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Home My WebLink AboutDRAKE BLK 1 LT 2BI)rake Block 1 Lot 2B #017-461-23 Municipality of Anchorage ; • i - Development Services Department • .r \ _ Building Safety Division O n -Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Boz 196650 Anchorage. AK 995736050 Page il of Z— www.d.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: �j w oS0 20 PID Number. of 7 _y4, ( _ — — wm.: r a✓• f ei4 n '-d h . Wastewater System: VNew ❑ Upgrade Aftm: Z95-0 YJL,,r, Qa .n,[fA lf-7 ABSORPTION FIELD Phdne: Nanew a e.aaxn.: 301— O(O01—( O DaeaTmrll KWUNIC.TroM O sed O U.,d a012x: LEGAL DESCRIPTION SodNenp (• Z Total Depth No, "°"V'i : -L Subdwagn: [ z f3 w s/p GPptt* DeRel b pOa batlon then*Vr,, Weed -� l .0 Ft. Grant depth b.n..e ,P.. F4 iowrwP: Rarpe: seceen: 3. o Ft._ ve FA added aboor.Ow papa: L1,o Ft . Grant To From Septic Tank v Well: ❑ New ❑ Upgr �"a"""'°°': eO J Fl. FI. N.ne•rae taatanc. benve Wn : Uasveoaan (Pngta, A, B. L): 7"al IhpPc Geed ex Tatar abapgon "u: FI. .�.__ FI. FESU Fe 3 t, -2 N Y«e. Puny sel n. Gaup Ilapnl Above Gouty. GDM FI. FE TANK SEPARATION DISTANCES Septic ❑ Holding [3S.T.EP. ❑ Other. To From Septic Tank Absorption Field Uft SfUft Holding Tank rhaie Sewer Line a'a'•r• �- y, e- T � tr. wea /O 0 f l D o t 4. N1,(, t41A (00 I wear: S .2 nt.nu: -� •e •e ( $"""• will" loo tf /00 LIFT STATION Lot Line /o •,f[ (p ti- •' xluar Gal Fourgrun /014- (V Fi- 'Fury on- eveaL 'Pure od'r a". t•pn vete, at. N. N N. Cun«n Dmn �F Parry Ma• 8 Yodel FJar. R"rwxa' OVIS, 401 � l` so I( BENCH MARK (3'CGpp L 44014 DN e- o P sl m ,, Lapeanant Desaia•on. sc 1\2 ri Eat., f_ctA4r 00 A /So = 900 /e 2 = 7s Aa "aaan. L9 /v 0 FI J 7�'71fThl`4. LV 4a47fh T ar LAA 14.'01 Inspections performed by: M, r-(noe( �(X l4 014 eel Dates: 1" ral'S 6441 2"0 /1 /5- 00 Development Services Department Approval F Reviewed and approved by: Date: 3 -26-40(0 Rw I: onl Engineers Stamp _^ E OF At t h~P�•• •••�'r;�y�t� *: 49TH I` P MICHAEL N. ANOLRs6N :'k- CE I+l9Fo p3/1 45". Permit No. SW050203 Page 2 of 2 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 Legal Description: LOT 28, BLK 1 DRAKE S/D PID No.: 017-461-23 MARK A B CR ELE D. PIPE ELEV. C01 35 19.0' — — — — — — — — — — — — — — — — — — — — — — — 35 21 98 95. TC01 34 22 '�i TCO2 31.0' 24.5 98 a 25 26 98. 94.7 COS 25 26 98. i MT 45 95 97. CO6 70 115 97. 94.8 <� r II ,ice III / / I I \ -TEST HOLE RADIUS 1 II / /r 1/ MT / I \\ 1,8 II I A II I � COS _ —MAN DOOR. BENCH MARK 04 \ 0TCO2 \ 0 C01 \ i C01 CO3 1 CO2 SCALE: 1"=30' \ \ M W'W} ,(Q, =2 SCM •'•,OF ,�, 4441t nrt. rec t ... .......... • i k �•. ♦ tr MICHAEL N. ANDERSON: i -..o ♦1 N••.��o.//,/((/}�`y�E/9� 469 _.. .N.LS. MARK A B CR ELE D. PIPE ELEV. C01 35 19.0' 98 96 CO2 35 20 98 95 CO3 35 21 98 95. TC01 34 22 98 TCO2 31.0' 24.5 98 C04 25 26 98. 94.7 COS 25 26 98. 94.8 MT 45 95 97. CO6 70 115 97. 94.8 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jul 01, 2005 Expiration Date: Jul 01, 2006 Permit Number: SWO50203 Parcel ID: 017-461-23 Legal Description: DRAKE BLK 1 LT 2B Design Engineer: 0088 Anderson Construction & Eng'g Site Address: 002750 HUFFMAN RD Owner Name: FERN WASHBURN Lot Size: 46200 SO. FT. Owner Address: 2750 E HUFFMAN RD Total Bedrooms: 5 Permit Bedrooms: 5 ANCHORAGE. AK 99516-2039 This permit is for the construction of: R Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. ZM309MA - Date: % 7 Date: 1 • Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING OIC? < y .O Parcel I.D. 61 1?- 4u 1- 93 Permit Number SW ZD Propertyowner(s) peen WmSY1 bufrt `i' Travis SIn-1—ovy Dayphone '70 — !ZZb Mailing address '?45'3,o 2 0 1-{ v ey C r e (e, Zip Code Site address ? Z� SO �� %�.-titer, pg Zip Code a 4 5 -o -2 - Legal description (Lot, Block & Sub'd.) t- /+ 2 B pdd k e , 13Uct L z 13 Legal description (Section, Township & Range) Lot Size LK.. P-00 Acre /Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ;. Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: _ % �i Waiver Fees: Date of Payment: //�/A Date of Payment: Receipt Number. / O Receipt Number: (Rev. 09/04) i Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4640 Shoshone Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 July 1, 2005 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Drake S/D Lot 2B REVISED: To Whom it may concern: This is a request for a new septic upgrade permit. The test hole excavation was completed near the northeast corner of the property, the soils consisted of silty sands for the complete depth. Water was observed at 16 feet with no change after the 7 day monitoring period. The perc rate was 2 minutes per inch. A new deep trench will be utilized for the leach field with an effective depth of 7 feet. The application rate has been reduced to 0.9 gallons per day per square foot for the design to increase the life of the system. The old system will be abandoned in-place due to it was designed for a smaller house. The surrounding properties have existing systems already and will not be impacted by this new expansion. A reserve system has been shown due to the increase in the number of bedrooms from the old system. The slope is 1 to 3 percent starting at the house and sloping down toward the southwest comer. No pounding of water has been observed near the site or in the surrounding area. If you have any question please call me at 345-3377 Sincerely Michael N. Anderson, P.E. Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4640 Shoshone Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 May 1, 2005 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Drake S/D Lot 213 To Whom it may concern: This is a request for a new septic upgrade permit. The test hole excavation was completed near the northeast comer of the property, the soils consisted of silty sands for the complete depth. Water was observed at 16 feet with no change after the 7 day monitoring period. The perc rate was 2 minutes per inch. A new deep trench will be utilized for the leach field with an effective depth of 7 feet. The application rate has been reduced to 0.8 gallons per day per square foot for the design to increase the life of the system. The old system will be abandoned in-place due to it was designed for a smaller house. The surrounding properties have existing systems already and will not be impacted by this new expansion. A reserve system has been shown due to the increase in the number of bedrooms from the old system. The slope is 1 to 3 percent starting at the house and sloping down toward the southwest comer. No pounding of water has been observed near the site or in the surrounding area. If you have any question please call me at 345-3377 Sincerely to Mil N. Anderson, P.E. DESIGN CRITERIA: 6 tDRM X 150 = 900 GPD APPLICATION RATE: 0.9 GPD/S0. FT. 2.0' WIDE TRENCH 900/0.90 = 1000 SQ. FT. REQURIED 1000/14 = 71' REQUIRED TRENCH TRENCH: 10.0' DEEP 7.0' EFFECTIVE 2.0' WIDE (1) 72' LONG (TH/I) o _y ORG -1.0 SM -10.0- -16 2.0' MOOAUNE OVER D FILTER FABRIC 4'0 PIPE SEWER ROCK 2d0, RADIUS R EW I I'?• `-'SCCb ARY GRAINFIELD - HI F M q�N ' - / R 0 A D- PROPOS! D DRAINFIELD , yu-T ` - - EXIS STH/1 f-100 ING WELL < LOTII -LOT 2� I ; RADIUS 2000 CALL M TANK x PMP ED HOUS(' I �,i - EXISTIN ELL a _ EXISTING WELL �. 100, S 100' RADIUS I LOT 2B I \ i L6T 3A LOT 38 W Y J I - M E R G A N S E R A V E N U E - Septic Design Prepared For TRAVIS STANTON LOT 2B DRAKE SUBDIVISION Prepared By MICHAEL N. ANDERSON, P.E. 4640 SHOSHONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: 1"=200' JUNE 19, 2005 �.# 49 n ° •�� P.A.MICHAEL N. ANDERSON,: No. CE 9469 0t ••. i • 10' UTILITY EASEMENT — — —/— —\— — — — — — — — — — — — — — — — — — — — — — — —1 0� — — — — — - y = ' LOT �` LOT 28 10. LOT 2A CO , / II )AT Lo� WL; 4HA1 II II I II II I C "� 7q I DRIVEWAY I r OPOSED TANK CO SEPTIC TRENCH W A DOUBLE CO i \ wVL / 1 PROPOSED 2.000 GALLON TANK \• 6EW CO TO E EXISITNC D NE m HOM USE ABANDONEPLACE \ �\ EXRNC TANK TOIR DEMOLISHED � 7r J\- \ � 1 \ i i \ \ 1 � I \ I I I \ \ LL 1p0• I 1 ST wftp PROPERTY LINE i \ 10' UTILITY EASEMENT , / \ `\ LOT 7B / Septic Design Prepared For ��\��, 44 TRAVIS STANTON •• LOT 2B ,!Gj,• DRAKE SUBDIVISION: 49TH ; .....• ....... . .............� Prepared By MICHAEL N. ANDERSON, P.E. �{ . ...••• •• ••••• v 4640 SHOSHONI DRIVE I f^4 MICHAEL N. ANDERSON: (907) 345-3377 / FAX (907) 345-1391 SCALE: 1"=40' JUNE 19, 2005.•••• DESIGN CRITERIA: — MOUND OVER -81JRM X 150 = 750 GPD (THa1) o caADE APPLICATION RATE: 0.8 GPD/SQ. FT. 2.0' WIDE TRENCH —2 ORc t FILTER FABRIC 750/0.80 = 937.5 SO. FT. REQURIED —3.0--Ty---4"0 PIPE 973.5/14 = 67' REQUIRED TRENCH SM SEWER ROCK TRENCH: 10.0' DEEP 7.0' EFFECTIVE —10.0 2.0' WIDE -1s 2.0 (1) 67' LONG HU_FFMAN ROAD — .'— _�. r � a LOT 11 -LOT 2A (` Y 'EXIS ING HOUSE ix CL EXISTING WELL ` 100' RADIUS N O W Y 6 J SECONDARY DRAINFIELD PROPOSED DRAINFIELD TH81 EXI INC WELL 100 RADIUS ROPOSED [)FT STATION 100' RA S LOT 2B —' LOT 38 — — — M E R G A N S E R A V E N U E— I Septic Design Prepared For TRAVIS STANTON LOT 2B DRAKE SUBDIVISION Prepared By MICHAEL N. ANDERSON, P.E. 4640 SHOSIIONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: 1"=200' MAY 9, 2005 Ln 49TH MICHAEL N. %. No. CE N ♦♦ 10UTILITY EASEMENT -----♦� --- --------- — — — — — — — — — — — — — 1y= -- .01 LOT LOT 28 LOT 2A ''� \ 10.0 .' CO % 11 T I [ I I II I I ♦f I I LA\ \♦ s / 'ITHI I / ♦ II II / , iR'♦ \ C I I / DRIVEWAY `` I C S / TANK O i SEPTIC TRENCH / R1 0 1 I DOUBLE CO PROPOSED 1,500 / GALLON TANK / PNEWW CO `�CO \ NEW `\ HOUSE .\ \ / / ♦ ♦ / 47 \ 1 1 I I 1 I 1 I I 1 WELL 10p' 1 1\ fk�SJ/NG Wf(1 PROPERTY UNE \ R1 p/�S i 1 / \ \ 10' UTILITY EASEMENT / \ \ ♦♦ / LOT 7B / Septic Deaton Prepared For ♦♦♦ TRAVIS STANTON :K P�E•�.....,, ♦♦ 2B C;0 ♦ ••�'i,� DRAKE SUBDIVISION ,' i 49TM � ♦i Prepared By ....•....... . . MICHAEL N. ANDERSON, P.E. 4640 SHOSHONI DRIVE• j/.................... f^° MICHAEL N. ANDERSON; i ♦� Jjm.• No. C� 9469 (907) 345-3377 / FAX (907) 345-1391 - SCALE: 1"=40- MAY 9, 2005 ♦♦♦♦,1'a: �� Municipality of Anchorage . DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: 1'10 V %A 5 {v 0% t4-0 n . DATE R LEGAL DESCRIPTION: AlOR�G L01, 2 Township. Range. Section: r_ SLOPE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17, 18• 19• 20 COMMENTS ur9tole S 'S/ /'-n 4#,7& Grob /Goare, e, WAS GROUND WATER y 5 ENCOUNTERED? � S IF YES. AT WHAT e L DEPTH? ` p E Cap to Wuu Atter � Monitoring? /V Wtc'r— ur Al *..49T►+ pAi *� 046 el MICHAEL N. ANDERSON 1 PERCOLATION RATE (mmutevmch) PERC HOLE DIAMETER ^T^ST RUN BETWEEN FT AND FT 17r A( r, r) +� i� A PERFORMED BY: Mej'N� P ,u A n rr/�!!L 1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE:S% 0 72 -WS (Rev. //85) \ Municipality of Anchorage C Development Services Department Building Safety Division : On -Site Water and Wastewater Program ` 141 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Legal description: DRAKE LOT 2B The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. _ ❑ Incomplete; missing _ ❑ Incomplete; missing _ ❑ Additional adequacy test information needed. _ ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. _ ❑ Proposed system too deep for soils information submitted. _ ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ ® Other. THE SITE PLAN NEED TO SHOW MEASURED DISTANCES TO ALL WASTEWATER DISPOSAL SYSTEMS, WELLS, SURFACE WATER OR DRAINAGE COURSES, ROADS, PROPERTY LINES AND STRUCTURES WITHIN 200 FEET OF THE LOCATION OF ANY EXISTING OR PROPOSED ON-SITE WASTEWATER DISPOSAL SYSTEMS. Name of reviewer: JOE GOODALL Date: 5/12/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK — MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME j �/ F2-- iD IA A- ss N. io Lu r t.,j PHONE 1 3+5 -31 ❑ NEW UPGRADE ,� MAILING ADDRESS Z-75 � � 1, FFM A n, 1 w t—j c r,`` Tr5r� J v I—Ivt t-! +a J J� LEGAL DESCRIPTION i ¢ V 15 t C y LOCATION GAFF OR S NO. OF BEDROOMS DISTANCE TO:1 Well / 107�C Absorpt�n area Dwelling /PERMIT zo NO. / v Y 52 h z W< Manufacturer // MaterrNo. of compartments y Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth TO: Well Dwelling PERMIT NO. JazDISTANCE 0z< Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. w = J LL z z No. of lines Length of each line Total length of lines Trench width Distance between lines F LU inches cTop of tile to finish grade Material beneath tile Total effective absorption area In inches Length Width Depth PERMIT NO. LU 0 Q H wa Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER T PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS . a7GF ig • T►� a °x,� — — o 0 7 .t.(J l '.° CE -5283 ®NOFESS�� .,,•°� APP O DATE LEGAL ��° IL gIA ../� 1t7j,��n-� 7Z-03 (Rev. 3/1 // ' ��Jr:-'h I 3r. "T" "'V' 0:3 F:_" �N INJ C_':� 0-4 IL�� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK- 99501 264-4720 1:J f%J__��-�� PERMIT NO: 850546 UPGRADE DATE ISSUED: 08/29/84 APPLICANT: FRED J. WASHBURN ADDRESS: 2750 E. HUFFMAN ANCHORAGE, AK 99516 CONTACT PHONE: 345-3166 ' LEGAL DESCRIP: SUBDIVISION: DRAKE LOT: 2B BLOCK: 1 SECTION: 28 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 54450 (8Q"FT. OR ACRES) certify that: 1. % am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the designcriteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing wellv wastewater disposal system or public sewerage system on this or any adjacent or nearby lot~ IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BU%LTG WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE B LICENSED ELECTRICIAN. SIGNED DATE: APPLICANT. FRED^ SHBURN� w' ISSUED BY DATE: -------------- -------- ---�-----�r---- ' GRE' 'r -R ANCHORAGE AREA B0r `IGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAM MAILING ADDRESS /✓GG/ 5 y PHONE AP / / // I _ /1 ./ / el D r� w LOCATION SEPTIC TANK: LEGAL DESCRIPTI DISTANCE /�VqF?3NUMBER OF FROM WELL MANUFACTURER MATERIAL S"1 -d COMPARTMENTS INSIDE LENGTH INSIDE WIDTH / LIQUID DEPTH ✓ LIQUID CAPACITY/bdo GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER � OR WIDTH—, LENGTH_, DEPTH y12,40, 6 j LINING MATERIAL .�'�Ger CRIB SIZE: DIAMETER DEPTH_(L DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION , NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION—,LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED NEAREST SEWER LINE REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK—,SYSTEM DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: �'✓ 'Oo" S'/ PIPE MATERIAL: LOT SLOPE: 6/ REMARKS: DATE APPROVED G.A.A.B. Form No. EQ -031 NOLASE 'T_Q_AkL-G2 2, N Z4 2 C.aQxy, 21 c$v� �5 r Lo r L1 MG DATE APPROVED G.A.A.B. Form No. EQ -031 ,'wHA[.AF.Nf GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 F TELEPHONE 274-4561 cfi SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT / ��% k So � �- MAILING ADDRESS S �� u.�_l � �� Do PHONE3-9� D 2- 011- 1 INSTALLATION - O`1 - INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH Fj SEEPAGE PIT e_�" , DRAIN FIELD , OTHER , //Y/ff" f-4i-�(---\ TO BE INSTALLED BY L� �� A SOIL TEST RESULTS/" vt� NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED /,-/-) X� FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE 10_TYPE "� �` [J�`��'I%£EPAGE AREA SIZE /6 c.-'/�� TYPE MINIMUM DISTANCES, REQUIREMENTS ` I FOUNDATION TO SEPTIC TANK J ` FOUNDATION TO SEEPAGE PIT - 1 DRAIN FIELD �10 S t SEPTIC TANK TO SEEPAGE PIT WALL /✓ SEPTIC TANK / SEEPAGE PIT DRAIN FIELD/O TO NEAREST LOT LINE. OD WELL TO SEPTIC TANK � SEEPAGE PIT DRAIN FIELD �'}_ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK l� SEEPAGE PIT /0 , DRAIN FIELD SEPTIC TANK, -Si2 SEEPAGE PIT 100 DRAIN FIELD TO RIVER, LAKE, STREAM, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER ,,--4 DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF CREATE ANCHORAGE AREA BOROUGH ORDINANCE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. -� _.` i DATE " APPLICANT'S SIGNATURE ` -- FORM NO. EQ -01 6 28-68 AND THAT THE ABOVE GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL (QUALITY Case # 3330 "C" Street ANCHORAGE, ALASKA 9950 �.C � �{-2-n�� Performed For Fr -e2 41 �,_ Dated Performed_ &zV2 _ Legal Description: Lot �2. B1 ock_/ Subdivision �Ira/L This Form Reports Soils Log —!„_ Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Was Feet Soil Characteristics 1— - 2-- Depth to H2O Net Drop 3- 3- 4- 4- 5-6- 5- 6- 7- 7-8-9- 8- 9- 10- 10- 12- 12- 13- 13- 14— 14— Was Ground Water Encountered? If Yes, At What Depth? S� F Reading Date Gross Time Net Time Depth to H2O Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit _ Drain Field Depth of Inlet Depth to Bottom of Pit or Trend_'— -T- C 0 M M E N T S : / ,s . — Gu tall LZZ Test Performed BY - Date Certified BY: Date. Well Log C For....,. ................ ... ......... I ...... ,. MUMCIPALI7Y 0� ANCHORAGE ON Location.... R-. , ...y AP1r/,1 , . J .......�(,�"!p,�,`„ , , , , ; K , , ENVI ONMEONTALEALOTEC.. . Date completed, ... J K / .....� ?� /�� .................. . . . . ........................ � .... , Depthof well,.,........ ..... .................................. ......... ... ...... I ... RE,C.E.IYE®.... Sizeof casing...... ................................................,........................,......,. Distance to water, . ......q K07:f 5 ... . ............... ....... . ............................. . r Distance to water while pumping,..,.a..............................................at rate of.......... .............................gallons per hour. I Formation from J to Q PeyA ✓;C- i c A4I C4'y U 4 S'z`iL lam, �.elUl�/ � �e 19 I I _ ( I I I I I I I I I ...................... ...... .................... Driller ' DELTA DRILLING COMPANY 5RA IBOX 394 8 ANCHORAGE, ALASKA 99507 June 21, 1973 Fred Washburn SRA Box 1515C Anchorage, Alaska 99502 SUBJECT: On-site Sewer Located at Lot 2, Block 1, Drake Subdivision Dear Mr. Washburn: An inspection of the subject sewer system was made on June 15, 1973. It was later discovered that the seepage pit was located 93 feet from a neighboring well. The required distance from an individual well,to a seepage pit is,100 feet. Therefore, the seepage pit will need to be moved to obtain the required distance. It was also reported that the home on the subject lot might be connected to a neighbor's well. If this is the case, the well will then be classified as a semipublic well and more stringent distance requirements from that well to any sewer system will need to be obtained. If they cannot be obtained another water supply will need to be used, such as a private well for the subject lot. If you have any questigns concerning this matter, please contact me at 274.4561, extension `133, Sincerely, Lynn Coad Sanitarian lb Air t$4 • '� Municipality of Anchorage 1Jn On -Site Water and Wastewater Program (907)343-7904 sar e.ry Certificate of On -Site Systems Approval Parcel I.D. 017-461-23 Expiration Date: a 3 ' 1. GENERAL INFORMATION Complete legal description Drake, Block 1, Lot 2B Location (site address) 2750 Huffman Rd. Current Property owner(s) Russell & Kiersten Glrten Day phone Mailing address 2750 Huffman Rd. Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: AU ❑ Single Family (w/wo ADU) p A ❑ Duplex OCT 2 1 INN F1Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 6 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request Received by: Date:./ aG t y COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J Date of Payment Receipt Number Ou{6'63G COSA # 05� W ISSD 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. _ In conducting an adequacy test, 1 attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 10/15/2014 4y I n 1t 6. DSD SIGNATURE %1 ' System #1 Approved for bedrooms %' : Sever System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: By: 0 >4ato 10(t. Original Certificate Date: The M rcipa ity of AnchoFage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other - COSA blue sheet_f _, - If more than 1 septic system is on the lot: COSA Checklist # 1 of Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Drake, Block 1, Lot 2B A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 7/18/1980 Sanitary seal (Y/N) Y Total depth 82 ft. Cased to 82 ft. FROM WELL LOG Date of test 7/18/1980 Static water level 0* Artesian ft. Well production 20 WATER SAMPLE RESULTS: Coliform N t� colonies/100 mL Nitrate C0.15 mg/L Arsenic ug/L Date of sample: 10/13/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 2,000 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Date of pumping 10/14/2014 Parcel ID: 017-461-23 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 12+ in. AT INSPECTION 10/13/2014 0* Artesian ft 3.5+ g.p.m. Collected by: PES Date installed 3/20/2006 Cleanouts(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed 10115/2005 Soil rating (g.p.d./ft2 or fe/bdrm) 1.2 GPD/SF System type Shallow Trench Length 80 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 9 ft. Eff. absorption area 750 ftz Monitoring tube Y Depression over field N Date of adequacy test 10/13/2014 Results (Pass/Fail) Pass For 6 bedrooms Fluid depth in absorption field before test 0 in. Water added 906 gal New depth 0 in. Elapsed Time: 260 min. Final fluid depth 0 in. Absorption rate >= 900+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. 'Pump off' level at E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 110+ Water Service line 10+ Curtain drain 50+ * Surface water Wells on adjacent lots 100+ Absorption field 5+ Surface water 33* Water main 10+ Driveway, parking/vehicle storage 10+ in. F. COMMENTS *Man made ponds found 33' from tank and 61' from field but 100' from all other waters. As-Qu;l� o� r;tc G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date COSA brown sheet -1 0-10-1 2.doc Municipality of Anchorage Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval 4 141550 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 2B of Drake subdivision. This inspection revealed a nitrate concentration of 6.15 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage • Development Services Department'; Building Safety Division On -Site Water 3 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsfe (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 011- 4W-95 COSA# D80311n 1. GENERAL INFORMATION Expiration Date: / oZ - % 6�" Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address DRAKE: BLOCK 1. LOT 2B 2750 HUFFMAN ROAD 'ANCHORAGE. AK TRAVIS STANTON Day phone PO BOX 110732 'ANCHORAGE. AK 99511 Day phone 868-8001 BOB KIRN W/KLONDIKE PROPERTIES Day phone 522-4341 PO BOX 112871 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 6 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certired by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certiricate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date _6/_V 13 Engineer's Comments: In conducting this evaluation, GEG, UD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines d Regulations. The reported results described the performance of Me 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. 5. DSD SIGNATURE `\\`�\C,\Qr•'.... •'•:'�Q J Approved forON-SITE_ bedrooms. �+s WATER AND •; Disapproved. WASTEWATER PROGRAM Conditional approval for bedrooms, with the filowing stipulations: J��•.,.� �,• Attachments: COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Reort Nitrate Advisory _� Other �� By Original Certificate Date: I4wi 11IK1 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw 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: DRAKE: BLOCK 1, LOT 2B Parcel ID: 0 / 7- q & / -A3 A. WELL DATA Date Well type PRNATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 7/18/1980 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 82 ft. Cased to 40+ ft, Casing height (above ground) 12+ In. FROM WELL LOG AT INSPECTION Date of test 7/18/80 8/26/08 Static water level 0 (ARTESIAN) ft. 0 (ARTESIAN) ft, Well production 20 g.p,rp, 5.55 g.p.m, WATER SAMPLE RESULTS: / Coliform 1 colonies/100 ml. Nitrate b. U mg./L. Other bacteria �colonies/100 ml. . '0 Arsenic: v ug./L Date of sample: 8/26/08 Collected by: GEG Ltd. w ONE OF THE PRE -TANK CLEANOUTS WAS NOT LOCATED BUT B. SEPTIC/HOLDING TANK DATA THERE IS AN EXISTING FOUNDATION CLEANOUT Tank Type/Material SEPTIC/STEEL Date installed 10/15/05 Tank size 2000 gat. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 8/26/08 Pumper MCDONALDS PUMPING T C. ABSORPTION FIELD DATA E ow EXISTING CRADE 14 NT- Date Installed 10/15/05 Soil rating (g.p.d./Wo /bd 1.2 System type TRENCH Length 80 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth *7 ft. Eff. absorption area 800 ft' Monitoring tube YES Depression over field NO Date of adequacy test 8/26/08 Results (Pass/Fail) PASS For 6 bedrooms Fluid depth in absorption field before test DRY in. Water added 900 gal. New depth DRY In, Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 900+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off"level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 59+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water "33'+ 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 '61' Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *MAN MADE PONDS FOUND 33' & 61' AWAY BUT 100' FROM ALL OTHER WATERS G. ENGINEER'S CERTIFICATION _c�F� ' ••• I certify that ! have determined through field inspections and a `.1 ' review of Municipal records that the above systems are in " ' ' " conformance with MOA COSA guidelines in effect on this 0 date. A (...A .......Ss:... Engineer's Printed Na e2 JEFFREY A. GARNESS QOM E-7953 FGi Date V �OW\Pro r e ssle�eo� COSA Fee $ - L 3 U .O o Date of Payment // 0/02? Receipt Number ga2rg5 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage : r Development Services Department j Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 080316 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 2B of Drake subdivision. This inspection revealed a nitrate concentration of 6.01 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. SCS RcLN 1084521001 Client Name Garness Engineering Group, Ltd. Project Name/N Drake Block 1 Lot 213 Client Sample ID Drake Block I Lot 213 Matrix Drinking Hater PWSID 0 Printed Dalefr]me 09/102008 8:10 Collected Datefrime 08262008 12:30 Received Datcfrime 08262008 13:20 Technical Director Stephen C. Ede Sample Remarks: ICP/MS Total Nitmtc/Nitrite-N 6.01 0.100 Parameter Allowable Results PQL Units Method Container ID Limits Prep Date Analysis Date ]nit Metals by ICP/MS Total Nitmtc/Nitrite-N 6.01 0.100 Arsenic hill ND 5.00 Waters Department EP200.8 Total Nitmtc/Nitrite-N 6.01 0.100 Microbiology Laboratory hill Colony Count 0 Total Coliform 0 Fecal Coliform 0 ug/L EP200.8 C (<10) 0827/08 0829/08 hill mg/L SM204500NO3-F B (<10) 09/08/08 LCP coUl00mL SM209222B A (<200) co9100ml. SM209222B A (<I) col/IOOml. SM209222B A (<I) 0826/08 DLC 0826/08 DLC 0826/08 DLC %SBUILT O HEREBY CERTIFY • J�v+"'w 4 THATI HAVE SURVEYED THE SCALE: DLLOWING DESCRIBED PROPERTY+ / %.os�fv� !oma-zeP JD THAT �'0 EH:HF1EN 5 EXIST I�CEP7 AS DATE DICAT'cD. IT IS THE RESPONSIBILITY OF T!?E /�/`e 1NER TO DETERMINE TH: EXISTENCE OF ANY GRIDr "CHDO NOT OR RESTRICTIONS aB,3/ "CH DO NOT APPEAR ON ,ION PLAT. UND• � R`C"n0 D SUBDI- ER NO CIRCUMSTANCES SHOULD FB -- Y DATA HEREON BE USED FOR CONSTRUCTION FENCE LINES, OR FOR ESTABLISHING BOUND - Y LINES. DRAWN: 0 - ZK Y 1 � �� lS•�910 ' tr ii^�sAr�t� Municipality of Anchorage • Development Services Department *A1 Building Safety DivisionOnsite Water and Wastewater Program 4700BragawStreet P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite _S (907) 343-790403'Zo CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. C91 -(4 (- 23 COSA# 0(60075 Expiration Date: 1 - ;;_) O ^0 -co - 1. c1. GENERAL INFORMATION Complete legal description ea a, e. SSI p Lo f 2 is a % k Location (site address) 'Z75 -o 4vvr AJ -A— qg s/L Current Property owner(s) T vo vt s S kv n t'S r+ e� Day phone 3v / - 0 (o o H Mailing address Lending agency Mailing address Real Estate Agent Mailing Address sow Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Day phone Day phone The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite 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 Onsite 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. TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite 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 Onsite 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 seat 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 Mtrko el Af d"ct ris e n Phone '3 4s-33 Address Engineer's Printed Name Date Sf—`? /04* :tt OF At, \l rhe •s9fto ..•amu.. r•r.... / �` MICHAEL N. ANDEMN ,0- 5. DSD SIGNATURE l� �� ••• CE 9 _� Approved for bedrooms. it ? R�.....0jZ1��\ r ...• Disapproved. Conditional approval for bedrooms, with the following stipulations: WASTEWATER Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. lti• Original Certificate Date: (Rev. 11105) Municipality of Anchorage Development Services Department Budding Safety Division On-site Water & Wastewater Program * • • , 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: re (tom 4,D ai k. t I t)+ Z.S Parcel ID: Of i -'111 l - 2-3 A. WELL DATA Well type kr t us, Lc, If A. B, or C provide PWSID # 7 �tf�YO Date completed _ Sanitary seal (Y/N) _V Total depth _Z —0ft. �1 fCasedto tf 0 ft. l k �'1Tr�� R4 h, hYW PVA" rM'rf' FROM WELL LOG Date of test ? /// v Static water level ft. Well production Z g.p.m. Well Log (YM) Ai y Wires properly protected (YM) Y Casing height (above ground) in. AT INSPECTION U, e f ( OCC 4 4-0 11 l4 OS 4vD �� L Kern S 0 g.p.m. WATER SAMPLE RESULTS: Coliform -h—oolonies/100 mL Nitrate16 1 mg/L Other bacteria --o—r colonies/100 mL Arsenic: —0— mgA Date of sample: 3 V O 1. Collected by: M/ A r4. B. SEPTIC/HOLDING TANK DATA Tank Type/Material 5 J--fr Tank size 'z o U gal. Number of Compartments *�_ Foundation cleanout (YM) -y— Depression over tank (Y/N) Date of pumping t4 eto Pumper Date installed /J /C O5'_ Cieanouts (Y/N) Y High water alarm (Y/N) C. ABSORPTION FIELD DATA Date installed /a/15h S Sod rating (g.p.d.M2 or ft2/bdrm) System type S Length IYO n. Width S.0 ft. Gravel below pipe ft. Total depth ir`9 rft. Eff. absorption area 29-0 ft Monitoring tube _ Y Depression over field IN Date of adequacy test ;� Results (Pass/Fail) -� For bedrooms Fluid depth in absorption field before test ✓ in. Water added_-- gal. New depth in. Elapsed Time: _e-� min. Final fluid depth e--� in. Absorption rate >= �_ g.p.d, Any rejuvenation treatment (past 12 mo.) (YM & type) / If yes, give date �_ D. LIFT STATION Date installed 'Pump on' level at _ in. Datum E. SEPARATION DISTANCES Size in gallons Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /00, tAbsorption field on lot Public sewer main 14 A Sewer /septic service line /00 '-if. Animal containment areas to ur f In. High water alarm level at Meets alarm & circuit requirements? On adjacent lots / b J t + On adjacent lots /00,+ Public sewer manhole/cleanout N �. Holding tank Manurelanimal excrete storage areas X00' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation /0 /4 Property line I D t Absorption field /c t A Water main PIA Water service line 451) t4— Surface water 10 V' -F Wells on adjacent lots 10 D' >L SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r Property line /g / + Building foundation jd 4 Water main . Water Service line W I-- Surface water /00 tf' Driveway. parkirgNehicle st«age Curtain drain NI,f Wells on adjacent lots /tom tl` F. COMMENTS G. ENGINEER'S CERTIFICATION `P;�•OF Q�,Cj I certify that l have determined through field Inspections and WTH review of Munk records that the above systems are In oo 0 49— conformance with MOA COSA guidelines in effect on this date. / i'.� t [t :: S: J✓ re ngNh eko fhrdn t Itti; / 7s • MICHAEL�!N. ANDERSCN Printed b f rri ,� //7�.��\��i COSA Fee $ q? Q 4 z-75;" 41,1c l/S L Date of Payment 3— Z 0— D 6 Waiver Fee $ Date of Payment Receipt Number Receipt Number (Rev. I1/05) in. Ear i�.soo 0/ Nei 0 Q moi. N odW,rY ASBUILT FAND RTIFY THAT I HAVE SURVEYED THE SEWARD h ASSOCIATES LAND SURVEYING 694-0829 SCALE: DESCRIBED PROPERTY: /"= Seo y HAOFA ENCROACHMENTS EXIST EXCEPT ASDATE: s (E ,....T IS THE RESPONSIBILITY OF THETERMINE THE EXISTENCE OF ANY .TS, COVENANTS OR RESTRICTIONS GRID: i ' : in i ... ........ „ d WHICH DO NOT APPEAR W THE RECORDED SUgpI_ f VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: ANY DATA HEREON BE USED FOR CONSTRUCTION I� •'• Dien- Merk Sw,rd OF FENCE LINES ��•'. ARY LINES. OR FOR ESTABLISHING BOUND- •' DRAWN f {1;slxal J Jw I 0 Q moi. N odW,rY ASBUILT FAND RTIFY THAT I HAVE SURVEYED THE SEWARD h ASSOCIATES LAND SURVEYING 694-0829 SCALE: DESCRIBED PROPERTY: /"= Seo y HAOFA ENCROACHMENTS EXIST EXCEPT ASDATE: s (E ,....T IS THE RESPONSIBILITY OF THETERMINE THE EXISTENCE OF ANY .TS, COVENANTS OR RESTRICTIONS GRID: i ' : in i ... ........ „ d WHICH DO NOT APPEAR W THE RECORDED SUgpI_ f VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: ANY DATA HEREON BE USED FOR CONSTRUCTION I� •'• Dien- Merk Sw,rd OF FENCE LINES ��•'. ARY LINES. OR FOR ESTABLISHING BOUND- •' DRAWN f {1;slxal J Jw I c3 -1? -v 1.1:02 Wi SCS Re LM 10611•11BOM Clknt Nagle Mike N. Andcrton, P.E. Project Vameil :750 E MIT:= B I L2 Client Semple ID 2750 E Huffnnn Dl L2 hbirt: Drinking We= Somplo RemuL•c K7 :51 5K, - 2/ 1 All Datofflmw are Alaska Standard Time Printed DateMme 03/162006 13:07 Collected DateTime 031072OC6 16:00 Rceelred Dawff Ime 03/03/2006 16:30 Technical Director Stephen C. Ede A:Ip %zllc Rep Analyso P=.eter Items VOL Units Merited Contains, 10 JT.n Dam Dem tail 11. tstls by ICP/MS Arsenic ND 5.00 u8/L RI:00.8 C (4-I0) 03108'05 OWN SCL Faterst Deepartlnettt \itvtc-\ 0.189 O.IOC MSc=ebSe�LLaboratory Totc1 CoMbrm o 1r.8/L EPA 353.2 D (4-10) coVl CfmL SM2097-12B A (<.I) 03/09!06 JC 03103106 TLP Page 2 of 4 �� L3LY.L 61l C?jC31 C 5. LEG (JSCR;PTN l / DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME NUMBER OF,BEDROOMS Fi\ C2-`! ❑ One ❑ Four ❑ Other DATE DATE DATE 6 Al -I M Three ❑ Six '�)— INSPECTOR INSPECTO PCC)L INSPECTOR MUNICIPALITY OF 'ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL'PROtWMONMENTAL P OTECTION 825 L Street - Anchorage, Alaska 99501 P,.�/aY 5 1981 ENVIRONMENTAL S0*ANITATION. DIVISION Telephone 264-4720 REL l D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWfR FACITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PR jPRTY OWNER r F �-e z s b �- PHONE MAF ING ADDRESS 5 ax /5-/ (� kn C- f- ao PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION r PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEG (JSCR;PTN l / IL� r� e✓ b STREET LOCATIONtVllle /7 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY M Three ❑ Six 7. WATER SUPPLY , K 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.) � B. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** �; YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) _ � d 1 max- — THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR _3 BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY rmn 72-010 ( Rev. 6/79) Fred Washburn BRA 1515 C Anchorage, Ak. 99507 Legal: Location: Owner: Residence: Water: Sewer: Tobben Spurkland P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 May 111 1981 SEWER ADE(%UACY TEST Lot 21 Block 1, Drake Subdivision On Huffman Fred Washburn Trailer Onsite well From Municipal Records. Tank: Absorption System: Absorption area: Soil Rating° 125 Date of Test: May 8 8: 9, 1981 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAY 12 1981 RECEIVED_ 11000 gal.., steel., 2 compartments 81x81x6 l log crib 602 sq.ft. Test Procedure: System was inspected on May 6th. Bottom of crib is 12 feet below ground, liquid depth_ 42/2 inch. y00,� Q`�``, Tank is 10 feet below ground. �PZE ,....Ajqs�� .. h: *V A, 1 o *:.491H Na 2225-E �'<ti k� '•* JUNE 2% 1971, �'+;ViONAL On May 8th the tank was pumped, the crib was charged with the following; readings taken: Water Volume 0 500 1,000 1,250 May 9 Depth in Crib 41'/2 52 56 58 38 Test Result., 11250 gal. was introduced to the tank. This volume was absorbed in a 24 hr. period. This system exceeds the Municipal requirements.