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HomeMy WebLinkAboutPTARMIGAN ROOST BLK 1 LT 2Ptarmigan Roost Block 1 Lot 2 #020-042-66 trcev utwuuiu) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201215 PID Number: 020-042-66 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name Thomas & Dana Cupp ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 16048 Wind Song Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907)317-2686 3 1.2 GPD/SF 10.2 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 6.2 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot Ptarmigan Roost 1 2 Fill added above original grade 0.1 Ft. Gravel length 38 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tk Tank Field an Tank Line 380 Ftz 1 Ft. Well >100' >1 00' N/A N/A >25' TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1,000 Gal. Surface Water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Plastic 1 Foundation >1 0' >1 0' N/A N/A LIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank D3034Tank to D3034 drainfield Installer R&S Services Drainfield D3034 CO/MT D3034 Inspector Luke Tidwell BENCH MARK (Assumed elevation) 100 ft Inspection15f 8/12/20 Location and description Bottom of back sliding door aro 4'h ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF Conditional Approval:Date ••`............... ���� Hca °• `9 °• 49th •' �� " �.. sus„mnuruun,u.uuonun.,na MICHAEL E. ANDERSON Septic System `' : `� �s No. ce—asap ,: �� Approved� pp �Edytj Date ma 30 .2o,�D °=°, 12/1/20 Note: this does include �4 "ROFF SS�� approval not well permit requirements. trcev utwuuiu) EXISTING WELL 100500 FEET 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND CO1 PERMIT # OSP201215 PID # 020-042-66 PTARMIGAN ROOST, BLOCK 1, LOT 2 A B CO 11.05 MH SV AB C C 39.0 44.25 2CO CO2 MT 46.1 49.6 53.0 43.15 CO1 44.85 41.2 15.4 33.8 38.25 43.3 51.6 3-BDRM HOME SHED DECK 20' UTILITY EASEMENT WIND S O N G D RI V E EXISTING SEPTIC TANK DECOMMISSIONED PER UPC. 1,000 GALLON SEPTIC TANK w/20' MANWAY. 38' LONG x 5' WIDE x 4' EFFECTIVE DEPTH ABSORPTION TRENCH. MT CO2 2CO SV MHTH1 EXISTING TRENCH. REMAINS IN PLACE FOR FUTURE USE. CO 12/9/20 PLAN AS-BUILT PROFILE AS-BUILT (NO SCALE) 91.8 87.5 92.1 97.0COMH SVPERMIT # OSP201215 PID # 020-042-66 PTARMIGAN ROOST, BLOCK 1, LOT 2 12/9/20 94.8 FINISH GRADE 38'MTTH#1NO GROUNDWATER 8/12/20CO CO78.5 84.5 2CO91.6 1000 GAL SEPTIC TANK DRAINFIELD ROCK88.5 88.5 94.7 ORIGINAL GRADE LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 5.12' 5.12' 5+6'2.#0 &#6'4'#&+0))41556+/' OKPWVGU 0'66+/' OKPWVGU &'26*VQ9#6'4 0'6&412 PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: KPEJGU KPEJGU 2VCTOKICP4QQUV$NQEM.QV  /CUQP DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH?Ä <1 6 6 7 ÄÄ 6QO%WRR 12:40 7/2 1 2 3 4 5 6 0/6 12:45 12:48 12:50 12:53 12:55 FILL MATERIAL Professional Engineers Stamp: 12/9/20 15 Sec. PQ PQPG  OG SM 16 Sec. 40 Sec. 45 Sec. 30 Sec. 28 Sec. 0/6 0/6 0/6 0/6 0/6 6 6 6 6 6 6 Test Hole Deepened Prior to Construction to verify lack of impermeable layers. Unsubdivided Unsubdivided N 89'59'30"E 205.00' 1 20' UTILITY EASEMENT — Lot 2 s 50,094 S.F. SEPTIC PIPE 0„ / 7.9'x11.7' tT Lot SHED \ N 2 STORY RESIDENCE o N o� F N 6 27.1' Lot 3 �� 5R$ POR li. GRAVEL d DRIVEWAY' - PLOT PLAN ___ AS BUILT _X_ SCALE _1"=60__ GRID _ SW 3238_ Project No. ___20=2701A2 __ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, in c . (907) 522-6476 Phone p0000p00 (907) 522-4625 Fax o0 OF A p04 Professional Land Surveyors kenOlangsurvey.com o.. 9 tonathanOlonasurvev.com G S Q I hereby certify that I have surveyed the following described property: LOT 2, BLOCK 1, PTARMIGAN ROOST (PLAT No. 71-214) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the I t_ Day of k'�r 3•` at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. .• Ac KENNETH LAN s� �• 4p0!S12$�'?A'lA .••'�i �Fo '..L; -5202..'' SSS aR deo SSIONAt- �o MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www, muni. org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201215 Work Type: Septic Upgrade Tax Code Number: 02004266000 Site Legal Address: PTARMIGAN ROOST BLK 1 LT 2 G:3238 Site Mailing Address: 16048 WIND SONG DR, Anchorage Owner: CUPP THOMAS S & DANA R Design Engineer: FORGE ENGINEERING This permit is for the construction of: Cit Disposal Field 0 Septic Tank ❑ HoldinTsnk, d Priory Effective Date Expiration Date 1. t'hiU'fIII C1)t 7/15/2020 7/15/2021 Lot Size in Sq Ft: 50094 Total Bedrooms: 0 Private Well C] Waater Storage All construction shall 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 shall notify the Development. Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather, shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: The test hole shall be deepened to at least 16 ft prior to construction of the drainfield to confirm separation to impermeable and seasonal high groundwater. Construction can proceed at your own risk prior to 7 -day groundwater reading. If results require a design change, construction shall stop pending On-site review and approval of a change order. Please submit results with inspection report (or change order, if required). X O i Received By: . Issued By: Date: _112t) Date: 7 115 1?O.-�0 t On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-042-66 Property owner(s) Thomas & Dana Cupp Day phone 317-2686 Mailing address P.O. Box 111237, Anchorage, AK 99511 Site address 16048 Wind Song Drive Anchorage, AK Legal description (Sub'd., Block & Lot) Ptarmigan Roost, Block 1, Lot 2 Legal description (Township, Range & Section) Lot Size 50,094 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade ❑X Duplex (D) ❑ Holding Tank ❑ Renewal❑ 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: � q �' Z Date of Payment: 30 6,20 Receipt Number: 42y%'O Permit No. QS f 101 Z 1 �> Permit App_'.:- :- Waiver Fees: _ Date of Payment: Receipt Number: Waiver No. PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) July 15, 2020 MOA Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Subject: Ptarmigan Roost, Block 1, Lot 2 – 16048 Windsong Drive Septic System Design Dear On-Site Services Engineer: The existing septic system on the subject lot has failed and must be replaced. We are submitting this permit application for the replacement and upgrade of the septic system to serve a three- bedroom home. The attached site plan identifies the location of the home and the existing well and existing and proposed septic system sites. No conflicts exist between this proposed system and any other well or septic system on this or adjacent lots. The ground surface on the lot is virtually flat in the area of the new trench but slopes up to 40% within 50’ of the proposed absorption trench. The trench has been designed to meet the steep slope provisions of the Municipal Code with the distribution line at 6’ below the surface. The test hole placed on the lot will be extended to 16’ to verify the lack of adamant soils or bedrock. The well log for the property indicates granular soils to depths of 33’. Wells on this and adjacent lots are shown. The new septic system will be a minimum of 100’ from the well on this lot and 100’ from all wells on adjacent lots and surface water The tank will be 10’ from the house foundation and 5’ from deck and stair supports. Please refer to the attached plan sheet for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, P.E Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201215, Rebecca Carroll, 07/15/20 EXISTING WELL 10050 0 FEET 1"=50' NOTE: SLOPES >25% WITHIN 50'. SYSTEM DESIGNED TO MEET STEEP SLOPE PROVISIONS OF THE ORDINANCE. NO SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND CO PTARMAGAN ROOST, BLOCK 1, LOT 2 7/15/20 2-BDRM HOME SHED DECK 20' UTILITY EASEMENT WIND SON G DRIV E DECOMMISSION EXISTING SEPTIC TANK PER UPC. 1,000 GALLON SEPTIC TANK w/20' MANWAY. 38' LONG x 5' WIDE x 4' EFFECTIVE DEPTH ABSORPTION TRENCH. MT CO DV 2CO SV MHTH1 CONNECT EXISTING TRENCH w/FLOW DIVERTER VALVE.0-5%0-5%0-5%2 5-4 0 % 2 5- 4 0 % Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201215, Rebecca Carroll, 07/15/20 PTARMIGAN ROOST, BLOCK 1, LOT 2 DESIGN FACTORS: SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: <1 MIN/IN APPLICATION RATE: 1.2 GPD/SF 5' WIDE SHALLOW TRENCH SYSTEM 1,000-GALLON SEPTIC TANK TYPICAL TRENCH SECTION (NO SCALE) 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 5' 6" 6" 5.5' 4' NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY BOTTOM OF TRENCH: 10' BELOW GRADE FLOW LINE ELEVATION: 6' BELOW GRADE TOP OF TRENCH: .5' ABOVE GRADE 450 GPD / 1.2 GPD/SF /5' WIDE * .5 (RED. FACTOR) = 37.5 LF TRENCH REQUIRED (38 LF SPECIFIED) 7/6/20 GEOTEXTILE FABRIC Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201215, Rebecca Carroll, 07/15/20 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) Ptarmigan Roost, Block 1, Lot 2 6/24/20 Mason DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? - <1 6 6 7 020-047-66 Tom Cupp 12:40 --- 1 2 3 4 5 6 0/6 12:45 12:48 12:50 12:53 12:55 FILL MATERIAL Professional Engineers Stamp: 7/6/20 15 Sec. no none 7/2/20 OG SM 16 Sec. 40 Sec. 45 Sec. 30 Sec. 28 Sec. 0/6 0/6 0/6 0/6 0/6 6 6 6 6 6 6 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201215, Rebecca Carroll, 07/15/20 PROJECT CLIENT:% GRAVEL 29.5 USCS SM PROJECT NAME:% SAND 49.0 USACOE FC N/A PROJECT NO.:% SILT/CLAY 21.5 % PASS. 0.02 mm N/A SAMPLE LOC.:% MOIST. CONTENT 15.7 % PASS. 0.002 mm N/A NUMBER/ DEPTH:UNIFORMITY COEFFICIENT (Cu) DESCRIPTION:COEFFICIENT OF GRADATION (Cc) DATE RECEIVED:ASTM D1557 (uncorrected)N/A TESTED BY:ASTM D4718 (corrected)N/A REVIEWED BY:OPTIMUM MOIST. CONTENT. (corrected)N/A SIEVE SIEVE TOTAL %SPECIFICATION SIZE (mm)SIZE (U.S.)PASSING (% PASSING) 152.40 6" 76.20 3"100 38.10 1.5"98 19.00 3/4"91 12.70 1/2"82 9.50 3/8"79 4.75 #4 71 2.00 #10 60 0.85 #20 49 0.43 #40 40 0.25 #60 33 0.15 #100 29 0.075 #200 21.5 ELAPSED DIAMETER TIME (MIN) (mm) 0 0.5 1 2 4 8 15 30 60 250 1440 HYDRAULIC COND. (ASTM D2434) DEGRADATION (ATM T-313) PLASTICITY INDEX ASTM 4318 UNKNOWN UNKNOWN Forge Engineering HYDROMETER RESULT N/A SIEVE ANALYSIS RESULT Ptarmigan Roost 5665-20 Block 1/ Lot 2 20-S-1 Silty sand w/ gravel 6/29/2020 JA RJPC TOTAL % 11301 Olive Lane ∙ Anchorage, Alaska 99515 ∙ Phone: 907-344-5934 ∙ Fax: 907-344-5993 ∙ www.nge-tft.com N/A N/A PASSING The testing services reported herein have been performed to recognized industry standards, unless otherwise noted. No other warranty is made. Should engineering interpretation or opinion be required, NGE-TFT will provide upon written request. 115 120 125 130 135 140 145 0 2 4 6 8 10 12 14 16DRY DENSITY (pcf)MOISTURE CONTENT (%) MOISTURE-DENSITY RELATIONSHIP ASTM D1557 SILT or CLAYCOBBLES GRAVEL Coarse Fine SAND Coarse Medium Fine 0 10 20 30 40 50 60 70 80 90 100 0.0010.010.1110100FINER BY MASS (%)GRAIN SIZE (mm) PARTICLE SIZE ANALYSIS ASTM D422 / C136 #200#40#101.5 1/2363/4 #4 #20 #60 #1003/8 U.S.SIEVE OPENING IN INCHES U.S.SIEVE NUMBERS HYDROMETER Unsubdivided N 89'59'30"E 205.00' Unsubdivided 20' UTILITY EASEMENT \50,094ot 2 s S.F.LA SEPTIC PIPELOtSHESHED Lot 3 5'x 16.0' PORCH J : -GRAVEL GRID _ SW 3238-- Project DRIVEWAY' 20=2701A1---- Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska (907) 522-6476 Phone 99515-3049 Professional Land Surveyors (907) 522-4625 FaxF kenOlangsurvey.com oo000p�4 p �.•. A . X04 , ,9 Q jonothanOlongsurvey.com �o�..• $a PLOT PLAN ___ AS BUILT _X— SCALE _1= 60_— GRID _ SW 3238-- Project No. ____ 20=2701A1---- Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska (907) 522-6476 Phone 99515-3049 Professional Land Surveyors (907) 522-4625 FaxF kenOlangsurvey.com oo000p�4 p �.•. A . X04 , ,9 Q jonothanOlongsurvey.com �o�..• I hereby certify that I have surveyed the following described property: LOT 2, BLOCK 1, PTARMIGAN ROOST (PLAT No. 71-214) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the y" Day of ---]ILLS_______- 1'-''_L_`� _, at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49?H y*( KENNETH G. LANG � �pFaFo -.1S-5202..- y�oG 0 440���FfSSIONA� o� AECC963 On -Site Water 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: OSP131399 Tax Code Number: 02004266000 Work Type: Well Permit Effective Dates: October 24, 2013 to October 24, 2014 Design Engineer: Subdivision: PTARMIGAN ROOST Site Legal Address: PTARMIGAN ROOST BLK 1 LT 2 G:3238 Owner/Address: ALLEN RONNIE J 16500 SOUTHCLIFF RIDGE CIR ANCHORAGE AK 995165414 Site Mailing Address: 16048 WIND SONG DR, Anchorage This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 50094 Total Bedrooms: 2 N Private Well Y 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 Issued By, 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. Property owner(s) Mailing address Site address I i Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size /. IS' 4c &q -R. Number of Bedrooms 2_ 7�YR-3Sov APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Single Family Absorption Field ❑ Initial ❑ (SF) Septic Tank ❑ Upgrade p9 ❑ (`N/wo ADU) Holding Tank El Renewal❑ (D) ElRenewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. _1__1 of property owner or Permit/Rush Fees: L-30 Waiver Fees: Date of Payment: O - 2 2 - / 3 Date of Payment: Receipt Number: Q 0 5l O Receipt Number: Permit No. Mf? 13134i°1 Waiver No. Permit APP_9-1-12.doc o 10/08/2013 15:23 9075636967 CRN h, FULL MECHANII To whom it may concern, LLC CRL—SERVICES MM569 FAX PAGE 01/01 As of 10/5/2013, CRL Services completed the installation of two (2), three hundred gallon domestic water storage tanks at 16048 wind Song Drive - Anchorage, Alaska. This work was performed to comply with local municipal code requirements. If you should have any questions or concerns regarding this work, please contact me at 907 563 6569. Regards, ROBERT REID OPERATING MEMBER MANAGER CRL SERVICES, LLc 907 563 6569 — main 907 748 3519 — call 907 563 6967 - fax PLANNED PREVENTIVE MAINTENANCE PLUMBING, HEATING B AIR CONDITIONING 0D., GREA�"ER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME � ( /4'Q' (�'' MAILING ADDRESS «.3l f\ 1 PHONE'S x>-- /y� (<, LOCATION G� (110 S Od G LEGAL DESCRIPTION �• t� ' Pf' r�/��l +i it RC'C St SEPTIC TANK: DISTANCE NUMBER OF FROM WELL MANUFACTURERMATERIAL �a`I z- ° COMPARTMENTS �9 INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /Q>b GALLONS. SEEPAGE `PPS: %RiZP1LId NUMBER OF PITS '� ')•. DIAMETER OR WIDTH_ LENGTH_, DEPTH LINING MATERIAL CRIB SIZE: DIAMETER_DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE qvc) BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA)SQ. FT. ADDITIONAL ABSORPTION 1 1�fz 11C t� -5 '�(� !`(' Lr'. e WELL: TYPE 1" t'J CONSTRUCTION BUILDING NEAREST FOUNDATION—,LOT LINE CESSPOOL OTHERSOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY: PIPE MATERIAL:`s —K-- l.- LOT SLOPE: _ REMARKS: NEAREST SEWER LINE REMA DEPTH SEPTIC TANK_ DIAGRAM OF SYSTEM .J DISTANCE FROM: SEEPAGE SYSTEM qP(,( DATE �� / f/( ��r' APPROVED CK, j (a -W DRILLING, 'INC. DRILLING LOG Well Owner (; orn Eristow) Terry i..a.z Lt� k� Use of WeI Location (address of: Township, Range, Section, if known; or distance main road 1-2, P1k 1, Pta.rnigan Poost Subdivision. Size of casing 1�epth of Hole 29G feet Gased to 36.7 feet Static water level e ft. (above) (below) land surface. Finish of well (check one) open end ( X ) ; Screen ( ); Perforated 1.Dno _ Describe screen or perforation Well pumping test at gallons per (dour) (minute) for 1 hours with 1Mr of drawdown from static level. Date of completion 27 `uly x.976 .` E Y� WELL LOG Depth in feet from ¢ss:j!. 's ground surface Give -details of.formations penetrated, size of material, color and hardness TO 2 3 TO — 3 TO 296 TO. .TO TO To— TO- TO— TC)- TO- To— .TO OTOTOTOTOTOTO TO ng $tickuD ��:Organics Silty G,.avel tedrock:.I light brown, oilstone/claystone ntractor Com{ (irate Nos. 814 & 973 3—CONTRACTOR �F:' r -i P�J C� RVA Cfl n k��� -DECIF F -HEALTH AND ENVP IRONMENTHL r ECTION 2516 E. �` }OR RD. H�C GE/ �HK 99 ~7 ��,�~� 276~2221 � - 9_ ��FE. FZ7. ���r.-I r. -T, PERMIT NO. ( 76454 HPPLICHNT TERRY CARJEE. 14]1 '/K'/ S� 27��1466 `^ � LOCHTION WTNDS8NG DR LEGHL L2 B1 PTARMIGAN LOT SIZE 44000'QUHRE FEET��r� TYPE OF SOIL HBSQRBTION SYSTEM IS: T'REF..ICH MAXIMUM NUMBER OF BEDROOMS = A3SOIL RATING (SQ'FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ��2. !:5 ����fc-3, 1- F -A Aimi_ ������L.- ��r::�a -n - k -4. 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). P-4 I F----. BHCKFILLING OF ANY SYSTEM WITHOUT FINAL. INSPECTION AND APPROVAL BY THIS IEPHRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND AN`? ON~SITE SEWAGE DISPOSAL. SYSTEM IS 100 FEET FOR H PRIVHTE WELL OR 200 FEET FOR H PUBLIC WELL WELL LOGS ARE REQUIRED HND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DAY', OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTHLLHTION. IF pi Ir ��F;,. ��E-E ��F-i lF;_m �F-7:"Cu irl T. -I.H.3' U_J EE�' I CERTIFY THAT 1� I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HND WELLS HS 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 ENLHRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED ISSUED ` � � �� (L_ o /V - R G-' <� 1- '567 "e-:- V 'LEGEND: IN Bross Cap Monwnent 0 Iron Pips yt 9 Steel Pin w survey muo is coca I hereb certify that I have surveyed Lot z Olock, Sub0islon, Anchorage Recording Precinct, Alaska, and have replaced all lost corners with 5/8" X 30" rebar. It is the responsibility of the owner, prior to construction, to verify proposed building location on lot, grade, and utility connections, also to determine the, existence of any easements, covenants, or restrictions which do not ppear on the recorded plot. Dated at Anchorage, Alaska this ' '3 U . day of-ij 41117 --C- , 19 Constructing Engineers, SRA Sox 60, Anchorage, Alaska. 344-0817 344-7960 C% 07N V 'LEGEND: IN Bross Cap Monwnent 0 Iron Pips yt 9 Steel Pin w survey muo is coca I hereb certify that I have surveyed Lot z Olock, Sub0islon, Anchorage Recording Precinct, Alaska, and have replaced all lost corners with 5/8" X 30" rebar. It is the responsibility of the owner, prior to construction, to verify proposed building location on lot, grade, and utility connections, also to determine the, existence of any easements, covenants, or restrictions which do not ppear on the recorded plot. Dated at Anchorage, Alaska this ' '3 U . day of-ij 41117 --C- , 19 Constructing Engineers, SRA Sox 60, Anchorage, Alaska. 344-0817 344-7960 �,ty"t'i I h erw �:...��-v'roc+'�nt^.., .,t n.-„wr1..,.•r-s •im,'+e' , r �.iPotan �....^�•....n r ..I_.A... .w, �...”—.�:��,,,a b)t I r. �, .. �m+m+•.,w, .rn.. "",IF'I'N'HY�9*v .,, of r'ry,F'dvw,w•.Y,ryry jrlilkp Ir, pliniltm, 011k of Awl J�,�av��P�r�is �4n� �aRantr,AS���I► / 2x16 k :IluI1 r Rcaw `# ,Alltchorage, Alaska 99507 ,�' _ 2742221 L hI trllI Il,I, 1 all's 11001 1 Irl�1A 1 ION I n I t'rlr9j�l�rinaAl ll 1dfJ11 �1114Gri 1�:'IU1r" r,. - ., ....I I._.r , ,_ , BMW Ili.rfurp►I'b1 �ti �'q •�� t. 1111? 1'lwlwl re1)0r1;,,; l f'T ��yPh��n• ��'O Per ���a1 io►i I,i, .I . „I ,.rrr r r 11 f nr, / ,•., w r, n 111�1►krll t Il"nUr: I! �.. �I •. , r nr.rn 1 ~ •rIA .r.r• r. r. r 4 it v rIN,w Ail Kl•1 do (`�' %/� K� -1�f / /" r' rrr .. • ...... ,.,..,�.. ..., I 4Vgt, ril'u►111�I dv11lot1111111? .., w 'ti 11' to Ivdl� d, i111F11JIY I 1 Id Itill 111+1 11i 1't i (J1'u5h J �Illfifl(� C r 11 life; fl( T.AI UQ�t k!! t 11. I r..n i p r.. .1 Ir 1 'In 1 , .1. „Y •Ir I n .• , ., r err , .• , r .q .r..l` • t q I en ri.rrr , , r • r r l r r r 1 v I. I' 1 A. r � IIIr1 If n r r n r r 'I rlr , r .. •rr1• , r•Fr Irl4irj h .I 1 4 •f r r 'e r r 1. .rl, n rr "..r r , ,, ,. .. Ir Ir .,.. r .. rl., n .. , r •" M I I t .... I r r r:r...,. ,•i t .. � yaw , I i'n"�hli � �rrk�� �►'�, �1(I „ � � r _ r . r r r , r nliilill,a •I I .r. .r,I �„�, ., 1, flr(11111f(s�ll �tlil ►11 jto �g111 d +611► flat f! d' lJll►1h • 111?.;P1 " , r ." I , r.,, , E 71 I til l�tl o 't'nr,ll 1 �,�o �,rf�r,4F, rRrr SU�Jllrl /C PII1ri'[11FI,I 11e fill a .� rr '•rr". ". r. n/I �' ..`.• ii '. �7+.r i'I I'r, .. ,e r r,. n ..e /.:,nn r Jvr Ifr a ,. r.r, r ... .rl 91 Parcel I. D. 020-042-66 RUSH Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 s ' Certificate of On -Site Systems Approval 1. GENERAL INFORMATION: Expiration Date:^2Co "Z Complete legal description PTARMIGAN ROOST; BLOCK 1, LOT 2 Location (site address) 16048 Wind Song Drive *Anchora Current Property owner(s) Tom & Dana Cupp Day phone 317-2686 Mailing address Real Estate Agent 2. TYPE OF DWELLING: © Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well z Individual Individual Water Storage ❑ Holding Tank ❑ Community Class_Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 1�ffo Waiver Fee $ Date of Payment 7 z-_olz t Date of Payment Receipt Number 0/_6gC116: Receipt Number COSA # O SC 2 11 1/11 l Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Narne of Firm: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage Alaska 99507 ( J Engineer's Printed Name: Jeffrey A. Garness Date: ! =r f r In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the �� Oji A �4 evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, ;S UH groundwater levels (that may fluctuate during the year), quality of construction (materials and ' workmanship),g y g yvary, .:.. .'r ......... ........:... and the water usa e of the Tamil utilizin the sstem/s. These conditions can and � • , are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of !//�• • • • . • • 'r the well or septic system. GEG makes no representation whether an alternative well or septic system �n 1�rrey H. Coyness. ` can be installed on the property in the event either of the current systems fail to perform adequately in 1I� 9(, CE -793 the future. The content of this report is for the sole benefit of the person/party that retained GEG to �` `� 7 P P P Y 1` �J �o perform the evaluation. Reliance upon the information provided in this report by any other person or �Q �Fa t ��o party (including subsequent property purchasers) is not authorized, nor will it confer any legal right �N�r0fesS,10, whatsoever. �Oo;v�o �kkkkk(i[Q (#� ECC884 6. DSD SIGNATURE P���Y OF,q, System #1 Approved for bedrooms �Q System #2 Approved for bedroomsir ON-SITE WATER AND Disapproved m WAST`_VATER z Conditional approval for bedrooms, with the followi �tiPUWRO ,AM moi. i9.�_ ,C•, SEP���C_ .,;.• Original Certificate Date: 7 -2 -G -2-i( The --ZG— The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory _ C Other (COSA Checklist Legal Description: PTARMIGAN ROOST; BLOCK 1, LOT 2 parcel ID: 020-042-66 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA 1-B-1 Well log is filed with Onsite (or attached) Well production at time of test 0.11+ gpm Date drilled 7127/76 Water storage tank volume *600 gallons Total depth 296 ft Well disinfected for coliform test? El Yes [» No Cased to 36.7 ft 19/coliform bacteria is Negative Sanitary seal is functioning correctly Nitrate mg/L [Nitrate less than MRL (ND) VVires are properly protected Arsenic ug/L Arsenic less than IVIRL (ND) Casing height (above ground) 12+ in. Collected by GEG, LTD. Date of flow test for COSA 7/6/21 Date of Sample 7/6/21 Static water level at beginning of test 34.2 ft Comments *2 x 300 GALLON TANKS - GEG DID NOT INSPECT THE WATER STORAGE SYSTEM B. TANK DATA C. LIFT STATION Age of tank(s) 1 years ❑ Required maintenance completed $EPtIUMUPE I ank type/material Age of lift station years (Measured operating fluid level in septic tank NEW Lift station material Standpipes/foundation cleanout per record drawing Comments: N/A Date Of pumping NEW D. ABSORPTIO1`Q FIELD DATA TRENCH Which systern tested (date installed) 8112/20 Adequacy test date NEW Fil ALL standpipes present per record drawing Results [Z]Pass For 3 bedrooms Total measured depth from grade *10.3 ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade *6.3 ft (ain) Water added gal ❑ N/A — pressurized field _ New depth in Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective SS�r-,=� �2 ;���' X Code -required soil cover over field Final fluid depth - in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) N/A Gallons introduced gallons If yes, enter date N/A Comments/Deficiencies: 'INFO FROM 2020 INSPECTION REPORT - PRIMARY & RESERVE TRENCH MTS DRY ON 7/6!21.6G DID NOT CHECK MT DEPTHS.—_I COSA Checklist yellow sheet 90 71 M Yes if No ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' Fv-1 Yes if No u� Wells on Adjacent Lots: Absorption Field > 5' F/� `i if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10' E. SEPARATION DISTANCES Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' Fv-1 Yes if No 1 j From Private Well on Lot to: (Please enter distances if less than required or if community well) if 2 Septic Tank/Lift Station on Lot > 100' Building Foundation > 10' Community Sewer Manhole/Cleanout > 100' Yes if No ❑✓ Yes if No ft 0✓ Yes if No ft Yes if No ft Wells on Adjacent Lots: J Neighboring Tank > 100' (]✓ Yes if No ft Private Sewer/Septic Line > 25' 71 Yes if No ft Q Yes if No ft Water Service Line > 10' 0✓ Yes if No ft Absorption Field on Lot > 100' F� Yes if No *97 ft Holding Tank > 100' 2✓ Yes if No ft Yes Neighboring Absorption Fields > 100' ft Animal Containment > 50' Z✓ Yes if No ft Q Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' R1 Yes if No ft F,�/ Yes if No ft Frons Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' M Yes if No ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' Fv-1 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F/� Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10' F71 Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' Fv-1 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' R1 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓0 Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' 0✓ Yes if No ft Community Wells > 200' P/ Yes if No ft Surface Water > 100'✓� Yes if No ft F. ENGINEER'S COMMENTS *WR#960053 G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review o;"f✓lunicipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yello:v sheet d0 H,� :.. .. n. I. ......r....:... w� n.U CE -79`= 0 14 rO{es s10` C 9AECC884 -������ `4V.� Municipality of Anchorage ® Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) 4 OSC211411 During a recent COSA on-site inspection and test of the potable water supply well on Block 1, Lot 2 of Ptarmigan Roost subdivision, the well's productivity was determined to be .11 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage On -Site Water & Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 020-042-66 Expiration Date: 1. GENERAL INFORMATION Complete legal description PTARMIGAN ROOST; BLOCK 1 LOT 2 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: 16048 WIND SONG DRIVE *ANCHORAGE. AK ESTATE OF ALLEN RONNIE Day phone N/A 16048 WIND SONG DRIVE *ANCHORAGE, AK N Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Afell ❑ 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" 1 u Date of Payment t b I 1 k3 ( Receipt Number 0 U11(G COSA # 0x1315a? Date 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, 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. 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 or 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. DSD SIGNATURE System #1 Approved for :21- bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date I D 9 13 bedrooms, with the following stipulations: tOF (A& f(Oii j ON-SITE WATER AND WASTEWATER By: Original Certificate Date: Z Q -22-/3 The Wnicipality 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 engineer's work. 7. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory 1R_ irrns� Nitrate Advisory Arsenic Advisory Other 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: PTARMIGAN ROOST BLOCK 1 LOT 2 Parcel ID: 020-042-66 A. WELL DATA *CASED TO BEDROCK **500 GALLONS OF STORAGE IN HOUSE A Well Log (YIN) YES Well type PRIVATE If A, B, or C provide PWSID# N �_ Date completed 7/27/76 Sanitary seal (YIN) YES Total depth 296 ft. Cased to *36.7 ft. FROM WELL LOG Date of test 7/27/76 Static water level 40 ft. Well production 1.0 g.p.m. WATER SAMPLE RESULTS: Coliform D colonies/100 ml. Arsenic: /NJ fO ug./L. B. SEPTIC/HOLDING TANK DATA Nitrate /ub mg./L. Date of sample: 4 /1 1 /13 Tank Type/Material SEPTIC/STEEL Wires properly protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION 9/16/13 32 ft. **0.18 g.p.m. Collected by: GEE Ltd. Date installed 7/19/76 1000 2 Cleanouts YIN YES Tank size gal. Number of Compartments _ (YIN) Nk Depression over tan(YIN) NO High water alarm (YIN) N/A Foundation cleanout (YIN) YES _ p ( ) — Date of pumping ) Pumper AA c 00eaC/ C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 7/19/76 Soil rating (g.p.d./ftor /bdrm 1125 System type TRENCH Length 55 ft. Width UNK ft. Gravel below pipe 4.0 ft. Total depth *9.25+ ft. Eff. absorption area 440 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **9/13/13 Results (Pass/Fail) PASS For E bedrooms Fluid depth in absorption field before test E in. Water added 420 gal. New depth E in. Elapsed Time: 29 min. Final fluid depth E in. Absorption rate >= 300+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE If yes, give date — **PRE—SOAKED WITH 2000 GALLONS ON 9/12/13 D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' level at�i . High water alarm level Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *97' Absorption field 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 N/A Animal containment areas 50'+ 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 wafter 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 60053 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 COSH guidelines in effect on this date. Engineers Printed Name JEFFREY A. GARNESS Date 10/0 li,-$, (Rev. 11105) Municipality of Anchorage --1 Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING C Parcel l.D.._ COSA # 0,51W Expiration Date: L a 3 — 0 9 1. GENERAL INFORMATION e__:Y_ Complete legal descript Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, 2. NUMBER OF BEDROOMS: Day phone C%Y7— .3/041 &ell. 4k, 99s/ / phone &/D l%fhil�z Day phone 223— 6263 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class _Well Public Water System L will be held by DSD for pickup. 42 TYPE OF WASTEWATER DISPOSAL: j Individual On-site ❑ Individual Holding Tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 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, 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 Address Engineer's Printed Name 5. DSD SIGNATURE Approved for 2 bedrooms. Disapproved. Conditional approval for Phone �4 j< /i/T 9 F 677 i Date /O ze/y r bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report Other Mw 11M) Original Certificate Date: / 0 ^ %S O U Municipality of Anchorage •� Development Services Department �s ` Building Safety Division" On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lal- 2 94CCV1 14 ArA2mr-fioi) /[647WLarcel ID:Qa Q—O'VP,-(p ro A. WELL DATA Well typep IJA? C Date completed Total depth/ _ft.' If A, B, or C provide PWSID # Sanitarysea (Y ) P S Cased to 3 eft. X)70 � ;Q 06 t-11- FROM /FROM WELL LOG Date of test Static water level /to ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform _colonies/100 mL Nitrate Qi NgebglL Arsenic: �LZLd ug/L date of sample: �Os B. SEPTIC/HeLCtMG TANK DATA Well Log 61 )- Wires properly protected Y ) -7 S Casing height (above ground) Z7 in. AT INSPECTION 0,310 g.p.m. Other bacteria O colonies/100 mL Collected by:S'IS Z j19.�Ne�rlq Tank Type/Material S'ir�2? Date installed 7 /212 Tank size Z= gal. Number of Compartments Cleanouts(Y/ ) Ve J Foundation cleanouON) SIP�J Depression over tank (1Q/Ny NO High water alarm (Y63 /{%0 Date of pumping O Pumper. _.L v G/ %!#<-7 C. ABSORPTION FIELD DATA Date installed 7 Length SCJ' ft. Total depth �/_ ft. Soil rating (g.p.d./ft2 r ft2/bdrm) ZS' Width ft. System type _! / nie, /9 �� Gravel below pipe �O � ? Eff. absorption area �'it2 Monitoring tube PS Depression over field IU 0 Date of adequacy test 0 0 Results as ail) Fluid depth in absorption field before test _ '!� in. Water added3z gal. For 4R7 bedrooms New depth in. '�� J"*3 -� Elapsed Time: L min. Final fluid depth in. Absorption rate >= >7D g.p.d. Any rejuvenation treatment (past 12 mo.) 0&type) N 0 If yes, give date — D. LIFT STATION /v M Dade na Size in gallons Manhole/Access (Y/N) "Pump on" level at _ in. 'Pump off eve h watelra. arm evel at in. Datum Cycles tested Meets alarm & circw mentsl E. SEPARATION DISTANCES SEPARATION DISTANCES FRO/M, WELL ON LOTTO: Septic tank/ -on lot %y66 Ae 9-100-bn adjacent lots /00 r � Absorption field on lot /OO f On adjacent lots Public sewer main N Irg Public sewer manhole/cleanout /� ✓� Sewer /septic service line 2S 1 It- Holding tank 0k)� / Animal containment areas .�0 /' Manure/animal excrete storage areas 'f i SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Jr /- Property line Absorption field '5- >` / r Water main A) li Water service line Surface water SOD !- Wells on adjacent lots /0 0 l4 - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main✓} r t Water Service line �U Surface water 100i- Driveway, parking/vehicle storage /Ort Curtain drain 4JOOE (CIV UJ Wells on adjacent lots /OD F. COMM ENTS -`'F4CW /2A4 7-,c /S ,oVD i G-Gt/} 21iU7EEJ� l//32/r4T/o! vS �ti hJ NS ' / cJCGIiAL, i L-'X?r.t/ 5 32S in o T -e 40:Pc�rvc G. ENGINEER'S CERTIFICATION rAQ�/.•••'�• j,•' �4.�t1 I certify that I have determined (h a field inspections and review of Municipal records that the above systere i i •••••-•�t••' conformance with MOA COSA uidel' s in ffe�on hisdate. ;= t`"'•' ,;;.••••....r Engineer's Printed Name Date% COSA Fee $ d ^ Waiver Fee $ Date of Payment to 1421O Date of Payment Receipt Number �� D Receipt Number (Rev. 11105) VII0°"O �` 201 Do Oil T URL Mr 3 SURWY C£RMrA¶ON,�► ♦♦a YT PLm r w�rrrwrt Arl rw �.i,r rr rr..w � 1 X41 =i R17ATI N AiBUIT % f YI L Ar A. art �F 41 :r•.�..r � rH r r w,r�w�ii r AL STOUC1111C AS-RACi 21 - S �,` IGT AjmtV SURVEY RfuOA" A►i1LT MY 11RR w AA ? RM RAN . . AA-1WL7 ... Im ATn IT THE EXISTENCE OF ANY OR OWNCR. PRIOR TO LINO CRAOC RCLATIVC •S AND TO OCTCRWNC mousc EC o CRAVrL OPIVE •CLL T O. Prepared by Robert E. Johns, Jr. & Assoc. Professional Land Surveyors 1700 SAW DRIVE ANOIOINA. ALASKA VWW& 111 a 5 01 N.L I.eT &F. RA Rol F'Lo ff")Vc 10-15-08 1J-16-08 .'Cci1T:.�CA1: i�D03t DRANACEOW rrj ASfNAIT FOR40 REHAR WOW F�CE {'-'A' lI _ CONCRCM ASSILMAM ELCY. �-r-t r . n THOSC NAPROVEATCNi'S ADOVE OROl1ND AND VISXILL TALL N frN , RFL=- =PT1C CLEANOEMUM SC XS ORIVErAYts. IARC SHQw RI THEIR APP.OXNlATC LOCATION, ONLY. SNOW RCYENT SOAK MPROvcwENTS FTTOY DCRIO SCE" AND LOCATM T 1R 00 NOT APT.FAN W lb4. RFCORDFn AIH "V. ON P..AT. I ALL OISTANC ..S ARE PfCORO UNLC�r. OTHf.RVN,r NOTF.O. WVP NO CIRCUMSTANCES SHOLLD AR AS -°ULT DE U30 RJt CCNSTRl1CTXN OR foot MAAUSF O W140OW Y OR fENDE LNd Municipality of Anchorage Development Services Department Building Safety Division ' ., ,.. On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Nater Well Advisory Health Authority Approval # 080368 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 1, Lot 2 of Ptarmigan Roost subdivision, the well's productivity was determined to be 0.3 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 2 -bedroom residence is 0.2 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. ' MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # O 2 D O Y 2 G� 000 HAA # 0 a) l n C`tL "41 1. GENERAL INFORMATION LL:'LokcOccC :'3 Complete legal description l.at 2 13/Gc� li P rmrgan Rcos>` S /D Location (site address or directions) 16 O `f WI/)dSynq Dr -1 vC Property owner / e ✓'rz 1-ee Day phone 3 ys" 18s1 Mailing address PC/. box l fos-6H f}nctiorge hIc 99511 Lending agency /i k USA F'eCe CvrerU Umbo Day phone 7156'' 215-1915 Mailing address yGGO CrPc(;f G(nu,; Drr,,e 19 At, ch /I- �-' 99q -o3 Agent N,4. Re r!naAce,) Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 2 F/V�/RQ '1117), . 3. TYPE OF WATER SUPPLY: N44Sep ?6 SF419 19 FSHo, so Individual well 1� Community wellc�'+ 2!61996 Public water C j vto (J NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site ✓ Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further 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. well - S'ancc hie01 r-� Name of Firm Fla hkp Techo i!o/ ServIce,Phone 3 yS-�3SS Address l yS3 Ectiy S�. hnckor f+ 4e f1 k 993-141 Engineer's signature �� Date 912-6-196 vl =1� a7 6w J a<a•ae a. arae 1. � � R 4 .n �S�aeae♦•.a.a •.aaa e � � J .t xa r3 �1 1.'._2., _..0 �L �? .._'a� 6. DHHS SIGNATURE c. Approved for bedrooms. Disapproved. Conditional 'approval for bedrooms, with the following stipulations: Additional Comments LLE22 / 7- j -c4121) VY.4i-,f72 ii>l-ie-, AP pl`ZWA-1 1 W�41vc—/Z_ WA qE'uOS3 Ts 7 - .J' c 7 a+ By. Date %UTlc The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M(Aw. 1/91) Back MOA #21 MUNICIPALITY OFANCHokgGE ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage SEP 2 6 1996 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division �� �. 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-47 Health Authority Approval Checklist Legal Description: 1-o fi 2!. g /oe kc ll, P fa vm'gan Rov-0- Parcel I.D.: Y A. WELL DATA Well type Pr-(va Fe If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) YDS Date completed 77 2 7 / 7 Total depth *a% 6 Cased to -3 6r-'7 ' Casing height (above ground) • g Sanitary seal (Y/N) Date of test Static water level Well production FROM WELL LOG `7/x-7 /7(, Hai WATER SAMPLE RESULTS: g.p.m. Wires properly protected (Y/1) Y ATINSPECTION Z,6-/ 9K I'27 , 2 7 g.p.m. Coliform 0Cv/!(jU m2 Nitrate0•! � /X Other bacteria N(J^e "r0l-kO! Date of sample: / Z55 / 9 ( Collected by: F I a l �P %c% Sv e B. SEpTIC/HOLDING TANK DATA Date installed 7 / 19 / 7 Tank size 1000 q& l Number of Compartments -2 Cleanouts (Y/N) Y � �� Y Depression (Y/N) N High water alarm (Y/N) N • A• Foundation cleanout (Y/N)P Date of Pumping 9 / ZS 19 6 Pumper ':Zra a C--,(, C. ABSORPTION FIELD DATA Date installed 7 / i 9 / 7 Soil rating (g.p.d./W or if/bdrm) 1 ' System type Ti_ Pn c IW 14 new Length SS Width _ Gravel thickness below pipe 'Y# O Total depth� 2�W?xkPel-f Effective absorption area Y'/0 D 1 Monitoring Tube present(YN Y Depression over field (Y/N) N Date of adequacy test 9 / ZS / 9 � Results (Pass/Fail) Pa -U For 3 bedrooms Fluid depth in absorption field before test (in.); 0 Immediately afterN?7 gal. water added (in.): Fluid depth ! (ins.) Minutes later: 1 Absorption rate = > 14-0 g.p.d. Peroxide treatment (past 12 months) (Y/1) N If yes, give date N • D. LIFT STATION N • 14 Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested _® E. SEpARATION DISTANCES Size in gallons ,,pump on" level at* ,gyp off level at* *Datum SEPARATION DISTANCES FROM WELL ONwL�OTc:: TO Septic/holding tank on lot 99 � iv e, o. requQS%e, On adjacent lots > too) Absorption field on lot l00 C. p, ; On adjacent lots 7 too Public sewer main !V � A Public sewer manhole/cleanout N. A. Sewer /septic service line > Lift station N • A SEPARATION DISTANCES FROM SEpTIC/HOLDING TANK ON LOT TO: Property line 6® Absorption field ( b Building foundation �2®e p � --�� Water main service line > l0� Surface water/drainage > l CO' Wells on adjacent lots > SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation `► 5 ' Property Line Water main service line > 2S' Surface water >100 Driveway, parking/vehicle storage area 8 S` Wells on adjacent lots e 100 ' Curtain drain None S�@n F. ENGINEER'S CERTIFICATION I certify that 7 have determined thru field inspections and review of Municipal records that the above -systems are uidelinin effect on this date. in conformance with MOA HAA g gs WCIi-s't+pl-tc Wexiver Y�G/aer�ylvo�i Signature Enginecting,Seal Here Engineer's Name Th e0dO rL Date HAA Fee $ Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ 6 - Date Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE M E M O R A N D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO.A/14 9(1,0.4 G During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot ;J��77 Block / of 1go- Subdivision, the well's productivity was determined to be O,Z2 gallons per minute. The minimum well productivity required by this Department (AMC 15.55), for a �_ bedroom residence is 49,Z/ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. Rick Mystrom, Mayor MIluici ali OfAnchorage r h � - o age Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 September 27, 1996 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 2 Block 1 Ptarmigan Roost Subdivision Waiver Request # WR960053, PID 4020-042-66, HA960430 Dear Mr. Moore: Your request for a waiver of the required 100 foot horizontal separation of an on-site wastewater disposal system to a private well has been approved. The approved separation distance is 97 feet from the on-site septic tank and the private well. This waiver approval applies to the existing on-site septic tank to private well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. If there are any further questions or concerns regarding this waiver, please call our office at 343-4744. /�iincrely, ", Cross,P.E. am Manager - - On-site Services JC/1jm:Cartee dhhs MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet t WR# WR96_ 0_ 053 PID# 020-042-66 HA# RA96�_ Permit # Date Received: September 26, 1996 Legal Description: Lot 2 Block 1 Ptarmigan Roost Subdivision Engineer: Ted Moore, P.E., Flattop Technical Services 14530 Echo Street, Anchorage, Alaska 99516 Applicant: Terry & Cathy Cartee Waiver Requested: On-site septic tank to the private on-site well of 97 feet Poi Criteria: 1. Geology: PoiInts:: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient v' E. Horizontal Separation J' L � TOTAL: 2. Special Conditions: 3, Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: iE �GlyiC %U/ ��c[ ol�C9 CBd a� �Eir� /1 Rec #: 02337/2607 Amount: $ 625.00 Date Paid: Sept 26, 1996 34m5�- 407/ C,4 � 3�,- -7 1.12,16 6�,�7 J`wL in37/ 7 3 --7 'AICLIC �14 lmr/iLvv q7 -4-01 CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 September 25, 1996 M.O.A. DHHS P. O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: 14530 ECHO ST. ANCHORAGE, ALASKA 99516 By means of this letter we -are requesting a waiver allowing the existing septic tank serving [the residence on Lot 2, Block 1, Ptarmigan Roost S/D-to-be approved in its_present.location 97 feet ,from the well on the same lot. During a recent adequacy test the distance from the well to the septic tank cleanout was measured to be just under 99 feet; the waiver request of 97 feet is to allow for probable underground projection of the tank closer to the well. A site plan, well and septic test data, water sample test results, the well log and a copy of the septic system inspection report are enclosed to assist you in your review. Your expedited processing of this waiver application and associated HAA certificate is requested, because the property owners must complete their refinancing by October 9 or else face higher interest rates. According to the driller's log, the well was completed on July 27, 1976 and has a total depth of 296 feet and a yield of 1 gpm. The well log indicates that the shallowest aquifer being drawn upon by the well is located 240 feet below ground surface. On August 28, 1996 the static water level stood at 85 feet below the top of the casing, and on September 25 it was at 137 feet. Steady pumping of 170 gallons of water from the well on September 25 at an average pump rate of 5.1 gpm caused the water level to be drawn down to 287 feet. I then monitored the water level recovery inside the well casing over the next 138 minutes, and determined the sustainable well„ yield to-be0.27 gpm. This measured yield is slightly over the minimum Municipal criteria for approval of a well serving a 2 bedroom residence. Water samples collected on August 28, 1996 were satisfactory, showing 0 coliform or other bacteria per 100 ml., and less than 0.1 mg/l of nitrate -N. According to the as -built inspection report, the wastewater disposal system was installed on July 19, 1976 and consists of a 1000 gallon steel septic tank followed by 55 lineal feet of soil absorption trench containing 4 feet of sewer gravel. Because neither of the 6” diameter sumps near the ends of the trench functions meaningfully as a monitor tube, the homeowners arranged with Carl's Excavating to install a new perforated monitor tube on September 24 which extends to a depth of 3' - 3" below the invert of the horizontal distribution pipe. At the time of the installation the sewer gravel was clean and dry and there was no fluid in the monitor tube. To test the adequacy of the system, on September 25, 1996 I added a total of 427 gallons of water into the trench, partly from the well and the rest by draining the hot tub. Even with this relatively large dose of water, no fluid ever built up in the bottom of the newly installed monitor tube. On the basis of this demonstrated surge capacity with over three feet of trench sidewall remaining, I concluded that the system is still functioning adequately for a three bedroom residence. As is illustrated on the site plan, the septic standpipe is just under 99 feet from the well, which necessitates this waiver request for 97 feet to allow for probable underground projection of the tank a little closer to the well. The easternmost 6" trench sump is located 100 feet from the well. Assuming that the trench is configured as shown on the site plan, it does not appear that the waiver needs to also address the separation distance between the well and the absorption system. The topography of the lot in the vicinity of the well and the septic tank is generally level, with the land further to the northwest sloping off at approximately 15%. Thus, there is no possibility of effluent daylighting from a failing septic tank or drainfield flowing towards the well. The following is a breakdown of how waiver analysis points could be assigned using D.E.C.'s 1985 "Separation Distance Waiver Guidelines for SCRO". Category Points Distance to water table, i.e. aquifer (240' - 1' - 9' = 230') 7.68 Soil sorption (predominantly impermeable bedrock) 6 Permeability (perc rate > 50 min./inch) 3 Water table gradient (0%) 2.9 Horizontal separation (97') 2.88 Total 22.46 Based on this assignment of points it appears that the waiver can be granted without concern as to contamination of the well from either the septic tank or soil absorption trench. Further support to the granting of the requested waiver is the fact that the systems have been in place and operating for 20 years without any indication of contamination to the well. Please feel free to give me a call if you have any questions on this submittal. Sincerely, Ted Moore, P.E. cc: Terry Cartee LOT 3 (VACANT) LOT 4 UNSUBDIVIDED PARCEL (NO WELLS WITHIN 100') 20' UTILITY EASEMENT EXISTING 55' LONG SOIL ABS. TR NEW MONITOR 6" C.O � WELL IO°,o LOT 1 (VACANT) - Jac 6 �pV IL 15% \ -- --------------- 20' UTILITY EASEMENT EXISTING 55' LONG SOIL ABS. TR NEW MONITOR 6" C.O � WELL IO°,o LOT 1 (VACANT) - Jac 6 �pV FLATTOP TECHNICAL SERVICES 14530 Echo St., Anchorage, AK 99516 Ph. (907) 345-1355 Legal Description: ADEQUACY TEST DATA SHEET kl S/. Street Address:_ (�pW 8 wlnGCronq DnLNC Client Name:_ "%erry CctfAy rrsr-1-ee Test Date:_ ��/2S19� Tested By: 77 F.Hoorp Initial Conditions: Float #1 in New Trenc.fr.I-set " b.t.o. So " pipe w.Q_" fluid Float #2 in EatF Tr. Sumr set b.t.o.�0" pipe w.`o " fluid Float #3.in_we F 7-v: tu.�, set b.t.o. is pipe w.�,r" fluid Float #4 in Cegl-tc 7-4mk set b.t.o. n " pipe w, i3 " fluid Water added through:_ C.U. O /-cr SeP -Ac �ctnlc �a. u+CU wuf-er ACTION TAKEN T TIME H2O METER •..c i.n..n NET. GAL mac+. rv. WELL LEVEL -i -... ..�.. �.-- FLUID LEVEL . Se hf .ew mtr welt- CAyh fuer Tun Ir Suo" ST i3 T 1 a:2B�y 2693 0 137' o - 0 1a:3 99G G3 19H' .` 1t/y d 2`/y y Le -:-q Z 023 21S 1'Iv o 23/B O Io : SS O '7s l y 2 2 GS 1 »wel/ /1:0/ 103 170 ZBo 1 `fib O Z`�y 8 Rr 14.7 l:dl obi way 287 11 /y 13s - 3S11:30 11:30 179 ZyG_ `l Z7 282 2G9 0 1'l� O Eno( 1. 22 2 6/ Measured Well Yield ^ a 24'(Ayq'j?al/�f)0.2788 :Adequate for 2 Bdrms 138.••/4 9P1 Unit Absorption Capacity Average Absorption Rate a > yam,grtle'(e Surge Capacity .> y2T art Adequate for 3 Bdrms To/V t 14D.fn r 2e 125- 102 ` MUNICIPALITY OF ANCHORAGE S F DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER 264-4720AND WATER FACILITY Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block: subdivision, section, township, T ( ) range) . , r> nn r -7✓ N FQ Location (address or directions) _ sBusiness G&&_E—Telephone: Home (b) ApplicantName 9 —/—I— ----- Applicant Address 16 Other D (explain); (c) Applicant is (checkong �— — e): Lending Institution ; Owner/builder ;Buyer ❑ Telephone (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone _ (f) Mail the H ASo the following iii 2. TYPE OF RESIDENCE Single -Family R Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual Well K Community ❑ Public ❑ artmentof Environmental Conservation Note: If community well system, must have written confirmation from the State Dep attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite 9 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. 72-025 (11184) 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 watersupply 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 A F (7-S 1 AIC, Telephone 6-61- 65 o !W Address 1ZOO ) 33'd fiVE .S(%/rl< ) ANC%% AK 17FSC%3 Date 5 _/ /17-/ GOW O1 ((0/V4L - TO FMC-f}SF WELL fel/%RIA16 IN C01VOVI b eto) C9 90ov'D S uAt-m cE tv lI bN c3 k'OIINIJ Tft/�u�S e' 9 7d�`fio�1u / I-e•»ovecl. 0,1 S --G-86 If o6servck 6e to rc,&, l y J') s f,q 11CJ the was de,-9ro4,,)d iuvidece Yi-uckload in�P o� I�1�San;-lacy Se�1 O _ Lvnctu:F' +rucKloaJ Enginee:It /I .m , � 1a 6(r eeeo eee A �eee•eea•e, e..�.• •eee•oY�e„� „///19 p11 0•Ve s'e.e Y.'ypefo •eee,(� I l � LE Y C. REIDJR.�y 4®'c , r: CE - 225Go 1` ��°eyes eee°;C�dO� 6. DHEP APPROVE Approved for Lf Lc -e-- J bedrooms b — n v1 bat Approved C Disapproved Terms of Conditional Approval Conditional Chep CAUTION 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 r �1 DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA1 ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) Pr{aY G p' Jgffi' CHECKLIST - FEBRUARY 1984 264-4720 R�P�,,/ Legal Description: 2- Q 1 � r+ r P/v Ro 7- A. WELL DATA Well Classification l NOt t1i OUB If A, B, C, D.E.C. Approved (Y/N)x/14 Well Log Present eY N) Date Completed Z7 3QL/ 76 Yield 6PI Total Depth 2-%16 r Cased to 36,7' Depth of Grouting N/ A Static Water Level Pump Set At ()niKWOUAl Casing Height Above Ground A 7 Sanitary Seal on Casing O/N) Electrical Wiring in Conduit (Y(9 Depression Around Wellhead (Yo Separation Distances from Well: To Septic/Holding Tank on Lot i 0Q / ; On Adjoining Lots ©Q To Nearest Edge of Absorption Field on Lot 100 ; On Adjoining Lots 106 To Nearest Public Sewer Line /^ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot 75 Water Sample Collected by J. K F?iTC' 4VCK Date' yLz5le6 E Water Sample Test Results 6-7-15 FAC rO A S E q T 7fi C f6d 'Re -6 I/G 7-,5, Comments _X 0061 f)U J_ NO T 8 ELOc) 6X001_1(4 S U (S F4Ce:, ) W€:[L R -,2,..l ZS 4-Z-5 B. SEPTIC/HOLDING TANK DATA Date Installed Size No. of Compartments 2 - Standpipes &N) Air -tight Caps ®/N) Foundation Cleanout &N) Depression over Tank (Y49 ) Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ��� ; for /yA Holding Tank High -Water Alarm (Y/N)61 1A Temporary Holding Tank Permit (Y/N).— Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation To Property Line (0 �7` To Disposal Field 10/74. To Water Main/Service Line IV / /ter To Stream, Pond, Lake, or Major Drainage Course 100 Comments �l �v Page 1 of 2 72-02601/841 2 l PIi¢/;MIG/fN P00 -S C. ABSORPTION FIELD DATA 2 `� Type of System Design i RENc/4 Soils Rating in Absorption St/rata S*5 i Date Installed 7119�7� Length of Field (��/ �•-&1V Depth of Field Width of Field Wik'y-c,v7` / Gravel Bed Thickness `7 Square Feet of Absorption Area VQ Standpipes Present &N)Z� l�PR gid Depression over Field (Yo Date of Last Adequacy Test Results of Last Adequacy Test 0 Separation Distance from Absorption Field: To Water -Supply Well Wo/To Property Line ?�[,� /�' — To Existing or Abandoned System on To Building Foundation 100 Lot N ( ; On Adjoining Lots To Cutbank (if present) To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments — D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) — Comments Dimensions Manhole/Access (Y "Pump_C*�Level at _ Vent (Y/N) , Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify thatWhae ked -ve fied, r conformedtoallM 'and Aguidelines in effect on the date of this inspection. Signed Date J , ItG%� //VC MOA No. �D27 ��®e�� Company ®® P Receipt No. 3,� a-,�, -I Date of Payment Amount: $ Page 2 of 2 72-026 (11/64) � 000•ooeoo ,{� in S4 419V* 7�® • REM,I&2251�JyS'AF Gf f?jG?�E�S1�i�c� Fi 60172 ALASKA Ci iUIR011m UAL C011TROL SDUIHS, Inc. engineering & 6nuironmental Studies 04/28/86 TERRY CARTEE SELI-ER=TERRY CARTEE P O BOX 110584 ANCHORAGE AK 99511 LECAL:PTARMIGAN ROOST BLOCK 1 LOT 2 ADEQJACY TEST FOR SEWER SYSTEM ADECXACY TEST DATE -04/25/86 TERRY CARTEE P O BOX 110584 ANCHCRAGE AK 99511 THE TYPE OF ABSCRPTION SYSTEM IS A TRENCH WITH AN AREA OF 440 SQFT. THE SYSTEM IS CAPABLE OF A=PT ING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1000 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS AOZEPTABLE FOR A 3 BEDROCA4 HDNE. SEPTIC TAW ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FCR THIS 3 BEDROCIVI HCUSE. THE SEPTIC TANK/PACKAGE PLANT WAS PUWED ON 04/25/86 THIS REPCRT DOES NDC VERIFY THE INTEGRITY OF THE PIPING FOR THE WATER SUPPLY OR WASTEWATER SYSTEM. FLOW TEST ON WELL WELL FLOW DATE -04/25/86 A FLOXf TEST WAS PERFOZVED ON THE WELL. 127 GALLONS OF WATER WAS PLWED AT A RATE OF 1 GPM OVER A DURATION OF 2 HOURS. THE DRAWDCMN WAS 56.6 ' WITH A REC3DVERY TIME OF 150 MINUTES AND THE STATIC WATER LEVEL WAS 34 FEET. THE WELL IS ADEQUATE FCR THIS 3 BEDROOM HOVE. A4 l �I� ` �j p000000°eb a r�9;°as ��to-a i*. 0000 logo. ve• a•o e••oaee• eeooee 00 d • LER Y C. REID, OR. CE -2251 0 �AoiL'Sal�iiG',tl� 1900 Illest Mrd Auenue %ite R • Anrhornne Alnskn 99.903 *(9071 561-5040 ALASKA ENVIRONMENTAL CONTROL SERVIC", INC. 1200 West 33rd Avenu.., Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB LL. LSl f /RKMf6RN norma SHEET NO. OF n CALCULATED BY J TI ` DATE 7-q AT A .2(2 CHECKED BY DATE Ii/�zni va-nn Ml :/A 11171K, WW MM 01471. 5. LEGAL DESCRIPTION 2P7—,9/Z c/G.+9N ROOST - DATE RECEIVED // INSPECTION APPOINTMENTS TIME - TIME TIME DATE ❑ MULTIPLE FAMILY DATE DATE INSPECTOR ❑ COMMUNITY INSPECTOR INSPECT(y�y/�\• 1 , C)35 V depth (attach log if available.) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & Iq?b YEAR ON-SITE SYSTEM WAS INSTALLED. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTPWIRONMENTAL PI=:OTECTION 825 L Street - Anchorage, Alaska 99501 • APR 2 9 1981 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R E C E VVES REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITI DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. PHONE 1. PROPERTYOWNER Tr'JeR /1//,# AJ CRX! f� MAI LING ADDRESS pp - ®i VQ /D'Sg /9wG040J2A CIEA�t�SK�! �gSP PROPERTY RESIDENT (If different ONE from above) PHONE 2. BUYER MAILING ADDRESS 3. LENDING INSTITUTION cG���t �S:�R,vt� PHONE MAILING ADDRESS ?Ouch/ (P�G/,3 - .` I/ h�itlCJ�02AG� JCRS�fJ �/eJ So Z 4. REALTOR/AGENT PHONE / 10 A MAILING ADDRESS 5. LEGAL DESCRIPTION 2P7—,9/Z c/G.+9N ROOST Su 8.©/v/S/0^3 1,ei STREET LOCATION — 6. TYPE OF RESIDENCE NUMBER OR EDROOMS ❑ One ❑ Four ❑ Other X SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY K Three ❑ Six 7. WATER SUPPLY 5e 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 CK INDIVIDUAL/ON-SITE** Iq?b YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 17 72-010 (Rev. 6/79) 61 1. TYPE OF RESIDENCE SINGLE FAMILY ❑ MULTIPLE FAMILY 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM ❑ INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY r onnection Verified epticTankor ❑HoldingTank : �� If Tank is homemade dimensions: E OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Ahmrotion Area to nearest Lot Line 5. COMMENTS THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX PERMIT DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT ---7— )C-e ILS RATING MANUFACTURER MATERIAL Septic/Holding Tank Absorption Area [D-,-KPPROVEDFOR 3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED ❑ OTHER ALASKA enUIR011 nTAL COnTROL SCR US, IIIC. Engineering & Enuironmental Studies MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL POTECTION MAY 4 1,981 RECEIVED MAY 4 1981 TERRY CARTEE P.O. BOX 10-584 ANCHORAGE AK 99511 SELLER — TERRY CARTEE SUBDIVISION—PTARMAGAN ROOST BLOCK -1 LOT -2 A TRENCH WITH AN AREA OF 440 THE TYPE OF ABSORPTION SYSTEM IS AFT. THETHE SOILSMRATING POFLTHEFSYSTEMTIN ATGGALLONS 450 FWATER PD IS CONSTRUCTIONWASS125AND NOWAY. IS 147 SQFT/ BEDROOM. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 5-4-81 . °% c s49 Lor0l.C. Roil. Jr.