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HomeMy WebLinkAboutPROSPECT HEIGHTS #4 BLK 1 LT 1Prospect Heights #4 Block 1 Lot 1 #015-091-52 Municipality of Anchorage Page ( of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -5w el -&Ai PID Number: 015 -Oct% -4;7-- SZName: Name: SOg �?jtiI.C2C.i Wastewater System: >t New El Upgrade Address: 000 r i�3(vo 'cep Of_If'�wLti. Ay si'iS(6 ABSORPTION FIELD Phone: 34 0 yi9F3o No. of Bedrooms: ❑Deep Trench )(ShallowTrench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: ® Total Depth from orlginal grade: Zt I SAtJo FI • GPD/S.Ft. i.� svr Lot: i Block: ` Subdivision: Depth to pipe bottom from original grade: r Gravel depth beneath pipe ca I 1 P�1J•JiaeG'r I�tALld`rS Vo 5 Ft. ©1 Ft. Township: Range: O Sectio n: Fill added above original grade: t Gravel length: �j y i; - Z. 5 Ft. i Ft. WELL: IE New ❑ Upgrade Gravel width: Number of lines: Distance between lines: Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: NSSCCA 0'3csy P 1,IAre: Ft. Ft. SQ. Ft. / V--b-to Driller: Date Drilled: Static Water Level: Installer: iW Date installed: Ft. Yield:Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES >f Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: , Capacity in gallons: From Tank Field Station Tank Sewer Lines ryiaLv\rsrta 7MiL a6 Well ­acid ", ' r f o 1d 9 �y Vii' Material: Number of Compartments: ,LJ Surfac iooi --- LIFT STATION Water 100 Lotf %U 4 t �� t Size in gallons: Manufacturer: Line Foundation iii. ,,, ,� "Pump on" level at: "P "'level at: High water alarm at: Curtain 'r ��u - { Pum clel Electrical Inspections performed by: Drain O ' J (�1 Remarks: 140T` BENCH MARK Location and Description: /VNf L ! nd 6zFt4 161S=rA1. Go NT I- 1S TIME - A s;�tC c Tate_ ,5w, Ila --,ilGy WaPIE Ro0i140 ,so;i i A - kAA '1 12E0LA f `i Assumed Elevation: 100 C) L-jkT fL fAvrdTl uL f, bl~i (f- ,Sr� Ft rAiop- 10 ,1 i"i,iF-. VZGIAC�/A�L• WtLL /Vcr )tv P ............. ..Ir A h_5 CkF 10 /,YAC. 5�dCdN�RiNG G - j Z' Inspections performed Dates: 1st W034 E'aple River Loop Road, No. 204 2nd % - Eagle fir„ ROBERT C. COWAN tf River, A)aske 99877 ,�) G' ei 0i,'� CE - 8501 .• Department of Health and Human Services approval Reviewed and approved b;� /✓� ���' "- Date�� 72-013 (Rev. 9/91) MOA 25 SW960321 Permit No. 2 3 Page of _ 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 LOT 1, BLOCK 1, PROSPECT HEIGHTS S/D #4 Legal Description: PID No.: 015-091-52 GWMT#3 i / , ,- / a01 / / MTl GWMT 4 T1 55.5' 30.0' T2 47.5' 36.5' DBL1 45.5' 37.0' DBL2 44.0' 3840.51 7.0' C01 21.0' 93.5' "DIVIDED / o ' / /'/ MT3 'TM /' GWM MT1 21.0' 93.5' CO2 103.0 30.0'/ MT2 102.0 29.0' MT3 40.0' 35.5' DF D L2 3LI / / // •T 4 S12 #4 � �'� STI � CO2 T2 �® NEW TIC TANK L �� ® / ® ,o kj 'V - LT. SITE �0 1 DO- � o / N 1V �L 4 / ' "' ��4 1 Pa00 (lost, D ATHry // / / / // / .TH#1 �/ 49,i7 .,• ... /ti. N.•Of• 1 HN.H fi7fl y/ NN / / pN ROBERT C. COWAN �Q `O,,•., CE - 8801 SCALE 1" = 40' .,, +4�Jf,%ap QOCj� -013 A (Rev. 9/91) MOA 25 / / / / / / / / SW960321 Permit No. 3 3 Page of — 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 LOT 1, BLOCK 1, PROSPECT HEIGHTS S/D #4 Legal Description: PID No.. 015-091-52 72-013 A (Rev. 9/91) MOA 25 ST1 ST2 INSULATI 9.4' NEW 9 .5 12 0 GAL , C01 = 95.6 CO = 95.9' MT1 MT2 01 MT3 02 INSULATIO FINAL C RADE liff— S I C01 = 92.8' CO2 = 92.8' MT1 = 92.0' MT2 = 92.0' MT3 = 92.0' 1 SAND (LAKE OTI FILTER GRAVEL) { ^. 9 if LWA r `"" � ?� ROBERT C. COWAN� 84.)' R FOUN B.O.H. NO \NATE 86.0' FOUND N.T.S. .O.H.// 7�O��4% CE -8801 rte• 1� //`•••'~+ • ` (\• may, 72-013 A (Rev. 9/91) MOA 25 C(%G% PAGE 1 OF 7 ' l r 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:SW960231 DESIGN ENGINEERS & S ENGINEERING OWNER NAME:BALLOW ROBERT B OWNER ADDRESS:11001 WILDWOOD DR. ANCHORAGE, AK. 99516 PARCEL ID:01509152 LEGAL DESCRIPTION: PROSPECT HEIGHTS #4 BLK 1 LT 1 LOT SIZE: 97525 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 8/01/96 EXPIRATION DATE: 8/01/97 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN COARSE SAND WITH 4% OR LESS PASSING A #100 SIEVE AND 2% OR LESS PASSING A #200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED ON THE SAND USED; OR USE MOA SPEC. FILTER SAND FROM AN MOA APPROVED SOURCE. RECEIVED ISSUED BY DATE r- DATE : 6e6d 7 f S& rnG July 17, 1996 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 SEWER & WATER MAIN EXTENSIONS REFERENCE: Lot 1, - Block 1, Prospect Heights S/D #4 Request you issue a permit to drill a well and install a SEWER&WATER septic system to serve the proposed four bedroom house on INSPECTION the referenced property. Test holes were excavated and percolation tests performed. The approximate location of the test holes are located on ENGINEERING STUDIES the attached site plan. ANDREPORTS At the time of excavation, no water was encountered in test holes #1, #2, and #4 ;and water was encountered in test hole #3 at 9.5 feet. After seven day ground water WEL &FLOWTEST CTION ES monitoring,thetubes in test holes #2 #3 and e monitoring / , #4 were found to be dry and the monitoring tube in test hole #1 was found to have water at 8.5 feet. SITE PLANS This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the ROADDESIGN installation of the proposed septic system. If you require additional information, please contact us. SOILTEST Sincerely, -"Rbc• V% PERCOLATION TEST Robert C. Cowan, P.E. RCC/gk Enclosure STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 i A ff onTm2 -I NIA .T 3�N'D m K NI1U� mo�K zm z mj 0I 1 OZI z ml I �1 SITE PLAN DESIGN I 00 oAa A oa / tj rAAvi W �J 70 pro / FF�k U) A� Fr I / tio6o�,�Fo SF r / b n r o r /All 0 o rt I � z W0 m� -DO 0ti 2 <� or m D n / ®Omm o (� � / O� DN � / ryii x m N m 0 »» Q <Mc I I I I I I I I I I I I I 1 I I I I r--r- 00-1Oy >00 O N Z S V)>< V >:E C m WO Aox ZE!I 1 O>nmt4-rltiN ?ZWCA� 2m 0309�//-- coN f>/1 "OmZaaV)m ONm {mm r Z M. gym>Z" rC� z x r > oom� z m4'>0 mmoOy NA Oy Z4 N> A y� 0 _ 0 > m O 30 Z Z0 ON m z o / y / C1 7 T / m O N _ O y D, o tTJ m D / Z r-0 -9m / ®Omm o (� � M j r Z n < / ryii x m N o / y / C1 7 T / O- wo z 5z >.Z1 / z> i O�Q �. > r O / Z y m 0 »» Q <Mc / �mA N O o / Z / O 0-)0(n t, 0-03 a,0rn (� O-aO O I� O � 0 \ -- o oONo :7-1 : m O 0 n v Vol A. Joon 03 e , Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST iJr,(S rn� kc� w PERFORMED FOR: DATE PERFORM Loo- J lei-ocee / n/toS,�gvr Nc16-647-5 V y Lrcnl nescRIPTION: Township, Range, Section: eQ,'(Ica ,,,,........ �1.1�) . N��,p•)ii', iOMNij1}ii f�I//./�/i//Vi/ N.wel •31 fW ROBERT C. COWAN �? Ac�� '' •. DEPTHy SLOPE SITE PLAN 10 WAS GROUND WATER pi p ENCOUNTERED? 11 s IF YES, AT WHAT L O 12 DEPTH? P E Depth to Water ARe I 'eG 1i$ �� 13 Monitoring? �� Date: 14- 15- 16- 17- 18- 19 41516171819 S 0+.o S Reading Date Gross Time (FEET) �('_S T 04- 'e- - 1 Z Zit B4C-A ic- t 2 7 ;le„ 1 MI eJ 7 3 �s p 1 6 ) 71ir w " 4- Y s/y 1, 5 5 Ci 6-A4v 6 7 8 Z c �-d-Gf. �32o2ac�t 9 10 WAS GROUND WATER pi p ENCOUNTERED? 11 s IF YES, AT WHAT L O 12 DEPTH? P E Depth to Water ARe I 'eG 1i$ �� 13 Monitoring? �� Date: 14- 15- 16- 17- 18- 19 41516171819 S 0+.o S Reading Date Gross Time Net Depth to Time Water Net Drop t2 i 3 J /Pic t 10 l y 7 ;le„ 1 MI eJ 7 to t 1 S -/y p 1 6 ) 71ir w " d ; 17 Y s/y 1, �o t 9 20 t__jPERCOLATION RATE I (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 3 FT AND y FT COMMENTS PERFORMED BY: 17034 Gagl..u:��..��..44_7N��rqq..oqp e___I s)_ 21n�w���� �-z � �7yy�_ CERTIFY THATTHIS TEST WAS PERFORMED IN pp ACCORDANCE WITH iiLIPS''QQfPrKAIIG1LPAUGUIDELINES IN EFFECT ON THIS DATE. DATE: i ct F' 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 806 IJ 4 L Lo t+J DATE PERFC Lor' 13 LocPRO SPic - /f rS f� LEGAL DESCRIPTION: Township, Range, Section: _ � SLOPE SITE PLAN (FEE DEPTH '� /LST Cf U LE- Z 1 1 1 1 -1 T1 f z ? Z r O.e�cl v c 5 2 3 6 5z> 6 Ci 7 d�it /i 9 10 11 12- 13- 14- 15- 16- 17 21314151617 18 19 20 COMMENTS S WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT — 0 DEPTH? P E Depth to Water After nR i Monitoring? Date: 7 /II` 11I1i Reading Date Gross Net Time Time Depth to Net Water Drop Al" c.. PERCOLATION RATE ? (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN `� FT AND 4_ FT S & S ENGINEERING PERFORMED BY: ffever0-10. ,F} CERTIFY THATHIS /TEST WAS PERFORMED IN ACCORDANCE WITtf�1%RRWRrIA� 9*9t28FAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) e Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 0 1 8 IL 1- 0 W DATE PERFC Loi t 13LDGk g 101t0l kcT ld°o�4,«rJ y LEGAL DESCRIPTION: Township, Range, Section: DEPTH SLOPE SITE PLAN 11 21314 12- 13- 14 51617 15- 16- 17 18 19 20 COMMENTS I r- Sr (/0L� # 3 ©'� (-,4.-j 1 C S GI�I s"I L 1 y , 14,,,,0 y G- k.4 V j� L 6/5 -Ac cl'H. gco'edc< WAS GROUND WATER ENCOUNTERED? ? IF YES, AT WHAT //a DEPTH? Depth to Water After Monitoring? "/'y Date: t ■■.■■.■M■ (FEET) Net Drop 6 0 !1'13 - '7'4'" s� 2 ° r ` . U6 3 4- .n r 5 5 ■■■■■■■■ 6 }" o r ■ ■■EZE■■■■■ g - 6-f( x� 9- 10 10 11 21314 12- 13- 14 51617 15- 16- 17 18 19 20 COMMENTS I r- Sr (/0L� # 3 ©'� (-,4.-j 1 C S GI�I s"I L 1 y , 14,,,,0 y G- k.4 V j� L 6/5 -Ac cl'H. gco'edc< WAS GROUND WATER ENCOUNTERED? ? IF YES, AT WHAT //a DEPTH? Depth to Water After Monitoring? "/'y Date: t ■■.■■.■M■ Depth to Water Net Drop 6 0 !1'13 - '7'4'" - MENEEMON ■■■■■■■■ ■ ■■EZE■■■■■ ■■EMSEE■■■ .■■ENE■■■■ ■■■EEM■■■■ ■■■■.■■■■■ ■■■■■■■■■■ ■■■■■■■■■■ ■■■■■■■■■■ ■■■■■■■.E■ MENEENEENE EMEMENNEME MENEENEE Reading Date Gross Net Time Time Depth to Water Net Drop 6 0 !1'13 - '7'4'" - r� PERCOLATION RATE -0A (minutes/inch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN q FT AND S— FT S & S ENGINEERING PERFORMED BY: I. CERTIFY THAT T IS TEST WAS PERFORMED IN 17034 Eagle River ovr "'nazi e c;. ; _ // ACCORDANCE WITFEftte`ERiVTrrAWd*W1 0M GUIDELINES IN EFFECT ON THIS DATE. DATE: b �� � 6 72-008 (Rev. 4/85) k * PERFORMED FO LEGAL DESCRIF DEPTH (FEET) 1 2 z?2 �2 A L 2 3 � 6� •a 4 5 3 _ ' Y 6 ° E H E Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST (J 0 p5 8 4 LLO W DATE PERF( )— o'r 1 8oc k 7 Pka &1wJfIS & �' )N: Township, Range, Section: SLOPE r—r—r—r—t r- 6�(rAN(L�• ry S.4�o y /1 Cr�,AV� L 8,0,14. ,QE0X2d(K 10 WAS GROUND WATER ENCOUNTERED? 11 S IF YES, AT WHAT L O 12 DEPTH? E E 13 Depth to Water Atter PR /� /� Monitoring? . Date: 14 15 16 17 18 19 SITE PLAN ®®®MWater -NPth to .. 20 I I PERCOLATION RATE i TO I (minuteshmh) PERC HOLE DIAMETER G ' I� TEST RUN BETWEEN I FT AND y- FT COMMENTS g L j 6,6F T LY i'qN,0 i 6—,Z- 7'04 / 'T&; T /i6 LI # 3 . PERFORMED BY: S & S ENGINEERING r� Iy ` �✓ CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River Fo—opff­cairlilo. ACCORDANCE WIT RT*V� AF0MIJMT7L GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) y S & Sl ROBERT C. COWAN, P.E. �InCCRIn ROBERTA. SHAPER, P.E. 11A - P AL YSTEM CIVILENGINEERS CONSTRUCTION PRACTICES (907) 694-2979 and FAX (907) 694-1211 MATERIAL SPECIFICATIONS SEPTIC TANK INSTALLATION: SOILTEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. TEST PERCOLATION 2, The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a STRUCTURAL& minimum of 12 inches above final grade. MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 REFERENCE: Lot 1, Block 1, Prospect Heights S/D #4 HEALTHAUTHORITY APPROVALS July Juy 1 7, 1996 GENERAL: SEWER&WATER MAIN EXTENSIONS 1. The scope of this project includes the installation of a 1250 gallon septic tank and a leachfield trench to serve the proposed four bedroom residence located on the referenced property. SEWER&WATER INSPECTION 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 ENGINEERING STUDIES Regulations. AND REPORTS 3. The contractor shall be responsible for obtaining any necessary underground utility locates. WELLINSPECTION &FLOWTEST 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. SITE PLANS 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the ROADDESIGN Municipal Health Department. SEPTIC TANK INSTALLATION: SOILTEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. TEST PERCOLATION 2, The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a STRUCTURAL& minimum of 12 inches above final grade. MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 1, Block 1, Prospect Heights S/D #4 July 147 1996 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 TRENCH/DRAINFIELD INSTALLATION: 1. 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. Page Three Lot 1, Block 1, Prospect Heights SID #4 July 17, 1996 5. 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. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe 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, Fernco, 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. Page Four Lot 1, Block 1, Prospect Heights S/D #4 July 17, 1996 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: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other 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. Page Five Lot 1, Block 1, Prospect Heights S/D #4 July 17, 1996 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 Municipality of Anchorage ss , On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 015-091-52 Expiration Date: 1. GENERAL INFORMATION Complete legal description PROSPECT HEIGHTS #4; BLOCK 1 LOT 1 Location (site address) 9601 SIDOROF LANE *ANCHORAGE AK 99507 Current Property owner(s) ROBERT & ANN BALLOW Day phone 250-5695 Mailing address Real Estate Agent 2. TYPE OF DWELLING: 9601 SIDOROF LANE *ANCHORAGE, AK 99507 JANELLE PFLEIGER W/ REMAX Day phone E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 257-0454 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well M Individual On-site N Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: ✓i, ,t� Date: Id', "/5__ - COSA to be released to the engineer, unless othemise requested by the engineer. COSA Fee $ qoc> `` Date of Payment _ l o, o l k a Receipt Number 00041% COSA# CbC�atiAb-1 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, t 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. 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 person or party is not authorized, nor will it confer any legal right whatsoever. 6. DSDr SIGNATURE V System #1 Approved for L/ bedrooms, System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date /o/s/1 L bedrooms, with the following stipulations: `\,,lllll(((((fffff fT r O r'� ON-SITE r 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 represenatations 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. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other By: t� Original Certificate Date: (R.v.1V05) If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: PROSPECT HEIGHTS #4; BLOCK 1, LOT 1 Parcel ID: 015-091-52 A. WELL DATA *CASED TO BEDROCK Well type PRIVATE If A, B. or C provide PWSID# N/A Date completed 9/2/97 Sanitary seal (Y/N) YES Total depth 65 ft. Cased to *20 ft. FROM WELL LOG Date of test 9/2/97 Static water level 14 ft. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 9/19/12 15 ft, Well production 15 9 -p.m. 4.21 g. p. m. WATER SAMPLE RESULTS: ''11 Coliform 0 colonies/100 ml. Nitrate�7�mg./L. Collected by: GEG. Ltd. Arsenic: ll 0 ug./L. Date of sample: 9/19/12 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (�Y//N)�YES � Depression over tank (YIN) Date of pumping JET tJJ Pumper A i C. ABSORPTION FIELD DATA *BELOW Date installed 9/12-17/96 Soil rating (g.p.d./ft`or /bdrm 1.0 Date installed 9/12-17/96 Cleanouts (Y/N) High water alarm (YIN) N/A System type SHALLOW TRENCH Length 124 ft. Width 5 ft. Gravel below pipe 0.5 ft. Total depth *3.31 + ft. Eff. absorption area 620 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 9/19/12 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 3.25 in. Water added 620 gal. New depth **$•E5 in. Elapsed Time: 120 min. Final fluid depth 6.25 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date **NO WATER IN TRENCH CLEAN—OUTS D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN "Pump on" level at in. "Pump off' level t — . High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout N/A Holding tank Manurelanimal 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 101+ Surface water 100'+ Driveway, parking/vehide storage 10'+ Curtain drain NONE KNOWN 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. Engineers Printed Name JEFFREY A. GARNESS Date 10/%42, (Rev. 1IM5) 4 �(1 YW 4� rse„moo `nNG� .use mrpNorNs onorvs xes:n5a11,'TOSN.w weT0 Pe V55o raP noA naurxanwinorvnt smurnmEs,,IFPaVE,Rm.w reuaLRFs. y EnaF^ENiS Gf PE[Cie,MIG¢AiMa T!yp/YEnNN6 CN TE iE[CPe 0.ai,io.S NJi MOWN '6HANE A. X LT Y NEP IIN➢Si MS 'm —V wrt: r5rusvixs THarM.v s�-,wa. Tws w.Wrus.PE .11. MSEom ceTEPMru EfsAb�^ s, <.�,,;� waePrv�,Lwt�swws,raN.emnaw�rwPor'Extmms. "a�a�,�'� n pWN r£P%pJ Mav B¢RRpXtMnrE euF iO E%RSflH SNDW nNILOPSW, ti Q RRFV ORDERED 811. NFLLE PFLEIGER g iPROPERTIES 1 1 1 l(/ A541RT SNRVEV .IW'� I � v I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 1, BLOCK 1, PROSPECT HEIGHTS NO, 4 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _18TH_ DAV OF _SEPTEMBER 2012. MaorLNA=J16 ms 3<r9513 I