA ROD: 625 SF M# MONITOR TUBE NO. SYS. TYPE: DEEP TRENCH 7.0'ED SS NEW SEPTIC R.I. RIGID INSULATION MIN LENGTH: 45.0 LF DCO DOUBLE CLEAN OUT DV DIVERTER VALVE USE: FS FLOW SPLITTER 50 LF X 3.0' WIDE, 7.0' E.D., 13.0' TD BFG BELOW FINISH GRADE TOTAL AREA: 700.0 SF _ OG ORIGINAL GRADE FG FINISH GRADE GB GRADE BREAK NOTESPANNONE ENG SVC, LLC -_O' `V� QF, /�Cgs�11 Date 4/16/2015 FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 -�� i�P + * ,49 TH *�,, .. ..- .......... I Scale NTS P.I.D. NO PROSPECT HEIGHTS #1, BLOCK 6, LOT 5A015-092-26 JAIRO & EUGEINIA BUITRAGO 7001 SITZMARK CIRCLE S'te've'n R. Pannone ;4' PF.� CE 8149 �� � c ��1lfgFDy7p PERMIT N0. OSP151083 Sheet DESIGN DETAILS ANCHORAGE, AK 99507 _ �� ESSIONP 2 OF 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 TEST HOLE 1 OR ORGANICS GM/ SILTY SAND SM AND GRAVEL SWI SAND WITH GW SOME GRAVEL BOH DATE PERFORMED: 4/8/15 SOILS LOG - PERCOLATION TEST SLOPE X TH SITE LAN 5BR / t, t HOUSE f \ �E) I. \ I" Wim_ N- TH 1 Y� SITZMARK CIRCLE WAS GROUND WATER ENCOUNTERED? N IF YES, AT WHAT DEPTH? DEPTH TO WATER AFTER MONITORING? -DRY' DATE: 4/15/15 SLOPE TH X READING DATE CLOCK TIME NET TIME WATER LEVEL READING NET DROP 1 4/8115 9:50 --- 4.88 --- 2 10:00 10 MIN 9.70 4.82 3 10:00 --- 4,88 --- 4 10:10 10 MIN 9.66 4.78 5 10:10 --- 4.88 --- 6 10:20 10 MIN 9.64 4.76 PEROLATION RATE 2.1 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 6 FT AND 7 FT COMMENTS: Test hole excavated by A+ HOME SERVICES. Prec hole was presoaked. Test run for one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMEI WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES:PANNONE ENG SVC LLC .��OF. A >, Date FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 '(� • .CqS,��) 4/1s/2o1s PHONE (907) 272-8218 FAX (907) 272-8211 %gip �y+� Scale TH .*%/ NTS /"" . P.LD. NO PROSPECT HEIGHTS #1, BLOCK 6, LOT 5A / 015-092-26 R�Pannone� JAIRO & EUGEINIA BUITRAGO / Steven" / PERMIT No. -/ 9F.•, CE 8149 ..4Q// 7001 SITZMARK CIRCLE j c OSP151083 SOILS LOG ANCHORAGE, AK 99507 '+,l%\ ES"�'' Sheet 3 m 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 _,— NAM ._ ` PHONE .NEW -e-^ ✓ y C�.-L C--Cfs'"� ❑ UPGRADE MAI LING ADDRES 70 6 LEGAL DESCRIPTION LOCATION ° NO. OF BEDR00 S U Y Well Absorption area DISTANCE TO: Dwelling A �i E tY PERMIT NO, �,, (` i I— Z a Q wF Manufacturer Materi No. compartments N Liq. ca acjty in gallons Inside length 7, IF HOMEMADE: Width - Li uid-de th q p 0 O" Z DISTANCE TO Well Dwelling PERMIT NO. 2 z FQ- M nu rer Material Liquid capacity in 0 w= DISTANCE TO: Well �L Foundation/�r Nearest lot lit _ - PERMIT NO. LL;2 Z W ~ No. of Ji.,n7) Length of ea ine (i! 1 Total length of line Trench width Dista`a een lines o f Top of tile to finish grade Material beneath tile inches r-f � Total e fective bsorption area -rhes w Length Width Depth PERMIT NO. Q F a a. ujW Type of crib rib dia eter ept T ective absorption area N(STANCE TO: Well Building foundation Nearest lot line s Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING IC2 5 INSTALLER REMARKS s�vt9-t.-�sv c IT APPRO D _ DATE LEGAL THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �E_-_ 01 -Y'l-I �� R_ E-_ r--1 C-� J -14-3-VEEP THE LENGTH DIMENSION 15 THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH DR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND 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). �r___ CA L.9 1 ��F-� -T- I C� -1���� 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. 7 "P-4 C-1 BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL. SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVfflTE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LIME IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. �rE F-"r"g I I- F` I ����FEE �E-'11E_ F;� ��, ����:JL. I CERTIFY THAT 1: I HM 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 'THE CODES. ]� I UNDERST-AND THAT THE ON-SITE SEWER SYSTEM MHY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS. SIGNED:�__��~��_~~��~~��~~���_�~��_����~__~��~� MPPLICAN" LEE MC CRNN ISSUED BY v\���~J HTE �J� / ^� V4 0 �/�7- ~ �~--��-���+`7�� � «`»�«����fi,-- r -o" Lnr . P. -A I— 0_1 r. -I L,.� 1 1-9 Uff " LA F.- �n DEPHRTMENT O�-HEHLTH AND ENVIRONMENTAL Er�OTECTI8N 825 'L STREET/ ANCHORAGE., HK. 9�?. /o-�5'9/ � 264-4720 . ��� ��� Co����� ������� ���� �� �==� �_r PERMIT NQ. ( G10436 ) /` -*,>0 APPLICANT LEE MC CHNN 6700 ARCTIC SPUR ROAD ~������«�\ ]49L=*���� LOCATION CONIFER CIRCLE LEGAL L 58 B 6 PROSPECT HEIGHTS #1 LOT SIZE 87120 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MHXIMUM NUMBER OF BEDROOMS = 5 SOIL RATING (SQ FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �E_-_ 01 -Y'l-I �� R_ E-_ r--1 C-� J -14-3-VEEP THE LENGTH DIMENSION 15 THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH DR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND 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). �r___ CA L.9 1 ��F-� -T- I C� -1���� 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. 7 "P-4 C-1 BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL. SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVfflTE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LIME IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. �rE F-"r"g I I- F` I ����FEE �E-'11E_ F;� ��, ����:JL. I CERTIFY THAT 1: I HM 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 'THE CODES. ]� I UNDERST-AND THAT THE ON-SITE SEWER SYSTEM MHY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS. SIGNED:�__��~��_~~��~~��~~���_�~��_����~__~��~� MPPLICAN" LEE MC CRNN ISSUED BY v\���~J HTE �J� / ^� V4 0 �/�7- ~ �~--��-���+`7�� � Y Y l Y 4 _ ''�``�f -.;� ' r i s }j fs +..�-�:+ fl sr` -'IR f _•s.. ,�f -i= i xi.,.?K : Y HEMA! Y ! A ti EPA -, ,� °r`'•, 3, _ =. ... i.. t�£�f -=;fir t__:,.r '-•� � r s ,} - j ' Nto! L 1 1:-g4�!t., h s.� � �, ., .4, 1—t I b" 3� , ta a•h S i i, (. . ,_, ,. .#.}:Sr. SrltY �' :�_ ,. ?.FE' :P�� "a�,�.i,'s,. u"•b .�ia.: Y4r jk�rk4 ..i 'yl ��*� - i Ly v4 ---v t.. „ 1 1 Y '.- e 3 f -I c .r1 V, off P . xi„ „ G n `aynt 4 � t VaN ..c 4 . r,., v , lF` r mol J i.} . i �rr ...��"�.� ..��` s ,z.3''yy�iE fr., ,€ !' 173 ;a bT3 Y{,� + 2 t 'k.,. X 9 r `: .s an7e x `i �.a. �"' '` T t 5 o s c _ -,_ _€'xt p 1 :: r. e.te,e Tr y �Sz�Y � <t»,.�, �..:; } ��>i t # -TOMS :# s t z' J"= r,>}may ' q BIOTTOM € t ` � 4E pin tY. 1,!~'2u# S• r SF: 11 .1.. % it; �t`z �„ "� i '� �7 d� �'+r« ..,.� w 15: I" # }:�s 'i,. s¢NI e'"fi E -H:,.. E`me wfrS'rf i3: - y3 AND T 1j psi t.� „yn b�'2': :1 k 1 o k€ Y F -. z Jr z* i i f. 1} 1 t tl • i ' i u e b i h 1 -1040�.. a€ y`e aY � c 8 y a Lr' rrt � c..xr J < f= aa' r x e ANY' T krEs fZ Mom $ Nr }€ s 'NT" .r .t::p THIS ; { A Mi!'UT1 F_ �( z��Ck'-. i f � ? F F FOM H R« Kn , r E,i# iJ F,{tl 4/-j. tt $y 1 . i5 §..5-.. t p ^l sf�a�'�•f; t 1g°F--J, i':i z ;'�� .ter }O.L. L- p € aSri i iY�3,-r`-- � ) e i [ Ef c v L .,C iv., ..% ` a` i 4 4,r o; lK, 11 �-- twits; , t [' .a t 'v .a -. _ NEI e... "e pp [ . I SFU L f s:i ��.. ATH THE F4'IQU n. !'e £,�_ � •.mak d <: E�. }. 19 '�.`=-i r$. r r,i �?yrt,,. �AN ffr:���„-... 'x .,1 k> t ;IA MY e H 14 f is li a :Lrr.3.$ 4Fs THE N'<< i' as WIN ^} 7 rS,F �x r ♦11- THE: 1 IV% )i � €£ a 'r THE rf f .* f= '� -_t �. t -t f s t C v. .r ,<,- , t ,�. .F r Y.Tty; ct 1r2 , 15 tx4Fui8 t � i 3 "if ,��ls i t:•�; 3¢� �-3`";�9q n. � � k 4j °�.;{rt-� 1 s� m, k.. a: r ., Municipality of OU-Y£ia 1 1.21 �t 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 31, 1980 Lee Mc Cann 6700 Arctic Spur Road Anchorage, Alaska 99502 Permit # 800681 Subject: Lot 5A Block 6 Prospect Heights Subdivision #1 A permit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264-4720. Sincerely, AQ Les N. Buchholz, R.S. Senior Environmental cialist LNB/ljw enc: Copy of Permit SWP/057 .. C-0 F= �r-J 9---. F -j __'A F.-- F:� #:i F::: ^ , DEPARTMENT HEALTH AND ENVIRONMENTAL .|QTECTION 825 'L/ STREET, ANCHORAGE, HK 99501 ^ 264-4720 PERMIT NO ( 800681 ) APPLICANT LEE MCCHNN 6700 ARCTIC SPUR RD. ]49-454] LOCHTI{)N CONIFER CIR. LEGAL LOT 5A BLK 6 PROSPECT HTS. #1 LOT SIZE 87120 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 5 SOIL RATING (SQ FT/BR):= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: F__4 _r 1-1 - �L;2 L_ EF r-4 C-3 -r " �" -4 CD ����F:1 %e'E: 0 U> -Y- H= E. THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H 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). r ---"EF- 91"! k-1 I FZE: E--- �F= Fz' -F I I::- ��r--1 0=-- 1 2' F=� 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. ­ — — -F &4 C --u < ;2 > I PA 23 F:=o FE k:� _T_ I 6=9 r4 F=1 Fl� FEE �E_= CA 13 Ir FR. E--- C -a ~— — 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 H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOSS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLYSPECIFICATIONS AND CONSTRUCTION DIAGRAM' ARE AVAILABLE TO INSURE PROPER INSTALLATION. ��r-:� r-1 I -IF �F=l I rR E_= _�=� ��A::: EE Irl EHO FEE F, :E_- —E. flz�u I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON -9 -ITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL. THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS. � I SSvE:/ or~�SL _UA|E-.Z_����_������ V4.0 SOILS LOG - f ' n MUNICIPALITY OF ANCHORAGE s ar DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION Pouch 6550, Anchorage, Alaska 99502 276.2221 TEST SOILS LOG — PERCOLATION TEST f I PERFORMED FOR: - �f DATE PERFORMED' LEGAL DESCRIPTIOI �F�' PTH—I SLOPE SITE PLAN 1 2 3 4 5 6 7 8' 9 10 11 12 13 14 15• 16• 17> 18- 19- 5 t. WAS GROUND WATER _ j S ENCOUNTERED? k I L 0 P IF YES, AT WHAT E DEPTH? ���ooc°oseaoa'�., o�° X94 G 49�(� s Doo°o0q�acae a°ea �' I {.T' Coro. 4 Talbot 20 f �JI �� No. 4069 ERCOLATION RATE OEESS\��P TEST RUN BETWEEN FT AND COMMENTS # Reading - Date Gross Time Net Time Depth to Water Net Drop I j I � i .o ' _ I I i i i Reading - Date Gross Time Net Time Depth to Water Net Drop .o rtFfl-UFiMtU by: - 72-008 (7/76) CERTIFIED BY: (minutes/inch) _. FT • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Parcel I.D. 015-092-26 Certificate of On -Site Systems Approval retches Stuller ()q -3b Expiration Date: 7" J 1. GENERAL INFORMATION Complete legal description Prospect Heights #1, Block 6, Lot 5A Location (site address) 7801 Sitzmark Cir. Current Property owner(s) Jairo He Eugenia BUitrago Day phone Mailing address 781 Sitzmark Cir. Anchorage, AK 99507 Real Estate Agent Day phone 2. TYPE OF DWELLING: 45 6 1 9 8 1p �l ❑ Single Family (w/wo ADU) w RUSH! ❑ Duplex a APR 2 92015 a ❑ Multiple Dwellings (Single Family and/or Duplex) — 3 �6 ti 2 3. NUMBER OF BEDROOMS: e, C,Aw 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Fx] Individual Q Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNadance request for: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ d1a?456 -f 16Ato 0A Waiver Fee $ Date of Payment q/a, Il Date of Payment Receipt Number NW76 Receipt Number COSA # 6S6I5118.3 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 Cerlifcate 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 nFn Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907)272-8..218 Date 4/27/2015 �}i:veri �. Pannone �{# E-8149 Conditional approval for bedrooms, with the following stipulations: By: �J}� Original Certificate Date: J✓ Thea 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 engineers work. 7. ATTACHMENTS: / COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic.Advisory Well Flow Advisory Other COSA blue sheet t > If more than 1 septic system is on the lot: COSA Checklist # 1 of Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Prospect Heights #1, Block 6, Lot 5A Parcel 1D:015-092-26 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 10/12/1981 Sanitary seal (Y/N) Y Total depth 170 ft. Cased to 170 ft FROM WELL LOG Date of test 10/12/1981 Static water level 130 ft Well production 10 9 - P.M - Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (aboveground) 12+ in. AT INSP�CT(ON 3/31/2015 126 ft. 4.Q+ g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 8.61 mg/L Arsenic ND ug/L Date of sample: 4/6/2015 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 4/22/2015" Tarik size 1,500 gal. Number of Compartments 2 Foundation cleanout (YIN) Y Depression over tank (YIN) N Date of pumping New Pumper N/A die anouts (YM) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 4/24/201.5, z z 1.2 GPD/SF Deep Trench Soil rating (g.p.d./ft or ft Ibdrm) System type Length 50 ft. Width 3 ft. Gravel below pipe 77 ft. Total depth 13 ft. Eff. absorption arae 700 ftz Monitoring tube Y Depression over field N Date of adequacy test New Results (Pass/Fail) Pass For 5 bedrooms Fluid depth in absorption field before test New in. Water added New gal. New depth New in. Elapsed Time: New min. Final fluid depth New in.. Absorption rate >_ 750+ g,p,d: Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in Datum Cycles tested Meets alarm & circuit requirements? .E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 10.0+ Sewer /septic -service line 25+ Holding tank. 100+ Animal containment areas 50+ Manure/animal excrete storage areas 1'D0+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I 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. Engineer's Printed Name Steven R. Pannone Date 4/27/2015 COSA canary sheet_2-6.15.doc Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage11 0+ 0 Municipality of Anchorage Community Development Department =t Yl4t�z Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 151183 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 6, Lot 5A of Prospect Heights #1 subdivision. This inspection revealed a nitrate concentration of 8.61 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. LOT 4 30' N89°53'55"E 420.00 �10' Utility Easement I HOUSE DETAIL Wood Service 1 hereby certify that an accurate survey of the following described 'V`t1ki Pole & Ancho F It �t LOT 5A, BLOCK 6 *�� o 00 Multi Level Wood N o N Frame Residence rn z 3143—S ; S. tff See Detail Below- elow- '4u�W as indicated hereon. Easements other than those shown on the record plat may not appear on this drawing. Anchorage Alaska, this 28th day of April 2015. --93.8 3.8 a Asphalt Pad GWaad Stairs & Landing , • I 30'Clean Out (TYp) Ln S�\` c.61 S0 Wood Retaining Wall for Flower Bed Cantilever Wood Deck Landing & Steps --< 3.0,- Cantilever - 0. T .0'Cantilever- 0.8' LOT 5A BLOCK 6 In S89°53'25 SITZMARK CIRCLE Cantilever 2"\ 2.8' 39.0' Multi Level Wood Frame n Residence a �o L 12.8' Cantilever L_65.13, R=57 0 M Brick Retaining Wall C Pad Cantilever I ,x--3.0' LOT 3 LOT 6A SCALE : 1 " = 50' 0' 25' 50' 00' NOTE: Distances are measured to the wood trim. HOUSE DETAIL SCALE: 1"=20' 1 hereby certify that an accurate survey of the following described 'V`t1ki property: OF q� Ott PROSPECT HEIGHTS SUBDIVISION, ADDITION NO. 1 ............Fp, LOT 5A, BLOCK 6 *�� was made on April 24, 2015 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 Kurabelnikoff: ♦ improvements on the property lying adjacent thereto encroach on 0 the premises in question and that there are no roadways, 3143—S ; S. tff transmission lines or other visible easements on said property except '4u�W as indicated hereon. Easements other than those shown on the record plat may not appear on this drawing. Anchorage Alaska, this 28th day of April 2015. Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING / Parcel I.D. O!S - 09 2 - 2K HAA # in IQ Expiration Date: .3-17-04 1. GENERAL INFORMATION Complete legal description /,aA Ste, f3 roclr 6 P2vpocf 14 f #7/ Location (site address or directions) 760/ S,f-Lrn ctn� Cry/� Current Property owner(s) Tip" p" rp-ext / Vvf 5> j' Day phone 3 y6- /s-97 Mailing address 780/ Sift mcsrL: Cr• -c% Anc4orloZe Arc 99So7 Lending agency Day phone Mailing address Real Estate Agent Rodt��.I c�pynanir c Pet>,oe-A.- Day phone 2e'/-,7r/,o Mailing Address slit it ' St. S4 a r4 I uo, AA c4 a.-avQ r A-(< 91sZ-i3 Unless otherwise requested, HAA will be held by DSD for pickup. P I taste ca !t TrA c y Lo Roy Cil-./.Y'- oF{rtc� py.na.";c P.ol*n-hel PA.26i�7S/6 2. NUMBER OF BEDROOMS: S wl t� y��p «--f ;l ick, Plcort alta Carl Gu�! f/pJhGv $�.lS'97 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site 19 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ 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 sample results. (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'13 wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined In the Health Authority 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 F Ice f -24Cp 7'acA1);cot/ Phone Sys -13s'S— Address /YS30 C—ctio S'f ln{Pf/!^�ho�yP 144r 9951 &e Engineer's Printed Name Th eo e,6 --P flcAcpn Date ►2 i 3 /a ? +F A4�E 5. DSD SIGNATURE : rr1EODORE F. AACORE @ � CE -3589 .6 (1' Approved for bedrooms. `";t,''••••••••�� Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Note: The well for this property meets existing State and Muhicipal Codes. There are nitrates present. It is suggested that periodic testing be performed to insure the wells continued suitability. Current nitrate concentration is 7.88 mg/1. EPA maximum concentration is 10.0 mg/1. More information on nitrates is available from the On—Site Services Program, at 343-7904. Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By. � Original Certificate Date: / a- —/ 7" O 3 (Rev. 01)02) r.. Municipality of Anchorage • ,"` Development Services' Department *A1 i Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST lv lc �r .ct Nor #► orS--o9Z—'Z.( Legal Description: C. o f S A 6 c 6 P Parcel ID: A. WELL DATA Well type Pion ✓a If If A, B, or C provide PWSID # N• A. Well Log (Y/N) Y Date completed 6/ zs/8i Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth' 110 ft. Cased to 170 fL Casing height (above ground) 2.2 in. FROM WELL LOG AT INSPECTION Date of test:. 6 / ZS / b / Static water level 17-0 ft 137 ft. Well production 10 9•P•m• G' WATER SAMPLE RESULTS: Coliform 10 colonies/100 ml. Arsenic: mg.A. Nitrate '7. &b mg -11. Date of sample: 2s/03 B. SEPTIC/HOLDING TANK DATA Tank Type/ Material Se�fcc l Sf�e/ Tank size ►S00 gal. Number of Compartments 2 Cleanodts (Y/N) `t Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N• A, Date of pumping 9 / 9 / 03 Pumper A + C. ABSORPTION FIELD DATA Date installed 679/5/ Soil rating (g.p.d./fe or ft2/bdrm) %2� System type Tri^c Length ft. Width 3 ft Gravel below pipe ft. Total depth 12.5 ft. Eff. absorption area 45 0 ft' Monitoring tube Y Depression over field n/ Date of adequacy test /2 z/ v3 Results (Pass/Fail) Pesci For S bedrooms Fiuid depth) in absorption field before test 57••5 in. Water added523 gal. • ' New depth90 � in. E:apsed Time: 80 min. Final fluid decth $2 in. Absorption rte >= 7S0 g.p.d. ,any re;uvenatlon treatment (past 12 mo.) (Y/N 3 f/pe) 1ja^e bc^ow., If ;yes. c.je date N• /} 9— p.m- Other bacteria _ 0 colonies/100 ml. Collected by: If 6 F fan i c4 S' c. � Date installed D. LIFT STATION N• A Date installed Size in gallons "Pump on" level at _ in. "Pump off" level at _ in. Datum E. SEPARATION DISTANCES Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 10 - Absorption field on lot 122' Public sewer main ". A. Sewer /septic service line -> 2S Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots > 100 On adjacent lots > 1 ao ' Public sewer manhole/cleanout Holding tank N. A. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S Property line SS Absorption field S ' Water main N /f. Water service line ru Surface water > 1 oa Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line 30' Building foundation 20' Water main > i0 ' Water Service line > (U'_ Surface water > r 0C.'P' Driveway parking/vehicle storage <-- Curtain Curtain drain Nooe S oin Wells on adjacent lots '> eyv ' F. COMMENTS G. ENGINEER'S CERTIFICATION /certify 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. Engineer's Printed Name Date n-ec-em Scr 3 2c O? HAA Fee S 3 7s" `=G Waiver Fee S Date of Payment I z /3 /0 4 Date of Payment Receipt Number O '¢5-% 8 7 Receipt Number, (Rev. 12!01) ICS ..-05; 6:C4 -w; ;CS Ref.# 1037615001 :tient Name Flattop Technical Srv. Project Name/# Prospect His # 1. LSA. B6 :tient Sample ID Prospect His #1, LSA, 136 datrix Drinking Watcr ample Remarks: :907 5CIE301 All Dates/1'Imes are Alaska Standard Time Printed Date/Time 12!01/2003 23:04 Collected Date/Time 11/25/2003 14:00 Received Date/time 11!25/2003 15:30 Technical Dlrector /, Step C. Ede Releasedi. cs/ anmctcr Results PQL Units Method CuntaittcrlD Allowable Prep Analysis 1. Imits Date Date Init raters Department Nitrated: 7.88 0.100 mg/L EPA 300.0 B (<-10) 11/25/03 JMP ticrobiology Laboratory Total Coliform 0 coV100mL SM189222B A (<-1) 11/25/03 DKC i I k I In A Do N r Z cn A arM Z_ v' GONI FEfi 03" xzaT W _ c Zm . 3 m ,o W 5; -1 n U1 66Z :. 13 N M S DO' OO' " N "a CLn Al r N ]ate ,.•,.' '• •� �,, ;so m � vi j� A �D;INr row o3�c F o D 0 \ -4 �'.� `1 x a < OBO • i w d 0 •�y..J:< :no ;aim v y •S'•' •--•1 n Al f ,Ad arM ]C.o,i 2�D v' .) 2e2 'V - F'N N 03" xzaT W o Cu � b b 0,-. xa�D . 3 m ,o 0 5; -1 n U1 66Z :. N ;E;z ° I � Al ]ate ,.•,.' '• •� �,, ;so M • "vo Qa a;s . N W � y oNHa^o� m 9 n U1 x o Al � vi j� A �D;INr 0Arocwm z DDGQ.SZ h z o • m r =•� o 9Z DDO •• mmr m -4 �'.� `1 X OBO • i w d 0 •�y..J:< D O D v y •S'•' •--•1 n Al f ,Ad p r 4 W o�� O N• N C•1 \, �t;•.y.1d oNHa^o� I 3z S 0 _ _STREET H J- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL' PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 bo/g's- Application Date g 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name _ d i(f41 Al _ Telephone: Home 2 - gp/ Business Applicant Address Z? Ifs AA 0ACie-f A4t� 1616 ( S (c) Applicant is (check one): Lending Institution ❑ ; Owner/bier ff; Buyer ❑ ; Other ❑ (explain); (d) Lending institution -A Ar 141- Telephone s Address (e) Real Estate Company and Agent ����1 y'//�,�' fiW__(2�. Address Telephone Z-162-133 (f) Mail the HAA to the fO lowing address: 2 Y 2. TYPE OF RESIDENCE Single -Family 9 Multi -Family ❑ Other Number of Bedrooms — 3. WATER SUPPLY Individual Well L5 Community © Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite e Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11,84) 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 and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 60 Wli1 1s'LIdl �iJ�ir t� _ Telephone Address _ANQ 1h ,0 Par& 6/j/ % Date 6. DHEP APPROVAL Approved for bedrooms by Approved I Terms of Conditio al Approval Con CAUTION Engineer's Seal The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION n U�l n RECEIVED A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: (_0:L /i A'^ 'g) oa�� (.P, Well Classification _- - UMIAJ If A, B, C, D.E.C. Approved (Y/N) NIA Well Log Present (Y/N)Date Completed _����� Yield j�t�iYl 7C Total Depth '70 4C Cased to 1 �� / Depth of Grouting 't1/A 7c V Static Water Level 13o, Pump Set Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot 10S ; On Adjoining. Lots +1190 r To Nearest Edge of Absorption Field on Lot On Adjoining Lots -I- JUL) To Nearest Public Sewer Line IA To Nearest Public Sewer Cleanout/Manhole NIA To Nearest Sewer Service Line on Lot 141A Water Sample Collected by LAUM, 01,66 .0 ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed 9 of / Size t No. of Compartments Z Standpipes (Y/N) _ y Air -tight Caps (Y/N) y Foundation Cleanout(Y/N) �- Depression over Tank (Y/N) hI f Date Last Pumped 0-14.65 Pumping/Maintenance Contract on File (Y/N) Al/AN A for Holding Tank High -Water Alarm (Y/N) hj Temporary Holding Tank Permit (Y/N) A Separation Distances from Septic/Holding Tank: To Water -Supply Well 0'r,� To Building Foundation �b r r i To Property Line To Disposal Field ' To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course l"4 1A Comments Page 1 of 2 C. ABSORPTION FIELD DATA /l7ircG� Soils Rating in Absorption Strata 1�% Type of System Design Date Installed Length of Field Width of Fields n Depth of Field r'rnval Rad Thickness 8 r Square Feet of Absorption Area &0 Standpipes Present (Y/N) Y Depression over Field (Y/N) k1 Date of Last Adequacy Test Results of Last Adequacy Testifi�ScG Separation Distance from Absorption Field: t + oi To Water -Supply Well td To Property Line To Building Foundation +�� r To Existing or Abandoned System on Lot MIA On Adjoining Lots 4" 50 � To Water Main/Service Line ��� NN rr -- To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course Tn hrl....emv Parlcinn Araa nr Vehicle Storage Area ^f Zo ` 1 D. LIFT STATION Nola, Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at ,Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check P milted Be room Rating Against HAA Request I certify th I e ch k , verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed 4 66 / ate Comp y ,n t �Gl4C'? MOA No. ST Receipt No. Date of Payment �''� e 9�� <b?� 1 _ ;if_ E oa Engineer's Seal Amount:Jw to • U.•ea.a. a•••.e a=a ••Kla* V Br c 1. Corwin W Page 2 of 2 �.� CE -5283 ��,; i. 72-026 (11/84) corwin & associates,inc. Consulting Engineers 4790 Business Park Blvd. • Bldg. D • Suite One • Anchorage, Alaska 99503 • (907) 561.6151 ADEQUACY TEST LOG LEGAL DESCRIPTION: L01 r3A atacIe, 1(o, T I�pcc�f >< - sato NUMBER OF BEDROOMS: S DATE TIME SEPTIC TANK LEVEL READINGS REMARKS la'Ss 10.45 4.1 10"G5 4,Z . i 11' 05 4.1ty ` ' -.04 LI: 15 4, 1'Z +,04- ,0¢11; 11: z5 4.IZ' it 0.0 11:35 4.0O +-04- .0411: 11:45 4.10 PERFORMED BY: Laum :5 kW DATE:��� FIELD PUMPING TEST DATA SHEET 1� PROJECT �♦r iA,�,il �jQ -i�,f DATE OF TEST: I LOCATION OF WELL (Legal Description): jf �A, SIZ/467, /�55�f ,S�h. */ 1 i WELL DEPTH: /70 FT. CASING: /70 FT SCREEN: DATE DRILLING COINPLETED: 61257101 DRILLER: STATIC WATER LEVEL (Top of Casing):_ FT Cf�e�icG �%flu0) apseo Time Sincel Pumping Started/ I Depth to Drawdown/ Pumping Remarks 1 Stopped, t4in. Water, ft. Recovery Rate, GPl1 l iv0 swl 0 0 Start RECO14ERY 0 Our) ours ours Durs Our �P , (suoTTe9) pagsosgy aageM LI 4 -0 _0 (J Q: E 4j O O a c w w a ut 0- a U m m Ll -o C: c m U% N •r1 co co co a � N 4r 00 N 00 - _ - ci ca - u -z---- - C -- - - - - ------ 41 I • I � — T_..- I 1 C I� __ r F _ co 1,4 _ ....... -- i I (suoTTe9) pagsosgy aageM A IQ lL INSPECTION APPOINTMENTS ��� LDsL-L.-) D TIME TIME `t� I ,� L77 n Q,{ TIME J DATE DATE p DATE , ` „ WOK✓/, < ;co - 4�� my t�L' ❑ MULTIPLE FAMILY ❑ Three ❑ Six INSPECT N�����sas INSPECTOR -21C)- INSPECTOR Mu MUNICIPALITY OF ANCHORAGE MU CIPALITY OF ANCHORAGE DEPT. OF I "=r,LT{-I & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTITNVIRONMENTAL f'::OTECTION 825 L Street - Anchorage, Alaska 99501 • J 7." 2 ENVIRONMENTAL SANITATION DIVISION Telephone 264.4720 1 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE 41'01 D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. - 1. PROPERTY QWNER PHONE ' 77 -,56 MAILING ADDRESS ._ L e PROPERTY RESIDENT (If different from above) PHONE 2. BUYER 72 PHONE MAILING ADDR SS 9c.2,3-24 3. LENDING INSTITUTION iJ PHONE MAILING ADDRESS n I ,$)n F 1 4. REALTOR/AGENT PHONE MAI LING ADDRESS 5. LEGAL DESCRIPTION ET LOCATION i o J 6. TYPE OF RESIDENe- NUMBER OF,BEDROOMS SINGLE E:1 One ❑Four ❑ Other FAMILY ❑ Two 2�Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY EeT'INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM PET�INDIVI YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FELE MUST ACCOMPANY EACH REQUEST BEFORE. PROCESSING CAN BE INITIATED. i 72-010 (Rev. 6/79)`- C/ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ TWO ❑ THREE ❑—FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM EMNDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER J =i ❑Septic ank or ❑Holding Tank Size: /" If Tank is homemade give dimensions: SOILS RATING J TYPE OF TANK MANUFACTURER f� m � T TOTAL ABSORPTION AREA - MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE C/ I � KS Sia tyAA October 6, 1981 ANCIi0F'AGC, /\I_ASKA `39501 (907) 264-4111 cFOI:1�F r ,:I,t 1_1V NnnvOR DEP.ARTte7ENT OF I-'[ A! M.AND fN-�oo .pn�TVEII `:TwO'N II\ tG U Y I / Alaska Statebank Post Office Box 420 Anchorage, Alaska 99510 Subject: Lot 5A Block 6 Prospect Heights Subdivision #1 Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. (2) A well log submitted to this office for our files and review. (3) The depression over the septic tank and the trench area needs to be backfilled and reinspected by this office. If there are any further questions, please call this office at 264-4720. Sincerely, James S. Roberts Associate Environmental Specialist JSR/ljw cc: Lee Mc Cann Star Route A Box 2073-M 99507